Análise da dimensão adesão/vínculo dos hipertensos com níveis pressóricos não controlados nas unidades de saúde da família do município de João Pessoa

• Autor(a) principal: Silva, Christiana Souto
• Data de Publicação: 2011
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/tede/6569
• topic: Hipertensão arterial; Atenção básica; Avaliação em saúde; Hypertension; Primary care; Health evaluation; CIENCIAS DA SAUDE::SAUDE COLETIVA

The Brazilian Ministry of Health advocates the control of systemic arterial hypertension through interventions of the Family Health Strategy (FHS). Therefore, it has been necessary to analyze FHS‟s performance and impact on the disease control, particularly in the units which have been finding difficulties for such control. In that context, this study aims to analyze the ongoing care of hypertensive users with uncontrolled blood pressure in primary health care from the city of Joao Pessoa. This is a population-based study whose randomized and probabilistic sample consisted of 343 hypertensive users. From that total, 72 individuals presented uncontrolled pressure levels. The instrument, consisting of eight dimensions, has been adapted from Primary Care Assessment Tool (PCAT) and revalidated in Brazil. For the present study, it was employed the dimension Adherence/Attachment to assess the already supported hypertensive users presenting uncontrolled blood pressure levels. Data qualification was performed by means of multivariate analysis: exploratory and confirmatory factorial analysis and analysis on validity and reliability properties. The results were described afterwards. The dimension Adherence/Attachment presented a final structure containing eight questions. Among the 343 hypertensives, 32.4% (n=111) had already been being supported by the FHS. From these, 61.2% (n=72) presented uncontrolled blood pressure during the interview time and, from these, 30.8% (n=21) had presented controlled blood pressure at registration to the Health Unit, and then showed altered blood pressure levels during the interview. The participants‟ profile revealed a high percentage of elderly and low educational level. Calculation of the index composed for the dimension indicated a satisfactory adherence in all sanitary districts. Two paradoxical situations were found: combined indexes confirming a good adherence and attachment to the service, and a percentage of individuals that although supported and revealing satisfactory adherence have presented uncontrolled blood pressure levels. Thus, it has been suggested that in order to achieve adequate blood pressure control it is necessary a full adherence, not only to the proposed treatment, but also to a change in habits and customs and a greater commitment to self-care and involvement of professionals with interventions related to the education in health‟ scope. The present study allowed to raise questions and to provide subsidies for health care managers in identifying the most vulnerable groups to non-adherence and, consequently, to blood pressure control failure, contributing to the decision-making process in order to subsidize the development and implementation of rational public policies and more efficient health practices for the control of hypertension. It is expected the adoption of this evaluation model, generating parameters for intra and inter-services comparison for the control of systemic arterial hypertension in the municipalities.