Association of social and clinical conditions to the quality of life of patients with heart failure. / Associação das condições sociais e clínicas à qualidade de vida de pacientes com insuficiência cardíaca.

OBJECTIVE: To analyze the association between sociodemographic and clinical conditions with the quality of life related to health of heart failure patients. METHOD: Cross-sectional study with a non-random sample of 84 outpatients with heart failure, performed in the city of João Pessoa, PB, Brazil, in the period from January to July 2015. The questionnaire by name Minnesota Living with Heart Questionnaire was used The following tests were applied in data analysis: t-Student, ANOVA and Pearson's Correlation, com a 5% significance level. RESULTS: The average scores of the Minnesota Living with Heart Failure Questionnaire showed a good quality of life in the group under study. There was a significant negative association between quality of life and age: thus the lower the age, the worse the quality of life. CONCLUSION: Health promotion actions become necessary to improve the coping capacity of this disease, especially for younger patients.

[Post-operative mediastinitis in a heart hospital of Recife: contributions for nursing care]. / Mediastinite pós-cirúrgica em um Hospital Cardiológico de Recife: contribuições para a assistência de enfermagem.

The objective of this study was to determine the prevalence of post-operative mediastinitis with the purpose to contribute to nursing care knowledge. To do this, an analysis was performed on 896 medical records of patients who underwent heart surgery involving sternotomy at the Cardiology Emergency Room of Recife-PE, in the period between June 2007 and June 2009. The following variables were considered: gender, age, type of surgery, personal history, length of stay, use of antibiotics, and culture of the surgical wound. A high death rate from mediastinitis was observed (33.3%). Several risk factors were identified, including: systemic arterial hypertension (80.9%); smoking (61.9%); diabetes mellitus (42.8%); and obesity (33.3%), most of which (76.2%) were identified in patients who underwent surgery for myocardial revascularization. It is concluded that mediastinitis is a serious infection that needs continuous nursing supervision and preventive measures to assure an early diagnosis and, thus, reduce mortality.

Class II radical hysterectomy for stage I-IIA cervix cancer: prognostic factors associated to recurrence and survival in a northeast Brazil experience.

BACKGROUND: The main aim of this study was describe the author's experience with class II radical hysterectomy and pelvic lymphadenectomy to treat stage I-IIA cervix cancer and reexamine some prognostic factors associated with disease recurrence and patient survival in this data from northeast Brazil. METHODS: A cross-sectional study was carried out on patients treated at our Centers from January 2001 to December 2008. Statistical analyses were performed using conventional methods. RESULTS: Eighty-eight patients were selected to analysis. Over the 7.3-year follow-up, 80 (91%) patients were alive and 8 (9%) disease recurrences were observed. Overall 1-, 2-, and 5-year patients survival was 96.5%, 95.3%, and 84%, respectively. Recurrence was associated to tumor size ≥1 cm (P = 0.021) and compromised vaginal margin (P = 0.020). Lower survivals were associated to tumor size ≥1 cm (P = 0.038), compromised vaginal margin (P < 0.001), and lymph node metastasis (P = 0.024). Postoperative complications (n = 11) included wound infection (5.7%), partial wound dehiscence (3.4%), and bladder atony (3.4%). CONCLUSIONS: Class II radical hysterectomy has provided appropriated disease control of cervix cancer with low morbidity in our experience. Furthermore, tumor size and compromised vaginal margin were significantly associated to recurrence. These factors and lymph node metastasis were also associated to lower 5-year survival according to our analysis.

Factors associated to the adherence to the non-pharmachological treatment of hypertension in primary health care.

OBJECTIVES: to evaluate the factors associated to the adherence to the non-pharmacological treatment of hypertension in primary health care. METHODS: cross-sectional study with 421 participants. The adherence was evaluated using the components: weight control, abdominal circumference, physical activity, and alcohol consumption. The chi-squared and Mann-Whitney's tests were used for analysis. RESULTS: the adherence to the control of the abdominal circumference was associated to smoking, sex, and stress. Smoking, age, and profession were associated to weight control. The adherence to a physical activity varied between the sexes and between people who used beta blockers and those who did not. Moderate alcohol consumption was associated to sex, age, profession, income, comorbidities, time using antihypertensive drugs, and using other medication. CONCLUSIONS: socioeconomic and clinical factors were associated to the adherence to the anti-hypertensive treatment. Innovative techniques, such as the transtheoretical model of change, motivational interviews, and supported self-care can help in behavioral changes.

Reiki protocol for preoperative anxiety, depression, and well-being: a non-randomized controlled trial. / Protocolo de Reiki para ansiedade, depressão e bem-estar pré-operatórios: ensaio clínico controlado não randomizado.

OBJECTIVE: To assess the effectiveness of Reiki in reducing anxiety, depression, and improving preoperative well-being in cardiac surgery. METHOD: A non-randomized, two-arm controlled clinical trial conducted in a cardiology referral hospital with patients in the preoperative period of cardiac surgery, with up to five days for surgery, between May and November 2018. The intervention group (n=31) was submitted to a Reiki protocol, and the control group (n=59) received only conventional care. RESULTS: One hundred twenty-four patients were assessed. The mean anxiety and depression did not obtain a significant difference between the groups. Spiritual well-being, in religious and existential dimensions, has improved significantly. CONCLUSION: Anxiety and depression were lower in the intervention group, with no statistically significant difference. There was a better result in the assessment of well-being with the intervention group. Religiosity may interfere in some cases with acceptance of holistic and integrative practices. Brazilian Registry of Clinical Trials: RBR-4cxw37.

Educational technologies on sexually transmitted infections for incarcerated women.

OBJECTIVE: to analyze in the scientific literature the educational technologies on sexually transmitted infections used in health education for incarcerated women. METHOD: an integrative review carried out by searching for articles in the following databases: Scopus, Cumulative Index of Nursing and Allied Health, Education Resources Information Center, PsycInFO, Medical Literature Analysis and Retrieval System Online, Latin American Literature in Health Sciences, Cochrane, and the ScienceDirect electronic library. There were no language and time restrictions. A search strategy was developed in PubMed and later adapted to the other databases. RESULTS: a total of 823 studies were initially identified and, after applying inclusion and exclusion criteria, eight articles were selected. Most of them were developed in the United States with a predominance of randomized clinical trials. The technologies identified were of the printed materials type, isolated or associated to simulators of genital organs, videos, and games. CONCLUSION: the technologies on sexually transmitted infections used in health education for incarcerated women may contribute to adherence to the prevention of this serious public health problem in the context of deprivation of liberty.

Attitudes, beliefs and barriers for adherence to the hyposodic diet in patients with heart failure.

OBJECTIVES: To identify attitudes, beliefs and barriers to adherence to the hyposodic diet in patients with heart failure and associated factors. METHODS: Cross-sectional study with 41 individuals. The Dietary Sodium Restriction Questionnaire was used. Fisher's test was applied for analysis. RESULTS: Attitudes were based on family and professional relationships; in the beliefs, it was highlighted to believe in the diet to improve health. As barriers, insufficient efforts were found to change the diet and taste of low salt foods. It was associated with adherence among the components factors such as: income, perception of cardiac improvement with the diet, family history of renal and heart failure and family adherence to the diet. CONCLUSIONS: The identified attitudes and beliefs refer, respectively, to social relationships and trust in the diet to improve health status. The barriers were: insufficient effort to modify the diet and food palatability. Economic, family and clinical factors were associated with hyposodic adherence.

Quality of life related to health for heart failure patients.

OBJECTIVE: To assess the quality of life related to health for heart failure patients and to relate sociodemographic and clinical data. METHOD: It is an observational and transversal study, with quantitative approach, carried out in a heart failure ambulatory in the state of Pernambuco. RESULTS: In the sample (n=101), there was prevalence of men older than 60 years old, married and professionally inactive. The quality of life related to health, based on the Minnesota Living With Heart Failure Questionnaire, was considered moderate (34.3±21.6), being significantly related to age (p=0.004), functional class (p<0.001), and patients with chagasic cardiopathy (p=0.02). CONCLUSION: The quality of life in the HF group of chagasic etiology was more compromised, specially in the emotional dimension. It is suggested that studies on the hypothesis that longer ambulatory follow-up improves quality of life and that having Chagas disease interferes negatively with the quality of life of heart failure patients.

Beliefs related to diet adherence of patients treated with oral anticoagulants. / Crenças relacionadas à adesão a dieta de pacientes tratados com anticoagulantes orais.

OBJECTIVE: Identify the beliefs related to adherence to diet of patients treated with oral anticoagulant. METHOD: Descriptive study, guided by the Theory of Reasoned Action, conducted with 57 patients in continuous use of oral anticoagulants, attended at a general cardiology outpatient clinic in João Pessoa and specialized in anticoagulation in Recife. Data were collected from February to May 2017, with an application form with open questions, through an interview, and submitted to a descriptive analysis. RESULTS: The most mentioned positive behavioral beliefs were to improve health/treatment in the general outpatient clinic and to control coagulation, in the specialized service. Children, spouses, doctors, and parents stood out proportionally in both scenarios as positive normative beliefs. CONCLUSION: In the outpatient clinic specializing in oral anticoagulation, patients add more specific beliefs about the interference of vitamin K-rich diet on coagulation, when compared to those in the general cardiology outpatient clinic.

Being-patient-waiting-for-cardiac-surgery: the preoperative period under the Heideggerian perspective.

OBJECTIVE: to investigate the patients' experience in the cardiac surgery preoperative period under the Heideggerian perspective. METHOD: exploratory qualitative research. Twelve patients were interviewed, from March to April, 2016, while they waited for myocardial revascularization surgery or valve replacement surgery. RESULTS: the analysis of the speeches allowed finding two dimensions of the being-there-patient-waiting-for-cardiac surgery, two meanings of the beingness: being-there-in-a-reduced-world and being-there-in-a-unknown-world. CONCLUSION: the experiences were related to alterations and limitations coming from the surgery, potential generators of anxiety, depression and existential conflicts in the cardiac surgery preoperative period. Reinforcing the care as being-with-the-other is suggested, considering the dimensions referred to and the patient's integrality.

Spiritual well-being and hope in the preoperative period of cardiac surgery.

OBJECTIVE: To characterize relations between spiritual well-being and hope of patients in the preoperative period of cardiac surgery. METHOD: Exploratory cross-sectional study with quantitative approach, performed in the infirmaries of a reference hospital in cardiology. We evaluated 69 patients hospitalized in preoperative period of myocardial revascularization, valve repair or replacement. RESULTS: We verified that patients hold relevant scores of hope and welfare in all areas, being the existential well-being significantly lower than the religious one. The average of the spiritual well-being score was below the required to be considered high. There was no significant correlation between welfare and hope. CONCLUSION: Nurses should develop a watchful eye to these issues, be trained in specific protocols of spiritual anamnese and use the real moments of care to strengthen the patients.

Coping religioso-espiritual de pacientes no período pré-operatório de cirurgia cardíaca / Coping religioso-espiritual de pacientes en el período preoperatorio de cirugía cardíaca / Religious-spiritual coping of patients in the preoperative period of cardiac surgery

Objetivo: avaliar o coping religioso-espiritual em pacientes no período pré-operatório de cirurgia cardíaca. Método: estudo transversal, analítico, no qual foram avaliados 62 pacientes internados no período pré-operatório de cirurgia cardíaca, entre os meses setembro e dezembro de 2020, em dois hospitais de referência em cirurgia cardíaca no Nordeste do Brasil. Resultados: os pacientes apresentaram um alto uso do coping religioso-espiritual total, com predominância para o positivo. Os principais fatores utilizados para o coping religioso-espiritual positivo foram Posição positiva frente a Deus e Afastamento através Deus/Religião/Espiritualidade. Conclusão: os enfermeiros podem considerar e investir em intervenções que favoreçam o coping positivo, visando repercutir melhor experiência do paciente diante de estressores importantes, como a cirurgia cardíaca.

Objetivo: evaluar el coping religioso-espiritual en pacientes en el período preoperatorio de cirugía cardíaca. Método: estudio transversal, analítico, en el cual fueron evaluados 62 pacientes internados en el período preoperatorio de cirugía cardíaca, entre los meses septiembre y diciembre de 2020, en dos hospitales de referencia en cirugía cardíaca en el nordeste de Brasil. Resultados: los pacientes presentaron un alto uso del coping religioso-espiritual total, con predominio para el positivo. Los principales factores utilizados para el coping religioso-espiritual positivo fueron Posición positiva frente a Dios y Alejamiento a través de Dios/Religión/Espiritualidad. Conclusión: los enfermeros pueden considerar e invertir en intervenciones que favorezcan el afrontamiento positivo, buscando repercutir mejor experiencia del paciente ante estresantes importantes, como la cirugía cardíaca.

Objective: to evaluate the religious-spiritual coping in patients in the preoperative period of cardiac surgery. Method: cross-sectional, analytical study, in which 62 patients hospitalized in the preoperative period of cardiac surgery, between September and December 2020, in two reference hospitals in cardiac surgery in northeastern Brazil, were evaluated. Results: the patients showed a high use of religious-spiritual coping, with predominance for the positive. The main factors used for positive religious-spiritual coping were Positive position towards God and Distancing through God/Religion/Spirituality. Conclusion: nurses can consider and invest in interventions that favor positive coping, aiming to reflect better patient experience in the face of important stressors, such as cardiac surgery.

Bem-estar espiritual, ansiedade e depressão no pré-operatório de cirurgia cardíaca / Spiritual well-being, anxiety and depression in the preoperative period of cardiac surgery

RESUMO Objective to correlate religiosity and spiritual well-being with anxiety and depression in patients in the preoperative period of cardiac surgery. Methods cross-sectional study conducted with 174 patients admitted to a university hospital using the Hospital Anxiety and Depression Scale, the Spiritual Well-Being Scale, and the DUKE Religiosity Index. Results the religious well-being and religiosity dimensions did not present significant differences between anxious and non-anxious patients. Existential well-being showed lower scores than religious well-being, being significantly lower among anxious patients. Among patients with depressive symptoms, the existential well-being score was significantly lower. Religiosity and religious well-being were not different between depressed and non-depressed patients. Conclusion religiosity and spirituality did not exempt patients from presenting anxiety and depression in the preoperative period of cardiac surgery, although they are cited as mediators of coping strategies and psychological adaptation. Contributions to practice the present study provides evidence that religiosity does not exempt patients from being anxious while waiting for heart surgery.

ABSTRACT Objetivo correlacionar a religiosidade e o bem-estar espiritual com a ansiedade e a depressão em pacientes no período pré-operatório de cirurgia cardíaca. Métodos estudo transversal realizado com 174 pacientes internados em um hospital universitário, utilizando a Escala Hospitalar de Ansiedade e Depressão, a Escala de Bem-Estar Espiritual e o Índice de Religiosidade de DUKE. Resultados o bem-estar religioso e as dimensões da religiosidade não apresentaram diferenças significativas entre ansiosos e não ansiosos. O bem-estar existencial apresentou escores mais baixos do que o religioso, sendo significativamente menor entre pacientes ansiosos. Entre pacientes com sintomas depressivos, o escore de bem-estar existencial foi significativamente mais baixo. A religiosidade e o bem-estar religioso não foram diferentes entre pacientes depressivos e não depressivos. Conclusão a religiosidade e a espiritualidade não isentaram os pacientes de apresentar ansiedade e depressão no período pré-operatório de cirurgia cardíaca, embora sejam citadas como mediadoras de estratégias de enfrentamento e adaptação psicológica. Contribuições para a prática o presente trabalho fornece evidência de que a religiosidade não isenta o paciente de se apresentar ansioso à espera da cirurgia cardíaca.

Efeitos do autocuidado apoiado sobre o perfil pressórico e cardiometabólico de hipertensos: ensaio clínico randomizado / Effects of supported self-care on blood pressure and cardiometabolic profile of hypertensive individuals: randomized clinical trial / Efectos del autocuidado apoyado sobre la presión arterial y el perfil cardiometabólico de los hipertensos: ensayo clínico aleatorio

RESUMO Objetivo: verificar os efeitos do autocuidado apoiado sobre o perfil pressórico e cardiometabólico de hipertensos. Método: ensaio clínico randomizado desenvolvido com 78 hipertensos acompanhados pela Estratégia Saúde da Família do município de Cajazeiras - PB - Brasil. A intervenção consistiu na aplicação de consultas de enfermagem baseadas no autocuidado apoiado. O grupo controle seguiu com o acompanhamento habitual da equipe de saúde. Para a coleta de dados foi utilizado um questionário sociodemográfico e clínico, análise de sangue, verificação da pressão arterial e das medidas antropométricas. Resultados: houve redução do peso, da circunferência abdominal, da relação cintura/quadril e do Índice de Massa Corporal no grupo intervenção, com melhora significativa da pressão arterial. Nenhuma melhora significativa foi visualizada no grupo controle. Conclusão: o autocuidado apoiado mostrou efeitos positivos sobre o perfil pressórico e cardiometabólico dos participantes, minimizando fatores de risco e configurando uma metodologia com potencial promissor quando aplicada pelo enfermeiro. REBEC - RBR-5m5qg8.

ABSTRACT Objective: to verify the effects of supported self-care on the blood pressure and cardiometabolic profile of hypertensive individuals. Method: randomized clinical trial developed with 78 hypertensive patients monitored by the Family Health Strategy in the municipality of Cajazeiras - PB - Brazil. The intervention consisted of nursing consultations based on supported self-care. The control group followed up with the usual monitoring by the health team. For data collection, a sociodemographic and clinical questionnaire, blood tests, blood pressure and anthropometric measurements were used. Results: There was a reduction in weight, abdominal circumference, waist-to-hip ratio, and Body Mass Index in the intervention group, with significant improvement in blood pressure. No significant improvement was seen in the control group. Conclusion: supported self-care showed positive effects on the participants' blood pressure and cardiometabolic profile, minimizing risk factors and configuring a methodology with promising potential when applied by nurses. REBEC - RBR-5m5qg8

RESUMEN Objetivo: verificar los efectos del autocuidado apoyado en la presión arterial y el perfil cardiometabólico de los pacientes hipertensos. Material y método: ensayo clínico aleatorio desarrollado con 78 pacientes hipertensos controlados por la Estrategia de Salud de la Familia en el municipio de Cajazeiras - PB - Brasil. La intervención consistió en la aplicación de consultas de enfermería basadas en el autocuidado apoyado. El grupo de control siguió con el control habitual del equipo sanitario. Para la recogida de datos se utilizó un cuestionario sociodemográfico y clínico, análisis de sangre, presión arterial y mediciones antropométricas. Resultados: hubo una reducción del peso, la circunferencia abdominal, la relación cintura/cadera y el índice de masa corporal en el grupo de intervención, con una mejora significativa de la presión arterial. No se observó ninguna mejora significativa en el grupo de control. Conclusión: el autocuidado apoyado mostró efectos positivos sobre la presión arterial y el perfil cardiometabólico de los participantes, minimizando los factores de riesgo y configurando una metodología con un potencial prometedor cuando es aplicada por las enfermeras. REBEC - RBR-5m5qg8.

Quality of life of patients who undergone myocardial revascularization surgery.

OBJECTIVE: to evaluate the quality of life of patients who underwent revascularization surgery. METHOD: a descriptive, cross sectional study, with quantitative approach carried out with 75 patients. The questionnaire WHOQOL-Bref was used to evaluate the quality of life (QOL). RESULTS: patients' QOL evaluation presented a moderate result, with need of improvement of all domains. Low income patients had the worst evaluation of QOL in the domain environment (p=0,021), and the ones from Recife/metropolitan area, in the domain social relationship (p=0,021). Smoker (p=0,047), diabetic (p=0,002) and alcohol consumption (p=0,035) patients presented the worst evaluation of the physical domain. Renal patients presented the worst evaluation of QOL in the physical (P=0,037), psychological (p=0,008), social relationship (p=0,006) domains and total score (p=0,009). CONCLUSION: the improvement of QOL depends on the individual's process of behavioral change and the participation of health professionals is essential to formulate strategies to approach these patients, especially concerning health education.

Assistência de enfermagem na terapêutica paliativa direcionada ao controle de sintomas / Nursing care in palliative therapy aimed at symptom control

Objetivo: buscar na literatura científica o que as evidências apontam sobre a assistência da enfermagem ao paciente em cuidados paliativos direcionada ao controle de sintomas. Método: Revisão integrativa da literatura realizada nas bases de dados Lilacs, Scielo, Medline e periódicos da Capes, cujo corpus da análise foi de 8 artigos. Foram incluídos artigos disponíveis nos idiomas inglês, português e espanhol, publicados nos últimos 5 anos, disponíveis na íntegra e gratuitamente. Resultados: Os artigos selecionados apresentaram características diversas, possuindo populações alvo, amostras, finalidades e métodos variados. Após análise dos dados foram encontradas informações que se complementaram acerca do tema, possibilitando apresentação dos resultados em duas categorias: Manifestações clínicas em pacientes em cuidados paliativos e Assistência de enfermagem no manejo de paciente em cuidados paliativos. Conclusão: A enfermagem tem papel de auxiliar na monitoração dos casos de câncer e intervir nos sintomas físicos e psicológicos através de tratamentos farmacológicos e não farmacológicos.(AU)

Objective: to search in the scientific literature what the evidence points about nursing care for patients in palliative care directed to symptom control. Method: Integrative literature review carried out in the Lilacs, Scielo, Medline and Capes journals databases, whose corpus of analysis was 8 articles. Articles available in English, Portuguese and Spanish, published in the last 5 years, were available in full and free of charge. Results: The selected articles had different characteristics, having target populations, samples, purposes and varied methodological means. After analyzing the data, information was found that complemented each other on the topic, made it possible to present the results in two categories: Clinical manifestations in patients in palliative care and Nursing assistance in the management of patients in palliative care. Conclusion: Nursing has the role of assisting in the monitoring of cancer cases and intervening in physical and psychological symptoms through pharmacological and non-pharmacological treatments.(AU)

Objetivo: buscar en la literatura científica qué apunta la evidencia sobre los cuidados de enfermería al paciente en cuidados paliativos dirigidos al control de síntomas. Método: Revisión integradora de la literatura realizada en las bases de datos de las revistas Lilacs, Scielo, Medline y Capes, cuyo corpus de análisis fue de 8 artículos. Los artículos disponibles en inglés, portugués y español, publicados en los últimos 5 años, estaban disponibles en su totalidad y de forma gratuita. Resultados: Los artículos seleccionados tenían características diferentes, teniendo poblaciones objetivo, muestras, propósitos y medios metodológicos variados. Luego del análisis de los datos, se encontró información que se complementaba sobre el tema, posibilitó presentar los resultados en dos categorías: Manifestaciones clínicas en pacientes en cuidados paliativos y Asistencia de enfermería en el manejo de pacientes en cuidados paliativos. Conclusión: Enfermería tiene el rol de asistir en el seguimiento de los casos de cáncer e intervenir en los síntomas físicos y psicológicos mediante tratamientos farmacológicos y no farmacológicos.(AU)

Factors associated to the adherence to the non-pharmachological treatment of hypertension in primary health care / Factores relacionados a la adhesión al tratamiento no medicamentoso de la hipertensión en la atención primaria / Fatores associados à adesão ao tratamento não medicamentoso da hipertensão na atenção primária

ABSTRACT Objectives: to evaluate the factors associated to the adherence to the non-pharmacological treatment of hypertension in primary health care. Methods: cross-sectional study with 421 participants. The adherence was evaluated using the components: weight control, abdominal circumference, physical activity, and alcohol consumption. The chi-squared and Mann-Whitney's tests were used for analysis. Results: the adherence to the control of the abdominal circumference was associated to smoking, sex, and stress. Smoking, age, and profession were associated to weight control. The adherence to a physical activity varied between the sexes and between people who used beta blockers and those who did not. Moderate alcohol consumption was associated to sex, age, profession, income, comorbidities, time using antihypertensive drugs, and using other medication. Conclusions: socioeconomic and clinical factors were associated to the adherence to the anti-hypertensive treatment. Innovative techniques, such as the transtheoretical model of change, motivational interviews, and supported self-care can help in behavioral changes.

RESUMEN Objetivos: evaluar factores relacionados a adhesión al tratamiento no medicamentoso de hipertensión en Atención Primaria. Métodos: estudio transversal, con 421 individuos. Evaluó la adhesión por los componentes: control de peso, circunferencia abdominal, actividad física y consumo de alcohol - conforme recomendaciones de la 7ª Directriz Brasileña de Hipertensión Arterial. Análisis se utilizaron los testes chi-cuadrado y Mann-Whitney. Resultados: adhesión al control de circunferencia abdominal relacionado al tabaquismo, sexo y estrés. Tabaquismo, edad y actividad laboral fueron relacionados al control de peso. Adhesión a actividad física varió entre los sexos y entre individuos que usaban o no beta-bloqueadores. Consumo de alcohol moderado relacionado al sexo, edad, actividad laboral, renta, comorbilidades (diabetes mellitus y tabaquismo), tiempo de tratamiento antihipertensivo y uso de otros fármacos. Conclusiones: factores socioeconómicos y clínicos relacionados a adhesión al tratamiento antihipertensivo. Técnicas innovadoras como el modelo transteórico de cambio, entrevista motivacional y autocuidado apoyado pueden auxiliar los cambios comportamentales.

RESUMO Objetivos: avaliar os fatores associados à adesão ao tratamento não medicamentoso da hipertensão na Atenção Primária. Métodos: estudo transversal, com 421 indivíduos. Avaliou-se a adesão pelos componentes: controle de peso, circunferência abdominal, atividade física e consumo alcoólico - conforme recomendações da 7ª Diretriz Brasileira de Hipertensão Arterial. Na análise, utilizaram-se os testes qui-quadrado e Mann-Whitney. Resultados: a adesão ao controle de circunferência abdominal associou-se ao tabagismo, sexo e estresse. Tabagismo, idade e atividade laboral foram associados ao controle de peso. A adesão à atividade física variou entre os sexos e entre indivíduos que usavam ou não betabloqueadores. O consumo alcoólico moderado associou-se ao sexo, idade, atividade laboral, renda, comorbidades (diabetes mellitus e tabagismo), tempo de tratamento antihipertensivo e uso de outros fármacos. Conclusões: fatores socioeconômicos e clínicos associaram-se à adesão ao tratamento anti-hipertensivo. Técnicas inovadoras como o modelo transteórico de mudança, entrevista motivacional e autocuidado apoiado podem auxiliar as mudanças comportamentais.

Adherence to antihypertensive medication, pressoric control and associated factors in primary health care / Adhesión a la medicación anti-hipertensiva, al control de la presión y a factores asociados en la atención primaria de la salud / Adesão à medicação anti-hipertensiva, controle pressórico e fatores associados na atenção primária à saúde

ABSTRACT Objective: to evaluate adherence to antihypertensive medication, blood pressure levels, and associated factors in hypertensive individuals monitored by primary health care. Method: a cross-sectional, descriptive and analytical study, carried out in Family Health Strategies in the city of Recife, Brazil. Data collection took place from April to August 2018. To assess adherence, the Morisky Medication Adherence Scale was used, an 8-item scale that addresses some behaviors when taking antihypertensive medication, such as: forgetfulness, non-intentional intake, reduced dose, interruption of treatment, and discomfort following the prescription. In the data analysis, the Chi-square and Kruskal-Wallis tests were used. Results: a total of 421 hypertensive individuals participated in the study. Low, medium and high adherence was observed, respectively, at 48.5%, 38.7% and 12.8%. High/Medium adherence was associated with single individuals (p=0.005), without work activity (p=0.043), who did not report stress (p=0.001) and hypertensive urgency/emergency (p=0.037), without side effects of antihypertensive drugs (p=0.012), and who made continuous use of other drugs (p=0.001). Blood pressure control was verified in 205 hypertensive individuals and an association was established with females (p=0.033), younger age (p=0.041), higher schooling (p=0.008), use of up to 2 antihypertensive drugs (p=0.006) and absence of side effects (p=0.026). Conclusion: the predominance of low adherence and uncontrolled pressure in some groups show the need to redirect health promotion actions in primary care, especially in the program for people with arterial hypertension and diabetes mellitus.

RESUMEN Objetivo: evaluar la adhesión a la medicación anti-hipertensiva, los niveles de presión y los factores asociados en personas hipertensas monitoreadas por el servicio de atención primaria de la salud. Método: estudio transversal, descriptivo e analítico, realizado en unidades de la Estrategia de Salud de la Familia del municipio de Recife, Brasil. La recolección de datos tuvo lugar en el período de abril a agosto de 2018. Para evaluar la adhesión se utilizó la Morisky Medication Adherence Scale, una escala de 8 ítems que aborda algunos comportamientos frente a la toma del medicamento anti-hipertensivo, como ser: olvido, no tomar el medicamento de manera intencional, reducción de la dosis, interrupción del tratamiento e incomodidad para respetar la prescripción. En el análisis de los datos, se utilizaron las pruebas chi-cuadrado y de Kruskal-Wallis. Resultados: del estudio participaron 421 personas hipertensas. Se observaron los niveles bajo, medio y alto de adhesión en el 48,5%, 38,7% y 12,8%, respectivamente. El nivel alto/medio de adhesión se asoció a personas solteras (p=0,005), sin actividad laboral (p=0,043), que no reportaron padecer estrés (p=0,001) y urgencia/emergencia relacionada con la hipertensión (p=0,037), con ausencia de efectos secundarios causados por los medicamentos anti-hipertensivos (p=0,012), y que consumían otros medicamentos en forma continua (p=0,001). El control de la presión arterial se verificó en 205 individuos hipertensos y se estableció una asociación con el sexo femenino (p=0,033), menor edad (p=0,041), mayor nivel de estudios (p=0,008), uso de hasta 2 medicamentos anti-hipertensivos (p=0,006) e ausencia de efectos secundarios (p=0,026). Conclusión: el predominio del bajo nivel de adhesión y el no control de la presión en algunos grupos ponen de manifiesto la necesidad de redireccionar las acciones de promoción de la salud en la atención primaria, especialmente en el programa para pacientes con hipertensión arterial y diabetes mellitus.

RESUMO Objetivo: avaliar a adesão medicamentosa anti-hipertensiva, os níveis pressóricos e os fatores associados nos indivíduos hipertensos acompanhados pela atenção primária à saúde. Método: estudo transversal, descritivo e analítico, realizado em Estratégias de Saúde da Família do município do Recife, Brasil. A coleta de dados ocorreu no período de abril a agosto de 2018. Para avaliação da adesão, utilizou-se o Morisky Medication Adherence Score, uma escala de 8 itens que aborda alguns comportamentos diante da ingestão do medicamento anti-hipertensivo, tais como: esquecimento, não ingestão intencional, redução da dose, interrupção do tratamento e incômodo no seguimento da prescrição. Na análise dos dados, foram utilizados os testes Qui-quadrado e Kruskal Wallis. Resultados: participaram do estudo 421 indivíduos hipertensos. A baixa, média e alta adesão foram vistas, respectivamente, em 48,5%, 38,7% e 12,8%. A alta/média adesão associou-se aos indivíduos solteiros (p=0,005), sem atividade laboral (p=0,043), que não referiram estresse (p=0,001) e urgência/emergência hipertensiva (p=0,037), com ausência de efeitos colaterais das drogas anti-hipertensivas (p=0,012), e que faziam uso contínuo de outros medicamentos (p=0,001). O controle da pressão arterial foi verificado em 205 indivíduos hipertensos e estabeleceu associação com o sexo feminino (p=0,033), idade mais jovem (p=0,041), maior escolaridade (p=0,008), uso de até 2 drogas anti-hipertensivas (p=0,006) e ausência de efeitos colaterais (p=0,026). Conclusão: o predomínio da baixa adesão e o descontrole pressórico em alguns grupos evidenciam a necessidade de redirecionamento das ações de promoção à saúde na atenção primária, especialmente no programa para portadores de hipertensão arterial e diabetes mellitus.

Religiosidade, bem-estar espiritual e cuidado transpessoal no pré-operatório de cirurgia cardíaca / Religiousness, Spiritual Well-Being and Transpersonal Caring in the Preoperative Period of Heart Surgery / La religiosidad, el bienestar espiritual y el cuidado transpersonal en el período preoperatorio de cirugía cardíaca

Introdução: A Teoria do Cuidado Transpessoal auxilia a compreensão de momentos críticos no processo saúde-doença, como a vivência de uma cirurgia de grande porte. O presente estudo tem por objetivo avaliar a religiosidade e o bem-estar espiritual de pacientes internados no período pré-operatório de cirurgia cardíaca, na perspectiva do Cuidado Transpessoal de Jean Watson. Materiais e Métodos: Estudo transversal realizado entre os meses de janeiro e junho de 2017, nas enfermarias cirúrgicas de hospital universitário cardiológico do Nordeste do Brasil. Foram avaliados 174 participantes no pré-operatório de cirurgia cardíaca, utilizando-se do Índice de Religiosidade de DUKE e a Escala de Bem-Estar Espiritual. Resultados: Os resultados apontaram que os pacientes utilizavam a religiosidade de forma significativa para manterem o bem-estar espiritual no pré-operatório. A análise dos resultados encontrados teve o referencial da teoria do Cuidado Transpessoal de Jean Watson. Discussão e Conclusões: As crises existenciais vivenciadas pelos pacientes diante da cirurgia cardíaca, envolvendo as restrições, mudanças impostas e o desconhecido, impactam na manutenção do bem-estar, na sua dimensão espiritual, que é, em uma análise transpessoal, uma dimensão da saúde integral do individuo.

Introduction: The theory of transpersonal caring is useful in understanding critical moments in the health-disease process such as the experience of major surgery. This study aims to evaluate the religiousness and spiritual well-being of patients hospitalized in the preoperative period of heart surgery from the perspective of Jean Watson's transpersonal caring. Materials and methods: A cross-sectional study was conducted between January and June 2017 at the surgical wards of a university cardiology hospital in northeastern Brazil. 174 participants were evaluated in the preoperative period of cardiac surgery using the Duke University Religion Index and the Spiritual Well Being Scale. Results: The results showed that patients made significant use of religion to maintain their spiritual well-being in the preoperative period. The analysis of the results found was carried out based on Jean Watson's theory of transpersonal caring. Discussion and conclusion: Existential crisis experienced by patients in the face of cardiac surgery, which involves restrictions, imposed changes and uncertainty, has an impact on the maintenance of well-being and its spiritual dimension which, in a transpersonal analysis, is a dimension of the individual's integral health.

Introducción: La teoría del cuidado transpersonal ayuda a comprender los momentos críticos del proceso de salud-enfermedad, como la experiencia de una cirugía mayor. El presente estudio tiene como objetivo evaluar la religiosidad y el bienestar espiritual de los pacientes hospitalizados en el período preoperatorio de cirugía cardíaca desde la perspectiva del cuidado transpersonal de Jean Watson. Materiales y métodos: Se trata de un estudio transversal realizado entre los meses de enero y junio de 2017 en las salas de cirugía de un hospital universitario de cardiología en el noreste de Brasil. 174 participantes fueron evaluados en el período preoperatorio de cirugía cardíaca mediante el Índice de Religiosidad Duke y la Escala de Bienestar Espiritual. Resultados: Los resultados mostraron que los pacientes hicieron un uso significativo de la religión para mantener su bienestar espiritual en el período preoperatorio. El análisis de los resultados encontrados se basó en la teoría del cuidado transpersonal de Jean Watson. Discusión y conclusión: Las crisis existenciales experimentadas por los pacientes frente a la cirugía cardíaca, que implican restricciones, cambios impuestos e incertidumbre, repercuten en el mantenimiento del bienestar y en su dimensión espiritual que, en un análisis transpersonal, es una dimensión de la salud integral del individuo.

Educational technologies on sexually transmitted infections for incarcerated women / Tecnologias educacionais sobre infecções sexualmente transmissíveis para mulheres encarceradas / Tecnologías educativas sobre enfermedades de transmisión sexual para mujeres encarceladas

Objective: to analyze in the scientific literature the educational technologies on sexually transmitted infections used in health education for incarcerated women. Method: an integrative review carried out by searching for articles in the following databases: Scopus, Cumulative Index of Nursing and Allied Health, Education Resources Information Center, PsycInFO, Medical Literature Analysis and Retrieval System Online, Latin American Literature in Health Sciences, Cochrane, and the ScienceDirect electronic library. There were no language and time restrictions. A search strategy was developed in PubMed and later adapted to the other databases. Results: a total of 823 studies were initially identified and, after applying inclusion and exclusion criteria, eight articles were selected. Most of them were developed in the United States with a predominance of randomized clinical trials. The technologies identified were of the printed materials type, isolated or associated to simulators of genital organs, videos, and games. Conclusion: the technologies on sexually transmitted infections used in health education for incarcerated women may contribute to adherence to the prevention of this serious public health problem in the context of deprivation of liberty.

Objetivo: analisar na literatura científica as tecnologias educacionais sobre infecções sexualmente transmissíveis utilizadas na educação em saúde de mulheres encarceradas. Método: revisão integrativa realizada por meio de busca de artigos nas bases de dados Scopus, Cumulative Index of Nursing and Allied Health, Education Resources Information Center, PsycInFO, Medical Literature Analysis and Retrieval System Online, Literatura Latino-Americana em Ciências da Saúde, Cochrane e na biblioteca eletrônica Science Direct. Não houve restrição de idioma e tempo. Foi desenvolvida uma estratégia de busca no PubMed e, posteriormente, adaptada para as demais bases. Resultados: foram identificados inicialmente 823 estudos e após aplicação de critérios de inclusão e exclusão, selecionaram-se oito artigos. A maioria foi desenvolvida nos Estados Unidos, com predomínio de ensaios clínicos randomizados. As tecnologias identificadas foram do tipo materiais impressos, isolados ou associados a simuladores dos órgãos genitais, vídeos e jogos. Conclusão: as tecnologias sobre infecções sexualmente transmissíveis, utilizadas na educação em saúde de mulheres encarceradas, podem contribuir na adesão à prevenção desse grave problema de saúde pública no contexto da privação de liberdade.

Objetivo: analizar en la literatura científica las tecnologías educativas sobre infecciones de transmisión sexual utilizadas en la educación sanitaria para mujeres encarceladas. Método: revisión integradora realizada por medio de la búsqueda de artículos en las bases de datos Scopus, Cumulative Index of Nursing and Allied Health, Education Resources Information Center, PsycInFO, Medical Literature Analysis and Retrieval System Online, Literatura Latinoamericana en Ciencias de la Salud, Cochrane y en la biblioteca electrónica Science Direct. No hubo restricciones de idioma y/o fecha de publicación. Se desarrolló una estrategia de búsqueda en PubMed y, posteriormente, se adaptó a las otras bases de datos. Resultados: en un principio, se identificaron 823 estudios y después de aplicar los criterios de inclusión y exclusión, se seleccionaron ocho artículos. La mayoría se desarrollaron en los Estados Unidos, con predominio de ensayos clínicos aleatorios. Entre las tecnologías identificadas, se encuentran materiales impresos, utilizados de forma aislada o asociados con simuladores de órganos genitales, videos y juegos. Conclusión: las tecnologías sobre infecciones de transmisión sexual, utilizadas en la educación sanitaria para mujeres encarceladas, pueden contribuir en la adhesión a la prevención de este grave problema de salud pública en el contexto de la privación de libertad.