Crenças e comportamentos em saúde de pessoas com hipertensão arterial e excesso de peso

Abstract

Hypertension (HT) and overweight (OW) are relevant public health problems whose prevention and control are complex, which requires lifestyle changes. These changes are influenced by factors that include health beliefs. The objective of this study was to investigate the association between beliefs and behaviors related to prevention and control measures for HTN and OW in people treated in primary health care. A cross sectional study was conducted with 382 people with HTN and OW in Basic Health Units in Campina Grande, Paraíba. An instrument was applied to characterize the sample, survey health-related behaviors and the Dela Coleta Health Belief Scale. Sociodemographic and clinical variables, lifestyle habits and health beliefs were analyzed in relative and absolute frequencies. To analyze beliefs about barriers and benefits to adopting healthy behaviors, a belief indicator was constructed. To analyze the association of the health belief indicator with behaviors, Pearson's Chi-square test or Fisher's exact test and the prevalence ratio with respective 95% confidence intervals were used. The prevalence of female gender (72.5%), age under 60 years (62.3%), marital status with partner (56.3%), complete elementary education (52.9%), family income of up to two minimum wages (86.1%) and practitioners of some religion (93.5%). The majority had a medical diagnosis of hypertension for more than a year (91.9%), had an indication for drug treatment (93.7%), reported having signs and symptoms of hypertension (69.6%), did not report diabetes (65.7%) or previous myocardial infarction (80.4%) and had a family history of CAD (58.1%). The participants were predominantly non-smokers (88.2%), did not practice physical activity at least three times a week (66.0%) and avoided consuming alcoholic beverages (85.1%). The analysis of the belief indicator showed the predominance of the category “health beliefs about benefits” for the thirteen measures of prevention and control of diseases, with an association between beliefs and health behaviors. Eating less salt was 19% (95% CI 1.03-1.38) more frequent for those who reported beliefs about the benefits of this behavior; avoiding alcoholic beverages and avoiding worries were respectively 2.0 (95% CI 1.15-3.50) times and 1.5 (95% CI 1.04 2.16) times more frequent for those with beliefs about their benefits than barriers. Regarding beliefs about healthy eating, the majority recognized the benefits of using less salt, less fat and less sweets, based on the perception of the health risks associated with the excessive consumption of these foods. Most participants recognized the benefits of exercising, avoiding alcohol consumption and smoking, also based on the perception of health risks associated with these behaviors. Although participants perceived the benefits of avoiding the risk behaviors studied, recognizing the health risks, the barriers indicated that quitting smoking, exercising and adhering to a healthy diet bring significant challenges. Strategies to overcome these barriers require health education, public policies and support from the health team.