Older Adults’ Explanatory Models of High Blood Pressure

Margo-Lea Hurwicz,Margaret Rose

doi:10.4236/health.2016.87072

Abstract

Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.

Highlights

Cultural beliefs and values shape the way disease and illness are understood and treated in any given society
The analysis presented in this paper is based on data from a study previously described in our paper, Older Adults’ Explanatory Models of Colds and Flu [12]: “Sampling and recruitment were consistent with other research that uses consensus analysis (CA) to identify shared cultural models of illness [9] [11]
We focus on the part of the data matrix that includes variables measuring cultural knowledge, or the elements of Explanatory Models (EM) for High Blood Pressure (HBP) or HTN

Summary

Introduction

Cultural beliefs and values shape the way disease and illness are understood and treated in any given society. This is true for illness/disease in general, for specific types of illness/disease and for particular episodes of ill-. Selecting elements that appeared in the EM of 20% of the interviewees, Blumhagen identified a shared EM. He considered the impact of biomedical information obtained at the clinic on his informants’ perceptions. Blumhagen’s informants’ model of HTN is a stress model. They recognized 3 major kinds of stress: chronic external stress, chronic internal stress and acute stress. Acute stress was perceived as any situation that temporarily affected an individual and made that person more vulnerable to becoming “hyper-tense” [5]

Methods

Results

Discussion

Conclusion