02-v1n1-1168-articles-4

ORIGINAL ARTICLES

 

Nursing research in brazil: the client with arterial hypertension or at risk  


Isabel Cristina Fonseca da Cruz1

1Universidade Federal Fluminense


Abstract
Uncontrolled high blood pressure is a major public health problem in Brazil, particularly among African-Brazilian people. Despite the advances related to the prevention and control of the disease, many clients are still suffering with the morbity or the mortality of the arterial hipertension and others present the risk factors related to cardiovascular diseases. 
Key-words: Arterial hypertension, Blacks, Nursing. 



INTRODUCTION

The purpose of this article is to review the brazilian current knowledge related to the nursing diagnoses and interventions related to the client presenting risk factors for high blood pressure, or with the disease. It is not intended to be an exhaustive review, but rather a brief review of the major nursing reseachs which form the basis for consideration of nursing roles and the nursing process in prevention and control of arterial hypertension.


NURSING RESEARCH RELATED TO THE CLIENT AT RISK FOR ARTERIAL HYPERTENSION

Every professional nurse must participate in activities directed toward the goal of prevention and control of high blood pressure. Early detection of high blood pressure is a primary goal for undetected populations. 

(2) studied the life style of 213 persons of the nursing staff to identify those who are at risk for high blood pressure. They concluded that many risk factors (contraceptive pill, salt, obesity, sedentarism, etc) are present in the population and they suggested the development of a nursing policy to the prevention of these problems. 

Others researchs related to historical aspects of cardiovascular risk factors (2,3) pointed out the colonial origins of our life style and diseases. Cruz et al (1998) suggested that the high blood pressure in the african-brazilian is an heritage of the slavery period and the process of acculturation. The NESEN - Núcleo de Estudos sobre Saúde e Etnia Negra (Health and Negro Etnicity), at the Fluminense Federal University, has the objetive to study the african-brazilian and the aspects related to the cardiac risk factors and arterial hypertension. 

But health promotion and prevention aren’t a major aspect of the brazilian nursing researchers because the disease is the focus of our care and cure. Neither etnicity and gender are major variables in our researchs, consequently women and african-brazilians are still having na unhealthy life stile and suffering with the morby-mortality of high blood pressure and other cariovascular diseases.


Nursing research related to the client with arterial hypertension 
The Brazilian nursing research is more concerned with the control of the disease, its signs and symptons(1,7,10) 

With the advance of the international nursing classification program, the direction of the nursing research focus is changing to the phenomens presented by the client with arterial hypertension and the nursing interventions to these phenomens. CRUZ (1993a) identified the following nursing diagnoses: knowledge deficit (disease and treatment), anxiety, constipation, sexual dysfunction, and activity intolerance.

(6,1) observed that there isn’t a safe parameter for the nursing interventions directed to the diagnoses of the hypertensive client. She suggested that futher reseachs should be developed to identify the nursing therapies and the criteria of evaluation for the resolution of these nursing diagnoses.

Cruz(6) propposed to includ the family in the treatment of the client with arterial hypertension. The authors considered that the changes in  the life style affects not only the client and the risk factors may be present in the members of the family who would be susceptible for the disease.

Nursing research related to the measurement of blood pressure
The sphigmomanometry is a b research area in Brazil, particularly at the University of São Paulo(10). Although these researchs stress the importance of the technique to diagnostic and control of arterial hypertension, we can observe that the technique is neglected by the health professionals.


CONCLUSION

The brazilian current knowledge related to the nursing diagnoses and interventions related to the client presenting risk factors for high blood pressure, or with the disease is still insipient.

The nursing research related to the client with arterial hypertension offers opportunities to reach undetected populations, particularly women and African-Brazilian. The nursing research should explore the engagement of the client in the health education activities, the development of screening na referral nursing services, the nursing therapies for prevention of cardiac risk factors and control of arterial hypertension for individuals, families and groups.

But it is also necessary that the nursing practice utilizes an up-to-date knowledge base, the recommended standards for measurement techniques, and the implementation of detection and follow-up activities, wich will expand the percentage of the population with a healthy life style and detected  and controlled blood pressure.


REFERENCES

1. Braga FLM, Covello CM. Follow-up como modalidade da assistência de enfermagem ao hipertenso. Rev Bras Enferm 1994;.47(2):165-77.

2. Cruz ICF. Da consulta de enfermagem ao cliente hipertenso [ Dissertação ]. Rio de Janeiro: Universidade Federal do Rio de Janeiro; 1988.

3. Cruz ICF .Diagnóstico de enfermagem: estratégia para sua formação e validação. [ Tese ]. São Paulo: - Universidade de São Paulo; 1993.

4. Cruz ICF .O cliente vivendo com Hipertensão Arterial Essencial: diagnósticos e prescrições na consulta de enfermagem. [ Tese ] Niterói: Universidade Federal Fluminense; 1994.

5. Cruz ICF. O negro brasileiro e a saúde: ontem, hoje e amanhã. Rev Esc Enf USP 1993; 27( 3):317-27.

6. Cruz ICF et al. O Cliente/Família com Hipertensão Arterial Essencial: considerações sobre o diagnóstico e tratamento de enfermagem na consulta Rev Enf UERJ 1995; 3(1):71-6. (Nota prévia).

7. Cruz ICF, Lima R. Detecção dos Fatores de Risco Cardiovasculares na Equipe de Enfermagem. Rev. Enf. UERJ 1998; 6(1):223-32.

8. Cruz ICF. El cliente viviendo con hipertensión arterial esencial. diagnósticos y prescripciones en la consulta de enfermería. Rev latinoam enferm 1995; 3(1):159-166.

9. Cruz ICF et al. Histórias de Esquecimento Brasileiro: Considerações sobre os Fatores de Risco da Hipertensão Arterial em Negros. Rev baiana enferm 1998; 11(1):75-85.

10. Peniche ACG, Arcuri EAM. Medida indireta da pressão arterial em função da largura do manguito, em pacientes nas fases pré-operatória imediata, recepção no centro cirúrgico e pós-anestésica. Rev Esc Enf USP 1992; 26(2):243-56.

11. Pierin AMG. A pessoa com hipertensão arterial em tratamento no ambulatório: estudo sobre os problemas, dificuldades e expectativas quanto à doença e ao tratamento. [ Dissertação ]. São Paulo: Universidade de São Paulo; 1985.

 

 

This lecture was presented at the XIII World Congress of Cardiology, Rio de Janeiro, Brazil,October 1998.

 

 

Received: 02/01/2002
Approved: 03/11/2002