scholarly journals Nasa dugo (‘It’s in the blood’): lay conceptions of hypertension in the Philippines

2020 ◽  
Vol 5 (7) ◽  
pp. e002295
Author(s):  
Gideon Lasco ◽  
Jhaki Mendoza ◽  
Alicia Renedo ◽  
Maureen L Seguin ◽  
Benjamin Palafox ◽  
...  

IntroductionUnderstanding explanatory models is important for hypertension, a leading risk factor for cardiovascular disease and stroke. This article aims to determine what adult patients with hypertension in the Philippines attribute their condition to, how these views might be explained and what the implications are for hypertension management.MethodsThis is a qualitative study drawing on 71 semistructured interviews (40 initial and 31 follow-up) and four focus group discussions with patients diagnosed with hypertension. The setting was urban and rural low-income communities in the Philippines.ResultsFour prominent perceived causes were identified—genetics, heat, stress and diet—for what patients refer to as ‘high blood’. We propose a ‘folk physiology’ that rests on local understandings of blood and blood flow, draws from broader cultural notions of illness causation and accounts for a dynamic, non-chronic view of hypertension that in turn informs the health behaviours of those affected.ConclusionsBy understanding that hypertension is frequently seen not as a chronic constant condition but rather as an episodic one triggered by external influences, although in those genetically predisposed to it, it may be possible to address patient’s beliefs and thus adherence to treatment.

2016 ◽  
Vol 10 ◽  
Author(s):  
Ma Regina M. Hechanova ◽  
Lynn C. Waelde ◽  
Pia Anna P. Ramos

This study evaluated the impact of Katatagan, a culturally adapted, group-based, and mindfulness-informed resilience intervention developed for disaster survivors in the Philippines. The intervention aimed to teach six adaptive coping skills: harnessing strengths, managing physical reactions, managing thoughts and emotions, seeking solutions and support, identifying positive activities, and planning for the future. Pre- and post-intervention assessments were conducted with 163 Typhoon Haiyan survivors. Six-month follow-up assessments were obtained for 37 participants. Pre- and post-results showed improvements in participants’ self-efficacy on all six coping skills. The 6-month follow-up revealed significant improvements in four of the six coping skills. Focus group discussions conducted at follow-up revealed that mindfulness, self-care, strengths, and reframing were some of the topics that were most memorable to participants. Among these, participants identified mindfulness as a skill that they continued to use. Participants also shared that they felt stronger because of the intervention and have shared what they learned with others in their communities.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Mendoza

Abstract Patients' conceptualisations of their disease do not always correspond to the biomedical definitions. Patients make sense of conditions by drawing on embodied experiences, beliefs circulating in their environments and information gathered from a variety of sources. Discrepancy between biomedical and patients' conceptualisations is problematic as it can affect treatment adherence, access to care, patient-provider communication and quality of patient experience. This is particularly the case for hypertension, an ‘invisible disease' that gives rise to various lay conceptions and practices. We examine how the disease is made ‘real' for Filipino hypertensive patients and the role their embodied experiences play in apprehending the chronicity of hypertension and in shaping care-related practices. Drawing from interview and focus group data from hypertensive patients in low-income communities in the Philippines, and on Annemarie Mol's notion of ‘multiplicity', the ‘symptom' plays a key role in the ways in which participants self-manage ‘hypertension'. Hypertension is a ‘multiple' condition that is understood and enacted differently by people who rely on their own experiential knowledge and ‘symptoms' to define its nature and act accordingly to maintain health. Their ‘symptoms' may or may not correspond with the biomedical view of hypertension, leading to a non-chronic view of hypertension that informs the decision (not) to take maintenance medications regularly. These findings have consequences for health communications and primary care. Failing to account for this ‘multiplicity' can also negatively impact experiences of care if patients feel that their embodied experiences are dismissed as less legitimate than biomedical indicators of the disease. Clinicians and public health officials must emphasize educational efforts that aim to address divergent views of noncommunicable diseases while respecting, listening to, and accounting for patients' experiential knowledge.


2001 ◽  
Vol 116 (6) ◽  
pp. 608-616 ◽  
Author(s):  
Virginia A Cardin ◽  
Richard M Grimes ◽  
Zhi Dong Jiang ◽  
Nancy Pomeroy ◽  
Luther Harrell ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044934
Author(s):  
Melanie Louise Plinsinga ◽  
Rebecca Mellor ◽  
Jenny Setchell ◽  
Kelsie Ford ◽  
Leonard Lynch ◽  
...  

ObjectiveTo explore participants’ perspectives on, and experiences of, being assigned to a wait-and-see arm of a gluteal tendinopathy trial.DesignDescriptive qualitative.SettingGeneral community in Brisbane and Melbourne, Australia.ParticipantsFifteen participants who had been randomly allocated to the wait-and-see group in a recent parallel group superiority clinical trial. That trial compared the wait-and-see approach to a physiotherapist-led education plus exercise approach, and an ultrasound-guided corticosteroid injection. The wait-and-see approach involved one physiotherapy session in which participants received reassurance, general advice and encouragement to stay active for the management of gluteal tendinopathy.Data collection and analysisSemistructured interviews were conducted by four interviewers in person or over the internet, audio recorded and transcribed verbatim. Transcripts were coded and data analysed using an inductive thematic approach.ResultsFive themes were extracted from the interview transcripts: (1) Feeling disenfranchised by being assigned to a wait-and-see approach; (2) the importance of having a clinical and imaging diagnosis during screening for inclusion into the clinical trial; (3) feelings regarding the effectiveness of the approach; (4) the convenient and easy to follow nature of the wait-and-see approach and (5) the connotation of wait-and-see not always being perceived as an intervention.ConclusionsParticipants found the wait-and-see approach convenient and easy to follow, yet almost always felt disenfranchised that nothing was being done. Participants highlighted the importance of a definite clinical and imaging diagnosis.Trial registration numberACTRN12612001126808; Post-results.


2021 ◽  
pp. 1-30
Author(s):  
Lisa Grace S. Bersales ◽  
Josefina V. Almeda ◽  
Sabrina O. Romasoc ◽  
Marie Nadeen R. Martinez ◽  
Dannela Jann B. Galias

With the advancement of technology, digitalization, and the internet of things, large amounts of complex data are being produced daily. This vast quantity of various data produced at high speed is referred to as Big Data. The utilization of Big Data is being implemented with success in the private sector, yet the public sector seems to be falling behind despite the many potentials Big Data has already presented. In this regard, this paper explores ways in which the government can recognize the use of Big Data for official statistics. It begins by gathering and presenting Big Data-related initiatives and projects across the globe for various types and sources of Big Data implemented. Further, this paper discusses the opportunities, challenges, and risks associated with using Big Data, particularly in official statistics. This paper also aims to assess the current utilization of Big Data in the country through focus group discussions and key informant interviews. Based on desk review, discussions, and interviews, the paper then concludes with a proposed framework that provides ways in which Big Data may be utilized by the government to augment official statistics.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Diane I. Lopez ◽  
Lauren Chacon ◽  
Denise Vasquez ◽  
Louis D. Brown

Abstract Background Hispanic immigrants continue to experience higher rates of overweight and obesity compared to their non-Hispanic counterparts. Acculturation may contribute to unhealthy weight gain among immigrant populations by shifting dietary patterns from high fruit and vegetable consumption to unhealthier high fat diets. Healthy Fit, a culturally tailored community health worker (CHW) intervention, aims to reduce obesity related outcomes by providing physical activity and nutrition education and resources in a low-income Hispanic population. This study aims to evaluate outcomes of Healthy Fit participants and examine changes in body composition in relation to level of acculturation at baseline and follow-up. Method In this longitudinal observational study, CHWs recruited 514 participants from community events and agencies serving low-income Hispanic populations in El Paso, Texas from 2015 to 2016. Following an in-person health screening, eligible participants received nutrition and physical activity education guided by fotonovelas, comic-like educational books. Telephone follow-ups made at 1, 3, and 6 months by CHWs encouraged follow-through on referrals. 288 participants completed the screening again during the 12-month follow-up. Results The sample was predominantly Hispanic (96%), female (82%), uninsured (79%), had a household income of less than $19,999 (70%), foreign-born (79%), preferred Spanish (86%) and few rated themselves as good or excellent for English proficiency (27%). Overall, Healthy Fit participants significantly improved (i.e., decreased) BFP by 0.71% (t = 2.47, p = 0.01) but not BMI (b = .01, t = − 0.14, p = .89). Contrary to expectations, acculturation was not associated with lower BMI (b = 0.09, p = 0.84) or BFP (b = 0.13, p = 0.85) at baseline. However, acculturation predicted changes in both BMI (b = 0.30, p = 0.03) and BFP (b = 1.33, p = 0 .01) from baseline to follow-up. Specifically, the low acculturation group improved in body composition measures over time and the high acculturation group did not improve in either measure. Conclusion Findings suggest Healthy Fit was most effective among less acculturated individuals. The influence of acculturation on the efficacy of nutrition and exercise interventions suggests that Hispanics should not be treated as a homogenous subgroup.


Author(s):  
Rebecca Bendayan ◽  
Yajing Zhu ◽  
A D Federman ◽  
R J B Dobson

Abstract Background We aimed to examine the multimorbidity patterns within a representative sample of UK older adults and their association with concurrent and subsequent memory. Methods Our sample consisted of 11,449 respondents (mean age at baseline was 65.02) from the English Longitudinal Study of Ageing (ELSA). We used fourteen health conditions and immediate and delayed recall scores (IMRC and DLRC) over 7 waves (14 years of follow up). Latent class analyses were performed to identify the multimorbidity patterns and linear mixed models were estimated to explore their association with their memory trajectories. Models were adjusted by socio-demographics, BMI and health behaviors. Results Results showed 8 classes: Class 1:Heart Disease/Stroke (26%), Class 2:Asthma/Lung Disease (16%), Class 3:Arthritis/Hypertension (13%), Class 4:Depression/Arthritis (12%), Class 5:Hypertension/Cataracts/Diabetes (10%), Class 6:Psychiatric Problems/Depression (10%), Class 7:Cancer (7%) and Class 8:Arthritis/Cataracts (6%). At baseline, Class 4 was found to have lower IMRC and DLRC scores and Class 5 in DLRC, compared to the no multimorbidity group (n=6380, 55.72% of total cohort). For both tasks, in unadjusted models, we found an accelerated decline in Classes 1, 3 and 8; and, for DLRC, also in Classes 2 and 5. However, it was fully attenuated after adjustments. Conclusions These findings suggest that individuals with certain combinations of health conditions are more likely to have lower levels of memory compared those with no multimorbidity and their memory scores tend to differ between combinations. Socio-demographics and health behaviours have a key role to understand who is more likely to be at risk of an accelerated decline.


2018 ◽  
Vol 27 (1) ◽  
pp. 87-101
Author(s):  
Juhn Chris Espia ◽  
Alma Maria Salvador

Purpose The recent shift in the Philippine Government’s emphasis from response to a more proactive approach came with the recognition that different stakeholders play important roles in the governance of disaster risk. The purpose of this paper is to look beyond the question as to whether all stakeholders are involved in disaster risk management planning and examines the extent by which the narratives of risk of actors at the margins shape how risk is framed in municipal DRM planning in Antique, Philippines. Design/methodology/approach This paper is based on a field study carried out in San Jose de Buenavista, Antique Province, Philippines. Data were gathered through key informant interviews and focus group discussions as well as a review of archival records and documents. Findings The narratives of CSOs and communities, which revolve around livelihoods and community life are conspicuously absent from the plans whereas that of government actors occupy a central position in the risk discourse. The study highlights the power-saturated process of defining and addressing risk to disasters, where knowledge is intimately linked to power as some voices shape plans and policies, whereas, others are excluded because their knowledge is socially constructed as less reliable and therefore irrelevant. Originality/value There is a dearth of studies that examine disaster risk as social constructions in the context of planning in the Philippines and in other disaster-prone countries.


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