Made available in DSpace on 2014-12-17T15:16:17Z (GMT). No. of bitstreams: 1 HeloisaMJSB_DISSERT.pdf: 1667099 bytes, checksum: 389f0ddd379405a8f7a32916a7240c60 (MD5) Previous issue date: 2012-12-21 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Introduction: Falls among older adults is a public health problem, therefore it is necessary preventive actions, however the adherence is the major problem faced by practitioners and researchers working on falls prevention programs. Objective: To evaluate the variables related to the adherence to falls prevention programs among the elderly enrolled in a Basic Health Unit (BHU). Methods: Was performed an observational cross-sectional analytical study. All elderly registered in a BHU and able to ambulate independently were invited to participate in a falls prevent program. The Elderly who Adhered to the Program (EAP) were evaluated at BHU; and the Elderly Not Adhered to the Program (ENAP) were identified and assessed at home. The assessment for both groups was performed using an evaluation form containing personal data, measures and clinical scales to assess cognitive status, balance, mobility, fear of falling, handgrip strength. Data were analyzed with SPSS 20.0. In addition to this assessment, the ENAP underwent a semi structured interview, in which we used the qualitative approach based on the figure of the Collective Subject Discourse. Results: The study included 222 elderly, 111 EAP and 111ENAP, most aged between 70 and 79 years (48.2%), female (68.5%), married (52.3%) and illiterate (47.7%). Consolidated as protective factors for adherence, worst rates of physical activity (p = 0.001), balance (p = 0.010) and cognition (p = 0.007). The interview of ENAP identified two themes: "Local implementation of programs for the prevention of falls" and "Relationship between BHU and the elderly health care," and found that the elderly who did not adhere were unable to displace and did not mention that primary care programs are related to health care in elderly. Conclusions: Elderly who do not adhere to the program differ from elderly who adhere as worst indices of cognition, balance and physical activity which implies greater risk of falling; and they were unable to participate in falls prevention program and by to be caregiver and showed displacement difficult / Introdu??o: Quedas entre idosos ? um problema de sa?de p?blica, por isso faz-se necess?rio a??es preventivas, no entanto a ades?o ? o maior problema enfrentado por pesquisadores e profissionais de sa?de que trabalham com programas de preven??o de quedas. Objetivo: Averiguar as vari?veis relacionadas ao processo de ades?o a um programa de preven??o de quedas em idosos cadastrados em uma Unidade B?sica de Sa?de (UBS). M?todos: Foi realizado um estudo observacional anal?tico de corte transversal. Todos os idosos cadastrados em uma UBS e com capacidade de deambula??o independente foram convidados a participar de um programa de preven??o de quedas. Os Idosos que Aderiram ao Programa (IAP) foram avaliados na UBS; j? os Idosos que N?o Aderiram ao Programa (INAP) foram identificados e avaliados em domic?lio. A avalia??o para ambos os grupos foi realizada por meio de uma ficha de avalia??o contendo dados pessoais e cl?nicos, escalas e medidas para avaliar o estado cognitivo, equil?brio, mobilidade, medo de cair, for?a de preens?o manual. Os dados foram analisados no software SPSS 20.0. Al?m desta avalia??o, os INAP foram submetidos a uma entrevista semiestruturada, na qual foi utilizada a abordagem qualitativa embasada na figura do Discurso do Sujeito Coletivo. Resultados: Participaram deste estudo 222 idosos, 111 IAP e 111 INAP, maioria com idade entre 70 e 79 anos (48,2%), do g?nero feminino (68,5%), casados (52,3%) e n?o alfabetizados (47,7%). Consolidaram-se como fatores de prote??o ? ades?o, piores ?ndices de pr?tica de atividade f?sica (p=0,001), equil?brio (p=0,010) e cogni??o (p=0,007). A entrevista dos INAP identificou dois temas: Local para execu??o de programas de preven??o de quedas e Rela??o entre a UBS e o cuidado em sa?de do idoso , que verificaram que os idosos n?o aderiram por impossibilidade de ir ao local de interven??o; e n?o mencionaram que programas de aten??o prim?ria est?o relacionados ao cuidado em sa?de do idoso. Conclus?es: Os idosos que n?o aderiram ao programa diferem dos idosos que aderiram quanto a piores ?ndices de cogni??o, equil?brio e pr?tica de atividade f?sica, o que pressup?e maior risco de queda; e estiveram impossibilitados de participar do programa de preven??o de quedas por ser cuidador e apresentar dificuldade de deslocamento

Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-04-18T11:51:47Z No. of bitstreams: 1 camilamenezesferreiraguerreiro.pdf: 1353311 bytes, checksum: 220d79b7b0f98180c3dd10ff39e8e739 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-04-20T11:55:56Z (GMT) No. of bitstreams: 1 camilamenezesferreiraguerreiro.pdf: 1353311 bytes, checksum: 220d79b7b0f98180c3dd10ff39e8e739 (MD5) / Made available in DSpace on 2018-04-20T11:55:56Z (GMT). No. of bitstreams: 1 camilamenezesferreiraguerreiro.pdf: 1353311 bytes, checksum: 220d79b7b0f98180c3dd10ff39e8e739 (MD5) Previous issue date: 2018 / A Psicologia Escolar e Educacional (PEE) constitui campo de atuação, pesquisa e produção de conhecimento com foco no processo de aprendizagem e desenvolvimento humano, tal como a Educação Superior. As investigações acerca da PEE na Educação Superior relacionadas à prevenção e promoção de saúde, mostram-se pouco exploradas pelos estudiosos da área, confirmando-se assim a relevância do presente estudo que objetivou investigar concepções e práticas sobre prevenção e promoção de saúde de Psicólogos com enfoque Educacional atuantes em Instituições Federais de Educação Superior Mineiras (IFES-MG). A primeira etapa da pesquisa envolveu, por meio de consulta ao setor de recursos humanos das IFES, um levantamento de Psicólogos, aderindo à pesquisa 14 IFES, nas quais foram identificados 128 Psicólogos. Na segunda etapa, esses Psicólogos responderam, de forma online, ao Instrumento de Rastreamento de Intervenções para Psicólogos com enfoque Educacional (IRIPE), delimitando-se 31 Psicólogos que foram solicitados a responderem ao Questionário para Psicólogos com enfoque Educacional (QPE). Responderam ao QPE 18 Psicólogos, investigados mais detalhadamente em relação às concepções e práticas sobre prevenção e promoção de saúde. Esse instrumento divide-se em 4 eixos de investigação, a saber: 1) atuação na Educação Superior; 2) prevenção, promoção de saúde e desenvolvimento humano na Educação Superior; 3) desafios encontrados e 4) capacitação. Para a análise dos resultados dos eixos 1, 3 e 4 utilizou-se metodologia quantitativa, já no eixo 2, qualitativa. A análise quantitativa evidenciou uma variabilidade de intervenções desenvolvidas pelos Psicólogos, revelando concepções tradicionais e emergentes dirigidas, em sua maioria, aos alunos. Verificou-se, contudo, ainda que de forma menos expressiva, intervenções mais amplas junto aos professores, coordenadores de curso/gestores e aos técnicos administrativos. Na vertente qualitativa da pesquisa, que investigou as concepções e práticas em relação à prevenção e promoção de saúde desses profissionais, constatou-se que a maioria dos Psicólogos está pouco familiarizada com o conceito ampliado e atual desse enfoque no âmbito da Psicologia. As práticas desses profissionais indicaram a utilização de estratégias voltadas para a prevenção universal/primária no contexto educativo, modalidade preventiva recomendada pela literatura na área. Houve uma tendência dos Psicólogos a valorizar estratégias proativas e desenvolvimentais por meio do incremento de competências e habilidades, lançando mão de uma compreensão do indivíduo inserido no contexto e suas inter-relações. Ressalta-se, contudo, a identificação, também, de estratégias informadas pelos profissionais como sendo preventivas e promotoras da saúde, tais como o atendimento/aconselhamento psicológico, que vem sendo considerado, pela literatura, como de cunho mais tradicional e reativo. Quanto aos desafios encontrados e capacitação submetidos à análise quantitativa, constatou-se que esses Psicólogos encontram dificuldades para desenvolver seu trabalho de forma mais proativa. Eles alegam buscar atualização tanto na área da PEE quanto na da prevenção e promoção de saúde. Enfatiza-se a necessidade de o Psicólogo Escolar/Educacional atuante no âmbito da Educação Superior preparar-se para realizar intervenções com foco na Prevenção e Promoção de Saúde por meio de uma atuação proativa, tendo em vista o objetivo mais amplo de promover saúde mental e desenvolvimento humano neste nível de escolaridade. / The School and Educational Psychology (PEE) is an area of practicing, research and knowledge production focused on the process of learning and human development, such as Higher Education. The investigations regarding PEE in Higher Education that are related to the prevention and health promotion, though, had been slightly exploited by the researchers in this field, what reaffirms the relevance of this work. The main goal of this research is to investigate the concepts and practices regarding prevention and health promotion of psychologists working in an Educational perspective in Federal Institutions of Higher Education from Minas Gerais (IFES-MG). The first stage of the research consisted of consulting the human resources department of the 14 IFES participating on the study in order to establish the number of psychologists among them. At this point, 128 professionals were identified. In the following stage, they answered online the Tracing Instrument of interventions for psychologists of Educational approach (IRIPE), and 31 psychologists were requested to answer the Questionnaire for psychologists of Educational approach (QPE). Among them, 18 psychologists answered it and their answers analyzed in more details, according to four investigative topics. They are:1) practice on Higher Education; 2) prevention, health promotion and human development in Higher Education; 3) challenges faced and 4) training. The results obtained on topics 1,3 and 4 were analyzed following the quantitative approach, while the topic 2 had a qualitative analysis. The quantitative analysis showed a variability in interventions among the psychologists, unfolding traditional and emerging concepts targetingthe students. It was possible to see, although less markedly, more extensive interventions including professors, coordinators/managers of the courses and administrative staff. Moreover, the qualitative approach helped in the investigation of concepts and practices regarding prevention and health promotion among the participants and it was possible to conclude that the most part of the psychologists are not very particular familiarly with the broad and current concept of such approach in the Psychology. The practices of these professionals indicate the use of strategies for promoting universal/primary prevention within the educational context, strongly recommended by the existing literature in the field. There was a tendency to value proactive and developmental strategies among the participants, mainly by increasing competences and skills through the understanding of an individual inside a context and their interrelationships. Some strategies listed by the professionals as preventive and health promoting, though, are considered responsive and traditional by the literature, such as psychological care/counselling. Considering topics 3 and 4, based on a quantitative approach, it is possible to understand that participants found difficulties to develop their jobs in a more proactive way. According to them, they have been trying to develop on the field of PEE and prevention and health promotion. Thus, aiming to promote mental health and human development in Higher Education, it is extremely relevant having the educational psychologist preparing themselves to be able to make interventions focusing the prevention and health promotion using a proactive approach.

Background: School-based mental health promotion aims to strengthen mental health and reduce stress. Results on the effectiveness of such programs are heterogeneous. This study realized a school-based mental health promotion program (StresSOS) for all students and aimed to identify moderators (mental health status, gender, grade level) of pre- to post-changes in stress symptoms and knowledge. Methods: Participants were N = 510 adolescents (from 29 classes; 46.7% female) aged 12–18 years (M = 13.88, SD = 1.00; grade levels 7–10). They were without mental health problems (65.9%), at risk for mental health problems (21.6%), or with mental health problems (12.5%) and participated in a 90 min per week face-to-face training with 8 sessions in class at school. Demographic variables, mental health status, stress symptoms, and knowledge about stress and mental health were collected at baseline. Program acceptance, stress symptoms, and knowledge were collected post-intervention. Multilevel mixed effects models were conducted with the fixed effects time (within factor), mental health status, gender, and grade level (between factors). Random effects for students within classes were included. Results: In the pre-post comparison, mental health status moderated the changes on psychological stress symptoms (p < 0.05). In adolescents with mental health problems the largest reduction in stress symptoms was observed between pre- and post-assessment. Gender and grade level were less relevant. For all adolescents knowledge gains were revealed (p < 0.001). Program acceptance was moderated by mental health status and grade level (p < 0.01). Mentally healthy adolescents and within the group of adolescents at-risk or with mental health problems, especially younger students (7th/8th grade), rated program acceptance higher. Conclusion: Psychological stress symptoms decreased among adolescents with mental health problems and not among adolescents at risk for or without mental health problems. Mental health-related knowledge increased for all adolescents. The results add to knowledge on school-based mental health intervention research and practice. Its implications for different prevention strategies (universal, selective or a combination of both) are discussed.

The aim of this Final Thesis is to characterize health in all relevant aspects essential for proper understanding of the relation between the "teacher and health". In the first part the author bring forward theoretical basis concerning the quality of health, subjective perception of health, behavior and health supportive life style, risk prevention in occupational safety and pre-professional preparation of teachers. The second part pursues collected data from 60 pedagogues in the questionnaires. The main intention of the empirical part was to reveal and describe the nature of perception of health in relation to the teacher occupation among preschool teachers; what do teachers assess as positive and negative regarding their health and which health problems are seen as obstruction to proper performance of the teacher occupation.

Made available in DSpace on 2016-04-28T20:40:11Z (GMT). No. of bitstreams: 1 Maria Ana Rita Souza Rocha.pdf: 1703484 bytes, checksum: f116e08134c09cd643b6a993da918bc1 (MD5) Previous issue date: 2009-11-12 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / This paper discusses the conceptions and interventions proposed by the Parenthood Clinic as a health promoting basis. The disharmony between parents-baby revealed during the visits to the pediatrician can arise from conflicts of the parents´psychism and interfere in the emotional availability necessary to the practice of preventive parenthood against pathologies and global development disorders. The method used was the open interview with six pediatricians according to their different personal ways: allopathy, psychoanalysis, anthroposophy, acupuncture, family. We based ourselves on the hypothesis that by knowing better the pedriatrician´s experience, it is possible to put same, during the consultation, into interdisciplinary dialogue with the findings available in the literature about the Parenthood Clinic developed by psychologists and psychoanalysts. The discussion of the material was effected using the winnicottan concepts and the more debated subjects in papers already published on Parenthood. We concluded that the disharmony between parents-baby reveals itself under the form of dysfunctional symptoms in the child or the caregiver. The pediatricians´intervention includes advice and encouragement to the parents, however there is no symbolic elaboration of the symptom, leaving the baby or even the foetus defenseless against more complex parental conflicts but that affect its health, with possibilities of affective, social and cognitive limitations in the adult phase. Vulnerabilities in the building of parenthood, since gestation, can hinder the caregiver´s emotional availability to follow the doctor´s advice and the practice of a healthy parenting. The interviews with the pediatricians brought evidences that they cannot treat the dysfunctional symptoms like a psychoanalyst due to their formation, the time and frequency of the puericulture consultation, but can understand them as a psychoanalyst can, promoting more integrating interdisciplinary interventions for the human coming about / Este trabalho discute as concepções e intervenções propostas pela Clínica da Parentalidade como base promotora de saúde. As desarmonias entre paisbebê que se revelam nas consultas pediátricas, podem emergir de conflitos do psiquismo dos pais e interferir na disponibilidade emocional necessária para o exercício da parentalidade preventiva das patologias e dos distúrbios globais do desenvolvimento. O método utilizado foi a realização de entrevista aberta com seis pediatras segundo diferentes percursos pessoais: alopatia, psicanálise, antroposofia, acupuntura, família. Partiu-se da hipótese que conhecendo melhor a experiência do pediatra durante as consultas é possível colocá-la em diálogo interdisciplinar com os achados encontrados na literatura sobre a Clínica da Parentalidade desenvolvida por psicólogos e psicanalistas. A discussão do material foi feita utilizando os conceitos winnicottianos e os temas mais discutidos em trabalhos já publicados sobre a Parentalidade. Concluiu-se que as desarmonias entre pais-bebê revelam-se sob a forma de sintomas disfuncionais na criança ou no cuidador; a intervenção dos pediatras inclui orientação e encorajamento aos pais, porém não há elaboração simbólica do sintoma, deixando o bebê ou mesmo o feto desprotegido dos conflitos parentais que afetam sua saúde com possibilidades de limitações afetivas, sociais e cognitivas na fase adulta. Vulnerabilidades na construção da parentalidade, desde a gestação, podem impedir o cuidador da disponibilidade emocional necessária para seguir as orientações do médico e o exercício da maternagem saudável. As entrevistas com os pediatras trouxeram evidencias de que eles não podem tratar os sintomas disfuncionais como um psicanalista, em função da especialidade, da formação, do tempo e da freqüência que dispõe na consulta de puericultura, mas podem entendê-los como um psicanalista promovendo intervenções interdisciplinares mais integradoras para o acontecer humano

Submitted by Johnny Rodrigues (johnnyrodrigues@ufcg.edu.br) on 2018-05-29T14:38:43Z No. of bitstreams: 1 SYMARA ABRANTES ALBUQUERQUE DE OLIVEIRA CABRAL - DISSERTAÇÃO PPGSA PROFISSIONAL 2016..pdf: 2849280 bytes, checksum: 59445e8e0fcf639042c42963f6ba87dd (MD5) / Made available in DSpace on 2018-05-29T14:38:43Z (GMT). No. of bitstreams: 1 SYMARA ABRANTES ALBUQUERQUE DE OLIVEIRA CABRAL - DISSERTAÇÃO PPGSA PROFISSIONAL 2016..pdf: 2849280 bytes, checksum: 59445e8e0fcf639042c42963f6ba87dd (MD5) Previous issue date: 2016 / A saúde pública é definida utilizando a qualidade de vida como uma importante medida de impacto em saúde, esta que, por sua vez, está intrínseca a promoção da saúde, mediante a quebra do paradigma do modelo biomédico com foco na patologia e objetivação na defesa da vida e desenvolvimento humano. No tocante à saúde do trabalhador rural, investir em sua saúde, pensando no contexto biopsicossocial, é uma garantia de reflexo direto na produtividade, ou seja, entendese que o agricultor saudável é ativo e produtivo na conjuntura da agroindústria, e por conseguinte da sua grande importância econômica e nutricional da população brasileira. Neste sentido, a intervenção selecionada é um mecanismo de trabalho em educação em saúde, com vistas ao foco de melhoria de qualidade de vida e saúde dos agricultores do município de Cajazeiras – PB partindo das necessidades reais, de modo que o objetivo geral consiste em garantir a promoção de ações e serviços direcionados para a garantia da qualidade de vida do agricultor na perspectiva do cuidado integral e interdisciplinar. A partir da realização de uma pesquisa de campo prévia e posterior a intervenção realizada com foco em ações direcionadas às fragilidades identificadas na população, conclui-se com o reconhecimento que, ações in loco, com objetivos bem definidos a partir do reconhecimento da realidade e pontuais no sentido de agir diante das fragilidades, e especificamente, pensar na saúde do agricultor configura-se pensar diretamente na agroindústria e na efetiva atuação destes para o fortalecimento deste processo, de modo que garantir a sua saúde do produtor rural é, sobretudo, assegurar o fortalecimento e crescimento da agroindústria. / Public health is defined using the quality of life as an important measure of health impact, this that, in turn, is intrinsic health to promoting by breaking the paradigm of the biomedical model focusing on pathology and objectification in life defense and human development. Regarding the health of rural workers, to invest in your health, thinking of the biopsychosocial context, is a direct reflection of assurance productivity, that is, it is understood that the healthy’s tiller is active and productive in the agribusiness environment, and therefore the it’s a great economic and nutritional importance of the Brazilian population. In this sense, the selected action is a working mechanism in health education, with a view to quality improvement focus of life and health of tillers in the municipality of Cajazeiras - PB starting from the real buyers, so that the overall goal is to ensure promoting targeted actions and services to guarantee the tillers quality of life from the integral and interdisciplinary perspective of care. From the realization of a prior and subsequent field research intervention conducted focusing on actions directed to the weaknesses identified in the population, it’s conclude with the recognition that on-site actions, with well-defined objectives from the recognition of the reality and specific in order to act in the face of weaknesses, and specifically, think about the health of the tiller is configured think directly in agribusiness and activeness of these to strengthen this process, to ensure your health tiller is primarily ensure strengthening and expansion of agribusiness.

Livssituationer præget af mange komplekse psykosociale og helbredsmæssige problemstillinger fordrer en anden grad af tværfagligt samarbejde i social- og sundhedssektoren. En samtidig øgetfokusering på forebyggelse og sundhedsfremme har øget behovet for udvikling af kundskaber og kompetencer, som kan matche disse udfordringer. Målet med studiet er, at identificere mulige mønstre vedrørende erfaringer med udvikling af fælles kundskaber og kompetencer i tværfaglige team som arbejder forebyggende og sundhedsfremmende. Der er tale om et kvalitativt studie, som bygger på fokusgruppeinterview med deltagelse af 25professionelle fra ni team inden for social-og sundhedssektoren. Otte faggrupper var repræsenteret.Der blev anvendt en memoreret temaguide til interviewene. Grounded theory blev anvendt til dataanalyse. Studiets overordnede kernekategori blev defineret som: ”sociokulturel organisation sætter dagsordenen for udvikling af kundskaber og kompetencer”. Der fremkom yderligere tre hovedkategorier som relaterede sig til kernekategorien: ”det nødvendige professionelle fundament,”den forebyggende og sundhedsfremmende diskurs”, og ”de tavse kundskaber og kompetencer”. Konklusion: Hovedfundet i studiet viste at sociokulturel organisation har væsentlig indflydelse påtværfaglige teams muligheder for at udvikle kundskaber og kompetencer i det forebyggende og sundhedsfremmende arbejde. Skabes der ikke lærings- og refleksionsrumi praksisfællesskabernereduceres mulighederne for, at den ”tavse” kundskab sættes i spil med den eksplicitte kundskab / Situations of life characterised by numerous complex psychosocial and health problems demand another extent in interprofessional co-operation in social and health service. At the same timeincreased focus on prevention and health promotion have raised the necessity of knowledge andcompetence creation that is able to deal with these complex challenges. The aim of this study is to identify possible patterns of experience with creation of shared knowledgeand competence in interprofessional co-operation with focus on prevention and health promotion.The studyis based on qualitative interviews in focus groups and memorized theme guide was used.The analyzing process was based on grounded theory. 25 professionals represented eight occupationgroups from nine social and health service teams. The overall core categories emerge as: ”social cultural organization sets the agenda for creation of knowledge and competence”. Three additional overall categories related to the core category definedas: ”the needful professional foundation”, “the discourse of prevention and health promotion” and“the tacit knowledge and competence”. Conclusions: The overall findings pointed out the essential influence of the social culturalorganization on the possibility of the interprofessional co-operation to create shared knowledge in the prevention and health promotion. If space for learning and reflection in community of practice is not created the feasibility of meetings between tacit and explicit knowledge will be reduced / <p>ISBN 91-7997-099-0</p>

Made available in DSpace on 2014-12-17T14:47:00Z (GMT). No. of bitstreams: 1 DanyellaARSC_DISSERT.pdf: 1002089 bytes, checksum: 8c39650c4f2757b157f3ced0428ababb (MD5) Previous issue date: 2013-06-21 / Universidade Federal do Rio Grande do Norte / Cancer of the cervix (cervical cancer) is the second most prevalent cancer among Brazilian women. The high rates of cervical cancer in Brazil justify the implementation of effective strategies to control this, which include actions to promote health, primary prevention, early detection, screening, treatment and palliative care. Despite the existence of the National Programme for Control of the CCU there was no reduction in the incidence and mortality of this disease in Brazil. The Family Health Strategy (FHS) has the potential to facilitate such control and, in this context, one should consider that nurses play a central role. The study aimed to know the general intervention strategies used by nurses FHS of Natal / RN in CCU control, and how specific: analyzing the knowledge of these nurses on the CCU, the actions developed in the ESF for the control of CCU and identify the difficulties faced by them to perform it. This is a descriptive exploratory quantitative developed through a structured interview guide with 106 nurses who have experience in controlling the CCU in FHS teams of Natal / RN. Data analysis was performed using descriptive statistic s. The results pointed to actions taken in the FHS to control the CCU, collection of cervical cancer screening, health education activities, nursing consultation, referral of suspected cases for medical monitoring and active women with abnormal test result . The actions that were not mentioned by the nurses included: forming groups of prevention and health promotion; expand coverage of exams and office hours of consultations, establishment of alternatives to end the pent-up demand in the health units, participation in treatment or rehabilitation process users with the CCU; interventions for pain management, alliances and partnerships with schools, in dustry and the use of protocols. This study can be seen that the practice nurses partially shares to the CCU in Natal / RN. The participants of this study, when asked about the CCU, specifically for signs and symptoms of disease and risk factors in general showed important gaps. Difficulties such as lack of materials for collection of Pap smear; inadequate physical space in the Health Units; pent-up demand in the service, delay in arrival of the test results; obstacles in the actions of referral and counter-referral and cultural factors make the CCU control is compromised. It is believed in this research contributed to a reflection on the importance of the role of nurses in the development of the ESF control actions CCU, pointing out the factors that affect these. It is important to involve all nurses who comprise the ESF as knowledgeable of the risk factors, signs and symptoms, and existing tools for the early detection of cervical cancer in the pursuit of quality improvement actions to promote women`s health, contributing in planning future interventions that may reduce mortality from this disease in Natal / RN. / O c?ncer do colo do ?tero (CCU) ? a segunda neoplasia mais prevalente entre as mulheres brasileiras. Os elevados ?ndices de CCU no Brasil justificam a implementa??o de estrat?gias efetivas para o controle deste, que incluem a??es de promo??o ? sa?de; preven??o prim?ria; detec??o precoce; rastreamento; tratamento e cuidados paliativos. Apesar da exist?ncia do Programa Nacional de Controle do CCU n?o houve redu??o na incid?ncia e mortalidade dessa doen?a no Brasil. A Estrat?gia Sa?de da Fam?lia (ESF) apresenta potencialidades para promover esse controle e, neste contexto, deve-se considerar que os enfermeiros t?m papel central. O estudo teve por objetivo geral conhecer as estrat?gias de interven??o utilizadas por enfermeiros da ESF do munic?pio de Natal/RN no controle do CCU, e como espec?ficos: analisar o conhecimento desses enfermeiros sobre o CCU, descrever as a??es desenvolvidas na ESF para o controle do CCU e identificar as dificuldades enfrentadas pelos mesmos para realiz?-la. Trata-se de um estudo descritivo explorat?rio, quantitativo desenvolvido por meio de um roteiro de entrevista estruturada com 106 enfermeiros que t?m experi?ncia no controle do CCU nas equipes de ESF de Natal/RN. A an?lise dos dados foi realizada por meio da estat?stica descritiva. Os resultados apontaram como a??es desenvolvidas na ESF para o controle do CCU, coleta do exame citopatol?gico, atividades de educa??o em sa?de, consulta de enfermagem, encaminhamento de casos suspeitos para o acompanhamento m?dico e busca ativa de mulheres com o resultado do exame alterado. As a??es que n?o foram citadas pelos enfermeiros constam de: forma??o de grupos de preven??o e promo??o ? sa?de; amplia??o da cobertura dos exames e do hor?rio de atendimento das consultas; estabelecimento de alternativas para acabar com a demanda reprimida nas Unidades de Sa?de; participa??o no tratamento ou processo de reabilita??o de usu?rias com o CCU; interven??es para o manejo da dor; alian?as e parcerias com escolas, ind?strias e utiliza??o de protocolos de atendimento. Com este estudo pode-se perceber que os enfermeiros praticam parcialmente a??es para o CCU no munic?pio de Natal/RN. Os participantes deste estudo, quando questionados sobre o CCU, especificamente quanto aos sinais e sintomas da doen?a e os fatores de risco, de forma geral apresentaram lacunas importantes. Dificuldades, como falta de material para coleta do exame preventivo; espa?o f?sico inadequado nas Unidades de Sa?de; demanda reprimida no servi?o; atraso na chegada do resultado dos exames; entraves nas a??es de refer?ncia e contra-refer?ncia e fatores culturais fazem com que o controle do CCU seja comprometido. Acredita-se com esta investiga??o contribuiu para uma reflex?o sobre a import?ncia do papel dos enfermeiros da ESF no desenvolvimento das a??es de controle do CCU, apontando os fatores que interferem nestas. ? importante o envolvimento de todos os enfermeiros que comp?em a ESF como conhecedores dos fatores de risco, sinais e sintomas e dos instrumentos existentes para a detec??o precoce do CCU na busca da melhoria da qualidade das a??es de promo??o ? sa?de da mulher, contribuindo no planejamento de interven??es futuras que possam reduzir a mortalidade causada por esta doen?a no munic?pio de Natal/RN

Background: Modern health systems are increasingly faced with the challenge to provide effective, affordable and accessible health care for people with chronic conditions. As evidence on the specific unmet needs and their impact on health outcomes is limited, practical research is needed to tailor chronic care to individual needs of patients with diabetes. Qualitative approaches to describe professional and informal caregiving will support understanding the complexity of chronic care. Results are intended to provide practical recommendations to be used for systematic implementation of sustainable chronic care models. Method: A mixed method study was conducted. A standardised survey (n = 92) of experts in chronic care using mail responses to open-ended questions was conducted to analyse existing chronic care programs focusing on effective, problematic and missing components. An expert workshop (n = 22) of professionals and scientists of a European funded research project MANAGE CARE was used to define a limited number of unmet needs and priorities of elderly patients with type 2 diabetes mellitus and comorbidities. This list was validated and ranked using a multilingual online survey (n = 650). Participants of the online survey included patients, health care professionals and other stakeholders from 56 countries. Results: The survey indicated that current care models need to be improved in terms of financial support, case management and the consideration of social care. The expert workshop identified 150 patient needs which were summarised in 13 needs dimensions. The online survey of these pre-defined dimensions revealed that financial issues, education of both patients and professionals, availability of services as well as health promotion are the most important unmet needs for both patients and professionals. Conclusion: The study uncovered competing demands which are not limited to medical conditions. The findings emphasise that future care models need to focus stronger on individual patient needs and promote their active involvement in co-design and implementation. Future research is needed to develop new chronic care models providing evidence-based and practical implications for the regional care setting.

Background: Modern health systems are increasingly faced with the challenge to provide effective, affordable and accessible health care for people with chronic conditions. As evidence on the specific unmet needs and their impact on health outcomes is limited, practical research is needed to tailor chronic care to individual needs of patients with diabetes. Qualitative approaches to describe professional and informal caregiving will support understanding the complexity of chronic care. Results are intended to provide practical recommendations to be used for systematic implementation of sustainable chronic care models. Method: A mixed method study was conducted. A standardised survey (n = 92) of experts in chronic care using mail responses to open-ended questions was conducted to analyse existing chronic care programs focusing on effective, problematic and missing components. An expert workshop (n = 22) of professionals and scientists of a European funded research project MANAGE CARE was used to define a limited number of unmet needs and priorities of elderly patients with type 2 diabetes mellitus and comorbidities. This list was validated and ranked using a multilingual online survey (n = 650). Participants of the online survey included patients, health care professionals and other stakeholders from 56 countries. Results: The survey indicated that current care models need to be improved in terms of financial support, case management and the consideration of social care. The expert workshop identified 150 patient needs which were summarised in 13 needs dimensions. The online survey of these pre-defined dimensions revealed that financial issues, education of both patients and professionals, availability of services as well as health promotion are the most important unmet needs for both patients and professionals. Conclusion: The study uncovered competing demands which are not limited to medical conditions. The findings emphasise that future care models need to focus stronger on individual patient needs and promote their active involvement in co-design and implementation. Future research is needed to develop new chronic care models providing evidence-based and practical implications for the regional care setting.