The role of health beliefs: Motivators for cardiovascular health preventative behaviours among postmenopausal women in Malaysia.
According to the World Health Organization(WHO, 2007), 45% of all deaths in older women globally were attributed to Cardiovascular Disease (CVD), and it is predicted, that the number of women who are affected by the disease is set to rise world wide (WHO,2007). The CVD is caused by buildup of atherosclerosis plaque, which result in the narrowed arteries causing insufficient supply of oxygen and nourishment to the heart (Suarez, 2003b). Temporary obstructions in the vital supply contribute to angina pectoris, and severe obstructions cause myocardial infarction (Suarez, Lewis, Krishnan & Young, 2004) . Sclavo (2001) indicated that a significant factor to the risk of CVD mortality in women over 50 years is menopause. Mendelsohn and Karas (1999) described that depletion of estrogen and increased LDL cholesterol levels at menopause negatively impacts the cardiovascular and metabolism function . Modifiable health damaging activities such as smoking, physical inactivity, poor eating habits and alcohol consumption are likely to cause CVD and other health complications such as diabetes, obesity and hypertension in post-menopausal women( Rich-Edwards, Manson, Hennekens & Buring, 1995). Personal, psychological and socio-cultural perspectives are said to influence the health-risk behaviour and illness in people(Matarazzo ,1994) . By exploring the health beliefs, perceived barriers and benefits to health seeking behaviour ( Rosenstock, Strecher & Becker, 1988), implementation of health promoting programs, prevention measures and adherence to medical advice can be structured to meet the CVD health requirement in postmenopausal women.
Sperry (1974) defined biologically based evidence as the only way to understand a wide variety of human health behaviour and illness development. Subsequently, numerous research investigations have strictly focused in the biochemical mechanisms such as gene interaction, neurons and chemical imbalance that alters the physiological state (Joseph, 2000) . For example, a considerable amount of research has been published about the role of cytokines in depression ( Kiecolt-Glaser & Glaser, 2002; Suarez, Lewis, Krishnan & Young, 2004). Whereby, increased level of cytokines was proven to cause chronic inflammation of the immune system which in turn contribute to heart and other health complications in women ( Suarez et al., 2004).
Biomedical treatments of CVD in postmenopausal women often include surgical and pharmacological therapies (Lynch, 2000). Despite the notable clinical success, Hormone Replacement Therapy (HRT), have been found to contribute to other health deteriorations in the high-risk groups of postmenopausal women (Bittner, 2001). Pradhan and colleagues (2002) investigated 75343 healthy postmenopausal women using observational study to determine whether oral HRT leads to increased risks for CVD. The study concluded that the use of HRT has been found to affect the inflammatory biomarkers of CVD (Pradhan et al., 2002). Another problem with the biomedical approach is that the burden of care rests solely on the medical professionals, including national and social health service providers (Liu, Maniadakis, Gray & Rayner, 2002).
On the other hand, psychologists such as Breslow and Enstrom (1980) argued that, preventable health behaviours often influence the illness manifestation. In a study sample of 6928 populations from the county of Alameda, California, the researchers recorded longer mortality rate among participants who practiced good health behaviours than participants who failed to do so (Breslow & Enstrom, 1980). Fornari and colleagues‘s (2010) study of cohorts which was conducted prospectively between 1983-1997 found that social elements such as marital , emotional stress and lower level of education are associated with the development of CVD among the Italian women.
Bridging the gap between health, behaviour and illness development, Berry (1998) posited that diseases are caused by the interaction of physiological and psychosocial elements. Therefore, understanding the cultural norms, attitudes, health beliefs and practices that contribute to a particular health behaviour is necessary for CVD prevention and maintenance of a healthy lifestyle in the postmenopausal women (Vaughn, Jacques & Baker, 2009).
The Health Belief Model (HBM) which was developed by Becker and Rosenstock (1984, as cited in Janz & Becker, 1984) has been useful in predicting why people fail or adhere to health behaviours . The HBM stipulated that the likelihood of people engage in a health promoting behaviours depend upon the level of perceived severity and vulnerability to the personal health threat within that person (Janz & Becker, 1984). Lovell, Ansari and Parker‘s (2010) research evaluated the benefits and barriers to physical exercise among the female University students in the United Kingdom, and found that the perceived cost associated with the physical exertion in exercise was rated higher than the perceived benefits of inactive lifestyle. Subsequently, the findings prompted for an effective intervention to promote benefits from regular exercise in female university students(Lovell et al., 2010).
According to the HBM, once the perceived threat is understood as imminent, then people evaluate whether changing or adopting a health behaviour is more beneficial than the cost associated with the previous behaviours (Rosenstock, Strecher & Becker, 1988). Sedlak, Doheny, Estok, Zelier and Winchell(2007) studied the impact of osteoporosis prevention behaviours(OPB) on bone density knowledge. The knowledge gained from the dual energy X-ray absorptiometry(DXA) increased the perceived susceptibility to osteoporosis, calcium intake and in promoting OPB in postmenopausal women (Sedlak et al., 2007).
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- Raja Sree R Subramaniam (Author), 2012, The role of health beliefs. Motivators for cardiovascular health preventative behaviours among postmenopausal women in Malaysia, Munich, GRIN Verlag, https://www.grin.com/document/313657