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.

ObjectiveThe objective of this study was to describe the involvement of patients or their representatives in quality management (QM) functions and to assess associations between levels of involvement and the implementation of patient-centred care strategies.DesignA cross-sectional, multilevel study design that surveyed quality managers and department heads and data from an organizational audit.SettingRandomly selected hospitals (n = 74) from seven European countries (The Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey).ParticipantsHospital quality managers (n = 74) and heads of clinical departments (n = 262) in charge of four patient pathways (acute myocardial infarction, stroke, hip fracture and deliveries) participated in the data collection between May 2011 and February 2012.Main Outcome MeasuresFour items reflecting essential patient-centred care strategies based on an on-site hospital visit: (1) formal survey seeking views of patients and carers, (2) written policies on patients' rights, (3) patient information literature including guidelines and (4) fact sheets for post-discharge care. The main predictors were patient involvement in QM at the (i) hospital level and (ii) pathway level.ResultsCurrent levels of involving patients and their representatives in QM functions in European hospitals are low at hospital level (mean score 1.6 on a scale of 0 to 5, SD 0.7), but even lower at departmental level (mean 0.6, SD 0.7). We did not detect associations between levels of involving patients and their representatives in QM functions and the implementation of patient-centred care strategies; however, the smallest hospitals were more likely to have implemented patient-centred care strategies.ConclusionsThere is insufficient evidence that involving patients and their representatives in QM leads to establishing or implementing strategies and procedures that facilitate patient-centred care; however, lack of evidence should not be interpreted as evidence of no effect.

A study was carried out with 23 hypertensive individuals after educational process in order to verify the retention of knowledge and its influence on the hypertension control. After drug treatment it was observed that the level of knowledge was inversely proportional to the blood pressure levels.

Aiming to describe daily living of hypertensive people after Arterial Hypertension (AH) diagnoses and to identify changes in their lives. The method of inquiry used was descriptive and qualitative using discursive method to figure out theme factors. The results showed different behaviors/reactions of being sick according to their daily living after discovering AH, that not always happened at the same time that the antihypertensive treatment began. Those differences seems to be associated with individual understanding of sickness itself and of impact in their lives. So, getting along with hypertension is to learn about the sickness and symptoms and also make the necessary changes.

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.