• hypertension;
  • worry;
  • stress;
  • critical discourse analysis;
  • critical social theory;
  • African American health

Purpose: To explore how a sample of rural Louisiana residents constructed accounts about worry and stress in relationship to their high blood pressure.

Design: Qualitative study combining critical social theories, African American studies, and critical discourse concepts. Study participants consisted of a convenience sample (N=30) of African American women (n=15) and men (n=15) with high blood pressure.

Methods: Over a 4-month period in 1999 a community-based population sample was interviewed twice. Field experiences in the community and the assistance of community consultants were critical to data analysis. Based on 60 interviews, 191 passages about worry and 58 passages about stress were analyzed using discourse analysis.

Findings: Participants not only distinguished between worry and stress in their everyday lives, but they also highlighted how those concepts were interrelated. Participants' concerns about themselves as well as their children, kin, and community were emphasized in passages about worry. Stress was primarily associated with doing multiple tasks and confronting multiple prejudices in the workplace and surrounding community.

Conclusions: Participants perceived worry and stress as important health-related concepts that affected their high blood pressure. Nursing strategies designed to address these concerns may better facilitate holistic health.