A efetividade do cuidado de enfermagem na melhoria da qualidade de vida de pessoas com hipertensão na estratégia saúde da família: um ensaio clínico randomizado tipo cluster

Abstract

Introduction: Systemic arterial hypertension is considered a public health problem that affects a large part of the Brazilian population, resulting in complications and deaths from cardiovascular events. The monitoring of hypertensive users in the Family Health Strategy (FHS) is essential for a better control of this pathology and consequently reduction of damages. In the FHS, the nurse must act in coordinating the care of hypertensive people. Objective: To analyze the effect of a multifaceted intervention of nursing care offered to people arterial hypertension, from the family health teams in São Caetano - Pernambuco and Jucurutu - Rio Grande do Norte, with the aim of improving the quality of life related to health of these users. Methodology: This is an epidemiological, experimental, cluster-randomized clinical trial. For the selection of the FHS and hypertensive users, the technique of simple random probability sampling was adopted. The research was composed by nurses working in the FHS of two cities (12 FHS / 12 nurses) and by hypertensive users (231 users), divided into two groups: control group and intervention group. Those in the control group were followed up through the usual nursing care, without an additional intervention from the team, and the intervention group followed the guidelines and application of the interventions recommended by the protocol of this study. Research data collection took place at two different times: at the beginning of the study (baseline) and three months after the intervention (follow-up). Results: Of the study participants, 72.3% are female, the mean age is 59 years (SE=0,9), 85.2% are overweight or obese, 69.7% do not practice physical activity, 52.4% had uncontrolled blood pressure. In the assessment of health-related quality of life, through by Miniquestionnaire on quality of life in hypertension (MINICHAL), the average General Score of quality of life mentioned by the participants was 90.5 (SE=1,0), with the Mental State domain = 92.8 (SE=1,0) and the Somatic Manifestations domain = 88.4 (SE=1,0). In addition, 32.5% of the participants reported that hypertension and its treatment affect their quality of life. For baseline and follow-up comparison, proportions/dichotomization was performed by median, obtaining good quality of life for participants in both groups. Final considerations: Seeking strategies to prevent the damage and minimize the complications of hypertension is fundamental in our clinical practice. Intervention strategies such as the protocol for nursing consultation proposed in our study, need to be discussed and used by health teams, since they are low cost and should be part of the routine and usual care to support people with hypertension. The positive results observed from a clinical and statistical point of view in both groups (control group and intervention group) demonstrate that the educational intervention offered to the nurses in the study can be repeated in the clinical practice of these professionals in the FHS.