Women With Hypertension: An Ethnographic Inquiry

449 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 1993.This dissertation documents the results of a 12-month ethnographic study of middle-aged black and white women (N = 45, aged 32-61), who had been diagnosed with essential hypertension and who were identified through one of two participating Champaign-Urbana, Illinois health care agencies. The ethnographic data were textually and statistically analyzed with appropriate qualitative and quantitative techniques.This research focused on the context, development, and effects of the disease; on the roles of heredity and stress factors; on each woman's perception of possible causes for her own hypertension; and on the cultural context within which each woman functioned. Although not all of these women came from central Illinois originally, their strategies for coping with and managing their lives were very similar, in spite of individual differences. The pattern of behavior that emerged is at least characteristic of smaller midwestern cities with possible generalizations across society in general.Research results do not support the hypothesis that there is a significant relationship between psychosocial factors and the development of hypertension in women--the null hypothesis, that there is no significant relationship, is supported. The relationship between race and stress levels and race and stress scores was inconclusive, and there was no significant relationship between race and the total number of health problems reported. Over 75% of the study population were overweight, and over 75% also had a family history of hypertension. This strong association supports prevailing medical opinion on the greater influence of physiological and genetic factors over behavioral ones in hypertension etiology.Several sociocultural issues are significant. The responses of many informants to quality-of-care issues, especially concerning their physician, provide important information on improving health care and compliance with treatment regimens for chronic disease patients. Informants were well informed both about their health needs and of the risks of uncontrolled hypertension. The degree of social support acknowledged by each informant was highly variable, the degree to which having social support helped informants to manage their hypertension could not be determined, and social support networks seemed to be of limited importance outside the immediate family. Personal inner strength and determination appear to be important motivators for action and for self-help. The interplay of multiple, interrelated variables produces different patterns of behavioral response for each woman, who does what she has to do to maximize personal autonomy and well-being within the limitations imposed by factors she cannot totally control. In general, however, having hypertension did not appear to be a determining factor in informant behavior and attitudes.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD