Illness beliefs about hypertension among non-patients and healthy relatives of patients

Objectives: Personal beliefs about illnesses have received increasing interest because these cognitions help to explain and predict preventive and therapeutic coping efforts, adjustment to a disease and health outcomes. We sought to explore and compare non-specialised illness representations of hypertension among adults never suffering from hypertension who had and had not lived with hypertensive patients. Design: Hypertension representations were explored in a community-based, convenient sample of normotensive Spanish adults of both genders from different educational backgrounds and with different family experience with this illness. Method: An adapted Illness Perception Questionnaire-R was used to assess such perceptions among healthy people in nine dimensions: Identity, Time-line, Consequences, Personal Control, Treatment Control, Illness Coherence, Evolution, Emotional Representations and Causes. Results: The participants’ beliefs mixed accurate and folk knowledge, while gender, age and education level had little impact, family experience (having or not having a relative with hypertension) strongly determined the content of hypertension representations. Participants with family experience held significantly stronger beliefs of controllability of the disease, both by patients and treatments, considered the disease as less stable and reported a lower emotional impact when thinking on suffering from hypertension. Family experience was the only significant predictor of illness cognitions. Conclusions: This study allowed us to know the perceptions of hypertension among non-patients and healthy relatives of patients. Our findings are useful in designing interventions aimed at hypertension prevention, particularly considering family experience with the disease.

Voice hearing over time: A qualitative study of a woman without a psychiatric diagnosis

Voice hearing, a complex perceptual phenomenon, is reportedly common in the general population yet understudied in nursing. Nurses meet voice hearers from diverse cultures;their understandings influence assessment. The aim was to explore voice hearing in everyday life in a non-patient population, revealing insights for assessing voice hearing. Method: Interview data was transcribed, translated into English and analyzed by qualitative content analysis. Outcome measures are thematic descriptions. Results: Voice hearing over time involved past (about year 2000) and recent (2009) time periods. Four main themes were: “Transitioning from not-being-at home when home alone to being at-home”, “Shifting overtime from frequent, repetitive voice hearing to inferquent intermittent voice hearing overtime”, “Changing from being disempowered to being empowered” and “Progressing from absence of significant others to presence of significant others”. Study Limitations: Interviewing a single participant residing in Scandinavia produced in-depth descriptions consistent with the study’s aim. The participant had no known psychiatric diagnosis and had not received mental health care when recruited and interviewed. However, we cannot be certain that her voice hearing was or was not non-pathological which raises issues concerning truth value of the study. Conclusions: The results reflect life world existential themes of lived time, lived space, lived body and lived human relation, and offers a framework for guiding and challenging nurses’ assessments of voice hearing. Voice hearing can be understood as a bereavement-grief response. Further research is needed in western and non-western cultures and non-patient populations.