Beliefs about hypertension among Nigerian immigrants to the United Kingdom: A qualitative study

Abstract

ObjectiveThe aim of the study was to elicit beliefs about hypertension among Nigerian immigrants in the United Kingdom.BackgroundThe distributions of cardiovascular risk factors and diseases are not shared equally across ethnic and economic groups in the United Kingdom. Its burden is more clustered among minority ethnic populations and migrant groups including black African Nigerian migrants. Similar patterns have been reported across Europe, Australia, Canada, Nordic countries and the United States of America. There are about 300 distinct ethnic groups in Nigeria and reliable information about their beliefs about hypertension is not available. Given that the United Kingdom has a large community of Nigerian immigrants from these different ethno-cultural backgrounds, understanding their unique beliefs about hypertension may help promote appropriate care for this population in the United Kingdom and Nigeria.SettingA single Pentecostal church community in West LondonParticipantsTwenty-seven Nigerian migrant members of the church entered and completed the studyMethods and outcome measureA qualitative interview study was conducted. The interviews were analysed using thematic framework analysis. The outcome measures were emerging themes from the thematic framework analysis.ResultsParticipants expressed beliefs in four major areas related to hypertension: (1) The Meaning of the term hypertension, (2) Perceptions of causation, (3) Effects of hypertension, and (4) Perceptions of treatment. The study revealed a diversity of beliefs about hypertension which incorporated both orthodox and culturally framed ideas.ConclusionsThis study identified important beliefs among Nigerian migrants about hypertension that can contribute to our understanding of the management of hypertension in this group and suggests the need for further research to determine whether these beliefs may be representative of this group.

Beliefs about hypertension among primary health care workers and clients in Nigeria: A qualitative study

“…In agreement with the findings from Akinlua et al 2017 [17], some PHC clients also held multiple beliefs about meaning of HTN at the same time. However, there was no evidence of a major overriding belief among those who had multiple understandings.…”

“…Notably, among some PHC workers, the idea that food seasoning such as Maggi is not salt and that cooked salt is less harmful than uncooked salt has not been reported in other studies. Also in agreement with other studies conducted on lay Nigerians [13, 14, 17] very few PHC clients thought that HTN could be inherited, but heredity was a key factor in some studies on African-Americans [24, 28].…”

“…Similar findings have been shown in studies on beliefs of hypertension in Nigeria [13, 14, 22] and in other places [23–29]. However, description of meaning hypertension among Nigerians in terms of cultural understanding is relatively new and was only recently described in a similar study conducted by the authors on Nigerian immigrants to the United Kingdom [17]. Interestingly, new cultural meanings such as- hypertension meaning a “disease that is in-curable and dangerous”- different from those highlighted in Akinlua et al 2017 [17] were elicited in this study.…”

“…Further, regarding the consequences of hypertension, it is important to note that no PHC client thought that it could be asymptomatic. This was also reported in the studies among Nigerian immigrants in the UK [17]. This finding is quite significant in that it may affect health seeking behaviour among lay people.…”

“…The topic guide used in both interviews and focus group discussions was based on previous studies on beliefs about hypertension in Nigeria [7–14, 17] and earlier work on explanatory models of illness by Kleinman [18, 19, 20]. When eliciting beliefs and comparing cultural understandings of illnesses the anthropological perspective may be very helpful, therefore Kleinman’s work on explanatory models(EM) which categorizes people’s beliefs about illnesses into the cause of an illness, its course, diagnosis, symptoms and treatment was used [19, 20].…”