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Perceção de Funcionalidade Familiar, Adesão Terapêutica e Qualidade de Vida nos Utentes com Diagnóstico de Hipertensão Arteria
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O presente relatório descreve as atividades de estágio em Enfermagem Comunitária, na área de Enfermagem de Saúde Familiar (EEECESF), realizado na Unidade Local de Saúde da Póvoa de Varzim/Vila do Conde (ULSPVVC) entre outubro de 2024 e março de 2025. O objetivo principal foi articular a prática clínica com a investigação científica, através de um
projeto que avalia a relação entre variáveis sociodemográficas e clínicas, a perceção de funcionalidade familiar e de qualidade de vida e a adesão ao regime medicamentoso em utentes com diagnóstico de Hipertensão Arterial (HTA) das Unidades de Saúde Familiar (USF) St. ª Clara e Aqueduto. A escolha do tema justifica-se pela elevada prevalência da HTA e o seu impacto na qualidade de vida e nos serviços de saúde, especialmente quando a doença não é controlada. Definiu-se como questão de investigação: Qual a relação entre as variáveis sociodemográficas e clínicas, a perceção de funcionalidade familiar, a qualidade de vida em hipertensão arterial e a adesão ao regime medicamentoso, nos utentes com diagnóstico de HTA das USF St. ª Clara e Aqueduto? O estudo adotou uma metodologia quantitativa, estudo observacional, descritivo-correlacional e transversal, com uma amostra de 240 utentes. Os dados foram recolhidos através de um formulário que integrou um questionário sociodemográfico e clínico e três escalas validadas: APGAR Familiar, Escala MAT e MINICHAL. A análise estatística, realizada no software R (versão 4.4.2), incluiu estatística descritiva e inferencial para testar as hipóteses formuladas.
Os resultados revelaram que a amostra apresentava um perfil predominantemente feminino e envelhecido, com um elevado número de comorbilidades. A maioria dos participantes (81,3%) percecionou a sua família como altamente funcional. Os níveis de adesão ao tratamento foram globalmente elevados, com a pontuação média da escala MAT a variar entre 5,08 e 5,77 (numa escala de 1 a 6), indicando uma frequência baixa de comportamentos de não adesão. A perceção de qualidade de vida foi maioritariamente positiva, com uma média total na escala MINICHAL de 12,6, onde pontuações mais baixas indicam melhor qualidade de vida. As análises inferenciais mostraram que a idade, através do teste de Kruskal-Wallis (H=11,80, p=0,02), e o número de comorbilidades, pelo teste do qui-quadrado (χ2(3) =8,61, p=0,035), influenciaram a adesão medicamentosa. O sexo (U=8353, p=0,02) e o número de comorbilidades (χ2(3) =26,11, p<0,001) afetaram a perceção de qualidade de vida. Simultaneamente, a funcionalidade familiar esteve estatisticamente associada à adesão ao tratamento (χ2(1) =19,03, p<0,001) e à qualidade de vida (U=6663,5,p<0,001). A análise de correlação de Spearman confirmou estas associações, com uma correlação positiva e significativa entre a funcionalidade familiar e a adesão (r=0,38, p<0,001), e uma correlação negativa e significativa com a qualidade de vida (r=-0,37, p<0,001). Estes resultados sublinham o papel central da família na gestão da HTA, com forte influência na adesão ao tratamento e na qualidade de vida. O estudo reforça, assim, a importância da intervenção do EEECESF na promoção da funcionalidade familiar e do bem-estar em contexto de doença crónica.
This report describes the activities of a Community Nursing internship in the area of Family Health Nursing (EEECESF), carried out at the Póvoa de Varzim/Vila do Conde Local Health Unit (ULSPVVC) between October 2024 and March 2025. The main objective was to articulate clinical practice with scientific research, through a project that evaluates the relationship between sociodemographic and clinical variables, the perception of family functioning and quality of life, and adherence to the medication regimen in users diagnosed with High Blood Pressure (HTN) of the Family Health Units (USF) St. Sra. Clara and Aqueduto. The choice of the topic is justified by the high prevalence of HTN and its impact on quality of life and health services, especially when the disease is not controlled. The research question was defined as: What is the relationship between sociodemographic and clinical variables, the perception of family functioning, quality of life in patients with hypertension, and adherence to medication regimens among patients diagnosed with hypertension at the St. Clara and Aqueduto Family Health Centers? The study adopted a quantitative, observational, descriptive-correlational, and cross-sectional methodology, with a sample of 240 patients. Data were collected using a form that integrated a sociodemographic and clinical questionnaire and three validated scales: Family APGAR, MAT Scale, and MINICHAL. Statistical analysis, performed in R software (version 4.4.2), included descriptive and inferential statistics to test the hypotheses. The results revealed that the sample had a predominantly female and older profile, with a high number of comorbidities. The majority of participants (81.3%) perceived their family as highly functional. Treatment adherence levels were overall high, with the mean MAT scale score ranging from 5.08 to 5.77 (on a scale of 1 to 6), indicating a low frequency of non-adherence behaviors. Perceived quality of life was mostly positive, with a total mean MINICHAL scale score of 12.6, where lower scores indicate better quality of life. Inferential analyses showed that age, using the Kruskal-Wallis test (H=11.80, p=0.02), and the number of comorbidities, using the chi-square test (χ2(3) =8.61, p=0.035), influenced medication adherence. Gender (U=8353, p=0.02) and the number of comorbidities (χ2(3) =26.11, p<0.001) affected the perception of quality of life. Simultaneously, family functioning was statistically associated with treatment adherence (χ2(1) =19.03, p<0.001) and quality of life (U=6663.5, p<0.001). Spearman's correlation analysis confirmed these associations, with a positive and significant correlation between family functioning and adherence (r=0.38, p<0.001) and a negative and significant correlation with quality of life (r=-0.37, p<0.001). These results highlight the central role of the family in the management of hypertension, with a strong influence on treatment adherence and quality of life. The study therefore reinforces the importance of the EEECESF intervention in promoting family functioning and well-being in the context of chronic disease.
This report describes the activities of a Community Nursing internship in the area of Family Health Nursing (EEECESF), carried out at the Póvoa de Varzim/Vila do Conde Local Health Unit (ULSPVVC) between October 2024 and March 2025. The main objective was to articulate clinical practice with scientific research, through a project that evaluates the relationship between sociodemographic and clinical variables, the perception of family functioning and quality of life, and adherence to the medication regimen in users diagnosed with High Blood Pressure (HTN) of the Family Health Units (USF) St. Sra. Clara and Aqueduto. The choice of the topic is justified by the high prevalence of HTN and its impact on quality of life and health services, especially when the disease is not controlled. The research question was defined as: What is the relationship between sociodemographic and clinical variables, the perception of family functioning, quality of life in patients with hypertension, and adherence to medication regimens among patients diagnosed with hypertension at the St. Clara and Aqueduto Family Health Centers? The study adopted a quantitative, observational, descriptive-correlational, and cross-sectional methodology, with a sample of 240 patients. Data were collected using a form that integrated a sociodemographic and clinical questionnaire and three validated scales: Family APGAR, MAT Scale, and MINICHAL. Statistical analysis, performed in R software (version 4.4.2), included descriptive and inferential statistics to test the hypotheses. The results revealed that the sample had a predominantly female and older profile, with a high number of comorbidities. The majority of participants (81.3%) perceived their family as highly functional. Treatment adherence levels were overall high, with the mean MAT scale score ranging from 5.08 to 5.77 (on a scale of 1 to 6), indicating a low frequency of non-adherence behaviors. Perceived quality of life was mostly positive, with a total mean MINICHAL scale score of 12.6, where lower scores indicate better quality of life. Inferential analyses showed that age, using the Kruskal-Wallis test (H=11.80, p=0.02), and the number of comorbidities, using the chi-square test (χ2(3) =8.61, p=0.035), influenced medication adherence. Gender (U=8353, p=0.02) and the number of comorbidities (χ2(3) =26.11, p<0.001) affected the perception of quality of life. Simultaneously, family functioning was statistically associated with treatment adherence (χ2(1) =19.03, p<0.001) and quality of life (U=6663.5, p<0.001). Spearman's correlation analysis confirmed these associations, with a positive and significant correlation between family functioning and adherence (r=0.38, p<0.001) and a negative and significant correlation with quality of life (r=-0.37, p<0.001). These results highlight the central role of the family in the management of hypertension, with a strong influence on treatment adherence and quality of life. The study therefore reinforces the importance of the EEECESF intervention in promoting family functioning and well-being in the context of chronic disease.
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Keywords
Hipertensão Qualidade de vida Funcionalidade familiar Adesão à medicação Relações familiares Enfermagem familiar