Made available in DSpace on 2014-12-17T14:46:38Z (GMT). No. of bitstreams: 1 IldoneFM.pdf: 388086 bytes, checksum: c062baf398bccd2e553102291f1ac5dc (MD5) Previous issue date: 2008-11-27 / The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caic?, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors / O presente estudo tem como objetivo analisar, na vis?o de enfermeiros, as mudan?as no processo de produ??o dos servi?os de sa?de, ap?s a implanta??o do Programa Sa?de da Fam?lia (PSF). Trata-se de uma investiga??o de natureza qualitativa, que utiliza entrevistas semi-estruturadas como principal ferramenta de abordagem emp?rica. Foram entrevistadas seis enfermeiras da cidade de Caic?/RN, que trabalhavam na aten??o b?sica, antes da implanta??o do PSF, e continuam trabalhando. Pela an?lise empreendida, as principais mudan?as verificadas no processo de produ??o dos servi?os de sa?de com a implanta??o do PSF, no contexto da aten??o b?sica, foram: a adscri??o e v?nculos com a comunidade; acolhimento e humaniza??o do atendimento; diminui??o das interna??es hospitalares; fortalecimento da preven??o de agravos e promo??o da sa?de; melhoria dos indicadores de sa?de; enfim, a??es que sinalizam para a realiza??o dos princ?pios da integralidade, eq?idade e universalidade, conforme preconiza o Sistema?nico de Sa?de (SUS). No entanto, apesar dos aspectos positivos identificados, o PSF apresenta algumas fragilidades, tais como: a dificuldade do trabalho coletivo; descompasso entre a forma??o dos profissionais e as exig?ncias do modelo de sa?de atual; alta rotatividade dos profissionais de sa?de e precariza??o do trabalho. Al?m disso, foram apontadas algumas estrat?gias que podem ser utilizadas para melhor orienta??o do processo de produ??o dos servi?os de sa?de, como a intersetorialidade, educa??o permanente, desprecariza??o do trabalho e melhoria na condu??o da gest?o dos servi?os de sa?de. Assim, conclu?mos que o PSF apresenta mudan?as significativas no processo de produ??o dos servi?os de sa?de para a consolida??o do SUS, embora esteja inserido em um contexto de adversidades que podem ser superadas atrav?s da luta coletiva dos distintos atores sociais

Made available in DSpace on 2014-12-17T14:46:43Z (GMT). No. of bitstreams: 1 ThiagoEAA_DISSERT.pdf: 585302 bytes, checksum: 7f11f2b4dc83522d81e56e5c1d64397f (MD5) Previous issue date: 2010-05-26 / The ongoing transformations in brazilian society, arising from technical and organizational changes in the working world, are making, with much emphasis, heated debates resurge related to themes and issues that refer to the relationship between work, skills and education. Thus, this study is inserted in the link between education and work, pointing to the work as an educational principle according to Antonio Gramsci. This paper aims to discuss the interfaces between education and work in the everyday health care teams and learn about the activities developed by health teams related to the learning processes in and with the work to analyze the opportunities and challenges of transforming spaces of health work in an environment of lifelong learning. This is a descriptive, exploratory with a qualitative approach case study developed from semi-structured interviews with the health staff professionals of the Unidade de Terapia Intensiva da Casa de Sa?de Dix-Sept Rosado in Mossor? / RN , who answered open questions about the relationship between education and work. The interviews were conducted during the month of January 2010, the same being recorded, transcribed and analyzed, culminating in the production of new knowledge on the subject. It is understood that work and education activities are eminently human, therefore only the human being works and educates. Given the statements of participants, it is noticed that all work processes in health are learning moments. This happens through new demands imposed by the everyday of the services, by interaction with a multidisciplinary team, participation in educational activities and individual study. It was noticed that the institution in this case does not promote study courses related to Intensive Care and that there are obstacles to the realization of educational activities on and with the work, such as: excessive workload, inability to release staff to participate in events, low pay, which leads the worker to have more than one employment, rejection of new knowledge by some workers and lack of physical infrastructure and incentives for the activities. The daily situations must be transformed in learning, selfanalyzing the problems of practice and valuing the work process itself in its intrinsic context. We conclude that dealing with the web of relationships between educational processes and production processes of health services, unraveling the intricacies of the world of work and education requirements in this sector are increasingly on the agenda of Sistema ?nico de Sa?de workers and managers. The continuing consideration of this issue becomes an essential condition for the proper discharge of their responsibilities. We consider that bringing the education to everyday life is the result of recognition of the educational potential of the work situation / As transforma??es em curso na sociedade brasileira, decorrentes das mudan?as t?cnicoorganizacionais no mundo do trabalho, est?o fazendo ressurgir, com muita ?nfase, acalorados debates relativos a temas e problemas que remetem ?s rela??es entre trabalho, qualifica??o e educa??o. Diante disso, este estudo encontra-se inserido no ?mbito da articula??o entre educa??o e trabalho, apontando para o trabalho como princ?pio educativo na perspectiva de Antonio Gramsci. Este trabalho tem por objetivos discutir as interfaces entre educa??o e trabalho no cotidiano de equipes de sa?de e conhecer as atividades desenvolvidas por equipes de sa?de relacionadas com os processos de aprendizagem no e com o trabalho para analisar as possibilidades e os desafios de transformar os espa?os de trabalho em sa?de em ambientes de aprendizado permanente. Trata-se de um estudo de caso de car?ter descritivo, explorat?rio, de abordagem qualitativa e desenvolvido a partir de entrevistas semi-estruturadas com os profissionais da equipe de sa?de da Unidade de Terapia Intensiva da Casa de Sa?de Dix-Sept Rosado em Mossor?/RN, os quais responderam quest?es abertas sobre a articula??o entre educa??o e trabalho. As entrevistas foram realizadas durante o m?s de janeiro de 2010, sendo as mesmas gravadas, transcritas e analisadas, culminando com a produ??o de novos conhecimentos sobre o tema. Entende-se que trabalho e educa??o s?o atividades eminentemente humanas; logo, somente o ser humano trabalha e educa. Diante das falas dos participantes da pesquisa, conclui-se que todos os processos de trabalho em sa?de s?o momentos de aprendizado. Este acontece por meio de novas demandas impostas pelo cotidiano dos servi?os, pela intera??o com a equipe multiprofissional, pela participa??o em atividades educativas e estudo individual. Percebeu-se que a institui??o em estudo n?o promove cursos relacionados ? Terapia Intensiva e que existem entraves ? realiza??o de atividades educativas no e com o trabalho, tais como: excesso de carga hor?ria de trabalho, impossibilidade de libera??o do funcion?rio para participa??o em eventos, m? remunera??o, o que leva o trabalhador a ter mais de um v?nculo empregat?cio, rejei??o ? aquisi??o de novos conhecimentos por parte de alguns trabalhadores e falta de estrutura f?sica e incentivos para realiza??o de atividades. Deve-se transformar as situa??es di?rias em aprendizagem, analisando reflexivamente os problemas da pr?tica e valorizando o pr?prio processo de trabalho no seu contexto intr?nseco. Conclui-se que lidar com a teia de rela??es entre os processos educacionais e os processos de produ??o de servi?os de sa?de, desvendando os meandros do mundo do trabalho e da educa??o nesse setor s?o exig?ncias a cada dia mais presentes na agenda dos trabalhadores e gestores do Sistema ?nico de Sa?de. A an?lise permanente dessa problem?tica torna-se um exerc?cio indispens?vel para o bom desempenho de suas responsabilidades. Considera-se que aproximar a educa??o da vida cotidiana ? fruto do reconhecimento do potencial educativo da situa??o de trabalho

Made available in DSpace on 2014-12-17T14:52:40Z (GMT). No. of bitstreams: 1 ArivaldaBS.pdf: 1467380 bytes, checksum: 1d741a3e11e90e76ab7729e977ec4cb8 (MD5) Previous issue date: 2009-09-09 / This thesis deals with the factors affecting customer satisfaction, loyalty and recommendation in the health care sector. It is adapted a model proposed by Johnson et al. (2001) of quality and loyalty antecedent factors and it is conducted a survey with a sample of 109 customers of a hospital on the ambulatory in Natal city, a capital of a Northeastern State of Brazil. It is carried descriptive and multiple regression statistical analysis. The main findings related to satisfaction are that quality factors of doctor professionalism, clerical staff efficiency, consultancy room comfort, time to provide the medical consultancy but also hospital localization are the most significant factors affecting satisfaction. Regarding personal full loyalty, satisfaction with the hospital and affective commitment are the main factors yet for partial loyalty image and calculate commitment play the main role. For recommendation satisfaction, image and brand are the main factors. The overall model used fairly explains the satisfaction, loyalty and recommendation outcomes with varying factors regarding each final purpose, e.g. loyalty or recommendation / Esta Tese de Mestrado investiga os fatores que afetam a satisfa??o, a fidelidade e a recomenda??o de clientes no setor de servi?os de sa?de. Utiliza-se um modelo estrutural baseado no modelo proposto por Johnson et al. (2001) contendo fatores antecedentes da satisfa??o e da fidelidade/ recomenda??o. A pesquisa consiste em question?rios com vari?veis e escala de 10 pontos aplicados a uma amostra de 109 pacientes de ambulat?rio de hospital em Natal-RN. Conduz-se uma an?lise descritiva e multivariada, usando-se an?lise de regress?o m?ltipla para cada vari?vel dependente satisfa??o, fidelidade, recomenda??o. Os principais achados relacionados ? satisfa??o s?o que os fatores de qualidade de profissionalismo dos m?dicos, efici?ncia dos funcion?rios, conforto da sala de consulta, al?m de outros fatores como tempo para o atendimento e localiza??o do hospital, foram os mais significativos. Em rela??o ? fidelidade pessoal, os fatores mais significativos foram satisfa??o com o hospital ou funcion?rios e comprometimento afetivo com o hospital. Para recomenda??o, apareceram como os principais fatores satisfa??o, imagem e marca. O modelo geral usado explica satisfatoriamente os resultados de satisfa??o, fidelidade e recomenda??o, com fatores diferentes para fidelidade e recomenda??o

Made available in DSpace on 2014-12-17T14:13:20Z (GMT). No. of bitstreams: 1 ThiagoPM.pdf: 545901 bytes, checksum: d3c74de1403d840f46b7c204a3818529 (MD5) Previous issue date: 2007-05-07 / This anthropological study investigates the lived-experience of oral diseases in the context of poverty in Northeast Brazil. During six months in 2004???, ethnographic interviews, narratives and participant-observation with 31 residents of the low-income community, Dend?, located in Fortaleza, Cear? were conducted and analyzed utilizing a hermeneutic-dialetic method. It is revealed that precarious life conditions make prioritizing caretaking a difficult task. Despite suffering tooth pain, seeking a dentist's care is perceived as "a luxury" not a citzens' right. Difficulties in accessing services and poor quality restorations, favor tooth extractions as the most effective intervention. The deterioration of one's oral health is lamented by community members who seek help from popular clinics, politicians and traditional healers. The experience of dental disease differs according to social class, leaves oral scars of inequity, harms self-esteem and inhibits social inclusion. In this context, "treating" the Teeth of Inequity demands that we deepen our comprehension of the social determinants of health, reduce injustice in the access to quality care, remove demoralizing stigmas and empower the community to confront structural forces which affect its life / Esse estudo antropol?gico investiga a experi?ncia vivida das doen?as bucais no contexto da pobreza do Nordeste brasileiro, com ?nfase nas desigualdades e exclus?o social. Foram realizadas entrevistas etnogr?ficas, narrativas e observa??o participante com 31 moradores do Dend?, comunidade de baixa renda em Fortaleza, Cear?, analisadas pelo m?todo hermen?utico-dial?tico. Resultados indicam que as prec?rias condi??es de vida e suporte social dificultam priorizar o cuidado em sa?de. Os informantes percebem as doen?as bucais especialmente no caso de dor, indicando a extra??o como mais resolutiva e principal demanda no dif?cil acesso aos servi?os. A deteriora??o da sa?de bucal ? lamentada, revelando marcas desiguais que impactam na auto-estima e no acesso ?s oportunidades de ascens?o social. A an?lise aponta que os fatores s?cio-econ?mico-culturais potencializadores da pobreza t?m rela??o com a experi?ncia em sa?de e doen?a e as formas de acesso aos servi?os. ? necess?rio intensificar a equidade melhorando as habilidades de comunica??o dos profissionais com o saber popular, atrav?s da redu??o das barreiras de acesso e aumento do poder de vocaliza??o da comunidade, criando redes de apoio ao processo decis?rio na busca por servi?os de qualidade

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2015-10-26T21:46:19Z No. of bitstreams: 1 JosileneMariaFerreiraPinheiro_DISSERT.pdf: 3185212 bytes, checksum: 56519f793fd36eb7ea7d22cd3c281a47 (MD5) / Approved for entry into archive by Elisangela Moura (lilaalves@gmail.com) on 2015-10-26T22:27:05Z (GMT) No. of bitstreams: 1 JosileneMariaFerreiraPinheiro_DISSERT.pdf: 3185212 bytes, checksum: 56519f793fd36eb7ea7d22cd3c281a47 (MD5) / Made available in DSpace on 2015-10-26T22:27:05Z (GMT). No. of bitstreams: 1 JosileneMariaFerreiraPinheiro_DISSERT.pdf: 3185212 bytes, checksum: 56519f793fd36eb7ea7d22cd3c281a47 (MD5) Previous issue date: 2014-06-04 / O per?odo neonatal, que compreende os primeiros 27 dias p?s-parto, ? uma fase considerada de vulnerabilidade ? sa?de infantil, fazendo-se necess?rio uma maior vigil?ncia pelo profissional de sa?de atrav?s de a??es que valorizam o bin?mio m?e/filho e o atendimento integral ao rec?m-nascido. Para tanto, esse trabalho objetivou avaliar as a??es de aten??o, a partir das estrat?gias preconizadas pelo Minist?rio da Sa?de. Trata-se de um estudo de corte transversal realizado a partir do banco de dados da pesquisa nacional de base populacional intitulada ?Chamada Neonatal: avalia??o da aten??o ao pr?-natal e aos menores de um ano nas regi?es Norte e Nordeste?. Utilizou-se como unidade amostral as m?es e as crian?as menores de 1 ano que compareceram a campanha de vacina??o do dia 12 de junho de 2010 nos nove munic?pios potiguares priorit?rios para o Pacto de Redu??o da Mortalidade Infantil e Neonatal. Para compor as vari?veis de estudo foram selecionadas as quest?es/a??es referentes ao per?odo neonatal e aos fatores sociodemogr?ficos, seguidas de uma an?lise descritiva e inferencial. Obteve-se uma amostra de 837 pares m?e/filho, sendo 57,6% na capital e 42,4% no conjunto dos interiores, que foi ponderada para representar os munic?pios do Estado. Predominaram as m?es com idade entre 20-29 anos, ensino m?dio completo, n?o benefici?rio de programa de transfer?ncia de renda; e crian?as do sexo masculino (51,2%). A freq??ncia das a??es de ?mbito hospitalar variou de 35% a 96% e as realizadas na Unidade B?sica de Sa?de (UBS) de 57% a 91,2%. A maioria das a??es teve associa??o com os hospitais de natureza p?blica e com a capital do estado (p<0,05). Os resultados para a maioria das a??es est?o abaixo do preconizado nos programas e pol?ticas de aten??o ? crian?a, e revelam as iniq?idades regionais em sa?de e a necessidade de envolvimento dos servi?os e dos profissionais na busca da integralidade do cuidado para possibilitarem melhor assist?ncia atrav?s de pr?ticas humanizadas nesse per?odo de maior vulnerabilidade. / The neonatal period, which includes the first 27 da ys postpartum, is a vulnerability phase in child health, making it necessary for a greater mon itoring by health professional through actions that add value to the binomial mother/child and comprehensive care to the newborn. To this end, this study aimed to evaluate the care actions the neonato from the strategies recommended by the Ministry of Health. This is a cr oss-sectional study carried out from the database of the national survey of population base entitled "Call Neonatal: evaluation of prenatal care and to children younger than one year old in the North and Northeast regions". It used as the sample unit the mothers and children yo unger than 1-year-old, costal residents of Rio Grande do Norte, Natal, Brazil, who attended th e vaccination campaign on June 12, 2010 in nine municipality?s priority for the Pact to Red uce Infant and Neonatal Mortality. To compose the study variables were selected issues/ac tions regarding the neonatal period and socio-demographic factors, followed by a descriptiv e and inferential analysis. A sample of 837 mother/child pairs was obtained, being 57.6% in capital and 42.4% in the whole from the interiors, which was weighted to represent the muni cipalities of the State. It was predominated by mothers aged between 20-29 years, complete high school, not entitled to income transfer program and male children (51.2%). The frequency of the actions of the hospital ranged from 35% to 96% and those performed at the Basic Health Unit (BHU) from 57% to 91.2%. Most actions had an association with hospitals and publi c nature of the state capital (p<0.05). The results for most of the actions are recommended in the care programs and policies for children, and reveal the regional inequities in hea lth and the need for the involvement of services and professionals in search of comprehensi ve care for enabling better care through humanized practices during this increased vulnerabi lity period.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-01-20T21:16:31Z No. of bitstreams: 1 JoaoMarioPessoaJunior_TESE.pdf: 3921808 bytes, checksum: 1bee1106b1451bcf958b0cd5cac9289e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-01-22T19:58:49Z (GMT) No. of bitstreams: 1 JoaoMarioPessoaJunior_TESE.pdf: 3921808 bytes, checksum: 1bee1106b1451bcf958b0cd5cac9289e (MD5) / Made available in DSpace on 2016-01-22T19:58:49Z (GMT). No. of bitstreams: 1 JoaoMarioPessoaJunior_TESE.pdf: 3921808 bytes, checksum: 1bee1106b1451bcf958b0cd5cac9289e (MD5) Previous issue date: 2014-12-11 / Na rede de aten??o psicossocial brasileira, os profissionais de sa?de s?o atores importantes no processo de transforma??o das pol?ticas p?blicas em sa?de mental entre os diversos servi?os. Na realidade do hospital psiqui?trico, entende-se a necessidade de ampliar o debate em torno do atual contexto de pr?ticas desenvolvidas. O estudo objetivou analisar o processo de reforma psiqui?trica e a pol?tica de sa?de mental no Estado do Rio Grande do Norte (RN) a partir dos perfis e pr?ticas dos profissionais de n?vel superior em dois hospitais psiqui?tricos. Pesquisa transversal e descritiva, com dados quantitativos e qualitativos, realizada em dois hospitais psiqui?tricos do RN. O universo da popula??o alvo foi de 95 profissionais, considerando-se a margem de erro de 8%, taxa de n?o resposta e os crit?rios de inclus?o: possuir v?nculo efetivo com a institui??o por meio de aprova??o em concurso p?blico por, no m?nimo, seis meses, sendo servidor estadual ou municipal; possuir uma carga hor?ria semanal m?nima de 20 horas no servi?o; participar diretamente de atendimento e/ou atividades com pacientes e familiares. A amostra final foi de 60 profissionais. Utilizou-se como instrumento de coleta de dados um question?rio de perguntas fechadas e semiabertas sobre o perfil socioecon?mico, as pol?ticas, as pr?ticas e a forma??o em sa?de mental. Tabularam-se os dados quantitativos no software estat?stico SPSS e para an?lise utilizou-se estat?stica simples e bivariada, do tipo qui-quadrado, adotando-se o n?vel de signific?ncia valor p<0,05. Para an?lise dos dados utilizou-se a an?lise de conte?do de Bardin. Os achados qualitativos obtidos com as quest?es semiabertas no Analyse Lexicale par Contexte d'un Ensemble de Segment de Texte (ALCESTE) foram agrupados em quatro eixos tem?ticos: Atua??o profissional em sa?de mental; Forma??o em sa?de mental; Cen?rios da reforma psiqui?trica e o hospital psiqui?trico; Pol?ticas e pr?ticas em sa?de mental: desafios para profissionais no hospital. O perfil dos profissionais revelou a maioria do sexo feminino (89,7%), enfermeiras (36,7%), faixa et?ria de 50-59 anos (42,9%), carga hor?ria de 40 horas semanais (52,4%), tempo de conclus?o da gradua??o de seis a 15 anos (57%) e 21,4% mencionaram ter especializa??o em sa?de mental. Sobre as pr?ticas desenvolvidas, no atendimento individual encontrou-se associa??o entre quem n?o constr?i ou faz parcialmente o projeto terap?utico associado a quem realiza cuidados de observa??o e anota??o. No atendimento familiar, obteve-se cuidado de consulta na crise; e, no atendimento de grupo a recrea??o. Na an?lise dos eixos tem?ticos observou-se que apesar de mudan?as identificadas nos perfis e pr?ticas dos profissionais de n?vel superior nos servi?os de aten??o ? sa?de mental, com a implementa??o de novas pol?ticas p?blicas para a ?rea, os achados sugerem a conflu?ncia de assimetrias e diverg?ncias na atua??o das equipes nos hospitais psiqui?tricos, ? dificuldades na gest?o do servi?os, as reinterna??es frequentes, reduzido quantitativo de servi?os e equipamentos dispon?veis, ? alta demanda de usu?rios, desarticula??o da rede de aten??o psicossocial, e a pr?pria escassez de recursos humanos qualificados para compor esses servi?os. Assim, os cen?rios evidenciados circunscrevem, em parte, o descompasso pol?tico e ideol?gico atual do processo de reforma psiqui?trica nacional que nega o papel da assist?ncia realizada no ambiente hospitalar, embora n?o tenha avan?ando o suficiente com a cria??o de novos servi?os que justifiquem a extin??o total dessa institui??o / In the Brazilian network of psychosocial care, health professionals are important actors in the process of transformation of mental health public policies among various services. In the reality of psychiatric hospitals, one should understand the need to expand the debate about the current context of practices developed. This study aimed at analyzing the process of psychiatric reform and the mental health policy in the State of Rio Grande do Norte (RN) from the profiles and practices of higher-level professionals in two psychiatric hospitals. This is a cross-sectional and descriptive research, with quantitative and qualitative data, conducted in two psychiatric hospitals of RN. The universe of the target population was 95 professionals, taking into account the margin of error of 8%, non-response rate and the inclusion criteria: holding effective link with the institution by means of approval in public examination for, at least, six months, being state or municipal servant; having a minimum weekly workload of 20 hours in service; participating in care and/or activities with patients and families in a direct way. The final sample consisted of 60 professionals. The tool for data collection was a questionnaire with closed and semi-open questions about socioeconomic profile, and mental health policies, practices and training. Quantitative data were tabulated in the statistical software SPSS, and simple and bivariate statistics, chi-square type, was used for analysis by adopting the significance level with the value p<0,05. In order to analyze data, the content analysis of Bardin was used. The qualitative findings obtained with the semi-open questions in Analyse Lexicale par Context d'un Ensemble de Segments de Texte (ALCESTE) were grouped into four thematic axes: Professional action in mental health; Mental health training; Scenarios of psychiatric reform and psychiatric hospitals; Mental health policies and practices: challenges for professionals in hospitals. The profile of professionals has revealed the majority of women (89,7%), nurses (36,7%), aged 50-59 years (42,9%), weekly workload of 40 hours (52,4% ), time of completion of graduation from six to 15 years (57%), and 21,4% reported to have specialization in mental health. Regarding the practices developed in individual care, it was found an association between those who do not build or partially conducts the therapeutic project and those who conduct care related to observation and annotation. In family care, it was obtained care consultation during crisis; and, in group care, recreational activities. In the analysis of thematic axes, it was noted that, despite changes identified in the profiles and practices of higher-level professionals in care services for mental health, with the implementation of new public policies for this field, the findings indicate the confluence of asymmetries and divergences in the actions of the teams in psychiatric hospitals, difficulties in managing services, frequent readmissions, reduced quantitative of available services and equipment, high demand of users, disarticulation of the network of psychosocial care, and the very shortage of skilled human resources to compose these services. Accordingly, the evidenced scenarios partially outline the current political and ideological mismatch of the national process of psychiatric reform that denies the role of care actions conducted within hospitals, although it has not gone far enough with the creation of new services that justify the total extinction of this institution

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 2017-01-10T15:20:08Z No. of bitstreams: 1 SamaraSirdeniaDuarteDeRosarioBelmiro_TESE.pdf: 3565404 bytes, checksum: d5824fbb2d942d69130cae7c5f22d9e5 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-11T15:42:12Z (GMT) No. of bitstreams: 1 SamaraSirdeniaDuarteDeRosarioBelmiro_TESE.pdf: 3565404 bytes, checksum: d5824fbb2d942d69130cae7c5f22d9e5 (MD5) / Made available in DSpace on 2017-01-11T15:42:13Z (GMT). No. of bitstreams: 1 SamaraSirdeniaDuarteDeRosarioBelmiro_TESE.pdf: 3565404 bytes, checksum: d5824fbb2d942d69130cae7c5f22d9e5 (MD5) Previous issue date: 2016-06-30 / Objetiva-se buscar evid?ncia de validade do instrumento para avalia??o de necessidades em sa?de de pessoas com defici?ncia f?sica, auditiva e visual. Trata-se de um estudo metodol?gico para desenvolvimento, valida??o de conte?do, valida??o sem?ntica e de apar?ncia de um instrumento avaliativo. O processo de constru??o e valida??o segue os preceitos de Pasquali, seguindo as etapas do polo te?rico, atrav?s de duas fases: 1) identifica??o das defini??es constitutivas e operacionais do constructo e elabora??o dos itens que compuseram o instrumento denominado Instrumento de Avalia??o de Necessidades de Sa?de de Pessoas com Defici?ncia F?sica, Auditiva e Visual (IANC-PcDFAV), atrav?s de revis?o integrativa da literatura, realizada no primeiro trimestre de 2015 nas bases de dados CINAHL, MEDLINE, LILACS e SCOPUS; experi?ncia dos pesquisadores; e na Taxonomia das Necessidades de Sa?de de Matsumoto e Cec?lio; 2) A an?lise te?rica dos itens, realizada no per?odo de setembro de 2015 a maio de 2016, atrav?s de duas etapas. Etapa 1 ? valida??o de conte?do, atrav?s de t?cnica Delphi. Nesta etapa, realizou-se busca por meio da plataforma Lattes, para identificar profissionais da ?rea da sa?de com expertise que atuassem como ju?zes do instrumento. A amostra foi de 33 especialistas na fase Delphi 1 e 18 para a Delphi 2. Para a coleta de dados submeteu-se, via online, o formul?rio aos especialistas. Realizou-se a an?lise adotando o ?ndice de Validade de Conte?do (IVC) > 0,80 e Alpha de Cronbach > 0,80. Utilizou-se o teste de Mann-Whitney para investigar as diferen?as entre as fases Delphi 1 e 2 com p > 0,05. Etapa 2 ? A valida??o sem?ntica e de apar?ncia utilizou amostragem n?o probabil?stica por conveni?ncia com oito PcDs, sendo dois com defici?ncia f?sica, quatro com defici?ncia auditiva e dois com defici?ncia visual cadastradas em tr?s institui??es de apoio a PcDs em Mossor?/RN. Foram aplicados tr?s instrumentos: o IANS-PcDFAV, o Question?rio DISABKIDS? - Impress?o geral, e o Question?rio DISABKIDS? - Impress?es espec?ficas. A an?lise deu-se por estat?stica descritiva. Consideraram-se os princ?pios da Resolu??o 466/2012. No processo de valida??o do conte?do, na primeira rodada Delphi verificou-se que cinco itens da dimens?o dados sociodemogr?ficos e dois itens da dimens?o condi??es de vida n?o alcan?aram o ?ndice da validade de conte?do estabelecido. Nos demais itens ocorreu concord?ncia, com IVC variando de 0,82 a 1. Na segunda rodada, depois de acatadas as sugest?es dos especialistas, todos os itens avaliados atingiram ?ndices excelentes. Apresentaram-se diferen?as significativas nas dimens?es dados sociodemogr?ficos, condi??es de vida e no dom?nio 1. No que diz respeito ? m?dia dos requisitos de avalia??o, todos os itens obtiveram m?dias melhores na segunda avalia??o, com signific?ncia estat?stica (p= 0,026) no requisito utilidade/pertin?ncia e na avalia??o geral do instrumento (p= 0,031). O alpha de Cronbach foi de 0,884 na fase Delphi 1 e 0,825 na fase Delphi 2. No que concerne ? valida??o sem?ntica e de apar?ncia, o instrumento foi avaliado como importante e os itens do instrumento foram considerados f?ceis de compreender. As respostas geraram modifica??es na constru??o dos itens do instrumento. Assim, se aceita a hip?tese alternativa do estudo, em que IVC, consist?ncia interna e valida??o sem?ntica geral alcan?aram valores acima de 0,80. O instrumento proposto apresenta valores satisfat?rios de validade e consist?ncia interna, servindo como guia para a avalia??o das necessidades de sa?de de pessoas com defici?ncia f?sica, auditiva e/ou visual. / The objective is to seek evidence of validity of the instrument for the assessment of needs in health for people with physical disabilities, auditory and/or visual. This is a methodological study for development, content validation, validation semantics and appearance of an instrument of evaluative dimension. The process of construction and validation follows the precepts of Pasquali, following the steps of the polo theoretician, through two phases: 1) Identification of the settings pane and the operational construct and preparation of items that comprised the instrument called a tool for evaluation of health needs of people with physical disabilities, Auditory and Visual (IANC-PcDFAV), through integrative literature review performed in the first quarter of 2015 in databases CINAHL, MEDLINE, LILACS and SCOPUS; experience of researchers; and in the taxonomy of Health Needs Of Matsumoto and Cec?lio; 2) The theoretical analysis of the items held in the period from September 2015 to May 2016, through two steps. Step 1 - Validation of content through Delphi Technique. In this step, we search through the Lattes platform, to identify health care professionals with expertise who acted as judges of the instrument. The sample consisted of 33 experts in Delphi 1 and 18 for Delphi 2. For data collection submitted via online, the form of specialists. The analysis by adopting the Content Validity Index (CVI) > 0.80 and Cronbach's alpha > 0.80. The Mann-Whitney test was used to investigate the differences between phases Delphi 1 and 2 with p > 0.05. Step 2 - Validation semantics and appearance we used random non-probabilistic by convenience with eight PWD, being two with physical disabilities, four with hearing disabilities and two with visual disabilities enrolled in three institutions to support the PWD in Mossoro/RN. There were applied three instruments: the ians-PcDFAV, the questionnaire DISABKIDS? - overall impression, and the questionnaire DISABKIDS? - specific prints. The analysis was based on descriptive statistics. They considered themselves the principles of Resolution 466/2012. In the process of validation of the content there was established in the first Delphi, it showed that five items of the scale demographic data and two items of the scale living conditions did not reach the index of content validity. The remaining items were agreed, with CVI ranging from 0.82 to 1. In the second round, once accepted the suggestions of the experts, all items assessed have achieved excellence. It showed significant differences in the dimensions of demographic data, living conditions and in domain 1. With respect to the average requirements for evaluation, all items obtained medium best in the second evaluation, with statistical significance (p= 0.026) in requirement usefulness/appropriateness and general assessment of the instrument (p= 0.031). The Cronbach's alpha coefficient was 0.884 in Delphi 1 and 0.825 in Delphi 2. With regard to the semantic validation and appearance, the instrument was evaluated as important and the items of the instrument were considered easy to understand. The answers generated changes in the construction of the items of the instrument. Thus, it is accepted the alternative hypothesis of the study, in which CVI, internal consistency and validation general semantics reached values above 0.80. The proposed instrument presents satisfactory values of validity and internal consistency, serving as a guide for the assessment of health needs of people with physical disabilities, auditory and/or visual.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-10T16:42:15Z No. of bitstreams: 1 CristianeSantosSanzioGurgel_TESE.pdf: 4190612 bytes, checksum: 773e7fec68bad460acc07eb6d8f76c81 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-02-10T21:19:07Z (GMT) No. of bitstreams: 1 CristianeSantosSanzioGurgel_TESE.pdf: 4190612 bytes, checksum: 773e7fec68bad460acc07eb6d8f76c81 (MD5) / Made available in DSpace on 2017-02-10T21:19:07Z (GMT). No. of bitstreams: 1 CristianeSantosSanzioGurgel_TESE.pdf: 4190612 bytes, checksum: 773e7fec68bad460acc07eb6d8f76c81 (MD5) Previous issue date: 2016-06-28 / Este estudo objetivou avaliar o estado de vitamina A de pu?rperas atendidas durante o parto na cidade de Natal/RN. Foram recrutadas no estudo 793 mulheres, 60.1% (n=485) da rede p?blica e 39.0% (n=310) a rede privada. Amostras de soro (n=619) e leite colostro (n=656) foram coletadas em ambiente hospitalar, ap?s jejum noturno. O leite maduro (n=154) foi coletado trinta dias ap?s o parto, em visita domiciliar. Os indicadores bioqu?micos (retinol no soro e leite materno) foram avaliados por local de moradia (capital vs interior) e por rede de atendimento em sa?de (p?blico vs privado). O consumo de vitamina A foi avaliado referente ao ?ltimo trimestre gestacional. Para avaliar as diferentes formas de suplementa??o materna com vitamina A e suas associa??es com os indicadores bioqu?micos (soro e leite materno) formaram-se subgrupos baseados nas suplementa??es que ocorreram durante a gesta??o: GC, F1, F2, F3 e no p?s-parto: GM. O retinol das amostras foi quantificado por cromatografia l?quida de alta efici?ncia (CLAE). Para o total de mulheres, a concentra??o m?dia de retinol s?rico foi de 41.8 ? 12.9?g/dL e a preval?ncia da DVA foi de 5.3% (n= 33) com retinol (<20 ?g/dL), com diferen?a significativa entre o retinol s?rico das mulheres provenientes da capital e do interior (p<0,01). Em Natal, as preval?ncias de defici?ncia encontradas nas regi?es norte, sul, leste e oeste foram respectivamente: 4.3% (n=6), 5.6% (n=7), 2.9% (n=3) e 11.9% (n=8). A m?dia de retinol no colostro no grupo total foi de 95,3+ 53.7?g/dL, entretanto 27.3% (n=179) apresentaram valores inadequados (<60 ?g/dL). Os valores m?dios estimados de retinol fornecido aos rec?m-nascidos atrav?s do colostro, n?o atingiram a recomenda??o m?nima de 400?g/RAE/dia da AI (Adequate Intake) para rec?m-nascidos, considerando a ingest?o de 396mL/dia. Houve diferen?a significativa entre o retinol no colostro das mulheres da capital e aquelas provenientes do interior (p<0.01). Ambos os grupos n?o forneceram a AI de vitamina A para o rec?m-nascido e tamb?m o mesmo foi observado com as lactantes das regi?es norte e oeste da cidade de Natal. No leite maduro, nenhum dos grupos de mulheres das diferentes regi?es atingiu a recomenda??o, considerando a ingest?o de 780mL/dia pelos rec?m-nascidos. Ao avaliar as pu?rperas separadamente por rede de atendimento em sa?de (p?blico vs privado) foi encontrada diferen?a significativa entre o retinol s?rico e retinol no colostro (p<0.0001), mas n?o houve diferen?a para o leite maduro (p>0.05). Na estimativa do fornecimento de retinol atrav?s do colostro e leite maduro, as mulheres da rede p?blica n?o forneceram vitamina A dentro da recomenda??o m?nima para o rec?m-nascido (AI=400?g/RAE/dia), ao contr?rio das mulheres da rede privada, que forneceram. O consumo diet?tico m?dio total de vitamina A das parturientes foi de 987.1 + 674.4 ?gRAE/dia, sendo 872.2 + 639.2 ?gRAE/dia na da rede p?blica e 1169.2 + 695.2 ?gRAE/dia na rede privada, com diferen?a altamente significativa (p<0,00001). Na avalia??o individual, 38.4% (n=100) e 17.3% (n=28) das mulheres das redes p?blica e privada tinham ingest?o abaixo da ideal. Ao se estudar as diferentes formas de suplementa??o com vitamina A, n?o foram encontrados casos de DVA nos grupos suplementados com F1, F2 e F3. Ao se analisar o efeito da suplementa??o sobre o retinol do colostro, o grupo F2 (betacaroteno) apresentou mais casos de inadequa??o (40%). Os grupos F2 e GM n?o forneceram a quantidade de retinol m?nima recomendada pela AI aos rec?m-nascidos. No retinol do leite maduro n?o houve diferen?a entre os grupos GC, F1, F2, F3 e GM e com percentuais de inadequa??o mais baixos no GM (14.3%) e os grupos GC e F2 n?o forneceram a quantidade de retinol m?nima recomendada pela AI para os rec?m-nascidos. Concluiu-se que a preval?ncia de DVA entre as pu?rperas atendidas em Natal foi considerada um problema "leve" de sa?de p?blica na popula??o em geral. Os grupos de alto risco neste estudo viviam em cidades do interior, eram atendidos na rede p?blica de sa?de e n?o tomavam vitamina A, como o suplemento regular durante a gesta??o. / This study aimed to evaluate the vitamin A status of women who delivered in Natal/RN. A total of 795 women were enrolled in the study. Serum (n=619) and colostrum (n=656) samples were collected in the hospital after an overnight fast. Mature milk samples (n=15) were collected at the women?s house thirty days after delivery. Biochemical indicators were evaluated according to home location (capital city vs. country towns) and type of health care system (public vs. private). Vitamin A intake was assessed using a food-frequency questionnaire (FFQ) corresponding to the last trimester of pregnancy. In order to evaluate the different forms of maternal supplementation with vitamin A and their associations with biochemical markers (maternal serum and breast milk), subgroups were formed based on the type of supplementation that occurred during pregnancy: GC, F1, F2, F3 and postpartum: GM. Retinol concentrations in the biological samples were quantified by high performance liquid chromatography (HPLC). For the total sample, the mean serum retinol concentration was 41.8 ?12.9?g/dL and the prevalence of VAD was 5.3% (n=33) of women presenting retinol concentrations (<20 ?g/dL), evidencing a significant difference in serum retinol concentrations between women from the capital city and from the countryside (p <0.01). In Natal, the prevalence of disability found in the north, south, east and west were, respectively, 4.3% (n= 6), 5.6% (n= 7), 2.9% (n= 3) and 11.9% (n= 8). The overall mean retinol concentration in colostrum was 95.3 ? 53.7?g/dL; however, 27.3% (n=179) of women presented inadequate values (<60 ?g/dL). The average estimated amounts of retinol provided to newborns through colostrum did not meet the minimum recommendation of 400 ?g/RAE/day of AI (Adequate Intake) for newborns in both groups, considering the intake of 396mL/day. It was found a significant difference in colostrum retinol concentrations between women from the capital city and from the countryside (p<0.01). In Natal, colostrum milk of women from the northern and western regions did not meet the AI. For mature milk, none of the groups from the different regions met the recommendation, considering the intake of 780mL/day. Evaluating the sample separately by childbirth care system (public vs. private), it was found a significant difference in serum and colostrum retinol concentrations between the groups (p <0.0001); there was no difference for the mature milk (p>0.05). Estimating the retinol supply through colostrum and mature milk, women attending the public health system did not provide the minimum vitamin A amount recommended for newborns (AI= 400?g/RAE/day), unlike women's private network, which provided. The average total dietary vitamin A intake of pregnant women was 987.1 ? 674.4 ?gRAE/day, was 872.2 + 639.2 ?gRAE/day for women attending the public health system and 1169.2 + 695.2 ?gRAE/day for those attending the private system, evidencing a highly significant difference (p<0.001). Individually assessing the participants, 38.4% (n=100) e 17.3% (n=28) of women in the public and private systems had vitamin A intakes below the ideal. There was no difference in serum retinol concentrations between the CG, F1, F2, F3 and MG groups (p<0.05), although only the supplemented groups F1, F2 and F3 had no cases of VAD. Regarding colostrum retinol levels, the F2 group (beta-carotene) presented the highest number of inadequate cases (40%). The F2 and MG groups did not provide the minimum amount of retinol recommended by AI for newborns. Regarding retinol concentrations in mature milk, there was no difference between the CG, F1, F2, F3 and MG groups, and the MG group presented the lowest percentage of inadequacy (14.3%), while the CG and F2 groups did not provide the minimum amount of retinol recommended by the AI for infants. It was concluded that the prevalence of VAD among mothers who delivered in Natal was considered a ?mild? public health problem in the overall population. High-risk groups in this study lived in towns, were attended in the public health system and did not take vitamin A as regular supplement during pregnancy.

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.