Defining older adults’ perceived causes of hypertension in the Brief Illness Perception Questionnaire

Abstract

Objectives: This study sought to make the Brief Illness Perception Questionnaire (BIPQ) to be more informative about illness representation among older adults with hypertension. The authors developed categories for coding the open-ended question regarding cause of illness in the BIPQ – a pervasive quantitative measure for illness representation. Methods: Using inductive thematic analysis, the authors described categories which emerged from analysing the open-ended question of the BIPQ applied to patients with hypertension. Then using deductive thematic analysis, we applied known categories in the literature to causes for hypertension elicited by the BIPQ. Our categories are: behavioural, natural, physical, psychosocial, supernatural, and other. Results: We established inter-coder reliability by applying the coding scheme to a sample of suburban central Illinois ( n=197) and urban Tucson, Arizona ( n=299) older adults with hypertension (initial kappa=0.61, revised kappa after decision rules=0.987). To demonstrate the utility of the coding scheme we found that both Illinois and Arizona nonwhite patients differ from white patients in how they understand the cause of their hypertension. Conclusion: A more complete illness representation can now be quantified and statistically analysed through the BIPQ using the categories we revised for cause of hypertension. Assessment of causal beliefs through the BIPQ and the authors’ coding scheme may enable tailored and efficient patient education, resulting in more effective provider–patient relationships.

Cognition and Health Literacy in Older Adults’ Recall of Self-Care Information

“…This finding suggests that the STOFHLA measure taps other processes that influence recall of health information. For example, the previous literature suggests that patients' beliefs about their illness, or their illness representation, influence their self-care behavior (e.g., Duwe et al, 2014;Leventhal et al, 1983). Although patients' illness representations are partly associated with health knowledge, presumably through experience with the illness (e.g., Chin et al, 2009), our measure of hypertension knowledge may not have adequately measured this construct.…”

Illness experience and illness representation among older adults with hypertension

“…The BIPQ also contained an open-ended question: ‘Please list the three most important factors that you think caused your high blood pressure’. Elsewhere, Duwe et al (2014) have identified different categories of causal beliefs from responses to this question: behavioural, natural, physical, psychosocial and supernatural.…”

“…The perceived cause of illness is an important but understudied IR dimension (Duwe et al, 2014). Understanding older adults’ causal beliefs is, therefore, important for patient–provider communication, individual coping and adherence to self-care (Perkins-Porras et al, 2006).…”

“…In their study, Patel and Taylor (2002) found that participants reported both modifiable risk factors, such as obesity, exercise and eating habits, and non-modifiable risk factors, such as genetics, as causes of hypertension. Other investigators cite psychosocial risk factors, such as stress, or supernatural risk factors, such as fate or luck, as potential causes of hypertension (Duwe et al, 2014; Martin et al, 2005).…”

“…Causal beliefs, a part of IR, are often measured and analysed separately (Duwe et al, 2014). Older adults may have beliefs about both cognitive (e.g.…”