Emergency Department Patients Self-Report Higher Patient Inertia, Hopelessness, and Harmful Lifestyle Choices Than Community Counterparts

Authors

  • JaNae Joyner PhD,

    1. From the The Consortium for Southeastern Hypertension Control (COSEHC);
    2. the Wake Forest University School of Medicine, Hypertension and Vascular Research Center;
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  • Ashley R. Moore BS,

    1. the Wake Forest University School of Medicine, Emergency Department;
    2. the Winston Salem State, Department of Biology, MARC U-STAR Program;
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  • David L. Mount PsyD,

    1. the Wake Forest University School of Medicine, Department of Internal Medicine, Maya Angelou Center for Health Equity;
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  • Debra R. Simmons MS, RN,

    1. From the The Consortium for Southeastern Hypertension Control (COSEHC);
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  • Carlos M. Ferrario MD,

    1. From the The Consortium for Southeastern Hypertension Control (COSEHC);
    2. the Wake Forest University School of Medicine, Department of General Surgery, Department of Internal Medicine/Nephrology, Department of Physiology/Pharmacology
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  • David M. Cline MD

    1. the Wake Forest University School of Medicine, Emergency Department;
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JaNae Joyner, PhD, The Consortium for Southeastern Hypertension Control (COSEHC), PO Box 5097, Winston Salem, NC 27113-5097
E-mail:jjoyner@wakehealth.edu

Abstract

J Clin Hypertens (Greenwich). 2012;14:828–835. ©2012 Wiley Periodicals, Inc.

Patient inertia is defined as an individual’s failure to take responsibility for proactive lifestyle change and health conditions including hypertension. Generalized and hypertension-specific patient inertia factors were compared in 110 patients (48% women; 52% African American) from a Forsyth County, NC, emergency department (ED) and 104 community members (79% women; 70% African American) using the patient inertia–facilitated survey Patient Inertia-36. Statistically, more ED than community participants added salt to food at the table and consumed fast foods 5 to 7 days a week. ED patients agreed less often with health literacy questions about salt and BP. Hypertension associated Patient inertia questions asked of 45 ED and 40 community participants with a personal history of hypertension revealed a statistically higher sense of hopelessness surrounding blood pressure management in ED participants. Past BP control experiences of family members had statistically greater impact on community participants regarding their own BP control. Using a logistic regression model, advancing age and being surveyed in the ED were correlated with hopelessness towards BP control. ED patients make unhealthier diet choices and possess heightened generalized and hypertension-specific patient inertia including hopelessness towards controlling their BP that increases with age. These factors may contribute to this population’s poor BP control, particularly self-efficacy barriers.

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