Hsiu-Jung Chen
Department of Applied Psychology Fu-Jen Catholic University
Bee-Horng Lue
Department of Family Medicine National Taiwan University Hospital

Hypertension is a common chronic disease, its because of asymptomatic characters, patients usually make wrongly somatic perceptions and inaccurate judgment. The purpose of this study was to assess the focusing attention on internal versus external illness cues, which could influence the individual’s cognitive appraisal, coping behavior, adherence and emotional response in hypertension patients.
Twenty-four patients with essential hypertension were purposively selected as our study participants. Patients were interviewed by a doctor of Family Medicine who was also a researcher in our study, and the interaction process was taped for qualitative analysis.
The qualitative data revealed that there were four patterns of focusing attention among our research participants. They were : 1. Self-focused attention, they were internally directed attention to illness cues, experienced more somatic distress and coped with illness more passively. 2. Attention focus on both internal and external illness cues, patients had active coping if they certainly became aware of the correct somatic cues. Otherwise, they tended to worry and comply with medication for security because of uncertainty feeling and severity of hypertension. 3. Situation-focused attention, they tended to focus on environmental factors, not as much emotional distress as well, and tried to decrease blood pressure by managing the stress from situation. 4. Unaware of both the internal and external cues, patients weren’t aware
of any cues and needed to find the hypertension by others, tended to use defensive coping for hypertension.
Our study suggests to know personal focusing attention pattern, meanwhile compares with the accurate objective medical knowledge, certainty and severity about illness, can predict patient’s illness behavior more precisely.

Keywords: focus attention, illness behavior, somatic distress, internal and external informational cues

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