Southcentral Foundation, Research Department Anchorage, AK, USA.
University of Washington, Department of Bioethics and Humanities, Seattle, AK, USA.
Int J Circumpolar Health. 2022 Dec;81(1):2049054. doi: 10.1080/22423982.2022.2049054.
The prevalence of self-reported hypertension is higher among Alaska Native and American Indian (ANAI) individuals than in the majority USA population. Although hypertension is the primary modifiable risk factor for cardiovascular disease and stroke, it can be difficult to manage successfully. The objective of this study was to explore patients' and providers' perspectives about hypertension, hypertension management strategies, and patient-provider communication strategies within a tribally-owned and operated health system in Alaska. We conducted four focus groups that included 16 ANAI patients and five primary care providers. Patient participants tended to consider hypertension a transient state, in contrast with providers' understanding of hypertension as a chronic condition. Differences were noted in participants' perceptions regarding providers' counselling and education efforts, with providers feeling that current strategies are effective and patients desiring a more personalised discussion about hypertension. Patients expressed preferences for behaviour change approaches compared with pharmacotherapy; providers often resorted to medication as a first step towards controlling blood pressure. Our findings suggest areas of potentially promising future research with respect to patient-provider communication and treatment of hypertension.
自我报告的高血压患病率在阿拉斯加原住民和美洲印第安人（ANAI）个体中高于美国大多数人群。尽管高血压是心血管疾病和中风的主要可改变风险因素，但成功管理高血压可能具有挑战性。本研究的目的是在阿拉斯加一个部落所有和运营的医疗系统中，探讨患者和提供者对高血压、高血压管理策略以及患者与提供者沟通策略的看法。我们进行了四项焦点小组讨论，包括 16 名 ANAI 患者和 5 名初级保健提供者。患者参与者倾向于将高血压视为一种短暂状态，而与提供者对高血压作为一种慢性疾病的理解形成对比。参与者对提供者咨询和教育工作的看法存在差异，提供者认为当前的策略是有效的，而患者希望更个性化地讨论高血压。患者表示更倾向于行为改变方法而不是药物治疗；提供者通常将药物作为控制血压的第一步。我们的研究结果表明，在患者与提供者沟通和治疗高血压方面，未来可能有一些有希望的研究领域。
