A influência do ambiente virtual de aprendizado (AVA) na adesão terapêutica e no efeito do jaleco branco

Abstract

Systemic arterial hypertension is a risk factor for cardiovascular disease and has become a public health problem. Health education associated with educational technology can be used to encourage better behavior adherence to treatment and behavior change by promoting quality of life. OBJETICVE: To evaluate the influence of a strategy in an individual orienta tion program associating educational technology - virtual learning environment (AVA) in the Distance Learning mode (EAD) for hypertension to be promoted by nurses and to verify the effect of the white apron and the Quality of life in patients of a state hospital in São Paulo. METHODS: A randomized clinical study with AVA Group (study group, 10 patients) and Con trol Group (16 patients). Both groups participated in six consultations with the nurse for 120 days at 20 day intervals. At the beginning of the study (randomization) and at the end, the following instruments were applied: Spielberg Trait-State Anxiety Inventory (IDATE), Morisky's Test and WHOQOL, as well as Ambulatory Blood Pressure Monitoring (ABPM). Both groups had their blood pressure, weight and abdominal circumference checked at each visit. Only the study group had remote access to AVA, consisting of six specific educational modules, with release at each meeting. RESULTS: At the beginning of the study, there was no statistical significance between the two groups in relation to sociodemographic and he modynamic variables. At the end of the 120-day follow-up no statistical difference was found between the means of SBP, DBP and HR; In relation to the differences obtained from the blood pressure at the end of the study, the following values were identified: Group AVA -16 ± 37.5 mmHg and -1 ± 21 mmHg and Control Group -8 + 15 mmHg and -2 ± 0 mmHg for SBP and DBP respectively, no significance was found for both groups. Regarding HR in the AVA Group, it was -2 ± 5.4bpm and in the Control Group -1 ± 10bom, statistical significance was not identified for both groups. At the end of the 120-day follow-up the AVA group presented statistical significance (p-value = 0.001) in the Morisky Green test, while in the Control Group there was no significance. As for the WHOQOL, at the end of the 120 days the AVA Group presented statistical significance (p-value = 0.001) in the Social Domain, while in the Control Group there was no significance. When analyzing the effect of the white coat between the groups no difference was found between the groups when associating Spielberger Trait State Anxiety with White Apron Effect in both groups. CONCLUSION: The strategy promoted improvement in social quality of life and adherence behavior according to the Morisky test in the AVA group.