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一项定性研究:黑人女性中的高血压污名现象

A Qualitative Study: Hypertension Stigma Among Black Women.

出版信息

J Cardiovasc Nurs. 2021;36(2):96-103. doi: 10.1097/JCN.0000000000000759.

Abstract

BACKGROUND

The prevalence of hypertension (HTN) in Blacks is among the highest in the world. For Black women, 46% experience stage 2 HTN (blood pressure [BP] ≥140/90 mm Hg) as compared with 42% of Black men. Because of higher rates of stage 2 HTN, Black women have greater rates of cardiovascular disease and stroke. For reasons unknown, nonadherence to lifestyle modifications and antihypertensive medications continues. An understudied potential factor associated with poor adherence to the treatment regimen and negative health outcomes is stigma.

OBJECTIVE

The aim of this study was to gain insight and describe the psychological factor of stigma as an influence on poorly controlled HTN in Black women.

METHODS

Hypertensive Black women attending a 6-week self-management program were invited to participate in an open-ended questionnaire. Six groups were held with 62 women aged 24 to 70 years, with group size ranging from 10 to 15. Women anonymously wrote their answer to 2 questions to capture individual responses without group persuasion. Data were analyzed using thematic analysis.

RESULTS

Five themes were generated inductively from the data and included (1) desire to get control, (2) shame and embarrassment, (3) obesity characterizations, (4) stereotype threats, and lastly, (5) disrupted normality. During member checking, younger participants were more vocal about stigma, whereas older participants did not view stigma as problematic.

CONCLUSIONS

Hypertension stigma could potentially deter adherence to high BP treatment. Further research is needed to explore the prevalence of stigma in this population and its impact on behaviors that hinder BP control.

摘要

背景

黑人高血压(HTN)的患病率居世界之首。对于黑人女性,有 46%的人患有 2 期高血压(血压≥140/90mmHg),而黑人男性的这一比例为 42%。由于 2 期高血压的发病率较高,黑人女性患有心血管疾病和中风的几率更大。由于未知的原因,她们对生活方式改变和降压药物的依从性仍然较低。与治疗方案依从性差和不良健康结果相关的一个研究较少的潜在因素是耻辱感。

目的

本研究旨在深入了解和描述耻辱感这一心理因素对黑人女性高血压控制不良的影响。

方法

邀请参加 6 周自我管理计划的高血压黑人女性参与开放性问卷调查。共进行了 6 组,每组 62 名年龄在 24 至 70 岁的女性,每组人数为 10 至 15 人。女性匿名回答 2 个问题,以获取个人的回答,而不受小组的影响。使用主题分析对数据进行分析。

结果

从数据中归纳出 5 个主题,包括(1)控制疾病的愿望,(2)羞耻和尴尬,(3)肥胖特征,(4)刻板印象威胁,以及最后(5)破坏常态。在成员检查过程中,年轻的参与者更多地提到了耻辱感,而年长的参与者则不认为耻辱感是个问题。

结论

高血压耻辱感可能会阻碍患者对高血压治疗的依从性。需要进一步研究来探讨该人群中耻辱感的普遍程度及其对阻碍血压控制的行为的影响。

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