The objective of this study was to understand the social reality of patients' daily life with chronic renal failure in hemodialysis. To understand this phenomenon from the theoretical-methodological referential of the historic and dialectic materialism. The interviews were performed with 18 patients submitted to analysis of speech procedure revealing dialectics subjects. These subjects were analyzed regarding the categories: health-disease process; possibility x reality and need x casualness. These patients, considered hemodialysis as a treatment unavoidable and the transplant casual, thus, between this dialectic relationship there is the nursing which needs to extend its comprehension on thr arduous, sad, difficult and monotonous reality and the possibilities o transformation.

RESUMENSe buscó comprender el modo de vida de portadores de hipertensión arterial asistidos por una unidad del Programa de la Salud de la Familia, sobre el referencial teórico-metodológico del materialismo histórico y dialéctico. Las once entrevistas realizadas con individuos hipertensos fueron sometidas al procedimiento de análisis de discurso, rebelando temas de la realidad social de la vida cotidiana. Las categorías empíricas identificadas creencias, sentimientos, además del individual, control y descontrol tensorial y causas de la hipertensión arterial, fueron analizadas delante de categorías dialécticas el subjetivo y el objetivo y proceso salud-enfermedad-cuidado. La vida cotidiana ha rebelado contradicciones cuanto al tratamiento necesario y a la enfermedad que no es asumida como enfermedad; necesidad de modificaciones en hábitos y valores humanos que se contraponen a esas modificaciones; imposibilitad concreta del control de los niveles tensoriales que transcurren de situaciones del modo de vida como el nerviosismo y problemas familiares. La Enfermería necesita repasar el modo de cuidado de la persona con enfermedad crónica. DESCRIPTORES ABSTRACTThe aim of this study is to understand the way life of hypertensive patients under the care of a Family Healthcare Program, regarding the theoretical-methodological historical and dialectical materialism. Eleven interviews were held with these patients, based on analysis of the speech procedures, which showed themes related to daily life social reality. The six empirical categories identified -beliefs, feelings, beyond-individual, under-control pressure, out-of-control pressure and hypertension causes -were analyzed according to two dialectical categories -the subjective and the objective -and the health-ill-nesscare process. Daily life has revealed contradictions related to the needed treatment and the illness not assumed as it is; need for changes of habits and human values which oppose to these changes; the impossibility of pressure levels control due to way of life conditions, such as nervousness and familiar problems. Nursing needs to change its way of caring about patients falling chronically ill. KEY WORDSHypertension. Health behavior. Nursing. Adult health.

This study intended to identify, in the way of life of hypertensive patients, connections which could clarify their compliance of hypertension treatment, to understand dialectical relationship of the assistance offered by a Family Healthcare Program expressed through contradictions and coincidences in the patients' way of life, and to create an educative program according to the emancipatory pedagogy based on Paulo Freire's conception of emancipatory education, with themes related to h ypertensive patients' required needs. The phenomenon "way of life" was grasped on the grounds of the theoretical and methodological aspects of the historical and dialectical materialism. The interviews, held with 11 hypertensive patients, were submitted to the analysis of the speech procedures, which showed the way of life of these patients. It can be represented by the following: beliefs, feelings, beyondindividual, under-control pressure, out-of-control pressure and hypertension causes These categories w ere analyzed according to dialectical categories -the subjective and the objective -and the health-illness-care process. Hypertensive patients' daily life shows many contradictions related to the treatment needed and the illness not assumed as it is; the need of changing habits and human values which oppose to these changes; the real impossibility of controlling pressure levels due to daily life conditions such as nervousness and financial and familiar problems. Once many contradictions in these patients' way of life have been identified, this study sugests the improvement of the acceptance of hypertension treatment by means of emancipatory education, according to Paulo Freire's theory. Nursing has to accept this reality, approach to it, and ethically change its own practice in order to show hypertensive patients under the care of nurses a better way towards their autonomy.