Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-03T20:30:22Z No. of bitstreams: 1 RosanaMariaFerreiraDeMouraLima_DISSERT.pdf: 2702977 bytes, checksum: eeffeaee6f760aaca6f729f00635fe54 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-08T22:42:35Z (GMT) No. of bitstreams: 1 RosanaMariaFerreiraDeMouraLima_DISSERT.pdf: 2702977 bytes, checksum: eeffeaee6f760aaca6f729f00635fe54 (MD5) / Made available in DSpace on 2016-03-08T22:42:35Z (GMT). No. of bitstreams: 1 RosanaMariaFerreiraDeMouraLima_DISSERT.pdf: 2702977 bytes, checksum: eeffeaee6f760aaca6f729f00635fe54 (MD5) Previous issue date: 2014-09-15 / O reconhecimento da alimenta??o como determinante e condicionante do processo sa?dedoen?a exige novas explica??es e interven??es da a??o pol?tica em alimenta??o e nutri??o e demanda modelo de aten??o ? sa?de pautado na integralidade das a??es e centrado na promo??o da sa?de. Este estudo, caracterizado como pesquisa-a??o de car?ter intervencionista, buscou desenvolver estrat?gias para apoiar a inser??o transversal das a??es de promo??o da alimenta??o saud?vel nas pr?ticas de profissionais de um N?cleo de Apoio ? Sa?de da Fam?lia e uma Unidade da Estrat?gia Sa?de da Fam?lia no munic?pio de Natal, capital do Rio Grande do Norte, a partir da an?lise das percep??es e processos de trabalho dessas equipes. Foram adotadas v?rias estrat?gias metodol?gicas: C?rculo Hermen?utico Dial?tico, Observa??o Direta, Encontros Tem?ticos Reflexivos e Oficina ?Repensando as pr?ticas educativas para promo??o da alimenta??o saud?vel?. Para registro de dados, foram utilizados os Di?rios de Pesquisa-DP e de Momentos-DM. A an?lise ocorreu de forma processual, em conjunto com os participantes da pesquisa, em constante movimento de reflex?o-a??o-reflex?o, com base na hermen?utica-dial?tica. Quanto aos resultados, em rela??o ? promo??o da sa?de, evidenciaram-se as seguintes percep??es: promo??o da sa?de associada ? preven??o de doen?as e agravos; promo??o da sa?de relacionada ? qualidade de vida e ao bem estar, em suas v?rias dimens?es; promo??o da sa?de enquanto responsabilidade do Estado; promo??o da sa?de relacionada ?s a??es de educa??o em sa?de; promo??o da sa?de como express?o da resolutividade e acessibilidade aos servi?os de sa?de. Quanto ? alimenta??o saud?vel, predominaram as percep??es referentes aos aspectos nutricionais. No que se refere ? educa??o alimentar e nutricional-EAN, observou-se predomin?ncia da percep??o de EAN como informa??o, orienta??o e transmiss?o de conhecimentos para mudan?as de pr?ticas alimentares. No que diz respeito ao processo de trabalho, observou-se que entre as a??es para promo??o da sa?de, predominam as atividades educativas, como palestras, rodas de conversas, que na maioria das vezes, ocorrem de forma fragmentada, sem planejamento conjunto entre as equipes, variando de acordo com os profissionais e o momento de trabalho em que s?o realizadas. Os resultados apontaram para a necessidade de reorganiza??o dos processos de trabalho, na perspectiva da articula??o intra e intersetorial e da constru??o de novas tecnologias, tais como: Projeto de Sa?de do Territ?rio ? PST, Projeto Terap?utico SingularPTS, Cl?nica Ampliada e Compartilhada, pr?ticas educativas com metodologias ativas de ensino-aprendizagem. A partir dos resultados consideramos que se faz necess?rio a ?reforma do pensamento?, por meio de mudan?as na forma??o profissional e do fortalecimento dos espa?os de educa??o permanente, considerando a complexidade que envolve a alimenta??o, a educa??o alimentar e nutricional e a promo??o da sa?de. A reforma do pensamento deve estar articulada e imbricada ? produ??o de saberes e pr?ticas que favore?am a intersetorialidade, a transversalidade, o di?logo e a postura democr?tica e solid?ria, com base na constru??o coletiva do saber-fazer. Esperamos que esse estudo possa contribuir com reflex?es e iniciativas que estimulem a constru??o de pr?ticas que promovam a alimenta??o saud?vel na Aten??o Prim?ria ? Sa?de, na perspectiva da integralidade do cuidado e da realiza??o da Seguran?a Alimentar e Nutricional. / The recognition of the food as determinant and health-disease process etching requires new explanations and interventions of the food and nutrition policy action and demand health care model based on the completeness of the actions and focused on health promotion. This study, characterized as research-action of interventionist character, sought to develop strategies to support the transverse insertion of healthy eating promotion in professionals practices a core of support for the health of the family and a family health strategy Unit in the city of Natal, capital of Rio Grande do Norte, from the analysis of perceptions and work processes of these teams. Several methodological strategies were adopted: Dialectical Hermeneutical Circle, direct observation, reflective and Thematic Meetings Workshop "Rethinking the educational practices for promoting healthy eating". For data logging, search diaries - SD were used and moments. The analysis of procedural form occurred in conjunction with research participants, in constant movement of reflection-action-reflection, based on hermeneutics-dialectic. About the results, in relation to the promotion of health, showed the following insights: health promotion and disease prevention-related harms; health promotion related to quality of life and well-being, in its various dimensions; health promotion as a responsibility of the State; health promotion related to the actions of health education; health promotion as an expression of efficaciousness and accessibility to health services. Regarding healthy nutrition, predominated the perceptions relating to nutritional aspects. With regard to food and nutritional education - FNE, it was observed a predominance of perception of FNE as information, guidance and knowledge transfer for changes of dietary practices. As regards the working process, it was observed that among the actions for health promotion, educational activities predominate, such as lectures, conversations, groups that mostly occur in fragmentary form, without joint planning teams, varying according to the professionals and the moment of work in which they are carried out. The results pointed to the need for reorganization of the work processes, in the context of intra-and intersectoral coordination and the construction of new technologies, such as: Health project of the territory ? HPT, Unique Therapeutic Project- UPT, Expanded Clinic and educational practices, Shared with active teaching and learning methodologies. From the results we believe that it is necessary to "thought reform", from changes in vocational training and strengthening of the permanent education spaces, whereas the complexity that involves feeding, food and nutrition education and health promotion. The reformation of thought must be articulate and closely tied to the production of knowledge and practices that encourage intersectoral approach, the transversality, dialogue and democratic and supportive attitude, based on the collective construction of know-how. We hope that this study can contribute with reflections and initiatives that encourage building practices that promote healthy eating in primary health care, in terms of completeness of the care and the attainment of food security and nutrition.

Made available in DSpace on 2014-12-17T15:31:00Z (GMT). No. of bitstreams: 1 MariaJMF.pdf: 624092 bytes, checksum: d2349adc0f4b4ef628ccf10c679d3f2a (MD5) Previous issue date: 2007-03-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Considering education a support to health promotion, care integration and citizenship formation,the purpose of this research was to analyze the perception of the oral surgeons from the Family Health Program of Natal-RN over education in health as well as their performance as educators based on their activities on the program. A qualitative study was accomplished by a semi-structured interview and a Free Association of Words Test with 80 oral surgeons from the Family Health Program of Natal-RN. The instruments were analyzed through the meaning analysis and the Central Nucleus of Verg?s Theory. The results showed a lack of planning in health actions so there is no standardization on the educative practices done by the oral surgeons which mostly are focused on scholars. There was an agreement among the group according to the oral surgeons? perception about education in health that education is related to its function of recall prevention ideas to the population. Most part of the context units analyzed by the professionals? speech show the knowledge of education in health as an inadequate behavior change instrument of the individuals. An interesting point was a quotation cited by some professionals that included actual themes such as citizenship, motivation and life quality, put inside the speech of education in health. To the oral surgeons the biggest difficulties on the development of the educative actions are due to the lack of incentive by the Municipal Health Bureau and to the detachment and lack of valorization of the themes by the population. The oral surgeons consider themselves co-responsible for the formation of a population which is able to request its health. They also mention the knowledge about the need of the community participation on the planning of the Family Health Program actions. Finally, it is notable the need for more encouragement so the oral surgeons can be more capable and have more interest in applying education in health on the perspective of a new model in health, because once capable and stimulated they can awake the population to education importance as a great transformation instrument for people searching for a fair, equalitarian and citizeness society / Considerando a educa??o como suporte para a promo??o da sa?de, integralidade da assist?ncia e forma??o da cidadania, o objetivo desta pesquisa foi analisar a percep??o dos cirurgi?es-dentistas do Programa Sa?de da Fam?lia (PSF) de Natal-RN sobre a educa??o em sa?de, bem como a sua atua??o como educador, a partir das atividades realizadas por eles no referido Programa. Foi realizado um estudo qualitativo, utilizando como instrumentos de coleta de dados uma entrevista semi-estruturada e um Teste de Associa??o Livre de Palavras com 80 cirurgi?es-dentistas do PSF de Natal-RN, que foram analisados respectivamente atrav?s de an?lise de conte?do e da Teoria do N?cleo Central de Verg?s. Os resultados mostram que h? uma falta de planejamento nas a??es de sa?de, de forma que n?o existe uma padroniza??o das pr?ticas educativas realizadas pelos cirurgi?es-dentistas, que em sua maior parte, s?o voltadas para escolares. A partir das percep??es dos entrevistados a respeito da tem?tica educa??o em sa?de, vimos que h? um consenso entre o grupo, ligado a hist?ria coletiva do mesmo em relacionar educa??o como tendo a fun??o de apenas repassar ? popula??o no??es de preven??o. A maioria das unidades de contexto analisada, a partir do discurso dos profissionais, demonstra o entendimento da educa??o em sa?de apenas como um instrumento de mudan?a de comportamento inadequado dos indiv?duos. Um ponto interessante foi a cita??o por parte de alguns profissionais de temas atuais como: cidadania, motiva??o e qualidade de vida, dentro do discurso da educa??o em sa?de. Para os entrevistados, as maiores dificuldades no desenvolvimento das a??es educativas se deve a falta de incentivo por parte da Secretaria Municipal de Sa?de e ao desinteresse e falta de valoriza??o das atividades por parte da popula??o. Os cirurgi?es-dentistas se v?em como corespons?veis pela forma??o de uma popula??o capaz de reivindicar por sua sa?de e relataram ter conhecimentos da necessidade da participa??o comunit?ria no planejamento das a??es do PSF. Finalmente, percebe-se a necessidade de mais incentivos para que os cirurgi?es-dentistas possam se capacitar e tenham interesse em utilizar a educa??o em sa?de na perspectiva do novo paradigma em sa?de, para uma vez capacitados e estimulados possam despertar na popula??o a import?ncia da educa??o como o grande instrumento de transforma??o das pessoas em busca de uma sociedade justa, igualit?ria e cidad?

Made available in DSpace on 2014-12-17T14:46:53Z (GMT). No. of bitstreams: 1 AnaDBS_DISSERT.pdf: 1545162 bytes, checksum: 3eb308408080c09bd237b78f5cc63a67 (MD5) Previous issue date: 2011-12-16 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The joint enters the teams of the Strategy Health of Family (ESF) and the Municipal Center of Infantile education (CMEI) blunts as a form to assure the monitoring and promotion to the health of the children of 2 the 5 years when entering the day-care center environment/daily pay-school. It was traced as objective: To analyze the actions developed for the team of the Strategy Health of the Family in the promotion the health of the child, taken care of in a CMEI. Description-exploratory is to a study, qualitative nature, the type research-action. Developed in a CMEI and the USF of the quarter of New City, Natal-RN. The population was constituted by the professionals of the team of the ESF and the CMEI and parents. During the stages of the research-action diverse techniques had been used as the individually interview and in group, focal group, comment participant, and daily of field. The analysis of the data occurred by means of the content analysis, in the thematic modality, proposal for Bardin (1977) and description of the stages of the research-action. In the stage of situational diagnosis that it investigates the reality lived deeply for the citizens of ESF and CMEI how much to the health of the child seven categories had emerged that they enclosed: the context of the attention child in the CMEI identifying the actions that already came being developed for the ESF in the CMEI; the functioning of the CMEI and its routine of activities; the paper of the CMEI in the care the child; the daily one of the ESF, how much to the care to the health of the child of 2 the 5 years involving the diverse difficulties faced for the ESF; difficulties faced in daily of the CMEI for the care the child of 2 the 5 years; paper of joint ESF and CMEI for the confrontation of the difficulties; e action of health to be developed that they had subsidized the stage of planning of the research-action. During the stages of planning and implementation of the actions the actions of education in health with professionals of the CMEI and parents had been materialize and the actions of direct attention the health of the child. In the stage of evaluation of the actions for the involved citizens one searched to ahead understand the perception of the actions developed and perspective of continuity of the actions, through 4 boarded subjects for the citizens. For all the passage of the research-action it can be inferred that joint ESF and CMEI is a necessary initiative ahead of the current situation of the services of health for the promotion of an integral attention the health of the child, but that the teams of the ESF not yet make use of material conditions and staff enough to develop actions that exceed the limits of the USF, being necessary for this the reinforcement of the joints mainly with the Federal University of the Rio Grande of the North. / A articula??o entre as equipes da Estrat?gia Sa?de da Fam?lia (ESF) e o Centro Municipal de Educa??o Infantil (CMEI) desponta como uma forma de assegurar a vigil?ncia e promo??o ? sa?de das crian?as de 2 a 5 anos ao ingressarem no ambiente de creche/pr?-escola. Tra?ou-se como objetivo: Analisar as a??es desenvolvidas pela equipe da estrat?gia sa?de da fam?lia na promo??o a sa?de da crian?a, atendida em um Centro Municipal de Educa??o Infantil. Trata-se de um estudo descritivo-explorat?rio, de natureza qualitativa, do tipo pesquisa-a??o. Desenvolvido em um CMEI e na USF do bairro de Cidade Nova, Natal-RN. A popula??o foi constitu?da pelos profissionais da equipe da ESF e do CMEI e pais. Durante as etapas da pesquisa-a??o utilizaram-se diversas t?cnicas como a entrevista individual e em grupo, grupo focal, observa??o participante, e di?rio de campo. A an?lise dos dados ocorreu por meio da an?lise de conte?do, na modalidade tem?tica, proposta por Bardin (1977) e descri??o das etapas da pesquisa-a??o. Na etapa de diagn?stico situacional que investiga a realidade vivenciada pelos sujeitos da ESF e CMEI quanto ? sa?de da crian?a emergiram sete categorias que abrangiam: o contexto da aten??o crian?a no CMEI identificando as a??es que j? vinham sendo desenvolvidas pela ESF no CMEI; o funcionamento do CMEI e sua rotina de atividades; o papel do CMEI no cuidado a crian?a; o cotidiano da ESF, quanto ao cuidado ? sa?de da crian?a de 2 a 5 anos envolvendo as diversas dificuldades enfrentadas pela ESF; dificuldades enfrentadas no cotidiano do CMEI para o cuidado a crian?a de 2 a 5 anos; papel da articula??o ESF e CMEI para o enfrentamento das dificuldades; e a??es de sa?de a serem desenvolvidas que subsidiaram a etapa de planejamento da pesquisa-a??o. Durante as etapas de planejamento e implementa??o das a??es foram concretizadas as a??es de educa??o em sa?de com profissionais do CMEI e pais e as a??es de aten??o direta a sa?de da crian?a. Na etapa de avalia??o das a??es pelos sujeitos envolvidos buscou-se compreender as percep??o diante das a??es desenvolvidas e perspectivas de continuidade das a??es, atrav?s de 4 temas abordados pelos sujeitos. Por todo o percurso da pesquisa-a??o pode-se inferir que a articula??o ESF e CMEI ? uma iniciativa necess?ria diante da atual situa??o dos servi?os de sa?de para a promo??o de uma aten??o integral a sa?de da crian?a, mas que as equipes da ESF ainda n?o disp?em de condi??es materiais e de pessoal suficientes para desenvolver a??es que ultrapassem os limites das USF, sendo necess?rio para isso o fortalecimento das articula??es principalmente com a Universidade Federal do Rio Grande do Norte.

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