The Relation of Culturally Influenced Lay Models of Hypertension to Compliance With Treatment

Heurtin-Roberts, Suzanne; Reisin, Efrain

doi:10.1093/ajh/5.11.787

Cited by 113 publications

(84 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Also consistent with other studies, the patients in this study viewed stress as an important causal factor. 7,8,[26][27][28][29] This suggests that stress is a fundamental and cross-culturally embedded dimension in a patient's EM of hypertension. Our results also suggest, however, that this EM may be more common among hypertensive immigrant patients than it is among indigenous populations and that migration is often seen as a trigger for stress.…”

Section: Discussionmentioning

confidence: 99%

“…However, patient adherence to hypertension treatment is often poor, particularly among ethnic minority populations in Western Europe and the USA. 1,[6][7][8] According to the theoretical model of medical anthropologist Kleinman, healthcare providers and patients have different 'explanatory models' (EMs) of sickness and treatment, including explanations for the aetiology of the condition, the timing and onset of symptoms, the patho-physiological processes involved, the natural course and severity, and appropriate treatments. 9,10 Lay EMs vary according to personality and socio-cultural factors, whereas those of healthcare providers rely more on scientific logic and evidence.…”

Section: Introductionmentioning

confidence: 99%

“…Studies among ethnic minority populations in the US and the UK suggest that cultural factors have an impact on the manner in which patients from these groups explain hypertension. 7,8,[11][12][13] For example, a study on the beliefs about hypertension among lower-class and middle-class African-Americans showed that many think that hypertension is caused by eating pork and that it can be treated with home remedies. 12 Another study indicated that AfricanAmericans are more focused on the present regarding their daily experiences with managing hypertension than white Americans are.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

‘Under pressure’: how Ghanaian, African-Surinamese and Dutch patients explain hypertension

et al. 2006

View full text Add to dashboard Cite

The aim of this study was to explore and compare explanatory models (EMs) of hypertension in nativeDutch, first-generation Ghanaian and African-Surinamese (Surinamese) hypertensives in Amsterdam, the Netherlands. Through semi-structured interviews, we elicited accounts of the nature, causes and consequences of hypertension in a purposive sample of 46 patients (aged 35-65 years, treated for hypertension in general practice 41 year). All three groups had difficulty in describing hypertension. All groups mentioned culturally specific nutritional habits as possible causes of hypertension (Dutch liquorice; Ghanaians fufu; Surinamese salty diet). Most respondents, particularly those of Ghanaian and Surinamese background, perceived stress as the main cause of hypertension and experienced symptoms of hypertension. Many Ghanaian and Surinamese respondents attributed hypertension to migrationrelated factors: changes in diet or climate, stress owing to adaptation to the Dutch society or obligations towards family in their homelands. Many immigrants felt a return to their homeland could cure hypertension and were concerned about the consequences of hypertension. Half of the Dutch and almost all Ghanaian and Surinamese respondents believed uncontrolled hypertension could cause immediate damage. Some Ghanaians expressed reservations sharing their concerns with community members because it might cause social stigma. Few respondents associated hypertension with obesity, even though many were overweight. Confirming findings from UK and US studies, this study reveals that EMs of hypertension in patients from three ethnic groups differ from the common medical perspective. These differences are greater for patients from migrant groups. Our findings can be useful in developing patientcentred hypertension interventions, particularly in new migrant populations.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

‘Under pressure’: how Ghanaian, African-Surinamese and Dutch patients explain hypertension

et al. 2006

View full text Add to dashboard Cite

show abstract

“…This lack of familiarity contributed to ''vague[ness] about illness management... and they did not understand that they had a role in managing their illness beyond taking medication.'' In addition to lack of exposure to biomedical care, culturally varying health beliefs may also influence patients' health-seeking behaviors and willingness to comply with treatment regimens [22,77]. For example, in a study of prophylactic TB treatment among Vietnamese immigrants, researchers found recent immigrants were more reluctant to complete the medication regimen because its side effects were deemed too ''hot'', ''while Asian herbal medicines were [seen as] more benign and cooling'' [57, p. 352].…”

Section: Health Literacy and Patient Adherencementioning

confidence: 99%

The Role of Culture in Health Literacy and Chronic Disease Screening and Management

Shaw

Huebner

Armin

et al. 2008

J Immigrant Minority Health

194

132

View full text Add to dashboard Cite

“…One study of black women found that the word hypertension had morphed into the term high-pertension, that is, perceptions that their tension in fact was high. 14 We surmise that lay people hear the word hypertension and interpret it to mean: hyper-too much and tension-stress. Studies of conceptualizations or explanatory models of hypertension have found as many as 50% of patients endorsing stress as a significant cause of hypertension.…”

Section: Language Of Hypertension 453mentioning

confidence: 99%

What Is in a Name?

Bokhour

Kressin

2015

Circ: Cardiovascular Quality and Outcomes

View full text Add to dashboard Cite

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.

show abstract

The Relation of Culturally Influenced Lay Models of Hypertension to Compliance With Treatment

Cited by 113 publications

References 0 publications

‘Under pressure’: how Ghanaian, African-Surinamese and Dutch patients explain hypertension

‘Under pressure’: how Ghanaian, African-Surinamese and Dutch patients explain hypertension

The Role of Culture in Health Literacy and Chronic Disease Screening and Management

What Is in a Name?

Contact Info

Product

Resources

About