Consulta de enfermagem ao paciente com hipertensão: fundamentação na teoria do Alcance de Metas

Abstract

The assumption defended that Imogene King Theory favors nurse-patient interaction to the mutual establishment of health goals. The objectives were to provide collective reflection on the context of the nursing consultation with hypertensive patients, discuss the Conceptual Model of Open Systems and the Theory of Goal Attainment with nurses relate the theory to the care of patients with hypertension and investigate the perception nurses about the Target Range Theory for implementation of the nursing consultation with hypertensive patients. The theory can facilitate the effective interaction of the nurse with the patient to lead to the identification of health problems, development goals, including discussions on ways and strategies to achieve these goals with continuous monitoring to reformulate them when necessary. Therefore, it developed qualitative and interventional research, with seven nurses working in the Family Health Strategy, to treat patients with hypertension in primary care Health of the municipality of Maracanaú-CE. The data were produced from February to August 2014, through the implementation of the technique Focus Group, taped and recorded and transcribed for analysis of the production of meanings based on discursive practices, as proposed by Spink. There were five meetings whose results yielded 17 categories and seven subcategories. About reflection of the situation of Nursing Consultation emerged six categories: the service vision with subcategories host, ambulatory and description of the consultation; nurse's perception about the patient; overload nurse in the ESF; scientific evidence; relationship with the medical professional; and compared with other sectors. On the perceptions, opinions and knowledge of nurses on the concepts proposed by King, five categories were elaborated: synthesis of the previous meeting; knowledge of the concepts proposed by theoretical, whose subcategories are personal system, interpersonal system, social system and three systems; demand; family participation; and care experiences. Regarding the Theory of Goal Attainment, the categories were formed: perception of interaction with the patient; and perception of nursing record metaorientado. The group's evaluation resulted in the following categories: perception of the instrument; everyday confrontations; the problem for implementation; completion of the study. These results describe the experience of evaluating a reality, reflecting on the difficulties and potential, the challenge of meeting the new, the Theory of Goal Attainment and experience its use in clinical nursing practice with patients with hypertension, for decision making to adhere to the change. In conclusion, the thesis was confirmed as the nurse used the Target Range Theory to support the nursing consultation with hypertensive patients, but the routine, the overhead and the demands of the service the adherence to its effective implementation the ESF.