published_or_final_version / Social Work / Master / Master of Social Work

Spiritual dimensions are an important focus for nursing care and nurses can be catalysts for spiritual care. The purpose of this descriptive comparative analysis is to examine the spiritual care needs as perceived by terminally ill clients, non-terminally ill clients, and well adults. The theoretical framework for this study is Leininger's "Cultural Care Theory" that supports the notion that spiritual care needs to be culturally congruent.Participants were obtained from a 225-bed hospital, hospice, home care, and a wellness program in a midwestern city. Permission was obtained from the hospital President, Vice President of Nursing, the directors of Hospice and Home Care, and the community's Wellness Program. The number of participants was 76. The process for the protection of human rights was followed.Findings were that terminally ill, non-terminally ill, and well-adults all agree that receiving spiritual care that is congruent with beliefs is important. The terminally ill clients rated spiritual needs higher than both non-terminally ill and well-adults. All groups rated the same in the persons from whom it was wished to receive spiritual care. Common themes of spiritual care desired from these persons for the terminally ill group was: pray for/with me and talk to me. For the non-terminally ill group it was: give me information, The understanding, and provide emotional and spiritual support. Finally, for the well-adults it was: listen to me, talk to me, be confident, and support me.No statistical difference between groups (.940) on the SPS. On the SPC, the terminally ill group was more satisfied (5.20) with spiritual support they were receiving than the non-terminally ill group or well-adults.It was concluded that regardless of the stage of illness, the same spiritual needs are prominent, all individuals have spiritual needs, and several types of interventions are preferred. It has been demonstrated in this study that prayer is the most sought after component of spiritual care among all three groups. Second to that would be someone to talk to and someone to listen to them.Implications call for nurses to facilitate spiritual care from family, friends, minister or priest, and hospital chaplain. This could be written into the plan of care by having the client describe the type of spiritual care they want to receive. Nursing Administration needs to work with nursing staff to define spirituality and religion and what they mean to the nurse. / School of Nursing

The problem of this study is to compare prior health care experience with satisfactory adjustment in a long-term care facility. Both quantity and quality of prior experience in a health care facility are examined in terms of the significance to successful relocation. Demographic data and perceived control of health are examined in relation to significance of the findings.

The problem with which this study is concerned is the delineation of current practices in therapeutic recreation in psychiatric treatment centers in Texas, The programs of the forty-two hospitals responding to the survey questionnaire were evaluated in terms of the National Therapeutic Recreation Society's "Standards for Therapeutic Recreation in Psychiatric Facilities." It was determined that, while the use of recreation in psychiatric rehabilitation is widespread, many programs are not administratively independent., A close association between recreation and occupational therapy was found. Extensive recreation facilities and activities were reported. Use of community resources was widespread, but follow-up and leisure counseling services were rare. Most personnel had no recreation training. The evaluation showed limited compliance with the standards.

"The purpose of this study is to examine the impact of the medicare law on a particular hospital: Flow Memorial Hospital, Denton, Texas. The scope of this study is limited to an analysis of changes in hospital car at Flow Memorial Hospital resulting from medicare. These changes are examined on the basis of 1. number of patients and days of care; 2. hospital services by department; 3. the means of payment; and 4. social characteristics of the aged patient group. A detailed examination of aged patient care was made for the fiscal years 1966 and 1967. The 1966 year was the year immediately preceding medicare. The 1967 year was the first year of medicare. Longer time periods were used where the data were available and pertinent."-- leaf 1.

WORK The aim of this work is to explore and describe the problem of nicotine clients of residential facilities voluntarily hospitalized for alcohol dependence. Learn whether it is on their side for such treatment if they are interested or might acquire in the course of his treatment of alcoholism motivation to quit smoking if they were offered such treatment if they were on a method of treating at least generally aware and if you know the benefits of such léčby.První stage research will consist of obtaining the basic sample. To obtain the respondents will choose the method of choice through deliberate purpose institutions. The population intended for actual research facility which clients will be allowed to participate in such research and who will be able to participate in research. Through the simple purpose a selection, Fagerström test for all survey respondents. Based on the results of this test determine how many people hospitalized for alcohol dependence with the diagnosis F10.2 simultaneously diagnoses F17.2-behavioral disorders due to use of tobacco. This finding generates the sample with which I will continue to work. To work with a sample of clients will be the main data collection method used questionnaire method. The questionnaire will be represented in both open and closed questions...

O trabalho em equipe representa estratégia para superação da frágil articulação entre profissionais, sendo potencializado pela prática colaborativa entre agentes e gestão participativa. Entretanto, os arranjos organizacionais não favorecem a interação entre os profissionais e dificultam o trabalho em equipe. A magnitude dos agravos cardiovasculares por serviços regulados e estruturados, pautados num enfoque multiprofissional em saúde, a carência de publicações científicas sobre trabalho em equipe na atenção hospitalar, a potência do trabalho em equipe para responder às demandas reais de saúde justificam investigações a respeito do trabalho em equipe de saúde em Unidade Coronariana, particularizando a compreensão de aspectos que dificultam e facilitam esse trabalho. Assim, esta pesquisa teve como objetivo analisar o trabalho em equipe, desenvolvido em unidade hospitalar de alta densidade tecnológica, segundo a perspectiva da equipe de saúde. É um estudo descritivo, utilizando dados qualitativos e quantitativos, realizado em Unidade Coronariana de um Hospital público, de ensino, de nível terciário, referência para atendimento de alta densidade tecnológica. A população constituiu-se de profissionais da equipe multiprofissional que atuavam na referida unidade há, pelo menos, um ano, sendo excluídos aqueles que se encontravam afastados do trabalho à época da coleta dos dados e os não localizados após três tentativas para agendamento da entrevista. Utilizou-se a Técnica do Incidente Crítico, e os dados primários foram coletados por meio de entrevista semiestruturada. A análise dos dados fundamentou-se em análise de conteúdo. Participaram do estudo 45 profissionais da equipe de saúde, sendo 20 técnicos/auxiliares de enfermagem; 11 médicos; nove enfermeiros; quatro fisioterapeutas e um psicólogo. Das entrevistas, emergiram 49 situações, das quais 38 (77,6%) receberam referências negativas e 11 (22,4%), positivas; 385 comportamentos, sendo 209 (54,2%) positivos e 176 (45,8%) negativos; além de 182 consequências que receberam 131 (71,9%) referências negativas e 51 (28,1%) positivas. As referências positivas indicam aspectos que facilitam o trabalho em equipe e as negativas, aqueles que dificultam. Foram considerados facilitadores do trabalho em equipe colaborar/relacionar-se com os outros profissionais, desenvolver assistência ao paciente conforme a competência profissional, relacionamento entre agentes pautado na prática colaborativa e comunicação. Aspectos como baixa colaboração entre profissionais, gerenciamento inadequado de agentes, despreparo profissional no atendimento à parada cardiorrespiratória/emergência, divergências nas condutas terapêuticas, limitação de recursos materiais e agir de maneira descomprometida com o trabalho dificultam o trabalho em equipe. Conclui-se que, apesar do predomínio de situações e consequências negativas relativas à dinâmica do trabalho em equipe nessa Unidade Coronariana, a ênfase em comportamentos positivos, favoráveis ao trabalho em equipe, evidencia investimento e esforço para superar dificuldades, na perspectiva da potência do trabalho em equipe para atingir a finalidade do trabalho em saúde. A partir dos resultados, acredita-se que aspectos relativos à formação/capacitação profissional e à organização do serviço precisam favorecer o trabalho em equipe, estando a centralidade do processo de trabalho dessa equipe nas relações entre agentes / Teamwork is a strategy for overcoming the fragile link between professionals, enhanced by collaborative practices between agents and participatory management. However, the organizational arrangements do not favor the interaction between professionals, hindering teamwork. The magnitude of cardiovascular diseases, worsened by regulated and structured services, guided by a multi-professional approach to health, and the lack of scientific publications on teamwork in hospital care and its potential to meet real health needs justify studying the teamwork of a health team in a Coronary Care Unit, individualizing the understanding of aspects that hinder and facilitate this work. Thus, the aim of this study was to analyze the teamwork developed in hospital of high technological density, from the perspective of the health team. It is a descriptive study using qualitative and quantitative data, held in a teaching, tertiary, reference Coronary Care Unit for a high technological density service. The population consisted of professionals from the multidisciplinary team who worked in that unit for at least one year, excluding those who were out of work at the time of data collection or who were not located after three attempts to schedule the interview. The Critical Incident Technique was used, and primary data were collected through semi- structured interviews. Data analysis was based on content analysis. Study participants were 45 health team professionals, 20 nursing technicians/aides; 11 physicians; 9 nurses; 4 physical therapists and 1 psychologist. The interviews revealed 49 situations, of which 38 (77.6%) were negative references and 11 (22.4%) positive; 385 behaviors, where 209 (54.2%) were positive and 176 (45.8%) negative; in addition to receiving 182 consequences of which 131 (71.9%) were negative and 51 (28.1%) were positive references. Positive references indicate aspects that facilitate teamwork and negative aspects that hinder it. The characteristics among staff such as collaboration/relationship with other professionals, development of patient care according to professional competence, relationship between guided agents in collaborative and communication practice were considered teamwork facilitators. Aspects such as low collaboration among professionals, inadequate agent management, lack of professional preparation to assist heart arrests/emergencies, differences in therapeutic approaches, limitation of material resources and lack of commitment to work hinder teamwork. In conclusion, despite the predominance of negative situations and consequences related to the dynamics of teamwork in this Coronary Care Unit, the emphasis on positive behavior, favorable to teamwork, shows investment and effort to overcome difficulties in view of the teamwork potential to achieve the purpose of health work. Analyzing these results, it is believed that aspects of the professional education/training and service organization must promote teamwork, with the centrality of the working process of this team focused on the relationships among agents

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2018-01-25T23:14:34Z No. of bitstreams: 1 DISSERTA??O - MARCOS VIN?CIUS SANTOS SILVA.pdf: 1867351 bytes, checksum: def26bc9b7fc279cafbb180af8d67b58 (MD5) / Made available in DSpace on 2018-01-25T23:14:34Z (GMT). No. of bitstreams: 1 DISSERTA??O - MARCOS VIN?CIUS SANTOS SILVA.pdf: 1867351 bytes, checksum: def26bc9b7fc279cafbb180af8d67b58 (MD5) Previous issue date: 2016-04-27 / The research aims to analyze the interface between humanization and technological resources in hospitals. It was the result of an investigation under a qualitative approach, while the data were analyzed in addition to the quantifiable dimensions, but a universe embraced by signs, senses and meanings attributed to the object in focus. The empirical universe of the study was two hospital equipments linked to the Department of Health of the State of Bahia, administered under different legal and administrative systems. The choice of these hospitals met the criteria: broad flow demand of massive technological development and that were allocated near the university in which the study is linked. Empirical research showed with the application of semi-structured interviews scripts together professionals from both units. Discussions necessary researches are categorized in the debate on hospital care, specifying on its structure and the adjacent and constituent subjects in defendants processes. The results of this study reflect issues to the very interface between humanization and technological resources in health, converging on the antagonistic character attributed to technology, now seen as making it humanizes, sometimes as dehumanizing mechanism. Also, the data also indicate on the various meanings attributed to humanization, converging with its polysemous attribute. Although, all the undertaken theoretical basis points directives that establish with the ideal of restructuring hospital care, with a focus to their practice. With regard, it urges the need to safeguard the qualities inherent in the principle of ethics, as they stand up for human values in much needed. Therefore, the discussions related to the paradigm of execution of humanization in the health field by the driver of technological resources, are recurrent. Thus, it points out the need to build care environments conducive to the introduction of targeted practices and demarcated by the complementarity between categories humanization and technology. Therefore, the need to adopt and reflect on an integrative approach is argued between them, facilitating the humans values to scale on the technologic practices, proceduralists, as combated. / A pesquisa tem como objetivo analisar a interface entre a humaniza??o e a incorpora??o tecnol?gica em unidades hospitalares. Foi fruto de uma investiga??o com abordagem qualitativa, ao passo que os dados foram analisados al?m das dimens?es quantific?veis, mas num universo abarcado por signos, sentidos e significados atribu?dos ao objeto em foco. O universo emp?rico do estudo foi dois equipamentos hospitalares vinculados ? Secretaria Estadual de Sa?de do Estado da Bahia, administrados sob diferentes regimes jur?dico-administrativos. A escolha desses hospitais se deu devido aos seus amplos fluxos demandat?rios, ? maci?a incorpora??o tecnol?gica em ambos e ao fato de estarem alocados pr?ximos ? universidade em que esse estudo est? vinculado. A pesquisa emp?rica evidenciou-se com a aplica??o de roteiros semiestruturados de entrevistas junto aos profissionais de ambas as unidades. As discuss?es necess?rias ? pesquisa categorizam-se no debate sobre o cuidado hospitalar, especificando sua estrutura e os sujeitos adjacentes e constituintes nos processos demandados. Os resultados desse estudo refletem quest?es referentes ? pr?pria interface entre a humaniza??o e a incorpora??o tecnol?gica em sa?de, convergindo quanto ao car?ter antag?nico atribu?do ? tecnologia, ora vista como fazer que humaniza, ora como mecanismo desumanizador. Igualmente, os dados indicam os v?rios sentidos atribu?dos ? humaniza??o, confluindo com seu atributo poliss?mico. Conquanto, todo o aporte te?rico empreendido aponta diretivas que coligem com o ideal de reestruturar o cuidado hospitalar, com enfoque ao campo das pr?ticas. A pesquisa incita a necessidade de resguardar as qualidades inerentes ao princ?pio da ?tica, ? medida que ressalta os valores humanos, em muito carecidos. Logo, as discuss?es relacionadas ao paradigma da efetiva??o da humaniza??o no campo da sa?de, mediante o fator condicionante da incorpora??o tecnol?gica, s?o recorrentes. Assim, aponta-se para a necessidade de se construir ambientes de cuidado prop?cios ? instaura??o de pr?ticas direcionadas e demarcadas pela complementariedade entre as categorias ?humaniza??o? e ?tecnologia?. Portanto, defendeu-se a necessidade de adotar e refletir acerca de uma abordagem integradora entre ambas, possibilitando aos valores humanos dimensionarem-se sobre as pr?ticas tecnicistas, em geral, muito combatidas.

O presente estudo teve como objetivo a avaliação psicológica de crianças hospitalizadas por meio do Desenho da Figura Humana (DFH) e do Desenho da Pessoa Doente (DPD) usando os Indicadores Emocionais e Indicadores Maturacionais de Koppitz (1973) e o levantamento de elementos complementares relativos à doença e à hospitalização. A amostra foi composta por 120 crianças de ambos os sexos, com faixa etária de 7 a 11 anos, divididas em dois grupos, um grupo de crianças hospitalizadas e outro de escolares. Os resultados indicaram que os dois desenhos das crianças hospitalizadas apresentaram um número maior de Indicadores Emocionais do que as escolares e menor média nos Indicadores Maturacionais, mostrando um maior comprometimento no primeiro grupo. Os Indicadores Emocionais com diferenças significantes no DFH foram figura pequena e pernas fechadas, mais freqüentes nas crianças hospitalizadas. Quanto aos Indicadores Maturacionais foram observadas diferenças significantes entre os dois grupos, a favor do grupo de escolares, tanto no DFH como no DPD. Nos dois grupos e também na amostra total, o DFH apresentou uma produção mais elaborada, em comparação com o DPD. No DPD os Indicadores Emocionais com maior freqüência do que no DFH foram integração pobre, sombreamento no rosto, sombreamento no corpo/membros, sombreamento no rosto/pescoço, figura pequena, mãos cortadas e omissão de pescoço. No DPD das crianças hospitalizadas ficou evidente a presença dos elementos complementares caracterizando doenças mais graves em relação ao DPD dos escolares, com mais representação do ambiente hospitalar, de objetos de procedimentos hospitalares, restrição de atividade, figura debilitada, expressão de tristeza e expressão de choro/dor. Pode-se concluir que o uso do DPD como instrumento de avaliação psicológica de crianças hospitalizadas permite emergir maior quantidade de indicadores de perturbação emocional em comparação ao DFH. Portanto, pode-se considerar que o DPD mostra-se como uma técnica eficaz para a avaliação de crianças hospitalizadas. / This study had the purpose to assess psychologically hospitalized children by the Human Figure Drawing (HFD) and by the Patient Person Drawing (PPD) using Koppitz Emotional and Maturational Indicators (1973) and by the survey of complementary elements related to illness and hospitalization. Sample was composed by 120 children, half of each sex, with age ranging from 7 to 11 years old, divided in two groups, one of hospitalized children and the other from schools. Results indicated that the hospitalized children drawings presented a bigger number of Emotional Indicators than school children and lower mean of Maturational Indicators, showing more emotional problems in the first group. The Emotional Indicators that had significant differences between groups were tiny figure and legs pressed together. In relation to Maturational Indicators were observed significant differences, in behalf of school children in HFD and in PPD. In both groups and in the whole sample, the HFD presented a more elaborate drawing than the PPD. In PPD the Emotional Indicators with more frequency than in HFD were poor integration, shading of face, shading of body and/or limbs, tiny figure, hands cut off and neck omission. In hospitalized children PPD it became evident the presence of complementary elements, characterizing serious illness in relation to PPD of school children, with more representation of hospital environment, hospital procedures objects, activity restriction, debilitated person, sadness and cry/pain expression. It can be concluded that the PPD use as a tool of psychological assessment with hospitalized children permits to emerge more indicators emotional disturbs comparing with the HFD. Therefore it can be considered that the PPD is a more efficient procedure to assess hospitalized children.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-05-25T13:30:59Z No. of bitstreams: 1 Denise Regina Disaró.pdf: 2573282 bytes, checksum: 6639bb953a5e32665d0fbf755ee62591 (MD5) / Made available in DSpace on 2017-05-25T13:30:59Z (GMT). No. of bitstreams: 1 Denise Regina Disaró.pdf: 2573282 bytes, checksum: 6639bb953a5e32665d0fbf755ee62591 (MD5) Previous issue date: 2017-04-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Palliative care (PC) is a new practice in the world and in Brazil, and even more recent with children. This study was developed in a palliative care setting. Its purpose is to reflect on psychoanalytic care of children in PC, their families, the health team and on the psychoanalyst. With psychoanalysis as a theoretical, technical and ethical reference, a three case study was developed which provided the opportunity to observe how psychoanalytic care occurs in this special condition. The traumatic potential present in the situational dimension tends to cause changes in the Self of the patients and their relatives, who present a psychic functioning and suffering, similar to the psychopathological dimension, such as narcissistic-identity disorders. Through this process, children and their families lose, even temporarily, some important Ego functions to face the circumstances, such as the capacity for mediation, organization, synthesis and integration of the elements present in the situational dimension. This requires that the analyst assume the deficient Ego functions until the people involved gradually rescue the dormant skills. It is as a mediator that the analyst can be a transformational object and enables the psychoanalytic work, the construction of meaning and the elaboration of experience. It is predominantly a more active care with an additional amount of implied presence, although the analyst has to keep, dialectically, the reserved presence which is essential for self-restraint, self-care and to avoid intrusion caused by the excess of implication / Cuidados paliativos (CP) são uma prática nova no mundo e no Brasil e ainda mais recente com crianças. É neste pano de fundo que se desenvolveu este estudo. Seu objetivo é refletir sobre os cuidados psicanalíticos destinados a crianças em CP e sua família, à equipe de saúde e ao próprio psicanalista. Tendo a psicanálise como referencial teórico, técnico e ético, foi desenvolvido um estudo de três casos, que permitiu observar como o cuidado psicanalítico ocorre nesta condição especial. O potencial traumático presente na dimensão situacional tende a provocar alterações no Eu dos pacientes e seus familiares, que passam a apresentar um funcionamento psíquico e um sofrimento semelhante ao da dimensão psicopatológica, isto é, aos transtornos narcísico-identitários. Nestes momentos, as crianças e suas famílias perdem, ainda que temporariamente, algumas funções egoicas importantes para o enfrentamento das circunstâncias, tais como a capacidade de mediação, de organização, síntese e integração dos elementos presentes na dimensão situacional. Este quadro requer que o analista assuma as funções egoicas deficientes naquele momento até que as pessoas resgatem gradativamente as habilidades perdidas. É como mediador que o analista pode ser um objeto transformacional e possibilitar o trabalho psíquico e a construção de sentido e de elaboração da experiência. Tratase, predominantemente, de um cuidado ativo com um quantum a mais de presença implicada, embora o analista tenha que manter dialeticamente a presença reservada, essencial para a autocontinência e o autocuidado e para evitar a intrusão provocada pelo excesso de implicação