Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-20T21:55:50Z No. of bitstreams: 1 LuciaHelenaCostaDeGois_TESE.pdf: 17633111 bytes, checksum: 9e03f521ad56720c0092820881f19c6a (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-07-21T20:40:27Z (GMT) No. of bitstreams: 1 LuciaHelenaCostaDeGois_TESE.pdf: 17633111 bytes, checksum: 9e03f521ad56720c0092820881f19c6a (MD5) / Made available in DSpace on 2016-07-21T20:40:27Z (GMT). No. of bitstreams: 1 LuciaHelenaCostaDeGois_TESE.pdf: 17633111 bytes, checksum: 9e03f521ad56720c0092820881f19c6a (MD5) Previous issue date: 2015-04-17 / O estudo tem como foco de aten??o as formas e modos de morar da fam?lia intergeracional, aquela constitu?da por pessoas de diferentes gera??es, que co-habitam e tem o idoso/idosa como refer?ncia. Quanto ?s formas de morar, deste tipo de fam?lia, ? interessante notar que as pesquisas, produ??es, tradicionalmente realizadas por arquitetos e designers de interiores, n?o a conceituam nem a definem porque n?o inclu?ram essa configura??o familiar nos seus estudos e n?o se preocuparam em atrelar esse tipo de fam?lia com alguma forma de morar. Encontra-se, portanto, at? o presente momento, um v?cuo te?rico conceitual, propositivo e interventivo que n?o corresponde ? realidade emp?rica. Face ?s constata??es, a investiga??o passou pelo desafio te?rico de desconstruir o modelo ?nico de habita??o contempor?nea, hoje destinada a todos os formatos de fam?lias sem considerar o que est? se gestando: o da fam?lia intergeracional de idoso e com idoso. O estudo constitui, portanto, um meio privilegiado para se ter um olhar diferenciado sobre diferentes modelos de espa?os dom?sticos a partir dos novos formatos de fam?lias, suas necessidades b?sicas e especiais bem como as identidades das moradias das camadas sociais m?dia-alta e alta indicando um diferencial em rela??o ?s condi??es de moradia e estilo de vida das camadas m?dias e pobres. Para descrever as formas e modos de morar do arranjo familiar intergeracional foi selecionado o m?todo interdisciplinar, que melhor articula n?o s? o m?todo de procedimento, como o m?todo de abordagem indutivo-reflexivo mediante pesquisa de natureza qualitativa. Para tal, selecionou-se como espa?o geogr?fico aquele em que se concentravam pessoas de grande proximidade socioantropol?gica e os que faziam parte do c?rculo de amizades e parentes da pesquisadora, entre estes, os residentes nos bairros de Capim Macio, Candel?ria, Tirol e Petr?polis, localizados nas zonas sul e leste, respectivamente, da cidade de Natal. Os moradores foram entrevistados e os ambientes fotografados. Constatou-se que, enquanto o espa?o intergeracional n?o se firma enquanto tal, rearranjos extremamente criativos se d?o no espa?o dom?stico em fun??o dos h?bitos, necessidades, rela??es entre g?nero e gera??es. Conclui-se que a fam?lia intergeracional continua na invisibilidade apesar de se firmar como novo arranjo domiciliar; que os estudos sobre cotidiano e moradia devem ser retomados na perspectiva hist?rica e epistemol?gica integrando substancialmente a dimens?o pessoa-ambiente; que foram validadas as categorias anal?ticas de g?nero e gera??o, bem como as formas de co-habita??o permanente, tempor?ria e em conex?o que contribuem para uma releitura das formas e modos de morar na contemporaneidade. / The focus of this study is to draw attention to the intergenerational family?s lifestyles and their various ways of cohabitation, in special to those families which are made by individuals of different generations, these families being constituted of, two or more individuals, or, two or more smaller families, which live under the same roof and have the elderly person as referential in their cohabitation. In those types of families, as for their ways of organization, it is interesting to note that the researches and productions done by inner architects and inner designers do not include this type of family arrangement because their studies do not cover this kind of structuralization nor was this type of organization put together with any of the ways of cohabitation. Therefore there is a theoretical concept void which is propositional, interventional and does not relate to the empirical reality. In observation to these remarks, the research starts a theoretic challenge of deconstruct or reconstruct our modern only habitational template, which is used today in all families configurations which out any regards to where this template will be used, unfitting to the intergenerational families who have elders. This study is then meant to give an differential analysis of the various domestic space?s templates in regards to the new families formats, their basic and special necessities, the home identities of those families which indicates the differential gap in housing and lifestyle from the higher social classes in comparison to the lower social classes. The interdisciplinary method was chosen in order to describe arrangements found in the lifestyles and the ways of cohabitation of the intergenerational families, this method is used for its knowledge base that better articulates the procedure method and the inductive reflexive approach made possible after an qualitative research. In order to accomplish that, an geographical space which tow real possibilities was selected, that is, the space where the people of great social and anthropological proximity are concentrated and the people which are the researcher kinships and friends, in between those are the habitants of Capim Macio?s, Candel?ria?s, Tirol?s and Petr?polis?s, neighborhoods, located in the south west zone of her home city Natal. It has been noticed that, meanwhile these intergenerational spaces do not claim their said spaces, because of their habits, necessities and relations in between generations and gender, their arrangements of said space are extremely creative. That means that alterations in the concepts of planning, construction and utilization of built spaces are imperative.

Made available in DSpace on 2014-12-17T15:16:09Z (GMT). No. of bitstreams: 1 GracileneRT_DISSERT.pdf: 1181628 bytes, checksum: 852f63bbbe08febda85d8edf419c5a92 (MD5) Previous issue date: 2010-08-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / It is known that sleep plays an important role in the process of motor learning. Recent studies have shown that the presence of sleep between training a motor task and retention test promotes a learning task so than the presence of only awake between training and testing. These findings also have been reported in stroke patients, however, there are few studies that investigate the results of this relationship on the functionality itself in this population. The objective of this study was to evaluate the relationship between functionality and sleep in patients in the chronic stage of stroke. A cross-sectional observational study was conducted. The sample was composed of 30 stroke individuals in chronic phase, between 6 and 60 months after injury and aged between 55 and 75 years. The volunteers were initially evaluated for clinical data of disease and personal history, severity of stroke, through the National Institute of Health Stroke Scale, and mental status, the Mini-Mental State Examination. Sleep assessment tools were Pittsburgh Sleep Quality Index, the Questionnaire of Horne and Ostberg, Epworth Sleepiness Scale, the Berlin questionnaire and actigraphy, which measures were: real time of sleep, waking after sleep onset, percentage of waking after sleep onset, sleep efficiency, sleep latency, sleep fragmentation index, mean activity score. Other actigraphy measures were intraday variability, stability interdi?ria, a 5-hour period with minimum level of activity (L5) and 10-hour period with maximum activity (M10), obtained to evaluate the activity-rest rhythm. The Functional Independence Measure (FIM) and the Berg Balance Scale (BBS) were the instruments used to evaluate the functional status of participants. The Spearman correlation coefficient and comparison tests (Student's t and Mann-Whitney) were used to analyze the relationship of sleep assessment tools and rest-activity rhythm to measures of functional assessment. The SPSS 16.0 was used for analysis, adopting a significance level of 5%. The main results observed were a negative correlation between sleepiness and balance and a negative correlation between the level of activity (M10) and sleep fragmentation. No measurement of sleep or rhythm was associated with functional independence measure. These findings suggest that there may be an association between sleepiness and xii balance in patients in the chronic stage of stroke, and that obtaining a higher level of activity may be associated with a better sleep pattern and rhythm more stable and less fragmented. Future studies should evaluate the cause-effect relationship between these parameters / Sabe-se que o sono exerce um importante papel no processo de aprendizado motor. Estudos recentes demonstraram que a presen?a do sono entre o treino de uma tarefa motora e o teste de reten??o promove um aprendizado da tarefa de forma superior ? presen?a apenas de vig?lia entre treino e teste. Estes achados tamb?m t?m sido encontrados em pacientes que sofreram acidente vascular encef?lico (AVE), entretanto, faltam estudos que investiguem os resultados desta rela??o sobre a funcionalidade propriamente dita nesta popula??o. O objetivo desta pesquisa foi verificar a rela??o entre capacidade funcional e sono em pacientes em est?gio cr?nico de acidente vascular encef?lico. Foi realizado um estudo observacional anal?tico transversal. A amostra foi composta por 30 indiv?duos com seq?elas motoras de AVE em fase cr?nica, faixa et?ria entre 55 e 75 anos, apresentando tempo de seq?ela entre 6 e 60 meses. Os volunt?rios foram inicialmente avaliados quanto aos dados cl?nicos e antecedentes pessoais, severidade do AVE, atrav?s da escala internacional de AVE do National Institute of Health, e estado mental, pelo Mini-Exame do Estado Mental. Os instrumentos de avalia??o do sono foram o ?ndice de Qualidade do Sono de Pittsburgh, o question?rio de Horne e Ostberg, Escala de Sonol?ncia de Epworth (ESE), o question?rio de Berlim e a actimetria, cujas medidas utilizadas foram: tempo real de sono, tempo de vig?lia ap?s o in?cio do sono, porcentagem de tempo de vig?lia ap?s o in?cio do sono, efici?ncia do sono, lat?ncia para o sono, ?ndice de fragmenta??o do sono, m?dia do escore de atividade. Outras medidas da actimetria foram a variabilidade intradi?ria, estabilidade interdi?ria, per?odo de 5 horas com n?vel m?nimo de atividade (L5) e per?odo de 10 horas com n?vel m?ximo de atividade (M10), obtidas para avalia??o do ritmo de atividade-repouso. A Medida de Independ?ncia Funcional (MIF) e a Escala de Equil?brio de Berg (EEB) foram os instrumentos utilizados para avalia??o da condi??o funcional dos participantes. O coeficiente de correla??o de Spearman e testes comparativos (t de student e Mann-Witney) foram utilizados para an?lise da rela??o dos instrumentos de avalia??o do sono e do ritmo de atividade/repouso com as medidas de avalia??o funcional. O programa estat?stico SPSS 16.0 foi empregado para as an?lises, adotando-se n?vel de signific?ncia de 5%. Os principais resultados observados foram uma correla??o negativa entre sonol?ncia e equil?brio e uma correla??o negativa entre o n?vel de atividade (M10) e fragmenta??o do sono. Nenhuma medida do sono ou do ritmo foi associada com a medida de independ?ncia funcional. Estes achados sugerem que pode haver uma associa??o entre sonol?ncia e equil?brio em pacientes em est?gio cr?nico de AVE, e ainda que a obten??o de um maior n?vel de atividade pode estar associada a um melhor padr?o de sono e ritmo mais est?vel e menos fragmentado. Futuros estudos devem avaliar a rela??o de causa-efeito entre estes par?metros

Made available in DSpace on 2014-12-17T15:30:53Z (GMT). No. of bitstreams: 1 RossanaMC.pdf: 935976 bytes, checksum: 50156580c3cc8444362ea3f7348f858f (MD5) Previous issue date: 2009-04-07 / Family Health Strategy (FHS), founded in 1994 has appeared to play a strategic role in the SUS construction and consolidation. It has reaffirmed its Principles and Guidelines and has elected family as core of attention. The principle that has guided the work concerns the quality of the relationship between professional and family. Thus, the FHS has the family as a subject of health-disease process, and relations with its own characteristics and can be partners in building their health and improvement of quality of life of its members and the entire community. This study aims to characterize the surgeon-dentist (SD) working process in the family health strategy, from the knowledge of the SD integration with other team members; organization of services; development of shares, changes perceived by SDs, as well as knowing the surgeon-dentist profile who is part of this strategy. The collecting tool used was a semi-structured questionnaire, in which participated 30 professionals. As for profile, most professionals were women, completed the graduation in public university and did not have any training to work by joining the FHS. Almost all have other public or private working ties. They often carry out activities with students, and occasionally do home visits. In relation to team work, in activities such as home visits, school health, community activities, among others, they sometimes seek the cooperation of other members. The way of accessing for users in the most part has occurred through the schedule. The most frequently activities made to the Centro Especialidades Odontol?gicas (CEO), are in Endodontics and Prosthesis. The majority of them participate in team meetings, but they do not have frequency set to happen. As for the planning and programming of activities to be conducted, most said that individually develops them. Concerning the performance of their duties, most reported being satisfied, but that improvements could happen. Besides, they reported improvements in dental care following the inclusion of SD in the FHS in various aspects, such as access, organization, humanization, care and oral disease prevention. The professionals had poor integration with other team members, in addition to have a profile to more individualistic work, a fact seized by way of development and planning of actions. They work the actions in individual and curative way, in detriment promotion and collective ones. They work humanization, definition of territory and adscript population. Thus, it is concluded that the working process developed by SDs, includes the part which is advocated by FHS. This points out to a greater undertaking of this process aiming to detect the weakness met in order to reach the potential that the FHS represents in organization of basic attention / A Estrat?gia Sa?de da Fam?lia (ESF), criada no ano de 1994 surge para desempenhar um papel estrat?gico na constru??o e consolida??o do SUS. Reafirma seus Princ?pios e Diretrizes e elege a fam?lia como n?cleo central da Aten??o. O princ?pio que norteia o trabalho diz respeito ? qualidade da rela??o entre o profissional e a fam?lia. Desta forma, a ESF tem a fam?lia como sujeito do processo sa?de-doen?a, com caracter?sticas e rela??es pr?prias e que podem ser parceiras na constru??o de sua sa?de e na melhoria da qualidade de vida de seus membros e de toda a comunidade. Este estudo tem por objetivo caracterizar o processo de trabalho do cirurgi?o-dentista (CD) na estrat?gia de sa?de da fam?lia, a partir do conhecimento da integra??o do CD com os demais membros da equipe; organiza??o do servi?o; desenvolvimento das a??es; mudan?as percebidas pelos CDs, bem como pretende conhecer o perfil do cirurgi?o-dentista que faz parte desta estrat?gia. O Instrumento de coleta utilizado foi um question?rio semi-estruturado, onde participaram 30 profissionais. Com rela??o ao perfil, a maioria dos profissionais ? do sexo feminino, concluiu a gradua??o em universidade p?blica e n?o possu?am qualquer capacita??o para o trabalho ao ingressarem na ESF. Quase que a totalidade possui outros v?nculos de trabalho quer p?blico ou privado. Realizam atividades com escolares com grande freq??ncia, e ocasionalmente fazem visitas domiciliares. Com rela??o ao trabalho em equipe, em atividades como visitas domiciliares, sa?de escolar, atividades na comunidade, entre outras, eles buscam ocasionalmente a coopera??o dos demais membros. A forma de acesso dos usu?rios em sua maior parte, se d? atrav?s do agendamento. Os encaminhamentos mais frequentemente feitos ao Centro Especialidades Odontol?gicas (CEO), s?o em Endodontia e Pr?tese. A maioria participa das reuni?es em equipe, por?m estas n?o t?m periodicidade definida para acontecer. Quanto ao planejamento e programa??o das atividades a serem realizadas, a maior parte afirmou que as elabora individualmente. No tocante ao desempenho de suas fun??es, a maioria relatou estar satisfeita, por?m que melhoras poderiam acontecer. Relataram tamb?m melhorias na assist?ncia odontol?gica ap?s a inclus?o do CD na ESF em v?rios aspectos como: acesso, organiza??o, humaniza??o, assist?ncia e preven??o de doen?as bucais. Os profissionais apresentaram baixa integra??o com os demais membros da equipe, possuem um perfil de trabalho mais individualista, fato apreendido pela forma de desenvolvimento e planejamento das a??es. Trabalham mais as a??es de natureza curativas e individuais, em detrimento das a??es de promo??o e coletivas. Trabalham a humaniza??o, delimita??o de territ?rio e com popula??o adstrita. Desta forma, cabe concluir que o processo de trabalho desenvolvido pelos CDs, contempla em parte o que ? preconizado pela ESF, o que sinaliza para um maior acompanhamento desse processo, buscando modificar as fragilidades encontradas, com a finalidade de atingir todo o potencial que a ESF representa na reorganiza??o da aten??o b?sica

Made available in DSpace on 2014-12-17T15:37:01Z (GMT). No. of bitstreams: 1 FranciscaPS_DISSERT.pdf: 2124364 bytes, checksum: fdbee75aadf5fa6b72cf6cdc5f8aa5a8 (MD5) Previous issue date: 2010-10-07 / The sleep patterns of students entering the university, is accompanied by many factors that can lead to changes in sleep habits, such as academic demands, new social opportunities, reduced parental care and irregular teaching schedules. The irregular pattern of sleep-wake cycle is usually accompanied by several daytime consequences, for example, reduced levels of motivation, performance, concentration, alertness and mood as well as increased fatigue and sleepiness.Thus, there are numerous reasons to support the fact that these students may suffer damage in their academic performance. The aim of this study was to evaluate the sleep-wake cycle (SWC) and cognition in medical students with different schemes teaching schedules. One group started classes at 08am, while the other started at 07am. We analyzed the data from 88 volunteers, 39 from each group. However, only those who participated in both stages of the study (n = 78) underwent cognitive testing. For subjective evaluation of the SWC was used questionnaires to check the quality of sleep, chronotype, daytime sleepiness and sleep habits. For objective evaluation was used actigraphy. For cognitive assessment was used the test MoCA (Montreal Cognitive Assessment). The results indicate that the group has class earlier had a greater irregularity of the SWC and a worse performance in cognitive testing. There was a difference between the schedules the week and weekend in the subjective variables, bedtime, wake up and sleep duration in both groups. The objective variables, time in bed showed difference between the schedules the week and weekend to the group started class at 08am and the variables bedtime, get up time, actual sleep time, time in bed and wake bouts in the class at 07am. In the cognitive test, there were differences between the groups in overall score and in the areas of executive function and memory recall. Thus, it is suggested that the class starting time may cause irregularity of the SWC and the irregularity may cause mild cognitive impairment. Moreover, cognitive testing MoCA was sensitive to detect differences among students, although the difference between the schedules is small / O padr?o de sono dos estudantes ao entrarem na universidade, ? acompanhado por muitos fatores que podem levar a mudan?as nos h?bitos de sono, tais como demanda acad?mica, novas oportunidades sociais, diminui??o do cuidado dos pais e hor?rios de aulas irregulares. O padr?o irregular de sono-vig?lia ? usualmente acompanhado por v?rias consequ?ncias diurnas, como diminui??o nos n?veis de motiva??o, desempenho, concentra??o, aten??o e humor, bem como aumento da fatiga e da sonol?ncia. Assim, existem in?meras raz?es para apoiar o fato de que, esses estudantes universit?rios, podem sofrer preju?zos em seu desempenho acad?mico. O objetivo desse estudo foi avaliar o padr?o ciclo sono-vig?lia (CSV) e a cogni??o em estudantes de medicina com diferentes esquemas de hor?rios de aulas. Uma turma iniciava as aulas ?s 08 horas da manh?, enquanto a outra iniciava ?s 07 horas. Para isso contamos com 88 volunt?rios. Por?m, desses, apenas os que participaram das duas etapas no estudo (n=78) realizaram o teste cognitivo. Para a avalia??o subjetiva do CSV foi utilizado question?rios para verificar a (1) qualidade de sono, (2) cronotipo, (3) sonol?ncia diurna e (4) h?bitos de sono. Para avalia??o objetiva foi utilizado o act?metro e para avalia??o cognitiva o teste MoCA (Montreal Cognitive Assessment). Os resultados indicam que a turma que tem aula mais cedo teve uma maior irregularidade do CSV e um pior desempenho no teste cognitivo. Houve diferen?a entre os hor?rios da semana e do fim de semana nas vari?veis subjetivas, hora de deitar, hora de levantar e dura??o do sono, em ambas as turmas. E nas vari?veis objetivas, tempo na cama na turma das 08h e, hora de dormir, hora de acordar, tempo real de sono, tempo na cama e despertares noturnos na turma das 07h. No teste cognitivo, houve diferen?a entre as turmas no escore geral e nos dom?nios de fun??o executiva e evoca??o de mem?ria. Assim, sugere-se que o hor?rio de in?cio das aulas pode provocar irregularidade do CSV e, essa irregularidade pode provocar um d?ficit cognitivo leve. Al?m disso, o teste cognitivo MoCA foi sens?vel para detectar diferen?as entre os estudantes, apesar da diferen?a entre os hor?rios ser pequena

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-21T21:50:00Z No. of bitstreams: 1 DalvaCezarDaSilva_TESE.pdf: 3335341 bytes, checksum: 675b0da6bffd6736231d5bb47989ac13 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-23T20:52:50Z (GMT) No. of bitstreams: 1 DalvaCezarDaSilva_TESE.pdf: 3335341 bytes, checksum: 675b0da6bffd6736231d5bb47989ac13 (MD5) / Made available in DSpace on 2018-02-23T20:52:50Z (GMT). No. of bitstreams: 1 DalvaCezarDaSilva_TESE.pdf: 3335341 bytes, checksum: 675b0da6bffd6736231d5bb47989ac13 (MD5) Previous issue date: 2017-12-13 / A pesquisa teve como objetivo avaliar a percep??o do suporte familiar e qualidade de vida de idosos com ?lcera venosa atendidos na Aten??o Prim?ria ? Sa?de. Estudo anal?tico com abordagem quantitativa, realizado em Santa Maria, Rio Grande do Sul, Brasil. Participaram 40 idosos atendidos nas unidades de sa?de, no per?odo de agosto a dezembro de 2016. Na coleta de dados utilizaram-se os instrumentos: formul?rio para caracteriza??o sociodemogr?fica, de sa?de, cl?nica e assistencial; o Charing Cross Venous Ulcer Questionnaire (CCVUQ) e o Invent?rio da Percep??o de Suporte Familiar (IPSF). Utilizou-se da estat?stica descritiva e inferencial, testes Qui-Quadrado, Exato de Fischer, Mann-Whitney e correla??o de Spearmann, considerando n?vel de signific?ncia estat?stica de ?-valor ? 0,05. O projeto de pesquisa foi aprovado pelo Comit? de ?tica em Pesquisa da Universidade proponente, (Processo n?mero 1.670.636 e Certificado de Apresenta??o para Aprecia??o ?tica 58255016.0.0000.5346). Houve predom?nio do sexo feminino, faixa et?ria dos 70 anos ou mais, sem companheiro, aposentados, com doen?as cr?nicas associadas, sono maior de seis horas/dia e presen?a de dor. Referiam como local predominante para a realiza??o do curativo o servi?o de sa?de (n=34, 85,0%), n?o faziam uso de terapia compressiva (n=24, 60,0%), os que faziam utilizavam bota de Unna (n=16, 40,0%). O Escore Total do CCVUQ apresentou mediana 43,9, para a avalia??o da qualidade de vida geral dos participantes; e nos dom?nios Intera??o Social (27,9), Atividades Dom?sticas (29,9), Est?tica (44,7) e Estado Emocional (57,4). Quanto ? percep??o do Suporte familiar, os idosos classificaram como Alto Suporte. Afetivo-Consistente foi 67,5%, com m?dia de 33,40(?11,29); Adapta??o familiar, o percentual de alto foi de 45,0%, com m?dia de 20,97(?6,42) e Autonomia foi de 70,0%, com m?dia de 14,65(?2,36). As vari?veis sociodemogr?ficas e de sa?de n?o apresentam associa??es significativas com os dom?nios do CCVUQ e IPSF. Sobre a qualidade de vida constatou-se diferen?a significativa da vari?vel cl?nica dor em rela??o aos dom?nios Atividades Dom?sticas (p=0,048), Estado Emocional (p=0,034) e Escore Total (p=0,022). Apresentaram diferen?a significativa as vari?veis assistenciais: quem realiza o curativo com Estado Emocional (p=0,045); uso de terapia compressiva com Atividades Dom?sticas (p=0,031); e n?mero de consultas com os dom?nios Intera??o Social (p=0,033), Atividades Dom?sticas (p=0,033), Estado Emocional (p=0,025) e Escore total (p=0,030). Quanto ao Suporte familiar, encontraram-se associa??es significativas entre as vari?veis cl?nicas: recidiva com o Suporte Total (p=0,031); tempo da ?lcera venosa atual em anos com os dom?nios Afetivo-Consistente (p=0,003) e Total (p=0,022), dor com o dom?nio Autonomia (p=0,041), sinais de infec??o com Suporte Total (p=0,044). Entre as vari?veis assistenciais: Tempo de tratamento em anos com o dom?nio Afetivo-Consistente (p=0,021). Uso de terapia compressiva com os dom?nios Afetivo-Consistente (p=0,002) e Total do Suporte (p=0,002). Verificaram-se correla??es negativas e significativas do suporte familiar na qualidade de vida em idosos com ?lcera venosa, entre Afetivo-Consistente e o escore total do CCVUQ (r=-0,323; p=0,042), o dom?nio Atividades Dom?sticas (r=-0,350; p=0,027) e Estado Emocional (r=-0,424; p=0,006). Entre Adapta??o Familiar e Estado Emocional (r=-0,443; p=0,004). Da mesma maneira, entre Autonomia e o escore total do CCVUQ (r=-0,514; p=0,001), o dom?nio Intera??o Social (r=-0,362; p=0,022), Atividades Dom?sticas (r=-0,513; p=0,001), Est?tica (r=-0,478; p=0,003) e Estado Emocional (r=-0,478; p=0,002). A qualidade de vida do idoso com ?lcera venosa foi mais comprometidas nos dom?nios Estado emocional e Est?tica. Aceita-se a hip?tese alternativa que o suporte familiar se correlaciona com a qualidade de vida em idosos com ?lcera venosa atendidos na Aten??o Prim?ria ? Sa?de. Necessitam-se a??es de promo??o e reabilita??o da sa?de do idoso, com enfoque na din?mica familiar, a fim de promover a autonomia e o conv?vio social para melhora da qualidade de vida. / This research aimed to evaluate the perception of family support and quality of life of elderly patients with venous ulcers treated at the primary health care. Analytical study with a quantitative approach held in Santa Maria, Rio Grande do Sul, Brazil. The study included 40 elderly attended in health units in the period from August to December, 2016. Data collection used these instruments: Form for the sociodemographic characterization, heath, clinical and care; Charing Cross Venous Ulcer Questionnaire (CCVUQ) and the Family Support Perception Inventory (IPSF). It was used descriptive and inferential statistics, used the chi-square test, Fisher's exact test, Mann-Whitney, and was Spearman correlation, considering a level of significance of ?-value ? 0.05. The research project has approved by the Ethics Committee Proponent University Research, (Case number 1670636 and Presentation Certificate for Ethics Assessment 58255016.0.0000.5346). Women predominated, age 70 years or more, without a partner, retired, with chronic diseases associated, greater sleep of six hours/day and the presence of pain. They referred as the predominant place for the accomplishment of the curative the health service (n=34, 85.0%), did not use compression therapy (n=24, 60.0%), those who used Unna boot (n=16, 40.0%). The Score Total CCVUQ presented a median 43.9, to evaluate the overall quality of life of participants; and in the fields Social Interaction (27.9), Household Activities (29.9), Esthetics (44.7) and Emotional State (57.4). Regarding the perception of Family Support, the elderly classified as High Support. In the evaluated domains was found that in the affective consistent was 67.5%, with a mean of 3.40 (?11.29), in family adaptation, high percentage was 45.0% with a mean of 20.97 (?6.42) and autonomy was 70.0% with a mean of 14.65 (?2.36). Sociodemographic and health variables do not have significant associations with areas of CCVUQ and IPSF. Regarding quality of life, there was a significant difference in the clinical variable: pain in relation to domains Domestic Activities (p= 0.048), Emotional State (p= 0.034) and Total Score (p= 0.022). There were significant differences in the care variables: who performed the dressing with Emotional State (p= 0.045), use of compressive therapy with Domestic Activities (p= 0.031) and number of consultations with the Social Interaction domains (p = 0.033), Domestic Activities (p= 0.033), emotional state (p= 0.025), and total score (p= 0.030). As for family support, significant associations were found between the clinical variables: relapse with Total Support (p = 0.031); time of current venous ulcer in years with Affective-Consistent (p= 0.003) and Total (p=0.022), pain with Autonomy domain (p= 0.041), signs of infection with Total Support (p= 0.044). Between healthcare variables: treatment time in years with the domain affective-consistent (p= 0.021). Use of compressive therapy with the Affective-Consistent (p= 0.002) and Total Support (p= 0.002) domains. There were negative and significant correlations of family support in quality of life in elderly patients with venous ulcer, between Affective-Consistent and the total CCVUQ score (r = -0.323, p= 0.042), the Domestic Activities domain (r = -0.350, p = 0.027) and Emotional Status (r = -0.424, p= 0.006). Between Family Adaptation and Emotional State (r = -0.443, p = 0.004). Similarly, between Autonomy and total CCVUQ score (r = -0.514, p= 0.001), the Social Interaction domain (r = -0.362, p= 0.022), Domestic Activities (r = -0.513, p= 0.001), Esthetics (r = -0.478, p= 0.003) and emotional state (r = -0.478, p= 0.002). The quality of life of elderly patients with venous ulcers was more committed in the domains Emotional state and Esthetics. It is necessary actions to promote and rehabilitate the health of the elderly, focusing on family dynamics, in order to promote autonomy and social interaction to improve the quality of life. The alternative hypothesis is accepted that the family support is correlated in the quality of life in elderly patients with venous ulcer attended in the Primary Health Care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-02T23:09:14Z No. of bitstreams: 1 RafaelRodolfoTomazDeLima_DISSERT.pdf: 1880031 bytes, checksum: 4721daefc45bff182c9e4a4a971a0cf9 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-13T17:53:52Z (GMT) No. of bitstreams: 1 RafaelRodolfoTomazDeLima_DISSERT.pdf: 1880031 bytes, checksum: 4721daefc45bff182c9e4a4a971a0cf9 (MD5) / Made available in DSpace on 2018-03-13T17:53:52Z (GMT). No. of bitstreams: 1 RafaelRodolfoTomazDeLima_DISSERT.pdf: 1880031 bytes, checksum: 4721daefc45bff182c9e4a4a971a0cf9 (MD5) Previous issue date: 2017-12-15 / No Brasil, constata-se um crescimento acentuado da popula??o idosa, onde isso se intensificar? nas pr?ximas duas d?cadas. No ?mbito do SUS, a assist?ncia a essa popula??o deve pautar-se em a??es desenvolvidas pelas equipes da ESF e do NASF. O estudo teve o objetivo de analisar a forma??o dos profissionais da ESF e do NASF para atender ?s necessidades das pessoas idosas. Trata-se de uma pesquisa com abordagem qualitativa, realizada em duas etapas e com procedimentos metodol?gicos distintos. Na primeira etapa, buscou-se analisar como ocorre a abordagem do envelhecimento na forma??o dos profissionais que atuam na ESF e no NASF, a partir da leitura dos projetos pedag?gicos dos seus cursos de forma??o. A segunda etapa consistiu em compreender, com a realiza??o de grupos focais, a percep??o das pessoas idosas atendidas por equipes da ESF e do NASF sobre as suas necessidades, bem como compreender a percep??o das mesmas sobre as compet?ncias profissionais necess?rias para o cuidado que essa parcela da popula??o precisa. Os resultados da primeira etapa revelaram que a forma??o profissional para o cuidado ? sa?de da pessoa idosa est? pautada exclusivamente na assist?ncia e condu??o de doen?as cr?nico-degenerativas, como tamb?m na identifica??o e preven??o de danos ? sa?de. Ademais, a operacionaliza??o dos grupos focais permitiu classificar as necessidades das pessoas idosas participantes do estudo em duas tem?ticas: Necessidade de boas condi??es de vida e necessidade de acesso aos servi?os de sa?de. De acordo com os participantes, os profissionais da ESF e do NASF s?o bem qualificados para lhes atenderem, por?m, n?o possuem autonomia para solucionar as suas necessidades. Para a resolu??o dessas necessidades, qualificar os gestores (municipais, estaduais e federais) do setor sa?de seria o caminho priorit?rio. Com a realiza??o deste estudo, percebe-se que a discuss?o acerca da tem?tica do envelhecimento no processo de forma??o dos profissionais que integram as equipes da ESF e do NASF ainda ? incipiente e est? desassociada das necessidades de sa?de das pessoas idosas. Assim, se faz necess?rio preparar pessoas que ofere?am aten??o integral ? crescente popula??o idosa, conhecendo as suas subjetividades e necessidades, bem como para formular e gerir pol?ticas p?blicas para a mencionada popula??o que ? usu?ria do SUS. / In Brazil, there is a marked increase in the elderly population, where this will intensify in the next two decades. Under the SUS, assistance to this population should be based on actions developed by the ESF and NASF teams. The aim of the study was to analyze the training of ESF and NASF professionals to meet the needs of the elderly. It is a qualitative research, carried out in two stages and with different methodological procedures. In the first stage, we sought to analyze how the aging approach occurs in the training of professionals working in the ESF and NASF, from the reading of the pedagogical projects of their training courses. The second stage consisted in understanding the perception of the elderly people assisted by ESF and NASF teams about their needs, as well as their perception about the professional competencies necessary for the care that this portion of the population needs. The results of the first stage revealed that the professional training for the health care of the elderly is based solely on the assistance and conduction of chronic-degenerative diseases, as well as on the identification and prevention of health damages. In addition, the operationalization of the focus groups allowed to classify the needs of the elderly participants of the study in two thematic ones: Necessity of good conditions of life and necessity of access to the health services. According to the participants, the professionals of the ESF and the NASF are well qualified to attend to them, however, they do not have the autonomy to solve their needs. To solve these needs, qualifying the managers (municipal, state and federal) of the health sector would be the priority path. With the accomplishment of this study, it is noticed that the discussion about the aging issue in the process of training the professionals that integrate the ESF and NASF teams is still incipient and is disassociated with the health needs of the elderly. Thus, it is necessary to prepare people who offer integral attention to the growing elderly population, knowing their subjectivities and needs, as well as formulating and managing public policies for the aforementioned population that is a SUS user.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-10-27T00:44:20Z No. of bitstreams: 1 AdrianaMariaAlves_DISSERT.pdf: 862896 bytes, checksum: 0b426717e302a89a5485ffa494b82d9f (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-12-28T16:44:04Z (GMT) No. of bitstreams: 1 AdrianaMariaAlves_DISSERT.pdf: 862896 bytes, checksum: 0b426717e302a89a5485ffa494b82d9f (MD5) / Made available in DSpace on 2016-12-28T16:44:04Z (GMT). No. of bitstreams: 1 AdrianaMariaAlves_DISSERT.pdf: 862896 bytes, checksum: 0b426717e302a89a5485ffa494b82d9f (MD5) Previous issue date: 2014-09-19 / O objetivo deste trabalho, caracterizado como uma pesquisa de abordagem qualitativa de car?ter explorat?rio descritivo, ? analisar os aspectos que contribuem para a morbimortalidade materna em Mossor?-RN ? luz da bio?tica. As informa??es foram coletadas entre os meses de Novembro e Dezembro de 2013, por meio de entrevistas semiestruturadas realizadas com 16 profissionais de sa?de, sendo metade deles trabalhadores de Aten??o Prim?ria ? Sa?de e a outra metade de urg?ncia obst?trica, e 04 mulheres que tiveram gravidez de alto risco com interna??o em UTI. O n?mero de profissionais e de mulheres foi determinado pelo m?todo da satura??o na coleta de informa??es em pesquisas qualitativas. As entrevistas foram transcritas e submetidas a t?cnica de an?lise de conte?do, especificamente a an?lise tem?tica, possibilitando um aprofundamento e ultrapassando o conte?do das falas. Diante disso, foram constru?das tr?s categorias de an?lise, a saber: a aten??o ? gestante no munic?pio de Mossor?/RN; os fatores que contribuem para a morbimortalidade materna em Mossor?/RN; e a morte de perto: O relato de gestantes de alto risco que foram internadas em Unidade de Terapia Intensiva. A interpreta??o das informa??es analisadas revelaram a realidade dif?cil da rede de aten??o ? gestante no munic?pio, nos seus tr?s n?veis, apontam alguns fatores que contribuem com o aumento da morbimortalidade materna e estes correlacionados com os princ?pios da bio?tica de BEAUCHAMP & CHILDRESS e os princ?pios da Declara??o Universal sobre Bio?tica e Direitos Humanos da UNESCO, sugerem algumas a??es que poderiam diminuir este ?ndice, relatam como lidam e percebem a morte materna e os sentimentos envolvidos, e relatam tamb?m a viv?ncia de mulheres que tiveram risco de morte na gesta??o. Percebemos ent?o, na fala dos profissionais a necessidade de p?r em pr?tica o que j? existe na teoria, nos protocolos, manuais e portarias do Governo Federal. Mais uma vez sabemos o que precisa ser feito para reduzir a mortalidade materna e melhorar a qualidade da aten??o, por?m n?o h? iniciativa concreta para que se efetive tudo isso e tenhamos o resultado esperado. O que existe ? neglig?ncia n?o de todos, mas de todas as partes. Precisamos inicialmente capacitar os gestores e sensibiliza-los para essa tem?tica. Os cidad?os tamb?m precisam ser empoderados de seus direitos e conhecedores das pol?ticas p?blicas, para que possam cobrar dos servi?os e dos gestores seu cumprimento. Por ?ltimo precisamos sensibilizar os profissionais na busca de conhecimentos e na luta por melhores condi??es de trabalho, recursos humanos suficientes e de sal?rio, para tamb?m cobrar deles a excel?ncia no atendimento. Desta forma os profissionais entendem que teremos menores n?meros da mortalidade materna e maior satisfa??o dos usu?rios do SUS, especialmente neste caso, das mulheres que necessitam do servi?o de obstetr?cia. / This study characterized as a qualitative descriptive exploratory approach is to analyze the aspects that contribute to maternal mortality in Mossor?-RN. Data were collected between the months of November and December 2013, through semi-structured interviews with 16 health professionals, half of them employees of Primary Health Care and the other half of obstetric emergency, and 04 women who had pregnancy high-risk ICU. The number of professionals and women was determined by the saturation method in information collection in qualitative research. The interviews were transcribed and subjected to content analysis technique, specifically the thematic analysis, enabling a deeper and beyond the content of the speeches. Thus, three categories were constructed of analysis, namely: to prenatal in the town of Mossor? / RN; the factors that contribute to maternal mortality in Mossor? / RN; and near death: The story of high-risk pregnancies who were admitted to the Intensive Care Unit. The interpretation of information reviewed revealed the harsh reality of the network of care for pregnant women in the county, in its three levels, point to some factors that contribute to increased morbidity and mortality, suggest some actions that could decrease the value, perceive and report how they deal death maternal and feelings involved, and also report the experience of women who had risk of death during pregnancy. We realized, in speaking of the need for professionals to put into practice what already exists in theory, the protocols, manuals and orders of the Federal Government. Again we know what needs to be done to reduce maternal mortality and improve quality of care, but there is no concrete initiative to be made effective and all have the expected result. What is there not to neglect all but of all parties. Initially need to train managers and sensitize them to this issue. Citizens also need to be empowered and knowledgeable of their rights of public policies, so that they can charge services and compliance managers. Finally we need to raise awareness among professionals in the pursuit of knowledge and the fight for better working conditions, sufficient human resources and pay for them also charge service excellence. Thus we understand that professionals smaller numbers of maternal mortality and greater satisfaction of SUS, especially in this case, women who require obstetrical service.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-13T20:30:56Z No. of bitstreams: 1 AlaneMariaDaSilva_DISSERT.pdf: 4445158 bytes, checksum: ecd090ca5e345980a649e5b23d8e6afb (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-02-16T20:41:05Z (GMT) No. of bitstreams: 1 AlaneMariaDaSilva_DISSERT.pdf: 4445158 bytes, checksum: ecd090ca5e345980a649e5b23d8e6afb (MD5) / Made available in DSpace on 2017-02-16T20:41:05Z (GMT). No. of bitstreams: 1 AlaneMariaDaSilva_DISSERT.pdf: 4445158 bytes, checksum: ecd090ca5e345980a649e5b23d8e6afb (MD5) Previous issue date: 2016-07-25 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / O Programa Bolsa Fam?lia ? PBF, implementado h? mais de uma d?cada, posicionase como o principal instrumento de combate ? pobreza e ? desigualdade no Brasil. Mesmo tendo o repasse direto de recursos monet?rios aos benefici?rios e ? exig?ncia de contrapartidas, como os aspectos mais frequentemente associados ? sua exist?ncia, o PBF n?o se limita a esses dois eixos estruturadores. As A??es e Programas Complementares, terceiro eixo do Programa, apesar de sua import?ncia, ainda se mostra uma ?rea n?o detentora da mesma considera??o e notoriedade que as demais. Perante essa realidade e buscando evidenciar a atua??o do referido Programa de Transfer?ncia de Renda Condicionada ? PTRC, este trabalho se prop?s a compreender a din?mica de funcionamento do PBF no munic?pio de Currais Novos - RN. Para tanto, respaldou-se no referencial de Katzman (1997) e Katzman; Filgueira (2006) a partir do enfoque Ativos, Vulnerabilidade e Estrutura de Oportunidades ? AVEO, al?m da incorpora??o da concep??o do Estado, mercado de trabalho e sociedade como ?ordens institucionais? intervenientes do enfoque. Com uma abordagem concomitantemente quantitativa e qualitativa, predominando esta ?ltima, realizou-se pesquisa bibliogr?fica, documental e de campo. No que concerne ao campo, al?m da observa??o devidamente registrada, fez-se uso de entrevistas semiestruturadas embasadas em roteiros. A an?lise foi concretizada por interm?dio da elabora??o de grelhas (?VORA, 2006) que compuseram um banco de dados e pelo emprego da an?lise de discurso (CHIZZOTTI, 2006). Diante das constata??es obtidas ao longo dessa disserta??o ? luz dos objetivos tra?ados pelo PBF, percebeuse que o referido Programa precisa de aperfei?oamentos em Currais Novos, pois existe uma s?rie de problem?ticas em torno do seu funcionamento principalmente no que concerne ao seu terceiro eixo que ainda carece de um verdadeiro desenvolvimento, o que faz com que a emancipa??o do PBF, como decorr?ncia do citado eixo, que j? se revela algo dif?cil de ser alcan?ada, permanece apenas em n?vel do idealizado nos instrumentos normativos. Ao ampliar o olhar, vislumbra-se que que as necessidade de melhorias no PBF como um todo, se expande em n?vel nacional. ? certo que essa estrat?gia governamental de combate ? pobreza tem passado por evolu??es e que representa um s?mbolo do rumo tomado pela pol?tica social no Brasil, no entanto, ainda h? muito o que ser realizado com vistas a potencializar os seus impactos. O PBF, inegavelmente, tem a sua relev?ncia para o p?blico por ele contemplado, por?m n?o possui, por si s?, potencial suficiente para verdadeiramente transformar o cen?rio que a pobreza delineia ao se concretizar em suas vidas. / The Program Bolsa Fam?lia - PBF, implemented more than a decade ago, it is positioned as the main combat instrument to the poverty and to the unequality in Brazil. Even having go over again it straightly of monetary resources to the beneficiaries and to the demand of counterentry, as the aspects more frequently associated to his existence, the PBF it does not content itself with these two structural axles. The Actions and Complement Programs, third axle of the Program, in spite of his importance, still shows an area not holder of the same consideration and renown that the rest. Towards this reality and looking to show up the acting of the above-mentioned Program of Transfer of Conditioned Income ? PTRC, this work was proposed understanding the dynamic of functioning of the PBF in the local authority of Currais Novos - RN. Therefore, it was polished in the referential system of Katzman (1997) and Katzman; Filgueira (2006) from the approach Assets, Vulnerability and Structure of Opportunities ? AVSO, besides the incorporation of the conception of the State, labor market and society as ?institutional orders? intervenient of the approach. With an approach concomitantemente quantitative and qualitative, when last this one is predominating, was made a bibliographic research, documentary and of field. In what it concerns the field, besides the observation properly registered, it was made use of semistructured interviews informed on scripts. The analysis was made real through the preparation of broilers (?VORA, 2006) that composed a database and for the job of the analysis of speech (CHIZZOTTI, 2006). Before the observations obtained along this dissertation by the light of the objectives drawn by the PBF, it was seen that the above-mentioned Program needs improvements in Currais Novos, since there are series of problems around his functioning mainly in what concerns his third axle that still lacks for a true development, which does with what the emancipation of the PBF, as consequence of the quoted axle, that already reveals itself something difficult of being reached, remains only in level of the idealized one in the prescriptive instruments. Broaden perspectives, it sees that the need of improvements in the PBF as a whole, expands in national level. It is certain what this government combat strategy to the poverty has been passing over evolutions and what represents a symbol of the course taken for the social politics in Brazil, however, there is still to much to be carried out for potentiate his impacts. The PBF, undeniably, has his relevance for the public as him contemplated, however it has not, by itself, enough potential to really transform the scenery which the poverty outlines while coming true in his lives.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-22T19:29:08Z No. of bitstreams: 1 AnnaCristinaDaCruzBezerra_DISSERT.pdf: 1559083 bytes, checksum: d1906c8d5f52eaa7dd39047859b70d24 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-07T00:24:05Z (GMT) No. of bitstreams: 1 AnnaCristinaDaCruzBezerra_DISSERT.pdf: 1559083 bytes, checksum: d1906c8d5f52eaa7dd39047859b70d24 (MD5) / Made available in DSpace on 2017-03-07T00:24:05Z (GMT). No. of bitstreams: 1 AnnaCristinaDaCruzBezerra_DISSERT.pdf: 1559083 bytes, checksum: d1906c8d5f52eaa7dd39047859b70d24 (MD5) Previous issue date: 2016-08-01 / O acesso e a qualidade do cuidado na primeira inf?ncia, no contexto brasileiro da Aten??o Prim?ria em Sa?de (APS) s?o influenciados pelos princ?pios do Sistema ?nico de Sa?de (SUS) e principais pol?ticas de sa?de da crian?a, representadas pelo Estatuto da Crian?a e do Adolescente (ECA), a Pol?tica Nacional de Sa?de da Crian?a e o marco legal da primeira inf?ncia. A Estrat?gia de Sa?de da Fam?lia (ESF) tem um papel central na reorienta??o do modelo de aten??o voltado para a integralidade e melhor desempenho do cuidado infantil. O presente estudo tem como objetivo avaliar o cuidado ? sa?de da crian?a na APS, na perspectiva do acesso e da qualidade da aten??o, em oito regi?es de sa?de do Estado do Rio Grande do Norte. Foram analisados 13 aspectos essenciais do cuidado infantil, nos componentes da oferta, da busca ativa e do registro, em dois momentos hist?ricos, a partir do banco de dados da pesquisa multic?ntrica do Programa Nacional de Melhoria do Acesso e da Qualidade da Aten??o B?sica/PMAQ/AB. O PMAQ, lan?ado no ano de 2011, configura uma nova estrat?gia para melhoria assistencial atrav?s de avalia??o, coordena??o de a??es e certifica??o enfocando o trabalho de equipes de Aten??o B?sica. Trata-se de um estudo avaliativo, descritivo transversal, com abordagem quantitativa, realizada com dados secund?rios do PMAQ/AB, do primeiro e segundo ciclos do programa, realizados em 2011 a 2014. O universo desta pesquisa compreende 407 equipes de sa?de da fam?lia de 112 munic?pios do Rio Grande do Norte que fizeram parte dos dois momentos da pesquisa. A an?lise dos dados foi desenvolvida quantitativamente, atrav?s do Statistical Package for Social Sciences (SPSS?) na vers?o 22.0, com posterior linkage dos dois bancos de dados criados, um para o 1? ciclo e outro para o 2? ciclo. Realizado o linkage dos bancos, os dados foram analisados por meio do teste Mcnemar, por tratar-se de dados pareados, cujas vari?veis estudadas s?o de natureza dicot?mica (sim/n?o). Em todas as compara??es, o n?vel de signific?ncia de 5% fora utilizado (p<0,05). Os principais resultados demonstram heterogeneidades regionais, com similaridades e especificidades, com tend?ncias de amplia??o do acesso e qualidade do cuidado na primeira inf?ncia no ?mbito da APS das 8 regi?es de sa?de. Por?m, com desafios na busca ativa e na aten??o aos grupos mais vulner?veis, como crian?as prematuras, que podem ser determinantes para o crescente aumento da mortalidade neonatal. O aumento das viol?ncias e acidentes na primeira inf?ncia demonstra uma qualifica??o da APS neste registro, por?m revela a necessidade de qualifica??o da oferta e da atua??o dos profissionais de sa?de para interven??es preventivas e de promo??o da sa?de voltadas para a primeira inf?ncia no contexto familiar e comunit?rio, frente a suas realidades locais. O desempenho quanto ao acesso e qualidade do cuidado na APS, na perspectiva do PMAQ, mostra um quadro diferenciado que revela a necessidade de serem adotadas interven??es precoces e oportunas para a primeira inf?ncia, apresentadas neste estudo. / Access and quality of care in early childhood, in the Brazilian context of Primary Health Care (PHC) are influenced by the principles of the Unified Health System (SUS) and the main health policies of the child, represented by the Children and Adolescents Statute (CAS), the National Children Health Policy and the early childhood legal milestone. The Family Health Strategy (FHS) plays a central role in reorienting the model of care toward the integrity and improved performance of child care. This study aims to evaluate the health care of children in APS, from the perspective of access and quality of care in eight health regions of the State of Rio Grande do Norte. 13 essential aspects of child care were analyzed, in the components of supply, of active search and registration throughout two historical moments, from the multicenter research database of the National Program for Improving Access and Quality Primary Care / PMAQ / PC. The PMAQ, launched in 2011, sets up a new strategy for improving care through assessment, coordination of actions and certification focusing on the work of primary care teams. It is an evaluative study, cross-sectional, with a quantitative approach, performed with secondary data from PMAQ / PC, the first two cycles of the program, carried out from 2011 to 2014. The universe of this research includes 407 family care teams, from 112 municipalities of Rio Grande do Norte who were part of the two phases of the research. Data analysis was developed quantitatively through the Statistical Package for Social Sciences (SPSS) version 22.0, with subsequent linkage of the two created databases, one for the 1st cycle and one for the 2nd cycle. As data is paired, after having performed the linkage, data was analyzed using the McNemar test, whose variables are dichotomous nature (yes/no). In all comparisons, the 5% significance level was used (p <0.05). The main results demonstrate regional heterogeneities, with similarities and specificities, expanding trends of access and quality of care in early childhood within the APS of 8 health regions. However there has been challenges in the active search for and attention to the most vulnerable groups such as premature infants, which could have been decisive for the increasing neonatal mortality. The increase in violence and accidents in early childhood shows a qualification of APS on this record, but reveals the need for qualification of supply and health professionals acting for preventive interventions and health promotion focused on early childhood in the family and community context face to their local realities. The performance in access and quality of care in PHC, from the perspective of PMAQ, shows a different picture that reveals the desirability of adopting precocious and timely interventions for early childhood, presented in this study.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-22T19:29:08Z No. of bitstreams: 1 AnneChristineDeMacedoSilvaGomes_DISSERT.pdf: 3602113 bytes, checksum: 0d646ecc7ff7b09df17b0cab12c49ee2 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-07T00:29:57Z (GMT) No. of bitstreams: 1 AnneChristineDeMacedoSilvaGomes_DISSERT.pdf: 3602113 bytes, checksum: 0d646ecc7ff7b09df17b0cab12c49ee2 (MD5) / Made available in DSpace on 2017-03-07T00:29:57Z (GMT). No. of bitstreams: 1 AnneChristineDeMacedoSilvaGomes_DISSERT.pdf: 3602113 bytes, checksum: 0d646ecc7ff7b09df17b0cab12c49ee2 (MD5) Previous issue date: 2016-07-29 / As pessoas com defici?ncia apresentam, de modo geral, mais problemas de sa?de bucal do que aquelas sem essa condi??o. Tais problemas tornam-se mais graves em pacientes com comprometimento motor ou intelectual, fazendo-se necess?rio, portanto, o aux?lio de cuidadores para a realiza??o da higiene bucal di?ria. O objetivo desse estudo foi identificar a percep??o de cuidadores de pessoas com defici?ncia acerca da sa?de bucal; conhecer sua condi??o de sa?de bucal e os impactos sobre sua qualidade de vida, al?m de verificar as a??es de higiene bucal realizadas, por eles, junto aos pacientes sob seus cuidados. Trata-se de uma pesquisa explorat?ria, seccional, com enfoque quantitativo e qualitativo realizada no munic?pio de Currais Novos/RN. A amostra foi composta por 50 cuidadores que acompanhavam pacientes em tratamento odontol?gico no Centro de Especialidades Odontol?gicas do munic?pio. Para a coleta de dados utilizou-se question?rios e entrevistas. O question?rio OHIP-14 buscou identificar o impacto dos problemas bucais sobre a qualidade de vida dos cuidadores e as entrevistas visaram conhecer a percep??o de sa?de bucal dos mesmos. Os dados quantitativos foram analisados atrav?s do programa estat?stico SPSS 22.0 e os dados qualitativos foram submetidos ? t?cnica de an?lise de conte?do ? luz do referencial te?rico de Minayo, originando tr?s categorias tem?ticas: concep??o de boca saud?vel, formas de cuidar da boca, concep??o acerca do edentulismo. Os resultados apontam que os cuidadores apresentam uma condi??o de sa?de bucal ruim, com repercuss?es negativas sobre sua qualidade de vida. Tal condi??o ? corroborada por percep??es de sa?de bucal centradas na doen?a, isto ?, aus?ncia de dor e presen?a de afec??es bucais. Pode-se inferir que tal percep??o compromete a higiene e os cuidados bucais das pessoas com defici?ncia sob seus cuidados. Fica clara a necessidade de implementa??o de programas educativos e motivacionais, com o uso de metodologias ativas, que permitam aos cuidadores se apropriarem de conhecimentos necess?rios ? manuten??o da sa?de bucal dos pacientes sob sua responsabilidade e deles pr?prios. / People with deficiency feature, generally, more problems of oral health than those without this condition. Such problems become more severe in patients with motor and intellectual commitment, making it necessary, therefore, the help of caregivers for the realization of daily oral hygiene. The objective of this study was to identify the perception of caregivers of disabled people about oral health; know your oral health condition and the impacts on their quality of life, besides checking the oral hygiene actions taken by them to the patients under their care. It is an exploratory research, sectional, with quantitative and qualitative approach conducted in Currais Novos/RN city. The sample was consisted of 50 caregivers that accompanying patients in dental treatment at Dental Specialty Center of the city. For data collection, it was used questionnaires and interviews. OHIP-14 questionnaire sought to identify the impact of oral problems on the quality of caregivers?s life, and the interviews aimed to know their perception about oral health. Quantitative data were analyzed using SPSS 22.0 and qualitative data were subjected to content analysis technique based on the theoretical framework of Minayo, resulting in three thematic categories: design healthy mouth, ways to take care of the mouth and conception of the edentulous. The results point that carers have a bad oral health condition, with negative repercussions on their quality of life. This condition is supported by perceptions of oral health focused on disease, this is, absence of pain and presence of oral disease. It can be inferred that surch perception compromises hygiene and oral care of people with disabilities in their care. It is clear the necessity to implement educational and motivational programs, using active methodologies that allow caregivers to appropriate knowledge necessary to maintain the oral health of patients under their responsibility, as well as their own.