MEDIDAS DE PRESSÃO ARTERIAL NA ATENÇÃO PRIMÁRIA: conhecimento e comparação em métodos distintos

• Ano de defesa: 2021
• Autor(a) principal: Marcelle Vanuza Lunardi
• Orientador(a): Fernanda Amendola
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Faculdade Israelita de Ciências da Saúde Albert Einstein
• Programa de Pós-Graduação: Mestrado Profissional em Enfermagem
• País: Brasil
• Palavras-chave em Português: Atenção primária à saúde; Hipertensão; Processo de enfermagem; Saúde da família
• Palavras-chave em Inglês: Primary health care; Hypertension; Nursing process; Family health
• Link de acesso: https://repositorio.einstein.br/publicacao/161388

Introduction: The precise measurement of arterial pressure is of fundamental importance for the diagnosis of arterial hypertension, because its elevation is usually the first sign of the disease.This procedure is considered simple and easy to perform, but if the principles for performing the technique are not observed, it will be subject to misconduct causing injuries to the patient submitted to treatment. The procedure should be performed by a qualified team, being indispensable to adapt the Drug Therapy. Professionals are of paramount importance in the actions of prevention, diagnosis, monitoring and control of the disease.Therefore, portraying the daily life of arterial pressure measures in Basic Health Units, through the theoretical and practical knowledge of the professionals who perform them and verify the results of their practices, using two distinct methods and more used in the services, may indicate important factors related to arterial pressure control in these primary care Units. Purposes: Evaluate the agreement of the theoretical and practical knowledge of professionals in relation to the Blood Pressure measurement with the Brazilian Arterial Hypertension Guideline 2020; to compare the blood pressure values obtained by the observer using the auscultatory method with the values of the oscillometer apparatus and; to verify the influence of the degree of agreement of the theoretical-practical responses with the difference of the values obtained in blood pressure measurements, with and without observer. Methods: Observational research with a quantitative approach. The study was carried out in 13 Basic Health Units in a Private Public Partnership agreement in the southern region of the city of São Paulo. The sample consisted of nursing assistants who works in the Family Health Strategy and patients with arterial hypertension or performing arterial pressure control for evaluation and diagnosis. The analyses were performed with the help of the R and SPSS programs and considering a significance level of 5%. Results: The main problems in performing the procedure were not measuring arm circumference, low prevalence of questioning about the patient's condition before the procedure, palpating the radial artery and inflating the cuff to estimate the value of systolic pressure and palpating the brachial artery. Low knowledge was observed on the systolic and diastolic pressure determination phases (Phase I and Korotkoff Phase V). Most of the differences between the measurements were between the values - 10 and 10mmHg, both in systolic blood pressure and diastolic blood pressure. Overall, half of the patients (50.9%) were classified in the same arterial pressure category obtained in both devices. The coefficient of agreement calculated was 0.405, considering moderate agreement between the methods. There is no evidence of significant associations between the number of correct answers in theoretical knowledge and the differences found in systolic and diastolic blood pressure measurements. Conclusions: Discrepant values that represent different arterial pressure classifications may impact on clinical practice and the influence of the observer should be considered for the planning of permanent education and updating actions.