Research Paper: Anger Expression and Blood Pressure in Adolescents
The summarizing article provides a thorough research about interaction between anger expression and blood pressure in adolescents. As the clinical significance of childhood and adulthood hypertension becomes increasingly important in modern researches the number of studies now starts to explore the relationship between emotional behavioral factors to the development of hypertension. Using Roy Adaptation Model the article investigates these issues among adolescents 16-18 years of age and gives particular recommendations to those working in the field of school nursing.
First the article gives the overview of the problem which has become the main challenge to the current experiment. As it is stated by Falkner and Sadowski, childhood hypertension (HTN) occurs in 0,8% to 5% at all children which places more than 3 million children as risk. The majority of children are imposed to such a disease due to hereditary predisposition, however, many of them are suggested to be influenced by certain group of factors contributing to HPN. These risk factors are considered to be non modifiable (e.g., age, gender, race, family history) or modifiable (e.g., obesity, sedentary lifestyle, smoking, responsiveness to stress). Among these factors emotional behaviors with hypertensive disease are researched, and above all the anger, which is the centre point of the article.
Basing on the knowledge that overall level of anger as well as different styles of anger expression such as suppression, outward expression, or control of anger) can have a significant impact on health the number of 63 urban public high school students was proposed to participate in experiment. All senior were given a written explanation on the study and parental consent form to take home. Further the article summarizes the sample, method, gives the discussion and conclusion of research. Method implies design and recruitment of participants. Here the process of selection and testing is described and also given a sample of study that has been conducted over participants. First there was used brief self-administered demographic questionnaire so that the age, gender, race and ethnicity of each participant could be identified. The questionnaire also contained tobacco and caffeine use, physiologic measurements (blood pressure (BP), height, weight) and history of high BP. Anger expression was determined based on scores obtained on the Anger Expression Scale that implied answering 24 questions on a 4-point Likert scale with three subscales designed to measure the patterns of anger expression. Afterwards BP was measured with normal percentiles of less then 90, high normal of more then 90 and less then 95, and hypertensive of more than 95 percentile. Method of the study also included measurement of body mass index (BMI) in order to determine an acceptable approximation of total body fat and the levels of overweight and obesity.
After the dates were collected in the separate room the results were presented.
Overall the results identified HPN in 43% of the total sample; 10% were found to have BP values in the high normal range; none of the boys and only seven of the girls had BP below the normal what indicates that 89% of the students were already at increased risk for developing HPN. As to anger expression the study fell within the normal range of its indicators, however a number of individual students were in the high categories for each pattern of anger expression. The significant opening was noted about girls who had much more higher level of overall anger expression than boys. Meanwhile no relationship with either SBP or DBP was showed by this study. Although not statistically significant, an inverse relationship was found between BP and anger-out scores for boys.
In “Discussion” part of the article the purpose and short description of Roy’s Adaptation Model basing on which the study was given is overviewed. Within this framework, it is theorized that adolescents’ coping response to an anger-provoking stimuli would be through the behavior of anger expression. If the behavior is ineffective, the integrity of the person is compromised as evidenced by increased BP. The study presented by the article proves the theoretical suggestion that the girls had ineffective response of increased BP when scores were high on overall anger and anger suppression. The boys of the study may have adaptive behavioral responses, as high scores on anger-in and anger-out did not result in elevated BPs.
As for the implication and usefulness of the study described in the article for school nurse practice it is needed to stress that hypertension remains a major public health concern and challenge for all health care providers including nurses who are responsible for undertaking preventive measurements to younger generations so that they could, to some extent, avoid the negative consequences of adolescent’s inattentiveness to personal health in the future. Taking into account the high hypertension rates among adolescent’s school nurses are in position to influence the development of those behaviors through education and counseling programs.
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