Alfabetización en salud y adhesión al tratamiento farmacológico de personas con hipertensión arterial

Silva, Iorana Candido da; Nogueira, Maria Rayssa do Nascimento; Cavalcante, Tahissa Frota; Felipe, Gilvan Ferreira; Morais, Huana Carolina Cândido; Moreira, Rafaella Pessoa; Oliveira, Andressa Suelly Saturnino de

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (6) • 2022 • https://doi.org/10.1590/0034-7167-2022-0008 copiar

Alfabetización en salud y adhesión al tratamiento farmacológico de personas con hipertensión arterial

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Analizar relación entre alfabetización en salud y adhesión al tratamiento farmacológico de brasileños con hipertensión arterial.

Métodos:

Estudio transversal, desarrollado con 234 participantes, que respondieron una encuesta online de caracterización sociodemográfica, clínica, evaluación de la alfabetización en salud y de la adhesión al tratamiento farmacológico. Los datos fueron analizados con estadística descriptiva y testes de diferencia y correlación.

Resultados:

Personas con postgrado, que trabajabany no tabaquistas obtuvieron mejores resultados de alfabetización en salud. Ancianos yjubilados/pensionistas presentaron mejor adhesión al tratamiento medicamentoso. Hubo correlación entre la dimensión numérica (r_s = 0,189; p = 0,004) yel resultado global de alfabetización en salud (r_s = 0,170; p = 0,009) con la adhesión.

Conclusiones:

Mejor comprensión numérica y global de alfabetización en salud estuvieron relacionados a mejores resultados de adhesión al tratamiento medicamentoso de la hipertensión arterial.

Descriptores:
Hipertensión; Alfabetización en Salud; Cumplimiento de la Medicación; Enfermería; Enfermedad Crónica

Variables	n	%	S-TOFHLA dimensions		S-TOFHLA	p value	MGT	p value
			Reading	Numeracy	Mean + SD		Mean + SD
			Mean + SD	Mean + SD	Mean + SD		Mean + SD
Sex
Female	206	88.0	71.2 ± 3.3	23.4 ± 6.4	94.6 ± 8.0	0.644^* * Statistically significant according with Mann-Whitney’s (p<0.05);	2.5 ± 1.4	0.638^* * Statistically significant according with Mann-Whitney’s (p<0.05);
Male	28	12.0	70.2 ± 4.6	25.2 ± 3.4	95.5 ± 5.0		2.5± 1.3
Age group
Adults	190	81.2	71.1 ± 3.5	23.7 ± 5.9	94.8 ± 7.4	0.577^* * Statistically significant according with Mann-Whitney’s (p<0.05);	2.4 ± 1.4	0.008^* * Statistically significant according with Mann-Whitney’s (p<0.05);
Elders	44	18.8	70.8 ± 3.4	23.2 ± 7.2	94.5 ± 8.7		3.0 ± 1.2
Years of formal education
Elementary school	20	8.5	70.2 ± 7.1	22.0 ± 6.9	92.2 ± 11.1	0.012^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation.	2.2 ± 1.2	0.092^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation.
High School	102	43.6	70.8 ± 3.5	22.4 ± 6.8	93.3 ± 8.6		2.4 ± 1.4
Higher education	57	24.4	71.6 ± 0.8	24.4 ± 5.6	96.1 ± 5.5		2.9 ± 1.1
Post-graduation	55	23.5	71.2 ± 3.3	25.5 ± 4.3	96.8 ± 5.3		2.5 ± 1.3
Marital status
Has a partner	117	50.0	71.1 ± 3.4	23.8 ±5.9	94.9 ± 7.6	0.463^* * Statistically significant according with Mann-Whitney’s (p<0.05);	2.6 ± 1.4	0.691^* * Statistically significant according with Mann-Whitney’s (p<0.05);
Does not have a partner	117	50.0	71.0 ± 3.7	23.3 ± 6.3	94.4 ± 7.8		2.5 ± 1.3
Region of residence
Midwest	16	6.8	71.7 ± 0.6	24. 9 ± 4.4	96.6 ± 4.6	0.727^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation.	2.2 ± 1.4	0.087^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation.
Northeast	66	28.2	69.9 ± 6.0	23.2 ± 6.7	93.1 ± 10.0		2.2 ± 1.5
North	9	3.8	71.7 ± 0.6	22.5 ± 6.8	94.3 ± 6.8		2.5 ± 1.0
Southeast	109	46.6	71.4 ± 1.9	24.0 ± 5.7	95.5 ± 6.1		2.7 + 1.3
South	34	14.5	71.7 ± 0.7	22.6 ± 6.9	94.3 ± 7.1		2.9 ± 1.4
Paid work
Yes	95	40.6	71.4 ± 2.6	24.6 ± 5.3	96.0 ± 5.8	0.034^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation.	2.4 ± 1.3	0.023^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation.
No	89	38.0	70.8 ± 4.4	22.3 ± 6.7	93.1 ± 8.8		2.3 ± 1.4
Retired/receives subsidies	50	21.4	70.8 ± 3.4	24.0 ± 6.1	94.9 ± 8.3		3.0 ± 1.1

S-TOFHLA	MGT
S-TOFHLA	r_s	p value^* * Statistically significant according with Spearman’s (p<0.05); S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test.
Reading comprehension	0.007	0.914
Numeracy	0.189	0.004
Total	0.170	0.009

Variables	n	%	S-TOFHLA dimensions		S-TOFHLA	p value	MGT	p value
			Reading	Numeracy	Mean + SD		Mean + SD
			Mean + SD	Mean + SD	Mean + SD		Mean + SD
BMI
Low weight	1	0.4	72.0	28.0	100.0	0.474^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation; BMI - body mass index; AH - arterial hypertension.	4.0	0.134^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation; BMI - body mass index; AH - arterial hypertension.
Normal weight	27	11.5	71.2 ± 3.0	24.6 ± 5.2	95.8 ± 6.3		2.8 ± 1.3
Overweight	77	32.9	70.2 ± 5.4	23.1 ± 6.5	93.4 ± 9.6		2.7 ± 1.4
Obesity	127	54.3	71.5 ± 1.7	23.7 ± 6.1	95.2 ± 6.6		2.3 ± 1.3
Did not answer	2	0.9	72.0	21.0	93.0		3.5 ± 0.7
Smoker
Yes	25	10.7	71.7 ± 0.8	20.7 ± 7.1	92.4 ± 7.0	0.022^* * Statistically significant according with Mann-Whitney’s (p<0.05);	2.4 ± 1.6	0.706^* * Statistically significant according with Mann-Whitney’s (p<0.05);
No	209	89.3	71.0 ± 3.7	23.9 ± 5.9	95.0 ± 7.7		2.6 ± 1.3
Drinks alcohol
Yes, occasionally	110	47.0	71.4 ± 2.6	24.6 ± 4.7	96.0 ± 5.6	0.152^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation; BMI - body mass index; AH - arterial hypertension.	2.4 ± 1.4	0.077^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation; BMI - body mass index; AH - arterial hypertension.
Yes, frequently	6	2.6	69.3 ± 4.6	23.3 ± 5.7	92.6 ± 9.8		1.6 ± 1.0
No	118	50.4	70.9 ± 4.2	22.6 ± 7.1	93.5 ± 9.0		2.7 ± 1.3
Practices physical exercise
Yes	80	34.2	71.3 ± 2.2	23.6 ± 6.0	94.9 ± 6.5	0.871^* * Statistically significant according with Mann-Whitney’s (p<0.05);	2.6 ± 1.3	0.987^* * Statistically significant according with Mann-Whitney’s (p<0.05);
No	154	65.8	70.9 ± 4.0	23.6 ± 6.2	94.6 ± 8.2		2.5 ± 1.4
Time since AH diagnosis
Less than 1 year	25	10.7	71.5 ± 0.8	23.2 ± 5.6	94.7 ± 5.8	0.573^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation; BMI - body mass index; AH - arterial hypertension.	2.6 ± 1.5	0.215^‡ ‡ statistically significant according with Kruskal-Wallis’s; S-TOFHLA - Test of Functional Health Literacy in Adults - Short version; MGT - Morisky-Green Test; SD - standard deviation; BMI - body mass index; AH - arterial hypertension.
1 to 5 years	56	23.9	71.1 ± 3.2	23.7 ± 6.8	94.8 ± 8.7		2.4 ± 1.3
5 to 10 yeras	66	28.2	71.5 ± 1.5	23.0 ± 6.4	94.5 ± 6.6		2.3 ± 1.3
More than 10 years	87	37.2	71.5 ± 0.8	23.2 ± 5.6	94.7 ± 5.8		2.6 ± 1.5
Diagnosed comorbidities
Yes	100	42.7	70.6 ± 4.5	22.8 ± 7.0	93.5 ± 9.4	0.166^* * Statistically significant according with Mann-Whitney’s (p<0.05);	2.5 ± 1.3	0.517^* * Statistically significant according with Mann-Whitney’s (p<0.05);
No	134	57.3	71.4 ± 2.6	24.2 ± 5.3	95.6 ± 6.0		2.6 ± 1.3
Number of medications
Até 3	141	60.3	71.1 ± 3.8	23.9 ± 5.8	95.0 ± 7.5	0.230^* * Statistically significant according with Mann-Whitney’s (p<0.05);	2.6 ± 1.4	0.717^* * Statistically significant according with Mann-Whitney’s (p<0.05);
4 or more	93	39.7	71.0 ± 3.1	23.1 ± 6.6	94.2 ± 7.9		2.5 ± 1.3

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[1] Corresponding author: Iorana Candido da Silva E-mail: ioranacandido@gmail.com