'Under pressure': how Ghanaian, African-Surinamese and Dutch patients explain hypertension
'Under pressure': how Ghanaian, African-Surinamese and Dutch patients explain hypertension
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DOI：
10.1038/sj.jhh.1002094
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发表时间：
2006-12-01
影响因子：
2.7
通讯作者：
Bindels, P. J. E.
中科院分区：
文献类型：
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作者：
Beune, E. J. A. J.;Haafkens, J. A.;Bindels, P. J. E.
本研究的目的是探索和比较荷兰阿姆斯特丹土著-荷兰人、第一代加纳人和非洲-苏里南人(苏里南人)高血压患者的解释模型(EM)。通过半结构化访谈，我们对46名有目的的患者(年龄35-65岁，全科治疗41年)的高血压的性质、原因和后果进行了描述。这三组人在描述高血压方面都有困难。所有群体都提到特定文化的营养习惯可能是高血压的原因(荷兰甘草；加纳人的豆腐；苏里南的咸味饮食)。大多数受访者，特别是加纳和苏里南背景的受访者，认为压力是高血压的主要原因，并经历过高血压症状。许多加纳人和苏里南人将高血压归因于与移民有关的因素：饮食或气候的变化、适应荷兰社会造成的压力或本国对家庭的义务。许多移民认为回国可以治愈高血压，并担心高血压的后果。一半的荷兰人以及几乎所有的加纳和苏里南受访者认为，不受控制的高血压会立即造成损害。一些加纳人对与社区成员分享他们的担忧表示保留，因为这可能会造成社会耻辱。很少有受访者将高血压与肥胖联系在一起，尽管许多人超重。这项研究证实了英国和美国的研究结果，揭示了来自三个民族的高血压患者的EM与常见的医学观点不同。对于来自移民群体的患者来说，这些差异更大。我们的发现有助于开发以患者为中心的高血压干预措施，特别是在新的流动人口中。
The aim of this study was to explore and compare explanatory models (EMs) of hypertension in native-Dutch, first-generation Ghanaian and African-Surinamese (Surinamese) hypertensives in Amsterdam, the Netherlands. Through semi-structured interviews, we elicited accounts of the nature, causes and consequences of hypertension in a purposive sample of 46 patients (aged 35-65 years, treated for hypertension in general practice 41 year). All three groups had difficulty in describing hypertension. All groups mentioned culturally specific nutritional habits as possible causes of hypertension (Dutch liquorice; Ghanaians fufu; Surinamese salty diet). Most respondents, particularly those of Ghanaian and Surinamese background, perceived stress as the main cause of hypertension and experienced symptoms of hypertension. Many Ghanaian and Surinamese respondents attributed hypertension to migration-related factors: changes in diet or climate, stress owing to adaptation to the Dutch society or obligations towards family in their homelands. Many immigrants felt a return to their homeland could cure hypertension and were concerned about the consequences of hypertension. Half of the Dutch and almost all Ghanaian and Surinamese respondents believed uncontrolled hypertension could cause immediate damage. Some Ghanaians expressed reservations sharing their concerns with community members because it might cause social stigma. Few respondents associated hypertension with obesity, even though many were overweight. Confirming findings from UK and US studies, this study reveals that EMs of hypertension in patients from three ethnic groups differ from the common medical perspective. These differences are greater for patients from migrant groups. Our findings can be useful in developing patient-centred hypertension interventions, particularly in new migrant populations.