Symptom perception (illness identity) | Beliefs about hypertension | Beliefs about treatment/medication | Potential mediating relationship with self-management |
---|---|---|---|
No hypertension symptoms | • Less serious consequences, less concern, lower personal and treatment efficacy | • Treatment is not necessary • Medication signifies ill health | • Benefit of taking medication, or the health risk of non-adherence, may not be immediately noticeable in the short term • Objective BP readings may provide convincing evidence for the necessity of medication adherence • Medication acceptance is more likely when a clear benefit or rationale for anti-hypertensive medication is presented |
Temporary increases in BP (fluctuating symptoms) | • High BP is perceived as separate to hypertension and occurring as a result of temporary modifiable factors such as stress or over-exertion | • Treatment only necessary when experiencing symptoms (i.e. to alleviate stress or to rest) | • BP monitoring would demonstrate that perceived fluctuations in symptoms are not a reliable indicator of when management is appropriate • Reductions in BP linked to appropriate self-management behaviours |
Perception of hypertension-related symptoms (strong illness identity) | • High perceived consequences and emotional response to illness | • Poor medication adherence if a reduction in perceived symptoms are not observed in line with adherence behaviour | • Self-monitoring over extended periods (i.e. 7 days per week each month) may be important in decoupling perceived symptom experience from treatment beliefs • Feeling better and the perceived benefits of anti-hypertensive medication were identified as reasons to take anti-hypertensive medication |