Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-21T21:50:00Z No. of bitstreams: 1 DalvaCezarDaSilva_TESE.pdf: 3335341 bytes, checksum: 675b0da6bffd6736231d5bb47989ac13 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-23T20:52:50Z (GMT) No. of bitstreams: 1 DalvaCezarDaSilva_TESE.pdf: 3335341 bytes, checksum: 675b0da6bffd6736231d5bb47989ac13 (MD5) / Made available in DSpace on 2018-02-23T20:52:50Z (GMT). No. of bitstreams: 1 DalvaCezarDaSilva_TESE.pdf: 3335341 bytes, checksum: 675b0da6bffd6736231d5bb47989ac13 (MD5) Previous issue date: 2017-12-13 / A pesquisa teve como objetivo avaliar a percep??o do suporte familiar e qualidade de vida de idosos com ?lcera venosa atendidos na Aten??o Prim?ria ? Sa?de. Estudo anal?tico com abordagem quantitativa, realizado em Santa Maria, Rio Grande do Sul, Brasil. Participaram 40 idosos atendidos nas unidades de sa?de, no per?odo de agosto a dezembro de 2016. Na coleta de dados utilizaram-se os instrumentos: formul?rio para caracteriza??o sociodemogr?fica, de sa?de, cl?nica e assistencial; o Charing Cross Venous Ulcer Questionnaire (CCVUQ) e o Invent?rio da Percep??o de Suporte Familiar (IPSF). Utilizou-se da estat?stica descritiva e inferencial, testes Qui-Quadrado, Exato de Fischer, Mann-Whitney e correla??o de Spearmann, considerando n?vel de signific?ncia estat?stica de ?-valor ? 0,05. O projeto de pesquisa foi aprovado pelo Comit? de ?tica em Pesquisa da Universidade proponente, (Processo n?mero 1.670.636 e Certificado de Apresenta??o para Aprecia??o ?tica 58255016.0.0000.5346). Houve predom?nio do sexo feminino, faixa et?ria dos 70 anos ou mais, sem companheiro, aposentados, com doen?as cr?nicas associadas, sono maior de seis horas/dia e presen?a de dor. Referiam como local predominante para a realiza??o do curativo o servi?o de sa?de (n=34, 85,0%), n?o faziam uso de terapia compressiva (n=24, 60,0%), os que faziam utilizavam bota de Unna (n=16, 40,0%). O Escore Total do CCVUQ apresentou mediana 43,9, para a avalia??o da qualidade de vida geral dos participantes; e nos dom?nios Intera??o Social (27,9), Atividades Dom?sticas (29,9), Est?tica (44,7) e Estado Emocional (57,4). Quanto ? percep??o do Suporte familiar, os idosos classificaram como Alto Suporte. Afetivo-Consistente foi 67,5%, com m?dia de 33,40(?11,29); Adapta??o familiar, o percentual de alto foi de 45,0%, com m?dia de 20,97(?6,42) e Autonomia foi de 70,0%, com m?dia de 14,65(?2,36). As vari?veis sociodemogr?ficas e de sa?de n?o apresentam associa??es significativas com os dom?nios do CCVUQ e IPSF. Sobre a qualidade de vida constatou-se diferen?a significativa da vari?vel cl?nica dor em rela??o aos dom?nios Atividades Dom?sticas (p=0,048), Estado Emocional (p=0,034) e Escore Total (p=0,022). Apresentaram diferen?a significativa as vari?veis assistenciais: quem realiza o curativo com Estado Emocional (p=0,045); uso de terapia compressiva com Atividades Dom?sticas (p=0,031); e n?mero de consultas com os dom?nios Intera??o Social (p=0,033), Atividades Dom?sticas (p=0,033), Estado Emocional (p=0,025) e Escore total (p=0,030). Quanto ao Suporte familiar, encontraram-se associa??es significativas entre as vari?veis cl?nicas: recidiva com o Suporte Total (p=0,031); tempo da ?lcera venosa atual em anos com os dom?nios Afetivo-Consistente (p=0,003) e Total (p=0,022), dor com o dom?nio Autonomia (p=0,041), sinais de infec??o com Suporte Total (p=0,044). Entre as vari?veis assistenciais: Tempo de tratamento em anos com o dom?nio Afetivo-Consistente (p=0,021). Uso de terapia compressiva com os dom?nios Afetivo-Consistente (p=0,002) e Total do Suporte (p=0,002). Verificaram-se correla??es negativas e significativas do suporte familiar na qualidade de vida em idosos com ?lcera venosa, entre Afetivo-Consistente e o escore total do CCVUQ (r=-0,323; p=0,042), o dom?nio Atividades Dom?sticas (r=-0,350; p=0,027) e Estado Emocional (r=-0,424; p=0,006). Entre Adapta??o Familiar e Estado Emocional (r=-0,443; p=0,004). Da mesma maneira, entre Autonomia e o escore total do CCVUQ (r=-0,514; p=0,001), o dom?nio Intera??o Social (r=-0,362; p=0,022), Atividades Dom?sticas (r=-0,513; p=0,001), Est?tica (r=-0,478; p=0,003) e Estado Emocional (r=-0,478; p=0,002). A qualidade de vida do idoso com ?lcera venosa foi mais comprometidas nos dom?nios Estado emocional e Est?tica. Aceita-se a hip?tese alternativa que o suporte familiar se correlaciona com a qualidade de vida em idosos com ?lcera venosa atendidos na Aten??o Prim?ria ? Sa?de. Necessitam-se a??es de promo??o e reabilita??o da sa?de do idoso, com enfoque na din?mica familiar, a fim de promover a autonomia e o conv?vio social para melhora da qualidade de vida. / This research aimed to evaluate the perception of family support and quality of life of elderly patients with venous ulcers treated at the primary health care. Analytical study with a quantitative approach held in Santa Maria, Rio Grande do Sul, Brazil. The study included 40 elderly attended in health units in the period from August to December, 2016. Data collection used these instruments: Form for the sociodemographic characterization, heath, clinical and care; Charing Cross Venous Ulcer Questionnaire (CCVUQ) and the Family Support Perception Inventory (IPSF). It was used descriptive and inferential statistics, used the chi-square test, Fisher's exact test, Mann-Whitney, and was Spearman correlation, considering a level of significance of ?-value ? 0.05. The research project has approved by the Ethics Committee Proponent University Research, (Case number 1670636 and Presentation Certificate for Ethics Assessment 58255016.0.0000.5346). Women predominated, age 70 years or more, without a partner, retired, with chronic diseases associated, greater sleep of six hours/day and the presence of pain. They referred as the predominant place for the accomplishment of the curative the health service (n=34, 85.0%), did not use compression therapy (n=24, 60.0%), those who used Unna boot (n=16, 40.0%). The Score Total CCVUQ presented a median 43.9, to evaluate the overall quality of life of participants; and in the fields Social Interaction (27.9), Household Activities (29.9), Esthetics (44.7) and Emotional State (57.4). Regarding the perception of Family Support, the elderly classified as High Support. In the evaluated domains was found that in the affective consistent was 67.5%, with a mean of 3.40 (?11.29), in family adaptation, high percentage was 45.0% with a mean of 20.97 (?6.42) and autonomy was 70.0% with a mean of 14.65 (?2.36). Sociodemographic and health variables do not have significant associations with areas of CCVUQ and IPSF. Regarding quality of life, there was a significant difference in the clinical variable: pain in relation to domains Domestic Activities (p= 0.048), Emotional State (p= 0.034) and Total Score (p= 0.022). There were significant differences in the care variables: who performed the dressing with Emotional State (p= 0.045), use of compressive therapy with Domestic Activities (p= 0.031) and number of consultations with the Social Interaction domains (p = 0.033), Domestic Activities (p= 0.033), emotional state (p= 0.025), and total score (p= 0.030). As for family support, significant associations were found between the clinical variables: relapse with Total Support (p = 0.031); time of current venous ulcer in years with Affective-Consistent (p= 0.003) and Total (p=0.022), pain with Autonomy domain (p= 0.041), signs of infection with Total Support (p= 0.044). Between healthcare variables: treatment time in years with the domain affective-consistent (p= 0.021). Use of compressive therapy with the Affective-Consistent (p= 0.002) and Total Support (p= 0.002) domains. There were negative and significant correlations of family support in quality of life in elderly patients with venous ulcer, between Affective-Consistent and the total CCVUQ score (r = -0.323, p= 0.042), the Domestic Activities domain (r = -0.350, p = 0.027) and Emotional Status (r = -0.424, p= 0.006). Between Family Adaptation and Emotional State (r = -0.443, p = 0.004). Similarly, between Autonomy and total CCVUQ score (r = -0.514, p= 0.001), the Social Interaction domain (r = -0.362, p= 0.022), Domestic Activities (r = -0.513, p= 0.001), Esthetics (r = -0.478, p= 0.003) and emotional state (r = -0.478, p= 0.002). The quality of life of elderly patients with venous ulcers was more committed in the domains Emotional state and Esthetics. It is necessary actions to promote and rehabilitate the health of the elderly, focusing on family dynamics, in order to promote autonomy and social interaction to improve the quality of life. The alternative hypothesis is accepted that the family support is correlated in the quality of life in elderly patients with venous ulcer attended in the Primary Health Care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-22T19:29:08Z No. of bitstreams: 1 AnnaCristinaDaCruzBezerra_DISSERT.pdf: 1559083 bytes, checksum: d1906c8d5f52eaa7dd39047859b70d24 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-07T00:24:05Z (GMT) No. of bitstreams: 1 AnnaCristinaDaCruzBezerra_DISSERT.pdf: 1559083 bytes, checksum: d1906c8d5f52eaa7dd39047859b70d24 (MD5) / Made available in DSpace on 2017-03-07T00:24:05Z (GMT). No. of bitstreams: 1 AnnaCristinaDaCruzBezerra_DISSERT.pdf: 1559083 bytes, checksum: d1906c8d5f52eaa7dd39047859b70d24 (MD5) Previous issue date: 2016-08-01 / O acesso e a qualidade do cuidado na primeira inf?ncia, no contexto brasileiro da Aten??o Prim?ria em Sa?de (APS) s?o influenciados pelos princ?pios do Sistema ?nico de Sa?de (SUS) e principais pol?ticas de sa?de da crian?a, representadas pelo Estatuto da Crian?a e do Adolescente (ECA), a Pol?tica Nacional de Sa?de da Crian?a e o marco legal da primeira inf?ncia. A Estrat?gia de Sa?de da Fam?lia (ESF) tem um papel central na reorienta??o do modelo de aten??o voltado para a integralidade e melhor desempenho do cuidado infantil. O presente estudo tem como objetivo avaliar o cuidado ? sa?de da crian?a na APS, na perspectiva do acesso e da qualidade da aten??o, em oito regi?es de sa?de do Estado do Rio Grande do Norte. Foram analisados 13 aspectos essenciais do cuidado infantil, nos componentes da oferta, da busca ativa e do registro, em dois momentos hist?ricos, a partir do banco de dados da pesquisa multic?ntrica do Programa Nacional de Melhoria do Acesso e da Qualidade da Aten??o B?sica/PMAQ/AB. O PMAQ, lan?ado no ano de 2011, configura uma nova estrat?gia para melhoria assistencial atrav?s de avalia??o, coordena??o de a??es e certifica??o enfocando o trabalho de equipes de Aten??o B?sica. Trata-se de um estudo avaliativo, descritivo transversal, com abordagem quantitativa, realizada com dados secund?rios do PMAQ/AB, do primeiro e segundo ciclos do programa, realizados em 2011 a 2014. O universo desta pesquisa compreende 407 equipes de sa?de da fam?lia de 112 munic?pios do Rio Grande do Norte que fizeram parte dos dois momentos da pesquisa. A an?lise dos dados foi desenvolvida quantitativamente, atrav?s do Statistical Package for Social Sciences (SPSS?) na vers?o 22.0, com posterior linkage dos dois bancos de dados criados, um para o 1? ciclo e outro para o 2? ciclo. Realizado o linkage dos bancos, os dados foram analisados por meio do teste Mcnemar, por tratar-se de dados pareados, cujas vari?veis estudadas s?o de natureza dicot?mica (sim/n?o). Em todas as compara??es, o n?vel de signific?ncia de 5% fora utilizado (p<0,05). Os principais resultados demonstram heterogeneidades regionais, com similaridades e especificidades, com tend?ncias de amplia??o do acesso e qualidade do cuidado na primeira inf?ncia no ?mbito da APS das 8 regi?es de sa?de. Por?m, com desafios na busca ativa e na aten??o aos grupos mais vulner?veis, como crian?as prematuras, que podem ser determinantes para o crescente aumento da mortalidade neonatal. O aumento das viol?ncias e acidentes na primeira inf?ncia demonstra uma qualifica??o da APS neste registro, por?m revela a necessidade de qualifica??o da oferta e da atua??o dos profissionais de sa?de para interven??es preventivas e de promo??o da sa?de voltadas para a primeira inf?ncia no contexto familiar e comunit?rio, frente a suas realidades locais. O desempenho quanto ao acesso e qualidade do cuidado na APS, na perspectiva do PMAQ, mostra um quadro diferenciado que revela a necessidade de serem adotadas interven??es precoces e oportunas para a primeira inf?ncia, apresentadas neste estudo. / Access and quality of care in early childhood, in the Brazilian context of Primary Health Care (PHC) are influenced by the principles of the Unified Health System (SUS) and the main health policies of the child, represented by the Children and Adolescents Statute (CAS), the National Children Health Policy and the early childhood legal milestone. The Family Health Strategy (FHS) plays a central role in reorienting the model of care toward the integrity and improved performance of child care. This study aims to evaluate the health care of children in APS, from the perspective of access and quality of care in eight health regions of the State of Rio Grande do Norte. 13 essential aspects of child care were analyzed, in the components of supply, of active search and registration throughout two historical moments, from the multicenter research database of the National Program for Improving Access and Quality Primary Care / PMAQ / PC. The PMAQ, launched in 2011, sets up a new strategy for improving care through assessment, coordination of actions and certification focusing on the work of primary care teams. It is an evaluative study, cross-sectional, with a quantitative approach, performed with secondary data from PMAQ / PC, the first two cycles of the program, carried out from 2011 to 2014. The universe of this research includes 407 family care teams, from 112 municipalities of Rio Grande do Norte who were part of the two phases of the research. Data analysis was developed quantitatively through the Statistical Package for Social Sciences (SPSS) version 22.0, with subsequent linkage of the two created databases, one for the 1st cycle and one for the 2nd cycle. As data is paired, after having performed the linkage, data was analyzed using the McNemar test, whose variables are dichotomous nature (yes/no). In all comparisons, the 5% significance level was used (p <0.05). The main results demonstrate regional heterogeneities, with similarities and specificities, expanding trends of access and quality of care in early childhood within the APS of 8 health regions. However there has been challenges in the active search for and attention to the most vulnerable groups such as premature infants, which could have been decisive for the increasing neonatal mortality. The increase in violence and accidents in early childhood shows a qualification of APS on this record, but reveals the need for qualification of supply and health professionals acting for preventive interventions and health promotion focused on early childhood in the family and community context face to their local realities. The performance in access and quality of care in PHC, from the perspective of PMAQ, shows a different picture that reveals the desirability of adopting precocious and timely interventions for early childhood, presented in this study.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-22T20:38:40Z No. of bitstreams: 1 PolyanaDeOliveiraCacho_DISSERT.pdf: 1111834 bytes, checksum: f6f1f9b3f70bea4a06e693e155b649ed (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-08T23:19:15Z (GMT) No. of bitstreams: 1 PolyanaDeOliveiraCacho_DISSERT.pdf: 1111834 bytes, checksum: f6f1f9b3f70bea4a06e693e155b649ed (MD5) / Made available in DSpace on 2017-03-08T23:19:15Z (GMT). No. of bitstreams: 1 PolyanaDeOliveiraCacho_DISSERT.pdf: 1111834 bytes, checksum: f6f1f9b3f70bea4a06e693e155b649ed (MD5) Previous issue date: 2016-08-31 / O prontu?rio ? o meio de comunica??o mais utilizado em todos os n?veis de assist?ncia na ?rea de sa?de. O seu preenchimento adequado ? fundamental para as Boas Pr?ticas dos Servi?os. Apesar de sua import?ncia, o preenchimento incompleto ainda faz parte da rotina de muitas unidades de assist?ncia. O presente trabalho teve como objetivo conhecer as principais dificuldades no registro de informa??es nos prontu?rios de uma Unidade B?sica de Sa?de, no munic?pio de Natal, na percep??o dos trabalhadores da sa?de. A pesquisa foi transversal de natureza qualitativa. Os dados foram obtidos atrav?s dos registros de ?udios das reuni?es de grupo focais realizadas com dezessete profissionais respons?veis pelo preenchimento de prontu?rios na referida Unidade. A an?lise dos dados foi feita atrav?s do software de an?lise textual Alceste, com ajuda do diagrama de causa efeito. Os resultados demonstraram que os profissionais conhecem a import?ncia do prontu?rio no processo de assist?ncia ? sa?de e valorizam as informa??es para pr?tica cl?nica. As dificuldades encontradas est?o relacionadas com a falta de apresenta??o dos documentos que permitem identificar os usu?rios durante a abertura de novos prontu?rios, falhas nos registros dos sinais vitais e dados antropom?tricos, al?m do grande n?mero de consultas. A resolu??o das dificuldades relatadas depende de v?rios n?veis de gest?o, e perpassam tamb?m pela melhoria do processo de trabalho local, implementa??o de educa??o permanente e empoderamento dos usu?rios atrav?s de um acolhimento mais humanizado. / The record is the most popular means of communication at all levels of care in the health area. Its proper fulfillment is critical to the Good Practices of the Services. Despite its importance, the incomplete filling is still part of the routine of many care units. This study aimed to identify the main difficulties in the registration information in the records of a Basic Health Unit in Natal, in the perception of health workers. The research was cross qualitative. Data were collected through focus group meetings audios records held seventeen professionals responsible for completing records in that unit. Data analysis was performed using the Alceste textual analysis software, with the help of the cause and effect diagram. The results showed that the professionals know the importance of medical records in the care process to health and value information for clinical practice. The difficulties encountered are related to the lack of presentation of documents identifying users through the opening of new records, shortcomings in the records of vital signs and anthropometric data, and the large number of queries. The resolution of the difficulties reported depends on various levels of management, and also run through the improvement of local labor, implementation of continuing education and empowerment of users through a more humanized care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-09T18:44:20Z No. of bitstreams: 1 SandraMariaDaSolidadeGomesSimoesDeOliveiraTorres_TESE.pdf: 1538231 bytes, checksum: 17e4af549a877dc2b32c7b1c988997b5 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-10T18:42:56Z (GMT) No. of bitstreams: 1 SandraMariaDaSolidadeGomesSimoesDeOliveiraTorres_TESE.pdf: 1538231 bytes, checksum: 17e4af549a877dc2b32c7b1c988997b5 (MD5) / Made available in DSpace on 2017-03-10T18:42:56Z (GMT). No. of bitstreams: 1 SandraMariaDaSolidadeGomesSimoesDeOliveiraTorres_TESE.pdf: 1538231 bytes, checksum: 17e4af549a877dc2b32c7b1c988997b5 (MD5) Previous issue date: 2016-09-30 / Objetivo: Analisar a associa??o dos aspectos sociodemogr?ficos, cl?nicos e assistenciais na qualidade de vida das pessoas com ?lcera venosa (UV) na aten??o prim?ria. M?todo: Estudo anal?tico e transversal conduzido na aten??o prim?ria ? sa?de com 101 pessoas com UV. Os dados foram coletados por formul?rio estruturado de medidas sociodemogr?ficas e biofisiol?gicas e o Medical Outcomes Short-Form Health Survey (SF-36). Aplicados os testes Qui-quadrado, Friedman, U de Mann-Whitney e Regress?o Log?stica Bin?ria. Obteve aprova??o por Comit? de ?tica em Pesquisa (CAAE n? 07556312.0.0000.5537). Resultados: A popula??o estudada era composta em sua maioria por mulheres, idosos, casados ou com uni?o est?vel, com baixa renda e n?vel de escolaridade. Entre os idosos, predominaram pessoas do sexo feminino (p=0,011), com companheiro(a) (p=0,025), escolaridade at? ensino fundamental (p=0,016), sem profiss?o (p<0,001), n?o etilistas (p=0,029), com diabetes mellitus (p=0,002) e hipertens?o arterial sist?mica (p=0,001). Quanto aos aspectos de sa?de e assistenciais, houve tend?ncia de piores resultados entre os idosos, com predom?nio de indiv?duos com assist?ncia inadequada. As vari?veis faixa et?ria, sono, intensidade e presen?a da dor, tempo de les?o, orienta??o de exerc?cios regulares, orienta??es para terapia compressiva, tempo de tratamento e refer?ncia e contrarefer?ncia colaboraram para pior QV, juntas, as vari?veis sono, presen?a e intensidade da dor e orienta??o para exerc?cios f?sicos explicam pior qualidade de vida. Conclus?o: os pesquisados em sua maioria eram idosas, sem ocupa??o, com companheiro, baixa renda, comorbidades, tempo de les?o superior a um ano, recidivas e dor presente. Evidenciou-se necessidade de cuidado integral ?s pessoas com ?lcera venosa, em especial aos idosos. Os aspectos sociodemogr?ficos, cl?nicos e assistenciais, isolados e em conjunto, estiveram associados a pior qualidade de vida, em especial, sono, dor, orienta??o de exerc?cios e refer?ncia e contrarrefer?ncia nos idosos, que devem ser reconsiderados na assist?ncia integral e multidisciplinar. / Objective: To analyze the association of sociodemographic, clinical and care aspects of quality of life of people with venous ulcers (VU) in primary care. Method: Analytical and cross-sectional study conducted in primary health care with 101 people with VU. Data were collected by structured form of sociodemographic and bio-physiological measures and the Medical Outcomes Short-Form Health Survey (SF-36). Applied the chi-square test, Friedman, Mann-Whitney U test and Binary Logistic Regression. That was approved by the Research Ethics Committee (RECs No 07556312.0.0000.5537). Results: The study population consisted mostly of women, older, married or in a stable relationship, with low income and education level. Among the elderly, predominated females (p = 0.011), with a partner (p = 0.025), education to primary education (p = 0.016), unemployed (p <0.001), non-alcoholic (p = 0.029), diabetes mellitus ( p = 0.002) and hypertension (p = 0.001). About the health and welfare aspects, there was a tendency of worse outcomes among the elderly, with a prevalence of individuals with inadequate care. The variables age, sleepiness, intensity and presence of pain, injury time, guidance for exercise, guidelines for compression therapy, treatment time and reference and counter-reference contributed to the worse quality of life. Moreover, the variables sleepiness, intensity and presence pain, and guidance for exercise, all together, explain the worst quality of life. Conclusion: The surveyed were mostly elderly, unemployed, with a partner, low income, comorbidity, the injury time was more than one year, recurrence and with presence of pain. It was evident the need for comprehensive care to people with venous ulcers, especially the elderly. The sociodemographic, clinical and care aspects, isolated and together, were associated with the worse quality of life, in particular, sleepiness, pain, guidance for exercise, and reference and counter-reference in the elderly, should be reconsidered in the comprehensive and multidisciplinary care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T23:36:52Z No. of bitstreams: 1 JanaineMariaDeOliveira_DISSERT.pdf: 1361256 bytes, checksum: d5e8f48759f866c073ff84c1e160458a (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-24T23:23:52Z (GMT) No. of bitstreams: 1 JanaineMariaDeOliveira_DISSERT.pdf: 1361256 bytes, checksum: d5e8f48759f866c073ff84c1e160458a (MD5) / Made available in DSpace on 2017-03-24T23:23:52Z (GMT). No. of bitstreams: 1 JanaineMariaDeOliveira_DISSERT.pdf: 1361256 bytes, checksum: d5e8f48759f866c073ff84c1e160458a (MD5) Previous issue date: 2016-07-29 / O processo de se pensar e fazer sa?de passou por grandes mudan?as desde a cria??o do Sistema ?nico de Sa?de, o que, consequentemente, impulsionou mudan?as nos processos de forma??o profissional em sa?de, movidas pela necessidade de ter profissionais com uma vis?o voltada para a integralidade do cuidado em sa?de. A partir dessa necessidade, a inser??o do estudante nos servi?os de sa?de passa a ser mais valorizada. Tendo assim o preceptor um papel fundamental na aproxima??o do estudante com a popula??o e o territ?rio, na consolida??o da integra??o ensino-servi?o-comunidade. Diante dessa import?ncia, esse estudo foi impulsionado a questionar quais os sentidos que levam os profissionais do servi?o a exercem a preceptoria? Eles t?m dimens?o do seu papel como articulador desse processo de integra??o? O que motiva esse profissional e quais suas fragilidades? Com essas quest?es em mente, este estudo objetivou investigar os sentidos de ser preceptor nas experi?ncias de integra??o ensino-servi?o-comunidade, a partir dos discursos dos profissionais preceptores na ESF, O estudo utilizou a abordagem qualitativa com alicerce na produ??o de sentidos presentes nos discursos dos profissionais preceptores, e tem como base te?rica a abordagem das pr?ticas discursivas no referencial construcionista e teve como atores 20 profissionais preceptores na ESF que recebem estagi?rios de gradua??es da sa?de de institui??es de ensino p?blica e privadas. Foram realizadas entrevistas semiestruturadas, posteriormente transcritas e analisadas, permitindo a constru??o dos sentidos do ser preceptor a partir de 4 eixos anal?ticos, a saber: 1. Motiva??es e potencialidades; 2. Limita??es e cr?ticas; 3. Rela??o ensino-servi?o-comunidade; e 4. Ser preceptor. Como resultados foi percebido que o preceptor exerce a fun??o de educador na sua atua??o pr?tica. Entretanto tem dificuldade de atribuir-se a fun??o de educador e, apesar de limita??es t?cnicas e educacionais, ele desempenha com compromisso a preceptoria, desejando qualifica??o e organiza??o dessa pr?tica de modo a n?o sobrecarregar seu trabalho na ESF. Percebeu-se tamb?m que o ser preceptor envolve o trabalho de articula??o ensino servi?o, mas n?o na sua dimens?o coletiva e tamb?m sem a articula??o com a comunidade e o territ?rio como contexto fundamental no processo sa?de-doen?a. Conclui-se que na luta para normaliza??o da fun??o de preceptoria ainda h? muito o que avan?ar, faz-se necess?rio, por?m, refletir sobre os caminhos a serem trilhados no enfrentamento dos obst?culos, com estudos que venham a suscitar solu??es para essa problem?tica, assim como progredir no sentido da qualifica??o do profissional preceptor para que este possa vim a cumprir essa fun??o com maior propriedade, contribuindo para o fortalecimento do SUS e reafirma??o da ESF como cen?rio para forma??o em sa?de. / Since de creation of the Health Unic System, the process of to do and to think health has been for big changes. Consequently, this drove changes on the formation process in the health, driven by need of to tue professionals with the vision to turned for the integrality of the health care. Starting from this need, the student insertion on the health services it?s more valued, where the preceptor has a fundamental paper in the aproximation between student, population and territory and in the consolidation for the integration between teaching, service and community. From that importance, this study was boosted for to question what are the feelings that lead the professionals of the service for exercised the preceptory? They are dimension for the your paper into articulation on the process of integration? Whats motivates this professiona and are they your frailties? Whith this questions on the mind, this study objected to investigate the feelings and directions from to be preceptor in the experiences for the integration between teaching, service and community, starting from the speeches of the preceptors professionals in the Family Health Strategy. This study used the qualitative approach, subatantiated in the senses productions on the speeches for the preceptors professionals and has with theoretical basis the approach of the discursive practices on the construction referential and participated 20 preceptors professionals from de Famlily Health Strategy who receive interns from the private and public graduation institutions. Were are realized interviews, transcribed and analyzed, which allowed the construction of the preceptors feelings from for 4 axes for analysis: 1. Motivations and potentialities; 2. Reviews and limitations; 3. Relationship between teaching, service and community; and 4. To be preceptor. The results showed what the preceptor has exercised your educator function in your practice, but has difficulty in to feel this function. Although for techniques and educacional limitations, plays with commitment the preceptor function and want organization and qualification of that practice for don?t overload your job in the Family Health Strategy. Besides that, the preceptor involves the articulation between teaching and service, but not in your collective dimension as well as articulation with community and territory as fundamental context in the health and disease process. This study concluded that in the struggle for standardization for the preceptor function there is so much to evolve. It?s required reflexion on the ways threshed on the obstacles, with studies that to arouse solutions for this problem, it?s required progression in the professional qualification for the preceptor exercise this function with biggest property and to contribute for the fortification of the Heath Unic System and the Family Health Strategy as scenario from health formation.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T20:58:06Z No. of bitstreams: 1 MariaValquiriaNogueiraDoNascimento_TESE.pdf: 1968707 bytes, checksum: 426f5acaf435127acdc436c73b2cb8b2 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-18T18:34:12Z (GMT) No. of bitstreams: 1 MariaValquiriaNogueiraDoNascimento_TESE.pdf: 1968707 bytes, checksum: 426f5acaf435127acdc436c73b2cb8b2 (MD5) / Made available in DSpace on 2017-04-18T18:34:12Z (GMT). No. of bitstreams: 1 MariaValquiriaNogueiraDoNascimento_TESE.pdf: 1968707 bytes, checksum: 426f5acaf435127acdc436c73b2cb8b2 (MD5) Previous issue date: 2016-12-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / A Pol?tica de Pr?ticas Integrativas e Complementares [PNPIC] foi implantada em 2006, por meio da portaria GM n? 971, contemplando as pr?ticas terap?uticas como Homeopatia, Fitoterapia, Acupuntura, Medicina Antropos?fica, Termalismo/Crenoterapia, Pr?ticas Corporais/Atividade F?sica e T?cnicas em Medicina Tradicional Chinesa, com base nos princ?pios de uma escuta acolhedora, desenvolvimento do v?nculo terap?utico, integra??o do ser humano com o meio ambiente e a sociedade, vis?o ampliada do processo sa?de-doen?a, promo??o global do cuidado humano e autocuidado. Embora n?o institu?das pela Pol?tica Nacional, as Pr?ticas Integrativas e Complementares [PIC?s] de natureza coletiva t?m crescido gradativamente nos servi?os de sa?de, em raz?o das demandas locais e das pr?prias reivindica??es da popula??o. Nesse sentido, o objetivo deste estudo consistiu em analisar a inser??o das PIC?s Grupais como estrat?gia de cuidado e aten??o integral ? sa?de na aten??o b?sica e as possibilidades de di?logo com a educa??o popular. A pesquisa teve como cen?rio as Unidades B?sicas de Sa?de [UBS] e Unidades B?sicas de Sa?de da Fam?lia [UBSF], e como participantes profissionais que realizavam PIC?s Grupais nos servi?os. Em termos operacionais, desenvolvemos a pesquisa a partir das seguintes etapas: (a) visita ? Secretaria Municipal de Sa?de [SMS]; (b) mapeamento dos equipamentos de sa?de e de profissionais da aten??o b?sica que desenvolviam atividades em PIC?s Grupais; (c) identifica??o e caracteriza??o das PIC?s Grupais; (d) realiza??o de entrevistas e rodas de conversa; (e) observa??o-participante nos grupos de PIC?s. O estudo identificou 56profissionais em sa?de que desenvolviam PIC?s Grupais, vinculados ?s seguintes categorias: 16 agentes comunit?rios de sa?de, 09 enfermeiras, 08 educadores f?sicos, 07 m?dicas, 04 nutricionistas, 03 psic?logas, 03 auxiliares de enfermagem, 03 dentistas, 02 farmac?uticos e 01 fonoaudi?logo. Dos 66 equipamentos de sa?de da aten??o b?sica contactados, 37 realizavam PIC?s Grupais, divididas em 14 modalidades, a saber: relaxamento, medita??o, yoga, tai chi chuan, grupos de suporte m?tuo, tenda do conto, grupo de prosa com mulheres, grupo de bordadeiras, grupo de idosos, grupo de caminhadas, grupo de terapia e arte, grupos de conta??o de hist?rias, terapia comunit?ria e teatro do oprimido. As PIC?s Grupais atuam com ?nfase na valoriza??o das trocas interpessoais entre profissionais e usu?rios, com um olhar integral e interdisciplinar sobre os sujeitos, de modo a garantir uma participa??o mais efetiva e o compartilhamento de saberes, elementos essenciais na produ??o da autonomia. Nessa dire??o, a educa??o popular pode ser instrumento de reorienta??o da aten??o ? sa?de e globalidade das PIC?s Grupais, com base numa perspectiva participativa, criativa, dialogada e emancipadora. / The Policy of Integrative and Complementary Practices [PNPIC - Pol?tica de Pr?ticasIntegrativas e Complementares] was implemented in 2006, through GM Administrative Rule No. 971, contemplating therapeutic practices, such as Homeopathy, Phytotherapy, Acupuncture, Anthroposophic Medicine, Thermotherapy/Cryotherapy, Body Practices/Physical Activity and Techniques in Traditional Medicine, based on the principles of a warm listening, development of the therapeutic bond, integration of the human being with the environment and society, an expanded vision of the health-disease process, global promotion of human care and self-care. Although not instituted by the National Policy, the Collective and Complementary Practices [PIC's] ? Pr?ticas Integrativas e Complementares] of collective nature have gradually grown in the health services, due to the local demands and the own demands of the population. In this sense, the objective of this study was to analyze the insertion of Integrative and Complementary Group Practices as a strategy of care and integral health care in basic care and the possibilities of dialogue with popular education. The research had as a scenario the Basic Health Units [UBS] and Family Health Basic Units [UBSF], and, as participants, professionals that carried out group PIC's in the services. In operational terms, we developed the research from the following stages: (a) mapping of health equipment and primary care professionals who developed activities in group PIC's; (b) identification and characterization of group PIC's; (c) conducting interviews and talk wheels; (d) observation-participant in groups of PIC's. The study identified 56 health professionals who develop group PIC's, linked to the following categories: 16 community health agents, 09 nurses, 08 physical educators, 07 physicians, 04 nutritionists, 03 psychologists, 03 nursing assistants, 03 dentists, 02 pharmacists and 01 phonoaudiologist. Among the 66contacted basic care health teams, 22 perform group PIC's, divided into the following modalities: relaxation, meditation, yoga, tai chi chuan, mutual aid groups, taletent, prose group with women, group of embroiderers, group of seniors, group of walks, therapy and art group, storytelling groups, community therapy and theater of the oppressed. Group PIC's work focusing onvaluing interpersonal exchanges among professionals and users, with a comprehensive and interdisciplinary view of the subjects, in order to guarantee a more effective participation and the sharing of knowledge, essential elements in the production of autonomy. In this direction, popular education can be an instrument to reorient attention to health and globality of group PIC's, based on a participatory, creative, dialogic and emancipatory perspective.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T23:08:14Z No. of bitstreams: 1 CileneNunesDantas_TESE.pdf: 2563015 bytes, checksum: b3aa845befddb2f6863a7e2507250995 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-20T20:01:01Z (GMT) No. of bitstreams: 1 CileneNunesDantas_TESE.pdf: 2563015 bytes, checksum: b3aa845befddb2f6863a7e2507250995 (MD5) / Made available in DSpace on 2017-04-20T20:01:01Z (GMT). No. of bitstreams: 1 CileneNunesDantas_TESE.pdf: 2563015 bytes, checksum: b3aa845befddb2f6863a7e2507250995 (MD5) Previous issue date: 2016-12-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Este estudo teve como objetivo desenvolver um software (prot?tipo) para consulta de enfermagem aplicada ao acompanhamento do crescimento e desenvolvimento infantil na Aten??o Prim?ria ? Sa?de, cujos objetivos espec?ficos foram construir e validar o conte?do de um instrumento de hist?rico de enfermagem para a primeira consulta e subsequente aplicada ao acompanhamento do crescimento e desenvolvimento infantil, fundamentado na Teoria das Necessidades Humanas B?sicas e na Classifica??o Internacional para as Pr?ticas de Enfermagem; propor um software (prot?tipo) para a consulta de enfermagem aplicada ao acompanhamento do crescimento e desenvolvimento infantil. Trata-se de um estudo metodol?gico para elabora??o do instrumento de consulta de enfermagem que constou de cinco fases: revis?o da literatura; estrutura??o dos instrumentos para valida??o do conte?do da consulta de enfermagem para o acompanhamento do crescimento e desenvolvimento infantil; sele??o dos ju?zes para participa??o no estudo; valida??o de conte?do do Hist?rico de Enfermagem: T?cnica de Delphi; e desenvolvimento do ambiente do Telenfermagem (software-prot?tipo) para o acompanhamento do crescimento e desenvolvimento infantil. A pesquisa seguiu os preceitos ?ticos que regem a pesquisa cient?fica com seres humanos do Conselho Nacional de Sa?de, aprovada pelo Comit? de ?tica e Pesquisa, por meio do Parecer Consubstanciado n? 925.408, de 18/12/2014, sob o n?mero CAAE 39640914.8.0000.5537. A an?lise dos dados ocorreu por estat?stica descritiva simples, atrav?s de frequ?ncias absolutas e relativa, m?dia, desvio padr?o, teste binomial e ?ndice de validade de conte?do. Os resultados foram apresentados em tr?s manuscritos: 1. Consulta de enfermagem para acompanhamento do crescimento e desenvolvimento infantil na Aten??o Prim?ria ? Sa?de: revis?o integrativa; 2. Valida??o de instrumento de hist?rico de enfermagem para o acompanhamento do crescimento e desenvolvimento infantil; 3. Software-prot?tipo para o acompanhamento do crescimento e desenvolvimento infantil na Aten??o Prim?ria ? Sa?de. O primeiro artigo, est? relacionado aos achados para caracteriza??o da consulta ? crian?a, que revelaram lacunas nesssa para o acompanhamento do crescimento e desenvolvimento infantil em virtude das limita??es relacionadas ao conhecimento te?rico e/ou pr?tico do enfermeiro na Aten??o Prim?ria ? Sa?de. O segundo artigo revela a valida??o de conte?do dos instrumentos para a primeira consulta e subsequente aplicada ? crian?a. Faz refer?ncia a utiliza??o da etapa Delphi 1, na qual oito ju?zes avaliaram os instrumentos de hist?rico de enfermagem, das etapas Delphi 2 e 3, seis. O hist?rico de enfermagem para primeira consulta e subsequente foram avaliados pelos ju?zes de acordo com o crit?rio de concord?ncia. Considerou-se v?lido em seu conte?do os instrumentos que obtiveram consenso de 80% entre os experts. O artigo 3 est? relacionado ao software, desenvolvido sobre plataforma web e apresenta os requisitos previamente estabelecidos que est?o relacionados ao sistema, resultando em atividades que est?o acess?veis para os usu?rios (administrador e enfermeiro usu?rio) cadastrados no sistema. Destarte, as conclus?es apontam que os instrumentos de hist?rico de enfermagem e software elaborados e validados possuem potencialidades e limita??es, poder?o nortear a pr?tica do enfermeiro da Estrat?gia de Sa?de da Fam?lia, oportunizar uma comunica??o mais efetiva, o empoderamento e autonomia do enfermeiro na Aten??o Prim?ria ? Sa?de. / This study aimed to develop a software (prototype) for nursing consultation applied to the monitoring of child growth and development in Primary Health Care, whose specific objectives were to build and validate the content of a nursing history instrument for the first consultation and Applied to the monitoring of child growth and development, based on the Basic Human Needs Theory and the International Classification for Nursing Practices; Propose a software (prototype) for the nursing consultation applied to the monitoring of child growth and development. This is a methodological study for the elaboration of the nursing consultation instrument that consisted of five phases: literature review; Structuring of the instruments for validation of EC content for the monitoring of children's CD; Selection of judges for participation in the study; Validation of Nursing History content: Delphi Technique; And development of the Telenfermagem environment (software-prototype) for the follow-up of the children's CD. The research followed the ethical precepts that govern the scientific research with human beings of the National Health Council, approved by the Committee of Ethics and Research, through Opinion No 925.408, of 12/18/2014, under the number CAAE 39640914.8.0000.5537 . The data analysis was performed by simple descriptive statistics, using absolute and relative frequencies, mean, standard deviation, binomial test and IVC. The results were presented in three manuscripts: 1. Nursing consultation to monitor child growth and development in Primary Health Care: integrative review; 2. Validation of a nursing history instrument for monitoring child growth and development; 3. Software-prototype for the follow-up of children's growth and development in Primary Health Care. The first article is related to the findings to characterize the child's consultation, which revealed gaps in the monitoring of children's CD due to limitations related to Theoretical and / or practical knowledge of the nurse in PHC. The second article reveals the validation of content of the instruments for the first and subsequent consultation applied to the child. It refers to the use of the Delphi 1 stage, in which eight judges evaluated the nursing history instruments of Delphi 2 and 3, 6 stages. The nursing history for the first and subsequent consultations were evaluated by the judges according to the criterion of agreement. The instruments that obtained a consensus of 80% among experts were considered valid in their content. Article 3 is related to software, developed on web platform and presents the previously established requirements that are related to the system, resulting in activities that are accessible to the users (administrator and nurse user) registered in the system. Thus, the conclusions point out that the elaborated and validated nursing and software tools have potentialities and limitations, could guide the practice of the nurse in the Family Health Strategy, provide more effective communication, nurse empowerment and autonomy in Primary Care the health.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-09-05T20:49:18Z No. of bitstreams: 1 AndrelinaAlvesMangueira_DISSERT.pdf: 917603 bytes, checksum: dab71cd720f89fabe1d383b7735b7a27 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-09-18T19:20:41Z (GMT) No. of bitstreams: 1 AndrelinaAlvesMangueira_DISSERT.pdf: 917603 bytes, checksum: dab71cd720f89fabe1d383b7735b7a27 (MD5) / Made available in DSpace on 2017-09-18T19:20:41Z (GMT). No. of bitstreams: 1 AndrelinaAlvesMangueira_DISSERT.pdf: 917603 bytes, checksum: dab71cd720f89fabe1d383b7735b7a27 (MD5) Previous issue date: 2016-08-09 / Este estudo tem como objetivo geral analisar os aspectos inerentes ? organiza??o do processo de trabalho e o planejamento das a??es das equipes de aten??o b?sica da Regi?o Nordeste no 1? e 2? ciclos do Programa de Melhoria do Acesso e da Qualidade da Aten??o B?sica (PMAQ-AB). E como objetivos espec?ficos, analisar o planejamento das a??es, as ferramentas utilizadas pelas equipes de aten??o b?sica e as a??es da gest?o para organiza??o do processo de trabalho das equipes na Regi?o Nordeste. Trata-se de uma pesquisa avaliativa realizada atrav?s de um estudo transversal e multic?ntrico com abordagem quantitativa. Os dados s?o referentes ao desdobramento da pesquisa de avalia??o externa do 1? e 2? ciclos do PMAQ ? AB na Regi?o Nordeste. Utilizou-se para a pesquisa o banco de dados do 1? e 2? ciclo do PMAQ. As vari?veis foram analisadas atrav?s da estat?stica descritiva, com uso do Software IBM SPSS Statistics 24.0 e os resultados foram organizados e agrupados em duas dimens?es: A??es da gest?o para organiza??o do processo. de trabalho das equipes e o planejamento das a??es e as ferramentas utilizadas pelas equipes. A pesquisa respeitou todos os preceitos ?ticos cab?veis tendo aprova??o pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Sul, sob o n?mero 21904 em 13 de Mar?o de 2012, estando em conson?ncia com a Resolu??o n? 166/2012, do Conselho Nacional de Sa?de. Os resultados demonstram o apoio da gest?o na organiza??o do processo de trabalho das equipes e no planejamento das a??es, disponibilizando informa??es para an?lise da situa??o, com discuss?o dos dados e monitoramento do sistema de informa??o. O estudo demonstra que as equipes de aten??o b?sica da Regi?o Nordeste, desenvolvem o planejamento das a??es e organizam o processo de trabalho, com a utiliza??o dos recursos ofertados pela gest?o, favorecendo o repensar das pr?ticas em sa?de, contribuindo para o fortalecimento da Aten??o B?sica. Realizam monitoramento e an?lise dos indicadores e informa??es de sa?de. Utilizando para o processo de autoavalia??o, o instrumento AMAQ, tanto no 1?ciclo quanto no 2? ciclo, sendo uma ferramenta de organiza??o do processo de trabalho. / This study has as general objective to analyze the aspects inherent to the organization of the work process and planning the actions of the primary care teams of the Northeast Region in the 1st and 2nd cycles of the Program for Improving Access and Quality of Basic Care (PMAQ-AB ). And as specific objectives, analyze the planning of the actions, the tools used by the primary care teams and the actions of the management to organize the work process of the teams in the Northeast Region. It is an evaluative research carried out through a cross-sectional and multicenter study with a quantitative approach. The data refers to the unfolding of the external evaluation research of the 1st and 2nd cycles of the PMAQ - AB in the Northeast Region. The PMAQ database for the 1st and 2nd cycle was used for the research. The variables were analyzed through descriptive statistics, using the IBM SPSS Statistics 24.0 Software and the results were organized and grouped into two dimensions: Management actions to organize the process. And the planning of the actions and tools used by the teams. The research complied with all ethical precepts that were approved by the Research Ethics Committee of the Federal University of Rio Grande do Sul under number 21904 on March 13, 2012, being in accordance with Resolution No. 166/2012 of the National Council The results demonstrate the support of the management in the organization of the work process of the teams and in the planning of the actions, providing information for analysis of the situation, with discussion of the data and monitoring of the information system. The study shows that the basic care teams of the Northeast Region develop the planning of actions and organize the work process, using the resources offered by management, favoring the rethinking of health practices, contributing to the strengthening of Primary Care. Conduct monitoring and analysis of indicators and health information. Using the self-assessment process, the AMAQ instrument, both in the 1st cycle and in the 2nd cycle, being a tool to organize the work process.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-10-18T21:24:04Z No. of bitstreams: 1 RosimeryCruzDeOliveiraDantas_TESE.pdf: 5591036 bytes, checksum: 13fb6a2c807443a41da890082aa5eb7e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-10-30T20:44:00Z (GMT) No. of bitstreams: 1 RosimeryCruzDeOliveiraDantas_TESE.pdf: 5591036 bytes, checksum: 13fb6a2c807443a41da890082aa5eb7e (MD5) / Made available in DSpace on 2017-10-30T20:44:00Z (GMT). No. of bitstreams: 1 RosimeryCruzDeOliveiraDantas_TESE.pdf: 5591036 bytes, checksum: 13fb6a2c807443a41da890082aa5eb7e (MD5) Previous issue date: 2017-08-16 / A Aten??o Prim?ria ? Sa?de (APS) configura-se como o primeiro contato do usu?rio com o sistema de sa?de, destacando-se com tr?s fun??es essenciais: resolutividade, comunica??o e responsabiliza??o. Apesar do seu fortalecimento, interna??es por agravos que sob sua a??o poderiam ser controlados, continuam ocorrendo, a exemplo da hipertens?o. Da? justifica-se a constru??o de um protocolo para atendimento interprofissional a hipertensos na APS. Objetivou-se construir uma estrat?gia que oriente a gest?o de um cuidado integral ao usu?rio com hipertens?o arterial assistido na APS. Para tanto realizou-se uma revis?o de integrativa, um estudo ecol?gico, um estudo de valida??o e um estudo transversal. Adotou-se, para o estudo ecol?gico e transversal, estat?stica anal?tica com regress?o linear e multivariada; para a valida??o adotou-se o m?todo Delphi, desenvolvido em 4 fases: 1. Leitura pr?via dos referenciais te?ricos, 2. Constru??o do instrumento e apresenta??o a banca de ju?zes, 3. Valida??o por Experts, 4. Reprodutibilidade. A valida??o foi analisada, utilizando uma escala de Likert, pelo ?ndice de concord?ncia (IC) entre os experts, ?ndice de Validade de Conte?do (IVC), Correla??o de Pearson; a an?lise da reprodutibilidade se deu pelos Coeficientes Kappa (?) e o de Correla??o Intraclasse (CCI). A pesquisa envolveu 20 experts (nove m?dicos e 11 enfermeiros) e 160 usu?rios hipertensos alocados por conveni?ncia. A coleta ocorreu de julho/2015 a agosto/2016. O estudo seguiu ?s recomenda??es da Resolu??o 466/2012 que trata de pesquisa com seres humanos, aprovado pelo Comit? de ?tica da Universidade Federal do Rio Grande do Norte, sob n? 1.144.406. Protocolos s?o ferramentas utilizadas para verificar ades?o ao tratamento, sua utiliza??o na gest?o de doen?as cr?nicas, seu impacto no controle da hipertens?o e a satisfa??o do usu?rio com o servi?o. As interna??es por hipertens?o se associam com o percentual de condi??es sens?veis as a??es da APS, renda e ?ndice de desenvolvimento humano. O protocolo revelou-se muito importante - Escala de Likert >4 -, O IC entre os experts foi de 98,1%, o IVC > 0,90, a correla??o de Pearson se mostrou de moderada a forte (p <0,001). Kappa de > 75 e o CCI >0,80; os fatores determinantes para o controle da press?o foram dieta hiposs?dica e interrup??o do tratamento; para a interrup??o do tratamento foram risco metab?lico, estresse e controle da press?o. Apesar da alta cobertura e resolutividade da APS as interna??es por hipertens?o continuam ocorrendo, principalmente na popula??o com vulnerabilidade social. O instrumento mostrou evid?ncias robustas de validade e confiabilidade, bem como de reprodutibilidade. Isso o torna prop?cio para sua utiliza??o na APS. Al?m de constituir-se um guia para a consulta e acompanhamento do usu?rio hipertenso, permite maior di?logo entre o profissional e o paciente. Tamb?m ? um espa?o para que os registros aconte?am de forma mais efetiva, garantindo atendimento mais personalizado, voltado para as necessidades individuais de cada um. O conhecimento dos determinantes do controle da press?o e da interrup??o do tratamento favorece o planejamento das a??es da APS. / Primary Health Care (PHC) is the first contact with the health system, highlighting three essential functions: resolution, communication and accountability. Despite its strengthening, hospitalizations for diseases that could be controlled under its action, continue to occur, such as hypertension. Hence the construction of a protocol for interprofessional care for hypertensive patients in PHC is justified. The objective was to build a strategy that guides the management of comprehensive care to the user with arterial hypertension assisted in PHC. For the ecological and cross-sectional study, we used analytical statistics with linear and multivariate regression. For the validation, the Delphi method was developed in four phases: 1. Preliminary reading of the theoretical references 2. Construction of the instrument and presentation to the judge's bench 3. Validation by Experts 4. Reproducibility. The validation was analyzed using a Likert scale, by the Index of concordance (CI) among experts, Content Validity Index (IVC), Pearson's Correlation; The reproducibility analysis was performed by Kappa (?) and Intraclass Correlation (ICC) coefficients. The research involved 20 specialists (nine physicians and 11 nurses) and 160 hypertensive users allocated for convenience. The collection occurred from July / 2015 to August / 2016. The study followed the recommendations of Resolution 466/2012 that deals with research with human beings, approved by the Ethics Committee of the Federal University of Rio Grande do Norte, under No. 1.144.406. Protocols are tools used to verify adherence to treatment, its use in the management of chronic diseases, its impact on the control of hypertension, and user satisfaction with the service. Hypertension hospitalizations are associated with the percentage of conditions that are sensitive to the actions of Primary Care, income and human development index. The protocol was very important - Likert scale> 4 -, CI among experts was 98.1%, CVI> 0.90, Pearson's correlation was moderate to strong (p <0.001). Kappa of> 75 and CCI> 0.80; The determinant factors for the control of the pressure were hyposodic diet and treatment interruption; For treatment interruption were metabolic risk, stress and pressure control. Despite the high coverage and resolution of PHC, hospitalizations for hypertension continue to occur, especially in the population with social vulnerability. The instrument showed robust evidence of validity and reliability as well as reproducibility. This makes it suitable for use in APS. In addition to constituting a guide for consultation and follow-up of the hypertensive user, it allows a greater dialogue between the professional and the patient. It is also a space for records to happen more effectively, ensuring a more personalized service, focused on the individual needs of each one. Knowledge of the determinants of pressure control and discontinuation of treatment favors the planning of PHC actions

Almost 40.000 Greeks became homeless the past 8 years due to the economic crisis. But there is still hope! This project reflects on how architecture can lead to a more humane society using democratic methods and a city’s urban strengths. It explores how volunteers, the State and the Private Sector can collaborate through competitions and win-win agreements in order to gradually transform an abandoned commercial center and landmark, MINION, into a qualitative pilot housing project with socialization space for hundreds of homeless people. This could finally lead to the revitalization of the decaying Athenian environment through a number of stages. The project has a dual purpose and the idea is very simple. On one hand the project needs to include stores and other commercial spaces that reflect the old Athenian character in order to attract the interest of the higher financial layers of Greece and invest their capital. On the other hand the State will use this capital in order to provide qualitative housing to people in need. MINION is actually turns from a ‘commercial machine’ that used to be, into a ‘social machine’. All these actions will be completed with the collaboration of the tenants of the building. / Nästan 40 000 greker har blivit hemlösa de senaste 8 åren på grund av den ekonomiska krisen. Men det finns fortfarande hopp! Detta projekt reflekterar över hur arkitektur kan leda till ett mänskligare samhälle med hjälp av demokratiska metoder och en stads urbana styrkor. Det utforskar hur volontärer, staten och den privata sektorn kan samarbeta genom tävlingar och win-win avtal genom att gradvis omvandla ett övergivet kommersiellt centrum och landmärke, MINION, till ett kvalitativt pilotbostadsprojekt med socialiseringsplats för hundratals hemlösa. Detta skulle slutligen leda till en vitalisering av den förfallande atenska miljön genom ett antal steg. Projektet har ett dubbelt syfte och tanken är mycket enkel. Å ena sidan måste projektet omfatta butiker och andra kommersiella utrymmen som återspeglar den gamla atenska karaktären för att locka de högre ekonomiska lagren i Grekland att investera sitt kapital. Å andra sidan kommer staten att använda detta kapital för att ge kvalitativa bostäder till människor i nöd. MINION förändras från en ’kommersiell maskin’ till en ’social maskin’. Alla dessa åtgärder kommer att utföras i samarbete med alla bostadsprojektets invånare.