Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:17:22Z No. of bitstreams: 1 CeciliaOliviaParaguaiDeOliveira_DISSERT.pdf: 2135958 bytes, checksum: 56bedb86af9f63fa031905a1f2c34209 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T18:56:21Z (GMT) No. of bitstreams: 1 CeciliaOliviaParaguaiDeOliveira_DISSERT.pdf: 2135958 bytes, checksum: 56bedb86af9f63fa031905a1f2c34209 (MD5) / Made available in DSpace on 2016-06-28T18:56:21Z (GMT). No. of bitstreams: 1 CeciliaOliviaParaguaiDeOliveira_DISSERT.pdf: 2135958 bytes, checksum: 56bedb86af9f63fa031905a1f2c34209 (MD5) Previous issue date: 2015-11-20 / A Seguran?a do Paciente (SP) representa motivo de grande preocupa??o nos servi?os de sa?de por sua dimens?o global. A fragilidade dos processos assistenciais predisp?e a ocorr?ncia de incidentes de seguran?a e eventos adversos (EAs), que na Unidade de Terapia Intensiva Neonatal (UTIN) s?o considerados graves e colocam em risco a vida dos rec?m-nascidos. O presente estudo objetivou a Identifica??o da ocorr?ncia de eventos adversos nos rec?m-nascidos internados numa UTIN de um hospital escola. Trata-se de um estudo transversal, explorat?rio, de natureza descritiva, e abordagem quantitativa realizado no ano de 2015. A amostragem ocorreu de forma n?o probabil?stica envolvendo 117 RNs que atenderam aos crit?rios de elegibilidade. A coleta dos dados foi realizada por meio da utiliza??o de um instrumento especifico do tipo ?gatilho?, composto por eventos sentinela na UTIN, adaptado do modelo americano utilizado pela Rede Vermont-Oxford. O projeto recebeu parecer favor?vel pelo Comit? de ?tica da Universidade Federal do Rio Grande do Norte (CEP/UFRN) com Certificado de Apresenta??o para Aprecia??o ?tica (CAAE): 43894515.6.0000.5537. Foram identificados pelo menos um tipo de incidente ou EA em todos os 117 RN. Prevaleceram RNs pr?-termos, com baixo peso ao nascer, filhos de m?e com DHEG. Dentre os eventos identificados destacaram-se: o controle de termorregula??o inadequado (61%), dist?rbios metab?licos (26%), infec??es relacionadas ? assist?ncia ? sa?de (8%) e terapia respirat?ria de risco ao RN (5%). O percentual dos eventos foi diretamente proporcional ? gravidade do RN e ao tempo de interna??o hospitalar. Assim, conclui-se, que a elevada taxa de incidentes e eventos adversos identificada na UTIN refor?a a necessidade de elabora??o de estrat?gias preventivas espec?ficas para esse ambiente de risco. / The patient safety is a major concern in health services for its global dimension, as evidenced by the fragility of care processes that predispose an occurrence of adverse events. These events in a neonatal intensive care unit are considered serious and hazardous to lives of newborns. The present study aimed to identify and analyze adverse events in a neonatal intensive care unit based in Trigger Tool. It is an epidemiological, cross-sectional , exploratory, retrospective study with quantitative, descriptive and analytical approach, performed in 2015 at a school hospital. The sample was not probabilistic, involving 116 newborns who met the eligibility criteria. Data collection was performed by retrospective review of medical records, using a specific kind of "trigger" instrument, composed of sentinel events in neonatology, adapted from the American model used by the Vermont-Oxford Network. Data were analyzed using descriptive and inferential statistics. The chi-square test for linear trend was used to assess the associations between the variables of interest. The research received a favorable agreement from Ethics Committee of the Federal University of Rio Grande do Norte, under number 1055533, and Presentation Certificate for Ethics Assessment 43894515.6.0000.5537. The results show among investigated newborns, 110 experienced at least one adverse event during their stay, with a total of 391 medical records analyzed and rate of 3.37 events per patient. Prevailed the preterm newborns with low birth weight, from mother who had hypertensive diseases during pregnancy and urinary tract infection. The average hospitalization time was 25 days, associated with hospital-acquired infections events (p = 0.01). Among the identified adverse events stood out the events related to thermoregulation disorders (39.0%), with prevalence of hypothermia (26.0%), followed by health care-related infections (16.4%) and blood glucose disorders, hypoglycemia (9.00%) and hyperglycemia (6.64%). Most of these incidents were classified in categories E and F, which represents that there was damage small proportion. Due to these damages come from the care practice with newborn, 78% were classified as avoidable. There was statistically significant association between the variable birth weight with infections (p = 0.006) as well as peri/intraventricular bleeding (p = 0.02), hypoglycemia (p = 0.021), hyperglycemia (p = 0.001), hyperthermia (p = 0.39) and death (p=0,02). Gestational age was associated with seizures (p = 0.002), hyperglycemia (p=0.017) e hyperthermia (p=0.027). The security institution culture was reported by the health workers as intermediate, even though the number of adverse events found in only one unit of service indicates that there is much to be done. Thus the high rate of adverse events identified in the neonatal intensive care unit reinforces the necessity to elaborate specific preventive strategies for this risk environment.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:17:23Z No. of bitstreams: 1 GleyceAnyFreireDeLima_DISSERT.pdf: 3848100 bytes, checksum: e6fd45cc0f1729541865b18bcb3b8832 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T19:28:57Z (GMT) No. of bitstreams: 1 GleyceAnyFreireDeLima_DISSERT.pdf: 3848100 bytes, checksum: e6fd45cc0f1729541865b18bcb3b8832 (MD5) / Made available in DSpace on 2016-06-28T19:28:57Z (GMT). No. of bitstreams: 1 GleyceAnyFreireDeLima_DISSERT.pdf: 3848100 bytes, checksum: e6fd45cc0f1729541865b18bcb3b8832 (MD5) Previous issue date: 2015-12-08 / Este estudo tem o objetivo de compreender o significado dos cuidados paliativos a pessoa idosa para profissionais de sa?de que atuam na aten??o prim?ria. Estudo descritivo e de abordagem qualitativa, com base no processo de codifica??o e compara??o constante da Teoria Fundamentada nos Dados (TFD). Realizado em um N?cleo de apoio ? Sa?de da Fam?lia, e mais tr?s Unidades de Sa?de da Fam?lia do bairro de Felipe Camar?o, Distrito sanit?rio oeste, munic?pio de Natal. Dos 25 participantes, 19 s?o profissionais da Estrat?gia Sa?de da Fam?lia, e 6 do N?cleo de Apoio a Sa?de da Fam?lia, sendo 21 homens e 4 mulheres com experi?ncia m?nimade um ano na aten??o prim?ria ? sa?de.O estudo foi aprovado pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte, sob CAAE n?43895815.4.0000.5537. As entrevistas individuais, realizadas entre julho a setembro de 2015. Os resultados coletados foram gravados em MP4 e transcritos para linguagem escrita, e analisados atrav?s do processo de codifica??o aberta, meio no qual, os conceitos foram identificados e posteriormente seguiu-se a codifica??o axial, onde as categorias foram desenvolvidas sistematicamente e relacionadas. Ap?s estes procedimentos, emergiram tr?s categorias: comportamento dos profissionais de sa?de frente ? assist?ncia em cuidados paliativos na Aten??o Prim?ria, valoriza??o da percep??o subjetiva dos profissionais de sa?de no cuidado a pessoa em processo de finitude e o significado desarticulado frente aos cuidados paliativos na aten??o prim?ria vivenciado entre os profissionais de sa?de. Na seq??ncia, as categorias foram interpretadas e analisadas, mediante o referencial te?rico da fenomenologia social de Alfred Schutz. Diante do comportamento dos profissionais, identificaram-se a descoberta e a profundidade das pressuposi??es atrav?s da estrutura??o e do significado em um sentido comum. Em rela??o ? valoriza??o da percep??o subjetiva dos profissionais, percebe-se a quest?o da complexidade das m?ltiplas rela??es atrav?s de diversos aspectos de sua tarefa central: concentrar uma filosofia da realidade do mundo, ou seja, uma fenomenologia da atitude natural; ante o significado da desarticula??o entre os profissionais de sa?de e a gest?o, compreende-se a realidade eminente representada pela individualidade de interesses especiais da experi?ncia. Conclui-se que a interpreta??o do significado da assist?ncia em cuidados paliativos ao idoso na aten??o prim?ria de sa?de, urge inserir um novo olhar diante da atua??o dos profissionais de sa?de e da gest?o, no que se refere ?s intera??es sociais e experi?ncias futuras, voltadas para popula??es mais velhas e em situa??es cr?nicas de sa?de, impingindo a necessidade de uma intera??o maior da equipe de sa?de na aten??o prim?ria, e consequente melhoria da assist?ncia em cuidados paliativos. / This study aims to understand the significance of palliative care for the elder health care professionals working in primary health care. Descriptive study of qualitative approach. Conducted in three health units of the Family and a core of support for Health, the Felipe Camar?o neighborhood, District of Natal Health West, RN. Of the 25 participants, 19 are professionals of the Family Health Strategy and six of the Center for Support to Health, the majority being women, with minimal professional work experience, a year in primary health care. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte, under CAAE no. 43895815.4.0000.5537. There were individual interviews between July and September 2015, with the use of questionnaire containing open and closed questions on the topic of study. Our results were recorded in MP4 and transcribed into written language, and analyzed using the open coding process medium in which the categories were interpreted and identified, followed by axial coding, where categories were developed and systematically related. Three categories emerged: enhancement of elder health professionals in palliative care, behavioral health professionals across care in palliative care in primary care and disjointed Meaning between palliative care and health professionals. The categories were interpreted and analyzed by the theoretical framework of social phenomenology of Alfred Sch?tz. Regarding the valuation of subjective perception of professionals, it is clear the issue of the complexity of multiple relationships through various aspects of his central task: focus a philosophy of the world's reality, namely a phenomenology of natural attitude; Before the professional behavior were identified: the discovery and depth of assumptions through the structure, and meaning in a common sense, and at the meaning of the disconnection between the health professionals-including that reality imminent can be represented by individuality special interest of the experience. It follows that health professionals understand there is a difficulty facing the assistance in palliative care to the elderly in primary care, and this difficulty, characterized by the complexity of social interactions across the joint teamwork. Although, I believe that the articulation between the teams, work and family, is essential for the subsequent improvement of care in palliative care favoring the health context surrounding the Elder.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:17:23Z No. of bitstreams: 1 GracimaryAlvesTeixeira_DISSERT.pdf: 932137 bytes, checksum: c111b9e55d4227ee4186c5c76f910320 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T19:34:38Z (GMT) No. of bitstreams: 1 GracimaryAlvesTeixeira_DISSERT.pdf: 932137 bytes, checksum: c111b9e55d4227ee4186c5c76f910320 (MD5) / Made available in DSpace on 2016-06-28T19:34:38Z (GMT). No. of bitstreams: 1 GracimaryAlvesTeixeira_DISSERT.pdf: 932137 bytes, checksum: c111b9e55d4227ee4186c5c76f910320 (MD5) Previous issue date: 2015-12-10 / O nascimento ou parto prematuro, com menos de 37 semanas de gesta??o, ? considerado um problema de sa?de p?blica mundial, pois ? tido como um dos principais fatores de risco para morbidade e mortalidade neonatal, principalmente na primeira semana de vida. O estudo teve por objetivo analisar o perfil das m?es de beb?s prematuros e a termo e o desfecho do nascimento. Trata-se de um estudo anal?tico-descritivo, seccional, com amostra de 109 m?es de todos os beb?s prematuros e 135 m?es de beb?s a termo selecionados de forma aleat?ria, por sorteio, ocorridos no per?odo de abril a setembro de 2015, em uma maternidade p?blica. Os dados foram tabulados no Software Excel 2013 tendo sido realizado o teste do Ki-quadrado. Antes de iniciar a coleta de dados o projeto foi submetido ao Comit? de ?tica e Pesquisa da Universidade Federal do Rio Grande do Norte, com parecer favor?vel de n? 1.047.431. Esse estudo possibilitou identificar que o perfil socioecon?mico de m?es de beb?s prematuros e a termo apresentaram em ambos: baixo n?vel de escolaridade, baixa renda. Al?m disso, os dados apontam nos dois grupos alta preval?ncia de sedentarismo antes e durante a gravidez; sobrepeso a obesidade antes da gravidez em 42,22% das m?es de beb?s prematuros e 48,62% m?es de beb?s a termo; com press?o alta durante a gesta??o em 32,11% das m?es de beb?s prematuros e 17,04% das m?es de beb?s a termo. Outrossim, a gravidez s? foi planejada em 33,33% e al?m disso indesejada por 21,1% das m?es de beb?s prematuros, enquanto as m?es de beb?s a termo 40,37% planejaram a gravidez e 17,78% tiveram gravidez indesejada. No que diz respeito ao fator agravante - drogas il?citas, houve aumento no consumo pelas m?es de beb?s prematuros de 3,70% antes da gravidez para 8,26% durante a gravidez; j? as m?es de beb?s a termo, apesar de ter-se reduzido a preval?ncia em 6,0% entre o per?odo antes e durante a gesta??o, ainda apresentou-se 3,70% do consumo durante a gesta??o. As intercorr?ncias mais frequentes foram o sangramento vaginal em 43,12% das m?es de beb?s prematuros e 20% das m?es de beb?s a termo; infec??o urin?ria em 44,95% das m?es de beb?s prematuros e 40% das m?es de beb?s a termo; gravidez estressante em 62,96% das m?es de beb?s prematuros e 47,41% das m?es de beb?s a termo. Logo, os beb?s nasceram com problemas de sa?de em 58,10% dos prematuros e nascimento saud?vel em 96,30% dos beb?s a termos. Portanto, o perfil de m?es com gravidez indesejada, usu?ria de drogas il?citas durante a gesta??o, gravidez estressante, sangramento vaginal podem associar-se ao nascimento do beb? prematuro como evento desfavor?vel e de risco ? sa?de da crian?a. / The birth or delivery under 37 weeks of pregnancy is considered a global public health problem, since it is seen as one of the main risk factors for neonatal morbidity and mortality, particularly in the first week of life. This study had the objective of analyzing the profile of mothers of premature and full-term babies for the outcome of birth. This is an analytical-descriptive and cross-sectional study, with a sample of 109 mothers of all the premature babies and 135 mothers of the randomly selected full-term babies, by drawing, occurred in the period from April to September 2015, in a public maternity. Data were organized on Microsoft Excel 2013; subsequently, there was the analysis of the analytical-descriptive statistics, through Statistica 10, through which the frequencies, proportions, p values, with 5% significance level, through the Chi-square test, were identified. The project was submitted to the Research Ethics Committee of the Federal University of Rio Grande do Norte, receiving a favorable opinion (n? 1047431/2015). This study has enabled us to identify that the socioeconomic profile of mothers of premature and full-term babies showed, in both, low schooling level and low income. In addition, our data point out in the two groups, before and during pregnancy, a high prevalence of sedentariness; statistical significance for overweight and obesity before and during pregnancy, with 42,22% prevalence before pregnancy of mothers of premature babies and 48,62% of mothers of full-term babies; with high blood pressure during pregnancy in 32,11% of mothers of premature babies and 17,04% of mothers of full-term babies. Moreover, pregnancy was only planned in 33,33%, and also unwanted by 21,1% of mothers of premature babies, while 40,37% of mothers of full-term babies planned pregnancy and 17,78% had unwanted pregnancy. With respect to the aggravating factor ?illicit drugs?, there was consumption during pregnancy on the part of 8,26% of mothers of premature babies. The most frequent complications were: vaginal bleeding (in 43,12% of mothers of premature babies and 20% of mothers of full-term babies); urinary infection (in 44,95% of mothers of premature babies and 40% of mothers of full-term babies); and stressful pregnancy (in 62,96% of mothers of premature babies and 47,41% of mothers of full-term babies). Accordingly, babies were born with health problems in 58,10% of premature births and there was healthy birth in 96,30% of full-term babies. Therefore, the profile of mothers with obesity and overweight, unwanted pregnancy, user of illegal drugs during pregnancy, stressful pregnancy and vaginal bleeding may be associated with the birth of premature baby as unfavorable and hazardous event for the child?s health.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:17:23Z No. of bitstreams: 1 JulianaRaquelSilvaSouza_DISSERT.pdf: 1507854 bytes, checksum: 6625f23a003b92633a287d83fad68866 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T19:47:10Z (GMT) No. of bitstreams: 1 JulianaRaquelSilvaSouza_DISSERT.pdf: 1507854 bytes, checksum: 6625f23a003b92633a287d83fad68866 (MD5) / Made available in DSpace on 2016-06-28T19:47:10Z (GMT). No. of bitstreams: 1 JulianaRaquelSilvaSouza_DISSERT.pdf: 1507854 bytes, checksum: 6625f23a003b92633a287d83fad68866 (MD5) Previous issue date: 2015-11-20 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Uma das quest?es mais relevantes na ?rea de sa?de da mulher ? o C?ncer de Mama, que de acordo com as estimativas nacionais, ? o segundo tipo de neoplasia que mais acomete mulheres em idade reprodutiva no Brasil. Em se tratando de conduta terap?utica, os m?todos comumente utilizados s?o: cirurgia conservadora, que retira uma parte da gl?ndula mam?ria que cont?m o tumor; e a mastectomia, t?cnica cir?rgica caracterizada pela ressec??o da pe?a anat?mica da mama. O estudo tem como objetivo geral avaliar a imagem corporal de mulheres submetidas ? cirurgia oncol?gica mam?ria. Trata-se de um estudo descritivo, explorat?rio, transversal, com enfoque quantitativo, realizado no ?mbito de uma institui??o filantr?pica de refer?ncia nacional em c?ncer. A popula??o do estudo ? composta por mulheres oncocirurgiadas de mama em tratamento na institui??o. A amostra foi calculada com base na f?rmula para popula??o finita com representa??o de 124 sujeitos. Os dados foram coletados no per?odo de mar?o a maio de 2015. A mensura??o da imagem corporal se deu atrav?s da escala Body Imagem After Breast Cancer Questionnaire - BIBCQ, do tipo Likert de cinco pontos, validada, traduzida para o portugu?s, e composta por 44 quest?es, que est?o dispostas em seis escalas com dom?nio da autoimagem (Escala de vulnerabilidade, Escala de estigma corporal, Escala de limita??es, Escala de preocupa??es com o corpo, Escala de transpar?ncia, Escala de preocupa??es com o bra?o). O perfil sociecon?mico da amostra revela a faixa et?ria predominante entre 40 a 59 anos (58,8%), casadas ou em uni?o est?vel (59,7%), cirurgia realizada h? mais de um ano (61,3%), em apenas uma mama (87,1%), do tipo mastectomia sem reconstru??o (41,9%). Ap?s mensura??o da imagem corporal, o dom?nio ?vulnerabilidade? destaca-se com maior escore de concord?ncia na vari?vel ?preocupo-me com pequenas dores? e o dom?nio ?preocupa??o com o corpo? apresenta o menor escore de discord?ncia na quest?o ?Estou satisfeita com a apar?ncia do meu quadril?. A investiga??o possibilitou inferir que os sujeitos do estudo acentuam quest?es ligadas ? patologia em detrimento da imagem ligada ? estrutura f?sica. Esse fato caracteriza associa??o com o perfil da amostra, sobretudo com o tempo de realiza??o da cirurgia, idade e mama afetada. O estudo contribui para a apreens?o das peculiaridades das mulheres oncocirurgiadas de mama e sua trajet?ria de reinser??o, t?o essencial para a pr?xis em Enfermagem. / Breast cancer is the second type of cancer that affects more women of reproductive age in Brazil. Surgical treatments include: conserving surgery or mastectomy. Aimed to evaluate body image of women undergoing breast cancer surgery, based on the scale Body Image After Breast Cancer Questionnaire. It is a descriptive, exploratory, transversal, with a quantitative approach. Data were collected in Norte-riograndense League Against Cancer, between the months from March to May 2015, after consideration of the Research Ethics Committee of that institution CAEE 35155714.1.0000.5293. The study population consisted of women undergoing breast onco-surgery. To calculate the sample considered the finite population, totaling 120 subjects, collected four guys the most. Data were analyzed by the software Statistical Package for Social Sciences version 20.0. The domain scores of the scale were evaluated using descriptive and inferential statistics. The surgical group mastectomy without reconstruction showed greater impairment of body image in the field "vulnerability", "Care for the body" and "transparency" in relation to other surgical types, and suggests susceptibility to cancer, body appearance and worry that disturb other. The Kruskal-Wallis test showed greater dissatisfaction with body image in the fields "body Stigma" and "transparency" to the radical neoplastic surgery over other surgical types. Dissatisfaction with body image and physical appearance was detected in this study in all six image fields present in scale, with emphasis on the "body Stigma" and "Transparency". This means that the body image disorder is formulated based on the perception of others about themselves and not by perception "self", which justifies the concern with appearance, with body and hide the consequences stemmed cancer. It is expected that the data obtained from the evaluation of body image presented in this study contribute to enable the assistance to oncocirurgiada woman breast integral, essential for the practice of Nursing.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:17:23Z No. of bitstreams: 1 KarilenaKarllaDeAmorimPedrosa_DISSERT.pdf: 1269835 bytes, checksum: c4e632f9e2f7369e346ae134b307ea35 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T20:04:02Z (GMT) No. of bitstreams: 1 KarilenaKarllaDeAmorimPedrosa_DISSERT.pdf: 1269835 bytes, checksum: c4e632f9e2f7369e346ae134b307ea35 (MD5) / Made available in DSpace on 2016-06-28T20:04:02Z (GMT). No. of bitstreams: 1 KarilenaKarllaDeAmorimPedrosa_DISSERT.pdf: 1269835 bytes, checksum: c4e632f9e2f7369e346ae134b307ea35 (MD5) Previous issue date: 2015-12-04 / Tratar-se-? de um estudo metodol?gico, com abordagem quantitativa; baseado no referencial metodol?gico da t?cnica Delphi, com objetivo de construir e validar um protocolo cl?nico para assist?ncia do enfermeiro ao paciente s?ptico na Unidade de Terapia Intensiva. A proposta metodol?gica seguiu duas etapas: elabora??o do instrumento por meio da revis?o integrativa da literatura e valida??o de conte?do do protocolo. O estudo foi aprovado pelo Comit? de ?tica em Pesquisa, mediante o Parecer CAAE 41873314.5.0000.5537. O universo amostral foi composto por profissionais enfermeiros, considerados peritos, doutores ou mestres na ?rea da sa?de, com experi?ncia em alta complexidade e/ ou estudos de valida??o de instrumento/protocolo, selecionados por meio da Plataforma Lattes. Referente ? primeira etapa elaborou-se um instrumento composto pela caracteriza??o profissional dos peritos; e baseado em evid?ncia cient?fica e nas diretrizes do Surviving Sepsis Campaign, contemplando tr?s t?picos assistenciais ao paciente com sepse, a saber: Triagem para Sepse- Reconhecimento das Manifesta??es Cl?nicas; Pacote de Ressuscita??o Inicial (Controle das Primeiras 6 Horas); Tratamento de Suporte. A segunda etapa caracterizou-se na valida??o de conte?do do instrumento para elabora??o final do protocolo, utilizando ? t?cnica Delphi, em duas fases. No que concernem as vari?veis referentes ao estudo, na 1? fase de Delphi, 34 peritos avaliaram o instrumento composto por 18 itens, no per?odo de maio a julho de 2015, e os dados foram analisados pela estat?stica descritiva (frequ?ncia, m?dia, mediana e desvio padr?o) e pelo ?ndice de Validade de Conte?do (IVC), demonstrando um IVC extremamente satisfat?rio para 15 itens, com total de 0,79, obtendo assim, a reformula??o e refinamento do conte?do do instrumento. Na segunda fase de Delphi, entre julho e agosto de 2015, participaram 26 peritos, e utilizou-se o percentual de concord?ncia acima de 75% para as vari?veis consideradas pertinentes ao protocolo de cuidados ao paciente s?ptico em UTI, obtendo nesta fase, o percentual de concord?ncia de 95%. O protocolo foi conclu?do com 15 itens, sendo respaldado e modificado, baseado em evid?ncia cient?fica, nas diretrizes internacionais e nas sugest?es dos peritos. A utiliza??o do protocolo proposto poder? contribuir para a pr?tica cl?nica do enfermeiro ao paciente s?ptico na Unidade de Terapia Intensiva.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:17:23Z No. of bitstreams: 1 MariaDasGracasMarianoNunesDePaiva_DISSERT.pdf: 1617534 bytes, checksum: bdf20a4c5dfbaa77ee6485f3f947ad4d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T20:12:19Z (GMT) No. of bitstreams: 1 MariaDasGracasMarianoNunesDePaiva_DISSERT.pdf: 1617534 bytes, checksum: bdf20a4c5dfbaa77ee6485f3f947ad4d (MD5) / Made available in DSpace on 2016-06-28T20:12:19Z (GMT). No. of bitstreams: 1 MariaDasGracasMarianoNunesDePaiva_DISSERT.pdf: 1617534 bytes, checksum: bdf20a4c5dfbaa77ee6485f3f947ad4d (MD5) Previous issue date: 2015-11-24 / O objetivo do estudo ? analisar o conte?do e as medidas de acur?cia do diagn?stico de enfermagem Autocontrole Ineficaz da Sa?de em pacientes submetidos ? hemodi?lise. Estudo do tipo metodol?gico, desenvolvido em duas etapas, a saber: an?lise de conte?do por ju?zes e acur?cia dos indicadores cl?nicos. Na primeira etapa, 22 ju?zes avaliaram a defini??o e localiza??o do diagn?stico, indicadores cl?nicos e fatores etiol?gicos e suas defini??es conceituais e emp?ricas. Utilizou-se o teste binomial para avaliar a concord?ncia entre os ju?zes. Na segunda etapa, utilizou-se o modelo de classe latente para a infer?ncia diagn?stica. Pesquisa aprovada pelo Comit? de ?tica, sob o Parecer no 387.837 e CAAE 18486413.0.0000.5537. Os resultados mostram que os ju?zes avaliaram como pertinentes 12 indicadores cl?nicos e 22 fatores etiol?gicos. Propuseram altera??o da nomenclatura de cinco indicadores cl?nicos e seis fatores etiol?gicos e a transposi??o de um indicador cl?nico para fator etiol?gico e tr?s fatores etiol?gicos para indicadores cl?nicos. Nas defini??es conceituais e emp?ricas, os ju?zes julgaram como n?o pertinentes as defini??es conceitual e emp?rica de um indicador cl?nico e defini??es conceituais de dois fatores etiol?gicos e defini??es emp?ricas de quatro fatores etiol?gicos. Ainda, foram sugeridas altera??es nas defini??es conceitual e emp?rica de dois indicadores cl?nicos, nas defini??es conceituais de 12 fatores etiol?gicos e em defini??es emp?ricas de 11 fatores etiol?gicos. Os indicadores cl?nicos analisados na primeira etapa foram validados clinicamente em pacientes submetidos ? hemodi?lise. Os indicadores cl?nicos mais frequentes foram Altera??es de exames laboratoriais (100%) e Escolhas de vida di?ria ineficazes para atingir metas de sa?de (81%) e, tr?s fatores etiol?gicos apresentaram maior frequ?ncia, s?o eles: Fatores sociodemogr?ficos desfavor?veis (94,5%), Cren?as (79%) e Comorbidades (77,5%). A partir do Modelo de Classe Latente, foi estimada a preval?ncia do diagn?stico em 66,28%. Os indicadores cl?nicos que apresentaram as melhores medidas de acur?cia para a sensibilidade do diagn?stico de enfermagem Autocontrole Ineficaz da Sa?de foram: Escolhas de vida di?ria ineficazes para atingir metas de sa?de e Express?o de dificuldade com os regimes prescritos. Por sua vez, os indicadores cl?nicos Uso inadequado de medicamentos, N?o Express?o de desejo de controlar a doen?a, Comparecimento irregular ?s sess?es de di?lise e Infec??o foram mais espec?ficos quanto ao referido diagn?stico. N?o ades?o ao tratamento foi o ?nico indicador que apresentou intervalos de confian?a com signific?ncia para sensibilidade e especificidade. Deste modo, o indicador cl?nico N?o ades?o ao tratamento ? mais preciso e fidedigno quanto ? infer?ncia do diagn?stico de enfermagem Autocontrole Ineficaz da Sa?de na clientela hemodial?tica. Assim, acredita-se que o aprimoramento dos componentes do diagn?stico de enfermagem em quest?o, ir? contribuir para a elabora??o de interven??es de enfermagem mais fidedignas ao estado de sa?de do indiv?duo em hemodi?lise, proporcionando um cuidado mais qualificado cientificamente. / The study aims to analyze the content and measures of accuracy of the nursing diagnosis Ineffective Self Health in patients undergoing hemodialysis. Study of nursing diagnosis validation carried out in two stages, namely: content analysis by judges and accuracy of clinical indicators. In the first stage, 22 judges evaluated the setting and location of the diagnosis, clinical indicators and etiological factors and their conceptual and empirical definitions. We used the binomial test to determine the proportion of the judges of the relevance of the components of the nursing diagnosis. In the second stage, we used the Latent Class Analysis for the diagnostic accuracy by evaluating 200 patients in a hemodialysis clinic in northeastern Brazil. Research approved by the Ethics Committee, under the Opinion No 387 837 and CAAE 18486413.0.0000.5537. The results show that the judges evaluated as pertinent clinical indicators 12 and 22 etiological factors. Proposed amendment of the nomenclature of five indicators and six factors and the implementation of a clinical indicator for etiology and three etiological factors for clinical indicators. In conceptual and empirical definitions, judges judged as not relevant the conceptual and empirical definitions of a clinical indicator, the conceptual definitions of two etiological factors and empirical definitions four etiological factors. Still, changes were suggested in the conceptual and empirical definitions of two clinical indicators, the conceptual definitions of 12 etiological factors and empirical definitions of 11 etiological factors. Clinical indicators analyzed in the first stage were validated clinically in patients undergoing hemodialysis. The most frequent clinical indicators were Changes in laboratory tests (100%) and daily life choices ineffective to achieve health goals (81%); and three etiological factors had a higher frequency, they are: unfavorable demographic factors (94.5%), beliefs (79%) and comorbidities (77.5%). From Latent class analysis, diagnosis prevalence was estimated at 66.28%. Clinical indicators that showed the best sensitivity measures for the nursing diagnosis Ineffective Self Health were: daily life choices ineffective to achieve health goals and Expression of difficulty with prescribed regimens. In turn, the clinical indicators of inappropriate medication use, no expression of desire to control the disease, irregular attendance to the dialysis sessions and infection were more specific as to that diagnosis. Non-adherence to treatment was the only indicator that showed confidence intervals with values for sensitivity and specificity, statistically above 0.5, being the one who has better diagnostic accuracy as the inference of the nursing diagnosis Ineffective Self Health in hemodialysis clientele. Thus, it is believed that the improvement of the components of diagnosis in question will contribute to the development of more reliable nursing interventions to the health status of the individual in hemodialysis, providing a more scientifically qualified care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:17:23Z No. of bitstreams: 1 RosaneSousaDeAndrade_DISSERT.pdf: 675189 bytes, checksum: a98d773786d7b38423df176ac2ea2c24 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T20:24:24Z (GMT) No. of bitstreams: 1 RosaneSousaDeAndrade_DISSERT.pdf: 675189 bytes, checksum: a98d773786d7b38423df176ac2ea2c24 (MD5) / Made available in DSpace on 2016-06-28T20:24:24Z (GMT). No. of bitstreams: 1 RosaneSousaDeAndrade_DISSERT.pdf: 675189 bytes, checksum: a98d773786d7b38423df176ac2ea2c24 (MD5) Previous issue date: 2015-11-23 / Estomia ? uma abertura de origem cir?rgica, quando h? necessidade de desviar, tempor?ria ou permanentemente, o tr?nsito normal da alimenta??o e/ou elimina??es. O paciente com estomia de elimina??o se v? diante de modifica??es em sua fisiologia, surgindo tamb?m ? necessidade de cuidados com a bolsa coletora. Neste estudo, objetivou-se analisar a Qualidade de Vida (QV) de pessoas vivendo com Estomias Intestinais (EI), atendidos no Centro de Reabilita??o Infantil e Adulto do Rio Grande do Norte (CRI/CRA-RN). Trata-se de um estudo anal?tico, com delineamento transversal e abordagem quantitativa, realizado com 89 pessoas que apresentaram EI. O estudo foi aprovado pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte (CEP/UFRN), CAAE: 19866413.3.0000.5537. Realizou-se a coleta de dados no per?odo de janeiro a mar?o de 2015 e se utilizou dois instrumentos: um question?rio geral adaptado abrangendo aspectos sociodemogr?ficos, cl?nicos e de autocuidado e um instrumento espec?fico de avalia??o de QV de pessoas com estoma intitulado como City of Hope Quality of Life - Ostomy Questionnaire (COH-QOL-OQ), validado e adaptado para o portugu?s em 2010, composto de quatro dom?nios, a saber: Bem Estar F?sico (BEF), Bem Estar Psicol?gico (BEP), Bem Estar Social (BES) e Bem Estar Espiritual (BEE). Os dados coletados foram inseridos num banco de dados na planilha do aplicativo Microsoft Excel 2007 e processados em software informatizado para as an?lises descritivas e inferenciais. Os resultados mostraram que 83,1% possu?am colostomia e 16,9% ileostomia. Na caracteriza??o sociodemogr?fica predominaram pessoas do sexo masculino (57,3%), acima de 50 anos (57,3%), de cor parda (46,1%), com presen?a de companheiro/a (57,3%), aposentados/benefici?rios (50,5%), renda mensal acima de um sal?rio m?nimo (68,5%) e que estudaram at? o ensino fundamental (67,4%). Quanto aos aspectos cl?nicos, observou-se que a maior causa que culminou com a confec??o do estoma foi ? neoplasia (59,6%) seguida de trauma (21,3%). A amostra apresentou pessoas com estoma h? mais de 6 meses (79,8%), de car?ter definitivo (57,3%), em uso de equipamento pe?a ?nica dren?vel (68,5%) de base plana (82,0%). Com rela??o ao autocuidado, 93,3% esvaziavam e lavavam a bolsa sozinhos (cuidados relacionados ? higiene), mas apenas 75,3% fixava a nova bolsa na pele, durante a troca (cuidados relacionados ? bolsa). A m?dia dos escores de QV dos pesquisados foi de 296,2 (68,90%) para QV Geral; 74,8 (68,03%) para o BEF; 88,8 (68,38%) para o BEP; 79,7 (66,46%) para o BES e 52,7 (75,41%) para o BEE. Diante dos resultados obtidos, conclui-se que se tratou de uma amostra predominantemente adulta/idosa (entre 50 e 70 anos), com baixa escolaridade e como causa motivadora do estoma, as neoplasias. Entretanto, tais achados n?o repercutiram em baixos ?ndices percentuais acerca da capacidade de realiza??o de autocuidado nem em baixos escores de QV. / Ostomy is an open surgical origin, when it is necessary to deviate temporarily or permanently, the normal transit of food and / or deletions. The patient with ostomy disposal is faced with changes in their physiology, also emerging on the need to care collection bag. This study aimed to analyze the quality of life (QOL) of people living with ostomy Intestinal (EI), who attended the Pediatric and Adult Rehabilitation Center of Rio Grande do Norte (CRI / CRA-RN). It is an analytical study with cross-sectional design and quantitative approach, accomplished with 89 people who had EI. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), CAAE: 19866413.3.0000.5537. Held data collection in the period January-March 2015 using two instruments: an adapted general questionnaire covering socio-demographic, clinical and self-care and a specific instrument for assessing QOL of people with stoma titled as City of Hope Quality of Life - Ostomy Questionnaire (COH-QOL-Q), validated and adapted to Portuguese in 2010, composed of four areas, namely: Welfare Body (BEF), Welfare Psychological (BEP), Welfare (BES ) and Spiritual Well-Being (BEE). The collected data were entered into a database in Microsoft Excel 2007 spreadsheet application and processed in computerized software for descriptive and inferential analysis. The results showed that 83.1% had a colostomy and ileostomy 16.9%. Sociodemographic characteristics prevailed in males (57.3%), over 50 (57.3%), mulatto (46.1%), with presence of companion / a (57.3%), retired / beneficiaries (50.5%), monthly income above the minimum wage (68.5%) and who have studied up to elementary school (67.4%). Regarding clinical aspects, it was observed that the main cause that led to the making of the stoma was the neoplasm (59.6%) followed by trauma (21.3%). The sample showed people with stoma for more than six months (79.8%) of permanently (57.3%), in use sink equipment piece drainable (68.5%) of flat base (82.0%). With respect to self-care, 93.3% emptied and washed the bag alone (care related to hygiene) and 75.3% fixed the new exchange on the skin during the exchange (care related to the stock). Patients with more than six months of ostomy and had no partner (a) had higher averages of self-care related hygiene and purse. The average of respondents QoL scores was 68.90% for General QOL; 68.03% for the BEF; 68.38% for the BEP; 66.46% for BES and 75.41% for BEE. Among the aspects that influenced QOL included: physical strength, pain, suffering and gases (physical domain); appearance, care of the stoma and adaptation to new condition (psychological domain); isolation, interference in personal relationships and social activities (social domain) and going to church or synagogue, spiritual activities and positive change after ostomy (spiritual realm). Based on these results, it is concluded that this was a predominantly adult sample / elderly (between 50 and 70 years), with low education and the cause motivating the stoma, neoplasms. However, such findings did not pass at low percentage levels on the self-care capacity to deliver even at low QOL scores.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:17:22Z No. of bitstreams: 1 SimoneReginaDeCarvalho_DISSERT.pdf: 2186853 bytes, checksum: 826bb3bb54b140e9bbf4a4bd298cdfcb (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T20:46:25Z (GMT) No. of bitstreams: 1 SimoneReginaDeCarvalho_DISSERT.pdf: 2186853 bytes, checksum: 826bb3bb54b140e9bbf4a4bd298cdfcb (MD5) / Made available in DSpace on 2016-06-28T20:46:25Z (GMT). No. of bitstreams: 1 SimoneReginaDeCarvalho_DISSERT.pdf: 2186853 bytes, checksum: 826bb3bb54b140e9bbf4a4bd298cdfcb (MD5) Previous issue date: 2015-11-16 / O estudo tem por objetivo analisar o efeito do topiramato sobre o craving em usu?rios de crack. Trata-se de um ensaio cl?nico aberto tipo crossover envolvendo usu?rios do Centro de Aten??o Psicossocial ?lcool e drogas (CAPSad) do munic?pio de Parnamirim/RN, aprovado pelo CEP CAAE: 38710614.1.0000.5537, respeitada a Resolu??o N? 466/2012/CNS. O estudo resultou em dois artigos cient?ficos, um ensaio te?rico e uma revis?o integrativa. No ensaio te?rico de Hinds, Chaves e Cypress, os contextos enfocam desde a problem?tica do uso individual ?s pol?ticas de enfrentamento deste consumo no Brasil, ressaltando que a situa??o de complexidade do fen?meno requerendo estrat?gias de enfrentamento a partir da aten??o integral ao usu?rio, fam?lia e sociedade. A revis?o integrativa captura, dentre os 902 registros trilingui recuperados, oito estudos apresentaram esquemas terap?uticos com efeitos positivos para o craving da coca?na, a partir do uso de nove drogas diferentes. N?o houveram resultados para o craving do crack. Os resultados da amostra do presente estudo foi composta predominantemente por usu?rios do sexo masculino, adultos e solteiros, totalizando 30 sujeitos que atenderam aos crit?rios de inclus?o: adultos, idade a partir de 18 anos, diagn?stico do Manual Diagn?stico e Estat?stico de Transtornos Mentais (DSM-IV) para coca?na/crack; capacidade cognitiva preservada; assiduidade ao servi?o, participar de, no m?nimo, tr?s consultas nos 12 meses anteriores ? coleta dos dados; e aceitar o acompanhamento ao tratamento proposto. Os dados foram coletados no per?odo de dezembro de 2014 a julho de 2015 e analisados por meio de estat?stica descritiva com o suporte do Statistical Package for Social Science (SPSS), atrav?s dos instrumentos: 1) Alcoohol, Smoking, and Substance Involvement Screening Test (ASSIST), aponta, entre outros resultados, que apenas 14% fizeram uso do crack/coca?na semanalmente durante o tratamento, enquanto 83% passaram a fazer uso diariamente ou semanalmente ap?s o per?odo de washout; 2) Escala de Impulsividade de Barratt, com uma m?dia de 80,23 e 77,47 com e sem o tratamento medicamentoso, respectivamente. Uma an?lise a partir do teste t de Student mostram que n?o h? diferen?a significativa na impulsividade com ou sem o uso do medicamento; e 3) Cocaine Craving Questionnaire-Brief (CCQ-Brief), indicando que o n?mero de usu?rios com n?vel de intensidade do craving ? expressivamente maior sem o tratamento medicamentoso (86%) do que com o tratamento (33%). A an?lise entre o craving e a grau de impulsividade mostram que h? uma baixa correla??o (Pearson) entre essas duas vari?veis com medicamento (0,282986) e sem (0,154614), demonstrando que a impulsividade tem baixainflu?ncia sobre o resultado do tratamento medicamentoso. Conclui-se que o topiramato produz efeito positivo para redu??o do craving em usu?rios de crack e que o seu uso constitui estrat?gia relevante para a efic?cia no tratamento de usu?rios de crack. / The study aims to analyze the effects of topiramato on the craving of crack users. It is an open crossover clinical trial involving users from the Psychosocial Care Center for Alcohol and Drugs (CAPSad) in city of Parnamirim, RN, approved by the CEP CAAE: 38710614.1.0000.5537, respecting the norms of the resolution n. 466/2012/CNS. The study produced preliminary two scientific papers: a theoretical essay and an integrative review, as a way of seeking the state of art. The first paper was based in the theoretical framework of Hinds, Chaves and Cypress, which focuses different contexts, from the issues of individual use to the coping policies in Brazil, highlighting that the situation and the complexity of the phenome requires coping strategies for the full attention to the user, family and society. As a result of the integrative review, among the 902 retrieved records, eight of them presented therapeutic schemes with positive effects for the craving of cocaine. They used nine different drugs. It is important to spot out that there was no result for the craving of crack. The data collection was conducted from December 2014 to July 2015 and has as sample predominantly single males. The sample was composed of 30 subjects who met the inclusion criteria: adults, age from 18 years, diagnosis of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for cocaine/crack; cognitive capacity preserved; attendance to the service, participated at least three visits in the 12 months prior to data collection; and accepted to be monitored in the proposed treatment. Data was analyzed using descriptive statistics from the Statistical Package of Support for Social Sciences (SPSS) on the instruments: 1) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), pointing out, among other results, that only 14% used crack/cocaine weekly during treatment, while 83% used daily or weekly after the washout period; 2) Barratt Impulsiveness Scale, with an average of 80.23 and 77.47 with and without drug treatment, respectively. An analysis from the Student t test show no significant differences in impulsivity with or without the drug; and 3) Cocaine-Craving Questionnaire-Brief (CCK-B), indicating that the number of users with craving intensity level is significantly higher without drug treatment (86%) than with treatment (33%). The analysis between craving and level of impulsivity showed that there is a low correlation (Pearson) between these two variables during treatment and after the washout, demonstrating that impulsivity has low influence on the outcome of drug therapy. As conclusion, it was noted that the topiramate produces positive effect on reducing the craving for crack users and their use is a relevant strategy for efficacy in the treatment of crack users.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-06T20:12:52Z No. of bitstreams: 1 TheoDuarteDaCosta_TESE.pdf: 4153788 bytes, checksum: 643d900d0fcc28097a487ca70c79ce87 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-07-07T20:35:41Z (GMT) No. of bitstreams: 1 TheoDuarteDaCosta_TESE.pdf: 4153788 bytes, checksum: 643d900d0fcc28097a487ca70c79ce87 (MD5) / Made available in DSpace on 2016-07-07T20:35:41Z (GMT). No. of bitstreams: 1 TheoDuarteDaCosta_TESE.pdf: 4153788 bytes, checksum: 643d900d0fcc28097a487ca70c79ce87 (MD5) Previous issue date: 2015-10-16 / A evolu??o tecnol?gica combinada ? assist?ncia em sa?de proporciona o aumento nos riscos relacionados ? seguran?a do paciente, que torna as institui??es de sa?de ambientes pass?veis e prov?veis de preju?zos no cuidado ofertado. Os setores de alta complexidade, como as Unidades de Terapia Intensiva, possuem tais caracter?sticas destacadas, pois esses espa?os t?m por objetivo cuidar de pacientes em condi??es cl?nicas graves quando o uso de aparatos tecnol?gicos avan?ados torna-se uma necessidade. Diante disso, o objetivo desse estudo foi avaliar o cuidado de enfermagem na perspectiva da seguran?a do paciente em Unidades de Terapia Intensiva. Trata-se de uma pesquisa avaliativa, quanti-qualitativa, que combina formas diferentes de coleta de dados, a saber: observa??o, aplica??o de instrumento de avalia??o e entrevista semiestruturada com pacientes, familiares e profissionais, avaliando, assim, a tr?ade estrutura-processo-resultado do cuidado em enfermagem nas Unidades de Terapia Intensiva. A coleta de dados ocorreu entre abril e julho de 2014, em Unidades de Terapia Intensiva. Para a parte quantitativa (estrutura e processos) foi utilizado a an?lise estat?stica da medida de concord?ncia interobservador denominada Kappa (K), e para a parte qualitativa (entrevistas) a t?cnica de interpreta??o dos dados deu-se com aux?lio do software Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires (IRAMUTEQ). Os resultados da an?lise da ?estrutura? e ?processos? demonstrou que a maioria dos achados se encontrava fora dos padr?es de adequa??o, o que aponta condi??es prec?rias nas estruturas e, processos incipientes nos servi?os de sa?de. Os ?resultados? indicam que as Unidades de Terapia Intensiva s?o locais seguros, contudo urgem por mudan?as, principalmente na estrutura f?sica e na disponibilidade de materiais. Portanto, aponta-se que o cuidado de Enfermagem desenvolvido nas unidades de terapia intensiva avaliadas cont?m falhas preocupantes com rela??o ? seguran?a do paciente, o que evidencia um quadro de inseguran?a na assist?ncia ofertada e a necessidade de interven??es urgentes no sentido de corrigir as n?o adequa??es apontadas, proporcionando estruturas apropriadas e implanta??o de protocolos e diretrizes de cuidado, para que se consolide um ambiente propicio a seguran?a do paciente. / Technological advances combined with healthcare assistance bring increased risks related to patient safety, causing health institutions to be environments susceptible to losses in the provided care. Sectors of high complexity, such as Intensive Care Units have such characteristics highlighted due to being spaces designed for the care of patients in serious medical condition, when the use of advanced technological devices becomes a necessity. Thus, the aim of this study was to assess nursing care from the perspective of patient safety in intensive care units. This is an evaluative research, which combines various forms of data collection and analysis in order to conduct a deepened investigation. Data collection occurred in loco, from April to July 2014 in hospitals equipped with adult intensive care unit services. For this, a checklist instrument and semi-structured interviews conducted with patients, families, professionals were used in order to evaluate the structure-process-outcome triad. The instrument for nursing care assessment regarding Patient Safety included 97 questions related to structure and processes. Interviews provided data for outcome analysis. The selection of interviewees/participants was based on the willingness of potential participants. The following methods were used to collect data resulting from the instrument: statistical analysis of inter-rater reliability measure known as kappa (K); observations from judges resulting from the observation process; and added information obtained from the literature on the thematic. Data analysis from the interviews was carried out with IRAMUTEQ software, which used Descending Hierarchical Classification and Similarity analysis to aid in data interpretation. Research steps followed the ethical principles presented by Resolution No. 466 of December 12, 2012, and the results were presented in three manuscripts: 1) Evaluation of patient safety in Intensive Care Units: a focus on structure; 2) Health evaluation processes: a nursing care perspective on patient safety; 3) Patient safety in intensive care units: perception of nurses, family members and patients. The first article, related to the structure, refers to the use of 24 items of the employed instrument, showing that most of the findings were not aligned with the adequacy standards, which indicates poor conditions in structures offered in health services. The second article provides an analysis of the pillar of Processes, with the use of 73 items of the instrument, showing that 50 items did not meet the required standards for safe handling due to the absence of adequate scientific guidance and effective communication in nursing care process. For the third article, results indicate that intensive care units were safe places, yet urges for changes, especially in the physical structure and availability of materials and communication among professionals, patients and families. Therefore, our findings suggest that the nursing care being provided in the evaluated intensive care units contains troubling shortcomings with regards to patient safety, thereby evidencing an insecure setting for the assistance offered, in addition to a need for urgent measures to remedy the identified inadequacies with appropriate structures and implement protocols and care guidelines in order to consolidate an environment more favorable to patient safety.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-25T22:06:08Z No. of bitstreams: 1 FranklinLearctonBezerraDeOliveira_DISSERT.pdf: 1813226 bytes, checksum: 94cc6f07139de7ed36c9e4adcb10e9bd (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-03T20:50:16Z (GMT) No. of bitstreams: 1 FranklinLearctonBezerraDeOliveira_DISSERT.pdf: 1813226 bytes, checksum: 94cc6f07139de7ed36c9e4adcb10e9bd (MD5) / Made available in DSpace on 2016-08-03T20:50:16Z (GMT). No. of bitstreams: 1 FranklinLearctonBezerraDeOliveira_DISSERT.pdf: 1813226 bytes, checksum: 94cc6f07139de7ed36c9e4adcb10e9bd (MD5) Previous issue date: 2016-01-29 / A dengue e o v?rus da Febre do Chikungunya (CHIKV) s?o consideradas doen?as de notifica??o compuls?ria transmitas por mosquitos do g?nero Aedes, sendo o Aedes aegypti o principal vetor. Encontram-se amplamente distribu?das no Brasil, ocasionando um dos maiores problemas de sa?de p?blica, devido as altera??es epidemiol?gicas que vem ocorrendo nos ?ltimos anos e por caracterizarem-se pela ampla distribui??o em todas as regi?es. O presente projeto tem como objetivo analisar a atua??o dos enfermeiros das Estrat?gias de Sa?de da Fam?lia (ESF) no controle da Dengue e Febre Chikungunya nos munic?pios de Parnamirim e Santa Cruz. Trata-se de pesquisa de cunho explorat?rio-descritivo, com abordagem quantitativa e qualitativa, que fora desenvolvida com enfermeiros dos munic?pios de Parnamirim e Santa Cruz. A pesquisa obteve parecer favor?vel do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte com o Certificado de Apresenta??o para Aprecia??o ?tica (CAAE), n? 48378515.8.0000.5537. A coleta de dados foi realizada no m?s de novembro e dezembro atrav?s de entrevista com question?rios semiestruturados compostos por quest?es abertas e fechadas, organizados em tr?s partes: o perfil dos entrevistados, o conhecimento sobre a doen?a e descri??o das pr?ticas realizadas. Os dados levantados foram categorizados e tabulados, utilizando o Microsoft Office Excel 2010. As tabula??es do instrumento das perguntas fechadas passaram por an?lises, utilizando o Programa Estat?stico Statistical Package for the Social Sciences (SPSS 22), e para as perguntas abertas utilizou a an?lise de conte?do de Bardin. Como resultado, os enfermeiros foram questionados quanto ao agente transmissor da Dengue e Febre Chikungunya, cinco enfermeiros responderam que o agente transmissor da Dengue ? o Aedes aegypti e somente um por ele e pelo Aedes albopictus; enquanto que para Febre Chikungunya, dois responderam que a doen?a ? transmitida pelos mosquitos Aedes aegypti e Aedes albopictus e os demais somente pelo Aedes aegypti. Versando relativamente os sorotipos virais, tr?s enfermeiros responderam que s?o 4 sorotipos da Dengue, dois disseram que s?o cinco e somente um que s?o dois sorotipos. Para a febre Chikungunya, um n?o soube responder, dois responderam que tamb?m s?o cinco sorotipos, dois responderam que existe somente um sorotipo e um que s?o dois. Todos desconhecem quais os tipos de dep?sitos que mais s?o encontrados focos do mosquito em sua regi?o, como tamb?m desconhecem o Programa Nacional de Controle da Dengue. Os profissionais de enfermagem sabem reconhecer um caso suspeito de Dengue, mas se confundem quando tentam explicar para a Febre Chikungunya, expondo os mesmos sintomas da Dengue. Nota-se que, apesar de todos terem participado de uma capacita??o sobre Febre Chikungunya e Dengue, um conhecimento bastante limitado dos enfermeiros a respeito do manejo cl?nico. Outra abordagem dos profissionais ? uso de medicamentos para os casos sintom?ticos das doen?as. Destarte, conclui-se o estudo com a aus?ncia de refer?ncias devidas que a equipe de sa?de deve se apropriar para planejar a??es de preven??o e controle vetorial, como treinamentos mais espec?ficos para estes profissionais. / The research aimed to analyze the role of nurses in the Family Health Strategy (FHS) in the control of Dengue and Chikungunya fever in the cities of Parnamirim and Santa Cruz. It is exploratory and descriptive nature of research, with a qualitative approach, which was developed with nurses of the Family Health Strategy in the municipalities of Parnamirim and Santa Cruz. All research process followed the ethical standards laid out research in Resolution No. 466/2012 of the National Health Council about research involving human beings. Data collection was performed using a semi-structured questionnaire with open and closed questions, organized into three parts: the profile of respondents, knowledge of the disease (transmission, prevention, control) and description of practices. The actions performed by nurses are punctual performed when there is growing disease of the number of cases in order to try to reduce the number of cases. The principal methodology used for them is to talk and guidelines resulting from campaigns and home visits, using leaflets and social networks. Regarding knowledge of nurses in the city of Santa Cruz on Dengue Fever and Chikungunya, is clearly some gaps. Nursing professionals know recognize a suspected case of dengue, but get confused when trying to explain to the Chikungunya fever, exhibiting the same symptoms of dengue. Although everybody had participated in a training on Chikungunya Fever and Dengue, a very limited knowledge of nurses regarding the clinical management. It is suggested that further studies are developed on the ground a few nurses have accepted to participate in the study, so that we can identify strategies, interventions, activities and nursing actions that are consistent with the reality of working in favor of coping Aedes epidemics aegypti that have positive impact on reducing the infestation rates and may be suitable and applied in other regions.