Social representations of hypertension and its treatment from the perspective of health professionals, people living with hypertension and their families.
Abstract
Systemic arterial hypertension (SAH) or simply arterial hypertension (HT) is characterized by the occurrence of pressure equal to or greater than 14 over 9, that is, when blood pressure values are equal to or higher than 140/90mmHg for individuals at 18 years old or older (Malachias et al, 2016). HT complications are responsible for more than 9 million deaths worldwide yearly, with 51% of these deaths caused by stroke and 45% due to heart disease (Malachias et al, 2016; World Health Organization, 2013). The treatment for this disease is the use of antihypertensive medication and changes in lifestyle, such as being careful with food intake, regular physical activity and control of alcohol intake. The motivation to adopt these new habits and perform treatment may be influenced by the knowledge acquired about the disease and the beliefs of the patients about it (Gusmão et al, 2009). Through beliefs, the individual organizes a coherent view of the object, which is constituted in practical knowledge, guiding their actions (Jodelet, 2001). Hence the importance of studying this form of knowledge based on the theory of social representations. These are specific phenomena that relate to a particular way of understanding reality and communicating with others (Moscovici, 1961/2012). The way to explain the disease and act on it is based on a relation between specialized and popular knowledge, and there is a variation in the way doctors and patients build their knowledge about diseases and health care (Jeoffrion, Dupont, Tripodi, & Roland-Lévy, 2016). Thus, it is assumed that health professionals, people living with hypertension and relatives make different representations about hypertension and its treatment.
This is a qualitative research, with descriptive and comparative design. 60 people have participated, being 20 health professionals, 20 people living with hypertension and 20 relatives, selected non-probabilistically. Data collection was performed in Florianópolis, SC, Brazil, in the health centers of the municipality. Semi-structured individual interviews were conducted. The research was submitted to the board of the Research Ethics Committee (CEPSH) of the Federal University of Santa Catarina (UFSC), in accordance with resolution no. 466/2012 of the National Health Council. The interviews were recorded, with the permission of the participants.
Among the participants, 45 were female, with a minimum age of 18 years and a maximum age of 87 years old. The textual material obtained through the interviews was transcribed into a text document. Subsequently, two separate corpora were organized according to the themes explored: corpus “hypertension” and corpus “treatment”, submitted to a Descending Hierarchical Classification (DHC) with the aid of the IRaMuTeQ software version 0.6, developed by Pierre Ratinaud (Ratinaud & Marchand, 2012). DHC illustrates relations between lexical classes characterized by text segments and their respective vocabularies (Camargo, 2005).
In the corpus “hypertension”, 83.73% of the total text segments were classified. According to Camargo (2005), DHC can adequately summarize the corpus when 75% or more of the text segments have been classified. Figure 1 shows the DHC dendrogram divided into five classes with the vocabulary of their respective text segments.
