Hypertension Among African American Women - Article Example

Hypertension among African American women al affiliation Background information: The mortality and morbidity rates of hypertension among African American women is high compared to other groups in the population. This is attributed to their beliefs, attitudes and perceptions of their condition. By verbalizing their understanding of their condition, interventions can be developed on how to manage high blood pressure. Method: Use of rigorous review of literature in English language through database search such as MEDLINE and PubMed. Results: African American women have very limited information regarding hypertension, including diet, exercise, treatment adherence and racial predisposition. Conclusion: So as to develop appropriate interventions for hypertensive African American women, one needs to find out their understanding on their condition. This helps the medical practitioners provide effective treatment and educate the group on how to manage their condition. Key words: African American women, hypertension, verbal Literature review 1 In evidence based medicine (EBM) recommends that clinical questions should be formulated in terms of problem or population, intervention, comparison and outcome (PICO). PICO questions are important in conducting search regarding a hypothesis that is relevant to the researcher’s practice (Huang, Lin, Demner-Fushman, 2006). It describes a process that is useful in making a suitable research question. In designing a research question, one must hypothesize how the topic affects the search for relevant information. A researcher should be able to think of a wider context of the topic and do explore preliminarily to find out relevant scientific aspects. The topic can then be narrowed to a specific group or condition which is a population such as a study based study on African Americans. Narrowing the search is strategically done by understanding the causal efficacy of a clinical intervention. In research question development, the researcher should ask a good question and choose the right study design (Bragge, 2010). First, the problem was identified among African American women with hy. These were the chief attributes used in the search. The other aspect is how they verbalize their understanding to the condition. This is also important since the researcher aims to find the relationship between chronically elevated blood pressure and their verbal expression of their understanding to their condition. It is important since it can help medical practitioners help the patients manage their condition. This study was aimed to develop a research question using PICO so as to perform a database search for relevant literature. In developing a good question, the second step is intervention where one needs to identify what they plan to do for the patient. In order to manage the condition among hypertensive African Americans, the best intervention is to determine how they understand their condition through verbal expression. For instance, o find out how African American women verbalize their understanding to their condition, once needs to explore their views through discussions that may be facilitated by open-ended questions, probes and visual aids. Transcripts of the sessions can then be analyzed to highlight concepts of the discussions. An outcome is important in developing a relevant question. A suitable outcome is one that describes the most effective when it describes how the intervention is more effective. Hypertensive patients can verbally express their understanding of their condition and this is useful in managing the condition. It has been established that from the verbal expression of the patients, one can assess the perceptions of the illnesses and examine the relationship between the patient understanding of their illness and outcomes. In qualitative study that uses focus groups to collect data, the qualitative research approaches applied is ethnographic research since the researcher studies specifically a certain group in a population and their understanding of their condition in their cultural framework. The data obtained is analyzed and interpreted and reported in either a structured or quantitative form. The search was done by using one keyword and a combination of keywords. Initially, one or two keywords were used as a starting point in finding information and was limited to articles In English language. General topics were avoided to prevent access to too many references. The purpose of the literature search was aimed at the hypertensive African American women. The discipline concerned with the topic was basically public health, and this provided a basis for the literature search. The search was mainly done through Google Scholar, MEDLINE and Pubmed. The search was also limited from 2003 so that the information collected was up to date (Grove, Burns & Gray, 2013). Successes There are many successes in using database search to collect information on how hypertensive African American women verbalize their understanding of their condition. First, the method is time saving and the information obtained was precise. In addition, it was easy accessing all the relevant information due to the fact that the research was limited to verbal behavior. From the data it is also easy analyzing and confirming the results. Second, database search enables access to inaccessible subjects that the researcher does not have physical access to due to location. Third, the researcher can be able to select articles at different periods of time and compare to figure out the changes among the African American women over time. Limitations The frustrations in finding relevant information on the topic is that it is quite difficult finding appropriate journals with all the keywords because it was a focused search on finding key articles in the topic. Some articles were inaccessible since they required passwords and username from the respective institutions. Moreover, some of the data that was found was inappropriate. The research articles are also subject to bias since the original researchers may manipulate information for their own benefit. Sampling bias for instance may occur because people of high education or income were not effectively represented. Limitations of the study is that it uses a small sample size that may not be the actual representation of the problem. After collection of the relevant information, the literature is analyzed. The researcher organizes the publications into content areas, develops a format for recording comments and analyses each publication. It has been found out that clinicians can serach PubMed using PICO format therefore affecting relevant results and improving healthcare through structured targeted interfaces ( Schardt, Adams, Owens, Keitz & Fontelo, 2007) Conclusion Search utilization is used in many aspects. After review of literature, the research findings can be applied to clinical practice. The research findings can also provide changes in understanding conditions therefore most suitable interventions can be developed. The findings from literature search will also increase the level of attention among some ethnic groups. References Bragge, P. (2009) Asking good clinical research questions and choosing the right study design. Injury. 41 (1): S3-S6 Huang, X., Lin, J., Demner-Fushman, D. (2006). Evaluation of PICO as A Knowledge Representation for Clinical Questions. AMIA Annu Symp Proc:359-363 Schardt, C., Adams, M.B., Owens, T., Keitz, S., Fontelo, P. (2007). Utilisation of the PICO framework to improve searching PubMed for clinical questions. BMC Medical Informatics and Decision Making, 7(16) Literature Review 2 Studies show that there is a link between stress and health particularly high blood pressure. Woods-Giscombe (2010) develops a framework by exploring women’s description of their roles, perception of contextual factors, benefits and their liabilities and beliefs on how this influences health. Researchers have suggested that health problems such as birth outcomes, obesity and untreated depression among African American women can be effectively explained by stress and coping and this can be applied to hypertension in the group. Compared to other populations in the United States, African Americans have the highest prevalence of high blood pressure. Therefore there is need to determine the cause and develop strategies to help reduce blood pressure in the group. This paper focuses on African American women with hypertension and how they verbalize their understanding on their condition. How African American women verbalize their understanding to their condition is basically a qualitative study that uses focus groups during data collection. The women are engaged in a discussion involving a moderator that facilitates the discussion between the selected groups It has been noted that higher body weight is a factor that can cause hypertension and African American women are more likely to be docile and maintain higher body weights. It was found that some women were successful in maintaining weight loss and this was motivated by health concerns, weigh control and stress reduction. From their views it was clear that culturally appropriate interventions should be developed for African American women (Young, Gittelsohn, Charleston, Felix-Aaron & Appel, 2010). In treatment and management of the condition, it is important to find out the cause of the problem. According to African American women, there is a relationship between racial discrimination and blood pressure. Therefore, there was examination of their emotional responses to perceived racial discrimination to blood pressure. In addition, the behavioral responses to perceived racial discrimination were explored (Baarksdale, Farrug & Harkness, 2009). It was also found out that the health beliefs affected adherence rates that contributed to the morbidity and mortality among hypertensive African Americans. Non adherent patients believe perceived medication to be no effective and addictive, some expressed distrust of pharmaceutical companies and physicians therefore opted for home remedies. Some patients expressed that the health practitioners did not listen to them. Their descriptions of dialogues with physicians suggested communication patterns that were ethnicity inappropriate (Lukoshek, 2003). Perceptions of illness have been proven in recent research to have an association with outcomes of chronic illness such as hypertension including quality of life and self-management behaviors. Nevertheless, few interventions have been developed designed to alter the perceptions of the illness and improve outcomes of the illness. Patient outcomes can be improved by new interventions based on this model and emerging research should focus on risk factor testing of application of illness perception (Petrie, Jago & Devcich, 2007). The data obtained from the review of literature to assess their knowledge, attitudes, beliefs and behaviors, indicated that hypertension continued to be a major health problem among African American women since they agreed that certain foods played a vital role in cause and treatment of hypertension but the diets recommended by practitioners were expensive owing to the rate of unemployment among the group. The diets were also considered deviating from the traditional and preferred diets, ineffective to obviate the need for medications and socially isolating (Horowitz, Tuzzio, Rojas, Monteith, & Sisk, 2004) References Baarksdale, D. J., Farrug, E. R., Harkness, K. (2009). Racial Discrimination and Blood Pressure: Perceptions, Emotions and Behaviors of Black American Adults. Issues in Mental Health Nursing. 30 (2): 104-111 Grove, S. K., Burns, N., & Gray, J. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence. St. Louis, Mo: Elsevier/Saunders. Horowitz, C. R., Tuzzio, L., Rojas, M., Monteith S. A., Sisk, J. E. (2004). How do Urban African Americans and Latinos View the Influence of Diet on Hypertension. Journal of Health Care for the Poor and Underserved. 15(4) 631-644 Lukoshek, P. (2003). African Americans’ Beliefs and Attitues Regarding Hypertension and its Treatment: A Qualitative Study. Journal of Health Care for the Poor and Underserved. 14(4): 566-587 Petrie, K. J., Jago, L. A., Devcich, D. A. (2007). The role of illness perceptions in patients with medical conditions. Current Opinion in Psychiatry: 20 (2) 163-167 Woods-Giscombe, C. L. (2010). Superwoman Schema: African American Women’s Views on Stress, Strength and Health. Qualitative Health Research. 20 (5) 668-683. Young, D. R., Gittelsohn, J., Charleston, J., Felix-Aaron, K., Appel, L. J. (2010). Motivation for Exercise and Weight Loss among African-American Women: Focus group results and their contribution towards program development. Ethnicity & Health. 6(3-4) 227-245 Read More