Illness representations and coping practices for self-managing hypertension among sub-Saharan Africans: A comparative study among Ghanaian migrants and non-migrant Ghanaians

Abstract

ObjectiveHypertension (HTN) control is a major obstacle among sub-Saharan African populations partly due to poor self-management. We explored and compared how persons’ social and physical context shapes their illness representations regarding HTN and the coping strategies they develop and adapt to mitigate challenges in self-managing HTN. MethodsA cross sectional multisite qualitative study using semi-structured interviews among 55 Ghanaians with HTN living in The Netherlands and urban and rural Ghana. A thematic approach was used in data analysis. ResultsFamily HTN history, personal experiences with HTN and outcomes of using biomedical and traditional treatments shaped participants’ illness representations and coping strategies. Migrants and urban non-migrants modified medication schedules and integrated taking medication into daily routine activities to cope with experienced side effects of taking antihypertensive medication while rural non-migrants used traditional remedies and medicines to mitigate experienced medication side effects and/or in search for a cure for HTN. ConclusionContextual factors within participants’ social and physical environments shape their illness representations and coping strategies for HTN though interactive phrases. Practice implicationsHealth professionals should harness the relationships within peoples’ social and physical environments, encourage implementation of family-wide behavioural changes and involve family and communities in HTN treatment to enhance patients’ self-management of HTN.