Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-02-01T21:54:03Z No. of bitstreams: 1 KalyaneKellyDuarteDeOliveira_TESE.pdf: 4371547 bytes, checksum: 0c56e32ff360130ff50c666f79e48635 (MD5) / Approved for entry into archive by Elisangela Moura (lilaalves@gmail.com) on 2016-03-07T21:33:34Z (GMT) No. of bitstreams: 1 KalyaneKellyDuarteDeOliveira_TESE.pdf: 4371547 bytes, checksum: 0c56e32ff360130ff50c666f79e48635 (MD5) / Made available in DSpace on 2016-03-07T21:33:34Z (GMT). No. of bitstreams: 1 KalyaneKellyDuarteDeOliveira_TESE.pdf: 4371547 bytes, checksum: 0c56e32ff360130ff50c666f79e48635 (MD5) Previous issue date: 2014-12-10 / Este estudo objetivou avaliar a atua??o dos profissionais no atendimento as fam?lias nos Centros de Aten??o Psicosocial (CAPS) do Rio Grande do Norte (RN), a partir dos pap?is e fun??es desempenhados pelos profissionais nestes servi?os. Para isso, apontou-se como objetivos espec?ficos: Descrever o perfil e as atividades desenvolvidas pelas equipes de sa?de mental nos CAPS do RN; Conhecer a opini?o dos profissionais das equipes de sa?de mental quanto ? pol?tica, ?s pr?ticas e ? forma??o em sa?de mental; Verificar a adequabilidade dos papeis e fun??es dos profissionais que atuam nos CAPS do RN em rela??o ao atendimento as fam?lias. Trata-se de um estudo anal?tico, transversal, de abordagem quantitativa e qualitativa. Coletaram-se os dados por meio de question?rio, em 33 CAPS do RN, entre mar?o e outubro de 2014, ap?s a aprova??o pelo Comit? de ?tica em Pesquisa/UFRN, parecer n?217.808, CAAE: 10650612.8.1001.5537, em 1 de mar?o de 2013. Adotou-se a amostra, definida atrav?s de crit?rios de inclus?o e exclus?o, compondo-se de 183 profissionais. A prepara??o do banco de dados seguiu dois passos: 1. Preparo e tratamento dos dados das quest?es fechadas do instrumento de pesquisa relativas ? caracteriza??o e pr?ticas em sa?de mental dos sujeitos da pesquisa por meio do recurso informacional do Statistical Package for the Social Scienses (SPSS) Statistics vers?o 20.0; 2. Para verificar o n?vel de signific?ncia optou-se pela aplica??o do teste Qui-quadrado e o Kruskal Wallis Test. Preparo e tratamento do corpus formado pelas respostas ?s quest?es abertas relativas ?s pol?ticas, pr?ticas e forma??o na psiquiatria por meio do software Analyse Lexicale par Contexte d?un Ensemble de Segments de Texte (ALCESTE) e categorizados conjuntamente pela t?cnica de An?lise de Conte?do. A an?lise de dados apoia-se na literatura pertinente. Explicitaram-se os resultados atrav?s de tr?s artigos que enceram os seguintes resultados: O primeiro artigo, perfil dos participantes, caracterizou-se por predomin?ncia do sexo feminino (76,5%), na faixa et?ria de 40 a 58 anos (61,7%). Trabalham entre 30 e 40 horas semanais (63,5%), com atua??o na sa?de mental h? mais de 10 anos (98,4%). A amostra estudada direciona o atendimento a grupos familiares (65,7%), predominando o atendimento em equipe entre os assistentes sociais, enfermeiros, psic?logos e terapeutas ocupacionais. O m?dico realiza os atendimentos sem intera??o com a equipe (48,6%). Sobre as dificuldades encontradas nos servi?os ordenam-se em: materiais e insumos (75,1%), financeiras (78,5%) e estruturais (66,9%). O segundo artigo encerra dados qualitativos organizados em cinco categorias: Promo??o da reabilita??o dos usu?rios dos CAPS; Necessidades de capacita??es; Conflitos e satisfa??es do trabalho em equipe; Pr?ticas desenvolvidas nos CAPS; Dificuldades de efetiva??o da Pol?tica de Sa?de Mental. O terceiro artigo evidencia a inadequabilidade do atendimento destinado as fam?lias (93,4%) e comparando-se os atendimentos as fam?lias e aos grupos nos CAPS os dois tipos mostram-se inadequados: fam?lia (92,63%), grupos (92,60%). Os principais dados obtidos revelam a necessidade urgente de transforma??o na aten??o psicossocial. Evidencia-se ainda, a import?ncia de investimentos em insumos, estrutura f?sica e na capacita??o de recursos humanos para os CAPS. / This study aimed to evaluate the work of professionals to care for families in Psychosocial Care Centers ( C APS) of Rio Grande do Norte ( RN), from the roles and functions performed by these professional services. For this, it was pointed out the following objectives: To describe the profile and the activities conducted by mental health teams in the RN CAPS ; Know the opinion of professionals in the mental health teams of the poli ti c , practices and training in mental health; Check the suitability of the roles and functions of professionals working in the RN CAPS in relation to care for families . This is an analytic al cross - sectional study of quantitative and qualitative approach . Data were c ollected through a questionnaire in 33 CAPS RN, between March and October 2014 , after being approved by the Research Ethics Committee / UFRN , opinion n?217.808 , CAAE : 10650612.8. 1001.5537 , on March 1 2013. T he sample was adopted , defined by inclusion and exclusion criteria , and is composed of 183 professionals. The database preparation followed two steps: 1. Preparation and processing of data of closed questions of the questionnai re concerning the characterization and practices in mental health research subjects through informational resource Statistical Package for Social Scienses (SPSS) Statistics version 20.0 ; 2. To check the significance level was chosen by applying the chi - squ are test. Preparation and treatment of the corpus formed by the answers to open questions relating to the policies, practices and training in psychiatry through Analyse lexicale pair Contexte software d' un Ensemble of Segments of Texte ( ALCESTE) together a nd categorized by content analysis technique , Bardin (2004) . The data analysis is supported in the literature . It m ade explicit the results through three articles waxing the following results. In the first, participants profile was characterized by a predo minance of females (76.5 %), aged 40 - 58 years ( 61.7 %). They work between 30 and 40 hours per week (63.5 %), working in mental health for over 10 years ( 98.4%). The sample directs the care of family groups ( 65.7%), predominantly the care team of social worke rs, nurses, psychologists and occupational therapists . The doctor performs emergency care without interaction with the staff (48.6%) . On the difficulties encountered in services are ranked in : materials and supplies ( 75.1%), financial ( 78.5%) and structura l ( 66.9%). The second article contains qualitative data organized into five categories : Promoting the rehabilitation of users of CAPS ; Needs training ; Conflicts and satisfactions of teamwork ; Practices developed in CAPS ; Effective difficulties of Mental He alth Policy . The third article highlights the inadequacy of care for families ( 93.4%) and comparing the care families and groups in CAPS both types show to be inadequate : family ( 92.63%), groups ( 92, 60%). The main data obtained reveal the urgent need for transformation in psychosocial care . It shows also the importance of investments in inputs, physical structure and training of human resources for the CAPS.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-02-29T22:37:42Z No. of bitstreams: 1 EdilmaDeOliveiraCosta_TESE.pdf: 2438441 bytes, checksum: bd7899ea3580f7e1c58d31f9884e7b31 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-02T00:08:56Z (GMT) No. of bitstreams: 1 EdilmaDeOliveiraCosta_TESE.pdf: 2438441 bytes, checksum: bd7899ea3580f7e1c58d31f9884e7b31 (MD5) / Made available in DSpace on 2016-03-02T00:08:56Z (GMT). No. of bitstreams: 1 EdilmaDeOliveiraCosta_TESE.pdf: 2438441 bytes, checksum: bd7899ea3580f7e1c58d31f9884e7b31 (MD5) Previous issue date: 2015-01-30 / A presente investiga??o teve como objeto de estudo a hist?ria da fiscaliza??o do exerc?cio profissional, no Conselho Regional de Enfermagem do Rio Grande do Norte (Coren-RN). Defende a tese de que a fiscaliza??o exercida pelo Conselho constitui uma ferramenta importante para a melhoria da qualidade da assist?ncia de enfermagem. Teve como objetivo analisar a hist?ria da fiscaliza??o do exerc?cio profissional da enfermagem, no Rio Grande do Norte, no per?odo 1993-2013. Pautou-se no aporte ?tico-filos?fico de Fourez e V?zquez. Trata-se de um estudo de natureza hist?rico-social, descritiva e anal?tica, com abordagem qualitativa, utilizando os m?todos de pesquisa documental e entrevistas. Teve como l?cus da pesquisa emp?rica o Coren-RN, contando com sua documenta??o e a participa??o de fiscais e presidentes. A hist?ria da fiscaliza??o foi sendo constru?da com base nos documentos, fotos e nas entrevistas com quem vivenciou essa trajet?ria. O projeto obteve aprova??o do Comit? de ?tica em Pesquisa, da UFRN, conforme Parecer 562.400/2014 (CAAE: 25452113.7.0000.5537). Os resultados indicam que o CorenRN, durante esses vinte anos, enfrentou in?meras dificuldades, como a escassez de fiscais, a realidade prec?ria da maioria dos servi?os de sa?de, a falta de qualifica??o dos profissionais, a ilegalidade do exerc?cio profissional e a defici?ncia estrutural da institui??o. Apesar disso, h? que se reconhecer que o processo de fiscaliza??o, exercido pelo Conselho, vem evoluindo ao longo desses anos. Essa evolu??o se expressa na amplia??o do n?mero de fiscais, na aquisi??o de uma nova sede e de tr?s ve?culos, na cria??o das subse??es nos munic?pios de Mossor?, Caic? e Pau dos Ferros, no encaminhamento dos processos ?ticos, entre outras conquistas. Ademais, registra-se uma maior credibilidade dos profissionais de enfermagem e de outros ?rg?os fiscalizadores. Em s?ntese, a fiscaliza??o, como atividade-fim do Conselho, vem passando por um processo de transforma??o, com vistas a realizar a interlocu??o entre a concep??o disciplinar e a pedag?gica, em defesa da qualidade da assist?ncia de enfermagem. Enfim, ? um processo inacabado, em cont?nua constru??o. / The present investigation had as its study subject the history of professional monitoring, at the Regional Nursing Council of Rio Grande do Norte (Coren-RN). It assumes that the fiscalization by the Council is an important tool for improving the quality of nursing care. This study aims to analyze the history of monitoring of the nursing profession in Rio Grande do Norte, in the period from 1993 to 2013. It was marked in the ethical-philosophical contribution of Fourez and V?zquez. This is a study of social history, descriptive and analytical, with a qualitative approach, using the methods of documentary research and the technique of oral history. It had the Coren-RN as locus of the empirical research, with its documents and the participation of inspectors and presidents. The history of monitoring was built based on documents and interviews with those who lived through this path. The project was approved by the Research Ethics Committee of UFRN as Opinion 562 400/2014 (CAAE: 25452113.7.0000.5537). The results indicate that the Coren-RN, during these twenty years faced many difficulties such as the shortage of inspectors, the precarious reality of most health services, lack of professional qualification, the illegality of professional practice and structural deficiency in the institution. Nevertheless, it must be recognized that the monitoring process exercised by the Council, has evolved over the years. This evolution is expressed in increasing the number of inspectors, in the acquisition of a new seat and three vehicles, the creation of the subsections in the cities of Natal, Caic? and Pau dos Ferros, the referral of ethical procedures, among other achievements. Similarly, it is registered an improvement in the credibility of nursing professionals and other regulatory agencies. In summary, the monitoring as core activity of the Council is going through a process of transformation, in order to make the dialogue between the disciplinary design and the pedagogical design, in defense of nursing care quality. Therefore, it is an unfinished process, in continuous construction.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-02-29T22:37:42Z No. of bitstreams: 1 ErikCristovaoAraujoDeMelo_TESE.pdf: 2993455 bytes, checksum: 83227d6e1cb8badd9760a585b04bf09c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-02T00:21:34Z (GMT) No. of bitstreams: 1 ErikCristovaoAraujoDeMelo_TESE.pdf: 2993455 bytes, checksum: 83227d6e1cb8badd9760a585b04bf09c (MD5) / Made available in DSpace on 2016-03-02T00:21:34Z (GMT). No. of bitstreams: 1 ErikCristovaoAraujoDeMelo_TESE.pdf: 2993455 bytes, checksum: 83227d6e1cb8badd9760a585b04bf09c (MD5) Previous issue date: 2015-01-30 / Este estudo objetivou construir um ambiente virtual de aprendizagem para aplica??o do Processo de Enfermagem baseado na NANDA-I, NOC, NIC e CIPE? . Diante de problemas relacionados ? aprendizagem do processo de enfermagem e das classifica??es, urge a necessidade da constru??o de recursos pedag?gicos inovadores que modifiquem a rela??o entre alunos e professores. A metodologia utilizada fundamentou-se nas etapas concep??o, elabora??o, constru??o e transi??o, do processo de desenvolvimento de software Rational Unifield Process. A equipe envolvida no desenvolvimento deste ambiente foi composta por pesquisadores e estudantes do Grupo de Pr?ticas Assistenciais e Epidemiol?gicas em Sa?de e Enfermagem e do curso de Engenharia de Software da Universidade Federal do Rio Grande do Norte, com a participa??o das Escolas Superiores de Enfermagem de Lisboa e do Porto, Portugal. Na concep??o, ocorreu a comunica??o entre os pesquisadores para defini??o das fun??es, recursos e ferramentas para o processo de constru??o. Na elabora??o, refinou-se o planejamento e ocorreu a modelagem, que resultou na cria??o de um diagrama e de desenhos de arquitetura que especificaram as caracter?sticas e as funcionalidades do software. J? na constru??o, realizou-se o desenvolvimento, testes unit?rios e integrados dos componentes das interfaces dos m?dulos e ?reas (administrador, docente, discente e constru??o do PE). Em seguida foi realizada a etapa de transi??o, que mostrou o sistema completo e em funcionamento, bem como o treinamento e utiliza??o pelos pesquisadores com o seu emprego na pr?tica. Conclui-se que este estudo possibilitou o planejamento e a constru??o de uma tecnologia educacional, e espera-se que a sua implementa??o desencadeie uma mudan?a substancial no aprendizado do processo de enfermagem e das classifica??es, com o aluno sendo agente ativo do processo de aprendizagem. Posteriormente, ser? realizada uma avalia??o do desempenho funcional, que possibilitar? o incremento do software, com uma realimenta??o, corre??o de defeitos e mudan?as necess?rias. Acredita-se que com o incremento do software ap?s as avalia??es, esta ferramenta cres?a ainda mais e ajude a inserir esta metodologia e linguagem de vez no ?mbito das institui??es de ensino e de sa?de, promovendo a mudan?a paradigm?tica t?o almejada pela enfermagem. / This study aimed to build a virtual learning environment for application of the nursing process based on the NANDA-I, NOC, NIC and ICNP? . Faced with problems related to learning of the nursing process and classifications, there is an urgent need to develop innovative teaching resources that modify the relationship between students and teachers. The methodology was based on the steps inception, development, construction and transition, and the software development process Rational Process Unifield. The team involved in the development of this environment was composed by researchers and students of The Care and Epidemiological Practice in Health and Nursing and Group of the Software Engineering curse of the Federal University Rio Grande do Norte, with the participation of the Lisbon and Porto Schools of Nursing, in Portugal. In the inception stage the inter research communication was in order to define the functions, features and tools for the construction process. In the preparation, step the planning and modeling occurred, which resulted in the creation of a diagram and a architectural drawings that specify the features and functionality of the software. The development, unit testing and integrated in interfaces of the modules and areas (administrator, teacher, student, and construction of the NP). Then the transition step was performed, which showed complete and functioning system, as well as the training and use by researchers with its use in practice. In conclusion, this study allowed for the planning and the construction of an educational technology, and it is expected that its implementation will trigger a substantial change in the learning of the nursing process and classifications, with the student being active agent of the learning process. Later, an assessment will be made of functional performance, which will enable the software development, with a feedback, correction of defects and necessary changes. It is believed that the software increment after the reviews, this tool grow further and help insert this methodology and every language under the educational and health institutions, promoting paradigmatic desired change by nursing.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-03T19:37:37Z No. of bitstreams: 1 AnnaLiviaDeMedeirosDantas_DISSERT.pdf: 2504084 bytes, checksum: 8f614fbee3a9881121a3800224934cf2 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-07T19:10:20Z (GMT) No. of bitstreams: 1 AnnaLiviaDeMedeirosDantas_DISSERT.pdf: 2504084 bytes, checksum: 8f614fbee3a9881121a3800224934cf2 (MD5) / Made available in DSpace on 2016-03-07T19:10:20Z (GMT). No. of bitstreams: 1 AnnaLiviaDeMedeirosDantas_DISSERT.pdf: 2504084 bytes, checksum: 8f614fbee3a9881121a3800224934cf2 (MD5) Previous issue date: 2014-12-17 / O estudo objetivou analisar os diagn?sticos de enfermagem do dom?nio seguran?a/prote??o da Nanda Internacional presentes nos pacientes internados em Unidade de Terapia Intensiva. Trata-se de um estudo transversal, realizado no complexo de terapia intensiva de um hospital universit?rio no Nordeste do Brasil. A pesquisa ocorreu em duas etapas. A primeira etapa consistiu na coleta de dados, por meio de um formul?rio de entrevista e de exame f?sico, com 86 pacientes internados na referida unidade, durante os meses de dezembro de 2013 a maio de 2014. As planilhas foram constru?das no Software Microsoft Office Excel 2010, nas quais foram assinaladas, pela pesquisadora deste estudo, a presen?a ou aus?ncia das caracter?sticas definidoras, fatores relacionados e fatores de risco dos 31 diagn?sticos estudados. Na segunda etapa, realizada entre julho e agosto de 2014, as planilhas foram enviadas a tr?s diagnosticadores, previamente treinados, para a realiza??o da infer?ncia diagn?stica. Os dados foram analisados por meio de estat?stica descritiva e inferencial para os diagn?sticos que apresentaram frequ?ncias maiores que 50%, com aux?lio do IBM SPSS Statistic vers?o 20.0 for Windows.O projeto recebeu parecer favor?vel no 440/414 e Certificado de Apresenta??o para Aprecia??o ?tica no 22955113.2.0000.5292. Os resultados apontaram a presen?a de 29 diagn?sticos de enfermagem do dom?nio seguran?a/prote??o na clientela internada em Unidade de Terapia Intensiva, dentre os quais cinco estiveram presentes em 100% dos pacientes, a saber: Risco de contamina??o, Risco de les?o, Risco de quedas, Risco de resposta al?rgica e Risco de trauma. Os diagn?sticos que apresentaram frequ?ncia superior a 50% foram: Risco de infec??o, Risco de olho seco, Risco de envenenamento, Risco de trauma vascular, Integridade da pele prejudicada, Denti??o prejudicada, Risco de sangramento, Risco de desequil?brio na temperatura corporal, Risco de les?o por posicionamento perioperat?rio, Integridade tissular prejudicada, Risco de disfun??o neurovascular perif?rica, Risco de resposta adversa ao meio de contraste com iodo, Risco de choque e Risco de aspira??o. Para esses diagn?sticos, foram identificados 35 fatores de risco, 11 caracter?sticas definidoras e tr?s fatores relacionados que apresentaram associa??o estat?stica significativa com os diagn?sticos estudados. Para os diagn?sticos: Risco de contamina??o, Risco de les?o, Risco de quedas, Risco de resposta al?rgica, Risco de 7 trauma, Risco de infec??o, Risco de olho seco e Risco de envenenamento n?o houve associa??o com nenhuma de seus fatores de risco. Conclui-se que a maioria dos diagn?sticos de enfermagem do dom?nio seguran?a/prote??o apresentam-se prevalentes nos pacientes cr?ticos, com aten??o especial para os diagn?sticos de risco. Ocorreu associa??o significativa entre esses diagn?sticos e seus componentes. Destaca-se, assim, que o levantamento desse perfil contribui com pistas relevantes para a infer?ncia dos diagn?sticos de enfermagem priorit?rios do dom?nio seguran?a/prote??o na popula??o estudada, auxiliando a pr?xis da enfermagem e estimulando o conhecimento a respeito do assunto. / The study aimed to analyze the field of nursing diagnoses safety / protection of NANDA International present in patients in the Intensive Care Unit. This is a crosssectional study in intensive care complex of a university hospital in northeastern Brazil. The research took place in two stages. The first step was to collect data through an interview form and physical examination, with 86 patients admitted to the unit, during the months of December 2013 to May 2014. Spreadsheets were built in Microsoft Office Excel 2010 Software in which were marked by the researcher of this study, the presence or absence of defining characteristics, related factors and risk factors of the 31 studied diagnoses. In the second stage, held between July and August 2014, the sheets were sent to three diagnosticians, previously trained to perform the diagnostic inference. Data were analyzed using descriptive and inferential statistics for the diagnoses that showed higher frequencies than 50%, using IBM SPSS version 20.0 for Statistic Windows.O project was approved by the 440/414 and Presentation Certificate for Ethics Assessment number 22955113 .2.0000.5292. The results indicated the presence of 29 field of nursing diagnoses safety / protection in hospital clientele in the Intensive Care Unit, of which five were present in 100% of patients, namely: Risk of contamination, injury risk, falls risk,risk of allergic response and risk of trauma. Diagnoses that presented more frequently than 50% were: Risk of infection, dry eye risk, poisoning risk, vascular trauma risk, impaired skin integrity, impaired dentition, bleeding risk, risk imbalance in body temperature, Risk perioperative positioning injury, impaired tissue integrity, peripheral neurovascular dysfunction Risk, Risk adverse response to contrast media with iodine, shock Hazard and Risk of aspiration. For these analyzes, we identified 35 risk factors, 11 defining characteristics and three related factors showed statistically significant association with the studied diagnoses. For diagnostics: Risk of contamination, injury risk, falls risk, allergic response risk, trauma Risk, Risk of infection, dry eye risk and risk poisoning there was no association with any of their risk factors. We conclude that most of the area of nursing diagnoses safety / protection feature is prevalent in critically ill patients, with special attention to the risk diagnoses. There was a significant association between these diagnoses and its components. It is noteworthy, therefore, that the lifting of this profile contributes relevant clues to the inference of the priority nursing diagnoses domain safety / protection in the study population, supporting the practice of nursing and stimulating knowledge on the subject.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-03T19:37:37Z No. of bitstreams: 1 BheatrizGondimLambertMoreira_DISSERT.pdf: 2653327 bytes, checksum: 34546767c287459868134f088ad4dca0 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-07T19:18:11Z (GMT) No. of bitstreams: 1 BheatrizGondimLambertMoreira_DISSERT.pdf: 2653327 bytes, checksum: 34546767c287459868134f088ad4dca0 (MD5) / Made available in DSpace on 2016-03-07T19:18:11Z (GMT). No. of bitstreams: 1 BheatrizGondimLambertMoreira_DISSERT.pdf: 2653327 bytes, checksum: 34546767c287459868134f088ad4dca0 (MD5) Previous issue date: 2014-12-17 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico - CNPq / A Insufici?ncia Venosa Cr?nica caracteriza-se como um conjunto de altera??es f?sicas que incluem como complica??o mais s?ria a ?lcera venosa, caracterizada pela perda irregular e progressiva da continuidade da pele. A ocorr?ncia da ?lcera venosa nas pessoas com insufici?ncia venosa cr?nica gera depend?ncia dos mesmos com servi?os de sa?de, com tratamentos de longa dura??o que provocam limita??es e altera??es de grande impacto, repercutindo em sua qualidade de vida, afetando os aspectos f?sicos, psicol?gicos, sociais, culturais e espirituais, constituindo um importante problema de sa?de p?blica. Este estudo objetivou narrar a experi?ncia de possuir uma ?lcera venosa, no cen?rio dos servi?os de Aten??o Prim?ria ? Sa?de, que compreende Unidades de Aten??o B?sica e de Estrat?gia de Sa?de da Fam?lia no Munic?pio de Natal/RN, partindo das hist?rias de vida dos usu?rios. Trata-se de um estudo de abordagem qualitativa, explorat?rio-descritivo, tendo a Hist?ria Oral de Vida como referencial metodol?gico. A partir do ponto zero houve o recrutamento dos participantes que compuseram a rede, totalizando seis colaboradores, de ambos os sexos, e idade entre 57 e 79 anos. Ap?s aprova??o pelo Comit? de ?tica em Pesquisa - UFRN, sob o Protocolo 653.788/2014 e CAAE 30408014.0.0000.5537, realizou-se a coleta de dados, entre os meses de julho e agosto, atrav?s de entrevista, utilizando instrumento de identifica??o e caracteriza??o dos colaboradores e perguntas abertas. As entrevistas foram gravadas, transcritas, transcriadas e retornadas aos colaboradores para confer?ncia. As narrativas foram submetidas ? t?cnica de An?lise Tem?tica de Conte?do, segundo Bardin, possibilitando a constru??o de tr?s eixos tem?ticos que englobam categorias, a saber: Eixo I - Olhares sobre as mudan?as: o impacto da ferida nas rela??es sociais (mudan?as ocorridas com a ?lcera venosa; a ?lcera venosa e as rela??es sociais e familiares); Eixo II - Marcas no corpo e na alma: trajet?ria do ser ferido (concep??es sobre o corpo ferido; itiner?rio terap?utico nos servi?os de aten??o b?sica); e Eixo III - Reconstru??o do ser ferido: mecanismos de enfrentamento (ressignifica??o do corpo ferido; resili?ncia frente ? ferida cr?nica). O impacto de ter uma ?lcera venosa cr?nica gera repercuss?es de ordem f?sica, psicol?gica e social. Como aspectos relacionados ?s mudan?as ocorridas ap?s o aparecimento da ?lcera venosa, os participantes da pesquisa relataram a presen?a de dor, limita??es f?sicas, sofrimento ps?quico, isolamento social e afetivo, incapacidade laboral, desconforto est?tico e depend?ncia dos servi?os de sa?de; a fam?lia foi o aspecto que n?o apresentou modifica??o consider?vel ap?s a ocorr?ncia da ferida para a maioria dos participantes, sendo uma aliada no processo terap?utico como rede de apoio. A ressignifica??o do corpo e da ferida constituem o principal mecanismo de enfretamento da condi??o cr?nica. Os servi?os que comp?em a Rede de Aten??o Prim?ria t?m papel fundamental na reabilita??o dos portadores de ?lcera venosa, embora existam dificuldades de acesso ao tratamento adequado e necessidade de amplia??o dos servi?os, com capacita??o permanente dos profissionais das equipes de sa?de e disponibiliza??o pelos gestores de recursos para o fortalecimento do cuidado integral da pessoa com ?lcera venosa nos servi?os de Aten??o Prim?ria ? Sa?de. / The Chronic Venous insufficiency is characterized as a set of physical changes including how most serious complication of venous ulcers, characterized by irregular and progressive loss of continuity of the skin. The occurrence of venous ulcers in people with chronic venous insufficiency generates dependence on them with health services, with long-term treatments that cause limitations and high-impact changes, affecting their quality of life, affecting the physical, psychological, social, cultural and spiritual as an important public health problem. This study aimed to describe the experience of having a venous ulcer, in the scenario of primary health care services to Health, which includes Primary Care Units and Family Health Strategy in the city of Natal / RN, based on the life histories of users. This is a qualitative study, exploratory and descriptive, with the Oral History of Life as a methodological framework. From the ponto zero was the recruitment of participants who formed the network, totaling six employees, of both sexes and aged between 57 and 79 years. After approval by the Research Ethics Committee - UFRN under the Protocol 653 788/2014 and CAAE 30408014.0.0000.5537 was held data collection, between the months of July and August, through interviews, using identification and characterization of the instrument employees and open questions. Interviews were recorded, transcribed, transcriadas and returned to employees for a conference. The narratives were subjected to Content thematic analysis technique, according to Bardin, allowing the construction of three themes that encompass categories, namely: Axis I - Perspectives on the changes: the impact wound in social relations (changes with ulcer venous, venous ulcer and social and family relationships); Axis II - Brands in body and soul: the story of being hurt (conceptions of the body injured; therapeutic itinerary in primary care services); and Axis III - Reconstruction of being hurt: coping mechanisms (redefinition of the wounded body, resilience to chronic wound). The impact of having a chronic venous ulcer generates impact of physical, psychological and social order. As aspects related to changes after the appearance of venous ulcers, survey participants reported the presence of pain, physical limitations, psychological distress, social and emotional isolation, incapacity, aesthetic discomfort and dependency on health services; the family was the aspect thatshowed no significant change after the occurrence of wound for most participants, an ally in the therapeutic process as a support network. The redefinition of the body and the wound are the main coping mechanism of chronic condition. The services in the Primary Care Network play a fundamental role in the rehabilitation of patients with venous ulcers, although there are difficulties in accessing appropriate treatment and need for expanded services, with permanent professional training of health teams and providing the resources managers to strengthen the comprehensive care of people with venous ulcers in Health Primary Care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-03T19:37:38Z No. of bitstreams: 1 PolyannaKeitteFernandesGurgel_DISSERT.pdf: 1420895 bytes, checksum: 18a379f3ac689e89e5304a7e91ccd891 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-07T19:44:44Z (GMT) No. of bitstreams: 1 PolyannaKeitteFernandesGurgel_DISSERT.pdf: 1420895 bytes, checksum: 18a379f3ac689e89e5304a7e91ccd891 (MD5) / Made available in DSpace on 2016-03-07T19:44:44Z (GMT). No. of bitstreams: 1 PolyannaKeitteFernandesGurgel_DISSERT.pdf: 1420895 bytes, checksum: 18a379f3ac689e89e5304a7e91ccd891 (MD5) Previous issue date: 2014-12-11 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Objetivou-se analisar a participa??o de m?es/cuidadores sob a ?tica do modelo de sa?de que direciona o acompanhamento coletivo de crescimento e desenvolvimento da crian?a. Trata-se de uma pesquisa explorat?ria e descritiva, com abordagem qualitativa, realizada em duas Unidades de Sa?de da Fam?lia localizadas no munic?pio de Natal/RN. Os dados foram coletados entre os meses de agosto e setembro de 2014, por meio da t?cnica da observa??o participante e entrevista semiestruturada, com m?es de crian?as atendidas nas consultas de acompanhamento coletivo do crescimento e desenvolvimento infantil. Foram inclu?das um total de 13 m?es que atenderam aos seguintes crit?rios de inclus?o: ser m?e/cuidador respons?vel pelo cuidado ?s crian?as que tenham frequentado uma ou mais reuni?o de acompanhamento coletivo de crescimento e desenvolvimento infantil. Como crit?rios de exclus?o estabeleceu-se: usu?rios n?o pertencentes ? ?rea de abrang?ncia da Unidade de Sa?de da Fam?lia e que n?o utilizavam o Sistema ?nico de Sa?de como principal servi?o de atendimento em sa?de. Para o tratamento do material coletado, foi utilizada a An?lise de Conte?do, modalidade tem?tica proposta por Bardin. A pesquisa seguiu os princ?pios ?ticos e legais que regem a pesquisa cient?fica com seres humanos preconizados pela resolu??o N? 466/2012, do Conselho Nacional de Sa?de e sua realiza??o ocorreu mediante aprova??o do projeto no comit? de ?tica e pesquisa da Universidade Federal do Rio Grande do Norte, que obteve aprova??o pelo Parecer Consubstanciado n? 719.949, de 27 de junho de 2014, e Certificado de Apresenta??o para Aprecia??o ?tica n? 32510514.7.0000.5537. Apesar de n?o conceituarem teoricamente, as m?es demonstraram que as consultas coletivas de crescimento e desenvolvimento infantil s?o a??es direcionadas ao modelo de vigil?ncia ? sa?de, uma vez que a maioria apontou o acompanhamento do seu filho ? a??es que podem ser mensur?veis. Mesmo com isso, foi poss?vel constatar a exist?ncia de a??es de promo??o da sa?de atrav?s do relato da troca de experi?ncia e protagonismo dos sujeitos na a??o coletiva, fator facilitado pelo v?nculo estabelecido entre usu?rios e profissionais e usu?rios. Nessa a??o h? a indu??o de uma rela??o horizontalizada, onde busca-se aliar o saber popular ao conhecimento cient?fico de modo a favorecer o cuidar integral da crian?a. No entanto, ainda ? poss?vel encontrar profissionais que direciona sua assist?ncia apenas aos processos patol?gicos e deixam de criar alternativas de cuidado integral. Al?m disso, ainda h? um desfalque nas equipes multiprofissionais que deveriam prestar o cuidado ? popula??o infantil. Tal fator pode estar relacionado ? pr?pria forma??o profissional, sendo desta maneira uma quest?o que pode perdurar por alguns anos. Conclui-se que ? necess?rio incorporar alternativas e modelos de aten??o que subsidiem a supera??o das limita??es e que favore?am a sa?de da popula??o, envolvendo-a na perspectiva de uma melhor qualidade de vida e consequentemente sa?de. / This study aimed to analyze the participation of mothers/caregivers from the perspective of the health care model that directs the collective monitoring of child growth and development. This is an exploratory and descriptive research with qualitative approach, carried out in two Family Health Units located in the city of Natal/RN. Data were collected between August and September 2014, through participant observation and semi-structured interview technique, with mothers of infants seen at follow-up visits collective child growth and development. A total of 13 mothers were included who met the following inclusion criteria: being a mother/caregiver responsible for the care of children who have attended one or more meeting of collective monitoring of child growth and development. Exclusion criteria was established: users outside the area covered by the Health Unit Family and who did not use the National Health System as the primary health care service. For the treatment of the collected material, the content analysis was used, thematic Bardin. The study followed the ethical and legal principles governing the scientific research on human subjects recommended by Resolution n?. 466/2012 of the National Health Council and its realization occurred with the approval of the project in the Research Ethics Committee of the Federal University of Rio Grande do North, which was approved by Opinion Embodied n?. 719 949, of June 27, 2014, and Certificate Presentation of Findings Ethics No 32510514.7.0000.5537. Although not conceptualize theoretically mothers demonstrated that collective consultations of child growth and development are actions aimed at health surveillance model, since most pointed monitoring your child to actions that can be measured. Even with that, it was established the existence of health promotion actions by reporting the exchange of experience and leadership of the subjects in collective action, factor facilitated by the link established between users and professionals and users. In this action there is the induction of permanent horizontal relationship where we seek to combine popular knowledge to scientific knowledge in order to promote the integral care for the child. However, it is still possible to find professionals who directs its assistance only to pathological processes and fail to create comprehensive care alternatives. In addition, there is still embezzlement in multi that should provide care to the child population. This factor may be related to their professional training, and thus an issue that can last for a few years. We conclude that it is necessary to incorporate alternatives and models of care that support overcoming limitations and enhancing the health of the population, involving it in the prospect of a better quality of life and therefore health.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-03T19:37:38Z No. of bitstreams: 1 RhuamaKareninaCostaESilva_DISSERT.pdf: 1330365 bytes, checksum: ff45fe839b00ef7436301fb1b06a2353 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-07T19:51:51Z (GMT) No. of bitstreams: 1 RhuamaKareninaCostaESilva_DISSERT.pdf: 1330365 bytes, checksum: ff45fe839b00ef7436301fb1b06a2353 (MD5) / Made available in DSpace on 2016-03-07T19:51:51Z (GMT). No. of bitstreams: 1 RhuamaKareninaCostaESilva_DISSERT.pdf: 1330365 bytes, checksum: ff45fe839b00ef7436301fb1b06a2353 (MD5) Previous issue date: 2014-12-17 / Este estudo objetivou avaliar o ganho de peso ponderal de rec?m-nascidos prematuros de acordo com a predomin?ncia do tipo de leite materno ofertado em suas dietas di?rias. Trata-se de uma pesquisa do tipo quantitativa, descritiva e observacional. Realizada na Unidade de Terapia Intensiva Neonatal e Alojamento Conjunto da Maternidade Escola Janu?rio Cicco (MEJC), unidade de refer?ncia para gravidez e nascimento de risco no Rio Grande do Norte. Foram envolvidos rec?mnascidos prematuros que atenderam aos seguintes crit?rios de inclus?o: idade gestacional entre 26 a 37 semanas, internados inicialmente na UTIN, com dieta oral, por gavagem, copo e/ou suc??o. Foram exclu?dos do estudo prematuros com dieta zero maior do que sete dias ou complica??es que interferissem na avalia??o do ganho de peso. A amostra foi selecionada por conveni?ncia e constou de todos os rec?m-nascidos hospitalizados na UTIN no per?odo de maio a junho de 2014, com seguimento at? a alta hospitalar, finalizado em agosto de 2014, e que atenderam aos crit?rios de inclus?o do estudo. Foram admitidos 60 rec?m-nascidos prematuros no per?odo correspondente ? coleta de dados e, destes, 39 compuseram a amostra. O projeto foi aprovado pelo Comit? de ?tica em Pesquisa da UFRN, sob CAAE n? 0699.0.000.294-11. Os dados foram analisados por meio de estat?stica descritiva e inferencial. Os resultados indicaram que os envolvidos no estudo nasceram de m?es com m?dia de idade de 25,36 anos, 21 delas com menos de nove anos de estudo (53,8 %), e 24 possu?am renda familiar menor que um sal?rio m?nimo (61,5 %). Predominou o sexo feminino, com 20 (51,3 %), parto ces?rea em 25 (64,1 %), prematuridade moderada em 29 (74,4 %), mais de 1.500 g ao nascer em 22 (56,4 %). A m?dia de peso ao nascer foi de 1.608,49 g. O total de dietas foi 9.994, e m?dia de 256 por rec?m-nascido, no per?odo de 32,12 dias de hospitaliza??o. O predom?nio de oferta das dietas (50,34 %) foi do Banco de Leite Humano, no entanto 56,4 % dos rec?m-nascidos receberam dieta com maior quantidade de leite materno ordenhado. Detectou-se que 38,5 % dos neonatos receberam, em algum momento, leite artificial. A m?dia de ganho de peso di?rio de todos os rec?m-nascidos foi de 2,59 g, e 35 % tiveram uma m?dia acima de 10 g/dia. Do grupo de neonatos (n = 25) que apresentaram ganho de peso apenas nove (36,0 %) receberam predominantemente Leite Materno Ordenhado de suas pr?prias m?es. Conclui-se que a maioria dos rec?m-nascidos apresentou ganho de peso com predom?nio de dietas fornecidas pelo Banco de Leite Humano, mostrando a necessidade de um maior incentivo ao aleitamento materno exclusivo. / This study aims to evaluate the weight gain of premature newborns fed with breast milk from their mothers' from those that are fed with breast milk from the milk bank. The research is the quantitative, descriptive and observational kind. It was conducted in the Neonatal Intensive Care Unit and Housing from the Maternity Hospital Escola Janu?rio Cicco (MEJC), that is a reference for high risk pregnancy and birth in Rio Grande do Norte. The premature newborns included were following these parameters: gestational age from 26 to 37 weeks, initially hospitalized at UTIN, with oral diet, by means by gavage, cup and/or suction. Studies with premature newborns with a zero diet longer than seven days or complications that interfered in the evaluation of weight gain were excluded from this study. The sample was selected for convenience and had data of all newborns hospitalized at UTIN from the May to June of 2014 time period, followed to their discharge, ended by August of 2014 and had the inclusion parameters of the study. From the period of the data collection, 60 premature newborns entered the maternity and 39 of those were the sample of research. The project was approved by the Research Ethics Committee from UFRN, under CAAE n? 0699.0.000.294-11. The data was analyzed by means of descriptive and deduced statistics. The results indicated that the involved in the study, were born from mother with average age of 25,36 years, with less than nine years education 21 (53,8%), had the family income less than a minimum wage 24 (61,5%). Among the newborn, the female gender predominated 20 (51,3%), had cesarean delivery 25 (64,1%), had moderate prematurity 29 (74,5%), more of 1.500g 22 (556,4%). The birth weight average was 1.608,49g. The total of diets were 9.994, and an average of 256 for each newborn, in a 32,12 days of hospitalization time period. Most of the diet supplies were from the breast milk bank (50,34%), however 56,4% of the newborns had most of the diet from their mothers' milked breast milk. It was detected that 38,5% of the newborns had, in some given moment, artificial milk. The daily weight gain average of all newborns was 2,59g, but 35% of them had an average above 10g per day. From the newborn's group (n=25) that had medium weight gain, only 9 of them (36,0%) received mainly their own mothers' milked breast milk. It's been conclusive that most of the premature newborns gained weight predominantly from diets from the breast milk of the Milk Bank, showing the need of a bigger incentive to exclusive breast feeding.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-08T23:58:05Z No. of bitstreams: 1 FlavioCesarBezerraDaSilva_TESE.pdf: 7608817 bytes, checksum: 5e37ebc4a3a662f626594f2e76bc5699 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-11T23:51:58Z (GMT) No. of bitstreams: 1 FlavioCesarBezerraDaSilva_TESE.pdf: 7608817 bytes, checksum: 5e37ebc4a3a662f626594f2e76bc5699 (MD5) / Made available in DSpace on 2016-04-11T23:51:58Z (GMT). No. of bitstreams: 1 FlavioCesarBezerraDaSilva_TESE.pdf: 7608817 bytes, checksum: 5e37ebc4a3a662f626594f2e76bc5699 (MD5) Previous issue date: 2015-07-03 / A pesquisa teve como objetivo construir e validar um instrumento de coleta de dados do casal gr?vido no ?mbito da aten??o b?sica. Considerou-se a hip?tese de que o n?vel de concord?ncia a partir de 70% entre as(os) participantes do painel de especialistas o validaria. O documento foi constru?do com base na Teoria das Necessidades Humanas de Horta ajustada por Garcia e Cubas. Trata-se de um estudo do tipo metodol?gico desenvolvido em quatro etapas: identifica??o dos indicadores emp?ricos relativos ? gestante por meio de revis?o integrativa da literatura; avalia??o dos indicadores emp?ricos e sua rela??o com as necessidades humanas por grupo focal; estrutura??o da segunda vers?o do instrumento conforme a categoriza??o dos indicadores e valida??o de apar?ncia e conte?do da terceira vers?o do instrumento por ju?zes, mediante uso da t?cnica Delphi. A coleta de dados da primeira etapa ocorreu de agosto a outubro de 2014, no peri?dico Journal of Midwifery and Women?s Health e nas bases de dados Scopus, Pubmed, Lilacs, Cinahl, Cochrane. As demais etapas foram realizadas entre os meses de novembro de 2014 a fevereiro de 2015. Para o grupo focal, contou-se com a participa??o de seis especialistas por meio de dois encontros. Quanto aos ju?zes, obteve-se uma popula??o de 63 enfermeiras(os) e amostra final de 51 distribu?das(os) em 46 Unidades B?sicas de Sa?de da Secretaria Municipal de Sa?de da cidade de Natal/RN, Brasil. A pesquisa obteve aprova??o do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte, sob o Protocolo n?mero 876.200. Para an?lise dos dados da primeira etapa utilizou-se a estat?stica descritiva e os resultados est?o apresentados em forma de tabelas e quadros. Nesta etapa identificaram-se 162 indicadores emp?ricos e, quando relacionados com as necessidades humanas, 64 encontravam-se nas necessidades psicobiol?gicas, 97 nas psicossociais e um (1) nas psicoespirituais. Com rela??o ? segunda e terceira etapas, os dados passaram por um processo de categoriza??o e an?lise pelo ?ndice de Validade de Conte?do. Os indicadores obtiveram um ?ndice de valida??o de 100%. Na fase de valida??o de apar?ncia e conte?do do instrumento os itens n?o validados foram exclu?dos e os demais alcan?aram ?ndice acima de 70%. Obteve-se ?ndice de validade de conte?do de 99% na segunda vers?o e de 95,7% na terceira vers?o do instrumento como um todo, sendo, portanto, o instrumento validado. O instrumento constru?do cont?m dados de identifica??o da institui??o de sa?de, da gestante, do companheiro, informa??es acerca das necessidades humanas da gr?vida e itens pertinentes ? sistematiza??o da coleta de dados do casal gr?vido durante o pr?-natal. Com a conclus?o do estudo, a(o) enfermeira(o) dispor? de um instrumento inovador por considerar as necessidades psicobiol?gicas, psicossociais e psicoespirituais da gestante, al?m de inserir dados de sa?de e sociodemogr?ficos do companheiro no contexto da gravidez. O documento servir? como ferramenta para o ensino e a pesquisa em enfermagem obst?trica. / The research aimed to construct and validate a data collection instrument of pregnant couple as part of primary care. It was considered hypothesis that level of agreement from 70% among participants to validate the expert panel. The document has been based on the Theory of Human Needs by Horta and adjusted by Garcia and Cubas. It is a study of methodological type developed in four stages: identification of empirical indicators to pregnant women through an integrative literature review; evaluation of empirical indicators and their relation to human needs by focus group; structuring of the second version of instrument by categorization of indicators and appearance and content validation of the third version of instrument by judges, by use of Delphi technique. The collection of data was the first stage in months from August to October 2014 in the Journal of Midwifery and Women's Health and Scopus, PubMed, Lilacs, CINAHL, Cochrane databases. The remaining steps were carried out from November 2014 to February 2015. For the focus group was counted with participation of six experts through two meetings. As for the judges, it was obtained a population of 63 and final sample of 51 judges divided into 46 basic health units of Municipal City Health Natal/RN, Brazil. The study was approved by the Research Ethics Committee of Universidade Federal do Rio Grande do Norte, under Protocol number 876.200. For data analysis of the first stage it was used descriptive statistics and results are presented in tables and charts. At that stage were identified 162 empirical indicators and, when they were related to human needs, 64 by them were on psycobiological, 97 on psychosocial and one (1) on psychospiritual needs. Regarding the second and third stages, data were treated by process of categorizing and analyzing the Content Validity Index. The indicators obtained a 100% validation index. In appearance and content validation phase of instrument non-validated items were excluded and other items obtained index above 70%. Furthermore, it obtained 99% content validity index in the second version and 95.7% in the third version of the instrument as a whole and, therefore, validated tool. This instrument contains Health Institution, pregnant woman and her partner identification data, information on the human needs of the pregnant and items pertaining to systematize the collection of pregnant couple data during prenatal care. By the conclusion of the study, nurse shall have an instrument to collect the data of pregnant couple in primary care innovative by considering psychobiological, psychosocial and psychospiritual pregnant needs and insert health and sociodemographic data of pregnant partner in the context of pregnancy. Also, the document will serve as a tool for teaching and research in obstetrical nursing.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-06T20:36:54Z No. of bitstreams: 1 AnaPaulaNunesDeLimaFernandes_DISSERT.pdf: 1379064 bytes, checksum: a03ad37f1ddd78ddc22531d83f0a3c8c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-08T19:52:06Z (GMT) No. of bitstreams: 1 AnaPaulaNunesDeLimaFernandes_DISSERT.pdf: 1379064 bytes, checksum: a03ad37f1ddd78ddc22531d83f0a3c8c (MD5) / Made available in DSpace on 2016-06-08T19:52:06Z (GMT). No. of bitstreams: 1 AnaPaulaNunesDeLimaFernandes_DISSERT.pdf: 1379064 bytes, checksum: a03ad37f1ddd78ddc22531d83f0a3c8c (MD5) Previous issue date: 2015-10-15 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / A S?ndrome do Olho Seco ? uma doen?a multifatorial do filme lacrimal, resultado da instabilidade da unidade funcional lacrimal que produz altera??o de volume, composi??o ou distribui??o da l?grima. Em pacientes internados em terapia intensiva a causa ? potencializada devido aos diversos fatores de risco, como ventila??o mec?nica, seda??o, lagoftalmia, baixas temperaturas, entre outros. O estudo tem por objeto a constru??o de um instrumento de avalia??o da Gravidade do Olho Seco em pacientes internados em unidades de terapia intensiva com base na Sistematiza??o da Assist?ncia de Enfermagem e seus sistemas de classifica??o. O objetivo geral deste estudo ? construir um instrumento de avalia??o da Gravidade do Olho Seco em pacientes internados em Unidade de Terapia Intensiva. Trata-se de um estudo metodol?gico realizado em tr?s etapas, a saber: an?lise de contexto, an?lise de conceito, constru??o das defini??es e magnitudes operacionais do resultado de enfermagem. Para a primeira etapa utilizou-se o referencial metodol?gico de Hinds, Chaves e Cypress (1992). Para a segunda etapa foram empregados o modelo de Walker e Avant e uma revis?o integrativa segundo Whitemore, Knalf (2005). Esta etapa possibilitou a identifica??o dos atributos do conceito, os antecedentes e os consequentes e fundamentou a constru??o das defini??es para o resultado de enfermagem gravidade do olho seco. Para a constru??o das defini??es e magnitudes operacionais, foi utilizada a Psicometria proposta por Pasquali (1999). Como resultado da an?lise de contexto, visualizou-se a partir da reflex?o que o assunto deve ser discutido e que a enfermagem necessita atentar para a problem?tica das les?es oculares, para que sejam criadas estrat?gias de minimiza??o deste evento com elevada preval?ncia. Com a revis?o integrativa foram localizados a partir dos cruzamentos 19.853 t?tulos, e selecionados 215, e a partir dos resumos 96 artigos foram lidos na ?ntegra Com a leitura 10 foram exclu?dos, o que culminou na amostra de 86 artigos utilizados para analisar o conceito e constru??o das defini??es. Os artigos selecionados foram encontrados em maior n?mero na base de dados Scopus (55,82%), realizados nos Estados Unidos da Am?rica (39,53%), e publicados principalmente nos ?ltimos 5 anos (48,82%). Em rela??o ? an?lise de conceito identificaram-se como antecedentes: idade, lagoftalmia, fatores ambientais, uso de medicamentos, doen?as sist?micas, ventila??o mec?nica e cirurgias oft?lmicas. Como atributos: TBUT< 10s, teste de Schimer I < 5mm, teste de Schimer II < 10mm, osmolaridade diminu?da. Como consequentes: dano ? superf?cie ocular, desconforto ocular, instabilidade visual. As defini??es foram constru?das e acrescidos indicadores como: mecanismo de piscar diminu?do e fadiga ocular. / Dry eye syndrome is a multifactorial disease of the tear film, resulting from the instability of the lacrimal functional unit that produces volume change, up or tear distribution. In patients in intensive care the cause is enhanced due to various risk factors, such as mechanical ventilation, sedation, lagophthalmos, low temperatures, among others. The study's purpose is to build an assessment tool of Dry Eye Severity in patients in intensive care units based on the systematization of nursing care and their classification systems. The aim of this study is to build an assessment tool of Dry Eye Severity in hospitalized patients in Care Unit Intensiva.Trata is a methodological study conducted in three stages, namely: context analysis, concept analysis, construction of operational definitions and magnitudes of nursing outcome. For the first step we used the methodological framework for Hinds, Chaves and Cypress (1992). For the second step we used the model of Walker and Avant and an integrative review Whitemore seconds, Knalf (2005). This step enabled the identification of the concept of attributes, background and consequent ground and the construction of the settings for the result of nursing severity of dry eye. For the construction of settings and operational magnitudes, it was used Psicometria proposed by Pasquali (1999). As a result of context analysis, visualized from the reflection that the matter should be discussed and that nursing needs to pay attention to the problem of eye injury, so minimizing strategies are created this event with a high prevalence. With the integrative review were located from the crosses 19 853 titles, selected 215, and from the abstracts 96 articles were read in full. From reading 10 were excluded culminating in the sample of 86 articles that were used to analyze the concept and construction of settings. Selected articles were found in greater numbers in the Scopus database (55.82%), performed in the United States (39.53%), and published mainly in the last five years (48.82). Regarding the concept of analysis were identified as antecedents: age, lagophthalmos, environmental factors, medication use, systemic diseases, mechanical ventilation and ophthalmic surgery. As attributes: TBUT <10s, Schimer I test <5 mm in Schimer II test <10mm, reduced osmolarity. As consequential: the ocular surface damage, ocular discomfort, visual instability. The settings were built and added indicators such as: decreased blink mechanism and eyestrain.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-06T20:36:54Z No. of bitstreams: 1 JessicaDantasDeSaTinoco_DISSERT.pdf: 1164249 bytes, checksum: 3ee3bbb39005b1d8b42779f8bccd39fa (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-08T20:08:46Z (GMT) No. of bitstreams: 1 JessicaDantasDeSaTinoco_DISSERT.pdf: 1164249 bytes, checksum: 3ee3bbb39005b1d8b42779f8bccd39fa (MD5) / Made available in DSpace on 2016-06-08T20:08:46Z (GMT). No. of bitstreams: 1 JessicaDantasDeSaTinoco_DISSERT.pdf: 1164249 bytes, checksum: 3ee3bbb39005b1d8b42779f8bccd39fa (MD5) Previous issue date: 2015-11-24 / Estudo transversal de acur?cia diagn?stica, cujo objetivo foi validar clinicamente o diagn?stico de enfermagem Prote??o Ineficaz em pacientes submetidos ? hemodi?lise. Duzentos pacientes submetidos ? hemodi?lise em uma cl?nica no nordeste do Brasil foram selecionados por conveni?ncia, de forma consecutiva, durante os meses de mar?o e abril de 2015. Na coleta de dados, utilizou-se o prontu?rio e um instrumento estruturado de entrevista e exame f?sico. A acur?cia dos indicadores cl?nicos do diagn?stico Prote??o Ineficaz se deu a partir da an?lise de classe latente. Foram identificadas a preval?ncia do diagn?stico, os valores de sensibilidade e especificidade de cada indicador cl?nico investigado e os respectivos intervalos de confian?a de 95%. O estudo foi aprovado pelo comit? de ?tica em pesquisa, com parecer n?mero 387.837 e Certificado de Apresenta??o para Aprecia??o ?tica: 18486413.0.0000.5537. Os resultados indicam uma preval?ncia de 60,5% do diagn?stico Prote??o Ineficaz na clientela investigada. Os indicadores cl?nicos com maior sensibilidade ao diagn?stico Prote??o Ineficaz foram: Fadiga, Resposta mal adaptada ao estresse e Altera??o na coagula??o. Os espec?ficos foram: Fadiga, Febre, Aumento do n?mero de hospitaliza??es, Fraqueza, Acesso vascular infeccionado e Disfun??o do acesso vascular. Conclui-se que o diagn?stico estudado ? v?lido clinicamente para a clientela em hemodi?lise, pois a identifica??o do conjunto de indicadores cl?nicos acurados, por meio das medidas de sensibilidade e especificidade, permitiu a predi??o fidedigna do mesmo. Destaca-se o indicador Fadiga com melhores medidas de acur?cia para a ocorr?ncia do diagn?stico investigado. Ademais, os achados contribuem para a pr?tica cl?nica do enfermeiro, auxiliando no processo de infer?ncia diagn?stica e no plano de interven??es preciso e direcionado ? realidade do paciente em hemodi?lise. / Cross-sectional study of diagnostic accuracy, with purpose the clinical validation of the nursing diagnosis Ineffective Protection in patients undergoing hemodialysis. Two hundred patients undergoing hemodialysis at a clinic in northeastern Brazil were selected by convenience, consecutively, during the months of March and April 2015. In the data collection, we used the medical records and a structured instrument of interview and physical examination. The accuracy of the clinical indicators of diagnosis Ineffective Protection took from the latent class analysis. It was identified the prevalence of diagnosis, the sensitivity and specificity of each clinical indicator investigated and their confidence intervals of 95%. The ethics committee in research approved the study, with sound number 387 837 and Certificate Presentation to Ethics Assessment: 18486413.0.0000.5537. The results indicate a prevalence of 60.5% in the diagnosis Ineffective Protection investigated clientele. Clinical indicators with greater sensitivity to the diagnosis Ineffective Protection were: fatigue, maladaptive response to stress and coagulation alterations. Specific were: fatigue, fever, increase in the number of hospitalizations, weakness, vascular access dysfunction and infected vascular access. It concludes that the studied diagnosis is clinically valid for the clientele in hemodialysis, since the identification of the accuracy of set clinical indicators, by the measures of sensitivity and specificity, allows for the consistent prediction of the same. Noteworthy is the fatigue indicator with better accuracy measures for the occurrence of the investigated diagnosis. In addition, the findings contribute to the clinical nursing practice, assisting in diagnostic inference process and intervention plan precise and directed to the patient's reality in hemodialysis.