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Theory Paper Montana State. 2024
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In the top leading causes of death, heart disease falls at number 1 and stroke falls at number 5 on the list according to the CDC (CDC 2021). Many different factors go into these causes of death, and some are even preventable; with hypertension being one of them. Hypertension is also known as high blood pressure which describes the condition. Physiologically, blood pressure is cardiac output and total peripheral resistance which can also
be described as the pressure of blood on the vessels in the body. The way the blood pressure is measured is by systolic and diastolic blood pressure. Systolic blood pressure (SBP) is the highest pressure recorded within the cardiovascular system during systole. A normal SBP is 110- mmHG whereas when hypertension is evident, it is raised to >140 mmHg. Diastolic blood pressure (DBP) is the lowest pressure within the cardiovascular system during diastole. A normal DBP is 65-85 mmHg and a hypertensive individual’s is >90 mmHg. Hypertension can be caused by being overweight, excess sodium in the diet, smoking, drinking, and genetic dispositions. “Almost half the United States are battling hypertension and only about a quarter of those are actually trying to manage it. Being that hypertension is mainly caused by preventable habits means that humans have control over whether their hypertension leads to their cause of death or to fix their actions to help their condition. In the study, Health Behavior of Hypertensive Elderly Patients and Influencing Factors, Li and Zhang study what factors older adults tend to respond to when dealing with hypertension. Li and Zhang collected information by giving 206 already hypertensive older adults a questionnaire about their lifestyle and how they would best react to a physician giving advice on how to best take care of themselves. The participants anonymously responded to the questionnaire. After tallying up all of the responses, researchers observed that only “23.8% of the subjects had high health behavior scores” (Li 2013). Meaning that most participants did not practice healthy behaviors which led to the worsening of their hypertension. This study mentioned that positive scores obtained from the questionnaire were directly proportional to those who had high self-efficacy. Self-efficacy is the idea that people will only do what they think they are actually able to do. In this case, people will only practice healthy behaviors if they believe that it is actually resulting in lowering their blood pressure. However, the problem with
relatively short time and didn’t see any positive results. This then is a barrier to the individual since they may believe the recommended actions didn’t help. However, in reality, they didn’t perform the actions for long enough. This causes the patient to believe that the recommended actions are ineffective or believe it is too hard to keep up with healthy behaviors for an extended period of time. The health belief model helps to explain the ways that individuals may not follow through with a regimen. Perceived barriers can often challenge patients since cutting out unwanted behaviors is difficult after it is part of a daily activity or habit. Some patients may even believe that hypertension isn’t as serious as it really is. If the physician isn’t able to relay the information that it can be fatal, the patient may never try to change their behaviors to improve their health. HBM allows physicians to consider these behaviors when giving a patient a plan to follow. Physicians can counteract the behaviors by understanding the perceived behaviors that can occur when following healthy guidelines. Attribution theory gives a cause or explanation for things that happen and people’s behaviors. “…Success or failure is the result of how difficult a task is and the person’s ability to do it, multiplied by how much effort the person puts into trying to do it” (Hayden 2009). When looking at patients with hypertension, it is difficult to follow a healthy guideline over a long period of time. Many factors may have to be changed to get the disease under control. Such as eating habits, alcohol consumption, and exercise. All of which are difficult factors to adjust in a daily lifestyle for someone who has lived with those things for a majority of their life. Since the factors that need to be adjusted are difficult to change, there might be little effort put into changing. If a patient is able to overcome the difficulties of changing their habits, and puts in the effort to try to change, they will see a decrease in blood pressure. On the other hand, if a patient ignores health advice and doesn’t change their behavior for a significant period of time, they will
see no positive results in their blood pressure levels. This theory can also be used in the perspective of how people explain their behavior and the outcome of it. “Attribution theory is concerned with how ordinary people explain the causes of behavior and events” (McLead 2012). A pessimistic person may try the healthy behaviors for a relatively short period of time and not see any results in their blood pressure. Actions taken towards hypertension take a good amount of time to show any positive effects. After not seeing any type of positive result due to cutting out unhealthy habits, this person may not believe anything will help the condition and quit trying to improve their health. According to the attribution theory in this case, unstable, internal factors are what is affecting this person. A patient may try to work towards a healthy behavior immediately after seeing a doctor and listening to the potential implications but then after some time, may return to their original habits. This theory can aid a person with hypertension since it helps to explain why people do the things that they do. Actions can be dependent on mood, desire, willingness, and effort. All things that determine if a person will succeed in their journey to reduce their blood pressure in order to live a healthier life and reduce the possibilities of a stroke or another heart complication caused by hypertension. In order to help the older-adult community in battling hypertension, certain factors can be of great help in understanding the best ways for this group to manage this condition. Better understanding factors that can help treat a dangerous condition will save many adults from heart diseases and give the knowledge on hypertension to other at-risk adults. Physicians know what needs to be done in order to treat hypertension. However, many of the actions that need to be completed can often be very challenging to complete. Many of the actions that need to be taken are giving up life-long habits such as eating unhealthy or drinking, coupled with sedentary behavior. Unhealthy eating consists of overeating, eating greasy foods, fattening food, etc. If
their wellbeing. This also can be a motivational stressor. Calls reminding patients of their upcoming health check may help to set an internal goal. For instance, if a patient has a check-in appointment once a month, they may change their actions in between appointments, but when those reminder calls come around, they may start practicing healthy behaviors in hopes that their blood pressure will have decreased in the last month. These cues to action affect unstable, external causes which fluctuate from day to day. Which is why routine reminders from the doctor are helpful to the patient since some days may be more difficult than others. More factors that are important for patients when dealing with hypertension are controllability and self-efficacy. Controllability is the extent to which behaviors can be willfully controlled. The actions that are needed in order to treat hypertension are things that are willfully controlled. Since they are willfully controlled, it is more difficult to manage them and keep up with them. This requires self-efficacy. If a person believes that they can achieve healthy habits, they will. Unfortunately, if they don’t believe they can overcome temptations with giving up unhealthy foods or drinking, they will not succeed in treating their hypertension. Long-term healthy habits are needed in order to have a successful treatment. Changing habits that a person has had over the course of their life can be difficult which is why self-efficacy is so important when trying to overcome a disease like hypertension. Cues to action can also affect controllability. Reminders from the doctor about what needs to be done and short-term goals will affect internal, unstable causes of behavior. These reminders and short-term goals can improve effort, which is an internal, unstable factor. Reminders can help patients remember what exactly needs to be done and possibly be an extra motivation for the day. Giving patients short-term goals allows the patient to always have something to look forward to. It keeps them motivated which in turn helps them maintain the
same amount of effort. Overtime, if no other goals are being achieved, a patient may give up on their routine. So, adding in a weight loss factor as well as small changes in blood pressure as smaller goals to get to the overall goal will extend the patient’s motivation. When combing all of these theories, it should make it easier for the patients to successfully overcome hypertension. These factors include reminders and motivation for the people who are battling hypertension. Overcoming barriers is the most difficult thing when trying to treat hypertension. There are many behavior habits that need to be changed or modified in order to successfully treat hypertension and keep it maintained which is why self-efficacy is a very important concept to understand when dealing with a condition like hypertension. All of the unhealthy behaviors need to be changed in order to treat hypertension and they take a lot of work. Changing eating and drinking habits people have had over the past 10 years is a definite change in their habits as well as their life. Exercise is another factor that is difficult to change, so having the self-efficacy for one’s self is a very important factor to be able to work through the challenges. The process that will be utilized in helping patients overcome hypertension will be seeing them in a clinical setting and diagnosing them with hypertension. Physicians should inform them of what causes hypertension, how to treat it, how to keep it maintained, and what they can do for themselves. This information is critical since it allows patients to make the best decision for themselves when knowing all of the factors that go into it. It allows the patient to be knowledgeable and have an internal, stable factor of controllability. The doctor should give a detailed list that is specific to the patient of the actions that need to be taken to decrease blood pressure. At this time, the doctor should also set short-term goals that will also occur due to the actions that will be taken to treat hypertension. Weight loss can be an example of this. To treat
In order for patients to overcome the challenges of hypertension, they have to have high levels of self-efficacy. In this case, they have to want to get healthier to live longer. There are many ways doctors and external factors can help patient’s internal responses. Knowledge behind hypertension, such as what causes it, what treats it, what it can cause and what keeps it at bay allows a patient to make an informed decision for themselves. The goal of knowledge is to help the patient make the right decision for their health. Cues to action such as reminder phone calls and outside billboards remind patients of the ultimate goal they are trying to achieve. Motivational factors also play a big role in treating hypertension since the patient always has a goal to reach. It doesn’t have to be treating the hypertension, but it can also be all of the benefits
that will result to their healthy behaviors. Such as weight loss, less fatigue, clearer skin, and much more. All of these factors combined will help older patients to achieve decreasing blood pressure which ultimately saves them from heart issues as they age. By completing this project, I learned that there are many factors that go into treating hypertension. Not only does a person have to build up the courage to change their behavior, but they also have to stick to it for a relatively long period of time and then stick to a plan to keep it away. So motivational goals, cues to action, and internal factors are very important to consider when trying to treat hypertension. Reminder calls may mean the world to someone who is having a rough day in trying to complete their goals. I also learned that there are many factors that can affect the behavior. The temptations of fast food and the price of healthy food options. These are more of a second order factor in deciding to be healthy, but they can definitely affect a person’s option of wanting to become healthy to improve hypertension. Something interesting that I thought about while completing this project is how many doctors don’t follow through with their patient in helping their hypertension. If more doctors and nurses gave patients the opportunity to succeed, we as a nation might see a decrease in the amount of older adults that suffer from hypertension and heart diseases. I found this project to be very informative and I learned quite a lot by doing it.
