Submitted by Celso Magalhaes (celsomagalhaes@ufrrj.br) on 2018-08-28T13:41:15Z No. of bitstreams: 1 2017 - Natanael de Freitas Silva.pdf: 3959556 bytes, checksum: 8943fd092c9031d528a367a7046b05f7 (MD5) / Made available in DSpace on 2018-08-28T13:41:15Z (GMT). No. of bitstreams: 1 2017 - Natanael de Freitas Silva.pdf: 3959556 bytes, checksum: 8943fd092c9031d528a367a7046b05f7 (MD5) Previous issue date: 2017-05-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / As a constellation of speaking and desiring bodies, producing displacements, dispersion of gender and individuality. This way I can tell that Dzi Croquettewas important in a period of great effervescence and creativity in the field of the arts (theater, literature, music), Customs and habits such as sexual liberalization, but also of control, censorship, repression and violence, between beards, purples and sequins, the Dzi Croquettes, in the years 70, with their artistic performances marked by the ambiguity of genre, in a fusion of theater and humor, with strong steps, dances and rolls and combining in an unusual way football socks with high heels, bras with hairy breasts, false eyelashes with beards, erased the historical borders of gender. Not by chance, they said: ?We are not men, nor are we women. We are people, people computed just like you!? In view of this, my goal is to historicize the meanings attributed to the experiences of masculinities and femininities in Dzi Croquettes. From a post-structuralist theoretical contribution, I appropriate some of the propositions of authors such as Michel Foucault, Joan Scott and Judith Butler, to think how generalized experiences and positions of identity are forged historically and to what extent Dzi Croquettes Helped to destabilize heteronormativity and a project/desire of social homogenization engendered by the "rotten powers" during the dictatorship / Como uma constela??o de corpos falantes e desejantes, produzindo deslocamentos, dispers?o do g?nero e do indiv?duo, assim posso caracterizar os Dzi Croquettes. Em um per?odo de grande efervesc?ncia e criatividade no campo das artes (teatro, literatura, m?sica), dos costumes e dos h?bitos como a liberaliza??o sexual, mas tamb?m de controle, censura, repress?o e viol?ncias, entre pelos, barbas, purpurinas e paet?s, os Dzi Croquettes, nos anos 70, com suas performances art?sticas marcadas pela ambiguidade de g?nero, numa fus?o de teatro e humor, com passos fortes, dan?as e rebolados e combinando, de maneira inusitada, meias de futebol com salto alto, suti?s com peitos cabeludos, c?lios posti?os com barbas, borravam as hist?ricas fronteiras de g?nero. N?o por acaso, eles diziam: ?N?s n?o somos homens, nem somos mulheres. N?s somos gente, gente computada igual voc?s!? Em vista disso, o meu objetivo ? historicizar os sentidos atribu?dos ?s experi?ncias de masculinidades e feminilidades em Dzi Croquettes. A partir de uma aporte te?rico p?s-estruturalista, me aproprio de algumas das proposi??es de autores como Michel Foucault, Joan Scott e Judith Butler, para pensar como as experi?ncias e posi??es de identidade generificadas s?o forjadas historicamente e, em que medida os Dzi Croquettes ajudaram a desestabilizar a heteronormatividade e um projeto/desejo de homogeneiza??o social engendrado pelos ?podres poderes? durante a ditadura

Bröstcancer är efter lungcancer den vanligaste dödsorsaken hos medelålders kvinnor i Sverige. Behandling av bröstcancer består vanligtvis av operation, där det cancerdrabbade bröstet tas bort, mastektomi. Både att få diagnosen bröstcancer och att genomgå mastektomi kan medföra komplexa förändringar för kvinnans identitet, samt innebära lidande, ångest och förändrad självbild. Så långt det är möjligt ska målet för omvårdnaden vara att kvinnan som vårdas ska vara självständig, samt uppleva hälsa. Sjuksköterskan måste ha kommunikativa färdigheter för att upprätthålla personcentrerad vård. Syfte: Att sammanställa kunskap om vilka erfarenheter kvinnor med bröstcancer har av omvårdnad efter genomförd mastektomi. Metod: En litteraturöversikt. Resultatet är baseras på 14 vetenskapliga artiklar. Resultat: Sammanfattningsvis hade vårdpersonalen svårt att tillgodose kvinnornas behov efter genomförd mastektomi. Resultatet visar att kvinnorna hade erfarenhet av bristfällig information av vårdpersonalen om rehabilitering och komplikationer efter mastektomin. Vårdpersonalen saknade kunskap om komplikationer som kan uppstå efter mastektomi för att tillgodose kvinnornas behov. Studiernas resultat indikerade att kvinnorna saknade uppföljning efter mastektomi. Kvinnorna var nöjda med vårdpersonalens känslomässiga stöd och att vårdpersonalen var stöttande, gav information samt att de var tillgängliga för frågor. Kvinnorna önskade att vårdpersonalen ska tillhandahålla ett personcentrerat förhållningssätt. Slutsats: Både positiva och negativa erfarenheter framkom i resultatet för litteraturöversikten gällande kvinnornas erfarenheter av omvårdnad efter genomförd mastektomi. Majoriteten av kvinnorna i de valda studierna ansåg att vårdpersonalen inte kunde tillgodose deras behov. / Breast cancer is the most common cause of death in middle-aged women in Sweden after lung cancer. Treatment of breast cancer usually consists of surgery, where the affected breast is removed, mastectomy. Diagnosis with breast cancer and walking through mastectomy can lead to complex changes in the woman's identity, as well as suffering, anxiety and altered self-esteem. The purpose of the nursing care must be that the woman being cared for should be independent, and experience health. The nurse must have communicative skills to maintain person-centered care. Purpose: To compile knowledge of what experiences women with breast cancer have of nursing after completed mastectomy. Method: A literature review. The result is based on 14 scientific articles. Results: In summary, healthcare staff had difficulty meeting the needs of women after completion of mastectomy. The results show that the women had experience of inadequate information from healthcare professionals about rehabilitation and complications after mastectomy. Nursing staff lacked knowledge of complications that may arise after mastectomy to meet the needs of women. The results of the studies indicated that women lacked follow-up after mastectomy. The women were pleased with the emotional support of healthcare professionals and that the healthcare staff were supportive, provided information and that they were available for questions. The women wished the care staff to provide a person-centered approach. Conclusion: Both positive and negative experiences were found in the results of the literature review regarding women's experiences of nursing after mastectomy. Most women in the chosen studies felt that healthcare staff could not meet their needs.

Bakgrund: Utskrivningen från slutenvården till hemmet är ett sårbart moment för patienter som övergår mellan två olika miljöer. Tidigare forskning visar att sjuksköterskor upplever utskrivningen som otydlig. Sjuksköterskor ser inte alltid utskrivningen som ett vårdande tillfälle eller upplever att det inte finns möjlighet att vårda. Det är oklart hur patienter påverkas av sjuksköterskans perspektiv på utskrivningen. Syfte: Att beskriva patienters upplevelser av vårdandet vid utskrivning. Metod: En systematisk litteraturstudie med deskriptiv design och analys av 13 kvalitativa vårdvetenskapliga artiklar. Resultat: Vårdrelationen vid utskrivning brister och patienter känner sig utelämnade. De upplever att deras behov inte blir uppmärksammade och att de blir utskickade. Patienter upplever att informationen är otillräcklig och att de inte får hjälp att förstå den. De vet inte vad de har att förvänta sig och blir oroliga. Omfattande information anses vara betryggande. Slutsats: Sjuksköterskor behöver förbättra sitt helhetsperspektiv på patienterna vid utskrivning. Mer uppdaterad kunskap angående vårdande relationer behövs för att synliggöra patientens behov och kunna utföra vårdande handlingar.

Bakgrund: Mer än 300 miljoner människor i världen lider av depression vilket skapar ett stort lidande. Den psykiatriska hälso- och sjukvården bör arbeta enligt ett holistiskt förhållningssätt och sjuksköterskan ska stödja patientens egenvårdsförmåga. Yoga och mindfulness har visat sig ha en hälsofrämjande effekt på många somatiska tillstånd.  Syfte: Att beskriva betydelsen av yoga och mindfulness för patienter med depression. Resultat: Litteraturstudie baserad på tio vetenskapliga artiklar med kvalitativ, kvantitativ och mixad design. Data analyserades med utgångspunkt från Wittenmore och Knafls (2005) metod för integrativ innehållsanalys. Resultatet om yogan och mindfulness betydelse utmynnade i två teman; ”Inre process” och ”Återhämtning” och åtta kategorier; Copingverktyg, Empowerment, Depressiva symtom, Kunskap och kompetens, Psykisk förändring, Fysisk hälsa, Holistisk upplevelse och Upplevda svårigheter. Yogan upplevdes som ett copingverktyg för symtomlindring och ledde till en ökad inre styrka och empowerment. Den minskade de depressiva symtomen. Deltagarna fick kunskap om hur kropp och sinne samverkar och de fick en ökad självacceptans. Yogaträningen gav lugn och avslappning samt fysiska hälsoförbättringar. Många upplevde en samhörighet och att vara del i ett större sammanhang. Upplevda svårigheter var fysiska begränsningar, koncentrationssvårigheter, inre press, dåligt samvete och planering. Diskussion: Resultatet diskuteras utifrån Phil Barkers Tidvattenmodell samt relevant forskning. / Background: More than 300 million people in the world suffer from depression, which creates a great deal suffering. The psychiatric health care system should work according to a holistic approach and the nurse should support the patient's self-care ability. Yoga and mindfulness have shown to have a health-promoting effect on many somatic states. Aim: To describe the importance of yoga and mindfulness for patients with depression. Method: Literature review based on ten scientific articles with qualitative, quantitative and mixed design. Data was analyzed based on the Wittenmore and Knafls (2005) method for integrative content analysis. Results: The result of the yoga's significance resulted in two themes; “Internal Process” and “Recovery” and eight categories; Coping tools, Empowerment, Depressive symptoms, Knowledge and competence, Mental change, Physical health, Holistic experience and Perceived difficulties.   The yoga was experienced as a coping tool for symptom relief and led to increased internal strength and empowerment. It reduced the depressive symptoms. The participants gained knowledge of how the body and mind interact and they gained an increased self-acceptance. Yoga training provided peace and relaxation as well as physical health improvements. Many experienced a sense of belonging and to be part of a larger context. Experienced difficulties were physical limitations, concentration difficulties, internal pressures, poor conscience and planning. Discussion: The results are discussed based on Phil Barker's Tide Model and relevant research.

Bakgrund: Intensivvårdsavdelningen är en avdelning där kritiskt- och akut sjuka patienter vårdas. Avdelningen har specialiserade rutiner och utrustning för omvårdnad samt övervakning. Sjuksköterskan på en intensivvårdsavdelning har ansvar över omvårdnaden av patienten tillsammans med ledandet av omvårdnadsarbetet i vårdlaget. Utöver har även sjuksköterskan ett ansvar att uppmärksamma den anhöriga. Därför är det viktigt för sjuksköterskan att förstå anhörigas upplevelser i denna situation för att kunna ge en god omvårdnad även till dem. Syfte:  Att beskriva anhörigas upplevda situation när en närstående vårdas på en intensivvårdsavdelning. Metod: Litteraturöversikt av vetenskapliga artiklar med kvalitativ ansats med ett anhörigperspektiv för att belysa upplevelser. Resultat: Anhöriga kunde uppleva flera faktorer som påverkade situationen negativt. Rutiner, teknisk utrustning och vårdinsatser upplevdes främmande och förvirrande. Situationen gjorde det svårt för den anhörige att uppleva sig nära patienten. Anhöriga upplevde att god kommunikation och information påverkade situationen positivt. Anhöriga upplevde det viktigt att kunna vara delaktig i vården och beslutsfattandet. Slutsats: Att som anhörigas hamna på en intensivvårdsavdelning är en främmande situation som skiljer sig från andra avdelningar. Det finns olika regler, utrustning och situationer som försvårar möjligheten för den anhörige att förstå och se sammanhanget. Det är av betydelse att vården uppmärksammar och skapar möjlighet för en ökad förståelse och ett sammanhang för de anhöriga. / Background: The intensive care unit is a department where critically and acute sick patients are being treated. The department has specialized routines, equipment to treat and screening. Nurses on a intensive care unit are responsible for the treatment of patients as well as the leadership of the workforce. The nurses are also responsible to acknowledge the patient’s relatives. Therefore, it is of great importance for the nurses to understand relatives’ experiences in this situation, to be able to give treatment of good quality to relatives too. Aim: To describe the experience of relatives to patients who are being treated at the intensive care unit. Method: A literature review of scientific articles with a qualitative standpoint, aimed towards the experiences of relatives to intensive care unit patients. Results: Relatives experienced that a lot of factors affected them negatively. Routines, equipment and treatment were experienced as unfamiliar and confusing. The situation made it hard for the relatives to experience being close to the patient. Relatives experienced that good communication and information made the situation positive. Relatives experienced that being a part and having a say in the patients’ treatment were important. Conclusion: To be a relative at the intensive care unit can feel unfamiliar and differ from other kinds of departments. There are rules, equipment and situations that makes it difficult for the relatives to see the context of the situation. It is of great importance that the healthcare is attentive and give the relatives the possibility to understand the context.

Under-acknowledged both clinically and socially as a threat to men’s health, breast cancer in men continues to be a critical health issue, with complex ramifications for those affected. Research exploring men’s breast cancer experiences and their lives beyond the diagnosis remain limited. Hence, this inquiry asks ‘How do men describe breast cancer and their experiences of the illness?’ the aim, to advance understandings about men’s meaning-making of breast cancer and masculinity, and to ‘give voice’ to this under-researched population. Embedded theoretically and methodologically within a critical qualitative health framework, the research has two parts. Part one is a qualitative synthesis of nine existing international studies exploring men’s breast cancer experiences, following Noblit and Hare’s (1988) method for synthesising interpretive qualitative data. The outcomes of this synthesis were used to inform part two: a multi-method phenomenological exploration of men’s breast cancer accounts using verbal and visual data. Thirty-One British men recruited through NHS records, Breast Cancer Care, and social media platforms, used self-authored photographs to illustrate their breast cancer experiences, which they later discussed as part of extended semi-structured interviews. All data were analysed together using Interpretative Phenomenological Analysis (Smith & Osborn, 2003). Integrating and triangulating the findings from the two study phases, the on-going marginalisation of men across the breast cancer trajectory, and how this influences men’s experiences of, and adjustment to the illness, are revealed. Findings from the qualitative synthesis suggest current approaches to breast cancer care and advocacy serve to isolate men, potentially alienating and emasculating them; while patient management practices and informational resources unequivocally marginalise men. Findings from the new inquiry corroborate those from earlier studies, further illuminating the difficulties men encounter and some of their coping strategies. Specifically, three superordinate masculinities were identified: ‘threatened and exposed’, ‘protected and asserted’, and ‘reconsidered and reconfigured’. A schematic representation is presented to show how these interconnected masculinities are encountered, performed and utilised by men from pre-diagnosis through treatment and beyond as they manage, make sense of, and live through breast cancer. How and why men encounter/perform these different masculinities at different points in time across the breast cancer trajectory, and how this aids men’s adjustment to illness, and life beyond the diagnosis, is considered. The findings are expected to have both academic and real-world impact through informing future research, and recommendations for advocacy and intervention for improved future breast cancer care and practices.

The United Kingdom (UK) is becoming increasingly diverse (Office for National Statistics, 2013). Educational psychologists in the UK will need to feel competent in providing services to an increasingly multicultural population. This research study used a mixed method, two-phase, sequential, explanatory study design to explore the self-perceived intercultural competence of UK educational psychologists and trainee educational psychologists (EP/Ts). The study also explored EP/Ts experiences of working with culturally diverse populations. The first phase of this research study used an online adapted version of the MCCTS-R (Holcomb-McCoy & Myers, 1999; Munoz, 2009), and the second phase built upon the first phase with follow-up semi-structured interviews, analysed using Braun & Clarke's (2006) thematic analysis. The results of this research study present a breadth and depth of information. EP/Ts generally perceived themselves to be competent to work cross-culturally with particular areas of competence including knowledge of assessment bias, poverty effects, and positive attitudes towards diverse cultures. EP/Ts also reported areas of lower competence including theories of racial/ethnic identity development, limited experiences of community work and limited knowledge of community resources. However, EP/Ts perceptions about development needs depended upon their awareness. The process of participating in the study raised awareness of gaps in knowledge and limitations in practice. The study concludes with a discussion of implications for the practice of EP/Ts.

A partir d’une pratique clinique auprès de patients douloureux chroniques dans un centre de la douleur il s’agira de mettre en évidence le rôle joué par des expériences précoces de douleur et leur éventuelle participation au processus de chronicisation de douleurs actuelles pour une catégorie de ces patients. Plus précisément il nous faudra examiner de quelle manière les relations premières de ces sujets avec leurs objets de soin pourraient s’être nouées en partie autour de la perception de douleur. Nous voulons montrer que cette population de patients s’est probablement trouvée très tôt confrontée de différentes manières à des vécus de douleur Pour ce faire nous nous proposons de faire appel de façon préférentielle à un ensemble de travaux et de réflexions développés ces dernières années dans les deux champs que sont d’une part les neurosciences et d’autre part la psychanalyse. Nous terminons par un retour à travers une monographie clinique sur les implications thérapeutiques que peut avoir la prise en compte d’un tel regard sur les avatars de la construction psychique du sujet et ces relations à des expériences ultérieures de douleur. / The subject of this thesis is to show the particular role played by early pain experiences and their possible link to present pain chronicising process for a part of these patients. More precisely, we will review how the first relationships of these subjects to their caregivers could have been partly tied up with pain perception.We want to show how this patients population has been probably very early confronted to pain experiences in different ways.To do so, we will bring up preferentially a set of work and reflection developed throughout these years in both psychoanalysis and neurosciences fields.We end up this work by a return through a clinical monography on therapeutic implications that such an approach can have on the subject psychic construction misadventures and his relationships to further pain experiences.

Este estudo busca questionar algumas das bases epistemológicas da psicologia clínica em relação à espiritualidade e à mística. Partindo da discussão entre Freud e o escritor Francês Romain Rolland a respeito do sentimento oceânico (baseado na correspondência entre eles no período de 1927 a 1931), abordaremos a compreensão da natureza ontológica da experiência de união com o universo (como descrito por Rolland) em um duplo vértice: tanto como um subproduto de dinâmicas psicológicas (inerentemente patológicas ou não) ou como uma experiência ontológica de alteridade, mais bem compreendida através de uma abordagem não psicológica que possa investigar seu significado em consonância ao registro da condição humana em si. Nessa última perspectiva, estaremos acompanhados da obra de Gilberto Safra, que em seus escritos evidencia uma preocupação com a busca de uma concepção antropológica que aborde o ser humano em toda sua complexidade, evitando o possível reducionismo psicológico de temas e áreas que possam se relacionar a outras categorias de experiência, como a religiosidade e a espiritualidade. Como eixo central dessa discussão, utilizaremos a vida do místico Indiano Ramakrishna Paramahansa (1836-1886) para ilustrar esses diferentes modos de se abordar a experiência espiritual. Ramakrishna foi uma das principais fontes das construções de Rolland acerca da religiosidade, levando o autor francês a escrever uma de suas principais biografias (A vida de Ramakrishna, 1929), que teve um importante impacto na recepção ocidental de concepções espirituais orientais. Contemplando exemplos da vida de Ramakrishna, através de uma leitura fenomenológica-hermenêutica da obra de Rolland (que abarcam desde sua infância até seu período como um famoso mestre espiritual na Índia), será apresentado, em cada um desses períodos, diferentes perspectivas de autores que consideram Ramakrishna tanto em uma chave psicológica-psicopatológica quanto em uma abordagem que inclua um registro espiritual não redutível a dinâmicas psíquicas em sua vida. Dentro desse estudo, nós percebemos que há uma limitação inerente às leituras exclusivamente psicológicas das experiências místicas, assim como uma há uma limitação das leituras exclusivamente espiritualistas. Assim, ao apresentar tal discussão nós pretendemos repensar a posição que a espiritualidade e a mística ocupam na prática clínica, tanto para reformular sua compreensão em psicoterapia quanto para expandir as concepções éticas e antropológicas subjacentes ao entendimento clínico da condição humana / This study aims at questioning some of the epistemological basis of clinical psychology concerning mystical experience and spirituality. Focusing on the discussion between Freud and French author Romain Rolland regarding the oceanic feeling (based on their letters exchange from 1927 to 1931), we will question the comprehension of the ontological nature of the feeling of union with the universe (as described by Rolland) through a twofold bias: either as a by-product of psychological dynamics (inherently pathological or not) or as an ontological experience of alterity, better comprehended through a non-psychological approach that investigates its inner meaning regarding the human condition as such. In the latter perspective, we will be accompanied by the work of Brazilian author Gilberto Safra, whose clinical writings are concerned with an anthropological conception that approaches the human being in its own complexity, avoiding possible psychological reductionism of themes and issues that relate to other areas of experience, such as religiosity and spirituality. As the main axis of this discussion, we will utilize the life of Indian mystic Ramakrishna Paramahansa (1836-1886) to illustrate these two different ways of approaching spiritual experience. Ramakrishna has been himself one of the main sources of Rollands constructions on religiosity, leading the French author to write one of his main biographies (The life of Ramakrishna, 1929), which had an important impact on Western reception of Eastern spiritual conceptions. Contemplating examples from Ramakrishnas life through a phenomenological-hermeneutical reading of Rollands work (that range from his childhood to his period as a famous spiritual master in India), we will present, in each situation, different perspectives from authors that either consider Ramakrishna exclusively on a psychological-psychopathological note or through a perception of a spiritual dimension non-reducible to psychical dynamics inherent to his life and teachings. Within this framework, we have come to realize that there are inherent limitations on a solely psychological reading of mystical experience, as well as a limitation on an exclusively spiritual approach. Therefore, by presenting such discussion we intend to rethink the position mysticism and spirituality occupy in clinical practice, both to reformulate their understanding in psychotherapy and as a way of enlarging the anthropological conceptions inherent to clinical understanding of the human condition

Bakgrund: Hjärtinfarkt drabbar människor över hela världen och kan leda till döden. Efter hjärtinfarkten påbörjar individerna sin återhämtningsperiod. Då ska individerna påbörja sina livsstilsförändringar samtidigt som de måste hantera den krissituation de plötsligt hamnat i. Syfte: Att beskriva individers upplevelser av det dagliga livet efter en hjärtinfarkt. Metod: En litteraturbaserad studie med tolv kvalitativa artiklar. Resultat: Individernas vardag förändrades drastiskt efter hjärtinfarkten och alla hinder var inte lika lätta att överkomma. Ur analysen framträdde tre teman; Ny verklighet att förhålla sig till, En andra chans samt Hjälp till återhämtning, med åtta underteman. Slutsats: Hjärtinfarkt är en sjukdom som drabbar hela individen. Individerna behöver arbeta med både fysiska och psykiska aspekter av sitt välmående under återhämtningsperioden. Sjuksköterskan är ett stöd under sjukhustiden som hjälper patienten att återgå till hemmet och sitt vardagliga liv. Dock måste sjukvården ta sitt ansvar på större allvar när det kommer till informationsbehovet hos de individer som drabbats av hjärtinfarkt. / Background: Myocardial infarction affects people all over the world and can result in death. After the myocardial infarction the individuals initiate their recovery. The individuals have to cope with lifestyle changes and at the same time dealing with the crisis that they are in. Aim: To describe individual's experiences of the daily life after a myocardial infarction. Method: A literature based study including twelve qualitative articles. Results: The individuals daily life drasticly changed after the myocardial infarction and all obstacles were not as easy to overcome.Three themes emerged from the analysis; New reality to relate to, A second chance and Help to rocery, with eight subthemes. Conclusion: Myocardial infarction is a disease that affects the whole individual. The individuals need to work with physical as well as psychic aspects of their well-being during the recovery. The nurse is a support during the hospital stay that helps the patient return to the home and their daily life. However the health care needs to take responsibility for the need of information that the individuals require more seriously.