El papel de la enfermería en la promoción de la salud de la persona hipertensa

Abstract

Hypertension is a health problem of first magnitude. Several scientific and research groups have established investigation patterns. The American Committee for Prevention, Evaluation and Treatment have recommended an arterial pressure lower than 140/90 mmHg for patients with hypertension and lower than 135/85 mmHg for patients with hypertension associated with diabetes. Some studies reveal the importance of education of Nursery in health and hypertension, for instance Rocío Tique (2006), Hypertension and Diabetes Nursery from Santa Fe de Bogota Foundation, in her investigation titled “Intervention of Nursery in a preventive approach towards diabetes and hypertension”, or Del Río Moro (2005), who made a study with more than 200 patients reaching a conclusion whereby patients who receive education through speeches and discussions with nurses keep and acquire cardio-appropriate health habits. The purpose of our investigation is four-fold: • Know the impact of education for health over hypertension control. • Know the influence of education for health over healthy life. • Observe the influence of the environment over hypertension. • Analyze the reasons why one individual attains or not a healthy life. The objective of our investigation is to evaluate the impact of education for health over the control of hypertension and the transformation of life style and to study the relationship between certain individual, psychological and social factors. The methodology covers experimental, quasi-experimental, comparative and unicentric in the city of Madrid. The sample is composed of hypertense patients who do not control arterial pressure (AP), all older than 18 years old and who meet the inclusion criteria. The duration of the nurse’s intervention with each patient is six months since the first evaluation until the final evaluation. The study commenced in September 2007 and has ended in December 2009. 186 patients were selected (out of a total of 200 patients) according to the study criteria and ended the follow-up process. We used the protocol proposed by the Nursery Model of C. Roy and we worked within the program Nursery Care Process. Patients were split in three groups, two constituting the experimental group. The first group received education for health during six visits to the nurse who taught them relaxation techniques. The second group received education for health only during three visits to the nurse. The third group (control group) did not receive any education or information; only one visit was arranged to register data and evaluate health (plus a final health evaluation six months later). The results attained at the end of the investigation are: 1. The influence of education for health in the appropriate control of hypertension was significative (almost 90 % was able to control hypertension). The influence of the nurse’s information obtained a control of 80 % whereas the control group reached 58 %. 2. Obesity. The influence of education for health does not influence significantly the decrease of body mass; however, the education group obtained the largest Lumber of people who lost weight. Patients that increased their hip size did not control their hypertension. 3. Exercise. The influence of education for health was significant over the practice of physical exercise. The group that initially walked less than 30 minutes started to concern 45 % of the people and afterwards 63 %. The group that initially walked more than 30 minutes started to concern 46 % and afterwards 62 %. 4. Relaxation. The influence of relaxation did result to be significant over hypertension control; however, the fact of enjoying part of the day to make relaxing activities did influence significantly on hypertension control. The conclusions of the investigation were the following: • The intervention of the nurse has been significantly efficient in the appropriate hypertension control and in obtaining a healthy life. • Healthy life influences significantly hypertension control. • Family life and affective relationship influence significantly hypertension control.