Submitted by Carvalho Cristiane (crisedangelo@yahoo.com.br) on 2012-06-12T13:18:08Z No. of bitstreams: 1 Dissertação Final - Rosilene Aparecida dos Santos.pdf: 844977 bytes, checksum: 4b860aa5d0b888068e0f5a68546999df (MD5) / Made available in DSpace on 2012-06-12T13:18:08Z (GMT). No. of bitstreams: 1 Dissertação Final - Rosilene Aparecida dos Santos.pdf: 844977 bytes, checksum: 4b860aa5d0b888068e0f5a68546999df (MD5) / Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Ensino. Programa de Pós-Graduação em Saúde da Criança e da Mulher. Rio de Janeiro, RJ, Brasil / O tema desse trabalho é “A construção da resiliência pelos trabalhadores de enfermagem na atenção a crianças e adolescentes cronicamente adoecidos”. Nesse estudo discutimos resiliência do trabalhador, dialogando com a assistência hospitalar e promoção da saúde. Houve um aumento significativo no número de crianças e adolescentes com doenças crônicas ao longo das décadas que seguiram os anos 60. Esse aumento alterou o perfil epidemiológico e resultou em nova demanda de assistência à saúde causada por maior dependência humana, científica e tecnológica. Questionamos que atributos e competências promotoras de resiliência são desenvolvidos por trabalhadores de enfermagem ao cuidarem dessa clientela. O estudo é relevante por contribuir com a produção de conhecimento sobre o tema e por propor uma interface entre a atenção de média e alta complexidade, a saúde coletiva e os aspectos socioantropológicos. Pressupomos que a vivência da prática assistencial do trabalhador de enfermagem junto a crianças e adolescentes cronicamente adoecidos contribui para a construção da resiliência, onde atributos e competências serão exaustivamente colocados à prova no enfrentamento das dificuldades. O objetivo geral é: analisar o processo de construção de resiliência pelos trabalhadores de enfermagem na atenção hospitalar junto a crianças e adolescentes cronicamente adoecidos. Objetivos específicos: identificar atributos e competências favoráveis à construção da resiliência desses trabalhadores; compreender as estratégias utilizadas pelos trabalhadores de enfermagem no processo de construção de resiliência; verificar quais são as marcas produzidas no trabalhador na assistência a crianças e adolescentes cronicamente adoecidos. É uma pesquisa qualitativa, realizada em unidades pediátricas de um hospital situado no Rio de Janeiro, em cenário de cuidado a crianças e adolescentes em situação de adoecimento crônico. Os sujeitos foram 56 trabalhadores de enfermagem. A produção de dados ocorreu em 3 momentos: aplicação da escala de resiliência, devolução das escalas em grupo e entrevista semi-estruturada. A análise teórica dos dados foi organizada a partir da vertente do interacionismo simbólico em diálogo com as categorias de resiliência e adoecimento crônico, procurando descobrir os núcleos de sentido com significado relacionado ao objeto analítico. A dimensão relacional da análise destacou 3 núcleos temáticos: 1) a relação entre os adultos e crianças; 2) a perspectiva da violência que emerge nas relações; 3) a cronicidade como uma marca que media interações no cuidado. Concluímos que os trabalhadores de enfermagem carecem de uma rede de apoio que os auxiliem no enfrentamento do sofrimento e na ressignificação de sua prática assistencial. O trabalho com criança e adolescente com adoecimento crônico apresenta uma série de peculiaridades que exige do trabalhador mais do que habilidade técnica. Neste campo, a interação humana é intensificada pelas circunstâncias do crescimento,desenvolvimento,sofrimento e morte da clientela. / This is a Master’s Degree in Children and Women Health dissertation of IFF/FIOCRUZ, which theme is The construction of resilience by the nursing staff in the attention to chronically ill children and adolescents. We discuss professional resilience dialoguing with hospital care and health promotion. There has been a significant increase in the number of chronically ill children in the decades past the 60’s, altering the epidemiological profile and entailing new human, scientific and technological dependencies. We question what attributes and skills that promote resilience are developed by nursing professionals in their work with this kind of patient. This study is relevant for contributing with the production of knowledge on this theme e for proposing an interface between the medium and high complexity attention, public health and the inherent socio-anthropological aspects. We start from the presupposition that the continuous labor with chronic illnesses and death during infancy and adolescence contributes to the construction of resilience by the nursing professional., where skills are exhaustively put to test in the coping of hardships. The general goal of this research is to analyse the process of resilience construction by the nursing staff in a situation of hospital care to chronically ill children and adolescents. Specific objectives: identify attributes and skills that favor this construction by these workers, better comprehend the strategies used by nursing professionals in the process of resilience building and verify what are the marks produced in the staff by the assistance to chronically ill children and adolescents. This is a qualitative research that took place at pediatric units of a hospital in the city of Rio de Janeiro, in a scenario of attention to chronically ill children and adolescents. The subjects were 56 nursing workers. Data collection occurred in 3 distinct moments: application of a resilience scale, group discussion for score analysis and semi-structured interview. The theoretical analysis was organized following the precepts of the symbolic interactionism while dialoguing with categories of resilience and chronic illness, trying to uncover possible meanings related to the analytical object. The relational dimension of the analysis highlighted 3 thematic nuclei: 1) the relationship between adults and children; 2) the perspective of violence that emerges in relations; 3) the chronicity as a mark that mediates interactions in health care. We conclude that nursing workers lack a support network capable of assisting them in the coping of hardships and the reframing of their assistancial practice. The work with chronically ill children and adolescents presents peculiarities that demand more from the professional than pure technical skill. In this field, human interaction is intensified by circumstances related to the growth, development, suffering and death of these patients.

This diploma thesis deals with the analysis of parental competence of mothers with psychiatric disorder, with an emphasis on the difficulties such diagnosis can have on the family's functionality. The most severe, in practice, seems to be the necessity to place the children in institutions, away from their families, in cases where no other family member can take care of these children during the mother's absence as a result of the attack. Due to the nature of the disorder, periodicity can be expected, which significantly disturbs the child's development and relationships within the family. The real impact was observed in the empirical part via a case study focusing on six families that have a mother diagnosed with a psychiatric disorder. The needs of these families were mapped through interviews and were later compared to the current offer of non-profit organizations. The results were used to find out, which services are offered and in which areas do these families require support. Due to the nature of this problem and the necessity for systematic solution when it comes down to the provided psychiatric care, I reached out to the current Minister of Health, who commented on the present situation. The presumption that the biggest impact is observed in families with single mothers proved to be right,...

The aim of this study was to examine how care professionals experienced the need of an elder counselor in communal geriatric care. The ambition was to discover how the caregivers viewed the need of an elder counselor to identify and antagonize the suffering from mental illness and loneliness against older people and to reach a greater understanding of what they experience is the opportunities and difficulties with the eldercounselor. The study was conducted through six semi-structured, qualitative interviews with six different home care staff in two municipalities who had counselors provided for the older people living there. We identified six themes in the interviews which were used for analyzing our results. The themes were: Professions treatment of mental illness and loneliness, A support for the care professionals, An anonymous profession, Loneliness and mental illness, Elders need to talk and Elders oppose counselor support. The results of our study shows that it is common that older people suffer from mental illness and loneliness. The care professionals experience that there is a need of having a counselor to support and help their patients to counteract mental illness. The care professionals also experience that the counselors can be used as a support for the care professionals themselves. The results also showed that a lot of the older people were offered professional talk with a counselor but resisted the offer. We also discovered difficulties with the collaboration within the organization between the counselor, the patients and the care staff.

Bakgrund: Fysisk aktivitet har identifierats som en möjlig komponent i tillfrisknande för personer med beroendeproblematik. Studier visar en positiv inverkan av fysisk aktivitet på abstinenssymtom och återfall. Trots detta finns det begränsad forskning om vardaglig fysisk aktivitetsnivå hos individer med beroendeproblematik. Ett ökat fokus på detta område kan leda till utveckling av effektiva interventioner och bättre resursallokering inom beroendevården. Syfte: Studien syftade till att undersöka aktivitetsnivåerna hos personer med beroendeproblematik  Metod: En tvärsnittsstudie genomfördes där data samlades in genom en enkätundersökning bland deltagare inom öppenvården för beroendeproblematik. En analys av aktivitetsnivåer, kön, ålder och boendeform genomfördes för att undersöka möjliga samband. Resultat: Studien hade 27 deltagare varav majoriteten var män (82%), med 63% som uppnådde lägsta rekommenderade aktivitetsnivå, vilket är lägra än samhället i stort. Trots få deltagare indikerar studiens resultat tendenser till att boendeform och stigande ålder påverkade aktivitetsnivåer negativt, där egen bostad associerades med lägre aktivitet än gruppboende. Konklusion: Baserat på studiens resultat krävs riktade insatser mot att förbättra aktivitetsnivåer hos individer med beroendeproblematik, särskilt de som bor i eget boende. Integration av fysioterapeutiska insatser i behandlingsplaner och ökat samarbete mellan socialtjänst och sjukvård rekommenderas för att förbättra vårdkvaliteten. Denna studie, vars resultat kan jämställas med en pilotstudie understryker behovet av fler och större studier för att bekräfta och utveckla studiens resultat. / Background: Physical activity has been identified as a potential component in the recovery process for individuals with substance use disorders. Studies show a positive impact of physical activity on withdrawal symptoms and relapse rates. Despite this, there is limited research on the daily physical activity levels of individuals with substance use disorders. Increased focus on this area could lead to the development of effective interventions and better resource allocation within addiction treatment services. Purpose: The study aimed to examine the activity levels of individuals with addiction issues.  Method: A cross-sectional study was conducted where data was collected through a survey among participants in outpatient care for addiction issues. An analysis of activity levels, gender, age, and housing form was conducted to examine possible correlations.  Results: The study had 27 participants, the majority of whom were men (82%), with 63% achieving recommended physical activity levels, which is lower than the general population. Despite few participants, the study's results indicate trends where housing form and increasing age negatively affected activity levels, with own housing associated with lower activity than group housing.  Conclusion: Based on the study's results, targeted efforts are needed to improve activity levels among individuals with addiction issues, especially those living in their own homes. Integration of physiotherapeutic interventions into treatment plans and increased collaboration between social services and healthcare are recommended to improve the quality of care. This study, which can be seen as a pilot study, underscores the need for more and larger studies to confirm and develop the study's results.