Understandings about blood pressure where also highly variable and in most of the interactions communication about blood pressure was not effective. In three of the interactions the patients had their blood pressure checked but none were able to accurately report the result. In one case, Wurrapa was found to have high blood pressure and the nurse felt that she had made this clear to her. However, in later discussions about her blood pressure Wurrapa said she was not told it was high and, although she talked confidently about the numbers she thought related to blood pressure, these numbers actually referred to her weight.
In another interaction, with the pending patient, the physician did tell
the patient and his family that Balaŋ's blood pressure was high and talked
at length about the importance of managing this problem. After the consultation,
however, none of the Yolŋu participants were able to respond to the Yolŋu
researcher's questions about Balang's blood pressure result. They had
understood -apparently for the first time - that it was important for
it to be checked regularly and were intending to ensure this happened.
The physician involved in this consultation explained the problem when
asked if he believed the Yolŋu understood the concept of blood pressure:
no, the visual blood pressure monitors (are good) because they can see
a number whereas when we do it (this way) .. it's all just witchcraft
- you can say this is where you are and this is what it should be and
they can actually see the number flashing - they can read the number and
that's much better
Another staff member suggested there is variable understanding about
blood pressure:
...and the blood pressure - all they know about that
is that the blood pressure cuff pumps up every hour while they are trying
to sleep on the machine and I don't know that they really know (about)
blood pressure - I'm talking generally - some of them do (interview with nurse educator)
According to Marrŋanyin (the Yolŋu researcher working on the project) many Yolŋu think that 'blood pressure' is a sickness. Once again, without some understanding of the biomedical story about the circulatory system, familiarity with the metaphors of quantitative measurement and consistency in the way the term is used by staff, there is little possibility of effective communication occurring about this very crucial aspect of renal management.