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n Health SA Gesondheid - Illness cognitions, doctor-patient communication and prescription adherence among first diagnosed hypertensive patients from a rural teaching hospital in South Africa : research

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Abstract

This study examines the relationship between illness cognitions, doctor-patient communication and the use of prescribed medication among patients first diagnosed with hypertension in the outpatient department of a rural South African teaching hospital. The sample included two men and 43 women, in the age range of 38 to 85 years, (M= 60.5 years, SD= 11.5 years); 14 (31%) were 65 years and above. Outcome measures included doctor-patient communication, recall interview, illness cognitions, and anthropometrical measurements. From the 45 patients studied 23 (51%) were not adherent with prescription medication. Major findings were that doctor-patient communication, most illness cognitions, and healthy behaviour of the patient were not associated with adherence behaviour. Perceived stress and the belief of incurability of hypertension were, however, related with adherence behaviour. Patients frequently mentioned mental and environmental stress as causative and management beliefs. On the contrary, the treating physicians did not allude to mental and environmental stress. Physicians gave little lifestyle health education. In instances where it was given, most patients seemed to practice it.

Hierdie studie ondersoek die verwantskap tussen siekte-kognisies, dokter-pasiënt kommunikasie en die gebruik van voorskrifmedisyne onder pasiënte wat die eerste keer met hipertensie gediagnoseer is, in die buitepasiëntafdeling van 'n landelike Suid-Afrikaanse opleidingshospitaal. Die steekproef het twee mans en 43 vroue, binne die ouderdomsgroep 38-85 jaar ingesluit (M=60.5 jaar, S=11.5 jaar); 14 (31%) was 65 jaar en ouer. Uitkomsmetings het dokter-pasiënt-kommunikasie, herbesoek-onderhoude, siekte-kognisies, en antropometriese metings ingesluit. Van die 45 pasiënte wat bestudeer is, het 23 nie gehoor gegee aan hul voorskrifmedikasie nie. Die belangrikste bevindinge was dat dokter-pasiënt-kommunikasie, die meeste siekte-kognisies en gesonde gedragswyses van die pasiënt, nie geassosieer was met gehoorsaming van voorskrifte nie. Stres wat waargeneem is en die oortuiging van dat hipertensie ongeneesbaar is, hou egter verband met die gehoorsaming van voorskrifmedisyne. Sielkundige en omgewingstres is dikwels deur pasiënte genoem as oorsaaklike en beheerbare oortuigings, maar nooit deur die geneeshere wat hierdie pasiënte behandel het nie. Die geneeshere het min riglyne ten opsigte van gesonde lewenswyses verskaf. Indien dit wel verskaf is, het dit geblyk dat die meeste pasiënte dit nagevolg het.

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/content/health/8/1/EJC35251
2003-03-01
2016-12-03
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