Self-Concept and Health Beliefs in Compliant and Noncompliant Hypertensive Patients

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Abstract
Hypertension is a chronic disease requiring life-long therapy, and noncompliance in hypertensive patients is a real and timely problem. The purpose of this study was to determine if there were differences in self-concept and health beliefs in hypertensive patients who practiced compliance and those who practiced noncompliance with regard to prescribed therapy. The sample consisted of 71 male patients enrolled in a hypertension clinic in a Veterans Administration Medical Center affiliated with a university school of medicine. These patients had been enrolled in this clinic for a minimum of one and one-half years prior to the study, experienced blood pressure control one year prior to the initiation of the study, were on antihypertensive drug therapy during the year prior to the study, kept their clinic appointments during the study, were able to read and follow directions on the study instruments correctly, experienced no physical or emotional stress at the time of the study, and signed the informed consent form. These patients were categorized as compliers or noncompliers based on a one year clinical record of their diastolic blood pressure levels and the clinic nurses' interpretation of their status of compliance over this period of time. Compliers and noncompliers completed two instruments, the standardized Tennessee Self Concept Scale (TSCS) and a Health Beliefs Questionnaire (HBQ). The HBQ measured beliefs about susceptibility to hypertension, severity of hypertension and benefits of following prescribed therapy for hypertension. Methods of data analysis included testing the null hypotheses for significance via a two-tailed t test using the criterion of .05 level of confidence for the t value. The findings revealed no statistically significant difference in the scores on the TSCS and the HBQ between compliant and noncompliant patients. It is concluded that in male hypertensive patients self-concept and health beliefs are no different in those who comply with prescribed therapy than in those who do not comply. It is recommended that further research to identify behavioral parameters in hypertensive patients differentiating compliers from noncompliers be continued. It is further recommended that future studies include hypertensive women, and that the sample of hypertensive patients be derived from a variety of settings using definitive criteria for classifying corn-pliers and noncompliers.

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