Protocol for hypertensive individuals assisted in Basic Health Care

Dantas, Rosimery Cruz de Oliveira; Roncalli, Angelo Giuseppe

doi:10.1590/1413-81232018241.35362016

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Ciência & Saúde Coletiva

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Português Español

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Free Themes • Ciênc. saúde colet. 24 (1) • Jan 2019 • https://doi.org/10.1590/1413-81232018241.35362016 copy

Protocol for hypertensive individuals assisted in Basic Health Care

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Hypertension has low control rate in Brazil and around the World, resulting in social and medical costs; thus there is the need to apply control strategies. This study aimed to create and validate a protocol for consultation and monitoring of hypertensive patients attended in primary health care. It is constituted a methodological research which uses the Delphi method for content validation. The analysis of the protocol by experts was performed in three cycles, using a scale that was not important to extremely important, with a graduation from 1 to 5. The analysis was performed by the Likert scale, percentage of agreement, content validation index, Pearson correlation. The percentage of agreement was 96%. The CVI of 0.98. The Likert scale scored items, at least, as very important. The Pearson correlation was positive for all items ranging from moderate to strong. The protocol is composed of 53 items, divided into seven dimensions. It was concluded that the protocol enables more expressive and systematics monitoring of hypertensive patients and it identifies social and individual conditions that contribute to high blood pressure, so it may be used to guide the consultation, encouraging dialogue between the professional and patient and effective recording of care.

Key words
Hypertension; Primary Health Care; Validation; Protocol

Scale of answers	Little Important		Important		Very Important		Extremely Important		Total		SD
Dimension		%		%		%		%		%	$\bar{X}$
Patient characterization	0.9	4.5	3.9	19.5	5.4	27.0	9.8	49.0	4.24	96.0	0.867
Health indicators	0.3	1.5	0.8	4.0	5.3	26.5	13.6	68.0	19.7	98.5	0.561
Psychosocial indicators	0.1	0.5	3.4	17.0	6.6	33.0	9.9	49.5	19.9	99.5	0.770
Signs of changes in blood pressure levels	0.5	2.5	2.7	13.5	4.0	20.0	12.8	64.0	19.5	97.5	0.779
Occurrence of complications	0.0	0.0	0.9	4.5	3.7	18.5	15.4	77.0	20.0	100.0	0.513
Laboratory tests	0.8	4.0	3.6	18.0	3.3	16.5	12.3	61.5	19.2	96.0	0.891
Conduct	0.0	0.0	0.0	0.0	5.0	25.0	15.0	75.0	20.0	100.0	0.444
$\bar{X}$	0.4	2.0	2.2	11.0	4.8	23.8	12.7	63.4	19.6	98.1	0.689

Dimension/ Items		% Concord	CVI-I	Likert	Pearson (Min-Max)	p value (Min – Max)
I	Name	100.0	0.85	4.25	0.45 – 0.85	0.044 – < 0.001
	Sex	90.0	0.80	4.20	0.46 – 0.95	0.037 – < 0.001
	Date of birth	100.0	0.90	4.50	0.45 – 0.86	0.047 – < 0.001
	Date of diagnosis	100.0	0.86	4.30	0.49 – 0.81	0.027 – < 0.001
	BP at the time of diagnosis	100.0	0.92	4.60	0.47 – 0.53	0.036 – 0.015
	Height	90.0	0.80	4.20	0.45 – 0.95	0.049 – < 0.001
	BMI	100.0	0.91	4.55	0.45 – 0.86	0.047 – < 0.001
	Occupation	95.0	0.79	4.05	0.45 – 0.88	0.048 – < 0.001
	Schooling	95.0	0.78	4.00	0.45 – 0.84	0.042 – < 0.001
	Income	90.0	0.75	3.75	0.50 – 0.84	0.024 – < 0.001
	Comorbidity	100.0	0.96	4.80	0.48 – 0.67	0.030 – 0.001
II	BP	100.0	0.95	4.75	0.45 – 0.86	0.047 – < 0.001
	Weight	100.0	0.93	4.65	0.45 – 0.83	0.048 – < 0.001
	Waist	95.0	0.86	4.40	0.50 – 0.72	0.023 – < 0.001
	Hip	95.0	0.81	4.15	0.45 – 0.70	0.049 – 0.001
	Abdominal circumference	100.0	0.93	4.65	0.45 – 0.79	0.049 – < 0.001
	Physical activity	100.0	0.96	4.80	0.45 – 0.86	0.045 – < 0.001
	Low-salt diet	100.0	0.91	4.55	0.46 – 0.88	0.041 – < 0.001
	Low-fat diet	100.0	0.91	4.55	0.45 – 0.90	0.048 – < 0.001
	Smoking	100.0	0.93	4.65	0.45 – 0.92	0.049 – < 0.001
	Alcohol	100.0	0.92	4.60	0.45 – 0.92	0.043 – < 0.001
	Insomnia	100.0	0.81	4.05	0.45 – 0.79	0.042 – < 0.001
	Treatment discontinuation	100.0	0.96	4.80	0.45 – 0.91	0.048 – < 0.001
III	Stress	100.0	0.92	4.60	0.46 – 0.78	0.040 – < 0.001
	Low self-esteem	100.0	0.86	4.30	0.45 – 0.91	0.049 – < 0.001
	Depression	100.0	0.86	4.30	0.45 – 0.92	0.043 – < 0.001
	Anxiety	100.0	0.88	4.40	0.46 – 0.93	0.037 – < 0.001
	Family support	100.0	0.87	4.35	0.45 – 0.89	0.048 – < 0.001
	Employment	100.0	0.83	4.15	0.45 – 0.91	0.048 – < 0.001
	Recreation	95.0	0.79	4.05	0.45 – 0.93	0.045 – < 0.001
IV	Headache	100.0	0.87	4.35	0.47 – 0.92	0.035 – < 0.001
	Visual changes	100.0	0.89	4.45	0.46 – 0.91	0.037 – < 0.001
	Neurological deficit	100.0	0.94	4.70	0.45 – 0.94	0.044 – < 0.001
	Precordial pain	100.0	0.95	4.75	0.46 – 0.94	0.043 – < 0.001
	Dyspnea	95.0	0.91	4.55	0.45 – 0.87	0.042 – < 0.001
	Cough	90.0	0.75	3.95	0.46 – 0.76	0.043 – < 0.001
V	Hospitaization	100.0	0.95	4.75	0.45 – 0.69	0.045 – 0.001
	Stroke	100.0	0.98	4.90	0.45 – 0.85	0.047 – < 0.001
	AMI	100.0	0.98	4.90	0.45 – 0.85	0.047 – < 0.001
	Angina	100.0	0.95	4.75	0.45 – 0.90	0.045 – < 0.001
	Cardiac insufficiency	100.0	0.95	4.75	0.45 – 0.90	0.045 – < 0.001
	Nephropathy	100.0	0.95	4.75	0.46 – 0.91	0.043 – < 0.001
	Atherosclerosis	100.0	0.92	4.60	0.45 – 0.87	0.045 – < 0.001
	Arrhythmias	100.0	0.92	4.60	0.45 – 0.87	0.045 – < 0.001
	Peripheral vascular disease	100.0	0.91	4.55	0.45 – 0.89	0.049 – < 0.001
VI	Cholesterol	100.0	0.91	4.55	0.45 – 0.90	0.049 - < 0.001
	Triglycerides	100.0	0.91	4.55	0.45 – 0.90	0.049 - < 0.001
	Urea	100.0	0.88	4.40	0.45 – 0.91	0.045 - < 0.001
	Creatinine	100.0	0.88	4.40	0.45 – 0.91	0.045 - < 0.001
	Potassium	95.0	0.82	4.20	0.45 – 0.91	0.048 - < 0.001
	EAS	80.0	0.69	3.85	0.45 – 0.86	0.049 - < 0.001
	ECG	100.0	0.90	4.50	0.45 – 0.84	0.047 - < 0.001
VII	Conducts	100.0	0.95	4.75	0.45 – 0.86	0.047 – < 0.001

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[1] Collaborations

RCO Dantas worked on design, research, methodology, analysis and writing of the article and AG Roncalli worked on methodology, analysis and final writing.