Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-01T19:24:53Z No. of bitstreams: 1 IvanildaMariaFreireMasullo_DISSERT.pdf: 993246 bytes, checksum: c815c405e742a7d330e28fbaa4904c68 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-06T21:41:00Z (GMT) No. of bitstreams: 1 IvanildaMariaFreireMasullo_DISSERT.pdf: 993246 bytes, checksum: c815c405e742a7d330e28fbaa4904c68 (MD5) / Made available in DSpace on 2016-04-06T21:41:00Z (GMT). No. of bitstreams: 1 IvanildaMariaFreireMasullo_DISSERT.pdf: 993246 bytes, checksum: c815c405e742a7d330e28fbaa4904c68 (MD5) Previous issue date: 2015-05-20 / A aten??o para as quest?es de sa?de no envelhecimento tem aumentado e torna-se um desafio para as pol?ticas p?blicas direcionadas ao idoso. Este estudo objetiva apreender as Representa??es Sociais constru?das por idosos sobre o atendimento na Unidade de Sa?de da Fam?lia. Trata-se de um estudo explorat?rio, subsidiado pela Teoria das Representa??es Sociais de Moscovici. Foi realizado na Unidade de Sa?de da Fam?lia de Felipe Camar?o, localizado no bairro de Felipe Camar?o no Munic?pio de Natal/RN-Brasil. Participaram da pesquisa cento e dois idosos/as, atendidos pela Estrat?gia Sa?de da Fam?lia. O per?odo de coleta de dados estendeu-se de julho a setembro de 2014. Os dados foram obtidos por meio do Teste de Associa??o Livre de Palavras e Entrevista Semiestruturada, e analisados com o aux?lio do software EVOC. As entrevistas foram realizadas com 20 idosos e submetidas ? An?lise de Conte?do. A pesquisa teve a aprova??o do Comit? de ?tica em Pesquisa do Hospital Universit?rio Onofre Lopes, sob o parecer 704.323. Foi poss?vel apreender conota??es negativas em rela??o ao atendimento, relacionando-o como p?ssimo e desrespeitoso, sendo o hor?rio limitado de atendimento, dificuldade para agendar consultas e exames e a infraestrutura inadequada, os aspectos mais assinalados. Os idosos expressam satisfa??o quanto ao atendimento m?dico, entretanto, eles entendem que ? preciso que todos os servi?os estejam adequadamente integrados para um atendimento qualificado. As falas revelam que o atendimento na unidade necessita implementar novas estrat?gias de acolhimento para que os usu?rios participem mais de a??es educativas e de promo??o da sa?de. Assinala-se, a necessidade da integralidade das a??es, do acolhimento, da escuta qualificada nos servi?os de sa?de que possam contemplar os idosos que buscam o atendimento na unidade de sa?de da fam?lia, sobressaindo assim os princ?pios do Sistema ?nico de Sa?de. / The attention to health issues in aging has increased and it becomes a challenge for public policies directed to the elderly. This study aimed at learning the social representations built by seniors about the service in the Family Health Unit. It is an exploratory study, funded by the Theory of Social Representations of Moscovici. It was held at the Health Unit of the Family Felipe Shrimp, located in the neighborhood Felipe Shrimp in the city of Natal / RN-Brazil. The participants were one hundred and two elderly / as, served by the Family Health Strategy. The data collection period was extended from July to September 2014. Data were collected through the Word Free Association Test and Interview semi-structured, and analyzed with the help of EVOC software. Interviews were conducted with 20 elderly and subjected to content analysis. The research was approved by the Ethics Committee of the University Hospital Research Onofre Lopes, in the opinion 704,323. It was possible to apprehend negative connotations regarding attendance, listing it as bad and disrespectful, and the limited hours of service, difficult to schedule appointments and tests and inadequate infrastructure, the most marked aspects. Seniors express satisfaction with the medical care, however, they understand that it is necessary that all services are properly integrated to a qualified service. The statements reveal that the service in the drive needs to implement new strategies host for users to participate more in educational and health promotion. It is noted, the need of integrated care, the host of qualified hearing in the health services that they address the elderly seeking care at the clinic of the family, so sticking to the principles of the Unified Health System.

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 2017-03-09T18:44:20Z 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 2017-04-17T23:08:14Z 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 2017-10-18T21:24:04Z 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

Made available in DSpace on 2015-04-14T13:53:55Z (GMT). No. of bitstreams: 1 447315.pdf: 1471181 bytes, checksum: b6dcca7f66bacd1dade40a96d998ff48 (MD5) Previous issue date: 2012-08-27 / OBJECTIVE: To identify the socio-demographic profile and the demands of the elderly population enrolled in a health unit in Santa Cruz do Sul, from the look of older people and professionals working in the clinic, as well as the profile of the professionals working this unit, with an emphasis on quality of services provided to this population. METHODS: The health unit has 198 seniors who were registered by the Community Health Agents (ACS), consisting in the Information System of Primary Care (SIAB), identified as residents of the area covered by the unit, whether they are users of unit health. All were interviewed in their homes, regardless of their health condition. Also participating in the research team professionals working in Estrat?gia de Sa?de da Fam?lia Menino Deus (ESFMD), plus an interview with members of the N?cleo de Apoio ? Sa?de da Fam?la (NASF), totaling 16 professionals. The core team of professionals participated in a focus group, addressing the needs and demands of the elderly, the possibilities and limits of network services in meeting the demands. After analysis of this population and professionals, was set the number of study participants. In addition, we obtained information from the coordination of the Estrat?gia de Sa?de da Fam?lia (ESF) on how the issue has been addressed in the old city. DATA ANALYSIS: The number of survey participants was initially of 198 seniors, selected by the data obtained in the Sistema de Informa??o da Aten??o B?sica (SIAB) relative to that health facility. Of these, 27 were excluded, resulting in a total of 171 elderly. The main reasons for exclusion were deaths (3), change of address (2), declined to participate (7) and the others were not found at home after 2 visitations and therefore considered as loss (15). In this selection, no elderly have been excluded for not able to answer the survey form, and all were interviewed in their homes. RESULTS: The most common age group was 60-69 years, with 106 elderly (62%), the majority being female (61%), white, married with 87 (50%) and 54 widowers (32%). Most have low education, having studied with 92 seniors completed primary education (up to 4 years) with 37 illiterate. This corresponds to 75% of respondents. Most live up to two minimum wages, which corresponds to 95% of this population. Most are retired and whose main occupation complement activity safrista tobacco companies in the city, this activity more common in both sexes. CONCLUSIONS: The study demonstrated that the profile of the elderly population has been found to meet reported by IBGE census 2010. Thus we find the need for it to be made an integrated work between university (UNISC) and municipal government intended to achieve better results in prevention work and both clinical and social care of the elderly. / OBJETIVO: Identificar o perfil s?cio-demogr?fico e as demandas da popula??o de idosos adscrita em uma unidade de sa?de de Santa Cruz do Sul, a partir do olhar dos idosos e profissionais que atuam na unidade de sa?de, bem como o perfil dos profissionais que atuam nesta unidade, com ?nfase na qualidade dos servi?os prestados para este segmento da popula??o. M?TODO: A unidade de sa?de possui 198 idosos que foram cadastrados pelos Agentes Comunit?rios de Sa?de (ACS), constando no Sistema de Informa??es da Aten??o B?sica (SIAB), identificados como moradores da ?rea de abrang?ncia da unidade, independente de serem usu?rios da unidade de sa?de. Todos foram entrevistados no seu domic?lio, independente da sua condi??o de sa?de. Tamb?m participaram da pesquisa os profissionais da equipe b?sica que atuam na Estrat?gia de Sa?de da Fam?lia Menino Deus (ESFMD), al?m de uma entrevista com os integrantes do N?cleo de Apoio ? Sa?de da Fam?lia (NASF), totalizando 16 profissionais. Os profissionais da equipe b?sica participaram de um grupo focal, abordando as necessidades e demandas dos idosos, as possibilidades e limites da rede de servi?os no atendimento das demandas. Ap?s a an?lise desta popula??o e dos profissionais, foi definido o n?mero de participantes do estudo. Al?m disso, obtivemos informa??es da coordena??o da Estrat?gia de Sa?de da Fam?lia (ESF) sobre a forma como tem sido abordada a quest?o do idoso no munic?pio. AN?LISE DE DADOS: O n?mero de participantes da pesquisa era inicialmente de 198 idosos, selecionados atrav?s dos dados obtidos no Sistema de Informa??o para a Aten??o B?sica (SIAB) relativo ?quela unidade de sa?de. Destes, 27 n?o foram inclu?dos, resultando no total de 171 idosos. Os principais motivos para a exclus?o foram ?bitos (3), mudan?a de endere?o (2), n?o quiseram participar (7) e os demais n?o foram encontrados em casa ap?s 2 visita??es e, portanto, considerados como perda (15). Nesta sele??o, nenhum idoso foi exclu?do por n?o possuir condi??es de responder ao formul?rio da pesquisa, sendo que todos foram entrevistados no seu domic?lio. RESULTADOS: A faixa et?ria mais frequente foi entre 60-69 anos, com 106 idosos (62%), sendo a maioria do sexo feminino (61%), de cor branca, com casados 87 (50%) e 54 vi?vos (32%). A maioria apresenta baixa escolaridade, com 92 idosos tendo estudado o prim?rio incompleto (at? 4 anos) sendo 37 n?o alfabetizados. Isto corresponde a 75% dos entrevistados. A grande maioria vive com at? 2 sal?rios m?nimos, o que corresponde a 95% desta popula??o. A grande maioria ? aposentada e tem como principal ocupa??o complementar a atividade de safrista nas empresas fumageiras do munic?pio, atividade esta mais comum em ambos os sexos. CONCLUS?ES: O estudo demonstrou que o perfil da popula??o de idosos encontrada vem ao encontro do relatado pelo censo do IBGE de 2010. Desta forma encontramos a necessidade de que seja feito um trabalho integrado entre universidade e prefeitura municipal para que se alcancem melhores resultados no trabalho de preven??o e assist?ncia tanto cl?nica quanto social destes idosos.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2017-11-29T00:37:35Z No. of bitstreams: 1 DISSERTA??O_ISMAEL_MENDES_ANDRADE.pdf: 2423968 bytes, checksum: 7c9dd9504eb53f3eb30471b6313e642f (MD5) / Made available in DSpace on 2017-11-29T00:37:35Z (GMT). No. of bitstreams: 1 DISSERTA??O_ISMAEL_MENDES_ANDRADE.pdf: 2423968 bytes, checksum: 7c9dd9504eb53f3eb30471b6313e642f (MD5) Previous issue date: 2015-04-07 / The territorialization stands out as a technique which ?creates?political territories for Health, is also an organizing tool in healthcare practices, included in the National Policy of Primary Care through attached territory, and allows for the planning, decentralized programming and the development of intersectoral actions in line with the principle of equality established by the Unified Health System. Therefore the main objective of the study was to analyze the territorialization in Primary Health Care in Santo Ant?nio de Jesus, Bahia. The methodology became the choice for exploratory approach from the quantitative nature. Therefore held survey of bibliographic references on the Unified Health System (SUS), on territory, health and primary health care and verification of documents related to legislation also ordinances and resolutions on the subject, made her survey of cartographic base the census tracts of the city under study, and research of the administrative organization of the Municipal Health Department, georeferencing of the Family Health Units and application forms with the Community Health Agents of the service areas of the Health Unit. The result showed need for territorial parameterized as many health facilities exceeded the population limits; weaknesses to the employment contract of top-level professionals. And contribution of adequacy proposals, in addition to thematic maps for organization in health districts and consequently in health units. / A Territorializa??o destaca-se como t?cnica que ?cria?territ?rios pol?ticos para a Sa?de, representa, tamb?m, um instrumento de organiza??o das pr?ticas de Sa?de, inserida nas diretrizes da Pol?tica Nacional da Aten??o B?sica por meio de territ?rio adstrito, e permite o planejamento, a programa??o descentralizada e o desenvolvimento de a??es intersetoriais na conson?ncia com o princ?pio da igualdade estabelecido pelo Sistema ?nico de Sa?de. Portanto o objetivo principal do trabalho foi avaliar a territorializa??o na Aten??o Prim?ria ? Sa?de no munic?pio de Santo Ant?nio de Jesus, Bahia. Na metodologia fez-se a escolha pela abordagem explorat?ria a partir da natureza quantitativa. Para tanto realizou-se levantamento de referenciais bibliogr?ficos sobre o Sistema ?nico de Sa?de (SUS), sobre territ?rio, sa?de e Aten??o Prim?ria ? Sa?de e verifica??o de documentos referentes ? legisla??o, tamb?m portarias e resolu??es sobre a tem?tica, fez se levantamento de base cartogr?fica dos setores censit?rios do munic?pio em estudo, al?m de pesquisa da organiza??o administrativa da Secretaria Municipal de Sa?de, georreferenciamento das Unidades de Sa?de da Fam?lia e aplica??o de formul?rios com os Agentes Comunit?rios de Sa?de das ?reas de atendimento da Unidade de Sa?de. O resultado mostrou a necessidade de uma territorializa??o com par?metros, pois muitas unidades de sa?de ultrapassaram os limites populacionais;fragilidades ao v?nculo empregat?cio de profissionais de n?vel superior. E contribui??o das propostas de adequa??o, com os mapas tem?ticos para organiza??o nos distritos sanit?rios e consequentemente das Unidades de Sa?de.

Submitted by Jadson Francisco de Jesus SILVA (jadson@uefs.br) on 2018-07-20T21:40:33Z No. of bitstreams: 1 DISSERTA??O VER?NICA GAMBOA cd.pdf: 3654035 bytes, checksum: bb1f7c26524d7edc5944ae2c6c8482b4 (MD5) / Made available in DSpace on 2018-07-20T21:40:33Z (GMT). No. of bitstreams: 1 DISSERTA??O VER?NICA GAMBOA cd.pdf: 3654035 bytes, checksum: bb1f7c26524d7edc5944ae2c6c8482b4 (MD5) Previous issue date: 2018-03-01 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Integrative Review Study, with a qualitative approach, based on a critical analytical perspective, aiming to understand the meanings of Health Promotion in the context of PHC in Brazil and in other countries of the world; to analyze the practices of Health Promotion in the context of PHC in Brazil and in other countries of the world and to discuss the concreteness between the areas of action established in the International Conferences on Health Promotion on Health Promotion practices in the context of Primary Care in Brazil and in the world. For the production of the empirical data, we cover the six (6) steps performed in the Integrative Review, delimiting the corpus of the study to 18 articles with peer review conditions published between January 2016 and July 2017 in different countries of Asia, Europe and America. As a method of analysis, we adopt Hermeneutics-dialectics. The results are organized in four empirical categories: Characterization of the corpus of the study: a reality to be achieved; Meanings of Health Promotion in the context of PHC: confluences and dissonances between theory and practice; Health Promotion in the context of PHC: contradictions, fragilities and challenges in the health work process; confrontations between the areas of action of the International Conferences on Health Promotion on practices in the context of PHC. We understand that Health promotion implies a 'new' and 'polysemic' practice that still generates theoretical and philosophical tensions, which has been associated with concepts such as lifestyles-healthy habits-health behaviors, empowerment, social participation, autonomy, intersectoriality, however there is a conflict, even reinforced by several authors, related to the conceptual misconception about health education, and more worrying about its differential character as approaches and practices to primary prevention. In the work process of Health Promotion, the purpose was to 'improve people's quality of life' as well as 'generate empowerment in users'; as the instruments were considered the theoretical models as fundamentals of practice, as well as the combination of strategies, practical guides and various educational materials; activities were related to health education, the use of online technologies, health advisory services and counseling; the agents were identified under the figure of collective agents, such as nurses and doctors with different training areas, health visitors, psychologists, social workers, as well as other professionals from the health service and the community itself; as for the interpersonal relationship, it was possible to see the strengthening of the links between users and health teams with a certain potentiality in the practice of Health Promotion. The evaluation emerged as a topic that presents weaknesses in the practice of Health Promotion and which represents a challenge to be conquered. In the confrontation of the areas of action of Health Promotion with its practice evidenced in the corpus of the study. In relation to the development of healthy policies was reinforced the importance of support for decision makers and joint responsibility of the State, health services with their professionals and community. The creation of favorable environments was invisible, even when it is considered relevant, since it could be of ?little importance? given to them in the practice and actions of Health Promotion. Community empowerment had a direct relation with the processes of empowerment and social participation, emphasizing the intersectoriality as key in this process. The development of personal skills was the area most studied in the articles analyzed, focusing on health education activities and once again the emergence of prevention as a conflicting concept in the understanding and practice of Health Promotion; finally, the reorientation of health services was visible when considering the paradigm shift and the strengthening of professional training in Health Promotion. We consider that Health Promotion contributes from its innovative, differentiated approach and with a positive approach to health services and specifically PHC. The protagonism of the professional with a profile in Health Promotion is significant in the development of strategies and corresponding actions with the areas of action, as well as to dispel conflicts by the conceptual misconceptions of Health Promotion in relation to the concepts of health education and prevention. / Estudo de Revis?o Integrativa, com abordagem qualitativa, fundamentado na perspectiva cr?tico anal?tica, com os objetivos de compreender os sentidos e significados da Promo??o da Sa?de no contexto da APS no Brasil e em outros pa?ses do mundo; analisar as pr?ticas de Promo??o da Sa?de no contexto da APS no Brasil e em outros pa?ses do mundo e discutir a concretude entre as ?reas de a??o estabelecidas nas Confer?ncias Internacionais de Promo??o da Sa?de sobre as pr?ticas de Promo??o da Sa?de no contexto da Aten??o Prim?ria no Brasil e no mundo. Para a produ??o de dados emp?ricos percorremos as seis (6) etapas realizadas na Revis?o Integrativa delimitando-se o corpus do estudo a 18 artigos com condi??o de peer review, publicados entre janeiro de 2016 e julho de 2017, em diversos pa?ses da ?sia, Europa e Am?rica. Como m?todo de an?lise adotamos a Hermen?utica-dial?tica. Os resultados encontram-se organizados em quatro categorias emp?ricas: Caracteriza??o do corpus do estudo: uma realidade a ser conquistada; Sentidos e Significados da Promo??o da Sa?de no contexto da APS: conflu?ncias e disson?ncias entre teoria e pr?tica; Promo??o da Sa?de no contexto da APS: contradi??es, fragilidades e desafios no processo de trabalho em sa?de; confrontos entre as ?reas de a??o das Confer?ncias Internacionais da Promo??o da Sa?de sobre as pr?ticas no contexto da APS. Compreendemos que a Promo??o da Sa?de implica uma pr?tica ?nova? e ?poliss?mica? que ainda gera tens?es te?ricas e filos?ficas, a qual esteve associada a conceitos como estilos de vida-h?bitos saud?veis-comportamentos em sa?de, empoderamento, participa??o social, autonomia, intersetorialidade, abordagem populacional, por?m, existe um conflito, refor?ado por diversos autores, diante do equ?voco conceitual em rela??o ? educa??o em sa?de e, mais preocupante pelo seu car?ter diferenciado enquanto a abordagens e pr?ticas, ? preven??o prim?ria. No processo de trabalho da Promo??o da Sa?de, foi destacada como finalidade ?melhorar a qualidade de vida das pessoas? assim como ?gerar empoderamento nos usu?rios?; como os instrumentos foram considerados os modelos te?ricos como fundamentos da pr?tica, assim como a combina??o de estrat?gias, as guias pr?ticas e diversos materiais educativos; j? as atividades estiveram relacionadas ? educa??o em sa?de, o uso de tecnologias online, as assessorias e os aconselhamentos em sa?de; os agentes constitu?ram-se nas figuras de agentes coletivos, como as enfermeiras e os m?dicos com diferentes ?rea de forma??o, os visitadores sanit?rios, os psic?logos, os assistentes sociais, assim como outros profissionais do servi?o de sa?de e a pr?pria comunidade; quanto a rela??o interpessoal, foi vis?vel o fortalecimento dos v?nculos entre usu?rios e as equipes de sa?de com certa potencialidade ? pr?tica de Promo??o da Sa?de. A avalia??o surgiu como um tema que apresenta fragilidades na pr?tica da Promo??o da Sa?de e que representa um desafio a ser conquistado. No confronto das ?reas de a??o da Promo??o da Sa?de com a sua pr?tica evidenciada no corpus do estudo, em rela??o ao desenvolvimento de pol?ticas saud?veis foi refor?ada a import?ncia do apoio aos respons?veis ?s decis?es e responsabiliza??o conjunta do Estado, dos servi?os de sa?de com seus profissionais e da comunidade. A cria??o de ambientes favor?veis ficou invis?vel, apesar da sua relev?ncia, uma vez que poderia estar associada ? ?pouca import?ncia? dada a eles na pr?tica e nas a??es de Promo??o da Sa?de. O fortalecimento comunit?rio teve rela??o direta com os processos de empoderamento e de participa??o social, ressaltando a intersetorialidade como chave nesse processo. O desenvolvimento de habilidades pessoais foi a ?rea mais trabalhada nos estudos analisados, focando em atividades de educa??o em sa?de e surgindo mais uma vez a preven??o como um conceito conflituante na compreens?o e na pr?tica da Promo??o da Sa?de; finalmente, a reorienta??o dos servi?os de sa?de foi vis?vel a necessidade de mudan?a de paradigmas e o fortalecimento da forma??o profissional em Promo??o da Sa?de. Consideramos que a Promo??o da Sa?de vem contribuir desde a sua abordagem inovadora, diferenciada e com um enfoque positivo aos servi?os de sa?de e especificamente de APS. O protagonismo do profissional com perfil em Promo??o da Sa?de ? significante no desenvolvimento de estrat?gias e a??es correspondentes com as ?reas de a??o, assim como para dissipar os conflitos pelos equ?vocos conceituais da Promo??o da Sa?de em rela??o aos conceitos de educa??o em sa?de e de preven??o principalmente.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-04-06T13:21:14Z No. of bitstreams: 1 DIS_LESLIE_TUANE_PENTEADO_CHARQUEIRO_COMPLETO.pdf: 2958975 bytes, checksum: 4a7418faecd62f7c0aa894222e469d3b (MD5) / Made available in DSpace on 2016-04-06T13:21:14Z (GMT). No. of bitstreams: 1 DIS_LESLIE_TUANE_PENTEADO_CHARQUEIRO_COMPLETO.pdf: 2958975 bytes, checksum: 4a7418faecd62f7c0aa894222e469d3b (MD5) Previous issue date: 2016-01-13 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / This work has as its theme: The Rural Population that makes part of the Primary Health Care from rural region of Viam?o/RS and the interface with the National Policy of Integral Health of Forest and Water Populations (PNSIPCFA), in the years 2014 and 2015. This work has as its ?locus? the Primary Health Care, and as its object: the PNSIPCFA. For this work, our qualitative research involved two groups: one with ?seated? (workers who receive government land) work farmers, and one with ?not seated? work farmers (work farms owners of their land). This way, we consider their living manners and their living conditions as well as the reflections of those in their health and their inclusion in the Primary Care. In addition, we realized three interviews with Primary Care professionals and with a Primary Health Care manager. In the analysis, we realized a complementary documental research and some observations. We used the dialectical-critical method, with Marxian base, along with the following core categories of the method: historicity, contradiction, totality, mediation and work. In this context, we recognize the vital need for the expanding of health services and intersectoral services to the rural population in their territories of living and working, territories that should be "used" (SANTOS; SILVEIRA, 2006), and should be experienced in the everyday labor, and also in the public services. Those represent the space production of health, while also it produces suffering, when it faced with adversities, such as the working for and on the land, with little investment, can cause. We point out that, despite the exploitation of the workforce, of the social inequalities and of the social question to be priority for the capitalist system, we present the historical bases of the Feudalism of Middle Ages, in the contemporary reality, these expressions connect increasingly, and it reflects the health of the population. Therefore, it is necessary the discussion about the health of the rural population, in its broader concept, to contribute with the implementation of the National Policy of Integral Health of Forest and Water Populations (PNSIPCFA), in Brazil. In the survey, we identified among the specific needs of the rural population, with cutout for work farm families. The specific necessities are regarded health injuries, and some connected with multi-causal processes that affect the general population of Viam?o, such as hypertension, heart disease, diabetes, overweight, and others with specific causes, but with similar diseases, such as musculoskeletal disease and mental suffering. The latter is due to the "uprooting", the historical violation of rights in the struggle for land and in the hard work on the land, causing depression (with high rates of controlled medication) and harmful use of alcohol, as well as diseases that may be related the use of pesticides. In this way, we aim to strengthen the essentiality of agricultural production that is free of pesticides, as a matter of public health and intersectoral, especially, in Brazil, the country that most use pesticides in the world. This discussion affects, directly and indirectly, the whole population, because the farm work family, basically, feeds us. Therefore, we should plan insertion strategies in the health that meet their entirety, as well as we should contribute to their quality of life, for the quality of life of the general population. / O presente trabalho tem como tema a Popula??o do Campo inserida na Aten??o B?sica em Sa?de (AB) da regi?o rural de Viam?o/RS e a interface com a Pol?tica Nacional de Sa?de Integral das Popula??es do Campo da Floresta e das ?guas (PNSIPCFA), nos anos de 2014 e 2015. Tendo como l?cus, a Aten??o B?sica em Sa?de e como objeto a PNSIPCFA. A pesquisa qualitativa contou com dois grupos focais, sendo um, com agricultores (as) assentados (as) e um com agricultores (as) n?o assentados (as), considerando seus modos e condi??es de vida e os reflexos destes em sua sa?de e inser??o na Aten??o B?sica. Tamb?m foram realizadas tr?s entrevistas, contemplando profissionais da Aten??o B?sica que atendem essa popula??o e um (a) gestor (a) da Aten??o B?sica em Sa?de. Assim como, foi realizada pesquisa documental e observa??o participante, para complementar a an?lise. Utilizamos o m?todo dial?tico-cr?tico, com base marxiana, tendo como categorias centrais do m?todo a historicidade, contradi??o, totalidade, media??o e trabalho. Neste contexto, afirmamos a necessidade de servi?os de sa?de e intersetoriais que acompanhem esta popula??o em seus territ?rios de vida e trabalho. Territ?rios que necessitam ser ?usados? (SANTOS; SILVEIRA, 2006), vivenciados no cotidiano de trabalho vivo e em ato, tamb?m pelos servi?os p?blicos. E que representa o espa?o de produ??o de sa?de, ao passo que tamb?m produz sofrimento, quando depara-se com adversidades, como as que o trabalho pela e na terra, com pouco investimento, pode ocasionar. Salientamos ainda, que apesar da explora??o da for?a de trabalho, das desigualdades sociais e portanto, da pr?pria quest?o social, ser anterior ao sistema capitalista, como apresentamos ao retomar as bases hist?ricas do feudalismo da Idade M?dia, na realidade contempor?nea, estas express?es se acirram cada vez mais, refletindo na sa?de da popula??o. Portanto, a necess?ria discuss?o sobre a sa?de da popula??o do campo, em seu conceito ampliado, visando contribuir com a implementa??o da Pol?tica Nacional de Sa?de Integral das Popula??es do Campo, Florestas e ?guas (PNSIPCFA) no Brasil. Na pesquisa identificamos entre as necessidades espec?ficas desta popula??o, com recorte para a agricultura familiar, referentes a agravos em sa?de, sendo que alguns v?o ao encontro dos processos multicausais que afetam a popula??o em geral do munic?pio, como hipertens?o, cardiopatias, diabetes e sobrepeso, outros com causas espec?ficas, mas com agravos semelhantes, como: osteomusculares, sofrimento mental decorrente do ?desenraizamento?, hist?rico de viola??es de direitos na luta pela terra e o trabalho ?rduo na terra, como: depress?o (altos ?ndices de uso de medica??o controlada) e uso prejudicial de bebida alco?lica, assim como agravos que podem estar relacionados ao uso de agrot?xicos. Desta forma, buscamos refor?ar a essencialidade da produ??o agr?cola livre de agrot?xicos, como uma quest?o de sa?de p?blica e intersetorial, principalmente no Brasil, pa?s que mais o usa no mundo. Uma discuss?o que afeta direta e indiretamente toda popula??o, pois ? a agricultura familiar que basicamente nos alimenta. Portanto, planejar estrat?gias de inser??o na sa?de que atenda sua integralidade, contribui para al?m de sua qualidade de vida, para a qualidade de vida da popula??o em geral.