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1 – 10 of over 1000Tashi Dendup, Pandup Tshering and Tandin Dorji
This study examined the risk factors associated with hypertension in Bhutan.
Abstract
Purpose
This study examined the risk factors associated with hypertension in Bhutan.
Design/methodology/approach
The cross-sectional data of 30,889 adults from the National Health Survey of Bhutan was used in this study. Multivariable regression accounting for the complex survey design was performed to identify the risk factors. The backward elimination approach was applied in the multivariable analysis.
Findings
The prevalence of hypertension was 17%. Increasing age, being female, being previously married, higher wealth status, past alcohol use, having diabetes, loneliness, health service use and low vegetable intake was associated with increased hypertension risk, whereas, higher education level, being employed and residing in the eastern region was associated with reduced risk. Age, gender, education, wealth status, diabetes status, loneliness and health service use were common factors in all the regions. Marital status and vegetable intake were associated with hypertension in the western and central regions, and alcohol use in the eastern and central regions.
Originality/value
Affecting around one-sixth of the population, hypertension is a significant public health problem in Bhutan. Interventions to improve health education and access, motivate healthy lifestyles, and reduce harmful alcohol use, and strategies to create health-promoting social and built environments are needed to curb the hypertension epidemic and its consequences.
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Rob Haile, Lilian Magalhães and Debbie Laliberte Rudman
Although Black individuals are disproportionately affected by hypertension as evidenced by higher prevalence and lower control rates, few studies have investigated this…
Abstract
Although Black individuals are disproportionately affected by hypertension as evidenced by higher prevalence and lower control rates, few studies have investigated this disparity from the lens of those most affected by this condition. This chapter explores how Black men make sense of their hypertension and how they negotiate this condition within their everyday lives, illuminating how racism and power dynamics embedded within their environments affect their experiences living with hypertension.
Critical Race Theory tenets were utilized alongside a narrative design to elicit stories of hypertension experiences of four Black men living in Ontario, Canada. Eight semistructured in-depth interviews were conducted, transcribed, and thematically analyzed to illuminate how participants create meaning in regard to their hypertension.
Participants’ experiences with discrimination, isolation, and migration raise awareness of how power relations embedded within social, political, and historical contexts can affect hypertension experiences.
The findings of this study are bounded by its narrative context, and the characteristics of the individuals who shared their experiences.
This study highlights the importance of how discussions concerning hypertensive minority men should be broadened to include the voices of such men, as well as the structures that discriminate against and oppress minority individuals.
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Dongxiang Zhao, Qiping Zhang and Feicheng Ma
Online health communities (OHCs) are attracting more and more healthy consumers, including patients, their families, caregivers and the general public. This paper aims to…
Abstract
Purpose
Online health communities (OHCs) are attracting more and more healthy consumers, including patients, their families, caregivers and the general public. This paper aims to explore the themes and characteristics of patient-generated content (PGC) in Chinese OHCs.
Design/methodology/approach
Baidu Tieba for hypertension was selected as the research site. Online ethnography (netnography) approach was utilized to explore the PGC and health communication in the online hypertension community. The final database included 300 randomly sampled threads and their 3,187 reply posts and was further analyzed from three perspectives: health information needs, attitudes and psychological reactions to hypertension and social support exchange.
Findings
The members' health information needs were mainly concentrated on five aspects: causes, symptoms, measuring instrument, tests and diagnosis and treatment. Their attitudes and psychological reactions to hypertension varied with the context, for example, disease stage, health condition. Within the health communication, three types of social support – information support, emotional support and network support – were generated, transmitted and exchanged among members.
Practical implications
OHCs are able to serve as important source of health information and tool for health education. The implications and suggestions for health promotion of individuals, health information services optimization of OHCs and national health strategy plans were also discussed.
Originality/value
This is the first netnography study in information field on Chinese online hypertension community. This study provides a new perspective to explore the needs, attitudes and social support behaviors of Chinese hypertension population and also enables the Chinese experience of using OHCs to reduce health disparities to come to the world.
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Rachel Fleishman, Eric Peritz and Bonnie Leibel
Describes a methodological study to evaluate the quality of care for an elderly population in the treatment of hypertension from a fairly simple analysis of medical…
Abstract
Describes a methodological study to evaluate the quality of care for an elderly population in the treatment of hypertension from a fairly simple analysis of medical records in primary care, with or without the use of additional information from patients, and shows how this type of data can be used to point out shortcomings in primary care. The data derive from a community survey of elderly people in one area of Jerusalem and relied on personal interviews, blood pressure measurements and an analysis of medical records over a period of four years. The measures used are: the percentage of persons without blood pressure (BP) measurement in a given year; the maximum “gap” between consecutive BP measurements in a given year; the rate of BP measurement per clinic visit; the percentage of hypertensives treated; and the percentage of hypertensives under control. The prevalence rates for hypertension in this elderly population vary between 40 per cent and 59 per cent according to the definition used. Using a simple and straightforward analysis of sick‐fund records several shortcomings in the surveillance and control of hypertension were detected. Calculation of the percentage of untreated hypertensives required a separate information source ‐ the screening. A BP survey is an important complement to an analysis of records. An ongoing evaluation of the quality of care of hypertensives in an elderly population should be based on screening, interviews with patients and analysis of the physician′s records. These provide an overall picture of the care in each medical practice enabling the physician to improve the quality of care provided to his or her patients.
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Describes a study designed to develop instruments for examining the quality of routine care of hypertension among the elderly and, using non‐medical predictors of quality…
Abstract
Describes a study designed to develop instruments for examining the quality of routine care of hypertension among the elderly and, using non‐medical predictors of quality ‐ such as elderly patient and doctor variables and doctor‐patient interaction variables ‐ to explain the variance in the quality of care. The study population comprised 352 elderly people (92 per cent) in one Jerusalem neighbourhood who were members of Israel’s largest sick fund. Interviews, screening, observation and examination of records were the sources of information. Multivariate analysis was performed. The findings indicated a plethora of deficiencies in the quality of routine care, mostly in the quality of surveillance and the control of hypertension. It was found that the outcome of care is primarily a result of the physician‐patient interaction, rather than of a lack of patient compliance. Proposes a national programme using the instruments developed.
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Abdulrahman O. Musaiger, Mariam Al‐Mannai and Khaldoon Al‐Roomi
Hypertension is one of important risk factors for cardiovascular disease, which represents 30 per cent of annual total deaths in Bahrain. Studies on factors associated…
Abstract
Purpose
Hypertension is one of important risk factors for cardiovascular disease, which represents 30 per cent of annual total deaths in Bahrain. Studies on factors associated with hypertension in Bahrain are very limited. The present paper aimed to highlight some social and lifestyle factors that may be associated with hypertension in Bahraini community.
Design/methodology/approach
A cross‐sectional household survey was carried out using a multistage sampling technique to select 514 Bahraini adults aged 30‐79 years. A pretested validated questionnaire was used. History of hypertension and diabetes was determined by positive response to previous diagnosis of these diseases.
Findings
The risk of occurrence of hypertension was greater in older people, women, illiterate people, non‐smokers, those who did not walk regularly, those who watched television daily, obese people, those who had a history of diabetes and those who consumed vegetables more than four times a week. However, age, gender, education, obesity and diabetes were the main risk factors statistically associated with hypertension using bivariate analysis (p<0.01). When multiple logistic regression was used, only age (p<0.01) and obesity (p<0.05) were found to be statistically significant.
Originality/value
Social, lifestyle and dietary factors should be considered in any intervention programme to prevent and control hypertension in Bahraini community.
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Purpose – To examine the effects of health insurance types on the use of prescribed medication that treat patients with hypertension, diabetes, and asthma. The study…
Abstract
Purpose – To examine the effects of health insurance types on the use of prescribed medication that treat patients with hypertension, diabetes, and asthma. The study distinguishes between individuals with private health maintenance organization (HMO) plans and private non-HMO plans. The study also distinguishes between people with health insurance and drug coverage and people with health insurance and no drug coverage.
Methods – Joint discrete factor models are estimated to control for endogeneity of each type of coverage.
Findings – The main findings suggest that the effect of health insurance varies across patients with different conditions. The strongest and most significant effect is evident among patients with hypertension while the weakest and least significant is among patients with asthma. These findings suggest that patients with asymptomatic conditions are more likely to exhibit moral hazard than patients with conditions that impose immediate impairment. Additional results suggest that, relative to the uninsured and people with health insurance but no drug coverage, patients with drug coverage are more likely to initiate drug therapy and to consume more medications.
Originality – The results of the study indicate that moral hazard of drug utilization is condition specific. The variation in “silence” of conditions’ symptoms could be a key reason for difference in insurance effects among patients with hypertension, diabetes, and asthma.
Nanthakan Woodham, Surasak Taneepanichskul, Ratana Somrongthong and Nanta Auamkul
Hypertension is a common disease among elderly. Adherence to antihypertensive medication is a key predictor of optimal blood pressure control that prevents the risk of…
Abstract
Purpose
Hypertension is a common disease among elderly. Adherence to antihypertensive medication is a key predictor of optimal blood pressure control that prevents the risk of cardiovascular disease and potentially death. The purpose of this paper is to assess adherence to antihypertension and identify associated factors among the elderly in a rural area, Buengkan province, Thailand.
Design/methodology/approach
A health facilities based cross-sectional study was conducted in Buengkan district. A simple random sampling method was used to select 408 participants. A structured questionnaire adapted from the World Health Organization STEPwise approach was used to collect data. The medication adherence level was identified by pill count with percentage ⩾70 defined as good adherence. Descriptive and summary statistics were used. Bivariate analysis was done using Pearson’s χ2 test, and multivariable analyses were also carried out.
Findings
A total of 408 (143 males and 265 females) elderly hypertension patients with uncontrolled blood pressure participated in this study. Most of the participants were found to have lower adherence to medication treatment (86.8 percent), whereas the remaining ones (13.2 percent) were found to have good adherence. The multivariable logistic regression analysis showed that having a daughter as a care taker (adjust odd ratio=7.99, 95% confidence interval: 1.23–51.778) was significantly associated with high medical adherence.
Originality/value
Hypertension medication adherence among elderly patients with uncontrolled blood pressure was poor. Having a care taker, especially a daughter, is a key to improve adherence. Effective strategy to improve adherence should focus on and involve family participation into the program.
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Petros Kostagiolas, Anastasios Milkas, Panos Kourouthanassis, Kyriakos Dimitriadis, Konstantinos Tsioufis, Dimitrios Tousoulis and Dimitrios Niakas
The ultimate aim of this study is to investigate how health information needs’ satisfaction actually makes a difference to the patients' management of a chronic clinical…
Abstract
Purpose
The ultimate aim of this study is to investigate how health information needs’ satisfaction actually makes a difference to the patients' management of a chronic clinical condition. The literature falls short of providing evidence on the interaction between patients' health information seeking behaviour and the successful management of a clinical condition. On the other hand, patient education and good information seeking practices are deemed necessary for hypertension management daily decisions.
Design/methodology/approach
A specially designed questionnaire study was developed: The survey design was informed by the information seeking behaviour model of Wilson for studying hypertension patients' information needs, information resources and obstacles patients face while seeking hypertension-related information. Moreover, clinical information was collected in order to make associations and inference on the impact of information seeking on patients' clinical outcomes.
Findings
The study included 111 patients submitted to the outpatient hypertension clinic of a university hospital in Athens for a 24-h ambulatory blood pressure measurement (ABPM). The analysis showed that those reporting higher satisfaction level of their information needs achieved lower values in ABPM (ABPM<130/80mmHg, p = 0.049). Stepwise the logistic regression analysis revealed three independent factors to predict the possibility of being optimally treated (ABPM<130/80mmHg). Dipping status (OR: 14.052, 95% CI: 4.229–46.688, p = 0.0001) patients with high satisfaction level of their disease (OR: 13.450, 95% CI: 1.364–132.627, p = 0.026) and interpersonal relationships were used as the main source of information (OR: 1.762, 95% CI: 1.024–3.031, p = 0.41).
Originality/value
Hypertensive patients with high satisfaction level of information achieve better disease control. Among different sources of information, interpersonal relationships emerge as the most appropriate factor for patients' disease control.
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Mohd Ramadan Ab Hamid, Mastura Mohd Isamudin, Siti Sabariah Buhari and Emmy Hainida Khairul Ikram
The purpose of this paper is to assess the value of websites accessible to patients looking for Web-based information regarding hypertension management.
Abstract
Purpose
The purpose of this paper is to assess the value of websites accessible to patients looking for Web-based information regarding hypertension management.
Design/methodology/approach
A cross-sectional research was carried out by finding out Malay and English language websites about hypertension. For this purpose, the keywords “hypertension and treatment” were entered on the Yahoo, Google, Ask.com, Bing and DuckDuckGo search engines, and the first five pages of the results obtained were inspected. The DISCERN tool was deployed for evaluating the quality of information. The actionability and understandability were assessed through the Patient Education Materials Assessment Tool (PEMAT). Eight assessors were asked to assess and grade the involved websites.
Findings
Of the 216 websites, eight (4.0%) conformed to the inclusion norms. All websites were classified into private, 4 (50%); government, 2 (25%) and personal, 2 (25%). The general rating of the eight websites was good (mean 51.6 ± 8.2 on a 75-point scale); however, half of the websites were rated as fair (mean 45.3 ± 3.1 on a 75-point scale). All websites conformed to the standard score of ≥70% for understandability (mean 76.1 ± 11.4), but none for actionability (mean 52.8 ± 13.9). Analysis of variance indicated there was no statistical difference with regards to quality (p = 0.525), understandability (p = 0.484) and actionability (p = 0.188) among the three website sets.
Originality/value
Considering the surplus of websites dedicated to information on hypertension, an independent assessment of the quality of these websites will be advantageous. Patients should be rendered high understandability, quality and actionability to evade deceptive online information.
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