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
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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.
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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