CHALLENGES
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The nurses seek training and pay for it themselves
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52 (94.5%) attended graduate studies |
I’ve sought most of my training myself because the city does not always make training programs available or even facilitate workers attending a training program (SUNSTONE, 31 y/o, specialist, Grande Oeste). |
Even though most nurses have a graduate degree or specialization, the initiative to seek training is personal, and managers provide little support. |
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Stigma due to a lack of knowledge
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[...] professionals who do not know and undervalue ICPH‡, lack of knowledge, of reading and studying. We have to change our process because the health system will not be able to deal with how we currently treat people (PYRATE, 35 y/o. MSc., Sul). |
Even with proper training, the nurses must show their knowledge to defend the effectiveness of ICPH ‡ constantly. |
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Limited time to implement practices
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41 (74.5%) adopt ICPH ‡ in their daily practice, and most of these, 34 (61.8%) spend from one to four hours per week with ICPH ‡ |
I work in an FHS [Family Health Strategy Unit], and implement ICPH‡in my practice less frequently than I’d like. It is implemented in a cross-sectional manner in my practice, it’s an additional tool. [...] (EMERALD, 32 y/o, specialist, Grande Florianópolis). |
Workload due to the many activities hinders the implementation of ICPH ‡ in daily practice when it is not a priority or is not seen as a cross-sectional tool to be used in the care and treatment of diseases. |
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Medicalization and biomedical culture
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23 (41.8%) nurses have a co-worker to discuss cases and determine the conducts related to treatments that include ICPH ‡ |
[...] overcoming barriers that prevent the valorization of therapies. We have a society where pharmacological treatments are more powerful, especially economically. So, these treatments overlap with other issues. We are in a totally medicalized society; it’s more attractive to think that a pill will make you happy, healthy, and beautiful than recognizing that it all depends on ourselves, and our choices (LÁPIS-LAZULI, 66 y/o, Physician, Grande Florianópolis).
The legal support nurses have when adopting the ICPH‡is seldom mentioned. We need to consolidate nursing as a profession to be appreciated as autonomous, independent, and trained professionals (RUBY, 46 y/o, specialist, Grande Florianópolis).
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The devaluation of ICPH ‡ on the part of managers and professionals may influence the number of professionals with ICPH ‡ training, contributing to the perpetuation of the biomedical care model. Additionally, there is a constant dispute between professions and the need to validate practices. |
POTENTIALITIES
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Treatment adherence
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55 (100%) believe that having knowledge, contact with, or using ICPH ‡ positively influences the patients’ autonomy |
The benefit is better treatment adherence. It is easier to give up if you take only pharmacological drugs, so this support with ICPH‡is much more effective (MOON STONE, 36 y/o, specialist, Planalto Norte and Nordeste). |
ICPH ‡ contributes to treatment adherence, both pharmacological and non-pharmacological treatment, and also influences a decrease in the use of medications, encouraging patients to be more active in their self-care. |
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Patient autonomy and health promotion
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ICPH
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helps a lot to change the [hypertensive patient’s] profile and quality of life. Many interventions are not implemented weekly; sometimes, they start weekly, but the idea is to generate autonomy and not replace the medication with integrative practices (TURMALINE, 46 y/o, Physician, Grande Florianópolis).
[...] the benefit is one’s own wellbeing and quality of life (ONYX, 30 y/o, MSc., Grande Oeste).
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Changes in people’s lifestyles were observed when ICPH ‡ was implemented, besides an influence in decreasing risk factors such as stress, insomnia, and anxiety, for the development of other cardiovascular diseases. |
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Research
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44 (80.0%) performed studies on evidence-based practices to support a technique or practice; most 27 (4.1%) in the VHL ICPH § |
It’s very good to be able to talk about and participate in studies addressing ICPH
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, because if we don’t talk about it, if we don’t show the population what we do, it won’t get disseminated (EYE OF TIGER, 39 y/o, MSc., Vale do Itajaí).
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The possibility of giving visibility to the practice and encouraging a reflection upon care practices and the incorporation of ICPH ‡. |