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?lcera de press?o em pacientes internados em um hospital universit?rio em Natal/RN: condi??es predisponentes e fatores de riscoPaiva, Lucila Corsino de 28 April 2008 (has links)
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Previous issue date: 2008-04-28 / The pressure ulcers (PU), also known as decubitus ulcers, are defined as injuries caused by the constant pressure exerted on a particular point of the body, causing impairment of blood supply with a decrease or interruption of tissue irrigation, causing occlusion of blood vessels and capillaries, ischemia and cell death. This is a descriptive study with longitudinal design, and panel type, with quantitative approach that aimed to examine the association between predisposing conditions (PC), intrinsic factors (IF) and
extrinsic factors (EF) with the occurrence of PU, in hospitalized patients in the Intensive Care Unit (ICU), pain clinical, surgical clinical and neurology wards of a university
hospital. The study population was composed of all patients who were restricted to bed during the period from December 2007 to February 2008. The study was approved by
the Ethics Committee of HUOL / UFRN (No 135/07). The data-collection took place through a structured formulary of observation, data from medical records and physical
examination of patients skins. The results were organized in SPSS 15.0 software, tabulated, categorized and analyzed by descriptive and inferential statistics. Of the 30
patients studied, 43.3% had been hospitalized in the pain clinical and surgical clinic wards, 20.0% in the ICU, 20.0% in the ICU / ward and 16.7% in neurology, being the
length of hospitalization in those units of 7 to 18 days (63.3%) and from 19 to 30 days (36.7%), predominantly female and aged ≥ 60 years (60.0%). 19 PU were diagnosed in
43.3% of patients monitored, being 38.5% with one PU between 7 to 18 days and 46.2% with two or more between 19 to 30 days of hospitalization, showing significant
relationship (ρ-value = 0029) between length of hospital stay and the number of PU. Was found an association of 35.7% of the PC (cardio-respiratory, hematological,
metabolic and psychogenic), IF (age group, oedema, skin changes in humidity and change of body temperature) and EF (type of mattress and strength of body pressure) for all patients studied, statistically significant (ρ-value = 0001), between the average scores in patients with and without PU, with reason chance to 12.0 for the development of PU and there was moderate correlation ( r = 0618) in the presence of this association. Results show the influence of the multiplicity of factors and conditions on the occurrence of PU, which brings us to reflect on the assistance focused on prevention and reduction of these injuries which will encourage the reduction of hospitalization length, physical and psychological suffering, and the possibility of improving the clinical condition of the patient. / As ?lceras de press?o (UP), denominadas tamb?m ?lcera de dec?bito, s?o definidas como les?es causadas pela constante press?o exercida sobre um determinado ponto do corpo, ocasionando comprometimento do aporte sangu?neo com diminui??o ou interrup??o da irriga??o tissular, ocasionando oclus?o de vasos e capilares, isquemia e morte celular. Trata-se de um estudo descritivo com delineamento longitudinal, tipo painel, com abordagem quantitativa que objetivou analisar a associa??o existente entre condi??es predisponentes (CP), fatores intr?nsecos (FI) e fatores extr?nsecos (FE) com a ocorr?ncia de UP, em pacientes internados em Unidade de Terapia Intensiva (UTI), enfermarias de cl?nicas m?dica, cir?rgica e neurologia de um hospital universit?rio. A popula??o do estudo foi composta por todos os pacientes que estiveram acamados durante o per?odo de dezembro de 2007 a fevereiro de 2008. O estudo foi aprovado pelo Comit? de ?tica do HUOL/UFRN (no 135/07). A coleta de dados realizou-se por meio de um formul?rio estruturado de observa??o, dados dos prontu?rios e exame f?sico da pele dos pacientes. Os resultados foram organizados no programa SPSS 15.0, tabulados, categorizados e analisados por meio de estat?stica descritiva e inferencial. Dos 30 pacientes pesquisados, 43,3% encontravam-se internados na enfermaria de cl?nica m?dica e cl?nica cir?rgica, 20,0% na UTI, 20,0% na
UTI/enfermaria e 16,7% na neurologia, sendo o tempo de interna??o nessas unidades de 7 a 18 dias (63,3%) e de 19 a 30 dias (36,7%), com predomin?ncia do sexo feminino
e faixa et?ria ≥ 60 anos (60,0%). Foram diagnosticadas 19 UP em 43,3% dos pacientes acompanhados, 38,5% com uma UP entre 7 a 18 dias e 46,2% com duas ou mais entre 19 a 30 dias de interna??o, mostrando rela??o significativa (ρ-valor = 0,029) entre tempo de interna??o e o n?mero de UP. Verificou-se associa??o de 35,7% das CP
(cardio-respirat?rias, hematol?gicas, metab?licas e psicog?nicas), FI (faixa et?ria, edema, altera??o na umidade da pele e altera??o da temperatura corporal) e FE (tipo
de colch?o e for?a de press?o do corpo) no conjunto dos pacientes pesquisados, estatisticamente significante (ρ-valor = 0,001), entre as m?dias dos escores nos
pacientes com e sem UP, com raz?o de chance de 12,0 de desenvolvimento de UP e exist?ncia de moderada correla??o (r = 0,618) na presen?a dessa associa??o. Os resultados denotam a influ?ncia da multiplicidade de fatores e condi??es na ocorr?ncia de UP, o que nos remete a refletir acerca da assist?ncia voltada para preven??o e diminui??o dessas les?es o que ir? favorecer a redu??o do tempo de internamento, sofrimento f?sico e psicol?gico, bem como a possibilidade de melhora do estado cl?nico do paciente.
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Fim do mundo: o imagin?rio coletivo da equipe de enfermagem sobre a gesta??o interrompida / End of the world: the collective imaginary of the nursing team about interrupted pregnancyTachibana, Miriam 23 February 2011 (has links)
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Previous issue date: 2011-02-23 / Pontif?cia Universidade Cat?lica de Campinas / The occurrence of a pregnancy s interruption requires not only medical and hospital care, but also emotional support, aiming at the patient s welfare and her ability to welcome other babies that she may have in the future. During hospitalization, the patient is under the care of an obstetrical nursing staff and therefore her experiences are affected by the attitudes and behaviors of these professionals. Thus, our project has the objective of investigating the collective imaginary of the obstetrical nursing staff towards the patient who has miscarried. We conducted individual interviews with sixteen professionals from an obstetrics clinic of a university hospital, using the Procedure Drawings-Story with Theme as dialogue mediator. After each interview, psychoanalytic narratives were written and were considered psychoanalytically together with the drawings-stories of the participants, aiming to capture interpretive fields of affective-emotional sense. We captured patterns denominated "End of the World", "Eternal emptiness" and "Monstrosity", which allows the perception that, in the collective imaginary, the interrupted pregnancy is perceived as a phenomenon humanly unacceptable, that would present apocalyptic traits associated with the evil and harmful motivations towards the pregnant patient. The overall picture shows that the nursing staff, as a human collective, might face difficulties in adopting and sustaining supportive behavior to this type of patient. This situation may be overcome only if the instruction and enlightenment of these professionals is supplemented with clinic psychological care that will allow them to perform their tasks more calmly and maturely / A ocorr?ncia de interrup??o da gesta??o demanda n?o apenas atendimento m?dico - hospitalar, mas tamb?m sustenta??o emocional, tendo em vista tanto o bem estar imediato da mulher, como a possibilidade de acolhimento a outros beb?s que possa ter futuramente. Durante a interna??o, a mulher permanecer? sob cuidados da equipe de enfermagem obst?trica, de modo que suas viv?ncias ser?o, em certa medida, afetadas pelas atitudes e condutas destes profissionais. Assim, justifica-se a proposta de investigar o imagin?rio coletivo da equipe de enfermagem obst?trica sobre a mulher que sofreu interrup??o da gesta??o. Realizamos entrevistas individuais com dezesseis profissionais de um servi?o de Obstetr?cia de um hospital universit?rio, fazendo uso do Procedimento de Desenhos-Est?rias com Tema como recurso mediador-dial?gico. Ap?s cada entrevista, foram redigidas narrativas psicanal?ticas que, juntamente com os desenhos-est?rias das participantes, foram considerados psicanaliticamente, visando a capta??o interpretativa de campos de sentido afetivo-emocional. Foram captados campos denominados Fim do mundo , Vazio eterno e Monstruosidade , que permitem a percep??o da vig?ncia de um imagin?rio coletivo no qual a gravidez interrompida ? concebida como um fen?meno humanamente inaceit?vel, que apresentaria contornos apocal?pticos, associados ? atribui??o de motiva??es maldosas e nefastas ? pr?pria gestante. O quadro geral evidencia que a equipe de enfermagem, como coletivo humano, provavelmente enfrentar? dificuldades na ado??o de condutas solid?rias e sustentadoras diante deste tipo de paciente. Esta situa??o poder? ser superada apenas se a instru??o e o esclarecimento das profissionais puderem ser complementados com aten??o psicol?gica cl?nica, que lhes permita exercer suas tarefas de modo mais tranq?ilo e amadurecido.
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Avalia??o dos clientes externos de um hospital sobre a qualidade dos servi?os de enfermagemFerreira, Paulo Henrique da Cruz 29 October 2015 (has links)
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Previous issue date: 2015 / RESUMO
Estudo de car?ter quantitativo e descritivo, que objetivou avaliar a qualidade da assist?ncia de
enfermagem e a satisfa??o do cliente externo de um hospital p?lo, refer?ncia para a regi?o
ampliada de sa?de. Para coleta de dados utilizou-se o instrumento adaptado e validado no
Brasil, intitulado de Instrumento de Satisfa??o do Paciente (ISP). An?lises descritiva e
univariada foram conduzidas. Dentre os clientes 53,4% era do sexo masculino, 43% com
ensino fundamental incompleto, 52,9% casados, m?dia de idade de 53,3 anos, m?dia de
interna??o hospitalar de 6,4 dias, 51,1% era a primeira interna??o na institui??o. Os resultados
apontaram que na avalia??o dos tr?s dom?nios, percebemos que os clientes externos relataram
satisfa??o com o cuidado de enfermagem recebido uma vez que obtivemos uma m?dia total
de 3,7%, sendo que o dom?nio profissional foi o melhor avaliado seguido respectivamente
pelos dom?nios de confian?a e educacional. Esperamos que tais resultados forne?am
ferramentas para subsidiar a gest?o do servi?o de enfermagem da institui??o e forne?a
subs?dios para a melhoria no processo de trabalho. / Disserta??o (Mestrado) ? Programa de P?s-gradua??o em Ensino em Sa?de, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2015. / ABSTRACT
Study of exploratory and descriptive character, which aimed to evaluate the quality of nursing
care and outpatient satisfaction of a pole hospital, a reference to the expanded health region.
For data collection we used the adapted and validated instrument in Brazil, entitled Patient
Satisfaction Instrument (PSI). Descriptive and univariate analyzes were conducted. Among
the customers 53.4% were male, 43% had not completed elementary school, 52.9% married,
average age 53.3 years, mean hospital stay of 6.4 days, 51.1% was the first hospitalization at
the institution. The results show that the assessment of the three domains, we realize that
external clients reported satisfaction with nursing care received since obtained an overall
average of 3.7%, and the professional domain was the best evaluated followed respectively by
domain confidence and educational. We hope that these results provide tools to subsidize the
management of the institution's nursing service and provide subsidies to improve the work
process.
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Assist?ncia a mulher com c?ncer de mama em um cenro de refer?ncia no Estado da Para?baSantos, Joselito 27 April 2012 (has links)
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Previous issue date: 2012-04-27 / The assistance to women who have breast cancer is studied in a Reference Center in Paraiba
and also the way this assistance is performed in a School Hospital maintained by SUS
(Single Health System) is questioned. Breast cancer demands institutional organization,
provision of financial, material and human resources, requiring, from the health system,
effective assistance with new technologies which make it possible for the population their
access to specialized medical services although it not always is able to guarantee those
services nor the rights which the legislation granted them, inhibiting a proper relationship
between the health professional and the patient. The theme is discussed through a transdisciplinary
knowledge view and has as its theoretical referential the contribution of
classical and contemporary authors from the human and social sciences and, as an empirical
research strategy, the structured interview. The objectives of the research were: identify
how the assistance to women with breast cancer is carried on at a Reference Center on
Oncology in Campina Grande, Paraiba, identifying their difficulties and their satisfaction
with the received assistance; draw up a profile of the women with breast cancer who were
assisted in this Reference Center; understand their gynecological and obstetric antecedents,
life styles, age group and stage of the disease when the treatment started; check their
knowledge about their rights and which benefits they had received. Most women ranged
between 40 and 59 years old (63%), which corresponds to the risk range of developing
breast cancer. As to their occupations, 38.3% were housewives and 30.1% retired, whose
family income was among those who received between less than a minimum salary and one
minimum salary (58.2%). This population was mainly constituted of married women
(60.2%), whose most frequent schooling was an incomplete elementary school (27.6%) and
complete elementary school (24.1%), which added up to 51.6%. It was observed that the
majority of the women seemed to be satisfied with the assistance received, noting that a
minimum care was enough to define this satisfaction, although it is perceived that the access
to the health system does not ensure the ideal attention conditions they need; it was verified
that the availability of the services and the assistance itself are seen (in the local culture) as a
favor and not as a right. It is also observed that only 30% of the women mentioned that they
knew about their rights and the most mentioned ones were the disease assistance (13%), the
medicines (13%) and the treatment (12%), which represent the most important triad to face
the disease and around which the oncologic assistance most focus on. It is concluded that the
condition of the users? minimum existential of a public health unit and the condition of
belonging to a lower social stratum were variables that influenced the respondents?
satisfaction in relation to the assistance received but the importance of the Reference Center
for the women with breast cancer?s assistance for the whole region cannot be denied as well
as the need to broaden the way the policy of the oncologic assistance in Brazil in the local
realm is seen / Estuda-se a assist?ncia a mulheres com c?ncer de mama, em um Centro de Refer?ncia da
Para?ba, indagando-se como se d? a assist?ncia em oncologia, oferecida por um Hospital-
Escola, que o mant?m atrav?s do Sistema ?nico de Sa?de (SUS). O c?ncer de mama exige
organiza??o institucional, provimento de recursos materiais, humanos e financeiros,
demandando ao sistema de sa?de assist?ncia eficiente e com novas tecnologias que
possibilitem o acesso da popula??o aos servi?os m?dicos especializados, mas nem sempre
consegue garantir esses servi?os, nem os direitos que a legisla??o conferiu ? popula??o,
inibindo a adequada rela??o entre sistema de sa?de, profissional e paciente. Discute-se o
tema em uma vis?o transdisciplinar do conhecimento, tendo como referencial te?rico aportes
de autores cl?ssicos e contempor?neos das ci?ncias humanas e sociais em sa?de e, como
estrat?gia de pesquisa emp?rica, a entrevista estruturada. Delimitaram-se como objetivos:
identificar como ? realizada a assist?ncia a mulheres com c?ncer de mama em um Centro de
Refer?ncia em Cancerologia, no munic?pio de Campina Grande, PB, identificando suas
dificuldades e satisfa??o com a assist?ncia recebida; elaborar o perfil das mulheres com
c?ncer de mama assistidas nesse Centro; conhecer seus antecedentes ginecol?gicos e
obstetr?cios, estilos de vida, faixa et?ria e est?gio da doen?a quando iniciou o tratamento;
verificar seus conhecimentos acerca dos seus direitos e quais os benef?cios recebidos. A
maioria das mulheres encontrava-se na faixa et?ria entre 40 e 59 anos (63,1 %),
correspondente ? faixa de risco para desenvolvimento do c?ncer de mama. Quanto ?
ocupa??o, 38,3 % eram do lar e 30,1 % aposentadas, cuja renda familiar se concentrava
entre aquelas que ganhavam menos de um sal?rio e um sal?rio m?nimo (58,2 %). Essa
popula??o era constitu?da em sua maioria por mulheres casadas (60,2 %), com n?vel de
escolaridade mais frequente no ensino fundamental incompleto (27,6 %) e fundamental
completo (24,1 %), perfazendo um total de 51,6 %. Constatou-se que a maioria das
mulheres mostrou-se satisfeita com a assist?ncia recebida, observando-se que um m?nimo de
cuidado lhes foi suficiente para definir essa satisfa??o, embora se perceba que o acesso ao
sistema de sa?de n?o garante as condi??es ideais para a aten??o de que necessitam; constatase
que a disponibilidade de servi?os e de atendimento ? vista (na cultura local) como favor e
n?o como direito. Observa-se ainda que apenas 30 % das mulheres mencionaram conhecer
os seus direitos, sendo os mais citados o aux?lio doen?a (13 %), o medicamento (13 %) e o
tratamento (12 %), que se apresentam como a tr?ade mais importante para o enfrentamento
da doen?a, e em torno dos quais mais se foca a assist?ncia ?s mulheres no ?mbito da
assist?ncia oncol?gica. Conclui-se que a condi??o de m?nimo existencial das usu?rias de
uma unidade p?blica de sa?de e a condi??o de pertencimento a um baixo estrato social
foram vari?veis que influenciaram a satisfa??o das entrevistadas com rela??o ? assist?ncia
recebida, mas n?o se pode negar a import?ncia do Centro de Refer?ncia para a assist?ncia ?s
mulheres com c?ncer de mama para toda a regi?o, bem como a necessidade de se ampliar o
olhar em torno da pol?tica de assist?ncia oncol?gica no ?mbito local
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