Original article Adding story-centered care to standard lifestyle intervention for people with Stage 1 hypertension Patricia Liehr, PhD, RN a, 4 , Janet C. Meininger, PhD, RN, FAAN b,1 , Robert Vogler, DSN, RN c,2 , Wenyaw Chan, PhD d,3 , Lorraine Frazier, DSN, RN-C b,4 , Sharon Smalling, MPH, RD, LD e,5 , Francisco Fuentes, MD f,6 a Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL 33431, USA b School of Nursing, University of Texas, Health Science Center at Houston, Houston, TX 77030, USA c College of Nursing, Prairie View A&M University, Prairie View, TX 77030, USA d School of Public Health, University of Texas, Health Science Center at Houston, Houston, TX 77030, USA e Memorial Hermann Wellness Center, Houston, TX 77030, USA f School of Medicine, University of Texas, Health Science Center at Houston, Houston, TX 77030, USA Received 11 January 2004; revised 18 November 2004; accepted 23 December 2004 Abstract This study examined the blood pressure (BP)-lowering effect of adding story-centered care (i.e., carefully attending to another’s narrative) to standard lifestyle intervention (i.e., exercise training and nutrition counseling) for people with Stage 1 hypertension. The subjects (N = 24), who were university and hospital employees, were unmedicated and received standard lifestyle intervention; half were randomly assigned to story-centered care. Their 24-hour BP was measured four times at 8-week intervals, twice before and twice after the intervention. Subjects who received story-centered care had greater decreases ( p b .05) in awake systolic BP over the 6-month study period. Neither systolic nor diastolic sleep BP was significantly affected. Story-centered care showed promise for contributing to the BP-lowering effect of lifestyle intervention. Approaches for integrating story-centered care into the treatment of people with hypertension are challenging but warrant further attention. D 2006 Elsevier Inc. All rights reserved. 1. Introduction More Americans see health care providers for hyperten- sion than for any other primary diagnosis; recent data sug- gest that there is a brising tide,Q with nearly one third of Americans diagnosed with hypertension (Fields et al., 2004). Lifestyle change is a fundamental part of treatment for people with hypertension. The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII, 2003) advocates weight loss, dietary adjustment, physical activity, and moderation in alcohol intake as lifestyle changes that are indispensable to the care of people with hypertension. However, these lifestyle changes can be difficult to accom- plish and people need help to accomplish them. The JNC VII (2003) recognizes this need for help and emphasizes the importance of empathetic communication to encourage adherence to hypertension treatment regimens. This research addresses empathetic communication by testing the effect of adding story-centered care (i.e., carefully attending to another’s narrative) to standard lifestyle intervention (i.e., exercise training and nutrition counseling) for people with Stage 1 hypertension (systolic blood pressure [BP], 0897-1897/$ – see front matter D 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.apnr.2004.12.001 4 Corresponding author. Tel.: +1 561 995 6758. E-mail addresses: pliehr@fau.edu (P. Liehr)8 janet.c.meininger@uth.tmc.edu (J.C. Meininger)8 robert _ vogler@pvamu.edu (R. Vogler)8 wenyaw.chan@uth.tmc.edu (W. Chan)8 lorraine.frazier@uth.tmc.edu (L. Frazier)8 sharon _ smalling@mhhs.org (S. Smalling)8 francisco.fuentes@uth.tmc.edu (F. Fuentes). 1 Tel.: +1 713 500 2124. 2 Tel.: +1 713 797 7000. 3 Tel.: +1 713 500 9321. 4 Tel.: +1 713 500 2114. 5 Tel.: +1 713 704 5800. 6 Tel.: +1 713 500 6579. Applied Nursing Research 19 (2006) 16 – 21 www.elsevier.com/locate/apnr