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

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

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-22T19:29:09Z No. of bitstreams: 1 ZuleikaDantasDoValeTavares_DISSERT.pdf: 1575063 bytes, checksum: a1b597dc11e8a2365198587ff24bc813 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-07T21:09:52Z (GMT) No. of bitstreams: 1 ZuleikaDantasDoValeTavares_DISSERT.pdf: 1575063 bytes, checksum: a1b597dc11e8a2365198587ff24bc813 (MD5) / Made available in DSpace on 2017-03-07T21:09:52Z (GMT). No. of bitstreams: 1 ZuleikaDantasDoValeTavares_DISSERT.pdf: 1575063 bytes, checksum: a1b597dc11e8a2365198587ff24bc813 (MD5) Previous issue date: 2016-06-10 / O envelhecimento populacional implica na necessidade de um novo olhar para preven??o de quedas e seguran?a domiciliar do idoso, principalmente diante da evid?ncia de que os idosos ficam a maior parte de seu tempo em casa. O objetivo principal deste estudo ? implantar uma estrat?gia de a??o para preven??o de quedas em pessoas idosas, a partir da elabora??o de um guia de seguran?a ambiental e utiliza??o da caderneta de sa?de da pessoa idosa. Para tanto, foi realizado uma pesquisa a??o com uma das etapas de diagn?stico feita a partir de um estudo anal?tico e observacional com abordagem quantitativa em 288 idosos, com idade acima de 60 anos, de ambos os sexos, na zona rural de S?o Jos? de Mipibu-RN, em 2016, atrav?s do m?todo de amostra probabil?stica aleat?ria simples (p=0,30 e e=0,05). Utilizou-se o question?rio de avalia??o ambiental e quedas pertencente ? caderneta de sa?de da pessoa idosa. Capacitaram-se os Agentes Comunit?rios de Sa?de (ACS) no reconhecimento e identifica??o dos riscos ambientais de quedas do domicilio da pessoa idosa atrav?s de um Guia produzido pelas autoras, fruto da interven??o da pesquisa, intitulado: Lar seguro, idoso ativo. Verificou-se que o ambiente domiciliar do idoso ? inseguro, grande parte das habita??es s?o oriundas de projeto de habita??o do governo federal e s?o entregues sem qualquer item de seguran?a ambiental. A avalia??o ambiental quanto ? ilumina??o mostrou-se segura, apontando para interruptores de f?cil acesso na entrada dos c?modos. O banheiro ? o c?modo mais inseguro e a cozinha e o quarto c?modos menos inseguros. Observou-se que os idosos apresentavam algum tipo de redu??o da sua capacidade de deambula??o, auditiva ou visual, por?m apenas 10,42% deles relataram essa dificuldade, fator que pode predispor a quedas. Foi observada queda em 24,65% dos entrevistados tendo a maioria ocorrido dentro de casa (63,38%). Verificou-se ainda que 23,94% das quedas resultaram em algum tipo de fratura e 21,13% dos idosos afirmaram ter paralisado suas atividades por medo de cair novamente, al?m de 15,49% terem ca?do mais de uma vez no ano. Os itens de seguran?a s? foram encontrados em domic?lios em que o idoso sofreu alguma queda, indicando que ? poss?vel a aquisi??o de itens de seguran?a. Entretanto, os idosos s? os obt?m ap?s a ocorr?ncia de quedas, evidenciando a falta de preven??o, que pode ser feita, n?o s? com a aquisi??o de itens de seguran?a, mas com algumas orienta??es encontradas no guia citado acima. O mesmo mostrou-se uma ferramenta coletiva eficiente, capaz de proporcionar o reconhecimento de um ambiente propenso a quedas, e poss?vel interven??o junto ao idoso e seus familiares para preven??o de quedas. / The population aging implies the need for a new look for fall prevention and home security of the elderly, especially in the face of evidence that elderly are most of their time at home. The aim of this study is to implement an action plan for preventing falls in older people, starting from the preparation of an environmental safety guide and elderly health booklet. Therefore, we performed an analytical, observational cross-sectional study with a quantitative approach, in 288 elderly people aged over 60 years old, of both male and female sexes, in the countryside of S?o Jos? de Mipibu City in the State of Rio Grande do Norte, in 2016, by the simple random probability sampling method (p = 0.30 and e = 0.05). We used the questionnaire environmental assessment and falls belonging to elderly health booklet. We enabled the ACS American College of Surgeons (ACS) criteria for recognition and identification of risks of elderly falls at home, method of recognition and identification of the risks of falls of domicile of the elderly producing a guide by the authors, result of the research intervention, titled Home security insurance, active seniors elderly. It was showed that the most homes of the elderly people are unsafe, and most of the houses are built from the Federal Brazilian housing project of the federal government and delivered without any environmental safety item. The environmental assessment regarding the lighting proved to be safe, pointing to switches for easy access at the room entrance. The bathroom is the most insecure room, and even though the kitchen and the bedrooms are the less unsafe rooms. It was observed that most of elderly people usually had present some type of reduced mobility, as well as walking, auditory or visual ability, but only 10.42% of them reported such deficiency, as factors that may predispose them to the risk of falls. Falls were observed in 24.65% of the seniors respondents and the majority of these falls occurred indoors (63.38%). It was also found that 23.94% of falls resulted in some kind of bone fracture and 21.13% of seniors said they had paralyzed their activities, for fearing of falling again, and 15.49% have fallen more than once a year. Security items were only found in households where the elderly had been dropped, indicating that the purchase of security items is always possible, however the elderly only get them after the occurrence of falls, indicating the lack of prevention that can be done not only with the purchase of safety items, but with some guidelines found in the Guide above mentioned. The same proved to be an effective collective tool, capable of recognizing a prone to falls environment and possible intervention with the elderly and their families to prevent falls.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T23:36:53Z No. of bitstreams: 1 JeaneOliveiraRamosDaSilva_DISSERT.pdf: 2214082 bytes, checksum: 353f7c0de8e55756bbd9c67108c73372 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-24T23:32:25Z (GMT) No. of bitstreams: 1 JeaneOliveiraRamosDaSilva_DISSERT.pdf: 2214082 bytes, checksum: 353f7c0de8e55756bbd9c67108c73372 (MD5) / Made available in DSpace on 2017-03-24T23:32:25Z (GMT). No. of bitstreams: 1 JeaneOliveiraRamosDaSilva_DISSERT.pdf: 2214082 bytes, checksum: 353f7c0de8e55756bbd9c67108c73372 (MD5) Previous issue date: 2016-08-31 / Considerando a reforma Sanit?ria brasileira, que institucionalizou atrav?s do Sistema ?nico de Sa?de - SUS a Aten??o Integral ? Sa?de, a Portaria GM/MS N? 971/2006, que implantou as Pr?ticas Integrativas e Complementares (PICs) no SUS, e a necessidade dos usu?rios do SUS, dos profissionais de sa?de e da gest?o de utiliza??o de pr?ticas integrativas promotoras da sa?de no servi?o, este estudo, do tipo Pesquisa A??o Existencial-PAE, visa a analisar e descrever, ? luz da abordagem Sociopo?tica, como os Ateli?s de Dan?a Circular para profissionais de sa?de poder?o promover sa?de, e contribuir com o reconhecimento e expans?o desta pr?tica na rede de servi?os do SUS. A pesquisa foi desenvolvida na cidade de Natal/RN com um grupo de 15 profissionais de sa?de do SUS. Os dados foram coletados atrav?s de tr?s instrumentos metodol?gicos: question?rios, di?rio vivencial e grupo focal. Visou-se conhecer as sensa??es e emo??es expressadas pelos profissionais da sa?de participantes dos Ateli?s de Dan?a Circular; identificar a influ?ncia das Dan?as Circulares na promo??o da sa?de das participantes; e avaliar como as experi?ncias vivenciadas na Roda de Dan?a Circular poder?o contribuir para o reconhecimento e a expans?o desta pr?tica como uma PIC no ?mbito da rede municipal de sa?de de Natal. Como principal referencial te?rico, foram utilizados o Paradigma da Salutog?nese e a Vis?o Sist?mica da vida. Conclui-se que um conjunto de fatores salutog?nicos presentes no Ateli? Dan?a Circular promoveram a sa?de dos profissionais de sa?de ao proporcionarem: equil?brio, expans?o da consci?ncia, ludicidade e criatividade. Al?m disso, expandiu-se a utiliza??o e reconhecimento da Dan?a Circular como Pr?tica Integrativa e Complementar na rede de servi?os do SUS, possibilitando a continuidade com a implanta??o da roda permanente de Dan?a Circular da SMS - Natal/RN: Roda Mandala de Luz. / Concerning the Brazilian health reform, which institutionalized, through the Unified Health System (SUS), the full healthcare assistance, the ordinance GM/MS N? 971/2006, which implemented the integrative and complementary practices (PICs) into SUS, and the need of SUS users, health professionals, and managers, this paper, as a PAE (Existential Action Research), aims at analyze and describe through the Sociopoetic approach (how Circle Dance workshops for health professionals can provide health, and contribute to the divulgation and development of this practice. The present research was conducted in Natal-RN, involving 15 health professionals who work for SUS. Data were collected using three methodological tools: surveys, daily notes and focal group. Aimed to know the feelings, thoughts, emotions expressed by health professionals participating in the Circle Dance workshops, identifying its influences in the participant?s health, and evaluating how their experiences during the dance perhaps contributes to the divulgation and development of this practice as a PIC in Natal. Studies about the Circle Dance, The Salutogenesis Paradigm, Health Promotion Politics, Integrative Practices, and Worker Health were used as theoretical background. This work concludes that Circle Dance workshops led to a health environment, which improved health, besides providing moments of consciousness expansion that deepened the understanding of important human values for a healthy daily living, such as equality, cooperation, unity, peace and respect for diversity. Moreover, it expanded the use and recognition of Circle Dance as an Integrative and Complementary Practice in the Unified Health System (SUS), enabling the continued with the establishment of permanent Circle Dance of the SMS - Natal / RN: Roda Mandala de Luz.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T23:36:54Z No. of bitstreams: 1 RejaneMartaDeMedeiros_DISSERT.pdf: 6153534 bytes, checksum: 70a57f3e86fa42f6031582673dfe976e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-24T23:58:53Z (GMT) No. of bitstreams: 1 RejaneMartaDeMedeiros_DISSERT.pdf: 6153534 bytes, checksum: 70a57f3e86fa42f6031582673dfe976e (MD5) / Made available in DSpace on 2017-03-24T23:58:53Z (GMT). No. of bitstreams: 1 RejaneMartaDeMedeiros_DISSERT.pdf: 6153534 bytes, checksum: 70a57f3e86fa42f6031582673dfe976e (MD5) Previous issue date: 2016-08-05 / A investiga??o da Mortalidade Infantil ? uma importante estrat?gia que permite dar visibilidade ao perfil dos ?bitos, e a boa qualidade das informa??es se faz necess?ria para garantir a efici?ncia da vigil?ncia dos ?bitos e subsidiar a??es de controle e preven??o de novos eventos. Apesar de importantes avan?os nos Sistemas de Informa??o, em especial o Sistema de Informa??o sobre Mortalidade (SIM), alguns estudos apontam fatores que comprometem a qualidade das informa??es, sobretudo os relacionados ? completude e ? consist?ncia. Esse estudo tem o objetivo de analisar a qualidade das investiga??es dos ?bitos infantis do munic?pio de Natal/RN, no per?odo de 2010 a 2015. Trata-se de um estudo epidemiol?gico do tipo transversal, de natureza explorat?ria e descritiva, que ser? realizado atrav?s de uma abordagem quantitativa. Foram utilizados os dados do SIM municipal, considerando o universo dos ?bitos de menores de um ano, de m?es residentes em Natal/RN, ocorridos entre os anos de 2010 a 2015. A completude e a consist?ncia foram analisadas a partir das vari?veis contidas na Declara??o de ?bito (DO) e na Ficha S?ntese (FS). Os resultados mostraram que ocorreu uma ascens?o gradual na propor??o de investiga??o dos ?bitos notificados ao longo dos anos do estudo, no entanto foram observados atrasos significativos para sua conclus?o. O preenchimento das vari?veis contidas na DO e na FS foi considerado satisfat?rio, entretanto algumas inconsist?ncias foram encontradas nos dados, mostrando a necessidade de melhorar a qualidade dos registros nas investiga??es. / The investigation of infant mortality is an important strategy that allows visibility to the profile of the deaths, and the good quality of the information is necessary to ensure the monitoring of deaths efficiency and support actions to control and prevention of new events. Despite important advances in information systems, in particular Information System Mortality (ISM), some studies point to factors that compromise the quality of information, especially those related to the completeness and consistency. This study aims to analyze the quality of investigations of infant deaths in the city of Natal/RN, in the period between 2010 and 2015. This is an epidemiological cross-sectional study, exploratory and descriptive, which will be held through a quantitative approach. The data of the municipal ISM were used, and included the deaths of children under one year of mothers living in Natal/RN, occurred the years between 2010 and 2015. The completeness and consistency were analyzed from the variables contained in Death Certificate (DC) and Summary Sheet (SS). The results showed that there was a gradual rise in the proportion of investigation of deaths reported over the years of the study, however were observed significant delays to completion. Fulfilment of the variables contained in the DC and SS was considered satisfactory, but some inconsistencies were found in the data showing the need to improve the quality of records in investigations.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-09-05T20:49:18Z No. of bitstreams: 1 AndrelinaAlvesMangueira_DISSERT.pdf: 917603 bytes, checksum: dab71cd720f89fabe1d383b7735b7a27 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-09-18T19:20:41Z (GMT) No. of bitstreams: 1 AndrelinaAlvesMangueira_DISSERT.pdf: 917603 bytes, checksum: dab71cd720f89fabe1d383b7735b7a27 (MD5) / Made available in DSpace on 2017-09-18T19:20:41Z (GMT). No. of bitstreams: 1 AndrelinaAlvesMangueira_DISSERT.pdf: 917603 bytes, checksum: dab71cd720f89fabe1d383b7735b7a27 (MD5) Previous issue date: 2016-08-09 / Este estudo tem como objetivo geral analisar os aspectos inerentes ? organiza??o do processo de trabalho e o planejamento das a??es das equipes de aten??o b?sica da Regi?o Nordeste no 1? e 2? ciclos do Programa de Melhoria do Acesso e da Qualidade da Aten??o B?sica (PMAQ-AB). E como objetivos espec?ficos, analisar o planejamento das a??es, as ferramentas utilizadas pelas equipes de aten??o b?sica e as a??es da gest?o para organiza??o do processo de trabalho das equipes na Regi?o Nordeste. Trata-se de uma pesquisa avaliativa realizada atrav?s de um estudo transversal e multic?ntrico com abordagem quantitativa. Os dados s?o referentes ao desdobramento da pesquisa de avalia??o externa do 1? e 2? ciclos do PMAQ ? AB na Regi?o Nordeste. Utilizou-se para a pesquisa o banco de dados do 1? e 2? ciclo do PMAQ. As vari?veis foram analisadas atrav?s da estat?stica descritiva, com uso do Software IBM SPSS Statistics 24.0 e os resultados foram organizados e agrupados em duas dimens?es: A??es da gest?o para organiza??o do processo. de trabalho das equipes e o planejamento das a??es e as ferramentas utilizadas pelas equipes. A pesquisa respeitou todos os preceitos ?ticos cab?veis tendo aprova??o pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Sul, sob o n?mero 21904 em 13 de Mar?o de 2012, estando em conson?ncia com a Resolu??o n? 166/2012, do Conselho Nacional de Sa?de. Os resultados demonstram o apoio da gest?o na organiza??o do processo de trabalho das equipes e no planejamento das a??es, disponibilizando informa??es para an?lise da situa??o, com discuss?o dos dados e monitoramento do sistema de informa??o. O estudo demonstra que as equipes de aten??o b?sica da Regi?o Nordeste, desenvolvem o planejamento das a??es e organizam o processo de trabalho, com a utiliza??o dos recursos ofertados pela gest?o, favorecendo o repensar das pr?ticas em sa?de, contribuindo para o fortalecimento da Aten??o B?sica. Realizam monitoramento e an?lise dos indicadores e informa??es de sa?de. Utilizando para o processo de autoavalia??o, o instrumento AMAQ, tanto no 1?ciclo quanto no 2? ciclo, sendo uma ferramenta de organiza??o do processo de trabalho. / This study has as general objective to analyze the aspects inherent to the organization of the work process and planning the actions of the primary care teams of the Northeast Region in the 1st and 2nd cycles of the Program for Improving Access and Quality of Basic Care (PMAQ-AB ). And as specific objectives, analyze the planning of the actions, the tools used by the primary care teams and the actions of the management to organize the work process of the teams in the Northeast Region. It is an evaluative research carried out through a cross-sectional and multicenter study with a quantitative approach. The data refers to the unfolding of the external evaluation research of the 1st and 2nd cycles of the PMAQ - AB in the Northeast Region. The PMAQ database for the 1st and 2nd cycle was used for the research. The variables were analyzed through descriptive statistics, using the IBM SPSS Statistics 24.0 Software and the results were organized and grouped into two dimensions: Management actions to organize the process. And the planning of the actions and tools used by the teams. The research complied with all ethical precepts that were approved by the Research Ethics Committee of the Federal University of Rio Grande do Sul under number 21904 on March 13, 2012, being in accordance with Resolution No. 166/2012 of the National Council The results demonstrate the support of the management in the organization of the work process of the teams and in the planning of the actions, providing information for analysis of the situation, with discussion of the data and monitoring of the information system. The study shows that the basic care teams of the Northeast Region develop the planning of actions and organize the work process, using the resources offered by management, favoring the rethinking of health practices, contributing to the strengthening of Primary Care. Conduct monitoring and analysis of indicators and health information. Using the self-assessment process, the AMAQ instrument, both in the 1st cycle and in the 2nd cycle, being a tool to organize the work process.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-10-05T00:28:19Z No. of bitstreams: 1 AnaKarinaSilvaCavalcantiFontela_DISSERT.pdf: 1824901 bytes, checksum: a254de7c0021428a7bf8f8b15aebb282 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-10-16T23:46:51Z (GMT) No. of bitstreams: 1 AnaKarinaSilvaCavalcantiFontela_DISSERT.pdf: 1824901 bytes, checksum: a254de7c0021428a7bf8f8b15aebb282 (MD5) / Made available in DSpace on 2017-10-16T23:46:51Z (GMT). No. of bitstreams: 1 AnaKarinaSilvaCavalcantiFontela_DISSERT.pdf: 1824901 bytes, checksum: a254de7c0021428a7bf8f8b15aebb282 (MD5) Previous issue date: 2016-08-12 / Diante da necessidade de diminuir a incid?ncia do c?ncer de colo de ?tero e as les?es causadas pelo v?rus HPV, o Minist?rio da Sa?de iniciou, em mar?o de 2014, a campanha de vacina??o contra o HPV nas meninas de 11 a 13 anos em todo o territ?rio nacional. Em virtude da procura dessas jovens adolescentes pelo servi?o da aten??o prim?ria, considerou-se importante desenvolver um estudo, cujo objetivo foi o de analisar como as usu?rias vacinadas contra o HPV, em uma Unidade de Sa?de de Recife, percebem a preven??o do c?ncer de colo uterino. Tratou-se de uma pesquisa-a??o, para cujo desenvolvimento foram constitu?dos dois grupos focais e duas oficinas. Cada grupo contou com um moderador, que conduziu a discuss?o, por meio de um roteiro-guia, com os seguintes temas: conhecimento e compreens?o sobre a infec??o pelo HPV e sua liga??o com o c?ncer do colo de ?tero; entendimentos e preocupa??es sobre a vacina??o contra o HPV; experi?ncia de vacina??o; entendimentos sobre a import?ncia do rastreio do c?ncer do colo de ?tero e conhecimento sobre as estrat?gias de preven??o do c?ncer uterino na aten??o b?sica, e com um anotador/registrador, respons?vel por gravar o ?udio e transcrever as discuss?es. A amostra foi composta de vinte meninas na faixa et?ria entre 11 e 14 anos, que j? haviam tomado a primeira dose da vacina, frequentavam a Unidade de Sa?de Professor M?rio Ramos h?, pelo menos, seis meses e eram acompanhadas pelo Programa de Agentes Comunit?rios de Sa?de. As reuni?es ocorreram em um local confort?vel e neutro, o encontro foi quinzenal, em dia e hora combinados com as adolescentes, e as participantes foram convidadas pelos agentes de sa?de que as visitaram no dia anterior para confirmar sua presen?a. Os dados foram interpretados ? luz da An?lise de Conte?do de Bardin. Conclui-se que a maioria das adolescentes sente necessidade de mais esclarecimentos sobre o HPV e sua rela??o com o c?ncer uterino. Ficou evidente que os conhecimentos a respeito do HPV e suas formas de preven??o e a vacina dispon?vel para essa faixa et?ria s?o limitados. Este estudo aponta para a import?ncia de se discutir sobre a preven??o do c?ncer uterino nas escolas p?blicas, nas privadas e nos servi?os de aten??o ? sa?de, e que ? preciso explorar com mais frequ?ncia o assunto na esfera da sexualidade. H? que se ressaltar que ? imprescind?vel conhecer e redimensionar as dificuldades das jovens e propor uma reflex?o sobre o autoconhecimento, esclarecendo d?vidas sobre os procedimentos cl?nicos, compartilhar experi?ncias com outras jovens, criar v?nculos com os profissionais de sa?de e aderir ?s pr?ticas participativas. Espera-se que, atrav?s dessas a??es, diminua-se o n?mero de casos e de ?bitos causados pelo HPV. / Faced with the need to reduce the incidence of cervical cancer and lesions caused by the HPV virus the Ministry of Health began in March 2014 the vaccination campaign against HPV in girls 11-13 years throughout the country, because that the demand for such young adolescents at the service of primary care has become important to develop a study, which the research objective to analyze the perception on the prevention of cervical cancer in vaccinated users against HPV in a Recife Health Unit. This is an action research in which there will be two focus groups and a workshop. Each group will consist of 01 moderator leading the discussion by a road map to guide the following themes: knowledge and understanding of HPV infection and its link to cervical cancer; understandings and concerns about HPV vaccination; vaccination experiments; understandings about the importance of cervical cancer screening and knowledge on strategies to prevent cancer of the cervix in primary care, 01 recorder / registrar responsible for recording with audio and transcribe the discussions minimum of five and maximum number 10 girls aged between 11 and 14 years, who have already taken the first dose of the vaccine, attending the Health Unit Professor Mario Ramos for at least six months and is accompanied by the Community Health Agents Program. The meetings will take place in a comfortable and neutral location, the meetings will be held monthly on day and time combined with the teenagers, and participants will be invited by CHWs who had visited the day before confirming their presence. Data analysis will be conducted through Bardin Content Analysis. It is concluded that the majority of adolescents feel the need for further clarification on HPV and its relation to uterine cancer. It was clear that knowledge about HPV and its forms of prevention and available vaccine for this age range are limited. This study points to the importance of discussing the prevention of uterine cancer in public schools, private schools and health care services, and that the issue of sexuality must be explored more frequently. It is necessary to emphasize that it is essential to know and resize the difficulties of young people and to propose a reflection on self-knowledge, clarifying doubts about clinical procedures, sharing experiences with other young people, creating links with health professionals and adhering to participatory practices. It is hoped that, through these actions, the number of cases and deaths caused by HPV will decrease.

Submitted by Verena Bastos (verena@uefs.br) on 2015-11-25T13:11:44Z No. of bitstreams: 1 M?RLON ALMEIDA - DISSERTA??O DE MESTRADO [FINAL] 2013.pdf: 4242831 bytes, checksum: 4c9485b578aa840334b961c017e0541e (MD5) / Made available in DSpace on 2015-11-25T13:11:44Z (GMT). No. of bitstreams: 1 M?RLON ALMEIDA - DISSERTA??O DE MESTRADO [FINAL] 2013.pdf: 4242831 bytes, checksum: 4c9485b578aa840334b961c017e0541e (MD5) Previous issue date: 2013-03-25 / The universal and equitable access is essential to analyze the relationship between the user and health services, as it provides the opportunity to host the man, individually and collectively, their entry into the system, in expressing their need for health, defense of equal rights and social justice, configuring it as an exercise to achieve citizenship. However, it is necessary to overcome reductionist link between access and "gateway", as commonly used, for achieving higher senses that portray as an instrument full of transformative possibilities of reality. This research aimed to discuss the organization of users' access to health services in family health and their interfaces with the model of health care in two scenarios of Bahia, Brazil, and analyze how social participation happens in the construction of collective demands for accessing health services in family health in those scenarios. Configured as a qualitative study, the number of subjects was defined by progressive inclusion, interrupted by saturation criterion. The study subjects were 102 people, distributed among three groups representing: group I (health team - 49), group II (USF users - 37) and group III (SUS municipal leaders - 16). Technical data collection: semi-structured and systematic observation. Method of analysis: thematic content analysis. The results show that the organization of access to family health occurs from scheduling demand or demand for free, while the latter refers to the urgent care and emergency mostly and the choice of marking model was agreed with users in community meetings. Many speeches converged on the difficulties that the lack of material resources and maintenance entail the construction of a universal access and quality. Much of the speech that brought the number of vacancies for additional tests and diagnostics, as well as consultations with experts, is insufficient and is far beyond the demand presented. From this perspective, the Health Councils arise within the conjuncture of popular participation and social control as a privileged place for listening to the community and the emergence of significant changes to society, though, only one respondent group II has demonstrated knowledge about the importance of social control and its potential is still very far from expected. Anyway, many times, we were awakened the sense that users had to go through a funnel to the realization of its entry in the health services, which represents the amount of barriers that need to be overcome in gaining entry into the system, although Many users can not, in practice, see their right to health care guaranteed. / O acesso universal e equitativo ? essencial para a an?lise das rela??es entre o usu?rio e os servi?os de sa?de, pois se constitui a ocasi?o de acolhimento do homem, individual e coletivo, seu ingresso no sistema, na express?o da sua necessidade de sa?de, em defesa da igualdade de direitos e justi?a social, configurando-se como um exerc?cio para o alcance da cidadania. Contudo, ? necess?rio ultrapassar-se a liga??o reducionista entre acesso e ?porta de entrada?, t?o comumente utilizada, para o alcance de sentidos maiores, que o retratem como um instrumento repleto de possibilidades transformadoras da realidade. Esta pesquisa teve como objetivos discutir a organiza??o do acesso dos usu?rios aos servi?os de sa?de na Sa?de da Fam?lia e suas interfaces com o modelo de aten??o ? sa?de em dois cen?rios da Bahia, Brasil e analisar como acontece a participa??o social na constru??o das demandas coletivas para acessar os servi?os de sa?de na Sa?de da Fam?lia nos referidos cen?rios. Configurou-se como um estudo qualitativo, tendo o n?mero de sujeitos sido definidos por inclus?o progressiva, interrompida pelo crit?rio de satura??o. Os sujeitos do estudo foram 102 pessoas, distribu?das entre tr?s grupos de representa??o: grupo I (equipe de sa?de - 49); grupo II (usu?rios da USF - 37) e grupo III (dirigentes do SUS municipal - 16). T?cnica de coleta de dados: entrevista semi-estruturada e observa??o sistem?tica. M?todo de an?lise: an?lise de conte?do tem?tica. Os resultados revelam que a organiza??o do acesso na Sa?de da Fam?lia d?-se a partir do agendamento da demanda ou por demanda livre, sendo que esta ?ltima refere-se aos atendimentos de urg?ncia e emerg?ncia na sua grande maioria e a escolha deste modelo de marca??o foi pactuada com os usu?rios em reuni?es comunit?rias. Muitos discursos convergiram para as dificuldades que a falta de recursos materiais e de manuten??o acarretam na constru??o de um acesso universal e com qualidade. Grande parte das representa??es trouxe que o n?mero de vagas para a realiza??o de exames complementares e de diagn?sticos, bem como as consultas com especialistas, ? insuficiente e est? muito al?m da demanda apresentada. Nessa perspectiva, os Conselhos de Sa?de surgem dentro da conjuntura da participa??o popular e do controle social como um espa?o privilegiado para a escuta da comunidade e o despertar de mudan?as significativas para a sociedade, embora, apenas um entrevistado do grupo II tenha demonstrado conhecimento acerca da import?ncia do controle social e seu potencial encontra-se, ainda, muito distante do esperado. Enfim, foi-nos despertado a sensa??o de que os usu?rios precisavam passar por um funil para a efetiva??o da sua entrada nos servi?os de sa?de, o que representa a quantidade de barreiras que precisam ser vencidas na conquista do acesso ao sistema, embora, muitos usu?rios n?o consigam, na pr?tica, ver o seu direito de assist?ncia ? sa?de garantida.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-09-28T22:30:36Z No. of bitstreams: 1 Disserta??o final Adje Silva Santos pdf.pdf: 976183 bytes, checksum: 0738d5bcc440442ce545e6899e27e5dd (MD5) / Made available in DSpace on 2016-09-28T22:30:36Z (GMT). No. of bitstreams: 1 Disserta??o final Adje Silva Santos pdf.pdf: 976183 bytes, checksum: 0738d5bcc440442ce545e6899e27e5dd (MD5) Previous issue date: 2015-03-31 / The theme of the production of elderly care mainstreamed by host and link launches look at the needs of the health system is facing from the perspective and effective increase in the elderly population around the world. It is important that the health system be able to meet, receive, take responsibility for the health needs of this segment, considering their peculiarities, offering a comprehensive care, targeted and equitable. This research aims to analyze the production of elderly care by health professionals and discuss the work process of these professionals in the Family Health Strategy. In this study for the care production analysis were adopted two dimensions, namely: reception and bonding. This is a qualitative study conducted in three Family Health Units (USF) belonging to Feira de Santana - BA, data were collected through semi-structured interviews and systematic observation. The study involved 23 professionals from USF. The method used for data analysis was content analysis, from which were formulated two categories of analysis: 1) health work process: producer of cozy and binding actions? 2) Reception and attachment: meetings, contradictions and singularities to provide care to the elderly. The study results, through the work process and its elements such as object of work, instruments, agents and purposes, the performance of the health care professional of the USF is structured preferably by biologicist logic in favor of physician-centered model, directed production procedures and fragmented practice, which reduces the therapeutic object to the treatment of diseases and the alleviation of symptoms, affecting directly the production of care. The production of care, analyzed from the bond and the host is carried out in a field of practice and contradictory and conflicting speeches, however, gives rise to new ways of welcoming the elderly. Therefore, the professionals expressed different ways to welcome, to meet and to relate to the elderly, revealing the dependence of individual willingness, commitment and subjectivity of each subject to their achievement, which compromises the uniformity of the degree of acceptance and linking population. Thus, the research indicates the need for reflection on the practice and organization of the work process developed in the context of USF, involving professionals, users and managers, in order to find solutions to provide comprehensive care, planned, equitable, with new attitudes, postures and commitments in order to provide comprehensive care, humanized and quality to the elderly, enhanced by warm and actions by prioritizing the use of relational technologies in search of effective production of health care. / A tem?tica da produ??o do cuidado ao idoso transversalizada pelo acolhimento e v?nculo lan?a o olhar para as necessidades que o sistema de sa?de est? enfrentando a partir da perspectiva e efetivo aumento da popula??o idosa a n?vel mundial. ? importante que o sistema de sa?de esteja apto para atender, acolher, responsabilizar-se pelas necessidades de sa?de desse segmento, considerando as suas peculiaridades, oferecendo um cuidado integral, direcionado e equ?nime. Esta pesquisa tem como objetivo analisar a produ??o do cuidado ao idoso pelos profissionais de sa?de e discutir o processo de trabalho desses profissionais na Estrat?gia Sa?de da Fam?lia. Trata-se de um estudo qualitativo, realizado em tr?s Unidades de Sa?de da Fam?lia (USF) do munic?pio de Feira de Santana - BA, os dados foram coletados atrav?s da entrevista semi-estruturada e da observa??o sistem?tica. Participaram do estudo 23 profissionais das USF. O m?todo utilizado para a an?lise de dados foi a An?lise de Conte?do, a partir da qual foram formuladas duas categorias de an?lise: 1) Processo de trabalho em sa?de: produtor de a??es acolhedoras e vinculantes? 2) Acolhimento e v?nculo: encontros, contradi??es e singularidades na produ??o do cuidado ao idoso. Os resultados evidenciam, atrav?s do processo de trabalho e seus elementos tais como: objeto de trabalho, instrumentos, agentes e finalidades, que a atua??o do profissional de sa?de das USF est? estruturada preferencialmente pela l?gica biologicista, em favorecimento do modelo m?dico-centrado, direcionada a produ??o de procedimentos e ? pr?tica fragmentada, que reduz o objeto terap?utico ao tratamento de doen?as e ao al?vio de sintomas, comprometendo diretamente a produ??o do cuidado. A produ??o do cuidado, analisada a partir do v?nculo e do acolhimento, ? realizada em um campo de pr?ticas e discursos contradit?rios e conflituosos, entretanto, enseja novas maneiras de acolher os idosos. Portanto, os profissionais manifestaram diferentes formas de acolher, de atender e de se relacionar com os idosos, revelando a depend?ncia da disposi??o individual, compromisso e subjetividade de cada sujeito para a sua realiza??o, o que compromete a uniformiza??o do grau de acolhimento e vincula??o da popula??o. Desse modo, a pesquisa sinaliza a necessidade de reflex?o sobre a pr?tica e organiza??o do processo de trabalho desenvolvido no contexto das USF, envolvendo os profissionais, os usu?rios e os gestores, com intuito de encontrar solu??es para oferecer uma aten??o integral, planejada, equ?nime, com novas atitudes, posturas e comprometimentos, a fim de proporcionar o cuidado integral, humanizado e de qualidade aos idosos, potencializado por a??es acolhedoras e pela prioriza??o do uso das tecnologias relacionais, em busca da produ??o efetiva do cuidado em sa?de.

Made available in DSpace on 2015-04-14T14:27:07Z (GMT). No. of bitstreams: 1 451612.pdf: 906442 bytes, checksum: c7a718721427beea9684709e18d312f9 (MD5) Previous issue date: 2013-05-29 / In 1994 was implemented by the Ministry of Health the Family Healthcare Program (PSF), with the goal of providing assistance to families and / or registered persons, in order to promote better living conditions. In 2005, 4.986 municipalities had adopted the program. In the following years, this number has increased and in 2010 the number of municipalities that had implemented the program was 5.294. This paper analyzes the impact of the Family Healthcare Program on infant mortality in cities with over 50.000 inhabitants in the state of Rio Grande do Sul for the years 2005-2010. Using the methodology of panel data, it was found that the population coverage of the PSF, analyzed individually, did not produce the expected results, was not effective in reducing child mortality in the municipalities of Rio Grande do Sul. However, considering it in conjunction with the Community Health Agents program (PACS) and lagged in one period, the results were significant in reducing child mortality. It can be concluded, therefore, that programs are complementary and influence the decline of infant mortality, and this effect occurs from a certain time interval. / Em 1994 foi implantado pelo Minist?rio da Sa?de o Programa Sa?de da Fam?lia (PSF), com o objetivo de prestar assist?ncia ?s fam?lias e/ou pessoas cadastradas, a fim de promover melhores condi??es de vida. Em 2005, 4.986 munic?pios brasileiros haviam adotado o Programa. Nos anos seguintes, tal n?mero aumentou sendo que em 2010 o n?mero de munic?pios que haviam implantado o programa era de 5.294. O presente trabalho busca analisar o impacto do Programa Sa?de da Fam?lia sobre a taxa de mortalidade infantil nos munic?pios com mais de 50.000 habitantes no Estado do Rio Grande do Sul para os anos de 2005 a 2010. Utilizando-se a metodologia de dados em painel, constatou-se que a cobertura populacional do PSF, analisado individualmente, n?o apresentou os resultados esperados, ou seja, n?o foi efetivo na redu??o da mortalidade infantil nos munic?pios do Rio Grande do Sul. Contudo, considerando-o em conjunto com o Programa Agentes Comunit?rios de Sa?de (PACS) e defasados em um per?odo, os resultados encontrados foram significativos no sentido da redu??o da mortalidade infantil. Pode-se concluir, portanto, que os programas s?o complementares e influenciam na queda da mortalidade infantil, sendo que esse efeito ocorre a partir de um determinado intervalo de tempo.