Made available in DSpace on 2014-12-17T14:46:55Z (GMT). No. of bitstreams: 1 MagnaMPS_DISSERT.pdf: 1336445 bytes, checksum: 2998e1c0551bf591c5ce1acc115c4190 (MD5) Previous issue date: 2011-11-18 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / A quantitative, descriptive, cross-sectional and retrospective study, using technical procedures of document consultation from secondary sources and health household survey with application form for face to face inter views, with the assent n?.039/2011 from the Ethics Committee of the Federal University of Rio Grande do Norte. The aim of this study was to analyze the cervix cancer control in the area47 of the Health Family Centre Nova Natal II. The cancer cervix is the second most common cancer among women worldwide. In Brazil screening for early detection and treatment of disease has been poorly done and follow-up to reduce mortality has not been executed. From a total of1170women belonging to area 47, who under went screening by the Pap test in the period from 2005 to 2010,was elected a sample of 38 women with positive cervical changes, over 18 years old. The calculation of frequency analysis of socio demographic and clinical and epidemiological selected variables with the results of cervical changes, using the X2 test and taking as significance level of p<0.05 was not statistically significant. The predominant age range was 25 to 64 years (68.9%), most no white women (60.5%), predominantly with primary education (57.9%), most married (68.4%) and housewives (68.4%) with early age of sexual activity (86.8%), the minority smokers (13.2%), with a sexual partner (36.8%). At the time of interview, 42.1% of the women voiced complaint of discharge, while only 2.6% reported bleeding. In relation to the occurrence of STDs (including HPV), 10.5% of women reported being a carrier. The use of oral contraceptives was 32.3% of women, from 2 to 4 years (44.4%). The result of the last screening test performed, showed prevalence of immature squamous metaplasia (55.3%), followed by intraepithelial low- grade lesion (including the cytopathologic HPV effect and cervical intra epithelial neoplasia grade I) (31.6%); intraepithelial high-grade lesion (including cervical intraepithelial neoplasia grade II and III) (7.9%), atypical squamous non neoplastic cells (5.3%). There was no squamous cell carcinoma and adenocarcinoma. Most women received information about the action that should be done after the last screening test result (55.3%), but how to perform follow, most women did not report having done so (55.3%). The follow-up group of women studied, with varying degrees of cervical abnormalities, should only be completed with the discharge by cure, established inconsecutive negative cytology, a goal that is not being achieved in the area 47 of the Health Family Centre of Nova Natal II / Estudo quantitativo realizado por meio de pesquisa descritiva, transversal e retrospectiva, utilizando procedimentos t?cnicos de consulta documental a fontes secund?rias e inqu?rito domiciliar com aplica??o de formul?rio de entrevistas face a face, ap?s parecer favor?vel n? 039/2011 do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte. O objetivo dessa pesquisa foi analisar a resolutividade do controle da neoplasia maligna do colo de ?tero na ?rea 47 da Unidade de Sa?de da Fam?lia Nova Natal II. A neoplasia maligna do colo de ?tero ? o segundo tipo de c?ncer mais frequente entre as mulheres no mundo. No Brasil o rastreamento para detec??o e tratamento precoces da doen?a tem sido efetuado precariamente e o seguimento, para reduzir a mortalidade, n?o tem sido executado. De um total de 1170 mulheres pertencentes ? ?rea 47, que se submeteram a rastreamento por meio do exame de Papanicolau, no per?odo de 2005 a 2010, elegeu-se uma amostra de 38 mulheres com resultado positivo de altera??es cervicais, maiores de 18 anos. A an?lise do c?lculo da frequ?ncia de vari?veis sociodemogr?ficas e cl?nico-epidemiol?gicas selecionadas com os resultados das altera??es cervicais, utilizando-se o teste de X2 e adotando como n?vel de signific?ncia p<0,05 n?o mostrou signific?ncia estat?stica. A faixa et?ria predominante foi de 25 a 64 anos (68,9%); a maioria parda (60,5%); com escolaridade predominante at? o ensino fundamental (57,9%); a maioria casada ou em conviv?ncia marital (68,4%) e donas de casa (68,4%); com in?cio precoce da atividade sexual (86,8%), a minoria fumante (13,2%), com um parceiro sexual (36,8%). No momento da entrevista, 42,1% das mulheres verbalizou queixa de corrimento, enquanto apenas 2,6% referiu sangramento. Em rela??o ? ocorr?ncia de DSTs (inclusive HPV), 10,5% das mulheres declarou ser portadora. Verbalizaram o uso de contraceptivos orais, 32,3% das mulheres, por 2 a 4 anos (44,4%). Quanto ao resultado do ?ltimo exame preventivo realizado, prevaleceu a metaplasia escamosa imatura (55,3%), seguido de les?o intraepitelial de baixo grau (compreendendo efeito citopatol?gico pelo HPV e neoplasia intra-epitelial cervical grau I) (31,6%); les?o intra-epitelial de alto grau (compreendendo neoplasias intra-epiteliais cervicais de grau II e III) (7,9%); c?lulas at?picas escamosas de significado indeterminado, possivelmente n?o neopl?sicas, (5,3%). N?o foi observado carcinoma de c?lulas escamosas e adenocarcinoma. A maioria das mulheres recebeu informa??es sobre o seguimento que deveria ser realizado ap?s o resultado do ?ltimo exame preventivo (55,3%), mas, quanto a realizar o seguimento, a maior parte das mulheres n?o referiu t?-lo feito (55,3%). O seguimento do grupo de mulheres analisadas, com diferentes graus de altera??es cervicais, somente deveria ser finalizado com a alta por cura, estabelecido em citologias consecutivas negativas, meta que n?o est? sendo atingida na ?rea 47 da Unidade de Sa?de da Fam?lia Nova Natal II

This study examines the accessibility and barriers that Polish immigrants face in public gynecological care in Sweden and explains their attitudes towards and frequency of gynecological visits. To understand attitudes of the research group, the study explores their knowledge about basic gynecological health topics such as Pap and HPV tests, HPV infections and vaccinations. Qualitative ethnographic methods were used in this research. Thirteen semi-structured interviews were conducted with 25 to 45-year old Polish women living in Stockholm, Sweden. Analysis was performed using descriptive and theoretical approaches. The results indicate several barriers to fully adapt to the Swedish healthcare system for Polish women. The barriers included the lack of understanding of how Swedish gynecological care works (division of specializations), problems in finding specialist care, an insufficient number of specialists, a lack of information in English or Polish, and a limited amount of knowledge among study participants about HPV tests and vaccinations. The adaptation of Polish immigrants to the Swedish system and their level of trust is influenced by their first experiences in Sweden, health literacy, experiences with the Polish private gynecological system, and the attitudes of partners and family with Swedish backgrounds or those who have long term experiences in Sweden.

La santé sexuelle des femmes touchées par un cancer gynécologique peut être affectée par la maladie et ses traitements. Même si l’infirmière est une professionnelle de choix pour aborder la discussion sur ce sujet, de nombreuses études constatent que la communication est minimale en raison d’un manque de formation et de connaissances en santé sexuelle. Peu d’interventions éducatives sont répertoriées pour améliorer la communication des infirmières intervenant auprès de cette clientèle. Cette étude avait pour but de tester et de documenter la faisabilité, l’expérience d’apprentissage et les retombées d’une simulation en ligne réalisée avec une patiente partenaire pour améliorer la communication des infirmières en santé sexuelle chez la clientèle gynéco-oncologique. Une étude de faisabilité utilisant une approche qualitative a été réalisée auprès de 11 infirmières œuvrant avec la clientèle oncologique. Une analyse thématique itérative a été effectuée. Les résultats indiquent que l’activité de simulation en ligne est faisable selon plusieurs indicateurs (p. ex., contexte, ressources). L’expérience d’apprentissage a été décrite comme offrant des interactions réalistes avec une patiente partenaire et encourageant un apprentissage actif et sécuritaire malgré une structure pédagogique pouvant entraver la collaboration en groupe. Les résultats suggèrent que cette intervention pourrait avoir plusieurs retombées positives entre autres sur l’amélioration des connaissances et des habiletés de communication en santé sexuelle oncologique. Cette étude a permis de proposer une intervention éducative novatrice pour améliorer la communication infirmière en matière de santé sexuelle gynéco-oncologique. Différentes recommandations énoncées soulignent l’importance de poursuivre le développement des connaissances et de la formation infirmière en santé sexuelle gynéco-oncologique. / Nursing communication with the gynecological cancer clientele about their sexual health threatened by cancer and its treatments is suboptimal due to the lack of training and knowledge in this field. Few educational interventions exist to improve communication about sexual health among nurses working in Canadian cancer care settings. The aim of this study was to test and to document the feasibility, the learning experience and the effects of an online simulation with a patient-partner to improve nursing communication on sexual health with gynecological cancer clientele. A feasibility study using a qualitative approach was conducted with 11 nurses working with cancer patients. An iterative thematic analysis was performed. The results suggest that the online simulation activity is feasible according to several indicators (e.g., context, resources). The learning experience has been perceived as providing realistic nursing interactions with a patient-partner and encouraging active and safe learning despite an educational structure that may hinder group collaboration. The results indicate that this intervention could have several positive effects, including improving knowledge and communication skills about sexual health in cancer. In sum, this study has proposed an innovative educational intervention to improve nursing communication on sexual health after gynecological cancer. Many recommendations have been elaborated and emphasize the importance of continuing professional development and nursing training in sexual health with cancer patients.

Title: Methods of secondary prevention of the pelvic floor after childbirth Objectives: This is a theoretical work with a descriptive-analytical part. It includes an analysis of the literature from available sources, an analysis of active approaches in the secondary prevention of the pelvic floor and the creation exercise unit for further research. Methods: Literature analysis including processing of information from available sources. Results: Handbook of pelvic floor training with methodical descriptions. Keywords: Pelvic girdle, pregnancy, gynecological weaknesses after childbirth, incontinence, pelvic organ prolapse, sexual dysfunction, pelvic floor examination, Arnold Kegel method, Ludmila Mojžíšová method, Alexander method, Feldenkrais method, Cantienica, exercise unit