Family Practice Advance Access originally published online on July 25, 2006
Family Practice 2006 23(6):637-643; doi:10.1093/fampra/cml039
How do newly diagnosed hypertensives understand ‘risk’? Narratives used in coping with risk
a Centre for Primary and Community Care, University of Sunderland UK
b School of Population Sciences, University of Newcastle UK
Correspondence to Dr NF Weaver, Centre for Primary and Community Care, School of Health, Natural and Social Sciences, University of Sunderland, Priestman Building, Green Terrace, Sunderland SR1 7PZ, UK; Email: nicola.weaver{at}sunderland.ac.uk
Background. In many clinical settings, there are concerns about communicating risk effectively in the absence of a clear understanding of what risk means to individuals.
Objectives. To explore the ways in which individuals think about risk in the context of a recent diagnosis of hypertension.
Methods. A qualitative interview study of 11 recently diagnosed hypertensive patients recruited from general practice.
Results. Participants presented a ‘narrative’ about their relationship to risk. Two general types of risk narrative were evident: ‘denial’ narratives and ‘acceptance’ narratives (though some examples fall along the spectrum in between).
The ‘deniers’ described risk as something they do not think about, or as applying to others but not themselves. The ‘acceptors’ described risk as an unavoidable part of everyday life. The use of a ‘denial’ or ‘acceptance’ narrative appeared to be independent of the level of understanding of evidence-based hypertension medical risks. Some participants who used a denial narrative also described taking a variety of risk-reducing actions in relation to the new diagnosis. For some people the distancing of risk achieved by the narrative seems to be an important way of coping.
Conclusions. Participants described risk by way of a personal narrative, which functioned as a coping position. The coping position adopted did not presuppose either levels of knowledge, or health-related behaviour. In communicating information about risk, practitioners need to be aware of the use of coping narratives; ‘denial’ does not necessarily imply lack of understanding or unwillingness to take medically appropriate health-related actions.
Keywords. Coping, narrative, perception, risk, understanding.
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