Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-06-02T22:57:53Z No. of bitstreams: 1 ThaisSousaRodriguesGuedes_DISSERT.pdf: 1935962 bytes, checksum: 964f84c4656c58a8ab445e8e4388d1f7 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-06-10T00:11:44Z (GMT) No. of bitstreams: 1 ThaisSousaRodriguesGuedes_DISSERT.pdf: 1935962 bytes, checksum: 964f84c4656c58a8ab445e8e4388d1f7 (MD5) / Made available in DSpace on 2017-06-10T00:11:44Z (GMT). No. of bitstreams: 1 ThaisSousaRodriguesGuedes_DISSERT.pdf: 1935962 bytes, checksum: 964f84c4656c58a8ab445e8e4388d1f7 (MD5) Previous issue date: 2016-07-26 / O c?ncer de mama ? a neoplasia mais comum entre as mulheres, sendo ?s altera??es decorrentes de seu tratamento respons?veis por mudan?as na forma em que a mulher com c?ncer v? sua imagem corporal e interage com outras pessoas. O objetivo do estudo foi verificar a preval?ncia de insatisfa??o com a imagem corporal e seus fatores associados em mulheres sobreviventes ao c?ncer de mama. Trata-se de um estudo transversal, que avaliou 103 mulheres residentes no munic?pio de Natal-RN, com diagn?stico de neoplasia mam?ria h? no m?nimo um ano, submetidas a tratamento oncol?gico e que ainda permanecem em acompanhamento cl?nico. A coleta de dados foi realizada por meio do acesso aos prontu?rios das pacientes diagnosticadas com c?ncer de mama e de entrevista individual. A vari?vel dependente imagem corporal foi mensurada atrav?s do question?rio validado Body Image Scale (BIS). Tamb?m foram coletadas vari?veis socioecon?micas, hist?rico ginecol?gico, cl?nico e h?bitos de vida. A an?lise bivariada foi realizada por meio do teste Qui-quadrado de Pearson (Exato de Fisher), calculando a raz?o de preval?ncia com intervalo de confian?a de 95%. A an?lise multivariada foi feita por meio da Regress?o de Poisson com vari?ncia robusta. Considerou-se o n?vel de signific?ncia estat?stica de 0,05. A m?dia da idade das pacientes inclu?das no estudo foi igual a 55,97 anos (?10,6), da ra?a branca, casadas, com v?nculo empregat?cio antes do tratamento (81,6%). A preval?ncia de insatisfa??o com a imagem corporal foi de 74,8%, IC (0,65-0,82). A imagem corporal apresentou associa??o estatisticamente significativa com o acompanhamento multiprofissional e ocupa??o ap?s o tratamento. Conclui-se que a preval?ncia de insatisfa??o com a imagem corporal foi elevada. Mulheres que relataram ter uma ocupa??o ap?s o tratamento para o c?ncer apresentaram mais altera??es na autopercep??o quanto a apar?ncia. Em rela??o ao acompanhamento multiprofissional, aquelas pacientes que n?o receberam o seguimento do cuidado relataram um impacto negativo na imagem corporal, evidenciando a necessidade de estrat?gias que aumentem a resolutividade dos servi?os de forma a atender as principais demandas dessa popula??o. / Breast cancer is the most common neoplasia among women. Consequential changes from treating breast cancer are responsible for the way women see their body image and how these patients interact with other people. This study aims to determine the prevalence of women dissatisfaction with their own body perspective and associated factors after surviving to breast cancer treatment. This is a cross-sectional study, which evaluated 103 women living in the city of Natal, Brazil, diagnosed with breast cancer at least one year ago, that were still under treatment against cancer, and remained in clinical follow-up. Data collection was performed by accessing medical records of patients diagnosed with breast cancer and conducting individual interviews. The dependent variable Body Image was measured using the validated questionnaire Body Image Scale (BIS). Socioeconomic variables, gynecological history, clinical and life habits were also collected. The bivariate analysis was performed using Pearson's chi-square test (Fisher's Exact), calculating the prevalence ratio using 95% confidence interval. Multivariate analysis was performed by Poisson regression with robust variance. The statistical significance level of 0.05 was considered. The mean age of patients included in the study was 55.97 years (? 10.6), mostly Caucasian, married, and employed before treatment (81.6%). The prevalence of dissatisfaction with body image was 74.8%, CI (0.65 to 0.82). Body Image showed a statistically significant association with multidisciplinary professionals monitoring the patient and the presence of employment after treatment. We conclude that the prevalence of body image dissatisfaction was high. Women who reported having an occupation after treatment for cancer showed more changes in self-perception regarding their appearance. Concerning the follow up by multidisciplinary professionals, those patients who did not receive care after the treatment reported a negative impact on their body image. This finding highlights the need for strategies to increase the resolvability of services to meet the main demands of this population.

Made available in DSpace on 2015-04-14T13:21:32Z (GMT). No. of bitstreams: 1 411471.pdf: 2014544 bytes, checksum: d2df8fc4353179ce9f46b034060d21ed (MD5) Previous issue date: 2009-03-06 / Esta disserta??o busca problematizar as pr?ticas de aten??o ? sa?de da crian?a, indagando como s?o produzidos os cuidados de sa?de das crian?as no SUS Sistema ?nico de Sa?de e que inf?ncia esses cuidados produzem. E, nesse sentido, quais s?o as condi??es de possibilidade para o aparecimento da crian?a como objeto das pol?ticas p?blicas de sa?de. O ponto de partida para a an?lise das pol?ticas p?blicas de sa?de da crian?a ? o documento Caderneta de Sa?de da Crian?a Passaporte de Cidadania (BRASIL, 2007). Foi esse recorte que possibilitou direcionar a compreens?o para os processos pelos quais o SUS produz os cuidados da sa?de da crian?a. Trata-se de compreender quais s?o os efeitos da articula??o entre SUS e crian?a, procurando distanciar-se da busca pelas verdades sobre as pr?ticas de sa?de da crian?a. Tr?s momentos tornaram poss?vel tal prop?sito: o momento em que se problematizou o modo como se tornou vi?vel tornar a sa?de das crian?as alvo de preocupa??o do Estado a partir de estrat?gias biopol?ticas. Em seguida e, como decorr?ncia desse processo, foi realizada uma an?lise da constru??o das pr?ticas de aten??o ? sa?de da crian?a no Brasil p?sproclama??o da Rep?blica. Esse per?odo foi evidenciado como o de constru??o e consolida??o da sa?de p?blica no pa?s. E, por fim, foi feita uma problematiza??o das racionalidades presentes no documento analisado, procurando evidenciar como o SUS constitui as pr?ticas de cuidado da sa?de da crian?a.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-05-31T20:44:53Z No. of bitstreams: 1 DiegoBonfada_TESE.pdf: 1650949 bytes, checksum: 8f847b9fbf8392c63fa9b22921738a13 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-03T20:17:21Z (GMT) No. of bitstreams: 1 DiegoBonfada_TESE.pdf: 1650949 bytes, checksum: 8f847b9fbf8392c63fa9b22921738a13 (MD5) / Made available in DSpace on 2016-06-03T20:17:21Z (GMT). No. of bitstreams: 1 DiegoBonfada_TESE.pdf: 1650949 bytes, checksum: 8f847b9fbf8392c63fa9b22921738a13 (MD5) Previous issue date: 2015-09-29 / O envelhecimento populacional no Brasil ressalta a necessidade de discutir o gerenciamento adequado do or?amento destinado ? sa?de, em especial nos setores de alta complexidade, onde coexistem procedimentos onerosos, recursos limitados e necessidade de conten??o de despesas, mesmo diante de uma demanda crescente e diretamente proporcional ao aumento do n?mero de idosos. Objetivo: Desta forma, esta pesquisa tem como objetivo geral analisar os gastos decorrentes da interna??o de idosos em Unidades de Terapia Intensiva (UTI) e seus fatores associados. M?todos: Trata-se de um estudo seccional, de abordagem quantitativa e com car?ter descritivo-explorat?rio. Os dados foram coletados em prontu?rios de idosos internados em UTI em Natal-RN, entre primeiro de novembro de 2013 e 31 de janeiro de 2014. As vari?veis coletadas relacionam-se ao perfil s?cio demogr?fico, quadro de morbidade e caracteriza??o da interna??o. A vari?vel dependente foi categorizada pelo quartil 75, em alto e baixo gasto de interna??o e submetida ao teste de Qui-quadrado com as vari?veis independentes da pesquisa. As associa??es que apresentaram p<0,20 na an?lise bivariada foram submetidas ? t?cnica da regress?o log?stica m?ltipla. Optou-se pela constru??o de tr?s modelos de regress?o a partir do algoritmo supracitado: um chamado de modelo de regress?o geral, composto por todas as 493 interna??es do estudo, outro somente para os 181 indiv?duos internados no Sistema ?nico de Sa?de (SUS) e um terceiro referente aos 312 casos provenientes da rede de assist?ncia privada. Resultados: No modelo de regress?o geral, as vari?veis doen?as respirat?ria, institui??o privada, paciente desorientado e acidente vascular cerebral pr?vio foram associadas ? maior probabilidade de alto gasto na interna??o em UTI. Por sua vez, nas interna??es do SUS, essa probabilidade foi associada ? paciente desorientado, com 80 anos ou mais, com Sepse e Interna??o por motivo cl?nico. J? nos casos provenientes da rede privada, o alto gasto foi associado ? doen?a respirat?ria, ventila??o mec?nica, interna??o por motivo cl?nico e aos pacientes desorientados. Conclus?o: O aumento dos gastos com a interna??o de idosos em terapia intensiva depende das condi??es clinicas dos indiv?duos. Isso evid?ncia a import?ncia de evitar interna??es decorrentes de agravos sens?veis ? aten??o prim?ria, por meio da preven??o a sa?de e garantia de assist?ncia integral ao idoso. Al?m disso, a obten??o de modelos explicativos distintos, segundo a esfera administrativa do hospital, demonstra a import?ncia da organiza??o dos servi?os de sa?de na composi??o dos gastos da interna??o de idosos. Outro destaque foi a necessidade de melhorar o financiamento em sa?de em termos quantitativos e qualitativos, usando de maneira racional os recursos dispon?veis e evitando interna??es desnecess?rias de idosos inseridos nos extremos de gravidade. Diante da car?ncia de toda ordem de recursos, internar em UTI um idoso em condi??es n?o cr?ticas ou em estado terminal pode comprometer a qualidade dos servi?os prestados ?queles que realmente necessitam de cuidado intensivo. / Introduction: Population aging in Brazil underscores the need to discuss the proper management of the budget allocated in health field, especially in the sectors of high complexity, where coexist costly procedures, limited resources and the need for cost containment. In the other hand, demand is growing in a way directly proportional to the increase in the number of elderly in country. Objective: In this way, this research had as main objective to analyze the costs resulting from the admission of elderly in intensive care units (ICU) and its associated factors. Methods: This is a cross-sectional study with a quantitative approach and featured as a descriptive and exploratory research. Data were collected from medical records of elderly hospitalized in ICU from a brazilian city called Natal-RN, between november first, 2013 and january, 31 of 2014. The variables collected relate to the socio demographic profile, morbidity framework and characterization of hospitalization. The dependent variable was categorized by quartile 75 in high and low expense of hospitalization and submitted to chi-square test with the independent variables of the survey. Associations with p value <0.20 in the bivariate analysis were submitted to the technique of multiple logistic regression. We opted for the construction of three regression models from the above algorithm: general regression model, composed by all 493 hospitalizations in the study, other made with 181 individuals admitted in health public system (SUS) and a third one related to 312 cases from private service in health area. Results: In the general regression model, the variables respiratory diseases, hospitalizations in the private system, disoriented patient and previous stroke were associated with greater probability of high spending in the ICU. In the other hand, in SUS kind of hospitalizations, this probability was associated with disoriented patient, 80 years old or more, sepsis and admission for clinical reason. In the cases from the private network health, the high expenditure was associated with respiratory disease, mechanical ventilation, hospitalization for clinical reason and disoriented patients. Conclusion: The increased expenditure on hospitalization of elderly in intensive care depends on the clinical conditions of individuals. This highlights the importance of avoiding hospitalizations due to diseases sensitive to primary care by health preventive actions and providing comprehensive care to the elderly. In addition, obtaining different explanatory models, according to kind hospital funding, demonstrates the importance of the organization in health services related to composition of costs of hospitalization among the elderly. Another question founded was the need that to improve the funding, we must use rationally the available resources by avoiding unnecessary hospitalizations of elderly people in the extremes of severity. On this kind of precarious funding, ICU hospitalization of elderly non-critical or in a terminal state can compromise the quality of services provided to those who really need intensive care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-10-27T00:21:29Z No. of bitstreams: 1 NayaraPriscilaDantasDeOliveira_DISSERT.pdf: 1338360 bytes, checksum: e4a924e9aed2ef9db758540f32e2a83f (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-12-27T20:05:19Z (GMT) No. of bitstreams: 1 NayaraPriscilaDantasDeOliveira_DISSERT.pdf: 1338360 bytes, checksum: e4a924e9aed2ef9db758540f32e2a83f (MD5) / Made available in DSpace on 2016-12-27T20:05:19Z (GMT). No. of bitstreams: 1 NayaraPriscilaDantasDeOliveira_DISSERT.pdf: 1338360 bytes, checksum: e4a924e9aed2ef9db758540f32e2a83f (MD5) Previous issue date: 2016-04-20 / O c?ncer de mama apresenta altas taxas de incid?ncia e atualmente observa-se aumento consider?vel na taxa de sobrevida, de modo que a qualidade desta sobreviv?ncia passa a ser considerada uma importante quest?o de sa?de p?blica. O objetivo do estudo foi verificar a preval?ncia de incapacidade funcional e seus fatores associados em mulheres sobreviventes ao tratamento do c?ncer de mama. Trata-se de um estudo transversal, realizado com 101 mulheres residentes no munic?pio de Natal-RN com diagn?stico de neoplasia maligna da mama, que foram submetidas ao tratamento oncol?gico h? no m?nimo um ano e que ainda permanecem em acompanhamento cl?nico na Liga Norte Riograndense contra o C?ncer. O estudo foi composto por duas fases de coleta de dados, realizadas com o acesso aos prontu?rios das pacientes e com entrevistas individuais. A capacidade funcional foi aferida por meio do instrumento Disabilities of the Arm and Shoulder (DASH). Coletaram-se tamb?m vari?veis relacionadas ?s caracter?sticas socioecon?micas, h?bitos de vida, condi??es de sa?de, hist?rico ginecol?gico e obst?trico, caracter?sticas cl?nicas do tumor e abordagem terap?utica. A an?lise bivariada foi realizada por meio do teste teste Qui-quadrado de Pearson (Exato de Fisher). A an?lise multivariada foi feita por meio da Regress?o de Poisson com vari?ncia robusta. Considerou-se o n?vel de confian?a de 95%. A idade m?dia das mulheres inclu?das no estudo foi de 56,19 anos (?10,6), com renda m?dia mensal de 3,88 (?4,5) sal?rios m?nimos e com acesso ao servi?o de sa?de p?blico predominante (50,5%). Em sua maioria, as pacientes foram submetidas ? abordagem cir?rgica conservadora (53,5%). A preval?ncia de incapacidade funcional foi de 22,8% (IC95%: 13,9-31,6). A capacidade funcional mostrou-se associada de maneira estatisticamente significativa ? idade e ao tipo de acesso ao servi?o de sa?de. Pode-se concluir que as pacientes mais jovens sofreram maior impacto do tratamento do c?ncer de mama na funcionalidade quando comparadas ?s mulheres mais idosas. Quanto ao acesso ao servi?o de sa?de, as mulheres que receberam acompanhamento cl?nico p?blico apresentaram maior ocorr?ncia de incapacidade funcional, o que aponta para a necessidade de servi?os de sa?de mais organizados na sua rede assistencial, menos burocr?ticos e efetivamente resolutivos, minimizando os impactos do tratamento oncol?gico nas condi??es de vida e sa?de das sobreviventes do c?ncer de mama. / Breast cancer shows high incidence and mortality rates. However, a considerable increase in the survival rate is observed, so that the quality of life is now considered an important public health issue. The goal of this study is to determine the prevalence of disability and associated factors in women undergoing treatment for breast cancer. It is a cross-sectional study made with 101 women living in a city named Natal, in the state of Rio Grande do Norte, diagnosed with malignant neoplasm of the breast, who underwent cancer treatment for at least one year and still remain in clinical attendance in the Northern League against cancer. The study consisted of two phases of data collection, performed with access to the medical records of patients and individual interviews. The functional capacity was measured by a questionnaire called DASH. Variables related to socioeconomic characteristics, lifestyle, health, gynecological and obstetrical history, clinical characteristics of the tumor and therapeutic approach were also collected. The bivariate analysis was performed using Pearson's chisquare test (Fisher's Exact), calculating the prevalence ratio with an interval of confidence of 95%. The multivariate analysis was performed by Poisson regression with strong variance. It was considered the statistical significance level of 0.05. The average age of the women included in the study was 56,19 years (? 10,6), which in majority were white, married or in stable relationship, with high levels of education, with an average monthly income of 3 , 88 (? 4.5) times the minimum wage and access to the overriding public health service (50.5%). The prevalence of disability was 22,8% (95% CI 13,9 to 31,6). The ductal carcinoma was the most common diagnosis among women, affecting 78,2% of the sample. Most of the patients underwent conservative surgical approach (53,5%) with axillary approach (92,1%). Late postoperative complications were reported by 71,3% of the interviewed women. Functional capacity was associated with a statistically significant manner to the age and type of access to health services. It can be concluded that younger patients had a greater impact of the treatment of breast cancer in functionality when compared to older women. About the access to health services, women who received public clinical monitoring reported higher rates of disability, which points to the need for health services more organized in your care network, less bureaucratic and effectively resolving capacity, minimizing the impact of treatment cancer in living conditions and health of survivors of breast cancer.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-14T22:07:07Z No. of bitstreams: 1 AmandaSantosDePaiva_DISSERT.pdf: 1848231 bytes, checksum: 4323faba71f4826ad85f14ec2f9d45f5 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-16T00:08:03Z (GMT) No. of bitstreams: 1 AmandaSantosDePaiva_DISSERT.pdf: 1848231 bytes, checksum: 4323faba71f4826ad85f14ec2f9d45f5 (MD5) / Made available in DSpace on 2017-03-16T00:08:03Z (GMT). No. of bitstreams: 1 AmandaSantosDePaiva_DISSERT.pdf: 1848231 bytes, checksum: 4323faba71f4826ad85f14ec2f9d45f5 (MD5) Previous issue date: 2016-09-30 / Esta disserta??o tem como objetivo analisar criticamente a rela??o entre a ocorr?ncia do dengue e as condi??es socioambientais no munic?pio de Natal-RN. Sua preocupa??o central consiste em investigar em que medida a politica de sa?de adotada para o combate ao dengue (des) considera-o como enfermidade socioambiental considerando o modelo hegem?nico e o seu (des)controle no cen?rio potiguar. O processo investigativo combinou pesquisa bibliogr?fica, documental e pesquisa de campo. A pesquisa bibliogr?fica possibilitou a apreens?o de categorias te?ricas e emp?ricas. Enquanto, a pesquisa documental consistiu na an?lise de not?cias veiculadas por m?dias locais e/ou nacionais, dados do IBGE e documentos produzidos pela Prefeitura do Natal no per?odo de 2014 a 2015. Ademais, a pesquisa de campo foi efetivada por meio da t?cnica de grupo focal (GF) composto por Agentes de Controle de Endemias (ACE) representantes dos 5 (cinco) diferentes distritos sanit?rios (DS) da cidade do Natal sendo dois oriundos do DS Leste, totalizando 6 (seis) ACE, al?m de 1 (um) supervisor t?cnico do Centro de Controle de Zoonoses. Constatou-se que tais profissionais de sa?de atribuem ? falta de consci?ncia sanit?ria como um dos principais entraves para o controle do dengue. Ficou evidenciado que apesar de iniciativas nas medidas de controle do dengue buscar ir al?m do setor de sa?de, as a??es direcionam-se para a??es emergenciais. E, principalmente que h? forte focaliza??o no ?combate ao mosquito? reduzido ao uso de venenos ao mesmo tempo em reitera-se a ?culpabiliza??o? do indiv?duo por seu adoecimento. Constatou-se que o abastecimento intermitente de ?gua, e a insuficiente e ineficiente da coleta de esgoto e de res?duos s?lidos s?o determinantes centrais para a consolida??o do dengue como doen?a end?mica no munic?pio do Natal. Conclui-se que a pol?tica de sa?de implementada no munic?pio do Natal desconsidera a realidade socioambiental e as macrodetermina??es do capital, expressa no aprofundamento das desigualdades sociais que se traduzem em prec?rias condi??es de moradia, acesso ? ?gua, esgoto e informa??o, em geral, elementos desprezados no cotidiano do combate ao dengue. Portanto, ignora que tais determina??es repercutem no aprofundamento da ruptura da din?mica harm?nica entre humanidade e o restante da natureza agravando o cen?rio de barb?rie socioambiental. / This dissertation aims to critically analyze the relationship between the occurrence of dengue and environmental conditions in Natal-RN. His main concern is to investigate the extent to which health policy adopted to combat dengue (un) considers it as social and environmental illness in the hegemonic model of its (un) control in the Potiguar scenario. The investigative process combined bibliographic research, documentary and field research. The literature search enables the seizure of theoretical and empirical categories. While the documentary research was the analysis of reports by local and/ or national media, the IBGE data and documents produced by the Natal City Hall in the period from 2014 to 2015. Moreover, the field research was carried out through focus group (FG) technique consisting of Endemic Disease Control Agents (EDSA) representatives of five (5) different Health Districts (HD) of the city of Natal with two natives of east HD, totaling six (6) EDSA, plus one (1) technical supervisor of the Zoonosis Control Center. It was found that these health professionals attribute to the lack of health awareness as a major constraint for the control of dengue. The study revealed that despite initiatives in dengue control measures seek to go beyond the health sector, the shares direct to emergency actions. Mainly that there is a strong focus on "Fight against mosquitoes" and the reiteration of "scapegoating" of the individual for his illness. It was found that the intermittent water supply, and insufficient and inefficient collection of sewage and solid waste are key determinants for dengue consolidation as an endemic disease in Natal. It is concluded that health policy implemented in Natal disregards the social and environmental reality and macro capital macrodeterminations expressed in deepening social inequalities that translate into poor living conditions, access to water, sewage and information in general elements neglected in the fight against dengue everyday. So ignore that such determinations have repercussions on deepening breakdown of harmonic dynamics between humanity and the rest of nature exacerbating the scenario of social and environmental barbarism.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-07-04T14:11:57Z No. of bitstreams: 1 JussaraLisboaViana_DISSERT.pdf: 2562225 bytes, checksum: ba61dbcba9e4968a48c542a640f52b12 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-07-14T11:10:36Z (GMT) No. of bitstreams: 1 JussaraLisboaViana_DISSERT.pdf: 2562225 bytes, checksum: ba61dbcba9e4968a48c542a640f52b12 (MD5) / Made available in DSpace on 2017-07-14T11:10:36Z (GMT). No. of bitstreams: 1 JussaraLisboaViana_DISSERT.pdf: 2562225 bytes, checksum: ba61dbcba9e4968a48c542a640f52b12 (MD5) Previous issue date: 2017-04-20 / Os debates no campo da Sa?de Coletiva produziram argumentos de que o SUS precisava de um novo ator estrat?gico para impulsionar as mudan?as n?o alcan?adas durante a Reforma Sanit?ria, j? que apenas a forma??o p?s-graduada na ?rea para a pr?tica de sanitaristas n?o era suficiente. Nesse sentido, foram criados os Cursos de Gradua??o em Sa?de Coletiva. Na Universidade Federal do Rio Grande do Norte (UFRN), esse curso ? denominado de Gest?o em Sistemas e Servi?os de Sa?de (GSSS). Esta pesquisa tem o objetivo de analisar como se d? a inser??o (espa?o, tempo e condicionantes) e a atua??o profissionais dos egressos do Curso de GSSS da UFRN, mais especificamente: identificar limites, potencialidades e estrat?gias na inser??o profissional dos egressos; identificar as atividades desenvolvidas pelos egressos no trabalho; analisar os desafios para os egressos no mundo do trabalho; analisar os condicionantes da forma??o desse Curso na inser??o e atua??o profissionais; e conhecer a vis?o das coordenadoras sobre a cria??o e forma??o do Curso de GSSS. O estudo se vincula ? no??o de pesquisadores implicados e ? reflexividade como corrente de pensamento da pesquisa. A produ??o dos dados ocorreu pela t?cnica de Grupo Focal e entrevista individual com roteiro semiestruturado, ambas realizadas com egressos concluintes do Curso nos per?odos de 2012.2, 2013.2 e 2014.2, sendo que tamb?m foram entrevistadas coordenadoras do referido Curso. Quanto ? inser??o, os desafios foram categorizados em: remunera??o; reconhecimento da profiss?o em Sa?de Coletiva; identidade profissional; e interfer?ncias pol?ticas. J? as potencialidades foram categorizadas em: forma??o; n?cleo de saber e pr?tica da Sa?de Coletiva; e o cen?rio da Secretaria Municipal de Sa?de do Natal; e as estrat?gias para inser??o s?o a??es de car?ter coletivo e individual que visam divulgar o Curso e seu profissional, bem como avan?ar na constru??o de uma nova profiss?o. Sobre a atua??o profissional, s?o descritas as atividades desenvolvidas no trabalho pelos egressos, estas est?o associadas ? linha de forma??o de Planejamento, Gest?o e Avalia??o em Sa?de. Essas atividades profissionais refor?am a ideia do Curso de GSSS em formar Gestores da Sa?de para atuarem nos servi?os e sistemas de sa?de. No entanto, consideramos que a atua??o de um generalista em Sa?de Coletiva ir? al?m dessa ?rea de atua??o. Os desafios na atua??o profissional dos novos sanitaristas aparecem como de car?ter estrutural do mundo do trabalho de outras profiss?es e foram categorizados em: rela??es de poder, cultura institucional e v?nculo empregat?cio, tais desafios influenciam na sa?de mental dos trabalhadores. Com rela??o ? influ?ncia da forma??o na inser??o profissional, destaca-se o Est?gio Curricular, visto que o aluno amplia seu conhecimento e d? visibilidade profissional a si pelo v?nculo com os demais profissionais. Ainda mais, os egressos trazem suas cr?ticas positivas e negativas da forma??o que influenciaram na atua??o profissional. Pela forma??o e pela atua??o profissional, os egressos do Curso de Sa?de Coletiva s?o novos sanitaristas com identidade diferenciada dos sanitaristas p?s-graduados oriundos de outras gradua??es. / The debates in the field of Public Health have claimed that SUS required a new strategic player to boost the changes not reached during the Sanitary Reform, since only the graduate training in the field for the practice of Public Health professionals was not enough. Accordingly, the Undergraduate Courses in Public Health were established. At the Federal University of Rio Grande do Norte (UFRN), this course is called Management in Health Systems and Services (GSSS, as per its acronym in Portuguese). This research is intended to analyze how the insertion (space, time and conditioning factors) and professional performance of newly-trained professionals from the GSSS Course at UFRN happen, more specifically: to identify limits, potentialities and strategies in the professional insertion of newly-trained professionals; to identify the activities developed by newly-trained professionals at work; to analyze the challenges for newly-trained professionals in the job market; to analyze the conditioning factors of this Course in the professional insertion and performance; and to know the viewpoint of coordinators about the establishment and training of the GSSS Course. This study is linked to the notion of researchers involved and to the reflexivity as a line of thought of research. The production of data took place through the Focal Group technique and individual interviews with a semi-structured script, both of which were conducted with newly-trained professionals of the Course in the periods of 2012.2, 2013.2 and 2014.2, being that coordinators of the aforementioned Course were also interviewed. Regarding the insertion, the challenges were categorized in: wage; recognition of the profession in Public Health; professional identity and political interference. Concerning the potentialities, they were categorized in: training; core of knowledge and practice of Public Health; and the scenario of the Municipal Health Department of Natal; and the strategies for insertion are actions of a collective and individual nature aimed at disseminating the Course and its professional, besides advancing in the construction of a new profession. As for the professional performance, the activities developed at work by the newly-trained professionals are described, which are associated with the training line of Planning, Management and Assessment in Health. These professional activities enhance the idea of the GSSS Course as it concerns the training of Health Managers to deal with health services and systems. Nevertheless, one can consider that the performance of a generalist in Public Health will go beyond this field of operation. The challenges for the professional performance of new Public Health professionals are displayed with a structural nature in the job market of other professions, and they were categorized in: power relations, institutional culture and employment bond, which are challenges that influence the mental health of workers. Regarding the influence of the training in the professional insertion, one can highlight the Curricular Internship, because the student expands his knowledge and gives professional visibility to himself by the bond with the other professionals. Furthermore, the newly-trained professionals bring their positive and negative criticism of the training that influenced their professional performance. Due to the training and professional performance, the newly-trained professionals of the Undergraduate Course in Public Health are new Public Health professionals with a differentiated identity in relation to the Public Health professionals graduated in Public Health and coming from other undergraduate courses.

Made available in DSpace on 2016-04-04T18:29:34Z (GMT). No. of bitstreams: 1 Rafael Cusatis Neto.pdf: 1385614 bytes, checksum: ad1071942d37b03e6c96255dc15a0e9d (MD5) Previous issue date: 2007-02-12 / Science in general needs each time more instruments that can supply measurable and replicable objectives. The objectives of this research were to elaborate and to validate a scale of occupational stressors for employees of the production line, carrying out content validation, construct validation, convergent validation, precision evaluation and scale normalization. 214 employees were the participants of the research all of whom work in the production line of several companies of the Alto do Tiete region. The sample was divided in three groups (G1, G2, and G3). G1 was composed of 10 employees for a pilot study, G2 was composed of 214 employees for the validation of the scale and G3 was composed of 40 employees who participated in the retest. The materials used were a list with 41 stressors in the initial version of the scale, the scale of occupational stressors with 36 items already after the pilot study was carried out, the Job Content Questionnaire (JCQ) for the convergent validity and the Inventory of Symptoms of Stress Lipp (ISSL). Also, it made use of terms of consent and authorizations whenever necessary. The results demonstrated high and positive correlations in the precision of the scale (p < 0.01), tendency to the convergent validity (p < 0.01) validity of concurrent criterion (p<0.01 and p < 0,005). In relation to the normalization the results showed no evidence of significant differences between age and level of schooling and the scores of the scale of stressors. This demonstrates the universality and practicity, important in system of numerical counting. It was concluded that the scale of occupational stressors of production line presented high coefficient of precision, internal consistency e temporal stability and it was possible to reach the objective of content validity, construct and convergent validity, demonstrating to be capable of identifying occupational stressors of production line. The normalization needs new studies to be carried out with the scale, increasing the number of participants or carrying out a study with random sample, so that bias concerning norms and standardization does not occur. / As ci?ncias em geral necessitam cada vez mais de instrumentos que forne?am medidas objetivas e reprodut?veis. Os objetivos da pesquisa foi elaborar e validar uma Escala de Estressores Ocupacionais para funcion?rios da linha de produ??o, realizando a valida??o de conte?do, valida??o de construto, valida??o convergente, avaliar a precis?o e realizar a normatiza??o da escala. Foram participantes da pesquisa 214 funcion?rios que atuam em linha de produ??o de diversas empresas da regi?o do Alto do Ti?te. A amostra foi dividida em tr?s grupos, sendo o G1 composto de 10 funcion?rios para o estudo piloto, o G2 composto pelos 214 funcion?rios para a valida??o da escala e o G3 composto por 40 funcion?rios que realizaram o reteste. Os materiais utilizados foram uma lista com 41 estressores na vers?o inicial da escala, a Escala de Estressores Ocupacionais com 36 itens j? com o estudo piloto realizado, o Job Content Questionnaire (JCQ) para a validade convergente e o Invent?rio de Sintomas de Stress Lipp (ISSL). Os resultados demonstraram correla??es altas e positivas na precis?o da escala (p<0,01), validade convergente (p<0,01) e indicou a validade de crit?rio concorrente (p<0,01 e p<0,005). Em rela??o ? normatiza??o os resultados evidenciaram que n?o foram encontradas diferen?as significantes entre idade e n?vel de escolaridade com os escores da escala de estressores. Conclui-se que a Escala de Estressores Ocupacionais de linha de produ??o, apresentou um alto coeficiente de precis?o com consist?ncia interna e estabilidade temporal e foi poss?vel atingir os objetivos proposto quanto ? validade de conte?do, construto e validade convergente. Mostrando ser capaz de identificar os estressores ocupacionais de linha de produ??o. A normatiza??o necessita que novos estudos sejam realizados com a escala, aumentando-se o n?mero de participantes ou realizando em uma amostra aleat?ria, para que n?o ocorra vi?s quanto ?s normas e padroniza??o.

Made available in DSpace on 2015-04-14T13:20:35Z (GMT). No. of bitstreams: 1 451964.pdf: 1639549 bytes, checksum: f1f9658ef0fa94ec53715564bdc9f22d (MD5) Previous issue date: 2013-12-10 / This study proposes to examine the effects of the implementation of the pact by management in labor relations and conditions of social workers in health in the border region of Foz do Igua?u and Ciudad del Est Brazil and Paraguay, as these phenomena affect or impact the illness professional and professional responses. The research design includes an intense revisiting the databases of different research projects of diversified research centers affiliated to CNPq, in its various lines of concentration, also incorporates field work to rescue some data and information management specifically Shaft trabalho.Parte is indicative that the implementation of the pact by management in twin city boundary line to not focus on labor management plastered the possibilities of change, innovation and repoliticisation SUS, showing adoption of the precepts of the reform of state formulated in 90.Compreende decade that the Pact for Health to enable a new bias reorganization of federal pacts, through decentralization, management and with it the allocation of financial resources associated with the proposed relaxation of the rule on behalf of flexible accumulation requires large amounts of changes in labor relations initially and subsequently in terms of achieving this. The indicative of this proposal rests on the centrality of labor management in SUS as the only possible and viable path to realization of the principles and values of the Brazilian health reform. / Este estudo prop?e examinar os efeitos da implanta??o do pacto pela gest?o nas condi??es e rela??es de trabalho dos assistentes sociais trabalhadores na ?rea de sa?de na regi?o da fronteira de Foz do Igua?u Brasil e Ciudad Del Est Paraguai e, como esses fen?menos interferem ou impactam no adoecimento e respostas profissionais destes. O desenho da pesquisa inclui uma intensa revisita??o aos bancos de dados de distintos projetos de pesquisas de diversificados n?cleos de pesquisa filiados ao CNPq, nas suas mais variadas linhas de concentra??o, incorpora tamb?m trabalho de campo para resgatar alguns dados e informa??es especificamente do eixo gest?o de trabalho. Parte-se do indicativo que a implementa??o do pacto pela gest?o nas cidades-g?meas de linha de fronteira ao n?o privilegiar a gest?o do trabalho engessou as possibilidades de mudan?as, inova??o e repolitiza??o do SUS, evidenciando ado??o dos preceitos da reforma de Estado formuladas ainda na d?cada de 90.Compreende-se que o Pacto pela Sa?de ao possibilitar um novo vi?s de reorganiza??o dos pactos federativos,pela via da descentraliza??o, da gest?o e junto com ela a aloca??o dos recursos financeiro, associadas as propostas de flexibiliza??o do Estado em nome da acumula??o flex?vel imp?e mudan?as de grande monta inicialmente nas rela??es de trabalho e posteriormente nas condi??es de realiza??o deste. Os indicativos desta proposta repousam na centralidade da gest?o do trabalho no SUS como ?nico, poss?vel e vi?vel caminho para efetiva??o dos princ?pios e valores da reforma sanit?ria brasileira.

Made available in DSpace on 2015-04-14T13:20:37Z (GMT). No. of bitstreams: 1 457557.pdf: 1378173 bytes, checksum: 20bd6a652eada21f449683ab10608bab (MD5) Previous issue date: 2014-02-28 / The work of social workers in primary care of the Unified Health System (UHS) is the central theme of this Doctoral Thesis in Social Work, which main goal was to explain the job settings of the social worker in Primary Health Care (PHC) in theoretical yield of Social Service, in order to unravel the interface of professional ethical-political project and the care in the Unified Health System (UHS) in the twenty-first century style. To this end, we resorted to the literature search, the explanatory type, with a qualitative approach, theoretical and epistemological framework based on the critical dialectical method of inspiration and its theoretical and methodological categories historicity, totality, contradiction and mediation articulated to the themes of social work assistant, professional ethical-political project of Social Service, Primary Health Care (PHC), the Unified Health System (UHS) and the model of care in health, inspired by the theoretical framework of Social Work and Public Health and publications and measures of the Ministry of Health (MOH). The twenty publications of Social Service about the work of social workers in primary care of the Unified Health System (UHS) in the period from 2005 to 2012, located in the bibliographical sources for collecting survey data were subjected to content analysis with themed cut. The results at the end of the spiral work process research show that, according to the incipient theoretical yield of Social Service, the work of social workers in primary care of the Unified Health System (UHS) in the XXI century is configured as merges the interface between professional ethical-political project of social work, with different models of care conformed within the Unified Health System (UHS) and the polysemy of theoretical-conceptual and technical-operative approaches to primary health care (PHC), in tension between the recognition of determinants or health needs as a social right of state responsibility in view of the completeness and the commodification of health in the form of goods restricted to the dictates of neoliberal capitalist society project, hegemonic on the contemporary scene. / O trabalho do assistente social na aten??o prim?ria do Sistema ?nico de Sa?de (SUS) ? o tema central desta Tese de Doutorado em Servi?o Social, que teve como objetivo geral explicitar as configura??es do trabalho do assistente social na Aten??o Prim?ria em Sa?de (APS) na produ??o te?rica do Servi?o Social, tendo em vista desvendar a interface do projeto ?tico-pol?tico profissional e o modelo de aten??o no Sistema ?nico de Sa?de (SUS) no s?culo XXI. Para tanto, recorreu-se ? realiza??o de uma pesquisa bibliogr?fica, do tipo explicativo, com abordagem qualitativa, fundamentada no m?todo dial?tico cr?tico e suas categorias te?rico-metodol?gicas historicidade, totalidade, contradi??o e media??o articuladas ?s categorias tem?ticas trabalho do assistente social, projeto ?tico-pol?tico profissional do Servi?o Social, Aten??o Prim?ria em Sa?de (APS), Sistema ?nico de Sa?de (SUS) e modelo de aten??o em sa?de, inspiradas no referencial te?rico do Servi?o Social e da Sa?de Coletiva e nas publica??es e medidas e medidas do Minist?rio da Sa?de (MS). As vinte publica??es do Servi?o Social sobre o trabalho do assistente social na aten??o prim?ria do Sistema ?nico de Sa?de (SUS), no per?odo de 2005 a 2012, localizadas nas fontes bibliogr?ficas de coleta de dados da pesquisa foram submetidas ? an?lise de conte?do com corte tem?tico. Os resultados encontrados ao final do processo de trabalho em espiral da pesquisa apontaram que, de acordo com a incipiente produ??o te?rica do Servi?o Social, o trabalho do assistente social na aten??o prim?ria do Sistema ?nico de Sa?de (SUS) no s?culo XXI, se configura como mescla da interface entre o projeto ?tico-pol?tico profissional do Servi?o Social, com os distintos modelos de aten??o conformados no ?mbito do Sistema ?nico de Sa?de (SUS) e a polissemia de abordagens te?rico-conceptual e t?cnico-operativa da Aten??o Prim?ria em Sa?de (APS), na tens?o entre o reconhecimento dos determinantes ou necessidades de sa?de enquanto direito social de responsabilidade do Estado na perspectiva da integralidade e a mercantiliza??o da sa?de sob a forma de mercadoria na perspectiva restrita aos ditames do projeto societ?rio capitalista neoliberal, hegem?nico na cena contempor?nea.

Made available in DSpace on 2015-04-14T13:21:36Z (GMT). No. of bitstreams: 1 415823.pdf: 284465 bytes, checksum: 360b86a473d2a33e3d86208b9a213c16 (MD5) Previous issue date: 2009-03-04 / A partir de um recorte das diferentes formas de concep??o do processo de sa?de e doen?a, incluindo os modelos t?cnico-assisteciais poss?veis que acompanhavam estas propostas, buscamos evidenciar a constru??o de um paradigma hegem?nico nas pr?ticas de aten??o ? sa?de nos ?ltimos s?culos. O atrelamento da medicina com as formas de legitima??o de uma saber cientificista, que privilegia o controle sobre o corpo dos sujeitos permitindo que medidas de organiza??o coletiva sobreponham ?s necessidades individuais e subjetivas. A for?a de liga??o entre as pr?ticas m?dicas, o controle exercido pelo Estado e os formatos de organiza??o econ?micas, demonstra o comprometimento do setor sa?de com a diferencia??o do valor a vida implicada nas pr?ticas diferenciadas oferecidas de forma excludente e segment?ria a popula??es de alta renda. Assim, os movimentos de transforma??o no cen?rio brasileiro, o desenvolvimento do movimento de reforma sanit?ria em congru?ncia com as propostas te?ricopr?ticas da sa?de coletiva acabam permitindo a legitima??o de uma nova concep??o do processo de sa?de e doen?a, que passa a incluir diferentes determinantes sociais em sua estrutura de compreens?o. A legitima??o desta proposta d?-se pela conforma??o de um sistema nacional de organiza??o e compreens?o no campo da sa?de: o Sistema ?nico de Sa?de(SUS). Este sistema prop?e diferentes bases te?ricas, diretrizes e princ?pios espec?ficos, entre os quais prev? a o desenvolvimento de pr?ticas de ensino para os pr?prios profissionais do campo. Apontando a atual dificuldade de forma??o e reconhecimento de trabalhadores comprometidos com o desenvolvimento deste sistema, e a cria??o de um modelo de ensino que busca basear-se na Pol?tica de Educa??o Permanente em sa?de, que legisla sobre pedagogias e metodologias de ensino no SUS, a proposta deste trabalho ? discutir qual o potencial pedag?gico a ser explorado nas estruturas organizativas das Resid?ncias Multiprofissionais em Sa?de para forma??o de um saber coletivo no campo da sa?de.