Este estudo teve como objetivo comparar padrões de percepções e de conhecimento sobre maconha em profissionais da área da saúde mental (psiquiatras, psicólogos, assistentes sociais, terapeutas ocupacionais e enfermeiros) em três instituições de diferentes perfis: Hospital Nossa Senhora de Fátima (Hospital filantrópico filiado ao SUS), CAPS-AD (Serviço especializado no atendimento de álcool e drogas do SUS) e Hospital das Clinicas - Instituto de Psiquiatria (Serviço acadêmico e assistencial). Setenta profissionais foram avaliados através de um questionário elaborado pelos pesquisadores composto de trinta e uma afirmativas. Dentre os resultados obtidos, observou-se que os psiquiatras tendem a discordar mais que os outros profissionais quanto à necessidade de tratamento para uso de maconha e que a maconha traz prejuízos cognitivos. Os profissionais do hospital Nossa Senhora de Fátima apresentaram uma percepção mais a favor da proibição da maconha e valorizam mais os possíveis prejuízos associados ao uso comparados aos profissionais das outras duas instituições. Conclui-se que a percepção dos profissionais varia de acordo com a profissão e local de trabalho. / The aim of this study was to compare mental health professionals - psychiatrists, psychologists, social workers, occupational therapists and nurses - perception and knowledge standards on marijuana in three institutions with different profiles: Nossa Senhora de Fátima Hospital (Philanthropic Hospital affiliated to SUS), CAPS-AD (service specialized on treating drugs and alcohol dependents - SUS) and the Institute of Psychiatry at the Clinics Hospital (academic and assistance service). Seventy professionals were evaluated through questionnaire developed by the researchers that contains thirty one affirmatives. As part of the results, it was noticeable that the psychiatrists disagreed more often than other health professionals on the need to treat marijuana use and the idea that it causes cognitive damages. The professionals at Nossa Senhora de Fátima Hospital were more in favor of the prohibition of marijuana use and value more the possible damages associated with its use when compared to professionals of the other two institutions. The conclusion is that the perception may vary according to the profession and work place.

Introdução: Uma das principais intercorrências que ocorrem com os pacientes renais crônicos é a queda da imunidade celular, o que torna esse paciente suscetível a desenvolver a tuberculose. Comparando o coeficiente de incidência de tuberculose entre pacientes renais crônicos e da população geral do estado de São Paulo, 40,69/100.000 pacientes (2005) e 43,9/100.000 hab (2004), respectivamente, pode sugerir que há um erro de notificação. Vários estudos sugerem a importância da tuberculose para o paciente renal crônico e a potencialidade de exposição de risco para os profissionais da área da saúde, especialmente os da enfermagem. Objetivo: Descrever o conhecimento e práticas de enfermagem, sobre a tuberculose, realizadas pelos profissionais da enfermagem, que trabalham em unidades de diálise da Grande São Paulo, considerando os aspectos epidemiológicos e clínicos.Método: Estudo descritivo que usou um questionário como instrumento de coleta de dados. A amostra utilizada foi de conveniência após uma seleção das unidades que possuíam mais do que 15 máquinas de diálise e concordaram participar da pesquisa. Os sujeitos foram todos os componentes das equipes de enfermagem dessas unidades (auxiliares, técnicos de enfermagem e enfermeiros).Resultados: Das 22 questões sugeridas por este estudo, 15 foram selecionadas para avaliar de forma direta o grau de conhecimento dos profissionais da equipe de enfermagem. Assim, o maior destaque de acertos foi obtido pelos enfermeiros (73,3%), que apresentaram 11 acertos nas 15 questões sugeridas; seguidos pelos técnicos de enfermagem que acertaram com maior freqüência quatro das 15 questões, ou seja, 26,6%. Os auxiliares de enfermagem obtiveram destaque de acertos em duas das 15 questões, com 13,3%. Ao analisar o número de acertos das 15 questões, sem diferenciar por categoria de profissional da equipe de enfermagem, não foram percebidas grandes diferenças nas porcentagens de acertos. Os resultados apontam que as equipes de enfermagem apresentam um bom domínio do conhecimento relacionado à tuberculose. Mas, isso não os isentou de expressar, em alguns momentos, conhecimentos limitados quanto as condutas de biossegurança diante da tuberculose. Conclusão: A sugestão desse estudo é que sejam intensificadas as atividades educacionais, voltadas para a tuberculose, incluindo esclarecimentos sobre as medidas de prevenção e controle específicas, para que sejam diminuídos os casos de tuberculose entre os pacientes renais crônicos e as situações de exposição de risco para a equipe de enfermagem. / Background: One of the main that occur with the chronic renal patients is the fall of the cellular immunity that makes this patient susceptible to the development of tuberculosis between chronic renal patients and the general population of the state of Sao Paulo, 40.69/100.000 ptients (2005) and 43.9/100.000 inhabitants ( 2004, respectively, can suggest that there is a error of tuberculosis to the chronic renal patients and the potentiality of exposition to the risk to professionals of the health area, specially nursing professionals. Objectives: Describe the knowledge and nursing's practices realized by nursing professional who work in dialysis centers of the metropolitan area od Sao Paulo, about the tuberculosis, considering the epidemiological and clinical aspects. Methods: Descriptive study which used one questionnaire has instrument of data collection. The sample used was the convenience sample after a selection which had more than 15 dialysis machines and agreed to participate of the study. The subjects were all nursing professionals of the dialysis centers ( assistants, technicians and nurses). Results: One of the 22 questions suggested by this study, 15 were selected to evaluate the directly the degree of knowledge of the nursing professional. So, the highest number of correct answers was obtained by the nurses (73.3%), who obtained 11 correct answers out of 15 questions suggested; followed by the technicians who obtained with highest frequency four correct answers out of 15 questions (26,6%). The assitants obtain two correct answers out of 15 questions (13.3%). Analysing the number of correct answers of the 15 questions, without differentiating by category of the nursing professionals there werent't big differences in the percentages of correct answers. The results showed that the nursing professionals have a good level of knowledge concerning tuberculosis aspects. But, that didn't exempt them from expressing, at times, limited knowledge about the biosafety aspects of tuberculosis. Conclusions: This study suggests a need for improvement in educational activities regarding to tuberculosis among nursing professionals, with special attention to prevention and control strategies. in order to diminish the number of reported tuberculosis cases among renal chronic patients and also to avoid risk exposures to the health care professionals.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-09T18:17:04Z No. of bitstreams: 1 camilaresendesoaresbrum.pdf: 806451 bytes, checksum: 2ab83192b5775b10a21d4fcf8f00ba0d (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-13T13:27:02Z (GMT) No. of bitstreams: 1 camilaresendesoaresbrum.pdf: 806451 bytes, checksum: 2ab83192b5775b10a21d4fcf8f00ba0d (MD5) / Made available in DSpace on 2016-09-13T13:27:02Z (GMT). No. of bitstreams: 1 camilaresendesoaresbrum.pdf: 806451 bytes, checksum: 2ab83192b5775b10a21d4fcf8f00ba0d (MD5) Previous issue date: 2011-10-24 / A presente pesquisa teve como objetivo principal investigar as crenças e atitudes dos profissionais da Atenção Primária à Saúde em relação à violência doméstica, antes e após a metodologia de intervenção, verificando possíveis mudanças. Participaram da pesquisa, 65 profissionais que responderam a um questionário auto-aplicável, estruturado, individual e anônimo. O instrumento foi aplicado antes e após uma capacitação conceitual sobre violência doméstica, com o intuito de analisar possíveis mudanças a partir desse tipo de intervenção. Os dados foram analisados através do programa SPSS, teste de significância McNemar. Os resultados indicaram algumas mudanças de crenças significativas a partir da intervenção proposta quanto à forma do profissional da Atenção Primária à Saúde lidar com vítimas de violência doméstica, o papel do profissional da atenção primária em detectar pacientes com problemas relacionados à violência doméstica, quanto ao interesse profissional sobre o padrão, os riscos de saúde relacionados e o aconselhamento para diminuir ou pará-la. Os dados não indicam mudanças em relação à confiança que os profissionais sentem na sua habilidade para lidar com a questão. / This research was focused on investigating the Primary Health Care providers' beliefs and attitudes towards domestic violence issues, before and after the intervention methodology, checking possible changes. The research involved 65 professionals who responded a self-administered, pre-formatted and anonymous questionnaire. In order to examine possible changes that resulted from this type of intervention, the instrument was administered before and after a conceptual training on domestic violence. Data was analyzed using SPSS, McNemar test of significance. The results from the proposed intervention showed some significant changes in the Primary Health Care providers' beliefs as to how to deal with victims of domestic violence, as well as in the role the Primary Health Care provider plays when detecting patients with domestic violencerelated problems, and in the providers' relation to the professional standards, health risks and counseling skills used to diminish or stop it. The data did not indicate changes in the level of confidence that providers have in their ability to deal with the issue.

The aim of this study was to understand how home care professionals construct older immigrants. The study was conducted by a social constructional perspective. The study consists of focus group interviews with three different home care groups. The data was analysed by using the theoretical concepts Categorizing and Making of the Others. The results of this study shows that the home care professionals are categorizing older immigrants as different from older Swedes, and therefore making older immigrants as the others. Besides mentioned social construction of older immigrants, we found that there were contradictions when the home care professionals made a reasoning that did not make older immigrants as the others. In this case they did not find the category older immigrants meaningful and useful, because they expressed that their needs were no different from elderly people in general.

This thesis aims to illuminate, through the lens of Murphy’s interpretation of Weber’s theory of social exclusion, contemporary challenges faced by the South African accounting profession pertaining to the shortage of professional accountants. In particular, increasing the throughput of students to the profession (Paper 1), member recruitment (Paper 2) and racial transformation of the profession (Paper 3) are considered. Paper 1 provides additional validity for the technique of biodata-based selection through the use thereof to differentiate between students in a dual medium university who will, or will not, complete their accounting education programmes in a society exhibiting tacit exclusionary closure. The models development suggested that education and language remains a tacit form of social exclusion of Blacks in the South African accounting profession. Paper 2 suggests that SAICA is the students’ preferred choice of professiona l accounting association, regardless of demographic group. The students appear to hold a collective view of the accounting profession. Consequently, in an environment characterized by the significant exclusionary closure achieved by a particular association, competing associations may need to look beyond marketing the attributes of the association to students and perhaps consider challenging the colonization of higher education by the dominant association. Competing associations, with their less onerous education requirements, should additionally consider promoting the alternate pathways to the profession they may offer to the Black students tacitly excluded from the dominant association, SAICA, on the basis of their inability to access to a quality education. An ideological challenge facing professional accounting associations in post-Apartheid South Africa, is racial transformation of the profession. Paper 3 explored the success or otherwise of the transformation projects implemented by SAICA through the lens of impression management and the use of voluntary disclosure. Given the disconnect between the slow pace of racial transformation achieved and the perceived ‘success’ of the profession transformation initiatives both in South Africa and abroad, it is suggested that the projects may have served more as a tool to manage the state’s impression of transformation, rather than achieving sufficient student outputs to redress the racial imbalances in the profession. Consequently, significant expansion and / or revision of these projects are encouraged.

The present study explored how authenticity is constructed by clinical psychologists and asked what might be the implications of these discourses. The study is concerned with offering a focus on the making of authenticity in discourse as well as providing an understanding of the complexity of authenticity within clinical psychology. The study used a discourse analytic approach known as critical discursive psychology to examine clinical psychologists’ talk of authenticity. Participants included twelve qualified clinical psychologists working in adult mental health services who took part in semi-structured interviews. Following a detailed critical discursive analysis of the texts, four discourses were identified with regard to the construction of authenticity. These discourses were commonly used to construct authenticity in extremely positive terms, however, some participants did draw attention to an ideological dilemma of authenticity versus professionalism. Participants used authenticity to establish their identity and manage their relationships with service users, colleagues and institutions. Drawing upon psychotherapeutic and professional discourses positioned participants as having power and being more authentic than others. Authenticity was problematised in relation to the participants need for professional boundaries. It is suggested that psychologists internalise dominant discourses of authenticity from the profession of clinical psychology, which is itself influenced by wider societal discourses around what it means to be authentic or inauthentic. Extra-discursive factors including institutions and embodiment were found to influence and constrain available discourses. The limitations of this study’s research findings are discussed as well as implications for future research and clinical psychology practice.

This investigation examines how knowledge of a researcher's intent, as well as gender, influences the clinical judgments of mental health professionals in sex role research. Conscious awareness of the study's aim was manipulated by varying experimental instructions to minimize (not salient) or maximize (salient) sex role awareness. Subjects were mental health professionals who rated a protocol of a female or male pseudopatient exhibiting masculine, and lacking feminine, stereotyped behaviors. It was hypothesized that if sex biases affect judgments, more negative ratings should be assigned to a female with cross sex role behavior than to male-appropriate role behavior. Differences should be greater when subjects were unaware of the nature of the study.

Bakgrund: Anorexia nervosa drabbar vanligen unga kvinnor. Sjukdomen grundar sig i en skev kroppsuppfattning vilket leder till bantning för att nå en idealvikt. Personer diagnostiserade med anorexia nervosa kan ha en dålig självbild och bristande självförtroende vilket kan leda till självdestruktivitet och lidande. Sjuksköterskan behöver visa tillit och skapa trygghet i mötet. Professionellt stöd i form av kommunikation och interaktion kan skapa en god vårdrelation. Syfte: Att beskriva hur unga kvinnor diagnostiserade med anorexia nervosa upplever mötet med vårdpersonal. Metod: Datamaterialet består av fem självbiografier som har analyserats med kvalitativ innehållsanalys. Resultat: Ur analysen framkom fyra kategorier; känna sig orättvist behandlad, hamnat i underläge, utsatt för maktmissbruk och tvång samt hopp och förtroende medåtta underkategorier. Konklusion:Mötet med vården upplevs både negativt och positivt. Det är viktigt att vårdpersonal respekterar de unga kvinnornas autonomi och engagerar dem i vården. Att vården präglas av ett etiskt perspektiv och att det avsätts tid till mötet är viktigt. Ett gott bemötande, adekvat kunskap och en icke-dömande attityd från vårdpersonalen är betydelsefullt. / Background: Anorexia nervosa usually affects young women. The disease is based on askewed perception of the body, which leads to dieting to reach an ideal weight. Individualswith anorexia nervosa can have bad self-image and low self-confidence which can result intoself-destructive behavior and suffering. The nurse during the meeting needs to show trustand create safety for the patient. Professional support by communication and interaction canestablished a good care relationship. Aim: To describe how young women diagnosed withanorexia nervosa experience the meeting with health professionals. Method: The datamaterial consists of five autobiographies that have been analyzed with qualitative contentanalysis. Results: The analysis revealed four categories; feel unfairly treated, ending up indisadvantage, exposed to abuse of power and compulsion, hope and confidence. A total ofeight subcategories emerged. Conclusion: The meeting with healthcare is experienced bothnegatively and positively. It is important that healthcare professionals respect the youngwomen’s autonomy and engage them in their healthcare. That the healthcare should becharacterized by an ethical perspective and that time is given in the meeting is important.Good treatment, adequate knowledge and non-judgmental attitudes from healthprofessionals are important.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research aimed to understand the social representations of physicians and nurses about excessive investment related to the terminal patient during the health care process in an Adult ICU. The specific aims of such project were to describe how physicians and nurses mean the end of life and the excessive investment regarding the terminal patient, to investigate how such professionals evaluate their academic learning process concerning health care during the dying process, and to identify reactions and feelings of physicians and nurses related to the death of the terminal patient. It consisted of a qualitative, exploratory/descriptive research, founded on Social Representations Theory. Data collection techniques consisted on focused interviews and participant observations. Analysis was based on content analysis. The ethical principles were respected, so that the participants rights were preserved, and an Informed Consent Document was signed as a condition to participate in the research. Among the results, it was possible to observe that physicians and nurses build their social representations about dysthanasia in the ICU under the influence of several factors, having as a starting point the absence of teaching and preparation to deal with death in the hospital context during undergraduate studies and medical residency, as well as the complexity of the daily contact with death and the dying process, together with feelings and defense mechanisms, spirituality and religiosity. Moreover, there are assertions that dysthanasia really happens, the firm pleads of the family of the terminal patient admitted in an ICU, the great complexity of decision making, that begins before admission of the patient in the ICU, decisions whether to invest on the patient or not, and the criteria used to decide when to stop investing, the role of the health professionals team on decision making, the enormous preoccupations concerning ethical and legal repercussions related to the decisions made as concerns the Code of Professional Ethics and the Brazilian Law, besides absences and euphemisms employed when registering the diagnosis, prognosis and care offered to the terminal patient, and last, the expectation of a dignified death as concerns the professional himself and the family, wishing to die at home, together with the family, having accepted the end of life. This study concludes that there are urgent needs of improvement regarding multiple aspects related to death: its approach during undergraduate studies and residency; adequate communication among professionals during decision making process and during the professional activities in the ICU, the ponderation between the wishes of the family and the real possibilities of survival of the patient. It is important to consider the situation of the patient and think that, concerning a hypothetical end of life, everything the professional dispenses to the patient in an ICU is solely what he would not desire as a dignified death, for himself or his family members. / Esta pesquisa objetivou compreender as representações sociais de médicos e enfermeiros acerca do investimento excessivo no paciente terminal durante o processo de cuidar em uma UTI Adulto. Os objetivos específicos visaram descrever como médicos e enfermeiros significam terminalidade de vida e o investimento excessivo no paciente terminal; investigar como estes profissionais avaliam a sua formação acadêmica face ao cuidado no processo de morrer; e identificar reações e sentimentos de médicos e enfermeiros frente à morte do paciente. Constou de uma pesquisa qualitativa, exploratório-descritiva, fundamentada na Teoria das Representações Sociais. As técnicas de coletas de dados foram a entrevista focalizada e a observação participante. O processo de análise foi embasado na análise de conteúdo. Os princípios éticos foram respeitados, de forma a proteger todos os direitos dos participantes, com formalização da participação por meio de Termo de Consentimento Livre e Esclarecido. Dentre os resultados, observou-se que os médicos e enfermeiros constroem as suas representações sociais sobre a distanásia em UTI sob influência de múltiplos fatores, partindo da ausência do ensino e preparação para lidar com a morte no cotidiano hospitalar durante a graduação e a residência médica; a complexidade da convivência cotidiana com a morte e o processo de morrer, juntamente com os sentimentos e mecanismos de defesa; a espiritualidade e a religiosidade; as afirmações de que a distanásia realmente acontece; os pedidos obstinados da família do paciente terminal internado na UTI; as grandes complexidades das tomadas de decisão, que se iniciam desde antes da admissão do paciente na UTI, passando pelas dúvidas em relação ao investimento, ou não, no mesmo e nos critérios utilizados para se saber até onde investir; o papel da equipe nas tomadas de decisão; o enorme receio das repercussões éticas e legais em relação às decisões tomadas, no que se refere aos códigos de ética profissional e o Código Penal brasileiro, além das ausências e eufemismos empregados nos registros de diagnóstico, prognóstico e cuidado ofertado ao enfermo terminal; e, por fim, os anseios de boa morte para o próprio profissional e seus familiares, com desejos de falecer em casa, junto com a família, como forma de aceitação da sua finitude. Concluiu-se, neste estudo, que existem necessidades de aperfeiçoamento no que tange a múltiplos aspectos referentes à morte: sua abordagem, na graduação e residência; comunicação adequada entre os profissionais durante os processos decisórios e durante o trabalho na UTI; a ponderação entre os desejos da família e as reais possibilidades de sobrevivência do doente. É importante se colocar no lugar do doente e considerar que, em uma hipotética terminalidade de vida, tudo o que o profissional dispensa ao paciente dentro de uma UTI é tão somente aquilo que não desejaria, como morte digna, para si ou familiares.

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