Lili Yang


The low rate of hypertension control in China has caught the attention of health providers. To achieve better outcomes, providers need to know what factors are significantly predictive of hypertension control. Researchers have rarely studied illness perception in China although it is one of the predictors for illness outcomes often studied in other countries. The purpose of this study was to examine the relationship among demographic and health-related characteristics, illness perception, adherence to medication and to self-management, and blood pressure in a sample of rural adults with hypertension in the Zhejiang Province of China. Leventhal’s Self-Regulation Model guided this cross-sectional, descriptive, correlational study. One hundred sixty-three adults with hypertension in two villages in Zhejiang province participated in the study. Self-report data were collected using structured questionnaires including the Chinese Illness Perception Questionnaire-Revised (CIPQ-R), the Medication Adherence Inventory (MAI), and the Inventory of Adherence to Self-Management (IASM). Additional data included demographics, health-related characteristics, weight, height, and blood pressure. Analysis involved use of descriptive statistics, two-sample-t-test, ANOVA, correlational analysis, and hierarchical regression. Of the 163 participants, 69 were male and 94 were female. The mean body mass index was 24.58 (SD = 3.51). The hypertension control rate was 28.80% with the mean systolic blood pressure of 146.59 mmHg (SD = 16.87) and the mean diastolic blood pressure of 80.52 mmHg (SD = 12.64). Participants rated balancing factors such as feeling overworked and sleeping problems as the main causes for hypertension. Gender, age, and household annual income were associated with diastolic blood pressure, explaining 23% of the variance in the regression model. Illness coherence contributed an additional 2%.The study findings offer implications for health care and future research. Rural adults need education on causes and consequence of hypertension. Recommendations from the study include education on healthful diets and behaviors to manage hypertension, especially for those who have higher incomes. In mainland Chinese populations, illness perception may not be directly associated with blood pressure. Lastly, the CIPQ-R and ISMA measures require validation and potential revision for use with rural Chinese populations.

LLU Discipline





School of Nursing

First Advisor

Winslow, Betty W.

Second Advisor

Taylor, Elizabeth

Third Advisor

Pothier, Patricia

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Hypertension; China;

Subject - Local

Illness perception; Health self-management; Self-Regulation Model; Medication Adherence Inventory; Inventory of Adherence to Self-Management



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives

Included in

Nursing Commons