Abstract
This study examines the relationship between health beliefs and the use of both prescribed medication and alternative healing agents among at least one year diagnosed hypertensives attending an hypertension out-patient clinic in a rural South African hospital. The sample included 33 men and 67 women, in the age range of 31 to 81 years, (M=60.7 years, SD=9.8 years). Main outcome measures included causative beliefs, health beliefs, and quality of the health care provider patient interaction. From the 100 patients studied 35% were not compliant with prescription medication. Most patients (almost 80%) had taken something else for their high blood pressure apart from prescription medication, especially those who had been non-compliant with prescription medication. Most popular were the use of home remedies and faith healing, followed by traditional healing and over-the-counter drugs. Non-compliant behaviour was associated with the use of alternative healing agents, the belief of curability of hypertension by traditional and faith healers, perceived benefits and barriers of antihypertensive medication and some items of the quality of the practitioner-patient relationship such as not explaining medical problems. Results are discussed in view of improving culturally sensitive compliance behaviour among hypertensive patients.
Highlights
The South African Demographic and Health Survey (DHS) (Department of Health, 1998: 32) showed that among per sons above 15 years 11 % of men and 13% of women were found to either have a blood pressure above 160/95mmHg or were taking appropriate medication to lower their blood pressure
A calculation based on these prevalence rates from the DHS and the census figures published for the South African population 15 years and older (Statistics South Africa, 1998: 5) leads to an estimate of about 3.3 million hypertensive people in the country
Anthropological research in clinical con texts has shown that differences between patient/practi tioner models of health and illness can be the source of many problems in complying with treatment and that the patient’s view o f his or her own illness is important in the choices of treatment and compliance (e.g. HeurtinRoberts & Reisin, 1992:787)
Summary
The South African Demographic and Health Survey (DHS) (Department of Health, 1998: 32) showed that among per sons above 15 years 11 % of men and 13% of women were found to either have a blood pressure above 160/95mmHg or were taking appropriate medication to lower their blood pressure. Fewer hypertensive men in nonurban areas know that they suffer from the condition than their urban countreparts This highlights that non-urban hypertensive males are the group with the most undiag nosed hypertension in the country and that they should be targeted to improve the diagnosis rate. Only 9% of all men with hypertension had controlled blood pressure (BP< 160/95 mmHg), compared to 23% of hypertensive women This is still a very low level of control and highlights the need to improve hypertension control in the country if premature death and disability are to be prevented. According to the HBM, it is at this point that individuals perform a type of cost/benefit analysis such that alternatives are subjectively evaluated in terms of their benefits and costs (or barriers) This cost/benefit analysis results in a preferred course of action or, in this research, a preferred health behaviour (Brown & Segal, 1996:904). The purpose of this research was to examine the relation ships between the health beliefs variables (health belief model, causative beliefs), quality of the health care patient relationship and drug use behaviour, i.e. compliance with prescribed antihypertensive medication, use of home rem edies, traditional and faith healing
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