Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2017-08-24T12:28:10Z No. of bitstreams: 1 DIEGO_SILVEIRA_SIQUEIRA_DIS.pdf: 1193582 bytes, checksum: cad7014fa8412a61994647486edc8e93 (MD5) / Rejected by Caroline Xavier (caroline.xavier@pucrs.br), reason: Devolvido devido ? falta de capa institucional. on 2017-08-25T17:56:57Z (GMT) / Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2017-08-30T11:26:00Z No. of bitstreams: 1 DIEGO_SILVEIRA_SIQUEIRA_DIS.pdf: 1121335 bytes, checksum: f6f699bc9f8c699563be863b36e27d98 (MD5) / Approved for entry into archive by Marcelo Texeira (marcelo.texeira@pucrs.br) on 2017-08-30T13:18:13Z (GMT) No. of bitstreams: 1 DIEGO_SILVEIRA_SIQUEIRA_DIS.pdf: 1121335 bytes, checksum: f6f699bc9f8c699563be863b36e27d98 (MD5) / Made available in DSpace on 2017-08-30T13:19:58Z (GMT). No. of bitstreams: 1 DIEGO_SILVEIRA_SIQUEIRA_DIS.pdf: 1121335 bytes, checksum: f6f699bc9f8c699563be863b36e27d98 (MD5) Previous issue date: 2017-03-20 / Introduction: chronic kidney disease (CKD) is characterized by structural changes or kidney function present for more than three months with health implications. Faced with these changes and complications, the patients undergo stressors capable of influencing their coping with the disease and treatment perspectives. Objective: to characterize the coping profile of patients on the waiting list for renal transplantation based on the Jalowiec Coping Scale (CJD) and to evaluate quality of life using SF-36. Method: a cross-sectional quantitative study that took place at the hemodialysis unit of Hospital S?o Lucas PUCRS, patients on the waiting list for renal transplantation, who are over 18 years of age and literate were included. Data was collected through a questionnaire with patient socio demographic information, CJD and SF36. Results: 58 patients were included, 51.7% (n = 30 males, mean age of 44.6 (? 15.2) years, 12.3% (n = 7) were above 65 years of age, more than half, 57.9% (n = 33) had elementary education. Thirty-one (54.4%) patients were married, (n = 31); 37.5% (n = 21) had one children and were of the catholic religion 62,5% (n = 35). In relation to CJD, the predominant profile was self - confident (0.455) and optimistic (0.404) 42 and 6 patients, respectively, of which 54 were focused on emotion. The dimensions evaluated with the best quality of life were: pain (67.2), social aspects (66.6) and mental health (65.4). There was a weak significant negative correlation, (r <0.333), between palliative style and vitality (r = -0.288, p = 0.028) and palliative and social aspects (r = -0.283; p = 0.031). There was a moderate negative correlation between general well being and emotive style (R = -0.424, p = 0.025) and palliative (r = -0.524, p = 0.004), as well as between Vitality and Palliative style (r = -0.530; P = 0.004). In males, there was a significant, negative moderate correlation result with a (0.300 <r?0.600) beteween Pain dimension with the Confrontive style (r = -0.413; p = 0.023) and Emotive (r = -0.370). Conclusion: the coping profile of patients on hemodialysis and in waiting list for tranplant was mostly self-confident and optimistic. The best domains in the quality of life were Pain, Social Aspects and Mental Health, and the worst physical and emotional aspects. / Introdu??o: a doen?a renal cr?nica (DRC) ? caracterizada por altera??es estruturais ou da fun??o dos rins presentes por mais de tr?s meses com implica??es para a sa?de. Diante dessas altera??es e complica??es os pacientes sofrem a??o de estressores capazes de influenciar no seu enfrentamento em rela??o ? doen?a e perspectivas de tratamento. Objetivo: caracterizar o perfil de enfrentamento dos pacientes em lista de espera de transplante renal baseado na Escala de Jalowiec Coping Scale (ECJ) e avaliar a qualidade de vida SF-36. M?todo: trata-se de um estudo transversal de abordagem quantitativa desenvolvida na unidade de hemodi?lise do Hospital S?o Lucas da PUCRS, em pacientes em lista de espera para transplante renal, com mais de 18 anos de idade e alfabetizados. Os dados foram coletados por meio de question?rio com informa??es s?cio demogr?ficas sobre o paciente, ECJ e SF36. Resultados: foram inclu?dos 58 pacientes com preval?ncia do sexo masculino 51,7% (n=30), m?dia de idade de 44,6 ?15,2 anos, 12,3% (n=7 ) acima de 65 anos e mais da metade da amostra, 57,9% (n=33) apresentou o ensino fundamental. Trinta e um (54,4%) pacientes eram casados (n=31); com um filho, 37,5% (n=21) e de religi?o cat?lica 62,5% (n=35). Em rela??o ? ECJ, o perfil predominante foi o Autoconfiante (0,455) e Otimista (0,404) 42 e 6 pacientes, respectivamente, sendo que 54 focados na emo??o . As dimens?es avaliadas com a melhor qualidade de vida foram: a dor (67,2), aspectos sociais (66,6) e sa?de mental (65,4). Houve correla??o significativa, fraca e negativa( r<0,333), entre o estilo paliativo e vitalidade (r=- 0,288; p=0,028) e paliativo e aspectos sociais (r=-0,283; p=0,031) . houve correla??o significativa, negativa classificada como moderada entre o Estado Geral de Sa?de e os estilos Emotivo (r=-0,424; p=0,025) e Paliativo (r=-0,524; p=0,004), bem como, entre a Vitalidade e o estilo Paliativo (r=-0,530; p=0,004). No sexo masculino, ocorreu resultado significativo, negativo com grau moderado (0,300<r?0,600) na compara??o da dimens?o Dor com os estilos Confrontivo (r=-0,413; p=0,023) e Emotivo (r=-0,370; ;p=0,044). Conclus?o: o perfil de enfrentamento dos pacientes em hemodi?lise e em lista de espera de transplante renal, foi em sua maioria autoconfiante e otimista. Os melhores dom?nios na qualidade de de vida foram Dor, Aspectos sociais e Sa?de mental, e os piores aspectos os f?sicos e os emocionais.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T22:18:32Z No. of bitstreams: 1 LaysPinheiroDeMedeiros_DISSERT.pdf: 2931997 bytes, checksum: bc17f556882bb10726ee26a84f71d688 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-23T21:35:22Z (GMT) No. of bitstreams: 1 LaysPinheiroDeMedeiros_DISSERT.pdf: 2931997 bytes, checksum: bc17f556882bb10726ee26a84f71d688 (MD5) / Made available in DSpace on 2017-03-23T21:35:22Z (GMT). No. of bitstreams: 1 LaysPinheiroDeMedeiros_DISSERT.pdf: 2931997 bytes, checksum: bc17f556882bb10726ee26a84f71d688 (MD5) Previous issue date: 2016-12-02 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Estomia ? uma abertura criada artificialmente a partir do trato gastrointestinal, ou trato urin?rio, para o abd?men, por onde ocorre o desvio e elimina??o do fluxo de fezes e urina. A estomia demanda atendimento a diversas necessidades adaptativas que envolvem aspectos fisiol?gicos, psicol?gicos e sociais. Isso requer a atua??o da enfermagem voltada para a promo??o da adapta??o da pessoa com estomia. A fim de sistematizar o cuidado ? pessoa estomizada, com vistas ? adapta??o eficaz e consequente melhoria da qualidade de vida, a enfermagem pode utilizar o Modelo de Adapta??o de Roy (MAR), que cont?m seis etapas do processo de enfermagem. O objetivo desse estudo foi construir e validar o conte?do de um instrumento para medir o n?vel de adapta??o do estomizado, com base no MAR. Trata-se de um estudo metodol?gico que ser? desenvolvido em duas etapas: constru??o dos itens do instrumento a partir das defini??es dos constructos, e a aplica??o do instrumento aos ju?zes. As defini??es constitutivas e operacionais foram feitas a partir da literatura e o processo de valida??o foi realizado por meio do ?ndice de Validade de Conte?do (IVC). Foram selecionados 116 ju?zes para a etapa de valida??o, dos quais nove foi realizada pela avalia??o de nove ju?zes, Todos responderam que consideram importante que o enfermeiro conhe?a o processo adaptativo da pessoa estomizada, a maioria referiu se sentir preparado para assistir a pessoa estomizada, incluindo as necessidades adaptativas e tamb?m conheciam o Modelo de Adapta??o de Roy. O primeiro modo adaptativo avaliado pelos ju?zes foi o fisiol?gico, no qual metade itens apresentaram IVC acima de 0,80 e, quanto ? perman?ncia do item no modo inicialmente alocado, apenas 3 (18,7%) tiveram 100% de repostas favor?veis ? manuten??o do item no modo. Dos 17 itens do modo autoconceito, Apenas 4 (23,5%) dos itens obtiveram IVC acima de 0,8 e 8 (47%) apresentam respostas 100% favor?veis ? manuten??o do item no modo. No modo fun??o de papel, 4 (100%) dos itens apresentaram IVC acima de 0,8 e 2 (50%) itens apresentaram total recomenda??o de perman?ncia no modo. Por fim, no modo interdepend?ncia, 3 (42,9%) itens apresentaram IVC acima de 0,8 e 4 (57,1%) tiveram todas as respostas voltadas para a manuten??o do item no modo. Ao final dessa etapa, 7 itens foram retirados do instrumento, dois foram agrupados em um s? e um foi alocado em outro modo diferente do preliminar. A vers?o final do instrumento possui 34 itens no total, sendo 11 no modo fisiol?gico, 14 no autoconceito, 4 no fun??o de papel e 5 no interdepend?ncia. Conclui-se que os itens constru?dos para compor a ENAE possuem validade de conte?do. / Ostomy is an opening that is artificially created from the gastrointestinal tract, or urinary tract, to the abdomen, from where it occurs a detour and the elimination of stool and urine. The ostomy?s construction requires several adaptive needs which involve from physiological aspects to psychological and social demands. This way, it is needed the performance of a nurse guided toward an improvement of the adaptation of the person with an ostomy. In order to systematize the care to the person with an ostomy, aiming an effective adaptation and consequent enhancement on their quality of life, the nurse can use Roy?s adaptation model (RAM), which is described on six stages of the nursing process. The first two are consisted on the stage of gathering data on stimulus and behaviors, of which will guide the subsequent stages. Therefore, the objective of this study is to construct and validate the content of the instrument entitled as ?Scale of the adaptation level of the person with an ostomy (ENAE). It is about a methodological study that will be developed on two phases: The first is consisted on the construction of the instrument?s items from the construct?s definitions, and the second will be based on the evaluation phase of the judges. The constitutive and operational definitions were made from the literature and the validation process will be analyzed using the Content Validation Index (CVI). 116 judges were selected for the validation phase, of which? by the evaluation of nine judges. Everyone answered that they considered as important that the nurse must know the adaptive process of the person with an ostomy, most of them referred that felt prepared to help the person with an ostomy, including the adaptive needs and also have to know Roy?s Adaptive Model. The first adaptive model evaluated by the judges was the physiological one, of which 8 (50%) items showed and CVI bigger than 0.80 and, regarding the item?s continuity on the initially allocated mode, only 3 (18.7%) had 100% of favorable answers about the item?s keeping on the mode. From the 17 items on the self ? concept mode, only 4 (23.5%) of the items had CVI above 0.8 and 8 (47%) showed answers 100% favorable to the item?s keeping on the mode. On the paper function mode, 4 (100%) of the items showed CVI above 0.8 and 2 (50%) of the items showed total recommendation regarding the continuity on the mode. Finally, on the interdependence mode, 3 (42.9%) items showed CVI above 0.8 and 4 (57.1%) had all the answers guided toward the item?s keeping on the mode. At the end of this stage, 7 items were removed from the instrument, two were grouped in only one and one was allocated on another mode different from the preliminary mode. The instrument?s final version has 34 items, being 11 on the physiological mode, 14 on the self ? concept mode, 4 on the paper function and 5 on the interdependence mode. Regarding the study?s limitations, the response?s reduced quantitative, and its delay, by part of the judges made it more difficult to construct these results. In addition to this, many of them did not comprehend some orientations, which made it harder to interpret some data. This project was approved by the Commission of Ethics in Research of UFRN, report number 421.342, CAAE of number 19866413.3.0000.5537.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-01-14T19:50:38Z No. of bitstreams: 1 RafaelTavaresSilveiraSilva_DISSERT.pdf: 950062 bytes, checksum: aa5f2be0a742377ddebcabcc5c270344 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-01-18T20:40:24Z (GMT) No. of bitstreams: 1 RafaelTavaresSilveiraSilva_DISSERT.pdf: 950062 bytes, checksum: aa5f2be0a742377ddebcabcc5c270344 (MD5) / Made available in DSpace on 2016-01-18T20:40:24Z (GMT). No. of bitstreams: 1 RafaelTavaresSilveiraSilva_DISSERT.pdf: 950062 bytes, checksum: aa5f2be0a742377ddebcabcc5c270344 (MD5) Previous issue date: 2014-12-16 / A S?ndrome da Imunodefici?ncia Adquirida (AIDS), considerada na atualidade uma doen?a de car?ter cr?nico devido ao advento do tratamento com antirretrovirais (TARV), traz aos indiv?duos que vivem com essa doen?a dificuldades relacionadas ? conviv?ncia social e ? adapta??o ? nova condi??o cl?nica e ?s rotinas impostas pelo tratamento. Essa realidade causa forte impacto na vida dessas pessoas que, no intuito da superar tais obst?culos, utilizam estrat?gias de enfrentamento, o Coping. Nesse contexto, objetivou-se neste estudo caracterizar o perfil sociodemogr?fico, cl?nico e de h?bitos de vida de pessoas vivendo com AIDS e analisar as estrat?gias de enfretamento utilizadas frente ? situa??o da doen?a, segundo vari?veis sociodemogr?ficas, cl?nicas e h?bitos de vida. Trata-se de um estudo transversal com abordagem quantitativa. A amostra foi composta por 331 pessoas cadastradas no ambulat?rio do Hospital Giselda Trigueiro (HGT), situado em Natal/RN, que possu?am agendamento para consulta m?dica ambulatorial no per?odo de janeiro a agosto de 2014. A pesquisa obteve parecer favor?vel do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte com o Certificado de Apresenta??o para Aprecia??o ?tica (CAAE), n? 16578613.0.0000.5537. A coleta de dados foi realizada atrav?s de entrevista estruturada e do Invent?rio de Estrat?gias de Enfrentamento de Folkman e Lazarus (IEEFL). Os dados da caracteriza??o social demonstraram predomin?ncia de homens (52%), jovens (42%), procedentes da capital (58%), cor parda (53%), solteiro (56%), heterossexuais (79%), pobres (68%). Em rela??o aos aspectos cl?nicos, verificou-se que a maioria realizou o primeiro exame anti-HIV h? menos de cinco anos (60%), tiveram sinais e sintomas da AIDS antes do exame (90%), foram internados (90%), iniciaram o TARV h? menos de cinco anos (60%), julgam ter bom conhecimento sobre a doen?a (75%) e acreditam que sua sa?de melhorou (92%). Relativamente aos h?bitos de vida, evidenciou-se que a maioria n?o consumem ?lcool (71%), n?o fumam (88%) e n?o usam drogas il?citas (92%) e nunca usaram preservativos antes do diagn?stico (62%) e apenas 192 (58%) usam o c?don atualmente. No que se refere ao Coping houve maior refer?ncia dos modos focados na emo??o, embora a resolu??o de problema tenha sido o segundo mais frequente. Os escores m?dios das mulheres, dos trabalhadores, dos religiosos e dos que nunca abandonaram o tratamento foram mais elevados para todos os fatores. Ter companheiro, morar com familiares e apoio no tratamento apresentaram maiores escores m?dios para v?rios fatores, coincidindo no confronto, afastamento e suporte social. Quanto ao lazer e a pr?tica de exerc?cios f?sicos, tamb?m predominou os modos focados na emo??o assim como foi observado na correla??o entre o tempo de tratamento, escolaridade e renda familiar e os fatores do IEEFL, embora com intensidade fraca. O perfil da popula??o estudada confere com as caracter?sticas nacionais, sugerindo feminiliza??o, interioriza??o, pauperiza??o, heterossexualiza??o, aumento da contagem de c?lulas CD4 e redu??o da carga viral durante o tratamento e a manuten??o de h?bitos de vida saud?veis. As estrat?gias de enfrentamento mais utilizadas foram as focadas na emo??o. Nesse contexto, entende-se que a identifica??o dessas estrat?gias pode facilitar o planejamento da assist?ncia, favorecendo a adapta??o dessas pessoas aos estressores frente ? situa??o da doen?a / The Acquired Immune Deficiency Syndrome (AIDS), considered today one chronic nature of the disease due to the advent of antiretroviral therapy (TARV), brings to individuals living with this disease, difficulties related to social interaction and adaptation to new physical condition and the routines imposed by the treatment. This reality has a strong impact on the lives of these people in order of overcoming them use coping strategies, Coping. In this context, the aim of this study was to characterize the epidemiological, clinical and life habits of people living with AIDS and analyze the coping strategies used with the situation of the disease, according to sociodemographic, clinical and life habits. This is a cross-sectional study with a quantitative approach. The sample consisted of 331 people registered at the clinic of the Hospital Giselda Trigueiro (HGT), located in Natal / RN, who had scheduling for outpatient medical consultation from January to August 2014. The study was approved by the Ethics Committee the Federal University of Rio Grande do Norte with the Presentation of Certificate for Ethics Assessment (CAAE), paragraph 16578613.0.0000.5537. The data of social characterization showed predominance of men (52%), young people (42%) coming from the capital (58%), mulatto (53%), single (56%), heterosexual (79%), poor (68 %). With regard to clinical aspects it has been found that most held the first HIV testing for less than five years (60%) had signs and symptoms of AIDS before the examination (90%) were hospitalized (90%) started ART for less than five years (60%) believe they have good knowledge of the disease (75%) and believe that their health has improved (92%). For lifestyle, it became clear that most do not consume alcohol (71%), do not smoke (88%) and do not use illicit drugs (92%) and never used condoms before diagnosis (62%) and only 192 (58%) use the currently codon. With regard to the reference was higher coping focused modes of emotion, although the problem solving has been the second most common. The mean scores of women, workers, religious and never abandoned the treatment were higher for all factors. Having a partner, living with family members and support in the treatment had higher average scores for various factors, coinciding in the confrontation, withdrawal and social support. As for the leisure and physical exercise also dominated the modes focused on emotion as was seen in the correlation between the time of treatment, education and family income and IEEFL factors, although with low intensity. The profile of the study population confers with national characteristics, suggesting feminization, internalization, pauperization, heterosexual, increased CD4 cell count and viral load reduction during treatment and maintaining healthy lifestyle habits. Coping strategies used were more focused on emotion. In this context, it is understood that the identification of these strategies can facilitate care planning, encouraging such persons to adapt to stressors with the situation of the disease