Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-13T14:15:29Z No. of bitstreams: 1 IsisCristianeBezerraDeMeloCarvalho_DISSERT.pdf: 5032090 bytes, checksum: af6f72d632d3881cb23969bdd8a646ca (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-26T12:31:35Z (GMT) No. of bitstreams: 1 IsisCristianeBezerraDeMeloCarvalho_DISSERT.pdf: 5032090 bytes, checksum: af6f72d632d3881cb23969bdd8a646ca (MD5) / Made available in DSpace on 2017-01-26T12:31:35Z (GMT). No. of bitstreams: 1 IsisCristianeBezerraDeMeloCarvalho_DISSERT.pdf: 5032090 bytes, checksum: af6f72d632d3881cb23969bdd8a646ca (MD5) Previous issue date: 2016-08-30 / A mortalidade materno-infantil ainda ? um grave problema de sa?de p?blica no Brasil, apesar do amplo acesso a partos institucionalizados. A Organiza??o Mundial da Sa?de desenvolveu o Safe Childbirth Checklist, uma tecnologia potencialmente ?til para melhorar a qualidade da assist?ncia durante o parto e favorecer melhores resultados em sa?de. O objetivo deste trabalho ? adaptar culturalmente e validar a Lista de Verifica??o para o Parto Seguro da OMS para os hospitais brasileiros, pois a simples tradu??o entra em choque com pr?ticas cl?nicas nacionais consolidadas. Ap?s tradu??o para o portugu?s do Brasil, houve tr?s etapas de adapta??o e valida??o: 1- grupo nominal com painel de especialistas, sendo tr?s enfermeiras obstetras e seis m?dicas (tr?s obstetras e tr?s pediatras), que se realizou de forma presencial (duas primeiras vota??es) e finalizou a dist?ncia (vota??o final); 2- Confer?ncia de Consenso em dois Hospitais Universit?rios, em reuni?es ampliadas para todos os profissionais que utilizariam a lista; e 3- question?rio estruturado aos profissionais de sa?de (n=40) ap?s estudo piloto de 30 dias utilizando a lista. Os crit?rios da valida??o foram a validade de face e conte?do da lista, adequa??o aos protocolos nacionais, terminologia e viabilidade no contexto local. Na primeira etapa, todos os 29 itens foram aprovados ap?s 3 rodadas e algumas adapta??es nacionais (ex. teste r?pido para HIV em vez de CD4). Na segunda etapa, ocorreu acr?scimo de 24 itens e modifica??es em itens iniciais. Na terceira etapa, ocorreu a exclus?o de 3 itens n?o vi?veis, 2 itens sofreram jun??o e 1 item foi acrescentado devido a sua import?ncia cl?nica no contexto brasileiro. O processo de valida??o possibilitou a disponibiliza??o de uma Lista de Verifica??o para o Parto Seguro de 49 itens potencialmente ?til para o contexto brasileiro, apresentando ind?cios de validade e viabilidade para o contexto nacional que devem ser confirmados em estudos futuros com foco na efetividade ou validade de crit?rio. / Maternal and infant mortality is still a serious public health problem in Brazil, despite the broad access to institutionalized deliveries. The World Health Organization has developed the Safe Childbirth Checklist, a potentially useful technology to improve the quality of care during labor and to promote better health outcomes. The objective of this work is culturally adapt and validate the Checklist for the WHO Safe Childbirth for Brazilian hospitals, for the simple translation collides with consolidated national clinical practice. After translation into Portuguese of Brazil, there were three stages of adaptation and validation: 1 nominal group panel of experts, three obstetricians and six medical nurses (three obstetricians and three pediatricians), held in person (first two polls ) and completed the distance (final vote); 2 Consensus Conference in two University Hospitals, in extended meetings for all professionals who would use the list; and 3 structured questionnaire for health professionals (n = 40) after 30-day pilot study using the list. The criteria for validation were the face validity and list content, suitability for national protocols, terminology and viability in the local context. In the first stage, all 29 items were approved after 3 rounds and some national adaptations (eg. Rapid test for HIV instead of CD4). In the second stage, there was an increase of 24 items and changes in initial items. In the third stage, was the exclusion of nonviable 3 items, 2 items were joint and 1 item has been added due to their clinical importance in the Brazilian context. The validation process enabled the provision of a Checklist for Safe Childbirth 49 potentially useful items for the Brazilian context, with evidence of validity and feasibility of the national context which must be confirmed in future studies focused on the effectiveness or validity of criterion.

Made available in DSpace on 2014-12-17T14:13:32Z (GMT). No. of bitstreams: 1 NilbaLS_Tese.pdf: 636235 bytes, checksum: 871e98d076a82a24e17c822a9ea7198e (MD5) Previous issue date: 2009-12-18 / Hypertensive syndromes in pregnancy (HSP) are configured as one of the major complications in the pregnancy and postpartum period and can lead premature newborn and subsequent hospitalization of the newborn to the Neonatal Intensive Care Unit (NICU). This study aimed to analyze the perceptions, meanings and feelings of mothers on the hypertensive syndromes in pregnancy and premature obstetric labor. The research was qualitative and has a theoretical methodological the Social Representations Theory(SRT) in the approach to the Central Nucleus Theory. The study included 70 women, mean age 29 years, predominantly school to high school, most of them married or in consensual union, primiparous and prevalence of cesarean delivery occurred between 32 and 37 weeks of pregnancy.The data were collected from may to december 2008 in the Maternity School Janu?rio Cicco in Natal , and obtained through the following instruments for data collection: questionnaire including questions about socio-demographic status; the Free Words Association Test (FWAT) and and verbalized mental image construction used three stimuli: such as pregnancy with high blood pressure, preterm birth and NICU, and interview with the following guiding question: what it meant for you to have a pregnancy with high blood pressure and consequently the birth of a premature baby? Data analysis was performed using multi-method obtained from the data processing by EVOC (Ensemble Programmes Permettant L 'Analyze des ?vocations) and ALCESTE (Analyse Lexicale par Contexte d'un Ensemble de Segment de Texte) and thematic analysis in categories. The results will be presented in four thematic units under the following representative universes: HSP, prematurity as a result of HSP, NICU and the social representations of mothers on the hypertensive disorder of pregnancy sequenced premature birth and hospitalization of the child in the NICU. The results obtained by multimethod analyses showed similar constructions and point to death as the central nucleus and negative aspects, coping strategies, need of care, knowledge about the disease, fragility and meanings of the NICU as peripheral elements. It is considered that the perceptions, meanings and feelings of puerperal women in relation to HSPs and to premature delivery are a negative social representation, with representational elements that may have influenced the adverse effects on the disease and its consequences. We suggest action on the peripheral elements of this representation, with adequate orientation, early diagnosis, effective conduct, receptive attitude on the part of the team, health promotion measures and effective public policies, in order to improve the care provided to puerperal women, making them feel welcome and minimizing their suffering / As s?ndromes hipertensivas da gravidez (SHG) s?o complica??es do per?odo grav?dico puerperal e podem levar ? prematuridade neonatal e consequente hospitaliza??o do rec?m-nascido em Unidade de Terapia Intensiva Neonatal (UTIN). O estudo objetivou compreender percep??es, significados e sentimentos de pu?rperas relativos ?s SHGs que tiveram como consequ?ncia o parto prematuro e a hospitaliza??o do filho na UTIN. ? um estudo qualitativo que teve como referencial te?rico metodol?gico a Teoria das Representa??es Sociais (TRS), na abordagem complementar da Teoria do N?cleo Central. Participaram do estudo 70 mulheres ; com idade m?dia de 29 anos; a maioria com n?vel m?dio de escolaridade; em uni?o consensual; prim?paras e com parto ces?rio ocorrido entre 32 e 37 semanas de gesta??o. Os dados foram coletados de maio a dezembro de 2008, na Maternidade Escola Janu?rio Cicco, em Natal/RN, por meio de: question?rio para caracteriza??o sociodemogr?fica das participantes; t?cnica de associa??o livre de palavras (TALP); constru??o verbalizada de imagens mentais; e entrevista, com a seguinte quest?o norteadora: O que significou para voc? ter uma gravidez com press?o alta e, como consequ?ncia, o nascimento de um filho prematuro? A an?lise de dados foi realizada por meio de multim?todos, a partir do processamento de dados pelos software EVOC (Ensemble de programmes permettant L analyse des evocations) e ALCESTE (An?lise lexical por contexto em um conjunto de segmentos de texto), e an?lise tem?tica categorial. Os resultados foram apresentados em quatro unidades tem?ticas, no ?mbito dos seguintes universos representativos: SHG; prematuridade como consequ?ncia das SHGs; UTIN; e as representa??es sociais de pu?rperas sobre as SHGs seguidas do nascimento prematuro e hospitaliza??o do filho na UTIN. Os resultados obtidos por meio dos multim?todos de an?lise apresentaram constru??es semelhantes entre si e apontam a morte como n?cleo perif?rico, aspectos negativos, estrat?gias de enfrentamento, necessidades de cuidados, conhecimento sobre a doen?a, fragilidade e significados da UTIN. Considera-se que as percep??es, significados e sentimentos de pu?rperas relativas ?s SHGs e ao parto prematuro constituem uma representa??o social negativa, com elementos representacionais que podem ter influenciado os efeitos adversos sobre a doen?a e suas consequ?ncias. Sugere-se atua??o sobre os elementos perif?ricos dessa representa??o, com orienta??es adequadas, diagn?stico precoce, condutas efetivas, postura acolhedora da equipe, atitudes de promo??o ? sa?de e pol?ticas p?blicas eficazes, de forma a melhorar a assist?ncia ?s mulheres/pu?rperas, acolhendo-as adequadamente e minimizando seus sofrimentos