Enfermagem e a pesquisa em hipertensão arterial

Abstract

Arterial hypertension is a multifactorial chronic disease characterized by high levels of sustained pressure (>140/90 mmHg in adults). This high levels cause organs alterations, especially in: heart, brain, kidneys and blood vessels, as well as metabolic alterations (1) . Thus, increases the risk of fatal and nonfatal cardiovascular events which represents the leading cause of morbidity and mortality, in our environment. In 2006, in Brazil, 302,682 deaths occurred due to diseases of the circulatory system, which corresponded to 29.4% of total deaths (2) . Most of the time, the arterial hypertension is asymptomatic, and the only way of identifying this disease is by measuring blood pressure. Despite the proven efficacy of drug and non-drug treatments, the control of hypertension remains as a challenge to be overcome. Only about one third of hypertensives have their blood pressure levels controlled, probably due to poor treatment adherence. Faced with this reality, we wonder: How nursing contemplates the context of caring for hypertensive people?, or What has been produced by researches that addresses the needs, contextualizes the problems and presents proposals?Analyzing the production published, on arterial hypertension, in four national magazines, rated by CAPES as Qualis A, we found 58 articles. Most articles (47) were descriptive and exploratory studies, only two interventions tests aimed to assist hypertensive patients, and the others were literature review articles and descriptions of experiences. It was identified that the main issue studied was the identification of hypertensive patients' characteristics, and the objective of studies was to identify patients' needs and draw a profile including variables such as: structural, socioeconomic, psycho-emotional, knowledge of the disease and its treatment, quality of life, among others. It is emphasized that the theme "adherence to treatment", most of the time, was not the main researched focus; but, it is believed that the quest to identify and learn, is more closely related to factors that hinder the process than those who facilitate the adherence.The expression "treatment adherence" refers to the degree of compliance with prescribed therapeutic measures, which can be medicinal or not, aiming at maintaining blood pressure levels controlled. Adherence is a complex behavioral process strongly influenced by the environment, by health professionals and by the given assistance care. Non-adherence is a major obstacle to translating treatment efficacy in the desired therapeutic objectives and may be a source of frustration for health professionals. Social variables should be considered in treatment adherence, such as age, sex, race, education, socioeconomic status, occupation, marital status, religion, lifestyle, cultural aspects and beliefs about health. The knowledge about the disease and treatment is also a variable to be highlighted, since it has been verified that, most of the time, hypertensive people have information about their health problems but, they aren'...

Concepções de graduandos de enfermagem sobre humanização e espiritualidade: uma pesquisa-ação

“…Nesse âmbito, a literatura científica convoca a mais estudos sobre a implementação e avaliação de estratégias, sobre os facilitadores, sendo que as variáveis biopsicossocioespirituais como idade, sexo, raça, escolaridade, nível sócioeconômico, ocupação, estado civil, religião, espiritualidade, hábitos de vida, aspectos culturais e crenças de saúde devessem ser considerados na prática em saúde [86][87][88] .…”

“…Há que se destacar, ainda, que enquanto o conhecimento tem caráter racional, a adesão ao tratamento em situação de doença é um processo complexo, que envolve fatores emocionais e barreiras concretas, de ordem prática e logística 86 . Isto pressupõe entendermos, também, o aspecto espiritual do ser humano.…”

“…e rituais que podem, portanto, levar à busca de respostas às perguntas essenciais sobre as questões de vida e morte[79][80][81][82][83] .Pontua-se que as dimensões espiritual e religiosa, também estão presentes na vida pessoal de profissionais de saúde e pesquisadores. E aí, denota-se a importância de os enfermeiros avaliarem a necessidade de intervenção nessa área, visto o papel desse profissional, de auxiliar paciente e família a se associarem aos elementos facilitadores do tratamento, quando em situação de doença, ou a tudo que pode viabilizar estímulo para a manutenção da saúde e da vida[84][85][86] . abstração e receberem pouco consenso da literatura em relação à definição, dentre outros aspectos82 .Evidencia-se portanto, que desde o início da formação do enfermeiro, faz-se necessário incluir temas voltados à dimensão espiritual dos indivíduos, familiares e profissionais de saúde.…”