INTRODUÇÃO: Observado inicialmente em países desenvolvidos, o envelhecimento populacional atualmente é uma realidade presente também em países em desenvolvimento. O diabetes mellitus consiste em uma doença de caráter crônico, envolve acompanhamento e tratamento por toda a vida, e apresenta dificuldades no monitoramento e na garantia de uma boa adesão dos pacientes às orientações das equipes de saúde. OBJETIVO: Estudar as características dos idosos com diagnóstico de diabetes mellitus tipo 2, cadastrados em uma unidade de saúde da família, em relação à assistência à saúde, parâmetros clínicos de monitoramento e estado nutricional, a partir da avaliação dos prontuários clínicos destes pacientes. MÉTODO: O estudo é descritivo, com abordagem quantitativa, com fonte de dados secundários. O grupo de estudo é composto por usuários atendidos em uma unidade de saúde da família de Ribeirão Preto-SP, com diagnóstico confirmado de diabetes mellitus tipo 2, cadastrados no Sistema de Informação da Atenção Básica (SIAB), com idade igual ou superior a 60 anos, apresentando ao menos uma consulta de acompanhamento no último ano. Foram compilados dados referentes aos hábitos de vida, assistência à saúde e estado nutricional no primeiro ano de acompanhamento na unidade e no ano da coleta da dados. As informações referentes aos dois períodos estudados foram comparadas por meio de estatística descritiva. Para a comparação de médias das variáveis foi usado o teste t de Student para dados pareados. RESULTADOS: Foram analisados os prontuários de 60 idosos, com média de 9 anos de acompanhamento no serviço. Os diagnósticos das comorbidades mais frequentes foram hipertensão arterial sistêmica, dislipidemias e obesidade. Entre os parâmetros bioquímicos, houve redução de hemoglobina glicada (HbA1C), glicemia de jejum e lipídios para homens e redução de colesterol total, HDL colesterol e LDL colesterol entre as mulheres. Ocorreu redução na frequência dos registros de orientação alimentar no segundo período, com orientação específica de nutricionista em apenas 15% dos prontuários. A orientação mais frequente relatada referiu-se ao fracionamento das refeições. Além do nutricionista, o farmacêutico e fisioterapeuta foram os profissionais com maior frequência de visitas domiciliares. Os registros de participação em grupos de educação em saúde representaram apenas 5% da amostra. CONCLUSÃO: Os resultados encontrados evidenciam atendimento clínico eficiente no monitoramento e controle do diabetes mellitus, porém reforçam a necessidade de estímulo às práticas de promoção e prevenção da saúde no âmbito da atenção básica, com o objetivo de prevenção de complicações relacionadas ao envelhecimento e ao diabetes mellitus, contribuindo para melhora da qualidade de vida dos usuários do serviço, aumento da resolutividade da atenção básica e redução dos custos para o Sistema Único de Saúde. / INTRODUCTION: Initially observed in developed countries, the aging population is now present in developing countries. The diabetes mellitus consists in a chronic disease that involves monitoring and treatment for a lifetime, with difficulties to monitoring and to assurance a patient compliance to health team recommendations. OBJECTIVE: To study type 2 diabetes mellitus aged characters, registered in a family health unit, in relation to de health care, medical parameter and nutritional assessment, from medical records of them. METHODS: It\'s a descriptive study, with quantitative approach and secondary data source. The study group is compose of patients treated in a family health unit in Ribeirão Preto - SP, with confirmed type 2 diabetes mellitus diagnosis, register in the Primary Care Information System, aged over 60 years, presenting at least one follow-up visit last year. Data were compiled relating to lifestyle, health care and nutritional status in the first and last year of the monitoring unit. Two periods information were compared using descriptive statistics. To compare the means of the variables we used the Student t test for paired data. RESULTS: The elderly medical records were analyzed with average of nine years in follow-up service. The most common comorbidities diagnosis were hypertension, dyslipidemia and obesity. Among the biochemical parameters, glycated hemoglobin (HbA1c), fasting plasma glucose and blood lipids decreased among men and total cholesterol, HDL cholesterol and LDL cholesterol decreased among women. The frequency of dietary guidance recording decreased in the second period, with specific nutritionist guidance in only 15% of the records.! Fractionation meal is the most frequent orientation reported. In addition to the nutritionist, pharmacist and physiotherapist were professionals with higher frequency of home visits. Records of participation in health education groups accounted for only 5% of the sample. CONCLUSION: The results show efficient medical care in monitoring and control of diabetes mellitus, but reinforce the need for stimulus to promotion and prevention health practices in the scope of primary care, in order to prevent complications related to aging and diabetes mellitus, contributing to improved quality of life for service users, increasing resoluteness of primary care and reducing costs for the Unified Health System.

Submitted by Daniella Santos (daniella.santos@ufma.br) on 2017-08-08T16:12:41Z No. of bitstreams: 1 ANTONIO JOSÉ ARAÚJO LIMA.pdf: 2092877 bytes, checksum: 8c1569f24bbbed888a7219971047055e (MD5) / Made available in DSpace on 2017-08-08T16:12:41Z (GMT). No. of bitstreams: 1 ANTONIO JOSÉ ARAÚJO LIMA.pdf: 2092877 bytes, checksum: 8c1569f24bbbed888a7219971047055e (MD5) Previous issue date: 2017-05-31 / Child hospitalization is a difficult process for the child's development in a hostile and indifferent environment with resistance to adapt to the new reality. The playful care helps to make the stay in the hospital easier, favors the child's development and healing. The feeling of finitude of life afflicts the child, the family those who accompany him in the hospital, during hospitalization. The imminent fear of death, the homesickness of the home makes difficult the relationship with: nurses, doctors, psychologists, physiotherapists, among others. In the context, we investigated the perceptions of professionals of the multidisciplinary health team in relation to the development of play activities in 2 pediatric public hospitals of São Luís/MA. An exploratory, descriptive research was developed. The participants were 8 professionals belonging to the health area, among them, 2 are doctors, 2 nurses, 2 psychologists and 2 occupational therapists, 6 of which are female and 2 are male, with an average of 6 years of professional experience in hospitals. The data were collected through semi-structured interviews. The results indicate that play activities developed with children are relevant in the processes of socialization and integration of the child to the reality of hospitalization. The professionals of the multidisciplinary health team emphasize that the play activities developed in pediatric hospitals contribute to the recovery process of the child's health, adding to the treatment of the pathology. / O atendimento lúdico contribui para tornar a permanência no hospital, mais fácil, favorece o desenvolvimento da criança e cura. O sentimento de finitude da vida aflige a criança, a família os que a acompanham no hospital, durante a internação. O medo iminente de morte, a saudade do lar dificulta o relacionamento com: enfermeiros, médicos, psicólogos, fisioterapeutas, entre outros. No contexto, investigaram-se as percepções de profissionais da equipe multidisciplinar de saúde em relação ao desenvolvimento de atividades lúdicas em 2 hospitais públicos pediátricos de São Luís/MA. Desenvolveu-se uma pesquisa exploratória, descritiva. Os participantes foram 8 profissionais pertencentes à área da saúde, dentre esses, 2 são médicos, 2 enfermeiros, 2 psicólogos e 2 terapeutas ocupacionais, sendo 6 pertencentes ao sexo feminino e 2 ao sexo masculino, possuindo em média 6 anos de experiências profissionais em hospitais pediátricos. Os dados foram coletados por meio de entrevistas semiestruturadas. Os resultados sinalizam que as atividades lúdicas desenvolvidas com crianças são relevantes nos processos de socialização e integração da criança à realidade da internação. Os profissionais da equipe muldisciplinar de saúde, enfatizam que as atividades lúdicas desenvolvidas nos hospitais pediátricos contribuem no processo de recuperação da saúde da criança, somando no tratamento da patologia.

Effective team working across disciplines is essential to solve the technological and managerial problems associated with construction projects. However, while it is widely accepted that this method of working is critical to the achievement organisational goals, it is a poorly understood process. Generic best practice recipes on how to improve team work in collaborative projects appears to have had limited impact on performance. Unless the realities of implementing and managing such joint endeavours are conceptualised and articulated in a manner that reflects the actual processes and patterns of behaviour, multi-disciplinary team working will remain a poorly understood working model. The goal of this work was to develop a conceptual framework that visualises the real success factors of multi-disciplinary working so that practitioners can apply a new understanding of predictable processes and patterns of behaviours to improve collaborative project outcomes. To achieve this, the project started with an exploration of critical success factors in multi-disciplinary design projects, encompassing extensive interviewing, workshops and a survey followed by a grounded theory (GT) study of collaborative working in six multi-disciplinary design projects. The switch to GT methodology offered possibilities to further probe into the dynamics of multi-disciplinary team working from the perspective of the team members. The findings show that team working in multi-disciplinary design projects can be explained through the social process of informalising. Informalising refers to the strategies practitioners use to cope with the multiple pressures and unforeseen demands that pervade the collaborative design environments. It portrays the relevance of managing of expectations and value-judging to remain effective and efficient in the face of change and uncertainty. These are critical factors that influence the project trajectory and experience of those involved. Alongside these results the work also demonstrates the importance of so called super soft factors such as shared values, creativity and innovation and passion and enthusiasm to achieve positive project outcomes. Overall, recognising that the process of informalising forms an essential part of cultivating collaboration, and hence getting the work done, more attention should be given to understand such activity in today s turbulent and transient project organisations. Knowledge and understanding of this form of emergent and improvisational strategy may enable managers to predict and control patterns of behaviour inherent in the management of collaborative design projects, and positively influence project outcomes in terms of perceived value and profit.

Darbo tikslas: Nustatyti specialistų komandos formavimo reikalingumą gydytojų ir slaugytojų, dirbančių LSMUL VšĮ Kauno klinikų filialo onkologijos ligoninėje, požiūriu. Uždaviniai: 1. Ištirti onkologijos ligoninėje dirbančių gydytojų ir slaugytojų požiūrį į multidisciplinines specialistų komandas; 2. Nustatyti gydytojų ir slaugytojų požiūrį į tai, kokių specialistų pagalbos reikėtų onkologine liga sergantiesiems; 3. Palyginti gydytojų ir slaugytojų nuomones apie specialistų komandos reikalingumą. Tyrimo metodika: Tyrimas atliktas 2012 m. liepos – rugpjūčio mėnesiais, naudojant anoniminę anketinę apklausą. Apklausos metu anketos buvo išdalintos keturiuose onkologijos ligoninės skyriuose (konservatyviosios onkologijos, paliatyviosios onkologijos, chirurgijos, anesteziologijos ir intensyvios terapijos) dirbantiems gydytojams ir slaugytojams. Iš viso išdalintos 127 anketos, iš kurių grįžo 114 (atsako dažnis 89,8 proc.). Statistinė duomenų analizė atlikta SPSS 17.0 ir MS Excel programomis. Statistinis duomenų reikšmingumas tikrintas pagal statistinį reikšmingumą (p < 0,05), chi kvadrato (χ2) kriterijų, laisvės laipsnių skaičių ir z kriterijų. Rezultatai: Atlikus tyrimo duomenų analizę nustatyta, kad tyrimo dalyviai žino apie komandinio darbo svarbą ir privalumus gydymo įstaigoje. 48,2 proc. teigė, kad ligoninėje vyrauja individualus ir komandinis darbas. 48,6 proc. apklaustųjų nurodė, kad konfliktai daugiausiai kyla dėl bendravimo problemų ir hierarchinių santykių, o sprendimai... [toliau žr. visą tekstą] / The aim of the study: To assess the need of multidisciplinary team formation from a perspective of doctors and nurses working in oncological hospital of Lithuanian University of Health Sciences Kaunas Clinics. Objectives: 1) To find out the attitude of doctors and nurses towards the need of multidisciplinary team; 2) To set the view on what kind of specialists are required for oncological patients according to doctors and nurses; 3) To compare opinions among doctors and nurses about the necessity of the multidisciplinary team. Research methodology: The research was carried out during July and August 2012 using an anonymous questionnaire method. Questionnaires were distributed among doctors and nurses working in four units of the oncological hospital. They were the following therapy units: conservative oncology, palliative oncology, surgery, anaesthetic and intensive therapy units. In total were distributed 127 questionnaires from which 114 questionnaires were returned (with a response rate of 89.8%). Statistical analysis of the data was done using SPSS 17.0 and MS Excel software. Statistical significance of the data was verified using statistical significance p value (p<0,05), chi-squared test, degrees of freedom and z value. Results: It was found that respondents are aware of significance and advantages of teamwork. 48.2% of the respondents stated that the most prevalent kind of work at the hospital was individual work and teamwork. 48.6% of the questioned noted that... [to full text]

O tratamento antineoplásico está associado a efeitos adversos sendo inúmeros na cavidade bucal que podem aumentar a morbidade e mortalidade nos pacientes. O suporte odontológico ao paciente com câncer se faz necessário, porém ainda não é uma realidade em vários centros de tratamento oncológicos. O objetivo do presente estudo foi capacitar as equipes de odontologia e equipe multidisciplinar dos centros oncológicos pediátricos da capital e interior do RS, a fim de gerar conhecimento técnico-científico sobre as complicações bucais do tratamento oncológico para melhorias no manejo do paciente infanto-juvenil com câncer. Foi realizado um curso de capacitação de profissionais da área de saúde no manejo de pacientes em tratamento oncológico com carga horária de 3 horas/aula. Os participantes responderam um questionário pré e pós-aula (19 questões). Foi realizada análise descritiva, teste não paramétrico de Wilcoxon para a avaliação do resultado geral préteste/ pós-teste e o teste não paramétrico de McNemar para avaliação das questões de forma individualizada O nível de significância de 5% de probabilidade ou o p-valor correspondente foi considerado. Foram realizadas 11 capacitações contabilizando na amostra final 270 participantes. Os participantes foram 215 (92,3%) do gênero feminino, principalmente dentistas/estudantes de odontologia (24,5%) e técnicos de enfermagem (23,6%) com experiência de até 5 anos (50,7%). A média de acertos no préteste foi de 9,85 (51,89%) e no pós-teste 14,35 (75,57%) sendo esta diferença estatisticamente significante (p>0.001). O aumento médio de acertos após a realização da intervenção foi de 68,66%. Conclui-se que a capacitação foi eficiente para disseminar e aprofundar os conhecimentos sobre o manejo odontológico do paciente em tratamento oncológico e atingiu os principais centros de referência de tratamento do câncer infanto-juvenil do estado. / The antineoplastic treatment is associated with side effects being several of them observed in the oral cavity contributing for patient’s morbidity and mortality. Oral care in cancer patients is necessary, but it is not yet a reality in several cancer treatment centers. The aim of the present study was to perform a training course to dental and multidisciplinary teams in the pediatric cancer centers in southern Brazil, in order to improve knowledge about oral complications in pediatric and juvenile cancer treatment. The training course for health professionals involved the management of patients undergoing oncological treatment with a 3 hours class. Participants answered a pre and post-test (19 questions). Descriptive analysis, non-parametric Wilcoxon test (for overall pre-test / post-test) and McNemar's non-parametric test (questions individually) were performed. The significance level of 5% probability or the corresponding p-value was considered. Eleven trainings were carried out and involved 270 participants. The sample was composed by 215 (92.3%) female, mainly dentists / dental students (24.5%) and nursing technicians (23.6%) with experience of up to 5 years (50.7%). The mean accuracy in the pre-test was 9.85 (51.89%) and in the post-test was 14.35 (75.57%), and this difference was statistically significant (p> 0.001). The average of correct answers after the intervention was 68.66%. It is concluded that the training was efficient to disseminate and improve the knowledge about the oral care of the patients submitted to cancer treatment. Also, we can reached the main centers of reference for pediatric and juvenile cancer in southern Brazil state.

This thesis concerns with the functioning of coordinated team co-operation in organizations which provide social services to persons after acquired brain injury. Due to the frequency of occurrence and its deadful impact, these injuries become one of the most serious diseases not only in the Czech Republic but in the world. A person who has suffered brain injury is struggling with a number of socio-economic changes. A precondition for achieving full social integration of this individual is to ensure timely care and cooperation of individual experts on the given case. Such cooperation among experts is often missing in interconnected organizations. This can cause slowdown of the process of integration of an individual back to their everyday life. Equally important is the cooperation with family members who have an irreplaceable influence on the rehabilitation. The thesis is divided into two parts - theoretical and research. The theoretical part focuses on the consequences of acquired brain injury as well as on the the possibilities of social security provided by the state. Also, much of the text concerns with the coordinated rehabilitation and multidisciplinary collaboration which has a significant impact on improving the quality of life of people after brain injury. The data collection was carried out with the help of the method of qualitative research strategy, the technique of semi-structured interview with social workers in organizations of the city of Ceske Budejovice who provide social services according to Act 108/2006 Coll., on social services, as amended. The research is aimed at finding out how the coordinated rehabilitation is implemented in social services working with persons after acquired brain injury and then to create a proposal to streamline the implementation of coordinated rehabilitation in these organizations. Following the objectives, two research questions were examined: Which experts are involved in coordinated rehabilitation in social services providing services to people after brain injury? How is the cooperation of the team working with people after brain injury implemented? The data was processed in Atlas.ti 7. The research was carried out within the successfully accepted project at the Faculty of Health and Social Sciences, called Coordinated rehabilitation of patients with brain injury (reg. No. GAJU 138/2016/S), funded by the Grant Agency of the University of South Bohemia. The research results show insufficient cooperation of experts in social services providing care to persons with acquired brain injury. In spite of an acute need of coordinated and multidisciplinary support to such persons, the organizations miss specific professionals or employ workers who carry out works of other professions without the necessary qualification. The time, organizational and financial demands of teamwork make it impossible to provide high-quality multidisciplinary care, which is an important precondition for reintegration of people with brain injury back into work and social life. Team multidisciplinary cooperation brings a lot of positives, on the other hand, it also encounters barriers, which need to be further discussed in order to come to suitable solutions that are not only in the interest of the client and his family, but also great for the whole multidisciplinary team.

This thesis is focused on concept of coordinated rehabilitation within individuals in care of Alzheimer's disease. Objective of the thesis is to find out the possibilities of coordinated rehabilitation in the current concept of care for people with Alzheimer's disease. The thesis divided to two parts. The first part is focused on Alzheimer's disease, which describes what Alzheimer's disease is, its history, course, epidemiology, its risk factors, symptoms of how Alzheimer's disease is diagnosed and how it is treated. Another part of the theoretical part is dementia, where it is briefly described, what is the disease and other forms and division of dementia. The third and final part of the theoretical part is coordinated rehabilitation. This part describes what is a coordinated rehabilitation, its individual components and the conclusion of a specific activity that is used in a coordinated rehabilitation for people suffering from Alzheimer's disease. The research part of this work is focused on its objective and research questions, the methodology, results, discussion and conclusion are described. The qualitative research method was used in the research part. The technique for obtaining data for this research was a semi-standardized interview that was carried out with residential and outpatient staff providing services to people suffering Alzheimer's disease. The informants were selected by the method of deliberate selection. The data was then processed in Atlas.ti 7. In order to achieve the objective of this work, which is already mentioned above, two research questions have been determined. The first research question was focused on the differences in perception and the possibilities of using components of coordinated rehabilitation in residential and outpatient care for people with Alzheimer's disease. The second research question was focused on how the system of coordinated rehabilitation for people suffering Alzheimer's disease is most limited. The results of my work show that care for people suffering from Alzheimer's disease is insufficiently applied within the coordinated rehabilitation because the vast majority of practitioners who deal with such ill persons every day have no knowledge of this concept.

This study was developed with the aim of analyzing the resilient behavior and their contribution to the learning of the multidisciplinary health team of Multiprofessional Residence Program in Health (PRMS), in a federal institution of higher education located in the center of Rio Grande do Sul. The PRMS constitutes a mode of post-graduation lato sensu education course that aims professionals training for health care, management and education. The methodology is based on quantitative and qualitative approach type exploratory case study. For the quantitative research were applied three instruments: Work Stress Scale (TSE) of Paschoal and Tamayo (2004), Resilience Scale Job & Job (2003) and the Index of Learning Styles of Felder and Soloman (1991). The study included 97 multidisciplinary residents enrolled in PRMS. Data were organized and stored in a database in Excel (Office 2007). The sociodemographic variables and the items that comprise the instruments were statistically analyzed with SPSS software version 18.0 and SAS 9.02. The internal consistency of the scales was assessed by Cronbach's alpha coefficient, attesting trust for measurement and evaluation of the constructs. The results indicate the prevalence of females, aged 20 to 29 years, most formed in the period from 2010 to 2012 (73.19%), predominantly in two local universities, one public (40.21%) and other private (38.14%), belonging to multiple areas of knowledge in the health field. Regarding the measurement of stress 57.73% of the subjects had low average stress. As for resilience 73.20% of respondents had an average high resilience. The four factors that make up resilience, was the predominant factor 1 - dispositional with 74.23%, followed by factor 2 relational, with 73.20%, both measuring average high resilience among those surveyed. As for the learning styles, the most prevalent was sensory style 76.29%, followed by sequential 67.01%, verbal 57.73% and the active 56.7%. The qualitative research was conducted with 12 PRMS managers, based on semi-structured interview. For data analysis, we used the method of content analysis. Emerged from this analysis four categories not a priori: PRMS Management, Entrepreneurial Behaviour, Resilient Behavior and Learning Process. The complement of the two approaches was performed by the data triangulation technique. The research results have identified behavioral aspects in multidisciplinary team that directly influence their willingness to overcome the challenges of implementing the PRMS Political Pedagogical Proposed. To cope with the difficulties that emerged from the professional activity, the multidisciplinary team lay hold of their ability to positive react and adapt, by structuring on the protective factors of resilience. The results allow us to affirm the importance of resilient behavior of multidisciplinary health team before the activities in the program, based on a critical reflexive methodology, assumptions grounded by the public health system, driven by a model that excels in the learning process. / Este estudo foi desenvolvido com o objetivo de analisar o comportamento resiliente e sua contribuição para a aprendizagem de multiprofissionais da saúde do Programa de Residência Multiprofissional em Saúde (PRMS), de uma instituição federal de ensino superior, localizada no centro do Estado do Rio Grande do Sul. O PRMS constitui-se de uma modalidade de ensino de pós-graduação lato sensu visando à formação de profissionais da área da saúde para a assistência, gestão e ensino. A metodologia empregada está fundamentada na abordagem quantitativa e qualitativa do tipo estudo de caso exploratório. Para a pesquisa quantitativa foram aplicados três instrumentos: Escala de Estresse no Trabalho (EET), de Paschoal e Tamayo (2004), Escala de Resiliência Job&Job (2003) e o Índice dos Estilos de Aprendizagem de Felder e Soloman (1991). Participaram do estudo 97 multiprofissionais residentes, matriculados no PRMS. Os dados foram organizados e armazenados num banco de dados no programa Excel (Office 2007). As variáveis sóciodemográficas e os itens que compõem os instrumentos foram analisados estatisticamente com o software SPSS versão 18.0 e SAS 9,02. A consistência interna das escalas, foi avaliada pelo Coeficiente de Alfa de Cronbach, atestando fidedignidade para medida e avaliação dos constructos. Os resultados obtidos apontam a prevalência do sexo feminino, faixa etária entre 20 a 29 anos, a maioria formada no período de 2010 a 2012 (73,19%), com predomínio em duas universidades locais; sendo uma pública (40,21%) e a outra particular (38,14%), pertencentes às múltiplas áreas do conhecimento no campo da saúde. Em relação à mensuração do estresse 57,73 % dos sujeitos apresentou médio baixo estresse. Quanto à resiliência 73,20% dos entrevistados apresentaram média alta resiliência. Os quatro fatores que compõem a resiliência, o de maior predominância foi o fator 1 - disposicional com 74,23%, seguido do fator 2 relacional com 73,20% ambos mensurando média alta resiliência entre os pesquisados. Quanto aos estilos de aprendizagem os de maior prevalência foi o estilo sensorial 76,29%, seguido do sequencial 67,01%, verbal 57,73% e o ativo 56,7%. A pesquisa qualitativa foi realizada com 12 gestores do PRMS, com base na entrevista semiestruturada. Para a análise dos dados, empregou-se o método de análise de conteúdo. Desta análise, emergiram quatro categorias não a priori: Gestão do PRMS, Comportamento Empreendedor, Comportamento Resiliente e Processo da Aprendizagem. O complementando das duas abordagens foi realizado pela técnica de triangulação dos dados. Os resultados da pesquisa permitiram identificar aspectos comportamentais nos multiprofissionais que influenciam diretamente na sua disposição de superação frente aos desafios de implantação da Proposta Político Pedagógica do PRMS. Para dar conta das dificuldades emergidas da atividade profissional, os multiprofissionais lançam mão da sua capacidade de reação positiva e adaptação, estruturando-se nos fatores de proteção da resiliência. Os resultados alcançados permitem afirmar a importância do comportamento resiliente dos multiprofissionais da saúde diante das atividades desenvolvidas no programa, com base numa metodologia critico reflexiva, embasada pelos pressupostos do sistema público de saúde, conduzidas por um modelo que prima pelo processo da aprendizagem.

O tratamento antineoplásico está associado a efeitos adversos sendo inúmeros na cavidade bucal que podem aumentar a morbidade e mortalidade nos pacientes. O suporte odontológico ao paciente com câncer se faz necessário, porém ainda não é uma realidade em vários centros de tratamento oncológicos. O objetivo do presente estudo foi capacitar as equipes de odontologia e equipe multidisciplinar dos centros oncológicos pediátricos da capital e interior do RS, a fim de gerar conhecimento técnico-científico sobre as complicações bucais do tratamento oncológico para melhorias no manejo do paciente infanto-juvenil com câncer. Foi realizado um curso de capacitação de profissionais da área de saúde no manejo de pacientes em tratamento oncológico com carga horária de 3 horas/aula. Os participantes responderam um questionário pré e pós-aula (19 questões). Foi realizada análise descritiva, teste não paramétrico de Wilcoxon para a avaliação do resultado geral préteste/ pós-teste e o teste não paramétrico de McNemar para avaliação das questões de forma individualizada O nível de significância de 5% de probabilidade ou o p-valor correspondente foi considerado. Foram realizadas 11 capacitações contabilizando na amostra final 270 participantes. Os participantes foram 215 (92,3%) do gênero feminino, principalmente dentistas/estudantes de odontologia (24,5%) e técnicos de enfermagem (23,6%) com experiência de até 5 anos (50,7%). A média de acertos no préteste foi de 9,85 (51,89%) e no pós-teste 14,35 (75,57%) sendo esta diferença estatisticamente significante (p>0.001). O aumento médio de acertos após a realização da intervenção foi de 68,66%. Conclui-se que a capacitação foi eficiente para disseminar e aprofundar os conhecimentos sobre o manejo odontológico do paciente em tratamento oncológico e atingiu os principais centros de referência de tratamento do câncer infanto-juvenil do estado. / The antineoplastic treatment is associated with side effects being several of them observed in the oral cavity contributing for patient’s morbidity and mortality. Oral care in cancer patients is necessary, but it is not yet a reality in several cancer treatment centers. The aim of the present study was to perform a training course to dental and multidisciplinary teams in the pediatric cancer centers in southern Brazil, in order to improve knowledge about oral complications in pediatric and juvenile cancer treatment. The training course for health professionals involved the management of patients undergoing oncological treatment with a 3 hours class. Participants answered a pre and post-test (19 questions). Descriptive analysis, non-parametric Wilcoxon test (for overall pre-test / post-test) and McNemar's non-parametric test (questions individually) were performed. The significance level of 5% probability or the corresponding p-value was considered. Eleven trainings were carried out and involved 270 participants. The sample was composed by 215 (92.3%) female, mainly dentists / dental students (24.5%) and nursing technicians (23.6%) with experience of up to 5 years (50.7%). The mean accuracy in the pre-test was 9.85 (51.89%) and in the post-test was 14.35 (75.57%), and this difference was statistically significant (p> 0.001). The average of correct answers after the intervention was 68.66%. It is concluded that the training was efficient to disseminate and improve the knowledge about the oral care of the patients submitted to cancer treatment. Also, we can reached the main centers of reference for pediatric and juvenile cancer in southern Brazil state.

Incidence of injury is currently the third leading cause of death in the Czech Republic. A good link between pre-hospital emergency care and hospital care becomes a priority. Nurses play an important role during an acute admission of patients with trauma to in-hospital care, they are the connecting link of all members of the multidisciplinary team, whose common mission is the patient and saturation of his /her needs. With the changing role of nurses in the modern concept of nursing, nurses become equal partners of physicians and other health care professionals. To be accepted by other members of the team and to be able to work with the full extent of her sphere of action in the acute phase of a trauma patient admission, she has to know perfectly her competencies under the applicable legislation. In the theoretical part the roles and responsibilities of nurses under the applicable legislation are defined. There are also chapters dealing with individual injuries and the organization of care for patients with trauma. In the final section of the theoretical part there is a chapter dealing with the holistic care for patients, including ethical care issues, the role of a patient and the importance of cooperation with the family of the trauma patient who is acutely admitted into the hospital. In the empirical part of the thesis three objectives were stated. To determine the cooperation of nurses with other members of the multidisciplinary team, as well as to find out whether the nurses involved in the admission of a trauma patient into hospital know their own competencies under the Decree No. 424/2004 Coll. The third objective was to determine how trauma patients perceive the process of admission to the hospital. Based on these objectives two hypotheses and two research questions were established. The objectives were successfully met, both hypotheses were confirmed and the questions answered. The research was conducted on the basis of a quantitative qualitative survey at departments of selected hospitals where the patients with acute trauma emergency were directed by emergency medical services. For the quantitative research the interviewing method using questionnaires was selected. Interviews with patients were conducted by the qualitative research method. The respondents were 117 nurses and 5 patients.