Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 151-159). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

Orientador: Luciane Miranda Guerra / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-25T11:30:00Z (GMT). No. of bitstreams: 1 Gondinho_BrunnaVernaCastro_M.pdf: 3730108 bytes, checksum: 01cd854fd700df402d02f1d2290b1243 (MD5) Previous issue date: 2014 / Resumo: Estudo descritivo transversal, quali-quantitativo, teve por objetivo identificar as atitudes dos profissionais da Estratégia Saúde da Família (ESF) do município de Teresina ¿ PI, frente à dependência química, bem como, conhecer a origem do referenciamento dos usuários de álcool e outras drogas ao Centro de Atenção Psicossocial Álcool e Drogas (CAPS AD). A pesquisa foi realizada nas 250 equipes de ESF implantadas em Teresina-PI, na Fundação municipal de Saúde (FMS) e no único CAPS AD da capital. Para as equipes de ESF, foram escolhidos dois profissionais de nível superior, sendo um médico e um enfermeiro. Considerando-se três regionais de saúde, calculou-se um número amostral de 203 entrevistas para cada categoria profissional com resposta para a população geral, considerando um nível de confiança de 95%, erro amostral de 5%. Portanto, 66 equipes da Regional Sul, 72 da Regional Leste/Sudeste e 65 da Regional Centro/Norte. Na FMS a pesquisa foi aplicada aos gerentes de Atenção Básica e Psicossocial, assim como também, aos diretores das três Diretorias Regionais de Saúde (DRS). No CAPS AD o estudo foi realizado com o gestor e para se conhecer a origem do referenciamento ao CAPS AD, foram analisados 272 prontuário de adesão, do período de julho a dezembro de 2013. A coleta de dados foi realizada por meio de questionário individual semiestruturado e sua análise se deu, por meio descritivo para as questões fechadas enquanto que as questões abertas foram analisadas pela teoria do Discurso do Sujeito Coletivo (DSC). Realizou-se um estudo piloto em 31 equipes de ESF do município e com 10 prontuários de adesão ao CAPS AD. Os resultados sociodemográficos para os profissionais da ESF demonstraram que 82,56% são do gênero feminino, que 59,3% são pós-graduados e que o tempo de trabalho na ESF é de seis a mais anos para 59,3%. Quanto aos sentimentos de médicos e enfermeiros da ESF; tristeza, desconforto, compaixão, insegurança, medo e receio foram os destaques para ambas as categorias profissionais, ambos os gêneros, todas as escolaridades e todos os períodos de atuação na ESF. Em relação ao referenciamento ao CAPS AD, nota-se um pequeno valor de usuários oriundos da ESF (2,94%), enquanto que a demanda espontânea e as indicações de amigos e familiares somam 53,3%, além de se ter constatado que existem vários pontos emissores de referenciamento para o usuário. Os discursos de gestores e profissionais revelaram que a maioria possui uma concepção teórica adequada sobre a necessidade, para atenção integral ao usuário, de um serviço organizado e com articulação entre suas partes, porém observou-se nos depoimentos dificuldades e limitações neste processo. Dentre os problemas identificados estão a falta de estrutura, organização e articulação dos serviços, assim como também, a deficiência na capacitação dos profissionais para atuar com a demanda de dependentes químicos. As limitações e dificuldades referentes à organização e articulação dos serviços, bem como, as relacionadas à capacidade dos profissionais em atuar com usuários dependentes químicos representam obstáculos na consolidação do Sistema Único de Saúde (SUS) enquanto estrutura organizada em redes garantidora de atenção integral ao usuário / Abstract: Qualitative and quantitative, cross-sectional and descriptive study had by its objective to identify the attitudes of professionals in the Family Health Strategy (ESF) in the city of Teresina - PI, in the face of chemical dependency, as well as, to know the origin of the referencing of alcohol and other drugs's users to Psychosocial Care Center Alcohol and Drugs (CAPS AD). The survey was carried out in 250 ESF teams deployed in Teresina-PI, in the Municipal Health Foundation (FMS) and in the only one AD CAPS from the capital. To the ESF teams were chosen two higger-level professionals, one physician and the other one nurse. Considering three regional health, was calculated a sample number of 203 interviews for each professional category with response to the general population, considering a level of 95% of confidence, sampling error of 5%. Therefore, 66 teams of Southern Regional, 72 of East / Southeast Regional and 65 of the Regional Centre / North. In the FMS the survey was administered to managers of Primary Care and Psychosocial, as well as, to the directors of the three Regional Health Directorates (DRS). In the CAPS AD the study was conducted with the manager and to get to know the origin of the referencing to the CAPS AD, 272 membership records were analyzed, from July to December 2013. The data collection was conducted through of individual semistructured questionnaire and its analysis was made by descriptive means to the closed questions while open questions were analyzed by the theory of the Collective Subject Discourse (CSD). We performed a pilot study in 31 teams of ESF from the municipality and with 10 membership records to the CAPS AD. The socialdemographic results for the professionals from the ESF showed that 82.56% are female, that 59.3% are postgraduates and also that the working time in the ESF is six up to more years for 59.3%. Concerning about the feelings of the doctors and nurses from ESF, they are: sadness, discomfort, compassion, insecurity and fear were the highlights for both professional categories, both genders, all the education levels and all the periods of operation at ESF. In relation to the referencing to the CAPS AD, there has been a small amount of users coming from the ESF (2.94%), while the spontaneous demand and indications from friends and family account 53.3%, besodes it was found that there are several emitters points of referencing to the user. The speeches of managers and professionals revealed that most have adequate theoretical conception about the need, for full attention to the user, of such an organized service and with articulation between its parts, but it was noted in the interviews difficulties and limitations in this process. Among the pointed problems, there are the lack of structure, organization and coordination of services, as well as, the deficiency on the professionals capacitation to work with the demand of chemical addicts. The limitations and difficulties related to the organization and coordination of services, as well as those related to capacity of professionals at working with users chemical addicts represent obstacles in the consolidation of the Unified Health System (SUS) while being organized structure into networks guarantor of full attention to the user / Mestrado / Odontologia em Saude Coletiva / Mestra em Odontologia em Saúde Coletiva

Bakgrund: Psykisk ohälsa och sjukdom är vanligt förekommande i Sverige, tidigare studier har visat att personer med psykisk ohälsa eller sjukdom löper större risk att drabbas av somatiska sjukdomar jämfört med den generella populationen. Det förekommer att dessa patienter upplever stigmatisering i så väl samhället i stort som inom hälso- och sjukvården, vilket kan medföra risk för bristfällig omvårdnad av denna patientgrupp inom den somatiska vården. Syfte: Syftet var att utforska verksamma och blivande sjuksköterskors attityder gentemot patienter med psykisk ohälsa och sjukdom inom den somatiska vården. Metod: Elva vetenskapliga studier inkluderades i en litteraturstudie inom det valda forskningsområdet. Databaserna PubMed, CINAHL och PsycInfo användes för datainsamling. Samtliga artiklar kvalitetsgranskades och besvarade frågeställning och syfte. Resultat: Resultatanalysen resulterade i tre kategorier som beskriver attityder till psykisk ohälsa bland sjuksköterskor och blivande sjuksköterskor. Dessa kategorier är; Positiv attityd, Negativ attityd och Undvikande attityd. Erfarenhet, utbildning och kunskap är några av de viktigaste faktorerna som visat sig ha en inverkan på attityden till att vårda patienter med psykisk ohälsa. Slutsats: Sjuksköterskor och sjuksköterskestuderande har varierande attityder till att vårda patienter med psykisk ohälsa och sjukdom inom somatisk vård. Bristande kunskap och erfarenhet av psykisk ohälsa kan bidra till stigmatiserande och avståndstagande attityder, vilket kan leda till att patienten inte alltid får en optimal och likvärdig vård. Kunskap om dessa attityder kan bidra till att utveckla omvårdnaden för personer med psykisk sjukdom inom somatisk vård. / Background: Mental illness is common in Sweden, previous studies demonstrate that people with mental illness have an increased risk of physical illness compared to the general population. These patients often experience stigmatization generally in society, as well as within health care, which can result in a deficient care of these patients in the somatic care. Purpose: The aim of the study was to explore registered nurses and nursing students’ attitudes towards patients with mental illness in somatic care. Method: Ten scientific studies were included in a literature study of the chosen research field. The databases PubMed, CINAHL and PsycInfo was used for data collection. All the articles reviewed for quality and answered the purpose. Findings: The analysis resulted in three categories that describe attitudes to mental illness among nurses and nursing students. These categories are; Positive attitude, Negative attitude and Avoiding attitude. Experience, education and knowledge are some of the factors that can have an impact on the attitude towards caring for patients with mental illness. Conclusion: Nurses and nursing students express varying attitudes towards caring for patients with mental illness treated in somatic hospital settings. Lack of knowledge and experience of mental illness can result in stigmatization and rejection attitudes towards the patient, as well as an unequal care. Increased awareness about such attitudes can contribute to developing nursing care for these patients.

Psykisk ohälsa är utbrett inom samhället och riskerar att påverka individers hälsolitteracitet negativt. Samsjukligheten för psykisk ohälsa är hög och personer med psykisk ohälsa löper stor risk att drabbas av andra sjukdomar. För att kunna ge personcentrerad vård krävs att vårdpersonal synliggör och tillgodoser psykiska behov i lika hög utsträckning som fysiska. Situationen inom akutsjukvården är ansträngd och en stor del av patienters klagomål som anmäls handlar om bristande kommunikation. Trots att personer med psykisk ohälsa har rätt till jämlik vård ses förbättringsbehov inom somatisk vård.Syftet var att beskriva vårdpersonalens attityder och erfarenheter avseende personer med psykisk ohälsa inom akutsjukvård. Metoden var en litteraturöversikt och genomfördes med hjälp av databassökningar i PubMed, Cinahl och PsycINFO samt manuell sökning. Sjutton kvalitativa och kvantitativa vetenskapliga originalartiklar inkluderades i litteraturöversikten. Resultatet visade att vårdpersonalens attityder gentemot personer med psykisk ohälsa var negativ inom akutsjukvård. Attityderna varierade beroende på vilket psykiskt ohälsotillstånd som åsyftades. Attityder till att personer med psykisk ohälsa inte hörde hemma inom akutsjukvård förekom och uppfattningen om att personer med psykisk ohälsa fick sämre vård jämfört med andra patienter lyftes fram. Vårdpersonal upplevde att attityder till personer med psykisk ohälsa hade förbättrats över tid men att stigmatisering fortfarande existerade. Erfarenheter och upplevelser som framkom i resultatet var bristande kompetens i form av okunskap om psykisk ohälsa och oförmåga att kunna ge likvärdig vård och omvårdnad till personer med psykisk ohälsa. Arbetsmiljö och arbetsbelastning var framträdande faktorer i vårdpersonalens erfarenheter och upplevelser om personer med psykisk ohälsa. Tidspress och personalbrist framhävdes som orsaker som påverkade vården av personer med psykisk ohälsa negativt, liksom bristfälliga lokaler. Känslor som frustration, rädsla och oro beskrevs av vårdpersonal. Kommunikation med personer med psykisk ohälsa ansågs nödvändig men svår med tanke på olika tillstånd av psykisk ohälsa. Utbildning i psykisk ohälsa efterlystes av vårdpersonalen. Slutsatsen var att på grund av vårdpersonalens negativa attityder till personer med psykisk ohälsa finns det anledning att utveckla medvetenheten och kunskap kring psykisk ohälsa för att kunna utveckla vård och omvårdnad inom akutsjukvård. / Mental illness is widespread in society and could affect individuals mental health literacy negative. The co-morbidity of mental disorders is high, and people with mental illness are likely to suffer from other diseases. In order to provide person-centered care requires health professionals identifies and meet the psychological needs to the same extent as physical. The situation in emergency care is strained and a large part of the patients' complaints are notified about a lack of communication. Despite the fact that people with mental illness have the right to equal care a need for improvement is seenin somatic care. The aim was to describe the health professionals' attitudes and experiences regarding persons with mental illness in emergency care. The method was in form of literature review and was carried out with database searches in PubMed, Cinahl and PsycINFO and manual. Seventeen qualitative and quantitative scientific original articles were included. The results showed that the nursing staff attitudes towards people with mental illness were negative in emergency care. Attitudes varied depending on the mental illness as alluded. Attitudes towards people with mental illness do not belong in emergency care occurred, and the perception that people with mental illness got not as goodcare than other patients was highlighted. Health professionals felt thatthe attitudes to people with mental health had improved over time but that stigma still existed. Experiences that emerged in the result was a lack of expertise in the form of ignorance about mental illness and the inability to provide equal care and nursing for people with mental illness. Time for caringand workload were prominent factors in health professionals' experiences and perceptions of taking careof people with mental illness. Time pressure and staff shortages were highlighted as factors that affectedthe care of people with mental health negatively, as well as flawed premises. Emotions like frustration, fear and anxiety was described by health professionals. Communication with people with mental illness was considered necessary but difficult given the various states of mental illness. Training in mental health was wishedby the health professionals. The conclusion showed that because of the health professionals' negative attitudes towards people with mental illness, it is necessary to develop awareness and knowledge about mental health to develop health care and nursing in emergency care.

Bakgrund: Cirka 35 miljoner människor i världen mellan 15-64 år uppskattas idag vara påverkade av ett substansmissbruk. Sjukligheten och dödligheten ökar vid ett substansmissbruk och det finns många skadliga hälsoeffekter som påverkar både den sociala och fysiska hälsa. Som vårdpersonal är det viktigt att sätta vårdsökandes behov i centrum och se personen bakom sjukdomen. För att kunna ge en personcentrerad vård till personer med substansmissbruk är det viktigt att belysa hur de upplever bemötandet inom hälso- och sjukvården, eftersom bemötandet kan påverka patientsäkerheten. Syfte: Studiens syfte var att beskriva personer med substansmissbruks erfarenheter av bemötande inom hälso- och sjukvården. Metod: En kvalitativ litteraturstudie utfördes, som baserades på 12 artiklar. Databassökningen utfördes i PubMed, Cinahl och PsycInfo. Analysen genomfördes utifrån Rebecca Popenoes analysmodell. Resultat: Resultatet presenteras i tre kategorier och sex subkategorier. De tre kategorierna som framkom var: Mötas av förändrade beteenden, Sakna professionellt bemötande och Bli professionellt bemött. Konklusion: Både positiva och negativa erfarenheter av bemötandet inom hälso- och sjukvården framkom. För att tillhandahålla en god och jämlik vård kan resultatet användas för att förbättra vårdpersonalens bemötande. / Background: Around 35 million people worldwide, between the ages of 15-65 are estimated today to be affected by a substance use disorder. Morbidity and mortality increases with substance use disorder and there are many harmful health effects that affect both social and physical health. As healthcare professionals, it is important to put the patient's needs at the center and see the person behind the illness. In order to be able to provide a person-centered care to people with substance use disorder, it is important to shed light on how they experience healthcare, because it can affect the patient's safety. Aim: The aim of the study was to describe people with substance use disorder experiences of healthcare. Methods: A qualitative literature study was performed, which was based on 12 articles. Database search was performed in PubMed, Cinahl and PsycInfo. The analysis was conducted on Rebecca Popenoe´s analysis model. Results: The results are presented in three categories and six subcategories. The three categories that were revealed were: Being met with changed behaviors, Lack of professionalism and Being treated professionally. Conclusion: Both positive and negative experiences appeared in healthcare. The result can be used to improve the attitude of health personnel to provide good and equal care.

Objetivo: Caracterizar o perfil de percepções e atitudes de médicos residentes frente às diferentes situações geradoras de incertezas na prática assistencial aos pacientes. Método: Estudo descritivo, comparativo e transversal. Amostra não aleatória de 90 residentes da instituição. O estudo foi conduzido entre abril e julho de 2013. Para a avaliação da percepção do enfrentamento da incerteza no cenário clínico foi realizada usando a escala \"Physician Reaction\'s to Uncertainty\", após realizados uma tradução transcultural para português do Brasil. A \"Physician Reaction\'s to Uncertainty\", contém 15 itens que são respondidos de acordo com a variante de escala de Likert de seis pontos (discorda completamente = 1; concorda plenamente = 6). Avaliamos os residentes de acordo com o gênero; idade, menores de 26 anos e 26 anos ou maiores; residentes de primeiro ano comparados com os segundo e terceiro anos e residentes clínicos comparados com os cirurgiões, ortopedistas e ginecologistas/obstetras. Resultados: As residentes mulheres mais jovens e os com menos tempo de treinamento (residentes do primeiro ano), tiveram uma pior percepção do enfrentamento da incerteza na atuação clínica quando comparados aos homens (p=0,002) aos >= 26 anos (p= 0,001) e com mais tempo de treinamento (p < 0,001). Não houve diferença entre os residentes clínicos comparados com os de ortopedia, cirurgia e ginecologia obstetrícia (p=0,792). Conclusões: Os médicos residentes mais jovens e com menor tempo de prática merecem um uma atenção especial para um melhor enfrentamento da incerteza na atuação clínica. São eles que apresentam as maiores dificuldades com o tema. Atuar junto a professores mais experientes e a inserção da formação humanística e filosófica podem ajudar aos colegas residentes com menos prática na medicina / Purpose: The aim of this study was to develop a characterization profile of the perceptions and attitudes of resident physicians in a general hospital in São Paulo, Brazil addressing the uncertainties related to the care of patients. Methods: Descriptive, comparative and cross-sectional study conducted from April to July 2013 with a convenience sample of 90 medical residents who completed the Physicians´ Reactions to Uncertainty (PRU) scale and provided demographic variables of gender, age and specialty. Results: Comparing the Physician´s Reaction to Uncertainty score, authors identified a significant difference between age, year of residence and gender. Physicians who were female, less than 26 years old and who were in their first year of residency and had greater clinical uncertainty than men (p=0.002), older residents (p= 0,001), those in their second and third year of residency (p < 0,001). There were no significant differences by medical speciality (p=0,792). Conclusion: Practical experience and age are important factors in clinical uncertainty in residence groups. The longer physicians are in practice, the less uncertainty they will experience. Ways to decrease the anxiety of and reluctance to disclose uncertainty to patient can include: 1) Practice together with experience doctors; 2) Clinical epidemiology; 3) knowledge of philosophy and 4) Humanistic teaching

Wong Shun-wah. / Thesis submitted on: December 2002. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 84-91). / Abstract --- p.i / Acknowledgements --- p.iii / Contents --- p.v / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Empirical Puzzle and Theoretical Questions / Chapter 1.2 --- Casing a Case: Hospital as a Critical Case for Studying Gender and Professional Authority / Chapter 1.3 --- The Methodology / Chapter 1.4 --- Overview of the Thesis / Chapter Chapter 2 --- Literature Review and Theoretical Framework --- p.10 / Chapter 2.1 --- Professional dominance and Professional Dependency / Chapter 2.2 --- Enthographic Studies of Resistance / Chapter 2.3 --- Gender and Organization / Chapter Chapter 3 --- Gendering Occupation in the Health Care Sector and the Gendered Occupational Structure of Hospitals --- p.16 / Chapter 3.1 --- Gender Segregation in the Health Care Workplace / Chapter 3.2 --- Hospital Setting: A Gendered Organization / Chapter Chapter 4 --- Resistance of Nurses --- p.45 / Chapter 4.1 --- Resistance Strategies of Women Nurses Mothering Gossip Symbolic Giving Explicit Resistance / Chapter 4.2 --- Strategies of Men Nurses: Resistance and Dilemma / Chapter 4.3 --- Divided and Not Organized / Chapter Chapter 5 --- Restrictive Authority of Doctors --- p.70 / Chapter 5.1 --- The Dependency of Doctors on Nurses in the Gendered Organizational Structure of Hospital / Chapter 5.2 --- Men Doctors' Means to Gain the Compliance of Nurses / Chapter 5.3 --- Women Doctors' Means to Gain the Compliance of Nurses / Chapter Chapter 6 --- Conclusion --- p.80 / Chapter 6.1 --- The Consequences of the resistance of women nurses: Accommodation and the Reproduction of Gender / Chapter 6.2 --- The Contribution of this Research and Issues for Future Study / Bibliography --- p.84

A história dos transplantes vem rompendo barreiras e enfrentando desafios embora de forma incipiente, por diversas décadas, conquistando impressionantes resultados, demonstrando a evolução científica e tecnológica aplicada ao setor. Assim, observa-se que, ao longo dos tempos, o número de doações tem aumentado. Porém, não o suficiente para reduzir a lista de espera, cabendo então a reflexão acerca das causas que dificultam esse processo. Diversos são os motivos pelos quais afetam a doação de órgãos, ressaltando-se a recusa dos familiares e a não notificação de possíveis doadores. Assim, vale ressaltar a importância do preparo profissional no que diz respeito à abordagem familiar, momento decisivo para que se possa dar continuidade ao processo de captação de órgãos. Diante do exposto, o estudo tem por objetivo explorar, recolher, organizar, sintetizar e compartilhar visão dos familiares em relação a atuação dos profissionais no processo de doação de órgãos. A metodologia retrata uma revisão sistemática da literatura brasileira sobre o tema central baseando na busca de artigos que demonstrassem resultados de pesquisas realizados no País, entre 2001 e 2011, no portal PubMed e nas bases de dados SCOPUS, CINAHL, EMBASE, Web of Science, Science Direct, LILACS, BDENF. Tal busca guiou-se pela pergunta: Qual a visão dos familiares, que passaram pela abordagem para doação de órgãos, referente à atuação dos profissionais que atuam neste processo? Como resultados dos 265 trabalhos encontrados, foram considerados pertinentes, à temática em apreço, 06 artigos, os quais foram submetidos à leitura criteriosa da metodologia utilizada, dos sujeitos investigados, dos resultados obtidos e das conclusões. As sínteses foram construídas a partir da análise temática dos resultados. Surgiram 03 categorias. Sendo elas: 1) Falta de confiança na atuação profissional; 2) Atuação profissional sem compreensão e acolhimento no momento familiar; 3) Falta de informação pelo profissional. Desta última, emergiram duas subcategorias: 1) Falta de informação pelo profissional à família referente à possível Morte Encefálica; 2) Falta de informação pelo profissional à família referente aos trâmites pós-doação. Consideramos, portanto, que a complexidade de ações que são necessárias no processo de doação de órgãos, foi revelada como burocrático, demorado, desgastante e cansativo, resultando em sofrimento e submetendo tanto a família quanto os profissionais a situações estressantes. Disto depreendemos haver necessidade de maiores investimentos na formação dos profissionais que atuam neste processo, melhorando seu suporte emocional e sua atuação, a qual é considerada incipiente pelos familiares. / Transplants\' history are breaking barriers and facing challenges for several decades achieving impressive results. It demonstrates scientific and technological developments applied to this sector. Although an increasing on organs donations have been noted, it is not enough to reduce waiting list. Therefore there is a need for reflection on the causes, which makes this process. There are several reasons that affect organ donation, and shall be emphasized: relatives\' refusal and failure in notifying potential donors. It is also worth highlighting the importance of professional competence in respect of family approach, a decisive moment that gives continuity to the process of organ retrieval. In this light, the study aims to explore, collect, organize, synthesize and share the opinion of relatives about the role of professionals during process of organ donation (POD). As methodology a systematic review of Brazilian literature was conducted between 2001 and 2011. Data was collected from (i) PubMed, (ii) SCOPUS, (iii) CINAHL, (iv) EMBASE, (v) Web of Science, (vi) Science Direct, (vii) LILACS, and (viii) BDENF. Such data collection was performed based on one question: What is the opinion of relatives, who went through organ donation approach, referring to professionals\' actions working in this process? Six out of 265 papers were considered relevant, and then a careful reading executed to assess methodology, subjects investigated, results and conclusions. Analyses have enable to define three categories: (a) lack of confidence in the professional, (b) professional attitude without understanding of relatives emotional state, (c) professional apathy in provide information to family. The last category was subdivided in (i) lack of info about a possible brain death, and (ii) subsequent procedures about POD. These study revealed a complexity in POD particularly on bureaucracy, delay, family\'s fatigue and wear. Thus, we may conclude to be necessary investing efforts on professional training involved in the POD to protect family\'s psychological state.

Orientador: Orlando Saliba / Banca: Rodolfo Francisco Haltenhoff Melani / Banca: Renato Moreira Arcieri / Resumo: A violência intrafamiliar caracteriza-se pelo abuso físico, psicológico e sexual de um membro da família por outro. Mesmo este sendo um problema que envolve vários setores sociais, os serviços de saúde e as instituições policiais acabam sendo procurados, devido às seqüelas decorrentes da agressão. Este estudo tem por objetivos, avaliar qual a responsabilidade dos profissionais de saúde ante a legislação e aos casos confirmados ou suspeitos de violência doméstica; verificar a prevalência do problema nos últimos 5 anos em Araçatuba-SP e analisar as impressões das vítimas sobre a situação após sofrerem violência. O projeto contou com aprovação do Comitê de Ética em Pesquisa da FOA-UNESP, processo 2005-01861. A primeira parte do estudo contou com pesquisa bibliográfica na legislação civil e penal pertinente e nos Códigos de Ética da Medicina, Odontologia, Enfermagem e Psicologia. Num segundo momento foram analisados os Termos Circunstanciados e Inquéritos Policiais registrados na Delegacia de Defesa da Mulher de Araçatuba-SP, entre os anos de 2001 a 2005. Por fim, foram feitas entrevistas semi-estruturadas com 21 vítimas de violência doméstica física que recorreram à referida unidade policial, no período de julho a agosto de 2006. Os resultados demonstraram que no referente à legislação civil e penal, a obrigação está disposta nas Leis 8.069/90, 10.741/03, 10.778/03 bem como no Decretolei 3.688/41 que prevêem sanções aos que omitirem a notificação destes casos. Dentre os Códigos de Ética, todos trazem implícita ou explicitamente a obrigação do profissional diante da situação de violência. A pesquisa epidemiológica foi realizada em 7.750 registros de ocorrências, dos quais 1.844 estavam relacionadas à agressão física cometida por pessoa da família ...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The familiar violence presents characteristics as physical, psychological and sexual abuse of a family member by another. Even if this problem involves many social sectors, the health services and police institutions are looked for victims, due to sequel from agression. The aim of this study is to evaluate what is the responsibility of health professional in relation to legislation and to confirmed or suspected cases of domestic violence; to verify the prevalence of this problem in the last 5 years in Araçatuba/SP - Brazil and to analyse victim's perceptions about situation after suffering violence. The project received ethical approval from the Research Ethics Committee of the Araçatuba School of Dentistry (file: FOA 2005-01861). The first part of the study was represented by the bibliographic research on civil and penal legislation and on Medicine, Dentistry, Nursing and Psychology Ethics Code. After, Circumstanced Terms and Police Assizes were analysed. They were registered on Police Post, between 2001 and 2005. Finaly, interviews were done with 21 physical domestic violence victims that appealed to Woman Defense Post Police Post of Araçatuba/SP - Brazil, on period from July to August, 2006. The results showed that about civil and penal legislation, the duty is disposed on Laws number 8.069/90, 10.741/03, 10.778/03 as well as on Decree-Law 3.688/41 that supposed sanctions for person that omits notification of these cases. Among Ethics Codes, all show implicitly and explicitly the duty of professional related to violence situation. Epidemiologic research was conducted on 7.750 registers of occurrence. Among them, 1.844 were associated with physical aggression committed by a family member. This kind of occurrence take place more frequently between Saturday and Sunday (37.30%), at 6pm-12am (44.20%) ...(Complete abstract, click electronic address below) / Mestre

Orientador: Orlando Saliba / Banca: Renato Moreira Arcieri / Banca: Rodolfo Francisco Haltenhoff Melani / Banca: Eduardo Daruge Júnior / Banca: Rogério Nogueira de Oliveira / Resumo: A violência intrafamiliar contra a criança é, sem dúvida, uma das mais cruéis formas de agressão. Este estudo tem por objetivos: a) evidenciar possíveis situações de violência vividas na infância por adolescentes; b) avaliar a formação e o conhecimento dos professores de educação infantil sobre o tema; c) averiguar o conhecimento dos profissionais da saúde que atuam na atenção básica do Sistema Único de Saúde (SUS) sobre a notificação de violência contra crianças. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da FOA-UNESP (2007-01343). Para aferir a ocorrência e a severidade de maus-tratos na infância, realizou-se estudo tipo inquérito com 372 adolescentes com idade entre 14 a 17 anos, matriculados em uma instituição pública de formação profissional de Araçatuba-SP em 2008. Utilizou-se instrumento traduzido, validado e auto-aplicável. O segundo estudo desenvolveu-se nas escolas de Araçatuba-SP e contou com a participação de 236 professores de educação infantil. Utilizou-se instrumento desenvolvido para o estudo e as questões receberam tratamento quanti-qualitaivo. A terceira investigação foi realizada em 4 municípios da região noroeste do Estado de São Paulo: Adolfo, Bady Bassit, Mendonça e Nova Aliança. Por meio de entrevista estruturada com os profissionais de saúde, abordou-se a temática violência contra a criança e a notificação compulsória. De acordo com os resultados: a) 72,3% dos adolescentes sofreram violência na infância, prevalecendo a emocional no grau leve (28,7%). Foram encontradas associações significativas entre: violência física/emocional (p=0,0001); física/sexual (p=0,0001); física/negligência emocional (p=0,0001); sexual/emocional (p=0,0007); emocional/negligência emocional (p=0,0001). b) Quanto ao recebimento de informações sobre violência contra a criança... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The violence against children is undoubtedly the most cruel among all forms of aggression. This study aims to: a) highlight possible situations of violence experienced in childhood by adolescents, b) assess the training of teachers in early childhood education on the subject; c) investigate the knowledge of health professionals who work in primary care of Unified Health System (SUS) on the reporting of violence against children. The project was approved by the Research Ethics Committee of the FOA-UNESP (2007-01343). To assess the occurrence and severity of ill-treatment in childhood, study are type investigation with 372 adolescents aged 14 to 17 years, enrolled in a public institution for training of Araçatuba-SP in 2008. Instrument used was translated, validated and self-administered. The second study was developed in schools in Araçatuba-SP, with the participation of 236 teachers in early childhood education. It was used instrument developed to study the issues and received treatment quanti-qualitaivo. The third study was carried out in 4 counties in the northwestern region of São Paulo State: Adolfo, Bady Bassit, Mendonça and Nova Aliança. Through semi-structured interviews with health professionals, we dealt with issues violence against children and compulsory notification. According to the results: a) 72.3% of adolescents have experienced violence in childhood, the emotional prevailing in mild (28.7%). We found significant associations between: physical / emotional (p = 0.0001), physical / sexual (p = 0.0001), physical / emotional neglect (p = 0.0001), sexual / emotional (p = 0.0007); emotional / emotional neglect (p = 0.0001). b) On the receipt of information on violence against children, 80.9% of teachers have said it received and 19.1% denied. 86.9% claimed to know the signs of violence on children, while 6.4% claimed not to have prepared for this; 6.7% did not respond... (Complete abstract click electronic access below) / Doutor