Comunicare la salute: bisogno informativo e comunicazione tailored in pazienti coronaropatici e ipertesi

This thesis is devoted to the analysis of the role of communication in the management of cardiovascular diseases. It is made up by two theoretical chapters and four empirical studies. The first chapter presents a brief description of cardiovascular diseases and it introduces the importance of primary and secondary prevention through optimal self-management and health behaviors. It also describes the main theoretical models of health behavior. The second chapter analyzes the concept of health communication, with the description of the history, the techniques and the practical applications of this growing field of research. In this chapter it is explained the importance of identifying patients’ information needs to enhance the quality of chronic disease management and to lead health-care systems to move toward more patient-tailored care. The concept and practice of tailoring health messages are also introduced. In the third chapter it is reported a longitudinal observational study aimed at exploring the information needs and perceived relevance of different information sources among patients affected by acute coronary syndrome and hypertension. The second study was designed to examine whether information needs and situational coping responses influence each other over time in a sample of hypertensive patients. A three-wave longitudinal design that allows for examining potential reciprocal relationships among study variables was adopted for this study, and two main hypotheses were tested. The first hypothesis was that patients’ strategies to cope with their hypertension would affect their need for specific information related to their illness. The second hypothesis was that the relationships between coping and the need for information would be bi-directional. Consequently, a greater need for information at baseline would also foster a greater adoption of active coping strategies in the following months, while patients less interested in information would adopt more disengagement strategies of coping. The third study describes the development and the initial evaluation of a theory-based tailored print message intervention to improve compliance with the self-care regimen recommended for patients with hypertension. The intervention was initially evaluated by assessing patients’ exposure and reading of the material, their reaction to the appearance and the content of the health brochures and the perceived relevance and usefulness of the information provided. Finally, the aim of the fourth study was to evaluate if the theory-based tailored intervention described in study three was effective in promoting changes in behavioral habits among patients with essential hypertension. The hypothesis was that the intervention group who had received the tailored health brochure would change wrong lifestyle habits more significantly than a comparison group in a usual care condition.