Benefícios dos grupos no manejo da hipertensão arterial sistêmica: percepções de pacientes e médicos

Abstract

Artigos originAisBenefícios dos grupos no manejo da hipertensão arterial sistêmica: percepções de pacientes e médicos Benefits of groups in managing systemic arterial hypertension: perceptions of patients and physicians ResumoObjetivo: investigar a natureza dos benefícios da utilização de grupos nos serviços de atenção primária à saúde no manejo da hipertensão arterial, sob a ótica de pacientes e médicos participantes. Métodos: estudo qualitativo descritivo por meio de entrevistas semiestruturadas com pacientes e médicos participantes de grupos distintos consolidados, selecionados intencionalmente, incluídos em pares médico-paciente, até ser percebida saturação nos dados. As entrevistas foram submetidas à análise temática. Resultados e discussão: a análise das entrevistas indicou benefícios em quatro campos: educação em saúde, adesão, apoio psicossocial e melhora na qualidade de vida. Efeitos promotores de saúde foram percebidos pelos participantes, embora restritos ao nível individual e comunitário. Os grupos atenuam a "inadequação comportamental" da estratégia preventiva de alto risco, segundo Geoffrey Rose, base do manejo atual da hipertensão. Também melhoram e facilitam a função educativa dos profissionais de saúde, auxiliando na adesão e incrementando significativamente o apoio social dos pacientes. Conclusões: a utilização dos grupos de hipertensos pode melhorar o manejo da hipertensão e promover a saúde dos envolvidos e, se conduzidos de forma dialogal e participativa, seus benefícios podem ser amplificados. AbstractObjective: To investigate the nature of the benefits of using groups within primary care services to manage hypertension, from the point of view of both patients and physicians. Methods: A qualitative descriptive study using semi-structured interviews with patients and doctors attending distinct consolidated groups, which have been purposely selected and carried out in physician-patient pairs until reaching data saturation. The interviews were subjected to thematic analysis. Results and discussion: The analysis of the interviews showed benefits in four fields: health education, compliance, psychosocial support, and quality of life improvement. Health promoting effects were perceived by participants, although restricted to individual and community levels. Participation in groups attenuates the "behavioral inadequacy" of high-risk preventive strategy, according to Geoffrey Rose, based on current management of hypertension. It also improves and facilitates health professionals' educational role, improving compliance and significantly increasing social support for patients. Conclusions: The use of groups for hypertensive patients can improve hypertension management and promote the health of those involved. These benefits can be amplified if management is conducted in a dialogical and participatory way.

Pistas para potencializar grupos na Atenção Primária à Saúde

“…In order to better understand the ideas expressed in the data from the above category, we split them into three subcategories. The first, "real love, friendship and family", emphasizes the identification among the group members as a defining characteristic of the group, who become companions, aware of each other, with a strong friendship being generated among them (3,26) . Such an aspect makes this affection possible, with the group acting in the same way as a family.…”

“…Pistas para potencializar grupos na Atenção Primária à Saúde Pistas para potenciar grupos de Atención Primaria de Salud INTRODUCTION Group practices in the everyday activities of Primary Health Care (PHC), as a tool to promote health, are included in the list to reorientate the services proposed by the Brazilian Ministry of Health (MS). These practices are part of the procedures funded by the Brazilian Unified Health System (SUS) (1) , because they are considered tools capable of extending user understanding regarding their problems and, consequently, of promoting changes in life habits that pose a risk to health (2)(3)(4) .…”

“…Group activities in PHC can enable the health situation of the users to be monitored, which is a tool that can streamline the professionals' work because it decreases the demand for consultations (3) . Streamlining financial resources and the work of professionals is important to make PHC services accessible to all countries in the world; however, the main purpose of using the group strategy, at this level of care, is based on the possibility of developing characteristics such as cooperation, partnerships, communication, critical and reflective adaptation to reality, among others aspects regarding the sustainable development of communities (5)(6)(7)(8) .…”

“…With the aim of being meaningful in the lives of its participants, the individuals within the group must compare their realities with each other, as well as to stimulate reflection and expand the ability of the members to resolve their own problems (4,12) . This process allows the individuals to organize and give meaning to their own experiences, feelings, perceptions, emotions and thoughts, as well as construct their own internal models (3,(13)(14) . The technique also makes it possible to socialize, provide support in times of transition, treatment or crises and help adaptation towards healthier behavior (11,15) .…”

Acesso ao cuidado na Estratégia Saúde da Família: equilíbrio entre demanda espontânea e prevenção/promoção da saúde

“…Similarly, low-risk children may arrange their check-up visits up to six months, with appointments associated with their immunization schedule, in addition to other strategies, such as childcare collective educational activities. As for hypertensive patients and high-risk diabetics, they have priority over those of mild and moderate risk patients and represent small slice within that highest risk group, also subject to collective educational actions (Amaral;Müller, 2013).…”