Made available in DSpace on 2014-12-17T15:46:17Z (GMT). No. of bitstreams: 1 AdrianaMS.pdf: 1189385 bytes, checksum: 0f5e0ae771f3df54a64288a00807bc4f (MD5) Previous issue date: 2009-10-13 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The treatment for abusive users of alcohol and other drugs suffered significant modifications until arriving to the psychosocial model that is used by Centro de Aten??o Psicossocial CAPSad II Eastern Natal/RN (Psychosocial Support Center). That model appears starting from Brazilian sanitary and psychiatric reforms which are expressed in the principles and propositions of Sistema ?nico de Sa?de SUS (Unique System of Health). The Psychiatric Reform meant a rupture with the mental hospital and hospital centered treatment pattern which was destined to the abusive users of alcohol and other drugs. The new proposal offers the universalization, democratization, regionalization and completeness of the actions in the field of mental health. It gathers a strictly interdisciplinary health staff. The purpose of this study is to evaluate the effectiveness of the treatment for abusive users of alcohol and other drugs offered by CAPSad II Eastern Natal/RN. The evaluation used, as priority, the qualitative social research through an evaluating study starting from the non-experimental model. The methodological process used different instruments of data collection: bibliographical and documental researches, systematic observations at CAPSad II Eastern Natal/RN and, mainly, the semistructured interviews (21) that were accomplished with the professionals, users and relatives of CAPSad II Eastern Natal/RN. The investigation showed the effectiveness of the service and, therefore, CAPSad II Eastern Natal/RN constitute itself as the main confronting strategy to the mental hospital and hospital centered treatment pattern of caring the abusive users of alcohol and other drugs / O tratamento para usu?rios abusivos de ?lcool e outras drogas, sofreu significativas modifica??es at? chegar ao modelo psicossocial, utilizado pelo Centro de Aten??o Psicossocial para usu?rios de ?lcool e outras drogas (CAPSad II leste Natal/RN). Esse modelo surge a partir das Reformas Sanit?ria e Psiqui?trica Brasileira expressas nos princ?pios e proposi??es do Sistema ?nico de Sa?de SUS. A Reforma Psiqui?trica significou uma ruptura com o padr?o de tratamento manicomial e hospitaloc?ntrico destinado aos usu?rios abusivos de ?lcool e outras drogas. A nova proposta prop?e a universaliza??o, democratiza??o, regionaliza??o e integralidade das a??es no campo da sa?de mental. Re?ne uma equipe de sa?de necessariamente interdisciplinar. Este estudo tem como objetivo avaliar a efetividade do tratamento para usu?rios abusivos de ?lcool e outras drogas oferecido pelo CAPSad II leste Natal /RN. A avalia??o utilizou, como priorit?ria, a pesquisa social de car?ter qualitativa atrav?s de um estudo avaliat?rio a partir do modelo n?oexperimental. O processo metodol?gico utilizou diferentes instrumentos de coleta de dados: pesquisa bibliogr?fica e documental, observa??es sistem?ticas no CAPSad II leste, e, principalmente, ?s entrevistas semi-estruturadas (21) que foram realizadas com os profissionais, usu?rios e familiares do CAPSad II leste. A investiga??o apontou para a efetividade do servi?o e, portanto, o CAPSad II leste se constitue enquanto principal estrat?gia de enfrentamento ao modelo manicomial e hospitaloc?ntrico de tratar os usu?rios abusivos de ?lcool e outras drogas.

Made available in DSpace on 2014-12-17T14:46:44Z (GMT). No. of bitstreams: 1 RaionaraCAS_DISSERT.pdf: 5523923 bytes, checksum: 6dbc354dffeeccfc2f257e94b956f061 (MD5) Previous issue date: 2010-10-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The Family Health Strategy (ESF) is emerging as a possible restructuring of services and new practices of intervention in health care; it requires skilled professionals to work with that framework. Within this purpose, we established the Education Programme for Work and Health (PET-Sa?de), in order to integrate teaching and service activities, focusing on primary care. On this basis, the aim of this work is to apprehend the social representation of nurse, doctor and dentist (Project PET-Natal Health RN preceptors) on the ESF, while practice field of them. It is a descriptive and exploratory study, with a qualitative approach, carried out in 07 Family Health Units (USF) included in the PET-Sa?de Natal (RN). The population was composed of 35 professional components of the primary care team with bachelor's degree of the USF linked to this project. The sample was composed of 05 nurses, 05 physicians and 05 dentists, for a total of 15 subjects. Data were collected through three instruments: the drawing-themed story, a semi-structured individual interviews and field diary. The data relating to the identification of the subjects were entered and tabulated by the Microsoft Excel software 2007 version. The drawing analysis and interpretation is given by the significance attributed to the resource chart from title and keywords assigned by the subjects, considering the ESF as an inductive term. The stories and interviews were transcribed and typed and then subjected to read/listen the material and a lexical analysis through Alceste. After this process, the discursive material was analyzed and discussed by theoretical and methodological feature of the Social Representations theory. The majority of health professionals were female, aged between 46 and 52 years old, married, income less than six minimum wage, time since graduation ranged from 22 to 29 years and working time in the ESF range from 02 to 11 years. From the classification system ALCESTE were selected categories identified by: Category 1 - ESF: relations and territory; Category 2 - Training and bond profile; Category 3 - Working process in the ESF; Category 4 - Articulation between teaching and service; Category 5 - Health care and disease prevention. The representational field construction, while a process, followed the logic of structural cores in existing categories. In this sense, it is clear that the ESF is an environment rich in diversity, experience and relationships with potential such as the relationship "very subject-subject" and the link established between professional-community, but also has some weaknesses such as poor working conditions, lack of popular participation and management support, thus difficulties in the achievement of teamwork. Being essential to that end, the teaching-service aimed at the formation of a new health professional able to work in the ESF. In this research, the training of the representational field encountered a diversity of structural cores, or thoughts on training, about the ESF because of the greater emphasis on the here and now of the interaction between health professionals, the ESF, the community, PET Health-UFRN and students, emphasizing that such proposals are still considered as concepts in the context of recent health and that, therefore, are not fully realized in the social imaginary / A Estrat?gia de Sa?de da Fam?lia (ESF) emerge como uma possibilidade de reestrutura??o dos servi?os e de novas pr?ticas de interven??o na aten??o ? sa?de, requerendo profissionais capacitados para atuarem nesse ?mbito. Para tal, foi institu?do o Programa de Educa??o pelo Trabalho e para a Sa?de (PET-Sa?de), visando integrar a??es ensino-servi?o, com foco na aten??o b?sica. Com base nisso, definiu-se como objetivo desse trabalho apreender a representa??o social do enfermeiro, m?dico e odont?logo (preceptores do projeto PET-Sa?de Natal RN) sobre a ESF, enquanto campo de pr?tica dos mesmos. Estudo descritivo-explorat?rio, de abordagem qualitativa, realizado em 07 Unidades de Sa?de da Fam?lia (USF) que integram o PET-Sa?de Natal (RN). A popula??o foi composta por 35 profissionais das equipes b?sicas de n?vel superior das USFs vinculadas ao referido projeto. A amostra consistiu em 05 enfermeiros, 05 m?dicos e 05 odont?logos, perfazendo um total de 15 sujeitos. Os dados foram coletados atrav?s de tr?s instrumentos: o desenho-est?ria com tema, a entrevista individual semi-estruturada e o di?rio de campo. Os dados referentes ? identifica??o dos sujeitos foram digitados e tabulados pelo software Microsoft Excel vers?o 2007. A an?lise e interpreta??o dos desenhos deram-se pela significa??o atribu?da ao recurso gr?fico a partir do t?tulo e das palavras-chave atribu?das pelos sujeitos, tendo a ESF como termo indutor. As est?rias e entrevistas transcritas e digitadas foram submetidas ? leitura/escuta flutuante do material e ? an?lise l?xica do ALCESTE. Terminado esse processo, o material discursivo foi analisado e discutido mediante o recurso te?rico-metodol?gico da Teoria das Representa??es Sociais. A maioria dos profissionais era do sexo feminino, com idade entre 46 e 52 anos, casados, renda m?nima de 6 sal?rios, tempo de formado entre 22 e 29 anos e de trabalho na ESF variando de 02 a 11 anos. A partir do sistema de classifica??o do ALCESTE foram elegidas as categorias identificadas por: Categoria 1 ESF: rela??es e territ?rio; Categoria 2 Forma??o e desenho do v?nculo; Categoria 3 Processos de trabalho na ESF; Categoria 4 Articula??o ensino-servi?o; Categoria 5 Aten??o ? sa?de e preven??o de doen?as. A constru??o do campo representacional, enquanto processo, seguiu a l?gica dos n?cleos estruturantes existentes nas categorias. Nesse sentido, inferiu-se que a ESF ? um ambiente com potencialidades como a rela??o muito sujeito-sujeito e o v?nculo estabelecidos entre profissional-comunidade, mas que tamb?m apresenta algumas fragilidades como prec?rias condi??es de trabalho, falta de participa??o popular e apoio da gest?o, al?m de dificuldades na realiza??o do trabalho em equipe. Sendo imprescind?vel, para tal, a articula??o ensino-servi?o com vistas ? forma??o de um novo profissional de sa?de apto para o trabalho na ESF. Nessa pesquisa, a forma??o do campo representacional encontrou uma diversidade de n?cleos estruturantes, ou pensamentos em forma??o, acerca da ESF devido ? maior ?nfase dada ao aqui-e-agora da intera??o entre os profissionais de sa?de, a ESF, a comunidade, o PET-Sa?de e os discentes da UFRN, ressaltando-se que tais propostas ainda s?o conceitos considerados como recentes no contexto da sa?de e que, portanto, n?o est?o totalmente concretizados no imagin?rio social

Made available in DSpace on 2014-12-17T14:46:53Z (GMT). No. of bitstreams: 1 IsabelleKFC_TESE.pdf: 2724396 bytes, checksum: 3b262a5786188d2dec0fcd890fc26fd4 (MD5) Previous issue date: 2013-02-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmiss?o of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care / As pessoas com ?lcera venosa constituem-se um importante problema de sa?de p?blica, o seu tratamento ? oneroso e necessitam de uma assist?ncia prestada por profissionais capacitados, sistematizada por meio de protocolos, contudo o que se encontra na assist?ncia ? que o manejo a este grupo de pessoas difere do que ? preconizado na literatura cient?fica, interferindo na cicatriza??o da ferida e na qualidade de vida dos acometidos. Nesse sentido, a constru??o de um protocolo de assist?ncia espec?fico para pessoas com ?lcera venosa (UV) pode auxiliar os profissionais da Estrat?gia Sa?de da Fam?lia tanto na avalia??o do paciente como no estabelecimento de uma assist?ncia de qualidade. Assim, este estudo objetivou analisar a validade de um protocolo de assist?ncia multiprofissional a pessoas com ?lcera venosa na aten??o prim?ria por profissionais de sa?de mediante t?cnica Delphi. Trata-se de um estudo quantitativo, do tipo metodol?gico realizado em duas etapas: primeira etapa referente a revis?o integrativa da literatura para subsidiar a elabora??o do protocolo; em seguida, esses aspectos foram organizados e propostos aos ju?zes do estudo por meio da t?cnica Delphi. O estudo foi iniciado ap?s aprova??o do Comit? de ?tica em Pesquisa. A primeira etapa foi realizada entre agosto e setembro de 2012, na biblioteca virtual de sa?de, na p?gina da Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior, de Secretarias Municipais de Sa?de e guidelines de associa??es internacionais e na etapa subsequente realizada no per?odo de setembro de 2012 a janeiro de 2013, realizou-se busca por meio da plataforma Lattes do Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico, a fim de identificar profissionais de sa?de do Brasil que atuassem como ju?zes do instrumento e em seguida, via online, submeteu-se o formul?rio aos pesquisados. A amostra para a segunda etapa foi de 51 ju?zes na primeira rodada e de 35 para a segunda rodada Delphi. A an?lise foi feita adotando-se ?ndice Kappa ≥0,81 e ?ndice de Validade de Conte?do (IVC)>0,80. Na primeira submiss?o aos ju?zes, os itens que n?o atingiram os ?ndices Kappa e IVC estabelecidos pertenciam as categorias: solicita??o/ realiza??o/ resultados de exames, dados sociodemogr?ficos, anamnese, fatores de risco, verifica??o de dor/ sinais vitais/ pulso/ sinais de infec??o/ localiza??o da les?o/ edema e tratamento da dor. Ap?s a remo??o dos itens que n?o obtiveram os ?ndices Kappa ou IVC estabelecidos, verificou-se alcance de n?veis ?timos desses ?ndices para as categorias. Na etapa seguinte houve a ressubmiss?o do protocolo aos ju?zes por meio da t?cnica Delphi em que se verificou que, das 15 categorias do protocolo, 12 apresentaram melhores escores na fase Delphi 2 e as outras tr?s categorias mantiveram os mesmos ?ndices Kappa e IVC da fase anterior. Quanto ? m?dia dos requisitos de avalia??o do protocolo verificou-se que as notas atribu?das pelos ju?zes na segunda fase foram maiores em nove dos 10 itens, permanecendo a mesma em apenas um dos itens indicando validade do instrumento perante o consenso dos ju?zes. Assim, aceita-se a hip?tese alternativa no estudo, a medida que foram obtidos na fase Delphi 2 ?ndices de validade maiores ou iguais aos da fase Delphi1. A formula??o deste protocolo de assist?ncia v?lido pode embasar a reorganiza??o e replanejamento da assist?ncia, com padroniza??o das a??es e a continuidade da assist?ncia ?s pessoas com ?lcera venosa na aten??o prim?ria

Made available in DSpace on 2014-12-17T14:46:55Z (GMT). No. of bitstreams: 1 SamiaVOD_DISSERT.pdf: 3414201 bytes, checksum: b0c157ca8d1929daa926a1111fd70295 (MD5) Previous issue date: 2012-02-27 / This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population?s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user?s care and the promotion of family health / O presente estudo objetiva analisar e comparar os pontos de vista de profissionais, dirigentes e usu?rios sobre a aten??o ? sa?de mental na Estrat?gia de Sa?de da Fam?lia (ESF). Nessa perspectiva, caracteriza-se como uma pesquisa operacional, ou Investiga??o em Sistemas de Sa?de (ISS), com desenho transversal de car?ter descritivo quantitativo, desenvolvida a partir da aplica??o de Escala de Medida de Opini?o - EMO no Munic?pio de Parnamirim/RN, aliada ?s t?cnicas de observa??o e entrevista estruturada. A amostra comp?e-se de 409 sujeitos, sendo 209 profissionais integrantes das equipes da Estrat?gia de Sa?de da Fam?lia, 30 da Estrat?gia de Sa?de Bucal, 19 dos N?cleos de Apoio ? Sa?de da Fam?lia, 24 diretores das Unidades B?sicas de Sa?de, acrescidos de 68 usu?rios portadores de transtorno mental e 59 acompanhantes, respeitando os par?metros ?ticos da Resolu??o 196/96 do Conselho Nacional de Sa?de, CAAE n? 0003.0.051.000-11. Os dados quantitativos foram submetidos ao Epi-info 3.5.2 para an?lise. A rede de sa?de mental de Parnamirim envolve o fluxo entre ESF, CAPS, centro cl?nico e institui??es hospitalares, possuindo como principais entraves a fragilidade do sistema de refer?ncia e contrarrefer?ncia, das confer?ncias municipais de sa?de, das equipes da ESF pelas limita??es em recursos materiais e humanos, assim como uma popula??o que desconhece a organiza??o do sistema, aspectos que prejudicam a integralidade na aten??o. Apesar de reconhecerem a import?ncia de sua atua??o, os profissionais da ESF questionam o pr?prio papel na assist?ncia em sa?de mental, sentindo dificuldade de acesso aos servi?os psiqui?tricos (76,5%). Apesar da maioria concordar que o doente mental ? mais bem tratado na fam?lia do que no hospital (65,2%), os agentes comunit?rios de sa?de foram a categoria predominante na discord?ncia parcial ou total dessa afirmativa (40,8%), justamente o profissional em maior contato com a fam?lia. Os acompanhantes, por sua vez, sentem falta do apoio da ESF, pelo atendimento focar nas receitas controladas. As opini?es de profissionais, portadores de transtorno e acompanhantes conflu?ram em v?rias afirmativas, demonstrando as principais fragilidades a serem abordadas pela rede de sa?de mental do munic?pio, como as percep??es de que: (a) h? necessidade de for?a f?sica para cuidar do portador de transtorno por sua tend?ncia ? agressividade, precisando permanecer no hosp?cio por representar perigo ? sociedade; (b) apenas o psiquiatra pode ajudar a pessoa com problemas emocionais; (c) n?o h? necessariamente desenvolvimento da doen?a mental pelo usu?rio de ?lcool e drogas; (d) entraves no acesso e questionamentos da qualidade dos servi?os psiqui?tricos; (e) n?o consideram que o cuidado ao doente mental traga sofrimento ao profissional. Logo, o empenho na forma??o de consensos, a monitora??o e avalia??o da rede s?o importantes mecanismos para uma gest?o eficaz do sistema, refletindo na import?ncia do fortalecimento das confer?ncias de sa?de e aproxima??o das diferentes institui??es. Os resultados refor?am a import?ncia do fortalecimento da aten??o prim?ria atrav?s de programas de educa??o permanente com enfoque nas a??es e fun??es dos profissionais em acordo com suas compet?ncias e atribui??es, contribuindo para a organiza??o e resposta do cuidado em sa?de mental, consequentemente favorecendo o cuidado ao usu?rio e a promo??o da sa?de familiar

Made available in DSpace on 2014-12-17T14:46:56Z (GMT). No. of bitstreams: 1 DanieleVD_TESE.pdf: 4938953 bytes, checksum: ba81cf3eb020178b1818aa9393647bed (MD5) Previous issue date: 2014-06-06 / Universidade Federal do Rio Grande do Norte / Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs <docs.google.com>. After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa &#8805; 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity / As ?lceras venosas s?o les?es resultantes da insufici?ncia venosa cr?nica, anomalias valvulares venosas e trombose venosa. Sua ocorr?ncia vem crescendo com o aumento da expectativa de vida da popula??o mundial. Consideram-se aspectos fundamentais na abordagem ? pessoa com ?lcera venosa a assist?ncia com atua??o interdisciplinar, ado??o de protocolo, conhecimento espec?fico, habilidade t?cnica, articula??o entre os n?veis de complexidade assistencial do Sistema ?nico de Sa?de e participa??o ativa dos pacientes e seus familiares, em uma perspectiva hol?stica. A constru??o de um protocolo assistencial para pessoas com ?lcera venosa pode auxiliar os profissionais dos servi?os de alta complexidade na avalia??o do paciente e no estabelecimento de uma assist?ncia de qualidade, de forma sistematizada e focada nos fatores que interferem na cicatriza??o da les?o. Assim, este estudo objetivou analisar as evid?ncias de valida??o de um protocolo assistencial para pessoas com ?lceras venosas atendidas em servi?os de alta complexidade. Trata-se de um estudo metodol?gico, com abordagem quantitativa, desenvolvido em tr?s etapas: revis?o da literatura, evid?ncia de valida??o de conte?do e evid?ncia de valida??o no contexto cl?nico. Aprovado pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte (Parecer: 147.452 e CAAE: 07556312.0.0000.5537). A revis?o da literatura foi realizada em agosto e setembro de 2012, tornando-se a base para a constru??o do protocolo. Em seguida, foi realizada a evid?ncia de valida??o de conte?do, que incluiu 53 ju?zes (especialistas) selecionados por meio da plataforma Lattes, para avaliar os itens do protocolo. Os ju?zes foram contatados por e-mail e avaliaram o protocolo via Google Docs <docs.google.com>. Ap?s a an?lise dos ?ndices obtidos nesta etapa, que apresentaram Kappa entre 0,75 e 0,96 e IVC entre 0,80 e 0,98, e as sugest?es dos ju?zes, o protocolo foi ajustado e submetido ? evid?ncia de valida??o no contexto cl?nico, no Hospital Universit?rio Onofre Lopes em Natal/RN. A evid?ncia de valida??o no contexto cl?nico envolveu quatro ju?zes, que atuaram em duplas (pareados), avaliando 32 pacientes com ?lceras venosas no contexto cl?nico de alta complexidade. Nas duas etapas, utilizaram-se o ?ndice Kappa e ?ndice de Validade de Conte?do para analisar as respostas dos ju?zes. Os par?metros estabelecidos como aceit?veis para esses ?ndices foram: Kappa &#8805; 0,61 e ?ndice de Validade de Conte?do > 0,80.Tanto na evid?ncia de valida??o de conte?do, como na evid?ncia de valida??o no contexto cl?nico, os itens do protocolo que n?o atingiram os ?ndices Kappa e ?ndice de Validade de Conte?do estabelecidos foram exclu?dos e alguns itens foram modificados ou inclu?dos ap?s sugest?es. Os processos de evid?ncia de valida??o de conte?do e evid?ncia de valida??o no contexto cl?nico permitiram o aprimoramento do protocolo para o cuidado ? pessoa com ?lcera venosa, proposto inicialmente. A vers?o inicial do protocolo, constru?do a partir da literatura, continha 15 categorias e 108 itens; ap?s a evid?ncia de valida??o de conte?do, mantiveram-se as 15 categorias com redu??o para 91 itens; a vers?o final, validada clinicamente, ? composta das mesmas 15 categorias, sendo 76 itens. O protocolo foi validado em seu conte?do e no aspecto cl?nico, sendo assim, aceitou-se a hip?tese alternativa no estudo. Esse protocolo poder? contribuir para a sistematiza??o da assist?ncia, permitindo adequar condutas e promover maior resolutividade no tratamento da pessoa com ?lcera venosa em servi?os de sa?de de alta complexidade

Made available in DSpace on 2014-12-17T14:19:52Z (GMT). No. of bitstreams: 1 AnaLS.pdf: 754560 bytes, checksum: 4352ce162cb36ae915a586c0706ec693 (MD5) Previous issue date: 2009-11-30 / We study the health care focused on care in an intercessor and dialogical relationship with the User, which involves the construction of therapeutic projects essential to the quality of the treatment of the user in health services, and it is necessary individual and collective actions. It is intended to acknowledge and analyze the perception of social subjects, users and professionals on the treatment given to a user of a Specialized Outpatient Service (Servi?o Ambulatorial Especializado SAE) in STD/HIV/AIDS state reference in Natal, RN. The study is structured in a transdisciplinary vision of science and knowledge, theoretical and methodological principles that give meaning to the expression of the institutional features of care and health care reconnecting them to the social context. As a research strategy we seek the expressions of 56 subjects of social research, which agreed to participate in the sample, from a symbolic map of the attention, coupled with the techniques of observation and semi-structured interview. For the analysis of the results, five categories of analysis were established: the meaning of the service, care perception, process of communication and interaction, treatment perception and organization and evaluation of the service. It is argued that the attention and care are developed in a technical health care assistance to the disease, focusing on attention based on treatment, on diagnostic and drug therapy of antiretroviral drugs, reflecting the traditional biomedical paradigm of attention to the disease. This is also the mode of organization of practical actions in daily SAE: the therapy proves to be fragmented in several specialties, vertical and feeds the same model, generating tension and overload for professionals; showing impersonal care focused on structured and informative technology, unrelated to an interactive dialogic. From the speech of the subjects, the SAE is understood as the place of confrontation with the disease, but also enables greater elaboration of the illness by meeting their peers. Living with HIV and AIDS is living with concern, apprehension and fear, but mainly with the stigma, prejudice and exclusion, which require that the disease is kept in secret. There is a movement of forces and power, expressed in the knowledge-power of those who dominate the technical and administrative capabilities, devices that concentrate the maintenance of the medicalization of care, rapid consultations and with little attention, making it difficult to interact with and listen to, combined with structural failures, organizational and inadequate management of the service. We conclude that there are dimensions that are not considered in the internal dynamics of the care service multiple forms, characterized by care conflicting models, marked by individual interventions related to the disease. The subject is not considered together with his speech as technical discourse is imposed and care production based on material technology is observed / Estuda-se a aten??o ? sa?de centrada no cuidar, em uma rela??o intercessora e dial?gica com o usu?rio, que envolve a constru??o de projetos terap?uticos essenciais para a qualidade do tratamento do usu?rio nos servi?os de sa?de, sendo fundamentais a??es individuais e coletivas. Tem-se como objetivo conhecer e analisar a percep??o dos sujeitos sociais, usu?rios e profissionais, sobre o tratamento dispensado ao usu?rio de um Servi?o Ambulatorial Especializado em DST/HIV/Aids, refer?ncia estadual em Natal, RN. Articulam-se, em uma vis?o transdisciplinar da ci?ncia e do conhecimento, referenciais te?rico-metodol?gicos que possam dar sentido ? express?o das caracter?sticas institucionais da aten??o e do cuidado em sa?de, religando-as ao contexto social. Como estrat?gia de pesquisa, buscam-se as express?es dos 56 sujeitos sociais da investiga??o, que aceitaram participar da amostra, a partir de uma cartografia simb?lica da aten??o, associada a t?cnicas de observa??o e entrevista semi-estruturada. Para an?lise dos resultados, estabeleceram-se cinco categorias de an?lise: significado do servi?o, percep??o do atendimento; processo de comunica??o e intera??o; percep??o do tratamento e organiza??o e avalia??o do servi?o. Discute-se que a aten??o e o cuidado desenvolvem-se em uma assist?ncia tecno-assistencial ? doen?a, centrados em uma aten??o focada no tratamento, na solicita??o de exames e na terap?utica medicamentosa dos anti-retrovirais, reflexo do paradigma tradicional biom?dico de aten??o ? doen?a. Este tamb?m ? o modo de organiza??o das a??es pr?ticas no cotidiano do SAE: a conduta terap?utica mostra-se fragmentada nas diversas especialidades, verticalizada e retro-alimentada no mesmo modelo, gerando tens?o e sobrecarga aos profissionais; evidenciam-se atendimentos impessoais focados em tecnologias estruturadas e informativas, desvinculadas da dial?gica interativa. A partir dos discursos dos sujeitos, o SAE ? interpretado como o lugar do confronto com a doen?a, mas tamb?m possibilita maiores elabora??es do adoecer pelo encontro com os iguais. Conviver com o HIV e Aids ? conviver com receios, apreens?o e medo, mas principalmente com o estigma, o preconceito e a exclus?o, o que requer o sigilo da doen?a. H? circula??o de for?as e de poder, expressos no saber-poder t?cnico-profissional e administrativo, dispositivos que concentram a manuten??o da medicaliza??o do atendimento, consultas r?pidas e com pouca aten??o, o que dificulta a intera??o e a escuta, aliados a falhas estruturais, organizacionais e a um gerenciamento inadequado do servi?o. Conclui-se que h? dimens?es n?o consideradas na din?mica interna das m?ltiplas formas do cuidar, caracterizado pelo modelo conflitante da aten??o, marcado por interven??es individuais relacionadas ? doen?a. Desconsidera-se o sujeito de seu discurso, imputando-lhe discursos tecnicistas, e observa-se a produ??o do cuidado baseada na tecnologia material

Made available in DSpace on 2014-12-17T14:36:02Z (GMT). No. of bitstreams: 1 AlinePDpdf.pdf: 699478 bytes, checksum: d1fd21dcb47fd1fb04069e9c8121ab69 (MD5) Previous issue date: 2009-07-10 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / This thesis aims to enable a wider comprehension on thought operation as well as suggest alternatives for the formation of reflexive, critical, autonomous and creative individuals. The research defends the idea that it is possible for an individual to develop vigilant attention that makes thought flexibilization and change in the course of action, possible. This operation is called Internal Dialogue and is essentially characterized by a continuous openness towards novelty and learning. This makes it possible to minimize the usual way thought operates, in a automatic fashion (automatism). The research was based on theoretical references and ideas of David Bohm (1989;1994;2005) and Michael Polanyi (1983). The main emphasis was the understanding that a crisis situation enables awareness and state of alert that favors a more flexible thought pattern (Arag?o Gomes, 1994, 1997). The methodology used was presentation and analysis of these moments through autobibliographical records with indication of crisis on behalf of the subjects. Other criteria were also used that enabled the composition of the analyzed material such as the fact that: the subjects were public and real, the data was available through accessible material; the subjects identified themselves as in crisis; these crisis were of varied kinds; they had different social, cultural and professional profiles. Thus, three auto-bibliographical elements were selected: the Infidel: the story of a woman that challenged Islam (2007), written by the political Muslim author Ayaan Hirsi; Still me: memories (2001), of the actor Christopher Reeve as well as Confessions of a Philosopher (2001), by the philosopher Bryan Magee. In these books an analysis was made related to parts that stated action an though operation that express internal dialogue. These were organized into categories that were pointed out as relevant for the identification of internal dialogue such as: Perceptions of physical reaction; emotions, beliefs and issues, individual actions, self judgment and thought, self questioning, comprehension, observation and empirical investigation, perception of the changes they performed in the world, escape of conditioning as well as action that resulted in new meaning. The analysis performed reinforces our goal once it sated that internal dialogue is an important tool that allows thought awareness, minimizing common automatism and making consciousness possible as well as favoring the occurrence of critical and reflexive thought. Thus, final considerations deal with the need for the development of teaching methodologies that address internal dialogue as a counterpoint to the many daily action that reinforce the automatism of thought / Esta tese tem como objetivo permitir maior compreens?o sobre a opera??o do pensamento e sugerir alternativas para a forma??o de indiv?duos reflexivos, cr?ticos, aut?nomos e criativos. Defendemos que ? poss?vel o indiv?duo desenvolver uma aten??o vigilante capaz de flexibilizar o pensamento e possibilitar mudan?as nas nossas a??es e pensamento. Denominada Di?logo Interno, esta opera??o caracteriza-se essencialmente pela abertura ao novo e cont?nua disposi??o para o aprendizado, minimizando o modo como o pensamento opera, na maior parte do tempo (automatismo). Este estudo teve como principais refer?ncias te?ricas as id?ias de David Bohm (1989;1994;2005) e Michael Polanyi (1983) e como pressuposto fundamental o entendimento de que situa??es de crise propiciam momentos de tomadas de ci?ncia e estado de alerta que favorecem o pensamento a operar de modo mais flex?vel. (Arag?o Gomes, 1994, 1997). Metodologicamente, optamos por apresentar e analisar estes momentos atrav?s de relatos autobiogr?ficos, cujo autor indicava vivenciar momentos de crise. Outros crit?rios foram utilizados para comporem o material a ser analisado: tratava-se de pessoas reais e p?blicas; os relatos estavam dispon?veis em obras de f?cil acesso; tratava-se de pessoas em situa??o de crise por elas identificadas; apresentavam situa??es de crise de naturezas distintas; eram pessoas com perfis s?cio-culturais, profissionais e de g?nero distintos. Assim, foram selecionados tr?s relatos autobiogr?ficos: Infiel: a hist?ria de uma mulher que desafiou o Isl? (2007), da escritora e pol?tica mu?ulmana Ayaan Hirsi; Ainda sou eu: mem?rias (2001), do ator Christopher Reeve e; Confiss?es de um fil?sofo (2001), do fil?sofo Bryan Magee. Nestas obras foram analisados diversos trechos nos quais identificamos opera??es e a??es de pensamento que expressam tra?os do Di?logo Interno, organizadas nas categorias que identificamos como relevantes para a identifica??o do Di?logo Interno: percep??o de rea??es f?sicas, percep??o dos pr?prios sentimentos, percep??o das pr?prias cren?as e pressupostos, percep??o das pr?prias a??es, percep??o e julgamento do pr?prio pensamento, a??o de questionamento, busca da compreens?o, observa??o e investiga??o emp?rica, percep??o de sua mudan?a de a??o no mundo, sa?da do condicionamento e a??o de ressignifica??o. As an?lises realizadas refor?am nosso pressuposto de que o di?logo interno ? uma importante ferramenta para acionarmos a aten??o vigilante do pensamento, minimizando o automatismo habitual e propiciando a tomada de consci?ncia e a emerg?ncia de pensamentos cr?ticos e reflexivos. Dessa forma, as considera??es finais desta tese apontam para a necessidade do desenvolvimento de metodologias de ensino que contemplem o Di?logo Interno como contraponto ?s diversas viv?ncias cotidianas que refor?am o automatismo do pensamento e a??o

Made available in DSpace on 2014-12-17T14:36:08Z (GMT). No. of bitstreams: 1 AlinePD_TESE.pdf: 699525 bytes, checksum: a35806955c1aa8e04da250ab8a863da9 (MD5) Previous issue date: 2009-08-23 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / This thesis aims to enable a wider comprehension on thought operation as well as suggest alternatives for the formation of reflexive, critical, autonomous and creative individuals. The research defends the idea that it is possible for an individual to develop vigilant attention that makes thought flexibilization and change in the course of action, possible. This operation is called Internal Dialogue and is essentially characterized by a continuous openness towards novelty and learning. This makes it possible to minimize the usual way thought operates, in a automatic fashion (automatism). The research was based on theoretical references and ideas of David Bohm (1989;1994;2005) and Michael Polanyi (1983). The main emphasis was the understanding that a crisis situation enables awareness and state of alert that favors a more flexible thought pattern (Arag?o Gomes, 1994, 1997). The methodology used was presentation and analysis of these moments through autobibliographical records with indication of crisis on behalf of the subjects. Other criteria were also used that enabled the composition of the analyzed material such as the fact that: the subjects were public and real, the data was available through accessible material; the subjects identified themselves as in crisis; these crisis were of varied kinds; they had different social, cultural and professional profiles. Thus, three auto-bibliographical elements were selected: the Infidel: the story of a woman that challenged Islam (2007), written by the political Muslim author Ayaan Hirsi; Still me: memories (2001), of the actor Christopher Reeve as well as Confessions of a Philosopher (2001), by the philosopher Bryan Magee. In these books an analysis was made related to parts that stated action an though operation that express internal dialogue. These were organized into categories that were pointed out as relevant for the identification of internal dialogue such as: Perceptions of physical reaction; emotions, beliefs and issues, individual actions, self judgment and thought, self questioning, comprehension, observation and empirical investigation, perception of the changes they performed in the world, escape of conditioning as well as action that resulted in new meaning. The analysis performed reinforces our goal once it sated that internal dialogue is an important tool that allows thought awareness, minimizing common automatism and making consciousness possible as well as favoring the occurrence of critical and reflexive thought. Thus, final considerations deal with the need for the development of teaching methodologies that address internal dialogue as a counterpoint to the many daily action that reinforce the automatism of thought / Esta tese tem como objetivo permitir maior compreens?o sobre a opera??o do pensamento e sugerir alternativas para a forma??o de indiv?duos reflexivos, cr?ticos, aut?nomos e criativos. Defendemos que ? poss?vel o indiv?duo desenvolver uma aten??o vigilante capaz de flexibilizar o pensamento e possibilitar mudan?as nas nossas a??es e pensamento. Denominada Di?logo Interno, esta opera??o caracteriza-se essencialmente pela abertura ao novo e cont?nua disposi??o para o aprendizado, minimizando o modo como o pensamento opera, na maior parte do tempo (automatismo). Este estudo teve como principais refer?ncias te?ricas as id?ias de David Bohm (1989;1994;2005) e Michael Polanyi (1983) e como pressuposto fundamental o entendimento de que situa??es de crise propiciam momentos de tomadas de ci?ncia e estado de alerta que favorecem o pensamento a operar de modo mais flex?vel. (Arag?o Gomes, 1994, 1997). Metodologicamente, optamos por apresentar e analisar estes momentos atrav?s de relatos autobiogr?ficos, cujo autor indicava vivenciar momentos de crise. Outros crit?rios foram utilizados para comporem o material a ser analisado: tratava-se de pessoas reais e p?blicas; os relatos estavam dispon?veis em obras de f?cil acesso; tratava-se de pessoas em situa??o de crise por elas identificadas; apresentavam situa??es de crise de naturezas distintas; eram pessoas com perfis s?cio-culturais, profissionais e de g?nero distintos. Assim, foram selecionados tr?s relatos autobiogr?ficos: Infiel: a hist?ria de uma mulher que desafiou o Isl? (2007), da escritora e pol?tica mu?ulmana Ayaan Hirsi; Ainda sou eu: mem?rias (2001), do ator Christopher Reeve e; Confiss?es de um fil?sofo (2001), do fil?sofo Bryan Magee. Nestas obras foram analisados diversos trechos nos quais identificamos opera??es e a??es de pensamento que expressam tra?os do Di?logo Interno, organizadas nas categorias que identificamos como relevantes para a identifica??o do Di?logo Interno: percep??o de rea??es f?sicas, percep??o dos pr?prios sentimentos, percep??o das pr?prias cren?as e pressupostos, percep??o das pr?prias a??es, percep??o e julgamento do pr?prio pensamento, a??o de questionamento, busca da compreens?o, observa??o e investiga??o emp?rica, percep??o de sua mudan?a de a??o no mundo, sa?da do condicionamento e a??o de ressignifica??o. As an?lises realizadas refor?am nosso pressuposto de que o di?logo interno ? uma importante ferramenta para acionarmos a aten??o vigilante do pensamento, minimizando o automatismo habitual e propiciando a tomada de consci?ncia e a emerg?ncia de pensamentos cr?ticos e reflexivos. Dessa forma, as considera??es finais desta tese apontam para a necessidade do desenvolvimento de metodologias de ensino que contemplem o Di?logo Interno como contraponto ?s diversas viv?ncias cotidianas que refor?am o automatismo do pensamento e a??o

Made available in DSpace on 2015-03-13T17:10:55Z (GMT). No. of bitstreams: 1 RaphaelC_DISSERT.pdf: 1901364 bytes, checksum: 85ebf467d310eac30b64a7f180d8d1bc (MD5) Previous issue date: 2014-01-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Through the analysis of the informational activity at the primary care of SUS at the scale of places, this dissertation has as central objective to observe the dispute for the concepts of health and sickness, in the ambit of Brazilian Health Movement, featuring, on one hand, the clinic, biomedical or flexnerian line hegemonic, scientifically restrict and the primary frame of references for the Brazilian health politics and on the other hand a multiplicity of new proposals and critic thoughts to the current model, which have , as common characteristic, the worry with a territorial way of thinking the health context, therefore beyond the biological processes. On the first chapter we jut out with details these scientific and ideological movements, on a wider way, but also on the specificities of the public health s information politics. On the second chapter we analyze the downward health information circle at the basic care, observing the operational processes of the information s technical systems SIAB and e-SUS. On the third and last chapter, we give references to think about an upward health information circle, centered on the places, ruled by the notions of autonomy, organic solidarity and communicational density. It would possess, as method s primary horizon, the local organization of production and managing of information through the work of the Health Community Agent, privileging therefore the urgency of the most contingent needs of the people in theirs every day s life / Atrav?s da an?lise da atividade informacional na aten??o B?sica do SUS, ou seja, na escala do lugar, esta disserta??o tem como objetivo central observar a disputa pelo conceito de sa?de e de doen?a no ?mbito da sa?de brasileira, destacando, de um lado, o pensamento cl?nico, biom?dico ou flexneriano hegem?nico, cientificamente restrito e principal quadro de refer?ncia da pol?tica de sa?de no Brasil e do outro lado uma multiplicidade de novas propostas e pensamentos cr?ticos ao modelo vigente que possuem como ponto comum a preocupa??o com a sa?de no contexto supra-biol?gico e, portanto, territorial. No primeiro cap?tulo destacamos com detalhes tais movimentos cient?ficos e ideol?gicos, tanto num sentido mais amplo quanto na dimens?o espec?fica das pol?ticas de informa??o em sa?de do SUS. No segundo cap?tulo, analisamos o c?rculo descendente de informa??o em sa?de na aten??o b?sica, observando o funcionamento dos sistemas t?cnicos de informa??o SIAB e e-SUS. Por fim, no terceiro e ?ltimo cap?tulo, lan?amos refer?ncias para se pensar um c?rculo ascendente de informa??o em sa?de, centrado a partir do lugar e pautado nas no??es de autonomia, solidariedade org?nica e densidade comunicacional, possuindo como principal horizonte metodol?gico a organiza??o local da produ??o e gest?o de informa??o a partir do Agente Comunit?rio de Sa?de, privilegiando dessa forma a urg?ncia das necessidades mais contingente das pessoas em sua vida cotidiana

Made available in DSpace on 2014-12-17T15:36:36Z (GMT). No. of bitstreams: 1 AndreLBM_DISSERT.pdf: 1779818 bytes, checksum: 62dcf6f324fa9f364c87ce6105fee4f5 (MD5) Previous issue date: 2010-11-13 / The cooperative behavior is no longer a dilemma for the theory of evolution, since there are models that explain the evolution of this behavior by means of natural selection at the individual level. However, there have been few studies on the proximal factors that interfere with cooperative behavior. In the study of the influence of cognition on cooperation, many authors have been interested in situations in which individuals decide whether to act cooperatively and select partners with different qualities to cooperate. Of the factors studied, we highlight the need for understanding the apparatus and communication between partners to the occurrence of cooperation. Recently, highlight is the proposal that the ability to cooperate would be greater in species with cooperative breeding system. Thus, the common marmoset (Callithrix jacchus) is a New World monkey which stands as a valuable species for this type of study because it presents cooperative actions in nature, such as sharing food and protection of the community territory. Our experiment investigated whether common marmosets unrelated females (n = 6) were able to cooperate using an electrical and a mechanical apparatus, if this cooperation is a byproduct of individual actions or involve social attention, if it occurs inter-individual variation in the use of devices and formation of roles (producer / scrounger) in dyads. We use the number of rewards obtained by animals (Ratio of Correct Pulls) as indicators of cooperation and glances for partners (Ratio of Correct Glances) as indicators of social attention and communication. The results indicate that the type of apparatus was not a constraint for the occurrence of cooperation between the marmosets, but still has not been verified formation of roles in the dyads. The performance of animals in the two devices showed a large variation in the learning time, not having relationship with the performance in the tests phase. In both devices the level of social glances at control phases were casually correlated with any other phase, but the data showed that there was not social attention, that is, the monkeys realized that they gave food to the partners, but the partners did / O comportamento de coopera??o n?o constitui mais um dilema para a Teoria da Evolu??o, j? existindo modelos que explicam a evolu??o deste comportamento por meio da Sele??o Natural em n?vel de indiv?duo. Entretanto, ainda s?o poucos os estudos sobre os fatores proximais que interferem no comportamento cooperativo. No estudo da influ?ncia da cogni??o na coopera??o, muitos autores tem se interessado por situa??es nas quais os indiv?duos decidem se v?o agir cooperativamente e selecionam parceiros com diferentes qualidades para cooperar. Dos fatores estudados, destaca-se a necessidade de compreens?o do aparato e de comunica??o entre os parceiros para a ocorr?ncia de coopera??o. Recentemente, ganha destaque a proposta de que a capacidade de cooperar seria maior em esp?cies com cuidado cooperativo a prole. Assim sendo, o sag?i (Callithrix jacchus) ? um macaco do Novo Mundo que se destaca como uma esp?cie valiosa para esse tipo de estudo, pois apresenta a??es cooperativas na natureza, como partilha de alimento e defesa comunit?ria de territ?rio. O nosso experimento investigou se sag?is f?meas n?o aparentadas (n = 6) s?o capazes de cooperar usando um aparato el?trico e um mec?nico, se essa coopera??o ? um subproduto de a??es individuais ou envolve aten??o social, e se ocorre varia??o inter-individual no uso dos aparatos e forma??o de pap?is (produtor/parasita) nas d?ades. Usamos o n?mero de recompensas obtidas pelos animais (?ndice de Puxadas Corretas) como indicadores de coopera??o e os olhares para os parceiros (?ndice de Olhares Sociais) como indicadores de aten??o social e comunica??o. Os resultados indicam que o tipo de aparato n?o foi uma limita??o para a ocorr?ncia de coopera??o entre os sag?is, mas mesmo assim n?o foi verificado forma??o de pap?is nas d?ades. O desempenho dos animais nos dois aparatos apresentou uma grande varia??o quanto ao tempo de aprendizagem, n?o tendo esta, correla??o com as performances nas fases teste. Em ambos os aparatos os n?veis dos olhares sociais nas fases controle apresentaram correla??es eventuais com outras fases, por?m os dados demonstram que n?o houve aten??o social, isto ?, os sag?is percebiam que doavam comida aos parceiros, mas n?o que o parceiro estava doando para eles. Isso indica que os poucos atos cooperativos observados foram um subproduto de atos individuais e n?o coopera??o verdadeira