Common-sense models of illness: The example of hypertension.

Abstract

Our premise was that actions taken to reduce health risks are guided by the actor's subjective or common-sense constructions of the health threat. We hypothesized that illness threats are represented by their labels and symptoms (their identity), their causes, consequences, and duration. These attributes are represented at two levels: as concrete, immediately perceptible events and as abstract ideas. Both levels guide coping behavior. We interviewed 230 patients about hypertension, presumably an asymptomatic condition. When asked if they could monitor blood pressure changes, 46% of 50 nonhypertensive, clinic control cases said yes, as did 71% of 65 patients new to treatment, 92% of 50 patients in continuing treatment, and 94% of 65 re-entry patients, who had previously quit and returned to treatment. Patients in the continuing treatment group, who believed the treatment had beneficial effects upon their symptoms, reported complying with medication and were more likely to have their blood pressure controlled. Patients new to treatment were likely to drop out of treatment if: they had reported symptoms to the practitioner at the first treatment session, or they construed the disease and treatment to be acute. The data suggest that patients develop implicit models or beliefs about disease threats, which guide their treatment behavior, and that the initially most common model of high blood pressure is based on prior acute, symptomatic conditions.

Cites (30)

1. Self-efficacy: Toward a unifying theory of behavioral change
   Bandura, Albert · 1978 · Advances in Behaviour Research and Therapy
2. Attitude-behavior relations: A theoretical analysis and review of empirical research
   Ajzen, Icek, Fishbein, Martin · 1977 · Psychological Bulletin
3. Cognitive, social, and physiological determinants of emotional state.
   Schachter, Stanley, Singer, Jerome · 1962 · Psychological Review
4. Attitudes versus Actions: The Relationship of Verbal and Overt Behavioral Responses to Attitude Objects
   Wicker, Allan W. · 1969 · Journal of Social Issues
5. The Psychology of Physical Symptoms
   Pennebaker, James W. · 1982 · Springer eBooks
6. Compliance in Health Care
   Robert Brian Haynes, D. Wayne Taylor, David L. Sackett · 1979 · DigitalGeorgetown (Georgetown University Library)
7. Sociobehavioral Determinants of Compliance with Health and Medical Care Recommendations
   Becker, Marshall H., Maiman, Lois A. · 1975 · Medical Care
8. Findings and Theory in the Study of Fear Communications
   Leventhal, Howard · 1970 · Advances in Experimental Social Psychology
9. Attitudinal and normative variables as predictors of specific behavior.
   Ajzen, Icek, Fishbein, Martin · 1973 · Journal of Personality and Social Psychology
10. Compliance with therapeutic regimens
    Jay, Susan, Litt, Iris F., Durant, Robert H. · 1984 · Journal of Adolescent Health Care

Show all 30 references

Cited by (641)

1. How does communication heal? Pathways linking clinician–patient communication to health outcomes
   Street, Richard L., Makoul, Gregory, Arora, Neeraj K., Epstein, Ronald M. · 2009 · Patient Education and Counseling
2. The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication
   Horne, Robert, Weinman, John, Hankins, Maittew · 1999 · Psychology & Health
3. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension
   McEvoy, John William, McCarthy, Cian P, Bruno, Rosa Maria, Brouwers, Sofie, Canavan, Michelle D, Ceconi, Claudio, Christodorescu, Ruxandra Maria, Daskalopoulou, Stella S, Ferro, Charles J, Gerdts, Eva et al. · 2024 · European Heart Journal
4. Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness
   Horne, Robert, Weinman, John · 1999 · Journal of Psychosomatic Research
5. Shaping perceptions to motivate healthy behavior: The role of message framing.
   Rothman, Alexander J., Salovey, Peter · 1997 · Psychological Bulletin

See all 641

Related (10)

1. Illness Representations of Hypertension among Nepali Patients at a Tertiary Care Hospital Clinic: An exploratory survey
   Ram Kishor Sah, Andrea M. Straus, Deepak Sundar Shrestha, Hari Har Khanal, Bishnu Dutta Paudel, Richard Reed Love · 2021 · Journal of Nepal Health Research Council
2. Commonsense illness beliefs, adherence behaviors, and hypertension control among African Americans
   Eric B. Hekler, Jennifer Lambert, Elaine A. Leventhal, Howard Leventhal, Eric G. Jahn, Richard J. Contrada · 2008 · Journal of Behavioral Medicine
3. Comportamento de pessoas com hipertensão arterial : estudo fundamentado no modelo de crenças em saúde
   Maria Vilaní Cavalcante Guedes · 2005 · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT)
4. The Relation of Culturally Influenced Lay Models of Hypertension to Compliance With Treatment
   Suzanne Heurtin‐Roberts, Efrain Reisin · 1992 · American Journal of Hypertension
5. Women's health beliefs regarding hypertension.
   Matthew J. Grant · 1993 · PubMed

See all