Made available in DSpace on 2014-12-17T14:46:57Z (GMT). No. of bitstreams: 1 SamaraKDB_DISSERT.pdf: 1388036 bytes, checksum: d582f2055c29a12c4b64a24bc155b77f (MD5) Previous issue date: 2013-02-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The nurses assistance in monitoring the growth and development of children has been characterized mostly a service based on the biological dimension of illness, when in reality, the actions should be combined in the reorientation of care model of the Family Health Strategy. Thus, the research aimed to examine the role of nurses in the growth and development of children. This is an exploratory and descriptive, qualitative approach. The project was approved by the Ethics Committee of the Universidade Federal do Rio Grande do Norte under Opinion No. 191/2012. Data collection was developed in the Health Units from the city of Natal, RN, Brazil. Survey participants were nurses who worked in the Family Health Strategy for at least two years and who performed the monitoring of child growth and development in the health unit selected. Data were collected through an in-depth interview, and seized material from speeches was treated as categorical thematic analysis proposed by Bardin. This process revealed three themes, which were analyzed in the light of Relief Models and Process Work in Health and Nursing and discussed based on the findings literary. The results elucidated that nurses consider their performance satisfactory as it has favored the accession of mothers of children under one year nursing visits, contributing to the reduction of morbidity and mortality due to prevalent diseases, as well as the establishment of a connection between the professionals and mothers. It was shown that despite having a promotion and prevention with the use of lightweight technologies, the nurses also emphasized the care of mothers in complaints and signs and symptoms of children, followed by referrals to professionals in the unit or to other sectors. Furthermore, we found that the process of working nurses face challenges regarding the organizational structure of services and social situation of the family. Given these statements, it is observed that despite the strong interference from hegemonic health model in the performance of nurses, it is found that these professionals have been investing in promotion and prevention to injuries to children in care, with a focus on family context. Thus, nurses are embarking on making the reorientation of health care through the use of relational technologies, which has contributed to solving the integral care to the pediatric population / A assist?ncia do enfermeiro no acompanhamento do crescimento e desenvolvimento da crian?a tem se caracterizado, em sua maioria, num atendimento baseado na dimens?o biol?gica do adoecer, quando na realidade, as a??es deveriam estar conjugadas na reorienta??o de modelo assistencial da Estrat?gia Sa?de da Fam?lia. Deste modo, a pesquisa teve como objetivo analisar a atua??o do enfermeiro no acompanhamento do crescimento e desenvolvimento da crian?a. Trata-se de um estudo explorat?rio e descritivo, em uma abordagem qualitativa. O projeto foi aprovado pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte sob parecer de n? 191/2012. A coleta de dados desenvolveu-se nas Unidades de Sa?de da Fam?lia do munic?pio de Natal-RN, Brasil. Os participantes da pesquisa foram ?s enfermeiras que atuavam na Estrat?gia Sa?de da Fam?lia por no m?nimo dois anos, e que realizavam o acompanhamento do crescimento e desenvolvimento da crian?a na unidade de sa?de selecionada. Os dados foram obtidos mediante uma entrevista em profundidade, e o material apreendido dos discursos foi tratado conforme a an?lise categorial tem?tica proposta por Bardin. Deste processo emergiram tr?s categorias tem?ticas, as quais foram analisadas ? luz dos Modelos Assistenciais e do Processo de Trabalho em Sa?de e de Enfermagem e discutidos com base nos achados liter?rios. Os resultados elucidaram que as enfermeiras consideram a sua atua??o satisfat?ria, pois tem favorecido na ades?o das m?es dos menores de um ano ?s consultas de enfermagem, na contribui??o para a redu??o da morbidade e mortalidade infantil por doen?as prevalentes, bem como no estabelecimento de v?nculo entre as profissionais e genitoras. Foi evidenciado, que apesar de realizarem a??es de promo??o e preven??o com a utiliza??o de tecnologias leves, as enfermeiras ainda enfatizam o cuidado nas queixas das m?es e sinais e sintomas das crian?as, seguido dos encaminhamentos aos profissionais da unidade ou a outros setores. Al?m disso, constatou que o processo de trabalho das enfermeiras enfrenta desafios quanto ? estrutura organizacional dos servi?os e da conjuntura social da fam?lia. Diante destas coloca??es, observa-se que apesar da forte interfer?ncia do modelo de sa?de hegem?nico na atua??o das enfermeiras, ? verificado que estas profissionais v?m investindo em a??es de promo??o e preven??o aos agravos no cuidado ?s crian?as, com o foco no contexto familiar. Assim, as enfermeiras est?o enveredando o fazer na reorienta??o do modelo assistencial de sa?de, mediante a utiliza??o das tecnologias relacionais, o que tem contribu?do para a resolutividade do cuidado integral a popula??o infantil

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T23:08:14Z No. of bitstreams: 1 CileneNunesDantas_TESE.pdf: 2563015 bytes, checksum: b3aa845befddb2f6863a7e2507250995 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-20T20:01:01Z (GMT) No. of bitstreams: 1 CileneNunesDantas_TESE.pdf: 2563015 bytes, checksum: b3aa845befddb2f6863a7e2507250995 (MD5) / Made available in DSpace on 2017-04-20T20:01:01Z (GMT). No. of bitstreams: 1 CileneNunesDantas_TESE.pdf: 2563015 bytes, checksum: b3aa845befddb2f6863a7e2507250995 (MD5) Previous issue date: 2016-12-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Este estudo teve como objetivo desenvolver um software (prot?tipo) para consulta de enfermagem aplicada ao acompanhamento do crescimento e desenvolvimento infantil na Aten??o Prim?ria ? Sa?de, cujos objetivos espec?ficos foram construir e validar o conte?do de um instrumento de hist?rico de enfermagem para a primeira consulta e subsequente aplicada ao acompanhamento do crescimento e desenvolvimento infantil, fundamentado na Teoria das Necessidades Humanas B?sicas e na Classifica??o Internacional para as Pr?ticas de Enfermagem; propor um software (prot?tipo) para a consulta de enfermagem aplicada ao acompanhamento do crescimento e desenvolvimento infantil. Trata-se de um estudo metodol?gico para elabora??o do instrumento de consulta de enfermagem que constou de cinco fases: revis?o da literatura; estrutura??o dos instrumentos para valida??o do conte?do da consulta de enfermagem para o acompanhamento do crescimento e desenvolvimento infantil; sele??o dos ju?zes para participa??o no estudo; valida??o de conte?do do Hist?rico de Enfermagem: T?cnica de Delphi; e desenvolvimento do ambiente do Telenfermagem (software-prot?tipo) para o acompanhamento do crescimento e desenvolvimento infantil. A pesquisa seguiu os preceitos ?ticos que regem a pesquisa cient?fica com seres humanos do Conselho Nacional de Sa?de, aprovada pelo Comit? de ?tica e Pesquisa, por meio do Parecer Consubstanciado n? 925.408, de 18/12/2014, sob o n?mero CAAE 39640914.8.0000.5537. A an?lise dos dados ocorreu por estat?stica descritiva simples, atrav?s de frequ?ncias absolutas e relativa, m?dia, desvio padr?o, teste binomial e ?ndice de validade de conte?do. Os resultados foram apresentados em tr?s manuscritos: 1. Consulta de enfermagem para acompanhamento do crescimento e desenvolvimento infantil na Aten??o Prim?ria ? Sa?de: revis?o integrativa; 2. Valida??o de instrumento de hist?rico de enfermagem para o acompanhamento do crescimento e desenvolvimento infantil; 3. Software-prot?tipo para o acompanhamento do crescimento e desenvolvimento infantil na Aten??o Prim?ria ? Sa?de. O primeiro artigo, est? relacionado aos achados para caracteriza??o da consulta ? crian?a, que revelaram lacunas nesssa para o acompanhamento do crescimento e desenvolvimento infantil em virtude das limita??es relacionadas ao conhecimento te?rico e/ou pr?tico do enfermeiro na Aten??o Prim?ria ? Sa?de. O segundo artigo revela a valida??o de conte?do dos instrumentos para a primeira consulta e subsequente aplicada ? crian?a. Faz refer?ncia a utiliza??o da etapa Delphi 1, na qual oito ju?zes avaliaram os instrumentos de hist?rico de enfermagem, das etapas Delphi 2 e 3, seis. O hist?rico de enfermagem para primeira consulta e subsequente foram avaliados pelos ju?zes de acordo com o crit?rio de concord?ncia. Considerou-se v?lido em seu conte?do os instrumentos que obtiveram consenso de 80% entre os experts. O artigo 3 est? relacionado ao software, desenvolvido sobre plataforma web e apresenta os requisitos previamente estabelecidos que est?o relacionados ao sistema, resultando em atividades que est?o acess?veis para os usu?rios (administrador e enfermeiro usu?rio) cadastrados no sistema. Destarte, as conclus?es apontam que os instrumentos de hist?rico de enfermagem e software elaborados e validados possuem potencialidades e limita??es, poder?o nortear a pr?tica do enfermeiro da Estrat?gia de Sa?de da Fam?lia, oportunizar uma comunica??o mais efetiva, o empoderamento e autonomia do enfermeiro na Aten??o Prim?ria ? Sa?de. / This study aimed to develop a software (prototype) for nursing consultation applied to the monitoring of child growth and development in Primary Health Care, whose specific objectives were to build and validate the content of a nursing history instrument for the first consultation and Applied to the monitoring of child growth and development, based on the Basic Human Needs Theory and the International Classification for Nursing Practices; Propose a software (prototype) for the nursing consultation applied to the monitoring of child growth and development. This is a methodological study for the elaboration of the nursing consultation instrument that consisted of five phases: literature review; Structuring of the instruments for validation of EC content for the monitoring of children's CD; Selection of judges for participation in the study; Validation of Nursing History content: Delphi Technique; And development of the Telenfermagem environment (software-prototype) for the follow-up of the children's CD. The research followed the ethical precepts that govern the scientific research with human beings of the National Health Council, approved by the Committee of Ethics and Research, through Opinion No 925.408, of 12/18/2014, under the number CAAE 39640914.8.0000.5537 . The data analysis was performed by simple descriptive statistics, using absolute and relative frequencies, mean, standard deviation, binomial test and IVC. The results were presented in three manuscripts: 1. Nursing consultation to monitor child growth and development in Primary Health Care: integrative review; 2. Validation of a nursing history instrument for monitoring child growth and development; 3. Software-prototype for the follow-up of children's growth and development in Primary Health Care. The first article is related to the findings to characterize the child's consultation, which revealed gaps in the monitoring of children's CD due to limitations related to Theoretical and / or practical knowledge of the nurse in PHC. The second article reveals the validation of content of the instruments for the first and subsequent consultation applied to the child. It refers to the use of the Delphi 1 stage, in which eight judges evaluated the nursing history instruments of Delphi 2 and 3, 6 stages. The nursing history for the first and subsequent consultations were evaluated by the judges according to the criterion of agreement. The instruments that obtained a consensus of 80% among experts were considered valid in their content. Article 3 is related to software, developed on web platform and presents the previously established requirements that are related to the system, resulting in activities that are accessible to the users (administrator and nurse user) registered in the system. Thus, the conclusions point out that the elaborated and validated nursing and software tools have potentialities and limitations, could guide the practice of the nurse in the Family Health Strategy, provide more effective communication, nurse empowerment and autonomy in Primary Care the health.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-04-07T20:28:06Z No. of bitstreams: 1 SulianeBeatrizRauberDissertacao2016.pdf: 3110782 bytes, checksum: 762f0395a902e6696c13444254c0df77 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-04-07T20:28:55Z (GMT) No. of bitstreams: 1 SulianeBeatrizRauberDissertacao2016.pdf: 3110782 bytes, checksum: 762f0395a902e6696c13444254c0df77 (MD5) / Made available in DSpace on 2017-04-07T20:28:55Z (GMT). No. of bitstreams: 1 SulianeBeatrizRauberDissertacao2016.pdf: 3110782 bytes, checksum: 762f0395a902e6696c13444254c0df77 (MD5) Previous issue date: 2016-02-24 / Sedentary behavior, coupled with poor diet has increasingly reached children, teenagers and their families worldwide. The drastic reduction in the time devoted to active and spontaneous movement has been a matter of great concern among professionals who are dedicated to the prevention of diseases in children and adolescents, since the sedentary lifestyle has contributed to the increasing incidence of obesity and chronic diseases such as hypertension. Educational programs have been considered an important tool to improve this situation. The objective of the study was evaluate the impacts of a Recreational Education Program in Children???s Health (PRESI) through a camp, weekly meetings and by the use of an application on metabolic control, cardiovascular responses, physical fitness, level of knowledge about healthy habits, lifestyle changes of children with overweight and obesity. The PRESI was divided into Phase 1 involved a five-day summer camp called ACAMP, and PHASE 2 comprised 12 weeks of follow-up with a weekly meeting totaling 12 meetings of two hours each (12 weeks). ACAMP participated in 20 children (9 boys and 11 girls; 9.4 ?? 1.1 years), and of these 20 children, 12 (9.4 ?? 0.96 years) also participated in the follow-up during 12 weeks. Anthropometric, blood pressure and resting heart rate were measured in addition to the completion of the thermal stress test Cold Pressor Test, blood collections for evaluating biochemical variables (glucose, lipemia and apolipoproteins A-1 and B), level of physical activity , food intake, sleep quality and level of knowledge about health. For pre and post camp comparison we used the Student t test (t) and three times (pre and post ACAMP and 12 weeks), with normal distribution, it used ANOVA for repeated measures. We use the test d'Cohen to verify the magnitude of the responses by the sample is small. For comparison of food proportions between groups, we used the McNemar test. Was adopted p <0.05 for statistically significant differences. Results Phase 1: Significant reduction in SBP (115.15 ?? 10.40 vs 105.80 ?? 8,58mmHg) and DBP (77.10 ?? 9.26 vs 70.00 ?? 6,49mmHg) was observed when pre- vs. post ACAMP were compared respectively (p <0.05). When comparing pre and post ACAMP observed that: HOMA beta showed a decrease of 56.2% (98.8); lipid profile was decreased CT 18.95 mg / dl, LDL 9,7mg/dL, non-HDL 16.15 mg/dL and triglycerides 27.05 mg / dl; and APO A1 and B had an average decrease of 8% (- 10.3 mg / dl) and 9% (- 7.6 mg/dL), respectively. Phase 2: the resting PAS reduced 8,92mmHg and 6,58mmHg and 1,67mmHg 2 mmHg and DBP after ACAMP and 12 weeks, respectively, when compared with the pre times. The average basal insulin fell 5.59 ??UI / ml after ACAMP compared with the pre and these values remained low after 12 weeks. CT decreased 13.4% after ACAMP (p <0.003) and 18.9% after 12 weeks and APO A1 fell by 9,42mg / dl post ACAMP (p = 0.31) and 4,42mg / dl (p = 0.59) after 12 weeks compared with pre. The total NAF increased (16.95%, 172.99 METs) and among the types of households that had higher increases the Leisure is what has improved significantly, both during the week (NAFLDS increase of 26.06%, p <0.001) as the weekend (NAFLFS increase of 14.1%, p <0.001). Hear drop in sedentary time during the week of 1585.71 ?? 208.58 to 1408.57 ?? 174,10min (p = 0.004) and at the end of the week time decreased from 282.14 ?? 41.23 to 240.71 ?? 36,17min (p <0.001). The score of sleep quality decreased after 12sem (58.46 ?? 4.87 to 50.52 ?? 4.63, p = 0.074) and the level of knowledge about health education compared to pre increased 16.7% post ACAMP and 19.12% after 12 weeks (p<0,05). We conclude that five days in a camp and 12 health education meetings, with physical activity and encouraging healthy lifestyle contributed to reducing and maintaining body mass, reduction of cardiovascular risk factors such as high blood pressure at rest, CT, triglycerides. Improves the lifestyle of children, an increase NAF and decreased time devoted to sedentary activities, improves sleep quality and choice for healthier foods. / O comportamento sedent??rio, aliado ?? m?? alimenta????o, tem atingido cada vez mais crian??as, adolescentes e suas fam??lias em todo o mundo. A redu????o dr??stica do tempo dedicado ?? movimenta????o ativa e espont??nea, aliada ?? m?? alimenta????o, tem gerado grande preocupa????o dos profissionais que se dedicam ?? preven????o de doen??as como obesidade, diabetes e hipertens??o arterial na inf??ncia e adolesc??ncia. Programas educativos t??m sido considerados uma ferramenta importante para a melhora deste quadro. O objetivo do estudo foi avaliar os impactos de um Programa Recreativo de Educa????o em Sa??de Infantil (PRESI), desenvolvido por meio de um acampamento e acompanhamento, com encontros semanais, sobre fatores de risco cardiovascular e mudan??as no estilo de vida em crian??as com sobrepeso e obesidade. O PRESI foi dividido em duas fases, na FASE 1 envolveu um acampamento de f??rias de cinco dias, denominado ACAMP, e a FASE 2 compreendeu 12 semanas de acompanhamento com um encontro semanal totalizando 12 encontros de duas horas cada (12 semanas). Participaram do ACAMP 20 crian??as (9 meninos e 11 meninas; 9,4??1,1 anos), e destas, 12 (9,4??0,96 anos) participaram tamb??m do acompanhamento durante 12 semanas. Foram mensuradas vari??veis antropom??tricas, da press??o arterial e frequ??ncia card??aca de repouso, al??m da realiza????o do teste de estresse t??rmico Cold Pressor Test, coletas sangu??neas para avalia????o de vari??veis bioqu??micas (glicemia, lipemia e apolipoprote??nas A-1 e B), n??vel de atividade f??sica, consumo alimentar, qualidade do sono e n??vel de conhecimento sobre sa??de. Para a compara????o entre pr?? e p??s-acampamento foi utilizado o teste t de student (t) e para tr??s momentos (pr?? e p??s-ACAMP e 12 semanas), que apresentaram distribui????o normal, foi utilizado ANOVA para medidas repetidas. Usou-se o teste d???Cohen para verificar a magnitude das respostas pela amostra ser pequena. Para compara????o de propor????es de alimentos entre os grupos, foi empregado o teste McNemar. Foi adotado p<0.05 para diferen??as estatisticamente significativas. Resultados da Fase 1: Redu????o significativa da PAS (115,15??10,40 vs 105,80??8,58mmHg) e da PAD (77,10??9,26 vs 70,00??6,49mmHg) foi observada quando os momentos pr?? vs p??s ACAMP foram comparados respectivamente (p<0,05). Quando comparamos pr?? e p??s ACAMP observamos que: o HOMA Beta apresentou uma diminui????o de 56,2% (98,8); do perfil lip??dico a m??dia do CT diminuiu 18,95 mg/dl, do LDL 9,7mg/dl, do N??o HDL 16,15 mg/dl e triglicer??deos 27,05 mg/dl; e as APO A1 e B tiveram uma queda m??dia de 8%(-10,3 mg/dl) e 9%(-7,6 mg/dl), respectivamente. Fase 2: a PAS de repouso reduziu 8,92mmHg e 6,58mmHg e a PAD 1,67mmHg e 2mmHg ap??s ACAMP e as 12sem, respectivamente, quando comparadas com o momento pr??. A insulina basal m??dia caiu 5,59 ??UI/ml ap??s o ACAMP, quando comparado com o pr?? e esses valores se mantiveram reduzidos ap??s as 12 semanas. CT diminuiu 13,4% ap??s o ACAMP (p<0,003) e 18,9% ap??s 12 semanas e a APO A1 teve uma queda de 9,42mg/dl p??s ACAMP (p=0,31) e 4,42mg/dl (p=0,59) ap??s 12sem, quando comparados com pr??. O NAF total aumentou (16,95%, 172,99 METs) e dentre os tipos de AFs que tiveram maiores aumentos, o Lazer foi o que melhorou significativamente, tanto durante a semana (NAFLDS aumento de 26,06%, p< 0,001) como no final de semana (NAFLFS aumento de 14,1%, p< 0,001). Houve queda no tempo sedent??rio durante a semana de 1585,71??208,58 para 1408,57??174,10min (p = 0,004) e durante o final de semana o tempo reduziu de 282,14??41,23 para 240,71??36,17min (p < 0,001). O escore da qualidade do sono diminuiu ap??s as 12 semanas (58,46??4,87 para 50,52??4,63, p=0.074) e o n??vel de conhecimento sobre educa????o em sa??de rela????o ao pr?? aumentou 16,7% p??s ACAMP e 19,12% ap??s 12 semanas (p0,05). Concluiu-se que cinco dias em um acampamento e 12 encontros de educa????o em sa??de, com pr??tica de atividade f??sica e incentivo ao estilo de vida saud??vel contribu??ram para redu????o e manuten????o da massa corporal, redu????o de fatores de risco cardiovascular como press??o arterial de repouso, CT, triglic??rides. Com isso, ocorreu a melhora no estilo de vida das crian??as, com aumento no NAF e diminui????o do tempo destinado ??s atividades sedent??rias, melhora na qualidade do sono e escolha por alimentos mais saud??veis.

Made available in DSpace on 2014-12-17T15:45:09Z (GMT). No. of bitstreams: 1 MarsileneGF_DISSERT.pdf: 576820 bytes, checksum: 50d0a6cc8569e446eb2bf8e01a3989a2 (MD5) Previous issue date: 2013-12-19 / Universidade Federal do Rio Grande do Norte / The study aims to evaluate the quality of the work processes of the teams from the Family Health Strategy regarding the comprehensive health care for children, in the view of users in the state of Rio Grande do Norte. This is a cross-sectional observational evaluative research with quantitative approach. The primary data are part of the External Review from the Program of Improving Access and Quality of Primary Care (PMAQ) in 2012. 190 women were interviewed. The inclusion criteria was the presence in the clinic at the time of the survey, have attended the service in the last 12 months and be a mother or companion of a child up to two years old. A research protocol was developed in the dimensions of Growth and Development, Breastfeeding and nutrition, and health problems and its variables. The results revealed that mothers / companions who responded to the questionnaire 71% were aged between 18 and 35 years, 92.1% were literate, 96.3% had a monthly income and 62.6% received financial assistance from the government. As for the children, 39.4% were aged between 13 to 24 months. In promotion and prevention actions for children, 64.2% had consultation up to the 7th day of life, 91.1% underwent the screening test, 95.3% had a health handbook, 98.9% had a vaccine, 17.9% breastfed or breastfeed from 6 to 24 months. As for link and continuity of care, 86.8% of the children were accompanied by the same professional staff and 59.5% left with next consultation scheduled. In acute situations 42.4% of the children went to the health unit and 64% of these were attended. It is concluded that the actions involving prevention and health promotion of children in RN, are evaluated positively by the service users and meet the requirements of MS, as well as link and continuity of care. The weakness in access and reception of users is evident, indicating the need to adapt the service to the demand of health and planning actions to welcome all who seeks basic health unit-UBS / O estudo tem por objetivo avaliar a qualidade dos processos de trabalho das equipes da Estrat?gia de Sa?de da Fam?lia referentes ? aten??o integral ? sa?de da crian?a na vis?o dos usu?rios no Estado do Rio Grande do Norte. Trata-se de uma pesquisa avaliativa observacional transversal com abordagem quantitativa.Os dados prim?rios fazem parte da Avalia??o Externa do Programa de Melhoria do Acesso e da Qualidade da Aten??o B?sica (PMAQ) em 2012. Foram entrevistadas 190 mulheres usu?rias. O crit?rio de inclus?o foi a presen?a na unidade de sa?de no momento da pesquisa , ter frequentado o servi?o nos ?ltimos 12 meses e ser m?e ou acompanhantes de crian?a at? dois anos de vida. Elaborou-se um protocolo de pesquisa com as dimens?es de Crescimento e Desenvolvimento , Amamenta??o e alimenta??o, e Problemas de sa?de e suas respectivas vari?veis. Como resultados observou-se que das m?es/acompanhantes que responderam ao question?rio 71% tinham idade entre 18 e 35 anos, 92,1% eram alfabetizadas, 96,3% possu?am alguma renda mensal e 62,6% recebiam bolsa fam?lia. Quanto as crian?as 39,4% estavam na faixa et?ria entre 13 a 24 meses. Nas a??es de promo??o e preven??o ? crian?a 64,2% fizeram a consulta at? o 7? dia de vida, 91,1% realizaram o teste do pezinho, 95,3% tinham a caderneta de sa?de, 98,9% tinham alguma vacina, 17,9% mama ou mamou no peito de 6 meses a 24 meses. Quanto ao v?nculo e continuidade do cuidado 86,8% das crian?as eram acompanhadas pelo mesmo profissional da equipe e 59,5% j? saiam com consulta subsequente marcada. Quantdo em situa??es agudas 42,4% das crian?as iam para unidade de sa?de e destas 64% eram atendidas. Conclui-se que as a??es que envolvem preven??o e promo??o ? sa?de da crian?a no RN, s?o avaliadas de forma positiva pelos usu?rios do servi?o e atendem as exig?ncias do MS, assim como o v?nculo e continuidade do cuidado. Sendo evidente fragilidades no acesso e acolhimento dos usu?rios, sinalizando a necessidade de adequa??o do servi?o a demanda das a??es de sa?de e planejamento das equipes para acolher a todos que procurarem a UBS

Made available in DSpace on 2014-12-17T14:46:41Z (GMT). No. of bitstreams: 1 ArianeRSMO_DISSERT.pdf: 1969348 bytes, checksum: c1e9d0216fc19a8611a11585d8f9445d (MD5) Previous issue date: 2008-12-29 / Alma-Ata declaration bring the Primary Attention to the Health (PAH) as first level of health attention for individuals, family and community, which considers infant group as priority. Several initiatives that gave bases to integral attention to the children health formalized in the principles of Unique Health System. Family Health Strategy (FHS) comes to strengthen this attention, instituting new ways of work organization and professional practices that gave impact in their quality indicators. One of them is children mortality, showing decline in their values. Though, studies indicates persistence of avoidable infant deaths. In Natal RN, this reality is also perceptible leading to inquietudes, mainly at the space of services production, it means, which motivated the accomplishment of the present study intending to analyse the way that the organizational and structural processes as long as the professional practices in FHS interfered in the quality of children s health attention who died by avoidable death in the year of 2007 in municipal district of Natal-RN. It treats, therefore, to an exploratory and descriptive survey of cases study type, thar had as primary sources the oficial documents of MH, the family prontuary, pregnant card, child card and testimony obt ined from instrument of research elaborated based in investigation form of infant death by MH, applied to 10 mothers of children who had avoidable death. In analysis it was appealed silmultaneous triangulation of methods and sources, allowing a bigger aproximation from obtained informations. To elucidate the cases, the aspects studied were analyzed to the light of explicative model of Social Determinants of Health. Among individual and family aspects were highlighted the related to age, schooling, family habits and customs and mother s economic condition, besides of pregnancy age, newborn weight and associated diseases, which don t differ from literature about the theme. Reffering to the factors organizational and structural processes and professionals practice, highlihgted, the treatment given by the professionals, the territorialization and adscription of areas, the difficulty of having access to the services or sleepers and the reference and counterreference. But also, the ausence or few greet, the lack of communication, few assiduity and ponctuality by professionals in service, among others. In a general way mothers considers the attendance received in the hospital good and very good , opnions that in the Basic Attention weren t so favorable, in spite of many of predictible actions in this level have been performed in the studied cases. It is observed, therefore, that the social determinants of health has a strong influence in ocurrence of infant deaths, what implicates in a large actuation by Infant Mortality Committee from municipal district. This way, it becomes fundamental the reflection and evaluation about the effectiveness and execution by the processes of vigilance to health in FHUs; the rethink about the social determinants of health in a wide and articulate way to the services quality, to permanent education, to management in service, to the given attention and to the way how it is installed the popular participation and social control. To the professionals it is presented the great challenge to review their daily practice, their values, behaviors and commitment, which ones must be guided by logical of sharing, work in team, humanescence and alterity, not only by the accomplishment of a professional duty / A Declara??o de Alma-Ata trouxe a Aten??o Prim?ria ? Sa?de (APS) como o primeiro n?vel de aten??o em sa?de para indiv?duos, fam?lia e comunidade, o qual considera o grupo infantil como priorit?rio. Diversas iniciativas deram bases para aten??o integral ? sa?de da crian?a formalizada nos princ?pios do Sistema ?nico de Sa?de (SUS). A Estrat?gia Sa?de da Fam?lia (ESF) vem fortalecer essa aten??o, instituindo novas formas de organiza??o do trabalho e pr?ticas profissionais que impactam nos seus indicadores de qualidade. Sendo um deles a mortalidade infantil, ao apresentar decl?nio de seus valores. Todavia, estudos indicam a persist?ncia de ?bitos infantis evit?veis. Em Natal RN, esta realidade tamb?m ? percept?vel, gerando inquieta??es rincipalmente, no espa?o da produ??o dos servi?os, o que motivou a realiza??o do presente estudo com vistas a analisar de que modo os processos organizacionais e estruturais, bem como, a pr?tica dos profissionais na ESF interferiram na qualidade da aten??o ? sa?de das crian?as que foram a ?bito evit?vel no ano de 2007, no munic?pio de Natal-RN. Trata-se, portanto, de uma pesquisa explorat?ria e descritiva do tipo estudo de casos, que tomou como fontes prim?rias os ocumentos oficiais do MS; o prontu?rio da fam?lia, cart?o da gestante, e da crian?a e os depoimentos obtidos a partir do instrumento de pesquisa elaborado com base na ficha de investiga??o de ?bito infantil do MS, aplicado a 10 m?es das crian?as que foram a ?bito evit?vel. Na an?lise recorreu-se a triangula??o simult?nea de m?todos e fontes, permitindo uma maior aproxima??o das informa??es obtidas. Para elucidar os casos, os aspectos estudados foram analisados ? luz do modelo explicativo dos Determinantes Sociais da Sa?de. Dentre os aspectos individuais e familiares ressaltaram os relacionados ? idade, escolaridade, h?bitos e costumes familiares e condi??o econ?mica da m?e, al?m da idade gestacional, peso do neonato e doen?as associadas, os quais n?o diferem da literatura sobre o tema. Quanto aos fatores organizacionais, estruturais e a pr?tica dos profissionais, ressaltam-se o tratamento dispensado pelos profissionais, a territorializa??o e adscri??o de ?reas, a dificuldade de acesso aos servi?os ou leitos e a refer?ncia e contra refer?ncia. Mas tamb?m, a aus?ncia ou pouco acolhimento, a falta de comunica??o, a pouca assiduidade e pontualidade dos profissionais no servi?o, dentre outros. De maneira geral as m?es consideraram o atendimento recebido no hospital bom e muito bom , opini?es que na Aten??o B?sica n?o foram t?o favor?veis, apesar de que muitas das a??es previstas nesse n?vel de aten??o tenham sido realizadas nos casos estudados. Observa-se, portanto, que os determinantes sociais da sa?de exercem forte influ?ncia na ocorr?ncia dos ?bitos infantis. Desse modo, torna-se fundamental a reflex?o e a avalia??o acerca da efetiva??o e efic?cia dos processos de vigil?ncia ? sa?de nas USF; o repensar sobre os determinantes sociais da sa?de de forma ampliada e articulada ? qualidade dos servi?o, ? educa??o permanente, ? gest?o em servi?o, ? aten??o dispensada e ? forma como se instala a participa??o popular e o controle social. Para os profissionais apresenta-se o grande desafio de rever a sua pr?tica cotidiana, seus valores, comportamentos e compromissos, os quais devem orientar-se pela l?gica do compartilhamento, do trabalho em equipe, da humanesc?ncia e alteridade e n?o apenas do cumprimento de um dever profissional

Made available in DSpace on 2014-12-17T14:46:46Z (GMT). No. of bitstreams: 1 IsabellePM_DISSERT.pdf: 1853141 bytes, checksum: c1b9542a45d8048b614bdda01b92d40c (MD5) Previous issue date: 2010-12-17 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The accompanying the growth and development of the child is the guiding line of basic health measures directed at this public, acting within the scope of health monitoring and inferring positively in the rate of infant morbidity and mortality, which are still a preoccupation worldwide and in Brazil. However, mostly, this practice is based on the biomedical model of care, individualized, with emphasis on the medicalization and complaints, favoring the passivity of users. Given this issue, aim to develop accompanying the growth and development of the child in a Basic Unit Family Health, through a collective approach of medical care next to a health team, especially nurses and caregivers. This is a qualitative study, with the research-action method. Involved the four nurses and twenty-six of children's caregivers of the area of Basic Unit Family Health of Cidade Nova, in Natal, in the period from February to July 2010. The results were analyzed following the direction of the thematic analysis of Freire. In the situation analysis of the current reality of the accompanying the growth and development the children in the Basic Unit Family Health, through participant observation and applying a questionnaire to the nurses, we realize that despite these professionals have a knowledge tied to the paradigm of health promotion, in practice the monitoring of child is done through individual consultations in outpatient room, based on complaints brought by caregivers, with little solvability in actions employed. Given the need for change in medical care model, we decided jointly, in the focal group, for the collective monitoring of children's the growth and development, featuring then this proposal to the multidisciplinary team, discussing the participation of professional categories and planned collectively the actions. In the implementation stage of collective action, we contemplate the execution by the caregivers of anamnesis and physical examination, recording data in the Child Health Handbook and discussion of clinical findings, under the supervision of nurses and facilitators. In the evaluation, we found that this collective accompanying strategy allowed to caregivers learn new knowledge, exchange experiences, assistance in home care, beyond reduce the waiting time for medical care and creating opportunity of more time for debate about the children&#8223;s health situation, differing of ambulatory care. As difficulties, we face with a high rate of defaulters (53.8%), lack of motivation and passivity of the users, little participation of other health professionals and nurses' involvement in other activities, technical and bureaucratic in the moment of care. Thus, we note also a strong rooting of individual clinical model on the way of thinking and acting of nurses and caregivers / O acompanhamento do Crescimento e do Desenvolvimento (CD) da crian?a ? o eixo norteador das a??es b?sicas em sa?de voltadas para essa clientela, atuando no ?mbito da vigil?ncia ? sa?de e inferindo positivamente nos ?ndices de morbidade e de mortalidade infantil, que ainda hoje s?o uma preocupa??o no mundo e no Brasil. Por?m, na maioria das vezes, essa pr?tica ? pautada no modelo biom?dico de atendimento, individualizado, com ?nfase nas queixas e medicaliza??o, favorecendo a passividade dos usu?rios. Diante dessa problem?tica, objetivamos desenvolver o acompanhamento do CD da crian?a em uma Unidade B?sica de Sa?de da Fam?lia (UBSF), atrav?s de uma abordagem coletiva de atendimento junto ? equipe de sa?de, em especial as enfermeiras, e cuidadoras. Trata-se de um estudo qualitativo, tendo como m?todo a pesquisa-a??o. Envolveu as quatro enfermeiras e vinte e seis cuidadoras de crian?as da ?rea de abrang?ncia da UBSF de Cidade Nova, no munic?pio de Natal, no per?odo de fevereiro a julho de 2010. Os dados foram analisados seguindo o direcionamento da an?lise tem?tica freireana. No diagn?stico situacional da realidade atual de acompanhamento do CD das crian?as na referida UBSF, atrav?s da observa??o participante e aplica??o de question?rio junto as enfermeiras, percebemos que apesar dessas profissionais terem um conhecimento atrelado ao paradigma de promo??o ? sa?de, na pr?tica o acompanhamento da crian?a ? feito atrav?s de consultas individuais em sala ambulatorial, pautado nas queixas trazidas pelas cuidadoras, com pouca resolubilidade nas a??es empregadas. Vista a necessidade de mudan?a no modelo de atendimento, decidimos conjuntamente, no grupo focal, pelo acompanhamento coletivo do CD das crian?as, apresentando, em seguida, essa proposta ? equipe multiprofissional, sendo discutida a participa??o das categorias profissionais e planejadas coletivamente as a??es. Na etapa de implementa??o da a??o coletiva, contemplamos a execu??o pelas cuidadoras da anamnese e exame f?sico, registro dos dados na Caderneta de Sa?de da Crian?a e discuss?o dos achados cl?nicos, sob supervis?o das enfermeiras e facilitadoras. Na avalia??o, constatamos que essa estrat?gia de acompanhamento coletivo permitiu ?s cuidadoras a aprendizagem de novos conhecimentos, a troca de experi?ncias, o aux?lio nos cuidados domicili?rios, al?m de diminuir o tempo de espera pelo atendimento e oportunizar maior tempo de discuss?o sobre a situa??o de sa?de das crian?as, diferenciando-se do atendimento ambulatorial. Como dificuldades, deparamos-nos com o alto ?ndice de faltosos (53,8%), falta de motiva??o e passividade das usu?rias, pouca participa??o de outros profissionais de sa?de e envolvimento das enfermeiras em outras atividades t?cnicas e burocr?ticas no momento do atendimento. Assim, constatamos ainda um forte enraizamento do modelo cl?nico individual no modo de pensar e agir das enfermeiras e das cuidadoras

Made available in DSpace on 2014-12-17T14:46:47Z (GMT). No. of bitstreams: 1 MariaCCVA_DISSERT.pdf: 4900266 bytes, checksum: cf1c835bda41230094ec7805a0e84252 (MD5) Previous issue date: 2011-05-02 / Unlike adult cancer, where cells usually originate from epithelial tissue and is linked to environmental factors, malignant tumors in childhood are mostly of embryonic origin and have a phase of rapid proliferation. When not started chemotherapy at this stage, the tumor increases in size, reducing their growth rate, thus reducing the response to chemotherapy. Childhood cancer is in Brazil, the second cause of mortality among children and adolescents from one to nineteen. His impact on the ranking of diseases becomes significantly important to public health since the first issue is related to accidents and violence. Many children are still sent to the centers of high complexity for cancer treatment with advanced stage disease. The delay in referral to diagnosis can be family, or the difficulty of access to the health sector, or the characteristics of the disease and lack of health staff regarding theme of childhood cancer. Before this problem, we aimed to assess the performance of health teams in the identification of child and adolescent symptoms of cancer in primary care, through the action research methodology, which includes the teaching-learning, seminars, describing the actions of the group and discussing the activities after the training. This study involved thirty-seven health professionals who provide care for children and adolescents in the USF Felipe Shrimp II, the Support Center for Children with Cancer and the pediatric hospital UFRN during the period from March to December 2010. The data were analyzed simultaneously to evaluate actions, following the direction of the analysis of ideas Freires, having as theoretical reference the primary health care. The diagnosis of current reality, as knowledge of the health team targeted for early identification of signs and symptoms raised through questioning, presented as generative themes: resistance to change, awareness of the need for apprehension of knowledge; prior knowledge through the media, fragmentation of the healthcare network, interfering with the operation of the reference and counter, the stigma of death, among others. The selected themes enabled the choice of content for the preparation of four seminars, such as implementation of collective action for discussion problematical. The teaching-learning process has allowed the study participants awareness of the problem and work through the knowledge acquired by interfering in decreasing the time interval between the identification of signs and symptoms of cancer and early specialist treatment. Their difficulties we are faced with a diagnosis of terminal cancer and associated with delayed access to laboratory tests and imaging necessary for the diagnosis of neoplasms. Thus, we find that when the team is consciously involved in the education process from identification of the problem situation, there may be significant changes in daily activities through awareness of being. However, we also realize that acquisition of knowledge and interest of the team are not enough, since to be efficiency of our service, we need an organization of cancer care network operating in the state of Rio Grande do Norte / Ao contr?rio do c?ncer no adulto, em que as c?lulas geralmente originam-se de tecido epitelial e que est? ligado a fatores ambientais, os tumores malignos na inf?ncia s?o, na sua maioria, de origem embrion?ria e apresentam uma fase de r?pida prolifera??o. Quando n?o iniciado o tratamento quimioter?pico nesta fase, o tumor aumenta de tamanho, reduzindo sua velocidade de crescimento, diminuindo, assim, a resposta aos quimioter?picos. O c?ncer infantil representa, no Brasil, a segunda causa de mortalidade entre crian?as e adolescentes de um a dezenove anos. Seu impacto no ranking das doen?as torna-se significativamente importante para a sa?de p?blica, j? que a primeira causa est? relacionada aos acidentes e ? viol?ncia. Muitas crian?as ainda s?o encaminhadas aos centros de alta complexidade para tratamento oncol?gico com a doen?a em est?gio avan?ado. A demora no encaminhamento para diagn?stico pode ser da fam?lia, ou da dificuldade do acesso ao Setor Sa?de, ou ainda das caracter?sticas da doen?a e do desconhecimento da equipe de sa?de quanto ? tem?tica de c?ncer infantil. Diante desta problem?tica, objetivamos analisar o desempenho das equipes de sa?de na identifica??o da crian?a e adolescente, sintom?ticos de c?ncer, na aten??o prim?ria, por meio da metodologia pesquisa-a??o, que contempla o ensino-aprendizagem, semin?rios, descrevendo a atua??o do grupo e discutindo as atividades desenvolvidas ap?s os treinamentos. Este estudo envolveu trinta e sete profissionais de sa?de que prestam aten??o a crian?as e adolescentes na USF Felipe Camar?o II , na Casa de Apoio ? Crian?a com C?ncer e no Hospital de Pediatria/UFRN, durante o per?odo de mar?o a dezembro de 2010. Os dados foram analisados simultaneamente ? avalia??o das a??es, seguindo o direcionamento da an?lise das ideias freireanas, tendo como referencial te?rico a aten??o prim?ria ? sa?de. O diagn?stico situacional da realidade atual, quanto ao conhecimento da equipe de sa?de direcionado para uma identifica??o precoce de sinais e sintomas levantada por meio da problematiza??o, apresentou temas geradores como: a resist?ncia para a mudan?a; a conscientiza??o para a necessidade de apreens?o de saberes; o conhecimento pr?vio por meio da m?dia; a fragmenta??o da rede de assist?ncia, interferindo no funcionamento do sistema de refer?ncia e contrarrefer?ncia; o estigma da morte, dentre outros. Esses temas geradores viabilizaram a escolha do conte?do para a elabora??o de quatro semin?rios, como implementa??o de a??o coletiva para discuss?o problematizadora. O processo ensino-aprendizagem permitiu aos participantes do estudo a conscientiza??o do problema e o agir por meio do conhecimento adquirido, interferindo na diminui??o do intervalo de tempo entre a identifica??o de sinais e sintomas de c?ncer e o in?cio do tratamento especializado. Como dificuldades, deparamo-nos com o diagn?stico de c?ncer associado a terminalidade e o dificultoso acesso a exames laboratoriais e de imagem, necess?rios para o diagn?stico de neoplasias. Assim, constatamos que, quando a equipe ? envolvida conscientemente no processo de educa??o desde a identifica??o da situa??oproblema, podem ocorrer mudan?as significativas no fazer cotidiano por meio da conscientiza??o do ser. Entretanto, percebemos tamb?m que aquisi??o de conhecimento e interesse da equipe n?o s?o suficientes, j? que, para haver efic?cia do atendimento, ? necess?ria uma organiza??o da rede de aten??o oncol?gica atuante no estado no Rio Grande do Norte

Made available in DSpace on 2014-12-17T14:46:34Z (GMT). No. of bitstreams: 1 SelmaSSO.pdf: 3511274 bytes, checksum: a54476d4b57bf09c9a0cdd92e829a531 (MD5) Previous issue date: 2007-12-28 / This study deals with a historical, descriptive and exploratory approach aiming to recall the origin and trajectory of the Pediatrics Hospital at Universidade Federal do Rio Grande do Norte. This research also deals with the insertion of the nursing department in the same Hospital. This was realized through existing records and discourse collected through interview of professionals-doctors, nurses, midwifes, nursing attendants and psychologists. Thus, a network was established and consisted of qualified informants, composed through reference analysis. Data treatment and analysis was performed based on the collection of oral data. The data was considered according to the font s context, all of which depending on process of comprehension and interpretation. The research was based on the main theme, through oral history used in order to build a historical background. These main themes were then subdivided and other discourses were made present such as: the historical scene, the dream came true and the insertion of nursing, present in the history construction; all of which enabled the research. Thus, in this process, it was possible to identify the most important characters of the origin of children s health services organization and assistance at Rio Grande do Norte. It was possible to perceive that this institution aimed to initiate health services that dealt with an education for future generations. This was observed through the creation of the Faculty of Medicine of Natal and as a consequence, the installation of a Pediatrics Hospital that dealt with medical education. The research made evident that the nursing contributed for a structuring of quality health assistance towards children, even though the resources and working conditions were scarce, extensive work shifts and low professional qualification. It was observed that the there was change in the category s profile, once nurses were introduced in the service. Once this happened, changes in mentality, and innovative processes as well as professional conducts were established. The distinctive relation between acting and doing of doctors and nurses were also dealt with. Thus, the first item is done towards the idealization, projection and prescription. The second issue deals with concretization in realization of something that was not projected and realized, causing suffering and unsatisfaction. At the end, it was possible to confirm that oral history is a very rich element and it is possible through subjects that build history, through their perceptation of the facts and the context in that their are inside / Trata-se de um estudo de enfoque hist?rico, explorat?rio e descritivo visando resgatar a origem e trajet?ria do Hospital de Pediatria da UFRN e a inser??o da enfermagem no mesmo. Este foi realizado a partir dos registros existentes e dos depoimentos colhidos dos profissionais - m?dicos, enfermeiras, parteira, auxiliar de enfermagem e psic?loga. Estabeleceu-se uma rede de informantes qualificados, partindo do marco zero, a qual foi configurada pelas refer?ncias dos entrevistados. O tratamento e a an?lise dos fatos aconteceram com base nas fontes orais coletadas tomando o contexto em que foram vivenciadas para compreend?-las e interpret?-las. Utilizou-se a oralidade na constru??o de uma hist?ria em que as informa??es, baseadas no tema central, foram desdobradas em sub-temas que emergiram do conjunto dos discursos: o cen?rio da hist?ria, do sonho ? realidade e a enfermagem na constru??o da hist?ria, temas que constitu?ram o corpo do trabalho. Nesse processo, identificou-se vultos de grande relev?ncia para a organiza??o da assist?ncia ? crian?a norte-rio-grandense, que deram origem ao sistema de aten??o ? sa?de da popula??o infantil. Percebeu-se a intencionalidade de se criar institui??es de sa?de voltadas para a educa??o de uma gera??o para o futuro. Observou-se a mudan?a desse olhar educacional, a partir da cria??o da Faculdade de Medicina de Natal e, conseq?entemente a estrutura??o de um hospital pedi?trico voltado para o ensino m?dico. Evidenciou-se a contribui??o da enfermagem na constru??o de uma assist?ncia de qualidade ? crian?a, apesar dos escassos recursos, prec?ria condi??es de trabalho, jornadas excessivas e baixa qualifica??o profissional. Observou-se a mudan?a do perfil da categoria, a partir da inser??o das enfermeiras no servi?o e com elas, novas mentalidades, processos inovadores e postura profissional. Constatou-se a distinta rela??o que se estabelece entre o pensar/fazer do m?dico e da enfermagem, o primeiro relacionado ? idealiza??o, proje??o e prescri??o, e o segundo localizado na concretiza??o e na realiza??o de algo que n?o se projetou nem idealizou, podendo ser geradora de insatisfa??o e sofrimento. Enfim, confirmou-se que a riqueza da hist?ria oral decorre da possibilidade dos sujeitos constru?rem a hist?ria, a partir da sua percep??o dos fatos e o contexto no qual est?o inseridos

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-03T19:37:37Z No. of bitstreams: 1 FernandaAparecidaSoaresMalveira_DISSERT.pdf: 2529565 bytes, checksum: 3db18d4214b034b392953296b837e7b4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-07T19:24:43Z (GMT) No. of bitstreams: 1 FernandaAparecidaSoaresMalveira_DISSERT.pdf: 2529565 bytes, checksum: 3db18d4214b034b392953296b837e7b4 (MD5) / Made available in DSpace on 2016-03-07T19:24:43Z (GMT). No. of bitstreams: 1 FernandaAparecidaSoaresMalveira_DISSERT.pdf: 2529565 bytes, checksum: 3db18d4214b034b392953296b837e7b4 (MD5) Previous issue date: 2014-12-11 / O acompanhamento do crescimento e desenvolvimento ? o ponto central do cuidado infantil no servi?o prim?rio de sa?de, em raz?o da sua contribui??o para a redu??o da morbidade e da mortalidade infantil, al?m de promover o desenvolvimento saud?vel. Apesar dessa import?ncia, a unidade de sa?de localizada no munic?pio rural de Parazinho convive com o problema das aus?ncias frequentes das crian?as nas consultas de acompanhamento. Nesse sentido, este estudo objetivou analisar a participa??o das m?es no acompanhamento do crescimento e desenvolvimento das crian?as na Estrat?gia de Sa?de da Fam?lia. Este ? um estudo com vi?s explorat?rio, descritivo com uma abordagem qualitativa, tendo como m?todo a pesquisa-a??o, o qual foi desenvolvido com as m?es que fazem parte do acompanhamento do crescimento e desenvolvimento das crian?as na ?rea rural do munic?pio de Parazinho/RN, no per?odo de maio a outubro de 2014. A coleta de dados foi desenvolvida utilizando as t?cnicas de grupo focal, de observa??o participante e entrevista individual. Os dados foram analisados por meio da an?lise tem?tica de categoriza??o. A pesquisa foi aprovada pelo Comit? de ?tica em Pesquisa, sob o parecer consubstanciado 617.559 e CAAE 28598014.7.0000.5537. Na etapa do diagn?stico situacional, foram realizados dois grupos focais, nos quais participaram ao todo 14 m?es de distintas localidades rurais. A partir das falas, percebeu-se que elas possuem entendimento satisfat?rio a respeito do acompanhamento do crescimento e desenvolvimento da crian?a, caracterizando-o como um momento de aprendizagem. A enfermeira foi mencionada como profissional-chave dessa a??o de acompanhamento. O principal motivo que leva as m?es a abandonarem as consultas ? o acesso ao servi?o de sa?de, devido ? dist?ncia de suas resid?ncias at? a unidade b?sica, ? escassez de transporte p?blico para o deslocamento dos usu?rios e ? demora entre o atendimento e a volta para casa. Como estrat?gia para tentar solucionar esses problemas, com a sugest?o das pr?prias m?es, foi criado o Acompanhamento do Crescimento e Desenvolvimento Itinerante, em que a equipe da ESF se deslocava para as localidades rurais, realizando atividades voltadas para a sa?de da crian?a. As m?es que participaram da a??o aprovaram a iniciativa quanto ? melhoria do acesso e do acolhimento das necessidades de sa?de, apesar de apontarem como insatisfa??es a prec?ria infraestrutura e a pouca privacidade nas consultas. Portanto, apesar das dificuldades encontradas muitas vezes por falta de apoio da gest?o e de envolvimento de alguns profissionais, o Acompanhamento do Crescimento e Desenvolvimento Itinerante se mostrou como uma importante ferramenta na resolu??o do problema do acesso aos servi?os voltados para a sa?de da crian?a. Al?m de funcionar como um espa?o para a realiza??o da educa??o em sa?de, passando a ser, desde ent?o, uma atividade inerente a programa??o da equipe de sa?de da fam?lia naquela localidade. / The accompaniment of growth and development is the central thrust of child care in primary health care in order to contribute to the reduction of infant morbidity and mortality and promote healthy development. Despite its importance, the family health unit located in rural Parazinhocounty experiences the problem of frequent absences of children to follow-up consultations. Thus, this study aims to analyze the participation of mothers in the accompaniment of growth and development of children in the Family Health Strategy. This is an exploratory, descriptive study with a qualitative approach with the method action research, developed with mothers who are part of the monitoring of the growth and development of children in the rural area of the municipality of Parazinho/RN from May to October 2014. Data collection was performed using the focus group techniques, participant observation and individual interviews. Data were analyzed using thematic analysis of categorization. The study was approved by the Research Ethics Committee, under the opinion embodied 617,559 and CAAE 28598014.7.0000.5537. In step situation analysis, were conducted two focus groups, attended by a total of 14 mothers of different rural locations. From the speeches, one realizes that they have a satisfactory understanding of the monitoring of the growth and development of the childwas a learning moment. The nurse was mentioned as key professional that actionof accompaniment. The main reason that mothers to abandon consultations is access to health services, due to the distance from their homes to the basic unit, the shortage of public transport for the movement of users and delay between the service and the back home. As a strategy to try to tackle these problems, at the suggestion of their mothers was created Monitoring of Growth and Development Itinerant, where the FHS team moved to rural locations, performing activities related to children's health. Mothers who participated in the action approved the initiative as improving access and care of health needs, despite indicate dissatisfaction as the poor infrastructure and little privacy in consultations. Therefore, it is concluded that, despite the difficulties encountered often for lack of management support and involvement of some professionals, the monitoring of growth and development itinerant proved to be an important tool in solving the problem of access to services oriented to the health of child, in addition to functioning as a space for the realization of health education, becoming, since then, an activity inherent in family health team schedule.

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