REPRINT
Nursing
Research in Brazil: The Client with Arterial Hypertension or at Risk
Isabel
Cristina Fonseca da Cruz, RN, PhD - Full Professor of Universidade Federal Fluminense
, Niterói, RJ, Brazil. E-mail isabelcruz@uol.com.br
or www.uff.br/nepae
REPRINT FROM:
CRUZ, I.C.F.da Nursing
Research in Brazil: The Client with Arterial Hypertension or at Risk
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 hypertension 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 researches
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.
CRUZ; LIMA (1998) 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 researches related to historical aspects of cardiovascular risk factors (CRUZ, 1993;
CRUZ et al, 1998) 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 objective
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 ethnicity and gender are major variables in our researchs, consequently
women and African Brazilians are still having na unhealthy life stile and
suffering with the morbi-mortality of high blood pressure and other
cardiovascular 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 symptoms (PIERIN, 1985; CRUZ, 1988;
BRAGA; COVELLO, 1994).
With the advance of the international nursing classification program, the
direction of the nursing research focus is changing to the phenomena presented
by the client with arterial hypertension and the nursing interventions to these
phenomena. CRUZ (1993a) identified the following nursing diagnoses: knowledge
deficit (disease and treatment), anxiety, constipation, sexual dysfunction, and
activity intolerance.
CRUZ (1994; 1995) observed that there isn’t a safe parameter for the nursing
interventions directed to the diagnoses of the hypertensive client. She
suggested that further researches should be developed to identify the nursing
therapies and the criteria of evaluation for the resolution of these nursing
diagnoses.
CRUZ et al (1995) proposed to include 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 strong research area in Brazil, particularly at the
University of São Paulo (PENICHE; ARCURI, 1992). Although these
researches
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 for a 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, which
will expand the percentage of the population with a healthy life style and
detected and controlled blood
pressure.
References
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Note: This
lecture was presented at the XIII World Congress of Cardiology, Rio de
Janeiro, Brazil, October 1998
Receiveid: Feb,1st,
2002
Accepted: March, 11th, 2002