191 |
Valida??o do conte?do do diagn?stico de enfermagem prote??o ineficaz para pacientes submetidos ? hemodi?liseFraz?o, Cecilia Maria Farias de Queiroz 29 January 2015 (has links)
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Previous issue date: 2015-01-29 / Estudo do tipo metodol?gico, com objetivo de validar o conte?do do diagn?stico de enfermagem Prote??o ineficaz em pacientes submetidos ? hemodi?lise. A pesquisa ocorreu em duas etapas, a saber: an?lise de conceito e de conte?do por especialistas. A primeira foi operacionalizada atrav?s da revis?o integrativa nas bases de dados LILACS, CINHL, PUBMED, SCOPUS e COCHRANE, com o cruzamento das palavras prote??o e hemodi?lise. Encontrou-se 32 artigos, nos quais foram identificados os atributos, antecedentes e consequentes. Na segunda etapa, elaborou-se um instrumento com os componentes do diagn?stico em estudo. Esse instrumento foi analisado por 22 especialistas em nefrologia e na terminologia da NANDA Internacional. O teste binomial foi utilizado para avaliar a propor??o de especialistas que classificaram cada item como adequado, considerando-se o n?vel de signific?ncia de 5%. Elaborou-se, assim, a seguinte proposta para o diagn?stico de enfermagem prote??o ineficaz em pacientes submetidos ? hemodi?lise: defini??o: a mesma apresentada na Taxonomia II da NANDA Internacional, localiza??o: dom?nio seguran?a/prote??o e classe les?o f?sica. Os fatores relacionados s?o: Aus?ncia das vacinas de rotina; N?o ades?o aos cuidados relacionados aos acessos vasculares; N?o ades?o ?s medidas de controle de infec??o; N?o ades?o ? dieta prescrita; N?o ades?o ? terapia medicamentosa; Presen?a de comorbidades; Abuso de drogas; Dist?rbios imunol?gicos; Extremos de idade; Perfis sangu?neos anormais; Medicamentos que reduzem a imunidade; e Efeitos colaterais e adversos relacionados ao tratamento. E caracter?sticas definidoras: Presen?a de invasores na corrente sangu?nea; Dist?rbios nutricionais; Aumento do n?mero de hospitaliza??es; Peso seco descontrolado; Acesso vascular infeccionado; Acesso vascular inadequado; Aumento da press?o arterial sist?mica; Febre; Altera??o da coagula??o; Defici?ncia da imunidade; Fadiga; Fraqueza; Prurido; e Resposta mal adaptada ao estresse. Conclui-se, assim, que a identifica??o dos atributos definidores, antecedentes e consequentes aumentou a riqueza do vocabul?rio, possibilitando a constru??o de defini??es te?ricas e emp?ricas para uma compreens?o mais ampliada do conceito prote??o. Outrossim, o estudo contribuiu para o enriquecimento do corpo de conhecimento espec?fico da enfermagem, assim como no direcionamento da assist?ncia do enfermeiro aos pacientes em hemodi?lise. / Methodological study, in order to validate the content of the nursing diagnosis
protection ineffective in patients undergoing hemodialysis. The research took place in
two stages, namely: concept
analysis
and content analysis
of the instrument
by
experts. T
he first step was operationalized through
an
integrative review
of the
databaes
LILACS, CINAHL, PubMed, Scopus and Cochrane, with the
key
words
protection and hemodialysis, in October and November 2013. The sample consisted
of 32
articles, which were analyz
ed by
a c
areful
reading to identify
the
sections that
correspond
ed
to the defining attributes
,
antecedents and consequences of protection
in patients undergoing hemodialysis.
T
he interpretation for
the
diagnosis
of
effective
protection
was made
by transpos
ing the components of
the
diagnosis (definition,
defining characteristics and related factors)
to the denial form
. In the second stage,
we elaborated an instrument with the components of the nursing diagnostic
s studied
and proceeded
to the analysis
conduct
ed in April 2014
by 22 specialists in
nephrology and in the terminology of the NANDA International, selected by
means of
th
e Lattes Platform
. We used the binomial
test
to assess the proportion of experts
who rated each item
as appropriate, considering a
si
gnificance level of 5%. The
project was approved by the Ethics Committee of the institution responsible for the
research, an opinion on num
b
er 387 837 and CAAE 18486413.0.0000.5537. The
results show that the proposal for the nursing diagnosis of ineffectiv
e protection in
patients undergoing hemodialysis is: definition
-
the same as that presented in the
NANDA International Taxonomy II, location
-
domain safety / protection and class
injury. Related factors are: Absence of routine vaccines; Non
-
adherence to
care
related to vascular access; Non
-
adherence to infection control measures; Non
-
adherence to prescribed diet; Non
-
adherence to drug therapy; Presence of
comorbidities; Drug abuse; Immune disorders; Extremes of age; Abnormal blood
profiles; Drugs that red
uce immunity; and side effects and adverse treatment
-
related.
The defining characteristics are: Presence of invading the bloodstream; Nutritional
disorders; Increase in the number of hospitalizations; Uncontrolled dry weight;
Infected vascular access; Vasc
ular inadequate access; Increased blood pressure;
fever; Bleeding disorder; Disability immunity; fatigue; weakness; itching; and
maladaptive response to stress. It follows that the identification of the defining
attributes, antecedents and consequences inc
reased the wealth of vocabulary,
allowing the construction of theoretical and empirical definitions for a broader
understanding of the concept protection. Furthermore, the study contributed to the
enrichment of nursing specific body of knowledge, as well a
s in the direction of
nursing care for patients undergoing hemodialysis.
|
192 |
Trajet?ria de vida dos pescadores v?timas de les?o medular por mergulho: experi?ncias, representa??es sociais e estresse / Life course of fishermen victim of spinal cord injury caused by diving: experiences, social representation and stressCavalcante, Eliane Santos 12 December 2014 (has links)
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Previous issue date: 2014-12-12 / A les?o medular ocasiona manifesta??es incapacitantes permanentes, afetando a integridade anat?mica, mudan?as corporais e limita??es funcionais pertinentes ao estado de defici?ncia. Objetivou-se analisar a trajet?ria de vida dos pescadores com les?o medular v?timas de acidente por mergulho nas praias do litoral Norte/RN. Trata-se de estudo explorat?rio-descritivo, com dados quantitativos, qualitativos e representacional, desenvolvido em col?nias de pescadores de nove praias do litoral Norte/RN, entre outubro de 2013 a agosto de 2014, ap?s a aprova??o do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte/UFRN, parecer n? 431.891/2013, CAAE 20818913.0.0000.5537. A amostra comp?s-se por pescadores acometidos por les?o medular, definida a partir dos crit?rios de inclus?o e de exclus?o dos participantes. Utilizou-se como instrumento de coleta de dados a entrevista semiestruturada. Analisaram-se os dados quantitativos por meio da estat?stica descritiva, apresentando-os em forma de tabelas, quadros e gr?ficos, utilizando o Microsolft Excel. Submeteram-se os dados das entrevistas ao software Analyse Lexicale par Contexte d`um Ensemble de Segments de Texte (ALCESTE) e ? luz da an?lise da Teoria das Representa??es Sociais e Teoria do N?cleo Central. Esclarece-se e apresentam-se os resultados da pesquisa a partir de quatro artigos, seguindo recomenda??es normativas dos peri?dicos: 1. Caracteriza??o dos pescadores artesanais atendidos em hospital naval v?timas de doen?a descompressiva, em an?lise documental. Dos 28 pescadores artesanais estudados, todos eram do sexo masculino, faixa et?ria de 31 a 40 anos (53,6%) e casados (35,7%). A doen?a descompressiva ocorreu prevalentemente no baixo ver?o (75,0%), litoral Norte (96,4%), tendo como principais agravos a parestesia e dor nos membros superiores (67,9%), seguido de les?o medular (57,1%) e ?bitos de 25,0%. 2. Estresse e ansiedade em pescadores artesanais v?timas de les?o medular. Estudo descritivo: Dos 44 participantes, todos eram do sexo masculino, m?dia de idades de 49,6 anos, ensino fundamental (68,2%), casados (77,3%); com sequela de paraplegia (50,0%). A maioria apresentava estresse (75,0%), encontrando-se na fase de quase exaust?o (33,3%), com sintomas prevalentes de ins?nia (95,5%) nas ?ltimas horas; hipertens?o (97,7%) na ?ltima semana e dificuldades sexuais (95,5%) no ?ltimo m?s. 3. Experi?ncias, mem?rias, scripts, representa??es sociais sobre les?o medular para pescadores v?timas de acidentes por mergulho: A an?lise de 10 entrevistas permitiu a constru??o de tr?s categorias: Incapacidade na coordena??o sens?rio-motora da deambula??o; Ressignifica??o da defici?ncia e o sentido da depend?ncia e Autonomia e adapta??o limitante. 4. Representa??es sociais de pescadores artesanais v?timas de les?o medular: repercuss?es na trajet?ria de vida. A an?lise de 31 entrevistas sob a ?tica da compreens?o das Representa??es Sociais da les?o medular permitiu a constru??o de sete categorias: Tratamento: limita??es e expectativas; Les?o Medular: antes e depois; Aposentadoria: uma realidade ainda distante; Defici?ncia: depend?ncia, incapacidade e vulnerabilidade; Supera??o e autonomia; Sentimentos do eu: perdas f?sicas e recome?o; Vida e trabalho: impedimentos, planos e mudan?as. Conclui-se esse estudo com o alcance dos objetivos, cuja tem?tica ? relevante para a sa?de p?blica de homens pescadores. Sugere-se medidas de preven??o, promo??o e recupera??o da sa?de do homem pescador, al?m das condi??es seguras, saud?veis e dignas como compromisso das pol?ticas de sa?de. / Spinal cord injury causes permanent disabling manifestations, affecting the anatomic
integrity, bodily changes and functional limitations related to the disability state. It was aimed
to analyze the social
representation, stress level and experiences of fishermen victims of
spinal cord injury caused by diving accident in the Northern beaches of Brazil. It is a
descriptive
-
exploratory study with quantitative, qualitative and representational data
developed i
n fishermen?s villages in nine beaches of Northern shore/RN, between October
2013 to August 2014, after the approval of the Ethics Committee in Research of the
Universidade Federal do Rio Grande do Norte, under the number 431.891/2013, CAAE
20818913.0.0000
.5537. The sample was composed by 44 fishermen with spinal cord injury,
defined from inclusion and exclusion criteria of the participants. It was used as instrument to
collect the data a semi structured interview. Quantitative data was analyzed by descrip
tive
statistics, showing the data through table, boxes and graphics by Microsoft Excel. Data from
interviews were submitted to the software called Analyse Lexicale par Contexte d?un
Ensemble de Segments de Texte (ALCESTE) using the analysis of the Social R
epresentation
Theory and Center Core Theory. It is shown the outcomes of the research through four
articles, following the normative recommendations of the journals. Participants of the study
were all male, age mean 49,6 years, elementary school (68,2%), m
arried (77,3%); paraplegia
sequel (50,0%). Most of them showed stress (75,0%), almost in the exhaustion stage (33,3%),
prevalent insomnia symptoms (95,5%) in the last hours; hypertension (97,7%) in the last
week and sexual troubles (95,5%) in the last mont
h). Decompressive illness caused spinal
cord injury (57,1%), occurred prevalently in low summer (75,0%), northern shore (96,4%),
having as main consequences the paresthesia and pain in the upper and lower limbs (67,9%),
followed by death (25,0%). Interview
analysis under the understanding of Social
Representation of spinal cord injury allowed the appearance of seven categories: Treatment:
limitation and expectative; Spinal Cord injury: before and after; Retirement: reality yet to
come; Disability: dependenc
y, incapacity, vulnerability; Overcoming and autonomy; Self
feelings: physics losses and new start; Life and labor: impediments, plans and changes. The
center core of the representation is found in the first category by the expectative and limitation
on th
e treatment, meanwhile the outskirt elements are in seventh and third categories. Physics
limitation for fishing activities and retirement expectative is the most outstanding of the
structure. Social representation concerning spinal cord injury is found in
a transaction moment
between before and after with the prevented fishing activity, coping of the situation with the
potential remaining. The anchoring is established in the desire for changes related to the
improvements of life and health conditions exper
ienced day by day through faith. This study
finishes pointing out the range of the objectives, which topic is relevant for public health of
fishermen. It is suggested prevention measures, promotion and health recovery of fishermen,
besides safe, healthy an
d worthy conditions as a compromise of social and health politics.
|
193 |
Avalia??o da estrutura e processo de trabalho dos centros de aten??o psicossocial / Work structure and process evaluation of psychosocial care centersClementino, Francisco de Sales 11 December 2014 (has links)
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Previous issue date: 2014-12-11 / No Brasil, a Reforma Psiqui?trica organiza-se com base nos pressupostos da Reforma Sanit?ria e da Psiquiatria Democr?tica Italiana com vistas a eliminar o modelo hospitaloc?ntrico. Objetivo: Avaliar a estrutura e o processo de trabalho desenvolvido nos Centros de Aten??o Psicossocial (CAPS), englobando a satisfa??o, o perfil, as condi??es e a sobrecarga de trabalho dos profissionais. Aprovado pela Comiss?o de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte (UFRN), protocolo n? 719.435, de 30/05/2014. M?todos: Estudo descritivo, com abordagem quantitativa, desenvolvido em cinco Centros de Aten??o Psicossocial, a saber: 02 CAPS I, 01 CAPS II, 01 CAPS III e 01 CAPSAD, de Campina Grande-PB. A popula??o do estudo constitui-se de todos os coordenadores dos cinco CAPS, incluindo 42 profissionais de n?vel superior, 71 de n?vel m?dio (t?cnicos e auxiliares de enfermagem, e cuidadores), e os prontu?rios referentes a 2.297 usu?rios atendidos. Para assegurar a representatividade das informa??es, calculou-se uma amostra aleat?ria estratificada com partilha proporcional, considerando-se os seguintes par?metros: erro ? de 5%, n?vel de confian?a de 95%, poder do estudo de 80%, estimativa de propor??o de 10% e o ?ndice de proporcionalidade espec?fico para os profissionais de n?vel (superior e m?dio) e os prontu?rios. Coletou-se os dados atrav?s de question?rios validados, elaborados para o estudo CAPSUL (Avalia??o dos CAPS da Regi?o Sul do Brasil), entre julho e outubro de 2014. Os question?rios foram duplamente digitados e submetidos ? valida??o no sub-programa Validate do Epi Info 3.5.4, utilizado juntamente com o SPSS, 17.0 para o processamento das an?lises estat?sticas. Resultados: A partir da an?lise dos prontu?rios dos usu?rios atendidos nos CAPS, observou-se um predom?nio de mulheres na faixa et?ria adulta. Destacou-se como psicopatologia mais frequente, ? esquizofrenia. Quanto ?s interna??es antes e ap?s o ingresso nos CAPS, registrou-se para o hospital geral 14 interna??es (3,5%) antes e sete (1,7%) depois, diferen?a n?o significante (p=0,612). Ressalta-se que, em hospitais psiqui?tricos, ap?s o ingresso, houve redu??o para o m?ximo de tr?s interna??es. O n?mero total reduziu de 117 (29,1%) para apenas 11 (2,7%); redu??o estatisticamente significante (p=0,002). Quanto ?s formas de contra??o dos profissionais de sa?de, os resultados evidenciam a exist?ncia de contrato tempor?rio. A maior propor??o de insatisfa??o com todos os par?metros avaliados deu-se naqueles profissionais que se consideram sobrecarregados no trabalho. Entretanto, a ?nica diferen?a estatisticamente significante estava relacionada com o ?grau de responsabilidade? (90,9%; p=0,04). Observou-se forte associa??o da insatisfa??o dos profissionais de sa?de com fatores relacionados ao conte?do e ?s condi??es de trabalho no CAPS, relativa ?s medidas de seguran?a, conforto e apar?ncia dos CAPS, contato entre as equipes e usu?rios, e tratamento das fam?lias por parte das equipes. Chama ? aten??o que estes aspectos s?o aqueles que n?o dependem diretamente da atua??o dos profissionais. Conclui-se que o fortalecimento dos CAPS requer e exige um compromisso intersetorial, a partir do n?vel governamental, em garantir os recursos para a operacionaliza??o de suas a??es e assegurar aos usu?rios e ? sua fam?lia a oferta e o acesso aos servi?os de sa?de. / Objective: Evaluate the work structure and process in Psychos
ocial Care Centers (CAPS) and
the professionals profile, the satisfaction, conditions and work overload. Methods: Cross
-
sectional study conducted in five CAPS in Campina Grande city. The study sample consisted
of five coordinators, 42 graduate professional
s, 26 mid
-
level (technical and auxiliary nurses,
and caregivers), and the medical records pertaining to 413 users followed up. Data were
collected using validated questionnaires (CAPSUL
-
rating CAPS in southern Brazil) and
adapted to the study, between July
and October 2014. The questionnaires were double entered
and submitted to validation in the sub
-
program
?Validate Epi Info 3.5.4?
, used along with the
?SPSS 17.0?
for processing the statistical analyzes. Measures of central tendency and
dispersion were ap
plied to the descriptive analyzes;
?Fisher's?
exact test to check the CAPS
impact on hospital admissions and the
?Bonferroni?
adjusted to verify the diagnoses
according to sex. 5% significance level was adopted. The study was approved by the Ethics
Committ
ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of
05.30.2014. Results: From the structure analysis were identified contextual factors that
influenced the work process of CAPS professionals, such as: deficiencies with regard to
h
uman resources; forms of health professionals employment and qualifications; temporary
contract existence. As to process dimension, it was found that the home visits performance by
health professionals shows to be ineffective, given its insufficiency and i
rregularity, which
can be explained by the high demand, reduced staff and transportation lack. It was low
coverage of items inherent to Therapeutic Individual Project, as the income generation
program, insertion at work and home visit. The reference and co
unter reference flow are still
not satisfactorily organized. There was statistically significant difference for the diagnosis,
with a predominance of mood disorders related to stress among women and those related to
alcohol and other drugs among men (p <0.
05). There was an association between the degree
of health professionals satisfaction and working conditions, overload and factors related to
the content and working conditions, the security measures, comfort and CAPS appearance,
contact between the teams
and users, families treatment by the teams, temporary employment
relationship. Conclusion: The data collected indicate the need for the CAPS organization
through increased investments in the sector in order to enhance the infrastructure as
potentiating el
ement of practices with a view to changing the care model for mental health
proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to
better planning in CAPS unit management, with another tool to improve the dimensions
involving the structure and the professional work process and improve this mental health care
model.
|
194 |
Atua??o dos profissionais no atendimento ?s fam?lias nos centros de aten??o psicossocial / Work of professionals to care for families in Care Centers PsychosocialOliveira, Kalyane Kelly Duarte de 10 December 2014 (has links)
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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.
|
195 |
A fiscaliza??o do exerc?cio profissional no Conselho Regional de Enfermagem do Rio Grande do Norte: um debate ?tico / The professional monitoring at the Regional Nursing Council of Rio Grande do Norte: an ethical debateCosta, Edilma de Oliveira 30 January 2015 (has links)
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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.
|
196 |
Constru??o de um ambiente virtual de aprendizagem para aplica??o do processo de enfermagem baseado na Nanda International, NOC, NIC e CIPE?Melo, Erik Crist?v?o Ara?jo de 30 January 2015 (has links)
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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.
|
197 |
Estudo do dom?nio seguran?a/prote??o da NANDA internacional em pacientes de unidade de terapia intensivaDantas, Anna L?via de Medeiros 17 December 2014 (has links)
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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.
|
198 |
Hist?ria oral de vida de pessoas com ?lcera venosa nos servi?os de aten??o prim?ria ? sa?de / Oral History of life of people with venous ulcers in primary care services in Natal, RNMoreira, Bheatriz Gondim Lambert 17 December 2014 (has links)
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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.
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Acompanhamento coletivo do crescimento e desenvolvimento infantil: participa??o de m?es/cuidadores / Collective monitoring of child growth and development: participation of mothers/caregiversGurgel, Polyanna Keitte Fernandes 11 December 2014 (has links)
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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.
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Avalia??o do ganho de peso de beb?s prematuros em rela??o ao leite materno cru e leite pasteurizadoSilva, Rhuama Karenina Costa e 17 December 2014 (has links)
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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.
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