Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-20T23:04:20Z No. of bitstreams: 1 VanessaDeLimaSilva_DISSERT.pdf: 542105 bytes, checksum: 986236b71016eeca0021f7562a7a3ae4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-02-24T23:04:15Z (GMT) No. of bitstreams: 1 VanessaDeLimaSilva_DISSERT.pdf: 542105 bytes, checksum: 986236b71016eeca0021f7562a7a3ae4 (MD5) / Made available in DSpace on 2017-02-24T23:04:15Z (GMT). No. of bitstreams: 1 VanessaDeLimaSilva_DISSERT.pdf: 542105 bytes, checksum: 986236b71016eeca0021f7562a7a3ae4 (MD5) Previous issue date: 2016-07-28 / A depress?o ? um transtorno mental que afeta todas as faixas de idade, no entanto com o envelhecimento demogr?fico da popula??o mundial, se configura como um problema de sa?de p?blica para os idosos, uma vez que pode afetar a qualidade de vida e aumentar o risco de morte nesta fase da vida. Um dos principais desafios para a pol?tica de aten??o ? sa?de do idoso, diz respeito ao rastreamento da depress?o. Al?m disso, t?o importante quanto rastear os indiv?duos com sintomas de depress?o, faz-se necess?rio identificar fatores que podem contribuir ou agravar esses sintomas. Algumas vari?veis podem afetar e agravar a depress?o, entre eles, os fatores socioecon?micos, a satisfa??o dos pacientes com os servi?os de sa?de e a rela??o familiar que podem comprometer a qualidade de vida dos idosos. Sendo assim, o presente trabalho tem o objetivo de comparar entre idosos n?o institucionalizados que apresentam ou n?o sintomas de depress?o, a qualidade de vida, aspectos sociais, econ?micos e cl?nicos, uso de antidepressivo e/ou ansiol?ticos, terapia comunit?ria integrativa, apoio familiar e a satisfa??o com os servi?os de sa?de. Trata-se de um estudo transversal do tipo caso-controle, sendo os casos formados por indiv?duos com score maior que 5 na Escala de Depress?o Geri?trica (EDG) e os controles, idosos com score na EDG menor ou igual a 5, realizado no Centro de Apoio Psicossocial das zonas Oeste e Leste e Centro Especializado na Aten??o ? Sa?de do Idoso, respectivamente na cidade de Natal, Rio Grande do Norte, Brasil. Foram utilizados os seguintes instrumentos de coleta de dados: Question?rio Socioecon?mico Demogr?fico e Cl?nico, Family Assessmente Device (FAD), World Health Organization Quality of Life-BREF (WHOQOL-BREF) e de Escala de Avalia??o da Satisfa??o dos Usu?rios com os Servi?os de Sa?de (SATIS-BR). Vari?veis s?cio-demogr?ficas e cl?nicas entre os grupos caso e controle foram comparados usando o teste qui-quadrado e an?lise de vari?ncia (ANOVA). Os escores do WHOQOL-BREF, FAD, e SATIS-BR escores foram comparados usando ANOVA. Foram considerados significantes os valores de p <0,05. O grupo de casos foi formado por 54 idosos e o controle foi formado por 61 idosos. No grupo de casos 51,85% da possui diagn?stico de depress?o e no grupo controle 27,87%, apresentando um p = 0,007. Quanto ? qualidade de vida, o grupo de casos apresenta??o um comprometimento no dom?nio das rela??es sociais (p = 0,003). O FAD identificou a solu??o de problemas como principal comprometimento familiar sendo para os casos, valores 2,09?0,70, enquanto controles 2,04?0,54 (p= 0,040). . Quanto ? satisfa??o com os servi?os de sa?de na faceta satisfa??o com o local onde ? oferecido o servi?o, o grupo de casos apresentou maior satisfa??o, (3,03?1,04), enquanto os controles (2,92?0,80) estavam menos satisfeitos (p = 0,007). A baixa renda e escolaridade da popula??o idosa contribuem para o aparecimento dos sintomas depressivos. Por?m, a terapia farmacol?gica com antidepressivos/ansiol?ticos n?o se mostra totalmente eficaz na remiss?o dos sintomas depressivos e a terapia comunit?ria integrativa se mostra como uma estrat?gia associada a terapia farmacol?gica para tratamento dos sintomas depressivos. / Depression is a mental disorder that affects people of all age groups. However with the aging of the world population, it became a public health problem for the eldest population, since it affects the quality of life and increases the risk of death at this stage of life. One of the main challenges that needs specific attention is the health of the ancient. In addition to this, the act of screening depression is equally important. Moreover, it?s necessary to trace individuals with symptoms and identify factors that can possibly contribute or even worsen these symptoms. Some aspects can affect and worsen depression including socio-economic factors and patient satisfaction with health services and family relationship. All of these can compromise the quality of life of the elderly. Therefore, the present study aims to make a contrast between noninstitutionalized elderly people who have or not depression symptoms and also considering the quality of life, social aspects, economic and clinical use of antidepressants and / or other drugs against depression, integrative community therapy, family support and satisfaction with health services. This is a cross-sectional study of cases formed by patients with scores greater than 5 in Geriatric Depression Scale (GDS) and the controls of the elderly with lower or equal score of 5 in GDS. It was conducted in a psychosocial support center of the west and east zones and in the specialized elderly health center, respectively in the city of Natal, Rio Grande do Norte Brazil. The following instruments have been used to collect data: a demographic and socioeconomic clinical quiz, family assessment device (FAD), world health organization quality of Life-BREF (WHOQOL-BREF) and the User Satisfaction Rating Scale with Health Services (SATIS -BR). Socio- demographic and clinical concerns between the case and control groups were compared using the chisquared test and analysis of variance (ANOVA). The scores of the WHOQOL-BREF, FAD, and SATIS-BR scores were also compared using ANOVA. p values lt; 0.05 were taken into account. The Group was composed of 54 cases of old people and the control was made up of 61. At 51.85% of cases group have had a diagnosis of depression and 27.87% in the control group, showing a p = 0.007. As to the quality of life, the Group of cases presenting a commitment in the field of social relations (p = 0.003).The FAD has identified a solution for main family commitment cases of, 2.09 ? 0.70 values, while 2.04 ? 0.54 controls (p = 0.040). Regarding satisfaction with health services in facet satisfaction with the place where the services are offered, the Group of cases showed the highest satisfaction (3.03 ? 1.04), meanwhile the controls (2.92 ? 0.80) were less satisfied (p = 0.007). Low income and education of the elderly population contributes to the onset of depressive symptoms. Although, pharmacological therapy with antidepressants and drugs against antianxiety don?t totally effective reverse the depressive symptoms. On the other hand, the integrative community therapy shows itself a great strategy when associated with the pharmacological therapy for the treatment of depressive symptoms.

Made available in DSpace on 2014-12-17T14:46:52Z (GMT). No. of bitstreams: 1 ReginaCD_DISSERT.pdf: 4065706 bytes, checksum: 3728d95ddfb6dc0370f79da6d3a87956 (MD5) Previous issue date: 2011-12-19 / This research, which appears in the form of a dissertation, entitled: Integrative Therapy Community: construction of a listening space to health care workers in primary care, addresses the Integrative Community Therapy (ICT) as a tool to create meeting spaces between health professionals where they can be receptive among one another. With the completion of this study aimed to analyze the ICT as a therapeutic approach and space of listening and speaking for health professionals cited here in order to identify their anxieties, doubts, worries and uncertainties arising from the context of labor relations and the impact of therapeutic experiences under the view of the participants. It was developed as an action-science research, involving several steps. The field of research was the ICT meetings of workers from the units under the Family Health Strategy of Northern Health Districts I and II of the city of Natal, using a qualitative approach. The interpretation of data collected was based on content analysis proposed by Bardin. Finally, this study showed the ICT as a space for dialogue and sharing, with repercussions on labor relations and expansions beyond the ICT meetings, reaching out to family and social relationships, contributing to creating bonds and solidarity networks. Under the view of the participants it was recognized as an experience that optimized the socialization, promoting the alleviation of suffering and increasing the well-being. Based on the study findings, it is inferred that ICT can be considered a viable tool for the receptiveness and humanized care of health care workers. / Esta pesquisa, que se apresenta no formato de uma disserta??o de mestrado, cujo t?tulo ?: TERAPIA COMUNIT?RIA INTEGRATIVA: constru??o de um espa?o de escuta para os trabalhadores da aten??o b?sica da sa?de, aborda a Terapia Comunit?ria Integrativa (TCI) como ferramenta para a cria??o de lugares de encontros entre os profissionais da sa?de, nos quais cada componente pode acolher o outro e ser acolhido tamb?m. Com a realiza??o desse estudo, objetivou-se analisar a referida terapia como abordagem terap?utica e espa?o de escuta dos depoimentos dos profissionais aqui citados, visando identificar suas ang?stias, d?vidas, inquietudes e incertezas decorrentes do contexto das rela??es de trabalho, bem como a repercuss?o das viv?ncias terap?uticas na vis?o dos participantes. O mesmo foi desenvolvido como uma pesquisa-a??o que envolveu v?rias etapas. Seu campo de investiga??o foram as rodas de TCI com trabalhadores das Unidades da Estrat?gia Sa?de da Fam?lia dos Distritos Sanit?rios Norte I e II do munic?pio de Natal-RN, utilizando-se uma abordagem qualitativa. A interpreta??o dos dados obtidos foi fundamentada na an?lise de conte?do proposta por Bardin. Por fim, este trabalho evidenciou a TCI como um espa?o de di?logo e de partilha, com repercuss?es nas rela??es de trabalho e expans?es para al?m das rodas, alcan?ando as rela??es familiares e sociais e contribuindo para a cria??o de v?nculos e a forma??o de redes solid?rias. Na vis?o dos participantes, este estudo foi reconhecido como uma experi?ncia que aperfei?oou a socializa??o, promoveu a atenua??o de sofrimentos e potencializou o bem-estar. Diante das conclus?es, infere-se que a TCI pode ser considerada uma ferramenta vi?vel para o acolhimento e cuidado humanizado dos trabalhadores da sa?de.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-10T23:03:02Z No. of bitstreams: 1 NeumaMarinhoDeQueirozSantos_DISSERT.pdf: 2679730 bytes, checksum: cf3f33476fbabb4c9117e7fbf53ae4a4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-18T20:23:33Z (GMT) No. of bitstreams: 1 NeumaMarinhoDeQueirozSantos_DISSERT.pdf: 2679730 bytes, checksum: cf3f33476fbabb4c9117e7fbf53ae4a4 (MD5) / Made available in DSpace on 2016-03-18T20:23:33Z (GMT). No. of bitstreams: 1 NeumaMarinhoDeQueirozSantos_DISSERT.pdf: 2679730 bytes, checksum: cf3f33476fbabb4c9117e7fbf53ae4a4 (MD5) Previous issue date: 2014-12-19 / Diante de um cen?rio repleto de cr?ticas a um modelo m?dico que privilegia a doen?a e n?o o doente s?o muitos os argumentos que defendem a necessidade de resgatar a rela??o humanizada entre m?dico e paciente. Tornou-se imprescind?vel formar durante a gradua??o m?dica um profissional capaz de realizar um cuidado integral, menos instrumental e mais humanizado. No entanto, apesar dos avan?os do projeto pedag?gico do curso de Medicina, ainda nos deparamos com in?meros desafios no processo de forma??o. Este estudo teve como objetivo geral compreender se a viv?ncia do estudante de Medicina com a Terapia Comunit?ria Integrativa (TCI) na Aten??o Prim?ria- APS /Estrat?gia Sa?de da Fam?lia- ESF, apresenta potencial para se configurar enquanto estrat?gia de ensino-aprendizagem para o cuidado integral e humanizado. Realizou-se uma pesquisa qualitativa com estudantes do curso de Medicina do d?cimo ao d?cimo segundo per?odo que tiveram viv?ncia com a TCI como parte do Internato de Medicina de Fam?lia e Comunidade - MFC. Utilizamos entrevistas em profundidade com roteiro e recorremos, para an?lise das narrativas, ? Hermen?utica Gadameriana. Foi poss?vel constatar que at? ingressarem no internato de MFC os estudantes desconheciam a TCI, e suas preconcep??es revestiam-se de car?ter depreciativo. A viv?ncia com a TCI possibilitou a ressignifica??o dos preconceitos e constru??o de novos conceitos. Estagiar na ESF e participar da TCI revelou potencialidades para o aprendizado do Cuidado Humanizado por meio do exerc?cio pr?tico com experi?ncias que privilegiam a constru??o de v?nculos; a autonomia do paciente; a realiza??o da longitudinalidade no cuidado do paciente; o reconhecimento do poder de resili?ncia dos pacientes, na for?a do coletivo, no compartilhar das dores, na for?a de uma boa comunica??o, nos ganhos do exerc?cio da escuta qualificada. A aus?ncia de modelos do que fazer foi substitu?da por viv?ncias de dores e alegrias no aprendizado do tornar-se m?dico. As dores falavam das dificuldades estruturais (insumos), no lidar com as vulnerabilidades sociais dos usu?rios e a dificuldade de realizar uma boa comunica??o com os pacientes. As alegrias foram experimentadas na constata??o do exerc?cio do Cuidado Humanizado. Quest?es como dificuldades estruturais, baixo n?mero de pessoas com forma??o em TCI, e pouco tempo de viv?ncias com a TCI, aparecem como limita??es para sua utiliza??o como ferramenta pedag?gica. Por sua vez, o potencial reflexivo e capaz de provocar ressignifica??es sobre o saber fazer diante da dor do outro est? muito presente nas narrativas, sinalizando o potencial de aprendizado com a TCI. Portanto, este estudo advoga que a participa??o dos alunos na TCI, al?m de poder oferecer aos estudantes uma estrat?gia de ensino-aprendizagem para o Cuidado Humanizado, representa a possibilidade de ampliar os horizontes destes futuros m?dicos em um olhar bem mais consciente das dificuldades e potencialidades de um profissional na ESF, contribuindo para a forma??o de profissionais mais sensibilizados e preparados para realizar uma abordagem integral e humanizada da pessoa e de sua comunidade, contribuindo para uma APS/ESF, mais resolutiva e gratificante para todos. / Before the scenario full of criticism about a medical model that gives privilege to the diseases and not to the diseased, there are many arguments that defend the need of redeem the humanized relationship between doctor and patient. It became indispensable to mold during the medical graduation a professional capable of perform a special care, less instrumental and more humanized; however, even though the advances of the pedagogical program of the medical graduation, we still face numerous challenges in the process of molding. This study has as general goal to understand if the students medicine experience with the Integrative Community Therapy (TCI) at the Primary Attention ? APS/Family Healthy Strategy-ESF, presents potential to configure itself while strategy of teaching-learning to the integral and humanized care. It was held a qualitative research with the students of the medical graduation from the tenth to the twelfth semester that had experience with the TCI, as part of the Boarding of Family and Community Medicine ? MFC. We used interviews with script and we resorted to analyze the narratives to Gadamerian Hermeneutics. It was possible to find that before join the boarding of MFC, the students were unaware the TCI and their preconceptions lined up with depreciated character. The experience with the TCI enabled the reframing of the prejudices and the build of new concepts. Internship in ESF and participate of TCI revealed potential to learning of the humanized care by the practical exercise with experiences that privilege the built of ties; the autonomy of the patient; the fulfillment of the longitudinality at the care of the patient; the acknowledgment of the power of resilience of the patients, at the strength of the collective, at the pain sharing, at the strength of a good communication, at the gains of qualified listening exercise. The absence of models of what to do was replaced by experiences of pains and joys at the learning of becoming a doctor. The pains spoke of the structural difficulties (inputs), at the get along with the socials vulnerabilities of the users and the difficult of perform a good communication with the patients. The joys were experienced at the finding of the humanized care exercise. Questions as structural difficulties, low number of people with TCI degree, a shortly experience of with TCI, show up as limitations to its utilization as pedagogical tool. In turn, the reflective potential is capable of cause resignifications about the know-how before the pain of the other being very much present at the narratives, signaling the potential of the learning of TCI. Therefore, this study advocate that the participation of the students at the TCI, beyond the power of offering the students a teaching-learning strategy to the humanized care, represents the possibility of enlarge the horizons of those future doctors at a glance much more conscious of the difficulties and potential of a professional at the ESF, contributing to the graduation of more sensitized professionals and prepared to perform an integral and humanized approach of the person and his/her community, contributing to an APS/ESF more resolute and rewarding to everyone.