Nurs Res. 2022;71(4):303-312. doi: 10.1097/NNR.0000000000000592. Epub 2022 Mar 18.
Uncontrolled blood pressure (BP) rates are persistently high among African Americans with hypertension. Although self-management is critical to controlling BP, little is known about the brain-behavior connections underlying the processing of health information and the performance of self-management activities.
In this pilot study, we explored the associations among neural processing of two types of health information and a set of self-management cognitive processes (self-efficacy, activation, decision-making, and hypertension knowledge) and behaviors (physical activity, dietary intake, and medication taking) and health status indicators (BP, health-related quality of life, anxiety, and depression).
Using a descriptive cross-sectional design, 16 African Americans with uncontrolled hypertension (mean age = 57.5 years, 68.8% women) underwent functional magnetic resonance imaging to assess activation of two neural networks, the task-positive network and the default mode network, and a region in the ventromedial prefrontal cortex associated with emotion-focused and analytic-focused health information. Participants completed self-reports and clinical assessments of self-management processes, behaviors, and health status indicators.
Our hypothesis that neural processing associated with different types of health information would correlate with self-management cognitive processes and behaviors and health status indicators was only partially supported. Home diastolic BP was positively associated with ventromedial prefrontal cortex activation ( r = .536, p = .09); no other associations were found among the neural markers and self-management or health status variables. Expected relationships were found among the self-management processes and behaviors and health status indicators.
To advance our understanding of the neural processes underlying health information processing and chronic illness self-management, future studies are needed that use larger samples with more heterogeneous populations and additional neuroimaging techniques.
高血压的非裔美国人的血压控制率持续居高不下。尽管自我管理对于控制血压至关重要，但对于处理健康信息和执行自我管理活动的大脑-行为联系知之甚少。
在这项初步研究中，我们探讨了两种健康信息的神经处理与一系列自我管理认知过程（自我效能感、激活、决策和高血压知识）以及行为（体力活动、饮食摄入和服药）和健康状况指标（血压、健康相关生活质量、焦虑和抑郁）之间的关联。
使用描述性横断面设计，16 名血压控制不佳的非裔美国人（平均年龄=57.5 岁，68.8%为女性）接受功能磁共振成像以评估两个神经网络的激活情况，即任务正性网络和默认模式网络，以及腹内侧前额叶皮层中与情绪聚焦和分析聚焦健康信息相关的区域。参与者完成了自我报告和自我管理过程、行为以及健康状况指标的临床评估。
我们假设与不同类型的健康信息相关的神经处理将与自我管理认知过程和行为以及健康状况指标相关的假设仅得到部分支持。家庭舒张压与腹内侧前额叶皮层的激活呈正相关（r=0.536，p=0.09）；在神经标志物和自我管理或健康状况变量之间未发现其他关联。在自我管理过程和行为以及健康状况指标之间发现了预期的关系。
为了深入了解健康信息处理和慢性疾病自我管理的神经过程，未来的研究需要使用更大的样本量、更多样化的人群以及额外的神经影像学技术。
