Bakgrund: Vårdcentraler är första instans vid vårdbehov om patientens tillstånd inte är akut. Av alla läkarbesök på vårdcentral utgörs 23 % av barn 0-18 år. Barn kommer sällan själva utan har med sig föräldrar eller vårdnadshavare. Därmed behöver vårdpersonalen förhålla sig till två individer i vårdsituationen. Föräldrar är en resurs för barnet och behöver ges möjlighet att tillsammans med barnet vara delaktiga i vårdsituationer. Vårdrelationen påverkar hur mötet mellan föräldrar, barn och vårdpersonal blir. Syfte: Att beskriva vårdpersonals reflektioner kring möten med föräldrar som söker vård för sina barn på vårdcentral. Metod: En kvalitativ innehållsanalys med en induktiv ansats. Det analyserade materialet utgörs av vårdpersonals reflektioner ur ett tidigare forskningsprojekt om barns delaktighet. Resultat: Att möta föräldrar som söker vård för sina barn på vårdcentral innebär att vårdpersonal balanserar mellan skilda perspektiv och förväntningar. Detta beskrivs som: Att ha föreställningar om föräldrars föreställningar och förväntningar; Att möta föräldrar och barn som en enhet och unika individer och Att vägleda föräldrar. Slutsats: Distriktssköterskans förutsättning för att upprätta en vårdande relation med föräldrar och barn i en vårdsituation innebär att försöka förstå och möta föräldrars och barns perspektiv och förväntningar. Genom en vårdande relation gynnas vårdsituationen, barnets hälsa och förälderns förtroende för vårdpersonalen. / Background: Primary Healthcare Centers (PHC) are the first instance to seek care for patients who are not acutely ill. Children between 0-18 years account for 23 % of all doctor visits at PHC. These children rarely arrive by themselves; they are accompanied by parents or guardians. Thereby the health care professionals (HCP) need to relate to two individuals in the care situation. Parents are a resource for their child and they should be given the opportunity to participate with the child in caring situations. The care relation influences the outcome of the encounter between parent, child and HCP. Aim: To describe HCP' reflections about the encounters with parents seeking care for their children at the PHC. Method: A qualitative content analysis with inductive approach was used. The analyzed material consists of HCP's reflections derived from a prior research project regarding children's involvement. Results: Encountering parents who seek care for their children at PHC means that HCP's in these care situations balance between different perspectives and expectations. This balance includes reflections that are described as: To have beliefs about parent's perceptions and expectations; To encounter parents and children as a unit and unique individuals and To guide parents. Conclusion: The prerequisite for district nurses to create a caring relationship with parents and children in a care situation involves understanding and encountering parents and childrens perspectives. A caring relationship benefits the care situation, the child's health and parent's trust in the HCP's.

Made available in DSpace on 2015-05-14T12:47:19Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 3698853 bytes, checksum: 2aef64808c364d9731b5fd0d369cfa20 (MD5) Previous issue date: 2015-02-10 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This study aimed to analyzing the potential of serious games as a pedagogical tool in the qualification of health professionals in the approach to domestic violence against women. Recognized as a universal problem and important epidemiological dimension, violence against women is a phenomenon based on gender, and its confrontation requires multidisciplinary interventions. To develop and evaluate the serious game presented in this research, the work included simultaneous adoption and complement of two methodological approaches: the qualitative and quantitative. The quality plan was used for defining the pedagogical dimension of the game, i.e. to identifying the themes that led to construction of the conceptual map categories (MC). Such categories and themes subsidized game implementation guiding the definition and creation of game elements: plot, challenges, images/scenes and method of evaluation. The theoretical dimension of the game and its pedagogical character are based on the Constructivist perspective based on the Freiriana methodology of problematization of reality. Pandora's box is a narrative about the life of a woman in a situation of domestic violence using public health services.The graphic design of the game and the method of evaluation were designed to work with concepts that guide professional practice by considering the knowledge and worldviews of the professionals are constituted as instruments of the health working process. In this approach, the game elements (illustrations, reflective dialogues, musical tracks and the method of valuation of the player, which acts as the intelligence of the game) were designed to awaken the motivations for reflection and awareness of the player. From the quantitative research, the game has been validated on the 85 professionals from family health teams. The results of this validation enabled verify the capability of the game for deserting the motivations towards learning about the issue, mobilizing new knowledge and enabling the production of new concepts by the players. The results showed that the game also proved powerful to steer changes of conceptions regarding the problem. Pandora's box was well accepted by health professionals as a pedagogical resource and training, having positive evaluation of more than 90% of the players. That way, the argument championed in this study that the serious games are capable of arousing motivation for learning and changing conceptions of the domestic violence committed against women. In particular, Pandora's box has the potential to working the theme of domestic violence in public health services and to contributing to a change of paradigmatic assistance on women's health. / Este estudo objetivou analisar as potencialidades dos serious games como uma ferramenta pedagógica na qualificação de profissionais de saúde na abordagem à violência doméstica contra a mulher. Reconhecida como um problema universal e de importante dimensão epidemiológica, a violência contra as mulheres é um fenômeno baseado no gênero e o seu enfrentamento requer intervenções multidisciplinares. Para desenvolver e avaliar o serious game apresentado nessa pesquisa, o trabalho comportou a adoção simultânea e complementar de duas abordagens metodológicas: a qualitativa e a quantitativa. O plano qualitativo foi utilizado para a definição da dimensão pedagógica do jogo, ou seja, para a identificação dos temas que conduziram a construção das categorias do Mapa Conceitual (MC). Tais categorias e temas subsidiaram a implementação do game orientando a definição e criação dos elementos do jogo: enredo, desafios, imagens/cenas e método de avaliação. A dimensão teórica do jogo e o seu caráter pedagógico fundamentam-se na perspectiva Construtivista com base na metodologia Freiriana de problematização da realidade. Caixa de Pandora trata de uma narrativa sobre a vida de uma mulher em situação de violência doméstica que recorre aos serviços públicos de saúde. O design gráfico do jogo e o método de avaliação foram projetados para trabalhar com concepções que orientam práticas profissionais por considerar que os saberes e as visões de mundo dos profissionais se constituem como instrumentos do processo de trabalho em saúde. Nesse enfoque, os elementos do jogo (ilustrações, diálogos reflexivos, trilhas musicais e o método de avaliação do jogador, que atua como a Inteligência do jogo) foram elaborados para despertar as motivações para a reflexão e a tomada de consciência do jogador. A partir da pesquisa quantitativa, o jogo foi validado por 85 profissionais de equipes de Saúde da Família. Os resultados dessa validação permitiram verificar a potencialidade do jogo para desertar as motivações no sentido da aprendizagem sobre o tema, mobilizando novos saberes e permitindo a produção de novos conceitos pelos jogadores. Os resultados evidenciaram também que o jogo se mostrou potente para orientar mudanças de concepções a respeito do problema. Caixa de Pandora foi bem aceito pelos profissionais de saúde como um recurso pedagógico e de treinamento, tendo avaliação positiva de mais de 90% dos jogadores. Dessa maneira, confirma-se o argumento defendido neste estudo de que os serious games são capazes de despertar motivações para o aprendizado e mudança de concepções sobre a violência doméstica cometida contra mulheres. Em especial, Caixa de Pandora apresenta potencialidades para trabalhar o tema da violência doméstica nos serviços públicos de saúde e contribuir para uma mudança paradigmática da assistência na saúde da mulher.

Made available in DSpace on 2014-12-17T14:46:53Z (GMT). No. of bitstreams: 1 JaquelineMBS_DISSERT.pdf: 1765859 bytes, checksum: 6d288bdaf8d4615845eb0265dedead22 (MD5) Previous issue date: 2011-12-13 / The counseling on HIV/Aids consists in a prevention strategy that contributes to increase the diagnosis of HIV and start earlier the treatment. The counseling has as pillars the emotional and educational support, risks evaluation that aim at the adoption of safe practices and the individual s responsibility for his own health. To accomplish these results, it is necessary that health workers understand counseling as a unique educational moment that stimulates the user s critical-reflection when it comes to his role as an active subject in this process. This study aimed to analyze the counseling on HIV/Aids conducted by the professionals of the Testing and Counseling Center (CTA), based on the educational perspective of Paulo Freire . This is a descriptive qualitative study with a critical reflexive design based on the principles of Action-Science. All the professionals acting as counselors in the Joao Pessoa, PB CTA, eight in total, took part in the study. Data were collected during the month of March, 2011, through non participative observation and semi-structured interviews with a critical-reflexive focus, analyzed according to the tenets of the critical-reflexive methodology, and discussed taking into consideration the Paulo Freire s pedagogy and pertinent literature. It was observed that most of the professionals expressed the work philosophy of CTA as the diagnosis and prevention of the disease, associated with the utilization and demonstration of condoms. However, upon observation of their counseling sessions, these ideas were not converted in actions. Educational themes were not covered and the condom wasn t offered at any time. The counseling actions focused on the provision of information and filling out the paper forms which are necessary for attendance. The sessions were conducted with brief dialogues and little opportunity for the users to expose or complement their thoughts and needs. The professionals mentioned as facilitating conditions for counseling, the team interaction and physical structure. The difficulties focused on the users low cognition, the large demand for attendance, aspects related to the service organization, and the counselors absences and delays. After reflecting about the actions observed in the counseling, the majority of professionals admitted the need to modify their practice in the incorporation of educational principles for the achievement of a broader prevention, and seemed to be willing to work in this perspective. In conclusion, although the counselors show ideas consistent with the purposes of CTA, these ideas are limited when it comes to the understanding of the meaning of prevention in HIV/Aids. Taking into consideration that they express a certain comprehension and act differently during the counseling, they demonstrate a lack of bond between the theories in use and the proposed ones, in accordance with the contribution of the action-science theory. The counseling, as an educative practice, doesn t materialize in the counseling itself and the orientation for reflection is not given during the attendance. These findings suggest the need to include the process of reflection in the execution of the actions of counseling, so that these practices are guided by reflexive practice, aiming at transforming the way of thinking and acting into a more educational perspective toward a more democratic and holistic assistance. / O aconselhamento em HIV/Aids consiste numa estrat?gia de preven??o pela qual ? poss?vel aumentar o diagn?stico do HIV e iniciar o mais precoce o tratamento. Os pilares que sustentam a estrat?gia s?o o apoio emocional e educativo, e a avalia??o de riscos, que visam ? ado??o de pr?ticas seguras e responsabilidade do sujeito como agente da sua sa?de. Para o alcance dos resultados, torna-se necess?rio que os profissionais de sa?de compreendam o aconselhamento como um momento educativo ?mpar, por estimular a reflex?o cr?tica do usu?rio no tocante ao seu papel como sujeito ativo nesse processo. Este estudo teve como objetivo analisar o aconselhamento em HIV/Aids realizado pelos profissionais do Centro de Testagem e Aconselhamento (CTA), na perspectiva educacional de Paulo Freire. Realizou-se um estudo descritivo com abordagem qualitativa e delineamento de investiga??o cr?tico-reflexiva, com base nos princ?pios da Ci?ncia-A??o. Participaram desta pesquisa todos os profissionais, totalizando oito, que atuam no aconselhamento no CTA de Jo?o Pessoa/PB. Os dados foram coletados no m?s de mar?o de 2011, por meio da observa??o n?o participativa e entrevista semiestruturada, com enfoque cr?tico-reflexivo, e analisados segundo os aportes da metodologia cr?tico-reflexiva e discutidos ? luz da pedagogia de Paulo Freire e autores pertinentes. Observou-se que a maioria dos profissionais compreende a filosofia de trabalho do CTA como sendo o diagn?stico e a preven??o associada ? utiliza??o e demonstra??o do preservativo. Contudo, ao observar as suas a??es durante os aconselhamentos, essas ideias se concretizam parcialmente. Temas educativos n?o foram abordados e o preservativo n?o foi oferecido em nenhum dos atendimentos. As a??es centraram-se no acolhimento de informa??es e no preenchimento dos formul?rios necess?rios ao atendimento, com di?logo breve e com pouca abertura para o usu?rio expor, ou completar, os seus pensamentos e necessidades. Os profissionais citaram as condi??es facilitadoras para o aconselhamento, a intera??o da equipe e estrutura f?sica. Focalizaram as dificuldades do baixo grau de cogni??o dos usu?rios, a demanda de atendimentos e outros aspectos da organiza??o de servi?o, e o descompromisso dos aconselhadores quanto ?s faltas e atrasos. Ao refletir sobre as a??es observadas nos aconselhamentos, a maioria dos profissionais reconheceu que precisa modificar algumas a??es do atendimento para incorpora??o dos princ?pios educativos na realiza??o de uma preven??o mais ampla, e se mostraram dispostos a trabalhar nessa perspectiva. Conclui-se que, embora os profissionais expressem ideias condizentes com os prop?sitos do CTA, estas s?o limitadas como apropria??o do significado de preven??o em HIV/Aids. Na medida em que expressam uma compreens?o e agem de forma diferente na realiza??o das a??es durante o aconselhamento, demonstram a desarticula??o entre as teorias em uso e as teorias propostas, conforme os aportes da teoria da ci?ncia-a??o. O aconselhamento como pr?tica educativa se concretiza parcialmente nos atendimentos e a orienta??o para uma reflex?o ? pouco oportunizada no atendimento. Esses achados sugerem a necessidade de inserir o processo de reflex?o na realiza??o das a??es de aconselhamento, de forma que estas sejam pautadas na pr?tica reflexiva, objetivando a transforma??o do seu modo de pensar e agir para uma perspectiva educacional com vistas a uma assist?ncia mais democr?tica e integral.

Bakgrund: När en patient vårdas palliativt innebär det att sjukdomen inte längre går att bota och vårdarbetet inriktas mot symtomlindring. Det finns lagar och föreskrifter som tydliggör hur information ska delges till närstående inom hälsooch sjukvårdsorganisationen så närstående ska få det stöd de behöver. Litteraturöversiktens teoretiska referensram förklarar hur stöd och information till närstående är en viktig del av den palliativa vården. Under den tiden som patienten vårdas palliativt är det viktigt att patientens närstående blir informerade om vad som sker med patienten. Syfte: Att belysa närståendes upplevelser av information kring den palliativa omvårdnaden av vuxna patienter. Metod: Studien har genomförts som en litteraturöversikt och baseras på tolv artiklar skrivna mellan år 2006-2016. Resultat: Resultatet visar olika faktorer som påverkar närståendes upplevelser av information vid palliativ omvårdnad av vuxna patienter. Det framkom i flera studier att närstående hade behov av att få information om patientens vård. Informationen skulle vara tydlig och enkel att förstå så närstående kunde känna sig förberedda och införstådda vad som skulle ske med patienten. Slutsats: Flera av faktorerna som är presenterade i litteraturöversiktens resultat är påverkansbara. Vårdpersonal behöver mer kunskap om utlämnande av information och dess betydelse för närstående till palliativa patienter. Denna kunskap bör spridas till alla vårdavdelningar inom hälso- och sjukvårdsorganisationen. Kunskapen om delgivning av information är viktig för att kunna ge närstående det stöd och den information som de har rätt till. Det kan leda till att närstående upplever att de kan hantera den svåra situation som de befinner sig i trots omständigheterna. / Background: When a patient is treated palliatively, it means that the disease can no longer be cured, and the care job focuses instead on symptom relief. There are laws and regulations that clarify how information is to be communicated to related people within the health care organization so relatives will get the support they need. The theoretical frame of reference in this study explains how support and information to close relatives is an important part of palliative care. During the time the patient is treated palliative, it is important that the relatives are informed of what happens to the patient. Aim: To highlight relatives experiences of the information concerning the palliative care of adult patients. Method: The study has been carried out as a literature review and is based on twelve articles written between 2006-2016. Results: The results of the study show various factors that affect the relatives experience of information on palliative care of adult patients. It appeared in several studies that relatives had the need to receive information about the patient's care. The information would be clear and easy to understand so that the close relatives could feel well prepared and understood what would happen to the patient. Conclusion: Several of the factors presented in the literature review result are influential. Healthcare professionals need more knowledge about the disclosure of information and its importance to relatives of palliative patients, and this knowledge should be spread to all healthcare organizations. Knowledge of information is important in order to provide the patients family support and information they are entitled to. This can lead to relatives experiencing that they can handle the difficult situation they are in despite the circumstances.

It is widely accepted that Higher Education should provide students with a challenging experience. Research on threshold concepts provides a framework for exploring challenging content within a discipline and has contributed to understanding how to support students with conceptual difficulties. However, less is known about how individual students experience challenge and difficulty in their academic studies, in particular how they respond and feel when they become stuck. This study explores students’ experience of challenge, difficulty and stuckness, how they responded and managed challenges and any associated feelings. The study, carried out in a university in the Southwest of England, used a Qualitative Longitudinal Research design to follow 16 students through the second year of a degree for Allied Health Professionals. Data were collected using the semi-structured and email interview methods. Data were analysed longitudinally and cross-sectionally using a constant comparison process. The findings and discussion are presented using a ‘natural’ style which aims to capture the student journey over the academic year. The study found that some form of challenge, difficulty or stuckness was commonplace in the students’ educational experience. The value of challenges which create uncertainty in education is recognised, particularly where students are grappling with boundaries around knowledge. Variation in students’ experiences was partly explained by their ‘spiky profiles’ (influencing factors such as prior education and work experience) and partly by differences in factors relating to strategy use. The students were creative and resourceful in developing a range of specific and generic strategies in several areas: the use of time and space; the management of expectations and acceptance of feelings; and monitoring and reflection. The study adds to current understanding of stuckness through an examination of the liminal spaces students encountered. The discussion argues for a more nuanced and holistic approach to understanding students’ engagement with a complex cycle of challenges and strategy use, which creates a range of expectations, tensions, feelings and opportunities. It identifies implications for Higher Education practice and calls for an understanding of the impact and interconnectedness of factors influencing students. It stresses the importance of providing structures for students to explore how they learn and develop their academic practice, in addition to discipline specific knowledge and skills.

The aim of this study was to gain knowledge about how professionals experience user influence within family-treating residential care. To collect empiricism for this study semi structed interviewes was conducted with eight employees within family-treating residential care. These interviews were later processed through a content analysis, it becomes clear that the participants acknowledged the importance of user influence within its own treatment. Further on, the result has been analysed by the theory called empowerment and previous research within the current subject, ”user influence within family-threating residential care”. However, the result of this study is that the user influence should always exist though in certain circumstances it should be limited.

Introdução: Os erros de medicação em hospitais têm origem multidisciplinar e multifatorial, podendo ocorrer em qualquer uma das etapas do processo de utilização dos medicamentos. A constatação de que os erros podem ocorrer implica no reconhecimento de que medidas devem ser tomadas. Os erros de medicação não devem ser banalizados, nem magnificados, devem ser adequadamente abordados em todas as suas repercussões pessoais, profissionais e institucionais. O Modelo de Bioética Complexa é um referencial adequado para abordar a temática dos erros de medicação, por refletir sobre situações de complexidade crescente, incluindo os múltiplos aspectos envolvidos. Objetivos: Avaliar o sistema de notificação de erros de medicação do HCPA segundo o referencial da Bioética Complexa. Analisar a percepção de colaboradores das áreas de Enfermagem, Farmácia e Medicina sobre a notificação e o monitoramento dos erros de medicação na Instituição. Identificar as barreiras para a notificação dos erros de medicação. Identificar os facilitadores para a notificação dos erros de medicação. Identificar os motivos para realizar a notificação de erros de medicação. Método: Trata-se de um estudo descritivo e exploratório. Foi realizada uma pesquisa online através da ferramenta Formulários Google®. O questionário, composto por 9 perguntas, foi elaborado tendo como referência perguntas de estudo prévio sobre o tema. O questionário era anônimo, não sendo possível identificar os participantes. Por e-mail institucional do HCPA, foi enviado convite com o endereço eletrônico para acessar o instrumento de coleta de dados. Não foram incluídos colaboradores vinculados ao Programa de Gestão da Qualidade e da Informação em Saúde (QUALIS) e à Gerência de Risco (GR), bem como coordenadores e assessores do HCPA. O envio dos e-mails foi realizado em um período de 60 dias. Foram realizados 2 a 4 envios, em diferentes dias da semana. Foi obtida uma amostra aleatória de 411 participantes, de um total de 3872 colaboradores (profissionais de nível superior das áreas de Medicina, Enfermagem e Farmácia, contratados ou residentes, e técnicos de Enfermagem e de Farmácia). O conteúdo das respostas às perguntas abertas do questionário foi submetido à técnica de análise de conteúdo de Bardin. Os dados foram armazenados e avaliados no software de análise qualitativo QSR NVivo® versão 10. Resultados: Foram identificadas três categorias principais de barreiras: Barreiras Individuais, Barreiras Organizacionais e Barreiras Culturais. Na categoria Barreiras Individuais, emergiram seis subcategorias: medo, desconhecimento, responsabilidade, falta de comprometimento, esquecimento e vergonha. Na categoria Barreiras Organizacionais, emergiram quatro subcategorias: demanda de trabalho, dificuldades com o sistema de notificação, falta de feedback e infraestrutura. Na categoria Barreiras Culturais, emergiram três subcategorias: cultura de segurança não priorizada, cultura de banalização dos erros e cultura de infalibilidade. O medo foi a barreira individual mais referida pelos participantes. A demanda de trabalho foi percebida como uma das principais barreiras organizacionais pelos colaboradores e foi relacionada à falta de tempo. A partir da análise das respostas dos participantes, emergiram 12 categorias de facilitadores para a notificação dos erros de medicação: Divulgação e informação, Condução adequada da análise, Sistema de notificação, Resposta não punitiva, Feedback, Clareza, Cultura, Treinamento, Anonimato, Trabalho em equipe, Demanda de trabalho e Comprometimento. Doze categorias foram identificadas como motivos para notificar os erros de medicação. As categorias foram agrupadas quanto à sua relação com os profissionais, com os processos e com os pacientes. Motivos relacionados ao profissional: a Educação, a Proteção do Profissional envolvido em um erro de medicação e a Responsabilidade. Motivos relacionados aos processos envolvidos: Prevenir novos erros, Revisão dos processos, Análise dos erros, Barreiras de segurança, Protocolo Institucional e Cultura de segurança. Motivos relacionados aos pacientes: Segurança do Paciente, Qualidade da assistência e Riscos. Considerações finais: Verifica-se o engajamento dos profissionais participantes que deram inúmeras contribuições para o entendimento e aprimoramento do processo de notificação de erros de medicação, com uma ênfase na segurança do paciente. / Background: Medication errors in hospitals have multidisciplinary and multifactorial origin and can occur at any stage of the process of use of medicines. The finding that errors may occur involves the recognition that measures should be taken. Medication errors should not be trivialized or magnified, they should be adequately addressed in all their personal, professional and institutional repercussions. The Complex Bioethics model is an appropriate framework to address the issue of medication errors, by reflecting on the increasing complexity of situations, including the many aspects involved. Objective: To evaluate the medication error reporting system of the HCPA under the framework of Complex Bioethics. To analyze the perception of employees in the areas of Nursing, Pharmacy and Medicine on the reporting and monitoring of medication errors in the institution. Identify barriers to the reporting of medication errors. Identify facilitators for reporting of medication errors. Identify the reasons to perform medication error reporting. Method: This is a descriptive and exploratory study. It was done a search online through Google Forms tool. The questionnaire consists of 9 questions, it has been established as a previous study questions reference on the subject. The questionnaire was anonymous, it is not possible to identify participants. Email invitation has been sent to the email address of the participants to access the questionnaire. The sending of e-mails was conducted in a period of 60 days. A random sample of 411 participants was obtained, a total of 3872 employees. The content of the answers to open questions of the questionnaire was submitted to Bardin content analysis technique. The data were stored and evaluated by qualitative analysis software QSR NVivo version 10. Results: We identified three main categories: individual barriers, organizational barriers and cultural barriers. In the category individual barriers emerged six sub-categories: fear, ignorance, responsibility, lack of commitment, forgetfulness and shame. In the category organizational barriers, four subcategories emerged: workload, difficulties with the reporting system, lack of feedback and infrastructure. In the category cultural barriers revealed three subcategories: not prioritized safety culture, banalization of errors and infallibility culture. Fear was the individual barrier most reported by the participants. The workload was perceived as a major organizational barrier by employees and was related to lack of time. From the analysis of the responses of the participants emerged 12 categories of facilitators for the reporting of medication errors: shared information, proper conduct of the analysis, reporting system, non- punitive response, feedback, clarity, culture, training, anonymity, teamwork, workload and commitment. Twelve categories were identified as reasons for reporting medication errors. The categories were grouped as to its relationship with the professionals, with the procedures and with patients. Reasons related to Professional: education, professional protection and responsibility. Reasons related to the processes involved: To prevent new errors, review of processes, analysis of errors, safety barriers, institutional protocol and safety culture. Reasons related to patients: patient safety, quality of care and risks. Conclusion: There is the engagement of the professionals who gave numerous contributions to the understanding and improvement of medication errors notification process, with an emphasis on patient safety.

Bakgrund: Personer med HIV föreligger ökad risk för olika infektioner på grund av deras låga immunförsvar. Omvårdnadsbehov för personer med HIV kan vara munhälsa, nutrition och psykiskt stöd. Det förekommer att vårdpersonal har otrevlig attityd mot personer med HIV och låg kunskapsnivå om sjukdomen. Syfte: Syftet med denna litteraturöversikt var att belysa hur personer med HIV upplever hälso- och sjukvården. Metod: En litteraturöversikt där elva vetenskapliga artiklar har sammanställts. Resultat: Resultatet presenteras i fyra huvudteman: Mötet med vårdpersonal, Stöd och kunskap och Smitta och sekretessbrott, Andra instanser och aspekter som inverkade på upplevelsen av hälso- och sjukvården. Diskussion: Diskussionen belyser hur patienter med HIV upplevde bemötande från vårdpersonalen och hur vårdpersonalens kunskapsnivå kan påverka bemötandet, samt att patienterna upplever att de har en kunskapsbrist om HIV. Resultatet diskuteras med hjälp av vetenskapliga artiklar och Katie Erikssons teori om ansa, leka och lära samt begreppet vårdlidande. Det har betydelse att utföra vårdhandlingar utifrån patientens behov för att minska vårdlidande. / Background: People with HIV has an increased risk of various infections due to their low immune system. Care needs for people with HIV can be a good oral health, nutrition and psychological support. Healthcare professionals can have a bad attitude towards people with HIV and low levels of knowledge about the disease. Aim: The purpose of this literature review was to illuminate how people with HIV experience the healthcare. Method: A literature review with eleven scientific articles have been compiled. Results: The result is presented in four main themes: Meeting with healthcare professionals, Support and knowledge and Contagion and confidentiality, Other instances and aspects that affected the experience of healthcare. Discussion: The discussion illustrates how patients with HIV experienced treatment from the healthcare staff and how the healthcare staff's level of knowledge can affect the treatment, and that patients experience a lack of knowledge about HIV. The key parts of the result were discussed with help of scientific articles and Katie Eriksson´s theory of tending, playing and teaching, as well as the concept of suffering related to care. It is important to carry out health care procedures based on the patient needs to suffering related to care.

Bakgrund: Kronisk smärta är ett globalt fenomen där var femte människa regelbundet upplever måttlig till svår smärta. Otillräcklig förståelse och kunskap om egenvård av kronisk smärta kan vara ett hinder för många äldre personer. Otillräcklig smärtlindring kan medföra onödigt lidande för patienten. Kronisk smärta kan också påverka den äldre personens vardag så väl som deras livskvalité. Syfte: Syftet med studien var att belysa hälso- och sjukvårdspersonalens erfarenhet av omvårdnad hos äldre personer med kronisk smärta. Metod: Denna studie var en litteraturöversikt med induktiv design med 11 kvalitativa artiklar som urval. Resultat: Hälso- och sjukvårdspersonalen uttryckte att det fanns ett ökat behov av kunskap om smärta, eftersom de stundtals tvivlade på sin egen förmåga att bedöma och lindra smärtan hos äldre personer, vilket gav en känsla av maktlöshet. Erfarenheten var att samarbete, tillit och en fungerande kommunikation inom det multi-professionella teamet var viktigt för att patientens smärtlindring skulle bli optimal. Slutsats: För att den äldre patienten med kronisk smärta ska få en god smärtlindring krävs att hälso- och sjukvårdspersonalen har kunskap, samarbetsförmåga och självinsikt. / Background: Chronic pain is a global phenomenon, where every fifth person experiences moderate to severe pain regularly. Insufficient understanding and knowledge of chronic pain can be an obstacle for elderly patients. Pain relief that is insufficient contributes to unnecessary suffering for the individual. Chronic pain can also influence elderly patients' everyday life, as well as their quality of life. Aim: The aim of this study was to describe the health care staffs’ experience of nursing in elderly patients with chronic pain. Method: This study was a literature review with an inductive design in addition to a selection of qualitative articles. Result: The health care staff expressed a need for increasing the knowledge about pain, as they sometimes doubted their ability to assess and alleviate the pain in the elderly, which gave a sense of the staff being powerless. The experience was that collaboration, trust, and a functioning communication within the multi-professional team had an important role for optimal pain relief. Conclusion: In order for the elderly patient with chronic pain to receive sufficient pain relief, the healthcare professionals need abilities such as knowledge, cooperation and self-awareness.

Submitted by Socorro Pontes (socorrop@ufersa.edu.br) on 2017-01-30T13:39:15Z No. of bitstreams: 1 GiselleSCO_DISSERT.pdf: 1058104 bytes, checksum: 89fd1032b2b20bfc50ba7056a41faafa (MD5) / Made available in DSpace on 2017-01-30T13:39:15Z (GMT). No. of bitstreams: 1 GiselleSCO_DISSERT.pdf: 1058104 bytes, checksum: 89fd1032b2b20bfc50ba7056a41faafa (MD5) Previous issue date: 2016-01-15 / The visceral leishmaniasis (VL) is an infectious disease and a zoonosis. It is still considered a public health challenge, due to the frequency and mortality caused on the population. The overall objective is to develop an instrument for prevention of Visceral Leishmaniasis in the context of the Family Health Strategy, analyzing the knowledge of health professionals. The specific objectives are characterizing the profile of health professionals on the Family Health Strategy Program; developing an instrument to assess the interest of Health Professionals in the Family Health Strategy Program (FHS) on measures to prevent visceral leishmaniasis in their community; identifying the influencing factors which come into play when those professionals take actions to prevent visceral leishmaniasis; identifying areas of greatest prevalence of visceral leishmaniasis in Mossoró and evaluating the influence of health professionals’ knowledge on the prevalence of visceral leishmaniasis. It is an exploratory, descriptive and quantitative research which was carried out in 30 Basic Health Centers (BHC) of the Family Health Strategy Program in the urban area in the town of Mossoró-RN. The population were health professionals from the FHSP, and the sample composed by 227 elements. Two questionnaires have been administered, one related to knowledge on VL and the other one for identifying the factors that guide health professionals. Data were expressed on standard average and deviation, minimum, maximum, simple frequencies and percentages obtained through the software Statistical Package for Social Science (SPSS) version 20.0. The instrument was developed and submitted to content validation with application of Kappa Index and Content Validity Index. Then, the instrument was applied to health professionals. Being validated with 20 items, divided into five factors such as the work process, environment, socio-personal difficulties, financing, prevention and control. The instrument is suitable and can be used for research in primary health care regarding to prevention and control of visceral leishmaniasis, particularly in endemic areas. Regarding to the knowledge on VL, it was identified that health professionals know the animals that may be affected, enabling an increase in the identification of cases of this disease (OR: 2.74; IC95%=1.17 – 6.41). Knowing the symptoms of the disease in animals is the key to realize its existence (OR: 2.75; IC95%=1.09 – 6.89). In addition, the fact of knowing prevention is a contributing factor to detect the disease in the regions (OR: 2.38; IC95%=1.07 – 5.31). Regarding the transmission times of the disease, it was most relevant to a greater detection of VL cases (OR: 2.75; IC95%=1.24 – 6.05). In conducting an active search for HVL and Canine Visceral Leishmaniasis (CVL), there is a greater risk of finding positive cases of the disease (OR: 2.57; IC95%=1.13 – 5.61). After the crude analysis of the O.R., the adjusted data revealed that these variables are more important. The health professionals have a limited knowledge about the VL, there are still gaps to be considered, especially on the prevention and control of disease in the researched areas. Thus, requiring an ongoing training and implementation of incisive governmental actions / A Leishmaniose Visceral (LV) é uma doença infecciosa e uma zoonose. Considerada um desafio à saúde pública pela frequência e morbimortalidade ocasionada. Objetiva-se desenvolver um instrumento para prevenção da Leishmaniose Visceral no âmbito da Estratégia de Saúde da Família, analisando o conhecimento dos profissionais de saúde. Mais especificamente, caracterizar o perfil dos Profissionais de Saúde da Estratégia de Saúde da Família; elaborar um instrumento que avalie o interesse dos Profissionais de Saúde da Estratégia de Saúde da Família (ESF) sobre as ações de prevenção da Leishmaniose Visceral da sua comunidade; identificar os fatores influenciadores dos Profissionais de Saúde da Estratégia de Saúde da Família (ESF) sobre as ações de prevenção da Leishmaniose Visceral; avaliar a influência do conhecimento dos Profissionais de Saúde da Estratégia de Saúde da Família (ESF) sobre a prevalência de Leishmaniose Visceral; realizar um levantamento das áreas de maior prevalência da Leishmaniose Visceral em Mossoró, Rio Grande do Norte. Trata-se de uma pesquisa exploratória, descritiva e quantitativa. Foi realizada em 30 Unidades Básicas de Saúde (UBS) da ESF na zona urbana, no Município de Mossoró-RN. A população foi composta pelos profissionais de saúde das ESF, sendo a amostra composta por 227 elementos. Foram aplicados dois questionários, um relacionado ao conhecimento sobre LV e outro para identificação de fatores que norteiam os profissionais de saúde. Os dados foram expressos em média e desvio padrão, valores mínimos, máximos, frequência simples e porcentagem obtidos através do programa (SPSS) versão 20.0. O instrumento foi desenvolvido, sendo submetido à validação de conteúdo com aplicação do Índice Kappa e Índice de Validade de Conteúdo. Em seguida, foi aplicado o instrumento aos profissionais de saúde. Ficando validado com 20 itens, subdividido em cinco fatores caracterizados em processo de trabalho, ambiente, dificuldades sócios pessoais, financiamento, prevenção e controle. O instrumento encontra-se adequado, podendo ser utilizado em pesquisas na atenção primária de saúde em relação à prevenção e controle da Leishmaniose visceral, principalmente em áreas endêmicas. Em relação ao conhecimento da LV, foi identificado que os profissionais de saúde conhecem os animais que podem ser acometidos, possibilitando um aumento na identificação de casos da doença (OR: 2,74; IC95%=1,17 – 6,41). O conhecimento da sintomatologia da doença no animal é um determinante para perceber a sua existência (OR: 2,75; IC95%=1,09 – 6,89). Além disso, o fato de conhecer a prevenção é um fator que contribui para detectar a doença nas regiões. (OR: 2,38; IC95%=1,07 – 5,31). Em relação aos horários de transmissão da doença foi relevante para uma maior detecção de casos de LV (OR: 2,75; IC 95%1,24 – 6,05). Na realização de busca ativa de LVH e Leishmaniose Visceral Canina (LVC), existe um maior risco de encontrar casos positivos da doença (OR: 2,57; IC95%=1,13 – 5,61). Após a análise bruta do OR, o ajustado revelou que essas variáveis são mais importantes. Os profissionais de saúde possuem um conhecimento restrito acerca da LV, existindo ainda lacunas a serem consideradas, principalmente sobre a prevenção e controle da doença nas áreas estudadas, necessitando assim, de capacitação continuada por parte das ações governamentais contudentes / 2017-01-27