The Role of Patients’ Explanatory Models and Daily-Lived Experience in Hypertension Self-Management

Bokhour, Barbara G.; Cohn, Ellen S.; Cortés, Dharma E.; Solomon, Jeffrey; Fix, Gemmae M.; Elwy, A. Rani; Mueller, Nora; Katz, Lois A.; Haidet, Paul; Green, Alexander R.; Borzecki, Ann M.; Kressin, Nancy R.

doi:10.1007/s11606-012-2141-2

Cited by 70 publications

(79 citation statements)

References 30 publications

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“…This was part of a larger study examining the role of Explanatory Models in hypertension control. 14 Explanatory Models, a theoretical framework developed by Kleinman et al 16 for understanding beliefs about disease pathophysiology, cause, course, treatment, and symptoms, were used to explore patient beliefs about hypertension. Explanatory Models are thought to influence patient behaviors 11,[17][18][19] and therefore may contribute to low adherence and poor hypertension control and to provide a framework to explore how people make sense of their health and illness in their daily lives.…”

Section: Methods Designmentioning

confidence: 99%

“…12,13 We are starting to learn how these beliefs influence hypertension self-management behaviors. 14 However, prior work has not considered how hypertensive patients with comorbidities think about their hypertension, adhere to recommendations, and self-manage their illness. Patients with comorbidities have unique self-management challenges, and there is limited understanding of how comorbidities may interfere with hypertension control.…”

Section: Introductionmentioning

confidence: 99%

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The role of comorbidities in patients’ hypertension self-management

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Section: Methods Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of comorbidities in patients’ hypertension self-management

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“…Although the term is used alternately with the term high blood pressure, studies from around the world indicate that patients may not understand the words in the same way as clinicians, and this may have significant implications for medication adherence and ultimately, outcomes. [1][2][3] Despite major advances in pharmaceutical treatment and more intensive therapy being prescribed, as many as 53% of those diagnosed with hypertension remain poorly controlled, resulting in high rates of target organ damage and stroke. 4 A recent Cochrane review of interventions to improve hypertension control notes that such interventions to issues of medication adherence and lifestyle factors have had limited success, 5 whether focused at the provider or clinic level or at educational programs for patients.…”

Section: What Is In a Name? How Biomedical Language May Derail Patienmentioning

confidence: 99%

“…3 Patients often associate particular symptoms with hypertension, including headaches, neck aches, and feeling anxious. 1,[11][12][13] These are symptoms of stress itself and although patients may experience symptoms from high blood pressure, most often such symptoms have little relationship with variations in blood pressure. By focusing on symptoms, these patients only treat their hypertension at times when they experience such symptoms and think their blood pressure is high.…”

Section: Language Of Hypertension 453mentioning

confidence: 99%

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What Is in a Name?

Bokhour

Kressin

2015

Circ: Cardiovascular Quality and Outcomes

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Abstract-Despite major advances in treating hypertension, >50% of all individuals diagnosed with the condition remain in poor control. A fundamental issue may be that patients may not fully understand the meaning of the term hypertension or its cause, leading to poor adherence to medications and limiting other effective self-management behaviors. We posit that the word hypertension itself may contribute to these misunderstandings, particularly in regards to the role of stress in causing hypertension, which thus suggests stress management as a primary strategy for control. The word hypertension is often interpreted by patients to mean too much tension. In conjunction with cultural framings of stress causing high blood pressure, many patients turn to stress management to control their hypertension. The word hypertension can thus cause patients to think of it as more of a psychological than physiological condition, thus discounting the value of antihypertensive medications and interfering with medication adherence. We therefore suggest that clinicians reconsider the use of the term hypertension and the ways in which they explain the condition to patients. Reorienting the language to the more patient-centered term of high blood pressure may help patients better understand the condition and to more readily embrace the available efficacious therapies. The word hypertension is common, even in lay parlance, and the medical establishment often assumes that patients understand what hypertension is and how it affects them. But language is easily interpreted in ways unintended by the speaker. The term hypertension is a prime example of the problem of medical language or jargon being misinterpreted by the lay person. Although the term is used alternately with the term high blood pressure, studies from around the world indicate that patients may not understand the words in the same way as clinicians, and this may have significant implications for medication adherence and ultimately, outcomes.

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Patients’ perception of changes and consequences after tumor resection

Trost

Heisinger

Funovics

et al. 2023

Wien Klin Wochenschr

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Summary Objective The aim of this study was to investigate the effects and consequences of surgical treatment of patients with musculoskeletal malignancies on everyday life. Methods A modified form of grounded theory was used for data collection and analysis. Data collection was systematic and analyzed simultaneously and 16 interviews were conducted: 2 narrative, 11 guided and 3 expert interviews (surgeon, physical therapist, support group). Data collection and analysis alternated until no new codes could be found. Once theoretical saturation was achieved, the main category was formed and described using the literature. Results The main category results from the combination of all categories and leads to the core category. In the center is the affected person and in the immediate environment are the patient’s relatives/partners. In the next instance the primary care physician is necessary to establish a sense of normalcy. This depends on the individuality of the person and the restored possibilities of movement. Conclusion Based on the results, the necessity of implementing psychosocial care involving the social environment is shown. The importance of relatives/partners for recovery is emphasized. Furthermore, the communication between the specialists and family physicians should be simplified.

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The Role of Patients’ Explanatory Models and Daily-Lived Experience in Hypertension Self-Management

Cited by 70 publications

References 30 publications

The role of comorbidities in patients’ hypertension self-management

The role of comorbidities in patients’ hypertension self-management

What Is in a Name?

Patients’ perception of changes and consequences after tumor resection

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