Stael na Bagno Eleutério da Silva

O efeito de intervenções educativas no conhecimento da equipe de enfermagem sobre hipertensão arterial

Hypertension is one of the main risk factors for cardiovascular diseases. Nursing carries a large responsibility in care delivery to hypertensive individuals. Thus, the goal was to assess a nursing teams knowledge on hypertension and its treatment before and after educational interventions. A questionnaire was used, addressing theoretical aspects of hypertension knowledge among nurses (5), technicians (2), auxiliaries (11) and community agents (37) at two Basic Health Units in São Paulo City, Brazil. For statistical analysis, Students T test was used, as well as variance analysis and p < 0.05. A knowledge increase was verified after the educational interventions for the group constituted by nurses, technicians and nursing auxiliaries (84.6 +/- 12.0% vs. 92.7 +/- 15.0%, p < 0.05), while no significant change occurred for community health agents (80.8 +/- 12.2% vs. 83.5 +/- 24.0%). Thus, it was concluded that the educational actions were effective and must be put in practice in the nursing team, which they can influence the improvement of care delivery for hypertensive patients.A hipertensao arterial e um dos principais fatores de risco para as doencas cardiovasculares, sendo grande a responsabilidade da enfermagem na atencao aos hipertensos. Objetivou-se, portanto, avaliar o conhecimento sobre hipertensao e seu tratamento com a equipe de enfermagem, antes e apos onze intervencoes educativas. Utilizou-se questionario abordando aspectos teoricos ligados ao conhecimento sobre hipertensao em enfermeiros (5), tecnicos (2), auxiliares (11) e agentes comunitarios (37), de duas Unidades Basicas de Saude da cidade de Sao Paulo. Para analise estatistica utilizou-se o teste T de Student, analise da variância e p<0,05. Verificou-se aumento no conhecimento apos as intervencoes educativas para o grupo formado por enfermeiros, tecnicos e auxiliares de enfermagem (84,6±12,0% vs 92,7±15,0%, p<0,05), enquanto que para agentes comunitarios de saude nao houve mudanca significante (80,8±12,2% vs 83,5±24,0%). Portanto, conclui-se que as acoes educativas foram efetivas e que devem ser implementadas junto a equipe de enfermagem, considerando que elas podem influenciar no aprimoramento da assistencia as pessoas hipertensas.

Prevalência de hipertensão arterial em Adventistas do Sétimo Dia da capital e do interior paulista

FUNDAMENTO: Infusao de intralipid e heparina resulta em aumento da pressao arterial e tambem em anormalidades autonomicas em individuos normais e hipertensos. OBJETIVO: Avaliar a sensibilidade a insulina e o impacto da infusao de intralipid e de heparina (ILH) sobre a resposta hemodinâmica, metabolica e autonomica em pacientes com a forma indeterminada da doenca de Chagas. METODOS: Doze pacientes com a forma indeterminada da doenca de Chagas e 12 voluntarios saudaveis foram avaliados. RESULTADOS: A pressao arterial basal e a frequencia cardiaca foram semelhantes nos dois grupos. Os niveis plasmaticos de noradrenalina encontravam-se ligeiramente aumentados no grupo de pacientes chagasicos. Apos o Teste de Tolerância a Insulina (TTI), houve um declinio significativo na glicose dos dois grupos. A Infusao de ILH resultou em aumento da pressao arterial em ambos os grupos, mas nao houve nenhuma mudanca significativa na noradrenalina plasmatica. O componente de Baixa Frequencia (BF) mostrou-se semelhante e aumentou de forma semelhante em ambos os grupos. O componente de Alta Frequencia (AF) apresentou-se menor no grupo chagasico. CONCLUSAO: Pacientes com forma indeterminada da doenca de Chagas apresentaram aumento da atividade simpatica no momento basal e uma resposta inadequada a insulina. Eles tambem tiveram um menor componente de alta frequencia e sensibilidade barorreflexa prejudicada no momento basal e durante a infusao de intralipid e heparina.BACKGROUND: Inadequate life habits are known to favor hypertension, and Adventists recommend healthy life habits. OBJECTIVE: To assess the prevalence of hypertension among Seventh-Day Adventists from the inner Sao Paulo state and Sao Paulo state capital. METHODS: This study assessed 264 Adventists (mean age, 41.17 ± 15.27 years; women, 59.8%) with a high religiosity level assessed by use of the Duke University Religion Index. Blood pressure was measured with a validated automatic device. The significance level adopted was p < 0.05. RESULTS: The total prevalence of hypertension was 22.7% (27.4% in the inner state and 15% in the capital). The Adventists from the capital differed from those of inner state as follows (p < 0.05), respectively: higher education (62% vs 36.6%); employed by a third party (44%) vs self-employed (40.9%); family income (8.39 ± 6.20 vs 4.59 ± 4.75 minimum wages); individual income (4.54 ± 5.34 vs 6.35 ± 48; couple responsible for family income (35% vs 39.6%); vegetarianism (11% vs 3%); blood pressure (115.38 ± 16.52/68.74 ± 8.94 vs 123.66 ± 19.62/74.88 ± 11.85 mmHg); white ethnicity (65% vs 81.1%); married (53% vs 68.9%); lower tangible support in the social aspect (15.7 ± 5.41 vs 16.9 ± 4.32); and recalling the last time ones blood pressure was measured (65% vs 48.8%). On multivariate analysis, hypertension associated with the following: 1) vegetarianism (OR 0.051; 95% CI: 0.004-0.681); 2) educational level (OR 5.317; 95% CI: 1.674-16.893); 3) recalling the last time ones blood pressure was measured (OR 2.725; 95% CI: 1.275-5.821); 4) being retired (OR 8.846; 95% CI: 1.406-55.668); and 5) being responsible for family income (OR 0.422; 95% CI: 0.189-0.942). CONCLUSION: The prevalence of hypertension among Adventists was lower as compared with that reported in Brazilian studies, and it was lower in the Sao Paulo state capital as compared with that in the inner Sao Paulo state, possibly because of the better socioeconomic conditions and life habits of the former.

The effect of educational interventions on nursing team knowledge about arterial hypertension

Hypertension is one of the main risk factors for cardiovascular diseases. Nursing carries a large responsibility in care delivery to hypertensive individuals. Thus, the goal was to assess a nursing teams knowledge on hypertension and its treatment before and after educational interventions. A questionnaire was used, addressing theoretical aspects of hypertension knowledge among nurses (5), technicians (2), auxiliaries (11) and community agents (37) at two Basic Health Units in São Paulo City, Brazil. For statistical analysis, Students T test was used, as well as variance analysis and p < 0.05. A knowledge increase was verified after the educational interventions for the group constituted by nurses, technicians and nursing auxiliaries (84.6 +/- 12.0% vs. 92.7 +/- 15.0%, p < 0.05), while no significant change occurred for community health agents (80.8 +/- 12.2% vs. 83.5 +/- 24.0%). Thus, it was concluded that the educational actions were effective and must be put in practice in the nursing team, which they can influence the improvement of care delivery for hypertensive patients.A hipertensao arterial e um dos principais fatores de risco para as doencas cardiovasculares, sendo grande a responsabilidade da enfermagem na atencao aos hipertensos. Objetivou-se, portanto, avaliar o conhecimento sobre hipertensao e seu tratamento com a equipe de enfermagem, antes e apos onze intervencoes educativas. Utilizou-se questionario abordando aspectos teoricos ligados ao conhecimento sobre hipertensao em enfermeiros (5), tecnicos (2), auxiliares (11) e agentes comunitarios (37), de duas Unidades Basicas de Saude da cidade de Sao Paulo. Para analise estatistica utilizou-se o teste T de Student, analise da variância e p<0,05. Verificou-se aumento no conhecimento apos as intervencoes educativas para o grupo formado por enfermeiros, tecnicos e auxiliares de enfermagem (84,6±12,0% vs 92,7±15,0%, p<0,05), enquanto que para agentes comunitarios de saude nao houve mudanca significante (80,8±12,2% vs 83,5±24,0%). Portanto, conclui-se que as acoes educativas foram efetivas e que devem ser implementadas junto a equipe de enfermagem, considerando que elas podem influenciar no aprimoramento da assistencia as pessoas hipertensas.

Nursing actions increases the control of hypertensive patients and reduces white-coat effect

A randomized comparative study was performed to evaluate the control of hypertension with use of home blood pressure measurement (HBPM) and casual blood pressure measurement, and analyze the white coat effect. Hypertensive patients in primary health care units were randomly divided into two groups: group I, participating of the educational activities and group II that followed the routine treatment. The hypertensive patients from group I realized HBPM at the beginning and the end of the study. White-coat effect was evaluated by the difference between the casual blood pressure measurement and HBPM. The study included 290 hypertensive patients, but realized HBPM 82 hypertensive patients. There was increase in blood pressure control from the beginning to end of study in hypertensive patients from group I (p < 0.05) measured by HBP (60% to 68.3%) and casual measurement (62% to 71%) and in group II, HMBP hypertension control was higher than the casual blood pressure measurement (63% vs 50%). The white coat effect was greater in hipertensive patients from group II.Realizou-se estudo comparativo randomizado para avaliar o controle de hipertensos, com uso da medida residencial da pressao arterial (MRPA) e medida casual, bem como para analisar o efeito do avental branco. Hipertensos atendidos em unidades basicas de saude foram divididos aleatoriamente em: grupo I, participante das atividades educativas, e grupo II, que seguiu a rotina de atendimento. Os hipertensos do grupo I realizaram MRPA no inicio e final do estudo. Efeito do avental branco foi avaliado pela diferenca entre a medida casual e MRPA. Foram incluidos 290 hipertensos, porem realizaram MRPA 82 hipertensos. Houve aumento no controle da pressao do inicio ao final do estudo nos hipertensos do grupo I (p < 0,05) avaliado pela MRPA (60% para 68,3%) e pela medida casual (62% para 71%); no grupo II o controle foi maior na MRPA do que na medida casual (63% vs 50%). O efeito do avental branco foi maior no grupo II.

Evaluation of the conditions of use of sphygmomanometers in hospital services

Objective: To evaluate the conditions of sphygmomanometers in use at public and private hospitals. Methods: A descriptive study using a quantitative approach, undertaken in four major hospitals in the State of Sao Paulo, in the period between 2009 and 2010. The aneroid manometers were tested against a calibrated mercury manometer. They were considered out of calibration when the differences were ≥ 4 mmHg. Results: We assessed 162 sphygmomanometers (78 in a public hospital and 84 from philanthropic and private institutions) and 98.1% were of the aneroid type. It was verified that 56.2% of the manometers were not calibrated (48.6% of private hospitals and 63.1% of public hospitals). Analyzing the mean differences of negative decalibration, there was a significant difference between the manometers of the private hospital and the public hospitals (-6.14 ± 2.66 mmHg vs. -8.97 ± 6.74 mmHg, respectively, p <0.05). It was also observed that in 70.2% there was no periodic evaluation made, 26.7% had aged rubber extension, 20.5% presented leaking valves, and 27% of the manometers did not rest with the pointer on the zero mark. Conclusion: The decalibration of the aneroid sphygmomanometers was significant and may lead to incorrect evaluation of blood pressure.OBJECTIVE: To evaluate the conditions of sphygmomanometers in use at public and private hospitals. METHODS: A descriptive study using a quantitative- approach, undertaken in four major hospitals in the State of Sao Paulo, in the period between 2009 and 2010. The aneroid manometers- were tested against a calibrated mercury manometer. They were considered out of calibration when the differences were > 4 mmHg. RESULTS: We assessed 162 sphygmomanometers (78 in a public hospital and 84 from philanthropic and private institutions) and 98.1% were of the aneroid type.- It was verified that 56.2% of the manometers were not calibrated (48.6% of private hospitals and 63.1% of public hospitals). Analyzing the mean- differences of negative decalibration, there was a significant difference between the manometers of the private hospital and the public hospitals (-6.14- ± 2.66 mmHg vs. -8.97 ± 6.74 mmHg, respectively, p <0.05). It was also observed that in 70.2% there was no periodic evaluation made, 26.7% had- aged rubber extension, 20.5% presented leaking valves, and 27% of the manometers did not rest with the pointer on the zero mark. CONCLUSION: The decalibration of the aneroid sphygmomanometers was significant and may lead to incorrect evaluation of blood pressure.

[The control of hypertension in men and women: a comparative analysis].

OBJECTIVE To compare men and women who have hypertension with reference to the following: high blood pressure, biosocial variables, habits and life styles, mental disorders, and social support networks. METHOD 290 hypertensive patients (women, 62.1%) were evaluated. The assessments involved the following: measuring blood pressure with an automatic measuring device, evaluating social status through the Social Support Scale, and the use of a Self-Report Questionnaire (SRQ-20) to identify common mental disorders. A value of p<0.05 was considered statistically significant. RESULTS Women were found to be different to men (p<0.05) in the following areas having: better control of their blood pressure (64.4% vs 52.7%), less salary incomes, less diabetes, higher total cholesterol, higher body mass index and wider abdominal circumferences. They also had lower systolic blood pressure, lower levels of alcohol consumption and a greater prevalence for mental disorders. The social support assessment revealed that hypertensive women received less help with preparing meals but had more company from people which allowed them to engage in enjoyable activities. CONCLUSION Women had more control over their blood pressure than men, despite the presence of negative biopsychosocial factors that may have influenced their adherence to the treatments.OBJECTIVE To compare men and women who have hypertension with reference to the following: high blood pressure, biosocial variables, habits and life styles, mental disorders, and social support networks. METHOD 290 hypertensive patients (women, 62.1%) were evaluated. The assessments involved the following: measuring blood pressure with an automatic measuring device, evaluating social status through the Social Support Scale, and the use of a Self-Report Questionnaire (SRQ-20) to identify common mental disorders. A value of p<0.05 was considered statistically significant. RESULTS Women were found to be different to men (p<0.05) in the following areas having: better control of their blood pressure (64.4% vs 52.7%), less salary incomes, less diabetes, higher total cholesterol, higher body mass index and wider abdominal circumferences. They also had lower systolic blood pressure, lower levels of alcohol consumption and a greater prevalence for mental disorders. The social support assessment revealed that hypertensive women received less help with preparing meals but had more company from people which allowed them to engage in enjoyable activities. CONCLUSION Women had more control over their blood pressure than men, despite the presence of negative biopsychosocial factors that may have influenced their adherence to the treatments.

Atuação da enfermeira eleva o controle de hipertensos e diminui o efeito do avental branco

A randomized comparative study was performed to evaluate the control of hypertension with use of home blood pressure measurement (HBPM) and casual blood pressure measurement, and analyze the white coat effect. Hypertensive patients in primary health care units were randomly divided into two groups: group I, participating of the educational activities and group II that followed the routine treatment. The hypertensive patients from group I realized HBPM at the beginning and the end of the study. White-coat effect was evaluated by the difference between the casual blood pressure measurement and HBPM. The study included 290 hypertensive patients, but realized HBPM 82 hypertensive patients. There was increase in blood pressure control from the beginning to end of study in hypertensive patients from group I (p < 0.05) measured by HBP (60% to 68.3%) and casual measurement (62% to 71%) and in group II, HMBP hypertension control was higher than the casual blood pressure measurement (63% vs 50%). The white coat effect was greater in hipertensive patients from group II.Realizou-se estudo comparativo randomizado para avaliar o controle de hipertensos, com uso da medida residencial da pressao arterial (MRPA) e medida casual, bem como para analisar o efeito do avental branco. Hipertensos atendidos em unidades basicas de saude foram divididos aleatoriamente em: grupo I, participante das atividades educativas, e grupo II, que seguiu a rotina de atendimento. Os hipertensos do grupo I realizaram MRPA no inicio e final do estudo. Efeito do avental branco foi avaliado pela diferenca entre a medida casual e MRPA. Foram incluidos 290 hipertensos, porem realizaram MRPA 82 hipertensos. Houve aumento no controle da pressao do inicio ao final do estudo nos hipertensos do grupo I (p < 0,05) avaliado pela MRPA (60% para 68,3%) e pela medida casual (62% para 71%); no grupo II o controle foi maior na MRPA do que na medida casual (63% vs 50%). O efeito do avental branco foi maior no grupo II.

Avaliação das condições de uso de esfigmomanômetros em serviços hospitalares

Objective: To evaluate the conditions of sphygmomanometers in use at public and private hospitals. Methods: A descriptive study using a quantitative approach, undertaken in four major hospitals in the State of Sao Paulo, in the period between 2009 and 2010. The aneroid manometers were tested against a calibrated mercury manometer. They were considered out of calibration when the differences were ≥ 4 mmHg. Results: We assessed 162 sphygmomanometers (78 in a public hospital and 84 from philanthropic and private institutions) and 98.1% were of the aneroid type. It was verified that 56.2% of the manometers were not calibrated (48.6% of private hospitals and 63.1% of public hospitals). Analyzing the mean differences of negative decalibration, there was a significant difference between the manometers of the private hospital and the public hospitals (-6.14 ± 2.66 mmHg vs. -8.97 ± 6.74 mmHg, respectively, p <0.05). It was also observed that in 70.2% there was no periodic evaluation made, 26.7% had aged rubber extension, 20.5% presented leaking valves, and 27% of the manometers did not rest with the pointer on the zero mark. Conclusion: The decalibration of the aneroid sphygmomanometers was significant and may lead to incorrect evaluation of blood pressure.OBJECTIVE: To evaluate the conditions of sphygmomanometers in use at public and private hospitals. METHODS: A descriptive study using a quantitative- approach, undertaken in four major hospitals in the State of Sao Paulo, in the period between 2009 and 2010. The aneroid manometers- were tested against a calibrated mercury manometer. They were considered out of calibration when the differences were > 4 mmHg. RESULTS: We assessed 162 sphygmomanometers (78 in a public hospital and 84 from philanthropic and private institutions) and 98.1% were of the aneroid type.- It was verified that 56.2% of the manometers were not calibrated (48.6% of private hospitals and 63.1% of public hospitals). Analyzing the mean- differences of negative decalibration, there was a significant difference between the manometers of the private hospital and the public hospitals (-6.14- ± 2.66 mmHg vs. -8.97 ± 6.74 mmHg, respectively, p <0.05). It was also observed that in 70.2% there was no periodic evaluation made, 26.7% had- aged rubber extension, 20.5% presented leaking valves, and 27% of the manometers did not rest with the pointer on the zero mark. CONCLUSION: The decalibration of the aneroid sphygmomanometers was significant and may lead to incorrect evaluation of blood pressure.

El control de la hipertensión arterial en mujeres y hombres: un análisis comparativo

OBJECTIVE To compare men and women who have hypertension with reference to the following: high blood pressure, biosocial variables, habits and life styles, mental disorders, and social support networks. METHOD 290 hypertensive patients (women, 62.1%) were evaluated. The assessments involved the following: measuring blood pressure with an automatic measuring device, evaluating social status through the Social Support Scale, and the use of a Self-Report Questionnaire (SRQ-20) to identify common mental disorders. A value of p<0.05 was considered statistically significant. RESULTS Women were found to be different to men (p<0.05) in the following areas having: better control of their blood pressure (64.4% vs 52.7%), less salary incomes, less diabetes, higher total cholesterol, higher body mass index and wider abdominal circumferences. They also had lower systolic blood pressure, lower levels of alcohol consumption and a greater prevalence for mental disorders. The social support assessment revealed that hypertensive women received less help with preparing meals but had more company from people which allowed them to engage in enjoyable activities. CONCLUSION Women had more control over their blood pressure than men, despite the presence of negative biopsychosocial factors that may have influenced their adherence to the treatments.OBJECTIVE To compare men and women who have hypertension with reference to the following: high blood pressure, biosocial variables, habits and life styles, mental disorders, and social support networks. METHOD 290 hypertensive patients (women, 62.1%) were evaluated. The assessments involved the following: measuring blood pressure with an automatic measuring device, evaluating social status through the Social Support Scale, and the use of a Self-Report Questionnaire (SRQ-20) to identify common mental disorders. A value of p<0.05 was considered statistically significant. RESULTS Women were found to be different to men (p<0.05) in the following areas having: better control of their blood pressure (64.4% vs 52.7%), less salary incomes, less diabetes, higher total cholesterol, higher body mass index and wider abdominal circumferences. They also had lower systolic blood pressure, lower levels of alcohol consumption and a greater prevalence for mental disorders. The social support assessment revealed that hypertensive women received less help with preparing meals but had more company from people which allowed them to engage in enjoyable activities. CONCLUSION Women had more control over their blood pressure than men, despite the presence of negative biopsychosocial factors that may have influenced their adherence to the treatments.

O controle da hipertensão arterial em mulheres e homens: uma análise comparativa

OBJECTIVE To compare men and women who have hypertension with reference to the following: high blood pressure, biosocial variables, habits and life styles, mental disorders, and social support networks. METHOD 290 hypertensive patients (women, 62.1%) were evaluated. The assessments involved the following: measuring blood pressure with an automatic measuring device, evaluating social status through the Social Support Scale, and the use of a Self-Report Questionnaire (SRQ-20) to identify common mental disorders. A value of p<0.05 was considered statistically significant. RESULTS Women were found to be different to men (p<0.05) in the following areas having: better control of their blood pressure (64.4% vs 52.7%), less salary incomes, less diabetes, higher total cholesterol, higher body mass index and wider abdominal circumferences. They also had lower systolic blood pressure, lower levels of alcohol consumption and a greater prevalence for mental disorders. The social support assessment revealed that hypertensive women received less help with preparing meals but had more company from people which allowed them to engage in enjoyable activities. CONCLUSION Women had more control over their blood pressure than men, despite the presence of negative biopsychosocial factors that may have influenced their adherence to the treatments.OBJECTIVE To compare men and women who have hypertension with reference to the following: high blood pressure, biosocial variables, habits and life styles, mental disorders, and social support networks. METHOD 290 hypertensive patients (women, 62.1%) were evaluated. The assessments involved the following: measuring blood pressure with an automatic measuring device, evaluating social status through the Social Support Scale, and the use of a Self-Report Questionnaire (SRQ-20) to identify common mental disorders. A value of p<0.05 was considered statistically significant. RESULTS Women were found to be different to men (p<0.05) in the following areas having: better control of their blood pressure (64.4% vs 52.7%), less salary incomes, less diabetes, higher total cholesterol, higher body mass index and wider abdominal circumferences. They also had lower systolic blood pressure, lower levels of alcohol consumption and a greater prevalence for mental disorders. The social support assessment revealed that hypertensive women received less help with preparing meals but had more company from people which allowed them to engage in enjoyable activities. CONCLUSION Women had more control over their blood pressure than men, despite the presence of negative biopsychosocial factors that may have influenced their adherence to the treatments.