Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-12T18:10:16Z No. of bitstreams: 1 RaiannyAlvesCostaMedeiros_DISSERT.pdf: 1661680 bytes, checksum: 6e7db62be4ce7dc09607a85dd29d2f5d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-15T20:38:22Z (GMT) No. of bitstreams: 1 RaiannyAlvesCostaMedeiros_DISSERT.pdf: 1661680 bytes, checksum: 6e7db62be4ce7dc09607a85dd29d2f5d (MD5) / Made available in DSpace on 2018-03-15T20:38:22Z (GMT). No. of bitstreams: 1 RaiannyAlvesCostaMedeiros_DISSERT.pdf: 1661680 bytes, checksum: 6e7db62be4ce7dc09607a85dd29d2f5d (MD5) Previous issue date: 2017-12-14 / Objetivou-se avaliar o DE Risco de Olho Seco e o Ressecamento Ocular em pacientes adultos em per?odo p?s-operat?rio imediato. Trata de estudo transversal, realizado no Centro Cir?rgico e na Unidade de Recupera??o P?s-Anest?sica (URPA) em um Hospital do nordeste do Brasil no per?odo de maio a agosto de 2017. A popula??o constituiu-se de pacientes adultos submetidos a procedimento cir?rgicos, amostra de 157 pacientes. O instrumento de coleta de dados constituiu-se de dados epidemiol?gicos e cl?nicos, fatores de risco da NANDA-I e os resultado de enfermagem Gravidade do Olho Seco da Nursing Outcomes Classification (NOC). Dois enfermeiros diagnosticadores fizeram a infer?ncia dos desfechos. Na an?lise descritiva utilizaram-se frequ?ncias, medidas do centro da distribui??o e respectivas variabilidades. Para as vari?veis associativas utilizou o Qui-quadrado de Pearson e em frequ?ncias menores que cinco, o teste de Fisher. A magnitude da associa??o pela Raz?o de Preval?ncia. Obteve-se parecer favor?vel do Comit? de ?tica em Pesquisa n? 2.004.545 e CAAE n? 64881717.5.0000.5537. Dos 157 pacientes do estudo 52,23% eram do sexo masculino, idade m?dia 48,90 (?15,98) anos, com companheiro (60,51%), nascido no interior do Rio Grande do Norte (RN) (56,05%), residem na capital do RN (49,8%), com tempo m?dio de estudo de 9,11 (?3,94) anos, trabalham com remunera??o (54,78%) e recebiam em m?dia 1,63 (?1,21) sal?rios m?nimos. A preval?ncia do DE Risco de Olho Seco foi de 14,65% e o Ressecamento Ocular de 85,35% nos pacientes em p?s-operat?rio imediato. Foi significantemente estat?stico a especialidade cir?rgica (p<0,017), a hipertens?o arterial (p<0,009) e diabetes (p<0,004) para o Ressecamento Ocular no Olho Esquerdo (OE) e a hipertens?o arterial (p<0,016) para o DE Risco de Olho Seco. Apresentou signific?ncia estat?stica a utiliza??o do anest?sico geral (p<0,004), o anest?sico raquidiano (p<0,046) e o inibidor/protetor de secre??o g?strica no Olho Direito (OD) para o Ressecamento Ocular e o anest?sico geral (p<0,017) para o DE Risco de Olho Seco. Quanto aos fatores de risco foram significante o hist?rico de alergia (p<0,048) para o DE Risco de Olho Seco e envelhecimento (p<0,046) e regime de tratamento (p<0,027) para o Ressecamento ocular. Em rela??o as caracter?sticas cl?nicas observou signific?ncia a hiperemia (p<0,010) e lacrimejamento excessivo (p<0,041) para o DE Risco de Olho Seco e hiperemia OD (p<0,032), hiperemia OE (p<0,002) e lacrimejamento excessivo OD (p<0,020) para o Ressecamento Ocular. Tamb?m foi significante o resultado do teste de Schirmer insuficiente (p<0,001) tanto para o DE Risco de Olho Seco quanto para o Ressecamento Ocular em ambos os olhos. Ao tratar da Gravidade do Olho Seco observou-se resultado significantemente estat?stico para o Ressecamento Ocular os indicadores diminui??o da produ??o lacrimal (P<0,001) e vermelhid?o da conjuntiva (p<0,028) para o OD e diminui??o de produ??o lacrimal (p<0,001) e vermelhid?o da conjuntiva (p<0,001) para o OE. O presente estudo foi relevante para incentivar iniciativas de preven??o do Ressecamento Ocular em pacientes em p?s-operat?rio imediato. / The objective of this study was to evaluate the risk of dry eye and eye dryness in adult patients in the immediate postoperative period. This is a cross-sectional study carried out at the Surgical Center and Post-Anesthetic Recovery Unit (URPA) at a Hospital in the northeast of Brazil from May to August 2017. The population consisted of adult patients submitted to surgical procedures, of 157 patients. The data collection instrument consisted of epidemiological and clinical data, NANDA-I risk factors and Nursing Outcomes Classification (NOC) Nursing Outcome results. Two diagnostic nurses made the inference of the outcomes. In the descriptive analysis we used frequencies, measures of the distribution center and respective variabilities. For the associative variables, Pearson's Chi-square was used and in frequencies smaller than five, Fisher's test. The magnitude of the association by the Prevalence Ratio. A favorable opinion was obtained from the Ethics Committee in Research n? 2,004,545 and CAAE n? 64881717.5.0000.5537. Of the 157 patients in the study, 52.23% were male, mean age 48.90 (? 15.98) years, with partner (60.51%), born in the interior of Rio Grande do Norte (Brazil) (49.8%), with a mean study time of 9.11 (? 3.94) years, paid (54.78%) and received an average of 1.63 ( ? 1.21) minimum wages. The prevalence of dry eye risk was 14.65% and ocular dryness of 85.35% in patients in the immediate postoperative period. Statistically significant was the surgical specialty (p<0.017), arterial hypertension (p<0.009) and diabetes (p<0.004) for left eye ocular resection (OE) and arterial hypertension (p<0.016) of Dry Eye. Statistical significance was found for the use of general anesthetics (p<0.004), spinal anesthetic (p<0.046) and the Right Eye (OD) inhibitor / protector for Ocular Dryness and general anesthetic (p<0.017) for the dry eye risk. Regarding the risk factors, the history of allergy (p<0.048) for dry eye risk and aging (p<0.046), treatment regimen (p<0.027) for ocular resection were significant. In relation to clinical characteristics, hyperemia (p<0.010) and excessive tearing (p<0.041) were observed for OD and OD hyperemia (p<0.032), OE hyperemia (p <0.002) and excessive tearing OD (p<0.020) for Ocular Dryness. The results of the insufficient Schirmer test (p<0.001) were also significant for both dry eye risk and ocular dryness in both eyes. In the treatment of dry eye severity, a statistically significant result for ocular dryness was observed for the indicators of decreased lacrimal production (P<0.001) and conjunctival redness (p<0.028) for DO and decreased lacrimal production (p<0.001) and conjunctival redness (p<0.001) for OE. The present study was relevant to encourage initiatives to prevent eye dryness in patients in the immediate postoperative period.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-15T13:28:13Z No. of bitstreams: 1 GleisseAguiarSilvaDeAlmeida_DISSERT.pdf: 634902 bytes, checksum: 77d1248d29a094cdfd5f9bdd3ccdbb9c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-20T19:35:38Z (GMT) No. of bitstreams: 1 GleisseAguiarSilvaDeAlmeida_DISSERT.pdf: 634902 bytes, checksum: 77d1248d29a094cdfd5f9bdd3ccdbb9c (MD5) / Made available in DSpace on 2018-02-20T19:35:38Z (GMT). No. of bitstreams: 1 GleisseAguiarSilvaDeAlmeida_DISSERT.pdf: 634902 bytes, checksum: 77d1248d29a094cdfd5f9bdd3ccdbb9c (MD5) Previous issue date: 2017-12-07 / INTRODU??O: Ensinar habilidades em t?cnica cir?rgica ? uma das tarefas mais importantes na ?rea de ensino em tocoginecologia e requer a presen?a de um tutor capacitado e de um m?todo avaliativo dispon?vel, de f?cil aprendizagem e que seja capaz de abranger as diversas etapas do ensino. OBJETIVO: Analisar e aplicar o Operative Performance Rating System (OPRS) como instrumento de avalia??o em cen?rios reais de pr?tica cir?rgica ginecol?gica a fim de avaliar alunos da gradua??o em medicina e residentes, como complementa??o dos m?todos avaliativos j? existentes. METODOLOGIA: Estudo transversal, descritivo, quantitativo que avaliou o desempenho de estudantes e residentes de ginecologia obstetr?cia, durante a execu??o de cirurgias ginecol?gicas em hospital universit?rio. Os alunos foram avaliados de acordo com os escores obtidos nos itens do OPRS (escala de Likert de 5- anatomia; instrumental cir?rgico; fluxo da cirurgia, intera??o com a equipe e desempenho global). O escore do instrumento varia de 4 a 20 pontos. O software Statistical Package for the Social Sciences, vers?o 21, foi utilizado para an?lise dos dados, aplicando An?lise de Vari?ncia, teste de Tukey e teste t de student. RESULTADOS: Foram realizadas 218 avalia??es, sendo composta por 24 residentes e 123 graduandos de medicina. Comparando as m?dias das vari?veis dos itens do OPRS, observou-se uma diferen?a entre as m?dias nos itens da avalia??o com o per?odo de gradua??o e resid?ncia (p < 0,001). Entre os graduandos, evidenciou-se diferen?a nas m?dias dos itens da avalia??o (p < 0,05), exceto para o item intera??o (p < 0,108). Para os residentes, a an?lise apresentou diferen?a nas m?dias dos itens da avalia??o relacionadas ao tempo de resid?ncia m?dica (p<0,001). CONCLUS?O: O uso do OPRS no processo de avalia??o de residentes e graduandos possibilita uma diferencia??o entre os n?veis de conhecimento, permitindo a monitoriza??o do progresso de acordo com o tempo de estudo oferendo ainda um feedback imediato sobre o desempenho na pr?tica cir?rgica. / INTRODUCTION: Teaching skills in surgical technique is one of the most important tasks in the area of teaching gynecology, and requires the presence of a trained tutor and an available evaluative method, easy to learn and capable of covering the various stages of teaching. OBJECTIVE: To analyze and apply the Operative Performance Rating System (OPRS) as a tool of evaluation in real scenarios of surgical practice, to evaluate undergraduate students and residents, as a complement to the existing evaluation methods. METHODS: Cross-sectional, descriptive, quantitative study that assessed the performance of students and residents during the execution of gynecological surgeries in a university hospital. The students were evaluated according to the scores obtained in the OPRS items (Likert scale of 5- anatomy, surgical instruments, surgery flow, interaction with the team and overall performance). The instrument score ranges from 4 to 20 points. The software Statistical Package for the Social Sciences, version 21, was used to analyze the data, applying Analysis of Variance, Tukey test and student t-test. RESULTS: Comparing the means of the variables of the OPRS items, a difference was observed between the methods in the evaluation items according to to the graduation and residence period (p <0.001). Among the undergraduates, there was a difference in the means of the evaluation items (p <0.05), except for the item interaction (p <0.108). For the residents, the analysis showed a difference in the means of the evaluation items related to the medical residence time (p <0.001). CONCLUSION: The use of OPRS in the evaluation process of residents and undergraduates allows a differentiation between levels of knowledge, allowing the monitoring of progress according to the study time and offering immediate feedback on the performance in the surgical practice.