O presente estudo teve como objetivo investigar as contribuições de uma intervenção psico-educativa para as estratégias de enfrentamento e a qualidade de vida de gestantes portadoras de HIV/Aids. Participaram 20 gestantes, entre 20 e 40 anos (M=29,9; DP=5,7), com 24 semanas ou mais de gestação e que engravidaram sabendo-se portadoras de HIV/Aids. Utilizou-se um delineamento quase experimental, com pré e pós-teste, e as contribuições da intervenção foram avaliadas por uma escala de estratégias de enfrentamento, outra sobre qualidade de vida, além de uma entrevista de avaliação da intervenção. A intervenção consistiu em cinco encontros individuais de aconselhamento, envolvendo diversos temas sobre gestação, parto, puerpério, desenvolvimento inicial do bebê, apoio social e o tratamento para HIV/Aids da gestante e do bebê. Quanto às estratégias de enfrentamento, os resultados corroboraram a hipótese inicial, ao revelar aumento significativo nos fatores Foco no Problema e Busca de Apoio Social e diminuição no fator Foco na Emoção. Análise de covariância revelou uma interação entre o tempo de diagnóstico e as diferenças entre as médias do fator Foco no Problema e uma interação entre a escolaridade e o Foco na Emoção, indicando que, quanto maior o tempo de diagnóstico e menor a escolaridade, maior foi o efeito da intervenção. Quanto à qualidade de vida, os resultados apoiaram parcialmente a hipótese inicial, ao revelarem um aumento significativo nos domínios Psicológico, Ambiente e Qualidade de Vida Geral, porém não houve o aumento esperado no domínio Relações Sociais. Análise de covariância revelou uma interação entre tempo de diagnóstico e o efeito da intervenção para o Domínio Ambiente indicando que quanto menor o tempo de diagnóstico maior foi o efeito da intervenção. Análise de conteúdo qualitativa das respostas à entrevista de avaliação da intervenção, com estrutura de categorias definida a partir das escalas utilizadas, também endossaram a importância da intervenção para as estratégias de enfrentamento e a qualidade de vida das gestantes. Juntos, os resultados indicam que, de modo geral, a intervenção apresentou contribuições importantes para as gestantes, embora o tempo de diagnóstico e uma maior ênfase em aspectos de relações sociais e apoio social devam ser considerados em futuras intervenções. / The aim of the study was to investigate the contributions of a psycho-educational intervention to coping strategies and quality of life among pregnant women living with HIV/Aids. Twenty pregnant women, aged between 20 and 40 years (M=29,9; SD=5,7), participated in the study. They were at least with 24 weeks of pregnancy, and got pregnant after knowing about their own seropositivity. We conducted a quasi-experimental study, with pre and post-test, investigating the contributions of the intervention through a coping strategies scale, a quality of life scale, and an interview on intervention evaluation. The intervention was composed by five counseling sessions on pregnancy, delivery, post-partum situations, early development of the baby, social support and treatment of pregnant women and babies. Considering coping strategies, findings confirmed the initial hypothesis, showing significant increasing in scores of Focus on Problem and Search for Social Support, and decreasing of Focus on Emotion. Covariance analysis showed interaction between time since diagnostics and the differences between means of Focus on Problem, and between school level and Focus on Emotion, indicating that the higher was time since diagnosis among pregnant women, and the lower was the school level, the better was the effect of intervention. Considering the quality of life, findings partially confirmed the initial hypothesis, showing significant increasing in scores of the domains: Psychological, Environmental, and General Quality of Life, without showing the expected increasing on Social Relations Domain. Covariance analysis showed interaction between time since diagnostics and the effect for Environmental Domain, indicating that the lower was time since diagnosis, the better was the effect of the intervention. Qualitative Contend Analysis of the answers to the interview evaluation used a structure of categories based on the scales, and also highlighted the importance of the intervention to coping strategies and to quality of life for pregnant women. Together, these findings show that the intervention represented an important contribution to pregnant women, although time since diagnosis, social relations and social support should be considered in future investigations.

Made available in DSpace on 2016-06-02T19:29:18Z (GMT). No. of bitstreams: 1 TeseCS.pdf: 1123125 bytes, checksum: 06d3bc00e94e177cc2f8ed580c21b364 (MD5) Previous issue date: 2003-08-25 / The central argument of this thesis is to promote the importance of observing peoples’ understanding of their environment in order to develop a popular environmental education programme with rather than for them, one that fosters participatory solidarity. As such, ecofeminismo and the theory of social representations have been explored as possible theories and practices to assist environmental educators in this task. This has been approached in three articles the first of which is about the theory and practice of ecofeminismo as possible directions for environmental education. As ecofeminism offers elements to understand the complex power interrelations and the increasing environmental inequalities that exist in contemporary society. Furthermore it proposes the deconstruction of the dualities that permeate our society and feed such inequalities. In the same direction, in the second article we present a research paper that applied the theory of social representations to assist in interpreting of the lifestyles, perceived needs and environmental activities, with a group of 10 urban women from Manaus, Amazonas, Brazil. The interpretation of the environmental social representations revealed some of the women's environmental practices and understanding, and that religion, situation, media, identity and cultural heritage are five mediators that influence the production of such representations. The results offered important information on the participants' theoretical frameworks; the final task was to verify if such data would assist in planning a popular environmental education intervention. The third article is a report on such a verification, which occurred during a workshop with a larger number of residents from the same neighbourhood. In which three themes detected in the research results were presented to the participants for them to choose one for the educational intervention. Handicrafts were selected and the intervention is at the present moment in full activity. This confirms, that although the theory of social representations cannot solve all the difficulties that environmental education faces in an unsustainable society; it can, assist in understanding people better and from this promote the construction of solidarity. The expected outcome is that the three papers bring elements to be debated within environmental education. Also that the group the women formed will flourish permitting them to grow together. / O argumento central desta tese é promover uma educação ambiental centrada no respeito da leitura do mundo realizada pelas pessoas e daí construir uma participação ambiental fundamentada na solidariedade. Para este fim, o ecofeminismo e a teoria das representações sociais foram explorados como possíveis teorias e práticas a serem aplicadas na educação ambiental popular. O relatório será apresentado em três artigos. No primeiro artigo abordamos a teoria e a prática do ecofeminismo como um possível rumo para que a educação ambiental alcance este objetivo. Pensamos que o ecofeminismo oferece elementos para promover um entendimento sobre a complexidade das inter-relações de poder e as desigualdades ambientais existentes na sociedade contemporânea, assim como propõe a desconstrução das dualidades que existem na nossa sociedade e que alimentam estas desigualdades. Na mesma direção, no segundo artigo pesquisamos a aplicação da teoria das representações sociais para ajudar numa interpretação do “cotidiano”, das “necessidades percebidas” e das “relações ambientais”, de um grupo de 10 mulheres da área urbana de Manaus, Amazonas. Os resultados revelaram as práticas e compreensões ambientais das mulheres, e que a religião, o contexto, a mídia, a identidade e a herança cultural foram cinco mediadores que influenciaram sua produção. Assim, a interpretação ofereceu informações importantes sobre os arcabouços teóricos das participantes. Faltou verificar se estes poderiam ser aplicados ou não no planejamento de uma intervenção educacional, aspecto explorado no terceiro artigo. Trata-se de um relatório sobre o planejamento de uma intervenção educacional, aplicando a estratégia de oficina participativa. Três temas que se destacaram nos resultados da pesquisa foram apresentados às participantes para que elas determinassem qual seria o foco da intervenção educacional. O tema artesanato foi o escolhido, e atualmente estamos em plena atividade. O processo confirmou que a teoria de representações sociais pode ajudar a entender melhor as idéias das pessoas e a trabalhar com elas na construção de uma participação solidária. Esperamos que as abordagens dos três artigos tragam elementos a serem debatidos no campo da educação ambiental, e que o grupo que as mulheres formaram floresça e permita que cresçam juntas.

O presente estudo teve como objetivo investigar as contribuições de uma intervenção psico-educativa para as estratégias de enfrentamento e a qualidade de vida de gestantes portadoras de HIV/Aids. Participaram 20 gestantes, entre 20 e 40 anos (M=29,9; DP=5,7), com 24 semanas ou mais de gestação e que engravidaram sabendo-se portadoras de HIV/Aids. Utilizou-se um delineamento quase experimental, com pré e pós-teste, e as contribuições da intervenção foram avaliadas por uma escala de estratégias de enfrentamento, outra sobre qualidade de vida, além de uma entrevista de avaliação da intervenção. A intervenção consistiu em cinco encontros individuais de aconselhamento, envolvendo diversos temas sobre gestação, parto, puerpério, desenvolvimento inicial do bebê, apoio social e o tratamento para HIV/Aids da gestante e do bebê. Quanto às estratégias de enfrentamento, os resultados corroboraram a hipótese inicial, ao revelar aumento significativo nos fatores Foco no Problema e Busca de Apoio Social e diminuição no fator Foco na Emoção. Análise de covariância revelou uma interação entre o tempo de diagnóstico e as diferenças entre as médias do fator Foco no Problema e uma interação entre a escolaridade e o Foco na Emoção, indicando que, quanto maior o tempo de diagnóstico e menor a escolaridade, maior foi o efeito da intervenção. Quanto à qualidade de vida, os resultados apoiaram parcialmente a hipótese inicial, ao revelarem um aumento significativo nos domínios Psicológico, Ambiente e Qualidade de Vida Geral, porém não houve o aumento esperado no domínio Relações Sociais. Análise de covariância revelou uma interação entre tempo de diagnóstico e o efeito da intervenção para o Domínio Ambiente indicando que quanto menor o tempo de diagnóstico maior foi o efeito da intervenção. Análise de conteúdo qualitativa das respostas à entrevista de avaliação da intervenção, com estrutura de categorias definida a partir das escalas utilizadas, também endossaram a importância da intervenção para as estratégias de enfrentamento e a qualidade de vida das gestantes. Juntos, os resultados indicam que, de modo geral, a intervenção apresentou contribuições importantes para as gestantes, embora o tempo de diagnóstico e uma maior ênfase em aspectos de relações sociais e apoio social devam ser considerados em futuras intervenções. / The aim of the study was to investigate the contributions of a psycho-educational intervention to coping strategies and quality of life among pregnant women living with HIV/Aids. Twenty pregnant women, aged between 20 and 40 years (M=29,9; SD=5,7), participated in the study. They were at least with 24 weeks of pregnancy, and got pregnant after knowing about their own seropositivity. We conducted a quasi-experimental study, with pre and post-test, investigating the contributions of the intervention through a coping strategies scale, a quality of life scale, and an interview on intervention evaluation. The intervention was composed by five counseling sessions on pregnancy, delivery, post-partum situations, early development of the baby, social support and treatment of pregnant women and babies. Considering coping strategies, findings confirmed the initial hypothesis, showing significant increasing in scores of Focus on Problem and Search for Social Support, and decreasing of Focus on Emotion. Covariance analysis showed interaction between time since diagnostics and the differences between means of Focus on Problem, and between school level and Focus on Emotion, indicating that the higher was time since diagnosis among pregnant women, and the lower was the school level, the better was the effect of intervention. Considering the quality of life, findings partially confirmed the initial hypothesis, showing significant increasing in scores of the domains: Psychological, Environmental, and General Quality of Life, without showing the expected increasing on Social Relations Domain. Covariance analysis showed interaction between time since diagnostics and the effect for Environmental Domain, indicating that the lower was time since diagnosis, the better was the effect of the intervention. Qualitative Contend Analysis of the answers to the interview evaluation used a structure of categories based on the scales, and also highlighted the importance of the intervention to coping strategies and to quality of life for pregnant women. Together, these findings show that the intervention represented an important contribution to pregnant women, although time since diagnosis, social relations and social support should be considered in future investigations.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-02-05T14:46:46Z No. of bitstreams: 1 eloisaelenanoe.pdf: 1720624 bytes, checksum: d1d97f9c41154e82675297c3f47df894 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-02-05T15:30:25Z (GMT) No. of bitstreams: 1 eloisaelenanoe.pdf: 1720624 bytes, checksum: d1d97f9c41154e82675297c3f47df894 (MD5) / Made available in DSpace on 2016-02-05T15:30:25Z (GMT). No. of bitstreams: 1 eloisaelenanoe.pdf: 1720624 bytes, checksum: d1d97f9c41154e82675297c3f47df894 (MD5) Previous issue date: 2014-08-21 / Esta pesquisa tem por objetivo investigar o processo de ampliação do Programa de Intervenção Pedagógica (PIP) da Secretaria de Estado de Educação de Minas Gerais para os Anos Finais do Ensino Fundamental (PIP/CBC) nas Escolas Estaduais da Superintendência Regional de Ensino de Ubá (SRE/Ubá), a partir da atuação dos Analistas Regionais. A investigação busca articular os planos macro e micro, sob o viés da abordagem do ciclo de políticas, formulada pelo autor Stephen Ball, partindo do Programa de Governo “Choque de Gestão (contexto de influência); da análise de principais documentos legais que subsidiam o PIP (contexto de produção de texto); de como os educadores se apropriaram das diretrizes do PIP (contexto da prática) e quais foram seus resultados (contexto de resultados/efeitos). A pesquisa abrangeu o período de agosto de 2011 a dezembro de 2013. No processo de ampliação do PIP, interessa saber se os resultados dos escolares melhoraram em decorrência de uma prática de intervenção pedagógica adequada e se os Conteúdos Básicos Comuns se materializaram no contexto da prática. Os resultados apontaram para a importância da reestruturação do trabalho dos analistas regionais, em vista de se promover a melhoria do acompanhamento às escolas e das ações relacionadas à Gestão Pedagógica. No último capítulo é proposto uma formação continuada para estes stakeholders com objetivo de desenvolver competências na área de implementação e na área de organização. / This research aims to ascertain the enlargement process of the State Department of Education of Pedagogical Intervention Program (PIP) for the last period of basic education (PIP/CBC) in public schools engaged with Ubá Educational Management (SRE), based on the performance Regional Analysts. This investigation demands to articulate macro and micro spheres, by the bias of the policy cycle approach, such as proposed by Stephen Ball, from the Government Program "Management Shock", of the Minas Gerais State (influency context); analysis of key legal documents that support the PIP (text production context); how educators understood the PIP/CBC (practice context) and what your results (results/effects context). The research covered the period in August, 2011 to December 2013. In the enlargement process of the PIP, need to know whether the results of the students improved as a result of a practice of appropriate educational intervention and the curriculum model (CBC) materialized in the context of practice. The results point the importance to restructuration in the work of the regional analysis, that promote improved the advice to schools and that actions related to educational management. In the last chapter, is presented an idea of intervention to these stakeholders continuing training for the purpose of developing implementing skills and organization skills.

O presente estudo integra interfaces das áreas de Psicologia, Educação e Música, com o objetivo de investigar como as professoras de creche de um Centro de Educação Infantil (CEI) da cidade de São Paulo utilizavam a linguagem musical junto aos bebês e se suas ações propiciavam ou não aprendizagem e desenvolvimento musical infantil. Investigou-se também sobre a formação musical do professor de Educação Infantil, bem como a interação e qualidade das atividades musicais ofertadas aos bebês. A pesquisa foi realizada em três fases, sendo a primeira e terceira fases ocorridas no CEI e a segunda fase na Faculdade de Educação da Universidade de São Paulo, como o Curso de Formação continuada em Música para as professoras, com carga horária de 60 horas. Os sujeitos da pesquisa foram: na primeira fase 16 bebês e 4 professoras oriundos dos Berçários I e II do CEI; na segunda fase 35 profissionais de Educação Infantil, entre elas as professoras participantes da pesquisa; na terceira fase 9 crianças pequenas e 5 professoras do agrupamento Mini Grupos I e II do CEI. O estudo enquadrou-se em uma pesquisa educacional, cujos princípios nortearam ações como investigação, formação e intervenção ao longo da pesquisa, envolvendo a participação de segmentos diferenciados que abrangeu desde a Universidade até os berçários da creche, formando uma rede colaborativa que propiciou mudanças na práxis pedagógica musical do CEI. A metodologia baseou-se no paradigma qualitativo, cujo tema musicalização infantil foi um estudo de caso dentro de um ambiente de pesquisa-ação, fundamentado pelas contribuições de W. Carr; S. Kemmis e J. Elliott. Estas contribuições proporcionaram uma investigação colaborativa respeitando eticamente as conquistas e transformações ocorridas no CEI durante os 3 anos de pesquisa. Como ferramenta para a coleta de dados foi utilizadas as Escalas de Empenho do adulto e de Envolvimento da criança de F. Laevers, na primeira e terceira fases da pesquisa; e a categorização do registro escrito e oral das atividades teóricas e práticas realizadas durante o curso de formação musical, na segunda fase da pesquisa. A análise dos dados foi fundamentada a partir das concepções mediacionais de Lev S. Vigotski e R. Feuerstein; da estrutura de aprendizagem da teoria de Jerome Bruner e da fase de audiação preparatória da Teoria da aprendizagem musical para recém-nascidos de Edwin Gordon, além das contribuições de estudos nas áreas da psicologia cognitivo musical e neurociências. Os resultados mostraram que a cada fase investigada se conduzia às outras, ou seja, a investigação inicial levou à orientação e formação musical das professoras e depois à intervenção in lócus. Portanto, ao final do processo foi possível concluir que a proposta de oferecer uma aprendizagem que conduza ao desenvolvimento musical infantil é também possível de ser realizada em creches públicas. Para tanto, sugere-se que se invista na formação musical continuada e no desenvolvimento potencial do professor dentro de uma perspectiva de Formação em Contexto. / This study integrates interfaces of the areas of Psychology and Music Education, with the aim to investigate how nursery teachers of an Early Childhood Center (CEI) of the city of São Paulo used the musical language with the babies and if their actions propitiated or not learning and children\'s musical development. Also investigated on music teacher education Early Childhood Education, as well as interaction and quality of musical activities offered to babies. The survey was conducted in three phases, the first and third stages occurred in the CEI and the second phase in School of Education at University of São Paulo as the continuing education course for teachers in music, with a workload being of 60 hours. The study subjects were in the first phase - 16 babies and 4 teachers coming from the nurseries I and II of the CEI, in the second phase - 35 professionals in early childhood education, including teachers participating in the research; in the third stage - 9 small children and 5 teachers from grouping called Mini Groups I and II of the CEI. The study is framed in an educational research, whose principles have guided actions such as research, training and assistance throughout the research , involving the participation of different segments that ranged from nursery teachers to the University, forming a collaborative network which brought changes in pedagogical musical praxis CEI . The methodology was based on the qualitative paradigm, whose theme \"music to baby\" was a case study in an environment of action research, grounded by the contributions of W. Carr; S. Kemmis e J. Elliott. These contributions have provided a collaborative research ethically respecting the achievements and transformations that occurred during the 3 years of research. As a tool for data collection was used of Scales of commitment of adult and Scales involving children of F. Laevers, on the first and third phases of the research, and the categorization of written records and oral theoretical activities and practices performed during the course of musical training in the second phase of the research. The data analysis was based from the mediational conceptions of Lev S. Vigotski and R. Feuerstein; the learning structure of the theory of Jerome Bruner and phase preparatory audiation of music learning theory for newborn Edwin Gordon, besides the contributions of studies in the areas of musical cognitive psychology and neuroscience. The results showed that each phase is investigated leading to the other, ie, initial research led to the orientation and training of music teachers and after the intervention in locus. Therefore, when the process was concluded that the proposal to offer learning conducive to children\'s musical development is also likely to be held in public nurseries. For this, it is suggested that continuing to invest in music training and on the potential development of the teacher within a training context perspective.

Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2016-08-03T14:42:15Z No. of bitstreams: 1 dulcymardemellogonçalvespimenta.pdf: 1148076 bytes, checksum: 0458d71e89c1589b8492b0fce1ab30e7 (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-08-04T11:15:38Z (GMT) No. of bitstreams: 1 dulcymardemellogonçalvespimenta.pdf: 1148076 bytes, checksum: 0458d71e89c1589b8492b0fce1ab30e7 (MD5) / Made available in DSpace on 2016-08-04T11:15:38Z (GMT). No. of bitstreams: 1 dulcymardemellogonçalvespimenta.pdf: 1148076 bytes, checksum: 0458d71e89c1589b8492b0fce1ab30e7 (MD5) Previous issue date: 2015-07-13 / Este trabalho, um Plano de Ação Educacional (PAE), tem por objetivo analisar as ações gestoras que contribuem para a implementação do Programa de Intervenção Pedagógica- PIP/CBC e impactam positivamente no desempenho dos alunos em três escolas públicas do Estado de Minas Gerais/Brasil. Para tanto, buscou-se conhecer as fases de implementação dessa política pública, analisar os gráficos de resultados das avaliações externas do SIMAVE das escolas pesquisadas e compreender até que ponto as ações gestoras contribuem para a melhoria dos resultados e implementação do PIP/CBC. Desta forma, no primeiro capítulo realizase uma descrição das escolas pesquisadas, apresentando as características gerais das instituições e os resultados educacionais das avaliações do PROEB e IDEB. No segundo capítulo, embasa-se o estudo nas obras de Luck referentes a gestão escolar e suas dimensões, no texto perfis de Liderança de Polon. Foi realizado, ainda, uma análise das ações gestoras a luz dessas autoras e de Eduardo Condé. A metodologia utilizada foi qualitativa através de instrumentos diversificados como observação do cotidiano dos gestores, análise de relatórios, revistas pedagógicas e entrevistas semiestruturadas. O estudo aponta a existência de boas práticas desenvolvidas pelas equipes gestoras das instituições pesquisadas que impactaram positivamente a elevação dos resultados e a implementação do PIP, mas, também identificou ações que precisam ser melhoradas para a obtenção de melhores resultados e eficácia da política. Sendo assim, o terceiro capítulo destina-se à proposição de um Plano de Ação tendo como objetivo central a elaboração de um Guia de Boas Práticas dos Gestores escolares e proposições para solucionar as fragilidades evidenciadas por este estudo, disseminando-as para todas as escolas da jurisdição. / This work, an Educational Action Plan (PAE), aims to analyze the management actions that contribute to the implementation of the intervention program Pedagógica- PIP / CBC and positively impact the performance of students in three public schools in the state of Minas Gerais / Brazil. Therefore, we sought to know the stages of implementation of this public policy, analyze the graphs of results of SIMAVE the external evaluations of the surveyed schools and comprehending to what extent management actions has contributed for the improved of the results and implementation of the PIP / CBC. Thus, in the first chapter, we conducted a description of the surveyed schools, presenting the general characteristics of the institutions and the educational results of the evaluations of PROEB and IDEB. On the second chapter, the study was based on Luck’s works related to school management and its dimensions and on Leadership profiles researched by Polon. It was also conducted an analysis of management actions under the perspective of such authors and Eduardo Conde. The methodology used was the qualitative through several instruments such as observation of the daily life of managers, report analysis, educational magazines and semi-structured interviews. The study shows the existence of good practices developed by the management who was surveyed in this study which positively impacted the evolution of the results and the implementation of the PIP, but, for the other hand, we found actions that need to be improved to achieve better results and effectiveness of the policy. Thus, the third chapter was dedicated to proposing an Action Plan with the main goal the create a Guide with good practices for school managers and proposals to solve the fragile points highlighted in this study, disseminating them to another schools of this jurisdiction.

The ETSU dental hygiene program is very competitive and rigorous for those admitted. Student dental hygienists may experience higher levels of anxiety and more stressors while completing their course work and clinical hours than they have previously experienced in general education and prerequisite courses. These increased number of stressors and higher levels of anxiety may have negative impacts on students’ academic performance and success in clinical learning environments. A better understanding of the actual need for a stress reduction and anxiety management curriculum will facilitate creating and implementing this type of curriculum. A total of 44 current ETSU dental hygiene students were included in the study, juniors (55%) and (45%) seniors. Nearly all respondents reported their current stress and anxiety levels are affecting their lives (97.5%). Consistently over a third of students who completed surveys from the ETSU dental hygiene program are experiencing physical symptoms of stress and anxiety including headaches, gastrointestinal distress, trouble sleeping, eating too much or too little daily, tense muscles, worry or phobias, anger or hostility, irritability or hostility, and nervousness 2-3 times a week. The average stress level of the 44 ETSU dental hygiene students reported on a 1-10 scale was a 7.65. Nearly half (40%) of all ETSU dental hygiene students currently enrolled reported their stress level as 8 out of 10 with 10 defined as “I can only think of my stress and anxiety”. Further research including an educational intervention to help teach students skills and coping mechanisms to manage and reduce stress and anxiety was recommended.

No description available.

Plusieurs études ont démontré que prés de deux tiers des patients subissant une chirurgie cardiaque souffrent de douleur d’intensité modérée à sévère. Ces niveaux de douleur semblent être partiellement expliqués par la présence de barrières individuelles face au soulagement de la douleur. Le savoir acquis sur les cognitions associées à la douleur ne semble pas avoir été traduit dans de nouvelles approches éducatives face à la douleur aiguë. Le but du projet doctoral était 1) de développer une intervention visant à faciliter l’autogestion de la douleur postopératoire après une chirurgie cardiaque et, 2) d’en évaluer l’acceptabilité et la faisabilité, ainsi que le potentiel d’efficacité sur le soulagement de la douleur de patients subissant une chirurgie cardiaque. Le développement de l’iintervention SOULAGE-TAVIE a inclus quatre étapes fondées sur les savoirs clinique, empirique et théorique et inspirées de plusieurs écrits méthodologiques. SOULAGE-TAVIE consiste en une session préopératoire éducative sur la gestion de la douleur post-chirurgie cardiaque d’approximativement 30 minutes sur un ordinateur, dispensée sur mesure en fonction d’un algorithme. Deux renforcements cliniques en personne sont aussi offerts en phase postopératoire. L’évaluation de l’intervention consistait en un essai clinique pilote à répartition aléatoire incluant 60 participants répartis entre le groupe expérimental (GE : SOULAGE-TAVIE) et le groupe contrôle (GC : soins usuels incluant un feuillet d’information). Les données étaient recueillies au moment de l’admission et dans les sept jours postopératoires. SOULAGE-TAVIE a été jugée comme acceptable et faisable. De plus, les participants du GE n’ont pas expérimenté une douleur de plus faible intensité mais ils ont rapporté significativement moins d’interférence de la douleur avec la toux et la respiration profonde, ont démontré moins de barrières face à la gestion de la douleur et ont consommé plus d’opiacés. Cette étude pilote procure des résultats prometteurs sur les bénéfices potentiels de cette nouvelle approche sur mesure utilisant les technologies de l’information et de la communication (TIC). L’autonomisation des personnes est cruciale et complémentaire pour soutenir le soulagement de la douleur dans le contexte actuel de soins. / Several studies have shown that many patients undergoing a cardiac surgery suffer from moderate to severe pain. These levels of pain may be explained by individual barriers toward pain relief. Knowledge acquired on pain-related cognitions has not been translated into new approaches. The aim of the doctoral project was 1) to develop an intervention to facilitate the self-management of postoperative pain after cardiac surgery and, 2) to assess its the acceptability and feasibility and to investigate its efficacy potential on pain relief in patients undergoing cardiac surgery. The development of SOULAGE-TAVIE included four steps based on clinical, empirical and theoretical knowledge and inspired by diverse methodological considerations. SOULAGE-TAVIE consists in a 30-minute computer-tailored preoperative educational session about postoperative pain management, tailored according to an algorithm. Two short reinforcements are provided in person. The evaluation of SOULAGE-TAVIE consisted in a pilot randomized controlled trial including 60 participants assigned to the experimental group (EG: SOULAGE-TAVIE) and the control group (CG: usual care including educational pamphlet). Data were collected at the time of admission and across Day 1 to 7 after surgery. The results provide preliminary support for the acceptability and feasibility of a tailored and virtual intervention. The results revealed that patients of the EG did not experience less intense pain but they reported significantly less pain interference when breathing/coughing, exhibited fewer pain-related barriers, and consumed more opioid medication. This pilot study provides promising results to support the potential benefits of this new web-tailored approach. Patient empowerment is complementary yet crucial in the current context of care and may contribute to improve pain relief.

Introduction : Les résultats de recherches ont démontré que la cessation tabagique augmente là où des interventions professionnelles préventives sont appliquées avec constance. On rapporte qu’au Québec, 62 % des infirmières (toutes pratiques confondues) évaluent le statut tabagique de leurs clients et 38 % suggèrent la cessation tabagique. En milieu hospitalier, l’évaluation du statut tabagique diminue à 30 %. Or, le personnel infirmier hospitalier est présent dans les unités de soins 24 heures sur 24, ce qui laisse prévoir une influence potentielle non négligeable dans la décision des patients de cesser de fumer. Objectif : La présente recherche a pour objectif de comparer, avec un groupe contrôle, l’efficacité de stratégies (formation interactive, rappel, multiple) pour augmenter les interventions réalisées en cessation tabagique dans des unités de médecine et de chirurgie. Le choix de ces stratégies repose sur leur efficacité et leur potentiel d’implantation dans d’autres centres. Méthodologie : Un devis expérimental avec randomisation par groupe a été choisi. Le modèle factoriel permet d’évaluer l’effet de chacun des groupes expérimentaux en regard du groupe contrôle. Des mesures préstratégies et poststratégies (à 1 mois et à 3 mois) sont privilégiées. Plusieurs outils permettent de mesurer les effets des stratégies et ce, avec des sources diversifiées (personnel infirmier, patients, dossiers des patients, gestionnaires et responsables des centres d’abandon du tabac). Résultats : Au total, 156 infirmières et infirmières-auxiliaires ont répondu à des questionnaires au temps 1, 78 au temps 2 et 69 au temps 3. Parallèlement au personnel infirmier, 156 patients ont été rejoints au temps 1, 89 au temps 2 et 98 au temps 3. Les résultats démontrent que le personnel infirmier évalue le statut tabagique chez 35,7 % de la clientèle seulement et la motivation à cesser de fumer chez 17,6 % des patients. Au cours de notre recherche, peu d’interventions en cessation tabagique ont été réalisées dans les unités de médecine et de chirurgie; la présence de plusieurs obstacles de même qu’une perception d’inefficacité des interventions de la part du personnel infirmier semblent en être les causes. Les résultats de notre recherche ne nous a pas permis d’appuyer nos hypothèses. Cependant, des analyses complémentaires ont démontré que la stratégie de formation interactive a permis d’augmenter certaines pratiques cliniques à court terme et de diminuer la perception d’obstacles à l’intervention. Le rappel n’a pas fonctionné correctement et n’a pu être évalué. Conclusion : En considérant les résultats modestes des stratégies implantées, la formation interactive a eu un impact à très court terme sur les interventions courtes en cessation tabagique réalisées par le personnel infirmier d’unités de soins en médecine et en chirurgie. Les difficultés rencontrées lors de l’implantation des stratégies ont été expliquées, ce qui permettra une planification plus éclairée de futures recherches dans le domaine. / Introduction : Research results demonstrate a decrease in cigarette smoking when preventive professional interventions are routinely carried out. The Quebec recent literature reports that, nurses from different working areas assess their patient smoking habits 62 % of the time and recommend cessation in only 38 % of the situations. When this assessment is realized by hospital nurses, this percentage drops around 30 %. Knowing that nursing staff is present at the bedside 24 hours a day, a non-negligible influence of tobacco counselling by nurses is of potential interest for hospitalized patients. The objective of the present study is to compare, on medical and surgical units, the effectiveness of three strategies (interactive educational session, recall, and both together) to a control group, on the number of nursing interventions pertaining to cessation of cigarette smoking. Choice of those three strategies is based on reported effectiveness and transferability potential. Research design is experimental with group randomisation. Factorial model opens possibility to assess impact of each of the three strategies versus the control group. Pre and post strategy multi-measurements (at 1 and 3 months) are sought from nursing staff, patients, patient charts, management, nurses in charge of the centers for tobacco cessation. Results : Nursing staff completed questionnaires at time 1 (N = 156), at time 2 (N= 78), and at time 3 (N=69). Similarly, 156 patients were interviewed at time 1, 89 at time 2, and 98 at time 3. Results show that nursing staff assesses cigarette smoking habits for only 35,7 % of the patients, and their intent to stop smoking only 17,6 % of the time. Very few tobacco counselling interventions are carried out on medical and surgical units by nursing staff. Some barriers are identified, and nursing staff perceives a non-self-efficacy with regard to those interventions. Results do not allow confirmation of hypotheses. However, complementary statistical analyses show that the educational strategy increases the number of nursing interventions during a short period, and decreases perception of barriers to tobacco counselling. Impact of recall could not be assessed as it was not introduced as planned. Conclusion : Considering modest results from the strategies, the interactive educational sessions shows a short term effect on the nursing staff’s interventions,. The difficulties encountered during implementation of the strategies have been explained, which will be useful when planning future research in tobacco cessation.