Paper
Thursday, July 22, 2004
African-American Women's Mental Representations of Hypertension
Mary S. Webb, RN, PhD and Lois Gonzalez, PhD, ARNP, BC. College of Nursing, University of South Florida, Tampa, FL, USA
| Learning Objective #1: Discuss perceptions of hypertension and risk reduction as described by African-American women |
| Learning Objective #2: Describe culturally appropriate interventions to reduce the high rates of hypertension and target organ damage in African-American women |
Objective: The purpose of this study was to describe the mental representations of a disease threat (hypertension) as generated by African American women. Their selection of and their ability to perform rational procedures for threat management was also explored. This study was guided by Leventhal’s Self-Regulation Model. Design: A focus group methodology was used for this qualitative study. Sample, Setting: Participants were recruited through established community leaders within a metropolitan area in the southeast United States. Forty-eight women participated in the study. Methods: Purposive snowball sampling techniques were used to initiate contact with potential informants. A total of five focus groups were conducted. A semi-structured interview was used to elicit perceptions of the threat and management of hypertension. Data was analyzed using thematic and domain analyses to categorize the participant’s responses. Findings: Four major themes were generated: (1) Vulnerability and Inevitability, (2) Psychological Burdens, (3) Barriers to Effective Management, and (4) Culturally Relevant Remedies. Vulnerability and inevitability fell into personal experience and a more global, societal view. Psychological burdens were described as contributing to the high rates of hypertension. Lack of access to health care, financial restraints, and negative perceptions of health professionals were identified as barriers to effective management. A strong belief in the need for community-based interventions that are culturally appropriate and affordable was reported. Conclusions and Implications: African American women have some of the highest rates of cardiovascular mortality and morbidity in the developed world. A major contributing cause is the high prevelance of hypertension in this population. Acquiring a clear perspective of African American women’s perceptions of hypertension can serve as a model for developing preventive health care for this population. Findings from this study are being used to facilitate the implementation of a community-based intervention modeled specifically for African American women.
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