Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T19:09:34Z No. of bitstreams: 1 EleniDeAraujoSalesCastro_DISSERT.pdf: 2226981 bytes, checksum: 604d29272bb7927dde8e89669d471ef4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-21T19:05:40Z (GMT) No. of bitstreams: 1 EleniDeAraujoSalesCastro_DISSERT.pdf: 2226981 bytes, checksum: 604d29272bb7927dde8e89669d471ef4 (MD5) / Made available in DSpace on 2017-03-21T19:05:40Z (GMT). No. of bitstreams: 1 EleniDeAraujoSalesCastro_DISSERT.pdf: 2226981 bytes, checksum: 604d29272bb7927dde8e89669d471ef4 (MD5) Previous issue date: 2016-06-20 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / A altera??o no padr?o de sono e vig?lia, uma das consequ?ncias do trabalho em turnos e noturno, causa in?meras altera??es biopsicossociais que interferem nos processos sa?de-doen?a dos trabalhadores. Um dos impactos dessas altera??es ? observado no processo de tomada de decis?o, um dos construtos das Fun??es Executivas. No contexto de trabalho de urg?ncias e emerg?ncias em sa?de, a tomada de decis?o torna-se um dos elementos mais importantes, pois embora a maioria das decis?es possa ser resolvida com a equipe preparada, o cen?rio de imprevisibilidade e gravidade das interven??es exp?e a equipe m?dica a um estresse constante, que pode prejudicar atividades como planejar respostas apropriadas. Este estudo teve como objetivos gerais avaliar a rela??o entre sono e tomada de decis?o em 26 m?dicos de unidades m?veis de aten??o ?s urg?ncias, submetidos a esquemas de turnos e traduzir e adaptar para o portugu?s cen?rios hipot?ticos de tomada de decis?o baseados na Policy Capturing-Technique. Para avalia??o do sono, foram utilizados o ?ndice de Qualidade de Sono de Pittsburgh (IQSP), o Question?rio de H?bitos de Sono, a Escala de Sonol?ncia de Epworth e o Question?rio de Identifica??o de Cronotipo de Horne-Ostberg. Para avalia??o da tomada de decis?o foi utilizado o Iowa Gambling Task (IGT) e cen?rios hipot?ticos criados de acordo com a T?cnica Policy-Capturing. Para crit?rios de inclus?o/exclus?o, os participantes responderam ? Escala de Fadiga de Chalder, ao Invent?rio de Ansiedade de Beck (BDI), ao Invent?rio de Depress?o de Beck (BDI) e ao Invent?rio de Sintomas de Stress para Adultos de Lipp (ISSL). Os participantes foram divididos em turno diurno (N=6) e alternante (N=20). Os resultados mostraram uma boa qualidade de sono para os m?dicos do turno diurno e uma m? qualidade do sono para os m?dicos do turno alternante. Uma boa qualidade de sono e menor sonol?ncia foram correlacionados com melhores desempenhos na tomada de decis?o. Foi feita uma avalia??o com o objetivo de verificar rela??o entre os dois protocolos de tomada de decis?o e o resultado mostrou correla??o entre eles, indicando pior tomada de decis?o avaliada pelo IGT relacionada a preju?zos na tomada de decis?o avaliadas pelos cen?rios. Foi encontrada tomada de decis?o prejudicada quando avaliada ao longo do turno. Conclui-se que o esquema de trabalho em turnos alternantes pode ser prejudicial para a qualidade de sono dos m?dicos e que uma boa qualidade de sono pode contribuir para um melhor desempenho na tomada de decis?o. / The change in sleep-wake patterns, one of the consequences of shift work and night shifts, causes many biopsychosocial changes that interfere on the health-disease processes of workers. One of the impacts caused by these changes is observed in decision-making, one of the components of executive functioning. In the context of emergency care in health work, decision making becomes one of the most important elements, because although most decisions can be resolved with a prepared team, the unpredictability scenario and the severity of interventions exposes the medical team to a constant stress, which can impair activities such as plan appropriate responses. This study aimed to assess the relationship between sleep and decision making in 26 medical technicians of the emergency care units undergoing shifts schemes and to translate and adapt to Portuguese decision-making hypothetical scenarios based on Policy-Capturing Technique. To sleep evaluation, we used the Pittsburgh Sleep Quality Index (PSQI), the Sleep Habits Questionnaire, the Epworth Sleepiness Scale and Chronotype Identification Questionnaire Horne-Ostberg. To evaluate the decision-making, was used the Iowa Gambling Task (IGT) and hypothetical scenarios created according to the Policy-Capturing Technique, which were translated into Portuguese and adapted according to the needs of our sample. For inclusion / exclusion criteria, the participants answered the Chalder Fatigue Scale, the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI) and the Inventory of Stress Symptoms for adults of Lipp (ISSL). Participants were divided into day shift (N = 6) and alternating shift (N = 20). The results showed a good sleep quality for physicians of the day shift and poor sleep quality for the alternating shift. A good quality sleep and less somnolence were correlated with better performance in decision-making. An assessment was made in order to verify the relationship between the two decision-making protocols and the results showed a correlation between them, indicating worse decision-making evaluated by IGT related to losses in decision making evaluated by the scenarios. It was found impaired decision making when measured along the shift. It is concluded that the scheme of alternating shift work can be detrimental to the sleep quality of doctors and a good sleep quality can contribute to a better performance in decision-making.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-01T19:39:20Z No. of bitstreams: 1 AdsonJoseMartinsVale_DISSERT.pdf: 14003565 bytes, checksum: c871eb04fc62efb93ff0f97e88496f17 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-07T19:49:49Z (GMT) No. of bitstreams: 1 AdsonJoseMartinsVale_DISSERT.pdf: 14003565 bytes, checksum: c871eb04fc62efb93ff0f97e88496f17 (MD5) / Made available in DSpace on 2016-04-07T19:49:49Z (GMT). No. of bitstreams: 1 AdsonJoseMartinsVale_DISSERT.pdf: 14003565 bytes, checksum: c871eb04fc62efb93ff0f97e88496f17 (MD5) Previous issue date: 2015-04-24 / Para a atua??o em urg?ncias, ? importante que os profissionais de sa?de desenvolvam habilidades espec?ficas e diferenciadas, partindo do planejamento da capacita??o em urg?ncia. Assim, os cursos de medicina e enfermagem devem favorecer o desenvolvimento dessas habilidades e avali?-las atrav?s de v?rios instrumentos direcionados para os diversos dom?nios. O objetivo do presente estudo foi implementar um componente curricular optativo e interprofissional, voltado para a educa??o interprofissional em urg?ncia pr?-hospitalar para os cursos de medicina e enfermagem da Universidade Federal do Rio Grande do Norte (UFRN). Trata-se de um estudo descritivo explorat?rio, com 24 discentes de medicina do internato e de enfermagem do est?gio supervisionado, que realizaram est?gio te?rico-pr?tico no atendimento de urg?ncias pr?- hospitalares. Foram realizadas aulas semanais te?rico-pr?ticas por um semestre letivo, ministradas por m?dicos e enfermeiros do Atendimento Pr?- Hospitalar (APH), cujos temas abordados foram: suporte b?sico de vida (SBV), suporte avan?ado de vida (SAV), transporte seguro em urg?ncias cl?nicas, traum?ticas, gineco-obst?tricas, pedi?tricas e psiqui?tricas, al?m de terem sido realizadas atividades pr?ticas em ambul?ncias. Os discentes foram avaliados por pr?-teste, p?s-teste e esta??es pr?ticas realizadas atrav?s do Objective Structured Clinical Evaluation (OSCE), no Laborat?rio de Habilidades do Centro de Ci?ncias da Sa?de. Durante as atividades, os alunos foram estimulados ao racioc?nio cr?tico-reflexivo, ressaltando a import?ncia da integra??o entre os diversos profissionais de assist?ncia ? sa?de. Observou-se que 88% dos alunos apresentaram aumento de escore em rela??o ao pr?-teste. Na avalia??o do processo realizada pelos estudantes de medicina e enfermagem da UFRN, foram apresentadas expectativas semelhantes ? rela??o com as habilidades essenciais adquiridas durante a atividade de forma??o. Al?m de contribuir para organizar esta??es pr?ticas, identificando habilidades cl?nicas b?sicas, e implementando instrumentos de avalia??o para discente da UFRN, os resultados do presente estudo servir?o de base para organiza??o da atividade de forma??o interprofissional em urg?ncia pr?-hospitalar do curso m?dico e de enfermagem. / To acting in emergencies it is important that health professionals develop specific and differentiated skills, which shows us the importance of training in emergency planning. So undergraduate courses in medicine and nursing should encourage the development of these skills and evaluate them through various instruments targeted to the different fields. The aim of this study was to implement an optional and interprofessional curricular component, focusing on interprofessional education in pre-hospital emergency for medical and nursing courses Federal University of Rio Grande do Norte (UFRN). This is an exploratory descriptive study, with 24 medical and nursing graduates of last year undergraduate of supervised training, who underwent theoretical and practical training in the care of pre-hospital emergency services. There were theoretical and practical lessons per week for one school semester, taught by doctors and nurses of the Emergency Medical Service (EMS), where the topics discussed were: basic and advanced life support, safe transport in clinical emergencies, trauma, gynecological, obstetric, pediatric and psychiatric diseases, and have been carried out practical activities in ambulances. The students were evaluated by pre-test, post-test and practical stations made through the Objective Structured Clinical Evaluation (OSCE), in the skills laboratory of the Health Sciences Center. During the activities the students were encouraged to critical and reflective thinking, highlighting the importance of integration between the various health care professionals. It was observed that 88% of the students had a score increase over the pre-test. In the evaluation process carried out by medical students and nursing UFRN have similar expectations regarding the essential skills acquired during the training activity. The results of this study will form the basis for the organization of interprofessional education activity in pre-hospital emergency medical students and nursing, as well as helped to organize practices stations, identifying basic clinical skills, and implementing student assessment tools UFRN.