Made available in DSpace on 2014-12-17T14:46:53Z (GMT). No. of bitstreams: 1 VannuciaKMN_DISSERT.pdf: 2729567 bytes, checksum: 0e970c46216f2daf44c7fcc5215be61d (MD5) Previous issue date: 2011-12-16 / We aim to understand the social representations of man's aggressive behavior from the perspective of women in situations of domestic violence. This is a descriptive, exploratory and representational study, whose methodological approach falls into the qualitative category. We chose as a scenario for research, by the Reference Center for Citizen Women (CRMC), Natal / RN. The criteria for selection of participants were women who lived/live in situations of domestic violence, with affective or relationship bonding with the assailant, in psychological and emotional positions appropriated to the reality; that are being protected or assisted by the service listed above; whose aggressor is male. We adopted as data collection instruments: questionnaire, Drawing-Story (DE) and a field diary. For analysis of textual data, we decided to use the ALCESTE software conjugated to editing analyze and initial reading. Were investigated 20 women victims of domestic violence, whose author of the attacks was the husband/partner. We identified, from the respondents, that 70% (n = 14) of men with aggressive behavior also had a family history of violence and fragile family relationships. About the physical and emotional condition of the assailant at the time of violence, 50% (n = 10) of these men, regardless the use of alcohol, had often quarrelsome and/or nervous behavior, impatient and unpredictable humor facing a setback, worry or annoyance. Regarding the nature of violence, we observed that women were victims of all types of violence, however, the psychological prevailed in 100% of cases. The corpus "Men" has three classes, whose focuses are, respectively: resignation, denounce and violence/aggression, being possible categorizing them as well: Category 1: The imprisonment of women; Category 2: Violence and its meanings; Category 3: Breaking the violent cycle. We show that the social representations of man s aggressive behavior, from the women in situations of violence, are anchored in the social roles of men in family and society, becoming a dominant model of masculinity. It is aimed, on one hand, from the reproduction of what is already known and/or experienced by male aggressors in the family, as repetitions of behavior. And on the other, present themselves as a state of illness, addiction or psychopathy / Objetivamos apreender as representa??es sociais do comportamento agressivo do homem sob a ?tica da mulher em situa??o de viol?ncia intrafamiliar. Trata-se de um estudo de car?ter descritivo, explorat?rio e representacional, cuja abordagem metodol?gica se insere na categoria qualitativa. Optamos, como cen?rio da investiga??o, pelo Centro de Refer?ncia ? Mulher Cidad? (CRMC), Natal/RN. Os crit?rios de sele??o das participantes foram: mulheres que viveram/vivem situa??es de viol?ncia intrafamiliar; com v?nculo afetivo ou de parentesco com o agressor; que estejam em condi??es psicol?gicas e emocionais adequadas ? realidade; que estejam sob prote??o ou atendidas pelo servi?o acima relacionado; cujo agressor seja do sexo masculino. Adotamos um enfoque multimetodol?gico a partir dos seguintes instrumentos de coleta: question?rio, Desenho-Est?ria (DE) e di?rio de campo. Dessa forma, foi poss?vel caracterizar as mulheres investigadas, seus agressores e a viol?ncia sofrida, bem como categorizar os discursos do corpus Homens . Para analise dos dados textuais, optamos pelo uso do software ALCESTE conjugado ? an?lise de edi??o e leitura flutuante. Foram investigadas 20 mulheres v?timas de viol?ncia intrafamiliar, cujo autor das agress?es era o marido/ companheiro. Identificamos, a partir das entrevistadas, que 70% (n=14) dos homens com comportamento agressivo apresentavam igualmente hist?rico familiar de viol?ncia e rela??es familiares fragilizadas. No que tange ?s condi??es f?sicas e emocionais do agressor na hora da viol?ncia, 50% (n=10) desses homens, independente do uso do ?lcool, apresentavam frequentemente comportamento briguento e/ou nervoso, impaci?ncia e humor imprevis?vel, frente a uma contrariedade, preocupa??o ou aborrecimento. Quanto ? natureza da viol?ncia, observamos que as mulheres foram v?timas de todos os tipos de viol?ncia, todavia, a psicol?gica prevaleceu em 100% dos casos. O corpus Homens gerou tr?s classes, cujo foco s?o, respectivamente: ren?ncia, den?ncia e viol?ncia/agress?o. Sendo poss?vel assim categoriz?-las: Categoria 1: O aprisionamento da mulher; Categoria 2: A viol?ncia e suas significa??es; Categoria 3: A ruptura do ciclo violento. Evidenciamos que as representa??es sociais do comportamento agressivo do homem, a partir da mulher em situa??o de viol?ncia, est?o ancoradas nos pap?is sociais do homem na fam?lia e na sociedade, configurando-se num modelo de masculinidade dominante. E objetivam-se, de um lado, a partir da reprodu??o do que j? ? conhecido e/ou vivenciado pelos homens agressores no ?mbito familiar, como repeti??es de comportamento. E, de outro, apresentam-se como um estado de doen?a, v?cio ou psicopatia

Made available in DSpace on 2014-12-17T14:46:54Z (GMT). No. of bitstreams: 1 RaneCPA_DISSERT.pdf: 892716 bytes, checksum: 9924f4c1243c3c933a5bc637ba69e84d (MD5) Previous issue date: 2011-09-30 / The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE n? 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury / O estudo teve como objetivo de identificar a qualidade da assist?ncia e o conhecimento do direito ? sa?de das pessoas com ?lcera venosa (UV) cr?nica no Sistema ?nico de Sa?de (SUS). Trata-se de um estudo descritivo transversal, com abordagem quantitativa, realizado no Hospital Universit?rio Onofre Lopes (HUOL). O estudo obteve parecer favor?vel do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte (CAAE n? 0148.0.051.000-10). A amostra por acessibilidade foi composta por 30 pessoas com UV atendidas no ambulat?rio de Cl?nica Cir?rgica do HUOL. Para coleta de dados foi utilizado um question?rio estruturado composto de duas partes: caracter?sticas sociodemogr?ficas e de sa?de, da assist?ncia e da evolu??o cl?nica da UV; e conhecimento das pessoas com UV acerca dos direitos ? sa?de. Os resultados foram processados no programa SPSS 15.0 e analisados por estat?stica descritiva. Diante das caracteriza??es sociodemogr?ficas e de sa?de apresentadas, identificamos uma clientela de usu?rios com UV predominantemente feminina (76,7%), com faixa et?ria a partir de 60 anos (66,7%), casados/uni?o est?vel (60,0%), com baixo n?vel de escolaridade (83,3%), renda familiar menor que um sal?rio m?nimo (73,3%), desempregados e com doen?as cr?nicas associadas (53,3%), sono maior ou igual a 6 horas (76,7%) e que n?o eram etilistas ou tabagistas (93,3%). Em rela??o ?s condi??es cl?nicas, foram evidenciados a presen?a de uma ou mais recidivas da UV (73,3%), predom?nio de granula??o/epiteliza??o no leito da UV (60,0%), exsudato serossanguinolento (43,3%), em quantidade m?dia/grande (60,0%), sem predom?nio de presen?a ou aus?ncia de odor (50,0%), totalidade dos pacientes com perda tecidual em grau III/grau IV, aus?ncia de sinais de infec??o (73,3%) e presen?a de dor intensa (50,0%). Nos ?ltimos 30 dias o principal local de realiza??o do curativo foi o HUOL (100,0 %), a principal terapia compressiva utilizada era a bota de Unna (60,0%) e, na impossibilidade de se realizar os curativos na unidade, eram os pr?prios pacientes que faziam a troca em domic?lio (40,0%). A maioria dos pesquisados elencou mais fatores positivos associados ? qualidade da assist?ncia (56,7%), mostrou-se satisfeita com o atendimento do SUS (76,7%), afirmou ter conhecimento sobre seus direitos (70,0%), mas ao mesmo tempo eles desconheciam o significado da sigla SUS (90,0%) e classificaram o seu n?vel de obten??o de informa??es como inadequado (70,0%). Percebemos que as pessoas com UV identificaram como boa a qualidade da assist?ncia e demonstraram conhecimento inadequado sobre seus direitos ? sa?de no SUS, por?m mostraram interesse em adquirir mais informa??es. Os direitos b?sicos ao ingresso no SUS encontram-se constitucionalmente garantidos e necessitam ser divulgados de modo a torn?-los conhecidos da popula??o, para que assim possa ser implementada e garantida uma assist?ncia de maior resolutividade no tratamento deste tipo de les?o

Made available in DSpace on 2014-12-17T14:46:54Z (GMT). No. of bitstreams: 1 SilvanaHNM_DISSERT.pdf: 798862 bytes, checksum: 714b2d8c0e6e3e7bcaa68e2efa23df0f (MD5) Previous issue date: 2011-12-15 / The demographic and epidemiological transition process caused by a declining in birth rates and in mortality, also changes occurred in morbidity and mortality is represented by the increasing of the aging population and the raising of chronic diseases. These diseases are characterized by multiple etiologies, risk factors, long latency period, a prolonged evolution, non-infectious origin and it has association with functional impairment and disability. Thus, elderly with chronic non-communicable disease has priority because they belong to a vulnerable group to get affection of comorbidities in aging, with increased demand and spending on health services. This study is aimed to analyse the understanding of elderly people with chronic non comunicable disease in the medium complexity service as a contribution to the improvement of health care in the city of Natal / RN. This is a descriptive and exploratory study with a quantitative approach, carried out at the Specialized Center for Elderly Health Care and at the Pescadores Hospital. The population was composed of 4,180 persons with a sample of 124 elderly aged above 60 years, attended in these medium complexity services. The instrument, a structured form, adapted from a questionnaire for monitoring risk and protective factors for chronic disease of the Ministry of Health. To collect data was was used the interview form containing demographic data, habits, health status and health care services. The results were processed using the Statistical Package for Social Science, version 18.0, analyzed by simple statistics. It was found that most seniors were female, predominantly between 70 and 74 years old, married, with a brown skin tone and Catholic religion, more than half had incomplete basic education, family income between one to two minimum wages and living with their families. Regarding the interviewers lifestyle, 94.4%, of them ate chicken and 97.6%, fruits, it was observed a reduction in smoking, alcoholism habits and physical activity according to the increasing age, 58.1 and 18.5% had insomnia18,5 % used sleeping pills. The elderly (51.6%) reported using services in times of sickness, seeking primary care at first (30.6%), 52% did not receive referral and was looking for free demand (38.7%). The most reported morbidity was hypertension, followed by musculoskeletal disorders. Regarding the difficulties in seeking health services, the delay in treatment and the waiting line were the most cited by the elderly. Almost all of them reported no activities to promote health in these services and those who received individual counseling on chronic diseases. Almost always, the health professionals who care of them, were mostly doctors followed by nurses. Based on the results presented, it is considered that the health services of medium complexity must undergone a more continuous dialogue with other attention level and focus on actions of health promotion and prevention. It is also recommended the necessity for qualified professionals to delivery health care to elderly and the implementation of protocols by a multidisciplinary health team, intending to provide better and continous care for the elderly with chronic diseases. The healthcare professionals who served them, were mostly physicians, followed by nurses. Through the results presented, it is considered that the medium complexity healthcare services need to perform a more continuous dialogue with the other levels of attention focusing attention to the health promotion and prevention actions. It is also recommended the necessity for qualified professionals to delivery healthcare for the elderly, in addition, a protocol implementation for the multidisciplinary health care team, to provide better care, and also the care continuity to elderly with chronic diseases / O processo de transi??o demogr?fica e epidemiol?gica causado pela diminui??o dos ?ndices de natalidade e mortalidade e modifica??o do perfil de morbimortalidade ? representado pelo aumento da popula??o idosa e das doen?as cr?nicas n?o transmiss?veis. Estas doen?as caracterizam-se por etiologia m?ltipla, fatores de risco, per?odo longo de lat?ncia, curso prolongado, origem n?o infecciosa e associa??o com defici?ncias e incapacidades funcionais. Desse modo, a pessoa idosa com doen?a cr?nica n?o transmiss?vel encontra-se em prioridade por tratar-se de um grupo vulner?vel para essas comorbidades no envelhecimento, com aumento da procura e gastos nos servi?os de sa?de. O objetivo deste estudo ? analisar o perfil da pessoa idosa com Doen?a Cr?nica N?o Transmiss?vel atendida em servi?os de m?dia complexidade. Trata-se de um estudo descritivo e explorat?rio, com abordagem quantitativa, realizado no Centro Especializado de Aten??o ? Sa?de do Idoso e no Hospital dos Pescadores. A popula??o foi de 4180 pessoas e com uma amostra aleat?ria simples de 124 idosos com idade igual ou acima de 60 anos, atendidos nesses servi?os de m?dia complexidade. O instrumento, um formul?rio estruturado, adaptado do question?rio de monitoramento para fatores de risco e prote??o para doen?a cr?nica do Minist?rio da Sa?de. Na coleta de dados usou-se a entrevista acompanhada de formul?rio contendo dados sociodemogr?ficos, h?bitos e condi??o de sa?de e o atendimento nos servi?os de sa?de. Os resultados foram processados no programa Statistical Package for the Social Science, vers?o 18.0, analisados atrav?s da estat?stica simples. Identificou-se que a maioria dos idosos era do sexo feminino, com predom?nio entre 70 e 74 anos, casados, de cor parda e cat?licos; mais da metade tinha ensino fundamental incompleto; renda familiar entre 1 a 2 sal?rio m?nimo e residia com a fam?lia. Quanto aos h?bitos de vida, 94,4% consumiam frango e, 97,6% frutas; observou-se haver redu??o do tabagismo, do alcoolismo e da atividade f?sica; 58,1% possu?am ins?nia e 18,5% utilizavam rem?dios para dormir. A procura pelo servi?o de sa?de deu-se devido adoecimento (51,6%), buscando a aten??o prim?ria no primeiro momento (30,6%); 52% n?o receberam encaminhamento e a procura era por livre demanda (38.7%). A morbidade mais referida foi a hipertens?o, seguida das doen?as musculoesquel?ticas. Sobre as dificuldades na procura pelos servi?os de sa?de, a demora no atendimento e as filas foram citadas pelos idosos. Quase todos relataram n?o haver atividades de promo??o ? sa?de nesses servi?os e que recebiam orienta??o individual sobre as doen?as cr?nicas. Os profissionais de sa?de que os atendiam, em sua maioria eram m?dicos, seguidos dos enfermeiros. Mediante os resultados apresentados, considera-se que os servi?os de sa?de de m?dia complexidade precisam exercer de forma mais cont?nua a interlocu??o com os demais n?veis de aten??o e enfocar no atendimento as a??es de promo??o e preven??o ? sa?de. Recomenda-se tamb?m a necessidade de qualifica??o dos profissionais para o atendimento ? pessoa idosa e a implanta??o de protocolos pela equipe multiprofissional de sa?de, de modo a proporcionar melhor atendimento e continuidade do tratamento ? pessoa idosa com doen?as cr?nicas n?o transmiss?veis

Made available in DSpace on 2014-12-17T14:46:56Z (GMT). No. of bitstreams: 1 DeboraDSM.pdf: 318175 bytes, checksum: 69936c4287b18c346f645bf8926587de (MD5) Previous issue date: 2006-06-06 / This study analyzes the point of view of nurses working at a pediatric teaching hospital on their work process within the scope of the Brazilian unified healthcare system SUS, in order to identify factors that interfere with its development and find out how work relations are taking place between nurses, other nursing professionals and the multidisciplinary staff. It is a descriptive and analytical study, qualitative in nature, which starts with a consideration of a nurse s current practices and moves on to reflect on a perspective of transformation aiming at rethinking their work process pursuant to the principles of SUS. In order to attain these objectives, we decided on using the focal group as a data-collecting technique, which took place from November to December 2005, by using as instruments a questionnaire for the characterization of the persons being researched and a discussion outline. Theoretical support has approached transformations in the world of work, placing it in the context of healthcare and nursing and has tried, specifically, to understand the work process of a nurse engaged in the production of health services. Therefore, the discourse analysis of participants, in the light of theoretical support, has evinced an ambiguity inasmuch as though identified as such in their work process, nurses are also fulfilling multiple functions in health services. Through this study it has also been possible to identify several factors that interfere with the work of these professionals, including poor working conditions and excessive hiring of high school graduate interns as an attempt to make up for a meager nursing workforce, as well as reveal the possibilities brought about by the SUS in retargeting its professional practice to interdisciplinarity and integrality / Este estudo analisa a vis?o das enfermeiras de um hospital pedi?trico de ensino acerca do seu processo de trabalho no contexto do Sistema ?nico de Sa?de (SUS), com vistas a identificar os fatores que interferem na sua efetiva??o e a forma como v?m se estabelecendo as rela??es de trabalho entre estas, os demais profissionais da enfermagem e a equipe multidisciplinar. ? um estudo descritivo/anal?tico de natureza qualitativa, que parte da reflex?o da atual pr?tica das enfermeiras para a perspectiva de transforma??o, no sentido de repensar o seu processo de trabalho em conson?ncia com os princ?pios do SUS. Para atingir tais objetivos, optou-se pelo grupo focal, como t?cnica de coleta de dados, o qual se realizou entre novembro e dezembro de 2005, utilizando-se como instrumentos um question?rio de caracteriza??o dos pesquisados e o roteiro de discuss?o. O referencial te?rico abordou as transforma??es no mundo do trabalho, contextualizando o trabalho na sa?de e na enfermagem e, especificamente, buscou compreender o processo de trabalho do enfermeiro inserido na produ??o dos servi?os de sa?de. Assim, as falas das participantes, analisadas ? luz das refer?ncias te?ricas, evidenciaram ambig?idade no reconhecimento do enfermeiro acerca do seu processo de trabalho, que, apesar de identific?-lo, assume m?ltiplas fun??es nos servi?os de sa?de. Este estudo ainda permitiu a identifica??o de diversos fatores que v?m interferindo na pr?tica desses profissionais, dentre os quais, as deficientes condi??es de trabalho e a excessiva contrata??o de bolsistas de n?vel m?dio, como alternativa de recompor a insuficiente for?a de trabalho da enfermagem, al?m de revelar as possibilidades trazidas pelo SUS na reorienta??o do seu fazer profissional com vistas ? interdisciplinaridade e a integralidade

Made available in DSpace on 2014-12-17T14:46:56Z (GMT). No. of bitstreams: 1 AnaEOM.pdf: 604292 bytes, checksum: 3065fdef9063126e0fc42becc6d45626 (MD5) Previous issue date: 2006-10-05 / Exploratory descriptive study, prospective with quantitative approach, performed in the nefrology outpatient service from the Onofre Lopes University Hospital (HUOL), Natal/RN, aiming to identify aspects that concern Quality of Life (QOL) on transplanted and hemodialysis patients, as measured by WHOQOL-bref and describe the aspects that differentiate QL between the two groups as measured by the same instrument. The population was of 62 renal patients in hemodialysis and 58 transplantd, with data collected from february to march 2006. The instrument used was WHOQOL-bref, translated to and validated for Portuguese by the multicentric group of the World Health Organization (WHO) in Brazil. The results show predominance of the masculine gender both in the post-transplant group (55,17%), as well as in the hemodialysis group (51,61%); the age strip of 28 to 43 prevailed, among which were 53,45% transplanted and 48,99% hemodialysis patients; 79,93% of the hemodialysis patients and 62,07% of the transplanted were provenient from ouside the capital of the state; from the hemodialysis population, 59,68% were married, while among the transplanted 48,28% were single; 58,06% of the hemodialisys patients had 1 to 3 children, while the majority of the transplanted, 44,83%, had no children; regarding scholarity level on both groups, there was a predominance of incomplete fundamental school, representing 62,9% of the hemodialysis patients and 46,6% of the transplanted; regarding work status, 98,39% of those in hemodialysis informed not to be working, and the same applied to the transplanted, with 75,86%; regarding treatment time, most patients of both populations were in the 1- to 4-year interval, of which were 62,9% of the hemodialisys patients and 53,45% of the transplanted. The analysis of WHOQOL-bref reliability through Crobach s Alpha coefficient had a value of 0,8816, demonstrating good internal consistency for the instrument. Regarding description of QOL tests, the average scores of the post-transplant were (Q-1) 18,14 e (Q-2) 18,69, and 12,3 (Q-1) and 11,29 (Q-2) for the group in hemodialisys. Regarding the aspects that differentiate QOL on the two groups observed through average scores from the Domains: Physical, 15,91 for the post-transplant group and 12,71 for the hemodialisys group; Psychological, 16,75 for the post-transplant group and 14,84 for the hemodialisys group; Social Relations, 17,79 on the post-transplant group and 16,58 on the hemodialisys group; Environment, 14,16 on the post-transplant group and 12,38 on the hemodialisys group. On every evaluated item, the post-transplant group achieved higher scores when compared to the hemodialisys group. The diference in QOL for both populations was significant on all items evaluated with a p<0,005 / Estudo explorat?rio descritivo, prospectivo com abordagem quantitativa, realizado no ambulat?rio de nefrologia do Hospital Universit?rio Onofre Lopes (HUOL) Natal/RN, com vistas a identificar, entre pacientes transplantados e em hemodi?lise, aspectos que digam respeito a sua Qualidade de Vida (QV) medida pelo WHOQOL-bref e descrever os aspectos que diferenciam a QV entre os dois grupos, medida pelo mesmo instrumento. A popula??o foi de 62 pacientes renais em hemodi?lise e 58 transplantados, com dados coletados de fevereiro a mar?o de 2006. Utilizamos o instrumento WHOQOL-bref, traduzido e validado para o portugu?s pelo grupo multic?ntrico da Organiza??o Mundial de Sa?de (OMS) no Brasil. Os resultados mostram que houve predomin?ncia do sexo masculino tanto no grupo p?s-transplante (55,17%) quanto no grupo em hemodi?lise (51,61%); prevaleceu a faixa et?ria de 28 a 43 anos, sendo 53,45% de transplantados e 48,99% de indiv?duos em hemodi?lise; 79,03% dos pacientes em hemodi?lise e 62,07% dos transplantados eram procedentes do interior do Estado; na popula??o em hemodi?lise 59,68% eram casados, enquanto que entre os transplantados 48,28% eram solteiros; 58,06% dos pacientes em hemodi?lise possu?am de 01 a 03 filhos, enquanto a maioria dos transplantados, 44,83%, n?o possu?a filhos; quanto ao n?vel de escolaridade nos dois grupos, houve predomin?ncia do ensino fundamental incompleto, representando 62,9% dos pacientes em hemodi?lise e 46,6% dos transplantados; quanto ao status de trabalho, 98,39% daqueles em hemodi?lise informaram n?o estar trabalhando e o mesmo ocorreu com os transplantados, com 75,86%; quanto ao tempo de tratamento, a maioria dos pacientes das duas popula??es ficou no intervalo entre 01 a 04 anos, sendo 62,90% dos pacientes em hemodi?lise e 53,45% dos transplantados. A an?lise da confiabilidade do WHOQOL-bref pelo coeficiente Alfa de Cronbach teve valor de 0,8816, demonstrando uma boa consist?ncia interna do instrumento. Quanto ? descri??o dos dados de QV, os escores m?dios do grupo p?s-transplante foram (Q-1) 18,14 e (Q-2) 18,69, e 12,39 (Q-1) e 11,29 (Q-2) para o grupo em hemodi?lise. Quanto aos aspectos que diferenciam a QV dos dois grupos observadas por meio dos escores m?dios dos Dom?nios: F?sico, 15,91 para o grupo p?s-transplante e 12,71 para o grupo em hemodi?lise; Psicol?gico, 16,75 para o grupo p?s-transplante e 14,84 para o grupo em hemodi?lise; Rela??es Sociais, 17,79 no grupo p?s-transplante e 16,58 no grupo em hemodi?lise; Meio Ambiente, 14,16 no grupo p?s-transplante e 12,38 no grupo em hemodi?lise. Em todos os itens avaliados, o grupo p?s-transplante obteve escores maiores quando comparado ao grupo em hemodi?lise. A diferen?a na QV das duas popula??es estudadas foi significativa em todos os itens avaliados com um p< 0,005

Made available in DSpace on 2014-12-17T14:46:56Z (GMT). No. of bitstreams: 1 CeciliaMFQF_DISSERT.pdf: 2879854 bytes, checksum: 0d04910a9d93fa3ece3250ea9028e1c6 (MD5) Previous issue date: 2012-10-26 / The nurses in the hemodialysis has an important role in the nursing process implementation, in the context of a theoretical referential. Among the nursing theories, highlights the Roy?s adaptations model, who considers a person as an holistic adaptive system that aims to adapt customers to different living conditions. Thus, it is believed that the Roy?s nursing process will guide nursing care to patients on dialysis. Therefore, the study aimed to analyze the nursing diagnosis present in patients with chronic kidney disease on hemodialysis based on the theoretical model of Roy and NANDA-International. Descriptive and cros-sectional study, performed at a dialysis center in a city in northeastern Brazil. Sample of 178 patients and consecutive sampling by convenience. Data collection ocurred from October/2011 until February/2012, through interview and physical examination forms. Data analysis was initiated by clinical reasoning, diagnosis judgment and similarity relation. Then, the data were entered into SPSS program, 16.0 version, generating descriptive statistics. The project was approved by the Ethics Research Committee (protocol n? 115/11) with a Presentation Certificate for Ethics Appreciation (in 0139.0.051.000-111) and was funded by the Universal edict MCT / CNPq 14/2010. The results revealed that most patients were male (52.2%), married (62.9%) and residents in the Natal?s metropolitan region (54.5%). The mean age was 46.6 years and the years of study, 8,5. Regarding nursing diagnosis obtained an average of 6.6, especially: Risk of Infection (100%), excessive fluid volume (99.4%) and hypothermia (61.8%). On the other hand the adaptive problems average was 6.4, and the most common: intracellular fluid retention (99.4%); Hyperkalemia (64.6%); Hypothermia (61.8%) and edema (53.9%). Were established 20 similarity relations between the NANDA-International nursing diagnosis and adaptive problems of Roy, namely: risk of falls / injury risk and potential for injury, impaired physical mobility and walking mobility and / or restricted coordination, dressing self-care deficit and loss of self-care ability; hypothermia and hypothermia; impaired skin integrity and impaired skin integrity; excessive fluid volume and intracellular fluid retention / Hyperkalemia / Hypocalcemia / edema; imbalanced nutrition: less than body requirements and Nutrition less than the body's needs; constipation and constipation, acute pain and acute pain, chronic pain and chronic pain, sensorial perception disturbed: visual, tactile and auditory disabilities and a primary sense: sight, hearing and tactile; sleep deprivation and insomnia, fatigue and intolerance to activities; ineffective self health and fails in the role; sexual dysfunction and sexual dysfunction; situational low self-esteem and low self-esteem, and diarrhea and diarrhea. We conclude that there is similarity between the typologies and was required a model?s analysis, because they present different ways to establish the nursing diagnosis. Moreover, the nursing process use, under the context of a theory and a classification system, subsidizes the care and contributes to the strengthening of nursing science / O enfermeiro atuante no setor de hemodi?lise tem um importante papel na implementa??o do processo de enfermagem, sob a ?tica de uma teoria. Dentre as teorias da enfermagem, destaca-se o modelo de adapta??o de Roy, que considera a pessoa um sistema hol?stico adaptativo, tendo como meta a adapta??o dos clientes ?s diversas condi??es de vida. Destarte, acredita-se que o processo de enfermagem de Roy guiar? os cuidados de enfermagem aos pacientes em hemodi?lise. Assim, objetivou-se analisar os diagn?sticos de enfermagem presentes em pacientes com doen?a renal cr?nica em tratamento hemodial?tico, tendo como base o modelo te?rico de Roy e a NANDA Internacional. Estudo descritivo e transversal, realizado em um centro de di?lise de uma cidade do Nordeste do Brasil. Amostra foi de 178 pacientes, e a amostragem por conveni?ncia consecutiva. A coleta ocorreu durante outubro/2011 a fevereiro/2012, atrav?s de um formul?rio de entrevista e exame f?sico. A an?lise dos dados iniciou-se pelo racioc?nio cl?nico, o julgamento diagn?stico e a rela??o de semelhan?a. Em seguida, os dados foram inseridos no programa SPSS vers?o 16.0, gerando estat?sticas descritivas. O projeto foi aprovado pelo Comit? de ?tica em Pesquisa (Protocolo n? 115/11) com Certificado de Apresenta??o para Aprecia??o ?tica (no 0139.0.051.000-111) e teve financiamento do Edital Universal MCT/CNPq 14/2010. Os resultados revelaram que a maioria dos pacientes era do sexo masculino (52,2%), casada (62,9%) e residente na regi?o metropolitana de Natal (54,5%). A m?dia da idade foi 46,6 anos, e a dos anos de estudos, de 8,5 anos. Em rela??o aos diagn?sticos de enfermagem obteve-se uma m?dia de 6,6, com destaque para: Risco de Infec??o (100%); Volume de l?quidos excessivo (99,4%) e Hipotermia (61,8%). Por outro lado, a m?dia dos problemas adaptativos foi de 6,4, sendo os mais frequentes: Reten??o de l?quido intracelular (99,4%); Hipercalemia (64,6%); Hipotermia (61,8%) e Edema (53,9%). Foram estabelecidas 20 rela??es de semelhan?a entre os diagn?sticos da NANDA Internacional e os problemas adaptativos de Roy: risco de quedas/risco de les?o e potencial para les?o; mobilidade f?sica prejudicada e mobilidade andar e/ou coordena??o restritos; d?ficit no autocuidado para vestir-se e perda de habilidade ao autocuidado; hipotermia e hipotermia; integridade da pele prejudicada e integridade da pele prejudicada; volume de l?quidos excessivo e reten??o de l?quido intracelular/hipercalemia/hipocalcemia/edema; nutri??o desequilibrada: menos do que as necessidades corporais e nutri??o menor que as necessidades do organismo; constipa??o e constipa??o; dor aguda e dor aguda; dor cr?nica e dor cr?nica; percep??o sensorial perturbada: visual, auditiva e t?til e defici?ncia de um sentido prim?rio: vis?o, audi??o e t?til; ins?nia e priva??o do sono; fadiga e intoler?ncia ? atividade; autocontrole ineficaz da sa?de e falha no papel; disfun??o sexual e disfun??o sexual; baixa autoestima situacional e baixa autoestima; e diarreia e diarreia. Conclui-se que h? semelhan?a entre as tipologias e que foi necess?ria uma an?lise do modelo, j? que apresentam formas diferentes de estabelecer os diagn?sticos. Outrossim, o uso do processo de enfermagem, sob o contexto de uma teoria e de um sistema de classifica??o, subsidia a assist?ncia e contribui para o fortalecimento cient?fico da ?rea

Made available in DSpace on 2014-12-17T14:46:56Z (GMT). No. of bitstreams: 1 ElaineMC_DISSERT.pdf: 1704527 bytes, checksum: aa7c64c579a8ec9dbc45f747ccda176d (MD5) Previous issue date: 2011-12-09 / The problem facing the incidence of pressure ulcers (UP) in the hospital environment especially in the intensive care unit (ICU), although it is an old and frequent event in our professional practice, it is not notified in the researches as much as it should be. We observed a tendency to invest in therapeutical and in studies about the production of sophisticated new bandages. Few, however, are the investments in research on preventive measures in order to prevent or at least slow down the development of lesions. In this sense, the study aimed to analyze the correlation between nursing care and the risk of developing UP measured by the Braden scale in ICU patients. This is a descriptive study of longitudinal quantitative approach. The project obtained a favourable opinion from the Ethics Committee of HUOL (no 486/10). Data collection was carried out in the Hospital of Unimed in Natal during six months in 2011. The sample was of 32 patients hospitalized in ICU for over four days. The results were processed in SPSS 15.0 for descriptive statistics and inferential statistics. We identified that, only 9.4% of our sample developed UP, being predominantly male, elderly people aged above 60 years, Caucasian, with diagnostic hypothesis at the time of hospitalization of sepsis, were clinical patients, who presented hemodynamic instability, using orotracheal tube (TOT), enteral probe (SNE), vesical probe delay (SVD) and had values of albumin and hemoglobin levels below normal. In addition, these patients had a longer hospital stay, longer usage of TOT, SNE, SVD, increased use of sedation and drain than those who did not develop UP and were all at risk for developing these injuries second Braden scores. 66.7% of the lesions developed were located in the sacral region, limiting the degree I and all patients that developed were considered serious, 100.0% of them have evolved since the death. Small were the differences between the averages of Braden scores between patients with and without UP, 11,9+2,4 against 12,4+2,6 with p = 0.627. The clinical aspects of the patients in the study were instrumental in the development of UP, once, these findings were statistically significant through the Mann-Whitney test, and appropriateness of nursing conduct was decisive for the prevention of pressure ulcers in critical patients, since many were those classified as at risk (28) and few who have developed lesions (03) / A problem?tica frente ? incid?ncia de ?lcera de press?o (UP) no ambiente hospitalar, especialmente na Unidade de Terapia Intensiva (UTI), embora seja evento antigo e frequente, se observado em nossa pr?tica profissional, ? fato pouco notificado e com escassos estudos. Observamos uma tend?ncia em investir em condutas terap?uticas e em estudos para produ??o de novas coberturas sofisticadas. Poucos, por?m, s?o os investimentos em pesquisas sobre medidas preventivas com intuito de evitar ou pelo menos retardar o desenvolvimento das les?es. Nesse sentido, o estudo teve como objetivo analisar a correla??o entre a assist?ncia de enfermagem e o risco de desenvolvimento de UP medido pela escala de Braden em pacientes de UTI. Trata-se de um estudo descritivo longitudinal de abordagem quantitativa. O projeto obteve parecer favor?vel do Comit? de ?tica do HUOL (n.486/10). A coleta de dados realizou-se no Hospital da Unimed Natal, num per?odo de seis meses, em 2011. A amostra foi de 32 pacientes internados na UTI por mais de quatro dias. Os resultados foram processados no programa SPSS 15.0 por estat?stica descritiva e inferencial. Identificamos queapenas 9,4% de nossa amostra desenvolveram UP, sendo predominantemente do sexo masculino, idosos com faixa et?ria acima de 60 anos, de ra?a branca, com hip?tese diagn?stica no momento da interna??o de sepse; eram pacientes cl?nicos, que apresentaram instabilidade hemodin?mica, utilizando tubo orotraqueal (TOT), sonda enteral (SNE), sonda vesical de demora (SVD) e tinham valores de albumina e hemoglobina abaixo do normal. Al?m disso, estes pacientes apresentaram um maior tempo de internamento, maior tempo de uso de TOT, de SNE, de SVD, maior tempo de uso de seda??o e de dreno do que aqueles que n?o desenvolveram UP, e eram todos de risco para o desenvolvimento destas les?es segundo escores de Braden. Das les?es desenvolvidas, 66,7% localizavam-se na regi?o sacral, limitando-se a grau I, e todos os pacientes que as desenvolveram eram considerados graves, visto que 100,0% deles evolu?ram a ?bito. Pequenas foram as diferen?as entre as m?dias dos escores de Braden entre os pacientes com UP e os sem UP, 11,9+2,4 contra 12,4+2,6 com p=0,627. Os aspectos cl?nicos dos pacientes do estudo foram determinantes para o desenvolvimento de UP, uma vez que esses achados foram significantes estatisticamente atrav?s do teste de Mann-Whitney, e a adequa??o das condutas de enfermagem foi decisiva para a preven??o das ?lceras por press?o em pacientes cr?ticos, uma vez que muitos eram aqueles classificados como de risco (28) e poucos os que desenvolveram les?es (3)

Made available in DSpace on 2014-12-17T14:46:57Z (GMT). No. of bitstreams: 1 RenataLP_DISSERT.pdf: 1109732 bytes, checksum: 950a12324466be8c294a3a55fb2995eb (MD5) Previous issue date: 2012-12-07 / This study is aimed to understand the nurse student s perception on death approach during the undergraduate course, to reveal feelings and meanings generated from studying this topic. The research was undertaken when the project has been approved by the ethics committee of UFRN in accordance to the Opinion Number n? 234/2012. Through a qualitative approach using a phenomenological design, grounding on the ideas of the German philosopher Martin Heidegger. It was interviewed ten students who answered the following questions: When during your undergraduate course the topic death and dying is approached? What kind of feelings that theme awakens? What is the significance of studying this subject in nursing education? The speeches analysis shows that the issue of death and dying is addressed in a very timely manner in different disciplines, there is no dialogue between them. Students reveal the fear and anxiety as feelings present when studying the topic; recognize as an important moment of reflection to understand that death is not a health care failure, but an opportunity to understand it as a natural phenomenon. In this perspective, we can conclude that the student need to be conducted in the undergraduate process, not being separated from itself to your world-with-others, but linking their concepts, understanding their feelings as human being then, respect and care for individuals as a being-toward-death. Therefore, the big challenge facing nursing education is to create an environment where death can be discussed about, between teachers and students, mainly in the disciplines that address the issue / O presente estudo tem como objetivo compreender a percep??o de estudantes de enfermagem acerca do estudo da morte no processo de forma??o acad?mica, desvelando sentimentos e significados gerados ao estudar essa tem?tica. Para sua realiza??o, o projeto foi aprovado pelo comit? de ?tica da UFRN, conforme Parecer n? 234/2012. Utiliza uma abordagem qualitativa, com enfoque fenomenol?gico, apoiando-se nas ideias do fil?sofo alem?o Martin Heidegger. Foram entrevistados dez estudantes que responderam ?s seguintes quest?es norteadoras: em que momento de sua forma??o a tem?tica morte e morrer ? estudada? A que sentimentos esse tema remete? Qual o significado de estudar esse tema na forma??o do enfermeiro? A an?lise das falas mostra que a tem?tica morte e morrer ? abordada de maneira muito pontual em disciplinas diferentes, inexistindo um di?logo entre elas. Revelam o medo e ang?stia como sentimentos presentes ao estudar o tema; reconhecem o estudo desta tem?tica como um momento importante de reflex?o para compreender que a morte n?o ? um fracasso da a??o de cuidar, sendo uma oportunidade para entend?-la como fen?meno natural. Nessa perspectiva, podemos concluir que o discente precisa ser conduzido em seu processo de forma??o n?o o separando do seu existir no mundo-com-os-outros, mas interligando seus conceitos, entendendo seus sentimentos enquanto ser, e, dessa forma, respeitar e cuidar do homem como um ser-para-a-morte. Portanto, o grande desafio para a educa??o em enfermagem ? criar espa?os de discuss?o acerca da morte, entre professores e estudantes, particularmente, nas disciplinas que abordam o tema

Made available in DSpace on 2014-12-17T14:46:57Z (GMT). No. of bitstreams: 1 SamaraKDB_DISSERT.pdf: 1388036 bytes, checksum: d582f2055c29a12c4b64a24bc155b77f (MD5) Previous issue date: 2013-02-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The nurses assistance in monitoring the growth and development of children has been characterized mostly a service based on the biological dimension of illness, when in reality, the actions should be combined in the reorientation of care model of the Family Health Strategy. Thus, the research aimed to examine the role of nurses in the growth and development of children. This is an exploratory and descriptive, qualitative approach. The project was approved by the Ethics Committee of the Universidade Federal do Rio Grande do Norte under Opinion No. 191/2012. Data collection was developed in the Health Units from the city of Natal, RN, Brazil. Survey participants were nurses who worked in the Family Health Strategy for at least two years and who performed the monitoring of child growth and development in the health unit selected. Data were collected through an in-depth interview, and seized material from speeches was treated as categorical thematic analysis proposed by Bardin. This process revealed three themes, which were analyzed in the light of Relief Models and Process Work in Health and Nursing and discussed based on the findings literary. The results elucidated that nurses consider their performance satisfactory as it has favored the accession of mothers of children under one year nursing visits, contributing to the reduction of morbidity and mortality due to prevalent diseases, as well as the establishment of a connection between the professionals and mothers. It was shown that despite having a promotion and prevention with the use of lightweight technologies, the nurses also emphasized the care of mothers in complaints and signs and symptoms of children, followed by referrals to professionals in the unit or to other sectors. Furthermore, we found that the process of working nurses face challenges regarding the organizational structure of services and social situation of the family. Given these statements, it is observed that despite the strong interference from hegemonic health model in the performance of nurses, it is found that these professionals have been investing in promotion and prevention to injuries to children in care, with a focus on family context. Thus, nurses are embarking on making the reorientation of health care through the use of relational technologies, which has contributed to solving the integral care to the pediatric population / A assist?ncia do enfermeiro no acompanhamento do crescimento e desenvolvimento da crian?a tem se caracterizado, em sua maioria, num atendimento baseado na dimens?o biol?gica do adoecer, quando na realidade, as a??es deveriam estar conjugadas na reorienta??o de modelo assistencial da Estrat?gia Sa?de da Fam?lia. Deste modo, a pesquisa teve como objetivo analisar a atua??o do enfermeiro no acompanhamento do crescimento e desenvolvimento da crian?a. Trata-se de um estudo explorat?rio e descritivo, em uma abordagem qualitativa. O projeto foi aprovado pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte sob parecer de n? 191/2012. A coleta de dados desenvolveu-se nas Unidades de Sa?de da Fam?lia do munic?pio de Natal-RN, Brasil. Os participantes da pesquisa foram ?s enfermeiras que atuavam na Estrat?gia Sa?de da Fam?lia por no m?nimo dois anos, e que realizavam o acompanhamento do crescimento e desenvolvimento da crian?a na unidade de sa?de selecionada. Os dados foram obtidos mediante uma entrevista em profundidade, e o material apreendido dos discursos foi tratado conforme a an?lise categorial tem?tica proposta por Bardin. Deste processo emergiram tr?s categorias tem?ticas, as quais foram analisadas ? luz dos Modelos Assistenciais e do Processo de Trabalho em Sa?de e de Enfermagem e discutidos com base nos achados liter?rios. Os resultados elucidaram que as enfermeiras consideram a sua atua??o satisfat?ria, pois tem favorecido na ades?o das m?es dos menores de um ano ?s consultas de enfermagem, na contribui??o para a redu??o da morbidade e mortalidade infantil por doen?as prevalentes, bem como no estabelecimento de v?nculo entre as profissionais e genitoras. Foi evidenciado, que apesar de realizarem a??es de promo??o e preven??o com a utiliza??o de tecnologias leves, as enfermeiras ainda enfatizam o cuidado nas queixas das m?es e sinais e sintomas das crian?as, seguido dos encaminhamentos aos profissionais da unidade ou a outros setores. Al?m disso, constatou que o processo de trabalho das enfermeiras enfrenta desafios quanto ? estrutura organizacional dos servi?os e da conjuntura social da fam?lia. Diante destas coloca??es, observa-se que apesar da forte interfer?ncia do modelo de sa?de hegem?nico na atua??o das enfermeiras, ? verificado que estas profissionais v?m investindo em a??es de promo??o e preven??o aos agravos no cuidado ?s crian?as, com o foco no contexto familiar. Assim, as enfermeiras est?o enveredando o fazer na reorienta??o do modelo assistencial de sa?de, mediante a utiliza??o das tecnologias relacionais, o que tem contribu?do para a resolutividade do cuidado integral a popula??o infantil

Made available in DSpace on 2014-12-17T14:46:57Z (GMT). No. of bitstreams: 1 RayssaHL_DISSERT.pdf: 1169638 bytes, checksum: aa667397d6455486347551ed4bb0f0d3 (MD5) Previous issue date: 2013-03-26 / Tuberculosis is a serious disease with high incidence and prevalence, and in many countries a priority public health problem, with persisting high epidemiological significance. Seeing the person with tuberculosis it is important to observe his/her self care, as well as the difficulties intertwined in this process, since it can be directly impacting the health/disease process. The aim of this study was to analyze the self care of people with tuberculosis. Descriptive study with qualitative approach, conducted in West Sanitary District of the city of Natal, RN. Data collection occurred through a semi-structured interview guided by questions concerning sociodemographic and about the disease, treatment, and self care, between the months of July to September 2012 and met the ethical precepts of research with human beings. To analyze the results we used the technique of thematic content analysis of Laurence Bardin, through the prism of the theoretical-philosophical self care discussed by Michel Foucault. From the analysis emerged two categories, the first being, Meaning of tuberculosis, with subcategories: tuberculosis as sadness and unhappiness and tuberculosis as a normal issue, and the second, Beware yourself to tuberculosis, which had subcategories: self care as attention to the health care of oneself as satisfaction of basic needs and difficulties to self care. Tuberculosis represents for some people, something really sad, causing psychological suffering, however the other presents as normal. Self care of persons with tuberculosis in this study are related in great part to seek health care and the satisfaction of basic needs. About the difficulties related to the practice of self-care, it is observed that these are tied to food, time for rest, slowness of health services for scheduling appointments and tests, as well as related habits and dependencies in the lives of these people. This study contributed to a reflection of the users with tuberculosis and self care, revealing aspects that healthcare professionals should pay attention to watch these people, being able to see everyday on the run, the need for a space and time for oneself / A tuberculose ? uma doen?a grave, com incid?ncia e preval?ncia elevadas, sendo em muitos pa?ses um problema de sa?de p?blica priorit?rio, persistindo com alta import?ncia epidemiol?gica. Ao vislumbrar a pessoa com tuberculose ? importante observar o seu cuidado de si, bem como as dificuldades imbricadas neste processo, visto que o mesmo pode estar repercutindo diretamente no processo sa?de/doen?a. O objetivo deste estudo foi analisar o cuidado de si da pessoa com tuberculose. Estudo do tipo descritivo e abordagem qualitativa, realizado no Distrito Sanit?rio Oeste do munic?pio de Natal/RN. A coleta dos dados ocorreu por meio de uma entrevista semiestruturada orientada por quest?es relativas aos aspectos sociodemogr?ficos e sobre a doen?a, tratamento e o cuidado de si, entre os meses de julho e setembro de 2012, e atendeu aos preceitos ?ticos de pesquisa com seres humanos. Para a an?lise dos resultados utilizou-se a t?cnica de an?lise de conte?do tem?tica de Laurence Bardin, sob o prisma do referencial te?rico-filos?fico do cuidado de si discutido por Michel Foucault. A partir da an?lise emergiram duas categorias, sendo a primeira, Significado da tuberculose, com as subcategorias: tuberculose como tristeza e infelicidade e tuberculose como algo normal; e a segunda, Cuidado de si com tuberculose, a qual teve as subcategorias: cuidado de si como aten??o para com a sa?de, cuidado de si como satisfa??o de necessidades b?sicas e dificuldades para o cuidado de si. A tuberculose representa, para alguns, algo deveras triste, causando sofrimentos psicol?gicos; entretanto a outros apresenta-se como normalidade. O cuidado de si das pessoas com tuberculose, nesse estudo, ? relativo, em grande parte, ? busca de cuidados com a sa?de e ? satisfa??o de necessidades b?sicas. Sobre as dificuldades relacionadas ? pr?tica do cuidado de si, observa-se que estas est?o atreladas ? alimenta??o, tempo para o descanso, morosidade dos servi?os de sa?de para agendamento de consultas e exames, bem como ligadas aos h?bitos e depend?ncias na vida destas pessoas. Este estudo contribuiu para uma reflex?o dos usu?rios com tuberculose sobre o cuidado de si, revelando aspectos que os profissionais de sa?de devem atentar ao assistir a estas pessoas, sendo poss?vel visualizar, na pressa cotidiana, a necessidade de um espa?o e tempo para si mesmo