scholarly journals ‘Blood pressure can kill you tomorrow, but HIV gives you time’: illness perceptions and treatment experiences among Malawian individuals living with HIV and hypertension

2019 ◽  
Vol 34 (Supplement_2) ◽  
pp. ii36-ii44 ◽  
Author(s):  
Matthew Hing ◽  
Risa M Hoffman ◽  
Juliet Seleman ◽  
Florence Chibwana ◽  
Daniel Kahn ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Illness Perceptions ◽  
Health Belief ◽  
Lifestyle Changes ◽  
System Level ◽  
Structured Interviews ◽  
Antihypertensive Medications ◽  
Belief Model ◽  
Past Experiences ◽  
Living With Hiv

Abstract Non-communicable diseases like hypertension are increasingly common among individuals living with HIV in low-resource settings. The prevalence of hypertension among people with HIV in Malawi, e.g. has been estimated to be as high as 46%. However, few qualitative studies have explored the patient experience with comorbid chronic disease. Our study aimed to address this gap by using the health belief model (HBM) to examine how comparative perceptions of illness and treatment among participants with both HIV and hypertension may affect medication adherence behaviours. We conducted semi-structured interviews with 75 adults with HIV and hypertension at an urban clinic in Lilongwe, Malawi. Questions addressed participants’ experiences with antiretroviral and antihypertensive medications, as well as their perspectives on HIV and hypertension as illnesses. Interviews were performed in Chichewa, transcribed, translated into English and analysed using ATLAS.ti. Deductive codes were drawn from the HBM and interview guide, with inductive codes added as they emerged from the data. Self-reported medication adherence was much poorer for hypertension than HIV, but participants saw hypertension as a disease at least as concerning as HIV—primarily due to the perceived severity of hypertension’s consequences and participants’ limited ability to anticipate them compared with HIV. Differences in medication adherence were attributed to the high costs of antihypertensive medications relative to the free availability of antiretroviral therapy, with other factors like lifestyle changes and self-efficacy also influencing adherence practices. These findings demonstrate how participants draw on past experiences with HIV to make sense of hypertension in the present, and suggest that although patients are motivated to control their hypertension, they face individual- and system-level obstacles in adhering to treatment. Thus, health policies and systems seeking to provide integrated care for HIV and hypertension should be attentive to the complex illness experiences of individuals living with these diseases.

Qualitative Analysis of the Cognition and Flow (CoGFlowS) Study: An Individualized Approach to Cognitive Training for Dementia Is Needed

2021 ◽  
pp. 1-17
Author(s):  
Lucy Beishon ◽  
Victoria Haunton ◽  
Hari Subramaniam ◽  
Elizabeta B. Mukaetova-Ladinska ◽  
Ronney B. Panerai ◽  
...  
Keyword(s):  
Cognitive Training ◽  
Controlled Trial ◽  
Cognitive Disorders ◽  
Health Belief ◽  
Analytical Framework ◽  
Structured Interviews ◽  
Home Based ◽  
Individualized Approach ◽  
Belief Model ◽  
Severity Of Dementia

Background: Cognitive training (CT) may have benefits for both healthy older adults (HC) and those with early cognitive disorders [mild cognitive impairment (MCI) and dementia]. However, few studies have qualitatively evaluated home-based, computerized CT programs. Objective: We present the qualitative arm of a feasibility randomized controlled trial evaluating a CT program for HC and people living with MCI or dementia. Methods: Participants underwent semi-structured interviews after 12 weeks of CT. Where possible, participants were interviewed with their carers. The interview schedule and analysis were underpinned by the health belief model. Interviews were audio-recorded, transcribed, open-coded, and categorized into themes. The analytical framework was developed, and themes were condensed under five major categories: benefits, barriers, threat, self-efficacy, and cues to action. Results: 37 participants underwent interviews. CT was feasible and acceptable to participants. Benefits included: enjoyment, improved awareness, benchmarking cognitive function, reassurance of abilities and giving back control. Barriers were more prevalent among those with dementia: problems with technology, frustration, conflict between patients and carers, apathy and lack of insight, anxiety or low mood, and lack of portability. HC and MCI perceived the severity of dementia risk as high, partially mitigated by CT. Participants living with dementia valued a more individualized approach to training, accounting for baseline characteristics. Conclusion: CT was a feasible intervention for HC and people living with dementia and MCI. Benefits were present, but the identified barriers need to be addressed for CT to be implemented successfully.

Exploring Older Adults’ Internalizations And Misconceptions Regarding Antihypertensive Medication Management

2021 ◽  
Vol 10 (1) ◽  
pp. 304-308
Author(s):  
Kenneth A. Blocker ◽  
Wendy A. Rogers
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Medication Management ◽  
Illness Representation ◽  
Effective Management ◽  
Structured Interviews ◽  
Antihypertensive Medications ◽  
Hypertension Knowledge ◽  
Management Behaviors

Hypertension, or high blood pressure, is an asymptomatic cardiovascular condition common with increasing age that must be controlled with proper management behaviors, such as adherence to prescribed antihypertensive medications. Unfortunately, older adults may struggle with consistent and effective management of this medication specifically and the disease generally, which can lead to poorer health outcomes. The goal of the study was to investigate older adults’ antihypertensive medication management using the Illness Representation Model as a lens to identify potential misconceptions that may contribute to medication management. We conducted semi-structured interviews with 40 older adults regarding management routines, hypertension knowledge, perceived nonadherence contributors, and perspectives related to their illness. We identified numerous misconceptions regarding hypertension knowledge, disease severity, as well as perceived adherence performance that may contribute to challenges older adults face with maintaining antihypertensive medication adherence. Moreover, these findings inform the need for and design of effective educational tools for improving antihypertensive medication adherence.

scholarly journals Text Message Preferences for Surveillance Colonoscopy Reminders Among Colorectal Cancer Survivors

2020 ◽  
Vol 47 (4) ◽  
pp. 581-591
Author(s):  
Sarah D. Hohl ◽  
Veena Shankaran ◽  
Ari Bell-Brown ◽  
Rachel B. Issaka
Keyword(s):  
Colorectal Cancer ◽  
Text Message ◽  
Health Belief ◽  
System Level ◽  
Surveillance Colonoscopy ◽  
Theoretical Frameworks ◽  
Communication Preferences ◽  
Sms Reminders ◽  
Belief Model ◽  
The Impact

Background. Surveillance colonoscopy 1-year after colorectal cancer (CRC) surgery effectively reduces CRC mortality, yet less than half of survivors undergo this procedure. Text message reminders can improve CRC screening and other health behaviors, but use of this strategy to address barriers to CRC surveillance has not been reported. Objectives. The goal of this qualitative study was to assess CRC survivor perspectives on barriers to colonoscopy to inform the design of a theory-based, short message service (SMS) intervention to increase surveillance colonoscopy utilization. Method. CRC survivors in Western Washington participated in one of two focus groups to explore perceived barriers to completing surveillance colonoscopy and preferences for SMS communication. Content analysis using codes representative of the health belief model and prospect theory constructs were applied to qualitative data. Results. Thirteen CRC survivors reported individual-, interpersonal-, and system-level barriers to surveillance colonoscopy completion. Participants were receptive to receiving SMS reminders to mitigate these barriers. They suggested that reminders offer supportive, loss-framed messaging; include educational content; and be personalized to communication preferences. Finally, they recommended that reminders begin no earlier than 9 months following CRC surgery and not include response prompts. Conclusions. Our study demonstrates that CRC survivors perceive SMS reminders as an acceptable, valuable tool for CRC surveillance. Furthermore, there may be value in integrating theoretical frameworks to design, implement, and evaluate SMS interventions to address barriers to CRC surveillance. As physicians play a key role in CRC surveillance, provider- and system-level interventions that could additively improve the impact of SMS interventions are also worth exploring.

scholarly journals The unbooked maternity patient in an academic hospital in Durban

Curationis ◽  
1992 ◽  
Vol 15 (3) ◽  
Author(s):  
R. Gcaba ◽  
H.B. Brookes
Keyword(s):  
Health Services ◽  
Service Failure ◽  
Health Belief ◽  
Interaction Model ◽  
Academic Hospital ◽  
Structured Interviews ◽  
Case Study Methodology ◽  
Study Methodology ◽  
Belief Model ◽  
The Health Belief Model

This paper examines the unbooked maternity patient in an academic hospital in Durban, Natal; This hospital is the biggest hospital serving the underprivileged population of this area. Of the 16000 annual deliveries in this hospital, about 12% are unbooked patients. The health belief model of Rosenstock, as interpreted by Mikhail and Cox’s interaction model of client health behaviour were used as a theoretical framework for this research. A qualitative case study methodology was undertaken and semi-structured interviews were conducted with unbooked mothers who had utilized appropriate health services in a previous pregnancy. The aim of such interviews was to explore reasons given by mothers for non-use of facilities in the current pregnancy. The basic trends reflected in the findings regarding non-utilization of health services were client instability, health service failure and socio-cultural constraints, The study is innovative and addresses the problem from a social-cultural and midwifery perspective.

scholarly journals MEDICATION ADHERENCE IN ELDERLY PATIENTS WITH HYPERTENSION

2017 ◽  
Vol 10 (8) ◽  
pp. 165
Author(s):  
Umi Athiyah ◽  
Rika Subarniati ◽  
Ana Yuda
Keyword(s):  
Medication Adherence ◽  
Drug Use ◽  
Significant Relationship ◽  
Health Belief ◽  
Knowledge And Beliefs ◽  
Validated Questionnaire ◽  
Perceived Benefit ◽  
Elderly Hypertensive ◽  
Belief Model ◽  
The Health Belief Model

  Objective: This study aimed to identify the relationship between knowledge and beliefs about drugs with adherence of drug use based on the health belief model (HBM) theory.Methods: Respondents were elderly hypertensive patients who received their medicine by prescription in one pharmacy in Surabaya. Knowledge and belief variables were measured by a validated questionnaire, while medication adherence was measured by pill count.Results: There were 57 respondents aged 60-88 years, 54.4% of which are female. A total of 57.9% of respondents used at least two kinds of anti-hypertension drugs and 54.4% had health problems other than hypertension. The results of Pearson analysis show that respondents’ knowledge about the drug had a significant relationship with perceived threat, perceived benefit (p=0.043), and perceived self-efficacy (p=0.015), but no significant relationship with adherence, while the result of Spearman analysis shows that only perceived barrier had a significant relationship to adherence (p=0.029).Conclusion: To conclude, efforts to improve adherence was to lower perceived barrier which was primarily associated with decreased physical ability and concerns about the dangers of long-term drug use.

scholarly journals Explaining Attitudes and Adherence to Antipsychotic Medication: The Development of a Process Model

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Martin Wiesjahn ◽  
Esther Jung ◽  
Fabian Lamster ◽  
Winfried Rief ◽  
Tania M. Lincoln
Keyword(s):  
Medication Adherence ◽  
Mental Health Professionals ◽  
Antipsychotic Medication ◽  
Process Model ◽  
Health Belief ◽  
Cost Benefit ◽  
Causal Beliefs ◽  
Need For Treatment ◽  
Negative Side Effects ◽  
Belief Model

Although nonadherence to antipsychotic medication poses a threat to outcome of medical treatment, the processes preceding the intake behavior have not been investigated sufficiently. This study tests a process model of medication adherence derived from the Health Belief Model which is based on cost-benefit considerations. The model includes an extensive set of potential predictors for medication attitudes and uses these attitudes as a predictor for medication adherence. We conducted an online study of 84 participants with a self-reported psychotic disorder and performed a path analysis. More insight into the need for treatment, a higher attribution of the symptoms to a mental disorder, experience of less negative side effects, presence of biological causal beliefs, and less endorsement of psychological causal beliefs were significant predictors of more positive attitudes towards medication. The results largely supported the postulated process model. Mental health professionals should consider attitudes towards medication and the identified predictors when they address adherence problems with the patient in a shared and informed decision process.

scholarly journals The circuits of healthcare: Understanding healthcare seeking behaviour—A qualitative study with tuberculosis patients in Lisbon, Portugal

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261688
Author(s):  
Rafaela M. Ribeiro ◽  
Philip J. Havik ◽  
Isabel Craveiro
Keyword(s):  
Health System ◽  
Health Belief ◽  
System Delay ◽  
Structured Interviews ◽  
Tuberculosis Patients ◽  
Healthcare Seeking ◽  
Health System Delay ◽  
Services Delivery ◽  
Belief Model ◽  
Diagnostic Delays

Background Understanding health delivery service from a patient´s perspective, including factors influencing healthcare seeking behaviour, is crucial when treating diseases, particularly infectious ones, like tuberculosis. This study aims to trace and contextualise the trajectories patients pursued towards diagnosis and treatment, while discussing key factors associated with treatment delays. Tuberculosis patients’ pathways may serve as indicator of the difficulties the more vulnerable sections of society experience in obtaining adequate care. Methods We conducted 27 semi-structured interviews with tuberculosis patients attending a treatment centre in a suburban area of Lisbon. We invited nationals and migrant patients in active treatment to participate by sharing their illness experiences since the onset of symptoms until the present. The Health Belief Model was used as a reference framework to consolidate the qualitative findings. Results By inductive analysis of all interviews, we categorised participants’ healthcare seeking behaviour into 4 main types, related to the time participants took to actively search for healthcare (patient delay) and time the health system spent to diagnose and initiate treatment (health system delay). Each type of healthcare seeking behaviour identified (inhibited, timely, prolonged, and absent) expressed a mindset influencing the way participants sought healthcare. The emergency room was the main entry point where diagnostic care cascade was initiated. Primary Health Care was underused by participants. Conclusions The findings support that healthcare seeking behaviour is not homogeneous and influences diagnostic delays. If diagnostic delays are to be reduced, the identification of behavioural patterns should be considered when designing measures to improve health services’ delivery. Healthcare professionals should be sensitised and perform continuous capacity development training to deal with patients´ needs. Inhibited and prolonged healthcare seeking behaviour contributes significantly to diagnostic delays. These behaviours should be detected and reverted. Timely responses, from patients and the healthcare system, should be promoted.

scholarly journals Adherence to Antihypertensive Medications and Its Determinants in Hypertensive Patients - A Complete Review

2021 ◽  
Vol 8 (2) ◽  
pp. 42-48
Author(s):  
Satish S ◽  
Manju Jose ◽  
A R Shabaraya
Keyword(s):  
Medication Adherence ◽  
Lifestyle Changes ◽  
Early Mortality ◽  
Control Blood Pressure ◽  
Antihypertensive Medications ◽  
Related Factors ◽  
Hypertensive Patients ◽  
Adherence To Medication ◽  
Common Barriers ◽  
Global Health Problem

Hypertension is a global health problem, it causes complications of cardiovascular diseases, stroke, and renal failure leading to early mortality and disability. Adherence to antihypertensive medications helps to control blood pressure levels. WHO defines adherence as ''the extent to which a person's behavior taking medication, following a diet, and / or executing lifestyle changes-corresponds with agreed recommendations from a health care provider. Poor adherence is the major cause of uncontrolled BP. Common barriers to adherence are under the patient's control, so that attention to them is a necessary and important step in improving adherence. The factors driving patients’ adherence to medication are multifactorial, but can be grouped under five main domains including socioeconomic factors, healthcare system related factors, disease related factors, therapy-related factors and patient-related factors. Identifying factors that affect medication adherence is the first step towards improving adherence. This article covers various factors influencing medication non adherence among hypertensive patients. Keywords: Hypertension, medication adherence.

scholarly journals An exploratory study of the acceptability of indoor residual spraying for malaria control in upper western Ghana

2020 ◽  
Author(s):  
Vitalis Mwinyuri Suuron ◽  
Lillian Mwanri ◽  
George Tsourtos ◽  
Ebenezer Owusu-Addo
Keyword(s):  
Malaria Control ◽  
Cultural Beliefs ◽  
Indoor Residual Spraying ◽  
Health Belief ◽  
Realist Evaluation ◽  
Evaluation Framework ◽  
World Health ◽  
Structured Interviews ◽  
Endemic Region ◽  
Belief Model

Abstract Background: Despite the implementation of the World Health Organisation’s recommended indoor residual spraying (IRS) intervention in the upper west region of Ghana to reduce malaria morbidity and mortality, the uptake of this intervention remains low. This study explores the facilitators and barriers to the acceptability and community uptake of indoor residual spraying in a highly endemic region of Ghana. Methods: The health belief model (HBM) and realist evaluation framework were used to inform the study. A qualitative enquiry was conducted between April to October 2016. Data were collected through focus group discussions and semi-structured interviews with program stakeholders including community members, AngloGold Ashanti malaria control (AGA Mal) spray operators, and AGA Mal officials. Results: A total of 101 people participated in the study. Considerable barriers to community acceptance of indoor residual spraying (IRS) were found, including, dislike of spray insecticides, inadequate information, religious and cultural beliefs, perceived low efficacy of IRS, difficulties with packing, unprofessional conduct of IRS spray operators, and other operational barriers to spraying. Facilitators of IRS uptake included a perceived effectiveness of IRS in preventing malaria and reducing mosquito bites, incidental benefits, respect for authority, training and capacity building, and sensitization activities. Conclusion: The numerous barriers to indoor residual spraying acceptance and implications show that acceptance levels could be improved. However, measures are required to address householders’ concerns and streamline operational barriers to increase community uptake of indoor residual spraying.

Health Belief Model and Medication Adherence in Patients with HIV

2021 ◽  
pp. 1-12
Author(s):  
Mujeeba Ashraf ◽  
Rabia Nisar Virk
Keyword(s):  
Medication Adherence ◽  
Antiretroviral Therapy ◽  
Health Belief Model ◽  
Health Belief ◽  
Hiv Positive ◽  
Awareness Campaign ◽  
Perceived Severity ◽  
Belief Scale ◽  
Belief Model ◽  
The Health Belief Model

Objectives: The aim of this study was to explore the components of the Health Belief Model (HBM) in order to predict medication adherence in patients with HIV. Method: A correlational study was conducted with 150 HIV positive patients including 109 men and 36 women with a mean age of 33. The data was collected in between March 2019 – May2019 from Jinnah Hospital Lahore. Those patients who were in between 18 to 55 years of age and taking antiretroviral therapy from atleast last three months were taken for the study. However those patients who were above age 55, and not taking antiretroviral therapy were not included in the study. They assessed through Urdu translated questionnaire of AIDS health belief scale (HBS), cues to action, and adherence determination questionnaire (ADQ). SPSS version 22 was used for data analysis. Results: The perceived severity and perceived cost significantly positively predicted medication adherence. However, other variables of the HBM model was not helpful to understand the medication adherence in the research participants. Conclusion: Perceived severity and perceived cost predicted the medication adherence in the studied sample. On the other hand these results also indicate that there is a need to introduce awareness campaign which will reflect on the importance of taking regular mediaction by HIV patients. Key Words: Health Belief Model, HIV in Pakistan, Medication Adherence, Perceived Severity, Continuous...

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