Illness representations and coping practices for self-managing hypertension among sub-Saharan Africans: A comparative study among Ghanaian migrants and non-migrant Ghanaians. Issue 9 (September 2019)

• Record Type: Journal Article
• Authors: Nyaaba, Gertrude Nsorma; Agyemang, Charles; Masana, Lina; de-Graft Aikins, Ama; Beune, Erik; Larrea-Killinger, Cristina; Stronks, Karien
• Is Part Of: Patient education and counseling. Volume 102:Issue 9(2019)
• Page Start: 1711
• Page End: 1721
• Publication Date: 2019-09
• Subjects: Hypertension -- Self-management -- Coping strategies -- Context -- Africans -- Migrants -- Urban and rural Africans -- Patient views -- Social support -- Traditional medicine for hypertension -- Medication adherence -- Dietary recommendations -- Alcohol recommendations -- Smoking recommendations -- Physical activity recommendations -- Social and cultural norms and practices; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2019.04.008
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Illness representations influenced by context and outcomes of treatment experiences. Coping strategies developed in interactive phrases. Differences in coping strategies between migrants and non-migrants. Traditional remedies used for coping with medication side effects. Gendered differences in coping with adherence to dietary recommendations. Abstract: Objective: Hypertension (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. Methods: A 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. Results: Family 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. Conclusion: Contextual factors within participants' social and physical environments shape their illness representations and coping strategies for HTN though interactive phrases. Practice implications: Health 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.