Introduction
This article presents the experience of an educational activity conducted by an
educational game, developed with a group of students in a School of Nursing
auxiliaries and technicians, city Jequie, Bahia. The experience is based on a
Constructivist Approach Interactions, based on the use of educational games and
learning strategy.
The use of educational games in the learning process and the interaction between
education and health, requires the development of an active subject when
interacting with users of health can help them build a lifestyle related to
their disease, contributing thus to improve the quality of life of users.
The concept of health approved the Constitution of 1988 points to a progressive
shift of health services, passing a healthcare model focuses on disease-based
and service to those who seek for a model of integrated health care, where there
is progressive incorporation the promotion and protection, beside those proper
recovery (BRASIL, 1988).
It is understood well, for health education in a field of practices that take
place on the level of social relationships usually established by health
professionals together with the institution, and especially with the user in
developing their everyday activities. One can not think health services without
reflecting on the relationships between these actors or subjects, since any
health care involves at least the interaction between two people.
We understand that the game is a strategy that facilitates the exchange of
experiences and the development of health education through playful activities,
noting that this strategy should be inserted in the educational practices
developed by health professionals in their work process in care users of health
services among these patients with Hypertension.
Hypertension is a major health problem that usually occurs in adulthood and is
accentuating the cases of death from cardiovascular disease (BRASIL, 2006).
Educational activities undertaken by the Primary care in people with high blood
pressure is, therefore, of great importance, since their carriers require full
attention aimed at quality of life through health promotion, disease control and
prevention complications.
Thus, in this study we used a strategy of using educational games, as we believe
that the development of health education activities through educational games
becomes more enjoyable, since the play activity inhibits, encouraging people to
propose justify and defend something they believe, thus facilitating the
teaching - learning process that aims to raise awareness of prevention and care
before a grievance health.
Thus we have the general objective: To assess the understanding of nursing
students about hypertension and educational activities in the care of people
with hypertension, using an educational game as a means of health education.
And, as specific objectives: check the knowledge of nursing students as
hypertension (concept, factors, preventive care, treatment, complications);
assess the implementation of educational games in teaching-learning process in
health education.
This study is important to know and to promote understanding of students about
the importance of carrying out health education to the quality of life of
patients with Hypertension. Besides the possibility of similar contribution to
the understanding of educational activities for hypertension present in
relationships that are in the process of job aids and nursing technicians in the
construction of knowledge and practices to develop joint projects for social
transformation, and also the ability to contribute to the training in
healthcare.
Also, seek prompt a new look from students, future health workers, about
understanding how is education in the context of human rights to health, thus
becoming fertile ground for reflections of the process of health education, the
from hypertension and its contribution to a possible modification of the
behavior of the community, which can provide them a better quality of life,
benefiting their health situation and allowing the promotion, prevention and
reduction of morbidity and complications of hypertension.
Hypertension
Arterial Hypertension (HBP) is a serious public health problem in Brazil and
worldwide. She is one of the most important risk factors for the development of
cardiovascular, cerebrovascular and renal, accounting for at least 40% of deaths
from stroke by 25% of deaths from coronary heart disease and, in combination
with diabetes 50% of cases of ESRD. With the current diagnostic criteria of
hypertension (BP 140/90 mmHg), the prevalence in the urban adult population
ranges from 22.3% to 43.9%, depending on the city where the study was conducted.
The main relevance of the identification and control of hypertension is the
reduction of its complications, such as cerebrovascular disease, coronary artery
disease, heart failure, chronic kidney disease, peripheral arterial disease
(BRASIL, 2006).
Epidemiological studies in Brazil have shown that hypertension affects 11-20% of
the adult population over 20 years (BRASIL, 2001). The number of people with
this disease is increasingly rising early and taking in Brazil about 17 million
people with hypertension, of which 35% of the population are over 40 years old
(BRASIL, 2006).
It is characterized as one of the biggest causes of reduced quality and life
expectancy of individuals since it has set an important risk factor for diseases
resulting from atherosclerosis and thrombosis, which are externalized by cardiac
involvement, brain, kidney and peripheral vascular (ASSIS; BARRETO; PASSOS,
2006).
There are several factors that complicate the treatment and control of
hypertension among these, non-adherence to treatment, a fact that is much
observed by health professionals. Although not an exclusive problem of
hypertension, being frequent in other therapeutic regimens prolonged lack of
adherence to antihypertensive treatment deepens in complexity (REINERS, 2004).
One factor that complicates the membership is the absence of symptoms in
hypertension because only half the people who suffer from high blood pressure
know they have the disease because no symptoms and often have the impression of
being in good health. These people may have changes in blood pressure (BP) and
together, habits and health behaviors that favor the persistence of this high.
Most noted the diagnosis of this condition when they are victims of some
complication, such as stroke, aneurysm and renal failure.
Health professionals have basic network prime importance in strategies to
control hypertension, but also in defining the clinical diagnosis and the
therapeutic or the efforts required to inform and educate the hypertensive
patient as to do so following the treatment.
Within the universe of chronic diseases, hypertension stands out for the high
medical and social costs as it has implications for cardiovascular disease,
renal and neurological, being one of the most important risk factors for
morbidity and mortality worldwide, as well as the cause of early retirements. It
is a syndrome characterized by increased blood pressure, both systolic and
diastolic, and direct or indirect cause of the high number of deaths caused by
stroke, myocardial infarction, heart failure and kidney (PORTO; RASSI, 1997).
Assistance to your users involves focused approach to the changing lifestyles
and the process of treatment compliance in order to avoid conditions such as
morbidity and contribute to the reduction of social and physical damage, it is
paramount to establish link users to treatment, enabling them to systematically
monitor.
Thus, health professionals should potentiate the actions of early diagnosis,
control, monitoring and treatment for users, with an emphasis on educational
about the risk factors, change of lifestyle and the co-responsibility of the
users about their treatment there quality of life. Changing lifestyle is a
difficult task, and is almost always accompanied by a lot of resistance, so most
people can not make changes, and especially keep them for long. However, health
education is a fundamental alternative to drive people to these changes, for the
prevention and / or control of risk factors of hypertension through healthy
habits and attitudes (SANTOS, 2003).
The experience of health education through groups favoring participation as a
way of ensuring the individual and the community the opportunity to decide their
own destiny, and capacity of these subjects to work on improving their health
(BUSS 2003).
Promoting
health care through educational games
Alves (2005) defines health education "as a set of knowledge and practices
aimed at disease prevention and health promotion." As authors, we believe
that this knowledge, mediated by health professionals through educational, may
mean re-designing health of people mainly from the understanding of the
determinants of health-disease process that should be made explicit in these
actions.
Therefore, health promotion is done through education, adoption of healthy
lifestyles, the development of individual and collective capacities and the
production of a healthy environment. Is therefore linked to the implementation
of public policies for the quality of life and developing the ability to
critically analyze reality and promote the transformation of the determinants of
health.
Education permeates people's lives from an early age. Whether through formal or
informal all teach and learn in their relationship with each other. Lima (2005)
conceives education as a dialogical process between actors; it favors the
development of their human qualities, the acquisition of knowledge, skills,
interests, attitudes and power for action providing your personal and social
growth and development of consciousness critical.
Health education carried out through the use of educational games has shown a
facilitating strategy in increasing knowledge, of autonomy and linking the
subject with the service and the health professional. Our practice showed
increased user participation in the meetings of the Programme of the Ministry of
Health This strategy aims at the understanding of hypertensive about their
disease process, stimulating changes in habits and change the way of life
(TORRES; HORTALE; SCHALL, 2003 ) and has contributed significantly to prevention
and control of diseases.
The games are educational action based on dialogue, enabling learning and
interaction, stimulating concentration and thought, and at the same time provide
fun. Act as instruments of communication, expression and learning, further
knowledge and enhance the various exchanges of knowledge, which are the basis of
learning (TORRES; HORTALE; SCHALL, 2003).
Valla (2000) considers that the health professional should use simple and
understandable language, suitable to reality and which has as a key point the
individual seeking for your needs regarding the disease. This language allows
the traders pursues an educational practice and carry out appropriate diagnosis.
Complementarily Stotz and Valla (1994) suggest that professionals should act as
a facilitator and mobilizing to improve the living conditions of the people and
prevent the onset of disease.
For Torres, Hortale and Schall (2003), the educational practices that promote an
interactive system between individual and health professionals, mediated and
structured by the concept of disease, provide the development of personal
attitudes that associate the concept of lifestyle.
Strategies of health education as active methodologies, properly structured
enable sharing of information in the search for improved quality of life and
promoting health. The health professional who has training and governance to
work in the health-illness, it is the construction of educational practices
supported in dialogic processes with horizontality of power and ways to share
knowledge appropriate to the target population and to meet the health needs, in
order to develop proposals for emancipation and not coercive. The discussion of
educational methodologies integrates the process of health education as a
pedagogical strategy, inseparable to the professions who work in health care
(ANDEDRADE 2004).
Understanding, the individual, the interactive system in educational practice,
the interfaces established between it and the healthcare professional, mediated
and structured by the concept of disease, favor the development of personal
attitudes that associate the concept of lifestyle.
The lifestyles do not match only some behaviors, such as exercise, diet or no
consumption of harmful substances, but also to other attitudes and practices,
such as tolerance, solidarity, respect for differences and human rights and
participation, which occur in the collective life. Restrepo (2001) affirms the
need to know more about the individual experience of diabetes, the physical and
social environment, the influence of culture in defining the disease and
attitudes towards it.
When referring to the educational process for the control of diabetes, talk
about the importance of adopting strategies whose actions should be
participatory nature of both the individual and his family. It is known that
education influence the lifestyle, improve the professional-individual and the
social and physical environments. In addition, health education, as a social
practice, based on dialogue, ie, exchange of knowledge, fosters the
understanding of this relationship in the disease process and, respectively, the
exchange between the scientific and popular knowledge (BRICEÑO-LEON, 1996).
Use of
the game as educational process. Methodology
This is a descriptive study and intervention with students of Technical
Education in Nursing, through an educational game applied to a School of Nursing
and Technicians assist in Jequie-BA. For the development of the activity we
designed a game with 24 questions about Hypertension, aiming to analyze the
understanding of nursing students about hypertension and educational care. The
contents were discussed concept, diagnosis, risk factors, signs and symptoms,
prevention, complications, treatment and educational activities.
The experience is based on a Constructivist Approach Interactionist, based on
the use of educational games, which was used as a pedagogical strategy for
enhancing learning dynamically interactionist and more significant.
We use therefore the "Game Data Allocated", developed and adapted to
Health Education for Hypertension, from the set Given Colorful, used by Heloisa
Torres, Department of Applied Nursing, Federal University of Minas Gerais and
Virginia Schall, researcher in Health Education at the Oswaldo Cruz Foundation
in its work with groups operating health education for people with diabetes.
This game had a poster and material satisfaction questions about the concept,
diagnosis, risk factors, signs and symptoms, prevention, complications,
treatment and educational activities organized in columns that followed the
numbering of data consisting of six sides, each given number has a specific
meaning: number one (01 - concept and diagnosis), 02 (two - risk factors), three
(03 - signs and symptoms), four (04 - treatment), five (05 - complications) and
06 (six-prevention and health education).
For the realization of the game divided the students into three groups, each
group member was playing dice and according to the number that came out, the
group answered a question about the theme of the game, as described above. All
members of the group could assist / complement response. If the group hit him
the answer won a prize and if he missed the turn going to another group.
Play
as educational process and its impact. Results and discussion
The educational process, developed with a group of students of the Course for
Practical Nursing, was effectively among professionals and students, leading
everyone to participate in the construction of knowledge and avoiding monopoly.
Students participated in an active teaching strategy, in constructing knowledge.
The experience of the development of the educational process by Games identified
that this educational strategy has the potential to stimulate the student to
reflect on the adoption of a practice of care that should be held by the
individual with hypertension, aimed at promoting health and prevention of
illness and complications, aiding the understanding of disease and practice a
healthy lifestyle, as well as the construction of knowledge through a dialogical
pedagogy, whether the activities of the individual, or in the collective.
The weather always went well, which prompted a positive meeting and indicated
that the health education a training process in which students and professionals
realize and take responsibility in the prevention, disease control and health
promotion.
Also, a few questions from the students during the course of the educational
process, and requested explanations regarding the issues raised in respect of
hypertension, which were performed by professionals. However, most students
demonstrated knowledge on the issues addressed.
Promote educational for hypertensive individual is the fundamental premise for
the treatment of disease. These offer you the opportunity to prevent the onset
of chronic complications and improve quality of life. To be effective, require a
set of conditions, such as good professional training, which boils down to a
good knowledge of pedagogical attitudes, good communication skills and the
ability to listen, understand and negotiate (DOTA, 2001).
Group dynamics stimulated the interpersonal relationship between students and
health professionals, facilitated discussion between people with the same goals,
enabling the exchange of information. The members shared common experiences,
which helped in understanding the disease, allowing them to express doubts and
expectations and providing mutual support.
The game is a learning strategy that contributes to a time of teaching and
learning in order to enhance creativity and encourage the search for new
alternatives in the educational process. The professionals who prepared the
teaching materials and worked with educational games identified advantages in
its use. One is to have created a pleasant environment for learning, necessary
to maximize potential to facilitate the promotion of knowledge.
Conclusion
The game used in educational activities conducted among students is an important
instrument for the development of knowledge about a certain topic, favoring a
learning experience built using a method that enables playful interaction and
exchange of knowledge that will guide the actions of health will be developed by
students, future health professionals.
However, it is necessary to plan educational activities considering contexts
that not only clinicians, as well as meet specific needs for the development of
new games or other educational activities. The described experiment showed,
albeit approximate, that such resources increased participation and commitment
of students and health professionals in clinical and environmental
transformation of the educational process itself. We can say that, taking into
account the comments made by the students involved in the end of the activity,
ie, at the time of evaluation of educational game.
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