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Efeito do topiramato sobre o craving em usu?rios de crack / The effects of topiramate on the craving of crack usersCarvalho, Simone Regina de 16 November 2015 (has links)
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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.
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Avalia??o do cuidado de enfermagem na perspectiva da seguran?a do paciente em unidades de terapia intensiva: na vis?o de profissionais, pacientes e familiares / Nursing care assessment on the perspective of patient safety in intensive care UNITS: perception of nurses, family members and patientsCosta, Theo Duarte da 16 October 2015 (has links)
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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.
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A atua??o do enfermeiro no combate ? dengue e a febre chikungunya: estudo comparativo nos munic?pios de Parnamirim e Santa Cruz/RNOliveira, Franklin Learcton Bezerra de 29 January 2016 (has links)
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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.
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Valida??o do resultado de enfermagem mobilidade em idosos acometidos por febre de Chikungunya / Validation of the nursing outcome mobility in the elderly affected by Chikungunya feverSilva, Amanda Barbosa da 05 December 2017 (has links)
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Previous issue date: 2017-12-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / O estudo teve como objetivo Validar o resultado de Enfermagem Mobilidade apresentado pela Nursing Outcomes Classification em idosos acometidos por Febre de Chikungunya. Estudo metodol?gico, segundo referencial de Pasquali (2010) realizado em tr?s etapas: revis?o integrativa da literatura, valida??o sem?ntica e valida??o cl?nica, a partir de um instrumento proposto por Moreira (2011), o qual apresentou para o Resultado de Enfermagem Mobilidade, oito indicadores bem como suas defini??es constitutivas, operacionais e magnitudes operacionais. Estes foram revistos e adaptados em nove indicadores direcionados ? popula??o idosa acometida por Febre de Chikungunya. A primeira etapa ocorreu mediante revis?o integrativa da literatura para adapta??o de instrumento validado em estudo anterior. A revis?o integrativa ocorreu entre os meses de fevereiro e abril de 2017, nas bases de dados: CINAHL, Cochrane, LILACS, PubMed, Scopus, Science Direct e Web of Science. Realizou-se uma busca n?o controlada das produ??es cient?ficas, sem recorte temporal, pelos descritores indexados e n?o indexados e os 12 indicadores da Nursing Outcomes Classification para o Resultado de Enfermagem Mobilidade. Em seguida, para a etapa de valida??o sem?ntica, o instrumento foi entregue no m?s de junho, a 12 enfermeiros que trabalhavam na aten??o prim?ria ? sa?de. Para avalia??o quanto a sua inteligibilidade. Ap?s atender as sugest?es propostas pelos enfermeiros nesta etapa, procedeu-se o estudo piloto e valida??o cl?nica. Esta etapa foi realizada nos meses de julho e agosto, por duas duplas de enfermeiros treinados, em Unidades de Sa?de do munic?pio de Natal/RN, com 90 idosos acometidos por Febre de Chikungunya. Uma dupla aplicou o instrumento proposto pela NOC para o Resultado de Enfermagem Mobilidade e outra com o instrumento adaptado e revisado. Para an?lise de conte?do textual da revis?o integrativa, utilizou-se o software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ) vers?o 0.7 Alpha 2. Os dados da valida??o sem?ntica e cl?nica foram organizados em planilha no programa Microsoft Office Excel 2012 e exportados para o programa estat?stico Statistical Package for Social Sciences vers?o 22.0 for Windows. Na valida??o sem?ntica foi aplicado teste binominal com concord?ncia igual ou superior a 85%. Na valida??o cl?nica, para an?lises descritivas foram calculadas as medidas do centro da distribui??o e suas variabilidades. Aplicou-se o teste de Friedman para verificar diverg?ncia entre avaliadores e calculado o Coeficiente de Correla??o Intraclasse para comparar a correla??o das avalia??es realizadas pelos enfermeiros avaliadores. O estudo foi aprovado pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte sob CAAE n? 64880017.9.0000.5537. Na revis?o integrativa, a Classifica??o Hier?rquica Descendente apontou dois eixos principais relacionados ? Febre de Chikungunya relacionados a artigos que priorizam evid?ncias cl?nicas da fase aguda, fase subaguda e cr?nica. O indicador Dor articular foi adicionado por ser considerado importante na literatura, representado na nuvem de palavras e foi constru?do suas defini??es operacionais, defini??es constitutivas e magnitudes operacionais. Quanto ? etapa de valida??o sem?ntica, o instrumento foi considerado intelig?vel para avalia??o proposta, por parte dos enfermeiros. Oito indicadores alcan?aram ou excederam o ?ndice de concord?ncia de 0,85, com exce??o do indicador Desempenho na transfer?ncia, pois a concord?ncia foi de 0,83 e p<0,05. Na etapa de valida??o cl?nica, houve uma predomin?ncia de participantes homens (75,56%), com mediana de idade de 70,00, com maioria de casados, aposentados, com ensino fundamental incompleto e renda mensal de at? um sal?rio m?nimo. O teste de Friedman indicou diferen?as entre avalia??o das duplas em sete indicadores, a saber: Equil?brio, Andar, Movimento dos m?sculos, Movimento das articula??es, Desempenho no posicionamento do corpo, Desempenho na transfer?ncia e Dor articular. Para os indicadores Coordena??o e Marcha n?o foram identificadas diferen?as significativas pelo teste de Friedman. Todos os indicadores apresentaram-se estatisticamente significantes (p< 0,001) e satisfat?rios, segundo o Coeficiente de Correla??o Intraclasse. Ao analisar os resultados mediante os testes estat?sticos, tem-se que os resultados foram satisfat?rios para maioria dos indicadores presentes no instrumento com as defini??es. Assim, a utiliza??o de instrumentos para uma popula??o espec?fica como os idosos acometidos por Febre de Chikungunya, s?o eficazes e devem ser continuamente realizados no intuito de refin?-los e aperfei?o?-los. / The study aimed to validate the result of Nursing Mobility presented by Nursing Outcomes Classification in elderly people affected by Chikungunya Fever. Methodological study, according to Pasquali's (2010) referential in three stages: integrative literature review, semantic validation and clinical validation, based on an instrument proposed by Moreira (2011), which presented for the Nursing Nursing Outcome, eight indicators as well as their constitutive, operational definitions and operational magnitudes. These were reviewed and adapted in nine indicators aimed at the elderly population affected by Chikungunya Fever. The first stage occurred through an integrative review of the literature for instrument adaptation validated in a previous study. The integrative review occurred between February and April 2017, in the databases: CINAHL, Cochrane, LILACS, PubMed, Scopus, Science Direct and Web of Science. There was an uncontrolled search of the scientific productions, without temporal cut, by the indexed and non-indexed descriptors and the 12 indicators of the Nursing Outcomes Classification for the Nursing Outcome Mobility. Then, for the semantic validation stage, the instrument was delivered in the month of June to 12 nurses who worked in primary health care. For evaluation as to its intelligibility. After following the suggestions proposed by the nurses at this stage, the pilot study and clinical validation were carried out. This stage was carried out in July and August, by two pairs of trained nurses, in Health Units of the city of Natal / RN, with 90 elderly people affected by Chikungunya Fever. One pair applied the instrument proposed by the NOC for the Mobility Nursing Outcome and another with the instrument adapted and revised. In order to analyze the textual content of the integrative review, we used the software Interface for Multidimensionnelles of Textes et de Questionnaires (IRAMUTEQ) version 0.7 Alpha 2. The data of the semantic and clinical validation were organized in a spreadsheet in the program Microsoft Office Excel 2012 and exported to the statistical program Statistical Package for Social Sciences version 22.0 for Windows. In the semantic validation, a binomial test with agreement equal or superior to 85% was applied. In the clinical validation, for the descriptive analyzes the measures of the distribution center and its variabilities were calculated. The Friedman test was used to verify divergence among raters and the Intraclass Correlation Coefficient was calculated to compare the correlation of the evaluations performed by the rater nurses. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under CAAE n? 64880017.9.0000.5537. In the integrative review, the Descending Hierarchical Classification pointed out two main axes related to Chikungunya Fever related to articles that prioritize clinical evidences of the acute phase, subacute and chronic phase. The articular pain indicator was added because it was considered important in the literature, represented in the word cloud and its operational definitions, constitutive definitions and operational magnitudes were constructed. As for the semantic validation stage, the instrument was considered intelligible for the proposed evaluation, by the nurses. Eight indicators reached or exceeded the agreement index of 0.85, except for the transfer performance indicator, since the agreement was 0.83 and p <0.05. In the clinical validation stage, there was a predominance of male participants (75.56%), with a median age of 70.00, most married, retired, with incomplete primary education and monthly income up to a minimum wage. The Friedman test indicated differences between the pairs' evaluation in seven indicators, namely: Balance, Walking, Muscle movement, Movement of joints, Performance in body positioning, Performance in transference and Joint pain. For the Coordination and March indicators, no significant differences were identified by the Friedman test. All indicators were statistically significant (p <0.001) and satisfactory, according to the Intraclass Correlation Coefficient. When analyzing the results through the statistical tests, it has been that the results were satisfactory for most of the indicators present in the instrument with the definitions. Thus, the use of instruments for a specific population such as the elderly affected by Chikungunya Fever are effective and must be continuously carried out in order to refine and improve them.
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Crescimento e desenvolvimento da crian?a com microcefalia relacionada ? transmiss?o vertical do Zika v?rus / Growth and development of the child with microcephaly related to the vertical transmission of Zika virusVitorino, Ana Beatriz Ferreira 14 December 2017 (has links)
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Previous issue date: 2017-12-14 / INTRODU??O: A infec??o pelo v?rus Zika ? caracterizada como uma doen?a febril aguda com maior preval?ncia da infec??o assintom?tica. A microcefalia ? uma anomalia, na qual h? m? forma??o cerebral, com irregularidades de estruturas e fun??es ao rec?m-nascido, presentes no momento do nascimento. Justifica-se o estudo pela import?ncia do conhecimento acerca do crescimento e desenvolvimento das crian?as portadoras de microcefalia relacionada ao Zika v?rus, com vistas ao acompanhamento e estimula??o de suas aptid?es junto ? fam?lia e profissionais. OBJETIVO: Analisar as altera??es no crescimento e desenvolvimento de crian?as com microcefalia relacionada ? transmiss?o vertical do Zika v?rus. METODOLOGIA: Trata-se de um estudo epidemiol?gico e descritivo de abordagem quantitativa realizado no ambulat?rio de pediatria da Universidade Federal do Rio Grande do Norte, localizado no munic?pio de Natal, Rio Grande do Norte. O estudo teve como p?blico alvo todas as crian?as diagnosticadas com microcefalia relacionada ? transmiss?o pelo Zika v?rus e acompanhadas no local de pesquisa que totalizou o quantitativo de 36 crian?as durante o per?odo de coleta. A coleta realizou-se entre os meses julho e outubro de 2017, mediante um instrumento dividido em duas partes, aplicado ?s m?es de crian?as portadoras de Microcefalia e a outra parte com dados da consulta de crescimento e desenvolvimento destas. O projeto teve aprova??o do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte sob o n? de parecer 2.166.462. Os dados foram submetidos ao software Statistical Package for the Social Sciences- SPSS vers?o 21, por meio da estat?stica descritiva e inferencial e foi aplicado o teste de Fisher e Mann Whitney ao n?vel de signific?ncia ? ? 5%. RESULTADOS: Os resultados apontaram altera??es, com base no padr?o de normalidade, de quase todo o marcos do desenvolvimento da crian?a. Dentre os marcos do desenvolvimento infantil, o ?nico que foi apresentado em 100% das crian?as investigadas foi o ?Emite sons, balbuciando?. Houve importantes altera??es no que diz respeito ao desenvolvimento neuropsicomotor da crian?a portadora de Microcefalia relacionada ao v?rus Zika, al?m de d?ficits oculares, visuais, na fala, na escuta, altera??es de cunho muscular como hipertonia ou hipotonia, al?m de descontrole cervical e altera??es tamb?m no crescimento concernente a peso, estatura e ?ndice de Massa Corporal. Registraram-se associa??es entre a hist?ria materna e infantil com os seus marcos de desenvolvimento. CONCLUS?O: As principais altera??es encontradas no crescimento e desenvolvimento de crian?as com microcefalia relacionada ? transmiss?o vertical do Zika v?rus foram altera??es no desenvolvimento neuropsicomotor, altera??es oculares, visuais, retardos na comunica??o e altera??es musculares. Quanto ao crescimento detectou-se comprometimento nos ?ndices de massa corporal. A partir do alcance dos objetivos pode-se pensar na realiza??o de estimula??o a esses pacientes no intuito de aumentar sua expectativa e qualidade de vida. / INTRODUCTION: Zika virus infection is characterized as an acute febrile illness with a higher prevalence of asymptomatic infection. Microcephaly is an anomaly, in which there is poor brain formation, with irregularities of structures and functions to the newborn present at birth. The study is justified by the importance of knowledge about the growth and development of children with microcephaly related to Zika virus, with a view to monitoring and stimulating their skills with family and professionals. OBJECTIVE: The objective was to analyze the changes in the growth and development of children with microcephaly related to the vertical transmission of the Zika virus. METHODOLOGY: This is an epidemiological and descriptive study of a quantitative approach performed at the pediatric outpatient clinic of the Federal University of Rio Grande do Norte, located in the city of Natal, Rio Grande do Norte. The study had as a target audience all children diagnosed with microcephaly related to transmission by the Zika virus and accompanied at the research site that totaled the quantitative of 36 children during the collection period. The collection was performed between July and October 2017, using an instrument divided into two parts, applied to the mothers of children with Microcephaly and the other part with data on the consultation of growth and development of this children. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under the number CAAE 64872817.2.0000.5537. Data were submitted to the Statistical Package for Social Sciences - SPSS version 21, using descriptive and inferential statistics, and the Fisher and Mann Whitney test was applied at significance level ? ? 5%. RESULTS: The results indicated changes, based on the normality pattern, of almost all the child developmental milestones. Among the milestones of child development, the only one that was presented in 100% of the children investigated was the "Emits sounds, babbling". There were important changes in the neuropsychomotor development of the child with Microcephaly related to the Zika virus, as well as visual, speech, hearing, muscular changes such as hypertonia or hypotonia, as well as cervical uncontrol and alterations in the growth related to weight, height and body mass index. Associations between maternal and infant history were identified with their developmental milestones. CONCLUSION: The main alterations found in the growth and development of children with microcephaly related to the vertical transmission of Zika virus were alterations in neuropsychomotor development, ocular, visual alterations, communication delays and muscular alterations. Growth was detected in the body mass index. From the reach of the objectives one can think of the accomplishment of stimulation to these patients in order to increase their expectation and quality of life.
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Evid?ncias de validade de instrumento para coleta de dados no pr? e p?s-operat?rio de estomizados intestinais a luz do Modelo de Adapta??o de RoyQueiroz, Cintia Galv?o 19 December 2017 (has links)
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Previous issue date: 2017-12-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Objetivou-se analisar a validade te?rica de instrumento para a coleta de dados no pr? e p?soperat?rio
de pessoas estomizadas intestinais ? luz do Modelo de Adapta??o de Roy. Estudo
metodol?gico, quantitativo desenvolvido em duas etapas: constru??o da vers?o preliminar de
um instrumento norteador de consulta de enfermagem fundamentado no Modelo de Adapta??o
de Roy, com aplicabilidade para o pr? e p?s-operat?rio de estomia (1? etapa), submiss?o do
instrumento para valida??o do seu conte?do aos especialistas (2? etapa). A amostra foi composta
por 11 ju?zes selecionados a partir dos crit?rios de inclus?o: atuar na pr?tica cl?nica na ?rea de
estomaterapia e/ou discentes a n?vel de mestrado e doutorado com conhecimento te?rico e de
pesquisa sobre estomias intestinais e/ou Modelo de Adapta??o de Callista Roy e aceitar
participar voluntariamente assinando o Termo de Consentimento Livre Esclarecido. Para
embasar a constru??o e valida??o do instrumento foi utilizada a teoria da psicometria, a qual se
baseia em tr?s polos: te?rico, experimental e anal?tico. Para fins de valida??o de conte?do, o
presente estudo deteve-se ao polo te?rico. A avalia??o dos itens do instrumento ocorreu a partir
da classifica??o em n?o tenho sugest?es para esse item, tenho sugest?es para melhoria do item
e o item deve ser retirado e a avalia??o geral de cada instrumento a partir de 10 requisitos. Ap?s
a avalia??o foi realizada a valida??o de conte?do com aplica??o do ?ndice Kappa (K) e ?ndice
de Validade de Conte?do (IVC), aceitando ?ndices superiores a 0,81 e 0,80, respectivamente.
O projeto de pesquisa obteve parecer favor?vel do Comit? de ?tica em Pesquisa/UFRN (CAAE
n? 65941517.8.0000.5537). Ap?s serem codificados e tabulados, os dados foram analisados por
meio de estat?stica descritiva. Dos 11 ju?zes que avaliaram o instrumento, 100% eram do sexo
feminino, com m?dia de idade de 34,4 (?9,1) anos, 88,9% possu?am mestrado acad?mico,
54,5% atuavam exclusivamente na assist?ncia e 36,4% disseram assistir e/ou pesquisar
estomias devido oportunidade de emprego/necessidade institucional. Em rela??o ao Modelo,
100,0% dos ju?zes responderam que consideram importante que o enfermeiro conhe?a o
processo adaptativo da pessoa estomizada, entretanto, apenas 72,7% tinham conhecimento. Na
avalia??o geral do instrumento, obteve-se ?ndices de IVC e Kappa de 0,90 e 0,96,
respectivamente, acima do considerado aceit?vel. A maioria dos itens avaliados obtiveram
n?veis de avalia??o da validade de conte?do dentro do estabelecido (IVC ?0,80 e Kappa?0,81)
sendo considerados adequados. Dez itens foram retirados, uma vez que n?o obtiveram n?vel de
concord?ncia dentro dos ?ndices estabelecidos. Foi levado em considera??o tamb?m as
sugest?es e justificativas individuais dos ju?zes para melhorar o item ou retira-lo. Algumas
sugest?es foram dadas por apenas um juiz, sendo analisadas, acatadas ou rejeitadas em fun??o
de sua pertin?ncia. Por fim, o instrumento foi reformulado baseando-se nos n?veis de
concord?ncia entre os ju?zes e a vers?o final apresenta 126 itens, mostrando-se v?lidos quanto
ao seu conte?do, permitindo sua aplica??o pr?tica, tanto pelos enfermeiros assistenciais como
tamb?m pelos graduandos de enfermagem a fim de identificar necessidades adaptativas das
pessoas estomizadas e subsidiar interven??es para promover a adapta??o. / The aim of this study was to analyze the theoretical validity of an instrument for the collection
of data in the pre and postoperative period of intestinal stomates in the light of Roy's Adaptation
Model. Methodological and quantitative study developed in two stages: construction of the
preliminary version of a nursing consultation guideline based on the Roy Adaptation Model,
with applicability for the pre and post-operative of the stommy (1st stage), submission of the
instrument for validation of its content to the experts (2nd stage). The sample consisted of 11
judges selected from the inclusion criteria: acting in the clinical practice in the area of
stomatherapy and/or students at master's and doctoral level with theoretical knowledge and
research on intestinal stomies and/or Callista's Adaptation Model Roy and agree to participate
voluntarily by signing the informed consent term. In order to base the construction and
validation of the instrument, the theory of psychometry was used, which is based on three poles:
theoretical, experimental and analytical. For purposes of content validation, the present study
was applied to the theoretical pole. The evaluation of the items of the instrument occurred from
the classification in I have no suggestions for this item, I have suggestions for improvement of
the item and the item should be withdrawn and the overall evaluation of each instrument from
10 requirements. After the evaluation, the content validation was applied with Kappa Index (K)
and Content Validity Index (IVC), accepting indexes above 0.81 and 0.80, respectively. The
research project obtained a favorable opinion from the Research Ethics Committee/UFRN
(CAAE n? 65941517.8.0000.5537). After being coded and tabulated, the data were analyzed by
means of descriptive statistics. Of the 11 judges who evaluated the instrument, 100% were
female, with a mean age of 34.4 (? 9.1) years, 88.9% had an academic master's degree, 54.5%
were exclusively on care and 36, 4% said attending and/or researching ostomies due to job
opportunity/institutional need. Regarding the Model, 100.0% of the judges answered that they
consider it important that the nurse knows the adaptive process of the stomized person,
however, only 72.7% were aware. In the general evaluation of the instrument, IVC and Kappa
indexes of 0.90 and 0.96, respectively, were obtained, above that considered acceptable. Most
of the evaluated items had levels of evaluation of the validity of content within the established
(IVC ?0.80 and Kappa ?0.81) being considered adequate. Ten items were withdrawn, since
they did not obtain level of agreement within the established indices. The judges' individual
suggestions and justifications were also taken into account to improve the item or to withdraw
it. Some suggestions were given by only one judge, being analyzed, accepted or rejected
according to their pertinence. Finally, the instrument was reformulated based on the levels of
concordance between the judges and the final version presents 126 items, proving valid as to
its content, allowing its practical application, both by nursing assistants as well as by
undergraduate nursing students to identify the adaptive needs of stommized people and to
support interventions to promote adaptation.
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Proposi??o do diagn?stico de enfermagem atraso no desenvolvimento: an?lise de conte?do e valida??o cl?nicaNogueira, Isadora Lorenna Alves 18 December 2017 (has links)
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Previous issue date: 2017-12-18 / O objetivo do estudo ? analisar o conte?do e as medidas de acur?cia da proposi??o
diagn?stica de enfermagem Atraso no desenvolvimento em adolescentes no ?mbito escolar. O
cuidado ? sa?de do adolescente ? um grande desafio, devido ?s in?meras mudan?as ocorridas
na adolesc?ncia. Faz-se necess?rio uma assist?ncia direcionada ?s peculiaridades dessa idade
mediante avalia??o do desenvolvimento. Para os enfermeiros, pode ser operacionalizada pelo
processo de enfermagem, por meio do racioc?nio cl?nico adequado a essa condi??o. Nessa
perspectiva, trata-se de um estudo metodol?gico direcionado por duas etapas: an?lise de
conte?do e valida??o cl?nica. A primeira etapa foi desenvolvida com nove especialistas, entre
janeiro e fevereiro de 2017, os quais avaliaram, por meio do grupo focal, os componentes do
referido diagn?stico. Na segunda etapa, foram identificados os indicadores cl?nicos com
melhor acur?cia para o Atraso no desenvolvimento. A amostra foi composta por estudantes
adolescentes das escolas estaduais do munic?pio de Natal/RN, distribu?das nas quatro zonas -
norte, sul, leste e oeste, incluindo 385 alunos de oito institui??es estaduais (duas escolas de
cada zona). Realizou-se a coleta de dados nos meses de julho a setembro de 2017, incluindo o
pr?-teste do instrumento de coleta de dados, realizado em duas institui??es, com 10% da
amostra prevista (39 alunos). A estat?stica dos dados foi realizada no IBM SPSS Statistic
vers?o 20.0 for Windows resultando em porcentagens absolutas e relativas para vari?veis
categ?ricas, e em medidas central e dispers?o para vari?veis num?ricas, com normalidade
constatada pelo teste de Kolmogorov-Smirnov (p<0,05). A associa??o estat?stica dos fatores
relacionados baseou-se nos testes de Fisher e Qui-quadrado. A acur?cia dos indicadores
cl?nicos foi verificada por medidas de sensibilidade e especificidade com constru??o do
modelo de classe latente. O estudo foi aprovado pelo Comit? de ?tica em pesquisa da
institui??o respons?vel, sob parecer 1.662.528 e Certificado de Apresenta??o para Aprecia??o
?tica 57945016.4.0000.5537. Os resultados da an?lise de conte?do evidenciaram que o
quantitativo de fatores relacionados do Atraso no desenvolvimento passou de 16 termos para
18, devido ? realoca??o do ?Transtorno do d?ficit de aten??o e hiperatividade? e inser??o de
?Trauma psicol?gico? para compor os antecedentes. Os indicadores cl?nicos passaram de 14
termos para 12, por exclus?o do ?Transtorno de d?ficit de aten??o e hiperatividade? e
?Dificuldade de expressar emo??es?. Relativo aos resultados da valida??o cl?nica encontrouse
uma preval?ncia do Atraso no desenvolvimento de 18,26%. Identificou-se que todos os
indicadores cl?nicos analisados no estudo eram espec?ficos ? proposi??o diagn?stica estudada,
entretanto, nenhuma se mostrou sens?vel. Conclui-se que o diagn?stico proposto foi validado
pelos especialistas, bem como esteve presente em adolescentes no ?mbito escolar. Espera-se,
assim, contribuir para o fortalecimento da pol?tica p?blica voltada ? sa?de do adolescente, o
racioc?nio cl?nico dos enfermeiros e a inser??o do diagn?stico de enfermagem ?Atraso no
desenvolvimento? na taxonomia da NANDA Internacional. / The objective of the study is to analyze the content and accuracy measures of the diagnostic
proposal of nursing Delay in the development in adolescents in the school environment.
Adolescent health care is a major challenge due to the many changes that occurred in
adolescence. It is necessary to focus on the peculiarities of this age through evaluation of
development. For nurses, it can be operationalized by the nursing process, through the
appropriate clinical reasoning for this condition. In this perspective, it is a methodological
study directed by two stages: content analysis and clinical validation. The first stage was
developed with nine specialists, between January and February of 2017, who evaluated,
through the focus group, the components of this diagnosis. In the second stage, the clinical
indicators with the best accuracy for Developmental Delay were identified. The sample
consisted of teenagers from the state schools of Natal / RN, distributed in the four zones -
north, south, east and west, including 385 students from eight state institutions (two schools
from each area). Data were collected from July to September 2017, including the pre-test of
the data collection instrument, performed in two institutions, with 10% of the expected
sample (39 students). The statistical data was performed in IBM SPSS Statistic version 20.0
for Windows resulting in absolute and relative percentages for categorical variables, and in
central measures and dispersion for numerical variables, with normality verified by the
Kolmogorov-Smirnov test (p <0.05) . The statistical association of the related factors was
based on Fisher's and Chi-square tests. The accuracy of the clinical indicators was verified by
measures of sensitivity and specificity with latent class model construction. The study was
approved by the Research Ethics Committee of the responsible institution, under opinion
1,662,528 and Certificate of Presentation for Ethical Appraisal 57945016.4.0000.5537. The
results of the content analysis showed that the number of factors related to developmental
delay increased from 16 terms to 18 due to the reallocation of attention deficit hyperactivity
disorder and insertion of psychological trauma to compose the antecedents. Clinical
indicators went from 14 terms to 12, by exclusion of "Attention Deficit Hyperactivity
Disorder" and "Difficulty of Expressing Emotions". Regarding the results of clinical
validation, a prevalence of Delay in the development of 18.26% was found. It was identified
that all the clinical indicators analyzed in the study were specific to the diagnostic proposal
studied, however, none were sensitive. It is concluded that the proposed diagnosis was
validated by the specialists, as well as was present in adolescents in the school environment.
It is hoped, therefore, to contribute to the strengthening of the public policy focused on
adolescent health, the clinical reasoning of nurses and the insertion of the nursing diagnosis
"Delay in development" in NANDA International taxonomy.
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Proposi??o diagn?stica para o atraso no crescimento em adolescentes escolares: an?lise de conte?do e valida??o cl?nicaL?cio, Kadyjina Daiane Batista 18 December 2017 (has links)
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Previous issue date: 2017-12-18 / O termo crescimento ? muitas vezes compreendido, conceitualmente, como sin?nimo de desenvolvimento. Apesar de correlatos, esses s?o fen?menos distintos. O crescimento ? um acontecimento biol?gico complexo, determinado geneticamente e modulado por fatores extr?nsecos. No per?odo da adolesc?ncia, o ser humano viv?ncia uma s?rie de altera??es, dentre elas seu segundo surto de crescimento. Diante da necessidade de clarificar esse termo e analisar os fatores influenciadores e as caracter?sticas do atraso no crescimento durante a adolesc?ncia, o presente estudo tem como objetivo analisar o conte?do e as medidas de acur?cia da proposi??o diagn?stica de enfermagem Atraso no crescimento em adolescentes escolares. Trata-se de um estudo metodol?gico, desenvolvido em duas etapas, a saber: an?lise de conte?do e valida??o cl?nica. Na primeira etapa, foram analisados os componentes e defini??es da proposi??o diagn?stica, por meio do grupo focal, com nove enfermeiras. Ocorreram tr?s encontros, nos meses de janeiro a fevereiro de 2017. A segunda etapa avaliou, na pr?tica cl?nica, as caracter?sticas definidoras mais acuradas para a proposi??o diagn?stica. Participaram 385 adolescentes de oito escolas estaduais, localizadas no munic?pio de Natal-RN. Para an?lise dos dados, foi utilizada a estat?stica descritiva e inferencial. Na an?lise descritiva, utilizou-se as medidas de tend?ncia central e de dispers?o. Na inferencial, a mensura??o das medidas de acur?cia ocorreu por meio da an?lise de classe latente, sendo obtidos valores de especificidade e sensibilidade. O projeto de pesquisa foi aprovado pelo Comit? de ?tica em Pesquisa, sob o n?mero 1.713.820. Os achados referentes ? primeira etapa resultaram em oito fatores relacionados a proposi??o atraso no crescimento e sete caracter?sticas definidoras. Como defini??o para a proposi??o diagn?stica, adotou-se: Crescimento abaixo do esperado para indiv?duos, de mesmo sexo, na faixa et?ria de 10 aos 19 anos. A preval?ncia do diagn?stico proposto foi de 1,3% na clientela investigada. As caracter?sticas definidoras com maior sensibilidade foram Velocidade de crescimento abaixo do esperado e Baixa estatura por idade. Os espec?ficos foram: Baixo peso por idade, Velocidade de crescimento abaixo do esperado, Estatura final inferior ao alvo gen?tico e matura??o sexual retardada. Conclui-se que a proposi??o diagn?stica atraso no crescimento foi analisada pelos especialistas e validada na cl?nica. Acredita-se que essa valida??o contribuiu para o avan?o do conhecimento da enfermagem ao fornecer um conjunto de caracter?sticas que auxiliam o enfermeiro na detec??o do atraso no crescimento em adolescentes escolares. Outrossim, permite ao profissional a aproxima??o das terminologias espec?ficas da profiss?o, a partir de elementos acurados para a sua pr?tica cl?nica. / The term growth is often understood, conceptually, as synonymous with development. Although correlates, these are different phenomena. Growth is a complex biological event, genetically determined and modulated by extrinsic factors. In adolescence, the human being experiences a series of alterations, among them his second growth spurt. Given the need to clarify this term and to analyze the factors influencing and the characteristics of growth retardation during adolescence, the present study aims to analyze the content and accuracy measures of the nursing diagnosis Delay in growth in school adolescents. It is a methodological study, developed in two stages, namely: content analysis and clinical validation. In the first stage, the components and definitions of the diagnostic proposal were analyzed, through the focal group, with nine nurses. Three meetings took place from January to February 2017. The second stage evaluated, in clinical practice, the most accurate defining characteristics for the diagnostic proposition. A total of 385 adolescents from eight state schools, located in the city of Natal-RN, participated. To analyze the data, descriptive and inferential statistics were used. In the descriptive analysis, the measures of central tendency and dispersion were used. In the inferential, the measurement of the accuracy measurements occurred through the latent class analysis, obtaining values of specificity and sensitivity. The research project was approved by the Research Ethics Committee under number 1,713,820. The findings related to the first stage resulted in eight factors related to the delayed growth proposition and seven defining characteristics. As a definition for the diagnostic proposition, we adopted: Growth below that expected for individuals of the same sex, in the age group from 10 to 19 years. The prevalence of the proposed diagnosis was 1.3% in the clientele investigated. The defining characteristics with greater sensitivity were growth velocity below the expected and Low stature by age. The specifics were: Low weight for age, Lower than expected growth velocity, Final height below the genetic target and delayed sexual maturation. It is concluded that the diagnostic proposition delayed growth was analyzed by the specialists and validated in the clinic. It is believed that this validation contributed to the advancement of nursing knowledge by providing a set of characteristics that help the nurse in the detection of growth retardation in school adolescents. In addition, it allows the professional to approach the specific terminologies of the profession, from elements that are accurate to their clinical practice.
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Viv?ncia de pais diante do filho prematuro no M?todo CanguruLopes, Thais Rosental Gabriel 19 December 2017 (has links)
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Previous issue date: 2017-12-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / No mundo, mais de 2,7 milh?es de rec?m-nascidos morrem todos os anos antes de completar cinco anos de idade. Neste contexto, a Aten??o Humanizada ao Rec?m-nascido de baixo peso ao nascer ? M?todo Canguru constitui uma estrat?gia de humaniza??o direcionada ? sa?de neonatal. A proposta deste m?todo ? realizar o contato pele-a-pele precoce e cont?nuo do rec?m-nascido prematuro com a m?e, o pai e familiares. Esta pr?tica aumenta do v?nculo afetivo, incentivo ao aleitamento materno, desenvolvimento neurocomportamental, alta precoce da unidade de sa?de, bem como o empoderamendo dos pais e familiares com vistas ? continuidade do m?todo no ambiente familiar. Com base no exposto, objetivou-se compreender a viv?ncia de pais diante do filho prematuro no M?todo Canguru. Deste modo, realizou-se uma pesquisa qualitativa, descritiva e interpretativa, junto a 15 homens que vivenciavam o m?todo canguru junto ao filho prematuro, na Unidade de Cuidados Intermedi?rios Canguru da Maternidade Escola Janu?rio Cicco em Natal/RN, Brasil. Conforme os crit?rios de inclus?o, os participantes deveriam estar com idade igual ou superior a 18 anos e que estivessem vivenciando o M?todo Canguru. A coleta de dados ocorreu no per?odo mar?o a julho de 2017. Para isso, utilizou-se um instrumento contendo quest?es relativas ? caracteriza??o s?cio demogr?fica e uma pergunta aberta contemplando a quest?o da pesquisa. Antecedeu essas etapas a anu?ncia do hospital referido, a aprova??o do Comit? de ?tica e Pesquisa da Universidade Federal do Rio Grande do Norte, CAAE n? 62020016.1.0000.5537 e parecer n? 1.850.383 como tamb?m assinatura do Termo de Consentimento Livre Esclarecido pelos entrevistados. Os dados coletados de acordo com as etapas da ?Teoria Fundamentada nos Dados? e analisados sob ?tica dos princ?pios do Interacionismo Simb?lico. Seguindo as etapa desses referenciais, foram elaboradas tr?s categorias, a saber: ?Sentimentos vivenciados pelos pais na realiza??o do M?todo Canguru?; ?Vis?o dos pais sobre a Unidade Canguru? e ?Participa??o de pais no M?todo Canguru?. A an?lise das dimens?es de tais categorias possibilitou a constru??o da categoria central ?Viv?ncia de pais junto ao filho prematuro no M?todo Canguru?. Deste modo, conclui-se que os pais vivenciam o M?todo Canguru com sentimentos diversos, tais como: preocupa??o, responsabilidade, medo e satisfa??o. Esses est?o relacionados ao modo como o pai interage com o filho e a sua companheira durante o m?todo canguru. Tais sentimentos s?o oportunizados pela sua vis?o sobre a unidade canguru e sua participa??o nos cuidados ao filho no per?odo em que o assiste. Diante disso, entende-se ser relevante que os profissionais de sa?de atuantes na metodologia assistencial do M?todo Canguru, em especial o enfermeiro, possibilitem a maior aten??o ao pai no contexto da prematuridade, compreendendo as particularidades do cuidado dispensado pelo pai ao filho, na tentativa favorecer v?nculo precoce entre a d?ade pai-filho, continuidade com efetividade do M?todo Canguru ap?s alta hospitalar, com vistas a minimizar indicadores de morbidade e mortalidade neonatal. / Around the world, over 2,7 million newborn children die every year before reaching the age of five. In this context, the Humanized Attention to low birth weight children - the Kangaroo Method represent a humanization strategy guided towards neonatal health. This method?s proposal is to make early and continuous skin-to-skin contact among the premature newborn and its mother, father and relatives. This practice increases the emotional bond, supports breastfeeding, neurobehavioral development, early discharge from the health unit, as well as the empowerment of the parents and relatives aiming the method?s continuity at their home. Based on what was exposed, the purpose was to comprehend the parents? experience before the premature son, inside the Kangaroo Unit of Intermediate Care from the Maternity School Janu?rio Cicco in Natal/RN, Brazil. According to the inclusion conditions, the participants must have age equal or higher than 18 years old and be exercising the Kangaroo Method. The data gathering occurred from March to July of 2017. It was used an instrument containing questions related to the sociodemographic characterization and an open question deliberating about the research. Before these stages, the referred hospital?s consent was made, the approval of the Committee of ethics and Research of Universidad Federal do Rio Grande do Norte, CAAE n? 62020016.1.0000.5537 and report n? 1.850.383 as well as the signature of the consent term by the interviewed. From the data gathered according to the stages of the Grounded Theory about the data and analyzed under the optic of the Symbolic interactionism principles. Based on these benchmarks? stages, three categories were elaborated: ?Experienced feelings by the parents in the accomplishment of the Kangaroo Method?; ?Parents? vision about the Kangaroo Unit? and ?parent?s participation in the Kangaroo Method?. The analysis of the dimension of such categories made it possible to construct a central category ?Parents? experience with the premature son in the Kangaroo Method?. Therefore, one concludes that the parents experienced the Kangaroo Method with several feelings, such as: Worries, responsibility, fear and satisfaction. These are related to the way of how the father interacts with the son and his companion during the Kangaroo Method. Such feelings are given by their vision about the kangaroo unit and their participation in the son?s care during the method?s period. In light of this, one understands to be relevant that the acting health professionals in the Kangaroo Method?s Care methodology, specially the nurses, provides a bigger attention to the father in the prematurity?s context, comprehending the care?s singularities given by the father to the son, in the attempt of favoring the early bond between father and son, the effective continuity of the Kangaroo Method after the hospital discharge, aiming to minimize neonatal morbidity and mortality indicators.
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Mapeamento cruzado dos t?tulos de diagn?sticos de enfermagem formulados segundo a CIPE? versus diagn?sticos da NANDA Internacional para pessoas vivendo com AIDS / Cross mapping of titles of nursing diagnoses formulated by ICNP? versus NANDA International diagnostics for people living with AIDSRocha, Cintia Capistrano Teixeira 06 December 2017 (has links)
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Previous issue date: 2017-12-06 / Tratar-se de um estudo transversal, com o objetivo de realizar o mapeamento cruzado dos t?tulos de diagn?sticos de enfermagem (DE) de pessoas vivendo com Aids formulados segundo a Classifica??o Internacional para a Pr?tica de Enfermagem (CIPE?) com os diagn?sticos da NANDA Internacional (NANDA-I), bem como classificar os t?tulos mapeados de acordo com a teoria das Necessidades Humanas B?sicas (NHB) de Horta com seguinte valida??o de conte?do do produto do mapeamento. Os t?tulos de diagn?sticos para pessoas vivendo com Aids da CIPE? e NANDA-I foram tabulados no programa Microsoft Excel (Office 2013) e elaboradas duas listas, em que os t?tulos de diagn?sticos de enfermagem foram comparados entre os sistemas de classifica??o, juntamente com suas, respectivas defini??es operacionais/conceito, em t?tulos constantes e n?o constantes. Em seguida, os t?tulos n?o constantes foram submetidos a an?lise utilizando os crit?rios advindos de Leal, sendo classificados como: similar, mais abrangente, mais restrito, n?o existe concord?ncia. Os produtos do mapeamento foram submetidos ? valida??o de conte?do. Para tanto, foi considerado o ?ndice de concord?ncia igual ou maior que 0,80 entre os especialistas. Selecionaram-se especialistas no sistema de classifica??o CIPE? no Centro CIPE, localizado em Jo?o Pessoa/PB; e no sistema de classifica??o NANDA-I utilizou-se a ferramenta de busca da Plataforma Lattes do portal do Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq). O projeto foi aprovado pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte mediante o Parecer n? 1.963.581 e certificado de apresenta??o para aprecia??o ?tica n?47380915.2.0000.5537. Foram encontrados 135 diagn?sticos de enfermagem, destes 84 do sistema de classifica??o CIPE? e 51 da NANDA-I. Ap?s realizar-se o mapeamento cruzado 81% dos DE CIPE? n?o contantantes na NANDA-I, enquanto 19% foram constantes. Dos 81% n?o constantes, foram classificados em: 27% similar, 12% mais restrito, 7% mais abrangente, 1% n?o existe concord?ncia e 58% n?o foi encontrado DE NANDA-I correspondente. Os DE foram classificados segundo as NHB, encontrou-se, respectivamente, para as classifica??es CIPE? e NANDA-I: 74% e 80% nas necessidades psicobiol?gicas; 23% e 16% nas necessidades psicossociais; 3% e 4% na necessidade psicoespiritual. Diante do quantitativo de DE para pessoas vivendo com Aids segundo a CIPE?, superior aos da NANDA-I, percebeu-se uma maior liberdade para sua elabora??o, j? que se baseia na utiliza??o de termos para elabora??o de seus DE, al?m de tais termos estarem, predominantemente, associados a sinais e sintomas cl?nicos, o que permite uma aproxima??o maior dos diagn?sticos da pr?tica cl?nica. Quanto as NHB, houve o predom?nio de diagn?sticos voltados para as NHB psicobiol?gicas tanto utilizando a CIPE? quanto a NANDA-I. Tal fato est? relacionado a hegemonia ainda do modelo de sa?de biom?dico, voltado para o corpo, al?m de ser justificada, em parte, pela especificidade da clientela, em que diversas altera??es fisiol?gicas ocorrem com a patologia instalada. Verificou-se que o processo de racioc?nio cl?nico para a elabora??o dos t?tulos diagn?sticos de enfermagem utilizando ambas as classifica??es, levou a formula??o de DE com padr?es semelhantes quando somamos os contantes 16 com os n?o contantes, mas similares 18, resultanto em 41% dos DE. Tal fato demostrou que utilizando-se um racioc?nio cl?nico com acur?cia o enfermeiro pode fazer uso de ambas as classifica??es. O estudo torna-se importante por comparar a utiliza??o pr?tica das duas classifica??es de enfermagem mais utilizadas no mundo, auxiliando a tomada de decis?o dos enfermeiros embasada no conhecimento cient?fico em uma clientela t?o complexa e espec?fica, al?m de contribuir para o desenvolvimento da CIPE? e NANDA-I e, consequente, fortalecer o estado da arte da Enfermagem / This is a cross-sectional study with the objective of cross-mapping the titles of nursing diagnoses (ED) of people living with AIDS formulated according to the International Classification of Nursing Practice (CIPE?) with NANDA International diagnoses (NANDA-I), as well as to classify the mapped titles according to Horta's Basic Human Needs theory (NHB) with the following validation of the product content of the mapping. The CIPE? and NANDA-I diagnostics certificates for people living with AIDS were tabulated in the Microsoft Excel (Office 2013) program and two lists were drawn up, in which the nursing diagnosis titles were compared between the classification systems, along with their, respective operational definitions / concept, in constant and non-constant securities. Then, the non-constant securities were submitted to analysis using the criteria derived from Leal, being classified as: similar, more comprehensive, more restricted, there is no agreement. The mapping products were submitted to content validation. For this, the agreement index was equal to or greater than 0.80 among the specialists. Specialists in the CIPE? classification system were selected at the CIPE? Center, located in Jo?o Pessoa / PB; and in the NANDA-I classification system was used the search tool of the Lattes Platform of the portal of the National Council of Scientific and Technological Development (CNPq). The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte through Opinion No. 1,963,581 and presentation certificate for ethical assessment n?47380915.2.0000.5537. We found 135 nursing diagnoses, of these 84 of the CIPE? classification system and 51 of NANDA-I. After cross-mapping, 81% of CIPE? DE were non-accommodating in NANDA-I, while 19% were constant. Of the 81% that were not constant, they were classified in: 27% similar, 12% more restricted, 7% more comprehensive, 1% no agreement and 58% not found NANDA-I correspondent. Were DE classified according to NHB, they were, respectively, for the CIPE? and NANDA-I classifications: 74% and 80% Psychobiological needs; 23% and 16% Psychosocial needs; 3% and 4% Psychospiral needs. Given the amount of ED for people living with AIDS according to CIPE?, superior to those of NANDA-I, it was perceived a greater freedom for its elaboration, since it is based on the use of terms for elaboration of its DE, in addition to such terms are predominantly associated with clinical signs and symptoms, which allows a greater approximation of clinical practice diagnoses. As for NHBs, there was a predominance of diagnoses for psychobiological NHBs using both ICNP and NANDA-I. This fact is related to the hegemony still of the biomedical health model, directed to the body, besides being justified, in part, by the specificity of the clientele, in which several physiological changes occur with the installed pathology. It was verified that the clinical reasoning process for the elaboration of the nursing diagnostic titles using both classifications led to the formulation of ED with similar patterns when we added the 16 counters to the non-constant, but similar 19, resulting in 41% of the DE. This fact showed that using a clinical reasoning with accuracy, the nurse can make use of both classifications. The study is important because it compares the practical use of the two most used nursing classifications in the world, helping the decision-making of nurses based on scientific knowledge in such a complex and specific clientele, besides contributing to the development of ICNP and NANDA-I and, consequently, strengthen the state of the art of nursing.
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