Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-27T23:08:07Z No. of bitstreams: 1 LarissaPracaDeOliveira_TESE.pdf: 7448576 bytes, checksum: 09888de563c3ebb53639645d6a095c11 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-27T23:16:57Z (GMT) No. of bitstreams: 1 LarissaPracaDeOliveira_TESE.pdf: 7448576 bytes, checksum: 09888de563c3ebb53639645d6a095c11 (MD5) / Made available in DSpace on 2017-04-27T23:16:57Z (GMT). No. of bitstreams: 1 LarissaPracaDeOliveira_TESE.pdf: 7448576 bytes, checksum: 09888de563c3ebb53639645d6a095c11 (MD5) Previous issue date: 2016-06-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / O envelhecimento populacional ? um fen?meno mundial. No Brasil, o aumento da propor??o de idosos na popula??o vem sendo acompanhado por mudan?as no perfil epidemiol?gico, onde prevalecem as doen?as cr?nicas e agravos n?o transmiss?veis, sendo estas as principais causas de morbidade, incapacidade e mortalidade, especialmente nos idosos que residem em Institui??es de Longa Perman?ncia. A escassez de trabalhos envolvendo a situa??o de sa?de e de mortalidade dos idosos institucionalizados motivou a realiza??o desta pesquisa, que tem como objetivo determinar a mortalidade e seus fatores progn?sticos em idosos institucionalizados no munic?pio de Natal-RN. Trata-se de um estudo de progn?stico, com popula??o din?mica, iniciado em Outubro de 2013, com dura??o de 18 meses de acompanhamento a todos os idosos residentes (n=345) em institui??es de longa perman?ncia, com e sem fins lucrativos. Durante este per?odo, foram realizados sete ondas de avalia??o, onde foram mensuradas as seguintes vari?veis antropom?tricas: peso (kg), altura (cm), per?metros braquial (cm) e da panturrilha (cm). A triagem nutricional foi realizada utilizando a Mini Avalia??o Nutricional. As informa??es referentes ao consumo alimentar e a concentra??o de albumina s?rica foram obtidas a partir da an?lise de dados de uma outra pesquisa a qual esse estudo faz parte. J? as informa??es sobre as morbidades, hospitaliza??es, tipo de dieta e n?mero de medicamentos, foram obtidas por meio dos prontu?rios. Os dados socioecon?micos, sociodemogr?ficos e socioculturais foram coletados atrav?s de entrevistas estruturadas com aux?lio de question?rios. As informa??es sobre a mortalidade foram obtidas ap?s a an?lise do atestado de ?bito. Realizou-se a an?lise estat?stica mediante a an?lise de sobrevida pelo m?todo de Kaplan-Meier e, em seguida, regress?o de Cox na an?lise multivariada, com os respectivos hazards ratios (HR). Os 345 idosos avaliados apresentaram m?dia de idade igual a 81,2 (9,3) anos, com maior propor??o da popula??o ?75 anos (74,8%). A maioria dos institucionalizados ? do sexo feminino (76,5%), s?o solteiros (45,8%) e possuem algum grau de escolaridade (61,4%). Um total de 179 idosos (51,9%) possui restri??o de mobilidade, 89,0% foram diagnosticados com doen?as cr?nicas, 54% com desnutri??o e 45,2% utilizam mais de cinco medicamentos ao dia. As doen?as cr?nicas como a hipertens?o (45,5%) e o diabetes (25,0%), s?o as mais frequentes. Durante o seguimento, 70 idosos (20,3%, IC 95%=16,25% - 25,00%) foram a ?bito, nos quais as doen?as do aparelho respirat?rio (44,3%) e circulat?rio (30,0%) foram as suas principais causas. A probabilidade de sobrevida global dos idosos institucionalizados foi de 78,7% (IC, 0,74-0,83) ao final da coorte, onde os principais fatores progn?sticos identificados na an?lise de Cox foram a idade ? 75 anos (HR=3,85), per?metro da panturrilha inferior a 31cm (HR=2,58), alimenta??o por sonda (HR=2,59), alimenta??o pastosa (HR=2,23), com restri??o de mobilidade (HR= 1,76), sexo masculino (HR= 1,75) e polifarm?cia (HR=1,55). Dessa forma, melhorias nas condi??es de sa?de, com a??es voltadas a preven??o de doen?as respirat?rias e cardiovasculares, bem como a recupera??o do estado nutricional e adequa??o na prescri??o de alimentos e medicamentos podem resultar na redu??o do risco de mortalidade precoce. / Population aging is a global phenomenon. In Brazil, the increase in the proportion of elderly in the population has been accompanied by changes in the epidemiological profile, which are prevalent noncommunicable chronic diseases, which are the leading causes of morbidity, disability and mortality, especially in the elderly residing in nursing homes. The shortage of studies involving the situation of health and mortality in institutionalized elderly motivated this research, which aims to determine the mortality and its prognostic factors in institutionalized elderly in the city of Natal-RN. This is a prognostic study with dynamic population, started in October 2013 with duration of 18 months follow-up to all elderly residents (n = 345) in nursing homes, with and without profit. During this period, were realized seven assessment waves, where the following anthropometric variables were measured: weight (kg), height (cm), brachial perimeters (cm) and calf (cm). The nutritional screening was performed using the Mini Nutritional Assessment. Information about the food consumption and serum albumin concentration were obtained from the data analysis of a survey which this study is part. As for the information about morbidities, hospitalizations, diet type and number of medications they were obtained through medical records. Socioeconomic, demographic and sociocultural data were collected through structured interviews with questionnaires assistance. The information on mortality was obtained after analysis of death certificate. The statistical analysis was carried out through the analysis of survival by the Kaplan-Meier method, and then Cox regression at multivariate analysis, with the respective hazards ratios (HR). Thes 345 elderly evaluated presented mean age equal to 81.2 (9.3) years, with the largest proportion of the population ? 75 years (74,8%). Most institutionalized are female (76.5%), are single (45.8%) and have some degree of schooling (61.4%). A total of 179 elderly (51.9%) have mobility restriction, 89.0% were diagnosed with chronic diseases, 54% with malnutrition and 45.2% use more than five drugs a day. Chronic diseases such as hypertension (45.5%) and diabetes (25.0%) are the most frequent. During follow-up, 70 elderly (20.3%, CI 95%:16.25%- 25.00%) died, in which respiratory diseases (44.3%) and circulatory (30.0%) were the its main causes. The probability of overall survival of institutionalized elderly was 78.7% (CI: 0.74-0.83) at the end of the cohort, where the main prognostic factors identified in the Cox analysis were age ? 75 years (HR = 3 85), calf perimeter less than 31cm (HR = 2.58), tube feeding (HR = 2.59), doughy food (HR = 2.23), with mobility restrictions (HR = 1, 76), male (HR = 1.75) and polypharmacy (HR = 1.55). In this way, improvements in health, with actions directed to prevention of cardiovascular and respiratory diseases, as well as the recovery of nutritional status and fitness on prescription food and medications can result in reducing the risk of early mortality.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-06-13T20:38:03Z No. of bitstreams: 1 LauraCamilaPereiraLiberalino_TESE.pdf: 1464543 bytes, checksum: d943890d84ea9073da51eb4cca7c6696 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-06-19T15:22:57Z (GMT) No. of bitstreams: 1 LauraCamilaPereiraLiberalino_TESE.pdf: 1464543 bytes, checksum: d943890d84ea9073da51eb4cca7c6696 (MD5) / Made available in DSpace on 2017-06-19T15:22:57Z (GMT). No. of bitstreams: 1 LauraCamilaPereiraLiberalino_TESE.pdf: 1464543 bytes, checksum: d943890d84ea9073da51eb4cca7c6696 (MD5) Previous issue date: 2016-08-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / A alimenta??o ? uma necessidade humana de livre demanda e com muitos significados, contudo, na Institui??o de Longa Perman?ncia para Idoso (ILPI) ela passa a ser um bem coletivo, com hor?rios delimitados e quantidades controladas, que podem alterar o comportamento alimentar e comprometer a sa?de dos idosos. Nesse sentido, identificar padr?es alimentares poder? melhorar a compreens?o das pr?ticas diet?ticas e auxiliar nas interven??es nutricionais e educativas. A escassez de informa??es sobre a situa??o alimentar e nutricional dos idosos institucionalizados de Natal-RN, motivou conhecer o padr?o alimentar desse grupo, para subsidiar a elabora??o de estrat?gias que propiciem melhor condi??o de sa?de para os idosos. Esse trabalho objetivou identificar e caracterizar o padr?o alimentar dos idosos que residem em Institui??es de Longa Perman?ncia e propor um Question?rio de Frequ?ncia Alimentar (QFA). Trata-se de uma pesquisa de delineamento transversal, envolvendo todos os idosos residentes nas ILPI (n=300), com e sem fins lucrativos, localizadas no munic?pio de Natal/RN. O consumo alimentar foi obtido no ano de 2013, a partir do m?todo do registro alimentar por pesagem direta dos alimentos e posterior an?lise do rejeito, durante dois dias alternados. O padr?o alimentar foi identificado a partir da An?lise de Componentes Principais, considerando-se a m?dia da quantidade de alimentos consumida (em gramas). Os escores fatoriais dos padr?es alimentares foram categorizados em tercis (baixo, moderado e alto consumo) e verificadas as associa??es com caracter?sticas sociodemogr?ficas, estilo de vida, condi??es de sa?de, estado nutricional e pr?ticas alimentares, revelando a exist?ncia ou n?o de tend?ncia para cada caracter?stica e os n?veis de consumo de cada padr?o. Para elabora??o do QFA, definiu-se uma lista de alimentos a partir da contribui??o percentual de energia, carboidrato, prote?na, gordura total, c?lcio e vitamina D. Entre os alimentos mais consumidos, destacam-se: Latic?nios, arroz e prepara??es, frutas e oleaginosas, feij?o e leguminosas e sucos e bebidas. Observou-se que o item alimentar mingaus e papas ? o principal contribuinte para o fornecimento de energia, prote?na, carboidrato e c?lcio da dieta. O QFA constou de um n?mero reduzido de itens alimentares, que poder? ser aplic?vel em popula??o semelhante ap?s aprimoramento do seu modelo. Foram identificados tr?s padr?es de consumo alimentar: ?Arroz, batatas e carnes?, ?Peixes e massas? e ?Feij?o e sopas?, explicando aproximadamente 70% da variabilidade total do consumo. Verificou-se que os idosos fisicamente ativos possuem tend?ncia para alto consumo do padr?o ?Arroz, batatas e carnes?. J? os idosos do sexo masculino, entre 60-69 anos, fisicamente ativos, fumantes, sem restri??o de mobilidade, com ingest?o excessiva de energia e que n?o necessitam de ajuda para se alimentar, t?m tend?ncia para alto consumo de ?Peixes e massas?. Por fim, os idosos do sexo masculino, com restri??o de mobilidade e com dieta pastosa, apresentam tend?ncia para alto consumo do padr?o ?Feij?o e sopas?. Sendo assim, a identifica??o do padr?o alimentar evidencia a necessidade de interven??es alimentares, a fim de evitar o aumento da preval?ncia da desnutri??o entre os idosos. No planejamento de card?pios das ILPI tamb?m ? preciso estabelecer medidas que incentivem o consumo de frutas, legumes e verduras. / Food is a human need on free demand and with many meanings. However, at the nursing homes it becomes a collective good, with defined schedules and controlled quantities, which may change the eating comportment and compromise the health of the elderly. In this sense, identify dietary patterns based on representative data for the population, can improve the understanding of dietary practices and assist the nutritional and educational interventions. The scarcity of information about food and nutrition situation of institutionalized elderly living in nursing homes in Natal, Rio Grande do Norte, Brazil, motivated to meet the dietary patterns of this group to support the development of strategies that provides better conditions of health to the elders. This study aimed to identify and characterize the dietary pattern of the elderly living in nursing homes and propose a Food Frequency Questionnaire (FFQ). This is a cross-sectional study, involving all elderly residents in philanthropic and private nursing homes located in Natal (n = 300). Food and dietary consumption data was obtained in 2013, through the food record method, by direct weighing of food for two alternate days. Dietary patterns were identified from the Principal Component Analysis, considering the average amount of food consumed (in grams). The factor scores of dietary patterns were categorized into tertile (low, moderate and high consumption) and were verified associations with sociodemographic characteristics, lifestyle, health, nutritional status and dietary practices, revealing the existence (or not) of tendency for each feature and the consumption levels for each pattern. To prepare the FFQ, it was previously defined a list of foods from the percentage contribution of energy, carbohydrate, protein, total fat, calcium and vitamin D. Among the most consumed foods are highlighted: dairy products, rice and preparations based on it, fruits and oil seeds, beans and legumes, fruit juices and drinks. It was observed that pap and porridge are the main contributor to the energy supply, protein, carbohydrate and calcium in the dietary. The FFQ consisted of a small number of Food Items that will be able to be applied in a similar population after improvement of its model. Three patterns were identified in food consumption, called "rice, potatoes and meat", "Fish and Pasta" and "beans and soups," explaining about 70% of total consumption variability. It was found that physically active elderly has tendency to a high consumption of the "rice, potatoes and meat" pattern. The elderly men, aged between 60-69 years, physically active, smokers, without mobility restrictions, which have excessive intake of energy and do not need help to feed, tend to high consumption of "fish and pasta". Finally, the male elderly with mobility restrictions and with pasty dietary tends to a high consumption of "beans and soups". Thus, the identification of dietary pattern shows the need of food interventions to avoid the increased prevalence of malnutrition among the elderly. In planning menus of the ILPI, it is necessary to establish measures that encourage the consumption of fruits and vegetables.

Made available in DSpace on 2015-04-14T14:46:07Z (GMT). No. of bitstreams: 1 438288.pdf: 790002 bytes, checksum: d022853cbf61e312eb27568da15d65ff (MD5) Previous issue date: 2012-03-23 / This study concerns the theme of elderly institutionalization. The current paper aims to verify what the process of elderly institutionalization at nursing homes in Porto Alegre- RS is like, verify elderly decision and choice concerning their institutionalization process, identify elderly participation and (not) acceptance concerning the situation of living at long-term institutions addressed to elderly (ILPIs) and verify the familiar relationships involved in such processes. To do so, 25 semi-structured interviews with elderly and nursing homes staff members were conducted between October 2010 and December 2011. The study shows that most of ILPIs residents were women, none of the interviewers were accompanied by their spouse at the moment of the interview and most of them had children. Most of the interviewees have stated that both the idea of moving in to a nursing home and the choice for such nursing home had been made by their family members. Among other reasons to sheltering risen by both elderly and ILPI staff members are: the demand for a place capable of providing better cares and/or health treatments, problem with caretakers and/or accompanying at home and search for a place where the elderly would not feel lonely. Most of elderly interviewed thinks that being at a nursing home is a good thing and this fact could be related to the kinds of cares devoted to elderly in such places as well as to the nursing home s physical space and also to the playful and leisure activities developed at such homes. All the elderly interviewed reported being visited by their family members. / Este estudo aborda a tem?tica da institucionaliza??o de idosos. O presente trabalho objetiva verificar como se d? o processo de institucionaliza??o de idosos em cl?nicas geri?tricas de Porto Alegre RS, verificar o poder de decis?o e escolha de idosos no seu processo de institucionaliza??o, identificar a participa??o e aceita??o ou n?o por parte dos idosos da condi??o de residir em institui??es de longa perman?ncia para idosos (ILPIs) e verificar as rela??es familiares envolvidas. Para tanto, foram realizadas 25 entrevistas semi-estruturadas com idosos e funcion?rios de ILPIs de Porto Alegre, no per?odo compreendido entre outubro de 2010 e dezembro de 2011. O estudo demonstrou que o maior n?mero de moradores de ILPIS eram mulheres, todos os pesquisados estavam sem c?njuge no momento da entrevista e a maioria tinha filhos. A maioria dos idosos entrevistados declarou que a id?ia de ir para uma cl?nica geri?trica, bem como a escolha do local foi feita por seus familiares. Dentre os motivos apontados pelos idosos e funcion?rios de ILPIs para o asilamento est?o: a procura de um local para maiores cuidados e/ou tratamento de sa?de, problemas com cuidadores e/ou acompanhantes em casa, e procura de uma institui??o para n?o ficar sozinho, para ter companhia. A maior parte dos idosos acha que estar no lar geri?trico ? bom, e isso estaria relacionado aos cuidados recebidos, ? estrutura f?sica e ?s atividades l?dicas e de lazer desenvolvidas no local. Todos os idosos entrevistados relataram que recebem visita dos familiares.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-03-11T12:27:30Z No. of bitstreams: 1 TES_RUBIA_GARCIA_DEON_COMPLETO.pdf: 1058928 bytes, checksum: b809495b4f56ed3e9426658b8a49246d (MD5) / Made available in DSpace on 2016-03-11T12:27:30Z (GMT). No. of bitstreams: 1 TES_RUBIA_GARCIA_DEON_COMPLETO.pdf: 1058928 bytes, checksum: b809495b4f56ed3e9426658b8a49246d (MD5) Previous issue date: 2015-11-23 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: The population aging process is growing in Brazil, and one of the important factors in this context is the institutionalization, which can reduce life quality, make it difficult to maintain a healthy weight and affect the decision-making capacity for the elderly. Objective: To evaluate life quality, nutritional status and decision-making capacity in institutionalized and non-institutionalized elderly of the city Santa Cruz do Sul in the Brazilian state of Rio Grande do Sul. Method: Transversal, descriptive and analytical study. The inclusion criteria were to be older than 60 years and live in the city of Santa Cruz do Sul. The exclusion criteria were being hospitalized at the time the survey was being conducted, or not being able to understand or to express their choices to the questions included in the instruments used. The data collection occurred in long-term care institutions for elderly and at the Family Health Strategies of the city of Santa Cruz do Sul in the Brazilian state of Rio Grande do Sul, with pairing criteria by age, gender, education and whether or not bedridden. The instruments used were the Mini Nutrition Examination, the Body Mass Index, the Psychological-Moral Development, the WHOQOL-BREF and WHOQOL-OLD. For the statistical analysis the software Excel and SPSS 18.0 were used. The associations between the variables were performed using the chi-square tests, linear correlation and ANOVA, with statistical significance of 5% (P <0.05). This study was approved by the Ethics Committee of the PUCRS, with CAAE number 11986413.5.0000.5336 and all the participants signed the Free and Informed Consent form. Results: 552 elderly were evaluated, 276 institutionalized and 276 non-institutionalized, with an average age of 76.83 ? 7.36 years old. Most were women (55.4%), with basic education (49.7%) and not bedridden (98.5%). In the life quality assessment, the average of WHOQOL-BREF was 13.59 ? 2.92, the WHOQOL-OLD was 46.09 ? 4.71 and associations with the institutionalization were statistically significant (p <0.05 ). In the nutritional status assessment by the Mini Nutritional Examination the majority (61,6%) was eutrophic, by the Body Mass Index (49,1%) were overweight and associations with the institutionalization were statistically significant (p <0.001). The Psychological-Moral Development evaluation has shown that all participants had the capacity for decision-making and the association with the institutionalization was statistically significant (p = 0.0001). Conclusions: The study of the results of this research shows relevant data and can guide for performing early intervention and contribute to the training of professionals for the real needs of this population. / Introdu??o: O processo de envelhecimento populacional est? crescendo no Brasil e um dos fatores importantes neste contexto ? a institucionaliza??o, que pode reduzir a qualidade de vida, dificultar a manuten??o do peso saud?vel e afetar a capacidade para a tomada de decis?o dos idosos. Objetivo: Avaliar a qualidade de vida, o estado nutricional e a capacidade para a tomada de decis?o em idosos institucionalizados e n?o institucionalizados de Santa Cruz do Sul/RS. M?todo: Estudo transversal, descritivo e anal?tico. Os crit?rios de inclus?o foram ter mais de 60 anos e residir em Santa Cruz do Sul/RS. Os crit?rios de exclus?o foram estar hospitalizado no momento da realiza??o da pesquisa ou n?o ter condi??es de compreender ou de expressar suas op??es ?s quest?es inclu?das nos instrumentos utilizados. A coleta de dados ocorreu nas Institui??es de Longa Perman?ncia para Idosos e nas Estrat?gias de Sa?de da Fam?lia, com crit?rios de pareamento por idade, sexo, escolaridade e por estar ou n?o acamado. Os instrumentos utilizados foram a Mini Avalia??o Nutricional, o ?ndice de Massa Corporal, o Desenvolvimento Psicol?gico-Moral, o WHOQOL-BREF e o WHOQOL-OLD. Para an?lise estat?stica foram utilizados os programas Excel e SPSS 18.0. As associa??es entre as vari?veis foram realizadas pelos testes qui-quadrado, correla??o linear e ANOVA, com signific?ncia estat?stica de 5% (p < 0,05). Este estudo foi aprovado pelo Comit? de ?tica em Pesquisa da PUCRS, com CAAE n?mero 11986413.5.0000.5336 e todos os participantes assinaram o Termo de Consentimento Livre e Esclarecido. Resultados: Foram avaliados 552 idosos, sendo 276 institucionalizados e 276 n?o institucionalizados, com m?dia de idade de 76,83?7,36 anos. A maioria eram mulheres (55,4%), com ensino fundamental (49,7%) e n?o acamados (98,5%). Na avalia??o da qualidade de vida, a m?dia do WHOQOL-BREF foi 13,59?2,92, a do WHOQOL-OLD foi 46,09?4,71 e as associa??es com a institucionaliza??o foram estatisticamente significativas (p < 0,05). Na avalia??o do estado nutricional pela Mini Avalia??o Nutricional a maioria (61,6%) eram eutr?ficos, pelo ?ndice de Massa Corporal (49,1%) tinham excesso de peso e as associa??es com a institucionaliza??o foram estatisticamente significativas (p < 0,001). O Desenvolvimento Psicol?gico-Moral mostrou que todos os participantes tinham a capacidade para a tomada de decis?o e a associa??o com a institucionaliza??o foi estatisticamente significativa (p = 0,0001). Conclus?es: O levantamento dos resultados desta pesquisa mostram dados relevantes e podem direcionar para a realiza??o de interven??es precoces e contribuir na capacita??o de profissionais para as reais necessidades desta popula??o.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-09-05T16:48:58Z No. of bitstreams: 1 TES_MICHELLE_BERTOGLIO_CLOS_COMPLETO.pdf: 2598161 bytes, checksum: 031ab8c75b00622d3aeeea78cff41317 (MD5) / Made available in DSpace on 2016-09-05T16:48:58Z (GMT). No. of bitstreams: 1 TES_MICHELLE_BERTOGLIO_CLOS_COMPLETO.pdf: 2598161 bytes, checksum: 031ab8c75b00622d3aeeea78cff41317 (MD5) Previous issue date: 2016-05-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / This is a study of descriptive and qualitative approach whose overall goal is to understand how care is being implemented at the end of life in Long Staying Institutions for the Aged in the metropolitan region of Porto Alegre. Six institutions in 6 municipalities in the metropolitan region, including the capital, were selected. We interviewed 19 subjects comprised of staff and responsible 13 / family for institutionalized elderly, summing up a total of 32 subjects. In this sense, we sought to investigate whether ILPI are structured to recognize the needs of care to ensure comfort and dignity in the dying process of their patients. The central categories of this study were outlined as: care, integrity, individuality, relationships and spirituality. From the analysis of the content of interviews and field observations, it can be said that there is insecurity in these host structures and ignorance of the philosophy of hospice care and end of life. Because there is weakness in the effectiveness of care, there is compensation for the structural difficulties with speech affection for the technical team. Also it is identified a relationship between care quality and availability of financial resources, demonstrating an indicative reification of care, or care as a commodity to be sold. / Este ? um estudo de natureza descritiva e abordagem qualitativa cujo objetivo geral ? compreender como vem sendo implementado os cuidados no fim de vida em Institui??es de Longa Perman?ncia para Idosos na regi?o metropolitana de Porto Alegre. Foram selecionados 6 institui??es em 6 munic?pios da regi?o metropolitana, incluindo a capital. Foram entrevistados 19 sujeitos do corpo t?cnico e 13 respons?veis/familiares pelos idosos institucionalizados, num total de 32 sujeitos. Neste sentido, buscou-se investigar se as Ilpi est?o estruturadas para reconhecer as necessidades de cuidados que garantam conforto e dignidade no processo de morrer de seus residentes. As categorias centrais deste estudo foram delineadas a priori: cuidado, integralidade, individualidade, v?nculos e espiritualidade. A partir da an?lise do conte?do das entrevistas e das observa??es de campo, pode-se dizer que h? precariedade nestas estruturas de acolhimento e desconhecimento da filosofia de cuidados paliativos e cuidados em fim de vida. Por haver fragilidade na efetiva??o do cuidado, h? compensa??o das dificuldades estruturais com o discurso do afeto por parte da equipe t?cnica. Tamb?m se identificou uma rela??o entre cuidado de boa qualidade e disponibilidade de recursos financeiros, demonstrando indicativos para a reifica??o do cuidado, ou seja, o cuidado enquanto mercadoria a ser comercializada.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-04-18T12:52:32Z No. of bitstreams: 1 PaulaReginadeOliveiraRibeiroDissertacao2016.pdf: 864102 bytes, checksum: a15ed917557dd70793f05d75d64fd72a (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-04-18T12:52:54Z (GMT) No. of bitstreams: 1 PaulaReginadeOliveiraRibeiroDissertacao2016.pdf: 864102 bytes, checksum: a15ed917557dd70793f05d75d64fd72a (MD5) / Made available in DSpace on 2017-04-18T12:52:54Z (GMT). No. of bitstreams: 1 PaulaReginadeOliveiraRibeiroDissertacao2016.pdf: 864102 bytes, checksum: a15ed917557dd70793f05d75d64fd72a (MD5) Previous issue date: 2016-02-26 / The ageing population in Distrito Federal has been growing with remarkable features that require long-term care services: low, medium and high complexity. Once this is an observational, exploratory, quantitative and qualitative, bibliographic and documentary study, it aimed to evaluate existing long-term care services in Distrito Federal in the light of the National Policy for the Elderly and pertaing legislation, whether these services meet the elderly population???s socio-demographic distribution, as well the characteristics set for each one. The State Secretariat and the Council of Elderly Rights??? data were analyzed in order to identify: a) number of CRAS and elderly assisted in SCFV; b) number of CREAS, their territorial distribution and the services delivered c) which services provided by law are offered in Distrito Federal; d) number of places available in such services, considering the degree of dependence, income, family ties and gender of the elderly in care; e) services territorial distribution. The results pointed out that only the CCI and ILPI services are developed by both the public and private, with such a poor social cover and an irregular socio-demographic distribution, highlighting the lack of planning. It has also been verified that the lack of social services of medium complexity, such as day centers, care homes and home care workers contributes for the institutional sheltering, putting an even greater burden on this service, as it is pursued like the only option by the elderly and their families. / O envelhecimento da popula????o do Distrito Federal vem apresentando acelerado crescimento e caracter??sticas marcantes, que demandam servi??os de cuidados de longa dura????o de baixa, m??dia e alta complexidade. De car??ter observacional, explorat??rio, quanti-qualitativo, bibliogr??fico e documental, o presente estudo teve como objetivo avaliar os servi??os de cuidados de longa dura????o existentes no Distrito Federal ?? luz da Pol??tica Nacional do Idoso e legisla????es correlatas, bem como se esses servi??os atendem ?? distribui????o sociodemogr??fica da popula????o idosa e ??s caracter??sticas definidas para cada modalidade. Foi analisada a base de dados da Secretaria gestora da pol??tica do idoso e do Conselho dos Direitos do Idoso, a fim de se identificar: a) n??mero de CRAS e idosos atendidos nos SCFV; b) n??mero de CREAS, abrang??ncia territorial e equipe de atendimento; c) quais servi??os previstos na legisla????o s??o ofertados no Distrito Federal; d) n??mero de vagas disponibilizadas nesses servi??os, considerando-se o grau de depend??ncia, a renda, o v??nculo familiar e o g??nero dos idosos atendidos; e) a distribui????o territorial dos servi??os. Os resultados identificaram que s??o desenvolvidos no Distrito Federal apenas os servi??os de CCI e ILPI, tanto pela rede p??blica como privada, com baix??ssima cobertura da popula????o idosa e m?? distribui????o sociodemogr??fica dos servi??os, evidenciando a falta de planejamento na execu????o da pol??tica do idoso. Demonstrou-se, ainda, que a aus??ncia de servi??os de m??dia complexidade, como centros-dia, casas-lares e cuidadores domiciliares, for??a os idosos e seus familiares a buscarem exclusivamente o abrigamento institucional, sobrecarregando a demanda por esse servi??o.

Made available in DSpace on 2014-12-17T14:46:52Z (GMT). No. of bitstreams: 1 JoseELL_DISSERT.pdf: 1209800 bytes, checksum: 6ccdf27e7399044ee694fed91b7f4663 (MD5) Previous issue date: 2011-03-30 / The Nursing Process (NP) is considered as the dynamics of the systemized and inter-related actions of human care. We believe that the nursing manager, as the representative of all the nursing care provided in the hospital setting, is an important agent for the implementation of institutional policies, such as the NP, in the service. However, there is little information in the literature about the NP in the perspective of the nurse manager. The objective of this study was to analyze the viability of the Nursing Process in the hospital context based on the attitudes of the nurse managers toward the Process. We conducted a descriptive-exploratory research study, of quantitative approach, with a population of 45 nurse managers that worked in the state hospitals located in Natal, RN and in the university hospitals of the UFRN. Two instruments were used for the collection of data: a nursing process questionnaire, constructed for use in this study, and the scale for the measurement of the attitudes titled Positions on the Nursing Process. The population is predominantly feminine (91,0%) and have relative nursing practice experience (Mean=17,6 years). However, they have little experience in management (Mean=8,6 years). They express little knowledge of the PE nursing terms and little experience with the Process. They have a positive atitude toward the NP (Mean = 110,9); are favorable to its developement in the service (86,7%); 48,9% indicated little possibility of institutionalization in the service and 37,8% indicated large possibility. The Spearman test for association between the variables of attitude about the NP and the possibility of its institutionalization demonstrated a weak negative association in the total individual scores of the attitudes (-,316) as in the 20 itens of the instrument, with coefficients varying from 0,014 to 0,464. Factorial analysis of the instrument identified three underlying factors to the attitudes of the managers in this study: relevance, operationalization and collaboration, with Cronbach Alpha coeficients of 0,955, 0,844 and 0,807, respectively, and 0,956 for the whole instrument, indicating that the scale and its factorial subscales have internal consistency. We conclude that there is a weak tendency for the managers with a favorable attitude to have a negative perception about the possibility of institutionalization of the NP in the service. The favorable position does not appear to be sufficient for the viability of this methodology in the hospital sector, results that is worrisome for nursing. This situation suggests that the difficulties with the institution of the NP in the hospitals may be related to other factors, including the organizational conditions. We believe that the institucionalization of the NP in a servisse where it is not known and not practiced, constitutes the introduction of an innovative work technology that involves many demands, among them the adherence of the persons to the proposed innovation. This demands time and the institutional adjustments and the human resources necessary. In this process, the involvement of the health professional of the institution is necessary. This situation brings to light the discussions of professional autonomy, the action limits and perspectives, the redefinition of roles, delimiation (or consensus) of the objects of study and of the work processes, among others. / O Processo de Enfermagem (PE) ? considerado como a din?mica das a??es sistematizadas e inter-relacionadas visando ? assist?ncia do ser humano. No entanto, percebemos a falta de uso do PE nos servi?os e observamos que a dificuldade de implanta??o dele est? relacionada ? pr?pria valoriza??o pelos enfermeiros e quest?es institucionais que envolvem recursos humanos e materiais. Acreditamos que o gerente, como representante de toda a assist?ncia prestada pela enfermagem da institui??o, ? um personagem importante para efetiva??o de pol?ticas de interesse da enfermagem, como a implanta??o do PE no servi?o. No entanto, a literatura ? escassa quanto ao PE na perspectiva do gerente de enfermagem. O objetivo geral deste estudo ? analisar a viabilidade do Processo de Enfermagem no contexto hospitalar a partir das atitudes dos gerentes de enfermagem das institui??es acerca desse instrumento. Realizamos uma pesquisa descritivo-explorat?ria, de abordagem quantitativa, com uma popula??o de 45 gerentes de enfermagem de hospitais atuando na rede p?blica estadual de Natal-RN e nas unidades hospitalares da UFRN. Foram utilizados dois instrumentos para a coleta de dados, um question?rio sobre o PE, desenvolvido para prop?sitos deste estudo e a escala para medi??o de atitudes, Posi??es sobre o Processo de Enfermagem. A popula??o ? predominante feminina (91,0%) e relativamente experiente na pr?tica da enfermagem (M?dia = 17,6 anos). No entanto, possuem pouca experi?ncia na ?rea gerencial (M?dia = 8,6 anos). Expressam ter pouco conhecimento dos termos relacionados ao PE e pouca experi?ncia com ele. Possuem uma atitude favor?vel ao PE (M?dia Geral = 110,9); s?o favor?veis a seu desenvolvimento no servi?o (88,9%) e sugeririam a sua implanta??o (86,7%); 48,9% indicaram pouca possibilidade de implanta??o no servi?o e 37,8% muita possibilidade. O teste de Spearman entre a Atitude sobre o PE e a Possibilidade de implanta??o no servi?o mostrou uma associa??o negativa fraca, tanto na atitude geral (-0,316), quanto nos 20 itens do instrumento, com coeficientes variando entre -0,014 a -0,464. A an?lise fatorial da escala realizada neste estudo identificou tr?s fatores subjacentes ?s atitudes dos gerentes neste estudo: relev?ncia , operacionaliza??o e colabora??o , com Coeficiente Alfa Cronbach de 0,955; 0,844 e 0,807, respectivamente e de 0,956 para todos os itens em conjunto, demonstrando que a escala geral e as fatoriais possuem coer?ncia interna para uso nessa popula??o. Presumimos que h? uma tend?ncia, embora leve, dos profissionais com atitude favor?vel ter percep??o negativa sobre a possibilidade de implanta??o do PE no servi?o. A posi??o favor?vel ao PE parece n?o ser suficiente para a viabilidade de implanta??o dessa metodologia no servi?o hospitalar, sendo esse resultado desconfort?vel para a enfermagem. Essa situa??o sugere que as dificuldades de implanta??o do PE est?o vinculadas ? outras quest?es, como as organizacionais. A implanta??o do PE em uma institui??o onde n?o ? conhecido, nem praticado, constitui a introdu??o de uma inova??o tecnol?gica e de trabalho que envolve m?ltiplos requisitos, entre eles a ades?o das pessoas ? inova??o proposta. Isso demanda n?o s? tempo, mas um processo com estrat?gias espec?ficas para a difus?o do conhecimento acerca do m?todo, bem como os ajustes institucionais e de recursos humanos necess?rios. Nesse processo o envolvimento de todos os profissionais da institui??o ? necess?rio. Essa situa??o retoma as discuss?es de autonomia profissional, limites e perspectivas da a??o e influ?ncia do enfermeiro no contexto hospitalar, (re) defini??o de papeis, delimita??o (ou consenso) do objeto de estudo ou do(s) processo(s) de trabalho, entre outras.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-08-22T23:36:42Z No. of bitstreams: 1 IrmaLuciaDaSilveiraSilva_DISSERT.pdf: 6533120 bytes, checksum: 796c8e3100dfd18264d7068d2c1c6d24 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-22T23:44:48Z (GMT) No. of bitstreams: 1 IrmaLuciaDaSilveiraSilva_DISSERT.pdf: 6533120 bytes, checksum: 796c8e3100dfd18264d7068d2c1c6d24 (MD5) / Made available in DSpace on 2016-08-22T23:44:48Z (GMT). No. of bitstreams: 1 IrmaLuciaDaSilveiraSilva_DISSERT.pdf: 6533120 bytes, checksum: 796c8e3100dfd18264d7068d2c1c6d24 (MD5) Previous issue date: 2015-02-12 / O trabalho do cuidador de idoso busca minimizar a morbidade advinda das limita??es f?sicas, cognitivas e emocionais deste indiv?duo, constituindo-se em uma pr?xis que tem influ?ncias da singularidade dos sujeitos envolvidos e, portanto, est? em constante constru??o. Neste sentido, conhecer as demandas por capacita??o, averiguar os conte?dos estudados durante a forma??o e identificar as percep??es e as dificuldades relacionadas ao trabalho do cuidador formal, pode contribuir para o aprimoramento do seu processo de forma??o profissional. E as Institui??es de Longa Perman?ncia para Idosos (ILPIs) s?o, por excel?ncia, as mais indicadas para levantar tais informa??es. Desta forma, este estudo de car?ter transversal, descritivo e anal?tico com abordagem quantitativa e qualitativa, objetivou investigar a forma??o profissional dos cuidadores que trabalham em ILPIs em Natal/RN no ano de 2014. Para tanto, realizou-se uma entrevista semiestruturada com 63 cuidadores em 09 ILPIs, representando 75% do total desses profissionais nessas institui??es. As entrevistas captaram dados relativos ao perfil socioecon?mico, a forma??o profissional e a percep??o sobre a profiss?o de cuidador. Para an?lise dos dados, foram utilizadas a estat?stica descritiva e a an?lise do conte?do de Bardin. De modo geral, identificou-se que a maioria dos cuidadores eram de baixa condi??o socioecon?mica e se inseriam na ocupa??o sem a realiza??o de um curso espec?fico pr?vio. Contudo, entre os que realizaram algum curso, a maioria relata que os conte?dos vistos na grade curricular deram seguran?a para a pr?xis do cuidado, embora tamb?m reportem a necessidade de capacita??o. A percep??o sobre o cuidado est? preponderantemente relacionada ao amar e ao cuidar do outro e a escolha profissional relaciona-se a identifica??o com a pr?tica do cuidar em si. Diante dos resultados, conclui-se que h? a persist?ncia de um baixo n?vel de prepara??o formal para a ocupa??o. Al?m disso, a forma??o apresenta fragilidades que se iniciam com a aus?ncia de um curr?culo b?sico norteador e se intensificam com a baixa escolaridade requerida para o exerc?cio profissional. / The old caretaker's work seeks to minimize suffering and morbidity resulting from physical, cognitive and emotional limitations of these individuals, being a practice permeated by the uniqueness of the subjects involved, therefore, a process in constant construction. In this notion, the caregiver's role is crucial to assist the elderly in everyday life, aiming at improving their quality of life. This study has descriptive and analytical character with quantitative and qualitative approach aimed to investigate the professional training of active caregivers in long-term stay institutions for the Elderly (ILPIs) in Natal/RN in the year 2014. For this, semi-structured interviews were conducted with 63 caregivers employed in nine ILPIs, representing 75% of the professionals performing activities in these institutions. The interviews captured data on the socioeconomic profile, the perception about the profession and training of caregivers. Data were analyzed by observation of absolute and relative measures of central tendency of the numeric variables frequencies. It was found that most caregivers had poor socioeconomic status and had no specific training course to practice caregiver role. However, among those who carried out courses, most reported that the content covered during the training gave security to perform the practice, although they have shown a contradiction when referred to the need to build capacity. The perception of care is mainly related to love and care for the other while the choice of profession is associated with care practice itself. The results also indicate the presence of a low level of formal training for the exercise of the occupation, also revealing the weaknesses ranging from the absence of a core curriculum that can guide the formation, compounded by the low educational professionals in focus.

Made available in DSpace on 2014-12-17T14:36:40Z (GMT). No. of bitstreams: 1 EuclidesTN_DISSERT.pdf: 3556483 bytes, checksum: b4ef676a09093dbfdacff6148b643e9a (MD5) Previous issue date: 2012-02-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / This study aims to reconstruct the story of Education of the School called Desembargador Vicente de Lemos in the city of Senador El?i de Souza in Rio Grande do Norte in Natal- Brazil. This is done considering activities that were realized by the teacher An?lia Maciel. Since the worl deals with an investigation that is related to Cultural History field, the research emphasized the school as well as the presence of female teachers, in particular An?lia Maciel. Concepts present in the work of Chartier (1990), Burke (1992), Le Goff (1992) and Morais (2002) were used in order to comprehend the transformation process in which local schools have been through. This is also done considering the state educational actions of behalf of the teacher. The documental fonts regarded available records such as Governmental correspondence, Law and Decrees. The information fonts used were available at the The Geographical and Historical Institute of Rio Grande do Norte as well as the State s Public Archive. Other information fonts were newspapers such as A Rep?blica, Di?rio de Natal and Tribuna do Norte. Some people that were contemporary with the teacher and were there when the school was created were interviewed. Discourses from the decades of 1930 and 1940 were analyzed. The research was guided by the History of Education and Scholar Institution field of analysis. The research also allows to reflect on the pedagogical practices of the time and permits to understand a past-still present -as well as all the development of process that the education went through in the historical context of the city of Senador El?i de Souza. It was also possible to acknowledge that the creation of the school represented thoroughly a landmark in the education in this city and it contributed in a determinant manner for the formation of the students / Este estudo tem como prop?sito reconstruir a Hist?ria do Grupo Escolar Desembargador Vicente de Lemos e as atividades exercidas pela professora An?lia Maciel, na cidade de Senador El?i de Souza, situada na regi?o Agreste do Estado do Rio Grande do Norte. Por se tratar de uma investiga??o na perspectiva da Hist?ria Cultural, enfocamos a hist?ria do Grupo Escolar e as presen?as de mulheres professoras, em particular a de An?lia Maciel. Para o estudo, recorremos aos conceitos dos autores Chartier (1990), Burke (1992), Le Goff (1992) e Morais (2002), para compreendermos os processos pelos quais se deram as transforma??es do ensino no ?mbito local, bem como no ?mbito estadual, nas a??es educativas deixadas pela professora. Utilizamos como fontes documentais os registros dispon?veis, tendo como principais suportes: Mensagens Governamentais, Leis e Decretos do Governo, provenientes do Instituto Hist?rico e Geogr?fico do Rio Grande do Norte e do Arquivo P?blico do Estado/RN. Investigamos tamb?m, os registros dispon?veis nos jornais: A Rep?blica, Di?rio de Natal e Tribuna do Norte, al?m de entrevistas com contempor?neos que vivenciaram a cria??o desse estabelecimento de ensino e foram alunos da referida professora. Optamos por analisar o decurso das d?cadas de 1930 e 1940, e elencamos, Hist?ria da Educa??o e Institui??o Escolar como palavras norteadoras. Os resultados desta pesquisa fornecem subs?dios para uma leitura da educa??o na cidade de Senador El?i de Souza/RN, e reflex?es acerca das pr?ticas pedag?gicas da ?poca a fim de compreendermos um passado ainda t?o presente e todo o processo de desenvolvimento da educa??o no contexto da pr?pria hist?ria de Senador El?i de Souza. Constatamos, ainda, que a cria??o desse Grupo Escolar representou um marco na educa??o deste munic?pio, contribuindo de forma determinante na forma??o dos alunos

Made available in DSpace on 2014-12-17T14:36:45Z (GMT). No. of bitstreams: 1 ClaudiaSF.pdf: 983119 bytes, checksum: dc31a09ca46d7d9017f671e87ff07edc (MD5) Previous issue date: 2007-10-25 / The present paper is a doctorate thesis, in the area of Education, that has as a goal to describe and to reflect on the construction/systematization of a relation between family and institution of Childhood Education, in favor of sharing the care and education actions of children, in the context of creation of a County Center of Childhood Education, located in the city of Natal-RN. Our intension with this paper is to share some of the ideas and actions collectively constructed by this experience, with the intention of bringing a contribution for the thematic debates concerning Childhood Education - as modality of education, in a general way; and the relations between families and Institutions of Childhood Education, in a more specific way. The paper presented here is endorsed by the postulates of the qualitative research with characteristics of a research-action, having as main instruments of the data construction the open or half-structuralized interviews, the personal notebook of registers, the participant s index cards characterizing the children and comments. Authors as Aries (1981); Bassedas, Huguet and Sol? (1999); Bhering and Blatchford (1999); Brasil (1998); Bujes (2001); Didonet (2002 - 2003); Formosinho (2007); G?mez (2000); Heywood (2004); Kramer (2005); Marchesi and Mart?n (2003); Marschal and Zohar (2006); Thiollent (2004); Tiriba (2006), amongst others, had theoretically based this paper. The experience described here points to the possibilities of sharing the care and education actions between family and Institution of Childhood Education, emphasizing the relevance of participative praxis in the interior of the institution, so that its job can propitiate this sharing with the families, throughout activities as meetings, lectures, workshops, participation in didactic projects, open expositions to the community, commemorative parties and valuation of the local culture, amongst other chances of dialogue and interaction between the educative institution and the families / O presente trabalho se constitui em uma tese de doutorado, na ?rea da Educa??o, que tem como objetivo descrever e refletir sobre a constru??o/sistematiza??o de uma rela??o entre fam?lia e institui??o de Educa??o Infantil, em prol do compartilhamento das a??es de cuidado e educa??o das crian?as, no contexto de cria??o de um Centro Municipal de Educa??o Infantil, localizado na cidade de Natal-RN. A nossa pretens?o com esse trabalho ? compartilhar algumas das id?ias e a??es constru?das coletivamente a partir dessa experi?ncia, com a inten??o de trazer uma contribui??o para os debates acerca das tem?ticas relativas ? Educa??o Infantil enquanto modalidade de ensino, de uma maneira geral; e as rela??es entre fam?lias e Institui??es de Educa??o Infantil, de forma mais espec?fica. O trabalho aqui apresentado se encontra respaldado pelos postulados da pesquisa qualitativa com caracter?sticas de uma pesquisa-a??o, tendo como principais instrumentos de constru??o dos dados ?s entrevistas abertas ou semi-estruturadas, o caderno pessoal de registros, as fichas de caracteriza??o das crian?as e as observa??es participantes. Autores como ?ries (1981); Bassedas, Huguet e Sol? (1999); Bhering e Blatchford (1999); Brasil (1998); Bujes (2001); Didonet (2002 2003); Formosinho (2007); G?mez (2000); Heywood (2004); Kramer (2005); Marchesi e Mart?n (2003); Marschal e Zohar (2006); Thiollent (2004); Tiriba (2006), dentre outros, embasaram teoricamente este trabalho. A experi?ncia aqui descrita aponta para as possibilidades de compartilhamento de a??es de cuidado e educa??o entre fam?lia e Institui??o de Educa??o Infantil, enfatizando a relev?ncia de uma pr?xis participativa no interior da institui??o, para que o trabalho da mesma possa propiciar esse compartilhamento com as fam?lias, a partir de atividades como reuni?es, palestras, oficinas, participa??o em projetos did?ticos, exposi??es abertas ? comunidade, festas comemorativas e valoriza??o da cultura local, dentre outras oportunidades de di?logo e intera??o entre a institui??o educativa e as fam?lias