Illness experience and illness representation among older adults with hypertension

• Published in: Health education journal 2018-06, Vol.77 (4), p.412-429
• Main Authors: Duwe, Elise AG, Holloway, Breanna M, Chin, Jessie, Morrow, Daniel G
• Format: Article
• Language: English
• Subjects: Adults; Aging (Individuals); Beliefs; Clinical outcomes; Cognitive ability; Confirmatory factor analysis; Coping; Coping strategies; Correlation analysis; Daily Living Skills; Diet; Dietetics; Diseases; Education; Educational Attainment; Emotions; Etiology; Exercise; Factor Analysis; Health; Health care; Health care access; Health education; Health literacy; Health status; Hypertension; Illnesses; Infrared radiation; Knowledge Level; Least Squares Statistics; Literacy; Older Adults; Older people; Predictor Variables; Psychosocial factors; Questionnaires; Regression (Statistics); Regression analysis; Representations; Self care; Self Concept Measures; Self evaluation; Social interactions; Social support; Statistical Analysis
• ISSN: 0017-8969; 1748-8176
• DOI: 10.1177/0017896917751553

Objective: This study investigated how older adults’ representations of hypertension relate to their illness experience (years of illness), health literacy and self-rated health. Design: Correlational study. Setting: Community-based older adults diagnosed with hypertension. Method: We measured health literacy (Short Test of Functional Health Literacy in Adults [S-TOFHLA]), hypertension knowledge (Hypertension Knowledge Questionnaire), self-rated health and illness representation (IR by Brief Illness Perception Questionnaire [BIPQ]). Results: Confirmatory factor analysis divided IR into cognitive (chronicity, understanding and control) and emotional (more concern, higher impact of illness on affect) dimensions. Ordinary least-squares regression analyses demonstrated that more years of education, more hypertension knowledge, longer duration of hypertension and natural cause beliefs predicted cognitive IR, while fewer years of education, less hypertension knowledge and behavioural cause beliefs (e.g. diet and exercise) predicted emotional IR. More years of education, emotional IR and belief in natural versus psychosocial causes of hypertension were associated with better self-rated health. Conclusion: More years of illness provides older adults with the opportunity to develop an understanding of their condition. More years of education is associated with a lower emotional impact of illness, perhaps through the development of coping strategies. Emotional IR is more important than cognitive IR in predicting self-rated health. Intervening to promote better health outcomes and self-care should take place not only through health education but also through social support and health care access.