Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-02-01T21:54:02Z No. of bitstreams: 1 ElianeSantosCavalcante_TESE.pdf: 2755677 bytes, checksum: 4bcc775074aae16da7d2b7146be18bab (MD5) / Approved for entry into archive by Elisangela Moura (lilaalves@gmail.com) on 2016-03-07T20:07:57Z (GMT) No. of bitstreams: 1 ElianeSantosCavalcante_TESE.pdf: 2755677 bytes, checksum: 4bcc775074aae16da7d2b7146be18bab (MD5) / Made available in DSpace on 2016-03-07T20:07:57Z (GMT). No. of bitstreams: 1 ElianeSantosCavalcante_TESE.pdf: 2755677 bytes, checksum: 4bcc775074aae16da7d2b7146be18bab (MD5) Previous issue date: 2014-12-12 / A les?o medular ocasiona manifesta??es incapacitantes permanentes, afetando a integridade anat?mica, mudan?as corporais e limita??es funcionais pertinentes ao estado de defici?ncia. Objetivou-se analisar a trajet?ria de vida dos pescadores com les?o medular v?timas de acidente por mergulho nas praias do litoral Norte/RN. Trata-se de estudo explorat?rio-descritivo, com dados quantitativos, qualitativos e representacional, desenvolvido em col?nias de pescadores de nove praias do litoral Norte/RN, entre outubro de 2013 a agosto de 2014, ap?s a aprova??o do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte/UFRN, parecer n? 431.891/2013, CAAE 20818913.0.0000.5537. A amostra comp?s-se por pescadores acometidos por les?o medular, definida a partir dos crit?rios de inclus?o e de exclus?o dos participantes. Utilizou-se como instrumento de coleta de dados a entrevista semiestruturada. Analisaram-se os dados quantitativos por meio da estat?stica descritiva, apresentando-os em forma de tabelas, quadros e gr?ficos, utilizando o Microsolft Excel. Submeteram-se os dados das entrevistas ao software Analyse Lexicale par Contexte d`um Ensemble de Segments de Texte (ALCESTE) e ? luz da an?lise da Teoria das Representa??es Sociais e Teoria do N?cleo Central. Esclarece-se e apresentam-se os resultados da pesquisa a partir de quatro artigos, seguindo recomenda??es normativas dos peri?dicos: 1. Caracteriza??o dos pescadores artesanais atendidos em hospital naval v?timas de doen?a descompressiva, em an?lise documental. Dos 28 pescadores artesanais estudados, todos eram do sexo masculino, faixa et?ria de 31 a 40 anos (53,6%) e casados (35,7%). A doen?a descompressiva ocorreu prevalentemente no baixo ver?o (75,0%), litoral Norte (96,4%), tendo como principais agravos a parestesia e dor nos membros superiores (67,9%), seguido de les?o medular (57,1%) e ?bitos de 25,0%. 2. Estresse e ansiedade em pescadores artesanais v?timas de les?o medular. Estudo descritivo: Dos 44 participantes, todos eram do sexo masculino, m?dia de idades de 49,6 anos, ensino fundamental (68,2%), casados (77,3%); com sequela de paraplegia (50,0%). A maioria apresentava estresse (75,0%), encontrando-se na fase de quase exaust?o (33,3%), com sintomas prevalentes de ins?nia (95,5%) nas ?ltimas horas; hipertens?o (97,7%) na ?ltima semana e dificuldades sexuais (95,5%) no ?ltimo m?s. 3. Experi?ncias, mem?rias, scripts, representa??es sociais sobre les?o medular para pescadores v?timas de acidentes por mergulho: A an?lise de 10 entrevistas permitiu a constru??o de tr?s categorias: Incapacidade na coordena??o sens?rio-motora da deambula??o; Ressignifica??o da defici?ncia e o sentido da depend?ncia e Autonomia e adapta??o limitante. 4. Representa??es sociais de pescadores artesanais v?timas de les?o medular: repercuss?es na trajet?ria de vida. A an?lise de 31 entrevistas sob a ?tica da compreens?o das Representa??es Sociais da les?o medular permitiu a constru??o de sete categorias: Tratamento: limita??es e expectativas; Les?o Medular: antes e depois; Aposentadoria: uma realidade ainda distante; Defici?ncia: depend?ncia, incapacidade e vulnerabilidade; Supera??o e autonomia; Sentimentos do eu: perdas f?sicas e recome?o; Vida e trabalho: impedimentos, planos e mudan?as. Conclui-se esse estudo com o alcance dos objetivos, cuja tem?tica ? relevante para a sa?de p?blica de homens pescadores. Sugere-se medidas de preven??o, promo??o e recupera??o da sa?de do homem pescador, al?m das condi??es seguras, saud?veis e dignas como compromisso das pol?ticas de sa?de. / Spinal cord injury causes permanent disabling manifestations, affecting the anatomic integrity, bodily changes and functional limitations related to the disability state. It was aimed to analyze the social representation, stress level and experiences of fishermen victims of spinal cord injury caused by diving accident in the Northern beaches of Brazil. It is a descriptive - exploratory study with quantitative, qualitative and representational data developed i n fishermen?s villages in nine beaches of Northern shore/RN, between October 2013 to August 2014, after the approval of the Ethics Committee in Research of the Universidade Federal do Rio Grande do Norte, under the number 431.891/2013, CAAE 20818913.0.0000 .5537. The sample was composed by 44 fishermen with spinal cord injury, defined from inclusion and exclusion criteria of the participants. It was used as instrument to collect the data a semi structured interview. Quantitative data was analyzed by descrip tive statistics, showing the data through table, boxes and graphics by Microsoft Excel. Data from interviews were submitted to the software called Analyse Lexicale par Contexte d?un Ensemble de Segments de Texte (ALCESTE) using the analysis of the Social R epresentation Theory and Center Core Theory. It is shown the outcomes of the research through four articles, following the normative recommendations of the journals. Participants of the study were all male, age mean 49,6 years, elementary school (68,2%), m arried (77,3%); paraplegia sequel (50,0%). Most of them showed stress (75,0%), almost in the exhaustion stage (33,3%), prevalent insomnia symptoms (95,5%) in the last hours; hypertension (97,7%) in the last week and sexual troubles (95,5%) in the last mont h). Decompressive illness caused spinal cord injury (57,1%), occurred prevalently in low summer (75,0%), northern shore (96,4%), having as main consequences the paresthesia and pain in the upper and lower limbs (67,9%), followed by death (25,0%). Interview analysis under the understanding of Social Representation of spinal cord injury allowed the appearance of seven categories: Treatment: limitation and expectative; Spinal Cord injury: before and after; Retirement: reality yet to come; Disability: dependenc y, incapacity, vulnerability; Overcoming and autonomy; Self feelings: physics losses and new start; Life and labor: impediments, plans and changes. The center core of the representation is found in the first category by the expectative and limitation on th e treatment, meanwhile the outskirt elements are in seventh and third categories. Physics limitation for fishing activities and retirement expectative is the most outstanding of the structure. Social representation concerning spinal cord injury is found in a transaction moment between before and after with the prevented fishing activity, coping of the situation with the potential remaining. The anchoring is established in the desire for changes related to the improvements of life and health conditions exper ienced day by day through faith. This study finishes pointing out the range of the objectives, which topic is relevant for public health of fishermen. It is suggested prevention measures, promotion and health recovery of fishermen, besides safe, healthy an d worthy conditions as a compromise of social and health politics.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-02-01T21:54:02Z No. of bitstreams: 1 FranciscoDeSalesClementino_TESE.pdf: 1510623 bytes, checksum: fdf66297c2127011707b0004cc2aa57f (MD5) / Approved for entry into archive by Elisangela Moura (lilaalves@gmail.com) on 2016-03-07T21:04:06Z (GMT) No. of bitstreams: 1 FranciscoDeSalesClementino_TESE.pdf: 1510623 bytes, checksum: fdf66297c2127011707b0004cc2aa57f (MD5) / Made available in DSpace on 2016-03-07T21:04:06Z (GMT). No. of bitstreams: 1 FranciscoDeSalesClementino_TESE.pdf: 1510623 bytes, checksum: fdf66297c2127011707b0004cc2aa57f (MD5) Previous issue date: 2014-12-11 / No Brasil, a Reforma Psiqui?trica organiza-se com base nos pressupostos da Reforma Sanit?ria e da Psiquiatria Democr?tica Italiana com vistas a eliminar o modelo hospitaloc?ntrico. Objetivo: Avaliar a estrutura e o processo de trabalho desenvolvido nos Centros de Aten??o Psicossocial (CAPS), englobando a satisfa??o, o perfil, as condi??es e a sobrecarga de trabalho dos profissionais. Aprovado pela Comiss?o de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte (UFRN), protocolo n? 719.435, de 30/05/2014. M?todos: Estudo descritivo, com abordagem quantitativa, desenvolvido em cinco Centros de Aten??o Psicossocial, a saber: 02 CAPS I, 01 CAPS II, 01 CAPS III e 01 CAPSAD, de Campina Grande-PB. A popula??o do estudo constitui-se de todos os coordenadores dos cinco CAPS, incluindo 42 profissionais de n?vel superior, 71 de n?vel m?dio (t?cnicos e auxiliares de enfermagem, e cuidadores), e os prontu?rios referentes a 2.297 usu?rios atendidos. Para assegurar a representatividade das informa??es, calculou-se uma amostra aleat?ria estratificada com partilha proporcional, considerando-se os seguintes par?metros: erro ? de 5%, n?vel de confian?a de 95%, poder do estudo de 80%, estimativa de propor??o de 10% e o ?ndice de proporcionalidade espec?fico para os profissionais de n?vel (superior e m?dio) e os prontu?rios. Coletou-se os dados atrav?s de question?rios validados, elaborados para o estudo CAPSUL (Avalia??o dos CAPS da Regi?o Sul do Brasil), entre julho e outubro de 2014. Os question?rios foram duplamente digitados e submetidos ? valida??o no sub-programa Validate do Epi Info 3.5.4, utilizado juntamente com o SPSS, 17.0 para o processamento das an?lises estat?sticas. Resultados: A partir da an?lise dos prontu?rios dos usu?rios atendidos nos CAPS, observou-se um predom?nio de mulheres na faixa et?ria adulta. Destacou-se como psicopatologia mais frequente, ? esquizofrenia. Quanto ?s interna??es antes e ap?s o ingresso nos CAPS, registrou-se para o hospital geral 14 interna??es (3,5%) antes e sete (1,7%) depois, diferen?a n?o significante (p=0,612). Ressalta-se que, em hospitais psiqui?tricos, ap?s o ingresso, houve redu??o para o m?ximo de tr?s interna??es. O n?mero total reduziu de 117 (29,1%) para apenas 11 (2,7%); redu??o estatisticamente significante (p=0,002). Quanto ?s formas de contra??o dos profissionais de sa?de, os resultados evidenciam a exist?ncia de contrato tempor?rio. A maior propor??o de insatisfa??o com todos os par?metros avaliados deu-se naqueles profissionais que se consideram sobrecarregados no trabalho. Entretanto, a ?nica diferen?a estatisticamente significante estava relacionada com o ?grau de responsabilidade? (90,9%; p=0,04). Observou-se forte associa??o da insatisfa??o dos profissionais de sa?de com fatores relacionados ao conte?do e ?s condi??es de trabalho no CAPS, relativa ?s medidas de seguran?a, conforto e apar?ncia dos CAPS, contato entre as equipes e usu?rios, e tratamento das fam?lias por parte das equipes. Chama ? aten??o que estes aspectos s?o aqueles que n?o dependem diretamente da atua??o dos profissionais. Conclui-se que o fortalecimento dos CAPS requer e exige um compromisso intersetorial, a partir do n?vel governamental, em garantir os recursos para a operacionaliza??o de suas a??es e assegurar aos usu?rios e ? sua fam?lia a oferta e o acesso aos servi?os de sa?de. / Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program ?Validate Epi Info 3.5.4? , used along with the ?SPSS 17.0? for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; ?Fisher's? exact test to check the CAPS impact on hospital admissions and the ?Bonferroni? adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-02-01T21:54:03Z No. of bitstreams: 1 KalyaneKellyDuarteDeOliveira_TESE.pdf: 4371547 bytes, checksum: 0c56e32ff360130ff50c666f79e48635 (MD5) / Approved for entry into archive by Elisangela Moura (lilaalves@gmail.com) on 2016-03-07T21:33:34Z (GMT) No. of bitstreams: 1 KalyaneKellyDuarteDeOliveira_TESE.pdf: 4371547 bytes, checksum: 0c56e32ff360130ff50c666f79e48635 (MD5) / Made available in DSpace on 2016-03-07T21:33:34Z (GMT). No. of bitstreams: 1 KalyaneKellyDuarteDeOliveira_TESE.pdf: 4371547 bytes, checksum: 0c56e32ff360130ff50c666f79e48635 (MD5) Previous issue date: 2014-12-10 / Este estudo objetivou avaliar a atua??o dos profissionais no atendimento as fam?lias nos Centros de Aten??o Psicosocial (CAPS) do Rio Grande do Norte (RN), a partir dos pap?is e fun??es desempenhados pelos profissionais nestes servi?os. Para isso, apontou-se como objetivos espec?ficos: Descrever o perfil e as atividades desenvolvidas pelas equipes de sa?de mental nos CAPS do RN; Conhecer a opini?o dos profissionais das equipes de sa?de mental quanto ? pol?tica, ?s pr?ticas e ? forma??o em sa?de mental; Verificar a adequabilidade dos papeis e fun??es dos profissionais que atuam nos CAPS do RN em rela??o ao atendimento as fam?lias. Trata-se de um estudo anal?tico, transversal, de abordagem quantitativa e qualitativa. Coletaram-se os dados por meio de question?rio, em 33 CAPS do RN, entre mar?o e outubro de 2014, ap?s a aprova??o pelo Comit? de ?tica em Pesquisa/UFRN, parecer n?217.808, CAAE: 10650612.8.1001.5537, em 1 de mar?o de 2013. Adotou-se a amostra, definida atrav?s de crit?rios de inclus?o e exclus?o, compondo-se de 183 profissionais. A prepara??o do banco de dados seguiu dois passos: 1. Preparo e tratamento dos dados das quest?es fechadas do instrumento de pesquisa relativas ? caracteriza??o e pr?ticas em sa?de mental dos sujeitos da pesquisa por meio do recurso informacional do Statistical Package for the Social Scienses (SPSS) Statistics vers?o 20.0; 2. Para verificar o n?vel de signific?ncia optou-se pela aplica??o do teste Qui-quadrado e o Kruskal Wallis Test. Preparo e tratamento do corpus formado pelas respostas ?s quest?es abertas relativas ?s pol?ticas, pr?ticas e forma??o na psiquiatria por meio do software Analyse Lexicale par Contexte d?un Ensemble de Segments de Texte (ALCESTE) e categorizados conjuntamente pela t?cnica de An?lise de Conte?do. A an?lise de dados apoia-se na literatura pertinente. Explicitaram-se os resultados atrav?s de tr?s artigos que enceram os seguintes resultados: O primeiro artigo, perfil dos participantes, caracterizou-se por predomin?ncia do sexo feminino (76,5%), na faixa et?ria de 40 a 58 anos (61,7%). Trabalham entre 30 e 40 horas semanais (63,5%), com atua??o na sa?de mental h? mais de 10 anos (98,4%). A amostra estudada direciona o atendimento a grupos familiares (65,7%), predominando o atendimento em equipe entre os assistentes sociais, enfermeiros, psic?logos e terapeutas ocupacionais. O m?dico realiza os atendimentos sem intera??o com a equipe (48,6%). Sobre as dificuldades encontradas nos servi?os ordenam-se em: materiais e insumos (75,1%), financeiras (78,5%) e estruturais (66,9%). O segundo artigo encerra dados qualitativos organizados em cinco categorias: Promo??o da reabilita??o dos usu?rios dos CAPS; Necessidades de capacita??es; Conflitos e satisfa??es do trabalho em equipe; Pr?ticas desenvolvidas nos CAPS; Dificuldades de efetiva??o da Pol?tica de Sa?de Mental. O terceiro artigo evidencia a inadequabilidade do atendimento destinado as fam?lias (93,4%) e comparando-se os atendimentos as fam?lias e aos grupos nos CAPS os dois tipos mostram-se inadequados: fam?lia (92,63%), grupos (92,60%). Os principais dados obtidos revelam a necessidade urgente de transforma??o na aten??o psicossocial. Evidencia-se ainda, a import?ncia de investimentos em insumos, estrutura f?sica e na capacita??o de recursos humanos para os CAPS. / This study aimed to evaluate the work of professionals to care for families in Psychosocial Care Centers ( C APS) of Rio Grande do Norte ( RN), from the roles and functions performed by these professional services. For this, it was pointed out the following objectives: To describe the profile and the activities conducted by mental health teams in the RN CAPS ; Know the opinion of professionals in the mental health teams of the poli ti c , practices and training in mental health; Check the suitability of the roles and functions of professionals working in the RN CAPS in relation to care for families . This is an analytic al cross - sectional study of quantitative and qualitative approach . Data were c ollected through a questionnaire in 33 CAPS RN, between March and October 2014 , after being approved by the Research Ethics Committee / UFRN , opinion n?217.808 , CAAE : 10650612.8. 1001.5537 , on March 1 2013. T he sample was adopted , defined by inclusion and exclusion criteria , and is composed of 183 professionals. The database preparation followed two steps: 1. Preparation and processing of data of closed questions of the questionnai re concerning the characterization and practices in mental health research subjects through informational resource Statistical Package for Social Scienses (SPSS) Statistics version 20.0 ; 2. To check the significance level was chosen by applying the chi - squ are test. Preparation and treatment of the corpus formed by the answers to open questions relating to the policies, practices and training in psychiatry through Analyse lexicale pair Contexte software d' un Ensemble of Segments of Texte ( ALCESTE) together a nd categorized by content analysis technique , Bardin (2004) . The data analysis is supported in the literature . It m ade explicit the results through three articles waxing the following results. In the first, participants profile was characterized by a predo minance of females (76.5 %), aged 40 - 58 years ( 61.7 %). They work between 30 and 40 hours per week (63.5 %), working in mental health for over 10 years ( 98.4%). The sample directs the care of family groups ( 65.7%), predominantly the care team of social worke rs, nurses, psychologists and occupational therapists . The doctor performs emergency care without interaction with the staff (48.6%) . On the difficulties encountered in services are ranked in : materials and supplies ( 75.1%), financial ( 78.5%) and structura l ( 66.9%). The second article contains qualitative data organized into five categories : Promoting the rehabilitation of users of CAPS ; Needs training ; Conflicts and satisfactions of teamwork ; Practices developed in CAPS ; Effective difficulties of Mental He alth Policy . The third article highlights the inadequacy of care for families ( 93.4%) and comparing the care families and groups in CAPS both types show to be inadequate : family ( 92.63%), groups ( 92, 60%). The main data obtained reveal the urgent need for transformation in psychosocial care . It shows also the importance of investments in inputs, physical structure and training of human resources for the CAPS.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T19:39:11Z No. of bitstreams: 1 SheniaMariaFelicioFelix_DISSERT.pdf: 1059481 bytes, checksum: 300825f13ac8f9d679f3ce4de4db18ff (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-27T18:15:16Z (GMT) No. of bitstreams: 1 SheniaMariaFelicioFelix_DISSERT.pdf: 1059481 bytes, checksum: 300825f13ac8f9d679f3ce4de4db18ff (MD5) / Made available in DSpace on 2016-06-27T18:15:16Z (GMT). No. of bitstreams: 1 SheniaMariaFelicioFelix_DISSERT.pdf: 1059481 bytes, checksum: 300825f13ac8f9d679f3ce4de4db18ff (MD5) Previous issue date: 2013-12-20 / A Pol?tica Nacional da Aten??o B?sica (PNAB), regulamentada pela portaria N? 2488 de outubro de 2011 reafirma a Estrat?gia de Sa?de da Fam?lia (ESF) como estrat?gia priorit?ria de expans?o, consolida??o e qualifica??o da aten??o b?sica ? sa?de no Brasil; para isso, os munic?pios, com coopera??o dos demais entes federativos, devem reorientar seu processo de trabalho aprofundando os princ?pios, diretrizes e fundamentos da Aten??o B?sica (AB). Al?m da ESF, a nova PNAB disp?e sobre os N?cleos de Apoio ? Sa?de da Fam?lia (NASF), reafirmando seu papel de ampliar o escopo das a??es da aten??o b?sica, e de sua resolutividade, ratificando seu car?ter de compartilhar saberes e de ser apoio junto aos profissionais da AB. Frente a isso, o objetivo deste trabalho ? investigar como o N?cleo de Apoio a Sa?de da Fam?lia - NASF est? estruturado em Jo?o Pessoa e quais as a??es por ele desenvolvidas no ?mbito da Sa?de Mental, e tem como objetivos espec?ficos: analisar as pr?ticas desenvolvidas pelos profissionais de Sa?de Mental que comp?em as equipes NASF e se elas se diferenciam das realizadas pelos demais membros das equipes; discutir a articula??o do NASF na operacionaliza??o das a??es em sa?de mental, no que se refere a sua organiza??o interna e na rede de sa?de municipal; e identificar as estrat?gias utilizadas para organiza??o das a??es em sa?de mental na Aten??o B?sica. Para o alcance dos objetivos, foram realizadas entrevistas individuais com duas gestoras municipais e quatro trabalhadoras do NASF que participavam do colegiado de sa?de mental como representantes dos seus distritos sanit?rios, al?m disso, foi realizado um grupo focal com diferentes apoiadores NASF, contemplando a diversidade de categorias profissionais que trabalham nas equipes e nos diferentes distritos sanit?rios. Foi poss?vel identificar no NASF em Jo?o Pessoa, uma organiza??o pautada pelo apoio matricial na qual as demandas da gest?o e do cuidado assistencial refletem um conjunto de pr?ticas desenvolvidas junto ?s ESF. Dentre as a??es realizadas pelo NASF, e no ?mbito da sa?de mental, destaca-se o matriciamento, as visitas domiciliares e o Projeto Terap?utico Singular; essas atividades foram descritas e dialogadas no grupo focal e faz parte do cotidiano de trabalho de todos dos apoiadores do NASF, independente de sua categoria profissional. Com vistas ao fortalecimento da AB frente ? amplia??o das a??es das equipes de sa?de da fam?lia, o NASF se apresenta como uma potente estrat?gia de qualifica??o e apoio no SUS. / The National Police for Basic Care (PNAB), regulated by ordinance n?2488 from October 2011, restates the Family Health Strategy (ESF) as a priority to the expansion, consolidation and qualification of basic attention to health matters in Brazil. In order to bring it about, city counsellors along with other federal entities ought to ordinate their work process deepening principals, directions and fundaments of Basic Care (AB). Besides ESF, the new PNAB expatiates on the Family Health Support Centres (NASF), reaffirming their role on broadening the scope of basic care actions and their improvements, ratifying their ability to share knowledge and support Basic Care professionals. All this considered, the purpose of this work is to investigate how NASF is currently structured in Jo?o Pessoa and what has been achieved by it on what concerns to mental health. Its main objectives are to analyse the practices of mental health professionals that are part of NASF teams and if they differ from what has been developed by the other members of the teams; to discuss the articulation of NASF in managing mental health measures on what concerns to internal organisatio n and to the city health network; to identify strategies used to organise such measures on mental health in Basic Care. To reach such goals, individual interviews have taken place two city health managers and four of NASF professionals that participated on the Mental Health Office as representatives of their sanitary districts. Also a focal group formed by various supporters of NASF was created, contemplating the diversity of professional categories involved with the teams and sanitary districts. It was possible to identify in NASF, in Jo?o Pessoa, an organisation based by the matrix support in which both management and basic care demands reflect a series of actions developed alongside with ESF. Amongst such actions, matrixing, home visits and the Singular Therapeutic Project (PTS) stand out. These activities have been discussed on the focal group and integrate the daily work of all NASF supporters despite their professional categories. NASF presents itself as a powerful strategy to SUS proper qualification and support to strengthen Basic Care and broaden family health teams?actions.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:17:22Z No. of bitstreams: 1 SimoneReginaDeCarvalho_DISSERT.pdf: 2186853 bytes, checksum: 826bb3bb54b140e9bbf4a4bd298cdfcb (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T20:46:25Z (GMT) No. of bitstreams: 1 SimoneReginaDeCarvalho_DISSERT.pdf: 2186853 bytes, checksum: 826bb3bb54b140e9bbf4a4bd298cdfcb (MD5) / Made available in DSpace on 2016-06-28T20:46:25Z (GMT). No. of bitstreams: 1 SimoneReginaDeCarvalho_DISSERT.pdf: 2186853 bytes, checksum: 826bb3bb54b140e9bbf4a4bd298cdfcb (MD5) Previous issue date: 2015-11-16 / O estudo tem por objetivo analisar o efeito do topiramato sobre o craving em usu?rios de crack. Trata-se de um ensaio cl?nico aberto tipo crossover envolvendo usu?rios do Centro de Aten??o Psicossocial ?lcool e drogas (CAPSad) do munic?pio de Parnamirim/RN, aprovado pelo CEP CAAE: 38710614.1.0000.5537, respeitada a Resolu??o N? 466/2012/CNS. O estudo resultou em dois artigos cient?ficos, um ensaio te?rico e uma revis?o integrativa. No ensaio te?rico de Hinds, Chaves e Cypress, os contextos enfocam desde a problem?tica do uso individual ?s pol?ticas de enfrentamento deste consumo no Brasil, ressaltando que a situa??o de complexidade do fen?meno requerendo estrat?gias de enfrentamento a partir da aten??o integral ao usu?rio, fam?lia e sociedade. A revis?o integrativa captura, dentre os 902 registros trilingui recuperados, oito estudos apresentaram esquemas terap?uticos com efeitos positivos para o craving da coca?na, a partir do uso de nove drogas diferentes. N?o houveram resultados para o craving do crack. Os resultados da amostra do presente estudo foi composta predominantemente por usu?rios do sexo masculino, adultos e solteiros, totalizando 30 sujeitos que atenderam aos crit?rios de inclus?o: adultos, idade a partir de 18 anos, diagn?stico do Manual Diagn?stico e Estat?stico de Transtornos Mentais (DSM-IV) para coca?na/crack; capacidade cognitiva preservada; assiduidade ao servi?o, participar de, no m?nimo, tr?s consultas nos 12 meses anteriores ? coleta dos dados; e aceitar o acompanhamento ao tratamento proposto. Os dados foram coletados no per?odo de dezembro de 2014 a julho de 2015 e analisados por meio de estat?stica descritiva com o suporte do Statistical Package for Social Science (SPSS), atrav?s dos instrumentos: 1) Alcoohol, Smoking, and Substance Involvement Screening Test (ASSIST), aponta, entre outros resultados, que apenas 14% fizeram uso do crack/coca?na semanalmente durante o tratamento, enquanto 83% passaram a fazer uso diariamente ou semanalmente ap?s o per?odo de washout; 2) Escala de Impulsividade de Barratt, com uma m?dia de 80,23 e 77,47 com e sem o tratamento medicamentoso, respectivamente. Uma an?lise a partir do teste t de Student mostram que n?o h? diferen?a significativa na impulsividade com ou sem o uso do medicamento; e 3) Cocaine Craving Questionnaire-Brief (CCQ-Brief), indicando que o n?mero de usu?rios com n?vel de intensidade do craving ? expressivamente maior sem o tratamento medicamentoso (86%) do que com o tratamento (33%). A an?lise entre o craving e a grau de impulsividade mostram que h? uma baixa correla??o (Pearson) entre essas duas vari?veis com medicamento (0,282986) e sem (0,154614), demonstrando que a impulsividade tem baixainflu?ncia sobre o resultado do tratamento medicamentoso. Conclui-se que o topiramato produz efeito positivo para redu??o do craving em usu?rios de crack e que o seu uso constitui estrat?gia relevante para a efic?cia no tratamento de usu?rios de crack. / The study aims to analyze the effects of topiramato on the craving of crack users. It is an open crossover clinical trial involving users from the Psychosocial Care Center for Alcohol and Drugs (CAPSad) in city of Parnamirim, RN, approved by the CEP CAAE: 38710614.1.0000.5537, respecting the norms of the resolution n. 466/2012/CNS. The study produced preliminary two scientific papers: a theoretical essay and an integrative review, as a way of seeking the state of art. The first paper was based in the theoretical framework of Hinds, Chaves and Cypress, which focuses different contexts, from the issues of individual use to the coping policies in Brazil, highlighting that the situation and the complexity of the phenome requires coping strategies for the full attention to the user, family and society. As a result of the integrative review, among the 902 retrieved records, eight of them presented therapeutic schemes with positive effects for the craving of cocaine. They used nine different drugs. It is important to spot out that there was no result for the craving of crack. The data collection was conducted from December 2014 to July 2015 and has as sample predominantly single males. The sample was composed of 30 subjects who met the inclusion criteria: adults, age from 18 years, diagnosis of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for cocaine/crack; cognitive capacity preserved; attendance to the service, participated at least three visits in the 12 months prior to data collection; and accepted to be monitored in the proposed treatment. Data was analyzed using descriptive statistics from the Statistical Package of Support for Social Sciences (SPSS) on the instruments: 1) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), pointing out, among other results, that only 14% used crack/cocaine weekly during treatment, while 83% used daily or weekly after the washout period; 2) Barratt Impulsiveness Scale, with an average of 80.23 and 77.47 with and without drug treatment, respectively. An analysis from the Student t test show no significant differences in impulsivity with or without the drug; and 3) Cocaine-Craving Questionnaire-Brief (CCK-B), indicating that the number of users with craving intensity level is significantly higher without drug treatment (86%) than with treatment (33%). The analysis between craving and level of impulsivity showed that there is a low correlation (Pearson) between these two variables during treatment and after the washout, demonstrating that impulsivity has low influence on the outcome of drug therapy. As conclusion, it was noted that the topiramate produces positive effect on reducing the craving for crack users and their use is a relevant strategy for efficacy in the treatment of crack users.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-08T20:36:43Z No. of bitstreams: 1 MauricioCiriloDaCostaNeto_DISSERT.pdf: 2292457 bytes, checksum: 86e692523220efb4495247b7548e98f4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-07-11T19:08:47Z (GMT) No. of bitstreams: 1 MauricioCiriloDaCostaNeto_DISSERT.pdf: 2292457 bytes, checksum: 86e692523220efb4495247b7548e98f4 (MD5) / Made available in DSpace on 2016-07-11T19:08:47Z (GMT). No. of bitstreams: 1 MauricioCiriloDaCostaNeto_DISSERT.pdf: 2292457 bytes, checksum: 86e692523220efb4495247b7548e98f4 (MD5) Previous issue date: 2016-02-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Moradores de assentamentos de reforma agr?ria t?m uma vida marcada por condi??es de vida e trabalho prec?rias, que aliadas ?s barreiras no acesso ?s pol?ticas e programas de sa?de e assist?ncia social, agravam as situa??es de vulnerabilidade psicossocial e ambiental que impactam na sa?de mental. Essa pesquisa objetiva caracterizar as ofertas de cuidado desenvolvidas pelas equipes de sa?de e assist?ncia social referente ?s demandas de transtornos mentais comuns e uso problem?tico de ?lcool de moradores de 9 assentamentos do Rio Grande do Norte. Foram entrevistados 53 profissionais de forma individual ou em grupo de diferentes categorias profissionais. Resultados indicam que os trabalhadores vivenciam condi??es prec?rias de trabalho, tra?os da heran?a patrimonial e assistencialista que ainda persiste no campo das pol?ticas sociais brasileiras e em especial nas gest?es locais no interior do pa?s. As equipes t?m pouco conhecimento do territ?rio e das necessidades de sa?de mental, o que impacta no acolhimento e cuidado ofertado. O cuidado implementado ainda corresponde ? l?gica biom?dica, caracterizada pelo etnocentrismo, tecnicismo, biologicismo, curativismo, individualismo e especialismo, com pouca participa??o dos moradores e desconsidera??o dos saberes e pr?ticas de cuidado tradicionais, n?o alcan?ando a resolutividade esperada. A aten??o psicossocial n?o funciona de forma articulada apresentando problemas quanto ao seguimento e continuidade de cuidados. O cuidado psicossocial em sa?de mental em contextos rurais tem como desafios a serem enfrentados a reorganiza??o das redes de aten??o, o estabelecimento de cuidados prim?rios pr?ximos do cotidiano das popula??es, a constru??o de pr?ticas intersetoriais tendo em vista a multidetermina??o da sa?de, e a educa??o em sa?de conectada com estes contextos espec?ficos. Em fun??o do desconhecimento das especificidades da popula??o assentada e da fragmenta??o da rede de aten??o psicossocial, essas equipes n?o conseguem acolher e responder ?s necessidades em sa?de mental de modo a interferir nas iniquidades em sa?de. / Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people?s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-13T14:15:29Z No. of bitstreams: 1 EricoGurgelAmorim_DISSERT.pdf: 1036507 bytes, checksum: 76703b25fa3210d3c77c667f6c23d32e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-26T12:00:56Z (GMT) No. of bitstreams: 1 EricoGurgelAmorim_DISSERT.pdf: 1036507 bytes, checksum: 76703b25fa3210d3c77c667f6c23d32e (MD5) / Made available in DSpace on 2017-01-26T12:00:56Z (GMT). No. of bitstreams: 1 EricoGurgelAmorim_DISSERT.pdf: 1036507 bytes, checksum: 76703b25fa3210d3c77c667f6c23d32e (MD5) Previous issue date: 2016-02-17 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / O movimento em favor da inclus?o de pessoas com defici?ncia, vivenciado atualmente, caracteriza um novo olhar sobre as possibilidades de vida outrora invisibilizadas. Entretanto, sobressai neste cen?rio um contexto lesivo, no tocante ao comprometimento da sa?de mental, no conv?vio com um d?ficit nas fun??es sensoriais, notadamente, na defici?ncia visual. Esta realidade infringe no sujeito sofrimento ps?quico e priva??o social, mutilando suas perspectivas de realiza??o pessoal, abarcadas em uma conjuntura micro e macrossocial em constante intera??o. Nesse sentido, na presente pesquisa objetivamos analisar a contribui??o dos determinantes sociais de sa?de no cotidiano de sujeitos com defici?ncia visual, com ?nfase na sa?de mental, identificando as dificuldades percebidas e as estrat?gias de enfrentamento utilizadas em rela??o ?s adversidades cotidianas. Trata-se, portanto, de uma pesquisa descritiva e explorat?ria com abordagem qualitativa. Para a coleta de dados, realizamos entrevistas semiestruturadas junto aos sujeitos deficientes visuais no ambulat?rio de oftalmologia do Hospital Universit?rio Onofre Lopes (HUOL), no per?odo de agosto a setembro de 2015. Os dados foram tratados ? luz do m?todo de an?lise tem?tica descrito por Minayo (2008); e os conte?dos das unidades de registro elencadas, inspirados no modelo de Determina??o social da sa?de, proposto por Dahlgren e Whitehead (1991). Assim sendo, organizamos as seguintes categorias tem?ticas: sa?de e sofrimento ps?quico no encontro com o n?o ver e seus modos de andar a vida; a autonomia e seus desafios cotidianos; intera??o social e suas redes de pertencimento; os valores e a cultura no processo de normaliza??o e estigmatiza??o; a educa??o, seus limites e possibilidades; e o trabalho nos contextos de exclus?o e inclus?o social vivenciados. A reflex?o das informa??es analisadas suscita discuss?es a respeito da persist?ncia de fatores sociais adversos ao processo de inclus?o plena e efetiva, geradores de atitudes normalizadoras. Destarte, a pesquisa revela desafios ?s inst?ncias gestoras e a toda a sociedade, no sentido de promover a aten??o ?s demandas da participa??o social e o respeito ?s diferen?as, a fim de concretizar o princ?pio da dignidade da pessoa humana, corol?rio da diversidade social, refletida nos modos de andar a vida, pr?prios de cada um. / The movement in favor of the inclusion of people with disabilities experienced nowadays features a new look at the possibilities of life once made invisible. However, stands out in this setting one harmful context that regards to mental health endanger about living with a deficit in sensorial functions, especially the visually impaired. This situation breaches to the person psychical suffering and social deprivation, mangling their prospects for personal fulfillment, embraced, on a micro and macro-environment, constant interaction. In this sense, this research aims to analyze the contribution of social determinants of health in the daily lives of individuals with visual impairment, emphasizing an emphasis on mental health, identifying the difficulties perceived and coping strategies used in relation to their daily hardships. It is a descriptive and exploratory research that deals with a qualitative approach. To collect data, semi-structured interviews were guided with the visually handicapped people in the Ophthalmology Clinic of the University Hospital Onofre Lopes (HUOL), between August and September 2015. The data were analyzed in the perspective of the thematic analysis method described by Minayo (2008). The matter of the chosen registration units have been inspired by the social health determination model, proposed by Dahlgren and Whitehead (1991). Thus, the following themes were organized: health and psychological suffering in the encounter with the action of ?no-see? in ways of living life; Autonomy and their daily challenges; Social interaction and their belonging networks; Values and culture in the standardization and stigmatization process; Education, its limits and possibilities; The work in contexts of experienced exclusion and social inclusion actions. The reflection of the information analyzed raises discussions about the persistence of adverse social factors to the full and effective inclusion process of normalizing attitudes generators. Therefore, the research reveals challenges to the management levels and to the whole society, to promote attention to the demands of social participation and respect for differences, in order to implement the principle of human dignity, a corollary of social diversity, reflected in ways of living life, proper to each one.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-02T14:33:25Z No. of bitstreams: 1 DanielleLorenCosta_DISSERT.pdf: 2734236 bytes, checksum: 355977e38196f1658804cb9d453b575e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-02-09T16:30:12Z (GMT) No. of bitstreams: 1 DanielleLorenCosta_DISSERT.pdf: 2734236 bytes, checksum: 355977e38196f1658804cb9d453b575e (MD5) / Made available in DSpace on 2017-02-09T16:30:12Z (GMT). No. of bitstreams: 1 DanielleLorenCosta_DISSERT.pdf: 2734236 bytes, checksum: 355977e38196f1658804cb9d453b575e (MD5) Previous issue date: 2016-08-26 / A sa?de mental e o trabalho t?m sido temas de grande relev?ncia em estudos e pesquisas, uma vez que o adoecimento mental do trabalhador est? cada vez mais presente no cotidiano laboral, gera afastamentos por longos per?odos, e causa preju?zos tanto para o empregador, quanto para o pr?prio trabalhador e a sua rede de rela??es. A doc?ncia ? considerada uma profiss?o com risco f?sico e mental, e que merece uma aten??o especial voltada ? sa?de desses profissionais. Ent?o, pretendese com esse estudo analisar a rela??o entre o trabalho e a sa?de mental de docentes de uma institui??o p?blica federal de ensino superior. Trata-se de um estudo de car?ter descritivo explorat?rio com abordagem qualitativa, que foi dividido em duas fases. Na primeira fase, foi realizada uma pesquisa documental com o levantamento dos afastamentos por licen?a para tratamento da pr?pria sa?de dos servidores da UFRN, por CID F (Transtornos Mentais e Comportamentais) no per?odo de 2010-2014, atrav?s de relat?rio gerencial obtido do Sistema da Administra??o P?blica Federal (SIAPE SA?DE). Na segunda fase do estudo, foi realizada uma pesquisa de campo, junto aos docentes, atrav?s de uma entrevista semiestruturada com quest?es norteadoras acerca de prazer e sofrimento no trabalho. Para a an?lise das entrevistas, foi utilizada a t?cnica de an?lise de conte?do, do tipo an?lise tem?tica, proposta por Minayo (2013), e a teoria da Psicodin?mica do Trabalho segundo Dejours (1992), como referencial te?rico. O per?odo de coleta de dados compreendeu entre novembro/2015 a junho/2016. Os resultados da primeira fase demonstraram que os transtornos mentais e comportamentais t?m ocupado os primeiros lugares das causas de afastamento do trabalho por motivo de sa?de dos servidores da UFRN (t?cnicosadministrativos e docentes), e chegou a ser em 2014, 25% das ocorr?ncias de licen?a para tratamento da sa?de. Os diagn?sticos mais frequentes nos afastamentos foram o transtorno misto ansioso e depressivo (F 41.2), o epis?dio depressivo grave sem sintomas psic?ticos (F 32.2) e o transtorno depressivo recorrente, epis?dio atual grave sem sintomas psic?ticos (F 33.2). Quanto ? segunda fase, foram extra?das duas categorias de an?lise: o sofrimento e o prazer no trabalho docente, com tr?s subcategorias correspondentes a cada uma, quais foram: Produtivismo acad?mico ? ?Publicar ou perecer?; Professor: um ser onipresente?; Desgastes nas rela??es de trabalho; O encanto da sala de aula; O reconhecimento e Viv?ncias que promovem qualidade de vida no trabalho. Diante dos resultados, pode ser percebido que os docentes, apesar do sofrimento vivenciado no trabalho, das condi??es de desconforto, de mal-estar, por vezes culminando at? em adoecimento, reconhecem o seu trabalho como estimulante, como uma mola propulsora, que d? sentido ? sua exist?ncia, e que o simples fato do ser professor e do exerc?cio da doc?ncia puderam ser considerados por eles, como promotores do prazer e da qualidade de vida no trabalho. / Mental health and work have been issues of great relevance in studies and research, since the mental illness of the worker is increasingly present in the everyday life of work, entails withdrawals for long periods and provokes losses to both the employer and to the worker itself and its network of relationships. The teaching practice is regarded as a profession with mental and physical risk and therefore deserves a special attention geared towards the health of these professionals. Accordingly, this study is intended to analyze the relationship between the work and the mental health of teachers of a federal public institution of higher education. It is an exploratory and descriptive study, with a qualitative approach, which was divided into two stages. In the first stage, we performed a documentary research with the survey of withdrawals due to leave for health treatment in the UFRN servants, by ICD-F (mental and behavioral disorders), between 2010 and 2014, through a management report obtained from the Federal Public Administration System (SIAPE-SA?DE, as per its acronym in Portuguese). In the second stage of this study, we performed a field research with the teachers, through a semi-structured interview with guiding questions about pleasure and suffering at work. In order to analyze the interviews, we used the content analysis technique, in its thematic analysis modality, proposed by Minayo (2013), and the theory of Psychodynamics of Work, according to Dejours (1992), as theoretical benchmarks. The data collection period encompassed between November/2015 and June/2016. The results of the first stage showed that mental and behavioral disorders have filled the first places of causes for withdrawing the work because of health reasons in UFRN servants (technical-administrative and teaching staff), and even reached, in 2014, 25% of occurrences of leave for health treatment. The most frequent diagnoses in the withdrawals were the mixed anxiety and depressive disorder (F 41.2), the severe depressive episode without psychotic symptoms (F 32.2) and the recurrent depressive disorder, current episode severe without psychotic symptoms (F 33.2). Regarding the second stage, we extracted two of analytical categories: suffering and pleasure in the teaching work, with three subcategories corresponding to each, namely: Academic productivism ? ?Publishing or perishing?; Teacher: is it an omnipresent being?; Wear in work relationships; The enchantment of the classroom; The recognition and Experiences that promote quality of life in the work place. Faced with the results, one can realize that teachers, despite the suffering experienced at work, the uncomfortable conditions, malaise, which occasionally even culminates in illness, recognize their work as a stimulant, as a propelling force, that gives their existence a meaning, and that the simple fact of being a teacher and the exercise of teaching could be considered by them as promoters of pleasure and quality of life in the work place.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T19:09:35Z No. of bitstreams: 1 IsabellyMarquesSouzaDeFranca_DISSERT.pdf: 1520354 bytes, checksum: 1d31be89300a2c417413b3d87b902fcd (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-21T19:12:42Z (GMT) No. of bitstreams: 1 IsabellyMarquesSouzaDeFranca_DISSERT.pdf: 1520354 bytes, checksum: 1d31be89300a2c417413b3d87b902fcd (MD5) / Made available in DSpace on 2017-03-21T19:12:42Z (GMT). No. of bitstreams: 1 IsabellyMarquesSouzaDeFranca_DISSERT.pdf: 1520354 bytes, checksum: 1d31be89300a2c417413b3d87b902fcd (MD5) Previous issue date: 2016-07-28 / O presente trabalho de pesquisa voltou-se para a descri??o e aprofundamento dos aspectos mais relevantes relacionados ? sa?de mental, sofrimento ps?quico e atividade de trabalho no ?mbito do servi?o p?blico federal brasileiro, mais especificamente com os servidores t?cnico-administrativos de institui??es federais de ensino superior. Participantes de universidade federal da regi?o nordeste representaram a categoria pesquisada. O pressuposto te?rico aqui compartilhado enfatizou a centralidade do trabalho para a constru??o da identidade psicossocial do indiv?duo, e, em decorr?ncia para sua subjetividade, sa?de e adoecimento f?sico e psicol?gico. Dados anteriores indicam que as doen?as mentais e o sofrimento ps?quico t?m especial relev?ncia como fatores incapacitantes para o trabalho. Transtornos mentais e comportamentais aparecem como respons?veis pelas principais causas para as faltas de servidores ao trabalho nos ?rg?os p?blicos brasileiros, o que correspondente a 60% dos motivos de afastamento. Nesse contexto de problematiza??o, a presente pesquisa realizou an?lises descritiva e cl?nico-interpretativa da atividade laboral de servidores p?blicos da Universidade Federal do Rio Grande do Norte, que apresentaram hist?rico de queixa de adoecimento ps?quico relacionado ao seu contexto laboral. Essa an?lise comportou dois estudos: o primeiro de car?ter descritivo-quantitativo e o segundo, cl?nico-qualitativo. Os resultados corroboraram os dados epidemiol?gicos de estudos anteriores quanto ? alta preval?ncia dos transtornos mentais e comportamentais (TMC) dentre as principais causas de afastamentos do trabalho dos servidores. Na institui??o pesquisada, os TMC representam o segundo lugar dentre as ocorr?ncias de Licen?a para Tratamento da pr?pria Sa?de, concedidas aos servidores entre os anos de 2012 a 2014. Por sua vez, a an?lise cl?nica qualitativa assinalou a potencialidade metodol?gica da cl?nica da atividade em contextos de sofrimento e/ou adoecimento ps?quico no trabalho, ao proporcionar um suporte terap?utico aos participantes e auxiliar na explica??o dos dados quantitativos. / This research work aimed to describe relevant aspects concerning mental health, psychological suffering and labor activity in the context of technical workers engaged in a Brazilian public federal university service. The main theoretical principle framing the present research established the centrality of working activity in building psychosocial identity of the individual, together with his/her subjectivity, health and both psychological and somatic illnesses. Previous research data indicate that mental illnesses and psychological suffering are among the most important aspects concerning suspension of working activity in Brazilian public service. Mental and behavioral conditions appear as disturbances justifying absence and medical license in Brazilian public service, corresponding to 60% of all mentioned causes of absence due to illnesses. In this context, the presented research performed both quantitative-descriptive and clinical-qualitative analysis of labor activity of public servants from Universidade Federal do Rio Grande do Norte, having received formal working license due to medical reasons as registered by specific medical control service. These analysis corroborate previous epidemiological available data concerning elevated prevalence of mental and behavioral disturbances (TMC) among the whole list f medical licenses of work activity at local public service. TMC appeared as second-place more frequently mentioned justification for Health Care Treatment License in the period from 2012 to 2014. Clinical qualitative analysis, on the other hand, showed the potential of Clinic of Activity approach in order to both help explaining quantitative data and provide therapeutic support.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-20T22:18:32Z No. of bitstreams: 1 YannaGomesDeSousa_DISSERT.pdf: 2198254 bytes, checksum: 4aee3f51410300eecc737623ec339b57 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-23T22:53:20Z (GMT) No. of bitstreams: 1 YannaGomesDeSousa_DISSERT.pdf: 2198254 bytes, checksum: 4aee3f51410300eecc737623ec339b57 (MD5) / Made available in DSpace on 2017-03-23T22:53:20Z (GMT). No. of bitstreams: 1 YannaGomesDeSousa_DISSERT.pdf: 2198254 bytes, checksum: 4aee3f51410300eecc737623ec339b57 (MD5) Previous issue date: 2016-12-02 / Objetivou-se analisar os fatores que contribuem para gera??o das cargas ps?quicas de trabalho e sobrecarga ocupacional dos profissionais de enfermagem inseridos nos CAPS III. Trata-se de estudo explorat?rio e descritivo com abordagem quantitativa. A coleta de dados ocorreu no per?odo compreendido entre os meses de agosto e setembro de 2016, utilizando-se dois instrumentos espec?ficos: (1) Roteiro de entrevista semiestruturada, gravada em dispositivo MP4, que objetivou identificar sentimentos de prazer e sofrimento vivenciados no ambiente de trabalho, as cargas ps?quicas e as estrat?gias defensivas para enfrentamento do sofrimento no trabalho e (2) Escala de Avalia??o do Impacto do Trabalho em Servi?os de Sa?de Mental - IMPACTO-BR com o intuito de avaliar a sobrecarga ocupacional. Entrevistou-se 46 profissionais de enfermagem atuantes nos CAPS III dos munic?pios de Campina Grande e Jo?o Pessoa. O tratamento e an?lise das falas foram realizados por interm?dio do software Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires (IRAMUTEQ) que realiza a an?lise lexical por CDH. J? os dados da Escala IMPACTO-BR foram organizados e armazenados em um banco de dados constru?do no programa Statistical Package for Social Science (SPSS), vers?o 20.0. Para a an?lise descritiva das subescalas do impacto BR foi realizado o teste de an?lise de vari?ncia (ANOVA) e para compara??o entre as subescalas e as vari?veis sociodemogr?ficas dos participantes aplicou-se o Teste t de Student. Para todos os testes estat?sticos, utilizou-se o n?vel de signific?ncia de 5%. Este estudo obteve licenciamento pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte ? UFRN de acordo com o CAAE: 57947916.4.0000.5537, parecer n? 1.675.537. Dos 46 entrevistados, 80,4% eram do sexo feminino, com faixa et?ria de 25-35 anos, correspondendo a 39,1% dos trabalhadores, a maioria era casada (41,3%). Em rela??o ? categoria profissional, 58,7% corresponderam aos t?cnicos de enfermagem e 41,3% ? categoria de enfermeiros. Quanto ao tempo de atua??o nos CAPS III, 67,3% atuam no per?odo entre 1 e 5 anos e 54,3% apresentam regime de trabalho de 30 horas semanais. Da an?lise lexical por CDH do IRAMUTEQ foram desveladas quatro dendogramas com os seguintes temas: o prazer no ambiente de trabalho; o sofrimento no ambiente laboral; as cargas ps?quicas e as estrat?gias defensivas utilizadas pelos profissionais de enfermagem. Os sentimentos de prazer foram identificados como atuar na ?rea de enfermagem em sa?de mental, o resultado do tratamento implementado, o significado do trabalho e o cuidado de enfermagem. O sofrimento relacionou-se ?s condi??es de trabalho, ? precariedade de recursos materiais e financeiros, ? falta de recursos humanos, ? fragilidade na rede de sa?de mental e ? pr?pria natureza do trabalho. As cargas ps?quicas est?o relacionadas ao ritmo de trabalho, estrutura f?sica, trabalho feminino, ao trabalho com usu?rio em sofrimento mental, ? falta de apoio da gest?o, equipe multidisciplinar insuficiente e ? falta de supervis?o cl?nica. As estrat?gias defensivas utilizadas pelos profissionais de enfermagem foram: realizar atividades f?sicas; relacionamento interpessoal; realiza??o de atividade de lazer; uso de psicof?rmacos; buscar apoio na religi?o; e distanciamento cr?tico. Entretanto, o h?bito de fazer uso de psicof?rmacos foi identificado como prejudicial ? sa?de dos profissionais. Da Escala IMPACTO-BR foi registrado escore m?dio global de 2,81 ? 0,67, o que resulta em moderado impacto para o trabalho. A subescala que contribuiu com o maior n?vel de impacto do trabalho foi a referente ?s repercuss?es emocionais do trabalho com 3,00 ? 0,77. Os dados obtidos demonstraram que o mais alto n?vel de impacto foi relacionado ?s repercuss?es emocionais do trabalho. A compara??o das subescalas com as vari?veis demogr?ficas apresentaram evid?ncia de diferen?a estat?stica entre as repercuss?es emocionais do trabalho (3,11 ? 0,67) e sa?de f?sica e mental (2,66 ? 0,77) com o sexo. O sexo feminino foi o que apresentou grau elevado de sobrecarga para o trabalho. Observou-se correla??o negativa nos resultados de sobrecarga ocupacional, com isso conclui-se que h? necessidade de realiza??o de avalia??es cont?nuas e regulares dos servi?os pesquisados a fim de monitorar a sobrecarga de trabalho com intuito de promover qualidade de vida aos profissionais de enfermagem e um melhor atendimento aos usu?rios. Espera-se que os resultados encontrados nesta pesquisa contribuam diretamente para produ??o cient?fica na ?rea de Enfermagem e Sa?de do Trabalhador. / This study aimed to analyze the factors that contribute to generation of psychic workloads and work overload of nurses inserted in CAPS III. It is an exploratory and descriptive study with a quantitative approach. Data collection occurred in the period between August and September 2016, using two specific instruments: (1) semi-structured interview map, recorded in MP4 device that aimed to identify feelings of pleasure and experienced suffering in the workplace the psychic loads and defensive strategies for suffering of coping at work and (2) labor Impact Assessment Scale Mental Health Services - IMPACT-BR in order to evaluate the work overload. We interviewed 46 nursing professionals active in CAPS III of the municipalities of Campina Grande and Joao Pessoa. The treatment and analysis of the speeches was carried out via the R interface software Analyses pour Multidimensionnelles of Textes et Questionneires (IRAMUTEQ) that performs the lexical analysis for CDH. Already the data Scale IMPACT-BR were organized and stored in a database built in the Statistical Package for Social Sciences (SPSS) version 20.0. For the descriptive analysis of the subscales of BR impact it was carried out the analysis of variance (ANOVA) and comparison between the subscales and the socio-demographic variables of the participants applied the Student t test. For all statistical tests were used as 5% significance level. This study was licensing by the Ethics Committee of the Federal University of Rio Grande do Norte - UFRN according to CAAE: 57947916.4.0000.5537, opinion No. 1,675,537. Of the 46 respondents, 80.4% were female, aged 25-35 years representing 39.1% of workers, a majority of 41.3% married. Regarding the professional category 58.7% corresponded to nursing technicians and 41.3% to the category of nurses. The time of work in CAPS III 67.3% work in the period between 1 and 5 years and 54.3% have working arrangements 30 hours per week. Lexical analysis HRC IRAMUTEQ were unveiled four dendograms with the following themes: the pleasure in the work environment; suffering in the work environment; psychic loads and defensive strategies used by nursing professionals. The feelings of pleasure were identified as: work in nursing in mental health, the result of implemented treatment, the meaning of work and nursing care. Suffering related to working conditions, the precariousness of material and financial resources, lack of human resources, the weakness in the mental health system and the very nature of work. Psychic charges are related to the pace of work, physical structure, women's work, work with user mental suffering, lack of management support, insufficient multidisciplinary team and the lack of clinical supervision. Defensive strategies used by nursing professionals were performing physical activities, interpersonal relationships, development of leisure activity, use of psychotropic drugs, seek support in religion and critical distance. However, the habit of making use of psychiatric drugs has been identified as harmful to health professionals. Scale IMPACT-BR was recorded global mean score of 2.81 ? 0.67 which results in moderate impact to the work. The subscale which contributed the highest level of impact of the work was related to the emotional impact of working with 3.00 ? 0.77. The data obtained demonstrated that the highest level of impact was related to the emotional impact of the work. Comparison of the subscales with demographic variables showed evidence of statistical difference between the emotional impact of working 3.11 ? 0.67, and physical and mental health 2.66 ? 0.77 with females which showed higher high degree to work overload. There was a negative correlation in the results of work overload, it concludes by the need to conduct continuous and regular evaluations of the services surveyed in order to monitor the workload in order to promote quality of life of nursing professionals and better calls to users. It is expected that the results found in this research contribute directly to scientific production for the nursing field and Occupational Health because it causes a reflection on the effects that work can trigger health professional and consistent quality of care provided.