[Diagnosis and Follow-up of Arterial Hypertension: is the Role of Nursing Staff Relevant?]
Overview
Affiliations
Objective: To determine the protagonism of the medical and nursing staff in the diagnosis and observation of hypertense patients in a primary care team.
Design: Cross-sectional descriptive study.
Setting: Urban primary care team.
Participants: Two random samples, with 325 clinical histories, of the hypertense patients under observation in the centre in the years 1995 (N = 1992) and 1996 (N = 1994).
Measurements: The following variables were gathered on which professional had conducted the following: the blood pressure triple take (BPTT), physical examination (weight, height and peripheral pulses), request for further tests, health education on factors of cardiovascular risk (FCR), changes in life-style, anamnesis on side-effects in patients under medical treatment, and the number of attendances. The following details of patients were recorded: age and sex, body mass index, known time of hypertension evolution, blood pressure figures at the start and finish of the periods.
Main Results: 33 people in 1995 (10.2%; 95% CI, 6.8-13.4) and 8 people in 1996 (2.4%; 95% CI, 1-4.8) were diagnosed with hypertension. Average visits per professional in each year was 2.8 and 2.9 for nursing, and 1.5 and 1.8 for the doctor. There was a record of BPTT in 75.6% of cases, analysis request, ECG and full physical examination in 50.5% of cases, tackling CRF in 56.9%, recommendations on changes in life-style in 85.2%, and anamnesis on side-effects in 26.1%. It was basically nursing personnel who conducted BPTT (79.8% in 1996). 1995 saw greater CRF intervention by nursing staff (49.4%; 95% CI, 42.8-56.3) than by medical staff (15.3%; 95% CI, 10.3-19.9). In the second year the figures became 57.5% (95% CI, 50.9-64.2) against 12.3% (95% CI, 7.8-16.7). The interventions on life-style changes and anamnesis on possible side-effects were mainly conducted by nursing staff, at 66.2% (95% CI, 60.2-72.3) against doctors at 25.7% (95% CI, 20.2-31.3).
Conclusions: The role of nursing staff is fundamental to the diagnosis and observance of hypertense patients in the primary care team.
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