Este estudo teve como objetivos avaliar os possíveis efeitos da utilização do aparelho propulsor mandibular removível (APM), sobre o crescimento da mandíbula e tipos de fibras nos músculos masseter superficial, pterigóideo lateral e digástrico em ratas. Vinte e sete ratas isogênicas (Fisher 344) foram divididas em três grupos randomizados: dois controles e um experimental, que utilizou o APM removível por 40 dias não consecutivos. Foram feitas reações histoquímicas para avaliar a distribuição dos tipos de fibras nos músculos mastigatórios. A mandíbula de cada animal foi dissecada e foram realizadas medições lineares da mesma. Não houve diferença estatisticamente significante entre os grupos quanto ao crescimento mandibular, e apenas masseter superficial anterior teve alterações, com aumento no número de fibras rápidas (tipo IIB). Em ratos, este modelo de APM, não estimulou aumento de crescimento mandibular e, somente o músculo masseter superficial sofreu alterações significativas quanto à distribuição dos tipos de fibras. / The aim of this study was to evaluate the possibles effects of removeble mandibular propulsive appliance (MPA) on mandibular growth and fiber types of superficial masseter, lateral pyterigoid and digastric muscles. Twenty seven isogenics rats (Fisher 344) were divided into three groups: two controls and one experimental that used the MPA during 40 days. Histochemical analyses was used to evaluate fiber type of masticatory muscles. The jaw of each animal was dissected and measurment was done. There was no signifcant difference on mandibular growth between the groups. Only the anterior portion of superficial masseter had an incresead of rapids fibers (IIB type). These results suggest that this MPA on a rat model, is not efficient to produce any alterations on mandibular growth and just on superficial masseter had significant alterations on muscles fibers types.

This master thesis is focused on producing orthopaedic implant materials and measuring their corrosion properties. It describes the bone and its structure, types, bone ossification and healing. It defines functions of orthopaedic implants and mentions the types of implants – biodegradable and non-biodegradable. The thesis interprets what corrosion is, what categories of corrosion exist and how does the corrosion influence orthopaedic implants. Preparing the solution of stimulated body fluid and manufacturing samples of different metal combinations (of iron, manganese, phosphorus, magnesium, silver and zinc) is included in this thesis, together with corrosion measurements, microscopic observations, EDAX analysis, metallographic analysis, microhardness testing of samples and pH changes measurements of solutions, and the results are interpreted and explained.

Total hip and knee arthroplasty surgeries form an integral part of orthopaedic practice. With an increase of the primary arthroplasty surgeries performed, comes also an increase in the number of complications. The most common complications of these otherwise very successful procedures is periprosthetic joint infections which are also one of the most difficult to treat. In the first part of the study, we evaluated the primary bacterial resistance of the 14 most commonly used materials in the construction of joint prostheses. More specifically, we concentrated on how their surface treatment resists colonisation by specific bacterial species (Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Enterococcus faecalis and Escherichia coli). The studied materials included metal alloys that are commonly used in the weight bearing parts of implants - CoCrNo, FeNiCr and Ti6A14V - but also polymeric and ceramic materials used in the bearing materials, represented by ultra-high- molecular-weight polyethylene (UHMWPE) and aluminium oxide (Al2O3). Our aim was to assess the relationship between material surface roughness and the sensitivity to colonisation by specific bacterial strains and to evaluate their affinity to different materials. Previous studies have proven that the roughness of...

<p>Intimate Partner Violence (IPV) includes physical, emotional, and sexual abuse. Under conditions of pronounced gender inequality, there is evidence that IPV represents an institutionalized practice in India. We investigated the feasibility of screening women for IPV at an orthopaedic hospital in India. Specifically, we assessed prevalence of IPV, method of questionnaire administration, response rate, availability of community services, environment of administration, and perspectives of health professionals regarding screening in this environment. We administered validated questionnaires to consenting women. The instrument was a compilation of two questionnaires designed for assessment of IPV status in primary care practices. Health professionals involved in conducting the study and in managing care for patients were also interviewed. Data from the interviews were analyzed for themes. Lastly, the investigator kept a field log with observations and interpretations to address other aspects of feasibility. Of 48 eligible women, 47 consented. All participants completed the Woman Abuse Screening Tool (WAST) and 45 completed the Composite Abuse Scale (CAS). Therefore, the response rate was high. Prevalence ranged between 30% (WAST) and 40% (CAS). Method of administration most used was self-report, which indicated a greater disclosure than interview-administration. The environment at this private hospital was considered adequate for conducting a larger study and we found several support networks in the area to help patients who disclosed IPV. Lastly, health professionals were found to be reluctant to screen for IPV. Our pilot study suggests that conducting a large-scale study in this region is feasible with some methodological modifications.</p> / Master of Science (MSc)

The issue of prosthetic infection leading to implant failure due to the formation of bacterial biofilms on biomaterial surfaces has been widely recognized as a major issue, often leading to revision surgery. The growing number of patients requiring synthetic biomaterials as implants is on the rise and so is the risk of infection arising from pre/peri-/post-operative surgical procedures. Traditional antibiotic treatment has led to the emergence of bacterial drug resistance. Therefore, the development of novel bactericidal methods to combat drug resistant microbial pathogens is the need of the hour. The first part of the thesis is an attempt to address prosthetic infection by the development of novel ultrasmall gold nanoparticles (AuNPs) which are cytocompatible and present a therapeutic dosage window for eliciting antimicrobial property. Towards this end, ultrasmall AuNPs with 0.8 nm and 1.4 nm gold core sizes, stabilized by monosulphonated triphenylphosphine ligand shells were synthesized. Such intricately designed AuNPs with ultrasmall gold cores and phosphine-based ligand chemistry were demonstrated to be highly potent bactericidal agents against staphylococci, the most common human pathogen causing biomaterial associated infection. The antibacterial efficacy of these AuNPs was significant even in mature staphylococcal biofilms. In another study, the application of high strength pulse magnetic fields (1-4 Tesla) was examined for bacterial growth inactivation in vitro. A magnetic field strength dependent decrease in bacterial viability with a concomitant increase in the production of reactive oxygen species (ROS) and longer doubling times were recorded. The mechanism of action was explained through an analytical model which involves ion-transport interference of essential ions like Ca2+ and Mg2+ and disruption of FeS clusters leading to inactivation of bacterial redox enzymes. On the contrary, such high magnetic fields did not pose any detrimental effects to eukaryotic cells under similar exposure. Additionally, the potency of low intensity direct current electric field (DC EF: 1V/cm) against biofilm formation by methicillin resistant Staphylococcus aureus (MRSA) was explored on antimicrobial surfaces of hydroxyapatite and Zinc oxide (HA-xZnO; x = 0, 5, 7.5 and 10 wt%). An EF exposure time dependent decline in the viability and stability of MRSA biofilms were noted. Further, EF treatment resulted in bacterial membrane depolarization and reduced biofilm formation on HA-ZnO composites, independent of the substrate composition. In summary, the above three studies were cases of the developmental methods to address prothetic infection. The second part of the thesis is focused on the development of magneto-responsive biomaterials as implants for orthopaedic applications. Under this category, the sintering/ hot pressing of hydroxyapatite-magnetite (HA-xFe3O4; x = 0, 5, 10, 20 and 40 wt%) powders in oxidizing and inert atmospheres was carried out and the resulting phases and microstructure were characterized. A detailed analysis of the phase assemblage by Rietveld refinement of the X-ray diffraction (XRD) data and Mössbauer spectroscopy revealed the major retention of Fe3O4 along with wustite (FeO) formation under reducing conditions while hematite (α-Fe2O3) was the oxidized product of conventional sintering in ambient atmosphere. A good correlation between the unit cell volume increases in HA observed from Rietveld refinements and Fe incorporation into the apatite lattice from Mössbauer spectral parameters was evident. Further, the Mössbauer data analysis indicated a preferential occupancy of Fe at the Ca(1) site under oxidizing conditions and Ca(2) site in inert atmosphere. The above phase analyses were further confirmed by X-ray photoelectron spectroscopy (XPS), Infrared spectroscopy (FT-IR) and CHN analysis. The microstructure of the hot-pressed samples observed under transmission electron microscope (TEM) divulged similar phases as deduced from XRD as well as the formation of translational Moire fringe patterns due to inference of overlapping crystal planes of HA and Fe3O4 in the HA-40 wt% composite. Such translational Moire fringes suggest a preferred arrangement and orientation of the crystallites resulting from hot-pressing, which correlated well with the room temperature magnetic measurements made with the help of a vibrating sample magnetometer (VSM). The compositional similarity of Fe doping in HA to that of the tooth enamel and bone presents these HA-Fe3O4 composites as potent dental/ orthopaedic implant materials. In the conclusive study, the hot-pressed HA-xFe3O4 composites were tested for their efficacy in supporting the osteogenesis of human mesenchymal stem cells (hMSCs) assisted by intermittent static magnetic field exposure. The magneto-responsive substrates were applied as platforms for the culture of hMSCs and the effect of static magnetic field (SMF) exposure on the viability, proliferation and differentiation of hMSCs were elucidated. With a mild compromise in viability, SMF triggered the osteogenic differentiation of hMSCs mediated by proliferative arrest in the G0/G1 phase and elevated intracellular calcium levels. The early bone marker genes - Runx2, Col IA and ALP were significantly up regulated upon SMF exposure on pure HA and HA-Fe3O4 composites. Further, the late osteogenic markers – OCN and OPN were detected exclusively in the HA-xFe3O4 (x = 10 and 40 wt%) composites. Matrix mineralization was enhanced and CaP nodules were detected on similar SMF treated HA-Fe3O4 composites. A substrate magnetization and time dependent modulation of gene expression was recorded which corroborated well with the temporal trending of osteogenic genes during bone development. In conclusion, substrate magnetization can be applied as a tool to modulate the behavior of stem cells and direct them towards osteogenic lineage. Such a pertinent combination of substrate magnetization and external magnetic field stimulation can be applied synergistically for stem cell based bone tissue engineering applications.

The topic of this diploma thesis is "Influence of footwear on foot deformities in women - the role of nurses in prevention". The theoretical part is devoted to the foot anatomy, it describes the issue of heels on the foot and represents the Giraffe certification. The practical part of the qualitative research shows the role of nurses in preventing foot deformities for patients. This thesis has two goals. To find out what footwear affects the deformities of the legs in women and to find out what role the nurse plays in preventing this issue. The research questions are 1. What is the importance of wearing high-heeled shoes for women and how will this be reflected later? 2. What role do nurses attribute to the prevention in this issue? Data collection was collected by semi-structured interviews with nurses in the orthopaedic ward and orthopaedic clinics. The research sample consists of 20 respondents, the choice was deliberate and formed by snowball sampling. In February 2019, data was collected, which was subsequently terminated at the moment of theoretical saturation. The interview covered themes: wearing high-heeled shoes, leg deformities caused by high-heeled shoes, nurse-led prevention and education. The results show that only a fraction of nurses adhere to the role of a nurse who helps patients prevent leg deformities. The rest of the nurses leave prevention and education to doctors. This diploma thesis presents as a work output a poster, which can be an information material for nurses from the orthopaedic clinics and beds. The output of the thesis is an educational poster that will reflect the entire nursing issue in prevention (the role of a nurse, the deformity of the feet caused by high-heeled shoes, etc.).

O objetivo deste estudo é o de comparar os resultados clínicos e radiográficos do tratamento cirúrgico das fraturas da diáfise do úmero com haste intramedular bloqueada ou placa em ponte. Quarenta fraturas da diáfise do úmero, em 39 pacientes, dos tipos A, B ou C da classificação do grupo A.O., foram tratadas no período compreendido entre junho de 2003 e dezembro de 2007. Destas, após seleção por sorteio, 21 fraturas foram submetidas à osteossíntese com placas em ponte de 4,5 mm e parafusos (grupo PP) e 19 com hastes intramedulares bloqueadas não fresadas (grupo HIB). Duas eram fraturas expostas, uma do tipo II e outra do tipo III-a de Gustilo. Vinte e cinco pacientes eram do sexo masculino (64%) e a idade variou de 19 a 75 anos (idade média de 41 anos e 10 meses). O lado direito foi acometido em 22 pacientes (55%) e a queda, o mecanismo de trauma mais freqüente (46%). O tempo mínimo de seguimento foi de seis meses e o máximo de 60 meses para o grupo PP (M=34,5 meses) e de oito e 58 meses (M=27meses) para o grupo HIB. Em apenas um caso, operado com haste intramedular bloqueada, não houve a consolidação. Houve um caso de infecção profunda no grupo PP e um de infecção superficial no grupo HIB. Dois casos do grupo PP evoluíram com capsulite adesiva e, em apenas um dos casos do grupo HIB, o parafuso distal ficou saliente. Ocorreu neuropraxia do nervo cutâneo lateral do antebraço em um dos casos do grupo HIB que regrediu em três dias. Não houve diferença entre os grupos com relação ao tempo total da cirurgia. O tempo de utilização da radioscopia no ato operatório foi maior no grupo HIB. Houve semelhança entre os dois métodos de fixação nos resultados referentes à dor, à função, à flexão ativa e à força de flexão na articulação do ombro e também com relação à dor, mobilidade, força muscular e estabilidade na articulação do cotovelo. Segundo os critérios da UCLA para o ombro, obtivemos resultados excelentes e bons em 85,7% no grupo operado com placa em ponte e 79% no grupo com haste intramedular bloqueada e de acordo com os critérios de Broberg e Morrey para o cotovelo, obtivemos resultados excelentes e bons em 85,7% no grupo operado com placa em ponte e 90,5% no grupo com haste intramedular bloqueada. Na avaliação subjetiva, duas pacientes, uma do grupo HIB e outra do PP, não ficaram satisfeitas. Conclusão: Não houve diferença no resultado clínico e radiográfico entre os dois métodos / The purpose of the study is to compare clinical and radiographic outcomes between nonreamed locked intramedullary nail and bridging plate for the treatment of humeral shaft fracture. Forty humeral shaft fractures in 39 patients, A, B or C AO types were treated between June 2003 and December 2007. The cases were randomly assigned into two groups being 21 fractures fixed by a 4.5 mm bridging plate, and 19 by nonreamed intramedullary locking nail. Two cases had open fractures, one Gustilo type II, the other type IIIa. Twenty five patients were male (64%), ages ranging from 19 to 75 years old (mean age 41 years and 10 months). The right side was treated in 22 patients (55%) and fall was the most frequent cause of fracture (46%). The minimal period of follow-up was six months and the maximum was 60 months for the bridging plate group (mean=34.5 months) and ranged from eight to 58 months (mean=27months) for the nail group. Only one case from the nail group presented a nonunion. One case, in the plate group, developed a deep infection, and another one, in the nail group, had a superficial infection. Two cases of the bridging plate group had adhesive capsulites and in one case of the nail group the distal screw became prominent. A transient neuropraxis of the antebrachial lateral cutaneous nerve was found in one case of the nail group, but it recovered in three days. There were no differences between the groups concerning pain, function, active flexion and strength of flexion of the shoulder, as well as pain, range of motion, muscle strength, and stability of the elbow. According to the UCLA score, we had 85.7% excellent and good results in the plate group and 79% in the nail group. According to Broberg and Morrey score for the elbow, we had 85.7% excellent and good results in the plate group and 90.5% in the nail group. Just one patient, from the nail group, was not satisfied with the final result, according to subjective criteria. In conclusion, there were no differences in the final clinical and radiographic results between the two methods of fixation

Les patients atteints de mono-traumatisme à un membre doivent consulter un médecin de première ligne qui assurera la prise en charge initiale et référera au besoin le patient vers un orthopédiste. L‟objectif principal de cette étude est de décrire ce mécanisme de référence envers un Service d‟orthopédie affilié à un Centre de traumatologie Niveau 1. La collecte de données concernant l‟accès aux soins spécialisés et la qualité des soins primaires a été faite lors de la visite en orthopédie. Nous avons étudié 166 patients consécutifs référés en orthopédie sur une période de 4 mois. Avant leur référence en orthopédie, 23 % des patients ont dû consulter 2 médecins de première ligne ou plus pour leur blessure. Le temps entre la consultation en première ligne et la visite en orthopédie (68 heures) dépasse le temps compris entre le traumatisme et l‟accès au généraliste (21 heures). Parmi les cas jugés urgents, 36 % n‟ont pas été vus dans les temps recommandés. La qualité des soins de première ligne fut sous-optimale chez 49 % des patients concernant l‟analgésie, l‟immobilisation et/ou l‟aide à la marche. Les facteurs associés à une diminution d‟accès en orthopédie et/ou une qualité de soins inférieure sont : tabagisme, jeune âge, habiter loin de l‟hôpital, consulter initialement une clinique privée, avoir une blessure au membre inférieur ou des tissus mous et une faible sévérité de la blessure selon le patient. Ces résultats démontrent qu‟il faut mieux cibler l‟enseignement relié aux mono-traumatismes envers les médecins de première ligne afin d‟améliorer le système de référence. / Patients with isolated traumatic limb injuries usually consult primary care for first line treatment. The primary care physician will often refer the patient to an orthopaedic surgeon when needed. The research objective was to study the referral mechanism to an Orthopaedic Service in a Level 1 Trauma Center for patients with an isolated limb injury. Access to specialized care and quality of primary care are used to describe the referral mechanism. We studied 166 consecutives patients referred to orthopaedic surgery over a 4 months period. Before the orthopaedic visit, 23 % had seen 2 or more doctors for their injury. The time between the first primary care visit and the orthopaedic evaluation was greater (68 hours) then the interval between the injury and the visit with primary care (21 hours). Among the cases that were considered urgent, 36 % had not been seen within the recommended delay. Quality of initial care was judged sub optimal for 49 % of patients in terms of immobilization, analgesia and/or walking aids. Factors associated with decreased access or quality of care are: smoking, younger age, living far from the hospital, consulting first in a private clinic, lower limb or soft tissue injury and a patient‟s low self-perception of severity. These results underline the necessity of targeting primary care education and improving the referral mechanism for patients with isolated limb injuries.

A Artroplastia Total de Quadril (ATQ) é um procedimento cirúrgico amplamente utilizado para o tratamento de afecções da articulação coxofemoral, sejam elas degenerativas inflamatórias ou traumáticas. Ela tornou-se um excelente método de tratamento no alívio da dor e melhora da capacidade funcional desses pacientes. No período pós-operatório, esses pacientes tornam-se dependentes da equipe enfermagem, devido à limitação para mobilizar-se e a restrição ao leito, visto que, não podem apoiar-se no chão, nem realizar exercício de adução com o membro operado pelo risco de luxação da prótese. Com base nestas características, o enfermeiro pode estabelecer o diagnóstico de enfermagem (DE) Mobilidade Física Prejudicada (MFP), dada a amplitude limitada de movimentos, trauma e dor no membro inferior afetado. Várias intervenções são realizadas, porém a avaliação de resultados ainda uma prática pouca explorada na enfermagem. A Classificação de Resultados Enfermagem (NOC) é uma terminologia usada no Processo de Enfermagem (PE) para medir, por meio dos Resultados de Enfermagem (RE), estados de saúde, comportamentos, reações e sentimentos dos pacientes, cuidador/familiar ou comunitário, e possibilita ao enfermeiro avaliar os efeitos das intervenções de enfermagem na prática clínica. Foi nessa perspectiva que se estabeleceu como objetivo geral avaliar a aplicabilidade da Classificação de Resultados de Enfermagem em pacientes com DE Mobilidade Física Prejudicada, submetidos à ATQ durante um período de até quatro dias. Trata-se de um estudo longitudinal realizado em um hospital universitário do sul do Brasil. Os dados foram coletados de agosto a dezembro de 2012 e os sujeitos foram pacientes submetidos à ATQ, que atenderam aos seguintes critérios: ambos os sexos; idade ≥ 18 anos; presença do diagnóstico MFP registrado em prontuário, com respectivos cuidados prescritos pelo enfermeiro assistencial; e permanecerem internados por quatro dias ou até a alta hospitalar. O instrumento de coleta de dados foi construído especialmente para esta pesquisa e cinco RE e 16 indicadores clínicos que compuseram o mesmo foram selecionados por meio de consenso. Os pacientes foram avaliados por duplas de coletadoras treinadas, de forma simultânea, por de maneira independente. Resultados: Participaram do estudo 21 pacientes, predominantemente do sexo feminino n=13(61,9%), brancos n=16 (76,1%), com idade média de 58,8 (±16,7), e 15 (71,4%) pacientes submetidos à ATQ primária. Os 21 pacientes mantiveram o DE MFP até o final das avaliações. De todos os pacientes, 15 (71,4%) foram avaliados num período de quatro dias de seguimento. Dentre os RE avaliados Posicionamento do Corpo: autoiniciado, Mobilidade, Conhecimento: atividade prescrita e Comportamento de prevenção de quedas apresentaram aumento significativo nos escores quando comparadas as médias da primeira com a última avaliação. Apenas o RE Nível de dor (p=0,265) não demonstrou diferença estatisticamente significativa. Esses dados indicam que o uso da NOC pode demonstrar a evolução clínica dos pacientes com Mobilidade Física Prejudicada submetidos à ATQ, sendo passível de aplicação neste cenário da prática de enfermagem. / The Total Hip Replacent (THR) is a widely used surgical procedure for the treatment of diseases of the hip joint, whether traumatic, degenerative or inflammatory. It be became an excellent method of treatment in relieving pain and improving functional capacity of these patients. In the postoperative period, these patients become dependent on nursing staff, due to the limitation to mobilize and bed restriction, since they cannot rely on the floor exercise or perform adduction with the operated limb at risk dislocation of the prosthesis. Based on these characteristics, the nurse can establish a nursing diagnosis Impaired Physical Mobility, given the limited range of motion, trauma and pain in the affected lower limb. Several interventions are performed, but the results evaluation still a little explored in nursing practice. The Nursing Outcomes Classification (NOC) is a terminology used in the Nursing Process to measure through Nursing Outcomes, health status, behaviors, reactions and feelings of patients, caregiver / family or community, and allows nurses to evaluate the effects of nursing interventions in the clinical practice. It was in this perspective that has established as purpose to evaluate the applicability of the Nursing Outcomes Classification in patients with Impaired Physical Mobility, undergoing THA for a period of up to four days. This is a longitudinal study conducted at a university hospital in southern Brazil. Data were collected from August to December 2012, and the subjects were patients undergoing THR, who met the following criteria: both sexes, age ≥ 18 years, presence of Impaired Physical Mobility recorded in patient records, with respective treatments prescribed by hospital nurses; and remain hospitalized for at four days. / La Artroplastia Total de Cadera (ATC) es un procedimiento ampliamente usado para el tratamiento quirúrgico de las enfermedades de la articulación de la cadera, si inflamatoria traumática o degenerativa. Ella se convirtió en un excelente método de tratamiento para aliviar el dolor y mejorar la capacidad funcional de estos pacientes. En el postoperatorio, los pacientes se vuelven dependientes de personal de enfermería, debido a la limitación de movilizar y por la restricción a la cama, ya que no pueden pisar el suelo o realizar la aducción de la extremidad operada en riesgo dislocación de la prótesis. En base a estas características, la enfermera puede establecer un diagnóstico de enfermería Deterioro de la Movilidad Física, dado el rango de movimiento limitado, el trauma y el dolor en la extremidad inferior afectada. En varias intervenciones se llevan a cabo, pero la evaluación de los resultados todavía poco explorado en la práctica de enfermería. La Clasificación de de Resultados de Enfermería (CRE) es una terminología que se utiliza en el Proceso de enfermería para medir a través de los Resultados de Enfermería, estado de salud, comportamientos, reacciones y sentimientos de los pacientes, cuidadores / familia o la comunidad, y permite a las enfermeras para evaluar los efectos de las intervenciones de enfermería en la práctica clínica. Es en esta perspectiva que se ha establecido como objectivo avaliar la aplicabilidad de la Clasificación de Resultados de Enfermería en pacientes con Deterioro de la Movilidad Física, sometidos a una Artroplastia Total de Cadera, por un período de cuatro días. Se trata de un estudio longitudinal realizado en un hospital universitario en el sur de Brasil. The data collection instrument was built specially for this study with five outcomes and 16 clinical indicators that were selected by consensus. Patients were evaluated by pairs of trained coletadoras, simultaneously, by independently. Results: The study included 21 patients, predominantly female n = 13 (61.9%), whites n = 16 (76.1%) with a mean age of 58.8 (± 16.7), and 15 (71.4%) patients undergoing primary THR. The 21 patients maintained of Impaired Physical Mobility until the end of the evaluations. In all patients, 15 (71.4%) were assessed over a period of four days of follow up. Among the nursing outcomes assessed Positioning Body: self-initiated, Mobility, Knowledge: prescribed activity and Fall prevention behavior showed a significant increase in scores when comparing the mean of the first with the last evaluation. Only the NOC Level of pain (p = 0.265) showed no significant difference. These data indicate that the use of the NOC can demonstrate the clinical course of patients with Impaired Physical Mobility undergoing THR, which might be applied in this scenario of nursing practice.

A Artroplastia Total de Quadril (ATQ) é um procedimento cirúrgico amplamente utilizado para o tratamento de afecções da articulação coxofemoral, sejam elas degenerativas inflamatórias ou traumáticas. Ela tornou-se um excelente método de tratamento no alívio da dor e melhora da capacidade funcional desses pacientes. No período pós-operatório, esses pacientes tornam-se dependentes da equipe enfermagem, devido à limitação para mobilizar-se e a restrição ao leito, visto que, não podem apoiar-se no chão, nem realizar exercício de adução com o membro operado pelo risco de luxação da prótese. Com base nestas características, o enfermeiro pode estabelecer o diagnóstico de enfermagem (DE) Mobilidade Física Prejudicada (MFP), dada a amplitude limitada de movimentos, trauma e dor no membro inferior afetado. Várias intervenções são realizadas, porém a avaliação de resultados ainda uma prática pouca explorada na enfermagem. A Classificação de Resultados Enfermagem (NOC) é uma terminologia usada no Processo de Enfermagem (PE) para medir, por meio dos Resultados de Enfermagem (RE), estados de saúde, comportamentos, reações e sentimentos dos pacientes, cuidador/familiar ou comunitário, e possibilita ao enfermeiro avaliar os efeitos das intervenções de enfermagem na prática clínica. Foi nessa perspectiva que se estabeleceu como objetivo geral avaliar a aplicabilidade da Classificação de Resultados de Enfermagem em pacientes com DE Mobilidade Física Prejudicada, submetidos à ATQ durante um período de até quatro dias. Trata-se de um estudo longitudinal realizado em um hospital universitário do sul do Brasil. Os dados foram coletados de agosto a dezembro de 2012 e os sujeitos foram pacientes submetidos à ATQ, que atenderam aos seguintes critérios: ambos os sexos; idade ≥ 18 anos; presença do diagnóstico MFP registrado em prontuário, com respectivos cuidados prescritos pelo enfermeiro assistencial; e permanecerem internados por quatro dias ou até a alta hospitalar. O instrumento de coleta de dados foi construído especialmente para esta pesquisa e cinco RE e 16 indicadores clínicos que compuseram o mesmo foram selecionados por meio de consenso. Os pacientes foram avaliados por duplas de coletadoras treinadas, de forma simultânea, por de maneira independente. Resultados: Participaram do estudo 21 pacientes, predominantemente do sexo feminino n=13(61,9%), brancos n=16 (76,1%), com idade média de 58,8 (±16,7), e 15 (71,4%) pacientes submetidos à ATQ primária. Os 21 pacientes mantiveram o DE MFP até o final das avaliações. De todos os pacientes, 15 (71,4%) foram avaliados num período de quatro dias de seguimento. Dentre os RE avaliados Posicionamento do Corpo: autoiniciado, Mobilidade, Conhecimento: atividade prescrita e Comportamento de prevenção de quedas apresentaram aumento significativo nos escores quando comparadas as médias da primeira com a última avaliação. Apenas o RE Nível de dor (p=0,265) não demonstrou diferença estatisticamente significativa. Esses dados indicam que o uso da NOC pode demonstrar a evolução clínica dos pacientes com Mobilidade Física Prejudicada submetidos à ATQ, sendo passível de aplicação neste cenário da prática de enfermagem. / The Total Hip Replacent (THR) is a widely used surgical procedure for the treatment of diseases of the hip joint, whether traumatic, degenerative or inflammatory. It be became an excellent method of treatment in relieving pain and improving functional capacity of these patients. In the postoperative period, these patients become dependent on nursing staff, due to the limitation to mobilize and bed restriction, since they cannot rely on the floor exercise or perform adduction with the operated limb at risk dislocation of the prosthesis. Based on these characteristics, the nurse can establish a nursing diagnosis Impaired Physical Mobility, given the limited range of motion, trauma and pain in the affected lower limb. Several interventions are performed, but the results evaluation still a little explored in nursing practice. The Nursing Outcomes Classification (NOC) is a terminology used in the Nursing Process to measure through Nursing Outcomes, health status, behaviors, reactions and feelings of patients, caregiver / family or community, and allows nurses to evaluate the effects of nursing interventions in the clinical practice. It was in this perspective that has established as purpose to evaluate the applicability of the Nursing Outcomes Classification in patients with Impaired Physical Mobility, undergoing THA for a period of up to four days. This is a longitudinal study conducted at a university hospital in southern Brazil. Data were collected from August to December 2012, and the subjects were patients undergoing THR, who met the following criteria: both sexes, age ≥ 18 years, presence of Impaired Physical Mobility recorded in patient records, with respective treatments prescribed by hospital nurses; and remain hospitalized for at four days. / La Artroplastia Total de Cadera (ATC) es un procedimiento ampliamente usado para el tratamiento quirúrgico de las enfermedades de la articulación de la cadera, si inflamatoria traumática o degenerativa. Ella se convirtió en un excelente método de tratamiento para aliviar el dolor y mejorar la capacidad funcional de estos pacientes. En el postoperatorio, los pacientes se vuelven dependientes de personal de enfermería, debido a la limitación de movilizar y por la restricción a la cama, ya que no pueden pisar el suelo o realizar la aducción de la extremidad operada en riesgo dislocación de la prótesis. En base a estas características, la enfermera puede establecer un diagnóstico de enfermería Deterioro de la Movilidad Física, dado el rango de movimiento limitado, el trauma y el dolor en la extremidad inferior afectada. En varias intervenciones se llevan a cabo, pero la evaluación de los resultados todavía poco explorado en la práctica de enfermería. La Clasificación de de Resultados de Enfermería (CRE) es una terminología que se utiliza en el Proceso de enfermería para medir a través de los Resultados de Enfermería, estado de salud, comportamientos, reacciones y sentimientos de los pacientes, cuidadores / familia o la comunidad, y permite a las enfermeras para evaluar los efectos de las intervenciones de enfermería en la práctica clínica. Es en esta perspectiva que se ha establecido como objectivo avaliar la aplicabilidad de la Clasificación de Resultados de Enfermería en pacientes con Deterioro de la Movilidad Física, sometidos a una Artroplastia Total de Cadera, por un período de cuatro días. Se trata de un estudio longitudinal realizado en un hospital universitario en el sur de Brasil. The data collection instrument was built specially for this study with five outcomes and 16 clinical indicators that were selected by consensus. Patients were evaluated by pairs of trained coletadoras, simultaneously, by independently. Results: The study included 21 patients, predominantly female n = 13 (61.9%), whites n = 16 (76.1%) with a mean age of 58.8 (± 16.7), and 15 (71.4%) patients undergoing primary THR. The 21 patients maintained of Impaired Physical Mobility until the end of the evaluations. In all patients, 15 (71.4%) were assessed over a period of four days of follow up. Among the nursing outcomes assessed Positioning Body: self-initiated, Mobility, Knowledge: prescribed activity and Fall prevention behavior showed a significant increase in scores when comparing the mean of the first with the last evaluation. Only the NOC Level of pain (p = 0.265) showed no significant difference. These data indicate that the use of the NOC can demonstrate the clinical course of patients with Impaired Physical Mobility undergoing THR, which might be applied in this scenario of nursing practice.