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

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-15T11:46:47Z No. of bitstreams: 1 AmandaBarbosaDaSilva_DISSERT.pdf: 2101947 bytes, checksum: 78c8744b1b5012818a8ed33b550e36cb (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-16T14:34:38Z (GMT) No. of bitstreams: 1 AmandaBarbosaDaSilva_DISSERT.pdf: 2101947 bytes, checksum: 78c8744b1b5012818a8ed33b550e36cb (MD5) / Made available in DSpace on 2018-02-16T14:34:38Z (GMT). No. of bitstreams: 1 AmandaBarbosaDaSilva_DISSERT.pdf: 2101947 bytes, checksum: 78c8744b1b5012818a8ed33b550e36cb (MD5) 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.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-15T11:46:47Z No. of bitstreams: 1 CintiaGalvaoQueiroz_DISSERT.pdf: 29677920 bytes, checksum: 8f177ae4fba2cbace33ad94b46139f8e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-16T14:47:00Z (GMT) No. of bitstreams: 1 CintiaGalvaoQueiroz_DISSERT.pdf: 29677920 bytes, checksum: 8f177ae4fba2cbace33ad94b46139f8e (MD5) / Made available in DSpace on 2018-02-16T14:47:00Z (GMT). No. of bitstreams: 1 CintiaGalvaoQueiroz_DISSERT.pdf: 29677920 bytes, checksum: 8f177ae4fba2cbace33ad94b46139f8e (MD5) 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.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-15T11:46:48Z No. of bitstreams: 1 IsadoraLorennaAlvesNogueira_DISSERT.pdf: 18928182 bytes, checksum: c08f30bcc26ce20b954f6132dbfabc74 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-16T15:02:33Z (GMT) No. of bitstreams: 1 IsadoraLorennaAlvesNogueira_DISSERT.pdf: 18928182 bytes, checksum: c08f30bcc26ce20b954f6132dbfabc74 (MD5) / Made available in DSpace on 2018-02-16T15:02:33Z (GMT). No. of bitstreams: 1 IsadoraLorennaAlvesNogueira_DISSERT.pdf: 18928182 bytes, checksum: c08f30bcc26ce20b954f6132dbfabc74 (MD5) 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.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-15T11:46:48Z No. of bitstreams: 1 KadyjinaDaianeBatistaLucio_DISSERT.pdf: 3355186 bytes, checksum: b009255aa6f89969fd6a17f2a45217f4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-16T15:10:23Z (GMT) No. of bitstreams: 1 KadyjinaDaianeBatistaLucio_DISSERT.pdf: 3355186 bytes, checksum: b009255aa6f89969fd6a17f2a45217f4 (MD5) / Made available in DSpace on 2018-02-16T15:10:23Z (GMT). No. of bitstreams: 1 KadyjinaDaianeBatistaLucio_DISSERT.pdf: 3355186 bytes, checksum: b009255aa6f89969fd6a17f2a45217f4 (MD5) 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.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-12T18:10:16Z No. of bitstreams: 1 JullianaFernandesDeSena_DISSERT.pdf: 3915986 bytes, checksum: 01fd76fc1bbdde0d71bc51f87bd1126b (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-15T20:30:14Z (GMT) No. of bitstreams: 1 JullianaFernandesDeSena_DISSERT.pdf: 3915986 bytes, checksum: 01fd76fc1bbdde0d71bc51f87bd1126b (MD5) / Made available in DSpace on 2018-03-15T20:30:14Z (GMT). No. of bitstreams: 1 JullianaFernandesDeSena_DISSERT.pdf: 3915986 bytes, checksum: 01fd76fc1bbdde0d71bc51f87bd1126b (MD5) Previous issue date: 2017-12-19 / Viver com a condi??o de ter uma estomia ocasiona diversas altera??es na vida das pessoas e de seus familiares. Nesta situa??o surgem dificuldades em que muitas vezes nem o paciente e a fam?lia est?o preparados para agir diante do problema. Tudo isso gera a necessidade de aquisi??o de novas habilidades para o autocuidado. Reconhecendo a import?ncia do material educativo com enfoque na promo??o do cuidado desses pacientes, o presente estudo objetivou construir uma cartilha educativa e analisar as evid?ncias de valida??o para o cuidado de pessoas com estomia intestinal. Trata-se de uma pesquisa metodol?gica do tipo de desenvolvimento. Para facilitar a compreens?o do m?todo, optou-se por dividi-lo em duas etapas: a primeira consistiu de uma revis?o de literatura, um estudo qualitativo com 30 pessoas com estomia intestinal do Centro Especializado em Reabilita??o e Habilita??o do Rio Grande do Norte ? CERHRN e constru??o da cartilha educativa, e a segunda consistiu da valida??o de conte?do, apar?ncia e adequabilidade do material por nove ju?zes especialistas, bem como valida??o quanto ? sua organiza??o, estilo da escrita, apar?ncia e motiva??o da cartilha com 25 pessoas da popula??o-alvo. O estudo foi realizado no CERHRN com autoriza??o da diretoria e ap?s aprova??o do Comit? de ?tica em Pesquisa/UFRN sob n? CAAE 65942517.9.0000.5537. Foi utilizado o ?ndice de Validade de Conte?do (IVC) para medir a concord?ncia dos ju?zes quanto ? representatividade dos itens em rela??o ao conte?do em estudo. O instrumento de avalia??o dos especialistas continha itens de avalia??o da escala Likert com quatro itens. O ?ndice foi calculado por meio do somat?rio de concord?ncia dos itens marcados como ?3? (adequado) e ?4? (totalmente adequado) pelos especialistas, dividido pelo total de respostas. Quanto aos objetivos da cartilha, todos os ju?zes validaram os itens, classificando-os como ?adequado? ou ?totalmente adequado?, o que conferiu um IVC de 1,00 para os objetivos propostos. Com rela??o ? estrutura e apresenta??o da cartilha, ela foi considerada validada, atingindo IVC total de 0,84. No quesito relev?ncia, o IVC total foi de 0,97 e o IVC geral da cartilha educativa foi de 0,89, confirmando a valida??o junto aos especialistas da ?rea. Ap?s as sugest?es feitas pelos ju?zes, foi realizada a adequa??o do material educativo, incorporando as sugest?es, a fim de atender ?s necessidades e expectativas a que se prop?e. N?o houve nenhuma resposta negativa nos itens avaliados pelo p?blico-alvo. Todos os itens da organiza??o, estilo da escrita, apar?ncia e motiva??o do material foram considerados validados, pois atingiram ?ndice de concord?ncia total de 99%. Acredita-se que a constru??o e valida??o da cartilha educativa para o cuidado de pessoas com estomia intestinal possam contribuir positivamente para a ades?o ?s pr?ticas de autocuidado dessas pessoas e tamb?m para os familiares e cuidadores que desempenham ou auxiliam nesse cuidado di?rio. Posteriormente, o material educativo foi encaminhado ? revis?o de portugu?s e ? gr?fica para impress?o. A tecnologia educativa ser? disponibilizada nos locais de atendimento ao estomizado, por?m, somente ser? fornecida ao paciente que demonstrar interesse. / Living with the condition of having an oedematum causes several changes in the lives of people and their families. In this situation, difficulties arise in which often the patient and the family are not prepared to act in the face of the problem. All this generates the need to acquire new skills for self-care. Recognizing the importance of educational material with a focus on promoting the care of these patients, the present study aimed to construct an educational booklet and analyze the evidence of validation for the care of people with intestinal stomies. It is a methodological research of the type of development. To facilitate the understanding of the method, it was chosen to divide it into two stages: the first consisted of a literature review, a qualitative study with 30 people with intestinal stomies of the Specialized Center for Rehabilitation and Qualification of Rio Grande do Norte - CERHRN and the construction of the educational booklet, and the second consisted of validation of content, appearance and suitability of the material by nine expert judges, as well as validation as to its organization, writing style, appearance and motivation of the booklet with 25 people of the target population. The study was carried out at the CERHRN with the authorization of the board of directors and after approval of the Research Ethics Committee / UFRN under CAAE number 65942517.9.0000.5537. The Content Validity Index (CVI) was used to measure the judges' agreement on the representativeness of the items in relation to the study content. The evaluation instrument of the specialists contained items of evaluation of the Likert scale with four items. The index was calculated by means of the sum of the items marked "3" (appropriate) and "4" (fully appropriate) by the experts, divided by the total answers. As for the objectives of the booklet, all the judges validated the items, classifying them as "adequate" or "totally adequate", which gave an IVC of 1.00 for the proposed objectives. Regarding the structure and presentation of the booklet, it was considered validated, reaching a total CVI of 0.84. Regarding relevance, the total IVC was 0.97 and the general IVC of the educational booklet was 0.89, confirming the validation among the specialists in the area. After the suggestions made by the judges, the adequacy of the educational material was carried out, incorporating the suggestions, in order to meet the needs and expectations proposed. There was no negative response to items evaluated by the target audience. All items of the organization, writing style, appearance and motivation of the material were considered validated, as they reached a total agreement index of 99%. It is believed that the construction and validation of the educational booklet for the care of people with intestinal stomies can contribute positively to the adherence to the self-care practices of these people and also to the relatives and caregivers who perform or assist in this daily care. Subsequently, the educational material was sent to the Portuguese revision and to the printing press. The educational technology will be made available at the stomatal care facilities, but will only be provided to the patient who shows interest.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-21T11:46:14Z No. of bitstreams: 1 CiceraMariaBrazDaSilva_TESE.pdf: 3615184 bytes, checksum: 11a6a822cf6844bef9f53f4c55d3284f (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-23T11:09:29Z (GMT) No. of bitstreams: 1 CiceraMariaBrazDaSilva_TESE.pdf: 3615184 bytes, checksum: 11a6a822cf6844bef9f53f4c55d3284f (MD5) / Made available in DSpace on 2018-03-23T11:09:30Z (GMT). No. of bitstreams: 1 CiceraMariaBrazDaSilva_TESE.pdf: 3615184 bytes, checksum: 11a6a822cf6844bef9f53f4c55d3284f (MD5) Previous issue date: 2017-12-13 / O processo de forma??o do enfermeiro exige o desenvolvimento das compet?ncias necess?rias ? sua atua??o, embora, seja comum pairar algumas d?vidas com rela??o ?s compet?ncias do rec?m-graduado. Objetiva-se validar o Nurse Competence Scale para a l?ngua portuguesa do Brasil. A escala avalia a compet?ncia do enfermeiro, constitu?da de 73 itens, distribu?dos em 7 categorias, demonstra ser sens?vel na diferencia??o dos n?veis de compet?ncia, incluindo a fase de transi??o de estudante de enfermagem para a fase de enfermeiro. Estudo metodol?gico desenvolvido entre setembro de 2016 a junho de 2017, ap?s a autoriza??o da autora principal do instrumento e a aprova??o pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte, sob o parecer n? 1.766.255. Conduziu-se as validades de conte?do e de construto (dimensionalidade), e an?lise da confiabilidade (teste-reteste e consist?ncia interna), em duas etapas: a primeira, correspondeu ? adapta??o cultural do instrumento, e a segunda, ? verifica??o das qualidades psicom?tricas da escala adaptada. Participaram do estudo, 141 concluintes do curso de Gradua??o em Enfermagem de Institui??es P?blicas de Ensino Superior do estado do Rio Grande do Norte. O ?ndice de Validade de Conte?do foi de 0,99, e o coeficiente Kappa foi considerado quase perfeito. Dos 73 itens da escala, apenas 13 apresentaram diferen?a significativa no teste de compara??o de m?dias durante o teste-reteste (n = 30) para o n?vel de compet?ncia. O alfa de Cronbach total nessa etapa foi 0,97, e variou de 0,75 a 0,92, entre as categorias. E a segunda, participaram 111 concluintes, com m?dia de idade de 24,2 (DP = 3,5); sendo 84,7% do g?nero feminino e 95,5% sem experi?ncia anterior na ?rea de Enfermagem. O instrumento foi considerado de f?cil preenchimento, com tempo m?dio de aplica??o de 15 minutos, em ambas as etapas. Os alunos se autoavaliaram como tendo um bom n?vel de compet?ncia (m?dia geral = 73,9), com uma m?dia de uso efetivo dos itens na pr?tica, igual a 2, o que corresponde a ?usado ocasionalmente?. O n?vel de compet?ncia foi maior para a Fun??o de Apoio (80,5), e menor, para as Interven??es Terap?uticas (67,8). A an?lise de correla??o entre os itens da escala, apresentou-se de moderada a forte, com destaque para a correla??o entre as Interven??es Terap?uticas com as Fun??es Educativas (0,71), com as Fun??es Diagn?sticas (0,74) e com as Fun??es Gerenciais (0,78). A an?lise fatorial confirmat?ria demonstrou que o instrumento adaptado est? razoavelmente ajustado ? estrutura original proposta pela autora principal. Nessa etapa, o coeficiente alfa de Cronbach foi superior a 0,70, com exce??o da categoria Fun??o de Apoio (0,65). O processo de valida??o da escala foi alcan?ado, e a vers?o brasileira, denominada Escala de Compet?ncia do Enfermeiro mostrou-se v?lida e confi?vel para a amostra estudada. Acredita-se que a escala pode ser utilizada como ferramenta de avalia??o das compet?ncias de graduandos de Enfermagem, apesar da regionalidade dos dados. Recomenda-se a realiza??o de novos estudos, que permitam uma avalia??o mais profunda das qualidades psicom?tricas e compara??es entre resultados de pesquisas sobre o uso da vers?o brasileira do Nurse Competence Scale. / Although it is common to have some doubts about the skills of the recent graduate, the process of nurses? training requires the development of the skills necessary for their performance. The objective of this study is to validate the Nurse Competence Scale to Brazilian Portuguese. This scale evaluates nurses? competence, consisting of 73 items, distributed in 7 categories, showing to be sensitive in the differentiation of competence levels, including the transition phase from nursing student to the nurse phase. This is a methodological study developed between September 2016 and June 2017, after the authorization of the lead author of the instrument and approval by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under opinion n? 1,766,255. The content and construct validities (dimensionality), the reliability analysis (test-retest and internal consistency) were conducted in two stages. The first stage corresponded to the cultural adaptation of the instrument, and the second stage was the verification of the psychometric qualities of the adapted scale. There were 141 undergraduate students enrolled in the Undergraduate Nursing course of Public Institutions of Higher Education in the state of Rio Grande do Norte participated in the study. The Content Validity Index was 0.99, and the Kappa coefficient was considered almost perfect. Only 13 of the 73 items on the scale presented a significant difference in the test of comparison of means during the test-retest (n = 30) for the competence level. Cronbach's total alpha at this stage was 0.97 and ranged from 0.75 to 0.92 in the categories. In the second stage, there were 111 participants participating, with a mean age of 24.2 (SD = 3.5); 84.7% were female and 95.5% had no previous experience in the Nursing area. The instrument was considered easy to fill up, with an average application time of 15 minutes, in both stages. The self-evaluation of the students was as having a good level of competence (average of 73.9), with an average of effective use of the items in practice, equal to 2, corresponding to ?used occasionally?. The level of competence was higher for the Supporting Function (80.5), and lower for the Therapeutic Interventions (67.8). The analysis of correlation between the items of the scale was moderate to strong, especially the correlation between Therapeutic Interventions with Educational Functions (0.71), Diagnostic Functions (0.74) and Functions Management (0.78). The confirmatory factor analysis has shown that the adapted instrument is reasonably adjusted to the original structure proposed by the lead author. At this stage, Cronbach's alpha coefficient was higher than 0.70, except for the Support Function category (0.65). The scale validation process was reached, and the Brazilian version, called Escala de Compet?ncia do Enfermeiro was valid and reliable for the sample studied. It is believed that this scale can be used as a tool to evaluate the skills of nursing undergraduates, despite the regionality of the data. Further studies are recommended to allow a more thorough evaluation of the psychometric qualities and comparisons between research results using the Nurse Competence Scale Brazilian version.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-10T15:20:08Z No. of bitstreams: 1 SamaraSirdeniaDuarteDeRosarioBelmiro_TESE.pdf: 3565404 bytes, checksum: d5824fbb2d942d69130cae7c5f22d9e5 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-11T15:42:12Z (GMT) No. of bitstreams: 1 SamaraSirdeniaDuarteDeRosarioBelmiro_TESE.pdf: 3565404 bytes, checksum: d5824fbb2d942d69130cae7c5f22d9e5 (MD5) / Made available in DSpace on 2017-01-11T15:42:13Z (GMT). No. of bitstreams: 1 SamaraSirdeniaDuarteDeRosarioBelmiro_TESE.pdf: 3565404 bytes, checksum: d5824fbb2d942d69130cae7c5f22d9e5 (MD5) Previous issue date: 2016-06-30 / Objetiva-se buscar evid?ncia de validade do instrumento para avalia??o de necessidades em sa?de de pessoas com defici?ncia f?sica, auditiva e visual. Trata-se de um estudo metodol?gico para desenvolvimento, valida??o de conte?do, valida??o sem?ntica e de apar?ncia de um instrumento avaliativo. O processo de constru??o e valida??o segue os preceitos de Pasquali, seguindo as etapas do polo te?rico, atrav?s de duas fases: 1) identifica??o das defini??es constitutivas e operacionais do constructo e elabora??o dos itens que compuseram o instrumento denominado Instrumento de Avalia??o de Necessidades de Sa?de de Pessoas com Defici?ncia F?sica, Auditiva e Visual (IANC-PcDFAV), atrav?s de revis?o integrativa da literatura, realizada no primeiro trimestre de 2015 nas bases de dados CINAHL, MEDLINE, LILACS e SCOPUS; experi?ncia dos pesquisadores; e na Taxonomia das Necessidades de Sa?de de Matsumoto e Cec?lio; 2) A an?lise te?rica dos itens, realizada no per?odo de setembro de 2015 a maio de 2016, atrav?s de duas etapas. Etapa 1 ? valida??o de conte?do, atrav?s de t?cnica Delphi. Nesta etapa, realizou-se busca por meio da plataforma Lattes, para identificar profissionais da ?rea da sa?de com expertise que atuassem como ju?zes do instrumento. A amostra foi de 33 especialistas na fase Delphi 1 e 18 para a Delphi 2. Para a coleta de dados submeteu-se, via online, o formul?rio aos especialistas. Realizou-se a an?lise adotando o ?ndice de Validade de Conte?do (IVC) > 0,80 e Alpha de Cronbach > 0,80. Utilizou-se o teste de Mann-Whitney para investigar as diferen?as entre as fases Delphi 1 e 2 com p > 0,05. Etapa 2 ? A valida??o sem?ntica e de apar?ncia utilizou amostragem n?o probabil?stica por conveni?ncia com oito PcDs, sendo dois com defici?ncia f?sica, quatro com defici?ncia auditiva e dois com defici?ncia visual cadastradas em tr?s institui??es de apoio a PcDs em Mossor?/RN. Foram aplicados tr?s instrumentos: o IANS-PcDFAV, o Question?rio DISABKIDS? - Impress?o geral, e o Question?rio DISABKIDS? - Impress?es espec?ficas. A an?lise deu-se por estat?stica descritiva. Consideraram-se os princ?pios da Resolu??o 466/2012. No processo de valida??o do conte?do, na primeira rodada Delphi verificou-se que cinco itens da dimens?o dados sociodemogr?ficos e dois itens da dimens?o condi??es de vida n?o alcan?aram o ?ndice da validade de conte?do estabelecido. Nos demais itens ocorreu concord?ncia, com IVC variando de 0,82 a 1. Na segunda rodada, depois de acatadas as sugest?es dos especialistas, todos os itens avaliados atingiram ?ndices excelentes. Apresentaram-se diferen?as significativas nas dimens?es dados sociodemogr?ficos, condi??es de vida e no dom?nio 1. No que diz respeito ? m?dia dos requisitos de avalia??o, todos os itens obtiveram m?dias melhores na segunda avalia??o, com signific?ncia estat?stica (p= 0,026) no requisito utilidade/pertin?ncia e na avalia??o geral do instrumento (p= 0,031). O alpha de Cronbach foi de 0,884 na fase Delphi 1 e 0,825 na fase Delphi 2. No que concerne ? valida??o sem?ntica e de apar?ncia, o instrumento foi avaliado como importante e os itens do instrumento foram considerados f?ceis de compreender. As respostas geraram modifica??es na constru??o dos itens do instrumento. Assim, se aceita a hip?tese alternativa do estudo, em que IVC, consist?ncia interna e valida??o sem?ntica geral alcan?aram valores acima de 0,80. O instrumento proposto apresenta valores satisfat?rios de validade e consist?ncia interna, servindo como guia para a avalia??o das necessidades de sa?de de pessoas com defici?ncia f?sica, auditiva e/ou visual. / The objective is to seek evidence of validity of the instrument for the assessment of needs in health for people with physical disabilities, auditory and/or visual. This is a methodological study for development, content validation, validation semantics and appearance of an instrument of evaluative dimension. The process of construction and validation follows the precepts of Pasquali, following the steps of the polo theoretician, through two phases: 1) Identification of the settings pane and the operational construct and preparation of items that comprised the instrument called a tool for evaluation of health needs of people with physical disabilities, Auditory and Visual (IANC-PcDFAV), through integrative literature review performed in the first quarter of 2015 in databases CINAHL, MEDLINE, LILACS and SCOPUS; experience of researchers; and in the taxonomy of Health Needs Of Matsumoto and Cec?lio; 2) The theoretical analysis of the items held in the period from September 2015 to May 2016, through two steps. Step 1 - Validation of content through Delphi Technique. In this step, we search through the Lattes platform, to identify health care professionals with expertise who acted as judges of the instrument. The sample consisted of 33 experts in Delphi 1 and 18 for Delphi 2. For data collection submitted via online, the form of specialists. The analysis by adopting the Content Validity Index (CVI) > 0.80 and Cronbach's alpha > 0.80. The Mann-Whitney test was used to investigate the differences between phases Delphi 1 and 2 with p > 0.05. Step 2 - Validation semantics and appearance we used random non-probabilistic by convenience with eight PWD, being two with physical disabilities, four with hearing disabilities and two with visual disabilities enrolled in three institutions to support the PWD in Mossoro/RN. There were applied three instruments: the ians-PcDFAV, the questionnaire DISABKIDS? - overall impression, and the questionnaire DISABKIDS? - specific prints. The analysis was based on descriptive statistics. They considered themselves the principles of Resolution 466/2012. In the process of validation of the content there was established in the first Delphi, it showed that five items of the scale demographic data and two items of the scale living conditions did not reach the index of content validity. The remaining items were agreed, with CVI ranging from 0.82 to 1. In the second round, once accepted the suggestions of the experts, all items assessed have achieved excellence. It showed significant differences in the dimensions of demographic data, living conditions and in domain 1. With respect to the average requirements for evaluation, all items obtained medium best in the second evaluation, with statistical significance (p= 0.026) in requirement usefulness/appropriateness and general assessment of the instrument (p= 0.031). The Cronbach's alpha coefficient was 0.884 in Delphi 1 and 0.825 in Delphi 2. With regard to the semantic validation and appearance, the instrument was evaluated as important and the items of the instrument were considered easy to understand. The answers generated changes in the construction of the items of the instrument. Thus, it is accepted the alternative hypothesis of the study, in which CVI, internal consistency and validation general semantics reached values above 0.80. The proposed instrument presents satisfactory values of validity and internal consistency, serving as a guide for the assessment of health needs of people with physical disabilities, auditory and/or visual.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T22:18:32Z No. of bitstreams: 1 LaysPinheiroDeMedeiros_DISSERT.pdf: 2931997 bytes, checksum: bc17f556882bb10726ee26a84f71d688 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-23T21:35:22Z (GMT) No. of bitstreams: 1 LaysPinheiroDeMedeiros_DISSERT.pdf: 2931997 bytes, checksum: bc17f556882bb10726ee26a84f71d688 (MD5) / Made available in DSpace on 2017-03-23T21:35:22Z (GMT). No. of bitstreams: 1 LaysPinheiroDeMedeiros_DISSERT.pdf: 2931997 bytes, checksum: bc17f556882bb10726ee26a84f71d688 (MD5) Previous issue date: 2016-12-02 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Estomia ? uma abertura criada artificialmente a partir do trato gastrointestinal, ou trato urin?rio, para o abd?men, por onde ocorre o desvio e elimina??o do fluxo de fezes e urina. A estomia demanda atendimento a diversas necessidades adaptativas que envolvem aspectos fisiol?gicos, psicol?gicos e sociais. Isso requer a atua??o da enfermagem voltada para a promo??o da adapta??o da pessoa com estomia. A fim de sistematizar o cuidado ? pessoa estomizada, com vistas ? adapta??o eficaz e consequente melhoria da qualidade de vida, a enfermagem pode utilizar o Modelo de Adapta??o de Roy (MAR), que cont?m seis etapas do processo de enfermagem. O objetivo desse estudo foi construir e validar o conte?do de um instrumento para medir o n?vel de adapta??o do estomizado, com base no MAR. Trata-se de um estudo metodol?gico que ser? desenvolvido em duas etapas: constru??o dos itens do instrumento a partir das defini??es dos constructos, e a aplica??o do instrumento aos ju?zes. As defini??es constitutivas e operacionais foram feitas a partir da literatura e o processo de valida??o foi realizado por meio do ?ndice de Validade de Conte?do (IVC). Foram selecionados 116 ju?zes para a etapa de valida??o, dos quais nove foi realizada pela avalia??o de nove ju?zes, Todos responderam que consideram importante que o enfermeiro conhe?a o processo adaptativo da pessoa estomizada, a maioria referiu se sentir preparado para assistir a pessoa estomizada, incluindo as necessidades adaptativas e tamb?m conheciam o Modelo de Adapta??o de Roy. O primeiro modo adaptativo avaliado pelos ju?zes foi o fisiol?gico, no qual metade itens apresentaram IVC acima de 0,80 e, quanto ? perman?ncia do item no modo inicialmente alocado, apenas 3 (18,7%) tiveram 100% de repostas favor?veis ? manuten??o do item no modo. Dos 17 itens do modo autoconceito, Apenas 4 (23,5%) dos itens obtiveram IVC acima de 0,8 e 8 (47%) apresentam respostas 100% favor?veis ? manuten??o do item no modo. No modo fun??o de papel, 4 (100%) dos itens apresentaram IVC acima de 0,8 e 2 (50%) itens apresentaram total recomenda??o de perman?ncia no modo. Por fim, no modo interdepend?ncia, 3 (42,9%) itens apresentaram IVC acima de 0,8 e 4 (57,1%) tiveram todas as respostas voltadas para a manuten??o do item no modo. Ao final dessa etapa, 7 itens foram retirados do instrumento, dois foram agrupados em um s? e um foi alocado em outro modo diferente do preliminar. A vers?o final do instrumento possui 34 itens no total, sendo 11 no modo fisiol?gico, 14 no autoconceito, 4 no fun??o de papel e 5 no interdepend?ncia. Conclui-se que os itens constru?dos para compor a ENAE possuem validade de conte?do. / Ostomy is an opening that is artificially created from the gastrointestinal tract, or urinary tract, to the abdomen, from where it occurs a detour and the elimination of stool and urine. The ostomy?s construction requires several adaptive needs which involve from physiological aspects to psychological and social demands. This way, it is needed the performance of a nurse guided toward an improvement of the adaptation of the person with an ostomy. In order to systematize the care to the person with an ostomy, aiming an effective adaptation and consequent enhancement on their quality of life, the nurse can use Roy?s adaptation model (RAM), which is described on six stages of the nursing process. The first two are consisted on the stage of gathering data on stimulus and behaviors, of which will guide the subsequent stages. Therefore, the objective of this study is to construct and validate the content of the instrument entitled as ?Scale of the adaptation level of the person with an ostomy (ENAE). It is about a methodological study that will be developed on two phases: The first is consisted on the construction of the instrument?s items from the construct?s definitions, and the second will be based on the evaluation phase of the judges. The constitutive and operational definitions were made from the literature and the validation process will be analyzed using the Content Validation Index (CVI). 116 judges were selected for the validation phase, of which? by the evaluation of nine judges. Everyone answered that they considered as important that the nurse must know the adaptive process of the person with an ostomy, most of them referred that felt prepared to help the person with an ostomy, including the adaptive needs and also have to know Roy?s Adaptive Model. The first adaptive model evaluated by the judges was the physiological one, of which 8 (50%) items showed and CVI bigger than 0.80 and, regarding the item?s continuity on the initially allocated mode, only 3 (18.7%) had 100% of favorable answers about the item?s keeping on the mode. From the 17 items on the self ? concept mode, only 4 (23.5%) of the items had CVI above 0.8 and 8 (47%) showed answers 100% favorable to the item?s keeping on the mode. On the paper function mode, 4 (100%) of the items showed CVI above 0.8 and 2 (50%) of the items showed total recommendation regarding the continuity on the mode. Finally, on the interdependence mode, 3 (42.9%) items showed CVI above 0.8 and 4 (57.1%) had all the answers guided toward the item?s keeping on the mode. At the end of this stage, 7 items were removed from the instrument, two were grouped in only one and one was allocated on another mode different from the preliminary mode. The instrument?s final version has 34 items, being 11 on the physiological mode, 14 on the self ? concept mode, 4 on the paper function and 5 on the interdependence mode. Regarding the study?s limitations, the response?s reduced quantitative, and its delay, by part of the judges made it more difficult to construct these results. In addition to this, many of them did not comprehend some orientations, which made it harder to interpret some data. This project was approved by the Commission of Ethics in Research of UFRN, report number 421.342, CAAE of number 19866413.3.0000.5537.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-28T20:24:16Z No. of bitstreams: 1 KessyaDantasDiniz_TESE.pdf: 11488560 bytes, checksum: c749f2ac40a688c78b0e6cbe40b8be53 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-29T23:20:22Z (GMT) No. of bitstreams: 1 KessyaDantasDiniz_TESE.pdf: 11488560 bytes, checksum: c749f2ac40a688c78b0e6cbe40b8be53 (MD5) / Made available in DSpace on 2017-03-29T23:20:22Z (GMT). No. of bitstreams: 1 KessyaDantasDiniz_TESE.pdf: 11488560 bytes, checksum: c749f2ac40a688c78b0e6cbe40b8be53 (MD5) Previous issue date: 2016-12-01 / O protocolo assistencial caracteriza-se por ser um conjunto de informa??es apresentado de forma dinamizada, que proporciona o cuidado sistematizado, e tem como intuito avaliar de maneira uniformizada os fatores relacionados aos aspectos cl?nicos, epidemiol?gicos e assistenciais, corroborando para a qualidade de vida e seguran?a do paciente. Diante disso, a elabora??o de um protocolo assistencial multiprofissional no ?mbito do servi?o de tomografia computadorizada poder? contribuir para uma avalia??o cl?nica precisa. Este estudo teve como objetivo elaborar e validar um protocolo assistencial no setor de tomografia computadorizada. Trata-se de uma pesquisa metodol?gica com abordagem quantitativa, realizada em duas etapas: a primeira constou de uma revis?o integrativa de literatura que subsidiou a constru??o do protocolo; a segunda caracterizou-se pela valida??o de conte?do por meio de especialistas de diversas profiss?es utilizando a t?cnica Delphi. A pesquisa foi iniciada ap?s a aprova??o do CEP da Universidade Federal do Rio Grande do Norte com o Certificado de Apresenta??o para Aprecia??o ?tica (CAAE) n?. 41872215.7.0000.5537. A primeira etapa foi operacionalizada entre outubro e novembro de 2015, por meio da revis?o da literatura nas bases de dados MEDLINE, SCOPUS, WEB OF SCIENCE e CINAHL, com o cruzamento dos descritores controlados: Diagn?stico por Imagem; Seguran?a do paciente e Tomografia. A amostra foi constitu?da por 23 artigos. Os resultados foram organizados em tr?s categorias: otimiza??o, monitoramento, qualidade e prote??o em rela??o ?s doses de exposi??o ? radia??o; rea??es adversas e nefropatias relacionadas ao uso do contraste; cuidados de enfermagem, gest?o e casos espec?ficos. Para a segunda etapa, os especialistas foram selecionados por meio da Plataforma Lattes do Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPQ), para identificar profissionais de sa?de do Brasil que atuassem como especialistas do instrumento. A amostra foi de 54 especialistas tanto no Delphi 1 como para o Delphi 2. A an?lise estat?stica foi realizada utilizando-se ?ndices de alfa Cronbach, ?ndice de Validade de Conte?do (IVC) e o ?ndice Relativo (IRA). Na primeira etapa, Delphi 1 a m?dia do alfa de Cronbach e IRA foram superiores a 0,80, o IVC foi de 0,924. Na fase Delphi 2, o alfa de Cronbach chegou a 0,868, com IVC de 0,934. Realizou-se uma compara??o entre as fases Delphi 1 e 2, e em ambas a confiabilidade foi bastante satisfat?ria. Atrav?s do teste de Mann-Whitney, observaram-se evid?ncias de diferen?a estat?stica da fase Delphi 1 com a fase Delphi 2 nas dimens?es de utilidade/pertin?ncia, consist?ncia, clareza, atualiza??o, precis?o, sequ?ncia instrucional dos t?picos e na avalia??o geral, onde obteve-se melhor avalia??o na fase Delphi 2 nas vari?veis descritas acima. Assim, alcan?ou-se a validade do protocolo em seu conte?do. / The clinical protocol is characterized by being a set of information presented in a streamlined manner, which provides systematic care, and has as aim to evaluate in a standardized manner the factors related to clinical, epidemiological and supportive aspects, corroborating for the patient's quality of life and safety. At that, the preparation of a multi professional assistance protocol under the computed tomography service can contribute to an accurate clinical evaluation. This study aimed to prepare and validate a supportive protocol in the field of computed tomography. This is a methodological research with a quantitative approach, carried out in two stages: the first consisted of an integrative review of literature that subsidized the construction of the protocol; the second was characterized by the content validation through experts of various professions using the Delphi technique. The research was initiated after approval by the Ethics Committee in Research from the Federal University of Rio Grande do Norte, with the Presentation Certificate for Ethics Assessment CAAE N?. 41872215.7.0000.5537. The first phase was implemented between October and November of 2015, through literature review in the MEDLINE, Scopus, Web of Science and CINAHL databases, with a cross-check of the controlled descriptors: Diagnostic Imaging; Patient safety and Tomography. The sample consisted of 23 articles. The results were organized in three categories: optimization, monitoring, quality and protection in relation to radiation exposure doses; adverse reactions and kidney diseases related to the use of contrast; nursing care, management and specific cases. For the second phase, experts were selected through the Lattes platform of the National Scientific and Technological Development Council (CNPQ) to identify health professionals from Brazil who decided to act as experts. The sample was of 54 experts both in Delphi 1 as for Delphi 2. Statistical analysis was performed using Cronbach's alpha index, Content Validity index (CVI) and the Relative Index (ARI). In the first stage, Delphi 1 the average of Cronbach's alpha and IRA were over 0.80, the CVI was 0.924. In Delphi 2 phase, the Cronbach's alpha reached 0.868, with CVI of 0.934. A comparison was made between Delphi phases 1 and 2, and in both cases the reliability was satisfactory. Through the Mann-Whitney test, we observed evidence of statistical differences between Delphi phase 1 and phase 2 in the dimensions of utility/relevance, consistency, clarity, update, precision, instructional sequence of topics and general evaluation, where we obtained a better evaluation in the Delphi phase 2 variables described above. Thus, it was reached the validity of the protocol in this content.