Dissertations/Thesis

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2024
Dissertations
1
  • LARISSA ARIELLY CUNHA DA SILVA
  • Construction and validation of a guide for the transition of care to patients with mental disorders

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ISABELLE CAMPOS DE AZEVEDO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Jan 23, 2024


  • Show Abstract
  • The transition of care is presented as a strategy to reorganize and continue the care provided with coordination between the team, family and services involved. From this perspective, the present study aims to develop a guide to support the transition of care for individuals with mental disorders. This is a methodological study with a mixed approach, organized into three procedures: theoretical, in which a focus group was carried out with 10 professional nurses from the mental health area of two reference hospitals and a Scoping Review on the transition of care to individuals with a disorder mental; empirical procedures for creating the guide and validating its content and appearance using the Delphi technique, with the collaboration of judges in the area in question; and analytical procedures, intended for data analysis using the Content Validation Coefficient. The present study was approved by the Ethics and Research Committee (CAAE: 67216423.0.0000.5537). The focus group lasted 61 minutes, in which nurses addressed their perceptions about the transition of care for patients with mental disorders. The Scoping Review showed that the transition of care for patients with mental disorders between levels of health care is carried out by a multidisciplinary team with the help of tools that facilitate communication between professionals by systematizing care, standardizing communication and directing care. The data from the focus group and the Scoping Review were the basis for creating the Guide, which was submitted to the judges for validation. In the Delphi I round, which had the participation of 16 judges, a general content validity coefficient of 0.93 was achieved for the three chapters. For appearance validation, an index of 0.93 was obtained. After adjustments suggested by the judges, in Delphi II the content and appearance validity indices were 100 for each. Therefore, the Guide was considered valid in its content and appearance, and can contribute to a safe continuity of care provided to the patient.

2
  • JESSICA IRIS FRANCO DA SILVA
  • The work of nurses in pediatric health units: satisfaction and dissatisfaction.

  • Advisor : JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • DENISE ELVIRA PIRES DE PIRES
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • MARCELO MAURICIO DA SILVA
  • SORAYA MARIA DE MEDEIROS
  • Data: Feb 7, 2024


  • Show Abstract
  • The experiences of pleasure and suffering determine the subject's relationship with their work,
    and can culminate in the production of health and psychological illness among workers.
    Pleasure tends to be manifested through feelings such as recognition and affinity with work,
    that is, positive experiences. On the other hand, failure, frustration and impotence point to
    suffering, when they contradict the expectations of this subject. Given this, the study's general
    objective was to analyze aspects of the work process that trigger satisfaction and dissatisfaction
    among nurses who work in pediatric services in a capital in northeastern Brazil. This is a
    descriptive and analytical study with a qualitative approach, using the Psychodynamics of
    Christophe Dejours' work as a theoretical framework. Eighteen nurses working in three public
    pediatric services of medium and high complexity in the city of Natal/RN participated in the
    study between September and November 2023. Semi-structured face-to-face interviews were
    used as a method to obtain data in a preferred location. of each participant, associated with a
    field diary. Subsequently, content analysis was conducted with the help of the Atlas.ti 23
    software. All research was developed in compliance with Resolution 466/12 of the National
    Health Council and the General Data Protection Law n.13.709/2018, having been approved by
    CEP/UFRN with opinion no. 6.278.155. The elements of satisfaction exposed were the
    development of care due to the affinity with the pediatric specialty, especially when the child
    recovers, good relationships with peers, both families and the multidisciplinary team, as well as
    the empathy of the immediate supervisor. However, work overload, distancing from
    institutional management, related to poor organization of Nursing staffing and staff shortages
    with frequent sector reassignments and undervaluation of the specialty, were the main factors
    that contributed to job dissatisfaction. It was concluded that the research participants are
    partially satisfied with their work and that the factors revealed could be fundamental to
    improving their work process in relation to their teams, institutional and political management.

3
  • ERICLES LOPES DE MOURA
  • Implantation of a Peripherally Inserted Central Catheter guided by ultrasound versus blind puncture for the prevention of vascular trauma: a Systematic Review,

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ISABELLE CAMPOS DE AZEVEDO
  • KLEYTON SANTOS DE MEDEIROS
  • Data: Feb 9, 2024


  • Show Abstract
  • Introduction: The evolutionary history of intravenous therapy points to a development
    observed as a result of the advancement of studies and research derived from several other
    areas of knowledge. For this reason, it should not be reduced to a simple technique for
    carrying out therapy, given its well-structured arsenal of knowledge. Tunneled central
    catheters began to be used in the 1980s, however, regarding Peripherally Inserted Central
    Catheters (PICC), there are records of the beginning of their implementation since the 1970s.
    Their significant use in the care setting Critics consider the existence of conditions that
    increase the chance of complications related to puncture, when compared to other
    intravascular devices. However, the benefits of this device do not exempt it from the
    occurrence of adverse events, such as vascular trauma that usually occurs after its
    implantation. The prevention of this outcome is what configures the object of this study.
    Objective: To compare the effectiveness of implanting a Peripherally Inserted Central
    Catheter using ultrasound-guided puncture with blind puncture for preventing vascular
    trauma in adult patients admitted to an intensive care unit (ICU). Methodology: This is a
    systematic review of effectiveness. This design comprises a type of study capable of
    synthesizing the results of primary studies that meet the eligibility criteria to answer a
    research question. The recommendations of the JBI Manual for Evidence Synthesis were met;
    and to provide greater methodological rigor to its structure and content, the initiatives of the
    Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2020
    statement were complied with. For data management purposes, a search and review protocol
    was drawn up, the registration of which on the International Prospective Register of
    Systematic Review platform it was registered under the following inscription:
    CRD42023467957. Data collection occurred through a paired search with independent
    reviewers in ten data sources, and the studies were selected according to the eligibility criteria
    adopted for the purposes of this review. Data extraction took place by completing a semi-
    structured instrument containing the variables of interest to the research, from which
    descriptive analyzes were processed as well as critical assessment of the methodological
    quality, risk of bias and strength of evidence of the studies that were part of the final sample.
    Results: After using the search strategy syntaxes, a total of 1.024 articles were retrieved to
    read the titles and abstracts. From this number, three studies were selected for full reading, as
    they met the scope of this review. All of them were randomized clinical trials, however, one
    of them was excluded because it was not available in full text in the database. The final
    sample was composed of four studies, which were subjected to a complete reading from

    which the form for data extraction was completed, as well as the JBI Critical Assessment
    Checklist for Randomized Controlled Trials was applied, in order to identify the risk of bias
    and the methodological quality of the studies. Both studies compared the effectiveness of two
    puncture methods for PICC implantation, between blind puncture and ultrasound-guided
    puncture. As a result, it was observed that the use of ultrasound to guide the puncture was
    superior to the conventional method for implanting the device, especially for the prevention
    of postoperative complications. Conclusion: Ultrasound-guided puncture is a safe,
    satisfactory and effective method for PICC implantation and prevention of vascular trauma in
    adult patients admitted to the ICU.

4
  • DAYARA AINNE DE SOUSA ARAUJO
  • Conventional infusion therapy and hypodermoclysis in palliative patients: comparison between general and oncology hospitals.

  • Advisor : QUENIA CAMILLE SOARES MARTINS
  • COMMITTEE MEMBERS :
  • ALCIDES VIANA DE LIMA NETO
  • ISABELLE CAMPOS DE AZEVEDO
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • QUENIA CAMILLE SOARES MARTINS
  • Data: Feb 23, 2024


  • Show Abstract
  • The objective of the study is to compare the clinical and therapeutic characteristics related to the hospitalization course in palliative patients undergoing conventional therapy and hypodermoclysis in a general and oncology hospital. It is a study with a quantitative approach, prospective cohort, to structure it, Strengthening the Reporting of Observational Studies in Epidemiologi was used. It took place in two oncology reference services with exclusive services to the Unified Health System in the state of Rio Grande do Norte. The study population consisted of cancer patients undergoing palliative care who were hospitalized. Therefore, to calculate the sample for this research, it showed a power of 80% and a level of evidence of 0.05, so the overall sample was 84 patients to be evaluated. This research included patients admitted to hospitals that present palliative care procedures or that are beyond therapeutic possibilities, and excluded patients whose at least the main caregiver had no knowledge about palliative care procedures. For the outcomes of this study, death, hospital discharge and transfer to other units will be considered. For data collection, an instrument for sociodemographic and clinical data was used, in addition to the algorithm for eligibility of hypodermoclysis in adult patients, the Edmonton Symptom Assessment Scale and the Palliative Performance Scale. The data was organized in Microsoft Excel and analyzed using the statistical software Statistical Package for the Social Sciences version 22.0, statistical tests were carried out to analyze the data, with a significance level of 0.05 adopted. The study obtained a favorable opinion from the Research Ethics Committee under number 6.289.214 and CAAE 71440423.6.0000.5537, thus following the ethical precepts in research with human beings described in Resolution 466/2012 of the National Health Council. Study was divided into hospital 1 (29 patients) and hospital 2 (55 patients), this is justified by the discrepancy in the number of hospital beds in hospital 2 in relation to hospital 1. The results indicate that in both hospitals the median age They are in the sixty-year-old age group, female (37.0% - 63.0%), and predominantly reside in the interior of the state (36.2% - 63.8%). The types of cancer that prevailed were of gastrointestinal origin (45.9%), followed by lung (11.8%) and breast (8.2%), in addition, the number of days of hospitalization had a median of six days in hospital 1 and four in hospital 2. The study showed that palliative patients used the peripheral venous catheter more frequently (53.3%) with a median of one day in usage time, the central venous catheter had a median in usage time of thirteen days and hypodermoclysis of one day. Therefore, the routes are effective, however, adverse events related to the catheter and assistance were observed, such as: infiltration, erythema, hematomas, venous fragility, which will present different levels of complications in relation to the catheter and puncture site of choice. Furthermore, infusion therapy works to control signs and symptoms, contributing to comfort and quality of life. This study verified the access route that guarantees quality, safety and comfort for patients in hospital, as well as contributing to a safe and cost- effective transition of care for health services and users. 

5
  • THUANNY NAYARA DO NASCIMENTO DANTAS
  • Middle Range Theory for the Nursing Diagnosis of Neonatal Abstinence Syndrome.

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • Data: Feb 27, 2024


  • Show Abstract
  • Introduction: In the health concept, Neonatal Abstinence Syndrome is a post-birth
    complication identified in newborns based on the observation of a set of signs and
    symptoms resulting from exposure to psychoactive substances during pregnancy or as a
    consequence of pharmacological exposure to the pain relief and control or sedation. In
    the context of Nursing, Neonatal Abstinence Syndrome is configured as a Nursing
    diagnosis that belongs to the NANDA International classification system and that,
    currently, requires the development of its diagnostic indicators (related factors and
    defining characteristics) to make it valid with a higher level of evidence. Thus, with the
    aim of identifying the etiological elements and clinical characteristics of this diagnosis,
    reducing the existing gaps between theory and practice and contributing to improving
    the quality of nursing care for newborns undergoing abstinence, it is proposed to
    develop a Theory of Medium Range (MRT) for the diagnosis under study. Objective:
    Develop a Middle Range Theory for the nursing diagnosis of Neonatal Abstinence
    Syndrome. Method: This is a methodological study of theoretical-causal validity,
    proposed by the Lopes e Silva framework, carried out in six stages: Definition of the
    approach for constructing the MRT; Definition of the theoretical-conceptual models
    adopted for MRT; Definition of key MRT concepts; Construction of a pictorial
    diagram; Construction of MRT propositions; and Establishment of causal relationships
    and practice-based evidence. Two approaches were adopted to construct the MRT:
    literature review, through the execution of two systematic reviews (on etiology and risk
    and diagnostic accuracy); and based on Callista Roy's Adaptation Model. Data
    collection occurred by searching the following data sources: SciELO, Web of Science,
    Science Direct, PubMed, COCHRANE, SCOPUS, CINAHL, EMBASE and LILACS.
    As a search strategy, the following descriptors were used: Newborn, Etiology,
    Causality, Signs and Symptoms and Neonatal Abstinence Syndrome, interspersed with
    the Boolean operator AND. The inclusion criteria were: studies addressing the Neonatal
    Abstinence Syndrome phenomenon, complete studies, available and free in any
    language. Exclusion criteria include: abstracts, editorials, letters to the editor, theses,
    dissertations, review articles, reviews, preliminary notes, reflection articles. Results:
    Eight etiological factors (related factors) and 12 clinical characteristics (defining
    characteristics) were identified. Based on these findings, conceptual and operational
    definitions were created for each of these clinical antecedents and consequences of
    MRT, which were summarized in a pictorial scheme and which also supported the
    construction of MRT propositions and causal relationships. These results were
    presented through the description and construction of flowcharts, tables, charts and
    figures. Conclusion: The MRT for the diagnosis of Neonatal Abstinence Syndrome was
    developed to describe, explain and predict the phenomenon, in order to guide nursing
    interventions more assertively, in order to meet the human needs of the population in
    focus and improve practice nursing, through the theoretical-causal validation study.

6
  • SHAYANNA MICKAELA DUQUE CARNEIRO
  • The (re)construction of the professional identity of migrant nurses.
  • Advisor : JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • JOÃO BOSCO FILHO
  • MARCELO MAURICIO DA SILVA
  • SORAYA MARIA DE MEDEIROS
  • Data: Feb 28, 2024


  • Show Abstract
  • The migration of nurses is an important phenomenon with varied implications, both for the places of origin and for the destinations. Individual, social and professional factors influence the decision to migrate these workers and the experiences lived by them directly reflect on the construction of their personal and professional identities. The objective of this study was to analyze the decision of nurses who have an employment relationship in a public teaching institution to migrate to another institution in the regions of Brazil. This is an analytical study, with a qualitative approach, mediated by Thematic Oral History. Nurses working in four university hospitals managed by the Brazilian Company of Hospital Services who migrated from these units as well as the other way around were invited to participate in the study. Semi-structured interviews were conducted and their analysis through the categories resulting from the dialogue between the authors studied in the theoretical framework on the theme. The research was approved by the Research Ethics Committee of UFRN with the Opinion number 6.278.154 and CAAE 70566623.5.0000.5537. Thirteen interviews were carried out respecting their availability and preference regarding format. Therefore, there were eleven face-to-face interviews and two through the Google Meet platform. There was a predominance of female employees, aged between 32 and 48 years old. Regarding academic degrees, all reported having at least two Lato Sensu postgraduate degrees and only three reported Stricto Sensu postgraduate degrees at the Residency and Master's level. The initial crisis in the insertion of the labor market of a capitalist society, with its frustrations of unemployment, precarious ties in cooperatives and the lack of recognition in society, stimulated the search for professional qualification as a means of getting out of that reality. This qualification, at all times, was filled with expectations due to the change in the environment in which they were inserted, which influenced the decision of the first migration of eleven of the thirteen collaborators in the study. However, the personal and
    professional maturation after their migratory experiences promoted a new identity crisis: the search for identity for themselves. The nurses in the study not only wanted social identity, but also the pleasure of belonging, and thus, of the eleven collaborators who migrated for the first time away from their states, eight decided to migrate once again to be close to their essence, promoting the (re)construction of their professional identities with a new beginning, new environments, new friendships and new work processes. It was found in the research that the professional identity is changeable, directly linked to the individual identity and that when they find their new belonging, through their choices and not only for an economic reason, the employees develop their work activities with satisfaction and pleasure. As nurses, this directly reflects not only on their professional careers, but also on their personal lives and the entire society that depends on their health care. 

7
  • CAMILA SAYONARA TAVARES GOMES
  • Care-educational technology aimed at risk-prone health behavior, sedentary lifestyle and overweight in university students.

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • DANDARA NAYARA AZEVEDO DANTAS
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • NIRLA GOMES GUEDES
  • PAULA FERNANDA BRANDAO BATISTA DOS SANTOS
  • Data: Feb 28, 2024


  • Show Abstract
  • The nursing diagnoses Risk-prone health behavior, Sedentary lifestyle and Overweight are common among university students, given the transitions experienced and the fragility in their health care during the undergraduate period. In this context, nurses can intervene through care-educational technologies aimed at promoting health. However, there are few technologies available for this audience. Thus, the present study aimed to: build and validate a care-educational technology for the nursing diagnoses Risk-prone health behavior, Sedentary lifestyle and Overweight in university nursing students. This is a methodological study, carried out in two stages. The first stage consisted of the construction and content validation of the care-educational technology and the multiple- choice questionnaire, with closed questions, applied in the pre-test and post-test. The construction of the technology was supported by scientific literature and the experience of the researchers involved. In the content validation process, a focus group was held with nine judges, considering the opinions frequently expressed by the judges and the final consensus. The second stage of the study corresponded to the application and evaluation of care-educational technology, through an experimental study. The nursing students were divided into an intervention and control group. The intervention group was subjected to this technology and the control group to the lecture in the format of a dialogued expository class. Both groups answered the pre- and post-tests. Data were analyzed using descriptive and inferential statistics. The research project was approved by the Ethics Committee of the Federal University of Rio Grande do Norte, under opinion number 5,917,687. The results show that the technology developed was a workshop, called “Workshop on health care”, divided into four thematic axes, with 35 minutes of execution in each axis and twenty minutes of application of the pre- and post-test. The thematic axes were aimed at health promotion, involving content on healthy eating, sedentary lifestyle, use of legal and illicit substances, sexual and reproductive health, mental health, time management, stress and quality sleep. As for the focus group, there was a final consensus among the judges, with adjustments being made to the technology and the questionnaire. In the experiment stage, it was identified that the care-educational technology was not effective in improving students' knowledge about health promotion, when comparing the pre-test (p=0.506) and the post-test (p=0.271) of the intervention and control groups. However, when the correct answers to the questions in the pre- and post- tests of the groups were analyzed, an increase in correct answers to the questions in the experimental group was observed when compared to the control. It is concluded that the care-educational technology developed and validated was not effective when comparing the tests before and after the intervention and control groups, however the average number of correct answers for students in the intervention group was higher. Therefore, it is expected that this technology can be applied in other studies with a larger number of university students, especially those in the health area. 

8
  • RAFAELA CAVALCANTI DE ALBUQUERQUE NASCIMENTO
  • Risk factors associated with nosocomial infection during hospitalization in adult intensive care units: Scoping Review.

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • RODRIGO ASSIS NEVES DANTAS
  • BARBARA COELI OLIVEIRA DA SILVA
  • Data: Feb 29, 2024


  • Show Abstract
  • Nosocomial Infection are recognized by the World Health Organization as a problem of broad global magnitude. In this context, Brazilian hospitals present an unfavorable scenario in terms of high rates, as they present approximately 6% of HAIs in the context of hospital admission, being triple the percentage of tolerance stipulated by the World Health Organization. When considering that HAIs are a serious public health problem, they can be caused by several risk factors, which vary according to the hospital context, patient profile and health care practices adopted, and can thus be assessed that Carrying out a comprehensive and systematic review to identify risk factors for HAIs will become a useful tool for infection control. Objetive: Identify and map the risk factors associated with healthcare-associated infections in people hospitalized in adult intensive care units. Method: This is a scoping review (DOI 10.17605/OSF.IO/MYEJ5) developed within the recommendations of the Joanna Briggs Institute and PRISMA Extension for Scoping Review, developed in five stages: 1) identification of the research question; 2) identification of relevant studies; 3) selection of studies; 4) data extraction, separation, summarization and reporting of results and 5) communication of results. According to JBI, the Participant, Concept and Context mnemonic was applied to construct the research question, in which Participant corresponds to “People in hospital”, Concept “Risk factors for healthcare-related infections” and the Context “ Adult ICU”, and the guiding question was: “What are the risk factors in the development of HAIs in people admitted to intensive care units?”. The search was carried out in twelve databases, using the following Boolean descriptors and operators, according to the crossing format: (Cross Infection) OR (Nosocomial Infection) OR (Patients) OR (Adult) AND (Risk Factors) AND (Intensive Care Units ) OR (ICU Intensive Care Units), in 2023 on the Federated Academic Community platform. The research inclusion criteria were: articles originating from primary, secondary studies, national regulations and policies, dissertations and theses available in full, without temporal delimitation, in any language and that answer the research question. Reflections, experience reports, editorials and summaries published in the annals of scientific events will be excluded. Results 5533 studies were found, 54 of which were included. 100% of the studies addressed some intrinsic characteristic associated with a risk factor for the development of HAIs, addressing age 62%, sex 53%, use of antibiotic agents in the previous 90 days 9%, use of corticosteroids 1%, diseases priors 29%, smoking 2%, nutrition 22%. For extrinsic risk factors, such as those associated with hospitalization, the study addressed length of stay 71%, ICU admission 42%, APACHE II 33%, APACHE III 27%, night admission 2%, nurse/patient ratio 1% , aseptic measures 19%, use of sedation 21%, blood transfusion 2%. The use of devices was also cited in studies as risk factors, with the following being addressed: central venous catheter, endotracheal intubation, tracheostomy tube, mechanical ventilation, nasoenteral tube, urinary catheter, drains, etc. Conclusion: The mapping of risk factors associated with Nososcomial Infections contributes to the advancement of scientific knowledge about Nosocomial infections in ICU, by providing a comprehensive mapping of risk factors, aiming to join efforts with existing national programs focused on prevention of nosocomial infection. 

9
  • KATARINE FLORENCIO DE MEDEIROS
  • APPLICATION OF THE INSTRUCTIONAL THERAPEUTIC TOY IN HOSPITALIZED CHILDREN UNDERGOING BLADDER CATHETERISM

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • EDMARA BAZONI SOARES MAIA
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • SORAYA MARIA DE MEDEIROS
  • Data: Feb 29, 2024


  • Show Abstract
  • Among the playful interventions proposed for children undergoing hospitalization, Therapeutic Play stands out,
    which can be classified into three types: dramatic; physiological and instructional function enabler. The
    Instructional Therapeutic Toy aims to clarify and train the child/family about hospitalization and the therapy involved in it. This is a descriptive and exploratory study with a qualitative approach through multiple case studies, supported by Winnicott's contributions, with the aim of understanding the meaning attributed by hospitalized children to participating in an instructional therapeutic play session in preparation for bladder catheterization. Ten children hospitalized in a university hospital in a northeastern capital participated in the period from October to November 2023. Data collection occurred in three phases: 1) collection of data from the medical records; 2) Intervention with Instructional Therapeutic Play and 3) semi-structured interview with the child. The second and third phases were recorded in video and audio using electronic media and transcribed in full. The field diary was used to record observations related to non-verbal communication during the application of the therapeutic toy and the interview. The criterion used to interrupt collection was theoretical data saturation. The data were analyzed based on inductive thematic analysis with the support of Winnicott's theoretical framework, resulting in the identification of three themes: Having control over reality; Perceptions related to instructional BT; Bladder catheterization from the perspective of hospitalized children. The study met the ethical prerogatives required by Resolution No. 466/2012, of the National Health Council and its supplementaries, being approved by opinion no. 6.417.881 and CAAE 71444523.0.0000.5537, issued by the Ethics and Research Committee of the Federal University of Rio Grande do Norte. For children, therapeutic toys allow them to have control over reality by giving them powers to oppress, decide what to do and want to be, be or have something for themselves. By reliving previous experiences, they had the opportunity to dramatize their experiences and retell their stories related to past and current hospitalizations in an attempt to process and re-signify them to discover the child's self, with the aim of, through creativity, coping better. with the situation. It was identified that they perceive therapeutic play as a pleasurable activity, as it allows them to enter their imagination and play, but it also awakens paradoxical and/or negative feelings by reviving memories of past experiences. For some children, bladder catheterization meant healing and care and, as it was an invasive procedure, it was associated with pain. For others, when contacting their internal reality, the therapeutic toy caused internal disorders and disturbed feelings emerged, which caused an escape from reality. Although the session was intended to instruct children about bladder catheterization, it became a dramatic therapeutic toy when it provided space for creativity, entering the children's universe, recounting their experiences and expressing emotions and perceptions related not only to catheterization, but also to other procedures experienced during hospitalizations.

Thesis
1
  • FERNANDO HIAGO DA SILVA DUARTE
  • USE OF AUDIOVISUAL RESOURCE IN THE ACQUISITION OF KNOWLEDGE AND REDUCTION OF THE LEVEL OF ANXIETY OF HOSPITALIZED PATIENTS NEWLY DIAGNOSED WITH HIV/AIDS: randomized clinical trial.

  • Advisor : DANIELE VIEIRA DANTAS
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • DANDARA NAYARA AZEVEDO DANTAS
  • DANIELE VIEIRA DANTAS
  • JULIANA RAQUEL SILVA SOUZA
  • RENATA SILVA SANTOS
  • Data: Feb 20, 2024


  • Show Abstract
  • The acquired immunodeficiency virus (HIV) is capable of developing the Acquired Human
    Immunodeficiency Syndrome (AIDS), with severe clinical manifestations, affecting physical
    and mental integrity. It is necessary to use technological tools in education, as lack of
    knowledge can cause anxiety in newly diagnosed patients. The objective of this study was to
    evaluate the effectiveness of an audiovisual resource in acquiring knowledge and reducing
    anxiety in patients newly diagnosed with HIV in an infectious disease hospital in the capital
    of Rio Grande do Norte. Developed in two phases: methodological and experimental study,
    from August to December 2023. The first phase was divided into three stages: stage 01 -
    scope review, identified and validated the relevant elements for the composition of the
    appeal, using the Fehring criteria, obtaining 22 judges. Step 02 - construction and validation
    of script content. And in stage 03 - construction and validation of the resource interface, in
    the respective stages the Delphi technique was used, with six judges in both. In the
    experimental phase, a randomized controlled and single-blind clinical trial was carried out,
    with a quantitative approach, according to the recommendations of the Consolidated
    Standards of Reporting Trials, with a size and Cohen effect of 0.50, test power of 0.88 and a
    level of 5%, generating a sample of 40 patients among 20 patients, who received the standard
    guidelines and 20 patients from the Experimental Group (EG). They received the standard
    guidelines and the audiovisual resource, with information about the disease, characteristics of
    the virus, forms of transmission and prevention, effectiveness of treatment and daily care. To
    evaluate the effectiveness of the resource, two instruments were used for data collection: 1)
    State Trait Anxiety Inventory (STAI); and 2) Knowledge Assessment Instrument
    (HAI). These were processed in a Microsoft Office Excel 2010 and Statistical Package for the
    Social Sciences (SPSS) version 20.0 databases, using descriptive and inferential
    statistics. The Chi-square test (χ²) or Fisher's test or Student's t-test and other necessary
    statistical tests were used, with p<0.05 for the relationship between the variables. This
    research was approved by the Research Ethics Committee of the Federal University of Rio
    Grande do Norte, with opinion: 4,619,717. Regarding the results, 30 (76.0%) were male and
    10 (24.0%) were female, marital status, 30 (76.0%) were single and 10 (24.0%) were married,
    21 (53.0%) lived in the interior of the state and 19 (47.0%) lived in the capital of Rio Grande
    do Norte, and 38 (93.0%) lived in urban areas. Regarding the acquisition of knowledge
    ascertained by the IAC, positive results were obtained with an average of 29.0% after
    application of the resource, regarding the anxiety addressed in the STAI, of the eight sub-
    items directly related to anxiety, an average of 28.5% reduction in anxiety was obtained after
    intervention. Thus, the data evidenced the effectiveness of the audiovisual resource for the
    acquisition of knowledge and reduction of anxiety, as promoting knowledge enables a better
    experience of users in the face of the diagnosis.

2
  • SILVIA KALYMA PAIVA LUCENA
  • Serious Game as an educational tool in stomatherapy in hospital care.

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ADRIANA CATARINA DE SOUZA OLIVEIRA
  • ALCIDES VIANA DE LIMA NETO
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • JESSICA DANTAS DE SA TINOCO
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Feb 21, 2024


  • Show Abstract
  • Objective: Build and validate a serious game as an educational tool in
    stomatherapy in hospital care. Method: Methodological study, with a
    quantitative approach, carried out in four stages: scoping review, with the aim of

    identifying the guidance provided to patients pre-operatively and post-
    operatively; research with hospital care nurses, in order to identify the

    knowledge and difficulties of these professionals regarding the care of people
    with an intestinal ostomy, information that supported the third stage;
    construction of the serious game; content validation (narrative, clinical,
    contextual aspects and whether the case is appropriate). For evaluation, the
    content validity index (CVI) will be used, with a value greater than or equal to
    0.8, to be considered valid. An adapted Egameflow instrument was also
    applied, with 24 questions, of which two are focused on aspects of contact with
    technologies and games, 21 questions related to the game as an educational
    strategy, in which its alternative answers were through a score of 1 it was weak
    to 7 strong and an open question regarding learning the game. The data was
    first passed into Excel and then a descriptive analysis was carried out using the
    Statistical Package for Social Science for Windows program, obtaining the
    relative and absolute frequencies of the categorical variables. The study was
    submitted to the research ethics committee of the Federal University of Rio
    Grande do Norte and received a favorable opinion under number 5.736.475,
    CAAE: 61762122.9.0000.5537. Results: Given the findings of the scoping
    review and research with hospital care nurses, it was possible to build the
    serious game with two scenarios, one for the pre-operative period of a surgery
    to create an intestinal ostomy and the second, for the postoperative period.
    Regarding content validation, the 10 experts experts in the area of
    stomatherapy, in the sentence “The narrative of the case/question presented is
    adequate and is close to representing reality” obtained a CVI of 0.9; “The
    clinical aspects presented in the case are adequate and are close to

    representing reality” CVI of 0.8; “The contextual aspects presented in the
    clinical case are adequate and are close to representing reality” CVI of 0.9; “Do
    you consider this case appropriate for teaching about intestinal ostomy care”
    CVI of 0.8, thus obtaining a total CVI of 0.85. In relation to the game as an
    educational strategy, the questions that obtained the best scores were “Do I try
    to apply my knowledge in the game?” average of 6.8; “I want to know more
    about the content presented” average of 6.8; “Does the game improve my
    knowledge?” average of 6.7; “Am I motivated by improving my skills?”, average
    of 6.6; “Do I receive information about my status such as score level?”, average
    of 6.6. Conclusion: Given these results, it is observed that the serious game
    represents a real situation that can be found in hospital environments.
    Furthermore, the game proved to be a good educational strategy. Furthermore,
    it is intended that with this study, the level of knowledge of health professionals,
    especially nurses, will increase regarding this topic.

3
  • LUANA SOUZA FREITAS
  • Serious game about intestinal ostomies as an educational technology for nurses in the context of primary health care.

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARINA DE GÓES SALVETTI
  • QUENIA CAMILLE SOARES MARTINS
  • RENAN ALVES SILVA
  • Data: Feb 28, 2024


  • Show Abstract
  • The nurse is the professional who cares for the person with a stoma after the initial impact caused and is the reference to provide guidance towards adapting to the new condition, which is why they need to be trained to provide this assistance. The use of educational technologies can be a tool to assist in this preparation, as an example of this type of resource, there are serious games, which are virtual games with responsive dynamics that aim to achieve learning using visual resources for motivation. In this sense, the objective of this study is to develop and evaluate a serious game as an educational technology about intestinal ostomies for nurses in the context of primary health care. This is an applied and methodological research with a technological focus to build a serious game, divided into two stages, 1st stage: identification of the difficulties of primary care nurses in caring for people with ostomies. 2nd stage: development of the serious game (conception, elaboration, finalization and feasibility). This study has reached the elaboration stage. In the first stage, a questionnaire was applied to primary care nurses who raised the following difficulties: guidance on the various types of collecting equipment, technical skills and frequency of changing and cleaning bags, emotional aspects of the person with a stoma and lack of training to assist this patient. public. After the first stage, the 2nd stage began with the alignment of goals and learning objectives, followed by the development of a scoping review that identified in 17 studies guidance from nurses with experience in the area, predominantly on aspects of self-care with stoma and peristomal skin, choices about collection bags and adjuvants, and adaptation and acceptance issues. With the information in hand, the prototype was built from June to December 2023, containing 7 fictional characters with different complaints and representing several possible simulated moments in the life of a person with a stoma. The scenarios cover initial concepts of intestinal elimination stoma, ostomy and peristomal skin hygiene, cleaning and changing collection bags, aspects of feeding and indication of bags, complications, social, emotional and adaptation issues, laws and rights of people with ostomy and intestinal continence methods. The 1st stage of evaluation takes place with six judges specialists in stomatherapy for content analysis and two specialists in technical and pedagogical aspects of the developed software. The judges' requests for improvements were considered and after the modifications made, the 2nd stage of evaluation began by the experts.

4
  • LAIS VASCONCELOS SANTOS
  • Validation of the situational low self-esteem diagnosis in nursing students

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ALEXSANDRO SILVA COURA
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • PAULA FERNANDA BRANDAO BATISTA DOS SANTOS
  • Data: Feb 29, 2024


  • Show Abstract
  • Low self-esteem can frequently occur in undergraduate nursing students, as they are a population vulnerable to mental imbalance and/or a crisis arising from stressors related to academic life. When present, low self-esteem can lead to self-destructive behavior, lower self- efficacy and course dropout. However, there are few studies on this diagnosis in this population. Thus, the present study aims to validate the nursing diagnosis of situational low self-esteem in nursing students. This is a methodological research, developed in three stages, namely: 1) theoretical-causal validation, based on the construction of a medium-range theory; 2) content analysis; and, 3) clinical validation, through a diagnostic accuracy study. Initially, the development of the middle range theory was operationalized through a scoping review. The antecedents, consequences and their respective conceptual and operational definitions were identified, as well as a pictogram, propositions and causal relationships. In the second stage, the elements of the theory were analyzed by 22 judges, with levels of expertise ranging from beginner to experienced. The data were analyzed using the content validity index, based on the collective wisdom approach. In the third stage, the research was carried out with 55 nursing students from a federal public institution, located in the city of Campina Grande- Paraíba. The research was approved by the UFRN Research Ethics Committee, through opinion number 5.632.922 and Certificate of Presentation for Ethical Assessment number 60617922.4.0000.5537. The results showed that in the first stage, 16 antecedents and 21 consequences corresponding to the diagnosis under study were identified, and their respective conceptual and operational definitions were elaborated. The analysis of these elements allowed the development of a pictogram, construction of 8 propositions and establishment of causal relationships. In the second stage, the analysis of the diagnostic content by the judges made it possible to improve the definition and elements previously developed, which resulted in a diagnostic structure consisting of 13 defining characteristics, 15 related factors, 5 associated conditions and 1 population at risk. In the third stage, the prevalence of the nursing diagnosis of situational low self-esteem was 78.18% among the students interviewed. The defining characteristics: Recalls trauma and Anxious symptoms presented the best sensitivity and specificity values. Related factors: Traumatic experiences and Individuals in psychological distress demonstrated a 13.65 times greater chance of developing the diagnosis of situational low self-esteem. It is concluded that the diagnosis Situational low self-esteem is verifiable in undergraduate nursing students and presents two defining characteristics with better accuracy values. Furthermore, it is expected to contribute to increasing the level of evidence for this diagnosis in the NANDA-I taxonomy.

5
  • JULIANE RANGEL DANTAS
  • Validation of the nursing diagnosis Risk-prone health behaviors in university students.

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • JESSICA DANTAS DE SA TINOCO
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • PAULA FERNANDA BRANDAO BATISTA DOS SANTOS
  • TAHISSA FROTA CAVALCANTE
  • Data: Feb 29, 2024


  • Show Abstract
  • The nursing diagnosis Risk-prone health behavior is present in different populations, however
    research is scarce on university students. These behaviors are associated with the occurrence of
    several negative consequences, in the short and long term, which can affect the quality of life of
    individuals, especially young people. Given this reality, it is necessary to validate the
    aforementioned nursing diagnosis for the university public. Therefore, the objective of the present
    study is to validate the nursing diagnosis Risk-prone health behavior in university students. This is a
    methodological study, developed in three stages, namely: theoretical-causal validation, based on the
    construction of a medium-range theory; content analysis; and, clinical validation, through a
    diagnostic accuracy study. The study was approved by the Research Ethics Committee of the
    Federal University of Rio Grande do Norte, under opinion no. 4.953.282 and Certificate of
    Presentation for Ethical Appreciation no. 48202221.6.0000.5537. In the first stage, a medium-range
    theory was developed for the diagnosis under study, which was operationalized through an
    integrative review in four databases. We sought to verify in the literature the essential attributes,
    clinical antecedents, clinical consequences, conceptual and operational definitions, propositions and
    the causal relationships between the identified concepts. The final sample consisted of 87 articles.
    The following were identified: a definition, an essential attribute, 14 clinical antecedents, 11 clinical
    consequences, 12 propositions and 14 causal relationships. A pictogram was also produced to
    illustrate the “ComPoRis Theory”. In the second stage of the study, content analysis was carried out
    by 48 judges, via an online Google Forms form, in order to judge the adequacy of the definition,
    attribute, antecedents and clinical consequences. The suggestions sent by professionals were
    analyzed, culminating in the readjustment of the definition of the diagnosis and essential attribute,
    as well as the 13 clinical antecedents and 12 clinical consequences and their respective conceptual
    and operational definitions.In the third stage, an accuracy study of the Risk-Prone Health Behavior
    diagnosis was carried out with 108 nursing students from the Federal University of Rio Grande do
    Norte. Data collection took place in October 2023 in the Nursing Department of that university. The
    SPSS software was used to carry out the descriptive statistical analysis and the R software was used
    to analyze the latent class of the clinical indicators of the diagnosis under study. The diagnosis
    presented a prevalence of 78.88% in the investigated clientele. The sensitive indicators were:
    Inadequate eating behaviors, Compensatory use of the internet and Excess body fat. The specific
    indicators were: Abuse of legal and illegal substances, Unsafe sexual behavior and Impaired
    emotional health. Thus, it is concluded that the Risk-Prone Health Behavior diagnosis is verifiable
    in nursing students and presents three sensitive and three specific indicators. Through this research,
    we hope to contribute to increasing the level of evidence regarding the clinical construct validity of
    the aforementioned diagnosis, strengthening its relevance and permanence in the NANDA-I
    taxonomy. Furthermore, it is expected to contribute to the advancement of nurses' work process,
    through more reliable identification of the diagnosis in this population and by strengthening the
    development of good habits and prevention of future health problems.

6
  • MARINA MARISA PALHANO DOS SANTOS
  • HIV Prevention in Adolescents: Development and Validation of a Peer Education Instrument in Nursing Context

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ALIETE CRISTINA GOMES DIAS PEDROSA DA CUNHA OLIVEIRA
  • BARBARA COELI OLIVEIRA DA SILVA
  • ERIKA SIMONE GALVAO PINTO
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • Data: Feb 29, 2024


  • Show Abstract
  • The shift in the age profile of HIV cases and the rising incidence rates among adolescents suggest vulnerabilities in preventive measures. As a refined methodology in health education, Peer Education enables collective interventions with individual reach, fostering significant changes in this scenario. These aspects are incorporated into the Combined Prevention Mandala, representing a modern approach integrating multiple HIV prevention strategies into a unified framework.It is essential to highlight the role of nurses, responsible for implementing and operationalizing health promotion actions, establishing connections between school health and education as a strategy. This study aims to construct and validate an instrument focused on HIV prevention in adolescents through peer education in the context of nursing. It is a methodological study with a quantitative approach, organized into six stages: Concept analysis; Scoping review; Data cross-referencing; Instrument item construction; Instrument content validation, and Instrument appearance validation.The concept analysis followed Walker and Avant's (2019) eight-step framework. The scoping review was guided by The JBI Manual for Evidence Synthesis for the selection of studies identifying items for the instrument. The nine axes of the Combined Prevention Mandala (CPM) underpinned the entire methodological process. For validation stages, judge selection and the Delphi Technique for content validation, Content Validation Coefficient (CVC) utilization, and Kappa Index calculation for judge agreement on the instrument and its items were performed.The study received approval from the Research Ethics Committee (CEP) of UFRN with Protocol No. 6.566.151 and Certificate of Ethical Presentation (CAAE) No. 75835223.2.0000.5537. The constructed instrument had nine main titles corresponding to the CPM axes, with 40 items derived from the scoping review. Validation involved 16 expert judges and the target audience, assessing "Representation," "Importance," and "Clarity," showing excellent agreement levels. Specific evaluation resulted in a Kappa index of 1,00 and CVC of 1,00. Overall evaluation of content yielded a Kappa index of 1,00 CVC of 1,00. Appearance evaluation about culture adequation also achieved Kappa 0.87, CVC of 0,89 indicating excellent concordance among evaluators. In conclusion, the constructed instrument meets HIV prevention needs in adolescents, proving innovative and useful for nurses. This thesis demonstrates the feasibility of building an instrument for HIV prevention in adolescents through peer education, with evidence of content and appearance validity for the nursing context.

7
  • ANA CAROLINA COSTA CARINO
  • Validation of the nursing diagnosis Overweight in university students

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • KADYJINA DAIANE BATISTA LÚCIO
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • Data: Mar 1, 2024


  • Show Abstract
  • Intense weight gain after entering university is common among undergraduate students. In this context, the importance of empowering professional nurses in the development of health promotion strategies, based on the inference of accurate and precise diagnoses, is emphasized. Thus, the objective of the present study is to validate the nursing diagnosis of Overweight in adolescents and young adults at university. This is a methodological study, developed in two stages, namely: content analysis; and, clinical validation, through a diagnostic accuracy study. The study was developed according to the Lopes e Silva framework. It should be noted that the theoretical-causal validation stage, based on the construction of a medium-range theory, was carried out in a previous study. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under opinion number 4.953.282 and CAAE 48202221.6.0000.5537. Regarding data analysis from the content analysis stage, the collective wisdom model was followed, with the participation of 48 judges. The Content Validity Index was used, through the application of the Wilcoxon statistical test, with p-value > 0.05, to determine the proportion of judges who agreed with the items presented. For clinical validation, 108 nursing students were interviewed. The latent class analysis model was followed to establish accuracy measures, namely: sensitivity and specificity. The analysis of the association of sociodemographic, clinical and behavioral variables with the nursing diagnosis of Overweight occurred through analysis of the Pearson Chi-square Test and Fisher's Exact Test. A p-value ≤ 0.05 was considered statistically significant. Regarding the results, in the first stage of the study, all items were considered statistically valid, and a new structure for the nursing diagnosis “Overweight” was proposed, containing 06 defining characteristics, 06 related factors, 06 risk population; 03 associated conditions. In the second stage of the present study, the prevalence of the nursing diagnosis among the clientele was 38.12%. The following were identified as sensitive defining characteristics: “Excessive calorie consumption” and “Dissatisfaction with body image”. On the other hand, the specific defining characteristics were: “Negative self-perception of health”, “Inadequate eating behavior” and “Impaired emotional health”. “Personal history of being overweight” stood out as the factor with the greatest impact on the occurrence of the diagnosis in the studied clientele. It is concluded that the Overweight diagnosis is verifiable in adolescents and young adults at university and presents two sensitive and three specific characteristics. Thus, it is expected to contribute to increasing the level of evidence of the aforementioned diagnosis in the NANDA-I taxonomy, as well as to greater knowledge about the accuracy of the defining characteristics of the Overweight diagnosis in adolescents and young adults at university.

2023
Dissertations
1
  • ANA CLARA DANTAS
  • Development of mid-range nursing theory for ineffective health maintenance behaviors in people with chronic conditions.

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • Data: Feb 3, 2023


  • Show Abstract
  • Objective: To develop a Mid-Range Nursing Theory for Ineffective Health Maintenance Behaviors in People with Chronic Conditions. Method: This is a methodological study, based on Lopes e Silva's (2016) referential of Theoretical-Causal Validity, developed in six stages, namely: definition of the approach to construct the Medium-Range Theory; definition of the theoretical- conceptual models to be analyzed; definition of the main concepts of Middle Range Theory; development of a pictorial scheme; construction of the propositions of the Middle Range Theory; and establishing causal relationships and evidence for practice. For the construction of the Middle Range Theory, two approaches were defined: literature review from an integrative review and derivation from the theoretical model of Imogene King (1981). Data collection for the review took place by searching the following databases: SCOPUS, Web of Science, Science Direct, CINAHL and COCHRANE. As a search strategy, the following descriptors were defined, ordered in the Descriptors in Health Sciences (DeCS) and Medical Subject Headings (MeSH): Health Behavior; Chronic Disease; Primary Health Care and Nursing Diagnosis, intermediated by the Boolean operator “AND”. The inclusion criteria adopted were: studies that addressed any element related to Ineffective Health Maintenance Behaviors, complete studies available in the applied data sources and studies in any language. Editorials, letters to the editor, expert opinion, abstracts, reviews, books and book chapters were excluded. Results: Of the 75,154 studies found, after applying the eligibility criteria, 75 studies made up the final sample. Twenty related factors and 14 defining characteristics were identified, in addition to five at-risk populations and two associated conditions. The presentation of the review results started the development of the Middle Range Theory. The derivation from the theoretical model of Imogene King (1981) allowed the extraction of elements that contributed to the development of the Middle Range Theory for the nursing diagnosis of Ineffective Health Maintenance Behaviors in people with chronic conditions. Conclusion: It is concluded that the Middle Range Theory for Ineffective Health Maintenance Behaviors in people with chronic conditions provides the theoretical-causal validation of this nursing diagnosis, supporting the planning of nursing interventions in terms of health promotion and disease prevention. complications related to these conditions.

     
2
  • KAUANNY VITÓRIA GURGEL DOS SANTOS
  • Use of music to relieve pain and anxiety in patients undergoing cardiac catheterization: a systematic review with meta-analysis

  • Advisor : RODRIGO ASSIS NEVES DANTAS
  • COMMITTEE MEMBERS :
  • RODRIGO ASSIS NEVES DANTAS
  • ALEXSANDRA RODRIGUES FEIJAO
  • KATIA REGINA BARROS RIBEIRO
  • KLEYTON SANTOS DE MEDEIROS
  • Data: Feb 3, 2023


  • Show Abstract
  • Objective: to evaluate the effectiveness of using music to relieve pain and anxiety in adult and elderly patients undergoing cardiac catheterization. Method: this is a systematic review with meta-analysis, carried out in October 2022, in 13 national and international data sources. The mnemonic “Population, Intervention, Control, Outcomes, Study design” (PICOS) was adopted for the elaboration of the research question. Randomized Clinical Trials (RCTs), involving patients aged 18 years or older, with no time or language restriction, were included, and studies that did not respond to the proposed research question were excluded. The present study was registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform and followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: the sample consisted of nine studies included in the quantitative and qualitative synthesis of the data. The studies were mostly published in Germany (22.22%), Iran (22.22%) and Turkey (22.22%), in the years 2005 to 2022. 1,324 patients were included, in the age group of 18 to 84 years, whose anxiety assessment was given, above all, by the State-Trait Anxiety Inventory (STAI) (66.67%) and Numeric Rating Scale (NRS) (33.33%). Of the nine total studies, only three mentioned pain assessment, using the following scales: Visual Analog Scale (VAS) (22.22%) and Numeric Rating Scale (NRS) (11.11%). The preferred route for performing cardiac catheterization was the femoral (44.44%), followed by the brachial (22.22) and radial (11.11%). The parameters evaluated were anxiety, pain, systolic and diastolic blood pressure, heart and respiratory rate. There was a reduction in these parameters in the experimental groups due to the use of music, especially instrumental (44.44%), slow and relaxing (44.44%), applied through headphones (44.44%) or loud speaker (33.33%), in a time interval of 15 to 45 minutes, with melodies of 60 to 80 beats per minute (55.55%), in a sound intensity of 60 to 70 decibels (33.33%). Conclusion: music is considered a low-cost, non-pharmacological strategy that increases the humanization of care and is effective in reducing pain and anxiety levels in patients undergoing cardiac catheterization.


3
  • TÂMARA TAYNAH MEDEIROS DA SILVA
  • Use of mentholated popsicles in the management of postoperative thirst in patients radical prostatectomy: a randomized clinical trial

  • Advisor : RODRIGO ASSIS NEVES DANTAS
  • COMMITTEE MEMBERS :
  • RODRIGO ASSIS NEVES DANTAS
  • ALEXSANDRA RODRIGUES FEIJAO
  • ISABEL KAROLYNE FERNANDES COSTA
  • KLEYTON SANTOS DE MEDEIROS
  • Data: Feb 6, 2023


  • Show Abstract
  • In order to improve the thirst problem, the technique of providing a little volume of cold liquid in the oral cavity to lubricate the mucosa is used. Therefore, interventions such as iced or mentholated popsicles, menthol chewing gum, wet gauze with cold saline solution, cold water for gargling, and frozen gauze with saline solution are the main methods used to stimulate thirst quenching in patients during the period preceding the surgery. This study aims to evaluate the effects of the use of menthol popsicle in the relief of postoperative thirst in patients undergoing radical prostatectomy in an oncology hospital. This is a randomized, controlled, single-blind clinical trial with a quantitative approach that complied with the standards recommended by the Consolidated Standards of Reporting Trials. This study was registered on the Brazilian Clinical Trials Registry platform. The present study was carried out in the surgical ward of Hospital Doutor Luiz Antônio da Liga Norte Riograndense Contra o Câncer, located in the city of Natal, Rio Grande do Norte. The population consisted of male patients undergoing elective radical prostatectomy who were in the immediate postoperative period. The sample has probabilistic and simple random characteristics. The study consisted of two groups: a control (CG) and an experimental (EG). The CG consisted of patients who received popsicle without the addition of the mentholated substrate and the EG of patients who received the popsicle with the addition of the mentholated substrate of 0.05%. The instrument for data collection is divided into three parts: 1) Patient identification, clinical and sociodemographic data; 2) Data regarding the surgical procedure and anesthetic process; 3) Data regarding thirst intensity using the Numerical Scale (EN) and thirst discomfort using the Perioperative Thirst Discomfort Scale (EDESP). Thirst must be characterized and treated appropriately, especially in the surgical patient, to provide comfort and pain relief, as this sensation has a relevant impact on patient satisfaction and can have a negative impact on anesthetic recovery, especially in the postoperative period. immediate. It is noteworthy that the outcomes were positive during the research, with few reports of complications related to the use of interventions to manage thirst.

4
  • LAHELYA CARLA DE ANDRADE OLIVEIRA
  • Impacts of prematurity on the neuropsychomotor development os newborns development: a systematic review with meta-analysis.

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • NILBA LIMA DE SOUZA
  • ERIKA SIMONE GALVAO PINTO
  • JULIANA RAQUEL SILVA SOUZA
  • KLEYTON SANTOS DE MEDEIROS
  • Data: Feb 8, 2023


  • Show Abstract
  • Newborns are considered premature when birth occurs before gestation reaches 37 weeks and, consequently, the lower the gestational age, the greater the risks of adverse biological conditions and possible abnormalities
    in the child's neurodevelopment. Objective: To verify the results on the impacts of prematurity on the neuropsychomotor development of newborns. Method: This is a systematic review with meta-analysis, a method designed based on strategies by the Cochrane Handbook (2011) and the instrument The PRISMA  Statement (PRISMA). The PICO (Patient or Problem, Intervention, Control or Comparasion, Outcomes) strategy was used to construct the guiding question: What are the impacts of prematurity on the neuropsychomotor development of newborns? Electronic data search was performed National Library of Medicine, Web of Science, Cumulative Index to Nursing and Allied Health Literature, SciVerse Scopus, Cochrane Library and Gale Academic OneFile, in addition to access to CAPES theses and dissertation directories for gray literature. . The search used MeSH indexed descriptors: Infant, Newborn, Diseases; Infant, Premature; Child development; Complication. Primary studies of the approved type were included, such as experimental and randomized clinical trials that were almost evaluated as complications of the neuropsychomotor evolution of newborns. A search was carried out without language restrictions and without time frame. Review articles, meta-analyses, abstracts, conference proceedings, editorials/letters, study reports and those carried out with secondary data were excluded. For a previous selection of studies, a previous selection of titles and selected abstracts, which was performed in a selection and a protocol, in a reliable way, strictly corresponding to the inclusion and selection criteria and other preliminary aspects selected in the protocol. of research. Results: Considering that, as gestational age decreases, the risk for developmental delays increases, it is hoped, with this study, to identify signs and risks in the development of premature newborns, which allows an effective action in the prevention and promotion of mental health, childhood and adolescence, as well as providing basic principles to help professionals to increase the repertoire of interventions and, in this way, actively collaborate in the development of children with atypical development.

5
  • SILMARA DE OLIVEIRA SILVA
  • MULTIMEDIA STRATEGY FOR THE ACQUISITION OF KNOWLEDGE AND REDUCING ANXIETY OF CAREGIVERS OF CHILDREN AND ADOLESCENTS IN CHEMOTHERAPY: RANDOMIZED CLINICAL TRIAL.

  • Advisor : DANIELE VIEIRA DANTAS
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • DANIELE VIEIRA DANTAS
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • MARIA DO CARMO DE OLIVEIRA
  • Data: Feb 8, 2023


  • Show Abstract
  • Chemotherapy is the main method used to age childhood cancer, which treat childhood cancer from zero to ten years of age. It is noteworthy that the beginning of chemotherapy treatment causes concern in caregivers of children/adolescents, mainly associated with knowledge of the treatment. In this way, the education process is necessary to seek education and the education process to seek education, therefore, with the education and education process seeking to seek the education process to seek education and the reduction of education. In this sense, the study aims to evaluate the effect of a multimedia strategy compared to standard guidelines for acquiring knowledge and reducing anxiety in caregivers of children and adolescents undergoing chemotherapy. This is a randomized and controlled clinical trial, carried out in a Philanthropic Hospital, a reference in the care of children and adolescents with cancer, in Natal-RN. The Experimental Group received the institution's standard guidelines associated with a multimedia strategy on the chemotherapy treatment process - Digital animation film lasting 12 minutes and 22 seconds. While the Control Group received only the standard guidelines that are provided at the institution. The data collection instrument used was the State Trait Anxiety Inventory (IDATE) and a Knowledge Assessment Instrument (IAC). The project was approved by the Central Research Ethics Committee of the Federal University of Rio Grande do Norte nº CAAE 52597121.9.0000.5537 and registered in the Brazilian Clinical Trial Registry (RBR-4wdm8q9). Most caregivers are female, with complete high school, with a family income of one to two minimum wages. It is evident that the intervention with the multimedia strategy contributed to the acquisition of knowledge by caregivers and reduction of the anxiety score. It is noteworthy that in the control and experimental groups, after the interventions, it was possible to prove the increase in the feeling of preparation and confidence to take care of children/adolescents undergoing chemotherapy. In this way, the study reinforces that multimedia strategies such as the digital animation film are technologies that can be used at the beginning of chemotherapy treatment, contributing to the health education process and reducing the anxiety of caregivers of children and adolescents with cancer.

6
  • BARBARA EBILIZARDA COUTINHO BORGES
  • Development of a Mid-Range Nursing Theory for Caregiver Role Tension.

     
  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • Data: Feb 13, 2023


  • Show Abstract
  • Introduction: Caregiver occupation is understood as one that watches over and supports an individual in their basic functions for the maintenance of health and well- being, providing an opportunity to improve the quality of life for the person who is in need of it, due to being restricted or with physical limitations. Therefore, it is increasingly routine for caregivers of individuals with chronic conditions to play a decisive role in supporting health and assisting the social services of the population they care for. However, these subjects have their own needs, which are influenced, especially, by the combination of the problems presented with the quality of life and the caregiver's tension, even when the influence of economic, epidemiological issues and variables related to care are decisive. The study and publication of new NANDA-I diagnoses contributes to the realization of new validation research in order to provide higher levels of scientific evidence for the taxonomy, and in the last editions investigations that contemplate and scientifically strengthen the conceptual core of the DE (00061) Caregiver role tension, hindering the development and consolidation of its evidence. Objective: To develop a mid-range nursing theory for Caregiver Role Tension. Method: This is a methodological study based on the development of a Middle Range Theory (AMR). For the construction, the model proposed by Lopes e Silva (2016) is adopted as a methodological reference, thus, the research will take place from the Theoretical-Causal Validity stage. For this purpose, six steps are described according to the methodological framework, and they are: Definition of the TMA construction approach, Definition of the theoretical-conceptual models to be analyzed, Definition of the main concepts of the TMA, Development of a pictorial scheme, Construction of the propositions of TMA, Establishing causal relationships and evidence for practice. Results: First, an integrative literature review was carried out to extract all the data that will compose the theory, thus operationalizing some stages of the TMA. The search took place in the following databases: Scopus, ScienceDirect, PUBMED/Medline, CINAHL, LILACS and Web of Science, using the descriptors “Caregivers”, “Nursing Diagnosis”, “Self Care” and “Caregiver Burden”, in all for crossings, the Boolean operator AND was used. With the findings, 25 defining characteristics, 38 related factors, 4 populations at risk and 2 associated conditions for the highlighted ND emerged. In addition, it enabled the construction of the propositions and their causal relationships of the present TMA. All data were organized in spreadsheets and presented in the form of charts and tables. It is added that the research does not involve human beings, therefore, it does not need to be referred to the Research Ethics Committee. Conclusion: the responsibility of care, the individual assumes an ambiguity of feelings and personal repercussions, and can then manifest positive and negative feelings. Therefore, nurses need to identify the clinical manifestations of tension and develop skills in the recognition and accurate inference of the diagnosis.

7
  • KALYNE ARAÚJO BEZERRA
  • Analysis of self-inflicted violence in adolescents in today's society

  • Advisor : JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • SORAYA MARIA DE MEDEIROS
  • SANDRA MICHELLE BESSA DE ANDRADE FERNANDES
  • LUCIANO MARQUES DOS SANTOS
  • Rosângela Aparecida Pimenta Ferrari
  • Data: Feb 24, 2023


  • Show Abstract
  • Self-inflicted violence is by practices of violence against oneself, and can be classified as self-harm, an idea of suicide, suicide attempt and suicide. It corresponds to the third leading cause of death among adolescents in the world and in the Brazilian reality, there is an increase in these cases. In this sense, it is essential to map the factors associated with self-inflicted violence in Brazil, as well as the development of efficient strategies for self-inflicted violence in adolescents, with the purpose of contributing to the formulation of specific policies for the care of this public and their families. This study has as its general objective the factors associated with self-inflicted violence and mapping the programs, as strategies and as coping interventions, aimed at developing the adolescents who are cared for. This is a descriptive study that will combine documented-exploratory data with qualitative ones. 20 data by authorship2 were considered as violence injuries by Not data for the identification of
    factors associated with adolescents, considering data from 2009 to 1 in Brazil. Data were selected for descriptive and reference analysis using the R Studio software, and Joinpoint for analysis of the temporal trend of the cases, with a significance level of 5%. The proposed methodological qualitative data were necessary for a scoping review, by the Joanna Briggs Institute Manual and following the PRISMA-ScR recommendations. To assist in the analysis of the studies, the Intelligent Systematic Review software was used, and later with the help of the Atlasti 9.0 software, the data were organized and coded for qualitative analysis. This was theoretically based on research by Guy Debord and Byung-Chul Han for understanding today's society. For this study, all the ethical requirements of research with human beings were followed, being appreciated by the Research Ethics Committee under opinion no. 5,521,288. Self-proven violence by adolescents in Brazil was shown to be associated with the female sex, age group from 15 to 19 years old, white color/race, incomplete high school and
    the Southeast region. As for the time trend, self-inflicted violence in adolescents showed an increase of 21.4 cases in the year 2009 between 2021. Among the objectives, the inclusion and exclusion criteria were applied, and the study by peers was applied to the study. It is concluded that self-inflicted violence in adolescents is a phenomenon that increases, in addition to health programs, strategies and interventions are still scarce.

8
  • KAROLAYNE CABRAL MATIAS
  • Development and analysis of the control concept of infections related to health care

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • DANDARA NAYARA AZEVEDO DANTAS
  • LAYS PINHEIRO DE MEDEIROS
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • Data: Feb 24, 2023


  • Show Abstract
  • Introduction: there are several problems that can affect the quality of care and patient safety, among them, Health Care-Related Infections. Nurses work at three levels in relation to the prevention of HAIs, in an interrelated and dynamic way, namely: care, management and in actions as a CCIH nurse. Objective: to develop and analyze the concept of Controller in the Scenario of Infections Related to Health Care. Method: This is a methodological study, conducted by the Hybrid Concept Development Model proposed by Schwartz-Barcott and Kim (2000), carried out in three stages, namely: The first phase will be a scoping review, the second phase will be the data collection through a consensus group of 30 experienced nurses, the third phase aimed to compare, analyze and integrate the results obtained in the previous phases, enabling the writing of the final report. Results: For this analysis, the metacontext was considered to be the norms, resolutions, laws and global, international and national public policies that deal with the subject. For the general context, the attributions of the Control of Infections Related to Health Care were considered. For the specific context, the potentialities and challenges of the Control of Infections Related to Health Care will be talked about and the immediate context will talk about the performance of the HAI controller and his specific actions. Conclusion: The analysis used explained the existing knowledge in the literature about the context of the controller and how it works in health care services.

9
  • LUISA ALVES PEREIRA DE AQUINO
  • Assessment of patient safety culture in a surgical center in different organizational contexts

  • Advisor : QUENIA CAMILLE SOARES MARTINS
  • COMMITTEE MEMBERS :
  • CAREN DE OLIVEIRA RIBOLDI
  • CECILIA OLIVIA PARAGUAI DE OLIVEIRA SARAIVA
  • QUENIA CAMILLE SOARES MARTINS
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Feb 24, 2023


  • Show Abstract
  • The study aims to assess the patient safety culture in a surgical center in different organizational contexts. This research is in line with the national recommendations prepared by the Ministry of Health, inserted in the National Agenda of Priorities in Research, in axis 9 (Programs and Health Policies) regarding the evaluation of adverse events, and their impacts on public health and the evaluation of the National Patient Safety Program (PNPS) of the Unified Health System (SUS). In addition, it internationally supports the Global Patient Safety Action Plan, prepared by the World Health Organization (WHO) to eliminate preventable harm in health care by the year 2030. Within the hospital environment, the operating room is considered a of the places with the highest technological density, with the performance of urgent or elective procedures capable of demanding, in most situations, resources and precise and efficient inputs in the face of the complex practices developed by health professionals. Given its complexity, it is estimated that unsafe surgical care can significantly affect individuals. In the hospital setting, nearly half of all adverse events in hospitalized patients are related to surgical care. It is believed that there are particularities in relation to the different management models (public and private) capable of favoring or hindering CSP, such as the hospital structure, staff dimensioning, number of employment relationships and financial incentives, as identified by researchers in another study. This study aims to evaluate the levels of patient safety culture in surgical centers in a public and a private institution. This is a cross-sectional study carried out in two hospitals, one publicly managed and the other privately managed. A total of 185 health professionals participated in the study, namely: nursing technicians, nurses and physicians from both surgical centers. The E-Questionnaire Software validated and adapted for Brazil, from the Hospital Survery on Patient Safety Culture (HSOPSC) of the Agency for Healthcare Research and Quality (AHRQ) was used as an instrument for data collection. The collected data were exported from the E-questionnaire Software to a database in the Microsoft Office Excel version 2020 program and a descriptive analysis was used containing patient safety indicators. To analyze the results, the statistical software Statistical Package for the Social Sciences (SPSS) temporary version 25.0 was used to compare the findings in the referred hospitals. This study was assessed by the Research Ethics Committee (CEP) of the Federal University of Rio Grande do Norte (UFRN) obtaining a favorable opinion with CAAE 61763422.5.0000.5537 and opinion number 5,664,688. When evaluating and comparing the profile of positive responses, it was observed that for the private hospital, four dimensions were strong, with a percentage of positive responses above 75%: 3-Expectations and actions of the direction/supervision of the unit/ services that favor safety (78.1%); 4-Organizational learning/continuous improvement (87.6%); 5- Teamwork in the unit/service (78.4%) and 10- Hospital management support for patient safety (79.4%) were the dimensions with the best results. As for the public hospital, no dimension showed values above 75%, with the best results being 4-Organizational learning/continuous improvement (73.9%); 5- Teamwork in the unit/service (70.8%); and 12-Problems with shift changes and transitions between units/services (52.1%). About the worst scores, for the private hospital, there are the following dimensions: 8-Non-punitive response to errors (33.6%); 1-Frequency of reported events (60.1%) and 12-Problems with shift changes and transitions between units/services (60.2%). In the public hospital we have: 8-Non-punitive response to errors (15.6%); 2-Perception of safety (34.3%) and 1-Frequency of reported events (35.4%). The study concluded that there are differences between the types of public and private management regarding the patient safety culture and guide managers in the actions promoted in the surgical center in both scenarios, allowing better health outcomes, quality of care and reduction of events adverse.

10
  • JOÃO DE DEUS DE ARAÚJO FILHO
  • FACTORS ASSOCIATED WITH ANXIETY AND DEPRESSION LEVELS AMONG NURSING RESIDENTS IN THE STATE OF RIO GRANDE DO NORTE

     
  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • ERIKA SIMONE GALVAO PINTO
  • BRUNO ARAÚJO DA SILVA DANTAS
  • GILSON DE VASCONCELOS TORRES
  • DULCIAN MEDEIROS DE AZEVEDO
  • Data: Mar 23, 2023


  • Show Abstract
  • In Brazil, the diverse, competitive and exhausting universe of work, most of the time, generates significant impacts on the physical and mental health of workers. Anxiety and depressive symptoms are present in several health professionals and in several places around the world. Studies show that the main reason for absence of health professionals for more than 15 days at work are depressive episodes. In addition, anxious, depressive and stress symptoms are observed among undergraduate and graduate students, as a result of that it is necessary to track scientific data that deal with the factors associated with these symptoms and/or illness. The objective of this work is to identify the prevalence of levels and associated factors of anxiety and depression in nursing residents in the state of Rio Grande do Norte, Brazil. This is a cross-sectional study, to be carried out with residents who are currently at the Hospital Universitário Onofre Lopes, Maternidade Escola Januário Cicco, located in the city of Natal/RN, Hospital Universitário Ana Bezerra in Santa Cruz -RN and primary care health services in the cities of Mossoró, Currais Novos and Caicó. At the end of the collection, 32 resident nurses responded from a total of 41 working in the RN. In the analysis of the material, categorical variables were used through the chi-square test and Fisher's exact test, according to the adequacy of the test to the data and likelihood ratio. Data were processed using SPSS software and presented in graphs and tables. Most residents were female (84%), single (71%), reported having been harassed at some point in the residence (71%), undergoing or requiring psychological and/or psychiatric therapy after entering the residence (59 %). In the Beck inventory classification, regarding anxiety, we have the following result: Minimum (3.13%), mild (40.63%), moderate (28.12%) and severe (28.12%). While in the depression inventory classification: 15.63% minimal, 37.50% mild, 34.37% moderate and 12.50% severe. At the end of the study, the presence of mild, moderate and severe symptoms of anxiety and depression was observed in these residents, especially in the first year of residency, making it necessary to share this result with the services, scientific and academic circles, in addition to exemplifying the need of care for this public, especially with regard to the prevention of mental illness.

11
  • ANNA THAYS DIAS ALMEIDA
  • Technologies for health promotion of university students: scoping review

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • DANDARA NAYARA AZEVEDO DANTAS
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • PAULA FERNANDA BRANDAO BATISTA DOS SANTOS
  • VIVIANE MARTINS DA SILVA
  • Data: Mar 24, 2023


  • Show Abstract
  • The impact of the new reality and student obligations in higher education can trigger a
    series of problems. Thus, university spaces are strategic environments for the
    development of health promotion actions for these students. For this, the use of tools is
    important to facilitate approximation, interest and collaboration, especially among young
    people. Thus, the objective of the present study was to analyze the technologies and their
    contributions to the promotion of the health of university students in the health area. The
    study developed a Scoping Review based on the JBI. The following research questions
    were adopted: “What are the technologies for promoting the health of university students
    in the health area present in the literature? What are the advantages and limitations of
    these technologies? The sources selected for the study were: Medline/Pubmed,
    Cumulative Index to Nursing and Allied Health Literature, Web of Science, Latin
    American and Caribbean Literature in Health Science, Nursing Databases, Scopus,
    Cochrane, SciElo, Education Resources Information Center, Catalog of Theses and
    Dissertations by the Coordination for the Improvement of Higher Education Personnel,
    The National Library of Australia's, Academic Archive Online, Digital Access to
    Research Theses, Europe E-Theses Portal, Electronic Theses Online Service, Repositorio
    Científico de Acesso Aberto de Portugal, National ETD Portal, Theses Canada and
    Google Scholar. A total of 42,294 studies were found and 71 articles were selected for
    this research. The studies were mostly published in the United States of America, with
    the main methodology being experimental studies. Among the target audience, there was
    a predominance of nursing and medicine students, aged between 17 and 40 years.
    Regarding technologies, the most predominant was light technology (63.4%), the use of
    health education, group training and mindfulness/mindfulness were the most used,
    followed by light/hard technologies with (19.7 %) and hard technologies with (16.9%).
    The main focus was on students' mental health in addition to their physical health. The
    most frequent time of application of the technology was up to eight weeks, being applied
    mostly in spaces of the university itself, such as classrooms, outdoors and gymnasiums.
    Due to the variety of technologies, the materials used were also diverse. Most of the
    studies did not consider the previous assessment of the health of the students, being only
    applied to technology. The use of these technologies has shown positive effects in
    promoting the health of students in the health area, with an improvement in depressive
    symptoms, anxiety, stress, as well as an increase in the practice of physical activities and
    also an improvement in the ability to deal with academic stressors. Academic stress
    experienced by healthcare students can impair health and performance. Thus, these
    technologies are important strategies to be adopted by educational institutions to ensure
    the health of their students.

12
  • DASE LUYZA BARBOSA DE SOUSA ALVES
  • Construction and Validation of an educational module based on Nursing Systems for the training of expert patients with Amyotrophic Lateral Sclerosis.

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • ISABEL KAROLYNE FERNANDES COSTA
  • MERCIO GABRIEL DE ARAUJO
  • Data: Mar 27, 2023


  • Show Abstract
  • Amyotrophic Lateral Sclerosis (ALS) is the most common form of motor neuron disease, characterized as a neurodegenerative and progressive disease associated with the loss of upper and lower motor neurons. Despite being recognized and initially characterized by changes in the motor system, ALS is defined as a multisystem disorder in which the motor system is entirely and most drastically affected. It should be noted that among all the implications of the disease, it leads to changes in the quality of life of the affected patient, as well as their caregivers and family members, because due to the progressive loss of muscle strength, the patient also loses the ability to perform activities of daily living. daily activities such as self-care, such as talking, eating or walking. And these patients need practical, social, informative, psychological, physical, emotional and spiritual support. Currently, the offer of courses structured by technologies in virtual environments has expanded significantly on the national scene, especially at higher and continuing education levels for professionals. Indeed, the possibility of reaching a large number of individuals, scalability, can favor this growth. Therefore, introducing technological innovations in the teaching process establishes the existence and necessity of educational environments. Therefore, in the educational materials that cover ICT, the Virtual Learning Objects (OVA) and the Virtual Learning Environments (VLE) are highlighted, which are extensively pointed out as potential support instruments in supporting the teaching/learning process. . Through this, the proposal of health education presents itself as a transforming vehicle of practices and behaviors, with the aim of developing autonomy for the user in addition to improving their quality of life. The present study aims to build and validate the content of an educational module based on the Nursing Systems Theory to train trainers for the development of expert patients with amyotrophic lateral sclerosis. This is a methodological study and for the construction and validation of the content of the educational module, the research will be systematized according to the Psychometrics framework of Pasquali (1999) composed of three specific steps, carried out through theoretical, empirical or experimental and analytical procedures. or statistical, these steps will be adapted for the construction of the educational module. During the theoretical procedure, the present study will develop the items that will be part of the content of the educational module, soon after the construction of the content, the empirical procedures that constitute the selection of judges for the Content Validation will begin, then the Semantic Validation by nurses representing the target population, this objective is to verify if the instrument and the items that compose it are intelligible to the population for which it is intended. And finally, in the analytical procedures, the collected data will be statistically analyzed in order to guarantee the validity and reliability of the built instrument that correspond to the statistical analyzes that verify the content validity. The collected data will be stored in the Microsoft Excel for Windows 2010 application and analyzed using the statistical program Statistical Package for the Social Sciences (SPSS) version 22.0 for Windows. From the reference of Pasquali et al. (2010) in this study, the item that presents more than 80% agreement between the judges (rated as adequate) and a Content Validity Coefficient (CVC) > 0.8 will be considered valid.

13
  • BRENO WAGNER ARAÚJO COSME DA SILVA
  • ANIMATION VIDEO ON SOCIAL ADAPTATION FOR PEOPLE WITH INTESTINAL STOMS

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ALCIDES VIANA DE LIMA NETO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • LAYS PINHEIRO DE MEDEIROS
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Mar 31, 2023


  • Show Abstract
  • Ostomy is the term used to describe the surgical opening that allows the communication
    of an internal organ with the surface of the skin. Its making represents a delicate period
    for the person with ostomy, where changes in the process of physiological eliminations
    can cause vulnerabilities, sadness, fear, shame, withdrawal from social cycles and
    routine activities, resulting in social isolation. Faced with this new reality, the nurse
    plays an important role in the process of social adaptation of the person and family,
    contributing with guidelines, which can be done in different ways, where animation
    videos stand out: a strategy with several possibilities to be explored and that help in the
    search for the objective of health education that can be applied to any public. In this
    perspective, the objective of this research is to develop an animation video about social
    adaptation for people with intestinal stomas. This is a methodological study in which
    three standardized operational steps were adopted for the production of educational
    films: Pre-production, Production and Post-Production. In pre-production, the content of
    the script was raised from the literature, the synopsis and argument were created, the
    script was constructed and organized. In addition, at this same stage, the script was
    validated with content specialists (nurses) and video production specialists (media).
    Two rounds of the Delphi technique were applied with the judges, 10 in the first and
    eight in the second round with the nurse judges. As for media professionals, three
    judges participated in the first round and the same number in the second round. In the
    production stage, the final version of the script was made available to the production
    team, which continued to build the animation. The Content Validity Index was used to
    measure agreement between judges and the Kappa Index. The data were organized in
    spreadsheets in the Microsoft Office Excel® program and the analytical procedures in
    the program itself and the results presented in the format of charts and tables, in view of
    the best presentation. After validation, a Content Validity Index ≥ 0.75 was considered
    acceptable, obtaining as a result all the items of the instrument used with the nurse
    judges greater than this established value, thus considering the validated material. After
    validation, the animation video was made available on online and free video platforms
    and shared on social networks in order to disseminate relevant information and help
    health professionals to promote health education for this audience.

14
  • RAFAEL MOREIRA DO NASCIMENTO
  • Elaboration of a podcast as an educational resource for people with stomas: a validation study

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ISABELLE KATHERINNE FERNANDES COSTA
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • JESSICA DANTAS DE SA TINOCO
  • Data: Mar 31, 2023


  • Show Abstract
  • People with stomas are those undergoing a surgical procedure whose objective is to exteriorize a part of the digestive, respiratory or urinary system, through an artificial opening that allows the communication of the internal organ with the external environment for the maintenance of life. The Ministry of Health published Ordinance GM/SAS/MS nº 400/2009, providing the National Guidelines for Health Care for People with Ostomies within the scope of the Unified Health System (SUS). Among the attributions, it defines that the health care of people with a stoma is composed of health education actions. Thus, podcasts are digital audio files available on internet platforms whose purpose is the transmission of information, and when properly applied they can be considered an innovative alternative for educational practice. With this, the objective of the study was to build and validate an educational podcast for people with intestinal stomas. This is a methodological study carried out from January 2022 to March 2023, divided into four phases: (1) Analysis of podcast productions; (2) Construction of the educational podcast; (3) Validation of podcast content; and (4) Recording and publishing the podcast. The analysis of the data collected through the content validation instrument, via Google Forms, was carried out considering the Content Validity Index (CVI) for each item, as well as for the entire instrument. The formula for calculating the CVI took into account the values of a Likert Scale ranging from 0 to 2 points, where “disagree” is assigned a value of 0, “partially agree” a value of 1 and “totally agree” the value of 2, thus using the answers with values “1” and “2” for its execution, resulting in the proportion of judges who considered the item valid. The minimum acceptable agreement index among the study judges for each item was 0.78, and for the instrument in general it was 0.80. The collected data were compiled and analyzed in spreadsheets with the help of the Microsoft Office Excel® 2016 program and the results presented in the format of charts and tables. After the content validation and adequacy stage, the Podcast was recorded and made available for free on digital online music platforms. The study was carried out based on ethical principles respecting Resolution 466 of 2012 of the National Council for Ethics in Research involving human beings, considered by the Research Ethics Committee of the Federal University of Rio Grande, with favorable opinion nº 5.521.293 and CAAE 59714122.8.0000.5537. The podcast content presented CVI = 0.98 for script I, and CVI = 0.978 for script II. Thus, the contents of the podcast scripts were considered valid for recording the episodes. However, in addition to content validation, it is necessary for the educational podcast to go through the other validation steps, such as semantics, appearance and suitability for the target audience. Thus, offering correct and quality information about health for this population.

15
  • EVA JORDANA DE OLIVEIRA DUTRA
  • EVALUATION OF HEALTH ACTIONS IN FIGHTING COVID-9 IN PRIMARY HEALTH CARE FROM THE PERSPECTIVE OF CALLISTA ROY'S ADAPTIVE MODEL

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • NILBA LIMA DE SOUZA
  • SUENIA SILVA DE MESQUITA XAVIER
  • MARIA AMÉLIA ZANON PONCE
  • Data: Apr 25, 2023


  • Show Abstract
  • The COVID-19 pandemic reached considerable numbers of the Brazilian population with the emergence of critical challenges for public and private health care networks. Plans to deal with COVID-19 within the scope of Primary Health Care (PHC) emerge as an important bridge in disease control, making their continuous monitoring and evaluation relevant so that they are improved and put into practice by nursing and other PHC professionals, based on evidence-based practice. In this sense, the objective was to evaluate the PHC structure and the actions carried out by health professionals in the municipality of Caraúbas/RN in the face of COVID-19 and how the pandemic context influenced these actions based on Callista Roy's theory of adaptation. An evaluative study of the normative type was carried out with emphasis on the degree of implementation in the dimensions of structure and process and of the evaluative research type. The research was developed in the APS of the municipality of Caraúbas, in the interior of Rio Grande do Norte, with professionals who are part of the family health teams directly involved in coping with COVID-19 and health managers. With regard to evaluative research, value judgment was used to analyze the existing relationships between the intervention and the context. The qualitative data obtained were analyzed using the content analysis technique proposed by Laurence Bardin (2011). As results and discussions, regarding the degree of implementation, the Structure dimension was classified as partially implemented. The Process dimension, in turn, was classified as fully implemented, but with some divergences from reality according to what was revealed by the statements of the interviewed professionals when exposing their perceptions. Regarding the perceptions referred to by health professionals who work to combat COVID-19 within the PHC, they raised three thematic categories: (I) influence of the pandemic on the development of actions by PHC professionals; (II) Potentialities and difficulties in professional performance during the pandemic; (III) Characteristics of patients assisted during the pandemic – suspected and confirmed for covid-19; (IV) Attributions of PHC professionals and managers in coping with covid-19. In view of this general panorama regarding the convergences and divergences of the results found between the degree of implementation and the perception of these same professionals involved in the study context, it can be inferred that, even with a partially implemented structure, the professionals, in their work process, as well as the way they idealize their assistance, have their activities based on an intrinsic understanding that corroborates the ideology of Callista Roy's theory. 

16
  • NATÁLIA DE OLIVEIRA VIEGA
  • Space-time analysis of syphilis in pregnant women and congenital syphilis in the state of Rio Grande do Norte.

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ANA ANGELICA REGO DE QUEIROZ
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • NILBA LIMA DE SOUZA
  • Data: Jul 19, 2023


  • Show Abstract
  • Syphilis is an infectious disease of a systemic nature, curable and exclusive to humans, caused by the bacterium Treponema Pallidum. During the period from 2011 to 2021, 466,584 cases of syphilis in pregnant women and 221,600 cases of congenital syphilis were reported in Brazil. Despite the elimination of congenital syphilis being a global priority, the infection still represents a huge public health challenge. The state of Rio Grande do Norte has been showing a growing trend regarding the incidence rates of syphilis in pregnant women and congenital syphilis, even, in some years, the incidence rate of congenital syphilis in the state has been higher than the national rate.For this reason, this study aimed to analyze the space-time distribution of cases of syphilis in pregnant women and congenital syphilis in the state of Rio Grande do Norte during the period from 2010 to 2019. It is an ecological time series study, with a quantitative approach that used data from the Department of Informatics of the Unified Health System.The study population consisted of all reported cases of syphilis in pregnant women and congenital notified through the Information System for Notifiable Diseases during the period from 2010 to 2019. As this is secondary data, in the public domain, it was not necessary appreciation by the research ethics committee of the Federal University of Rio Grande do Norte. However, all ethical precepts were respected in accordance withResolution 466/2012 dealing with research with human beings.Thematic maps of the spatial distribution of syphilis cases were constructed using the QGIS software version 3.28. During the period of this study, 3,420 cases of syphilis in pregnant women and 3,727 cases of congenital syphilis were reported. The VII health region concentrated the highest number of cases of the two diseases, the equivalent of1,851 cases of syphilis in pregnant women and 3,016 cases of congenital syphilis. Regarding the characterization of pregnant women, it was noticed that the age group from 20 to 39 years was the most affected by syphilis during pregnancy. As for schooling, most had incomplete primary education. Most were also diagnosed with primary syphilis. As for the characterization of children diagnosed with syphilis, the vast majority were diagnosed in the neonatal phase, with up to 6 days of life. Most of the children were female, and most of the children were born to mothers who received prenatal care.

17
  • HALLYSON LENO LUCAS DA SILVA
  • Temporal analysis of differentials in work relationships for nurses in the five regions of brazil between the years 2003-2021.

  • Advisor : JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • COMMITTEE MEMBERS :
  • INÊS SANTOS ESTEVINHO FRONTEIRA
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • KARINA CARDOSO MEIRA
  • MARIO ROBERTO DAL POZ
  • SORAYA MARIA DE MEDEIROS
  • Data: Sep 28, 2023


  • Show Abstract
  • With regard to the legal attributions of the nurse, according to the precepts of Law n.
    7,498/1986, which provides for the regulation of Nursing practice, the nurse is
    responsible for exercising all nursing activities, including private actions: planning,
    organization, coordination, execution and evaluation of nursing care services nursing;
    nursing prescription; direct care for critically ill patients; and nursing care of greater
    technical complexity. The objective was to analyze the temporal trend of the nurses'
    workforce in the regions of Brazil in the period 2003-2021. This is an exploratory-
    analytical-descriptive research, with a quantitative approach and with a focus on the
    ecological study of temporal trends, related to the differences in the employment
    relationships of nurses in the five regions of Brazil. The database of the Annual List of
    Social Information was used. The analysis, treatment and temporal distribution were
    carried out by exporting the database for descriptive and inferential appreciation using
    Software R Studio version 4.3.1. Statistical analyzes were extracted regarding frequency
    distribution, measures of central tendencies and positions. Trend analyzes were
    performed using polynomial equations, which consisted of: simple linear regression,
    second-degree or parabolic and third-degree or exponential regression. The choice of
    the model that best fitted the data was considered. The temporal trend analysis was
    performed in two stages: the Durbin-Watson test to assess the autocorrelation of the
    historical series and exploratory analysis using the autocorrelation function. The
    adoption of the significance test was also considered as a criterion for choosing the
    model, where a significant trend was considered when p-value < 0.05. It was a research
    that used public domain information, in a database, without the possibility of individual
    identification. The temporal trend of the differential of employment contracts for nurses
    was stationary in the Northeast, South, Southeast and Midwest regions, that is, four of
    the five regions of Brazil. The North Region was the only one that showed an upward
    trend. Based on the analysis of the time series obtained, this study showed a stable

    situation in the generation of employment contracts in four of the five regions of Brazil.
    It is concluded that in Brazil the trend of employment contracts for nurses is
    predominantly stationary, despite the upward growth in the North of the country.

18
  • VALÉRIA DANTAS DE AZEVEDO
  • Development of a flowchart for nursing care in outpatient autologous hematopoietic stem cell transplantation. Natal. Dissertation, 122p – Postgraduate Program in Nursing, Department of Nursing, Federal University of Rio Grande do Norte, Natal, 2023.

  • Advisor : ISABELLE CAMPOS DE AZEVEDO
  • COMMITTEE MEMBERS :
  • ISABELLE CAMPOS DE AZEVEDO
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • MARCOS ANTONIO FERREIRA JUNIOR
  • Data: Dec 15, 2023


  • Show Abstract
  • Care planned and executed through management technologies, such as flowcharts, causes transformations in the reorganization of health services and contributes to the training of health professionals who work in certain contexts, such as outpatient autologous hematopoietic stem cell transplantation. As it is a complex procedure, it requires specialized care plans, high competence and well-established flows. Therefore, the present study aims to develop a flowchart for nursing care for patients undergoing outpatient autologous hematopoietic stem cell transplantation. It is a methodological study with a mixed approach, based on Pasquali's psychometric framework, structured in the following procedures: theoretical, empirical and analytical. For the theoretical procedures, a Scoping Review was carried out and a focus group composed of the nursing team (nurses and nursing technicians) who work in the bone marrow transplant outpatient clinic of a reference hospital for this treatment in Rio Grande do Norte to support the definition of the flowchart contents. In the empirical procedures, the information collected in the previous stage was compiled to support the construction of the flowchart. Validation of the content and appearance of the flowchart was carried out using the Delphi technique, with the evaluation of the criteria proposed by Pasquali and the Suitability Assessment of Materials. Finally, the analytical procedures occurred using the content validation coefficient, when the responses were considered valid, the items obtained a minimum agreement of 80% between the judges and the content validation coefficient above 0.8. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte and obtained an approval opinion under CAAE: 58796722.8.0000.5537. After building the flowchart, it was submitted to the first Delphi round and reached a general content validation coefficient > 0.9. After the adjustments suggested by the judges, in the second round the content and appearance validity indexes were > 0.9 each and the general validation coefficient > 0.9. Therefore, it is concluded that the flowchart is valid in its content and appearance as a useful management technology for organizing nursing care in services that offer outpatient autologous hematopoietic stem cell transplantation with a view to improving care management and decision-making. decisions in this context.

19
  • ELOÍSA ARAÚJO DE CARVALHO
  • Self-care for users with diabetes mellitus and systemic arterial hypertension in post-COVID-19 conditions.

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • ANA ANGELICA REGO DE QUEIROZ
  • LUCIANE PAULA BATISTA ARAUJO DE OLIVEIRA
  • REJANE MARIA PAIVA DE MENEZES
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • TATIANA MARIA NOBREGA ELIAS
  • Data: Dec 20, 2023


  • Show Abstract
  • Diabetes mellitus and systemic arterial hypertension are chronic diseases of multiple etiologies, responsible for the main causes of mortality and morbidity among adults and the elderly, becoming a challenge for public and health policies in Brazil and around the world. These challenges, accentuated by the COVID-19 pandemic, are risk factors for both the severity of the infection and the inability to carry out post-COVID activities of daily living. With the aim of analyzing the self-care actions of people with diabetes mellitus and systemic arterial hypertension in post-COVID-19 conditions, in light of Orem's Theory, a descriptive, cross-sectional and exploratory research was carried out, with a quantitative approach, in the municipality of Ceará Mirim, metropolitan region of Natal, capital of the State of Rio Grande do Norte, in 9 Basic Family Health Units, in the urban area of the municipality. The population of 6,932 included diabetic and hypertensive users, registered in the 9 Units and the sample corresponded to 363, obtained from stratified random sampling, considering a 95% confidence interval with a margin of error of 5%. Users registered in these Units, diagnosed with diabetes mellitus and/or high blood pressure, and having been affected by COVID-19, were included. Data were obtained through structured forms, composed of closed questions, “Clinical File for post-COVID condition”, adapted for the research, for demographic data and health condition and the “WHO Disability Assessment Schedule (WHODAS 2.0) Manual”, for data related to self-care. They were applied through structured interviews, carried out in the Units and at the participant's home, depending on their availability. The data were tabulated, organized and analyzed using the Statistical Package for Social Science version 22.0 and the self-care variables were analyzed according to the “WHO Disability Assessment Schedule WHODAS 2.0 Manual” score. All procedures were governed by the ethical precepts of Resolution no. 466/12 of the National Health Council for research with human beings. The results indicate that individuals in a post- COVID-19 condition are mostly male, with an average age of 57 years, with at least one comorbidity, with diabetes mellitus and high blood pressure being more prevalent and also more developed in those who required hospitalization and oxygen support during the acute phase of the infection. In the post-COVID phase, it was identified that self- care actions such as inability to move and limitations in activities were affected. The most frequent physical symptoms were fatigue and dyspnea and the cognitive ones were memory loss, concentration problems and anxiety. In the end, it was possible to identify that the post-COVID-19 condition causes the emergence of symptoms and consequences in the self-care of diabetic and hypertensive individuals. This identification is essential to assist in the rehabilitation of functional disabilities and contribute to defining flows and priorities in health services and nursing care in the post-pandemic scenario.

20
  • LOUISE CONSTANCIA DE MELO ALVES SILVA
  • Effectiveness of aromatherapy with Lavandula angustifolia on postoperative pain after heart surgery: randomized
    clinical trial.

  • Advisor : RODRIGO ASSIS NEVES DANTAS
  • COMMITTEE MEMBERS :
  • HYLARINA MARIA MONTENEGRO DINIZ SILVA
  • KATIA REGINA BARROS RIBEIRO
  • RODRIGO ASSIS NEVES DANTAS
  • SANDY YASMINE BEZERRA E SILVA
  • Data: Dec 20, 2023


  • Show Abstract
  • Pain in the postoperative period of heart surgery is considered common due to the
    sternotomy and placement of drains and, when poorly controlled, can lead to
    hemodynamic consequences and pulmonary complications. Therefore, timely and
    adequate pain relief leads to a reduction in these complications and the length of
    hospital stays. There is a growing use of Integrative and Complementary Health
    Practices as non-pharmacological methods for reducing pain, especially aromatherapy,
    which is characterized by the inhalation of essential oils. This study aims to evaluate the
    effectiveness of aromatherapy with inhalation of Lavandula angustifolia essential oil in
    relieving pain during the immediate postoperative period in patients undergoing heart
    surgery. This is a single-blind randomized controlled clinical trial with a quantitative
    approach, conducted in accordance with the Consolidated Standards of Reporting Trials
    (CONSORT) guidelines. The population consisted of patients in the immediate
    postoperative period of heart surgery, carried out in the Intensive Care Unit of the Heart
    Hospital in Natal, with a probabilistic, random and simple sample of 52 participants
    divided equally into the following groups: Control Group (CG), who received the
    diffuser collar without the essential oil and the Experimental Group (EG), who received
    a drop of essential oil in the diffuser collar for inhalation over the course of 30 minutes.
    The data collection instrument is subdivided as follows: 1) identification of the patient;
    2) information about the surgery; 3) pain assessment scales; 4) vital signs table; 5) space
    to assess whether there was relaxation in the patient's facial expression. This study
    followed all the ethical requirements for research with human beings, and was approved
    by the Research Ethics Committee of the Federal University of Rio Grande do Norte.
    The patients' vital signs, pain and facial expression were assessed before the diffusion
    collar was fitted, and they were assessed in the same way ten minutes after the collar
    was fitted and 30 minutes after the collar was removed. Of the 52 patients collected, 33
    (64%) were male and 19 (36%) were female. Among the types of heart surgery
    performed on the study sample, 40 surgeries (77%) were Revascularization of the
    myocardium and the remaining surgeries were divided between Revascularization of the
    myocardium plus valve replacement (4%), correction of atrial septal defects (2%) and
    valve replacement or retrocautery (9%). The patients who reported the most pain were
    male and the main sites of pain were in the back, at the sternotomy and at the site of the
    drains, especially the mediastinal drain. There was pain relief for some patients who
    received the Lavandula angustifolia oil intervention and many reported liking the aroma
    they were receiving, showing relief in their facial expressions or even smiles when they
    received the aroma. Studies on this subject are important so that the use of non-
    pharmacological methods by nurses, as part of humanized, holistic care based on
    scientific evidence, can gain an even greater place in clinical practice, complementing
    standard therapies and improving the quality of life of the patient.

Thesis
1
  • ROMANNINY HEVILLYN SILVA COSTA ALMINO
  • Development and Content Validation of the Proposition of the Occupational Stress Nursing Diagnosis from a Medium-Range Theory

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • CAMILA TAKÁO LOPES
  • HARLON FRANÇA DE MENEZES
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • RAFAEL OLIVEIRA PITTA LOPES
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Feb 15, 2023


  • Show Abstract
  • Occupational stress has affected several workers. The recognition of related factors and symptoms of occupational stress facilitates the development of interventions by nurses, but it is evident that the nursing diagnosis Occupational Stress does not exist in NANDA International. In this sense, the general objective of this study was to develop and validate the content of the proposition of the Occupational Stress as a nursing diagnosis based on a Medium-Range Theory. Therefore, this is a methodological study, which was carried out in two stages, which were: theoretical-causal validation and content validation. The research was approved by the Ethics Committee of the University Hospital Onofre Lopes (HUOL) of the Federal University of Rio Grande do Norte under nº 4.695.488 and amendment under nº 5.498.40 and CAAE: 45570821.7.0000.5292. Data analysis was performed using descriptive and inferential statistics. Initially, a concept analysis was carried out based on the theoretical framework of Walker and Avant, which was operationalized by scoping review using the following data sources: The Cochrane Library, Scopus, Web of Science, National Library of Medicine (MEDLINE /PubMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Latin American and Caribbean Literature in Health Sciences,Science Direct, and Google Scholar. The final sample corresponded to 138 studies. Four attributes, 24 antecedents and 28 clinical consequences of the concept Occupational Stress in health professionals were listed. Then, the Medium Range Theory of Occupational Stress in Health Professionals (TMA-EOPS) was built based on the derivation of Betty Neuman's Systems Model, according to the theoretical framework of Fawcett and Gigliotti. Sixteen concepts, 20 propositions and 35 causal relationships between Occupational Stress and the stressors and symptoms present in the TMA-EOPS were identified, in addition to the construction of the pictogram/diagram and C-T-E structure. The second stage included content validation by judges about the elements of the diagnostic proposition. Forty-nine judges participated in this step, who validated the following elements regarding relevance: 04 attributes, 22 related factors and 28 defining characteristics of the proposed nursing diagnosis. Furthermore, they validated 03 attributes, 19 related factors and 25 defining characteristics regarding the clarity and precision of the conceptual and operational definitions of the respective elements of the diagnostic proposition. In this sense, the diagnostic proposal presented after content validation: 02 attributes, 29 defining characteristics, 21 related factors and 01 associated condition. Subsequently, the evaluation of TMA-EOPS was carried out in two rounds. Five judges participated. In the first round, TMA-EOPS was considered adequate for all items related to significance, parsimony, testability and empirical adequacy; only 01 item related to internal consistency and 01 item related to pragmatic adequacy were not considered adequate. In the second round of TMA-EOPS evaluation, items not previously validated were considered adequate. It is concluded that the study contributed to the advancement of knowledge in the discipline of Nursing through the development of a proposal for a nursing diagnosis based on a Medium Range Theory that does not exist in the NANDA International taxonomy.

2
  • MANACÉS DOS SANTOS BEZERRIL
  • Construction, validation, and effect of a course for training nurses in the training of expert patients.

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • ISABELLE CAMPOS DE AZEVEDO
  • QUENIA CAMILLE SOARES MARTINS
  • FRANCISCA SANCHEZ AYLLON
  • ANA LUISA PETERSEN COGO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • Data: Mar 31, 2023


  • Show Abstract
  • The object of the study is the development of a course for nurses in the training of expert patients. And it aims to evaluate the effect of the course for the training of Primary Health Care nurses in the training of expert patients. It is a research structured in two stages: the first is a methodological investigation, which sought to build and validate the course for training Primary Health Care nurses in the formation of expert patients, based on theoretical, empirical and analytical procedures; to this end, a Scoping Review was carried out, in addition to visits to active health schools by an expert patient for the construction of the course; then, a Google Forms was created with the course content based on criteria adapted from Pasquali, to be evaluated by specialists using the Delphi technique for course validation; finally, from the application of the Content Validation Coefficient, it was possible to assess the agreement between the judges. The second stage, quasi-experimental research of the before-after type with intervention with a single group of participants that proposed to evaluate the effect of the course, which had the participation of nurses from Basic Health Units in the city of Natal, Rio Grande do Norte, who participated in the course itself. Data collection was carried out with the application of multiple-choice pre- and post-tests and scales associated with the simulation scenarios present in three of the six meetings of the course. The information obtained through the instruments was tabulated in the Statistical Package for Social Science for Windows software, analyzed in a simple descriptive way and through inferential tests. The research follows the ethical precepts of the National Health Council with approval by the Research
    Ethics Committee (CAAE: 46980621.2.0000.5537). The Scoping Review resulted in a sample of 234 studies, identifying Diabetes Mellitus (110; 39.9%) as the most prevalent chronic disease and physical activity (234; 08.7%) among the main self-care actions. The course was structured in the following sessions: characterization, syllabus, objectives, contents, methodologies, evaluation, programming, references, and appendices, following the principles of Andragogy, the Theory of Meaningful Learning and the Theory of Self-efficacy. In validation, two Delphi rounds were performed: the first had nine judges and a total Content Validation Coefficient above 0.90, while the second with six and a total Content Validation Coefficient of 0.99. The effectiveness assessment had seven nurses, with a predominance of females (06; 85.7%) and time working in Primary Health Care between one and ten years (04; 57.1%). The pre and posttest ratio reached a statistically significant result (p-value=0.008830). The Student Satisfaction and Self-Confidence in Learning Scale showed an average greater than 4.5 (±0.5) in two items of satisfaction and four of self-confidence; the Debriefing Experience Scale showed two items on the teacher's ability to conduct the debriefing and one on the appropriate guidance from the teacher, with an average of 5.0 (±0.0); and the Simulation Design Scale, an average of 5.0(±0.0) in only one item pertaining to objectives and information, and two related to Feedback/Reflection. It was concluded that the course built and validated is considered effective for training Primary Health Care nurses in training the expert patient.

3
  • FRANCISCO MAYRON MORAIS SOARES
  • Elaboration and evidence of validity of educational hypermedia in reception and obstetric risk classification

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • GILSON DE VASCONCELOS TORRES
  • KARINE DE CASTRO BEZERRA
  • IGOR CORDEIRO MENDES
  • LARA LEITE DE OLIVEIRA
  • Data: Apr 19, 2023


  • Show Abstract
  • Faced with the scenario of health complications related to pregnancy, the recognition of risk implies the need for specialized evaluation, with additional tests and services, and for these pregnant women the current strategies focus on improving the quality of care during this critical period. In obstetrics, the reception presents characteristics inherent to the needs and demands related to the pregnancy process that is permeated by several holistic changes. Thus, the objective of this research is to verify the evidence of validity of an educational hypermedia about the embracement and classification of obstetric risk. This is a methodological research, with development by the basic instructional design model that involved the technological production, of the educational hypermedia type, for the teaching of the Acolhimento and Obstetric Risk Classification Protocol, carried out in five stages. Twenty-two judges participated to validate content and usability. For the analysis, the Content Validity Index the System Usability Scale and the binomial test were used. The study was submitted to the Research Ethics Committee with a favorable opinion under protocol number 5.042.351. The research was conducted according to the required ethical standards, with a request for prior signature of the ICF. An educational hypermedia was developed, in the form of a website, entitled "Acolhimento e Classificação de Risco Obstétrico", or simply, ACRO. The theoretical content developed for the educational hypermedia was organized in the following topics: conceptual approach, Module I: Approaching the theme of Acolhimento and Obstetric Risk Classification; Module II: Emergency Obstetric Acolhimento; Module III: Obstetric Risk Classification; Module IV: Decision-making Process in Acolhimento and Obstetric Risk Classification; Module V: Classifying Risk - Classification Exercises, References, Supplementary Material (virtual library) and Presentation of the authors. The content obtained a Content Validity Index of 0.96 and for usability it obtained 91.9. In the global evaluation, all the requirements obtained a 0.98 index. The developed educational hypermedia presents evidence of validity and constitutes an innovative resource for the teaching and learning process in Nursing.

4
  • SANDY YASMINE BEZERRA E SILVA
  • Elaboration and validation of the content and appearance of a mobile application to subsidize the monitoring of tuberculosis cases in Primary Health Care

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • MARIA AMÉLIA ZANON PONCE
  • MARIA SANDRA ANDRADE
  • NILBA LIMA DE SOUZA
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • Data: May 4, 2023


  • Show Abstract
  • The development of new tools, interventions and strategies that implement tuberculosis control has been encouraged worldwide. The general objective of this study was to develop and validate the content of a mobile application, for use on smartphones, to support the monitoring of tuberculosis cases in Primary Health Care. This is a methodological, multiphase study, with a quantitative and qualitative approach, systematized according to the methodological framework of User-Centered Design. The research phase had a descriptive-exploratory study, developed with nurses, doctors and people living with tuberculosis, distributed in health units in the city of Natal; and a scope review. In the design phase, the application content was elaborated and in the prototyping phase, the application prototype was developed. In the test phase, content and appearance validations were carried out using the Delphi technique. At this stage, the content validity coefficient greater than 0.8 and the percentage of agreement equal to or greater than 80% were used as parameters for validation. The study complied with the ethical foundations of Resolutions nº 466/2012 and 510/2016. Based on the results of the descriptive-exploratory study and scope review, the application's content was structured into six sections in the version for health professionals: Personal data; Information about tuberculosis; Register user; Search patient; Contact; Query; and six for people living with tuberculosis: Tests; Personal data; Information about tuberculosis; Contact; Treatment; Alerts; For content and appearance validation, two Delphi rounds were carried out: the first had 19 judges and a total Content Validation Coefficient above 0.86, the second, with 9 judges and a total Content Validation Coefficient of 0. 95. It is concluded that the mobile application has validity to support the monitoring of tuberculosis cases in Primary Health Care.

5
  • FLAVIA BARRETO TAVARES CHIAVONE
  • SafeCare-serious game to support patient safety teaching: appearance validation, usability and effectiveness testing.

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • ISABELLE CAMPOS DE AZEVEDO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: May 31, 2023


  • Show Abstract
  • The current student, Student 3.0, is characterized by the demand for technologies that support their teaching-learning process, by making it dynamic and innovative. This student profile is concatenated with social changes understood as cyberculture and cyberspace, which reflect on the relationships between human beings and technologies in different contexts, among them, within the scope of teaching. As an option for this, serious games emerge, which promote an interactive, immersive and safe teaching environment. Thus, the objective is to validate the appearance, usability and effectiveness of SafeCare: serious game to support the teaching of patient safety. It deals with a validation study and a quasi-experiment of the before and after type, divided into two stages. The first consisted of the development of the serious game, based on the Analysis, Design, Development, Implementation, Evaluation model. And in the validation of appearance and usability, using the adapted Suitability Assessment of Materials and the System Usability Scale Validation judges were nursing professors and students. For whom, after agreeing to participate, a link was sent to access SafeCare: serious game and Google Forms to fill in the validation forms. At this stage, the data were tabulated and analyzed in Microsoft Excell 365, according to specific calculations for each instrument. Therefore, the verification of the effectiveness of the serious game was carried out. For this, an extension course was developed to train undergraduate nursing students from the fourth academic period on patient safety. It was structured in four meetings and one of them was dedicated to the use of SafeCare: serious game. In the first moment of the course a pre-test was carried out and at the end the post-test. Data were tabulated and analyzed using descriptive and inferential statistics in the Statistical Package for Social Science for Windows. Furthermore, the study was submitted and approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte with registration number: 4.954.453 and CAAE: 49774921.7.0000.5537. The validation steps were performed in two Delphi rounds, the first with 15 judges and the second with ten. The evaluators were mostly teachers (80%), between 41 and 45 years old (30%) and female (70%). In the first Delphi conference, appearance validation reached agreement of 0.88 and 92.94%, in the second, 0.90 and 100%. As for usability, the Delphi 1 round obtained a score of 90 points and the second 92.5. In the effectiveness test, the sample consisted of 18 students, mostly female (83.3%), aged between 21 and 25 years (55.5%) and attending the fourth period (44.5%). The average score in the pre-test was 4.7 and in the post-test 6.3. Data were analyzed using correlational bivariate analysis between means, Pearson's correlation, which detected a large effect association of 0.456 and a significant p of 0.029. It ends like this. that SafeCare: serious game obtained approval scores in the validation procedures and in the effectiveness test, therefore, it is feasible to infer that the game developed has the capacity to support the teaching of patient safety and, in addition, represents a teaching tool associated with current educational demands, which can promote meaningful learning.

6
  • VANESSA PINHEIRO BARRETO
  • Construction and validation of the content of an instrument aimed at guiding the filling in of notification forms and epidemiological investigation of arboviruses

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ERIKA SIMONE GALVAO PINTO
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • DANIEL GUILLÉN MARTÍNEZ
  • PATRÍCIA PERES DE OLIVEIRA
  • Data: Jun 26, 2023


  • Show Abstract
  • The concomitant circulation of dengue, chikungunya and zika viruses in Brazil has become a public health problem for the country. Arboviruses are considered notifiable diseases, therefore, every suspected or confirmed case must be notified to the Epidemiological Surveillance Service, so that strategies are adopted to reduce viral
    proliferation. However, it was observed that there are flaws in filling out the notification forms, thus, the incompleteness of this information reflects an underestimation of the real number of cases that occurred in epidemics, as well as making it impossible to identify the real health situation in which find the population. Thus, the objective is to build and validate the content of an instrument aimed at guiding the correct completion of the notification forms and epidemiological investigation of arboviruses. This is a methodological research composed of two steps. The first consisted of a document review, carried out through the analysis of Ministry of Health manuals and technical notes on guidelines for completing the notification forms. In the second stage, the instrument was constructed and validated based on the material identified in the previous stage and on the arbovirus notification and epidemiological investigation form. The instrument's items were constructed and evaluated based on Pasquali's theoretical framework and the calculation of the Content Validity Coefficient was performed using the Hernandez-Nieto framework. The validation steps were carried out with expert judges, using the Delphi technique. The Kappa test was applied to assess the judges' degree of agreement on the analyzed items. Data were tabulated in Microsoft Excel 365 and analyzed in SPSS statistical software, version 25.0. Ethical precepts were followed in accordance with Resolution No. 466, of December 12, 2012, of the National Health Council. The research was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, through opinion no 5.463.378 and Certificate of Ethical Appreciation Presentation 57846222.0.0000.5537. The validation process was carried out in two Delphi rounds, 13 judges participated in the first and 9 in the second. The judges were mostly female (61.54%), had an average age of 36 years, an average time of training of 13 years and an average time of experience in arboviruses of 8 years. The items were evaluated according to the criteria of clarity of language, practical pertinence and theoretical relevance, these were changed, deleted and included based on the analyzes and pertinent suggestions of the judges. The final version of the instrument had 50 items. They were obtained in Delphi 1 Content Validity Coefficient 0.92 and Kappa 1.00; in Delphi 2, the Content Validity Coefficient was 1.00 and Kappa 1.00, which indicates almost perfect agreement between the evaluators. It is concluded that the content of the constructed instrument was validated according to the evaluated dimensions. Thus, it has evidence that it represents a technology that can be used by health professionals, who act directly in filling out arboviruses notification forms, which can promote a better quality of this information.

7
  • TATIANA MARIA NOBREGA ELIAS
  • Development of an instrument for nursing
    care in the prevention of congenital syphilis in Primary Health Care.2023.

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • ALEXANDRA DO NASCIMENTO CASSIANO
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • LUCIANE PAULA BATISTA ARAUJO DE OLIVEIRA
  • NILBA LIMA DE SOUZA
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Jul 21, 2023


  • Show Abstract
  • Brazil faces high rates of cases of perinatal morbidity and mortality caused by
    congenital syphilis since the 1990s, although actions for the promotion,
    prevention and control of diseases are applicable in prenatal programs during
    assistance to the binomial. Consultations for pregnant women are carried out as
    a priority in Primary Health Care, accompanied by a multidisciplinary team,
    including a nurse. However, despite the improvement in access to prenatal
    care, important gaps persist, such as: late start of consultations, number of
    consultations lower than recommended, deficit of tests performed and,
    sometimes, the inefficient conduction of specific treatments and forms of
    prevention of illnesses. Therefore, the objective of this study is to build and
    validate an instrument for nursing care in the prevention of congenital syphilis in
    Primary Health Care. For this purpose, Jean Watson's theory of nursing care
    was used, constituting the application of nurses' critical thinking, in a
    transpersonal perspective, enabling the recognition of care by the pregnant
    woman to support her in the prevention of congenital syphilis. This is a
    methodological study consisting of four phases: the first being the
    operationalization of the construct, supported by the theory of transpersonal
    nursing care and a scope review, containing a final sample of 35 articles that
    enabled the categorization of 33 care nursing for the prevention of congenital
    syphilis which, together with the ten elements of the Clinical Caritas Process,
    made up the first version of the instrument, with ten dimensions and 27 items;
    the second phase corresponded to content validation for the analysis of
    agreement between the item-dimension and the validation of the instrument
    items and its operational guide and took place in two Delphi rounds with the
    participation of 12 judges; in the third phase, face validation took place, with 38
    judges and a Delphi round to assess the instrument's verbal compression. Both
    in the second and in the third phase, the Kappa coefficient and the Content
    Validation index were used for the statistical analyses. And, finally, the fourth
    phase, which consisted of validating the construct and assessing its reliability;
    15 nurses who accompany the prenatal consultation and 138 pregnant women
    participated in it. For construct validation, exploratory and confirmatory factor
    analysis and Cronbach's alpha were used to assess the instrument's internal
    consistency and thus ensure its reliability. The study complied with the ethical
    prerogatives required by Resolution nº 466/2012, of the National Health Council
    and its complementary ones, being approved by opinion nº. 5,632,945 and
    CAAE 61762422.3.0000.5637, issued by the Ethics and Research Committee
    of the Federal University of Rio Grande do Norte. From the results obtained, in

    the validation of the instrument's content, an agreement between the items and
    the dimensions was greater than 0.60 in the first round of Delphi in 77.78% of
    the items; however, of the six items that did not show satisfactory agreement, 3
    were excluded and the other 3 were adjusted in their allocation and description.
    Items validated with a Kappa index of less than 1.00 were submitted to the
    second Delphi round, with all of them presenting values higher than those of the
    first round and greater than 0.61. Still in this phase, regarding the content
    validation of the instrument and the operational guide, all items and their
    respective operational descriptions obtained a CVI ≥ 0.80 and a Kappa ≥ 0.60,
    giving rise to the second version of the instrument with 24 items. In face
    validation, the instrument was submitted to the evaluation of verbal
    compression, with all items obtaining a Kappa ≥ 0.80 and a CVI greater than
    0.89, not requiring another round or adjustments, moving on to the last phase
    validation, with 24 items. The construct validation was carried out through factor
    analysis, where in the exploratory analysis the variables generated 9 factors
    with a variance greater than 50%, which brings security to the confirmatory
    analysis that obtained statistically significant values in the adequacy indices of
    the final model (Ratio X2 /g.l, RMR, RMSEA, PCFI, CFI and IFI). Regarding the
    verification of reliability, the instrument obtained a Cronbach's Alpha above 0.70
    and below 0.90 in all items, that is, the consistency of the data is classified as
    adequate. In view of these results, it is concluded that the instrument developed
    for nursing care in the prevention of congenital syphilis demonstrated to have
    psychometric quality and satisfactory validity to support and qualify nurses'
    practice with pregnant women in Primary Health Care.

8
  • JÉSSIKA WANESSA SOARES COSTA
  • Instrument for identifying transitional care in
    adults with Post-Intensive Care Syndrome characteristics.

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • ELIABE RODRIGUES DE MEDEIROS
  • KATIA REGINA BARROS RIBEIRO
  • RAPHAEL RANIERE DE OLIVEIRA COSTA
  • REJANE MARIA PAIVA DE MENEZES
  • SORAYA MARIA DE MEDEIROS
  • YANNA GOMES DE SOUSA
  • Data: Jul 28, 2023


  • Show Abstract
  • Critical illness is associated with a multitude of heterogeneous conditions,
    however, given the imposed hemodynamic instability, it predisposes the individual to
    the need for advanced means of life support. In this perspective, individuals who face a
    critical illness and a long period of hospitalization in the Intensive Care Unit are
    exposed to the development of Post-Intensive Care Syndrome, characterized and related
    to physical, cognitive and psychological dysfunctions. Consequently, survivors of the
    syndrome and their support network face difficulties in providing care when returning
    home and in daily activities, with nursing professionals being one of the main
    responsible for training self-care and the support network for hospital discharge. With
    this, the objective was to build and validate an instrument to identify transitional care in
    adults with characteristics of Post-Intensive Care Syndrome. This is a theoretical study,
    of methodological development, with a quantitative approach and use of the
    Psychometric Data Theory. The total sample consisted of 194 participants, including 10
    judges, 30 Nursing students and 154 assessments of adults with Post-Intensive Care
    Syndrome characteristics. Data collection took place between August 2022 and May
    2023, after a favorable opinion from the Research Ethics Committee under no
    5.388.801. The construction of the instrument was arranged in three stages: Stage 1:
    Operationalization of the construct; Step 2: Content Validity and Face Validity; and
    Step 3: Construct Validity and Instrument Reliability. The conceptual theoretical basis
    is anchored in the Theory of Basic Human Needs and in the Theory of Transition. In
    Step 1, the construction of the instrument was carried out based on the theoretical bases
    and a Scoping review, which followed the recommendations of the Joanna Briggs

    Institute and the checklist Preferred Reporting Items for Systematic reviews and Meta-
    Analyses extension for Scoping Reviews. The preliminary version of the instrument had

    33 items divided into 5 dimensions. In Step 2, the instrument was submitted to content
    validity by 10 judges, in 2 rounds, resulting in a pre-final version with 30 items and 5
    dimensions: D1 - Clinical aspects (9 items); D2 – Feeding and physiological
    eliminations (4 items); D3 – Mobility, hygiene, comfort and safety (4 items); D4 – Skin
    and mucous membranes (4 items); and D5 – Cognitive and psychological (9 items). In
    round 1, dimension 5 underwent changes in the writing of item 24, initially written as
    “How is the communication?” passing the formulation “How is communication after
    admission to the ICU?”, with such modification obtained a Kappa coefficient of 1.00, in
    round 2. Still in dimension 5, items 25, 26, 27 and 28 were regrouped as the item “25 -
    How is the sensory perception?”, obtaining Kappa with perfect agreement (1.00), the
    Operational Guide followed the reformulation changes of the items, without impact on
    the operational definitions of the initial version. In face validation, carried out with
    judges and Nursing students, the instrument followed the pre-final version without
    changes, with perfect Kappa in general analysis, by dimension and items. In Step 3,
    regarding construct validity and internal reliability, the instrument proved to be valid
    and reliable, with a total Cronbach's Alpha equal to 0.835, not indicating the presence of
    redundancy or duplication of it’s items. The assumption of unidimensionality was
    verified through the analysis of principal components and it was detected that the first
    factor is able to explain 30.1% of the variance, that is, it can be considered that the

    instrument has a dominant factor, validating the assumption of unidimensionality and,
    therefore, of local Independence. According to the Gradual Response Model, the
    discrimination parameter ranged from 0.097 to 3.265. It was found that most items have
    a moderate to very high power of discrimination. For factorial validity, the model
    quality parameters were evaluated: χ2., CFI, TLI and RMSEA. Thus, analyzing the
    statistics of the final model, it should be noted that by TLI and CFI, it is possible to
    verify that they presented values above 0.90 (CFI = 0.92 and TLI = 0.90), which
    indicates a good fit of model. The RMSEA presented a value of 0.086, below the
    maximum limit of 0.10, which also indicates a good model fit. Therefore, the instrument
    proved to be reliable and has consistent evidence of content, face and construct validity
    to identify transitional care in adults with characteristics of Post-Intensive Care
    Syndrome.

9
  • ISADORA LORENNA ALVES NOGUEIRA
  • Development of an online course plan for user health education in the context of syphilis.

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • ALIETE CRISTINA GOMES DIAS PEDROSA DA CUNHA OLIVEIRA
  • ALCIDES VIANA DE LIMA NETO
  • ALEXANDRA DO NASCIMENTO CASSIANO
  • ALEXSANDRA RODRIGUES FEIJAO
  • NILBA LIMA DE SOUZA
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Aug 25, 2023


  • Show Abstract
  • Syphilis, a sexually transmitted infection, is considered a serious public health problem, with worldwide rates of 7.1 million cases, being prevalent in the reproductive age group of 15 to 49 years. These indicators motivated the World Health Organization to develop an intervention program for the adequate management of sexually transmitted infections, by the year 2030. This research aims to validate an online course prototype for health education in the context of syphilis in primary health care. Methodological study with a quantitative approach, based on the four fundamental stages of Filatro: analysis, design and development, implementation and evaluation. In the first stage, a scoping review was carried out, mapping the knowledge of users assisted in primary health care about syphilis, subsequently a cross-sectional study was carried out, with 269 users assisted in the municipality of Natal, Rio Grande do Norte. Descriptive and inferential statistics were used, using the Chi-square and Fisher tests, evaluating the significance of p ≤ 0.05; in the second stage, the thematic axes were structured for the content of the online course plan, in the low-fidelity prototype version, using google forms, based on objectives, contents, methodological path, evaluation and curriculum structure. The plan was conceived from the perspective of the Moodle platform and the template provided by the virtual learning environment of the Unified Health System; in the third stage, the educational resources were configured, based on the needs of tools such as: training, setting, teaching-learning situation, modules and evaluation; in the evaluation stage, the content was validated with specialists in the field of nursing, recruited through the Lattes platform and the snowball strategy, according to Fehring's framework, considering a minimum cutoff of 4 points. The sample included 11 specialists. Descriptive and inferential statistics were performed for Kappa values ≥ 0.6 and CVI ≥ 0.8, and adjustments of items, including information, content and grammar. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in compliance with the ethical precepts of Resolution 466/12. The results of the scoping review demonstrated the existence of gaps in the knowledge of syphilis regarding clinical manifestations, deficits in prevention, testing, diagnosis and implemented therapeutic practices, categorized based on Orem's self-care deficit theory. In the cross-sectional study, about the sociodemographic characterization of the participants, users with a mean age of over 30 years (55.02%) were identified, a proportion of women (79.3%) higher than that of men (20.7%) , single (47.21%), mixed race (44.24%), Catholic religion (34.20%), complete high school (41.64%) and self-employed (42.50%). As for knowledge about syphilis, understanding of the importance of using condoms (96.28%), definition of the disease (88.48%), signs and symptoms of syphilis (72.08%) and medication for the syphilis treatment (47.22%). Regarding health education actions in the prevention of syphilis, most users said they had access to educational materials in health services, mainly lectures (27.14%), addressing prevention measures (58.44%). Users who sought information on the internet totaled 94.05%, but with a low percentage for health matters (13.04%). When asked if they would participate in an online course on the subject, 93.31% responded positively that they would join. The analysis and relationship between the variables showed that the definition of sexually transmitted infections was related to the level of education, obtaining p<0.001; as well as for the variable on condom use (p=0.011). A similar proportion was observed between the definition of syphilis according to the service sector (p=0.004), marital status (p=0.001), religion (p=0.026) and education (p=0.008). For the variable identification of signs and symptoms, significance was obtained for the service sector (p=0.0031), marital status (p=0.057), religion (p=0.059) and education (p=0.001). The right answers regarding medications for the treatment of syphilis were related to the service area (<0.001) and religion (p=0.019). The variable participation in lectures was related to sector (p=0.058) and education (0.099). The use of the computer or cell phone in the search for information was related to the sector (p<0.001). Concerning the creation of the online course on syphilis, significance was obtained for education (0.013). Based on the results and these analyses, an online course plan instrument was created, consisting of four modules: sexually transmitted infections and their social impact; clinical aspects of the disease; limitations for self-care; effective self-care and the contribution of technologies. The instrument was validated for the number of 84 items related to the content, in a Delphi round carried out with 11 specialists. Kappa values ≥ 0.6 and CVI ≥ 0.8 were considered for the criteria clarity of language, practical relevance, theoretical relevance and theoretical dimension, reaching satisfactory rates for 80 items, resulting in the exclusion of item 04 from the general aspects; adjustments to items 48 and 50 of module II and item 59 of module III, for the clarity criterion. Given these consensuses greater than 80% and global with satisfactory values, the items could be kept in the instrument and validated with just one Delphi round. It is concluded that the online course plan prototype, with a focus on health education, is relevant and will have an impact on the final development of the online course technology, and may contribute to the knowledge of Primary Health Care users about from syphilis.

10
  • ROMEIKA CARLA FERREIRA DE SENA
  • Impact of the COVID-19 pandemic on depressive symptoms and anxiety among the elderly in the world scenario: A systematic review with meta-analysis.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • ISABELLE CAMPOS DE AZEVEDO
  • GILSON DE VASCONCELOS TORRES
  • FLAVIA DANIELLI MARTINS LIMA
  • FRANCISCO MAYRON MORAIS SOARES
  • Data: Aug 28, 2023


  • Show Abstract
  • Brazil and the world went through a pandemic due to the COVID-19 virus, given the new
    mutation of the coronavirus. In this pandemic scenario, the elderly were characterized as a
    vulnerable population due to the interinsectic characteristics of this public. In addition to non-
    communicable chronic diseases, psychological comorbidities such as depression and anxiety
    have been described as diseases with a higher incidence in the elderly population, including
    during and after the pandemic. Thus, the study aims to analyze the impacts caused by the
    covid-19 pandemic on depressive symptoms and anxiety among elderly people on the world
    stage. This is a systematic review that followed the PRISMA guidelines, PVO strategy,
    registered in PROSPERO - CRD42023451218. The databases used were: SCOPUS,
    MEDILINE/PubMed, EMBASE and Psychoinfo. The following Boolean descriptors and
    operators “AND” and “OR” were used as a search strategy and inclusion of alternative terms:
    “COVID-19 pandemics OR COVID 19 Virus Infection” AND “Depression OR Depressive
    Disorder OR depressive symptoms” AND “Anxiety OR Anxiety Disorders) AND (Aged OR
    Geriatrics), selecting studies from 2020 to 2023, with data collection in the same period,
    considering that on January 30, 2020, the World Health Organization declared a Public Health
    Emergency of International Concern disclosed in various social media due to the spread of the
    coronavirus. For this study, age related to the elderly refers to people aged ≥60 years. General
    data analysis was carried out using the R 4.0 software. the DerSimonian-Laird model with
    random effect and calculation of proportion and correlation using a confidence interval of
    95% and significance of 0.05. In addition, a predictive analysis was performed analyzing the
    meta-regression. studies with a high risk of bias in addition to determining the risk of
    publication bias with the funnel plot, together with the meta-regression analysis. In addition,
    outliers were excluded and subgroups were analyzed. A total of 6,595 articles were found,
    with 16 articles being eligible after application of inclusion and exclusion criteria. Levels of
    stress, quality of life, quality of sleep, emotional distress, concern and family care stood out as
    factors that significantly contributed to the development of depressive symptoms and anxiety
    among the elderly worldwide. According to the analysis carried out, there was a prevalence of
    more than 50% of association between variables related to the pandemic and the development
    of depression and anxiety with CI from 0.45 to 0.60 and p-value &lt; 0.05. With analysis of the
    studies, almost 16 thousand people of the interest group were evaluated, already considering
    the losses that occurred in the researches. According to the bias analysis, no bias was
    identified. Through the results, it is concluded that the restrictive measures adopted in the
    COVID-19 pandemic, as well as the entire pandemic scenario, had a considerable impact on
    the mental health of the elderly in the global context.

11
  • ISABELLE CHRISTINE MARINHO DE OLIVEIRA
  • Digital educational technologies in the prevention of HIV in adolescents and young people: systematic review

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • BARBARA COELI OLIVEIRA DA SILVA
  • ELIÃ PINHEIRO BOTELHO
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • KLEYTON SANTOS DE MEDEIROS
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Aug 29, 2023


  • Show Abstract
  • The technological age brought new directions to the teaching-learning process. In this sense,
    Digital Educational Technologies (TED) have been applied as useful tools in building
    knowledge on the subjects of difficult approach to adolescents and young people, such as
    human immunodeficiency virus prevention (HIV). The objective of this study was to analyze
    the scientific evidence about TED in the prevention of HIV in adolescents and young people.
    This is a systematic review developed based on the recommendations of the manual for
    evidence synthesis of Joanna Briggs Institute and the Preferred Reporting items for
    Systematic Review Sand Meta-Aalyses: The Prism Statement. This study was recorded on the
    prosperous platform under the CRD42023418826 identifier. Through peak strategy
    (population, intervention, control and outcomes/outcome) the question of research was built:
    “What is the effectiveness of digital educational technologies in the prevention of HIV in
    adolescents and young people according to the scientific literature?” The search and
    collection of this review was performed in the 16 data sources: Scopus elsevier; Medical
    Literature Analysis and Retieval System Online via National Library of Medicine; Web of
    Science; Science Direct Elsevier; Embrase Elsevier; Scientific Electronic Library Online;
    Latin American and Caribbean Literature in Health Sciences; Virtual Health Library;
    ClinicalS.gov; International Clinical Trials Registry Platform; Cochrane Library; CAPES
    Theses and Dissertations Catalog; Brazilian Portal of Publications and Scientific Data in Open
    Access; Federated Network of Institutional Repositories of Scientific Publications; Open
    Access Theses and Dissertations; and OpenGrey Database, through the crossing of the
    descriptors in Health Sciences/ Medical Subject Headings (decs/ mesh) and keywords:
    Educational Technology, Digital Technologies, Information Technology, Mobile
    Applications, Technology, Primary Prevention, Prevention, Health Education, , Human
    Immunodeficiency Virus, HIV Adolescent, Tenager, Young Adult, Young, using Boolean and
    OR and OR operators. Primary quantitative primary studies were included in full and free,
    without temporal limit, in any language and answered the research question. Editorial, letters
    to the editor, protocols, reflections, experience reports, revisions, summaries published in
    scientific events, and studies whose outcome did not evaluate aspects related to TED. Of the
    7403 studies found, the sample consisted of 14 articles. The methodological quality of the
    studies was verified and the level, importance and recommendation force of evidence used the
    grid system. Digital educational technologies represent an important tool in the teaching-
    learning process that has generated behavioral changes about HIV prevention in adolescents
    and young people. The studies were analyzed regarding the characteristics, implementation
    and evaluation of the intervention. The outcomes knowledge about HIV/AIDS and changes in
    risk behavior have had a high level of evidence. The general risk of bias was identified as low
    for most studies. There was a strong recommendation of TED as conduct for professionals.
    The results are encouraging and support the use and development of more educational
    technologies for HIV prevention in this population. The study contributes to nursing science
    as it drives research and clinical practice, with production or readjustment of available
    technological resources.

12
  • CARLOS JORDAO DE ASSIS SILVA
  • Development of middle-range nursing theory for healthy aging.

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • REJANE MARIA PAIVA DE MENEZES
  • ROSANE BARRETO CARDOSO
  • SORAYA MARIA DE MEDEIROS
  • Data: Oct 11, 2023


  • Show Abstract
  • The life expectancy of the population had a considerable increase in the last century and
    it is projected that Brazil will be the 6th country in the world in number of elderly
    people in the next decade. It is emphasized that it is a relevant social and health gain,
    but that does not mean that people are living healthier. Therefore, a transformation in
    health systems is required, focusing on a model of comprehensive care, centered on the
    elderly, requiring more specialized training from nurses and focused on healthy aging.
    However, the lack of a specific theoretical framework for gerontological nursing care,
    based on the discipline&#39;s values and concepts, and focused on the elderly, favors the
    need for a medium-range theory in this context. Thus, the aim of this study is to develop
    a mid-range theory for healthy aging from the perspective of transitions. This is a
    theoretical study, aimed at building a mid-range nursing theory. The development of the
    Mid-Range Theory for Healthy Aging (MRTHA) was based on the methodological
    framework of Theoretical-Causal Validity in its six stages. As a theoretical approach for
    the construction of the theory, the starting point was the concept of healthy aging and
    the nursing diagnosis, Disposition for improved healthy aging, associated with the
    derivation from a specific theoretical model, in this case Meleis&#39; theory of transitions.
    Anchored in these concepts, healthy aging and nursing diagnosis and, and later the
    evaluation of the theory of transitions from the Evaluation Model proposed by Meleis
    from the elements of description and criticism. The main concepts that emerged from
    the MRTHA were derived from the conceptual and theoretical models used. Then the
    pictorial scheme was built using the Canva tool, and a posteriori the propositions and
    established causal relationships of the MRTHA. The prerogatives of Law nº 9.610/1998,
    regarding copyright of the authors of the primary studies used, were fully respected. The
    MRTHA originated the formulation of eight propositions and the established causal
    relationships between the phenomenon and clinical nursing practice. It was concluded
    that the development of MRTHA clarified the occurrence of a health promotion nursing
    diagnosis focused on healthy aging. It is expected that the construction of the MRTHA
    will contribute to the diagnostic reasoning and theoretical support of gerontological
    nursing practice.

13
  • ANDERSON BRITO DE MEDEIROS
  • Prevalence of mental disorders in pregnant and lactating women deprived of liberty in the prison system: systematic review.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GLAUBER WEDER DOS SANTOS SILVA
  • JAIME ALONSO CARAVACA-MORERA
  • JANMILLI DA COSTA DANTAS SANTIAGO
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • KLEYTON SANTOS DE MEDEIROS
  • THAIS ROSENTAL GABRIEL LOPES
  • Data: Oct 20, 2023


  • Show Abstract
  • Introduction: Female incarceration has increased due to several factors, including changes in criminal policies, social and economic inequalities, abuse of psychoactive substances and issues related to gender and mental health. Being a woman and experiencing pregnancy or lactation in the prison system can be an even more challenging and difficult experience due to precarious sanitary conditions, lack of adequate medical care, stigma, isolation and separation from the child. The restrictions of the prison environment can increase the risk of problems related to the mental health of these women. Objective: To evaluate the prevalence of mental disorders among pregnant and breastfeeding women in the female prison system. Method: This is a systematic review, which evaluates and brings together similar studies for statistical analysis. To write this review, the PRISMA checklist guidelines were followed. Furthermore, the protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform, under registration number CRD42022350737. Using the PECOT strategy (Population, Exposure, Control, Outcomes/Outcomes and Types of Studies/Observational), the research question was constructed: “What is the prevalence of pregnant and lactating women with mental disorders in the female prison system?” Included were studies on pregnant women and the development of mental disorders (depression, anxiety, stress and insomnia, postpartum depression) during incarceration in comparison to pregnant women not exposed to incarceration or deprivation of liberty in the prison system. Literature reviews, case series, case reports and qualitative studies were not considered. Searches were carried out in the following databases: PubMed, Web of Science, Embase, Latin American and Caribbean Literature in Health Sciences (LILACS), Scopus and Nursing Database (BDENF), without restriction on the language of the articles or of the year of publication. The search strategy used medical subjective vocabularies (MeSH) and a variety of other keywords. To assess the risk of bias, the Newcastle Ottawa Scale was used to assess the methodological quality of the research, while the Grading of Recommendations Assessment, Developing and Evaluation (GRADE) method was used to classify the evidence into the quality levels of the studies. As these are secondary and public data, submission to the Research Ethics Committee was waived. Results: Of the 2165 studies found, the final sample consisted of four articles. The analysis and level of methodological quality were carried out, as well as the strength of recommendation of the evidence with the GRADE system. The studies were carried out in the last decade, in the United States and Canada and evaluated regarding characteristics, implementation and evaluation of the evidence. The prevalent mental disorders found in pregnant and lactating women in the women's prison system were anxiety, common mental disorders, schizophrenia, self-harm, and postpartum depression. The Risk of Bias assessment of the included studies was essentially classified as low, which demonstrates the quality of the research regarding bias, making the results provocative for carrying out interventions in the scenario. Final considerations: It was concluded that the prevalence of mental disorders in pregnant and lactating women in the prison system indicates a growth trend, as the context of imprisonment increases illness and psychological suffering. However, it is suggested that new studies be carried out to better elucidate the prison scenario, as well as to develop measurement instruments/scales aimed at the prison scenario due to the uniqueness of the environment.

14
  • MARILIA SOUTO DE ARAUJO
  • Construction, validation and evaluation of the effectiveness of a low- cost simulator aimed at teaching medication administration to infants.

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • ALESSANDRA MAZZO
  • EDILMA DE OLIVEIRA COSTA
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • R0DRIGO GUIMARÃES DOS SANTOS ALMEIDA
  • RAPHAEL RANIERE DE OLIVEIRA COSTA
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 15, 2023


  • Show Abstract
  • Nursing education has several limitations, among which practical training in administering medications to infants stands out, due to the scarcity of opportunities to train this skill. Clinical simulation and simulators are, respectively, potential teaching methods and technologies to reduce this gap. The objective was to build, validate and evaluate the effectiveness of a low-cost simulator for the purpose of administering medications to infants, subcutaneously, intravenously and intramuscularly. This is a mixed methods research, using the concomitant triangulation strategy, consisting of three types of study: one methodological, one interventional and one descriptive. Five steps were necessary for the research: planning, building and testing the simulator; simulator validation; validation of the simulation scenario; intervention study; and descriptive study. For the validation stages, the Kappa index, the Content Validity Index and the Factor Validity Index were calculated. In the intervention study, descriptive and inferential statistics were used, through the use of frequencies and the McNemar test. In the descriptive study, interviews were carried out and received lexicographic information processing in the IRAMUTEQ software, for subsequent content analysis. The simulator construction stage involved the creation of a prototype of an infant, produced with materials of low purchasing value, with a final cost of R$326.20. The second stage involved the validation of the simulator by nine judges, who analyzed its functionality, appearance and general aspects. The assessment of functionality using the Kappa, CVI and FVI indices was 0.99. Both when evaluating the general aspects of the simulator and its appearance, a Kappa index of 0.96 and a CVI and FVI of 0.98 were obtained. Therefore, excellent agreement between the evaluators was obtained. The third stage involved content validation of the simulation scenario by 31 judges, who evaluated its representativeness, importance and clarity, resulting in a representativeness CVI of 0.83; CVI importance of 0.94; CVI clarity of 0.88; Kappa of 0.81; FVI of 0.89. In the fourth stage, the medication administration skills of 18 undergraduate nursing students were compared before and after offering a course focused on the topic, with improvements in the 73 items evaluated, of which 25 were statistically significant. There was also an increase in the percentage of self-confidence in the three routes of administration. The last stage involved the students&#39; perception regarding the use of the simulator, emerging four thematic categories: potentialities of using the low-cost simulator in the subcutaneous, intravenous and intramuscular administration routes; the realistic experience of using the low-cost simulator; practical application of theoretical knowledge learned; and practical gaps and repercussions on the safety of medication administration. In effect, the simulator constructed is innovative and reproducible, confirming the thesis that it is possible to construct a low-cost simulator aimed at administering medications to infants that presents evidence of validity in appearance and functionality and that promotes the improvement of patient skills students.

15
  • CINTIA GALVÃO QUEIROZ
  • Efficacy of non-instrumental techniques for feeding tube insertion in critically ill patients: randomized clinical trial.

  • Advisor : RODRIGO ASSIS NEVES DANTAS
  • COMMITTEE MEMBERS :
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • ISABEL KAROLYNE FERNANDES COSTA
  • KATIA REGINA BARROS RIBEIRO
  • LAYS PINHEIRO DE MEDEIROS
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Dec 15, 2023


  • Show Abstract
  • The insertion of the nasoenteral tube, despite being a frequent procedure, is invasive and traditionally inserted ‘‘blindly’’, with the patient’s head in the neutral position and without instrumental assistance or external laryngeal manipulation. This procedure sometimes becomes difficult and traumatic, presenting greater complexity in patients in coma (physiological or induced) and intubated, becoming a challenge in the face of anatomical obstacles. Therefore, its insertion presents no risks, adverse events may occur during this procedure and compromise patient safety. To this end, the objective was to compare the effectiveness of two non-instrumental methods of nasojejunal feeding tube insertion in patients in coma (physiological or induced) and intubated. This is a prospective, planned and controlled clinical trial, carried out in the Intensive Care Unit of Hospital Dr. José Pedro Bezerra, where adult patients in a physiological or induced coma and intubated were selected. They were randomly distributed into two groups: those who had the probe inserted conventionally, with the head in the neutral position (Control Group) and the group with the head positioned laterally to the right (Intervention Group). In both cases, the patients were in a supine position, without a pillow, in a semi-Fowler position and there were no chin, jaw or larynx maneuvers. The following calculations were recorded: (1) Success rate of the selected technique in the first attempt, second attempt and total; (2) Time required for the first successful attempt and the sum of all attempts; (3) Complications during insertion, including probe kinking, twisting, knotting, mucosal bleeding and insertion into the trachea; (4) Mandatory patient signals. The project was assessed by the Research Ethics Committee of the Federal University of Rio Grande do Norte, where it received a favorable opinion and was registered on the Brazilian Clinical Trials Registry platform (RBR-8cktds4). 32 patients were distributed according to randomization and allocated as follows: 16 (50%) in the CG and 16 (50%) in the IG. There was no significant difference in terms of age, sex, weight, height and body mass index between the groups. The overall success rate was 75%. Success in the first attempt to insert in intubated patients was 87.50% in the IG and 62.50% when compared to the CG. The time required for successful insertion
    was shorter in the IG (53.31 ± 17.50) compared to the CG (84.38 ± 29.81), showing a statistical difference in the insertion time between the groups (P &lt; 0.001). Complications were higher in the CG (31.25%) compared to the IG (6.25%). There were no cases of serious complications. Furthermore, when evaluating the average hemodynamic parameters (systolic and diastolic blood pressure, heart rate, pulse and oxygen saturation), there was no significant difference between the two groups, before and after probe insertion. It is concluded that the simple neck lateralization maneuver, as a stand-alone maneuver, results in faster and more successful insertion times, with low complication rates, avoiding unnecessary manipulations of the thyroid, larynx and airway instrumentation.

16
  • BRUNA RODRIGUES MONTEIRO
  • Prevalence of congenital syphilis in newborns in the global context: systematic review.

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • CAROLINA PEREIRA DA CUNHA SOUSA
  • ERIKA SIMONE GALVAO PINTO
  • KLEYTON SANTOS DE MEDEIROS
  • MARIA DE LOURDES COSTA DA SILVA
  • NILBA LIMA DE SOUZA
  • Data: Dec 18, 2023


  • Show Abstract
  • Objective: Detect the prevalence of congenital syphilis in newborns in the global context. Method: This is a systematic review. To construct the guiding question, I use the PECOT mnemonic (Population, Exposure, Comparator, Results, Type of Study). After formulating the mnemonic, the review presented the following research question: “What is the prevalence of congenital syphilis in newborns in the global context? ”. The search was carried out in the following databases: Embase, PubMed, Scopus, Ebsco, Web of Science, Latin American and Caribbean Literature in Health Sciences (LILACS). As a search strategy, a combination of descriptors indexed in the Medical Subject Headings (MeSH) was adopted: Pregnancy; Vertical Transmission of Infectious Diseases Syphilis; Observational study, mediated by the Boolean operator “AND” and “OR”. Observational studies on the vertical transmission of gestational syphilis and the association of gestational syphilis with congenital syphilis were included as inclusion criteria. There were no language or time restrictions for study selection. The systematic review period was six months. Article selection and data extraction were performed by two independent, blinded reviewers using Rayyan Intelligent Systematic Review software and based on the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) flowchart. To evaluate the quality of the evidence of the included data, the Grading of Recommendations Assessment, Developing and Assessment (GRADE) method was chosen, while the Newcastle-Ottawa Scale was used to analyze the risk of bias. The review protocol was sent to the database of the International Prospective Registry of Systematic Reviews with registration number CRD 42022349359 and since it involved research data already published in a scientific database, the Research Ethics Committee was exempt. Results: In total, 6,268 studies
    were identified in the databases, after using the PRISMA software and based on the PRISMA flow chart. The sample was composed of 30 studies (16 cohort studies; 04 case-control; 10 cross-sectional studies) that involved 15,593 pregnant women diagnosed with gestational syphilis who transmitted the infection vertically. The studies were carried out mainly in China, Brazil and the United States of America, from 1995 to 2023. As a diagnostic test for gestational syphilis, the rapid treponemal test is referred to as a diagnostic tool, while benzathine penicillin G is the first drug of choice . for the treatment of syphilis. As an effect of transmission, the complications found in newborns were: Congenital syphilis and adverse events associated with prematurity, low birth weight and fetal/neonatal mortality. The main cause of verticalization was associated with incomplete treatment of syphilis during pregnancy and late diagnosis of the disease in the third trimester. Conclusion: Despite the high number of studies identified in the databases, regardless of period and language, only 30 studies contextualize the global reality of congenital syphilis and its association with gestational syphilis. However, the outcome of congenital syphilis was represented by late diagnosis and treatment of gestational syphilis.

2022
Dissertations
1
  • KLEBIA KAROLINE DOS SANTOS NECO
  • The influence of social media on the risk perception of young people acquiring HIV: scope review.

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ELIÃ PINHEIRO BOTELHO
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Jan 27, 2022


  • Show Abstract
  • The need for a life connected to the internet and digital communication technologies is strongly perceived in the younger part of the world population. The use of the internet can provide benefits when it is used as a means of communication, education, information, expression and leisure. However, it also becomes an environment of vulnerability in relation to exposure to risks, including that of acquiring HIV and AIDS. The aim of this study was to analyze the influence of social media on the risk perception of young people to acquire HIV. This is a scope review developed in accordance with JBI recommendations. The Participant, Concept and Context (PCC) mnemonic resulted in the research question: "What is the influence of social media on the risk perception of young people acquiring HIV?" The Health Sciences Descriptors/ Medical Subject Headings (DeCS/MeSH) selected were: HIV; Adolescent AIDS; Teenager; Young; Social Networking; Social media; Internet; Risk; Health Risk and Risk Perception. The search was performed in the data sources: Elsevier SciVerse Scopus (Scopus); US National Library of Medicine - NLM (MEDLINE/PubMed), Web of Science, Scientific Electronic Library Online (SciELO), Science Direct, Latin American and Caribbean Literature on Health Sciences (LILACS), Spanish Bibliographic Index of Health Sciences (IBECS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), CAPES Theses and Dissertations Catalog, Open Access Scientific Repositories of Portugal (RCAAP); DART-Europe; Trove from the National Library of Australia; Theses Canada; Digital Library of Theses and Dissertations at the University of São Paulo (USP) and Google Scholar. Original and review articles, complete works, theses and dissertations, available in full, without time limit, in any language and that answered the research question, were included. Data were extracted using an instrument built in Microsoft Excel 2010, which included: title; author(s); year of publication; database/library/database/academic search engine; kind of study; study site, objective(s); methodological design; level of evidence; results; conclusion/recommendations/suggestions. For analysis, a synthesis matrix that included the extracted information. A total of 4135 publications were identified, of which 128 of the full texts were assessed for eligibility, 87 were excluded and 41 made up the final sample. The predominance of publications between 2011 and 2021 was highlighted, with an international coverage of the topic (95.1%). The studies showed that the most accessed social media was facebook, followed by text messaging apps. And that some of these platforms have varied resources that are used to disseminate information about HIV/AIDS prevention. Other research shows that more time accessing social media and being male was associated with an increase in the chances of searching for an online partner, which is also related to the growth in HIV testing. Thus, the risk perception of young people acquiring HIV involves knowledge about the disease, the social context in which it is inserted and their coexistence with social media, which inter-related influences positively or negatively.

2
  • LARISSA DE LIMA FERREIRA
  • Omission of nursing care in a care unit for patients with COVID-19

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • ISABELLE CAMPOS DE AZEVEDO
  • QUENIA CAMILLE SOARES MARTINS
  • ELIZABETH BARICHELLO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • Data: Jan 28, 2022


  • Show Abstract
  • The pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 fostered the rapid increase in new hospital beds, reorganization of care flows and demand for professionals, especially in nursing. However, with the increase in the need for hospital care, the fear of contagion of the disease, the physical and emotional wear of the professional, the lack of Personal Protective Equipment and the lack of supplies for carrying out care provide interruptions and incidents in nursing care. In the meantime, this study raises the following guiding questions: what nursing care is omitted during patient care with Coronavirus disease 2019? What are its causes and associated factors? And, it aims to describe the care omitted from the perspective of the nursing team in a care unit for patients with Coronavirus disease 2019. It is a cross-sectional study with a quantitative approach, carried out at the Onofre Lopes University Hospital with nurses and nursing technicians who work in the ward and Intensive Care Unit for the care of patients affected by the new coronavirus. For this purpose, the Missed Nursing Care Survey-BRASIL instrument was used for data collection, in the second half of 2021. Data were analyzed descriptively, with simple frequency calculation, central tendency and dispersion. The study had its approval authenticated by the consolidated opinion of the Research Ethics Committee, nº 4.812.664, CAAE:47765821.0.0000.5537. The most omitted care described by 71 nursing professionals were evaluated, 28 (40%) nurses and 43 (60%) nursing technicians, 51 (72%) were female, with a mean age of 41 years and 65 (91) %) with a 12-hour work shift. Of these, 44 (62%) worked in the Intensive Care Unit and 27 (38%) in the ward. It should be noted that 37 (52%) were permanent professionals at the hospital and 34 (48%) came from the emergency selection process to complement the workforce in the face of disease caused by the new coronavirus. The length of experience in the patient care sector with Coronavirus disease 2019 ranged from one to 16 months and the length of professional experience from three to 33 years. Among the most overlooked care, the most prevalent was walking three times a day, or as prescribed. Regarding the perceptions of nursing professionals, it was observed that, among the cares with statistically significant differences, nurses scored higher frequencies in omitted care. As for the reasons attributed to the omissions, those related to material resources, such as lack of equipment and medicines, were highlighted. And, among the reasons with statistically significant differences, nursing technicians had higher frequencies in the reasons indicated for omission during care. It is concluded that the nursing care omitted during the care of the patient affected by Severe Acute Respiratory Syndrome Coronavirus 2 was related to daily nursing care such as patient mobilization and, that the reasons for this are associated with the management of materials and time, which can be minimized with organizational measures to promote safe and quality care practices based on preventive measures.

3
  • DONÁTILA CRISTINA LIMA LOPES
  • SPECIALIZED NURSING LANGUAGE TERMS FOR THE CARE OF PEOPLE WITH SEQUENCES BY COVID-19 

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • MARIA ALZETE DE LIMA
  • HARLON FRANÇA DE MENEZES
  • NUNO DAMÁCIO DE CARVALHO FÉLIX
  • Data: Feb 1, 2022


  • Show Abstract
  • The objective was to build a specialized terminology for the care of people with sequelae by COVID-19, based on the Seven Axes Model of the International Classification for Nursing Practice (ICNP®) and on the Roy Adaptation Model (MAR), and validate the terminology content constructed by specialist nurses. Methodological study developed between 2020 and 2021, operationalized by the following steps: 1) Identification and extraction of relevant terms contained in the literature related to people with sequelae by Covid-19; 2) Standardization and standardization; 3) Cross mapping of the identified terms with the terms of the ICNP®, version 2019/2020; 4) Classification of terms found according to Roy's Adaptation Model; and, 5) Validation of the content of terms through a focus group with specialist nurses. The last stage takes place through two meetings lasting around two hours each and composed of eight specialist nurses, members of a research group from a Federal University, who developed research on an ICNP®. It was used in the Content Validity Index (CVI), validating those with a value of ≥0.80. This study was approved by the Research Ethics Committee, under Opinion No. 4,099,646, in accordance with Resolution 466/12, of the National Health Council. There were a total of 2,146 publications, of which 45 were fully examined and met the pre-established criteria. These documents were created by the creation of the corpus, where the information was extracted and grouped in a document in the Word for Windows® program, containing 308 pages. After an analysis process, the PorOnto program was drawn up, extracting a total of 1,659 terms. The extracted terms were organized in an Excel for Windows® spreadsheet and submitted to a normalization and standardization process, resulting in 478 useful terms. In the cross-mapping, each list of terms was submitted, separately, to a crossover process with the terms contained in the ICNP® through the Access for Windows® Version 2016 tool, resulting in constant and non-constant terms in the Seven Axis model of ICNP®. Thus, 157 terms were classified as constant and 321 as non-constant. Regarding the constant and non-constant terms in the ICNP®, it was identified that the most frequent were from the “Focus” and “Judgment” Axis. The study allowed the structuring of a specialized terminology for people with sequelae due to COVID-19, with the constant terms being prevalent, in the Focus and Means axes. However, it is noteworthy that the significance of non-constant terms was notorious, which can be suggested for inclusion in the International Council of Nurses and subsequent updating of the ICNP®. It is believed that the results of this study may contribute to the operationalization of the systematization of nursing care, in addition to contributing to the comprehensiveness of health care for people with sequelae due to COVID-19 and the real demands of these subjects, which will support the steps subsequent to the construction of a Terminology Subset for information and communication to Nursing practice.

4
  • VINÍCIUS COSTA MAIA MONTEIRO
  • Assessment of the degree of implementation of primary health care actions in quilombola communities in Rio Grande do Norte

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • NILBA LIMA DE SOUZA
  • SUENIA SILVA DE MESQUITA XAVIER
  • WESLLA KARLA ALBUQUERQUE SILVA DE PAULA
  • Data: Feb 4, 2022


  • Show Abstract
  • Quilombola communities can be defined as ethnic-racial groups that carry cultural, historical, and territorial characteristics arising from their ancestry. These communities are located in the rural context and suffer from difficulties in accessing essential public services, including health care. Primary Health Care (PHC) is configured as the closest health service to this population and needs to ensure that the actions carried out in quilombola communities can resolve their health problems, ensuring the integrality of the care provided. Thus, studies that assess the quality of care provided in quilombola communities become very relevant. Given the above, the general objective of this study was to assess the degree of implementation of PHC actions in quilombola communities in the State of Rio Grande do Norte. This is evaluative research of the normative type, with a quantitative approach, in which the PHC attributes established by Barbára Starfield were used as a theoretical-methodological framework. The study scenario was the 33 quilombola communities in the State of Rio Grande do Norte registered and recognized by the Palmares Cultural Foundation. The study sample consisted of 51 professionals, physicians, nurses, and nursing technicians, who work in Family Health Strategies and Primary Health Care Teams. For data collection, the PCATool 2020/Brazil (Instrument of Evaluation of Primary Health Care). For data tabulation and analysis, the SPSS software was adopted, using descriptive statistics. To analyze the degree of implementation of PHC actions in quilombola communities, the essential attributes, capacity and performance, and the derived attributes were considered: accessibility, logitudinality, coordination - information systems, coordination - integration of care, comprehensiveness, family guidance, and guidance community. The percentage of responses identified were distributed into four classifications: not implemented (from 0 to 25%); implanted incipient (26% to 50%); partially implemented (from 51% to 75%); fully implemented (from 76% to 100%). From the analyzes carried out, it was found that the PHC actions in quilombola communities in Rio Grande do Norte were classified as fully implemented (82.2%), considering the dimensions capacity (77.92%) and performance ( 85.56%). By observing the derived attributes: accessibility (74.51%), longitudinality (92.94%), coordination – information systems (80.88%), comprehensiveness – available services (85.91%), family guidance (87, 45%), and community guidance (92.16%), it is noted that these dimensions were also fully implemented. Only the dimension coordination – integration of care (56.86%) was considered as partially implemented. It is concluded that, from this study, it was possible to carry out a situational diagnosis of PHC actions in quilombola communities in Rio Grande do Norte, identifying the weaknesses and potential in the provision of health care to these communities.

5
  • BIANCA CALHEIROS CARDOSO DE MELO
  • The nursing care executed by specialist nurses at teaching hospitals in the northeast region of Brazil

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • SÓSTENES ERICSON VICENTE DA SILVA
  • EDILMA DE OLIVEIRA COSTA
  • ELAINE CRISTINA NOVATZKI FORTE
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • SORAYA MARIA DE MEDEIROS
  • Data: Feb 9, 2022


  • Show Abstract
  • Nowadays, the job market has demands due to social, political, economic, and technological needs faced by workers globally. Those requirements also exist in the health sector, which increasingly requires training, updates, and continuous professional improvement. In this manner, lato sensu graduate nursing courses suggest an education aimed at a particular area of knowledge.  These enable updates, learning, and better quality of care for the patient, family, and the community. The study aimed to analyze how nursing managers identify the quality of care in university hospitals based on the inclusion of specialist nurses. It is a descriptive-exploratory study of the qualitative approach. The managers of the nursing division in teaching Hospitals in Northeast Brazil were interviewed for information collection through Google Meet. The data were analyzed following the Content Analysis with the help of the Atlas.ti 9.0 software which helped to visualize the main results. The interview was conducted with fivenursing managers after submission and approval by the Research Ethics Committee of the Federal University of Rio Grande do Norte, opinion nº 5.004.512, under the number 50938721.5.0000.5537.The results found two categories of analysis: effects on nursing care after hiring specialist nurses and factors that promote and impede the insertion of the specialist nurses in the job market. The leading repercussions were: teaching and research improvements; systematized organization of own knowledge; security in performance/knowledge; enthusiasm; targeted treatment/work process; faster care; early identification of risks; reduced morbidity and mortality; shorter hospital stay/bed turnover; decrease in operating cost; user satisfaction; greater emphasis of the institution. The facilitating factors were: opening of vacancies in public tenders; better score in contests; institutionalization of the career plan; institutional incentive for the accomplishment of the post-graduation; same financial investment, in the private market, compared to general nurses; requirement of specialties by regulatory bodies; mastery of knowledge in the area of activit As for the complicating factors: reduced vacancies for specialist nurses; a need for greater financial investment for hiring; devaluation of specializations; inflexibility; female specialist/professional illness; lack of specific regulation and quality of lato sensu postgraduate training; experience in the area and appreciation of specializations by the private network.

6
  • NARYLLENE MACIEL DE ARAÚJO
  • EFFECTIVENESS OF THE USE OF VIDEO IN REDUCING THE ANXIETY LEVEL AND IN HEALTH EDUCATION OF PATIENTS IN MYOCARDIAL REVASCULARIZATION PRE-OPERATIVE: RANDOMIZED CLINICAL TRIAL

  • Advisor : DANIELE VIEIRA DANTAS
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • DANIELE VIEIRA DANTAS
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • MARIA DO CARMO DE OLIVEIRA
  • Data: Feb 9, 2022


  • Show Abstract
  • Myocardial revascularization surgery is still the most used in the treatment of many coronary artery diseases in an attempt to improve patient survival. In the preoperative period, anxiety can appear as a precursor of unwanted responses before surgery and worsen the postoperative prognosis. Thus, a non-pharmacological method to reduce this negative feeling and assist in the patient&#39;s surgical process is nursing guidance, which serves in the acquisition of knowledge within health education and can rely on technological tools to facilitate communication and bring reality closer. of the patient. In this sense, the objective is to evaluate the effectiveness of using video to acquire knowledge and reduce the level of anxiety in the preoperative period of myocardial revascularization. This is a randomized controlled clinical trial, carried out in the cardiology ward of Hospital Rio Grande, with 52 patients undergoing coronary artery bypass graft surgery, equally divided into Control Group and Experimental Group, which received guidance with the audiovisual resource of a video, while the Control Group received only the institution&#39;s standard guidelines. For data collection, the first researcher applied the instrument to assess the patient&#39;s anxiety before interventions both groups, in the second moment, the main researcher performed the different interventions for the two groups, and, finally, the first researcher returned to apply the anxiety assessment instrument again – now after the interventions – and the instrument to assess the knowledge acquired, without knowing which patient is part of each group. This project was approved by the Central Research Ethics Committee of the Federal University of Rio Grande do Norte No. CAAE 40743520.9.0000.5537 and registered in the Brazilian Registry of Clinical Trials (RBR-24c5qwm). The patients had a mean age of 63 years and the majority had completed elementary school. It was possible to prove that the audiovisual resource of the video was significant in increasing the patient&#39;s knowledge about the surgical procedure. In the control and experimental groups, it was observed that both interventions increased patients&#39; confidence in the operation, proving that nursing guidelines help the patient in this perioperative period. Thus, the study reinforces that audiovisual tools can help in nursing guidance, providing further explanations and increasing patient education about their health condition. This study proves the importance of nurses in interventions in the preoperative period and contributes to a better patient experience in terms of surgery.

7
  • NATALLY ARAÚJO PEREIRA DOS SANTOS
  • MEANINGS OF PREGNANCY ATTRIBUTED BY WOMEN IN STREET SITUATIONS BASED ON THE ORAL HISTORY OF LIFE

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • NILBA LIMA DE SOUZA
  • ERIKA SIMONE GALVAO PINTO
  • PAULA FERNANDA BRANDAO BATISTA DOS SANTOS
  • WESLLA KARLA ALBUQUERQUE SILVA DE PAULA
  • Data: Feb 11, 2022


  • Show Abstract
  • Introduction: Prenatal care has the ability to contribute to the health and prevention of maternal-fetal and infant morbidity and mortality. For the Homeless Population, however, the context of vulnerability in which they live makes pregnancy a moment of concern and need for specific health care, since the absence of this continuous and adequate care during pregnancy can have negative impacts on quality of life. Objective: This study aimed to evaluate the implementation of health actions and the influence of the context on pregnancy and childbirth experience of homeless women. Methods: This is a Health Evaluation Research of the Normative Evaluation and Evaluative Research type from a mixed approach parallel convergent in which the quantitative and qualitative elements were collected simultaneously, with the same level of significance, analyzed separately and culminatted in a process of confluence. The research were developed in public places used by homeless people and at Casa Lumen São Felipe Neri, a Foster home for homeless women located in the city of Natal-RN. The population consisted of five homeless women in urban areas of Natal, by spontaneous demand and by women who previously lived on the streets, but who during the period of data collection were residing in the foster home. Data collection took place between September and October 2021 through an instrument designed for the study. Data analysis corresponded to the evaluation of the implementation according to the Starfield Primary Health Care attributes, with the analysis of the implementation of health activities from the perspective of the experience of pregnancy and childbirth by homeless women, according to the Oral History of Life. This research project was submitted to the UFRN Research Ethics Committee, being approved with report  number 4,908,889 and CAAE 48035521.3.0000.556. Results: The study highlighted the inequity in the health care provided to this population, which reported a difficulty in accessing prenatal care, laboratory or gynecological tests, and health education focused on pregnancy. In addition to these, they revealed little care and acceptance by professionals, violation of social rights and unattended births. Such aspects reveal the need for a cohesive care network, attentive to the needs and particularities of this population, and which is covered by ministerial programs. Conclusion: The attributes of primary health care for women whose pregnancy happened on the streets were not covered and the oral life history of these women showed the inequity in the health care provided to women during pregnancy with failures, especially in prenatal care.

8
  • PRISCILA KALINE DE ANDRADE SILVA
  • Middle Range Theory of Nursing Diagnosis Risk of aspiration in critically ill patients

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • DANDARA NAYARA AZEVEDO DANTAS
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • TAHISSA FROTA CAVALCANTE
  • Data: Feb 22, 2022


  • Show Abstract
  • Aspiration is a common adverse event in the hospital environmentespecially in patients admitted to the intensive care unit. In view of thisthe development of a medium-range theory on the risk of aspiration in critically ill patients will allow the identification of causal relationships between risk factors and the phenomenon of interestwith a focus on preventionThereforethe present study aimed to develop a mid-range theory of the nursing diagnosis Risk of aspiration in critically ill patientsThis is a methodological researchcarried out in accordance with the references on middle-range theory. The study was operationalized through a scoping review on the subjectfollowed by the stages of conceptual and operational definitionspictogramelaboration of propositionsand, establishment of causal relationshipsFrom 74 included studiesseven risk factors were identifiednamelylow headboarddysphagia, high gastric residual volume, underinflation of the tracheal cuffinadequate position of the feeding tube, regurgitationdecreased gastrointestinal motility; 11 associated conditionsprolonged presence of orotracheal tube, enteral nutritionreduced level of consciousnesssedationreduced and/or absent cough reflexdelayed gastric emptyinggastroesophageal refluxincreased intragastric pressurereduced laryngeal sensitivitydecreased gag reflex and invasive procedures; andtwo populations at riskelderly and critically ill patients. Its conceptual and operational definitions were established. The pictogram was presented using the Ishikawa diagramEleven propositions were created andfinallythe causal relationships between risk factorsassociated conditions and the diagnosis Risk of aspiration in critically ill patients were determined. It is concluded that the construction of the middle-range theory on the nursing diagnosis Risk of aspiration in critically ill patients provides a consistent theoretical basis for decision-making and clinical judgment of nurses. It is suggested that further studies be carried out in order to analyze the content of the theory developed and clinically validate its elementsAndthus, continue contributing to the advancement of Nursing as a science and art.

9
  • LEANDRO MELO DE CARVALHO
  • Development of an application for managing the self-care of patients with Amyotrophic Lateral Sclerosis

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • MERCIO GABRIEL DE ARAUJO
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Feb 23, 2022


  • Show Abstract
  • Introduction: Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease that mainly affects the human motor system. The patient affected by this disorder gradually loses the ability to perform routine tasks, such as talking, eating or walking. It is believed that in chronic conditions, self-care can improve the quality of life of active patients involved in managing their conditions. From this perspective, technologies can work as a means of promoting this self-care and nursing professionals can act in its management, as they are able to clarify doubts and transmit information, qualifying the patient and their family. Objective: The aim was to develop an application for self-care management of patients with Amyotrophic Lateral Sclerosis. Methods: This is a methodological study of a quali-quanti approach to be carried out through User Centered Design (UCD). This strategy aims at the participation and collaboration of users in the development of applications, promoting the creation of useful products that meet the requirements and characteristics of users and are easy to handle, comprising four stages: analysis, design, construction and evaluation. Results: In the first stage, a Scoping Review was carried out with the aim of mapping the self-care strategies of people with Amyotrophic Lateral Sclerosis; in the second stage, there were investigations and discussions about the interactivity solutions for the user and the application; in the third stage, the application was built. The last stage was not performed during this study. The application was built in partnership with the Laboratory of Technological Innovation in Health at the Onofre Lopes University Hospital (LAIS/HUOL) of the Federal University of Rio Grande do Norte (UFRN). Conclusion: Self-care performed through technologies, such as an application, can be a powerful tool in promoting the quality of life of patients with Amyotrophic Lateral Sclerosis, as well as in self-care for other chronic diseases.

10
  • SABRINA DAIANE GURGEL SARMENTO
  • EFFECT OF MUSIC IN THE RELIEF OF PAIN DURING BED BATH OF INDIVIDUALS IN POST-OPERATIVE HEART SURGERY: RANDOMIZED CLINICAL TRIAL

  • Advisor : RODRIGO ASSIS NEVES DANTAS
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • KATIA REGINA BARROS RIBEIRO
  • MARIA DO CARMO DE OLIVEIRA
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Feb 24, 2022


  • Show Abstract
  • A frequent complication reported by patients in the postoperative period of cardiac surgery is pain, therefore, this event can be mitigated through pharmacological and non-pharmacological therapies. The latter includes music as a non-pharmacological alternative to minimize the patient's pain. Thus, the present study has the general objective of evaluating the effect of music on pain relief during the bed bath of patients in the immediate postoperative period of cardiac surgery. This is a randomized, controlled, double-blind clinical trial, carried out in the Intensive Care Unit (ICU) of Hospital Rio Grande. The sample group will be 52 patients undergoing cardiac surgery for myocardial revascularization, divided equally into Control Group (CG) and Experimental Group (EG), where the EG will receive the intervention with headphones with sound of their choice, while the CG, only headphones without sound, during the first post-surgery bed bath. As for data collection, the main researcher performed the randomization and applied the headphone in both groups, during the bed bath, then the second researcher applied the assessment instrument before, during and ten minutes after the bed bath. Finally, the main researcher removed the headphone, thus guaranteeing the ignorance of the second researcher of the group to which the patient belonged, with the researcher and the patient being blind. This project was submitted to the Research Ethics Committee of HUOL and approved under registration 3.425.285 and CAAE: 11745419.6.0000.5292 and registered in the Brazilian Registry of Clinical Trials (RBR-69w6f5z). The present investigation consisted of a sample group of 38 participants, 52.26% from the CG and 44.74% from the EG. As for the socio-epidemiological profile, 81.58% of the patients were male, 60.53% were aged up to 64 years, 65.79% were married and 44.74% had elementary education. The variables related to the intervention instrument showed that 86.84% liked and/or used to listen to music, with a preference for gospel songs and Brazilian popular music, when comparing their effect during the bed bath between the CG and EG, observed- whether there was significance (p<0.05%) in the reduction of pain and between the EG there was a reduction in heart rate when the times of therapy studied were compared. Thus, it is possible to infer that this study demonstrated the use of a simple and low-cost tool, but with the potential to reduce the patient's pain during nursing care, being an important ally in the provision of humanized nursing care and quality.

11
  • FERNANDA RAFAELA DOS SANTOS
  • Terminological subset of the International Classification for Nursing Practice for people with Covid-19 in the context of Primary Health Care

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • AUREAN DECA JÚNIOR
  • HARLON FRANÇA DE MENEZES
  • MARIA ALZETE DE LIMA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Feb 24, 2022


  • Show Abstract
  • With a high worldwide incidence, Covid-19 consists of a disease transmitted mainly by the respiratory route, and has symptoms that can vary from mild to severe. Thus, the importance of Systematization of Nursing Care is highlighted, since it provides evidence-based care, and consequently an improvement in the quality of care provided to these patients. The objective of this study was to build a standardized nursing terminology for people with Covid-19 in the context of Primary Health Care, based on the Seven Axis Model of the International Classification for Nursing Practice (ICNP®), in the light of the theory of Needs. Basic Humanities by Wanda de Aguiar Horta. This is a terminological study, which was developed in four stages, namely: 1) identification of terms relevant to the care of people with Covid-19 in the context of Primary Health Care; 2) Standardization and standardization; 3) Cross-mapping of the terms identified with the terms of ICNP®, version 2019/2020; 4) Classification of the terms found according to the Horta Model. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, with opinion No. 4,099,646, under Presentation Certificate for Ethics Assessment No. 33494920.8.0000.5537. From the process of selection and analysis of articles, a total of 42 publications were identified, among which 20 studies were examined in full and that met the pre-established criteria. In addition, 9 official documents were identified. Such documents went through the creation of the corpus, where the information was extracted and grouped in a document in the Word for Windows® program, containing 250 pages. After the analysis process, they were submitted to the PorOnto program, extracting a total of 18,109 terms. The extracted terms were organized in an Excel for Windows® spreadsheet and subjected to a normalization and standardization process, resulting in 844 useful terms. In the cross mapping, each list of terms was submitted, separately, to a process of crossing with the terms contained in the ICNP® through the Access for Windows® Version 2016 tool, resulting in constant and non-constant terms in the Seven Axis model of the ICNP®. Thus, 145 terms were classified as constants and 699 as non-constants. Among the constant terms, 24 made up the Action axis, 4 made up the Customer axis, 90 made up the Focus axis, 5 made up the Judgment axis, 2 made up the Location axis, 13 made up the Means axis and 7 made up the Time axis. The study allowed the structuring of a standardized nursing terminology for people with Covid-19 in the context of Primary Health Care, which could support the creation of a Terminological Subset of the International Classification for Nursing Practice (ICNP®) for care of nursing. Finally, it is believed that the results obtained will promote an improvement in the clinical practice of nurses for people with Covid-19, and consequently guarantee quality care, especially in the context of Primary Health Care, as it is in this scenario that the longitudinal follow-up of the population with this disease.

12
  • BRUNA RUSELLY DANTAS SILVEIRA
  • Ideal type of Family Health Strategy professionals about Palliative Care: comprehensive phenomenological approach

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • DANIELE VIEIRA DANTAS
  • GLEYCE ANY FREIRE DE LIMA CARVALHO
  • LUCIANE PAULA BATISTA ARAUJO DE OLIVEIRA
  • MARIA CÉLIA FREITAS
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Feb 25, 2022


  • Show Abstract
  • Palliative Care promotes comfort and quality of life through prevention and relief of biopsychosocial-spiritual suffering resulting from experiences with serious illnesses. In Brazil, this care is determined to be integrated into the services of the Health Care Network, with emphasis on Primary Health Care, whose principles and attributes are aligned with the palliative philosophy. Such similarity tends to the provision of care that addresses the palliative demands of users, even if performed intuitively by health professionals. In this meander, the present study proposes to understand the typical ideal of the Family Health Strategy professional regarding the action of caring for users with palliative needs in Primary Health Care following the principles of Alfred Schütz's phenomenological-comprehensive approach sedimented by Zeferino: the researcher's disinterested attitude; rules of sociological relevance; logical coherence; subjective interpretation; adequacy; and scientific logical rationality. The study was carried out in three Family Health Units in the West, North I, and North II Health Districts, located in the city of Natal, State of Rio Grande do Norte. The participants were: 11 nurses, 9 physicians, and 7 dentists, in a total of 26. Data were collected from audio-recorded semi-structured interviews online and at the workplace of the health care professionals, guided by a script of questions regarding the biographical situation of the participants and by the topics triggers of the interview, later transcribed in Microsoft Word 2010 and added to the Atlas.ti Cloud® software for organization, aid in the coding and categorization of the material. The analysis of sociodemographic data was carried out using simple descriptive statistics in Microsoft Excel version 2010, while for the qualitative analysis of the speeches, Zeferino's principles were applied in the light of Schütz's theoretical-methodological framework. The study complied with the ethical and legal principles that govern scientific research in human beings, according to Resolution 466/2012 of the Conselho Nacional de Saúde, being approved by the Comitê de Ética em Pesquisa da UFRN nº 4,836,686, CAAE nº 48553621.9.0000.5537. The analysis of the speeches allowed us to identify the categories of human action expressed in the second-degree constructs “actions to take care of users with palliative needs” and “actions to integrate palliative care in primary care”, considering the "In-order-to motives" and "motives because", for allowing the interpretation of the actions of the social actors in this investigation, revealing the ideal type analyzed by Alfred Schütz's comprehensive phenomenology. In conclusion, the Strategy Family Health caregivers have significant experience in offering primary palliative care for patients and their families in Primary Health Care, and they recognize the importance of integrating Palliative Care assistance into the primary care services to guarantee the comfort and quality of life for those who are suffering, even in the face of difficulties and/or obstacles in the approach of this care wich still happen in a pre-reflective way.

13
  • ANNY SUELEN DOS SANTOS ANDRADE
  • Use of phototherapy in newborns in a neonatal unit: analysis of the implementation

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • JULIANA TEIXEIRA JALES MENESCAL PINTO
  • NILBA LIMA DE SOUZA
  • WESLLA KARLA ALBUQUERQUE SILVA DE PAULA
  • Data: Mar 29, 2022


  • Show Abstract
  • Neonatal hyperbilirubinemia has a high worldwide prevalence and affects 84% of healthy newborns in the first week of life. For 60% of them, it is a physiological phenomenon, which appears on the second or third day after birth. However, some neonates present the most accentuated condition that requires treatment with phototherapy as an intervention. Therefore, the present study aimed to determine the degree of implementation in the use of phototherapy for the treatment of neonatal hyperbilirubinemia. It is a normative assessment, with a quantitative approach, with emphasis on the degree of implementation of an intervention. The study took place in a public maternity hospital located in Natal, Rio Grande do Norte. The population consisted of nurses working in neonatal units, who provide direct care to newborns using phototherapy, and the final sample consisted of 20 participants. Data collection took place between December 2021 and January 2022, using an instrument designed for the study. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS)® software, from the perspective of descriptive statistics and attribution of value judgment, according to the degree assigned. The study complied with the ethical and legal principles that govern scientific research in human beings according to Resolution No. 466/2012 of the National Health Council, being approved by the Embodied Opinion of the Research Ethics Committee, No. 5,133,140, under CAAE No. 51872521.0 .0000.5537. It was observed that the degree of phototherapy implantation was classified as partially implanted (58.10%), where the structure (62.79%) and process (80.94%) dimensions are partially and fully implanted, respectively. Only the items checking the newborn's temperature (22.50%) and checking the light irradiance of the phototherapy device (23.75%) are not implanted. It is concluded that the definition of the degree of implementation of phototherapy brings the situational diagnosis of phototherapy in a maternity hospital, since it makes it possible to identify strengths and weaknesses related to the care offered to the neonate under phototherapy, in order to transform them into improvements. We suggest the development of a nursing care instrument for newborns under standardized phototherapy, according to already established norms and criteria.

14
  • BEATRIZ TAVINA VIANA CABRAL
  • Nursing workload in rooming-in at a university hospital

  • Advisor : QUENIA CAMILLE SOARES MARTINS
  • COMMITTEE MEMBERS :
  • QUENIA CAMILLE SOARES MARTINS
  • ISABELLE CAMPOS DE AZEVEDO
  • CRISTIANE DA SILVA RAMOS MARINHO
  • FRANCISCA MARTA DE LIMA COSTA SOUZA
  • CAREN DE OLIVEIRA RIBOLDI
  • Data: Mar 31, 2022


  • Show Abstract
  • The nursing team has sought to ensure care with scientific support and autonomy, for which it is necessary to design coherent nursing professionals. The rooming-in is the place within a hospital system where the healthy mother and newborn binomial will go soon after birth and continue together until hospital discharge. In this perspective, the present study has as its guiding questions: which care indicators arouse a greater need for assistance in puerperal women and newborns? And what are the existing classifications for the binomial in rooming-in?. The general objective is to apply the workload instrument to classify the mother-child binomial in rooming-in that subsidizes the sizing of nursing professionals. This is an observational, descriptive study with a quantitative approach, which will be carried out in the rooming-in sector of a University Hospital. The data collection instrument will be organized in three stages, in which the first is composed of seven care indicators, as follows: Mode of delivery; Maternal morbidity and complications; Neonatal morbidity and complications; Breastfeeding; Social aggravating factors; Education and care guidance and Interaction and bonding, with scores from one to four being assigned, the second will be sociodemographic, personal and obstetric data and the third will collect data from the Safe Childbirth Checklist, present in the medical record, the The search will be active in the rooming-in daily, every 24 hours, in the form of an interview. The information collected will be stored and processed in a computerized database using Microsoft Office Excel and Statistical Package for the Social Sciences, version 20.0. The descriptive treatment will be through the means and medians, the data analysis will be used the chi-square test. It is noteworthy that this research will follow the ethical precepts in research with human beings described in Resolution nº 466, of December 12, 2012, of the National Health Council upon approval by the Research Ethics Committee of the Faculty of Health Sciences of Traíri / Federal University of Rio Grande do Norte, under Certificate of Ethical Appreciation No. 54027921.7.0000.5568. The present investigation consisted of 211 mother-child binomials and 471 evaluations, with (105; 49.3%) being vaginal/normal delivery and (108; 50.7%) cesarean delivery, with regard to the guidelines of childbirth (124; 58.2%) received it during prenatal care and (89; 41.8%) did not obtain it, while breastfeeding guidelines (131; 61.5%) received and (82; 38.5%) %) did not receive, in the care of the newborn (124; 58.2) received and (89: 41.8%) did not receive. 64.8 were in rooming-in, while 35.2 were in the pre-delivery, delivery and post-delivery room. It is concluded that from the present study, it became possible to classify the binomials in relation to the levels of care and, based on the importance of the life and well-being of the mother and the newborn, it is possible, despite the accommodation together being a seasonal sector, establish a number of professionals.

15
  • RAYANE SARAIVA FELIX
  • ASSESSMENT OF THE ATTRIBUTES OF PRIMARY HEALTH CARE IN THE ASSISTANCE TO PATIENTS WITH SYSTEMIC ARTERIAL HYPERTENSION IN THE MUNICIPALITY OF PARNAMIRIM / RN

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • NILBA LIMA DE SOUZA
  • MARIA AMÉLIA ZANON PONCE
  • WESLLA KARLA ALBUQUERQUE SILVA DE PAULA
  • Data: Apr 29, 2022


  • Show Abstract
  • Systemic Arterial Hypertension (SAH) represents a serious epidemiological problem in Brazil and in the world, both due to its high prevalence and the complications it causes with high rates of morbidity and mortality and relevant impacts on hospital costs. In Brazil, the challenges of controlling and preventing SAH and its complications are, above all, for the teams that provide Primary Health Care (PHC), whose work process presupposes a bond with the community and the attached clientele. Evaluating the performance of PHC in the care of people with SAH is an important need for propositions that seek to improve the quality of care, since the evaluation is an instrument that supports decision-making and guides changes. In this sense, this study aimed to evaluate the attributes of primary health care in the care of patients with Systemic Arterial Hypertension in the city of Parnamirim/RN. This is an evaluative study with a quantitative approach of a normative nature. The evaluation model created by Barbara Starfield was used as a theoretical-methodological framework, which suggests a normative method to measure the achievement of primary health care, evaluating the capacity and performance of attributes at this level of care in relation to the actions developed/offered. The study was carried out in units that offer primary health care services in Parnamirim, a municipality in the Metropolitan Region of Rio Grande do Norte. The study population consisted of nurses and doctors (110 subjects) from the Family Health Strategy teams, responsible for follow-up consultations for patients with SAH within the primary care of the municipality. Medical professionals and nurses who work in the unit surveyed for at least three months were included in the sample. Professionals who were on sick leave and professional leave were excluded. Data collection was carried out between the months of October 2021 and January 2022, using an instrument to assess the capacity and performance of care for hypertensive patients in PHC. This instrument was created based on the Primary Care Assessment Tool in the Brazil version (PCATool-Brasil) and on Caderno de Atenção Básica nº 37, both published by the Ministry of Health. The instrument consists of 5 questions to characterize the professionals and 29 questions that seek to assess the elements related to the capacity and performance of each PHC attribute, namely: first contact access; longitudinality, integrality and coordination. Data were analyzed using descriptive statistics, in which scores were calculated, classified as High (score ≥ 6.6) and Low (score < 6.6), with the High score being characterized by the presence and extent of PHC attributes, revealing services better oriented. The study followed the ethical and legal principles that govern scientific research in human beings, recommended in Resolution No. 466/2012, of the National Health Council, being submitted to the Research Ethics Committee of the Federal University of Rio Grande do Norte and approved under the number: 4,954,487. Sixty-nine subjects participated in the research, of which 76.81% were female, 72.46% had a nursing degree, 59.42% said they worked for 1 to 2 years in the current Primary Health Care unit. Of the 4 attributes evaluated in this study, only the attribute Longitudinality had a high score (7.61), the others had a low score, namely: Access to the first contact (5.92), Integrality (5.96), Coordination (5.57) . In this way, it can be seen that the municipality did not obtain a satisfactory score, evidencing the absence of the extension of the PHC attributes in the care of patients with arterial hypertension and improvement in health care processes, qualification of the system's performance, and consequently, impacts on improving the health of this population.

16
  • MICHELL PLATINY CÂNDIDO DUARTE
  • Web/mobile application development to identify and guide people with signs of anxiety, depression and low self-esteem in relation to covid-19

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • IGOR CORDEIRO MENDES
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • Data: Jul 13, 2022


  • Show Abstract
  • Introduction: The pandemic started from the new coronavirus (COVID-19) was established by the World Health Organization (WHO) as an acute respiratory infection caused by a subtype of the coronavirus. The imposed social isolation could worsen and enhance loneliness, sadness, anxiety and, consequently, affect sleep eating patterns, religious manifestations, among others. Can the use of an application called APASMC.COVID-19 as digital technology be effective in identifying and guiding people with signs of anxiety, depression and low self-esteem in the current and post-pandemic context caused by Covid-19? Objective: To develop a web/mobile application (APASMC.Covid-19) with an intuitive and easily accessible interface as a technology for identifying and guiding people with signs of anxiety, depression and low self-esteem in the current and post-pandemic context caused by Covid-19. Method: This is a methodological study that will be carried out from the creation of a web/mobile application, with free or paid domain, using an engine called Bubble.io, which presents block programming consisting of Javascript, HTML, Node. js and Postgres. The application will be developed and created, under the name App.APASMC.Covid-19, characterized by its use of technological, practical and easy access, in which it is intended for care related to the social isolation imposed by the new coronavirus. The application, as described below, will be built and developed using Javascript, Node.js and Postgres. All the results of this research will be consolidated and used to support future studies of longitudinal and transversal designs and propose strategies and policies to reach comprehensive actions with quality in the health care network, implementing actions of integrality and universal coverage of populations, as well as, also, favoring the improvement of the teaching-learning process in undergraduate and graduate health and other areas of interest.

17
  • REBECCA STEFANY DA COSTA SANTOS
  • MIDDLE RANGE THEORY FOR THE CARE OF PEOPLE LIVING WITH THE HUMAN IMMUNODEFICIENCY VIRUS

     
  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • HARLON FRANÇA DE MENEZES
  • NUNO DAMÁCIO DE CARVALHO FÉLIX
  • Data: Dec 8, 2022


  • Show Abstract
  • Introduction: Chronic conditions, such as those of people living with the human immunodeficiency virus, cause necessary changes in lifestyle, which sometimes conflict with socially ingrained and apprehended behaviors and beliefs that impact the health-disease process and the way to take care of yourself. The latest version of NANDA International brought changes in the nursing diagnosis Ineffective Health Self-Management, formerly called Ineffective Health Control, a diagnosis that has a high prevalence among people living with this disease, resulting in compromised health. The presence of diagnoses like this infer high care at all levels of health care by nursing, which transposes the biologicist character and refers to a greater need to deepen the issues that influence it. Objective: To develop a mid-range Nursing theory for Ineffective Health Self-Management in people living with the human immunodeficiency virus, in the light of Roy's Adaptation Model. Methods: This is a theoretical, predictive and deductive study based on the theoretical references of Callista Roy. The study was carried out in five stages, namely: definition of the approach to construct the middle-range theory, definition of the main concepts (key concepts), construction of a pictorial scheme, construction of propositions and the establishment of causal relationships and the evidence for practice. Initially, a scoping review was carried out, which served as the basis for the theory with searches in the following databases: Scopus, Web of Sciense, PubMed, CINAHAL, Cochrane, LILACS and Scielo. The following descriptors were used: “Acquired immunodeficiency syndrome”, “HIV”, “Patient acceptance of health care”, and “Cooperation and adherence to treatment” intermediated by the Boolean operators AND and OR. From this search, the essential elements of the validation process (attributes, factors and indicators) were extracted and analyzed in order to establish the causal relationships between them. Results: Of the 5622 articles obtained, after applying the eligibility criteria, 51 articles made up the final sample. The results show the identification of five essential attributes, 37 antecedents and 19 consequents. Finally, a pictogram was constructed representing the establishment involved in causal relationships with seven prepositions. Conclusion: It is concluded that the middle-range theory on the nursing diagnosis Ineffective health self- management in patients living with the human immunodeficiency virus developed in this study provides a consistent theoretical basis for the aid of nurses' diagnostic reasoning.

18
  • ANALIA ANDREIA DE ARAUJO NASCIMENTO
  • Construction and validation of educational technology for training hematopoietic stem cell transplant nurses on the Expert Patient Program.

  • Advisor : ISABELLE CAMPOS DE AZEVEDO
  • COMMITTEE MEMBERS :
  • ISABELLE CAMPOS DE AZEVEDO
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • ADRIANA CATARINA DE SOUZA OLIVEIRA
  • MARCOS ANTONIO FERREIRA JUNIOR
  • Data: Dec 16, 2022


  • Show Abstract
  • Educational technologies (ET) are facilitating instruments in the educational process of chronic patients such as hematopoietic stem cell transplant recipients and their families. However, theoretical knowledge is needed to incorporate new technologies in teaching during nursing care provided to these patients. At this moment, the Expert Patient Program emerges, as a strategy created to equip the subject with regard to the proper management of their health condition, in which they develop skills for an active and leadership role through shared and collaborative management with professionals related to their condition. of health. In order to conduct health education in the formation of Expert Patients, several types of technologies and methodologies can be used with a view to systematizing scientific knowledge and clinical practice as an instrument that facilitates essential information for self-care in health. In this perspective, the present study has as its guiding question: What should be the content and appearance of an educational technology for the training of hematopoietic stem cell transplant nurses on the Expert Patient Program? And, it aimed to develop an educational technology for training hematopoietic stem cell transplant nurses on the Expert Patient Program. This is a methodological study with a mixed approach, based on Pasquali's psychometry, organized into three procedures: theoretical, in which a focus group was held with eight Nurses who work in the Bone Marrow Transplant sector of a reference Hospital and nurses of Primary Care in the Municipality of Natal/RN, in addition to a Scoping Review on the educational technologies used for teaching self-care in the context of post-transplantation of hematopoietic stem cells; empirical procedures for the construction of the TE, and validation of the content and appearance through the Delphi technique, in two rounds, with the collaboration of 18 judges in the first round and 11 judges in the second, all with experience in the area in question; and analytical procedures, aimed at analyzing the data on which the Content Validation Coefficient was calculated. The study was approved by the Ethics and Research Committee, under Certificate of Ethical Appreciation nº 55774621.5.0000.5537. The focus group was held in 20 minutes, and the nurses addressed some of the content necessary for discharge instructions, the main complaints of the patient upon returning to the outpatient clinic, the reasons for seeking primary care and urgency and emergency by the patient. With the data from the focus groups and from the Scoping Review, TE was built, which was submitted to the judges for validation. In the Delphi I round, 0.81 was reached in the general content validity coefficient, while in appearance validation, for the Suitability Assessment of Materials criteria, an index of 0.80 was obtained. After adjustments proposed by the judges, in round II the content validation indexes reached a total of 0.87 and appearance equal to 0.88. Thus, the TE was considered valid in its content and appearance.

Thesis
1
  • KADYJINA DAIANE BATISTA LÚCIO
  • Efficacy of clinical simulation in line with the conceptual map on the diagnostic reasoning ability of nursing students

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • DANIELE VIEIRA DANTAS
  • JESSICA DANTAS DE SA TINOCO
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • RAPHAEL RANIERE DE OLIVEIRA COSTA
  • Data: Feb 21, 2022


  • Show Abstract
  • The diagnostic inference in nursingbecause it is something complexcan lead to difficulties for studentsThusthere is a need to develop educational technologies aimed at improving this reasoningThusthe objective isto evaluate the effectiveness of clinical simulation in line with the conceptual map in the diagnostic reasoning ability of nursing students. The research was developed in three stagesthe first two being subsidized by a methodological study and the third by a controlled and randomized clinical trial. The first includes the construction of two clinical cases for the pre-test and post-test instrumentstwo clinical simulation scenarios on diagnostic reasoning in nursing and the elaboration of the studentsleveling assessment. The second stage corresponded to content analysis of clinical cases, simulation scenarios and assessment of studentsplacement by judges. The evaluation of the scenarios had 45 judges in diagnostic reasoning and/or clinical simulationwho analyzed each item using a likert scaleTo assess the degree of diagnostic accuracythe Nursing Diagnosis Accuracy Scale was usedClinical cases and leveling questions had their content evaluated by 8 judges in a focus group. The third stage included the application of clinical simulation in line with conceptual maps to improve the ability of diagnostic reasoning for undergraduate nursing studentsStudents were randomized into intervention and control groups. The intervention group was submitted to the use of educational technology and the control group to the traditional class. The following inclusion criteria were adopted: age 18 years or olderbeing a student of the nursing course at a Federal University of Rio Grande do Norte and having attended or being studying the curricular component referring to the Nursing Process contentspecificallyNursing diagnosis. The following were used as exclusion criteriastudents who had any cognitive or behavioral difficultieswhich made communication unfeasible and also those who had a grade higher than 7 in the leveling assessment. As discontinuation criteriathe following were consideredwithdrawal from participating in the research after the beginning of data collection and/or the appearance of flu-like symptoms during this period. Data were analyzed by descriptive and inferential statistics. For the simulation scenariosan agreement of 85% of the judges was considered. For the Nursing Diagnosis Accuracy Scalethe S coefficient was calculated for all diagnoses. The students' performance was analyzed using inferential statistics in the pre-test, post-test and Diagnostic Reasoning Inventory instrumentsadopting a significance level of 5% (p≤0.05). The research project was approved by the responsible Ethics Committeeunder number 3,084,032. It was registered in the Brazilian Clinical Trials Registry databasereceiving the number: RBR-7qjpn6. The results show that the scenarios were judged with acceptable agreement by the experts, the proposed diagnoses showed a high degree of accuracy. The clinical cases used in the pre-test and post-test had an average content validity index of 93.7%. In the last stagethe intervention group stands out in the inference of the diagnostic labelwhich presented a statistically significant difference when comparing the preand post-test moments (p = 0.001). The same happened in the correct answers regarding related factors (p=0.004) and defining characteristics (p=0.004). Thus, it is concluded that the educational strategy clinical simulation in line with the conceptual map was effective in improving the diagnostic reasoning of nursing studentsFurthermorethe study provides visibility for two active teaching methodologiesclinical simulation and the conceptual mapwhich represents an advance in the role of students as active subjects in the teaching-learning process.

2
  • ILDONE FORTE DE MORAIS
  • PET-Saúde Interprofissionalidade: intentionality and contributions of projects to promote changes in health education

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • FRANKLIN DELANO SOARES FORTE
  • JENNIFER DO VALE E SILVA
  • MARCELO VIANA DA COSTA
  • RODRIGO ASSIS NEVES DANTAS
  • SORAYA MARIA DE MEDEIROS
  • Data: Feb 21, 2022


  • Show Abstract
  • Introduction: the debate on the reorientation of health education is increasingly necessary due to the epidemiological and demographic transition, in addition to complex health needs. Furthermore, the uniprofessional teaching model based on silos and the tribalism of professions is still hegemonic. Therefore, Interprofessional Health Education is an approach that aims to strengthen collaboration and teamwork in the health care of users, families, and community. For this, the PET-Saúde Interprofessionalidade has been a strategy to promote changes in the teaching of health professions in Brazil. However, the presence of different professions sharing the same space does not configure interprofessionality. Objective: analyzing the intentionality and contributions of the PET-Saúde Interprofessionalidade projects to promote changes in health education. Method: this is qualitative research with a comprehensive approach. Three academic units of a public university in the state of Rio Grande do Norte configured the investigative scenario. As a result of the restrictions on in-person contact imposed by the COVID-19 pandemic, data production took place remotely through the Google Meet platform, in virtual rooms restricted to individual online interviews with tutors, preceptors, and students of the PET-Saúde Interprofissionalidade . This technique was complemented by conducting an online focus group session with the preceptors. The non-probabilistic sample consisted of 22 subjects with experiences in the program. The material produced was submitted to content analysis in three stages: pre-analysis, exploration of the material, and treatment of the results. The first allowed a panoramic view of the empirical material and the systematization of a pre-classification of the elements in two thematic axes. In the following steps, the groupings of textual segments were consolidated, and their nuclei of meaning were identified, enabling the organization of thematic categories analyzed in the light of the theoretical, conceptual, and methodological framework of interprofessional education and collaborative practice. The investigation was approved by the Ethics Committee in Research with Human Beings from the Federal University of Rio Grande do Norte, under number 4,630,008. Results: perceptions about the intentionality of the PET-Saúde Interprofessionalidade encompass aspects such as an environment of shared knowledge; theoretical deepening, distancing from traditional uniprofessional education, and the idea of something similar to the concept of Interprofessional Education. These elements express that shared learning experiences are relevant but do not represent the essence of an intervention based on Interprofessional Education, which is to foster the development of collaborative skills. This initiative provided contributions associated with the review of Pedagogical Course Projects; guided the discussion of Interprofessional Education in the Structuring Teaching Centers of some undergraduate courses; it stimulated the implementation of disciplines with an interprofessional character; strengthened teaching-service integration and contributed to the implementation of a Permanent Commission on Interprofessional Education. Despite these positive characteristics, the program faced obstacles arising from the hegemony of uniprofessional training; charges for productivity in the management of health services; turnover of members, difficulties in reconciling schedules, and, above all, the impact of the COVID-19 pandemic on the redesign of planned proposals and implemented interventions. The projects conducted revealed the demand for structuring and longitudinal actions, which require health education policies that enable the sustainability of Interprofessional Education. Final considerations: the development of collaborative competences must be clearly understood and safeguarded as an intention of Interprofessional Education in initiatives with this perspective. This demands sustainable strategies and policies at the macro, middle, and micro levels, which consider interprofessionality as a permanent approach in the reorientation of the training and qualification of the health workforce towards effective teamwork.

3
  • ALEXANDRA DO NASCIMENTO CASSIANO
  • When to go to maternity? Care-educational technology for primiparous pregnant women on signs of labor and obstetric risk.

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • CRISTYANNE SAMARA MIRANDA DE HOLANDA DA NÓBREGA
  • ELIZABETH TEIXEIRA
  • FLAVIA ANDREIA PEREIRA SOARES DOS SANTOS
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • REJANE MARIA PAIVA DE MENEZES
  • SORAYA MARIA DE MEDEIROS
  • Data: Feb 23, 2022


  • Show Abstract
  • The gestational period is a phase of complex and unique transformations accompanied by physical, hormonal, psychological and social changes, and there may also be a variation of ambivalent feelings ranging from doubts, apprehension, love, joy, reaffirmation of pregnancy and anxiety and worry, especially when it comes to the pregnancy of a primigravidae. It is a fact that the primiparous pregnant woman has doubts about the right time to go to the maternity hospital, often generating anguish, fear and insecurity, sensations always observed by professionals in the daily routine of health services and are highlighted by the literature. Faced with this reality, it is believed that the use of an animated video on the signs of labor and obstetric risk in prenatal consultations can be a useful technological tool in expanding knowledge about pregnancy and childbirth in women about to be pregnant. to be a mother. The objective is to develop a care-educational technology for primiparous pregnant women about the signs of labor and obstetric risk. Methodological study, carried out through four stages, namely: 1) Construction of the animated video script on signs of labor and obstetric risk; 2) Validation of the animated video script content by expert judges; 3) Construction of the animated video on signs of labor and obstetric risk and, 4) Influence of the animated video on the knowledge of primiparous pregnant women through an EQE. To analyze the data referring to the validation process, the Content Validity Index and the Kappa Coefficient were used; In the quasi-experiment data analysis phase, descriptive statistics, trend measures, data dispersion were applied, in addition to the McNemar, Chi-square and Student's t tests, with a significance level of 5%. The study was submitted to the Research Ethics Committee of the Federal University of Rio Grande of Norte in accordance with the recommendations of Resolution 466/2012, of the National Health Council and its complements, with opinion approved under No. 4,396,786 and CAAE 39211420.4.0000.5537. The validation of the technology was carried out by 21 expert judges, fifteen of them with expertise in obstetric nursing and eleven in primary health care. Most were female (71.4%) with an average age of 35 years; of these, 42.9% were masters with an average of 8 years of experience in the field; The total Content Validation Index of the animated video script was 0.97. All the variables analyzed had an index greater than 0.81, with a lower value of 0.85 in the judgment regarding the adequacy of the material to the sociocultural level of the pregnant women. The Kappa coefficient obtained was 0.55, which corresponded to a moderate agreement. Ninety primiparous pregnant women were interviewed, whose profile corresponds to women with an average age of 23 years; mixed race (64.45%); in a stable union (74.44%) and an average of 10 years of schooling. Most (62.22%) were housewives and 54.45% had a family income of 1 minimum wage; half of the pregnant women (50%) were in the third trimester of pregnancy and 85.56% were undergoing usual risk prenatal care. Only 12.22% of them reported having access to information about signs of labor and obstetric risk. Data analysis using the McNemar test showed a statistical difference (p<0.0005) between before and after the animated video in questions 1, 2, 3, 4, 5 and 6. Regarding the total performance, it was verified if, through the Student's t test, there was a significant difference (p<0.001) between before and after viewing the animated video in the number of correct answers for the questions. Finally, in the evaluation of primigravidae regarding the importance of the video, the average grade attributed was 9.92. At the end of this study, it was concluded that its results confirmed the thesis that the use of a care-educational technology, such as an animated video, on the knowledge of the signs of labor and obstetric risk, had a positive influence on most of the participating pregnant women, indicating its importance and applicability to primary care services during the follow-up of women in prenatal consultations.

4
  • CINTIA CAPISTRANO TEIXEIRA ROCHA
  • CONSTRUCTION AND VALIDATION OF AN EDUCATIONAL TECHNOLOGY FOR NURSING CARE IN KIDNEY TRANSPLANTS

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • QUENIA CAMILLE SOARES MARTINS
  • ANA ELZA OLIVEIRA DE MENDONCA
  • MARIA ALZETE DE LIMA
  • AUREAN DECA JÚNIOR
  • HARLON FRANÇA DE MENEZES
  • Data: Feb 23, 2022


  • Show Abstract
  • This is a methodological study with the objective of building and validating an educational technology for nursing care in kidney transplant recipients, aimed at academics and nursing professionals. The research was conducted by Ausubel's theoretical framework of meaningful learning. To guide the construction of the didactic material, the Contextualized Instructional Design proposed by Filatro (2004) was used, structured in five correlated stages: 1) analysis, 2) design, 3) development, 4) implementation and 5) evaluation. The survey of the needs of the didactic material was carried out through the scoping review which, after being constructed, was submitted to content validation by expert judges, using an Instrument for Validation of Educational Content in Health. The collected data were entered into a Microsoft spreadsheet Office Excel 2013 and the Statistical Package for Social Sciences (SPSS) version 20.0, and analyzed using descriptive statistics and presented in the form of tables. To measure the proportion of judges in agreement on a given aspect of the assessment, the Validity and Content Index (IVC), Intraclass Correlation Coefficient (ICC), Kappa Index (K) and Validation of Educational Health Content (IVCES) were used. Items with a minimum agreement of 80% among experts were considered valid. Data collection took place from May to July 2021, with a total of 29 participants in content validation. The research was approved by the Ethics Committee of the Federal University of Rio Grande do Norte, through certificate of Ethical Appreciation Presentation nº 32033020.4.0000.5537. In the reliability assessment, IVCES showed excellent agreement among experts with a global CVI of 0.99 and Kappa > 0.9. Total internal consistency was considered satisfactory with ICC > 0.9 and significant p-value (p<0.05) in all domains: “objectives”, “structure/presentation” and “relevance. The study made it possible to map and develop didactic and technology-mediated material on nursing care for kidney transplant patients in the immediate, mediate, late postoperative period and in Primary Health Care. It is believed that the development of this study will provide the strengthening of care offered in the health care network in the line of care for people with chronic kidney disease using renal replacement therapy, kidney transplantation. In addition, it is an instrument that induces co-responsibility and quality in continuously improving health outcomes. It also stands out as an important driver for the praxis (action-reflection-action) of science and for the appreciation of nursing. It is noteworthy that the inclusion of primary health care in the care of the renal transplant patient becomes a differential of this study, care that is essential in the process for the maintenance of the graft in the transplanted patient, as it allows better adherence to therapeutic treatment, promotion and prevention of diseases such as opportunistic infectious diseases, reduction of anxiety regarding doubts and treatment difficulties and greater emotional support for the user and the family.

5
  • AMANDA BARBOSA DA SILVA
  • Development of mid-range nursing theory for impaired health literacy

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • DANDARA NAYARA AZEVEDO DANTAS
  • ANA PAULA NUNES DE LIMA FERNANDES
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • Data: Aug 17, 2022


  • Show Abstract
  • This study has as its research object the development of a Mid-Range Theory (AMR) for nursing on Impaired Health Literacy. The research is consistent with the trend of studies worldwide regarding the encouragement of scientific investigations by considering Health Literacy (HL) as an essential element for the care and improvement of the individual's ability to respond to their health status. The recent inclusion of the SL in Nanda Internacional (NANDA-I) reinforces the importance and the need to work on theoretical and practical aspects of the SL, especially from the perspective of Nursing science. In this way, theorizing on the subject in question provides a framework of knowledge to strengthen nursing as a discipline and science, in addition to providing limits for professional performance based on ethical precepts and guidelines for professional practice. TMA studies have been developed in order to support and contribute to the development of NANDA-I in order to clarify concepts or even insert diagnoses not yet covered. This study aims to develop a Middle Range Theory for Impaired Health Literacy. This is a methodological study of a diagnostic proposal for Impaired Health Literacy from the development of a TMA. Thus, the study was carried out in two stages, namely: 1) Theoretical-Causal Validity for the development of the TMA for Impaired Health Literacy and 2) Content analysis by judges of the proposed nursing diagnosis Impaired Health Literacy. The theoretical-causal validity was operationalized from an integrative literature review, developed in five data sources, namely: SCOPUS, WEB OF SCIENCE, LILACS, MEDLINE AND SCIENCE DIRECT. After applying the inclusion and exclusion criteria, 78 studies made up the final sample of the first stage. The content analysis by judges took place through the participation of 44 judges according to previously established criteria, whose diagnostic proposition constructed from the causal theoretical validity was refined according to criteria of relevance, clarity and precision evaluated. For the descriptive analysis of the characterization of the participants, the frequencies, measures of the distribution center and their variability were considered. The Kolmogorov-Smirnov test was applied to verify the normality of the cases. A statistical analysis was performed to calculate the CVI to identify the proportion of judges who consider the instrument with its respective clinical indicators and etiological factors to be adequate. This study obtained a favorable opinion from the Research Ethics Committee (CEP) of the Federal University of Rio Grande do Norte (UFRN) (ANNEX A) with number 4,745,373 and CAAE 46968421.4.0000.5537. In the first stage, 14 etiological factors, eight defining characteristics, two populations at risk and three associated conditions were identified. The TMA made it possible to construct nine propositions and establish causal relationships between the phenomenon and clinical practice, in addition to the construction of the pictogram. In the second stage, the judges considered the diagnostic proposal adequate, considering 15 etiological factors, eight defining characteristics, four associated conditions and five populations at risk. It was concluded that the development of the TMA enabled the construction of a diagnosis focused on the problem until now, non-existent in the NANDA International taxonomy, which was considered valid by the specialists, based on the content analysis.

6
  • ELIABE RODRIGUES DE MEDEIROS
  • School nursing in the care of infectious diseases: elaboration and validation of a service organization protocol

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • DANIELE VIEIRA DANTAS
  • ERIKA SIMONE GALVAO PINTO
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • MARIA SANDRA ANDRADE
  • ELIÃ PINHEIRO BOTELHO
  • Data: Aug 19, 2022


  • Show Abstract
  • Infectious diseases are pathologies relevant to the epidemiological situation of communities. Several efforts are made by health professionals to reduce the rates of these diseases and nursing, the most frequent category in health services, has stood out for offering preventive and health promotion services in community spaces, such as schools. The actions that it performs are already documented, however, there are no protocols that guide the execution of those that have this focus. Therefore, the objective of the present study is to analyze the evidence of validity of a protocol for organizing the school nursing service in the care of infectious diseases. This is methodological research composed of two stages. The first operationalized through a scope review to search for constructs on the available evidence on this aspect. In the second, the construction and validation of the protocol was carried out based on the evidence identified in the previous phase. Luiz Pasquali&#39;s theoretical framework was used for the construction of the items and Rafael Hernandez-Nieto&#39;s framework for the content validation process. The analysis considered agreement rates and the content validity coefficient, and the values were presented in tables. The ethical principles in research involving human beings were followed, in accordance with Resolution No. 466/2012 of the National Health Council, so that it was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte through opinion No. 4.758.536 and CAAE No. 45645621.3.0000.5537. In the scope review, 83 documents were included, from which 87 actions were identified after grouping. Four functions of school nursing (research, care, educational and manager), also called domains, were used to systematize the protocol for organizing services. The validation process was carried out with 13 expert judges through three rounds of Delphi evaluation. They identified agreement with the domains and items that integrated them and suggested adjustments. They also analyzed the need for changes in the items and, based on the criteria of clarity of language, practical relevance and theoretical relevance, scored the agreement for the validation of the content. At the end of the three rounds, all domains had concordance rates greater than 90% and all items had a content validity coefficient greater than or equal to 0.91 and thus were classified as excellent validity. The thesis that the school nursing protocol in the care of infectious diseases has evidence of content validity was confirmed. This instrument can be used by nursing teams that carry out activities in schools aimed at different infections. It can also be suitable for any need identified in the different contexts in which it is used.

7
  • SIMONE KARINE DA COSTA MESQUITA
  • Artificial Neural Network to assist nurses in decision making about venous ulcer dressings

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • JULIANO TEIXEIRA MORAES
  • DANIELE VIEIRA DANTAS
  • ISABELLE KATHERINNE FERNANDES COSTA
  • JESSICA DANTAS DE SA TINOCO
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • Data: Aug 26, 2022


  • Show Abstract
  • Venous ulcer is considered a major public health problem due to the socioeconomic impact it causes on society due to the increase in its incidence, as well as the gaps in health services, in particular, the difficulty of professionals in clinical judgment during treatment. choice of injury coverage, which slows down the healing process. In this way, a computer system can help nurses to minimize the difficulties facing the treatment of venous ulcers, through artificial intelligence. Among the intelligent technologies, the Deep Artificial Neural Networks have been standing out for their high power to solve complex problems, which makes it possible to maximize the quality of care offered to patients and contribute to the decision-making of professionals during clinical practice. Given the context, the study aims to provide computational assistance to nurses in decision-making about dressings for venous ulcers, through two neural networks. This is a methodological, descriptive research with a quantitative approach. The study was divided into four phases, according to the Unified Process (UP) methodological model. Phase 1 refers to the design and requirements gathering. In this phase, an integrative review was carried out on dressings used in the treatment of venous ulcers, construction of an image bank and the classification of tissues and coverage suggestions, by expert nurse judges in the treatment of chronic ulcers. Phase 2 comprises the elaboration of the structure of neural networks. Phase 3 refers to building, testing and evaluating the networks. To make it possible to evaluate usability, it was necessary to create a VenoTEC application containing 9 screens, aimed at classifying coverage options from photos taken of venous lesions of patients. Thus, the usability assessment process took place with 13 nurses, in the period of June 2022, using a scale, guided by the System Usability Scale (SUS). Data were analyzed according to a calculation guided by the SUS, as well as exported to the Statistical Package for Social Science 20.0 program, where they were analyzed using relative and absolute frequency statistics. The construction of the neural network aimed at tissue classification obtained an accuracy of 70% of correct answers, while the neural network aimed at the classification of coverage obtained an accuracy of 100% of correct answers. In this way, the networks proved to be effective for the application. Phase 4 refers to the finalization of the product. The result of the usability evaluation obtained an average of 88.07; which characterizes a very good usability. The participating nurses, when using the system, felt satisfied and stated that they would use the technology in their work activity. The development of the two deep ANNs aimed at offering computational support to nurses during VU treatment may bring contributions as a work tool based on scientific evidence and protocols, in order to standardize conduct in health services, which may favor the improvement of care , by minimizing errors, in addition to providing quick and professional decision making.  

8
  • JULLIANA FERNANDES DE SENA
  • DISTANCE EDUCATIONAL TECHNOLOGY ABOUT THE CARE OF PEOPLE WITH INTESTINAL STOMACY

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ALCIDES VIANA DE LIMA NETO
  • ANDRÉ APARECIDO DA SILVA TELES
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • JESSICA DANTAS DE SA TINOCO
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • Data: Nov 23, 2022


  • Show Abstract
  • Health professionals are important agents of educational health actions and these are of great importance in the lives of patients, particularly in relation to ostomy care, in which the professional must guide self-care, adaptation and assist in the prevention of complications. In this context, Virtual Learning Environments have been providing significant impacts on the traditional educational paradigm and the use of technology has allowed the creation of virtual environments and patients, in addition to simulating practices to assist in the development of skills and the acquisition of knowledge for assistance. With this, the present study aims to build and evaluate an educational technology in the form of distance learning on the care of people with intestinal ostomies for academics and health professionals. This is a methodological, quantitative study and had as theoretical reference the psychometric theory of Pasquali and the Instructional Design of Filatro (2019). It was developed in four stages: Analysis: Literature review and Scoping Review, Design: elaboration of the technology project with content mapping; Development: Construction of educational technology in the EaD modality, and Evaluation of the technology content by expert judges in the area with pedagogical support to the conceptions of Ausubel&#39;s theory of Meaningful Learning. This last step consisted of the assessment of content and suitability by 13 expert judges. Data analysis was related to the evaluation of the technology by the judges through descriptive and inferential statistics, using Microsoft Excel and SPSS 20.0 programs, using the Kappa index (K) to measure the level of agreement and consistency of the judges in relation to the permanence or not of the items in the technology units, taking into account the indications of “inadequate” or “adequate” for them and the Content Validity Coefficient (CVC), considered acceptable K ≥0.50 and CVC&gt;0.75 , respectively. The overall CVC of the objectives was 0.87 and K was 0.51; structure and presentation had CVC of 0.85 and K of 0.46 and in the matter of relevance the CVC was 0.94 and K of 0.67. After the suggestions made by the judges, the adequacy of the educational technology will be carried out, incorporating the suggestions, in order to meet the needs and expectations proposed. The technology can be very useful in the hands of academics and health professionals to use as a care instrument in the guidelines for patients with intestinal ostomy. Soon, access to technology will be through the internet through the Virtual Environment if they wish to understand the care that will be necessary to help the new life condition of patients with intestinal ostomy.

9
  • THAIS ROSENTAL GABRIEL LOPES
  • The construction of paternal identity mediated by love for the premature child in the Kangaroo Method Care.

     
  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • FLAVIO CESAR BEZERRA DA SILVA
  • GLAUBER WEDER DOS SANTOS SILVA
  • MÔNICA CECÍLIA PIMENTEL DE MELO
  • VERBENA SANTOS ARAÚJO
  • Data: Dec 19, 2022


  • Show Abstract
  • Introduction: the construction of paternal identity is a transactional process and requires the involvement of men in the context in neonatal care, when the premature delivery of the child occurs unexpectedly. It involves subjective and complex aspects in addition to new adaptive activities and affective skills, so that it can be participated in the third stage proposed by the Kangaroo Mother Care Method. Objective: to describe the experience of the father in the care of the preterm child in the third stage of the Kangaroo Mother Care Method. Method: descriptive study with qualitative approach, carried out at the Maternity School Januario Cicco, reference in neonatal care, in the municipality of Natal, Rio Grande do Norte, from March to July 2022. Seven parents who experienced care for the premature child in the third stage of the Kangaroo Mother Care Method participated in the participants. For data collection, a questionnaire with sociodemographic data was used and in-depth open interviews were conducted, closed by the criterion of data saturation. The participants' characterization variables were typed into a Microsoft Office Excel spreadsheet and analyzed using descriptive statistics (absolute and relative values). The interviews were recorded, transcribed and transcribed in a LibreOffice document, giving rise to the corpora for processing and analysis. Initially, exploratory reading of the interviews was performed to highlight the main ideas of the participants and preparation of methodological and substantial memoranda.  The corpora were processed in the SOFTWARE IRAMUTEQ, through lexographic analyses: Descending Hierarchical Classification, Similitude Analysis and Factorial Analysis of Correspondence by categorical variable, associated with Bardin content analysis. Study approved by CEP/UFRN, Opinion: 5.269.9903, CAEE: 52591021.9.0000.5537. Results: the integration of the categories allowed the emergence of the central category: "The construction of paternal identity mediated by the love of the premature child in the Kangaroo Mother Care Method" from four dominant categories: Category I (Class 02) - The transition of care experienced by the nursing-mediated father; Category II (Class 01 and 05) - Producing new paternal senses from the routine of child care and the desire to care for the premature child; Category III (Class 03 and 04) - Positive religious/spiritual coping as a coping strategy to deal with the child's prematurity; Category IV (Class 06) - Feeling like a father in child care in the MC. It was identified that the construction of paternal identity is mediated by paternal love for the child, which is built from the maturation and sense of responsibility that arise substantially in the postpartum period.  The early connection established with the premature child, the new care routine initiated in the hospital environment and extended to the family home mediated by nursing in the third phase of the Kangaroo Method and the continuous contact mediated by love and desire to care and contribute to the confrontation of obstacles and acquisition of new paternal competencies in the daily relationship between father and child. Thus, paternal love is propitiated by the intimacy established between father and child in parenting. Final considerations: it was revealed that the construction of paternal identity is based on the relationships established with the child as he acquires a proactive and engaging posture, in the redefinition of personal priorities experienced in daily care and by the love he feels for the child, in the third stage of the Kangaroo Mother Care Method. It is considered that the results support the thesis that the father should be involved early in all phases proposed by the neonatal care of the Kangaroo Method, for the effectiveness of care after hospital discharge. Moreover, the health professionals involved, in particular, nursing should recognize the paternal role in the child's life and in the positive impacts for their growth and development, as well as and promote the use of positive strategies, such as religious coping, in overcoming the challenges of fatherhood.

     

2021
Dissertations
1
  • CAMILA PRISCILA ABDIAS DO NASCIMENTO
  • Evaluation of street teams that serve people living with tuberculosis


    https://video.rnp.br/portal/transmission?idItem=98522

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • ALINE ALE BERALDO
  • ERIKA SIMONE GALVAO PINTO
  • MARIA DE LOURDES COSTA DA SILVA
  • NILBA LIMA DE SOUZA
  • Data: Jan 22, 2021


  • Show Abstract
  • OBJECTIVE: to evaluate the street office teams that serve people living with tuberculosis in the city of Natal. METHOD: This is an evaluative research of a normative type, with a quantitative and qualitative approach with emphasis on the degree of implementation, structure and process of the office team on the street. Avenis Donabedian was used as a theoretical-methodological framework for health assessment. The study population was made up of 15 health professionals distributed in the following categories: nurses, social worker, doctor, psychologist and nursing technician from the three office teams in the street of the city of Natal / RN. Data collection was carried out from August to October 2020 through a questionnaire based on the Manual of Recommendations for Tuberculosis Control in Brazil, which consists of questions related to professional characterization, the structure / process dimension, and perceptions referred by professionals from health teams that make up office teams on the street to care for people living with tuberculosis. Quantitative data were organized and analyzed using the Statistical Package for the Social Sciences (SPSS), version 22.0 from IBM, using descriptive statistics. For the analysis of the implementation of the Street Consultation Teams in the city of Natal, the dimensions (structure and process) and their sub-dimensions (resources: human and material; process: operational activities) were considered. Regarding the assessment of implantation, 20 criteria were selected and the percentage of responses identified was divided into four classifications: not implanted (from 0% to 25%), incipient (from 26% to 50%), partially implanted (from 51% to 75%) and implanted (76% to 100%). Qualitative data were recorded in audios, transcribed, organized, and analytical processing was carried out with the help of the Interface software from R pour les Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), version 7 alpha 2. The research was approved by the Research Ethics Committee at the Federal University of Rio Grande do Norte, under CAEE: 30796020.9.0000.5537. The construction of the logical-operational model allowed the identification of the structural organization, the activities developed and the expected / developed results of the tuberculosis control program for the homeless population of the city of Natal. RESULTS: Of the 15 professionals selected in the sample, 01 were away from their activities during data collection, thus totaling 14 participants. From the data collected, it was possible to identify the degree of implementation of the Consultancy Teams on the Street in the city of Natal / RN, which was classified as implanted (76.79%). In the structure dimension, material resources were classified as partially implemented (72.73%). As for the process dimension, the operational activities obtained the degree implemented (81.75%). Regarding the perceptions mentioned by the health professionals who make up the office teams on the street to assist people living with tuberculosis, three thematic categories emerged: (1) the reasons that contribute to living on the street; (2) the duties and activities of the eCnaR and health managers and (3) the challenges and difficulties in the daily work. The results found for category 1 were: multifactorial, unemployment, family problems and drugs, for category 2 monitoring, guidance, care, dispersion of medication and referral to the health network and in the lack of recognition of the network and difficulty in working hours work respectively. CONCLUSION: The logical-operational model of the tuberculosis control program for the homeless population allowed an understanding of the program organization and supported the evaluation process. The identification of the criteria related to the structure and process made it possible to identify the degree of implementation of the program of the municipality of Natal as implemented, which emphasizes the need to continue the operational improvement that is essential for the integrality of assistance in addition to health education activities.

2
  • RAYLA PATRÍCIA DA SILVA ANDRADE
  • Completeness of the Tuberculosis Information System in the Municipality of Parnamirim/RN

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • NATHALIA HALAX ORFÃO
  • NILBA LIMA DE SOUZA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Jan 29, 2021


  • Show Abstract
  • Introduction: Tuberculosis affects people with low purchasing power and is still seen as neglected. Until 2035, a global reduction of 4 to 5% per year would be necessary for a tuberculosis-free world. The Primary Health Care services are the gateway to a possible suspected case of tuberculosis and after confirmation, the case notification must be carried out and inserted in the Information System for Notifiable Diseases for tuberculosis. Objective: This study aimed to analyze the completeness of the tuberculosis data in the Information System for Notifiable Diseases in the municipality of Parnamirim / RN from 2009 to 2019. Method: This is a descriptive, retrospective, historical series study based on secondary data. The population was composed by the database of the Information System of Notifiable Diseases, with information from the notification forms for tuberculosis in the municipality of Parnamirim / RN, totaling 891 cases. Data collection took place in the second half of 2020. The selected variables are represented by the sociodemographic, clinical, laboratory variables and the outcome of the case. The database was built in Excel format, version 2017, to create descriptive tables and graphs. For the application of statistical tests, the free statistical software R, version 3.6.1, was used. In the qualitative variables, a descriptive analysis was carried out through distributions of absolute and relative frequencies (%). In the comparison of completeness with the time under study, the Spearman’s non-parametric statistical test was applied with a significance level of 5%. After the conclusion of the descriptive analysis, the evaluation of variables was started according to the completeness criterion. The completeness analysis was based on the classification of the Notifiable Diseases Information System for qualitative assessment, establishing the following division: category 1 (bad), when there is 0 to 25% of completeness; category 2 (regular), between 25.1% and 50%; category 3 (good), between 50.1% and 75%, and category 4 (excellent), for completeness between 75.1% and 100%. The study followed the ethical precepts in research with human beings described in Resolution 466/2012 of the National Health Council. Approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, through the report 4,009,967 and Certificate of Presentation for Ethical Consideration 30793920.1.0000.5537. Results: 891 cases were analyzed in the period from 2009 to 2019. It was found that the predominance of reported cases was male (70.93%); between 20 and 29 years (31.09%); as for the level of education, (25.34%) had between the 1st to the 4th grade incomplete elementary school. The situation of the patient's entry into the Health Unit, a new case predominated (78.56%); clinical form was pulmonary (86.76%); (60.20%) underwent chest radiography with a suspicious result (91.15%); (75.59%) performed sputum smear microscopy in a sample for diagnosis, of these (71.90%) had a positive result; only (37.50%) performed the rapid test, with (87.04%) detectable sensitive to rifampicin and (1.23%) detectable resistant to rifampicin; (17.96%) underwent sputum culture, of these (35%) had a negative result. For the situation of closure of the notified case (77.63%) they obtained a cure for tuberculosis. While 8.20% abandoned treatment. Regarding completeness, it was classified as regular: illicit drug, smoking and rapid test, as good education and other conditions and as excellent sex, age, type of entry, clinical form, chest X-ray, AIDS, alcoholism, diabetes, disease mental, sputum smear, sputum culture and outcome of the case. Evidence of a statistically significant correlation was obtained between the time under analysis and the completeness of education level, chest X-ray and the outcome of the case (drop in completeness); illicit drug, smoking and rapid test (increase in completeness). Conclusion: Considering the completeness of the fields of the notification / investigation form for tuberculosis, it was found that of the 17 variables analyzed, 18% were classified as regular, 12% as good and 70% as excellent between the years 2009 to 2019 In the mandatory field variables, a behavior was verified, with the fields being completely filled out. As for the quality of the essential fields, there was a variability in completeness. Thus, it is necessary to establish strategies for the importance of the quality of the registration of notifications.

3
  • SYLVIA SILVA DE OLIVEIRA
  • Social representations of Prenatal for men who experienced consultations with partner

  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • FLAVIO CESAR BEZERRA DA SILVA
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JOAO MARIO PESSOA JUNIOR
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • Data: Jan 29, 2021


  • Show Abstract
  • For a long time, in the history of mankind, men were stablished as the financial providers of the family and, therefore, distanced themselves from their children development. However, new scientific evidence highlights the affective involvement of the male during the gestational period is crucial for paternity construction, establishment of the bond between father and baby and promotion of the mental health of the child and well-being of the woman. The prenatal assistance is very important of these process. Aim: to analyze the Social Representations attributed by the man during the prenatal consultations Method: this is a descriptive exploratory research, with a qualitative approach, in the light of the Theory of Social Representations, in the structural aspect, carried out with 38 men who experienced their partner's prenatal consultations and who were present at a maternity school located in the state of Rio Grande do Norte, from January to November 2020. To make data collection feasible, a sociodemographic questionnaire, the theme-story design and the Free Words Association Technique were used, using the inductive term “father and prenatal consultations”. The data were analyzed using the aid of the Interface R software for the Multidimensional Analyzes by Textes et de Questionnaires (IRAMUTEQ), version 7 alpha 2, through the prototypical processing (frame of four houses) for the matrix which is automatically calculated ; intermediate frequency (± 5.67) and Average Evocation Orders (± 2.8). It should also be noted that the research was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under the Certificate of Presentation for Ethical Appreciation (CAAE) numbering 21360719.0.0000.5537. Conclusions: the execution of the present research made it possible to reveal that the Social Representations of the men who participated in the partner's prenatal consultations presented feelings, as well as general meanings of what it is to “wear the identity of a father even before birth of the child”, which direct the core of meanings towards love which is established and strengthened throughout the partner's gestational period.

4
  • DHYANINE MORAIS DE LIMA RAIMUNDO
  • SPATIAL ANALYSIS AND TEMPORAL TREND OF NOTIFIED CASES OF CONGENITAL SYPHILIS IN RIO GRANDE DO NORTE

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • ALIETE CRISTINA GOMES DIAS PEDROSA DA CUNHA OLIVEIRA
  • ANA ANGELICA REGO DE QUEIROZ
  • RENATA KARINA REIS
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Feb 8, 2021


  • Show Abstract
  • Congenital syphilis is a multiple system infection, caused by Treponema pallidum and transmitted to the fetus via the placenta, at any time during pregnancy. The State of Rio Grande do Norte has rates above the national average (12.5 cases / 1,000 live births). The general objective of the research was to analyze the spatial distribution of notified cases of congenital syphilis and its temporal trend in the State of Rio Grande do Norte. This is an ecological study, with secondary data for the period from 2008 to 2018, with the population reported cases of congenital syphilis. For this purpose, data reported in the Notifiable Diseases Information System and in the Live Births Information System were used. In the analysis of the data, the maps of the eight health regions of Rio Grande do Norte from the Brazilian Institute of Geography and Statistics were extracted and the local and global Moran was performed with QGIS software version 2.18, being smoothed by the local empirical Bayesian method that resulted in the thematic maps . After calculating the incidences, which were standardized per 1,000 inhabitants, it was possible to carry out the analysis of the temporal trend using the Jointpoint model. The study obtained a favorable opinion from the Research Ethics Committee of the Federal University of Rio Grande do Norte, under Opinion No. 3,775,828 and CAAE No. 25687519.4.0000.5537. The results of this study show that 88% of children were diagnosed during prenatal care or childbirth / curettage, even with 76% of them being considered asymptomatic. On the other hand, the treponemic test was not performed in 81% of them. As for the treatment performed by the mothers, 70% was considered incomplete or inadequate. Moving averages showed a tendency to increase congenital syphilis in the 7th and 3rd health regions. Regarding the temporal analysis, this investigation showed a spatial cluster in the 3rd, 5th and 7th health regions, with an increased risk for congenital syphilis up to 2.65 times. Finally, the temporal trend showed a continuous growth curve across the state. It is concluded that there is a sensitive weakness regarding prenatal care, given the growing incidence in the State with an expectation of increase in the next five years. Finally, we emphasize the importance of implementing strategic and priority actions, as well as expanding the commitment to new partnerships, with a focus on reducing the transmission of congenital syphilis.

5
  • THATIANE MONICK DE SOUZA COSTA
  • Massage for pain relief in newborns undergoing puncture: a systematic review

  • Advisor : DANIELE VIEIRA DANTAS
  • COMMITTEE MEMBERS :
  • DANIELE VIEIRA DANTAS
  • ALEXSANDRA RODRIGUES FEIJAO
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • MARIA DO CARMO DE OLIVEIRA
  • Data: Feb 10, 2021


  • Show Abstract
  • Introduction: Premature newborns are exposed to about 75.1 ± 42.6 painful procedures during hospitalization, which generate an impact on changes in blood pressure, heart rate and respiratory rate, and it is necessary to apply measures to relieve pain. Non-pharmacological treatments are currently an effective alternative in pain management, since they mitigate neonatal suffering and reduce the chances of future comorbidities. Massage is part of these non-pharmacological measures, which is based on the comfort and relaxation of the individual, since it is linked to the improvement of blood circulation, reinforcing oxygenation and nutrition of tissues, having important efficacy in reducing pain. Objective: To evaluate scientific evidence on massage in pain relief in newborns undergoing to puncture. Method: Is this a systematic review, with the research question by pico strategy (Patient or Problem, Intervention, Control or Comparasion, Outcomes): Does massage produce pain relief when used in newborns submitted to puncture? The search was performed in the electronic data sources National Library of Medicine (MEDLINE - PubMed), Web of Science, CINAHL, Scopus, Cochrane Library and Gale. Different combinations of the keywords "infant, newborn", "massage", "pain" were used. The crossing of the research descriptors indexed in The MesH were: (((infant, newborn) OR (premature) OR (baby)) AND ((massage) OR (reflextherapy)) AND ((pain) OR (Pain measurement) OR (Pain management) OR (Pain relief) OR (Pain assessment) OR (Puncture assessment) OR ())). Primary quantitative studies were included, such as near-experimental and randomized clinical trial, which evaluated pain in newborns submitted to puncture using massage. The research was performed without language restriction and without time frame. This review was submitted to the PROSPERO database. Results: Of the 878 studies found, after reading titles and abstracts, excluding duplicates and reading in full, the sample consisted of 12 articles. A high level of agreement was observed among the reviewers who tracked the articles (Kappa index>90%). Of the twelve records included in this review, eleven (91.6%) randomized clinical trials and one (8.3%) is characterized as a non-randomized clinical trial (almost-experimental study). Regarding the specifications of the study population, the total number of participants enrolled in the studies was 981 neonates, and the age varied between 24 hours of life and 42 gestational weeks. About the place of application, seven (58.3%) studies performed the intervention in the lower limbs, five (41.6%) upper limbs and five (41.6%) on the feet of newborns. Regarding the time of application, seven (58.3%) studies performed the massage for 2 minutes, two (16.6%) for 3 minutes, one (8.3%) for 1 minute and one (8.3%) for 30 minutes. The instruments most used by researchers to evaluate the response to pain felt by newborns were the Neonatal Infant Pain Scale (NIPS) and the Premature Infant Pain Profile (PIPP). The researchers identified the effectiveness of massage over other techniques (or control group) in pain relief in 83.3% of the studies. The main benefits generated by massage were: reduction of pain scores during and after puncture, better mental development, lower heart rate change, shorter duration of crying and shorter procedure time. Conclusion: The application of massage can contribute to the relief of neonatal pain by reducing the pain assessment score, reducing crying time and stabilizing vital signs in newborns submitted to puncture.

6
  • RENILLY DE MELO PAIVA
  • Construction and validation of a graphic protocol for the evaluation of safe care for chronic renal patients in Renal dialysis

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ISABELLE CAMPOS DE AZEVEDO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • QUENIA CAMILLE SOARES MARTINS
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Feb 19, 2021


  • Show Abstract
  • Safe and quality care in hemodialysis services aims to reduce or eliminate the occurrence of adverse events. This is because, it is an environment that presents several risk factors because it is an invasive and complex procedure. Thus, it is necessary to implement measures for patient safety in these services, as well as to identify problems and measure the quality of care and management. Thus, this study aimed to build and validate the content and appearance of a protocol for evaluating safe care in hemodialysis. It deals with a methodological study conducted by Pasquali's psychometric framework organized in three procedures, namely: theoretical procedures in which a Scoping Review was carried out to support the definition of the contents included in the protocol; empirical procedures construction of the protocol through scientific evidence and content and appearance validation via Google forms and Delphi steps with expert judges in the area of patient safety and kidney diseases; and, analytical procedures in which the analysis of the data from the previous phase was carried out using the content validation coefficient, items with a minimum agreement of 80% between judges were considered valid. This study is approved by the Ethics and Research Committee of the Federal University of Rio Grande do Norte, under Certificate of Ethical Appreciation No. 3,915,158 and CAAE: 29259020.7.0000.5537. After construction of the protocol, it was submitted to the appreciation of nine judges who responded to all Delphi stages, who made suggestions for improvement and improvement. This achieved a general content validity coefficient of 0.87 and 0.94 for appearance validation. Thus, the graphic protocol for evaluating safe care for patients on Renal dialysis is considered valid in its content and appearance.

7
  • ISABELLE PEREIRA DA SILVA
  • Construction of a prototype application to assist in self-care of people with intestinal ostomy

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ISABELLE KATHERINNE FERNANDES COSTA
  • RODRIGO ASSIS NEVES DANTAS
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • HELENA MEGUMI SONOBE
  • Data: Feb 22, 2021


  • Show Abstract
  • Living with an intestinal ostomy negatively affects psychological, physiological, social aspects and demands adjustments in lifestyle, mainly related to self-care. The nurse is one of the components of the support network for people with ostomy and works in health education for this population with the aim of helping people in the development of their self-care. Several tools can be used to assist in the education of people with stomata to achieve self-care skills, with emphasis on the use of technologies such as mobile devices, which have a worldwide reach and have mobility and portability as their main benefits. Thus, the objective of this study was to develop a prototype of an application on a multimedia platform to assist in the self-care of people with intestinal ostomy. This is a methodological study in the technological innovation modality, which was based on the Design Science Research methodology. The study was carried out in two stages, respectively: a scoping review in order to map the recommendations related to self-care of people with intestinal ostomy and the development of a prototype of the application. The first step followed the recommendations of the Joanna Briggs Institute and the extension for scoping review of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. A search was carried out in eight databases and six portals of gray literature that totaled 14,318 studies and, after the selection and refinement process, a sample of 83 was obtained, of which 74 are articles, 8 dissertations and 1 thesis. Recommendations for self-care were categorized into the following themes: care for the stoma and peristomal skin; changing, cleaning and emptying the collector; nutrition; stomach and peristomal complications; use of equipment and adjuvants for ostomy; leisure and physical activities; body image and sexuality. In the end, self-care recommendations were organized to compose the content of the prototype. In the second stage of building the prototype, four phases followed: identification of the need, logical design of the artifact, development and initial tests. The prototype in its final version, conceived as a minimum viable product, resulted in 20 screens with interactive graphic animations, composed of the initial with registration options for accessing the platform and the initial menu, which brings the elements “register”, “my records”, “stoma care” and “contact”. The records offer the possibility for the person with a stoma to store information about stoma care and insert photos, while the “stoma care” element brings information about self-care, mapped in the literature, and has a filter to prioritize the order of information related to the main difficulty that the person has. In addition, the “contacts” screen allows access to doubts and the option to send questions to researchers, via the application. It is concluded that the prototype was successfully developed and has important resources for teaching self-care, being able to help people with stomas in learning about stoma care, as well as professionals in the health education process for this population.

8
  • JOSÉ RENATO PAULINO DE SALES
  • Gestational and congenital syphilis: epidemiological analysis of factors related to notifications in the state of Rio Grande do Norte.

  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • DANIELE VIEIRA DANTAS
  • GRACIMARY ALVES TEIXEIRA
  • MÔNICA CECÍLIA PIMENTEL DE MELO
  • Data: Feb 24, 2021


  • Show Abstract
  • Syphilis is considered a sexually transmitted infection, of a systemic and curable character, caused by Treponema pallidum and treatable with antibiotics. It has high rates of vertical transmission, aggravating serious problems of morbidity and mortality as a congenital syphilis. Its general objective is to analyze the factors related to the reported cases of gestational and congenital syphilis in the state of Rio Grande do Norte. This is a research with a quantitative epidemiological approach, of a descriptive and ecological type, derived from secondary data, having the state of Rio Grande do Norte as its coverage area, carried out in 2020. The sample was composed based on the criteria of eligibility and totaled 1892 notifications of syphilis in pregnant women and 2101 notifications for congenital syphilis in the period from 2014 to 2018. Data collection took place between the months of October to December through the bank of the Information System for Notifiable Diseases. The data were organized in the Microsoft Excel program for tabulation and statistical analysis using the software Statistical Package for the Social Sciences version 23.0. For statistical analysis, the Chi-square or Fisher's exact tests were used, as well as Odds Ratio with respective 95% confidence intervals (95% CI), followed by logistic regression to obtain the adjusted values to verify the associations between the variables of interest. The significance adopted was p <0.05. Finally, statistical differences between the values spent (R$) for hospitalization between gestational and congenital syphilis were obtained, when parametric, by independent t test and when the Gaussian assumption was broken by Mann-Whitney and as a measure of the quality of fit of the logistic model was the Hosmer and Lemeshow test was used, in which a p> 0.05 will indicate that the model is adjusted. Inherent to ethical aspects, the research was conducted in accordance with Resolution 510/16 of the National Health Council, which addresses the guidelines and regulatory standards for research involving human beings and how the study made use of secondary data, analysis by the Ethics and Research Committee. During the investigated period, an increase in reported cases was observed in the year 2018. The registered maternal profile points to women with an average age of 20 to 29 years (50,0%), brown (57,9%), with low education (61,2%). The analysis of prenatal care identified a predominance of maternal diagnosis in the third gestational trimester (40,0%) despite the fact that (84,3%) of these pregnant women performed it and the presence of nontreponemal reactive tests in (86,2%) and treponemal tests (49,5%) of women at delivery. With regard to maternal treatment, only (3,3%) of these women were registered with an appropriate treatment scheme and (18,6%) of partners were treated concurrently with pregnant women. In the outcomes related to children, (98,5%) were diagnosed with recent congenital syphilis and a number of (1,1%) of deaths from the disease in the state. Regarding hospitalizations for the notified condition, it presented an average number of 79,2 for congenital syphilis with an average value of R$ 4,217 per child. The results point, moreover, to important gaps in the processes of epidemiological surveillance regarding the filling of notifications regarding ignored and blank information. The analysis of notification of gestational and congenital syphilis made it possible to conclude that vertical transmission was related to missed diagnostic and therapeutic opportunities. The development of strategies for early detection and adherence to the treatment of the disease must be adopted, with a view to strengthening care and breaking the chain of vertical transmission of syphilis, in addition to avoiding and / or minimizing hospitalizations of children as a result of congenital syphilis. We emphasize the need for professional qualification for notification of the disease, as well as care for hospitalization of the newborn affected by the disease and expansion of the provision of information to epidemiological surveillance, in order to allow the continuity of the analysis of the disease.

9
  • VALÉRIA GOMES FERNANDES DA SILVA
  • Social Representations of people who have HIV serodiference drawn up by health professionals from specialized assistance services

     

    https://video.rnp.br/portal/transmission?idItem=98519

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • MARIA APARECIDA ALVES DE OLIVEIRA SERRA
  • REJANE MARIA PAIVA DE MENEZES
  • RENATA KARINA REIS
  • Data: Feb 25, 2021


  • Show Abstract
  • In the context of specialized health care services, professionals are constantly faced with the reality of people living with HIV serodifference. The present study aims to analyze the Social Representations under the structural aspect of people with HIV serodifference, elaborated by health professionals from Specialized Assistance Services in Sexually Transmitted Infections HIV / AIDS. This is a descriptive, exploratory, qualitative study, anchored on the assumptions of the Theory of Social Representations, in the structural aspect. The place of performance included three Specialized Care Services in STI / HIV / AIDS in the metropolitan region of the state of Rio Grande do Norte, and had the participation of 51 health professionals, working in multidisciplinary care teams, in addition to the coordinating professionals of the respective health services and programs. Data collection took place from October to December 2020, and was mediated by the use of the Free Word Evocation Technique associated with the replacement and decontextualization model (silent zone), with the inductive term “People in serodifference for HIV”. The data were analyzed through the prototypical processing (table of four houses) for each matrix, for which the intermediate frequencies (± 9 matrix 1 and ± 9.32 matrix 2) and the Average Evocation Orders (matrix 1: ± 3.04; matrix 2: ± 2.96), and similarity analysis, in order to vify the compositions and co-occurrence of words. The analytical processing took place in the Interface R software for Multidimensional Analyzes by Textes et Questionnaires (IRAMUTEQ), version 7 alpha 2. The research was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, 30794020.6.0000.5537. The 51 participants were mostly female (82.35%), with a predominant age range from 41 to 54 years old (45.10%). Regarding the level of education, 78.43% had higher education and 21.57% technical education, and 41.18% reported having specialization or specific training to work in the service. Of the total participants, 11.76% were coordinators of the responsible services and programs, and 88.24% were professionals from the multiprofessional care team, of which 33.33% were doctors, 24.44% were nursing technicians, 15.55% were pharmacists, 13.33% nurses, 6.66% social worker and 6.66% psychologists. As for the training time of professionals, there was a variation of 1 year and 10 months to 46 years of profession, as well as the time of service in the SAE was in the range of 9 days to 37 years. In the prototypical analysis, it was found that the term inducer referring to matrix 1, resulted in 255 evocations and 93 distinct words, while matrix 2 (substitution and decontextualization zone) had 255 evocations and 156 distinct words. After the processes of stemming and categorization, the number of different evocations was 43 for matrix 1 and 41 for matrix 2. After the exclusion of evocations with a frequency lower than three, 62.79 evoked evocations % (27) and 65.85% (27), respectively. In matrix 1, the possible representation of people living with HIV serodifference, semantically crystallized in the central nucleus, by the terms: love (f = 19; OME: 2.6), fear (f = 18; OME: 2.7), sexual behavior (f = 9; OME: 2.3), acceptance (f = 9; OME: 2.7) and respect (f = 9; OME: 2.6). In matrix 2, the representations were objectified by the terms prejudice (f = 27; OME: 2.7), ignorance (f = 21; OME: 2.0), fear (f = 16; OME: 2.8), madness (f = 10; OME : 2.4) and love (f: 10; OME: 2.5). Thus, there is a semantic crystallization of the terms love and fear between the two central cores. In the analysis of similarity to matrix 1, the terms that showed strong co-occurrence and connectivity were: “partnership”, “love”, “fear”, “prevention”, “care”; and matrix II, with the terms: "assistance", "reception", "ignorance", "prejudice", "fear". The Social Representations held by health professionals about serodifference were concentrated on the meanings attributed structurally to love, fear, partnership, assistance, prejudice, ignorance, which denotes the valorization of meanings that are beyond the field of health care provision.
10
  • RENATA MARINHO FERNANDES
  • Construction of a mid-range theory for nursing diagnosis sedentary lifestyle

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • CECILIA MARIA FARIAS DE QUEIROZ FRAZAO
  • Data: Feb 26, 2021


  • Show Abstract
  • Sedentary lifestyle has an increasing curve between adolescents and young adults. In this context, it is essential that the nurse knows in depth this nursing diagnosis. The objective of this study is to build a medium-range theory for the nursing diagnosis Sedentary Lifestyle in adolescents and young adults. This is a methodological study, according to Lopes e Silva's theoretical framework for the development of medium-range theory for nursing diagnoses. The study was made operational through an integrative literature review in the databases: National Library of Medicine and National Institutes of Health; Scopus; Cumulative Index to Nursing and Allied Health Literature and Web of Science. The crossing of the following descriptors Sedentary Behavior; Sedentary Lifestyle; Young Adult; and Adolescent allowed 2974 articles to be obtained. After applying the eligibility criteria, the final sample resulted in 57 articles. The results show the identification of six essential attributes; 23 clinical antecedents and 11 clinical consequents. The essential attributes were aging; excessive screen time on the internet; student; watch television >2h/day; women; and physical activity lower than recommended. The clinical antecedents were live in an urban area; aging; unemployment; excessive screen time on the internet; student; prolonged sitting time; physical inactivity; lower health perception; less satisfaction with life; watch television >2h/day; women; high socioeconomic status; physical activity lower than recommended; mismanagement of free time; insufficient resources for physical activity; insufficient interest in physical activities; high maternal education; air pollution; unfavorable climatic conditions; deficient knowledge; migration; high education level; and family history of physical inactivity. And the clinical consequents were impaired memory; backache; inadequate sleep time; lack of physical conditioning; depression; stress; anxiety; excess adiposity; cardiovascular disease; impaired cognitive function; and less visual attention. It is concluded that the understanding of nursing diagnosis sedentary lifestyle based on a medium-range theory is timely and generates tools that can promote health and quality of life in this specific population.

11
  • BRUNO NEVES DA SILVA
  • Intersections between quality of life of and resilience of rural women: a mixed methods research

     

    https://video.rnp.br/portal/transmission?idItem=98514

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • DEISE LISBOA RIQUINHO
  • ERIKA SIMONE GALVAO PINTO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JOSÉ LUÍS GUEDES DOS SANTOS
  • NILBA LIMA DE SOUZA
  • Data: Feb 26, 2021


  • Show Abstract
  • BACKGROUND: historically, the Brazilian rural scenario is surrounded by social inequalities that influence the people's life trajectories. Rural women suffer with these inequalities due to their class and gender condition and there is a need to consider the processes that lead these women to resist daily adversities, like resilience as well their quality of life. AIM: to analyze the influence and association between resilience and quality of life in rural women. The general aim of this study was to analyze the influence of resilience on the quality of life of rural women. METHOD: mixed methods study of convergent parallel type (QUAN + QUAL), in which two studies were conducted: a quantitative seccional study, whose sample consisted of 87 rural women; and a qualitative study, guided by the oral life history method, in which seven women participated. Data were collected simultaneously from July to November 2020, in the rural area of the municipality of Nazarezinho, Paraíba. In the quantitative study were applied a sociodemographic formiulary, the Resilience Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Qualitative data were collected through open interviews, which were recorded. The processing of quantitative data was performed using SPSS software version 25.0® in which descriptive and inferential statistical analyzes were performed. For qualitative data, they were initially transcribed, textualized and transcrieted, when they were then submitted to the thematic analysis proposed by Braun and Clarke (2006). The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under CAAE number 29253420.3.0000.55373. RESULTS: After parallel analysis, the data were integrated, and it was found that the degree of resilience has a positive linear relationship with the domains of quality of life obtained from the application of SF-36, and, while the degree of resilience increases, they increase the domains of quality of life of rural women, which was corroborated by the very narratives of these women's lives, which denote that, despite the difficulties and difficulties experienced, they are able to see their daily lives with satisfaction, and reinforce that contact with work was important to your current physical health. CONCLUSION: based on the understanding that resilience influences the quality of life of rural women it is expected that this study will contribute to subsidize future interventions and public policies that make it possible to increase the quality of life and reduce inequalities in the rural environment, and contribute to the health promotion of women who (re) exist in this context.

12
  • FRANCISCA SIMONE DA SILVA
  • Venous puncture in external jugular: self-referred knowledge by nursing students

  • Advisor : MARIA ALZETE DE LIMA
  • COMMITTEE MEMBERS :
  • ANA ROBERTA VILAROUCA
  • FERNANDO JOSÉ GUEDES DA SILVA JÚNIOR
  • MARIA ALZETE DE LIMA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Feb 26, 2021


  • Show Abstract
  • Peripheral venous access is a common procedure in health care services, becoming a challenge for professionals. It is a procedure performed by nurses that requires precise clinical assessment, skills, mastery of physiology and anatomy, specific skills achieved in professional technical-scientific training, which requires the integration of multiple and complex knowledge. In this sense, the objective was to verify the self-reported knowledge of undergraduate nursing students to perform peripheral venipuncture in the external jugular vein. This is a research developed by a quantitative approach, with a cross-sectional design and descriptive analysis, carried out with students from the sixth to the ninth period, enrolled in the second semester of 2020, of the Undergraduate Nursing Course at the Federal University of Rio Grande do Norte. Data collection was carried out via the Internet, via e-mail and WhatsApp messaging application, through the application of an electronic questionnaire by access link. The data were organized in a Microsoft Excel Software spreadsheet, version 2017 and converted to the free statistical software R for the application of statistical tests. The quantitative variables were analyzed by descriptive statistics of measures of trend and dispersion of data and in the comparison of academic characteristics with the dimensions of the instruments under study, the Mann-Whitney, Friedman and Kruskal Wallis tests were applied, adopting the level of significance was 5%. Study developed through Certificate of Presentation for Ethical Appreciation, CAAE: 36707320.2.0000.5537. Responses were obtained from 59 students, predominantly female (81,36%), age group up to 25 years (72,88%), most singles (84,75%), in which, 22,03% of the students were in the sixth period, 25,42% seventh, 28,82% eighth and 23,73% ninth. As for the learning process, it was found that 35 (59,32%) had no experience of attending an external jugular venipuncture, and even though 12 (20,34%) they did not know how to use flexible intravenous catheters such as polyurethane. In general, students from the last periods presented a higher level of theoretical knowledge, before and during the procedure, with proactive actions (p-valor 0,007) and academics from the ninth post-procedure period. There is no difference in the level of satisfaction when comparing the different periods in academic training. Thus, the domain of knowledge and high level of academic management present in the final periods of training reflects on the quality of the care practice of these graduates, as future professionals.

13
  • ANA CAROLINA COSTA CARINO
  • CONSTRUCTION OF A MEDIUM SCOPE THEORY OF OVERWEIGHT NURSING DIAGNOSIS

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • CECILIA MARIA FARIAS DE QUEIROZ FRAZAO
  • Data: Feb 26, 2021


  • Show Abstract
  • The present study aims to build a Mid-Range Theory for the diagnosis of Overweight nursing in adolescents and young adults. This is a methodological study in the light of the theoretical framework of Lopes and Silva (2016). The study was made operational through an integrative literature review, carried out in the databases Scopus; Cumulative Index to Nursing and Allied Health Literature; Web of Science; and National Library of Medicine and National Institutes of Health. The descriptors “Overweight”; “Adolescent” and “Young Adult” were used, as well as the Boolean operators AND and OR. It were obtained 4,505 articles, which were evaluated through a consensus between three researchers with the aid of the State of the Art through Systematic Review software. The final sample consisted of 30 articles. The results show 6 essential attributes, 25 clinical antecedents and 18 clinical consequences related to the nursing diagnosis of overweight. The essential attributes are: female gender; moderate or high per capita income; residence in an urban area; inadequate eating habits; sedentary lifestyle; and alcohol consumption. The clinical history of Overweight was found: female gender; moderate or high per capita income; high childhood weight; high weight in adolescence; overweight in the family; use of obesogenic drugs; alcohol consumption; menarche age before 12 years; poor sleep quality; residence in an urban area; high consumption of carbohydrates; marital status; high maternal weight during pregnancy; age over 20 years; deficient knowledge about healthy eating; intake of soda at the expense of water; eating sweets over fruits; routine intake of protein supplements and energy drinks; habit of snacking between meals several times a day; increase food consumption in situations of stress and pressure; sedentary lifestyle; playing video games during the week; irregular eating pattern; inadequate eating habits; beginning of university life. Finally, the clinical consequences are: depression; anxiety; psychosocial stress; successive weight loss attempts; food negativity; binge eating; negative self-perception of health; recurrent adherence to restrictive diet, diet pills, food substitutes and medication-related diet; unhealthy behaviors for weight control; dissatisfaction with body reality; shame of the body; negative and derogatory feelings associated with self-image; concern about weight; desire to be thinner; overvaluation of the silhouette of the ideal body; risky attitudes towards smoking; propensity to metabolic disorders, hypertension and dyslipidemia; and increased risk for renal cell carcinoma. Then, the Middle Reach Theory of that diagnosis was developed. It was found that, from the creation of the Medium Reach Theory, it was possible to better understand the nursing diagnosis of Overweight in the context of adolescents and young adults. The understanding of this phenomenon allows the advancement of nursing science through the direction of nursing interventions and the provision of holistic care focused on the needs of the clientele.

14
  • JOYCE VIANA BARBOSA
  • CONSTRUCTION AND VALIDATION OF ALGORITHM FOR THE USE OF HYPODERMOCLYSIS

  • Advisor : QUENIA CAMILLE SOARES MARTINS
  • COMMITTEE MEMBERS :
  • LUCAS MELO DE SOUZA
  • ISABELLE CAMPOS DE AZEVEDO
  • PATRÍCIA PERES DE OLIVEIRA
  • QUENIA CAMILLE SOARES MARTINS
  • Data: Feb 26, 2021


  • Show Abstract
  • The use of Hypodermoclysis as subcutaneous therapy presents itself as an effective technique for medication and fluid replacement, when the oral and intravenous routes are not viable in any way. Especially in the fields of geriatrics and oncology, due to the clinical conditions that patients have. Therefore, it is necessary to develop and implement instruments to standardize care in relation to the technique, from its choice to its use, in an attempt to support the decision-making of health professionals, and thus, promote care in a planned manner. . In this perspective, this study establishes the following guiding question: What elements are needed to build and validate the content and appearance of an algorithm that helps in the indication of patients to use hypodermoclysis? And, it aims to develop and validate an algorithm to assist in the indication of hypodermoclysis in an adult patient. This is a methodological study for the construction and validation of the content and appearance of an assistance tool. The research considers the proposal of the Pasquali Model, which is organized in three stages, namely: theoretical procedures, in which a scope review was carried out to identify and map the evidence on the eligibility / indication criteria of adult patients for use hypodermoclysis; empirical procedures, which took place through the construction of the algorithm, which was developed using Bizagi Modeler software, for content and appearance validation via Google Forms and the Delphi steps with expert judges in the area to reach consensus. And, analytical procedures in which the analysis of the data from the previous phase was carried out using the content validation coefficient. Items with a minimum agreement of 80% between judges were considered valid. The study is in line with the ethical precepts, with approval approved by the opinion of the Research Ethics Committee of the Faculty of Health Sciences of Trairí of the Federal University of Rio Grande do Norte, under CAAE: 39785520.6.0000.5568. After the construction of the algorithm, the Delphi I and Delphi II steps were performed to validate the content and appearance. At the end of the stages, the level of agreement between the judges was calculated, which presented values above 80% and content validation coefficient above 0.8. It is concluded that the algorithm is relevant as an instrument to support decision making and the strengthening of evidence-based nursing practice.

15
  • RAFFAELA PATRICIA DA SILVA SOARES
  • DEVELOPMENT AND ANALYSIS OF THE EXPERT PATIENT CONCEPT IN THE BRAZILIAN SCENARIO

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ADRIANA CATARINA DE SOUZA OLIVEIRA
  • ALLYNE FORTES VITOR
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Mar 26, 2021


  • Show Abstract
  • The Family Health Strategy teams are responsible for knowing the reality of the population and encouraging co-responsibility and social participation. The present study addresses a new concept of health education as a strategy to achieve patient empowerment in self-care practices. Such a concept is called Expert Patient. Objective: Analysis and development of the Expert Patient concept in the Brazilian scenario. Method: Study developed based on the Hybrid Concept Development Model proposed by Schwartz-Barcott and Kim (2000), operated in two stages: 1. Context analysis of the Expert Patient; 2. Development of the Expert Patient concept. The first took place from the perspective of Hinds, Chaves and Cypress (1992), in which the four interactive levels of the context (immediate, specific, general and meta-context) were used. The data were collected through a scoping review, which resulted in a final sample of 14 studies. The second stage was carried out according to the three phases recommended by the model: 1. Field phase, where the data were collected through a second scoping review, with a sample number of 145 studies; 2. Theoretical phase; in which an online form was applied to 15 health professionals who are part of the Family Health Strategy teams; 3. Final analytical phase, carried out through a thematic content analysis that allowed to compare, integrate and analyze the data and arrive at a definition of the concept. Results: In the first stage, the following context levels were identified: Particularities of the expert patient and interprofessional care; Implications and challenges for the Health Care Model; Self-management of health care and the expert patient; and Patient-centered health care. In the second stage, the presence of chronic diseases and comorbidities became the main antecedent of the concept, as the main attribute of health education for self-care and as the main consequence of independence in carrying out activities of daily living. Conclusion: The hybrid approach provided the opportunity to build the concept of Expert Patient and offered clarification, knowledge and new insights on patient empowerment for self-care in health. However, it is recommended that other studies be developed as a way to support the analysis of the object from an expanded perspective, taking into account other realities.

16
  • ALANY CARLA DE SOUSA PAIVA
  • Control measures for Mycobacterium tuberculosis infection in the hospital service.

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • JULIANA TEIXEIRA JALES MENESCAL PINTO
  • NILBA LIMA DE SOUZA
  • WESLLA KARLA ALBUQUERQUE SILVA DE PAULA
  • Data: Jun 18, 2021


  • Show Abstract
  •         The Ministry of Health, through the Manual of Recommendations for the Control of Tuberculosis in Brazil, warns that control measures be taken to interrupt the chain of transmission of the disease. The objective of this work is to evaluate the positive and negative factors of the implementation of administrative control measures, engineering and individual protection in the control of Mycobacterium tuberculosis in the hospital service, presenting an action plan to minimize the challenges of these measures. It is an integrative review of the literature with a summary of the studies published in the years between 2016 and 2020. Articles available in their entirety for free access in English, Spanish, Portuguese and French were included. Editorials, letters to the editor, review studies, theses, dissertations, duplicate articles and studies that did not correspond to the relevant topic for the purpose of the review were excluded. A research protocol was constructed and the guiding question was elaborated based on the PICO strategy. The search for the studies was carried out in February 2021, on the basis of the US National Library of Medicine, ScienceDirect, Cumulative Index to Nursing and Allied Health Literature and Literatura Latino-Americana e do Caribe em Ciências da Saúde. The research strategy was given by crossing the descriptors "Tuberculosis", "Infection Control" and "Hospitals". For the information analysis, a Microsoft Excel spreadsheet was used, which allowed the compilation and further categorization of the data. The synthesis of the information also allowed the construction of the SWOT matrix with the identification of positive (strengths and opportunities), negative (weaknesses and threats), internal and external factors related to the tuberculosis infection control measures and the strategic planning of actions identified as negative. By preparing the 5W2H matrix, in order to minimize the weaknesses and threats to the tuberculosis infection control process in the hospital service. Of the 22 studies selected in the sample, (63.6%) were included in the US National Library of Medicine (50%) published in 2019, (95.46%) were in English. There was a prevalence in the use of the quantitative approach in (95.46%) of the articles and a predominance of the investigations carried out in the regions of Asia (40.91%) and Africa (36.37%). Regarding the objective and method of the studies, (45.4%) of the studies use the infinite verb "evaluate" in the objective, but they do not use any methodological evaluation tool or methodological framework that defines the study design as evaluative. The data analysis allowed to identify the tuberculosis infection control measures carried out in the hospital service, being (90.9%) administrative measures, (63.6%) environmental measures and finally (54.4%) measures of individual protection. These results were separated by strengths, opportunities, weaknesses, and threats. This data was organized this way, because it was what the SWOT matrix setup required. What later allowed the construction of the 5W2H matrix focused on the negative points (weaknesses and threats) that the studies bring. The measures categorized as internal force were an infection control plan, isolation criteria of the suspected or confirmed case of Tuberculosis, Tuberculosis Infection Control Committee, bacteriological diagnosis, disinfection of potentially contaminated areas, reduction of the patient's stay in the service, promotion of education / training of personnel, education in cough etiquette and respiratory hygiene, screening / identification of tuberculosis cases, screening of the professional tuberculosis team, screening of suspected or confirmed tuberculosis cases, notification of tuberculosis cases , provision of treatment, diagnostic imaging, indication of air isolation, professional responsible for tuberculosis infection control, prioritization of tuberculosis control, hospital discharge after negative result, periodic monitoring of infection control actions, waiting room for tuberculosis cases s Respiratory intomas, sputum collection area and independent entrance for professionals in risk areas with a high tuberculosis burden, existence of ultraviolet lighting in the environment, presence of airborne isolation room, opening of doors and windows, existence of air filter in the rooms, exclusive room for tuberculosis cases and bacteriological analysis laboratory. Regarding external opportunities, the policy / guideline / regulation for the control of tuberculosis infection and communication with sectors / departments external to the service were identified. Regarding internal weaknesses, it was observed under follow-up of mechanical ventilation, lack of training, delay in the start of treatment, low adherence to the use of the N95 mask, limitation in the supply of N95, insufficient number of isolation rooms, delay in patient isolation, isolation in the wrong place, low tuberculosis detection rate, inadequate facilities, incorrect precautionary signs in environments, late diagnosis, under-registration of tuberculosis cases, lack of a professional responsible for tuberculosis infection control Regarding external threats, we find the limitation of financial resources. It was concluded that the construction of the SWOT matrix allowed the organization of the control measures found in the studies, so that they were distributed in positive and negative factors, since these data were presented in the selected investigations. Thus, it was possible to observe which aspects required a strategic action to minimize the weaknesses and threats to the tuberculosis infection control process. From this moment, with the construction of the 5W2H planning matrix, it was possible to outline an action plan, which emphasizes the importance of strengthening these control measures and highlights the need to evaluate the implementation of measures to control Tuberculosis thus contributing towards decision making.

17
  • DAYANA KELLY SOARES FERREIRA
  • TEMPORAL ANALYSIS OF MATERNAL MORTALITY IN THE STATE OF RIO GRANDE DO NORTE

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • SORAYA MARIA DE MEDEIROS
  • CECILIA NOGUEIRA VALENCA
  • KARINA CARDOSO MEIRA
  • MARIA FRANCINETE DE OLIVEIRA
  • ANNELISSA ANDRADE VIRGÍNIO DE OLIVEIRA
  • Data: Aug 27, 2021


  • Show Abstract
  • Introduction: pregnancy is a phase full of changes and that involves not only the woman, but everyone around her. When we think about maternal death, we must reflect on the consequences that involve this fact and shake an entire family. About 830 women die daily due to avoidable situations related to pregnancy and childbirth. Objective: to analyze the temporal evolution of maternal mortality between age groups and its correlation with prenatal and childbirth variables in the state of Rio Grande do Norte from 2000 to 2019. Methodology: This is an ecological study, of the type time series, based on secondary data, with the total number of maternal death records and total reported live births, obtained from the Live Birth Information System and the Mortality Information System. Trend analysis was performed using generalized linear regression, the Prais-Winsten method and the correlation between maternal mortality and prenatal and delivery variables, using Spearman's Correlation Coefficient. In addition to using the Chi-square, Fisher, Wilcoxon, Kruskal Wallis and Dunn tests to analyze demographic characteristics, the type of obstetric cause, direct and indirect obstetric causes, and health regions, according to maternal age group. The significance level was 5%. Data were tabulated in Microsoft Office Excel program (version 365) and statistically analyzed in R software (version 3.5.3.). The project waived submission to the Ethics and Research Committee for dealing with secondary data in the public domain. Results: in the period 2000-2019, there were 495 cases of maternal deaths in the state, with a predominance of women aged 25 to 29 years; self-declared brown; single; instruction ignored; type of direct cause of death, with hypertensive disorders being the main direct cause, followed by hemorrhages. The Metropolitan Region had the most expressive number of deaths as a region of residence and occurrence of death. The Maternal Mortality Ratio ranged from 24.93 to 75.72/100,000. In the Corrected Ratio analysis, there was a variation from 39.27 to 118.09/100,000. There was evidence of an association between marital status and indirect obstetric causes with maternal age; that there is a difference between the medians in the schooling classifications of the age groups 10-19 years and 30-34 years with RMME; the indication of differences between the median level of education ≥ 8 years compared to the other classifications. As well as, between the medians of the type obstetric cause for the age groups 20-24; 25-29 and 30-34 years with RMME. In the period studied, the corrected RMME showed an increasing trend, in the range 10-19 years and 25-29 years, with a significant result and an estimated annual increase of 7.96% and 36.72%. The RMMC indicated a growing trend, in the 10-19 age group, with a significant result and an estimated annual increase of 3.62%. On the other hand, the 30-34 age group showed a decreasing trend of -1%. The correlation coefficient between RMME, according to prenatal variables and the type of delivery showed a statistically significant inverse relationship between the number of prenatal consultations and the RMME of adolescent mothers, that is, consultations 1 to 3 (r = -0.50 and p-value=0.024) and 4 to 6 (r= 0.49 and p-value= 0.028). This same inverse and significant relationship was verified for the variable type of vaginal delivery with age range 10-19 years (r= -0.50 and p-value= 0.025) and 25-29 years (r= -0.63 and p-value=0.003). And according to prenatal variables and the type of delivery, they showed a statistically significant positive relationship between the number of prenatal consultations and the RMMC with a range of 30-34 years, that is, no consultation (r= -0.53 and p-value=0.017) and 1 to 3 (r=0.46 and p-value=0.043). A correlation was identified between prenatal coverage and MMR, and also with the choice of type of delivery, in which the greater the number of vaginal deliveries, the lower the MMR. Conclusion: in the state of Rio Grande do Norte, maternal mortality remains high, with a significant increasing trend for adolescents and young people during the period studied. The results point to the need for reflections and strategies implemented by management and health teams to improve obstetric care in prenatal care, childbirth and puerperium, at national and local levels, and reduce maternal deaths.

18
  • FERNANDA BELMIRO DE ANDRADE
  • Graphic protocol for the assessment of safe nursing care for hospitalized individuals with mental health problems: validation study

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • ISABELLE CAMPOS DE AZEVEDO
  • BIANCA CRISTINA CICCONE GIACON ARRUDA
  • MARCOS ANTONIO FERREIRA JUNIOR
  • Data: Dec 17, 2021


  • Show Abstract
  • Safety in the care of individuals with mental health problems who have been hospitalized for years has been neglected, therefore, when considering their particularities, it is necessary to qualify professionals and services to minimize the risks associated with care. Thus, nursing plays an important role in the development of safer actions, as it has a continuous role during the hospitalization period. Thus, the importance of carrying out periodic assessments in services to identify weaknesses and potential in assistance is also highlighted, in order to promote the adequacy of units through the implementation of measures that increase safety. From this perspective, the present study has as a guiding question: What should be the content and appearance of a protocol for the assessment of safe nursing care for hospitalized individuals with mental health problems? And, the general objective is to develop a graphic protocol validated in its content and appearance to assess safe nursing care for hospitalized individuals with mental health problems. This is a methodological study with a mixed approach, based on Pasquali's psychometrics, organized into three procedures: theoretical, in which two focus groups were held with 13 mental health professionals and a Scoping Review on the safe care of individuals with mental health problems. mental health to define the contents that make up the protocol; empirical procedures for the construction of the graphic protocol and validation of its content and appearance using the Delphi technique, in two rounds, with the collaboration of seven judges/experts in the area in question; and analytical procedures, aimed at analyzing the data where the Content Validation Coefficient was calculated. The study was approved by the Research Ethics Committee, under Certificate of Ethical Appreciation no 48213421.0.0000.5537. The focus groups lasted 45 minutes each, in which the nurses addressed actions they carry out and that need to be developed in order to obtain safe care. With the data from the focus groups and from the Scoping Review, the graphic protocol was constructed, which was submitted to the judges for their validation. In the Delphi I round, a general content validity coefficient ≥0.95 was reached for all elements of the protocol and checklist, while in the appearance validation for the criteria of the Suitability Assessment of Materials, indices greater than 0.90 were obtained. After adjustments proposed by the judges in round II, the content and appearance validity indices were 0.99 each. Thus, the graphic protocol was considered valid in its content and appearance.

19
  • LUCAS BATISTA FERREIRA
  • TERMINOLOGICAL SUBSET OF THE INTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE FOR PEOPLE WITH SEQUENCES BY COVID-19

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • MARIA ALZETE DE LIMA
  • PAULINO ARTUR FERREIRA SOUSA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • RUDVAL SOUZA DA SILVA
  • Data: Dec 20, 2021


  • Show Abstract
  • The general objective was to build and validate a terminological subset of the International Classification for Nursing Practice (ICNP®) for adults with sequelae by COVID-19, based on Roy's Adaptation Model. Methodological study, developed between 2020 and 2021, operationalized in five stages, namely: 1) Identification of terms relevant to the practice, contained in the literature, related to the sequelae of Covid-19 in adults; 2) Cross-mapping of the terms identified in the literature with those contained in the ICNP®, version 2019/2020; 3) Construction of statements of diagnoses/outcomes and nursing interventions for adults with sequelae due to COVID-19; 4) Structuring the ICNP® terminological subset for people with Covid-19 sequelae, in light of Roy's adaptation model; 5) Validation of the content of the terminological subset. For the assessment of the degree of agreement among the experts, the content validity index was used, taking into account the cutoff point ≥ 0.80 for the consensus of diagnosis statements/ nursing outcomes and interventions. The study complied with the regulatory precepts for research involving human beings, being approved by the research ethics committee of the Federal University of Rio Grande do Norte, receiving opinion nº 4,099,646. The experts had more than 10 years of professional experience in the field of infectology (65.2%), with titles of specialists (60%) and masters (68.2%). 178 nursing diagnoses/outcomes were elaborated, in addition to their corresponding operational definitions and 450 nursing interventions. 140 statements of nursing diagnoses/outcomes were validated, as well as 388 nursing interventions, for presenting a Content Validity Index ≥ 0.80. The predominance of nursing diagnoses in Roy's Adaptive Physiological Mode (73%) was highlighted, followed by the Self-Concept Mode (22.1%), Interdependence Mode (2.8%) and Role Function Mode (2.1%). It is concluded that the terminological subset of the ICNP® developed showed statements of diagnoses/outcomes and nursing interventions that were validated by specialist and active nurses, and that, therefore, are relevant to the clinical nurse in the nursing care setting. adults with sequelae by Covid-19. Thus, the subset contributes to clinical reasoning and decision-making that strengthen safe and holistic care through the application of specialized language terminology and the look of the theoretical model used, in addition to enabling the implementation of the nursing process using phenomena of their daily lives.

Thesis
1
  • MILLENA FREIRE DELGADO
  • EFFECTIVENESS OF REALISTIC SIMULATION IN TEACHING DIAGNOSTIC REASONING IN NURSING IN CHILD AND ADOLESCENT HEALTH

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • CLEMENTE NEVES DE SOUSA
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • ERIKA SIMONE GALVAO PINTO
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • RAPHAEL RANIERE DE OLIVEIRA COSTA
  • Data: Jan 22, 2021


  • Show Abstract
  • The teaching of diagnostic reasoning in nursing focused on the health of children and adolescents is very relevant for the training of critical, reflective nurses with specific knowledge about these unique periods in the individual's life cycle. In this context, it is believed that realistic simulation is a positive and beneficial teaching strategy for the training of future nurses. This study aims to analyze the effectiveness of realistic simulation in teaching diagnostic reasoning in nursing focused on the health of children and adolescents. Methodological study, carried out in three stages, namely: construction of scenarios for realistic simulation; validation of the content of these scenarios by specialists; and, application of simulation as an educational strategy in the teaching of diagnostic reasoning in nursing aimed at the health of children and adolescents. In the first two stages, four clinical cases were prepared for the pre and post-test and two scenarios for the simulation process, which had their contents analyzed by 25 experts who judged the relevance, specificity and coherence of the clues provided in each case. and nursing scenario and diagnosis, using the Diagnostic Accuracy Scale. In the third stage, the strategy was applied to students in the seventh period of the undergraduate course at a public university in northeastern Brazil. They were randomly divided into the intervention and control groups. The intervention group, in addition to participating in the simulation, also assessed satisfaction with the process. The data were analyzed using descriptive and inferential statistics. The project was approved by the Research Ethics Committee of the responsible institution, under opinion number 3,175,619 and Certificate of Presentation for Ethical Appreciation 07990418.4.0000.5537. The results showed that the four clinical cases (S coefficient: 0.916) and the two scenarios (S = 0.535) created obtained an acceptable coefficient of agreement among specialists. In the experiment, the pre-test indicated homogeneity of the intervention and control groups. In the post-test, there was no statistically significant difference in performance between the groups, however the results showed a slight improvement in the diagnostic reasoning performance of the intervention group compared to the control group. The intervention group was able to infer more diagnoses and their components than the control group. In evaluating the educational strategy, students expressed high satisfaction and relevance to improve diagnostic reasoning skills aimed at the health of children and adolescents. It is concluded that the strategy on teaching diagnostic reasoning in nursing focused on the health of children and adolescents was effective, as well as promising and attractive for undergraduate students

2
  • ANNE KAROLINE CANDIDO ARAUJO
  • MEDIUM REACH THEORY FOR NURSING CARE TO ADOLESCENTS WITH OBESITY

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • DANDARA NAYARA AZEVEDO DANTAS
  • LARISSA SOARES MARIZ VILAR DE MIRANDA
  • NATHALIA COSTA GONZAGA SARAIVA
  • Data: Jan 29, 2021


  • Show Abstract
  • Introduction: Nursing care for adolescents with obesity occurs in the school context or in Primary Care services, through multiprofessional interventions, with a view to promoting healthy habits. The lack of a specific theoretical framework for nursing care, based on the values, principles, and concepts of the discipline, and focused on the needs of adolescents, indicates the need for a medium-range theory in this area. The construction of these theoretical bases becomes important when considering the increasing rates of this disease among adolescents. Objective: To develop a medium-range theory of nursing care for adolescents with obesity, in the context of Primary Health Care. Method: Methodological study, developed in three stages and based on the Walker and Avant Theory Derivation strategy and on the Model Health Promotion Program. In the first stage, an integrative literature review was conducted to describe the actions of nursing care performed with a focus on adolescents with obesity. In the second stage, the concepts, attributes, antecedents and consequences of nursing care, were identified in the literature and the statements of relationship between the concepts were established. In the third stage, the theory itself was constructed through the derivation process, through which the elements identified in the conceptual analysis were compared analogously with the concepts and statements contained in the Pender Health Promotion Model and redefined for the context of Primary Health Care. Results: A final sample of 58 studies served as a basis to identify care actions for adolescents with obesity. Eight essential attributes of the phenomenon were identified, 12 antecedents and 10 consequent. The theory of nursing care for adolescents with obesity, built in the third stage, integrates the principles of the Pender model, as well as the specific concepts of individual characteristics and experiences, cognitions and behavioral affects, and other factors that lead to the result of promoting Cheers. The statements derived from this process structure the descriptive and explanatory theoretical model of care for this population in the context of Primary Care. Conclusion: It is concluded that the medium-range theory developed in this study allows nurses to understand their role in the multidisciplinary team in caring for the population of adolescents with obesity; it allows to minimize the gap between theory and nursing practice in adolescent health care; and contributes to the advancement of nursing theoretical knowledge and the implementation of evidence-based practice.

3
  • WILMA FERREIRA GUEDES RODRIGUES
  • CONSTRUCTION AND VALIDATION OF A HOSPITAL CARE QUALITY SCALE IN THE PUERPERIUM (EQUAP)

  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • DANIELE VIEIRA DANTAS
  • FLAVIO CESAR BEZERRA DA SILVA
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • NILBA LIMA DE SOUZA
  • SERGIO RIBEIRO DOS SANTOS
  • STELIO HENRIQUE MARTIM DANTAS
  • Data: Feb 22, 2021


  • Show Abstract
  • Introduction: The puerperium is a period of physical and mental transformation that begins after childbirth and ends when breastfeeding ends. This process of involution to the pre-gravid condition can cause more severe complications and evolve to death; however, 92% of the cases of maternal deaths in this phase are avoidable, mainly at the hospital level, when related to bleeding, puerperal infection and hypertension. In this context, the evaluation of the quality of puerperal hospital care is fundamental for monitoring possible complications. However, the indicator that evaluates this type of assistance does not include the intercurrences susceptible to complications, or the specific causes related to maternal deaths. Objective: To develop and validate scale for evaluating the quality of hospital care in the puerperium. Method. Methodological study, developed in two stages: theoretical foundation and theoretical analysis. In the theoretical foundation stage, an instrument based on the Theory of General Systems was developed, proposed by Adevis Donabedian and a review of the scope that allowed the construction of the items of the instrument from the constitutive, operational and behavioral definitions. The second stage began with the evaluation of expert judges in the field. They agreed or disagreed with the items based on the following criteria: objectivity, simplicity, clarity, relevance, precision and variety. The inclusion of expert judges was based on the following criteria: having published and researched on the subject and being an expert in the construction of an instrument. Those who presented incorrect or incomplete answers were excluded. To assess the level of agreement between judges on a given item, the Content Validity Index (CVI) and the Kappa Index were used. The relevance criterion of the study was CVI>0.80 and Kappa>0.61. The sample was made up of ten judges. In addition, the instrument was submitted to a lexical and grammatical correction in order to adapt it to another language. After the lexical and grammatical analysis and validation of the expert judges, the evaluation of puerperal women (target population) was carried out. They agreed or disagreed with the items from the following criteria: item easy to understand and I did not understand the item. This step allowed the evaluation by the smallest cognitive stratum of the target population. For convenience and at random, 10 puerperal women admitted to the Flavio Ribeiro Coutinho maternity hospital in Santa Rita, Paraíba, were selected. The inclusion criteria for women were: being over 18, knowing how to read and write and being in the puerperium. Exclusion criteria: puerperal complication, some against medical indication and/or with suspicion of COVID-19. At this stage, the Content Validity Index and the Kappa Index were also used. The relevance criterion was CVI>0.80 and Kappa>0.61. The instrument underwent a second evaluation by expert judges, to validate the final version of the instrument. The method chosen for the construction and theoretical validation of this assessment instrument followed Pasquali's recommendations. It should be noted that this study was submitted to the Research Ethics Committee (REC) of the Federal University of Rio Grande do Norte (UFRN), in accordance with resolution 466/2012 and obtained a favorable opinion under CAAE number 18967519.6.0000.5176. Results: At the end of this stage, eight items were removed from the instrument, 11 were unified and three had the wording modified. Performed the lexical and grammatical correction the scale was submitted to analysis of the target audience and presented CVI ≥ 0.9 in all items, except the items 16, 24, 34, 37, 38 with which presented CVI<80, however they were reformulated was not removed. Finally, a second round was held with the participation of judges and the scale obtained an CVI ≥0.9 on all items. The scale for evaluating the quality of hospital care provided in the puerperium is presented with theoretical validity, average of CVI = 0.99, with 49 items in total, 17 in the structure dimension, 23 in the process dimension, nine in the result dimension. It is concluded that the scale for assessing the quality of hospital care provided in the puerperium has theoretical validity. 

4
  • LAYS PINHEIRO DE MEDEIROS
  • DEVELOPMENT OF SERIOUS GAME AS AN EDUCATIONAL STRATEGY ABOUT NIPPLE-AREOLARY INJURIES

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • EURIDES ARAUJO BEZERRA DE MACEDO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • KELLY PEREIRA COCA
  • LUCIANA MARA MONTI FONSECA
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • SIMONE PEDROSA LIMA
  • Data: Feb 24, 2021


  • Show Abstract
  • Defined as “the basis of life”, breastfeeding offers children the best possible nutrition, in addition to providing physical and mental health throughout their growth and development. Despite its proven relevance, most mothers face difficulties that culminate in the early interruption of breastfeeding, especially in the first six months, which must be performed exclusively. Among the alleged reasons for weaning, breast problems, including pain and nipple-areola lesions, stand out. In this scenario, the role of the nurse professional is fundamental in promoting breastfeeding through the prevention and clinical management of complications, including nipple-areolar injuries. The objective of this research is to develop a serious game as an educational strategy on care for nipple-areolar lesions in lactating women. This is a methodological study, with a quantitative approach, carried out in two stages that make up the process of developing educational software: elaboration and evaluation. Entitled “aleitagame”, the product of this research is based on Papert's Constructionist theory. From the findings of the researcher's scope review and empirical experience, three scenarios were developed to compose the game, namely: hospital, basic health unit and home visit, addressing the following causes of nipple-areolar injury, respectively: inadequate technique breastfeeding, fungal infection and ankyloglossia. After the elaboration phase, the educational software was submitted to the evaluation stage, which was carried out through the participation of nine research judges, six to evaluate the content and three for the technical and pedagogical aspects. The scenarios that received the most recommendations for changes in content were the basic health unit and home visits. Regarding the technical and pedagogical question, the most pertinent suggestions were about the game commands to the participant during the execution and adjustments in the feedback to better understand the error, if it occurs. In the evaluative scores of satisfaction with the game, through GameFlow, better scores were observed, as well as similarity between the two categories, in the elements "challenges", "player skills", "objectives", "feedback" and "improvement of the knowledge". The other categories, "control", "concentration" and "immersion" had scores that differed by more than 1.5 points in each item. Conclusion: The “aleitagame” is under development and has completed two stages of the process. After appraisal by the judges, changes were made to improve the quality of the software as an innovative teaching strategy. It is recommended to continue the development stages, which are the validation and completion so that it can be operationalized in the context of the training of professional nurses.

5
  • MARJORIE DANTAS MEDEIROS MELO
  • Advanced Practice Nursing in the context of Primary Health Care: a strategy for transforming the Brazilian health scenario.

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ANDREA SONENBERG
  • BERTHA CRUZ ENDERS
  • ISABELLE KATHERINNE FERNANDES COSTA
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • MARINA DE GÓES SALVETTI
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • Data: Feb 25, 2021


  • Show Abstract
  • In view of the growing global dimension on the strengthening of Primary Health Care through the expansion and training of human resources, especially nursing, it is essential to present the role of Advanced Practice Nursing and its potential for transformation in Primary Health Care in Brazil. The objective of this study is to understand Advanced Practice Nursing, focusing on the role of Family Nurse Practitioners, in order to assist its implementation in Brazil. This is a multi-method study with three steps, with a conceptual focus on the PEPPA framework, described below: Literature review on the impact of the management of Advanced Practice Nurses on NCDs in Primary Health Care; Case study with Family Nurse Practitioners in the USA; Theoretical-Philosophical Essay in the light of Max Horkheimer's Critical Theory. In step 1, it was possible to verify the positive impact that advanced nursing practice has on the four most frequent categories of Noncommunicable Diseases, namely: Diabetes, Cardiovascular Diseases, Chronic Respiratory Diseases and Cancer. In step 2, from the analysis of the interviews carried out with the Family Nurse Practitioner in the USA, three partitions emerged based on the content of the participants' statements: 1) Being an advanced practice nurse; 2) Educational routes and possibilities of action and 3) Being political: a path for transformation, where it was possible to describe competences and skills considered to be outstanding points in relation to other professional categories, points of improvement in their educational background and the importance of political representation and being active in performing the role. In the last stage of the research, the emergence of a change in the scenario of primary health care in Brazil was highlighted, placing nurses as a primary tool in the struggle for social transformation and the search for autonomy as citizens and professionals in the light of Critical Theory and its concepts. The complexity of the nurse's work dialogues with the concepts of Critical Theory and stimulates the critical behavior towards praxis in knowledge / action, strengthening their function. At the present time, there is a tendency to expand the practice of nurses through the implementation of Advanced Nursing Practice as one of the possible solutions for the reduction of social inequalities caused by the lack of equal access to health. Through this study, it is expected to subsidize the implementation of Advanced Nursing Practice in the context of Primary Health Care, along the lines of the PEPPA framework, by understanding what Advanced Nursing Practice is in the scope of family health, reflecting on the path traveled here and the next steps we need to take, always in the constant search for recognition, autonomy and transformation.

6
  • YANNA GOMES DE SOUSA
  • Elaboration and validation of an instrument to identify the workload of nurses working in the Psychosocial Care Center.

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • ANA ELISA PEREIRA CHAVES
  • HUGO RAFAEL DE SOUZA E SILVA
  • JACILEIDE GUIMARAES
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • SORAYA MARIA DE MEDEIROS
  • Data: Apr 30, 2021


  • Show Abstract
  • This study aimed to develop and psychometrically validate an instrument to identify the workload of nurses working in the Psychosocial Care Center - CAPS II. This is methodological development research with a quantitative approach that used the Psychometric Theory of Data, developed in three stages: Stage 1: we carried out the construction of the Nurse's Workload Instrument - CTENF through an Integrative Literature Review and according to the theoretical bases of Christophe Dejours, Edith Seligmann Silva, Laurell and Noriega, and Joyce Travelbee. CTENF was synthesized in six important domains: Domain 1: Organization and Working Conditions, Domain 2: Nurse and Patient Relationship in Mental Suffering, Domain 3: Nurse and Multidisciplinary Team Relationship, Domain 4: Nurse Relationship and Service Management, Domain 5: Mental Repercussions and Domain 6: Physical Repercussions with 75 items. Stage 2: Ten expert judges identified in the Lattes Platform performed the Content Validity based on the criteria proposed by Benner, Tanner, and Chesla. The judges assessed the item / domain relationship at this stage and their agreement was assessed using Kappa, thus obtaining: in domains 1, 2, 3, 4, 5 and 6 concordances above (0.80) in all items among the evaluators, in addition, the general Kappa by domains was calculated: (0.84; 0.92; 0.80; 0.80; 0.98 and 0.84) and the CTENF general Kappa of 0.86. The expert judges and students enrolled in the Nursing Course at the Federal University of Rio Grande do Norte-UFRN Campus Natal-RN also carried out the CTENF Face Validity, with a General Kappa value of 1 in this validity. Stage 3: The Construct Validity was carried out with 300 nurses who work at the Psychosocial Care Centers II in the Northeast Region. In this phase of the research, the data were analyzed using the Item Response Theory (IRT) to assess the latent traits of professionals working in the Psychosocial Care Center - CAPS II. For this, the Gradual Response Model (MRG) was applied, in which the Likert scale was fixed between 1 and 5, representing satisfaction, adequacy and frequency in relation to the item. According to the results of the TRI, all items had a satisfactory power of discrimination and it was possible to identify the items of greatest importance to differentiate professionals with different levels of the latent trait studied. Confirmatory Factor Analysis (AFC) of the psychometric structure of the instrument scale (CTENF) was also performed. In addition, the quality of the fit in the model was verified using the parameters χ2 / G.L., CFI, TLI, GFI and RMSEA, indicating a good or reasonable adjustment of the fixed structure. This study obtained a favorable opinion from the Ethics Committee of the Federal University of Rio Grande do Norte - UFRN under opinion nº. 3.640.801/2019.

7
  • BARBARA COELI OLIVEIRA DA SILVA
  • CONSTRUCTION AND VALIDATION OF AN INSTRUMENT TO OPERATIONALIZE THE NURSING PROCESS FOR AIDS PATIENTS IN THE CONTEXT OF HOSPITAL ADMISSION
    .

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • ALINE RODRIGUES FEITOZA
  • PATRÍCIA PERES DE OLIVEIRA
  • Data: May 31, 2021


  • Show Abstract
  • The nurse is paramount in caring for people living with AIDS. To this end, in view of the peculiarities of this clientele, the professional needs to provide systematized care during hospitalization in order to meet biological to psychosocial nuances, reduce complications during treatment, assist in adaptation and self-care, and even carry out appropriate interventions according to the presented problem. In addition, the standardization of the nursing process aimed at this clientele enables agile reasoning in decision-making for specialized and scientific care. Thus, health services, including those that care for people with AIDS, need an instrumentalized nursing process. The study aims to construct and validate an instrument to operationalize the nursing process for AIDS patients in the context of hospital admission in the light of Wanda Horta’s Theory of Basic Human Needs. This is a methodological research. The instrument was systematized according to the model proposed by Pasquali et al., namely: theoretical, empirical and analytical procedures. The theoretical procedures aimed at the construction of the instrument, being divided as follows: two scoping reviews, the first for the research stage and the second for diagnosis, followed by cross-mapping to check the diagnoses extracted with the NANDA-I 2018-2020 Nursing Diagnoses version, with subsequent consultation to the books Nursing Outcomes Classification and Nursing Interventions Classification to extract the results and interventions referring to the planning and implementation stages of the instrument respectively. After that, the Alafaro-LeFevre book was consulted for insertion of the items of the evaluation stage. It is worth underlining that the instrument followed the five steps of the Alfaro-LeFevre nursing process and the principles of Wanda Horta’s Theory of Basic Human Needs. In the empirical procedures, the content validation steps were conducted with nurse judges by means of the Delphi technique using Google Forms. Finally, in the analytical procedures, in order to validate the content of the instrument, the content validity coefficient for validation (≥ 0.7) was calculated. Kappa (>0.80) was applied to evaluate only the degree of agreement of the judges on the evaluation of the analyzed items. Cronbach’s alpha (≥ 0.7) was used to evaluate the internal conscience among the items of the instrument. Regarding the global validation of the instrument, Delphi 1 obtained the items: investigation (Content Validity Coefficient 0.97 and Kappa 0.97), diagnosis (Content Validity Coefficient 0.95 and Kappa 0.94), planning (Content Validity Coefficient 0.93 and Kappa 0.82), implementation (Content Validity Coefficient 0.91 and Kappa 0.78) and evaluation (Content Validity Coefficient 0.88 and Kappa 0.73); in turn, Delphi 2: investigation (Content Validity Coefficient 0.99 and Kappa 0.99), diagnosis (Content Validity Coefficient 1.00 and Kappa 1.00), planning (Content Validity Coefficient 0.97 and Kappa 0.94), implementation (Content Validity Coefficient 0.97 and Kappa 0.94) and evaluation (Content Validity Coefficient 0.96 and Kappa 0.87). As for the overall reliability of the instrument, Delphi 1 obtained the items: investigation (Cronbach’s alpha 0.94), diagnosis (Cronbach’s alpha 0.81), planning (Cronbach’s alpha 1.00), implementation (Cronbach’s alpha 1.00) and evaluation (Cronbach’s alpha 0.98); with regard to Delphi 2: investigation (Cronbach’s alpha 0.96), diagnosis (Cronbach’s alpha 1.00), planning (Cronbach’s alpha 1.00), implementation (Cronbach’s alpha 1.00) and evaluation (Cronbach’s alpha 1.00). The instrument based on a validated theory represents a care technology for nurses who work in the care of AIDS patients in the context of hospital admission, in addition to having valid content and reliability to safely adopted in care practice.

8
  • CAROLINA PEREIRA DA CUNHA SOUSA
  • The oral ability of preterm newborns for breastfeeding: proposal for an assessment instrument.

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • NILBA LIMA DE SOUZA
  • ERIKA SIMONE GALVAO PINTO
  • IZAURA LUZIA SILVERIO FREIRE
  • HUGO RAFAEL DE SOUZA E SILVA
  • MARCELO COSTA FERNANDES
  • WESLLA KARLA ALBUQUERQUE SILVA DE PAULA
  • Data: Jul 15, 2021


  • Show Abstract
  • The aim was to develop and psychometrically validate an instrument to assess the oral ability of preterm newborns for breastfeeding. This is a theoretical study of methodological and quantitative approaches. We used the psychometric theory of data, and the sample was obtained by criteria of convenience and intentionality, leading to 243 individuals among Nursing, Speech Therapy, and Medicine workers. The method design had three stages: 1. Operationalization of the Construct, 2. Content and Face Validity, 3. Construct Validity and Instrument Reliability. In step 1, the instrument construction was carried out based on Alaf Ibrahim Meleis, Sister Callista Roy, Arnold Sameroff, Heidelise Als, in addition to the Integrative Literature Review. An operational guide was created based on scientific articles, manuals from the Health Department, books, protocols, and technical standards. The preliminary version of the instrument had 28 items clustered in five dimensions: D1: Clinical Parameters and General Evaluation; D2: Tonic-Postural Organization and Oral Reflexes; D3: Nutritive Suction; D4: Signs of Stress in the Preterm Subsystems and D5: Physical and Human Environment of Neonatal Units. In step 2, the instrument went through content validity with the judges' evaluation - selected considering the Dreyfus and Dreyfus model for speech therapists and physicians and the Benner, Chesla, and Tanner model for nurses. Finally, ten judges were elected and performed three rounds of evaluation, which resulted in the final version of the instrument: with 27 items and five dimensions. Of these items, 26 had substantial to perfect agreement, but only one had moderate. The kappa coefficient per dimension in the three rounds (D1= 0.84/-/0.75), (D2= 0.57/0.73/0.75), (D3= 0.48/0.62/0 .81), (D4= 0.90/0.82/0.64) and (D5= 0.77/0.47/0.43) and the overall kappa (0.70/0.69/ 0.83). For the operational guide, two cycles of analysis were needed and the CVI and kappa per dimension were calculated based on these two rounds D1 (R1=0.76/0.64 and R2=086/0.76), D2 (R1=0 .98/0.95 and R2=1.00/1.00), D3 (R1=0.88/0.780 and R2=094, 0.88), D4 (R1=0.93/0.85 and R2 = 0.98 / 0.95) and D5 (R1 = 0.83 / 0.69 and R2 = 0.93 / 0.85). The CVI and the general kappa of the operational guide were 0.89 and 0.81. For face validity, the kappa per dimension was calculated for judges and students (D1= 1.00/0.90), (D2= 1.00/0.97), (D3= 0.97/0.84), (D4=1.00/0.54) and (D5=1.00/0.89). At the end, the general kappa of the instrument for judges was (0.99) and for students (0.84). The third stage revealed that the instrument had adequate factorial and convergent validity. The Classic Test Theory and the Item Response Theory found high discriminatory power, an acceptable degree of difficulty, and validation of its measurement model and its quality. This study was approved by the Research Ethics Committee under opinion Number 4,219,662. Therefore, the instrument proved to be reliable and has evidence of content, face, and construct validity to assess the oral ability of preterm infants to breastfeed.

9
  • MARCELA PAULINO MOREIRA DA SILVA QUEIROZ
  • OUTPATIENT NURSING CARE MODEL FOR INDIVIDUAL SELF-MANAGEMENT IN POST-CORONARY ANGIOPLASTY

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • ANNE KAROLINE CANDIDO ARAUJO
  • BERTHA CRUZ ENDERS
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • CLAUDINALLE FARIAS QUEIROZ DE SOUZA
  • DANDARA NAYARA AZEVEDO DANTAS
  • Data: Aug 27, 2021


  • Show Abstract
  • Introduction: Outpatient nursing care for individuals undergoing percutaneous transluminal coronary angioplasty needs a care structure for self-management of care. Self-management of this individual provides better results in the therapeutic process, such as mitigation of complications and the acquisition of well-being and quality of life. Objective: to develop an outpatient nursing care model for self-management of individuals undergoing percutaneous transluminal coronary angioplasty. Methodological path: This is a methodological, theoretical research, with a qualitative approach carried out through the process of deductive-inductive logical reasoning and based on Betty Neuman's Systems Model and The Individual and Family Self-Management Theory. The study was carried out in three stages, namely: the first corresponded to the selection of concepts, based on the framework, and the integrative literature review, which identified the strategies used by nurses in the care of individuals in post-coronary angioplasty for support to self-management; the second was conducted at the Alcides Carneiro University Hospital, located in Campina Grande, Paraíba, through interviews with nurses, individuals undergoing coronary angioplasty and their families; in the third moment, the previous results were analyzed and integrated under the light of the theoretical framework, which allowed the elaboration of a graphical representation of the care model that culminated in the development of a conceptual structure in the form of a model. The study received a favorable opinion from the Research Ethics Committee under number 4.630.775 and CAAE 43329321.8.0000.5182. Results: The research developed the “Ambulatory Nursing Care Model for Self-Management of the Individual in Percutaneous Transluminal Coronary Post-angioplasty”. The integrative review data showed three strategies used by nurses to support self-management, namely: educational, emotional support and social support network. In the field phase, two categories emerged: participants' perceptions about aspects of care for self-management and factors that interfere with support for self-management with their respective subcategories. Nurses, individuals and their families understood that the following aspects are essential in self-management care: strategies for monitoring care, dialogue with the nurse, importance of the nurse in care, family support, management support and the need to guide the family for continuity of care. Final considerations: The nursing care model from the perspective of self-management developed in this study offers a guiding and strategic theoretical framework for assistance to people with coronary artery disease undergoing angioplasty and represents a contribution to the knowledge of nursing in secondary prevention in health . Thus, it is believed that the present study contributes to the advancement of nursing knowledge and the direction of care provided by this professional to post-angioplasty patients.

10
  • GLAUBER WEDER DOS SANTOS SILVA
  • Grounded theory on the acceptance of the travestis and transsexuals for survival to suicidal ideation

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • ISABELLE CAMPOS DE AZEVEDO
  • EDU TURTE CAVADINHA
  • DULCIAN MEDEIROS DE AZEVEDO
  • JAIME ALONSO CARAVACA-MORERA
  • JOSÉ LUÍS GUEDES DOS SANTOS
  • FRANCISCA GEORGINA MACEDO DE SOUSA
  • Data: Aug 27, 2021


  • Show Abstract
  • Introduction: the suicide, a complex phenomenon, is a serious public health problem and suicidal ideation has been identified in the literature as the best predictor to prevent a suicide attempt, particularly among travestis and transsexuals. Discovering strategies, mechanisms and devices to overcome suicidal ideation among travestis and transsexuals constitute, in itself, an important step to enhance their lives. Objective: to understand how travestis and transsexuals deal with suicidal ideation. Methods: multiphase and mixed methods study. In the first phase, a study was developed with concomitant data triangulation in the period from 2015 to 2016. In the cross-sectional phase, 58 travestis and transsexuals from non-governmental organizations in Rio Grande do Norte/Brazil participated. The prevalence of suicidal ideation was verified through The Beck Scale for Suicide Ideation (BSSI) and received descriptive statistical treatment. In the qualitative stage, 24 travestis and transsexuals with suicidal ideation in the previous group participated. The meanings attributed to suicide were described and analyzed through thematic content analysis. Quantitative and qualitative data were analyzed as they were similar, complementary or opposite. Later, in the second phase, between 2018 and 2021, the procedures of the Grounded Theory were used in the way proposed by Strauss and Corbin and the theoretical framework of Symbolic Interactionism. Twenty-four travestis and transsexuals with suicidal ideation in the previous phase were eligible for the first sample group. From the hypotheses raised in the analysis process and by the principle of theoretical saturation, the study enrolled 18 participants divided into five sample groups: first - nine travestis and transsexuals with suicidal ideation in the first phase; second - three travestis and transgender social leaders/activists; third - two family members from the first group; fourth - two travestis and transsexuals undergoing hormone therapy; fifth - two health professionals from the transgender health clinic in Rio Grande do Norte, Brazil. Data were collected through in-depth interviews from 2016 to 2021, with simultaneous data collection and analysis, with open, axial and selective coding procedures and construction of diagrams, memos and consequential matrices. A theoretical-explanatory model of the identified phenomenon was elaborated. Study approved by CEP/UFRN in two phases: opinions No. 1.314.559 of 11/09/2015 and No. 3187.452 of 03/08/2019, respectively. Results: the prevalence of suicidal ideation among participants was 41.4% (n=24) (CI% 41.3 -54.51%). From the descriptive statistical analysis in line with the codification, classification and categorization process, a joint-display was elaborated with three phases: 1st phase "He arrived and put me under his arms": the grandparents as the family nucleus, "What am I doing here in this life?": elaborating feelings and reasons for committing suicide and BSSI item "reasons for suicide attempt"; 2nd phase "Having a second of courage you go and do it": experiencing suicide and BSSI items “previous suicide attempt, wish to die and active suicide attempt”; 3rd phase "They will never accept our transsexuality": experiencing transphobia in the family and society, "Friend and mother's shoulder": overcoming suicidal behavior and BSSI item "attitude towards ideation". Seeking to understand how transvestites and transsexuals deal with suicidal ideation, three components, eleven themes, forty concepts, 115 categories and 799 codes emerged in the theorizing procedures that integrate the central category (substantive theory) - "Acceptance of the transvestite and transsexual person ”: 1st component: the family grant (conditions) – living in the family (non-acceptance by the parents, the father violating the transgender child, suffering from family rejection vs. maternal acceptance, acceptance of grandparents and family understanding about transsexuality); 2nd component: Sociality (actions/interactions) – social activism (feeling the responsibility of activism vs. identifying with trans activism, becoming an activist, overcoming suicidal ideation in activism and acting for trans health); social networks (rejecting trans people, raping trans people, living abusive relationships vs. supporting trans people); the school (rejecting trans people vs. studying for a living); the world of work (not accessing the job market, being stigmatized in the job market vs. being accepted in the job market, surviving with the help of work); health services (being rejected from health services vs. receiving specialized health care); health professionals (attitudinal negativity vs. offering comprehensive care); 3rd component: Self-assertion (results/consequences) – self-regulation (self-mutilation); suicidal behavior (surging suicidal ideation, attempting suicide vs. eliminating suicidal ideation); hormonization (frustrated by the lack of support, self-hormonization, consequences of misuse vs. helping to accept oneself, achieving authenticity, receiving professional support, and possibly not using); and being who you are (not conforming to the skin you inhabit, psychic suffering vs. understanding being trans and becoming who you are). Final considerations: The theoretical-methodological articulation between the data showed that the survival of travestis and transsexuals is based on the acceptance of the trans person in the scenarios they occupy, integrating the family, the social context and the self-affirmation of who they are. The convergences and divergences of the results are considered to support the thesis: the survival of the travestis and transsexual person to suicidal ideation is possible when the family and society accept them and provide them with social identity and conditions of access to the world of work and reach of policies that grant them autonomy over their bodies, the libertarian expression of their gender identity and the right to be who they really are.

11
  • RAYRLA CRISTINA DE ABREU TEMOTEO
  • Adhesion process for the treatment of tuberculosis in the context of Primary Health Care. 

  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • FRANCISCA GEORGINA MACEDO DE SOUSA
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JOSÉ LUÍS GUEDES DOS SANTOS
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • MARCELO COSTA FERNANDES
  • Data: Oct 29, 2021


  • Show Abstract
  • Introduction: Adherence to tuberculosis treatment is one of the main challenges for the control of the disease. The strategies adopted so far are not considered effective enough to ensure therapeutic success, and the lack of a theory that adequately explains this adherence are reasons that impede progress in research and development of this action. For the systematic development of effective interventions and evaluation, it is necessary to investigate what barriers may still exist to achieve better adherence to this therapy. Objectives: to understand how the process of adherence to tuberculosis treatment occurs in Primary Health Care, based on the experience of adherent people and to build a theoretical model on the process of adherence to tuberculosis treatment. Method: qualitative study that followed the Straussian strand of Grounded Theory as a methodological framework and Symbolic Interactionism as a theoretical framework. Twenty people participated in the study, distributed into three sample groups, which: first – eleven people who underwent complete tuberculosis treatment between 2018 and 2019; second – seven professionals from Basic Health Units in the city of Cajazeiras, Paraíba, Brazil, being three doctors, three nurses and one community health agent; and third – two relatives of participants from the first group. Data were collected through in-depth interviews from 2019 to 2021, with concomitant data collection and analysis, considering open, axial and integration coding procedures, construction of diagrams and memos. Data were analyzed for context and process. A theoretical-explanatory model was developed considering the paradigm, an analytical tool that helps to classify concepts and establish relationships. The NVivo® software version 12 was used as a technological support to help organize the data. Study approved by CEP/UFRN under opinion nº 3.246,634 of April 5, 2019. Results: from the data analysis, three major themes were listed that represent the conditions (feeling with threatened recovery: treatment context - explained by the categories physical threats; psychological threats and programmatic threats), actions-interactions (performing the treatment: the recovery process - explained by the categories strategic actions related to the diagnosis; guided recovery actions and self-initiated recovery actions) and the consequences (recovering: the resignification of life - explained by the categories improvement; achieving healing and new life), all aspects of the paradigm. The nine categories, each with its subcategories and their respective concepts, were all interconnected and represented by the theoretical model whose central category was “Threats, treatment and recovery from tuberculosis: transmuting suffering into a new life”. The main objective of the people who adhered to the tuberculosis treatment was to recover, to solve the threats to health and recovery, for this they needed to change the circumstances experienced and transformed circumstances that caused suffering into circumstances that promoted a new life. Final considerations: The interaction with the data, theoretical and methodological procedures showed that adherence to tuberculosis treatment is based on the desire for health recovery, but also on aspects of life that existed prior to the illness, in the individual and family spheres. , social and labor. Advances in knowledge about this phenomenon make it possible to design policies and intervention strategies that meet the specific realities of the treatment of tuberculosis. It is considered that the results support the thesis: people with tuberculosis act in relation to their care, anchored in what it represents for them. However, it is the action-interaction with people and with themselves that allows them to signify and re-signify their perspectives in relation to care, which progressively lead them and help them to make decisions.

12
  • ALCIDES VIANA DE LIMA NETO
  • Mobile app to aid in patient education in the preoperative period of myocardial revascularization

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • DANIELE VIEIRA DANTAS
  • ISABELLE KATHERINNE FERNANDES COSTA
  • JOSE ADAILTON DA SILVA
  • PATRÍCIA PERES DE OLIVEIRA
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • TACIANA DA COSTA FARIAS ALMEIDA
  • Data: Nov 25, 2021


  • Show Abstract
  • The obstructions caused by coronary artery disease, in certain cases, prevent normal arterial blood flow in the heart, which can lead to suffering and even tissue death in the affected area. In some situations, when other treatments have not been effective, myocardial revascularization is indicated, which is a complex and large-scale surgery, also known as saphenous bypass or breast bypass. Thus, it is necessary to educate the patient in the preoperative period, so that he can understand and actively participate in the entire care process. This may imply a postoperative period with fewer complications and adverse events. Thus, the objective was to develop and validate a mobile app to aid in patient education in the preoperative period of myocardial revascularization surgery. This is a methodological research, with a mixed approach, elaborated from the stages of contextualized instructional design: 1) analysis - carried out from a scoping review and a qualitative study with 13 patients admitted to a university hospital to receive pre- operatives to identify the learning needs of patients before surgery; 2) design and development, in which the flow diagram and the low and high fidelity prototypes of the application were structured by a team composed of researchers and software developers; 3) implementation, with availability of the high-fidelity version of the prototype for analysis on a digital platform; 4) evaluation, in which the application's content and usability were validated by judges in the field of cardiology nursing, in two rounds organized using the Delphi technique. At this stage, the content validity coefficient greater than 0.8 and the percentage of agreement equal to or greater than 80% were used as a parameter for validation. The research took place from January to September 2021 and was approved by the ethics committee of the Federal University of Rio Grande do Norte, through Certificate of Presentation for Ethical Appreciation no 39198020.0.0000.5537. Thus, through the scoping review and the cross-sectional study, the learning needs of patients before surgery were identified, which were categorized into: cardiovascular system and coronary artery disease; care, procedures and routines before, during and after surgery. Based on these categories, the application's content was organized into nine thematic sections: understand more about the heart; understand your illness; understand the bypass surgery or breast bypass; care before surgery; care after surgery; rehabilitation and lifestyle changes; patient records; schedule; quiz. After the second Delphi round of analysis of the application by the judges, a content validity coefficient equal to or greater than 0.91 and a percentage of agreement of 100 were obtained, with the exception of only one of the 12 criteria analyzed. As for usability, of the 18 items, 17 obtained 100% agreement from the judges. After all adjustments, the current version of the software has 90 screens. With that, it is concluded that the developed application was validated. It is believed that this technology can contribute to the literacy and health education of patients who will undergo myocardial revascularization.

13
  • CLARISSA MARIA BANDEIRA BEZERRA
  • Stress and its interface with obesity, sleep quality and obstructive sleep apnea in nurses

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • KARINA CARDOSO MEIRA
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • REJANE MARIA PAIVA DE MENEZES
  • ROSÂNGELA MARION DA SILVA
  • SORAYA MARIA DE MEDEIROS
  • Data: Nov 29, 2021


  • Show Abstract
  •         Nurses are prone to alterations in the sleep-wake cycle, with prejudices to their performance, not work and health. can run through long working days, modifications to our sleep and reposition hours, inappropriate eating habits, irregular physical activity and stress. Objective-to analyze the level of stress in relation to the prevalence of obesity, quality of sleep, obstructive apnea of sleep in nurses two shifts day and night. Cross-sectional study with a quantitative approach, of the analytical type. The target Audience was composed by nurses of the Hospital university Onofre Lopes, 122, do Hospital University Ana Bezerra 53 and of the  maternity scholl Januário Cicco 30 not total to show was of 205 professionals in both shifts. At the data collection period from December 2020 to April 2021 the nurses prepare the instruments: to obtain two sociodemographic data, assessment of the stress level, the quality of the sound that is or the Quality Index of the Sound of Pittsburgh-Brazil, o Berlim questionnaire to verify obstructive apnea of sleep and questionnaire on feeding behavior to verify obesity. To organization two dice are due in spreadsheet. It provides a descriptive analysis to assess the profile of the sample, second to the individual characteristics, sociodemographic and eating habits of the two research subjects, including the frequency of categorical variables, with absolute (n) and percentual (%) frequency values and descriptive statistics of position. (average and median) and dispersion of two dice (standard deviation) for the numerical and order variations. It was submitted to the Brazil platform and endorsed by the Research Ethics Committee of the Federal University of Rio Grande do Norte, respecting the normatization of Resolution No. 466/12 of the National Health Council, regarding the ethical aspects of research involving human beings. The subjects involved will be requested to assassinate the Term of Free and Informed Consent. The results will show statistically significant data in relation to stress and the characteristics of two interviewees as not having sons (0.008) and who at a non hourly night (<0.001). For the quality of those who use medications daily (0.002), that at no hour of the night (<0.001) and those who feed on TV (0.049). How many years were the nurses stressed (56.10%) two interviewees presented a median level of stress, how much the quality of sleep (66.38%) was bad and how many year of sleep disturbance (81.46%) did not appear disturbed. Concerning sleep disturbance, age and obesity, the logistic regression showed the chance of a professional meal of at least 35 years, presenting sleep disturbance, decreased in 66%, compared to professional years eating over 35 years. At a chance of professionals classified as obesity, they have a sleep disorder that is 19.77 times higher, compared to professionals who do not have obesity. It confirms that the same cross-sectional structure study ratifies the interface of stress, quality of sound and obstructive apnea of sound in nurses, the established objectives. As statistically significant associations affirmed the difficulty of facing professional hairs that act not night shift.

2020
Dissertations
1
  • SILVIA KALYMA PAIVA LUCENA
  • Effectiveness of educational intervention as a teaching-learning strategy in intestinal irrigation.

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ISABELLE KATHERINNE FERNANDES COSTA
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • JESSICA DANTAS DE SA TINOCO
  • Data: Jan 27, 2020


  • Show Abstract
  • Objective: To analyze the effectiveness of educational intervention as a teaching-learning strategy of the intestinal irrigation procedure with undergraduate students of the Federal University of Rio Grande do Norte. Method: This is a randomized clinical trial conducted at the Nursing Department of the Federal University of Rio Grande do Norte, with 31 undergraduate students who attended the discipline of Adult Comprehensive Attention I who were divided into a control and intervention group. randomly. Knowledge analysis was performed by applying an instrument containing 10 questions in three stages: pretest, posttest and retention. Both groups received materials for previous reading. In addition, the control group was given a lecture-dialogued about the procedure of intestinal irrigation and for the intervention group a clinical simulation. Data analysis was performed using SPSS 20.0 software, performing descriptive, inferential statistical analysis, Chi-square test and Mann-Whitney test. The study was approved by the Research Ethics Committee of the institution in charge, under number 3.050.149 and Certificate of Presentation for Ethical Appraisal 02977518.8.0000.5537. Results: Regarding socio-demographic characterization, most were female 27 (87.1%), single 14 (45.2%), with family income of 3 minimum wages 12 (38.7%), with average age of 24.93 years (standard deviation 1.184), childless 27 (87.1%), with no previous experience in health 27 (87.1). There were no statistically significant differences between groups in the pretest; Post-test scores showed better scores in the control group (with statistically significant differences p = 0.008) and an average of 9.19; and at retention, performed 30 days after the intervention, better scores were observed in the intervention group (with statistically significant differences p = 0.015) and an average of 9.0. Conclusion: The study showed that both strategies were effective, with the expository-dialogued class in the immediate posttest and the clinical simulation in retention in the long term.

2
  • GABRIELA SOUZA DAMÁSIO GUEDES
  • Development and validation of a service flowchart for people living with human immunodeficiency virus in the city of Natal, RN.

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ERIKA SIMONE GALVAO PINTO
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • ALINE RODRIGUES FEITOZA
  • Data: Feb 28, 2020


  • Show Abstract
  • The immunodeficiency virus infection has changed since the beginning of the epidemic, currently, it is considered a chronic and potentially controllable disease. This evolutionary character brings with it a complexity of factors that requires continuous health care, quality of life and investment in integrality. In this context, health care for people living with Acquired immunodeficiency syndrome makes interdisciplinary and intersectoral work necessary. Therefore, a challenge to seek and create health technologies that respond to this population’s needs is found. The study aims to develop and validate a flowchart of care for people living with HIV and acquired immunodeficiency syndrome (AIDS) for existing health services in the city of Natal, Rio Grande do Norte. This is a methodological study for construction and content validation. The study is based on Pasquali's Model (2010), and follows the steps of theoretical pole, namely: theoretical procedures, in which a search of the theoretical basis was carried out through documentary research; experimental procedures. in which the instrument was validated for content validation via Google Forms and the Delphi steps; analytical procedure, in which the calculation and analysis of the content validation coefficients and level of agreement was performed. The sample size considers Pasquali, who suggests from six to twenty subjects, and the selection of judges used criteria adapted from Fehring (1994) to support inclusion. The Content Validity Coefficient (CVC) evaluated the agreement between the judges, and the analysis comprehends the concept of language clarity, practical and theoretical relevance. The study agrees and respects ethical precepts, having approval certified by the opinion of the Research Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), under CAAE nº 17815219.4.0000.5537. 16 documents were listed in order to compose the constitutive and operational definitions. The study found out that the theme addressed was mainly related to the protocols that guide assistance within the scope of Brazil’s public health system. In this scenery, this research proposed to elaborate the items and build the flowchart. After construction, Delphi steps were performed to validate the content. At the end of the stages, the level of agreement between the judges was calculated, it was found that during the two Delphi rounds, the judges agreed that the constructed material had valid content, which consists of CVC values equal to or greater than 0.8. Therefore, we concluded that the instrument is relevant and favors the success for its use in the managerial and assistance practice to which it is proposed.

3
  • JÉSSICA CRISTHYANNE PEIXOTO NASCIMENTO
  • Analysis of the risk of Post Traumatic Stress Disorder in emergency professionals

  • Advisor : RODRIGO ASSIS NEVES DANTAS
  • COMMITTEE MEMBERS :
  • RODRIGO ASSIS NEVES DANTAS
  • ALLYNE FORTES VITOR
  • ISABEL KAROLYNE FERNANDES COSTA
  • MARINA DE GÓES SALVETTI
  • Data: Nov 5, 2020


  • Show Abstract
  • The human kind deals with stressful and potentially traumatic situations from the most remote stories of humanity. In modern life, where stressful situations are in evidence, the work field and the economy suffer losses due to the short time of service of professionals caused by mental disorders. Diseases caused by stress and trauma, then, come into discussion as one of the causes of shortening the time of service provision among job professionals with high physical, emotional and / or high dangerousness demands, such as military firefighters, military police and health professionals, working in urgent and emergency contexts. Posttraumatic Stress Disorder - a disease caused by exposure to traumatic and stressful events, is characterized by the chronicity of symptoms of remembering, avoidance or autonomic hyperstimulation related to a traumatic event. Therefore, this study aims to analyze the risk of developing Post-Traumatic Stress Disorder in professionals who work in emergency situations by tracking the symptoms of PTSD with health professionals from the Emergency Room Clóvis Sarinho, from the Emergency Care Units located in Natal / RN, the Mobile Emergency Service, military firefighters and military police in the city of Natal / RN and the metropolitan region. An analytical, transversal, exploratory method with a quantitative approach was used, which will use two instruments of data collection: the Scale of the Impact of the Event - Revised and an instrument for collecting sociodemographic information and related to the potentially traumatic event. The research was carried out in the service facilities where each professional was inserted. This project was approved by the Research Ethics Committee (REC) under the protocol number: 2,628,475, and Certificate of Presentation for Ethical Appreciation: 88024818.2.0000.5537. It was found that the participating emergency professionals consisted mostly of men, aged 36-45 years, with service time above 10 years, with graduate education, with spouses, who work in work schedules of 41 to 60 hours a week. It was possible to verify that 31.07% of the sample had a score compatible with a probable diagnosis of PTSD. Among the professionals working in public safety, 39.67% had scores corresponding to the probable diagnosis of PTSD, and in those working in health, 20.78%; security professionals were 40% more likely to have scores compatible with the diagnosis of PTSD. In the subscales of the IES-R, participants aged 36 to 45 years, mostly firefighters and nurses; with time of work in the emergency field of about 15 years, had higher average score in the subscale of symptoms of intrusion; in the subscale of avoidance, military police and nurses, with time of activity from 15 years; and in hyperstimulation subscale, had higher average scores participants in the 36-45 age group, and military police officers. The main potentially traumatic events experienced by professionals in the work environment were also pointed out; the main signs manifested, the main coping strategies and factors that hinder professional practice.

4
  • JACQUELINE TARGINO NUNES
  • Sleep quality and overweight in nurses in different work shifts

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • SORAYA MARIA DE MEDEIROS
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • KARINA CARDOSO MEIRA
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • Data: Dec 14, 2020


  • Show Abstract
  • The aim of this study was to analyze the quality of sleep and investigate whether it influences the BMI of professional nurses during the day and night shifts. This is an analytical study with a quantitative approach. The study was carried out at the University Hospital of Rio Grande do Norte. Data were collected between January and March of the year 2020, using the following instruments: Pittsburgh Sleep Quality Index Questionnaire and socio-demographic data to characterize their subjects. 268 nurses will be surveyed in their work shifts. The instruments were made available according to the work shift of each professional. 120 nurses participated in the research. The data, after being coded and tabulated, underwent statistical analysis using the SPSS version 2.0 program. The study obtained a favorable opinion from the Ethics and Research Committee of the Federal University of Rio Grande do Norte, under Opinion with CAAE nº 25693119.4.0000.5537. For qualitative variables, descriptive analysis was carried out by means of distributions of absolute and relative frequencies (%) and quantitative variables were analyzed descriptive statistics of measures of trend and data dispersion, such as: minimum, maximum, average and standard deviation The sociodemographic profile was characterized by a predominance of females, 85.00% of nurses, and in the work shift, 75.00% in the night shift and 92.65% in the day shift. When grouped in relation to the age group, up to 35 years old (58.33%) and over 35 years old (41.67%), the majority were aged up to 35 years. As for the PSQI, the nurses on the night shift, totaling 84.62% had poor sleep quality, while the subjects on the day shift, only 17.65% had poor sleep quality. We also found that 84.62% of night shift nurses have an inadequate BMI, that is, they are overweight, with statistical significance (p = <0.001). It was concluded that night work causes losses in sleep quality and changes in the weight of professional nurses

5
  • NANETE CAROLINE DA COSTA PRADO
  • TERMINOLOGICAL SUBCONJECT OF THE INTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE (ICNP®) IN NEONATES WITH PERIPHERALLY INSERTED VENOUS CENTRAL CATHETER IN THE LIGHT OF THE THEORY OF BETTY NEUMAN

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • MARIA ALZETE DE LIMA
  • PAULINO ARTUR FERREIRA SOUSA
  • NUNO DAMÁCIO DE CARVALHO FÉLIX
  • Data: Dec 15, 2020


  • Show Abstract
  • The Peripherally Inserted Central Venous Catheter (PICC) stands out among the central catheters inserted in neonatal intensive care units. By allowing drug therapy to be performed, the device is able to save the life of critically ill newborns. The handling of the PICC catheter presupposes skills and competencies that favor the safety of the newborn and that reduce the risks of complications associated with the catheter. In this directive, as a tool that organizes the practice and directs the patient's needs, the Nursing Care Systematization (SAE) has a significant impact on the quality of care directed to the patient. It is emphasized that for systematic nursing practice, it must be supported by a theory. When considering the newborn as a being composed of lines of preservation that protect him from stressors, the nurse has the fundamental role of strengthening the lines of protection of the newborn, in order to maintain the balance and well-being of the newborn. In this sense, the study had as objectives: to elaborate a set of CIPE® nursing diagnoses, results and interventions, version 2019, for newborns with peripheral insertion central venous catheters in the light of the Betty Neuman model, based on scientific literature and in professional practice; validate the set of diagnostic statements and interventions with expert nurses. This is a methodological study, developed in four stages: 1st - identification of the Nursing Practice phenomena for newborns using the PICC; 2nd - elaboration of Nursing Diagnostics, Results and Interventions; 3rd - validation and statistical analysis of the statements of Nursing Diagnoses, Results and Interventions; 4rd - Structure of the CIPE terminology subset. The project was submitted to the Research Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the Certificate of Presentation for Ethical Appreciation (CAAE) 48990515.0.0000.5292. Data were analyzed using descriptive and inferential statistics. To analyze the degree of agreement of specialist nurses, the Agreement Index (CI> 0.80), Agreement Validation Index (IVC> 0.80) and the Binominal Test (p < 0.005). As a result, 34 nursing diagnoses were identified, with the most frequent ones being discussed. Regarding nursing interventions, 35 interventions were developed. It is concluded that from the phenomena of practice it was possible to elaborate the ICNP® nursing diagnoses, results and interventions. In addition, the use of the Neuman systems model represented a conceptual-philosophical foundation capable of directing clinical evaluation to identify stressors and their possible causes.

Thesis
1
  • MERCIO GABRIEL DE ARAUJO
  • VALIDATION OF NURSING OUTCOME DRY EYE GRAVITY IN ADULT PATIENTS IN AN INTENSIVE THERAPY UNIT.

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • MARCOS ANTONIO FERREIRA JUNIOR
  • FABIANE ROCHA BOTARELI
  • ADRIANA CATARINA DE SOUZA OLIVEIRA
  • MARIA PALOMA ECHEVARRIA PÉREZ
  • Data: Feb 13, 2020


  • Show Abstract
  • This study aimed to validate the Dry Eye Severity Nursing Outcome in adult patients admitted to an intensive care unit. Methodological study developed in three steps: content validation, semantic validation and clinical validation. In the first stage, content validation, 23 experts captured through the Lattes Curriculum and 10 nurses participated in the composition of the consensus group belonging to the research group Clinical Nursing Studies and Research Group. The second step, semantic validation, consisted of 15 clinical clinic nurses from a university hospital located in northeastern Brazil. to verify the understanding of the instrument items. The third stage, clinical validation, consisted of 72 patients admitted to the intensive care unit of this hospital unit. The collected data were organized and stored in a database built in Microsoft Office Excel 2016 and analyzed by a specific statistical program. This study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte by CAAE nº 71452817.5.0000.5537 and opinion nº 2444761 and followed the Resolution nº 466/12, approved by the National Health Council of the Ministry of Health, in 12 December 2012. In the first stage of the 14 indicators evaluated by the experts, seven presented content validity index below 0.80. Then, in the consensus group validation six indicators were reformulated. In the semantic validation stage, of the 15 nurses 86.67% were female, 73.33% are up to 40 years old. Regarding the degree, 46.67% are specialists, while masters and graduates had the following percentages: 40.00% and 13.33%. At the time of operation, 40.00% with up to 10 years and 60.00% over 10 years. At this stage, the 14 indicators presented Kappa coefficient ≥ 0.80 and were considered semantically valid. Regarding clinical validation, 72 patients were selected and 144 eyes were evaluated by two pairs of evaluators: one with the Nursing Outcomes Classification Dry Eye Severity Nursing Outcome indicators without definitions and the other with the indicators validated in previous stages with their constitutive definitions, operational values and operating magnitudes. The evaluations were compared by the intraclass correlation coefficient. The evaluators who used indicators with the definitions agreed in the evaluation of the results. From this, the indicators with constitutive, operational definitions and operational magnitudes of the Dry Eye Gravity nursing result are valid for adult patients admitted to the intensive care unit.

2
  • GIOVANNA KARINNY PEREIRA CRUZ DE ANDRADE
  • Corneal donation-transplantation process: predictors of corneane tissue quality and graft failure.

  • Advisor : MARCOS ANTONIO FERREIRA JUNIOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ELEN FERRAZ TESTON
  • MARCOS ANTONIO FERREIRA JUNIOR
  • OLECI PEREIRA FROTA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Feb 14, 2020


  • Show Abstract
  • The objective of this study was to identify the factors inherent to the donation-transplantation process, the predictors of the quality of the corneal tissue captured and the cases of post-transplant graft failure in a reference service in the state of Rio Grande do Norte (RN). This is an epidemiological study with a quantitative approach, consisting of two steps. The first consisted of a retrospective, longitudinal, descriptive and analytical cohort study that addressed the process of corneal uptake by the Human Ocular Tissue Bank (BTOH) until transplantation was performed. The second stage corresponded to a hospital-based, longitudinal, descriptive and analytical case-control study, which included transplanted patients with corneal graft failure from a newborn reference service. For the cohort study sample, the corneas processed by the newborn BTOH (n = 419) were considered in order to identify the predictors of the quality of the donated corneas. The case-control study sample consisted of patients transplanted with corneal tissue who developed graft failure after transplantation (n = 27 cases and 54 controls). The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under opinion No. 2,454,077 and CAAE 80007117.8.0000.5537. Data were collected in their entirety from January to October 2018 and organized into spreadsheets for descriptive and inferential analysis procedures. For descriptive analysis, the Statistical Package for Social Sciences (SPSS), version 25.0 software was used. The description of the variables and their distribution patterns were presented by frequencies and measures of central tendency, while for multivariate analysis measures of magnitude of effect (odds ratio and relative risk) and association measures (chi-square or exact test) were applied. Fisher) to a significance level of 0.05. Logistic regression analysis was used to adjust the final model. The results were presented in two chapters referring to the cohort and case-control studies, entitled respectively: “the donation process and corneal tissue quality” and “the donation-transplantation process and corneal graft failure”. Regarding corneal donors (cohort / n = 419), it was found that the epidemiological profile showed a prevalence of individuals with a mean age of 42.53 years, male (73.99%), living in the state capital and region. metropolitan area (45.35%). The main cause of death was associated with the pathophysiological mechanism of cardiorespiratory arrest (86.4%). Regarding the chronological variables of the donation process, the following means were obtained: death-enucleation (5 hours and 33 minutes), death-preservation (7 hours and 43 minutes) and enucleation-preservation (2 hours and 9 minutes). Of the donated corneas 17.18% were discarded due to expiration date. The quality of the corneal tissue evaluated by slit lamp presented excellent (1.91%), good (51.79%), fair (20.29%) and poor (26.01%) final ratings. The clinical profile of patients undergoing corneal transplantation in the case-control study was characterized by male subjects (50.62%), with an overall mean age of 52.31 years (cases: 56.15 years; control: 50, 39 years old). The average time since tissue immersion in preservation medium and transplantation was 9.46 days. The variable corneal quality in the comparison between groups was excellent / good (cases: 59.26% versus controls: 79.63%) and fair / poor (cases: 40.74% versus controls: 20.37%). ). Corneal graft failure showed a statistically significant relationship with the variables: donor corneal button size, donor-recipient button size difference, cause of death, stromal disturbances, and time between enucleation and death. The identification of the inherent variables in the donation-transplantation process that may interfere with the survival of the corneal tissue after transplantation in a particular service requires proper investigation, due to the growing rate of corneal transplants performed each year worldwide and because they are treated. of a procedure that involves risks of failure.

3
  • JULIANA RAQUEL SILVA SOUZA
  • Elaboration of mobile application for nursing consultation for women with breast cancer.

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • FRANCISCO STÉLIO DE SOUZA
  • MARIA DE LOURDES COSTA DA SILVA
  • NILBA LIMA DE SOUZA
  • REJANE MILLIONS VIANA MENESES
  • Data: Feb 14, 2020


  • Show Abstract
  • Breast cancer is a public health problem due to the high morbidity and mortality rates and the physical and psychological sequelae. In this context, nursing consultation subsidized by specific instruments for women with breast cancer is strengthened as an effective strategy for comprehensive care, a fact that justifies this study. The objective of this study is to develop a mobile application for nursing consultation for women with breast cancer in light of Roy's Adaptation Model. This is a methodological study developed in four steps: 1) Review of the national and international literature for the search for empirical indicators performed in the Web of Science, Lilacs, Pubmed, Care and Cinahal databases, with the descriptors breast cancer, disorders adaptation, social adjustment and psychological adaptation, previously selected in the Health Sciences Descriptors and Medical Subject Headings; 2) Elaboration for the construction of the nursing consultation instrument for women with breast cancer in the light of the Roy Adaptation Model. 3) Validation of content and appearance by judges, intentionally selected on the Lattes Platform. Validation was performed by two rounds of submission of the instrument to the judges, pilot test and lexical and grammatical correction. Twenty judges, nurses with a minimum degree of oncology nursing specialist, or with professional experience in breast oncology / breast cancer, of at least one year, and / or academic experience with at least one year of experience in oncology nursing were selected. . Likewise, the instrument was submitted to students of the last period of undergraduate nursing for evaluation and primary understanding of the instrument. Subjects who did not follow the Delphi Technological methodological process for content and form validation were excluded; 4) Adaptation of the instrument to free software available in three languages. This study was approved by the Research Ethics Committee of CAAE: 13927619.2.0000.5537 and Parecer: 3.382.745 and followed National Health Council Resolution No. 466/12. Data regarding content validation were analyzed using the content validity index, which assumed> 0.80, programmed in Microsoft Excel version 2010, for analysis of descriptive statistics with absolute and relative frequencies. Thus, we accept the hypothesis that the instrument has evidence of validity. It is expected that the use of a mobile application for nursing consultation for women with breast cancer, built on a theory and scientifically validated, can contribute to the nursing care practice for women with breast cancer.

4
  • KAROLINA DE MOURA MANSO DA ROCHA
  • Translation and cross-cultural adaptation of the Good Perioperative Nursing Care Scale instrument.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • ISABEL KAROLYNE FERNANDES COSTA
  • ISABELLE KATHERINNE FERNANDES COSTA
  • KALYANE KELLY DUARTE DE OLIVEIRA
  • MARIA ALZETE DE LIMA
  • Data: Feb 17, 2020


  • Show Abstract
  • Perioperative nursing care is developed in order to minimize the risks and possible complications from a biopsychosocial and physiological view of the individual. Interventions by all stakeholders must be quality and conscious, and assessment of care through reliable instruments is a strategy to ensure this end. Thus, the aim of this study is to cross-culturally adapt the Good Perioperative Nursing Care Scale (GPNCS) instrument to the Portuguese language in the Brazilian context. The instrument was developed in Finland and has been translated and used in several countries in Europe and Asia to evaluate perioperative nursing care from the patient's perspective. The relevance of the nursing care content of the instrument in various contexts makes it suitable for use in Brazil. This is a methodological study with a quantitative approach to translation and cross-cultural adaptation of instruments according to Beaton et al. (2007), conducted from May to July 2019. The steps were: initial translation from English to Portuguese by 02 translators; synthesis of the translation; back-translation from portuguese to english, by 02 translators; content validation by a committee of reviewers; and pretest. The pretest stage was performed in July 2019, at Onofre Lopes University Hospital, in the surgical clinic sectors with intentional sample of 40 patients who underwent elective surgical procedures. Data analysis was performed by Fisher's test and Kappa coefficient. The research was approved by the UFRN Research Ethics Committee under the CAAE protocol: 0800131860005537 and opinion 3305610. Thus, in the translation stage, 07 divergences were noticed in items 1, 5 and 7 of the first part of the instrument and items 1, 6, 7, 10 of the second part of the instrument, which after discussion, the translators and researchers of the study reached a consensus. In Back-Translation the translators confirmed that the translated version accurately reflects the content of the original version. For the content validation, the Evaluators Committee was formed, composed of 09 professionals, who, in each item of the instrument considered adequate and totally adequate regarding semantic, idiomatic, experimental and conceptual validation, generating agreement higher than 80. %. However, 06 experts suggested unifying item 29 and 30 because they are two statements with similar ideas. Thus, it can be stated that the instrument was translated and adapted cross-culturally to the Brazilian reality, becoming the Good Nursing Care Scale. However, due to structural problems in the collection unit, psychometric validation was not developed, however the study was not compromised because the proposed objectives were achieved. Thus, it is essential to develop this last step so that the instrument can be used in the various national scenarios.

5
  • ANA PAULA NUNES DE LIMA FERNANDES
  • Dryness Eye: development of a medium-range nursing theory.

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • MARCOS ANTÔNIO GOMES BRANDÃO
  • ALLYNE FORTES VITOR
  • BERTHA CRUZ ENDERS
  • FABIANE ROCHA BOTARELI
  • PRISCILLA ALFRADIQUE DE SOUZA
  • Data: Feb 19, 2020


  • Show Abstract
  • This is a study about the development of a medium-range nursing theory, based on Callista Roy's adaptation model, about dryness eye. Its general objective was to develop a mid-range nursing theory of eye dryness based on Roy's adaptation model. This is a theoretical research, of descriptive-exploratory nature, with a qualitative approach. To reach the objectives, the strategies for the development of theories proposed by Walker and Avant (2019) were adopted, electing the concept analysis strategy to present the concepts, the establishment of relational statements from the statement synthesis and the strategy. From theory analysis to the realization of theoretical deduction. This study took place in five stages, namely: scoping review, concept analysis, statement synthesis, theoretical modeling and construction of elements for nursing taxonomies from the developed theory. In the first stage a Scoping Review was conducted guided by the steps recommended by the Joana Briggs Institute (2015). After identifying the research question, a search protocol was established and from the descriptors “dry eye syndromes” and “keratoconjuntivite cicca”, based on: Scopus, Web of Science, Science Direct, the identified synonyms were used as keywords in the electronic search engine in order to broaden the search. We obtained a sample of 193 studies that served as the basis for building the elements of the theory. The concept and statements were obtained from the primary studies included in this sample. When analyzed and synthesized, they were modeled from the theoretical deduction made by the analysis of Roy's adaptation model. From the analysis of the theory, it was found that this model starts from the metaparadigmatic understanding that the environment is an actor in human adaptive systems; health as a state in which the person seeks to stay through adaptation; nursing as a profession that promotes adaptation; and the person as an adaptive system that is controlled by stimuli, control and feedback. The central proposition of this medium range theory is that the event of eye dryness occurs as a result of activation of focal stimuli (intrinsic factors that lead to decreased tear production), contextual (environmental / extrinsic factors that promote instability and increased film evaporation lacrimal) and residual (combined), which can lead to adaptation or an adaptation problem. Nursing by identifying the unwanted human response provides conditions that act effectively and are able to reiterate human adaptive mechanisms promoting eye health. From the construction of the theory, propositions of taxonomic elements were elaborated that could serve as basis for the individual to recover the adaptive mechanisms and obtain eye health. It was built the proposition of the nursing result entitled: behavior for prevention of eye dryness and a proposition for the construction of the nursing intervention entitled: control of eye dryness. Based on the propositions, the theory will support the practice by proposing to describe, explain, predict and intervene in the phenomenon under study.

     

6
  • LORRAINY DA CRUZ SOLANO
  • Evaluation of health residences in practice scenarios in primary health care in the state of Rio Grande do Norte.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JOAO MARIO PESSOA JUNIOR
  • RICARDO BURG CECCIM
  • RODRIGO ASSIS NEVES DANTAS
  • ROSANGELA DINIZ CAVALCANTE
  • Data: Feb 28, 2020


  • Show Abstract
  • The objective was to evaluate the structures, processes and results of the Multiprofessional Residency Programs in Family and Community Health and Physicians in Family and Community Medicine in the practice scenarios of Primary Health Care in the State of Rio Grande do Norte. It is a mixed study, supported by cartography, developed in Basic Health Units that are scenarios of practice of joint action of health residency programs in the municipalities of Mossoró and Caicó, unique in this area of the specialty of Family and Community Health in the state. Users, health workers, residents and managers participated in the collective field of these residences, who were invited to collaborate with the study through the “snowball” method. The production of the data took place in three stages, coordinated with each other. The first consisted of a comparative analysis of the performance reports in the quality standards verified in the external evaluation action planned and carried out by the Program for Improvement of Access and Quality of Primary Care, conducted by the Ministry of Health. The second was through the production and registration of data in the form of field reports, as occurs in the sharing related to the so-called “existential territory” where the practice fields of the residences are inserted. The third took place at the meeting with users, workers, residents and managers mediated by semi-structured interview scripts. Qualitative data were processed using the IRaMuTeQ software and submitted to Bardin's Content Analysis. In compliance with Brazilian legislation, it followed the precepts determined by Resolution No. 466/2012, of the National Research Ethics Committee, of the National Health Council registered at CEP / UFRN CAAE: 12101019.5.0000.5537. The results showed that the PMAQ reports have inconsistencies that make it impossible to make a comparative analysis between the 6 UBS research fields, 4 in Mossoró and 2 in Caicó, in addition none of the teams read or analyzed the results contained in the reports. The field records are shown on the cartographic maps of each BHU and express the production of subjectivity around SUS, Primary Care and professional training. The interviews generated a corpus referring to 58 interviews that confirm the fact that the scenarios of practices in the state are positively altered in the production of care offered to the population and the work process of the teams. Evaluation of residency programs resulted in the problematization of Health Units as Schools, which needs to be systematized to generate resolutive spaces in which all those who are in the scenarios of practices in Primary Health Care learn: students, professionals, managers, users and teachers. The study presents the concept / tool of Mandala Formative on in-service training threads.

7
  • DANYELLA AUGUSTO ROSENDO DA SILVA COSTA
  • ELABORATION AND VALIDATION OF INSTRUMENT FOR NURSING CONSULTATION TO PEOPLE LIVING WITH MENTAL DISORDERS UNDER THE FAMILY HEALTH STRATEGY.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • DEYLA MOURA RAMOS
  • DULCIAN MEDEIROS DE AZEVEDO
  • FRANCISCA PATRÍCIA BARRETO DE CARVALHO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARIA ALZETE DE LIMA
  • Data: Jul 3, 2020


  • Show Abstract
  • This is a methodological study, which aimed to validate an instrument for nursing consultation to people living with mental disorders within the scope of the Family Health Strategy. The instrument was developed based on the phases of the Nursing Process, in accordance with Federal Nursing Council Resolutions number 358/2009 and 429/2012, which deal with the use of its phases in health units, namely: data collection, diagnoses nursing, nursing actions and interventions, expected results and formal registration. Wanda Aguiar Horta's Theory of Basic Human Needs was used as a theoretical-analytical framework. The project was submitted to the Human Research Ethics Committee of the Federal University of Rio Grande do Norte, being approved with the Certificate of Presentation for Ethical Appreciation (CAAE) nº. 25688219.4.0000.5537 and opinion No. 3,736,262. The investigation was carried out in two stages: the first consisted of an integrative literature review to obtain aspects related to assistance to support the construction of an instrument for nursing consultation to people living with mental disorders within the scope of the Family Health Strategy. The following electronic databases were used: Latin American and Caribbean Literature in Health Sciences (Lilacs); Medical Literature Analysis and Retrieval System Online (MEDLINE / PUBMED); SCOPUS; Web of Sciense; Cumulative Index to Nursing, Allied Health Literature (CINAHL) and The Cochrane Library (Cochrane). The sample consisted of 14 articles. The second stage took place through the content validation of this instrument by specialists using the Delphi technique. These were selected through the Lattes Platform of the National Council for Scientific and Technological Development (CNPQ). The sample consisted of 42 specialists in Delphi 1 and 32 for Delphi 2, reaching the final version of the instrument for nursing consultation to people living with mental disorders within the scope of the Family Health Strategy. Statistical analysis was performed using: Content Validity Index (CVI), Relative Index (ARI) and alpha Cronbach. In the first stage, Delphi 1, the mean of Cronbach's alpha and ARI were greater than 0.80, and the CVI was 0.803. In the Delphi 2 phase, Cronbach's alpha reached 0.896, with a CVI of 0.998. A comparison was made between the Delphi 1 and 2 phases, and in both the reliability was quite satisfactory. Thus, the validity of the instrument in its content was achieved.

8
  • GLEYCE ANY FREIRE DE LIMA CARVALHO
  • Elaboration of a nursing model in palliative care in home care.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CECILIA NOGUEIRA VALENCA
  • LARISSA SOARES MARIZ VILAR DE MIRANDA
  • MARIA CÉLIA FREITAS
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Jul 31, 2020


  • Show Abstract
  • Nursing care of individuals in palliative home care involves management and direct care based on the principles and knowledge of theoretical and methodological nursing concepts. The nursing care model provides a guiding framework for that care. The objective of this study was to develop a Nursing Care Model for individuals receiving home palliative care. Nursing Care Models are structures/instruments derived from a conceptual framework and a care methodology that guide the provision of nursing care to specific populations.  The theoretical framework for the study included the humanistic and holistic perspective of the person in his context, palliative care concepts and the theoretical principles of nursing care. A qualitative study using the Convergent Care Research method was conducted in Natal, Rio Grande do Norte, Brazil. Nineteen nursing professionals, members of the multiprofissional teams of the Home Care Services were selected by convenience and participated in the study. The study was conducted in four stages: 1) Insertion. The researcher imersed in the healthcare team of the Home Care Services; 2) Definition of the subsidizing base. In this stage, the theoretical base was constructed by means of: review of literature and identification of relevant conceptual definitions; the profile identification of persons receiving palliative care in the services; the search of reality, or the data collection, that enabled the  imersement and the integration of nursing care and research, in the identification of the perceptions of health professionals regarding nursing care in the provision of palliative care, 3) Analises and Interpretation. This stage involved the organization and synthesis of data using an organized system and the Atlas Ti.1 software, resulting in the theorization of information and the construction of the conceptual structure in model form. Incentives were also given for committment atitudes, transferibility and the dialogue of knowledge, and for the use of the model as a practical reliable instrument. The study was approved by the Research Committee of the Universidade Federal do Rio Grande do Norte, CAAE 91773018.8.0000.5537.  The“Nursing Care Model for Individuals on Home  Palliative Care” developed in this study is based on the theortical and methodological concepts of nursing care. The aim of the Model is to guide nursing professionals in the systematized care, while valuing the centrality of care on the person and family, and in the promotion of quality of life and comfort in the home environment.  Home care permits reflexion on the knowing/doing of nursing to people  under palliative care and on the nurse´s role as articulator of care  and management actions. It is concluded that the utilization of the model may enhance the nursing values in the home palliative care of humanism and scientific principles, thereby providing comfort and relief to the person and family,

9
  • ANDRESSA KALINE FERREIRA ARAUJO JALES
  • Assistive Technologies on sexually transmitted infeccions for blind persons: validation of content and semantics in the light of David Ausubel.

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • ALEXSANDRO SILVA COURA
  • ELIÃ PINHEIRO BOTELHO
  • ELUCIR GIR
  • MARIA ALZETE DE LIMA
  • MARISE REIS DE FREITAS
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Aug 21, 2020


  • Show Abstract
  • The objective was to investigate evidence of content validation and semantic validation of virtual booklet and sound media for blind people about the prevention of sexually transmitted infections (STIs), acquired immunodeficiency syndrome and viral hepatitis. Methodological development study, carried out with experts in special education and sexual and reproductive health and with blind people enrolled at the Support Center for the Visually Impaired (CADV), located in Mossoró/RN and at the Institute of Education and Rehabilitation of the Blind of Rio Grande do Norte (IERC/RN), located in Natal, from May 2018 to July 2020. The research was developed in four stages: (1) construction of content on prevention of STI/HIV/AIDS and Viral Hepatitis by conducting literature review on STI/AIDS prevention and blind people carried out in five databases (Virtual Health Library, Cochrane, PubMed, Scopus and Web of Science) and verification of the adequacy of blind people's knowledge about prevention and transmission of STI/AIDS carried out with blind people registered at CADV according to defined eligibility criteria; (2) construction of the virtual booklet considering the five phases proposed by Falkembach (2005) - analysis and planning, modeling, implementation and evaluation and maintenance and distribution; and, of the podcast considering the steps proposed by Silva (2019) - definition of the theme, choice of participants, definition of the necessary equipment, preparation of the agenda, recording of the episode, editing of the podcast and publication of the episode); (3) content validation of the assistive technologies developed, carried out by means of evaluation by judges in the areas of special education and sexual and reproductive health, chosen by searching the lattes platform and according to the criteria established by Joventino; and, (4) semantic validation of the podcast performed by blind people enrolled at IERC / RN and who met the inclusion criteria of the research. The content and semantics validation steps were guided by Pasquali and all the research was developed in the light of the Theory of Meaningful Learning proposed by David Ausubel. The collected data were compiled and analyzed in an electronic data spreadsheet and, to respond to the research objectives, absolute and relative frequencies of the adequacy of knowledge about STI/AIDS prevention and transmission and the content validation verification instruments were calculated. semantic validation. The Content Validity Index was also calculated in order to analyze the agreement index between the judges in relation to the analyzed items, having been considered validated the items that obtained agreement greater than or equal to 70%. Ethical recommendations for research involving human beings were followed in accordance with Resolution No. 466/2012, having been submitted to the Research Ethics Committee of the Federal University of Rio Grande do Norte, CAAE Nº 91753918.4.0000.5537. Inadequate knowledge of all participants on ways of transmitting some STIs / AIDS was identified and adequate control by most participants on HIV prevention and control methods. It was noticed that the manuscripts focused on the sexuality and sexual practices of people with visual impairments as risk factors for the development of STI/AIDS and the development, validation and testing of technologies as instruments for access of people with visual impairment to STI/information. AIDS. The virtual booklet was built following the international accessibility recommendations defined by the W3C and the podcast was recorded in a radio station studio, considering the transcribed agenda elaborated by the researcher. The content validation was performed by 29 judges in special education and 28 judges in sexual and reproductive health, in two rounds, and all items in the virtual booklet and the podcast had their content validated by these specialists. The items of the produced sound media were considered intelligible to all strata of the target population, conferring the podcast's appearance validation. It was concluded that the virtual booklet and podcast developed and validated in this research represent health education tools on STI / HIV / AIDS and Viral Hepatitis for blind people.

10
  • ISADORA COSTA ANDRIOLA
  • Advanced Practice Nursing: analysis of United States context to underlie the implementation process of this practice in Brazil.

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • ANDREA SONENBERG
  • BERTHA CRUZ ENDERS
  • FLAVIA ANDREIA PEREIRA SOARES DOS SANTOS
  • MARCELLY SANTOS COSSI
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • Data: Sep 18, 2020


  • Show Abstract
  • This research aims to analyze the Advanced Practice Nursing, focusing on the role of Certified Nurse-Midwives and Nurse Practitioners, in the United States context, in order to underlie its implementation in Brazil. This is a qualitative study, which kind is a case study. The questions that guided this research were: How is the Advanced Practice Nursing, especially  Certified Nurse Midwives and Nurse Practitioners, developed in a real context in the United States of America (USA)? How can the understanding of the context contribute to its implementation the Advanced Practice Nursing in Brazil?. The assumptions were the following: (a) Advanced Practice Nursing allows Nurses to act in a differentiated scope of practice, which includes advanced clinical evaluation, diagnosis and treatment skills, so that these professionals are allowed to meet the health needs of a large part of the population in an autonomous and recognized way. (b) Understanding the contextual levels of  Advanced Practice Nursing in the United States of  America allows the identification of which aspects of the Brazilian reality need to be modified or encouraged to support a proposal of implementation of this practice in Brazil. (c) Advanced practice nursing can turn into a valid reality in Brazilian context and contribute to improve the health outcomes especially in the maternal and child health. The unit of analysis ("the case" itself) was the practice of Certified Nurse-Midwives and Nurse Practitioners in New York, United States of America. The logic that links data to propositions is based on the relevant literature. The data were collected through a literature review, which has been developed during the research; non-participant observation in a large hospital in New York (USA); and interview with six Certified Nurse-Midwives / Nurse Practitioners. As a criterion for the interpretation of the findings, the method of analysis of responsive interviews proposed by Rubin & Rubin (2005) will be used, which is described over two phases: preparation of the transcripts, with identification of concepts, themes and events, with subsequent codification that data; and the construction of the narrative that culminates in building up a theory. The data will be examined under the theoretical lens of Hinds et al. (1992), which deals with the analysis of the context at all its levels: the immediate, specific, general context, and the metacontext. Based on this analysis we could understand clearly which activities belongs to the Advanced Practice Nurses; how this practice can be define and what makes it different from the practice of other health workers; and how this practitioner situate themselves in the health system and achieve the expected outcomes. Understanding this practice subsidised a proposal for Advanced Practice Obstetric Nurses in Brazil using the PEPPA framework as a guide.

2019
Dissertations
1
  • LAÍSI CATHARINA DA SILVA BARBALHO BRAZ
  • Participative educational strategy in the promotion of sexual health with adolescents

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • BERTHA CRUZ ENDERS
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • MARCELO COSTA FERNANDES
  • Data: Feb 15, 2019


  • Show Abstract
  • Adolescence is a life period marked by conflicts, modifications and discoveries, one of which is the first sexual intercourse, activity generally conducted precociously and usually without orientation and protection. This has resulted in increased vulnerability to sexually transmitted diseases and undesired pregnancy, cases that continue to be on the increase despite the existing health policies for adolescent health and the educational strategies on sexual health. In this study an active educational strategy on sexual health was implemented using a thematic game. The study was based on the need for educational strategies that link information to reflection, thus integrating knowledge to reality enabling the adolescent to be an active participant in the promotion of own sexual health, and in the permanent process of autonomy and learning, essential elements for decision making. The objectives were: 1) To analyze the perceptions of adolescents regarding their experience in a participative educational action about sexual health, and 2) To identify the adolescents´ knowledge regarding behaviors related to their sexual health as they participate in a participative educational strategy. Descriptive and exploratory qualitative study conducted in public high school located in Natal, RN. The population was composed of 122 enrolled adolescents, in average of 15 year of age. The educational activity was conducted in April and May 2018, in four sessions of 50 minutes duration. The sessions were used to identify the previous knowledge of sexual education, to implement round group discussions, and to apply the sexual health educational game. Data were collected by a semi-structured questionnaire, open discussions in the round group discussions, comments during the game sessions, and direct non-participative observations. Bardin´s thematic content analysis techniques were used to categorize the data. The thematic categories formed were: Interest in themes and methodology; Desire for continuation of activity; Activity as diversion, play; Activity as a participative class; Importance of the educational activity in health; Knowledge constructed and positive life results; Lack of dialogue in the. It is concluded that educational activities on sexual health with adolescents using active methodologies and educational games, incite interest and promote active participation of the students, also enable learning and reflection about health issues. This study seeks to contribute to strengthening of public health policy in adolescent health and for clinical thinking by nurses in the school context.

2
  • TÁSSIA REGINE DE MORAIS ALVES
  • Mothers’ livingness regarding the interruption of Exclusive Breastfeeding

  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • JOSÉ LUÍS GUEDES DOS SANTOS
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • LUCIANE PAULA BATISTA ARAUJO DE OLIVEIRA
  • MARIA CLAUDIA MEDEIROS DANTAS DE RUBIM COSTA
  • SIMONE PEDROSA LIMA
  • Data: Feb 21, 2019


  • Show Abstract
  • Introduction: The exclusive breastfeeding is a vital practice for the mother and its child, since it fights malnourishment and extreme hunger at the first years of life, and, in many cases, it is responsible to ensure the child survival. It is estimated that 823,000 fatalities would be avoided each year in relation to five years old children if the breastfeeding were universally amplified. Objective: To comprehend the livingness of mothers regarding the interruption of exclusive breastfeeding. Method: Qualitative research, underpinned at the straussian aspect of the Grounded Theory. The research scenario was a Health Unit that acts in the field of Family’s Health Strategy in the city of Caicó (Rio Grande do Norte). 19 subjects took part in the study, distributed on three sample groups: the first one was composed of thirteen mothers, the second, by three health professionals and the third, by three relatives. The data gathering occurred between April and September of 2018, using an in-depth interview, with the support of memos and diagrams. An analysis of the data was made concurrently with the data gathering, in three stages of codification: open, axial and of integration. The software NVivo® 11 was used to organize data during the analysis process. The Symbolic Interactionism was adopted as theoretical frame. Results: From the analytic process, emerged a phenomenon or central category of the research, entitled as ”living the multidimensionality of the interruption of exclusive breastfeeding”, sustained by three categories that promotes a driving movement for the central phenomenon, accordingly to the paradigmatic model’s components: conditions –“ living the myths and taboos related to exclusive breastfeeding”; “receiving influence from the family nucleus and from health professionals regarding exclusive breastfeeding”; “not feeling protected by the Brazilian laws”; actions/interactions – “interrupting the exclusive breastfeeding” and “developing mammary complications”; and consequences – “introducing artificial milk and complementary breastfeeding before the sixth month of life” and “experiencing negative feelings and sensations in front of the interruption of exclusive breastfeeding”. Conclusion: The current study highlighted that the exclusive breastfeeding is a complex phenomenon, which transcends biological dimensions, being influenced by cultural factors, interference of family and health professionals that provides direct care to the mother. Moreover, the lack of law coverage that protects exclusive breastfeeding contribute for the non-adhesion of this practice, which awakens negative feelings.

3
  • BEATRIZ MEDEIROS DE MACEDO
  • Accuracy of the clinical indicators of the nursing diagnosis of fatigue in patients with heart failure

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA BEATRIZ DE ALMEIDA MEDEIROS MOURA
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • KESSYA DANTAS DINIZ
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • Data: Feb 21, 2019


  • Show Abstract
  • Accurate clinical indicators are important for nursing care and teaching. The identification of these components occurs through studies of diagnostic accuracy. Thus, the present study aims to analyze the accuracy of the clinical indicators of nursing diagnosis Fatigue in patients with heart failure. This is a cross-sectional, diagnostic accuracy study. The sample consisted of 96 patients in attendance at the University Hospital Onofre Lopes, selected for convenience, consecutively. The instrument of data collection was a form, containing questions related to sociodemographic, clinical aspects and diagnostic indicators. In addition, to support the data collection, a protocol was used with the conceptual and operational definitions of the clinical indicators. The research was approved by the ethics committee in research of the unit responsible, under number 2,517,527 and Certificate of Presentation for Ethical Appreciation: 80923217.7.0000.5537. The results showed that the majority of the clientele investigated were male, brown, with companion, from the interior of the state, practicing a religion, with incomplete elementary school and retired or benefited. The mean age was 57.78 years. The most prevalent clinical indicators were: Impaired ability to maintain habitual level of physical activity, Increased physical symptoms, Increased need for rest, Impaired ability to maintain habitual routines, Insufficient energy, Non-restorative sleep pattern, Introspection, and Tiredness. There was statistical association of the nursing diagnosis investigated with the variables gender and jugular engorgement. The most sensitive clinical indicators were: Increased physical symptoms and Tiredness. And the one of greater specificity was: Disinterest in the environment that surrounds it. The diagnostic study was present in 42.54% of patients with heart failure. Thus, it is concluded that the Fatigue diagnosis presents accurate clinical indicators in the clientele with heart failure. Furthermore, it is expected that, from the identification of these accurate clinical indicators, the diagnostic inference of the nurse will be facilitated in clinical practice.

4
  • BELARMINO SANTOS DE SOUSA JÚNIOR
  • Institutional Analysis of Nursing Practices in the Prevention of Pressure Injury

  • Advisor : CECILIA NOGUEIRA VALENCA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CECILIA NOGUEIRA VALENCA
  • DOMINGO PALACIOS CEÑA
  • Data: Feb 22, 2019


  • Show Abstract
  • Pressure injuries are strong indicators of the quality of health care provided by nurses. Institutional analysis allows access to contradictions and possibilities for changes in practices. This study had the following guiding question: What are the practices of the nurse related to the prevention of pressure injury in a University Hospital in the city of Natal / RN? The objective of this study was to analyze nurses' practices related to the prevention of pressure injury in a university hospital in the city of Natal / RN. It is a quantitative and cross-sectional study. Participated 48 nurses at the Intensive Care Unit and Surgical Center of the university hospital. The data collection was done through a questionnaire after the approval of the Ethics and Research Committee of the University Hospital Onofre Lopes. The data obtained were entered in a database of the Statistical Package for the Social Sciences, version 20.0, for treatment of the results with inferential statistical analysis. As a result, nurses were questioned about their practice in the prevention and treatment of pressure injuries in the sector where they work. The errors and correctness in the questions about prevention of pressure injury represented a quantitative greater than 50% of the errors to the questions. We also analyzed questions about the applicability of preventive measures, whose answers showed little applicability in clinical practice. The nurses' practice in skin care with a view to preventing pressure injury is relevant for the evaluation of the exposure of risks and damages related to adequate health care in the hospital unit. The research concluded that the use of care practices in the prevention of pressure injury by nurses help to develop a safety culture, with improvements in the quality of care in health and nursing services. Thus, nurses' ongoing training strategies in patient safety with pressure injury prevention approaches represent a management tool to minimize or mitigate the occurrence of these injuries.

5
  • JÉSSICA DE ARAÚJO OLÍMPIO
  • Accuracy of clinical indicators of nursing diagnosis Hypothermia in patients with heart disease
  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ALLYNE FORTES VITOR
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • Data: Feb 25, 2019


  • Show Abstract
  • This study aims to evaluate the accuracy of the nursing diagnosis of hypothermia in patients with heart disease. This is a methodological study with a quantitative approach, to be conducted in two stages: Concept analysis of hypothermia and analysis of the accuracy of clinical indicators of nursing diagnosis Hypothermia in patients with heart disease. The first step proposes to clarify the concept of hypothermia, its attributes, antecedents, consequent and empirical referentials, based on the model proposed by Walker & Avant (2011). In order to search the literature, an integrative literature review was carried out, which obtained a sample of 66 articles, identified from the following search engines and databases: Cochrane, Lilacs, Scielo, Web of Science, Scopus, Pubmed and Google Scholar, accessed by middle of the periodical directory of the Coordination of Improvement of Higher Level Personnel. In addition to the material selected through the databases, previous reading articles obtained from reverse search were used. The second step proposes to analyze the accuracy of the clinical indicators of the nursing diagnosis Hypothermia in patients with heart disease and verify the prevalence of this diagnosis in the presence of its clinical indicators based on the Latent Class Analysis method. Data were collected through an instrument containing sociodemographic, clinical information and clinical indicators of nursing diagnosis.
    Hypothermia through physical examination and collection of information in the medical records of patients admitted to the cardiology unit. The study has a sample of 120 patients selected from the following eligibility criteria: being 18 years of age or older and hospitalized for pre-surgical or clinical treatment. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in compliance with Resolution no. 466/2012 of the National Health Council of the Ministry of Health and obtained a favorable opinion from the CEP under number 2,574,889 and CAAE 85607418.3.0000.5537. From the integrative review, the United States of America was the country with the highest production of articles (44.0%), a large part of the research was produced in the last five years (43.7%) and in the English language (97%). Regarding the concept analysis, the main attribute was the reduction of the central body temperature to less than 36 ° C. As antecedent are all the factors that influence in the reduction of the temperature as the metabolic ones and exposure to the cold. Among the consequences are: cardiac events, respiratory events, increased susceptibility to infections, tremors, hypoglycemia, increased metabolic rate, peripheral vasoconstriction, piloerection and cold skin on the touch. The sociodemographic characterization of the patients who participated in the second stage of this study identified: a majority male (62.5%), companion (74.2%), born and resident in the state of Rio Grande of the North (65% and 59.2%), retired (59.2%), practicing religion (87.5%). Most of them had incomplete elementary education (37.5%), with an approximate income of two or more minimum wages (50.8%) and a mean age of 59.7 years. Among the hospitalization reasons identified, congestive heart failure occurred with a higher prevalence (30%).

6
  • ISABEL NEVES DUARTE LISBOA DE OLIVEIRA
  • Acuracy of clinical indicators of nursing diagnosis constipation in oncological pacients in antineoplastic chemotherapy 

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • MARIA ALZETE DE LIMA
  • WERUSKA ALCOFORADO COSTA
  • Data: Feb 26, 2019


  • Show Abstract
  • Nursing diagnosis constipation is prevalent in cancer patients and may decrease their quality of life. The inference of nursing diagnoses, through sensitive and specific clinical indicators, allows rapid and effective interventions to obtain results for which the nurse is responsible. Thus, the present study aims to analyze the accuracy of the clinical indicators of the nursing diagnosis constipation in cancer patients on antineoplastic chemotherapy. Diagnostic accuracy study, of the transversal type, developed at the chemotherapy outpatient clinic of the Norteriograndense Hospital League against Cancer. The population was composed of patients undergoing antineoplastic therapy attended at the outpatient clinic of said hospital. The sample was 240 individuals. The data collection took place from February to September 2018, through a form containing questions related to sociodemographic, clinical data and diagnosis indicators. The project was approved by the Research Ethics Committee of the institution responsible, under the number of opinion: 2,417,240. The results showed that the majority of the interviewees were female, with a mean of 55.62 years, with a partner, practicing some religion, coming from the capital and retired or pensioners. Regarding the nursing diagnosis constipation, its prevalence was 86.6%. The sensitive clinical indicators of the diagnosis were: effort to evacuate, hypoactive bowel sounds. The specific clinical indicators were: headache, abdominal pain, pain when evacuating, exertion when evacuating and liquid stools. Thus, it is concluded that constipation is a prevalent nursing diagnosis in cancer patients on antineoplastic chemotherapy. Also, there are clinical indicators that accurately predict their occurrence in this clientele. Thus, nursing interventions should be directed to this diagnosis, in order to prevent side effects, promote support and contribute positively to the quality of life of patients submitted to antineoplastic chemotherapy.

7
  • LUANA SOUZA FREITAS
  • Effectiveness of telenursing in the accompanying of ostomy persons: from the perspective of the Roy Adaptation Model

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ALEXSANDRO SILVA COURA
  • ANA ANGELICA REGO DE QUEIROZ
  • ISABELLE KATHERINNE FERNANDES COSTA
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Feb 28, 2019


  • Show Abstract
  • Stomy is the name given to any artificially created opening of the internal environment of the body structure to the external environment. The fact of becoming aesthetic entails a change to a new excreta elimination condition generating an adaptation to this situation. Attempts to access care may result in poor knowledge of the stomatomania about the care of the stomach, in view of this. Roy's Model of Adaptation as a guideline for nursing actions. It is aimed at analyzing the effectiveness of the telephone intervention without the adaptive process of the stomized person. This is a longitudinal, almost experimental, type-of-trial, randomized, and unicego study conducted with 2 groups of individuals with up to one year of oestrus, the only conventional treatment. , the monitoring by phone. The indicators indicated that they were not able to differentiate statistically between the control and intervention groups, because their sociodemographic, clinical and adaptation variables, a sample characterization, identified a predominance of people with a lower gender, with lesser or equal age to 60 years, pardos, retired, living with companion, elementary school, with income of 1 minimum wage, catholics. According to asics as well as non-orquality and uravities, have anti-therapy, have anti-therapy or radiotherapy, have had behavior of the stoma and peristomal, has not colostomy, with comestible temporary, Use the device collector of 1 piece, being the patient who makes an exchange of his bag, and feels adapted. Regarding the adaptive modes, an absence of significant statistical significance was identified between the control groups and their adaptation without pre-test. However, in the post-test it was pointed out that, since the means and medians of the control group were lower than those in the group that received an intervention in a statistically significant way. An adaptive score of the control group in the post-test was also lower when compared to the pre-test of the group, whereas an analysis of the intervention group evidenced an elevation of the adaptive levels of the group when comparing the pre- and post-east . It is noticed the effectiveness of a telephone intervention in the levels of adaptation of the person with health, emphasizing the importance of a complementary and regular accompaniment in the promotion of health actions that influence the self-esteem, self-care and the adaptation of the public.

8
  • ÂNGELA MONIC LIMA DE SOUZA
  • Emotional status and sleep quality in nursing professionals in hospital shifts

  • Advisor : MILVA MARIA FIGUEIREDO DE MARTINO
  • COMMITTEE MEMBERS :
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • REJANE MARIA PAIVA DE MENEZES
  • SORAYA MARIA DE MEDEIROS
  • ROSÂNGELA MARION DA SILVA
  • Data: Mar 15, 2019


  • Show Abstract
  • The Emotional State exerts a significant influence in the social, behavioral and even in the work process, nursing deals directly with this extension, especially those who work in turns arriving to fulfill a workload of up to 12 hours, this day can generate emotional disturbances characterized by subjective feelings of discomfort and accompanied by changes in the level of activity in cognitive functions, language and physiological functions such as appetite, sexual activity, biological rhythms and sleep quality. Such altered physiological functions can directly influence nursing professionals. The present study aimed to describe the emotional state and to investigate whether it exerts influence on the quality of sleep of the nursing professionals in the day and night shifts. It was developed at the University Hospital of Rio Grande do Norte. The data collection in its entirety was collected from January to December of 2018, using the instruments: Present Emotional Status List, Pittsburgh Sleep Quality Index Questionnaire and Sociodemographic Characterization Form. The questionnaires were made available according to the work shift of each professional. A total of 74 nurses and 107 nursing technicians participated in the study. The data after being coded and tabulated, passed through statistical analysis through the SPSS version 2.0 program. The study obtained a favorable opinion from the Ethics and Research Committee of the Federal University of Rio Grande do Norte, under Opinion with CAAE of nº 80922717.8.0000.5537. The sociodemographic profile presented a predominance of female gender for both classes, in 79% of the sample, with age range between 24 and 45 years, corresponding to approximately 94%. There was a statistically significant difference for the variable more than one work (p = 0,001) and significant similarity for the children variable (p = 0,047). For the variable use of stimulants, they affirmed that 81% of nurses and 75% of nursing technicians use it. As to PSQI, only 22% of nursing professionals presented good sleep quality. Regarding the emotional state, the phrases "I am reflecting", "I am tired", "I am taking care", "I miss someone" and "I am sleepy" have presented more responses to the intensities more or less and strongly. It is concluded that shift work causes impairment of sleep quality of nursing professionals, who may also be influenced by changes identified in emotional states.

9
  • MOIZIARA XAVIER BEZERRA
  • CROSS MAPPING OF NURSING DIAGNOSTIC TITLES FORMULATED ACCORDING TO CIPE® VERSUS DIAGNOSTICS OF NANDA INTERNATIONAL, INC FOR CHILDREN WITH RENAL DISEASES

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • MARIA ALZETE DE LIMA
  • RUDVAL SOUZA DA SILVA
  • Data: Nov 25, 2019


  • Show Abstract
  • This is a cross-sectional study with a quantitative approach that aimed to cross-map the nursing diagnosis titles of children with kidney disease prepared according to the International Classification for Nursing Practice (ICNP®) with NANDA International diagnoses, Inc (NANDA-I), as well as classifying diagnostic titles according to levels of basic human needs theory and cross-mapping product content validation. The present study was divided into methodological steps, namely: construction of the term bank for children with kidney disease, elaboration of diagnostic titles for children with kidney disease according to the term bank. Data were collected between May and October 2015. The diagnoses were made in two lists and tabulated in the Microsoft Excel program (Office 2013) and also classified according to the levels of the theory of basic human needs. The diagnoses were compared between these classification systems, and thus classified into constant and non-constant titles. Thus, non-constant titles were classified as: similar, broader, more restricted and there is no agreement. Then the mapping product was subjected to the content validation process by experts. Content Validity Index of 0.80 or greater was considered. The experts who participated in the cross-mapping validation process were from the ICNP® Development Center of Brazil. The project was approved by the Research Ethics Committee of Onofre Lopes University Hospital with Opinion No. 1,007,954 and presentation certificate for ethical appreciation No. 42666815.0.0000.5292. A total of 67 nursing diagnoses were identified, 48 from ICNP® and 19 from NANDA-I. After cross-mapping, 85.4% of ICNP® diagnoses were not constant in NANDA-I. Non-constants were classified into: similar (7.3%), narrower (7.3%), broader (12.1%), and 73.3% of the diagnoses were not found in NANDA-I. The constant or non-constant diagnostic titles were classified in ICNP® and NANDA-I, respectively: Psychobiological 68% and 32%; Psychosocial 82.4% and 17.6%. No psychospiritual needs were identified. In cross-mapping, seven NANDA-I and ICNP® diagnoses were validated by the specialists and 11 non-constant diagnoses, with CVI> 0.8. The study presented numerical differences during the identification of nursing diagnoses with the use of two classification systems; however, the contribution of these systems to the development of nursing promotes effective results in care delivery, since the identification of the nursing diagnosis incorporated into a nursing diagnosis. Standardized language contributes to support nursing interventions and the strengthening of the profession.

10
  • HANNA PRISCILLA DA SILVA
  • Construction of the proposal Nursing Diagnosis infeffective peripheral venous retourn in adult patients with cardiovascular clinical conditions.

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • CAMILA TAKÁO LOPES
  • ALLYNE FORTES VITOR
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Dec 2, 2019


  • Show Abstract
  • This study aimed to construct the Nursing Diagnosis (ED) ineffective peripheral venous return in adult patients with cardiovascular clinical conditions directed to the NANDA International taxonomy. This is a methodological study, operationalized by the model of Lopes, Silva and Araújo (2012), consisting of three steps: Concept analysis, content analysis, and accuracy of clinical indicators. To achieve the objectives proposed in this study, the concept analysis step was performed based on the model proposed by Walker and Avant (2019) and operationalized through an integrative review, according to Walttemore Knalf (2005). The search in the literature took place between February and June 2019, and was carried out by a pair of researchers on the same days and places, on different computers, without communication, until the crossing exhaustion, according to the protocol built for this review. The following data sources were used: Science Direct, Scopus, Cumulative Index to Nursing and Allied Health Literature (Cinahl), Pubmed (Public Medline), Cochrane, Web of Science and the Virtual Health Library (VHL). I was opted for an advanced, non- controlled search using the keyword: “Peripheral” and the Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS) indexed descriptors “Venous Insufficiency”, “Lower Extremity” and “Leg”. The crossings were performed through the “AND” shot operator. In the initial search, 24,559 studies were found, which through screening, application of inclusion and exclusion criteria and thorough reading totaled the final sample of 136 publications. Of the studies found, were highlighted the ones from the last 5 years, 44 (32.35%), from North America, 69 (50.74%), with urgency for review studies, 52 (38.24%), with quantitative approach, 97 (71.32%) found in the Medline data source, 59 (43.48%) predominantly in the English language, 131 (96.32%). The information provided by the integrative review was presented descriptively and supported the stages of concept analysis. The analysis of the articles that made up the study sample allowed us to identify the components of the nursing diagnosis Ineffective peripheral venous return in adult patients with cardiovascular clinical conditions, identifying three attributes, 17 antecedents and 11 consequences of the diagnostic focus in question. Of the identified antecedents, were highlighted the structural and / or functional incompetence of the valves, 56 (41.18%), advanced age, 54 (39.71%), female, 42 (30.88%), obesity 40 (29, 41%) and calf muscle pump dysfunction, 33 (24.26%). Regarding the consequent, there were edema, 60 (44.12%), skin changes, 49 (36.03%) and pain, 35 (25.74%). In order to offer total, individualized and well-planned care, it is essential that nurses have nursing diagnoses that cover the human responses found in care practice in order to accurately infer the real needs of caring individuals to offer total, individualized and well planned care. It is concluded that the obtained data can support the construction of ND Ineffective peripheral venous return, promoting taxonomy improvement and offering a ND that contemplates the human responses presented by this group of patients, until then incipient.

     

11
  • ANDERSON BRITO DE MEDEIROS
  • Social representations of motherhood elaborated by pregnant and lactating women who experienced pregnancy deprived of liberty in the prison system.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • DULCIAN MEDEIROS DE AZEVEDO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JAIME ALONSO CARAVACA-MORERA
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • Data: Dec 4, 2019


  • Show Abstract
  • Introduction: The gestational period during the deprivation of liberty in the prison system, as well as lactation, are delicate, complex and marginalized processes, attacking the best experience of motherhood. The experience of the gestational process in the prison environment enables interactions that rework the senses and symbolic world of these women. Objective: To analyze the social representations of motherhood among pregnant and lactating women who experienced pregnancy deprived of liberty in the prison system. Method: This is a qualitative study, anchored in the assumptions of the Theoretical Paradigm of Social Representations in the structural aspect, conducted with 42 pregnant women, lactating women who experienced pregnancy deprived of freedom in the prison system of the state of Rio Grande do Norte. From May to September 2019. For data collection, we used a sociodemographic questionnaire, thematic drawing-story and the free word evocation technique associated with the substitution and decontextualization model (mute zone), with the term inductor. “Being a mother in prison”. Data were analyzed by prototypic processing (four-box table) for each matrix, for which intermediate frequencies (± 8.37 matrix 1 and ± 8.10 matrix 2) and mean evocation orders (matrix) were automatically calculated. 1: ± 3.08; matrix 2: ± 3.01) according to requirements. Thus, it composed the central nuclei, the peripheries and the contrast zones. The words composition and co-occurrence test (similarity analysis) was also performed. The analytical processing was carried out using the Software interface for Multidimensional Analysis of Textes and Questionnaires (IRAMUTEQ), version 7 alpha 2. The research was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under CAAE. : 08005219.7.0000.5537. Results: Most participants were between 18 and 28 years old (n = 20; 47.62%); were single (n = 20; 47.62%). They had two or more pregnancies (n = 38; 90.47%) and reported one or more miscarriages (n = 21; 50%). In the prototypic analysis, it was found that the term inductor resulted in 420 evocations and 133 distinct words. After categorization and lemmatization, the number of different words evoked by women were 84 between matrix 1 and 2. Excluding the evocations with frequency less than three, resulted in a use of 31.15%. In matrix 1, the possible representation of being a mother in prison crystallized, principally and semantically, by the terms: separation (f = 27; OME: 2.9), sadness (f = 18; OME: 2.3), horrible (f = 16; OME: 2.1), pain (f = 12; OME: 2.8). In the substitution and decontextualization zone (matrix 2), the representations were objectified by the terms separation (f = 18; OME: 3), sadness (f = 13; OME: 2.5), fear (f = 11; OME: 2.2), horrible (f = 10; OME: 1.5). Thus, the only representational difference between the two cores was the change of the word pain for fear in matrix 2, maintaining the crystallization between the two frames with respect to the first square of the frame. In the similarity analysis, the central nucleus, composed by the term “separation”, had a strong co-occurrence with the words: “suffering (11), distant (4), abandoned (3), horrible (9), adoption (4) and sadness (8)”. Final considerations: Experiencing motherhood in the prison system, whether pregnant or lactating, represents for women a set of meanings and meanings, which are attributed from institutional norms and prison laws that weaken the mother-child dyad and potentiate the mother. female imprisonment, meaning for these women, essentially, suffering for the dichotomy of the bond with the child.

12
  • MARILIA SOUTO DE ARAUJO
  • Conformity, satisfaction and self-confidence of face from infirmary simulation.

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • EDILMA DE OLIVEIRA COSTA
  • RAPHAEL RANIERE DE OLIVEIRA COSTA
  • SORAYA MARIA DE MEDEIROS
  • VERÔNICA RITA DIAS COUTINHO
  • Data: Dec 6, 2019


  • Show Abstract
  • The objective of this study was to analyze the knowledge, satisfaction and self-confidence of nursing technical students from the use of simulation in basic life support teaching in the context of Primary Health Care. This is a longitudinal intervention study. and quantitative approach. The quasi-experimental design of a non-equivalent pre-test and post-test control group was used through a non-probabilistic convenience sampling. The study was carried out at the School of Health of the Federal University of Rio Grande do Norte with 46 students of the technical nursing program of that institution. The assessment of knowledge, satisfaction and self-confidence in learning and self-confidence to act in emergency situations, validated, were applied in three moments: pretest, immediate posttest and secondary posttest (after 30 days). The control group participated in the theoretical-practical course of Basic Life Support with emphasis on Primary Health Care with the following methodological strategies: lecture and demonstration of skills. The experimental group participated in the same course, however, with the following strategies: lecture plus clinical simulation. To perform the simulation, the NLN / Jeffries Simulation conceptual model for nursing teaching was followed. The study included 46 students, predominantly female (69.6%), aged 16 to 25 years (63%), who had never studied basic life support in the technical course (76.9%) and without professional experience in health (100%). Regarding the comparison of the level of knowledge, it was found that, at the 5% level of significance, there was a statistical difference between the medians of the control and experimental group in post-test 2, thus, students in the experimental group retained more knowledge than students. of the control group. In addition, the students in the experimental group maintained higher levels of self-confidence for emergency work, with a difference in post-tests 1 and 2. In this respect, female students had higher levels of self-confidence for emergency work when compared to those of the male. Regarding satisfaction and self-confidence in applied learning for students in the experimental group after the use of simulation, there is a predominance of students who are strongly satisfied and self-confident with learning after participating in the clinical simulation. Thus, learning from the clinical simulation methodology gave higher scores of knowledge, satisfaction and self-confidence, compared to those acquired through lectures with demonstration of skills.

13
  • MARINA MARISA PALHANO DOS SANTOS
  • Peer education in the prevention of human immunodeficiency virus in adolescents: a systematic review

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ELIÃ PINHEIRO BOTELHO
  • ALEXSANDRA RODRIGUES FEIJAO
  • ERIKA SIMONE GALVAO PINTO
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • Data: Dec 9, 2019


  • Show Abstract
  •       As a refined methodology for health education, peer education has been delineated as a significant form of prevention and health promotion in adolescents, an age group that has gained prominence in the face of the global epidemic of the human immunodeficiency virus. Aim: To evaluate the scientific evidence on peer education in the prevention of immunodeficiency virus in adolescents. Method: This is a systematic review with the PICO strategy research question: Can peer education produce health-related behavioral changes when used as a prevention method for human immunodeficiency virus in adolescents? The search was performed on the Elsevier, PubMed Central, PubMed, DART-Europe, Web of Science, Capes Thesis and Dissertation Catalog, RCAAP, LILACS, Scopus, Scielo, Open Access Thesis and Dissertations (OATD), Cyberthesis, DART- Europe, Ethos, New Zealand theses by crossing the indexed descriptors 1.peer influence, 2.peer group, 3.health educativon, 4.peer education (1 OR 2 OR 3 OR 4) 4.adolescent, 5.adolescence, 6.youth (4 OR 5 OR 6) 7.acquired immunodeficiency syndrome, 8.HIV (8 AND 9) 9.primary prevention, 10.school-based prevention (9 OR 10). The method design was developed based on the guidelines defined by the Cochrane Handbook (2011) and the instrument The PRISMA Statement (PRISMA). All comparative study designs will be included in the review, including clinical trials, pretest / posttest, cohort, case-control and cross-sectional studies. Of the 6,142 studies found, after the first selection of reading titles and abstracts, excluding duplicates, the sample consisted of 11 articles. Studies were evaluated from 2000 onwards. ROBIS: A Risk of Bias Assessment Tool for Systematic Reviews was used for risk assessment of bias. This review was submitted to registration in the PROSPERO database under the identifier 150530. Results: Data from 11 studies were analyzed for behavioral and non-behavioral outcomes. Concerning the former, peer education had a positive impact on reducing risk attitudes (63%), self-efficacy against condom use (18.1%), intention to refuse unprotected sex (9%), intention to use condoms (90%) and condom use (90%). Non-behavioral aspects include effective results for elements such as knowledge related to sexual health (81.8%), conversation and sharing of knowledge with friends / colleagues about the use of preventive methods. Behavioral changes were also found to be more pronounced soon after the intervention than at follow-up months. Conclusion: Peer education represents a new genre of promotion and prevention that promotes individual and community health behavior changes that can maintain long-term modified habits.

14
  • BRUNA RODRIGUES MONTEIRO
  • Intervening factors in skin-to-skin contact between mother and baby in the first hour after normal delivery

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • ANA BEATRIZ DE ALMEIDA MEDEIROS MOURA
  • ANA LÚCIA DE MEDEIROS CABRAL
  • ERIKA SIMONE GALVAO PINTO
  • NILBA LIMA DE SOUZA
  • Data: Dec 17, 2019


  • Show Abstract
  • Skin-to-skin contact between the mother and the baby after normal delivery is sometimes considered fragmented; especially when there are factors that are involved in the implementation of good obstetric practices, which forms gaps between what is recommended by the World Health Organization, the Ministry of Health and what is implemented in social reality. In this scenario, this study aimed to analyze the factors that interfere with skin-to-skin contact between mother and baby in the first hour after normal delivery. This is a cross-sectional observational study with a quantitative approach. The research was conducted at the Leide Morais Maternity Hospital and the Ana Bezerra University Hospital, both references in the usual risk delivery in the state of Rio Grande do Norte. The sample consisted of 105 parturients admitted to the preparatory, childbirth and postpartum sector with the following eligibility criteria: gestational age > 37 weeks; pregnant women at normal risk who were on the verge of normal birth. Data collection is carried out from May to July 2019, through a structured instrument based on scientific literature and ministerial recommendations, with a total of 36 questions. For the analysis, the data were entered into a database and analyzed quantitatively using descriptive and inferential statistics using the Statistical Package for Social Sciences version 20.0. The level of significance adopted was 5% with a 95% confidence interval. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte with the opinion number 3,187.28. It was identified that of the 63 deliveries observed in the maternity of Leide Morais and the 42 deliveries observed in Ana Bezerra at the beginning of the contact the immediate treatment was favored by obstetrics 62 (59%) and interrupted by pediatrics 85 (80%). Regarding the factors responsible for the delay in skin-to-skin contact, 6.6% (7) of newborns experienced complications, while 5.7% (6) underwent neonatal procedures before contact, and maternal factors were absent during this period. While the factors responsible for the interruption of skin-to-skin contact were observed in 67.6% (71) of neonatal procedures, followed by 15.2% neonatal complications (16). At follow-up, it was found that contact occurred immediately after normal delivery in 87.6% (92) of the cases, however, only three newborns (2.8%) experienced golden hour and greater durability of skin-to-skin contact. Between one and five minutes of life of the newborn was recorded in 82.8% (87) of deliveries. The study allowed the identification of factors that intervene in the skin-to-skin contact between the mother and the baby, both in terms of delay, durability and interruption, which allows proposals for the reduction of non-recommended procedures and no scientific evidence on the delivery observed in the present study.

15
  • LORENA FERNANDA SILVA DE OLIVEIRA NUNES
  •  Construction of an educational technology on bladder catheterization for nursing
  • Advisor : CECILIA NOGUEIRA VALENCA
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • SORAYA MARIA DE MEDEIROS
  • ROSANGELA DINIZ CAVALCANTE
  • Data: Dec 17, 2019


  • Show Abstract
  •        The advent of new Communication and Information Technologies establishes the emergence of educational strategies consistent with the current transformations, presenting impacts on the world of work, a productive scenario for the realization of educational practices. The distance education offered by Virtual Learning Environments is a relevant educational strategy for the Permanent Education of the nursing team, as it allows for time flexibility, the transposition of geographical barriers and the opportunity for digital inclusion. Thus, the proposal of building an educational technology on bladder catheterization for the qualification of the nursing team, based on the gap identified in a public health service, emerged. The study aims to describe the construction of a distance course on bladder catheterization for nursing. This is a methodological study for the construction of a technology-mediated educational instrument, developed according to the methodological framework of Pasquali Psychometry. The study is in line with the ethical precepts established by the National Health Council and was approved by the opinion of the Research Ethics Committee, nº 3.187.303, CAAE: 08005519.6.0000.5537. The construction of the distance learning course proved to be a challenging experience, since it was sought to develop it with high methodological rigor, considering the constructivist perspectives of education, such as problematization and meaningful learning. Given the use of educational technologies in continuing education, it is concluded that the study may contribute to improve nursing care, aiming at patient safety. The validation of educational technology is suggested later.

16
  • JULIANE RANGEL DANTAS
  • Accuracy of nursing diagnosis Ineffective airway clearance in patients admitted to intensive care units

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • HELEN CRISTINY TEODORO COUTO RIBEIRO
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • Data: Dec 20, 2019


  • Show Abstract
  •         The nursing diagnosis Airway clearance is common in critically ill patients admitted to the intensive care unit. The adequate inference of this diagnosis becomes necessary to provide more qualified nursing care. Thus, the present study aims to analyze the accuracy measures of clinical tests to diagnose airway clearance in adult patients admitted to intensive care units. Cross-sectional diagnostic accuracy study. One sample consisted of 104 critically ill patients, who were selected by convenience, consecutively trained in a university hospital in northeastern Brazil. The data collection instrument was a structured script of interview and physical examination, applied from June to October 2019. An accuracy of the clinical indicators of the associated diagnostic test through latent class analysis. The study was approved by the Research Ethics Committee of the responsible institution, under opinion number 3,241,219 and Certificate of Presentation for Ethical Appraisal 09901619.0.0000.5537. The results indicate a prevalence of 36.54% of the diagnosis Airway clearance in the investigated clientele. Clinical indicators applicable to the diagnosis were: Change in respiratory rate; Change in breathing pattern; Absence of cough; Orthopnea; Adventitious noises and decreased breathing sounds. The indicators used were: Change in respiratory rate and Change in breathing pattern. It can be concluded that the clinical indicators Respiratory Changes and Respiratory Pattern Changes show better precision measures for nursing diagnosis inference. Airway clearance in adult patients admitted to intensive care units. Moreover, the results contributed to the process of accurate diagnostic inference of the nurse until the end of improving nursing care to sick patients.

17
  • CARLOS JORDAO DE ASSIS SILVA
  • Human responses, culture, and self-care of indigenous elders: a mixed methods study.

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • REJANE MARIA PAIVA DE MENEZES
  • LUCIANE PAULA BATISTA ARAUJO DE OLIVEIRA
  • MÔNICA CRISTINA RIBEIRO ALEXANDRE D'AURIA DE LIMA
  • ANA ANGELICA REGO DE QUEIROZ
  • JOSÉ LUÍS GUEDES DOS SANTOS
  • Data: Dec 20, 2019


  • Show Abstract
  •           BACKGROUND: The human aging process is a worldwide phenomenon and also exists among indigenous people, however, in Brazil, information about the health conditions and self-care culture of indigenous elderly people is still scarce and fragmented. Researching about the human responses and the self-care culture in this population is needed as it enables a qualified, systematized and culturally congruent nursing care. OBJECTIVE: To analyze human responses in nursing and the self-care culture of indigenous elderly. METHOD: This is an exploratory and descriptive study with a mixed method approach, of convergent parallel type. Quantitative and qualitative data were collected concurrently, with equal weighting for both data. Data integration was performed, in which the results of quantitative and qualitative data were mixed and produced mutually supported information. Finally, Leininger's Theory of Culture Care Diversity and Universality was used, which is the theoretical perspective that conducted this research. The study population consisted of indigenous people of Potyguara ethnicity, living in the indigenous community of Amarelão, João Câmara, Rio Grande do Norte. In the quantitative approach, a Nursing Consultation with 51 participants was held, and in the qualitative approach phase, a semi-structured interview with 17 indigenous elderly was performed in August 2019. Data obtained from the Nursing Consultation were analyzed following two steps: phase I - data analysis and synthesis; phase II - establishment of nursing diagnoses using the North American Nursing Diagnosis Association Internacional (2018-2020). Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) program. Absolute and relative frequencies were used and Fisher's Q-Square and Exact Test were applied. Qualitative data were analyzed from thematic content analysis. The research was submitted to the Ethics and Research Committee of the Federal University of Rio Grande do Norte and the National Research Ethics Committee under the CAAE: 07990219.7.0000.5537, being approved by the opinion nº. 3,475,904. RESULTS: Regarding nursing diagnoses, 38 were identified, being the prevalent ones: Impaired dentition (98.0%), Risk of impaired skin integrity (66.7%), Chronic pain (64.7%), Risk of deficient fluid volume (54.9%), Impaired Swallowing (45.1%), Impaired Ambulation (45.1%), Sleep Pattern Disorder (43.1%), Stress Urinary Incontinence (41.2%), Discus falls (35.3%) and sexual dysfunction (33.3%). Concerning the qualitative data, three thematic categories were identified: 1) Meaning of health in the conception of indigenous elderly; 2) Indigenous experience of becoming ill and 3) Indigenous self-care practices. CONCLUSION: Based on the convergences and combinations of qualitative and quantitative results, the human responses most present in the indigenous elderly are those resulting from factors leads to decrease in their functionality and independence, corroborated by the participants' statements. Regarding self-rated health, reported problems relate to limiting conditions that also interfere with the performance of daily activities. Regarding self-care practices, the use of medicinal plants for disease prevention and treatment was evidenced, as well as the performance of domestic activities, manual labor and autonomy in problem solving, as ways of obtaining health, which is, an active aging. However, the medicalization is still present in this unique ethnic health-disease process, shown in the statements of the elderly, when citing the dependence on the use of drugs, including psychotropic drugs. This finding is also evidenced by quantitative data, which points to necessary reflections on the abusive use, self-medication and indiscriminate prescription of drugs for this population. The quantitative data also revealed a low presence of preventive practices adopted by the group, which makes evident the influence of the medical-curative model absorbed in the self-care practices of this population, as a result of contact with non-indigenous society through health services.

18
  • SÉRGIO BALBINO DA SILVA
  • Evaluation of Mycobacterium tuberculosis infection Control Measures in Primary Health Care in Natal/RN

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • ALINE ALE BERALDO
  • ANA ANGELICA REGO DE QUEIROZ
  • ERIKA SIMONE GALVAO PINTO
  • NILBA LIMA DE SOUZA
  • Data: Dec 20, 2019


  • Show Abstract
  •        Tuberculosis remains a public health problem throughout human history. For effective coping strategies and improvement of the results, infection control measures are needed to be used by Primary Health Care in its’ services. Aim: to evaluate the infection control measures for Mycobacterium tuberculosis in Primary Health Care, in Natal, Rio Grande do Norte. Method: this is a normative evaluative research, of quantitative approach, with emphasis on the degree of implementation of control measures. The methodological reference used was the health evaluation model by Avenis Donabedian. The final sample was composed by 235 professionals and 22 Basic Health Units, distributed equally among the professional categories (doctors, nurses and nursing technicians). The sampling process used was stratification, in order to obtain data representativeness, thus the sample was proportionally distributed throughout basic health units in each health district. Data collection took place between April and July 2019 through a questionnaire consisting of 49 questions, developed by the Manual of Recommendations for Tuberculosis Control in Brazil (2018) which divides the infection control measures of tuberculosis in: administrative, environmental and individual or professional protection. Data were organized and analyzed using the IBM Statistical Package for Social Science, version 22.0. To identify the degree of implementation of the actions, 46 criteria were listed, and the percentage of responses were distributed into four classifications: Not implemented (from 0% to 25%); Incipient (from 26% to 50%); Partially implemented (from 51% to 75%); Implemented (76% to 100%). The study followed the Resolution 466 of 2012 of the National Health Council and was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, through Opinion 3.250.817 and Certificate of Presentation for Ethical Appreciation 08005818.6.0000.5537. Results: the development of the logical model funded the evaluation process and provided compression of the disease control actions, through the assessment (Structure-Process). Of the 235 selected professionals, 184 composed the final sample. The reasons for not including the remaining number of professionals in the study were: (31) professional refusal and absent during the data collection period (20). The study found that the degree of implementation of actions related to infection control measures of Mycobacterium tuberculosis in Primary Health Care services, in Natal / RN was incipient (49.5 %). The structure and process dimensions were classified as partially implanted (38.36%) and incipient (10.88%), respectively. Regarding Structure, the sub-dimensions related to environmental measures were evaluated as non-implanted (0.76%), followed by management measures whose degree was partially implanted (25, 82%) and, lastly, the individual respiratory protection measures. as partially implanted (11.78%). Regarding the process dimension, the sub-dimension related to the management measures analyzed presented incipient implantation (10.88%). Conclusion: The construction of the logical model provided comprehension about the relation to disease infection control measures and provided subsidies to foster the evaluation process. In addition, the infection control actions of Mycobacterium tuberculosis in the city of Natal were classified as incipient. Thus, there is a need for coordination between management and professionals in the implementation of actions in health services.

Thesis
1
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • Construction and validation of nursing diagnosis Ocular dryness in adult patients hospitalized in an intensive care unit

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • FABIANE ROCHA BOTARELI
  • KALYANE KELLY DUARTE DE OLIVEIRA
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Feb 1, 2019


  • Show Abstract
  •  

    This study aimed to construct and validate the nursing diagnosis Ocular dryness in adult patients hospitalized in an intensive care unit (ICU). This is a methodological research of validation of nursing diagnosis developed in three interrelated stages, namely: STAGE 1: Construction of the nursing diagnosis Ocular dryness in adult patients hospitalized in an ICU and construction of the definitions, based on the concept analysis framework and operationalized through Scoping Review. STAGE 2: Analysis of diagnostic content, in which the evaluators judged the adequacy of previously created concepts, through focus group. STAGE 3: Clinical validation of nursing diagnosis Ocular dryness in adult patients hospitalized in an ICU, performed by means of a study of the accuracy of clinical indicators of nursing diagnosis Ocular dryness, with a cross-sectional design and quantitative approach, performed with 206 patients hospitalized in an ICU of adults of a university hospital located in the Brazilian northeast. The data collected was organized and stored in a database built in Microsoft Office Excel 2016 and analyzed by a specific statistical program. The study obtained a favorable opinion from the Research Ethics Committee under number 918.510 and CAAE 36079814.6.0000.5537. The recommendations of Resolution nº 466/12, approved by the National Health Council of the Ministry of Health, on December 12, 2012, were obeyed. In the first stage, 169 articles were selected and two attributes, 32 antecedents and 12 consequent ones were identified. In the second stage, after discussion in the focus group, the judges obtained a consensus regarding the adequacy of each component and definition of the diagnosis. We defined 14 defining characteristics, nine related factors, two populations at risk and 22 associated conditions. In the third stage, was verified using the latent class model the prevalence of nursing diagnosis Ocular dryness in 76.22% of the sample. The clinical indicators decreased lacrimal volume and excess mucoid secretion presented high values of specificity. In addition, dilated blood vessels on the ocular surface, excess mucoid secretion, mucoid filament and chemosis presented higher values for sensitivity. It is concluded that the data obtained can contribute to a better understanding of the manifestation of the diagnosis in adults hospitalized in an ICU, as well as the most important signs for inference of Ocular dryness. Thus, the nursing diagnosis Ocular dryness is valid in adult patients admitted to the ICU.

2
  • SUZANE GOMES DE MEDEIROS
  • Assessment of safety in the use of vaccines in primary health care

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • KISNA YASMIN ANDRADE ALVES
  • MARCOS ANTONIO FERREIRA JUNIOR
  • PATRÍCIA PERES DE OLIVEIRA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Mar 1, 2019


  • Show Abstract
  • The importance of safety in Primary Health Care services raises the need for studies on adverse events arising from medication errors, especially vaccines, which are frequently used at these sites. Therefore, the objective was to evaluate the safety of nursing care in the use of vaccines in primary health care. Methodological research, with a quantitative approach, divided into the following stages: 1) literature review - through national and international materials, ministerial manuals, laws, decrees, updated scientific articles, among others; 2) elaboration of a graphic protocol for the evaluation of safe nursing care in the use of vaccines in primary health care; 3) validation of content and appearance of the graphical protocol - which counted on the participation of twelve judges in Delphi 1 and eight in Delphi 2, with the completion of an electronic form made available by Google Forms. The relevance analysis of these items was by the Content Validity Coefficient (CVC) ≥ 0.78; 4) evaluation of vaccination rooms - occurred by the graphic protocol previously validated in its content and appearance, in 13 Health Units of the Family of Natal / RN / Brazil. The protocol was used in person, through the technique of non-participant observation, by two evaluators. The data collection period was from November 2016 to August 2018. The analysis of the data regarding the evaluation of the vaccination rooms was carried out using the instructions of the protocol itself and the Kappa coefficient, in order to demonstrate inter-observer reliability. All the steps of the research followed the ethical precepts with approval under Certificate of Presentation and Ethical Appraisal (CAAE) nº 59962316.8.0000.5537. The valid protocol in its content and appearance reached General Content Validity Coefficient (0.83) in Delphi 2. This value demonstrates that the instrument has reliability and reliability, with a recommendation of 75% of the judges for the application of the instrument in the practice of health services. The results and discussion are organized into four topics: patient safety in primary care, which identified a variety of patient safety actions at this level of attention, with emphasis on the importance of improving safety culture in primary care , using appropriate instruments to assess the safety culture in this context; the role of the nursing team in vaccine care, which allowed the listing of important aspects for the actions in the vaccine room, with emphasis on the need for professional training and supervision by the nurse. In the third topic, construction and validation of content and appearance of the graphic protocol, the evaluation of the judges considered valid the items of the instrument, with recommendation of its use in the primary care services. The fourth, safety assessment of nursing care in the vaccine rooms, identified unsafe care in seven investigated settings and partially safe care in five vaccine rooms. These results point out that nursing care with vaccines in Primary Health Care in the city of Natal presents fragilities capable of compromising patient safety. Thus, the periodic evaluation of the vaccine environments is necessary to detect factors that can affect the proper conservation of vaccines and their potency and efficacy, with damages to the health of the population. Thus, it is emphasized the importance of training and sensitization of the vaccinators to act according to the recommended norms, and the implementation of improvement cycles to qualify the services. It is also worth noting that further research in this area will be deepened to consolidate safe nursing practices in all vaccine contexts and to implement the public policies that involve the national immunization program.

     

3
  • MAYARA LIMA BARBOSA
  • CONSTRUCTION AND VALIDATION OF A VIRTUAL LEARNING OBJECT TO SUPPORT PENITENTIARY HEALTH EDUCATION. 

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ANA LUISA PETERSEN COGO
  • GABRIELA MARIA CAVALCANTI COSTA
  • MARCOS ANTONIO FERREIRA JUNIOR
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Jun 19, 2019


  • Show Abstract
  • This study aims to build and validate a Virtual Learning Object to support teaching on prison health. It is a methodological study, with a quantitative approach, developed from June / 2017 to March / 2019, whose stages followed the model proposed by Pasquali: theoretical, empirical and analytical procedures. Theoretical procedures included the identification of the contents that comprised the Virtual Learning Object, based on interviews with the health professionals of the Prison Basic Attention Teams and a scoping review. For the construction of hypermedia was considered the Pasquali reference for content elaboration, the organization followed the principles of Significant Learning Theory and the concepts of Instructional Design (ADDIE model). In the empirical procedures the content validation stages were carried out, in which the frame proposed by Pasquali, using the Delphi technique, was also adopted. This stage was carried out with experts through electronic form (Google forms), for the selection of the judges the criteria of eligibility proposed by Fehring were adopted. In the analytical procedures the analyzes were carried out regarding the agreement and the Content Validity Coefficient. The usability assessment was performed with nursing students, using the System Usability Scale and, in a complementary way, the Suitability Assessment of Materials, to measure the adequacy of educational material to the target audience. The ethical determinations present in Resolution 466/2012 of the National Health Council were respected, so a study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under CAAE 62825716.8.000.5537. From the interviews with the health professionals and the results of the scope review, the work process developed and the assistance practices carried out by the prison staff and the health condition of the persons deprived of their liberty are revealed. This information resulted in the structuring of the Virtual Object of Learning in seven screens, namely: presentation, concepts, legal apparatus, penitentiary system, work process, publications and final provisions / credits. The screens presented information regarding its theme, interactive text, reading suggestion for deepening and exercise. After the construction, content validation followed, in which 11 and 8 judges participated in the first and second rounds, respectively. After the first round of Delphi, the Virtual Object was reformulated and submitted to Delphi 2, where the agreement was 97.6% and Content Validity Coefficient equal to 1. In this study, the usability evaluation with the System Usability Scale obtained an average of 82.9 and Suitability Assessment of Materials of 88.36%. The Virtual Learning Object - Penitentiary Health had its content validated and the usability assessment satisfactory. In this sense, the future availability of educational material can foster and contribute to the teaching of prison health among health students.

4
  • AMANDA JÉSSICA GOMES DE SOUZA
  • Scale of adaptation to the care of the venous ulcer based on the roy model: construction and validation

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • DANIELE VIEIRA DANTAS
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • MIRIAN ALVES DA SILVA
  • Data: Jun 19, 2019


  • Show Abstract
  • Methodological study, with the objective of constructing and validating a scale to measure the level of adaptation to venous ulcer care based on the Roy Adaptation Model. The research took place in two stages: definition and operationalization of the constructs, and theoretical and semantic analysis. In the first step, the scale items were constructed from the Roy Adaptation Model, two integrative reviews of the literature and the interview to people with venous ulcer. In the second stage, 24 judges were selected to judge the adequacy of the items, which underwent a grammatical lexical correction, and a pilot test was then carried out with 11 people with venous ulcer to evaluate the comprehension of the items. This stage was completed with a new submission to the judges. The theoretical validation process of the instrument followed the Pasquali reference and adopted the Delphi technique for its operationalization. The item with a Content Validity Index (CVI) ≥ 0.9 was considered valid. The present study obtained a favorable opinion from the Research Ethics Committee of the Federal University of Rio Grande do Norte, through CAAE nº 65941417.8.0000.5537 and 65941817.1.0000.5537. The first step resulted in the construction of the preliminary items of the instrument, with a total of 76 items divided into Roy's four adaptive modes, 28 items in the physiological mode, 16 in the self-concept mode, 21 in the role function mode and 11 in the interdependence mode. In the second stage, 14 judges participated in the Delphi 1 round. The percentage of items that presented IVC≥ 0.9, in each mode were: physiological 78%; self-concept 81.2%; real-life function 61.9%; and 100% interdependence. At the end of this stage, 17 intes were removed from the instrument, 11 were unified and 3 were relocated within the modes. After the lexical and grammatical correction, the scale was submitted to the pilot test and presented IVC≥ 0.9 in all items, except for one item that presented IVC≥ 0.8 but was not withdrawn but modified. Finally, the Delphi 2 round was performed with participation of 12 judges and the scale reached consensus with IVC≥ 0.9 in all items. The scale of adaptation to care with venous ulcer with theoretical validity is presented - IVC = 0.98, with 48 items in total, being 17 in the physiological mode, 14 in the self-concept mode, 4 in the real-life function mode and 5 in the interdependence mode. It is concluded that the Scale of adaptation to the care with venous ulcer has theoretical validity.

5
  • JESSICA DANTAS DE SA TINOCO
  • Efficacy of Virtual Clinical Simulation on Nursing Diagnostic Reasoning in Adult Health. 

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • HELEN CRISTINY TEODORO COUTO RIBEIRO
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • Data: Jun 21, 2019


  • Show Abstract
  • Methodological study, with the aim to evaluate the efficacy of virtual clinical simulation, grounded on problem based learning, as an educational strategy for the Nursing diagnosis reasoning in adult health. The study was developed in four stages, namely: construction of the scenarios for virtual clinical simulation on diagnostic reasoning; content analysis of scenarios by specialists; development of the virtual learning object for clinical simulation; and application of virtual clinical simulation with undergraduate students in Nursing. The creation of the simulated scenarios was based on the literature, through diagnostic validation studies. The scenarios were analyzed by 22 experts in diagnostic reasoning and / or clinical simulation. The third stage allowed to allocate the scenarios in the virtual clinical simulation. After the final engineering, the virtual object was submitted to the test of its usability next to a team composed by eight students of Nursing and nurses. In the last step, the virtual clinical simulation strategy was tested by an experimental study with undergraduate students of the Nursing undergraduate course at a public university in Northeast Brazil. The students were randomized into the intervention and control groups. The intervention group was submitted to virtual clinical simulation and evaluated the quality of the virtual learning object. Data were analyzed using descriptive and inferential statistics. The project was approved by the research ethics committee, with favorable opinion nº 2.171.393. The results show that the simulated clinical scenarios were created by the responsible researcher, who were later judged by the specialists as relevant (CVI equal to or greater than 0.85). All the proposed diagnoses presented a high degree of accuracy, with an acceptable measurement for CVI and Kappa index. As a third step, the virtual learning object was developed. It presented good usability (final score of 87.81). In the experimental stage, the comparison of the intervention and control groups for diagnostic inference showed a significant increase in the number of correct answers for diagnostic inference (p = 0.008) and identification of related factors (p = 0.031) at the post-test stage of the intervention group. The prioritization of the diagnoses showed a statistically significant difference when the pre- and post-test moments (p = 0.08) were compared in the intervention group, as well as when the intervention and control groups were compared (p = 0.014). There was a greater difference in performance between the pre- and post-test in the scores of the students who participated in the intervention (p = 0.003). In addition, the virtual object obtained a high average quality score (4,66). Thus, it is concluded that the virtual clinical simulation grounded on problem-based learning was presented as an effective educational strategy for the nursing diagnosis reasoning in adult health. Moreover, the educational technology developed was attractive and favored the active and meaningful learning of the student.

6
  • FRANCISCA MARTA DE LIMA COSTA SOUZA
  • APPLICATION FOR MOBILE DEVICE AS  TOOL FOR ACCESSION OF PREGNANT TO PREGNANT

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • FATIMA RAQUEL ROSADO MORAIS
  • LEILA DE CASSIA TAVARES DA FONSECA
  • MARIA ALZETE DE LIMA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Jun 28, 2019


  • Show Abstract
  • This is an experimental technological development study, followed by a randomized controlled trial, with the general objective of evaluating the use of a mobile application for smartphone as a tool in adherence to prenatal consultations and the following specific objectives: to develop a mobile application for smatphone as a tool in adhering to prenatal consultations; validate the mobile application for smartphones by judges in the area of women's health and information and communication technology; evaluate the effectiveness of the mobile application for smartphone in the adhesion prenatal consultations. The research will be conducted at the Basic Health Unit Armando Álvares Padilha in the municipality of Parnamirim, located in the state of Rio Grande do Norte. To achieve the proposed objectives, the study will be developed in three phases. First, we present the data related to the application development, according to the validation of the application by judges and later, the evaluation of the application in the adhesion to the prenatal consultations. The study will include 46 pregnant women registered in this unit and 10 judges. In compliance with Resolution 466/12, of the National Health Council, which guides research on human beings, the project was submitted and approved by the Research Ethics Committee of Federal University of Rio Grande do Norte under protocol CAAE no: 76787917.0.0000.5537 and Opinion no 2.356.769. It is believed that the use of technology can facilitate the approximation of pregnant women to the team of the Family Health Strategy, as well as health professionals, to the data that contribute to health indicators, since it is a further monitoring instrument, evaluation and possible improvement in the reduction of maternal and child deaths. The technological product will also be a support for pregnant women in order to facilitate access to information in any geographical environment. In the light of the above, the research presents a great relevance to the health area, specific to nursing, which acts directly with pregnant women in the prenatal period, allowing to know new models of prenatal technologies, and to evaluate their effectiveness in the adherence of these pregnant women to. With this, it is expected to improve the rate of prenatal care and to reduce maternal-neonatal morbidity and mortality associated with poorer behaviors in pregnancy. In addition to arousing the interest of nursing by the use and elaboration of technologies in the promotion of care.

7
  • CECILIA OLIVIA PARAGUAI DE OLIVEIRA SARAIVA
  • EVALUATION OF NURSING SAFE CARE IN NEONATAL INTENSIVE CARE UNITS.

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • HELEN CRISTINY TEODORO COUTO RIBEIRO
  • NILBA LIMA DE SOUZA
  • QUENIA CAMILLE SOARES MARTINS
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • WILIAM WEGNER
  • Data: Sep 25, 2019


  • Show Abstract
  • The objective of this study was to evaluate safe nursing care in neonatal intensive care units. Evaluative research with quantitative approach, conducted in six hospitals in the metropolitan region of Natal / RN / Brazil. The study was subdivided into three methodological steps: 1) identification and mapping of Patient Safety in the Neonatal Intensive Care Unit, based on a scoping review; 2) elaboration of a safe care evaluation instrument, with subsequent validation of content and appearance; 3) evaluation of safe nursing care through a quasi-experimental, before-after study, with intervention. In step 1, a scoping review was performed in order to list the essential elements for safe nursing care. The construction of the assessment instrument (graphic protocol) of safe care (step 2) was based on the triad structure-process-result, with adaptations for neonatal care, supported by scoping review data. To validate the content and appearance of the graphic protocol, nurse judges were enrolled from a Lattes Platform search according to previously established inclusion criteria. The Delphi technique was used, divided into two steps (Delphi 1 and 2) and the validation process took place through an electronic form in Google forms. The relevance of the items was judged by the result of the Content Validation Coefficient. In step 3, for the measurement of safe care, a previously validated pre- and post-test instrument was used, interspersed with an intervention in the neonatal units. Data collection of this stage occurred from January to July 2019 through the non-participant observation of two trained evaluators and without interaction between them. The results were analyzed by descriptive statistics, thus the care classification was performed from the score listed in the graphic protocol. The Kappa coefficient was measured to assess interobserver agreement. All ethical precepts were respected and the project received approval from the Research Ethics Committee of the Federal University of Rio Grande do Norte, issued CAEE No. 64879717.4.0000.5537.Scoping review resulted in a total of 87 scientific productions, whose themes were subdivided into : Adverse Event Investigation (49; 56.3%) and Safe Practice Assessment / implementation (38; 43.7%). The construction of the protocol was based on these results. A structured checklist script was elaborated, consisting of ten items and 111 sub-items about the elements "structure, process and result". The protocol was considered valid for content, with Content Validity Coefficient of 0.97 in the second Delphi round. The overall estimate of the instrument for appearance validation was 0.99 at Delphi II. In addition, 100% of the judges recommended the use of the protocol after inclusion of suggested changes. In step 3, the process element presented the best compliance percentage, above 50% for all neonatal units. The process element varied so that those services that did not have the active patient safety center had their items considered inadequate (below 50% of compliance) in three services, in the first evaluation. The result element had the highest number of inadequacies (below 50% compliance in three intensive care units). In the metropolitan region of Natal, partially safe care prevailed, evidenced by 83.3% of NICUs with a protocol score between 7 and 13. It is concluded that, in the investigated services, nursing care is partially safe. Moreover, the evaluation, through the graphic protocol, was essential to identify problems that impact the safety of newborns. Similarly, the intervention played an important role in achieving improvements. However, it is necessary that these actions occur continuously to subsidize the practice of nursing professionals in the face of harm reduction.

8
  • ISABELLE CAMPOS DE AZEVEDO
  • FACTORS ASSOCIATED WITH HEMATOPOETIC STEM CELL RETRANSPLANT: A CASE-CONTROL STUDY

  • Advisor : MARCOS ANTONIO FERREIRA JUNIOR
  • COMMITTEE MEMBERS :
  • ELEN FERRAZ TESTON
  • ALLYNE FORTES VITOR
  • MARCOS ANTONIO FERREIRA JUNIOR
  • OLECI PEREIRA FROTA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Oct 31, 2019


  • Show Abstract
  • This research has as object of study the cases of hematopoietic stem cell retransplantation (HSCR) performed in patients previously transplanted in a reference service for this procedure of high complexity in the state of Rio Grande do Norte. In this context, the present study aimed to analyze the factors associated with failure of hematopoietic stem cell transplants (HSCT) in patients undergoing retransplantation in a referral service in the state of Rio Grande do Norte from 2008 to 2018. The study It consisted of a quantitative, case-control, descriptive and analytical research. Data were collected from secondary sources, from the medical records of patients treated by the study service and were analyzed in order to verify the association between clinical and sociodemographic variables and the performance of HSCR among patients undergoing previous transplantation. To calculate the probability of association between the analyzed characteristics and gender, the chi-square trend test, Fisher's exact test and Mann Whitney test were used, according to each case. Bivariate and multivariate analyzes were used to assess the association between the selected variables and to estimate the magnitude of the odds ratio, respectively, using the Statistical Package for Social Sciences version 25.0. The significance level adopted was 0.05. The first part of the study was the construction of an analysis of the concept of HSCR. The Research Protocol was approved in its ethical and methodological aspects by the Research Ethics Committee of the Federal University of Rio Grande do Norte, with approval on April 12, 2019 under opinion 2,596,384 and CAAE: 80927417.9.0000.5537. For the concept analysis, the sample consisted of 31 studies. As a substitute term, “Second Transplant” and the related concept “Secondary Graft” were highlighted. The most frequent attributes, antecedents and consequences were, respectively: only option / form of treatment for graft rejection or failure; graft failure; and increased survival. Of the 84 patients surveyed in the case-control study, 28 (33.33%) were classified as cases and 56 (66.67%) as controls, with a mean age of 34.11, 51 (60.71%) were male, 65 (77.38%) lived in Rio Grande do Norte, 41 (48.81%) were married, 42 (50.00%) received care in the transplant sector for about 21 months, 43 (51, 19%; p <0.001) waited for up to 15 days from the beginning of the conditioning regimen until the first HSCT, the mean time to perform the HSCR was 14.74 months and 42 (50.00%) had a survival of about At 17 months, 35 (41.67%) died and the most prevalent causes were sepsis (28; 33.34%), multiple organ failure (14; 16.67%) and pulmonary infection (8; 9.52 %). Graft versus host disease (OR = 9.17; CI = 95%: 0.97-86.38; p = 0.040) proved to be a risk factor for HSCR. Bile acid is also directly related to HSCR (OR = 16.12; CI = 95%: 2.05-128.12; p = 0.001) and the use of immunosuppressive is a protective factor for HSCT (OR = 4.50; CI = 95%: 1.38-14.69; p = 0.009). The chance of patients with sepsis (OR = 6.03; 95% CI: 1.386-26.205; p = 0.017) using bile acid (OR = 24.32; 95% CI: 2.853-261-608; p = 0.004) and anticoagulant (OR = 3.12; 95% CI: 1.023-10.756; p = 0.046) performing HSCR is higher compared to patients who did not develop sepsis and do not use these medications. The average overall survival (SG) was 26.97 (p <0.001). This study provides relevant scientific evidence regarding risk factors for HSCR and patient survival. Sepsis, GVHD and bile acid are directly related to retransplantation and sociodemographic factors are also related to HSCR.

9
  • ANNA CLÁUDIA FREIRE DE ARAÚJO PATRÍCIO
  • Analysis of the health and disease conditions of homeless people

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • KHIVIA KISS DA SILVA BARBOSA
  • LUIPA MICHELE SILVA
  • MARIA ALZETE DE LIMA
  • MIRELLA ALVES DA CUNHA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Nov 13, 2019


  • Show Abstract
  •         This is a cross-sectional study conducted with 100 homeless people in the city of João Pessoa, Paraíba, with the objective of analyzing the health and disease conditions of homeless people. Data were collected between February and May 2018. For this purpose, a structured interview script, Self-Reporting Questionnaire Scale, Beck Anxiety Scale, Beck Depression Scale, Beck Desperation Scale, Resilience, Hamilton Depression Scale and HIV / AIDS Vulnerability Questionnaire. In addition, rapid tests for HIV, virus, hepatitis B and C were performed. One research was approved by the Ethics Committee on Research on Human Beings of the Federal University of Paraíba, according to opinion number 2456847. Initially, the questionnaire on vulnerability to HIV was validated. HIV, Tuberculosis, and other Sexually Transmitted Infections through Item Response Theory. To verify the influence of variables on the diagnosis of HIV and tuberculosis, perform the Weight of Evidence by measuring the Information Value. The latent class model and confirmatory factor analysis are also used to verify an association of variables with psychological, sociodemographic and behavioral factors. These procedures were performed with the aid of the software SPSS 19.0, Software R and MPLUS. It was found that 79% of respondents have common mental disorders, 37% mild, 29% desperate, 48% low resilience, 69% depression; 74% use drugs, 29% are HIV positive, 5% HIV, 1% hepatitis B, 75% do not use condoms in all sexual relations, 52% have sex with casual partners, 54% have sex with drug users, 71% suffered physical violence. An analysis using the Item Response Theory validated as reliable for measuring vulnerability to HIV, the following items: early diagnosis of STI (F = 0.473), partner with STI symptom (F = 0.518), drug use (F = 0.509), sex for money (F = 0.552), STI symptoms (F = 0.448), amount of sexual partner (F = 0.616), sharpening (F = 0.398) and being a victim of sexual violence (F = 0.347). Factors considered by the Weight of Evidence that influence HIV were: hopelessness, anxiety, time spent living on the street, age, oral sex. For tuberculosis found: hopelessness, resilience, dwelling time on the street, anal and oral sex. We highlight the Latent Class Model for three classes with Akaike Information Criterion of 1828.24, Bayesian Information Criterion of 1989.76, relative entropy of 95.89%, being interpreted as ≤ 30 years, men, single, low resilience, depression, 85% mental disorder, oral, anal and vaginal sex, anxiety symptoms and mild depression. A confirmatory factor analysis found a presence of factors that influence or harm homeless people, such as: sociodemographic, psychic and behavioral, with a Comparative Adjustment Index of 0.986; Tucker-Lewis Index of 0.982; Mean Square Root of Approximation Error Squares 0.022; Mean Square Index 0.075. Conclusion: The study allowed identifying factors that predispose to postponement and that can be inserted in the care provided as homeless people in order to find early factors that favor the postponement, minimizing them and providing the necessary assistance.

10
  • MARCELLY SANTOS COSSI
  • Effectiveness of the virtual learning object about diagnostic reasoning in obstetric nursing.

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • CRISTYANNE SAMARA MIRANDA DE HOLANDA DA NÓBREGA
  • JESSICA DANTAS DE SA TINOCO
  • Data: Nov 29, 2019


  • Show Abstract
  • Experimental study aimed to analyze the effectiveness of a virtual object on obstetric nursing, based on problem-based learning, for the diagnostic reasoning of undergraduate students. The search was performed in four steps: elaboration of the problems used in the virtual learning object; expert content analysis of problems; development of the virtual learning object and application of the virtual object in the experimental group. In the first stage, five problems were elaborated, in the form of clinical cases involving the contents of obstetric nursing. In the second stage, the problem contents were analyzed by 22 specialist nurses. The third step involved the development of the virtual object, which was tested through a usability test in order to identify possible problems. This test was performed by users using technology, who analyzed educational technology through the System Usability Scale. Then, the experiment was performed using the virtual object with undergraduate Nursing students from a public university in the Northeast of Brazil. Students were randomly assigned to intervention and control groups. The intervention group assessed the quality of OVA through the Learning Object Review Instrument 2.0
    instrument. Data were analyzed using descriptive and inferential statistics. The project was approved by the Research Ethics Committee of the institution in charge, under opinion No. 2,155,907 and Certificate of Presentation for Ethical Appraisal 69855917.1.0000.5537. The results showed that the five clinical cases created obtained acceptable agreement among the specialists. The virtual object was developed as a web application, written with HTML, CSS and Java Script language. It obtained excellent usability (SUS 85.5 score) among users. In the experiment, there was a slight improvement in the performance of the intervention group in identifying the indicators of the nursing diagnosis Ineffective breastfeeding, as well as better performance in writing it. Finally, the virtual learning object presented good quality with a high average score (LORI 4.88). Therefore, this strategy was promising and attractive for undergraduate nursing students. It was concluded that there was no difference in performance between the groups, as the application led to similar learning between them. This may be justified by the small sample size. Thus, further studies with larger samples are suggested.

11
  • EMANUELLA DE CASTRO MARCOLINO
  • NURSE'S APPROACH TO CHILDREN IN VIOLENCE: AN ANALYSIS OF THE THREE LEVELS OF HEALTH CARE.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • FRANCISCO DE SALES CLEMENTINO
  • GILSON DE VASCONCELOS TORRES
  • NILBA LIMA DE SOUZA
  • RAFAELLA QUEIROGA SOUTO
  • Data: Dec 6, 2019


  • Show Abstract
  • The objective of this study was to analyze the approach of nurses (a) children and adolescents in situations of violence in the three levels of health care based on the line of care for children and adolescents in situations of violence. Analytical study with qualitative approach, conducted in the city of Campina Grande, Paraíba, in primary, secondary and tertiary health care services that assist children and adolescents in situations of violence. Approved by CEP/UFRN, Parecer: 2.456.493, CAEE: 80006417.2.0000.5537. The sample consisted of 76 nurses distributed: in primary care, working in the Family Health Strategy; in secondary care, in a municipal hospital for child and adolescent care in the reception, red room and pediatric ward sectors; in tertiary care, the nurses of the reception, red room, pediatric observation, pediatric ward and pediatric intensive care unit of a referral trauma hospital. Data were collected through sociodemographic form and recorded and transcribed semi-structured individual interviews. The collected data were analyzed by IRAMUTEQ software through Descending Hierarchical Classification, Similitude Analysis and Word Cloud. In Primary Care we obtained, from the lexicographic analysis classes, five categories named: Category I (Class 1) - Living and identification by the nurse of situations of violence with children and adolescents; Category II (Class 4) -Family context and violence; Category 3 (Class 5) - Health promotion actions by nurses; Category IV (Class 3) - Multidisciplinary team and services of the care network as support for the approach of the nurse; Category V (Class 2) -Capacitation and performance of the nurse facing the victim of violence. In Secondary Care emerged five categories defined as: Category I (Class 1) - Conducts directed to children and adolescents victims of violence in the service of medium complexity; Category II (Class 4) -Scope of medium complexity and actions of the nurse; Category III (Class 5) -Capacitation and the nurse's way of dealing with victims of violence; Category IV (Class 3) -Nurse's perception of the family context and the victim; Category V (Class 2) -Identification of violence against children and adolescents by nurses through nursing consultation; and for Tertiary Care the data produced six categories named: Category I (Class 1) - Reception, notification and follow-up of cases of violence; Category II (Class 5) -Nursing consultation: signs of identification of violence; Category III (Class 6) -Relation of the nurse with the relative; Category IV (Class 4) -Nurse training to approach children and adolescents victims of violence; Category V (Class 2) -Specificities of the service sectors in the highly complex service; Category IV (Class 3) -High complexity health service as a reference for situations of violence. The analysis of the three levels of health care identified weaknesses in the approach of nurses to children and adolescents in situations of violence regarding scientific and technical knowledge in undergraduate or training, in the identification of cases of violence, in relationships with victims and family, in articulation. multidisciplinary and intersectoral approach and in defining the internal flows of each It is concluded that the approach of nurses to children and adolescents in situations of violence needs qualification through specific professional training, definition of flows and protocols, articulation with the Forensic Nursing protection and advancement network for an advanced practice of nurses at victims of violence.

12
  • DEYLA MOURA RAMOS
  • SELF-ESTIMA ASSOCIATION, USE OF ALCOHOL, TOBACCO AND OTHER LIFE-QUALITY SUBSTANCES OF PEOPLE WITH HIV / AIDS.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • FELISMINA ROSA PARREIRA MENDES
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • MAURA VANESSA SILVA SOBREIRA
  • Data: Dec 13, 2019


  • Show Abstract
  • It is noted that people affected by AIDS are targets of stigma, prejudice and social exclusion, concomitantly arise undesirable feelings, which can trigger mental illness. Assuming that self-esteem and the use of alcohol and other substances may be associated with alterations in the quality of life of people with AIDS, the following hypotheses are proposed: H1 - There is an association of self-esteem, the use of alcohol, tobacco and other substances. quality of life of people with HIV / AIDS accompanied by the Specialized Assistance Service. H0 –There is no association between self-esteem, use of alcohol, tobacco and other quality-of-life substances in people with HIV / AIDS accompanied by the Specialized Assistance Service. The objective of this study was to evaluate the association of self-esteem, the use of alcohol, tobacco and other substances with quality of life of people with HIV / AIDS accompanied by the Specialized Assistance Service, in Parnamirim / RN-BR. This is an analytical study, cross-sectional design and quantitative approach to treatment and data analysis, which aims to identify aspects related to quality of life, self-esteem and use of alcohol and other substances by people living with AIDS. The accessibility sample consisted of 150 people registered with Specialized Assistance Services. In the data collection process, four specific instruments were used, namely: 1. Questionnaire with sociodemographic characterization; 2. Medical Outcomes Study 36 instrument - item Short Form (SF-36); 3. Rozemberg Self-Esteem Scale; 4. Alcohol, Smoking and Substance Involvement Screening Test Questionnaire (ASSIST). Data obtained from the four instruments were initially entered in an Excel spreadsheet, version 2016, with a check for possible typing errors. These data were later exported to the Statistical Package for Social Science (SPSS), version 21.0. Descriptive analyzes were performed with absolute and relative frequencies of nominal variables, and minimum, maximum, mean (SD) and median scores of scalar variables. To assess the reliability of the SF-36 questionnaire and Rosemberg Self-Esteem Scale instruments, internal consistency analysis was performed using the Cronbach's alpha coefficient. The nonparametric association tests (Chi-square and Fisher's exact tests, Mann Whitney U test and Friedman's test) and correlation (Spearman's correlation test) were chosen and the p <0 level was adopted. 05 of statistical significance. All ethical precepts were respected and the project received approval from the Research Ethics Committee of the Federal University of Rio Grande do Norte, issued CAEE 01426918.4.0000.5537. It was found that more than half of the sample consisted of men (69%) aged up to 59 years, single (50%), monthly family income of up to 1 minimum wage, living in a rented house (37.3% ), with time of study according to high school (32%). Regarding the domains and dimensions of quality of life, it is observed that the Functional (80.3), Physical (66.7) and Emotional (60.4) Aspects obtained the best scores and Body Pain (24, 1) with the lowest score. Regarding the self-esteem scale according to gender, it can be verified that the female was better than the male, but without significant difference. In the distribution of substances used by people with AIDS, the highlight was alcohol 80 (53.3%), tobacco products 61 (40.7%) and marijuana 37 (24.7), mostly in males when compared with female. People with the lowest self-esteem achieved in some domains better quality of life, except in two dimensions, General Health and Body Pain. In conclusion, it is accepted the alternative hypothesis that there is an association of self-esteem, the use of alcohol, tobacco and other substances with quality of life of people with HIV and AIDS accompanied by the Specialized Assistance Service, showing that the quality of life has changed. according to the self-esteem of the interviewed individuals.

13
  • DANDARA NAYARA AZEVEDO DANTAS
  • Development of the concept Rehabilitation Nursing for the Brazilian context.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ALEXSANDRO SILVA COURA
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • FRANCISCA GEORGINA MACEDO DE SOUSA
  • Data: Dec 16, 2019


  • Show Abstract
  • Introduction: Rehabilitation nursing has not been widely established in Brazil. Many nurses are unaware of their role and importance as members of the rehabilitation team. It is believed that there is a conceptual gap in the area of nursing in rehabilitation in this country, which may be contributing to this problem. Objective: To develop the concept of Rehabilitation Nursing for the Brazilian context, based on the hybrid concept development model. Method: The Hybrid Concept Development Model was implemented in three phases: Theoretical, Field and Final Analytic. In the Theoretical Phase, 120 studies that described the practice of nurses focusing on rehabilitation were analyzed. The Field Phase was conducted at a University Hospital and a Specialized Rehabilitation Center (CER), both located in a northeastern capital of Brazil, through participant observations and semi-structured interviews with nurses, health team members, patients. and companions. Field Phase data were analyzed using Theoretical Phase results as the theoretical axis and Thematic Analysis as the methodological framework. In the final analytical phase, the results of the theoretical and field phases were compared, analyzed and integrated in the light of the Nursing Theoretical Model based on Life Activities, which allowed a definition of the concept. The research project was approved by the Research Ethics Committee (CEP) of the Federal University of Rio Grande do Norte (UFRN) with CAAE 03986518.0.0000.5537. Results: The facts show that Rehabilitation Nursing in Brazil can be defined as an educational and care process, developed by the nursing team, based on a systematized care that involves the patient, the family and the multidisciplinary team and aims at prevention. complications, promoting independence and autonomy in life activities, quality of life, adapting to a new life situation, social and family reintegration and / or well-being. Conclusion: It is believed that the hybrid approach allowed to expand and clarify essential aspects of definition and measurement of the concept under study, which favored the development of a concept that could be applicable in different contexts of professional practice in the Unified Health System (SUS).

     

14
  • GRACIMARY ALVES TEIXEIRA
  • Understanding family care for child with Zika Virus Congenital Syndrome: Grounded Theory.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ALEXSANDRO SILVA COURA
  • BERTHA CRUZ ENDERS
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • FRANCISCA GEORGINA MACEDO DE SOUSA
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • Data: Dec 16, 2019


  • Show Abstract
  • Introduction: Zika Virus Congenital Syndrome are congenital anomalies in the brain of children that can cause microcephaly, retarded cognitive, motor and speech development; cerebral palsy; epilepsy; irritability; dysphagia; changes in vision and hearing. Thus, care should be focused on the child's development according to its neurological and / or motor complications, through early stimuli. Thus, there is an indispensable need for family members to take care of the particularities inherent to these children, because the team of specialized professionals should stimulate the child's growth and development, but it requires the family to continue these stimuli in their daily life. Such considerations are important for nursing given the role that the Family Health Strategy nurse has in the home environment. Objective: To understand the family care process for child with Congenital Syndrome by Zika virus. Method: This is a descriptive and exploratory research with a qualitative approach, as Grounded Theory, which was used in the theoretical / philosophical reference Callista Roy and Leonardo Boff. The study was conducted at the Child Rehabilitation Center in Natal-RN, Brazil, with 19 participants in four sample groups: twelve mothers, three fathers, two physical therapists and two nurses, determined by the principle of theoretical saturation. Data were collected through in-depth interviews from April to October 2018, simultaneously analyzing the collection by the constant comparison method. In addition, it was part of the collection and analysis of data, memos and diagrams. In the data analysis we used the open, axial and selective coding procedures, according to Straus and Corbin, forming the theoretical model with the categories / components of actions-interactions, conditions and consequences. Results: the theoretical model: Understanding the care of the mother to the child with congenital syndrome by Zika virus in the family context of the child consists of five categories: Revealing family care, centered on the mother, to the child with congenital syndrome by Zika virus; Identifying the maternal attachment that determines the care for children with Zika virus congenital syndrome in the family context; Identifying the factors that hinder the care of mother to child with congenital syndrome by Zika virus; Recognizing the evolution of children with congenital syndrome by Zika virus through the care of early stimulation; Recognizing losses due to absence of farly stimulus for children with Zika Virus Congenital Syndrome. Final considerations: The phenomenon permeates the family care of children with mother-centered Zika virus congenital syndrome and come across the need for shared responsibility among family members. In addition, the theoretical model that explained the phenomenon: understanding the mother's care for the child with Zika virus congenital syndrome in the child's family context, guides nursing care in this process by strengthening the support network for the care of these children. . Thus, it is expected that this study will contribute to the science of nursing, and subsidize the qualification and vocational training.

2018
Dissertations
1
  • PRISCILA FERNANDES MEIRELES
  • Effectiveness of fibrinolytic therapy for prehospital treatment of acute myocardial infarction

  • Advisor : MARCOS ANTONIO FERREIRA JUNIOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • MARCOS ANTONIO FERREIRA JUNIOR
  • OLECI PEREIRA FROTA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Feb 22, 2018


  • Show Abstract
  • Fibrinolytic Therapy (TF) is the pharmacological treatment for myocardial reperfusion in patients with a diagnosis of ST-segment elevation myocardial infarction (STEMI) in accordance with the criteria of indication and contraindication. Its pre-hospital administration is associated with a significant reduction in mortality rates. This study aimed to describe the effectiveness of the use of TF in prehospital care for the treatment of patients with STEMI. Epidemiological research, with a quantitative approach, of the descriptive, analytical, observational, individuated type, performed through a sectional design. It was carried out in two stages in which the first occurred with the Mobile Emergency Service (SAMU) and Emergency Care Units (UPA) in the city of Natal/RN and the second in the services referenced as entrance doors of those units. Data were collected from secondary sources from March to October 2017. For this study, the effectiveness was related to the outcome of the patients, considered as clinical improvement, refractory AMI, reinfarction, worsening of the clinical picture or death. The data were organized in a spreadsheet using the Microsoft Excel® 2010 program, submitted to statistical analysis through the Statistic Package for Social Sciences - SPSS® version 20.0. Frequencies and measures of central tendency were used and association measures were applied (chi-square test). The level of significance was set at 0.05 (p <0.05). The Research Protocol of this study was approved in its ethical and methodological aspects by the Research Ethics Committee of the Federal University of Rio Grande do Norte under opinion no. 1.762.797 and CAAE no. 59963416.5.0000.5537. Of the 53 patients' charts of the final study sample, there was a predominance of care by the UPA with 88.68%, when 41.51% were discharged with clinical improvement still in the prehospital care, 37.73% were transferred to other services and 13.21% died. The main signs and symptoms at admission were precordialgia (84.62%), sweating (36.54%), dyspnea (26.92%), hypertension (19.23%), nausea (17.31%), malaise (17.31%) and emesis (13.46%). The main characteristic of chest discomfort was precordialgia (70.45%). The TF drug administered in all patients was tenecteplase. The median time to symptom-port was 180 minutes, symptom-reperfusion 300 minutes and needle-holder 160 minutes. As outcome, 74.47% had clinical improvement, 19.15% died, 4.25% refractory AMI and 2.13 reinfarction. The main characteristic of the clinical improvement was the reversal of precordialgia (68.57%), characterized as myocardial reperfusion criterion. Early administration of TF could still optimize the outcome of clinical improvement (100%) when performed within 3 hours. In 60.78% of the cases, there was no record of occurrences that could be related to the use of TF and among the occurrences after its use, 21.56% presented some bleeding. As a limitation, it was observed the insufficiency of important records. The present study presented scientific evidence of the effectiveness of TF with improvement of the clinical outcomes of patients who used it and the shorter times related to chest discomfort and the administration of TF were responsible for increasing the outcomes of clinical improvement and reducing the outcome of death.

2
  • CRISTIANE DA CÂMARA MARQUES
  • Association between the presence of the nursing diagnosis Risk of infection and the development of infections in hospitalized AIDS patients - Control case study

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • ALINE RODRIGUES FEITOZA
  • Data: Feb 26, 2018


  • Show Abstract
  • The need for hospitalization of people living with Acquired Immunodeficiency Syndrome makes patients more susceptible to Health Care Related Infections as well as death. Infections related to care are among the main causes of morbidity and mortality, considering a relevant public health problem. Faced with the need to identify the risk of infection and factors related to them, in order to recognize deficits and patient needs with AIDS and improve the quality of health care, this study aims to analyze the predictive value of risk factors nursing diagnosis risk of infection in patients with AIDS. This is a retrospective study, analytical, observational, case control study in Statistical and Medical Archive Service of the Hospital Giselda Trigueiro, located in Natal, in the state of Rio Grande do Norte. The case group was formed by 104 patients who presented infection related to health care. The control group consisted of 104 individuals who did not evolve to hospital infection during the hospitalization period. The collection was performed between April and August 2017 through an instrument divided into four parts: sociodemographic data; clinical data; hospital infection data; and Risk Factors of Nursing Diagnosis Risk of Infection. For data analysis, we used statistical inference by applying the Pearson chi square test, we calculated the odds ratios with 95% confidence interval, and the prevalence of infected patients. The accuracy of the risk factors of the diagnosis was measured by sensitivity, specificity and predictive values. The results were organized in tables and discussed with the pertinent literature. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte, with Certificate of Presentation for Ethical Appraisal nº 46209215.0.0000.5537. The results showed that among the risk factors and prevalence of over 50% were identified: invasive procedure, changes in skin integrity, decreased hemoglobin, immunosuppression, abnormal peristalsis, chronic illness and leukopenia. There were three statistically significant associations with the nursing diagnosis investigated: three invasive procedures, altered skin integrity and decreased hemoglobin. Among those, the ones with the highest odds ratios were invasive procedure and altered skin integrity. The most sensitive risk factor was the invasive procedure and alteration in skin integrity and the suppressed inflammatory response and chronic disease were more prominent. It is concluded that the identification of accurate clinical indicators assist in the decision making of the nurse, which will facilitate the early identification of risk factors for developing an infection during care provided to people living with acquired immunodeficiency syndrome, thus ensuring patient safety.

3
  • ROMEIKA CARLA FERREIRA DE SENA
  • Prevalences and factors associated with suicidal ideation, depressive states and work satisfaction among nursing professionals in urgency and emergency hospital assistance in hospitals in Rio Grande do Norte

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JOAO MARIO PESSOA JUNIOR
  • KARINA CARDOSO MEIRA
  • Data: Feb 28, 2018


  • Show Abstract
  • Introduction: Among the precarious working conditions, many nursing professionals who work in the emergency and emergency hospital network are subjected to high levels of stress, putting at risk physical and mental health. Objective: To analyze the prevalence and factors associated with suicidal ideation, predisposition to depression, and job satisfaction with sociodemographic, occupational and suicide risk factors among nursing professionals from the emergency and emergency (EU) sectors of regional hospitals in Rio Grande From north. Method: A cross-sectional study involving 56 nurses and 91 nursing technicians (n = 147) from the Public Hospitals of the Network of Emergency and Emergency Care of the II, IV and VII URSAP / RN. Data collection took place from January to November 2017, using four instruments: Socio-demographic, Occupational Characterization and Risk Factors for Suicide, Beck Depression Inventory, Beck Suicidal Ideation Scale, Satisfaction Scale in the Work by Martins. Data were entered in a Microsoft Excel® v.2016 worksheet and checked by double entry. Descriptive analysis (absolute and relative frequencies, measures of central tendency and dispersion), univariate analysis (Pearson's Chi-square test or Fisher's exact test, Likelihood ratio, Student's t test, Mann-Whitney U test or Kruskal Walliss, depending on the presence of normality of the variables) and multivariate analysis (the prevalence ratio and confidence intervals -IC95% were calculated using Poisson regression with robust variance). The software SPSS v.20 and Package R v.2.7.1 were used. The level of significance was 5%. The research project was approved by CEP / UFRN under Opinion No. 1,877,910 of December 21, 2016 and CAAE: 62824216.6.0000.5537. Results: Suicidal Ideation (IS) was identified in 4.8% (n = 7) of the participants, and depressive states - minimum: 86.4% (n = 124), mild: 12.2% (= 18), moderate: 1.4% (n = 2). Mean overall satisfaction at work: 85.7% (n = 126) indifferent, 10.9% (n = 16) satisfied, 2% (n = 3) dissatisfied and 14% (n = 2) very dissatisfied. There was a statistically significant relationship between: IS and the variables sexual orientation (p = 0.006), low self-esteem (p-value = 0.010) and depressive states (p = 0.012). Depressive states and last training on emergency situations (p = 0.041), evaluation of family relationship (p = 0.012), self report of low self-esteem (p = <0001) and hopelessness (p = 0.001); Average overall job satisfaction with average length of service in the EU area (p = 0.016), living with the family (p = 0.015) and having a family member who attempted suicide (p = 0.024). The adjusted models showed that heterosexuals were 0.60 less likely to develop IS when compared to homosexuals (95% CI -0.44-0.83). Those with low self-esteem had 1.17 higher odds of developing IS (95% CI -1.02 - 1.34). Individuals with a poor family relationship (95% CI -3.87-12.30) and low self-esteem (CI 95% -2.07-10.57) were more likely to present mild / moderate depressive status, 1.35 and 4, 76 respectively. Conclusion: It is evidenced that the nursing professionals of this study presented processes of mental illness in the context of the hospital emergency and emergency service. Specifically, suicidal ideation and depressive states have been associated with personal and collective factors of the work environment. It is suggested the development of analytical studies that can mainly evaluate the issues of self-esteem and social support, in order to reach new evidences.

4
  • HELOIZA TALITA ADRIANO DA SILVA
  • Selfcare of the user with diabetes inside the primary health care.
  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • ALEXSANDRO SILVA COURA
  • ANA ANGELICA REGO DE QUEIROZ
  • ERIKA SIMONE GALVAO PINTO
  • REJANE MARIA PAIVA DE MENEZES
  • Data: May 29, 2018


  • Show Abstract
  • The diabetes mellitus is among the chronic diseases of the highest global impact regarding health. It is one of the main causes of mortality in Brazil, probably a reflex of the population’s current profile, a consequence of demographic changes, with high prevalence and low control rates, in the adult population. Therefore, there is the need of a higher focus in the actions of control, prevention and early detection of the cases, in order to diminish complications. With this in mind, the afflicted patients must be modifying agents of their health, and it is possible to foresee in the actions of selfcare a path in the pursue of more health, damage reduction and improvement in the quality of life.  The study’s objective is to analyze the actions of selfcare accomplished by the patients with Diabetes Mellitus, that were treated in the primary health care. It is a descriptive, exploratory study with a quantitative approach. The testing place was on the Units of Family Health Strategy (FHS), from the North and South sanitary Districts of Natal. It was used a random, stratified sample with a confidence interval of 95% and margin of error of 5%, corresponding to 379 diabetics, and a total of 387 researched patients. The subjects had a diagnosis of diabetes at 18 years old, registered in the researched Health Units. A Term of Consent was used, according to the Resolution 466/12 of the National Health Council. The instruments used were two: the first, having questions about the unit’s characterization, alongside the administrator; and, the second, made by two parts: the first, with socioeconomical variables and the second, containing questions about the activities of the selfcare with diabetes (QAD). The descriptive statistical analysis, with average, medium, standard deviation and the Student’s application of a parametric test t for a significance level of 5%, regarding the comparison of the QAD items by region. The gathered data were analyzed from the software Statistica SPSS, version 20.0. The results showed that by studied region the majority of the interviewed were from the North District (91.73%), the predominance of an age group higher than 60 years old (53.23%), female (71.06%), married (49.87%), with more than five years of diabetes diagnosis (53.75%), that did not attend to the support meetings (90.44%), mostly because there was no reunion at all inside the Health Unit (32.29%). The majority affirm to know about the selfcare (50.13%) and carry out selfcare actions regarding diabetes (68.22%). In relation to the results about selfcare with diabetes (QAD) based on the seven days of the week, the items related to medication had higher number of days of executed actions (6,39), meanwhile the actions related to physical activity (1.10) and glycemia control (0.97), were the least executed actions. When compared to the researched districts the evidences about statistical differences, based on the seven days of the week related to following a healthy diet (4.94), ingesting red meat and/or whole milk derivatives (3.34) and accomplish physical activities for at least 30 minutes (2.56). The results pointed out the most and least accomplished selfcare activities by the disease carriers, as well as, the existing difficulties, and indicate a few characteristics of the health units, that can hamper the daily support alongside the patients These results contribute to an improvement of the patient’s care, by identifying the mainly difficulties in the selfcare actions, as well as make it possible to identify the need of care protocols guided towards the patient’s selfcare.

     

5
  • WENYSSON NOLETO DOS SANTOS
  • Concept analysis of nursing diagnosis ineffective health control in people living with AIDS

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • MARIA ALZETE DE LIMA
  • RUDVAL SOUZA DA SILVA
  • Data: Nov 9, 2018


  • Show Abstract
  •  

    This is a concept analysis, according to the Walker and Avant method, operationalized through integrative review, aiming to analyze the concept of nursing diagnosis ineffective control of health in people living with AIDS. To do so, we searched the databases: Scopus, Cinahl, PubMed, Web of Science, Science Direct, Cochrane and Lilacs, using the descriptors: Cooperation and Adherence to Treatment; adherence to medication and acquired immunodeficiency syndrome. Data collection was performed between January and March 2018, by a pair of researchers. The initial sample was 7693 articles, 1,029 in Scopus, 427 in CINAHL, 3,673 in PubMed, 1,280 in the Web of Science, 646 in Science Direct, 354 in Cochrane and 284 in LILACS. Next, the inclusion criteria were applied to refine the search, ie: articles available in the selected databases in Portuguese, English or Spanish; studies that respond to the proposed guiding questions. The following exclusion criteria were applied: prior notice, protocols, ongoing research, reviews, editorials and letters to the editor. After the application of the established criteria, a final sample of 46 articles was obtained, 14 in Scopus, 3 in Cinahl, 8 in PubMed, 6 in Web of Science, 5 Science in Direct, 7 in Cochrane and 3 in Lilacs. Five attributes, 34 antecedents and 17 consequent ones were identified. The concept was defined as: a dynamic and multifactorial process that involves physical, psychological, behavioral, socio-cultural, environmental and economic aspects related to the difficulty of following the therapeutic plan agreed between the person / caregiver and the health professional, negatively affecting their condition clinical and quality of life; and bringing personal, social and economic consequences to people living with AIDS. The definition of NANDA International for the diagnosis Ineffective control of health and its components need a complementation, aiming at a better targeting of care to people living with AIDS. It is necessary to carry out other studies on this subject and future research is intended to validate content and clinical validation of the concept of ineffective health control in people living with AIDS. Finally, this study may represent an advance for the literature on the subject by synthesizing, defining and analyzing the phenomenon of ineffective health control in people living with AIDS.

6
  • SANDY YASMINE BEZERRA E SILVA
  • EVALUATION OF THE IMPLEMENTATION LEVEL OF THE TUBERCULOSIS CONTROL PROGRAM IN THE CITY OF NATAL / RN

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • ALINE ALE BERALDO
  • ERIKA SIMONE GALVAO PINTO
  • EWERTON WILLIAM GOMES BRITO
  • MARIA DE LOURDES COSTA DA SILVA
  • NILBA LIMA DE SOUZA
  • Data: Nov 13, 2018


  • Show Abstract
  • Introduction: The National Tuberculosis Control Program aims reduce morbidity, mortality and transmission of the disease through prevention, diagnosis and treatment. Tuberculosis control is the responsibility of all spheres of government, which should promote the adequate implementation of tuberculosis control programs and ensure the user's access to the health care network. Objectives: The general objective of this study was is evaluate the implementation level of the Program of Control of Tuberculosis in Primary Health Care in the city of Natal, Rio Grande do Norte. The specific objectives were: develop a logic model of the Tuberculosis Control Program focusing on the structure and process dimensions and identify the implementation of the Tuberculosis Control Program in Primary Health Care in the city of Natal, Rio Grande do Norte. Method: This is an evaluative research, with a quantitative approach, with emphasis on the level of program implementation, using Avenis Donabedian's health evaluation as a theoretical-methodological reference. The study population consisted of primary health care nurses from Natal/RN distributed in the 54 Health Units of the municipality. The inclusion criteria used were: nurses working in the professional period in the period of collection of the research and who performed actions in the control of Tuberculosis. The Barbetta formula was used to calculate the sample of Health Units, considering a sample error of 5% and a 95% confidence interval, resulting in 48 Health Units and a participation of at least 02 nurses per unit, totaling 96 nurses. Data collection was carried out from November 2017 to February 2018 through a questionnaire based on the Manual of Recommendations for Tuberculosis Control in Brazil, consisting of questions on the professional characterization and on the structure and process dimensions of the Tuberculosis Program . The data were organized and analyzed through the Statistical Package for the Social Sciences (SPSS), version 22.0 IBM, using descriptive statistics in absolute and relative numbers. In order to analyze the implementation of the Tuberculosis Control Program in the city of Natal, the dimensions (structure and process) and its sub-dimensions were considered (human, structural and material resources; operational activities, health education and information systems). Regarding the evaluation of the level of implantation, 31 criteria were selected and the percentage of responses identified were distributed in four classifications: Not implemented (from 0% to 25%); Incipient (26% to 50%); Partially implanted (from 51% to 75%); Implanted (76% to 100%). Results: The construction of the logic, model allowed the identification of the structural organization, the activities developed and the expected results of the program. Of the 96 nurses selected in the sample, 08 were distant from their activities during data collection, 06 refused to participate in the study and in two units there were only 02 nurses responsible for the activities of the unit, totaling 80 participants. From the data collected, it was possible to identify the level of implementation of the Tuberculosis Control Program in Natal RN, which was classified as partially implanted (62.85%). The structure and process dimensions were also classified with the same degree of evaluation (61.80% and 63.17%, respectively). In the structure dimension, material resources were classified as implanted (86.92%), human resources as partially implanted (55.00%) and structural resources, with incipient implantation (49.58%). As for the process dimension, the operational activities obtained the degree of partially implemented (59.26%), health education activities, incipient (36.88%) and information system activities were classified as implemented (87.00 %). Conclusion: The logic model of the Tuberculosis Control Program that was built allowed an understanding of the organization of the program and subsidized the evaluation process. The identification of the criteria related to the structure and process made it possible to identify the level of implementation of the program in the municipality of Natal as partially implemented, which highlights the need for improvement for its proper operation. It is necessary structuring the spaces destined to the care of this clientele, as well as the integrality in the assistance, with greater participation of the other professional categories, besides the intensification of the activities of health education.

7
  • MANACÉS DOS SANTOS BEZERRIL
  • Perceptions and experiences of teachers of the health sciences center on teaching of patient safety

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • MARCOS ANTONIO FERREIRA JUNIOR
  • QUENIA CAMILLE SOARES MARTINS
  • ANA LUISA PETERSEN COGO
  • Data: Dec 5, 2018


  • Show Abstract
  • With a view to stimulating broader professional training regarding patient safety, the World Health Organization has launched the Multiprofessional Curriculum Guide on Patient Safety to encourage the introduction of the theme in the activities carried out by teachers in educational institutions and encourage their insertion in teaching. Therefore, it is relevant to understand how the patient's understanding of patient safety is verified, as well as to verify if the theme is present in the training of the different courses in the health area of the institution under study. Therefore, the guiding question of this study was: what are the perceptions and experiences of health professors from a federal university about teaching patient safety? And, it aimed to identify the perceptions and experiences of teachers of the Health Sciences Center of a federal university on the teaching of patient safety. It is a descriptive study, with a mixed approach; the research scenario was the Federal University of Rio Grande do Norte, and involved the professors of the departments of the Health Sciences Center, the sample was stratified type and had 96 participants. For the collection of data was used the Google Forms or printed form composed by the characterization data of the participants and open questions about the experiences and perceptions of teachers for patient safety. Data analysis was carried out in a simple descriptive way and we used the Descending Hierarchical Classification and similarity analysis with the aid of the Interface Software of R for Multidimensionnal Analyzes of Textes et de Questionneires. The study is in accordance with the ethical precepts established by Resolution No. 466 of December 12, 2012, of the National Health Council and had its approval authenticated by the Consubstantiated Opinion of the Research Ethics Committee of the Federal University of Rio Grande do Norte, nº 2.454.034, Certificate of Presentation for Ethical Appreciation: 80929617.1.0000.5537. Among the participants in the courses, physical education (7.4%), nursing (8.3%), pharmacy (7.4%), physiotherapy (7.4%), speech therapy (3.1%) , medicine (42.7%), nutrition (6.0%), dentistry (12.5%) and collective health (5.2%). From the processing of the Descending Hierarchical Classification, five classes emerged: perceptions about patient safety; actions to include patient safety in academic training; difficulties to implement patient safety in the training process; theoretical and practical improvements in teaching patient safety; experiences with patient safety in teaching and research. It was concluded that the teachers of the Health Sciences Center understand the relevance of inserting patient safety as a cross-cutting theme in the teaching-learning process in the most diverse academic levels, as a way to enhance the training of future and current health professionals, and therefore provide effective, safe and quality care.

8
  • FLAVIA BARRETO TAVARES CHIAVONE
  • Construction and validation of contents of the prototype of a serious game to support the teaching of patient safety in nursing 
  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • MARCOS ANTONIO FERREIRA JUNIOR
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • ANA LUISA PETERSEN COGO
  • Data: Dec 7, 2018


  • Show Abstract
  • Patient safety stands out as a current area of great relevance to the care provided by the health sector, so it is imperative that the teaching of this subject be carried out in a transversal and effective way, mainly subsidized by digital technologies with the purpose of meeting the students' current demands. In the meantime, this study establishes the following guiding question: what contents are valid to compose a Serious game to support the teaching of patient safety? And, it aims to build and validate the content of the prototype of a Serious game to support the teaching of Patient Safety in Nursing. This is a quantitative approach methodological study for the construction and validation of content of a Serious game. For that, it was based on the proposal of Pasquali, that is to say: theoretical procedures, in which a search in the scientific literature was carried out through a Scoping review, to elucidate the relevant themes for construction of the contents that composed the educational resource; procedures, which was done by the construction of the content, the instrument for its validation via Google Forms and the Delphi stages. Finally, the analytical procedures, in which the calculation and analysis of the content validation coefficients and level of agreement were performed. The study is in accordance with the ethical precepts established No. 466, of December 12, 2012, of the National Health Council and had its approval authenticated by the consubstantiated opinion of the research ethics committee of the Federal University of Rio Grande do Norte, nº 2.455. 166, CAAE: 80922917.0.0000.5537, dated December 22, 2017. It was found that teaching of patient safety is based mostly on aspects related to the international goals established by the world health organization. In this scenario, it was proposed game scripts based on international goals, in which the player will motivate himself to seek his knowledge with the loss and gain of the scores, as well as immediate feedbacks and the end of the game. After the construction of six scripts, the Delphi I and Delphi II stages were validated, at the end of the stages the level of agreement between the judges was calculated, which presented values above 80% and content validation coefficient above of 0.8. It is concluded that the constructed scripts are valid in their content for construction of the prototype of the Serious game. However, it should be noted that in addition to content validation, it is necessary for the educational resource to undergo other validation steps such as use and effectiveness in order to prove its effectiveness in teaching patient safety.

9
  • DANIELLY OLIVEIRA PITOMBEIRA
  • ANALYSIS OF HYPOTHERMIA IN CARDIOPATHIC PATIENTS

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ANA CARLA DANTAS CAVALCANTI
  • DANIELE VIEIRA DANTAS
  • MARIA ALZETE DE LIMA
  • Data: Dec 11, 2018


  • Show Abstract
  • Hypothermia is defined as the core body temperature below 36 ° C, which may be present regardless of temperature, if the patient reports cold sensation and / or presents with tremors, peripheral vasoconstriction and piloerection. Unintentional hypothermia is the focus of this research and was observed in patients with heart disease who did not undergo a surgical procedure. This is a retrospective cohort study with computerized charts, whose main objective is to analyze the phenomenon of hypothermia in patients with heart disease between the admission period and the occurrence of this outcome. All medical records of the patients admitted to the cardiology unit for adults of a university hospital in the Brazilian Northeast, from August 2016 to July 2018 were considered. The collection resulted in 1006 records, of which 645 were hospitalized for heart disease. These were analyzed and 109 were selected because they met the eligibility criteria previously established and therefore are present in this study. Data were collected from July to September of 2018 through the use of an instrument with sociodemographic, clinical data and nursing diagnosis indicators Hypothermia. Data were categorized and organized into a spreadsheet built in Microsoft Excel for Windows and exported to statistical package for simple frequency analysis, central tendency and variability measures, Chi-square test, Fisher, relative risk calculation, Kolmogorov-Smirnov test et de Student. The results showed that 45% of the sample presented hypothermia on the second follow-up day. Concerning the sociodemographic characterization, there was a greater frequency of males, with 61.4% of the total studied. Regarding the age group, 55.9% were younger than 60 years. Regarding schooling, 33% attended incomplete primary education, followed by 20.2% with complete medical education and 19.3% with no literacy. Regarding marital status, 66% of the sample lives with a partner. Regarding the place of birth and residence, 67.8% were born in the interior of the state and 51.3% live in the interior. Regarding the days of hospitalization, an average of 18 days was obtained. From the charts analyzed, 60.5% of the patients did not perform cardiac surgery. Regarding drug therapy, analgesic use was observed in 95% of patients, followed by antihypertensives with 69.7% and beta-blockers with 63.3% of the total studied. There were difficulties in obtaining records of anthropometric measurements in the medical records, with 62.3% of the missing height data and 34.8% of the absent weight data during the follow-up period. This study reinforces the need to develop instruments to improve care management regarding hypothermia in patients with heart disease.

10
  • ANA RAQUEL CORTÊS NELSON
  • Accuracy  of clinical indicators of nursing diagnosis imparied  physical mobility  in patients submitted to invasive cardiovascular procedures

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • MARIA ALZETE DE LIMA
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • Data: Dec 14, 2018


  • Show Abstract
  • The objective of this study was to analyze the accuracy of the clinical indicators of the nursing diagnosis, physical mobility impaired in patients submitted to invasive cardiovascular procedures. This is a diagnostic accuracy study, developed in the surgical clinic of a University Hospital of Rio Grande do Norte, with a sample of 140 patients older than 18 years, in the postoperative period of invasive cardiac procedures, using an elaborate instrument according to the clinical indicators of impaired physical mobility diagnosis, based on NANDA International. The data were evaluated based on the Latent Class analysis model, identifying the prevalence of diagnosis, sensitivity and specificity values of each clinical indicator investigated and the respective 95% confidence intervals. There was a predominance of males, with a mean age of 59 years, smoking history and associated chronic comorbidities. The results indicated a prevalence of 55.45% of the impaired physical mobility diagnosis, with the clinical indicators that best predict the diagnosis, the limited ability to perform gross motor activities (99.3%, 95% CI = 95.5 - 100.0 ), difficulty in turning (92.1%, 95% CI = 85.2 - 95.3), limited range of motion (79.3%, 95% CI = 71.4 - 85.5), discomfort and changes and gait (71.4%, 95% CI = 63.1-78.6). Spastic movements (OR: 0.07) and engaging in stroke replacement (OR = 0.09) were the clinical predictors that least predicted the diagnosis. It was verified that individuals submitted to large cardiac surgeries have 100 times (OR = 0.01) more chances of having impaired physical mobility. The evidence generated by this study contributed to the knowledge of the impaired physical mobility diagnosis among cardiac patients in the postoperative period of invasive cardiologic procedures, thus, it helps to strengthen Nursing as a science, generating subsidies for validation research of nursing diagnoses and greater reliability in the clinical evaluations of the nurse, fundamental factors for the nursing in its diverse contexts, including in the consolidation and recognition of advanced practice nursing. 

11
  • JÉSSICA VALESKA HERCULANO LIMA
  • Evaluation of teaching / learning about prenatal habitual risk for nursing graduation students.

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • DIANA PAULA DE SOUZA REGO PINTO CARVALHO
  • ERIKA SIMONE GALVAO PINTO
  • MARIA JACQUELINE ABRANTES GADELHA
  • NILBA LIMA DE SOUZA
  • Data: Dec 17, 2018


  • Show Abstract
  • INTRODUCTION: Evaluation in prenatal education at usual risk may identify factors that hamper the development of students' skills and abilities in prenatal consultations. OBJECTIVE: The purpose of this study was to evaluate the skills and abilities of undergraduate students in nursing for prenatal visits. METHODS: This is a transversal evaluation with quantitative data, carried out in the Nursing Department of the Federal University of Rio Grande do Norte (UFRN), with 54 nursing students regularly enrolled in the 7th and 8th period, enrolled in the disciplines : Integral Health Care III and Supervised Internship I: the nursing work process in basic health care. The data collection was performed through a questionnaire that had as theoretical basis of the normative evaluation the documents related to prenatal consultation recommended by the Ministry of Health. Data were analyzed through statistical software in the program SPSS 21.0. The study was approved by the Ethics and Research Committee of UFRN under the number 2,698,375. RESULTS: Strong definitions and words for each of the following assertives: Axis 1: General and specific physical examination - 59.82% said to perform fully safely - Axis 2: Laboratory exams - 82% reported to request, Axis 3: Warning signs - 54 , 28% said they fully identify with safety; Axis 4: Risk factors - 64.28% said they fully identify with safety; Axis 5: Fill of the pregnant woman's book - 84.28% said they performed totally safely; Axis 6: Prescribe with supervision - 91.07% said they perform fully safely; Axis 7: Immunization - 92.85% said they perform fully safely; Axis 8: Educational guidelines - 66.42% said they perform fully safely.  CONCLUSION: This study showed satisfactory results in most of the axes, but unsatisfactory results are found in Axes 1, 3, 4, especially in Axis 8, regarding educational actions, a primary factor in conducting prenatal consultations.

12
  • VANESSA PINHEIRO BARRETO
  • Analysis of the epidemiological situation of arboviruses dengue, zika and Chikungunya in the state of Rio Grande do Norte, Brazil

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ERIKA SIMONE GALVAO PINTO
  • KARINA CARDOSO MEIRA
  • PATRÍCIA PERES DE OLIVEIRA
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Dec 20, 2018


  • Show Abstract
  • Or accompanying the epidemiological behavior of arbovirosis of extreme relevancy, comprehensive comprehension of the regional reality and essential for the establishment of important strategies for the reduction of risk and vulnerability of individuals and communities, further adaptation of current public policies, not the local epidemiological context. Faced with the need for investigations that cover factors that may be associated with epidemics, this study aimed to analyze the epidemiological profile and geographical distribution of dengue, chikungunya and zika cases in the State of Rio Grande do Norte. It is an ecological study that analyzed all the confirmed cases of Dengue, Chikungunya and Zika in the System of Information of Notification Diseases (SINAN) during the period from 2015 to 2017, which totaled in a sample of 50,529 cases. These data were obtained through the forms of notification and investigation of the cases confirmed and available at the Public Health Secretariat of the State of Rio Grande do Norte (SESAP-RN). Data were treated using frequencies, central tendency measures (mean, median, standard deviation), incidence rate and thematic maps. Although the study did not directly involve human beings, it was submitted and  obtained a favorable opinion from the Research Ethics Committee of the Federal University of Rio Grande do Norte (CEP-UFRN) under Certificate of Presentation for Ethical Assessment (CAAE): 80007217.0.0000.5537. The results of the sociodemographic characterization of dengue, in the three years analyzed, indicated the age group with the highest frequency was 20-34 years, with 30,8% of the total cases. In relation to sex, the majority was female with 57% of the total. Regarding schooling, the percentage of ignored / white significantly exceeded the total of information filled with 63.1% of the files without information on this variable. The most frequent  schooling rate in the period was high school with 5,5% of the cases. Regarding the need for hospitalization, a percentage of only 9,8% was found. However, this data is underestimated, due to the large percentage of ignored/white that corresponds to 48,8% in the period. It should be noted that in 2017 all cases were classified as yes or no in this variable, so there was no ignore/blank, which resulted in 16,8% hospitalizations this year. Regarding the evolution of the cases, 48 dengue-related deaths were reported. Regarding the geographical distribution of cases, the health region with the highest number of cases was Mossoró, with 2.274 confirmed cases, corresponding to 22,7%. Regarding the confirmed cases of chikungunya, the age group with the highest frequency was 20-34 years with 27,5% of the cases. As for sex, the majority were female (62,4%). Regarding schooling, 5,9% of the cases correspond to complete secondary education. Regarding the clinical evolution, there were more deaths due to the disease in 2016, with 48 reports. The geographical distribution pointed to the metropolitan region of Natal with the highest frequency of confirmed cases (35,2%). Relative to zika virus, 254 cases were confirmed. It was observed that all health regions reported a decrease in reported cases of zika in 2017 compared to 2016. Most of the cases corresponded to the female sex (76,6%). The most frequent age group was 20-34 years, with 37,8%. Regarding schooling, the ignored/white number significantly outpaced the total information filled with 56,64%. Finally, it was possible to identify the main health regions that presented the largest number of cases and the epidemiological situation of the concomitance of the three arboviruses in the state of Rio Grande do Norte.

13
  • RAFAELLA GUILHERME GONÇALVES
  • Nursing Education in Palliative Care at the State of Rio Grande do Norte

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • REJANE MARIA PAIVA DE MENEZES
  • LUCIANE PAULA BATISTA ARAUJO DE OLIVEIRA
  • ANA ANGELICA REGO DE QUEIROZ
  • FABÍOLA DE ARAÚJO LEITE MEDEIROS
  • Data: Dec 20, 2018


  • Show Abstract
  • In Brazil, the increase in life expectancy and the ageing population, associated with high levels of degenerative chronic diseases, provided an increment on the demand of palliative care, which is vital for the person’s quality of life and their relatives in face of diseases that threaten the continuity of life. In this regard, the nurse must attend the patient in an integral and sensitive way, always concerning the physical, psychological, social and spiritual dimensions, acting as a link between the patient, family and the other team members, being the professional with the highest opportunity to establish the care practices. However, one highlights that the nurses or the nursing students are not yet ready to deal with the patient in palliative care. This study’s objective is to analyze the teaching of palliative care in the nursing education at the state of Rio Grande do Norte. It is about an exploratory-descriptive study, with a qualitative approach. The place of study will be both, public and private university education institutions, from the state of Rio Grande do Norte, recognized by the Minister of Education and Culture, on-site and active courses in 2018. Its participants were eleven coordinators from graduation courses in nursing and nine pedagogical projects. The research was fulfilled with two stages: 1) Semi structured interview accompanied by a script with the coordinators, regarding the teaching of palliative care during the nurse’s formation, with the participants’ characterization; 2) Descriptive analysis of the pedagogical projects and the investigated institution’s characterization. Bardin’s thematic content analysis with Minayo’s adaptation and the philosophic theoretical reference of Edgar Morin was used. The study received the assent from the Committee of Ethics in Research from the Federal University of Rio Grande do Norte with CAAE nº 91830118.7.0000.5537. As results, three thematic categories were identified: 1. Palliative care regarding the coordinators point of view; 2. Nursing formation in palliative care; 3. Capabilities and challenges of teaching alluding palliative care. The analyzed results, from the pedagogical projects, highlighted the absence of the palliative care content as a mandatory or optional discipline in all researched university education institutions, as well as the lack of the term “palliative care” inside the academic discipline summaries on most institutions. These findings reinforce the thesis that Brazilian nursing, especially regarding this study’s context, shows a void in the nursing formation related to palliative care, and it responds to the literature evidences about the lived hardships and unpreparedness of professionals and nursing student when assisting patients with palliative care. One highlights the need of a reflection in relation to the nursing formation, given the theme’s current importance in the health professionals’ teaching, upon considering the population’s epidemiologic profile for chronic conditions, and the crescent need of palliative care, that reveals itself as a challenge for the coordinators, professors and nurses, as it is a new demand of care.

Thesis
1
  • SUENIA SILVA DE MESQUITA XAVIER
  • VALIDATION OF THE SCALE OF THE OSTOMATE`S ADAPTATION LEVEL (SOAL) IN THE LIGHT OF ROY´S THEORY
  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • IZAURA LUZIA SILVERIO FREIRE
  • MIRIAN ALVES DA SILVA
  • Data: Feb 26, 2018


  • Show Abstract
  • Ostomy is the surgical opening of any of the hollow viscera to the exterior of the body, with the purpose of supplying alimentary or disposal needs. Undergoing an ostomy can lead the patient to regard life as limited given that the physical alterations crossover from the physiological field to the psychosocial field, requiring adaptation of the individual faced with the new reality. Thus, the usage of an instrument based on a theory of nursing that focuses on adaptation, such as the Roy’s Adaptation Model (RAM), can complement the Systematization of Nursing Care (SNC) and ostomy patient care. In this sense, the objective of this study was to analyze the validity of the Adaptation Level of People with Stoma Scale (ALPSS) based on the perspective of Roy’s model. This work is characterized as a methodological study of the ALPSS validation, developed in four phases: the first phase refers to the theoretical pole that consisted of two rounds of the instrument submission to the judges, the realization of the pilot test and lexical and grammatical correction; the second phase constituted the experimental pole that involved planning the application of the instrument, application and data collection, with the instrument being applied to 200 people with stoma at the Child and Adult Rehabilitation Center of Rio Grande do Norte (acronym in Portuguese, CRI/CRA); the third phase within the analytic pole, involved the carrying out of a statistical analysis, using the statistical software SPSS, 20.0 version, and Cronbach’s alpha for the internal item consistency analysis, Pearson correlation and T test for the instrument precision analysis, and Kruskal-Wallis test for the verification of evidence of criterion validity; lastly, in the fourth phase the association between the sociodemographic, clinical and health characteristics was made, as well as the ALPSS dimensions using the Mann-Whitney test. Results of this study showed, in the first phase 13 items received improvement suggestions, 3 items were unified by their similarity of approach and 1 item was excluded. After the adjustments made in the first phase, the judges unanimously agreed on representativeness of the items and the permanence of the modes. The final version of the instrument was composed of 32 items distributed in four adaptive modes, following Cronbach’s alpha rates: physiological mode (α = 0,680), self-concept (α =0,889), role function (α =0,749), and interdependence (α =0,793). In addition, a global rating for Alpha of 0,980 was found. Also verified was the relation between sex, age, income, stoma time, permanence criteria and presence of complications and APS domains. Thus, the alternative hypothesis of the study is accepted, in that the instrument presented strong evidence of validation. The expectation is that using an instrument built on a scientifically valid theory, contributes to the care of people with stomas and the development of nursing as a science.

2
  • IZABELLA BEZERRA DE LIMA
  • Health needs of people with physical disabilities: a concept analysis

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCA PATRÍCIA BARRETO DE CARVALHO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • SANDRA MARIA DA SOLIDADE GOMES SIMÕES DE OLIVEIRA TORRES
  • Data: May 30, 2018


  • Show Abstract
  • This study is a concept analysis of the health needs of people with disabilities, according to the model of Walker and Avant. The general objective was: to analyze the concept of health needs of people with disabilities using the Walker and Avant model. The specific objectives were: to identify and synthesize the concept of health needs of people with disabilities through an integrative review (IR); identify the attributes, antecedents, consequents and empirical referents of the concept of health needs of people with disabilities; elaborate a model case, a case-related and a contrary case of the concept of health needs of people with disabilities. The eight steps proposed by the Walker and Avant model were followed, namely: concept selection, conceptual analysis objectives, identification of possible uses of the concept, determination of the search criteria in the literature; concept identification; definition of the purpose of the analysis; verification of the uses of the concept; identification of defining attributes; example of a model case; determination of additional cases; definition of the antecedent and consequent terms to the concept; and determination of empirical references. For this study, the concept of the health needs of people with disabilities was selected, aiming to identify the main characteristics of these needs and whether they are applied to all people with any type of disability or can be specific to each group. A guideline protocol for an integrative review was then prepared. Data collection was carried out in the following databases: PUBMED, SCOPUS and Cumulative Index to Nursing and Allied Health Literature (CINAHL), accessed through the Capes Journals Portal, using descriptors indexed in the Medical Subject Headings (MeSH); and the Latin American Literature in Health Sciences (LILACS) and Scientific Electronic Library Online (SCIELO) databases, accessed through the Virtual Health Library (VHL) with Descriptors in Health Sciences (DeCS). The use of the concept of the health need of people with disabilities presented two training poles, the first one, the understanding about health needs, and the second, the understanding of who are disabled people. The most frequent antecedents were strongly associated with disability limitations, social vulnerabilities and weaknesses, lack of accessibility and disarticulation of health services. The defining attributes identified were the needs of health services, self-care activities, psychosocial support and specialized equipment. As a consequence of this concept, health commitment was predominantly found; poor access and contact with health professionals, medical consultations and services; social isolation and feelings of social devaluation and dependence for the maintenance of life, among others. This concept analysis made it possible to deepen the discussion about the health needs of people with disabilities, with a view to supporting health care for this group. To this end, it will contribute to the validation of the Health Needs Assessment Tool for physically, hearing and visual impairment (IANS - PCDFAV), which is under way

3
  • DEBORAH DINORAH DE SA MORORO
  • Institutional culture and childcare management with chronic illness: the nurse in this context.

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • CLAUDIA SANTOS MARTINIANO SOUSA
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • JOÃO BOSCO FILHO
  • REJANE MARIA PAIVA DE MENEZES
  • Data: May 30, 2018


  • Show Abstract
  • Based on the principle of integrality, care management requires a culture of integration between services and interaction among professionals in the levels of complexity of the Health Care Network, associated to the reorganization of the work processes of professionals. A demographic and epidemiological transition is experienced in the healthcare of the child due to the prevalence of the chronic disease. This new standard of health and disease imposes an extended care model, consistent with the proposal of the Unified Health System. In this child healthcare management, the insertion of the nurse as coordinator of the nursing team or as care manager is of fundamental importance. The objective of this study is to analyze the influence of hospital culture on the organization of care management for children with chronic disease or health condition in a pediatric unit of a general university hospital and the nurse´s role. This is a descriptive and analytical study of a qualitative approach, based on the principles of institutional ethnography as a theoretical and methodological reference. The research site is a unit of pediatrics of a university general hospital in a capital of northeastern Brazil. The study population included the professionals of this specialized unit with a total of 20 of them including general coordinator, nursing supervisor, internal regulation coordinator, nurse, psychologist, nutritionist, physiotherapist, pharmacist, social worker, and physician. The data collection instruments used were the participant observation technique, the field diary, the documentary analysis and the semi-structured interview carried out from May to August 2017. The information collected were analyzed followed the Bardin content analysis technique, helped by the Scientific Software Atlas version 8.0, emerging the following categories: institutional culture of the management of the care of a pediatric unit; visit as a management mechanism of care; nurses' performance in child care management; potentialities and weaknesses in care management. The results analyzed showed a culture of care management under the influence of the hegemonic care model, fragmentation of attention and care, although it glimpses advances in the multi-professional work. Also, the medical visit stood out as a care management mechanism with potential to strengthen teamwork but needs to be rethought to become effectively inter-professional. In this context, Nursing Care Management understood as the articulation and integration between care and management actions, through the exercise of leadership, interactive, communicative and cooperative relationships is developed by a professional nurse with a care profile, who performs all the stages of the Nursing Process. However, the nurse sees herself as a manager since she organizes and mediates the relationships between the doctor, the patient and the different professional categories to provide the material conditions necessary for the care process. Similarly, other professionals see the nurses with a responsibility beyond care management, as a possible consequence of the nurses´ historical, cultural and social reproduction as the service organizer. Given this, nurses feel overwhelmed, hindering to integrate the managerial and care dimensions, as well as their communication and articulation with the Child Health Care Network. Finally, the physical structure of the university hospital and the patient safety project stood out as potential for the management of care. However, local fragilities related to the lack of definition of an organized care management model in the team and difficulties to continue home care were evidenced.

4
  • RAPHAEL RANIERE DE OLIVEIRA COSTA
  • Efficacy of realistic simulation in the teaching of immunization of adults in the context of nursing graduation

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • EDILMA DE OLIVEIRA COSTA
  • JOÃO BOSCO FILHO
  • MARIA LUCIA AZEVEDO FERREIRA DE MACEDO
  • SORAYA MARIA DE MEDEIROS
  • VERÔNICA RITA DIAS COUTINHO
  • Data: Jun 8, 2018


  • Show Abstract
  • Realistic simulation is a valuable teaching and learning strategy that has been disseminated and used in undergraduate courses in health and nursing. However, its effectiveness, when compared to traditional teaching methods, still lacks better evidence. The aim of the study was to analyze the effectiveness of teaching and learning strategies in the acquisition of knowledge and satisfaction of undergraduate nursing students in the teaching of immunization in the context of Primary Health Care (PHC). This is an experimental study, of the type Controlled and Randomized Controlled Trial (ECCR), pre-test and post-test. The sample of the non-probabilistic type for convenience was composed of 34 nursing students, assigned to two groups of 17 (control and experimental) respecting control variables: gender, age, Academic Income Index (ARI), professional experience in APS, and diagnosis of the Preferential Representational System (SRP). It obtained a favorable opinion from the Research Ethics Committee, CEP / UFRN, protocol no. 1,958,827, and registered in the platform of Brazilian Registry of Clinical Trials under protocol RBR-9sqr6b. Data were collected between May and June 2017. Students participated in a 40-hour course on adult immunization. The Control Group (GC) participated in the course in modality 1: (dialogue exhibition and skills training). The Experimental Group (GE) was directed to modality 2 (dialogical presentation, skills training and realistic simulation). The effectiveness of teaching and learning strategies was assessed through pre and post-test evaluation. The Satisfaction and Self-Confidence Questionnaire in Learning, the Educational Practices Questionnaire, and the Simulation Design Scale were also applied. In all inferential calculations the significance level of 5% was adopted. The GE students presented better performance than the CG in the four assessments of cognitive performance, with statistical significance in the assessments of immediate knowledge (p value = 0.031) late 1 - 20 days (p value = 0.031). Regarding satisfaction and self-confidence in learning, there was no statistical significance between groups in both subscales (p value ≥ 0.05). However, the GE presented higher averages. The Simulation Design Scale presented a Cronbach Alpha total of 0.930. All the dimensions of the scale obtained global averages equal to or higher than 4.60, with problem solving and realism being the dimensions that showed the greatest agreement and importance among the students of the GE. Regarding educational practices, modalities (1 and 2) were evaluated positively by the students. In EG, statistical significance was found in the subscale of importance in the "different ways of learning" domain (p = 0.018). The alternative hypothesis of the study is accepted as in module 2 students learn better and for longer. In addition, it promotes greater satisfaction and self-confidence in students. We conclude that these educational practices present their structural dimensions closer to meaningful learning. It is recommended to use the simulation and it is hoped that the evidence produced in the study will contribute to the improvement in undergraduate nursing education.

5
  • MÔNICA GISELE COSTA PINHEIRO
  • Association between the degree of physical disability, activity limitation and social participation with quality of life in discharged haneniasis patients: a cross-sectional study

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • CLELIA ALBINO SIMPSON
  • FELISMINA ROSA PARREIRA MENDES
  • FRANCISCA PATRÍCIA BARRETO DE CARVALHO
  • Data: Aug 30, 2018


  • Show Abstract
  • Considering the high prevalence of leprosy in Brazil, as well as the incapacitating potential of such disease even after therapy is concluded, it is assumed that those who have been discharged from leprosy may present physical disabilities and limitations regarding performance of activities and social participation. Such impairments might directly impact in one`s quality of life (QOL). In this perspective, it is questioned: what is the level of these physical and social limitations in individuals who were discharged from leprosy, and how can it be associated with quality of life? Hypothesis 0 (H0): There is no association between the degree of physical disability, activity limitation and social participation with the quality of life of individuals who were discharged from leprosy; H1: There is an association between the degree of physical incapacity, activity limitation and social participation with the quality of life of individuals who were discharged from leprosy. The main goal of the present study is to evaluate the association between the degree of physical disability, activity limitation and social participation with QOL of individuals who were discharged from leprosy. The specific objectives are: to characterize sociodemographic, therapeutic and clinical profile of discharged leprosy patients; to determine the degree of physical disability in individuals who were discharged from leprosy; to estimate the activity limitation of users who were discharged from leprosy; to characterize the degree of restriction to social participation in such patients; to describe the quality of life of patients receiving treatment for leprosy; to compare the average levels of quality of life with the degree of physical incapacity, activity limitation, social participation and operational classification of discharged leprosy patients. This is an analytical, cross-sectional, quantitative approach developed in the city of Natal / RN. The population was comprised by 214 cases of leprosy reported in Natal from the years 2011 to 2015. The sample of 90 users was calculated and selected by draw and followed the eligibility criteria. Inclusion criteria were: treatment discharged patients who completed MDT in the years 2011, 2012, 2013, 2014 and 2015, with the duration standardized by the WHO, according to the operational classification; patients registered in the database of the Center of Notifiable Diseases of the Municipal Health Department of Natal; who performed the treatment in Natal; residents in the address registered in the database or those who use the same telephone number registered in order to allow the contact with a possible research participant; to be at least 18 years old; and to be alive. It were excluded  from the present study: individuals with communication barriers that could impair the effectiveness of the interview; people with psychic suffering; individuals with neurological impairment due to causes unrelated to leprosy; hospitalized patients; as well as those whose addresses were not properly registered to allow access to the “user's place of residence”. Five instruments were defined for data collection: form of clinical and social characterization, guidelines of dermato-neurological exam, SALSA scale, Scale of Participation and the WHOQOL-bref. The Kolmogorov-Smirnov test was used to evaluate the distribution of the normality of the collected data, choosing to work with non-parametric tests. The research project was submitted to Plataforma Brasil and approved by the Research Ethics Committee, number 2,054,508 and CAAE 64874316.3.0000.5537. There was a predominance of female individuals (61.1%), housewives, up to 59 years old (62.2%), living with a partner (61.1), non-white (55.6%), educational level up to elementary school (45.6%) and family income around R $ 1,800.00. In the treatment and clinical characterization, a prevalence of new cases (87.8%) was detected by referral (90.0%) in the specialized reference center (97.8%), classified as tuberculoid (53.3% %), negative bacilloscopy (63.3%) and lack of any degree of physical disability at the beginning of treatment (53.3%). It is worth mentioning the return of discharge of medication. The presence of some degree of physical incapacity, activity limitation, and restriction of social participation was more frequent in multibacillary cases. When it comes to quality of life, paucibacillary cases present better scores when compared to multibacillary patients, with statistical significance for general quality of life(p = 0.003), physical (p <0.001) and psychological (p <0.001) status . The best quality of life scores were also found in individuals without physical disabilities, activity limitations and without restriction to social participation. As a conclusion, the alternative hypothesis accepted is that there is an association between the degree of physical disability, activity limitation and social participation with the quality of life of individuals who were discharged from leprosy, evidencing better quality of life scores in those individuals classified as paucibacillary, with no physical disability, activity limitation or social participation restriction

6
  • FERNANDA BEATRIZ BATISTA LIMA E SILVA
  • Validation of vascular trauma nursing diagnosis for patients undergoing antineoplastic therapy

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • MARIA ALZETE DE LIMA
  • WERUSKA ALCOFORADO COSTA
  • Data: Aug 31, 2018


  • Show Abstract
  •       Studies of validation of nursing diagnoses are of great value for legitimizing the specific events, as well as for the construction of diagnoses that are not yet contemplated by the taxonomy. Thus, they contribute to a safer nursing care. In this context, the present study aimed to validate the diagnosis of cerebral vascular trauma in patients submitted to antineoplastic therapy. It is noteworthy that the occurrence of venous trauma in these cases is frequent, and is mainly related to the reduction in visibility, palpation and reduction in network venous caliber during the treatment. Although an expressive amount of existing diagnoses in NANDA-International is identified, "vascular trauma" is not contemplated. It was a methodological study, launched in three stages: concept analysis, content analysis and analysis of the accuracy of clinical indicators. The first phase was operationalized through an integrative review and an analysis of 56 articles, being possible to analyze the concept with the mark of four attributes, 13 antecedents and 13 consequents. The second phase, 9 experts evaluated the content identified in previus phase, through focal group, reaching a consensus on the adequacy of each component and diagnosis definitions. As result from content expert analysis, remained three attributes, 13 related factors and 11 defined characteristics after some adjustments. In the third phase, the accuracy of the clinical indicators was analyzed. 200 subjects, most of them female, from the state of Rio Grande do Norte country area, retired or benefited, were evaluated. The analysis of the accuracy of clinical indicators was performed based on three different adjusted models from analysis of classic latent classes. The last model presented 11,17% of the patients with vascular Trauma, showing the best result. Analyzing the clinical indicators, "Decreased vascular elasticity", "Pain" and "Signs of infection at the site of catheter insertion" presented high specificity values. These Indicators are very important to confirm the diagnosis. Thus, the study supported the nursing “Vascular trauma” diagnosis is useful in patients with cancer submitted to antineoplastic therapy. The project was forwarded to the Ethics Committee of the Liga Norte Riograndense Contra Câncer, respecting the ethical aspects in human related research, according to Resolution no. 466/12 of the Conselho Nacional de Saúde. The same was approved, under the number of opinion 1.717.695 and CAAE number 57967816.3.0000.5293.

7
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • Proposal for intervention to improve the quality of life of people with venous ulcer

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • ALINE MAINO PERGOLA MARCONATO
  • DANIELE VIEIRA DANTAS
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • ROBERTA AZOUBEL
  • Data: Aug 31, 2018


  • Show Abstract
  • Venous ulcers are characterized by lesions of skin with loss of tissues, usually located in the distal third of the leg, of variable width and depth. The rates of failure in healing are very high and, in addition, the wound can cause pain, depression, low self-esteem, deficits in body self-image, social isolation, frustration, anger, anxiety, impairment in sexual activity and limitations in daily living activities. The purpose of this study was to analyze the quality of life of people with venous ulcers and to propose nursing interventions to improve the quality of life, starting from the nursing process, in the city of Parnamirim, Rio Grande do Norte, Brazil. This is a methodological, analytical study, with a quantitative approach, performed with 54 people in the primary care of the municipality of Parnamirim, Rio Grande do Norte, Brazil, with people with active venous ulcer. Socio-demographic, clinical and care data, health-related quality of life and venous ulcer were evaluated from the Short Form 36 and Charing Cross Venous Ulcer Questionnaire, respectively. From the data found, nursing diagnoses were drawn, expected results and proposed nursing interventions. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, with CAAE nº 65941417.8.0000.5537. Predominant female, elderly, low income and schooling, people without partners, with associated chronic diseases, good sleep, non smokers and alcoholics, with chronic injury and pain. People performed the dressing at home, have been not use compression, received professional guidance and had difficulty accessing the angiologist. There was impairment in quality of life. The emotional aspect presented a significant discrepancy between the instruments. Adults had better social interaction and worse score for esthetics. In relation to nursing diagnoses, priority was given to the following titles: poor community health, impaired tissue integrity, risk of infection, followed by impaired comfort, risk of falls, risk of low self-esteem, risk-prone health behavior, mobility physically impaired, among others less frequently. The interventions were proposed: development of community health, promotion of venous circulation, protection against infection, infection control, anxiety reduction, environmental control, aromatherapy, energy control, relaxation therapy, fall prevention, strengthening of self-esteem, control behavior training, ambulation training, occupational therapy, stretching exercises, balance and muscle control. In relation to nursing diagnoses, priority was given to the following titles: poor community health, impaired tissue integrity, risk of infection, followed by impaired comfort, risk of falls, risk of low self-esteem, risk-prone health behavior, mobility physically impaired, among others less frequently. The interventions were proposed: development of community health, promotion of venous circulation, protection against infection, infection control, anxiety reduction, environmental control, aromatherapy, energy control, relaxation therapy, fall prevention, strengthening of self-esteem, control behavior training, ambulation training, occupational therapy, stretching exercises, balance and muscle control. It is proposed that the interventions be done in groups, with weekly meetings lasting two hours, where the dressing and application of compressive therapy will be performed, in addition to collective activities of setting goals, actions for adaptation, self-development, change of health behavior. The observation of care being given to other individuals, the judgments of the participants in relation to one another, the emotional state, stress, anxiety and excitement will be worked out in the moments of intervention. In this way, the results can allow nursing and multiprofessional interventions focused on the quality of life of the person with venous injury, assisted in Primary Health Care, with a reduction in injury time and working hours, health promotion and self-care incentive.

8
  • CLEYTON CÉZAR SOUTO SILVA
  • ABSTRACT

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • LUCIA DE FATIMA AMORIM
  • MARIA ELMA DE SOUZA MACIEL SOARES
  • NICOLE LEITE GALVAO COELHO
  • RENATA PASCOAL FREIRE
  • SORAYA MARIA DE MEDEIROS
  • Data: Aug 31, 2018


  • Show Abstract
  •        Auriculotherapy uses specific ear points to treat various body disorders. Burnout Syndrome (BS) is a response to chronic stress and has three dimensions: emotional exhaustion, dehumanization and disappointment with work. The aim of the study is to analyze the application of auriculotherapy in coping with and controlling the BS in Primary Health Care (PHC) nurses. This is a descriptive study, with a quantitative approach and quasi-experimental design, of pre-test and post-test types. It was carried out in the APS units of the municipality of Natal, RN. The non-probabilistic sample consisted of 75 nurses diagnosed with the disease at mild, moderate and severe levels by the Burnout Characterization Scale (BCS). Salivary cortisol was collected in all nurses to compare the concentration before and after auriculotherapy in the workers identified with the syndrome, and the hormone dosage was performed using the competitive ELISA technique. Twelve sessions were performed and the points used were: specific action (anxiety), Traditional Chinese Medicine (liver, spleen/pancreas and heart), nervous system (Shem Men and sympathetic) and endocrine system (adrenal). A favorable technical advice was obtained from the Research Ethics Committee (CEP/UFRN), protocol no. 2.444.525, and registered on the platform of the Brazilian Registry of Clinical Trials under the number RBR-4xbqbw. Data were collected from January to June of 2017 through a sociodemographic and occupational questionnaire, BCS and salivary cortisol by the Salivette™ device. Descriptive statistics techniques were used with frequency measures for categorical variables. In the inferential analysis, the Chi-Square test was used to verify the association between categorical variables: marital status, children and professional qualification. Subsequently, the normality of the data for the numerical variables was tested using the Kolmogorov Smirnov test and the Student's t test and analysis of variance (ANOVA) were used to compare the groups. All dimensions of BCS presented alpha values above 0.60: exhaustion = 0.943; dehumanization = 0.824; disappointment at work 0.738. PHC nurses had a moderate percentage of emotional exhaustion (74.7%), accompanied by mild dehumanization (81.3%) and slight disappointment at work (60%). The prevalence of SB at levels was: severe (n = 2), moderate (n = 5) and mild (n = 64). Only four nurses did not present the disease. Correlations between socio-demographic and occupational variables showed weak statistical significance for the negative correlations between exhaustion and length of service; and between disappointment and length of service; and weak positive correlations between dehumanization with exhaustion and deception; and between deception and exhaustion, as well as a strong statistical tendency for the positive correlation between disappointment and age. ANOVA between BCS dimensions revealed a statistically significant difference between all dimensions of the disease. Comparison of salivary cortisol within the groups (mild, moderate, severe, and non-sickness Burnout) between collection shifts (morning and afternoon) showed statistical significance among the groups of mild, severe and non-disease BS. Comparing the concentration of salivary cortisol (morning and evening) before and after the intervention, there was a significant reduction in the nurses who performed the therapy and who had the disease at a severe level. In conclusion, BS is associated with service time of less than 8 years and 40-hour workweek, and auriculotherapy is efficient in reducing salivary cortisol concentration in nurses with serious disease level.

9
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • Construction and validation of nursing diagnosis risk of excessive fluid volume from a medium-range theory

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CECILIA MARIA FARIAS DE QUEIROZ FRAZAO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • Data: Aug 31, 2018


  • Show Abstract
  • This study aimed to build and validate the nursing diagnosis Risk of excessive fluid volume in patients undergoing hemodialysis from a medium-range theory. Methodological research, developed in three stages: theoretical-causal validation, content validation and clinical-causal. In the first stage, the Risk of excessive fluid volume was constructed from a medium-range theory and operationalized by an integrative literature review. In the second stage, 48 judges judged the adequacy of the diagnosis. In the third stage, the diagnosis was clinically validated, based on a case-control study, with 392 patients on hemodialysis. The project was approved by the Ethics Committee, under the opinion nº 1.257.908 and Certificate of Presentation for Ethical Appraisal nº 49324015.0.0000.5537. The results show that, in the first stage, 82 articles were selected. Were identified eight attributes, 31 clinical antecedents, 12 propositions, 31 causais relations and a pictogram. In the second stage, the judges considered the valid diagnostic proposal, being considered 23 risk factors. In the third stage, risk factors Improper fluid removal during hemodialysis, Excessive intake of fluids, Elderly, Excessive sodium intake, Schooling and Poor knowledge were able to increase the chances for the development of excessive fluid volume in patients undergoing hemodialysis. It is concluded that the construction of the nursing diagnosis Risk of excessive fluid volume is clinically valid for patients undergoing hemodialysis

10
  • EURIDES ARAUJO BEZERRA DE MACEDO
  • Knowledgeand skills of nursing students in care of the person with cutaneous injury: evidence of validity of instruments

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • ALINE MAINO PERGOLA MARCONATO
  • EDILMA DE OLIVEIRA COSTA
  • GILSON DE VASCONCELOS TORRES
  • ROBERTA AZOUBEL
  • RODRIGO ASSIS NEVES DANTAS
  • Data: Aug 31, 2018


  • Show Abstract
  • Nurses play a key role in caring for the injured person as they are directly involved in decision making in assisting these individual satall level sof health care. Their knowledge and practice are essential factors for prevention and treatment of injuries and should beinitiated in graduate courses. The discipline of Semiology and Semiotechnics of Nursing has been responsible for providing basic knowledge and skills development necessary for nursing practice related tosk in lesion care. The evaluation of these competencies must bed one by validated instruments. Thus, the objective was to investigate the validity evidences of knowledge skills instruments about nursing care to the person with cutaneous lesion for nursing students.This is a methodological study, developed in the period from April 2017 to April 2018 in a federal institution of nursing higher education, in Rio Grande do Norte, in twostages: the validation of knowledge instrumentand skills instrument. A total of 117 undergraduate student senrolled in the discipline of Semiology and Semiotechnics of Nursing participated in the validation phase of knowledge instrumentand 38 professionals from a research group from the same institution that Works with thematic of wounds. A total of 109 undergraduates participated of validation of skills instrument. The instrument sused were a question naire with 10 multiple choice question sapplied before and after wound classes and a checklist observation scriptwith 20 items, applied at the beginning of the practice class, before being given guide line sabout the procedure of dressing, and after the guidelines. Both instrument shadal ready been validated for content, buthad not yet been applied to the target public. The items of the questionnaire were analyze daccording to the index of difficulty and discrimination and those of the checklist as to the percentage of correct answers, using the Signal Test in the comparison of the two moments of application of the instruments. The research obtained a favorable opinion from the Research Ethics Committee of the University Hospital Onofre Lopes (CAAE nº: 0002.0.294.000-10). In the first stage of the application of the questionnaire, of the 10 questions 06 presented low level of difficulty before the classes, and after classes, this number increased to 09, with only 01 question of médium difficulty, and 08 questions in need ofrevision regarding the power discriminatory After the first review by there searchers of the study, 04 questions presenteed average difficulty after classes and 05 questions satisfactory discriminative power. After thelast review stage, according to the suggestions pointed out by there search group, 05 questions presented average level of difficulty, 03 questions low level of difficulty and 02 high difficulty before classes, 05 with a satisfactory index of discrimination. As for the application of the checklist, out of a total of 20 items, only 01 presented a percentage of accuracy above 70% before the guidelines. After the guidelines, 19 items presented na increase in the level of correctness, being this difference significant, except in the item related to hand hygiene before the procedure. The results indicate the validity evidence of the skills check list and, after the revisions, na improvement in the validity of the questionnaire, al though still in need of refinement.

11
  • DÉBORAH RAQUEL CARVALHO DE OLIVEIRA
  • Permanent education as a strategy for the nursing consultation at the patient with tuberculosis in primary health care.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • JOÃO BOSCO FILHO
  • KALYANE KELLY DUARTE DE OLIVEIRA
  • Data: Dec 20, 2018


  • Show Abstract
  • This study aims to evaluate the implementation of the Nursing Process in the consultation of patients with Tuberculosis in Primary Care through the verification of the effectiveness of an educational training program. This is a qualitative and exploratory study, anchored in the ideas of action research, to be carried out in the Municipality of Parnamirim, with primary care nurses. The study will take place in four stages: in the first, the nurses, through a focus group, will be submitted to a situational diagnosis about knowledge and application of the nursing process in Primary Care; In the second stage will be the development and validation of an educational program on the management of the Nursing Process within the nursing consultation to the patient with Tuberculosis; The third stage will be the application of the educational program with the nurses and finally the evaluation of the educational program with the nurses in order to learn their knowledge and implementation of the Nursing Process after the training. The educational process will be supported by the theoretical and philosophical concepts of Paulo Freire, one of the most respected personalities of Pedagogy and Education, with intense activity in Brazil and internationally. The proposal is an educational program that compares to a training process. The program aimed at nurses should not be extended, because it is a process of education in service, where professionals can not be absent for a long time from the health service. Thus, it will have an average duration of a 30-hour course. Analysis of action-research data will take place through content analysis. In order to be possible, the project will follow the ethical aspects that govern Resolution 466/2012 on research involving human beings. It will be sent to the Brazil Platform Online System, to initiate the ethical assessment, passing, prior to that, by the authorization of the Municipality through the issuance of an agreement term. The study becomes relevant as it can promote greater professional foundation in managing its actions in the care of patients with tuberculosis, as well as generating as a product an assistance technology that promotes greater professional emancipation in the care process.

2017
Dissertations
1
  • CAMYLLA CAVALCANTE SOARES DE FREITAS
  • Knowledge and skills of nursing academics on the measurement of blood pressure

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • RODRIGO ASSIS NEVES DANTAS
  • SIMONE CAMARGO DE OLIVEIRA ROSSIGNOLO
  • ALINE MAINO PERGOLA MARCONATO
  • Data: Feb 21, 2017


  • Show Abstract
  • The blood pressure’s measurement is a routine procedure in the practice of nurses, and learning this procedure is a concern for educational institutions, due to failures that can occur by knowledge deficit. Moreover, the lack of knowledge culminates in compromise of the values obtained, interfering in the patient’s clinical evaluation.The aim of this study is to analyze the knowledge and skills of undergraduate nursing students from the 5th to 9th grade of the course, regarding the measurement of blood pressure. Cross-sectional and quantitative analytical study carried out at the Nursing Department of the Federal University of Rio Grande do Norte, Natal / Rio Grande do Norte.The population refers to 204 academics, and the sample was scale in 76 participants based on an alphabetical list with all the academics ‘names of each period, which all the odd numbers was select to develop this research. This study was evaluate by CEP / HUOL (CAAE nº 0002.0.294.000-10) with a favorable opinion. The identification of knowledge occurred through the application of a structured and validated survey questionnaire, with objective questions divided into: sociodemographic characteristics and professional / work experience, and knowledge about the procedure. The verification of the ability occurred in a simulated laboratory, with the appropriate or inadequate judgment of the items that make up the validated checklist regarding the procedure. There was a predominance of women (92.1%), young people (85.5%), with incomes of up to 5 minimum wages (68.4%), single, widowed or divorced women (84.2%), with no previous experience in health (82.9%) and training in the nursing area (86.8%), with only 6.6% working in the health area, which 5.3% still work. No student in the seventh period had adequate knowledge (0.0%), with total of 82.8% of inadequacies between the periods, and a level of correct answers of 61.8% of the questions. The technique was adequate in all periods with total of 89.5% and 60.5% adequacy in all steps, acquiring a judgment for "regular" knowledge and for the "good" technique. No significant association was found for the number of correct answers in the knowledge and percentage of correct answers between the course periods, with the p-value being significant only for the domain knowledge concepts and course periods (p = 0.05). The percentage of knowledge accuracy (mean 56.6 and SD 14.3) was more compromised than the technique adequacy percentage (mean 78.6 and SD 8.1), with a significant difference between the variables (p = 0.00), as well as in all five periods. It was found a correlation between the amount of knowledge adjustment and the amount of adequacy of the technique (r = 0.222; p = 0.05).

2
  • PATRICIA NAIARA DE OLIVEIRA MOREIRA
  • Nurses' conduct in the prevention of falls in the elderly in hospital institutions

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • JOÃO BOSCO FILHO
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Feb 21, 2017


  • Show Abstract
  • The objective of this study was to analyze nurses&#39; behavior in the prevention of falls in elderly people hospitalized in public hospitals, in the Eastern Sanitary District, in the city of Natal-RN. This is a descriptive and Exploratory study carried out in Public Hospitals of the Eastern Sanitary District of the city of Natal, through a descriptive observational sample with 130 nursing assistants from the medium and surgical clinic sectors, from December 2016 to January 2017. Data collection Beginning after obtaining letters of agreement from the institutions and approval by the Ethics and Research Committee, under No. 1,850,668, followed by the testing of the instrument. The data processing was performed in Excel spreadsheet, version 2010, for the accomplishment of the descriptive tables and application of statistical tests. Statistica SPSS 20.0, temporary free version software was used. About the results, the majority of the participants were female (87.6%), the majority were young adults between 31-40 years old (49.2%), married (51.5%) and admitted for 4 years (46.9%), who worked in the medical clinic (76.1%), working in the morning shift (49.2%), with only one link (57.6) and having a care position (96.9%). . Regarding the occurrence of the fall in hospitalized elderly, the results showed that (26.9%) of the nurses know of the occurrence of falls in the elderly in the institution, although the majority (73.0%) affirm that they do not know about the event in the institution. Among the main factors of the institution, which were able to increase the occurrence of falls were: absence of companion (70.77%), beds without grids (51.54%), bathroom without grab bars and non-slip floor (41, 54%), absence of alarms (39.23%), slippery floor (35.38%) and reduced luminosity (33.85%). According to a comparative analysis, by means of the X2 test, some variables such as: type of institution (university, place of study), graduation time, admission to the institution, only an employment relationship, besides higher professional qualification, presented statistical significance, Use or adhesion of the security protocol for the event falls in the university institution. It was observed that nurses' affirmations in the use of the nursing diagnosis to guide falls interventions, when compared to the age group and the institution, obtained a significant difference (0.0014) and, at the type of institution (0.000), by the Fisher&#39;s test. In conclusion, the importance of the use of instruments for reporting adverse events by institutions and control of occurrences and for the preparation of really effective preventive measures was concluded. It is observed the need to stimulate the safety culture that will allow discussing with the nursing team, prevention strategies that ensure patient safety in health institutions.

3
  • DANIELLE REZENDE FERREIRA
  • IDENTIFICATION OF NURSES' WORK LOADS IN THE FAMILY HEALTH STRATEGY

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • SORAYA MARIA DE MEDEIROS
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • JOÃO BOSCO FILHO
  • Data: Feb 22, 2017


  • Show Abstract
  • The workload is embedded in the work context and in the work process, which interacts with each other and with the worker&#39;s body, which can cause changes in the biopsychic state and, consequently, physical and psychological exhaustion. The present study aimed to identify the workloads of nurses who work in the Family Health Strategy in a Municipality of Northeast Brazil. The research is linked to a larger project entitled "Non-material technological innovation in health: workloads and satisfaction";, from the research group Praxis - Center for studies on work, citizenship, health and nursing, of the Graduate Program in Nursing Of the Federal University of Santa Catarina. This is an exploratory, descriptive, qualitative study of the type of field research guided by theories of historical-dialectical materialism and workloads. The sample consisted of 14 nurses of the Family Health Strategy (FHS), distributed in the five sanitary districts of the city of Natal (North I, North II, South, East and West). Data collection was done through semi-structured interviews aimed at each nurse working at the FHS. Data analysis was performed based on the thematic content analysis of Bardin. The project was approved by the Ethics and Research Committee (CEP) of the Federal University of Rio Grande do Norte (UFRN) under opinion nº 1.880.221 and CAAE: 62021516.7.0000.5537. The study was conducted on the basis of the principles of ethics set forth in resolution 466/12. The population interviewed is female (100%), with more than 5 years of professional experience (100%) and FHS (100%), most between 50 and 59 years old, with specialization / residency (50%), effective / With a 40-hour working day (85.71%) and only one job (85.71%). Among the factors that increase workloads are excess demand, management failures, solving problems, insecurity, being responsible for the work of other professionals, excess demand, and the lack of materials. The factors that help reduce workloads are bonding, teamwork, management support, enjoying working at the ESF. Workloads are influenced by the interrelation of work with the health professional, and this dialectic relationship can lead to the sickness of the nurse member of the FHS.

4
  • JÉSSIKA WANESSA SOARES COSTA
  • Impacts of stress and its association with eating behavior in undergraduate nursing students

  • Advisor : MILVA MARIA FIGUEIREDO DE MARTINO
  • COMMITTEE MEMBERS :
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • SORAYA MARIA DE MEDEIROS
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • TERESA CELIA DE MATTOS MORAES DOS SANTOS
  • Data: Jun 21, 2017


  • Show Abstract
  • Introduction: With the increasing opportunities to enter the academic milieu, thousands of people cross the doors of universities every year. In this new scenario, the student faces numerous stressors in the face of new challenges. Objective: To analyze the levels of stress and its association with the eating behavior of undergraduate students in Nursing at a public university. Method: This is a cross-sectional, observational study with a quantitative approach carried out with 280 undergraduate students in Nursing. The information was collected from February 20 to March 21, 2017, through three questionnaires: Questionnaire for the survey of sociodemographic data, Scale for Stress Assessment in Nursing Students and the Dutch Questionnaire on Eating Behavior. The application of the instruments occurred in the classroom simultaneously, after the period of the first evaluation tests and with the authorization of the disciplinary coordination. The schedules for the collection were pre-established by the coordination of the disciplines, distributed in the shifts: morning and evening. All participants were instructed on procedures for data collection, with a maximum application time of 15 minutes. Results: With the analysis, it was possible to establish the levels of stress per domain according to the period of the students' course. Corroborating to the following result considering the highest level of stress in relation to each domain: practical activity and professional communication higher level in the 4th period; Time management, 9th period; Environment and vocational training, 5th period; And theoretical activity, in the 7th period. Conclusion: It was found by designing the results a significant correlation between three of the six domains of the stress scale and the eating behavior of the students of the Nursing course. The analyzes showed a positive correlation between the domains of professional communication and time management versus eating behavior, evidencing that the greater the stress the greater the binge eating. The domain professional training versus eating behavior, presented negative correlation when related, demonstrating that the higher the stress the less the binge eating. In this sense, it is relevant to develop future research in the attempt to develop actions and strategies aimed at working the orientation of these students in dealing with stressors in an attempt to control them, and, consequently, to minimize the impacts of stress on activities of daily life of this university student.

5
  • MICHELINE DA FONSECA SILVA
  • Culture of patient safety of the nursing team in the urgent and emergency service

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • THEO DUARTE DA COSTA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Jun 26, 2017


  • Show Abstract
  • The culture of patient safety is shown as a topic of relevance, regarded as a strong indicator and an important diagnostic tool for evaluating the quality of health services. Its adherence is a challenge in the current days, since the process of changing attitudes and behaviors in health care is slow, demands time and work, besides requiring knowledge and participation of all professionals that are part of a service-rendering body of this type, which warns us about the essential need for combining these efforts to achieve the goals proposed by the Brazilian Ministry of Health to ensure Patient Safety and, consequently, contribute to the adherence to an effective and efficient safety culture. Accordingly, the object of this study is the safety culture in the urgent and emergency service. In light of the above, we ask: How do nursing professionals perceive the safety culture? In order to answer this question, the objective is to analyze the safety culture of nursing team in the urgent and emergency service. This is a descriptive-analytical study, developed in the Clóvis Sarinho Emergency Room (PSCS). The data were obtained through the completion of the “Research on Patient Safety in Hospitals” (HSOPSC) instrument, which is composed of 42 items addressing objective and subjective questions and encompassing 12 dimensions that assess the culture of patient safety, and these topics are evaluated according to the five-point Likert scale regarding the degree of agreement. Other questions contained in the instrument are related to the assignment of notes to patient safety, report of the number of notified events and sociodemographic profile. The data were descriptively analyzed by means of a statistical package, with the purpose of determining the average and percentage values concerning the calculations of the dimensions of the safety culture. The comments on patient safety, which constitute the last question of HSOPSC, were processed and analyzed with the support of the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ) software. This study was submitted to the Research Ethics Committee of the Federal University of Rio Grande do Norte and obtained approval by means of a consubstantiated opinion numbered as 1,847,136, under the Certificate of Presentation for Ethical Consideration numbered as 61201316.3.0000.5537. We found that the dimensions more prone to improvements were organizational learning – continuous improvement (49.7%), expectations about your supervisor/boss, actions to promote patient safety (47.5%) and team work within the units (45.5%); however, non-punitive answers to errors (58.8%), frequency of event reports (51.5%) and suitability of professionals (51.1%) were regarded as critical areas. As for the perception of professionals on patient safety, the aspects regarded as essential for promoting it in the urgent and emergency service are the safe and propitious environment for the effective and efficient patient care, in order to mitigate or prevent possible damages; the availability of physical structure and human resources; team work; and the use of protocols. Therefore, we noted the presence of a punitive culture in the research scenario and the need for action on the part of managers, with the aim of disseminating and strengthening good safety practices in the urgent and emergency environment and, consequently, providing support to health professionals in their work process.

6
  • ALCIDES VIANA DE LIMA NETO
  • Perception of patient safety culture by nurses of intensive care units.

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • MARCOS ANTONIO FERREIRA JUNIOR
  • SUSANE DE FÁTIMA FERREIRA DE CASTRO
  • VILANI MEDEIROS DE ARAUJO NUNES
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Nov 23, 2017


  • Show Abstract
  • The safety culture, understood as the product of values and attitudes in an organizational environment is an important factor to be considered in the context of safe care in health services. It is necessary to meet it for professionals to adopt strategies to ensure patient safety in various scenarios of healthcare practice. Thus, the object of this study was the safety culture in the context of intensive care units (ICUs), under the watchful eye of nurses, once they are entered into this environment and are responsible for the management of actions related to care. So, the objective was to analyze the perception of culture of patient safety in intensive care units through the perspective of nurses. This is a descriptive and exploratory study with a mixed approach. The field of study was made in four general ICUs in the municipality of Natal/RN/Brazil, which present similar characteristics, but belonging to different hospital services and with public and private managements. 45 nurses participated in the study. Data collection occurred through filling instrument with socio-demographic data, semi-structured interview with open-ended questions and filling in the questionnaire entitled research on patient safety in hospitals (HSOPSC), from April to June 2017. The interviews were analyzed with aid of the Iramuteq software and the software figures Statistical Package for the Social Sciences (SPSS) through descriptive statistical analysis. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte (CEP-UFRN), with certificate of introduction to ethics assessment: 62818516.7.0000.5537. From the interviews emerged the understandings of professional nurses on patient safety and actions for the promotion of this in ICU, as well as aspects that facilitate and/or hinder, highlighting the weaknesses of the structural resources. With respect to safety culture, we identified that the dimensions related to teamwork, organizational learning and openness to the communications they obtained the best percentage of positive responses. As regards weaknesses and opportunities for improvement, emphasized the dimensions not punitive responses to errors and the personal dimension. Those that presented the greatest results classified as neutral responses were teamwork by hospital units and frequency of reports of events. With that, the nurses of ICU analyzed realize the strong presence of a punitive culture and weaknesses of resources that are essential to patient safety. Thus, it becomes necessary to a look of management to these issues in order to contribute to the reduction of these us-critics and implement safety culture.

7
  • ALEXANDRA DO NASCIMENTO CASSIANO
  • REPERCUSSIONS OF SERIOUS PRE-ECLAMPSIA IN NEONATAL DISEASES

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • CRISTYANNE SAMARA MIRANDA DE HOLANDA DA NÓBREGA
  • MARIA DE LOURDES COSTA DA SILVA
  • NILBA LIMA DE SOUZA
  • Data: Nov 24, 2017


  • Show Abstract
  • Introduction: The analysis of neonatal and maternal health indicators is used globally as a marker of the effectiveness of health services in a country. The perinatal period demands special attention, since the vulnerability of the fetus and neonate in the face of exposure to obstetric pathologies that influence perinatal health, such as severe preeclampsia. Objective: To analyze the factors associated with the neonatal outcomes of pregnant women diagnosed with severe preeclampsia. Methodology: This is a cross-sectional study developed in a maternity school, whose population corresponded to the fetuses / neonates of pregnant women diagnosed with severe preeclampsia. The sample corresponded to 157 charts, in a 12-month cut-off. Fetuses / neonates of pregnant women diagnosed with severe preeclampsia were excluded, and the fetuses / neonates of pregnant women with diagnosis of other hypertensive syndromes were excluded. SPSS 2.0 was used to analyze the data. The pre-project was approved with opinion number: 2,013,851 and C. A. A. E: 64881817.5.0000.5537. Results: As for vitality at birth, most newborns were born alive (91.1%). The incidence of fetal death was 7.6% and neonatal precocious 1.3%. Gestational age had a mean of 36 weeks (SD: 3.38); with a mean birth weight of 2,596 g (SD: 855.08), a higher proportion of low birth weight (43.3%) patients. The APGAR index in the first and second minutes was 7.1 (SD: 2.64) and 8 (SD: 2.55), respectively. 56, 7% of the neonates were male and 20.2% of the newborns required resuscitation in the delivery room. The most frequent neonatal morbidity was respiratory discomfort (14.6%). Admission to the neonatal intensive care unit occurred in 18.5% of the cases. The characterization of the mothers corresponds to a profile of women with a mean age of 27 years (SD: 7.38), 9 years of schooling (SD: 2.72), income of up to 1 salary (91.7%), union stable (64.3%), brown (80.3%), primigravida (41.4%) and primipara (46.5%). The mean prenatal visits were 6.73 (SD: 2.74). Conclusions: Exposure of the fetus / neonate to severe preeclampsia had repercussions on the incidence of fetal intrauterine death, preterm gestational age, presence of intrauterine growth restriction and, consequently, low birth weight, and the need for resuscitation respiratory distress and admission to the intensive care unit.

8
  • AMANDA BARBOSA DA SILVA
  • VALIDATION OF NURSING RESULTS MOBILITY IN ELDERLY PATIENTS WITH CHIKUNGUNYA FEVER

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • FABIANE ROCHA BOTARELI
  • MARCOS ANTONIO FERREIRA JUNIOR
  • RAFAELLA PESSOA MOREIRA
  • Data: Dec 5, 2017


  • Show Abstract
  • Chikungunya fever represents a problem with international renown for public health and epidemiology, because the aborvirus-transmitted disease is part of the group of infectious diseases with emerging and re-emerging potential. The study aimed to validate the Nursing Mobility Outcome in the elderly with Chikungunya Fever. Methodological study carried out in three stages: integrative literature review, semantic validation and clinical validation. The first stage of the study consisted of an integrative review of the literature with the objective of adapting the instrument constructed and validated by Moreira (2011), to the elderly population with Chikungunya Fever. The integrative review occurred from February to April 2017, in the databases, namely: CINAHL, COCHRANE, LILACS, PubMed, SCOPUS, Science direct and Web of science. There was an uncontrolled search of the scientific productions, without temporal cut, by the indexed and non-indexed descriptors and the 12 indicators of the Nursing Outcomes Classification for the Nursing Outcome Mobility. Then, for the semantic validation stage, the instrument was delivered to 12 nurses working in primary health care. Subsequently, the third step consisted in the clinical validation of the instrument adapted to the elderly population affected by Chikungunya Fever. The study was carried out in seven health units belonging to the Municipal Health Department of the Municipality of Natal / RN. The data collection occurred in July and August of 2017 in 90 elderly patients affected by Chikungunya Fever evaluated by two pairs of nurse evaluators. For the analysis of the textual content of the integrative revision, the software Interface of Routles Analyzes Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ) version 0.7 Alpha 2 was used. The data of the semantic and clinical validation were organized in spreadsheet in the program Microsoft Office Excel 2012 and exported to the statistical program Statistical Package for Social Sciences version 22.0 for Windows. In the semantic validation, a binomial test with agreement equal or superior to 85% was applied. For clinical validation, descriptive analyzes were calculated on the measures of the distribution center and its variabilities. The Friedman test was used to verify divergence between evaluators with previous post hoc analysis by the method of least significant difference in cases of statistically significant difference. The intraclass correlation coefficient was calculated to compare the correlation between the evaluations performed by the nurses evaluators and the Cronbach's alpha coefficient to verify the internal consistency of the double evaluators. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under CAAE nº 64880017.9.0000.5537. In the Integrative Review, the Descending Hierarchical Classification pointed out two main axes related to Chikungunya Fever related to articles that prioritize clinical evidences of the acute phase and by signs, long-lasting symptoms and disabilities of the subacute and chronic phase. The articular pain indicator was added because it was considered important in the literature through word cloud. As for the semantic validation stage, the instrument was considered intelligible for evaluation by the nurses. Eight indicators reached or exceeded the agreement index of 0.85 with the exception of the transfer performance indicator, since the agreement was 0.83 and p <0.05. Thus, the need to revise the Performance indicator in the transference regarding the intelligibility criterion. It is concluded that the study allowed to adapt the instrument validated for the elderly population with Chikungunya. In this way, it was possible to observe that the instrument applies to the population in question and its adaptation will contribute to measure the impact of the assistance provided by the nurses to the attacks of the Chikungunya Fever. The validity of the indicators capable of measuring the mobility of the elderly patients affected by Chikungunya Fever by the nurses was also verified, however, the need for improvement of the transfer performance indicator was verified.

9
  • CINTIA CAPISTRANO TEIXEIRA ROCHA
  • CROSS MAPPING OF TITLES OF NURSING DIAGNOSES FORMULATED BY ICNP® VERSUS NANDA INTERNATIONAL DIAGNOSTICS FOR PEOPLE LIVING WITH AIDS

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • GREICY KELLY GOUVEIA DIAS BITTENCOURT
  • MARIA MIRIAM LIMA DA NÓBREGA
  • QUENIA CAMILLE SOARES MARTINS
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Dec 6, 2017


  • Show Abstract
  • This is a cross-sectional study with the objective of cross-mapping the titles of nursing diagnoses (ED) of people living with AIDS formulated according to the International Classification of Nursing Practice (CIPE®) with NANDA International diagnoses (NANDA-I), as well as to classify the mapped titles according to Wanda de Aguiar Horta's Basic Human Needs theory (NHB) with the following validation of the product content of the mapping. The CIPE® and NANDA-I diagnostics certificates for people living with AIDS were tabulated in the Microsoft Excel (Office 2013) program and two lists were drawn up, in which the nursing diagnosis titles were compared between the classification systems, along with their , respective operational definitions / concept, in constant and non-constant securities. Then, the non-constant securities were submitted to analysis using the criteria derived from Leal (2006), being classified as: similar, more comprehensive, more restricted, there is no agreement. The mapping products were submitted to content validation by consensus. For this, the agreement index was equal to or greater than 0.80 among the specialists. Specialists in the CIPE® classification system were selected at the CIPE Center, located in João Pessoa / PB; and in the NANDA-I classification system was used the search tool of the Lattes Platform of the portal of the National Council of Scientific and Technological Development (CNPq). The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte through Opinion No. 1,963,581 and presentation certificate for ethical assessment nº47380915.2.0000.5537. We found 135 nursing diagnoses, of these 84 of the CIPE® classification system and 51 of NANDA-I. After cross-mapping, 81% of CIPE® DE were non-accommodating in NANDA-I, while 19% were constant. Of the 81% that were not constant, they were classified according to Leal (2016) in: 23% similar, 12% more restricted, 6% more comprehensive, 1% no agreement and 58% not found NANDA-I correspondent. When classified according to the NHB, they were, respectively, for the CIPE® and NANDA-I classifications: Psychobiological 77% and 80%; Psychosocial 19% and 16%; Psychospiral 4% and 4%. Given the amount of ED for people living with AIDS according to CIPE®, superior to those of NANDA-I, it was perceived a greater freedom for its elaboration, since it is based on the use of terms for elaboration of its DE, in addition to such terms are predominantly associated with clinical signs and symptoms, which allows a greater approximation of clinical practice diagnoses. As for NHBs, there was a predominance of diagnoses for psychobiological NHBs using both ICNP and NANDA-I. This fact is related to the hegemony still of the biomedical health model, directed to the body, besides being justified, in part, by the specificity of the clientele, in which several physiological changes occur with the installed pathology. It was verified that the clinical reasoning process for the elaboration of the nursing diagnostic titles using both classifications led to the formulation of ED with similar patterns when we added the 16 counters to the non-constant, but similar 19, resulting in 42% of the DE . This fact showed that using a clinical reasoning with accuracy, the nurse can make use of both classifications. The study is important because it compares the practical use of the two most used nursing classifications in the world, helping the decision-making of nurses based on scientific knowledge in such a complex and specific clientele, besides contributing to the development of ICNP and NANDA-I and, consequently, strengthen Nursing as a science.

10
  • RAIANNY ALVES COSTA MEDEIROS
  • Prevalence of Ocular Resurrection and Nursing Diagnosis Dry Eye Risk in adult post-operative patients

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • FABIANE ROCHA BOTARELI
  • MARCOS ANTONIO FERREIRA JUNIOR
  • RHANNA EMANUELA FONTENELE LIMA DE CARVALHO
  • Data: Dec 14, 2017


  • Show Abstract
  • The objective of this study was to characterize Ocular Dryness and the Diagnosis of Nursing (OD) Dry Eye Risk in adult patients in the immediate postoperative period. This is a cross-sectional study, carried out at the Surgical Center and Post-Anesthetic Recovery Unit (URPA) of the Onofre Lopes University Hospital, from May to August 2017. The population consisted of adult patients submitted to elective surgical procedures, final sample of 157 patients. The data collection instrument consisted of epidemiological and clinical data, Aldrete and Kroulik scale, risk factors for NANDA-I dry eye risk, Schirmer's test and NOC nursing result (Eye Gravity Seco) improved by Fernandes (2015). Two diagnostic nurses analyzed the data and defined the study outcomes. The data were analyzed by the Statistical Package for Social Science (SPSS) version 22.0. In the descriptive analysis we used frequencies, measures of the distribution center and respective variabilities. In the normality of the data used Shapiro-Wilk; in the comparison of the average of independent samples, Student t; for asymmetric data, Mann-Whitney; in the analysis of associative variables, Pearson Chi-square and in frequencies smaller than five, Fisher test. The magnitude of the association by the Prevalence Ratio and the Confidence Interval (CI) of 95%. A significance level of 95% (p≤0.05) was considered in all tests used. A favorable opinion was obtained from the Research Ethics Committee No. 2,004,545 and CAEE 64881717.5.0000.5537. The patients were informed of the objectives of the study and asked to sign the Informed Consent Form (TCLE). It was obeyed the determinations of Resolution 466/2012 of the National Health Council, of the Ministry of Health of Brazil. Of the 157 patients in the study, 52.23% were males, with a mean age of 48.90 (± 15.98) years, with a partner (60.51%) born in the interior of Rio Grande do Norte, 05%), reside in the capital of the RN (49.8%), have an average study time of 9.11 (± 3.94) years, work with remuneration (54.78%) and receive on average 1.63 (± 1,21) minimum wages. The prevalence of Ocular Dryness was 85.35% and of the OD of Dry Eye Risk of 14.65% in patients in the immediate postoperative period. The Right Eye Ocular Dryness (OD) was 95% more prevalent in patients who used the general anesthetic and 21% more prevalent in the use of the gastric secretion inhibitor / protector. Patients with dry eye risk factors who used the general anesthetic had a 30% lower prevalence of developing this outcome. Patients with aging factors and treatment regimen had 82% and 62% less prevalence of developing Ocular Dryness in OD and Left Eye (OE) respectively. Patients with hyperemia presented 3.19 times more prevalence of Ocular Dryness in the DO. Excessive tearing was 3.77 times more prevalent in patients with ED. Schimer presented statistical significance (P <0.001) in the studied outcomes. The present study is relevant to encourage initiatives to prevent eye dryness in surgical patients.

11
  • ANA BEATRIZ FERREIRA VITORINO
  • GROWTH AND DEVELOPMENT OF THE CHILD WITH MICROCONFALIA ASSOCIATED WITH VERTICAL TRANSMISSION OF ZIKA VIRUS

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • CRISTYANNE SAMARA MIRANDA DE HOLANDA DA NÓBREGA
  • ERIKA SIMONE GALVAO PINTO
  • NILBA LIMA DE SOUZA
  • Data: Dec 14, 2017


  • Show Abstract
  • INTRODUCTION: Zika virus infection is characterized as an acute febrile illness with a higher prevalence of asymptomatic infection. Microcephaly is an anomaly, in which there is poor brain formation, with irregularities of structures and functions to the newborn present at birth. The study is justified by the importance of knowledge about the growth and development of children with microcephaly related to Zika virus, with a view to monitoring and stimulating their skills with family and professionals. OBJECTIVE: The objective was to analyze the changes in the growth and development of children with microcephaly related to the vertical transmission of the Zika virus. METHODOLOGY: This is an epidemiological and descriptive study of a quantitative approach performed at the pediatric outpatient clinic of the Federal University of Rio Grande do Norte, located in the city of Natal, Rio Grande do Norte. The study had as a target audience all children diagnosed with microcephaly related to transmission by the Zika virus and accompanied at the research site that totaled the quantitative of 36 children during the collection period. The collection was performed between July and October 2017, using an instrument divided into two parts, applied to the mothers of newborns with Microcephaly and the other part with data on the consultation of growth and development of newborns. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under the number CAAE 64872817.2.0000.5537. Data were submitted to the Statistical Package for Social Sciences - SPSS version 21, using descriptive and inferential statistics, and the Fisher and Mann Whitney test was applied at significance level α ꞊ 5%. RESULTS: The results indicated changes, based on the normality pattern, of almost all the child developmental milestones. Among the milestones of child development, the only one that was presented in 100% of the children investigated was the "Emits sounds, babbling". There were important changes in the neuropsychomotor development of the child with Microcephaly related to the Zika virus, as well as visual, speech, hearing, muscular changes such as hypertonia or hypotonia, as well as cervical uncontrol and alterations in the growth related to weight, height and body mass index. Associations between maternal and infant history were identified with their developmental milestones. CONCLUSION: The main alterations found in the growth and development of children with microcephaly related to the vertical transmission of Zika virus were alterations in neuropsychomotor development, ocular, visual alterations, communication delays and muscular alterations. Growth was detected in the body mass index. From the reach of the objectives one can think of the accomplishment of stimulation to these patients in order to increase their expectation and quality of life.

12
  • ELIABE RODRIGUES DE MEDEIROS
  • Evaluation of the degree of implantation of the Health in School Program in Municipaly of Natal

  • Advisor : ERIKA SIMONE GALVAO PINTO
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • NILBA LIMA DE SOUZA
  • OSVALDO YOSHIMI TANAKA
  • PAULA FERNANDA BRANDAO BATISTA DOS SANTOS
  • Data: Dec 18, 2017


  • Show Abstract
  • Introduction: The School Health Program proposes an execution of actions of prevention, promotion and attention to the health of the students of basic education with a purpose to contribute to the integral formation of these. Objectives: The general objective was to evaluate the degree of implantation of the School Health Program in the Municipality of Natal. The specific objectives: to elaborate the normative logic model of the School Health Program; identify the components of the structure and process of the Health in School Program; attribution of the diploma of the School Health Program. Method: Use a normative appreciation in all the steps of the research. A construction of the logical model was carried out through methodological research and based on Avedis Donabedian's theoretical methodological reference framework that considers a triad structure, process and result. Follow as steps of: problem description, data collection on the capabilities, resources and gaps of the intervention, presentation of proposed activities, identification of the products and / or expected results for each activity, organization of the components of the model and presentation of each component used. The quantitative approach for the evaluation of the degree of implantation of the School Health Program without Municipality of Natal/RN. During the enrollment period, the capital has 37 Family Health Units. In each worker, at least one professional of different categories (doctor, nurse, technician or auxiliary in nursing, community health agent, dentist and auxiliary or technical in oral health) counting 228 professionals. From the sample calculation for finite populations we identified that participatory 144 professionals in 24 units, equally distributed among professional categories. Predicting the representativeness of data throughout the municipality, it was recommended that a sample be distributed proportionally to the quantitative of Family Health Units in each health district. A structured questionnaire was constructed, based on the normative of the program, and filled with open and closed questions, organized in structure and process dimensions. A data collection took place between May and July 2017 and there was no replacement in case of non-participation in the program activities, professional refusal or absence during this stage. The data were organized into spreadsheets and analyzed using descriptive statistics without IBM SPSS Statistics Base 22.0. In order to identify the degree of implementation of the test we have closed questions that indicate a presence or absence of elements of the program through 13 criteria. The percentage of responses identified was distributed in four classifications corresponding to their degree of implantation: totally implanted (76% to 100%) partially implanted (51% to 75%), incipient implantation (26% to 50%) and not implanted (0% to 25%). Follow Resolution 466 of 2012 of the National Health Council, where it was studied by the Research Education Committee of the Federal University of Rio Grande do Norte, through opinion 2.064.901. Results: The logical model that is a promoter of an educational process conducive to the integral development of the student and the expected result of the School Health Program. Implementation of human resources, resources, infrastructures and materials to carry out clinical and psychosocial evaluation activities, health promotion and prevention of diseases and injuries, training of health professionals and education, monitoring and evaluation, and management planning meetings. Of the 144 professionals selected in the sample, 28 did not participate in school health activities, seven recruited and four servers in the data collection, resulting in 105 participants. From the obtained answers, it was possible to evaluate the degree of implantation of the School Health Program in Natal/RN. The intervention presents incipient implantation (33,23%), classification also found in the dimensions structure (29,39%) and process (34,94%). Financial resources and infrastructures, Public Health Week, clinical and psychosocial assessment activities and health promotion, prevention of diseases and injuries are not implemented. Human and material resources, municipal management planning meetings, school education, people training activities and continuing education and registration and information on the implementation of the incipient implant. The scheduling of activities for partially implemented evaluation. As non-territory planning meetings were fully implemented. Conclusion: The logical model made it possible to understand the structural organization, activities and results of the School Health Program and subsidized its evaluation process. The program presents an incipient implantation in Natal/RN, where it is necessary that the resources be made available to attend the needs of the program, that there is the articulation between the management and the professionals and that the training processes are intensified.

13
  • KADYJINA DAIANE BATISTA LÚCIO
  • Diagnostic proposition for Delayed growth in adolescents: content analysis and clinical validation

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • PAULA FERNANDA BRANDAO BATISTA DOS SANTOS
  • NIRLA GOMES GUEDES
  • Data: Dec 18, 2017


  • Show Abstract
  • The term growth is often used loosely as synonymous with development. Although correlates, these are different phenomena. Growth is a complex biological phenomenon genetically determined and modulated by extrinsic factors. In the period of adolescence, the human being experiences a series of alterations and his second outbreak of growth. In view of the need to clarify this term, to analyze the factors influencing and the characteristics of this delay during adolescence and to contribute to the advancement of nursing, this study aims to make a diagnostic proposal on the delay in growth in adolescents before the stages of analysis of content and clinical validation. It is a methodological study, developed in two stages, namely: content analysis and clinical validation. In the first stage, the opinions of the specialists were requested regarding the adequacy of the components and definitions of the diagnostic proposal, through the focus group with nine nurses from the clinical practice and who work with nursing diagnoses. There were three meetings, from January to February, 2017. The second stage was evaluated in clinical practice, the most accurate consequences for the diagnostic proposal Delay in Growth in adolescents. The instrument was applied to 385 adolescents from eight state schools located in the city of Natal. To analyze the data, descriptive and inferential statistics were used. In the descriptive analysis, measures of central tendency and dispersion were adopted. In inferential, measurement of the accuracy measurements of the defining characteristics of the presented diagnosis. This process was performed through the latent class analysis, obtaining values of specificity and sensitivity. The research project was submitted and approved by the Research Ethics Committee under number 1,713,820 and Certificate of Presentation for Ethical Appreciation: 57945016.4.0000.5537. The diagnostic proposal resulted in 15 indicators, eight factors related to the delay in growth and seven defining characteristics. As a definition for the proposed diagnosis, it was adopted: Growth below that expected for individuals of the same sex, in the age group from 10 to 19 years. The experts judged by the allocation of the diagnosis according to the NANDA taxonomy in Domain 13 "Growth / development" and in Class 1 "Growth". Thus, it is hoped to contribute to the nurses' diagnostic reasoning regarding adolescent care, as well as to broaden the nursing state of the art.

14
  • FERNANDO HIAGO DA SILVA DUARTE
  • BANK OF SPECIAL NURSING LANGUAGE TERMS FOR PATIENTS WITH PRESSURE INJURY

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARIA ALZETE DE LIMA
  • MARIA MIRIAM LIMA DA NÓBREGA
  • MIRIAN ALVES DA SILVA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Dec 18, 2017


  • Show Abstract
  • Pressure injury is the result of prolonged pressure on an area of the patient's body by decreasing blood circulation, minimizing the distribution of blood, nutrients, and oxygen in this area, triggering destruction and tissue death, as the soft tissue is compressed between a bone prominence and a hard surface for an extended period of time. The terms bank of the special nursing language identifies concepts that contribute to the construction of nursing diagnoses, results and interventions. The use of this bank aimed at patients with pressure lesions allows the development of a pyramidal identification of an own vocabulary directed to nursing care. The aim of the study was to construct a bank of terms of the special nursing language for patients with pressure injury, using the International Classification for Nursing Practice version 2015. This is a terminological study in a private hospital in the northeast capital of the Brazil developed in six steps: 1) Identification and collection of terms relevant to the practice of Nursing related to pressure injury; 2) Extraction of the terms of the medical records and elimination of repetitions; 3) Standardization of terms; 4) Cross-mapping between extracted terms and the terms in CIPE® version 2015; 5) Refinement of terms; 6) Validation of the terms bank statements. Approval was obtained from the Research Ethics Committee of the Federal University of Rio Grande do Norte, under opinion no. 2.356.736 and Certificate of Presentation for Ethical Appreciation nº 76777017.20000.5537. It was identified 391 terms that were submitted to the process of cross-mapping and validation of specialists that resulted in 391 terms, being 225 constant terms and 166 terms not included in the International Classification for Nursing Practice, version 2015. The study allowed to explore and to know the terms used by nurses in the care provided to the patient with pressure injury, allowing the development of statements of diagnosis/results and nursing interventions and also the unification of nurses' professional language.

15
  • ISADORA LORENNA ALVES NOGUEIRA
  • Nursing diagnosis related to delayed development: content analysis and clinical validation

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • PAULA FERNANDA BRANDAO BATISTA DOS SANTOS
  • NIRLA GOMES GUEDES
  • Data: Dec 18, 2017


  • Show Abstract
  • Adolescent health care is a major challenge, due to the needs of this age group and the configuration of health services. In this sense, the National Policy for Integral Attention to the Health of Adolescents and Young People arises in order to include this population in the network of attention of the Unified Health System, guaranteeing assistance directed to the peculiarities of that age. Adolescence is the period between childhood and adulthood, responsible for numerous physical, social, psychological and cognitive changes in the individual. The term development encompasses a continuous, maturational process that takes place at different stages of life. It differs from the concept of growth, which is exclusively related to quantitative aspects. The aim of the study is to analyze the content and accuracy measures of nursing diagnosis Delay in development. It is a methodological study, directed by two stages: content analysis, developed with nine specialists who evaluated, through the focal group, the components of said diagnosis, and clinical validation, which has been carried out in order to identify the characteristics defining adolescents with better accuracy in the school environment of Natal-RN. The study was approved by the Research Ethics Committee of the institution responsible, under protocol number 070.358 and Certificate of Presentation for Ethical Appraisal 57945016.4.0000.5537. The results of the Content Analysis evidenced that the quantitative of related factors went from 16 terms to 17 antecedents, inserted in the nursing diagnosis. Delay in development, due to the relocation of the consequent term Attention deficit and hyperactivity, to compose the antecedents. Likewise, the defining characteristics changed from 14 terms to 12 consequent, by exclusion of the consequent Attention deficit and hyperactivity and Difficulty of expressing emotions. As such, the focus group worked, partially or totally, on the restructuring of the terms related to the conceptual analysis carried out by Delgado (2016). For the second stage of the research, the pre-test of the instrument of data collection, including 10% of the predicted sample, was carried out to verify its suitability. It was held during the month of July 2017, in two school institutions, totaling 39 students. It was verified the adequacy of the instrument adopted, being therefore included the 39 adolescents in the final sample of the study (385 students). Data were collected from July to September 2017 to measure the accuracy of the defining characteristics in the East Zone (119 students), the Northern Zone (78 adolescents), the West Zone (92), and the South Zone (96). The data tabulation in Microsoft Excel was completed for subsequent routing to statistical analysis, data organization and discussion with relevant literature. From the study, it is hoped to contribute to the strengthening of the public policy focused on adolescent health and to the clinical reasoning of nurses, regarding the assistance provided to adolescents in the school environment.

16
  • CINTIA GALVÃO QUEIROZ
  • EVIDENCE OF VALIDITY OF ADAPTIVE INSTRUMENT FOR THE PRE- AND POST-
    OPERATIVE OF INTESTINAL STOMISES IN THE LIGHT OF THE ROY ADAPTATION MODEL

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MIRIAN ALVES DA SILVA
  • Data: Dec 19, 2017


  • Show Abstract
  • Taken for therapeutic purposes, the stomies are called ileostomy and colostomy, depending on the segment to be externalized, of a temporary or definitive character. This surgically created opening divert the stool directly from the gastrointestinal tract to the outside, making it necessary to use an external collection bag to the body. The person is faced not only with the loss of an important segment, but with altered body image, gastrointestinal physiological changes, self-esteem, sexuality and daily activities. These changes require adaptive skills in all areas of life. In this perspective, nursing care in pre and postoperative care is essential. The nurse is fundamental in the process of orientation and adaptation of the stomeized and should be able to identify the level of adaptation and intervene to promote it. The process of rehabilitation of stomates, when elaborated in a holistic and systematized way, through the first stage of the PE, data collection becomes an incentive tool for adaptation. To do so, it is necessary to create instruments that facilitate the collection of data, providing a significant improvement in the quality of care. Thus, the importance of the organization of the care given to stomized patients is reinforced, based on a theory that meets the needs of this clientele. In this context, a relationship can be established with Roy's Adaptation Model, since the range of physical, social and psychological needs that affect this population function as stimuli that promote adaptive or inefficient responses. This is a quantitative methodological study carried out in three stages: the construction of the preliminary version of a nursing consultation guiding instrument based on the Roy Adaptation Model, based on the definitions of constitutive and operational, from the components of the model of Adaptation of Roy (1st stage), submission of this instrument for validation of its content to the specialists through the technique of focus group (2nd stage) and pre-test of the pilot instrument for semantic analysis performed by a sample of the population (3rd stage). To support the construction and validation of the instrument, the Theory of Psychometry was used, which is based on three poles: theoretical, experimental and analytical. For purposes of content validation, the present study was stopped at the theoretical pole. The validation process was analyzed by applying the Kappa Index, to verify the level of agreement and level of consistency of the judges in relation to the permanence or not of the items that make up the instruments, and the Content Validity Index. 09 judges were selected for the validation stage. The final version of the instrument has 34 items in total, of which 16 are patient identification, 6 are clinical history, 6 are surgical data, 67 are physiological, 15 are self-concepts, 3 are paper, 7 are interdependent. The results may have repercussions in the hospital environment, since it will enable patient data/behaviors to be obtained, guiding nurses, teachers and nursing students in the first stage of the nursing process. Finally, this study provides the technological development of nursing coming from the construction of an instrument in the light of Roy's Model of Adaptation, ratifying the systematization of nursing care. This study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, opinion 421,342 (CAAE nº 65941517.8.0000.5537).

17
  • THAIS ROSENTAL GABRIEL LOPES
  • LIVING OF FATHERS ARISING FROM THE CANGURU METHOD

  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • ANA CRISTINA ARAUJO DE ANDRADE GALVAO
  • ANA DORCAS DE MELO INAGAKI
  • FLAVIO CESAR BEZERRA DA SILVA
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • Data: Dec 19, 2017


  • Show Abstract
  • Worldwide, more than 2.7 million newborns die every year before they reach the age of five. In this context, Humanized Attention to Low Birth Weight Infant - Kangaroo Method is a strategy of humanization directed at neonatal health. The purpose of this method is to perform early and continuous skin-to-skin contact of the premature newborn with the mother, father and family. This practice increases the affective bond, encouragement to breastfeeding, neurobehavioural development, early discharge of the health unit, as well as the empowerment of parents and family members in view of the continuity of the method in the family environment. Based on the above, the objective was to understand the experience of the father in the kangaroo method with premature child. It is an exploratory and descriptive research, with a qualitative approach, anchored in the assumptions of the Theory Grounded in the Data and analyzed from the point of view of the principles of Symbolic Interactionism. The data were obtained with 15 men who lived the kangaroo method with the premature child, in the Kangaroo Intermediate Care Unit of the Maternity School Januário Cicco in Natal / RN, Brazil. According to the inclusion criteria, participants should be 18 years of age or older and living the Kangaroo Method. Data collection took place from March to July 2017. For this purpose, an instrument was used containing questions related to the socio-demographic characterization and an open question contemplating the research question. Preceded these steps the approval of the hospital, the approval of the Ethics and Research of the Federal University of Rio Grande do Norte Committee, CAAE No. 62020016.1.0000.5537 and opinion No. 1,850,383 as well as signing the Consent Agreement Informed by respondents. From the data collected and analyzed emerged the central category named "Parent experience in the Kangaroo Method" and three categories with their respective subcategories: Feelings experienced by the father in the realization of MC; Vision of the father on the kangaroo unit and parental involvement in the kangaroo method. Thus, it was evidenced that prematurity influences the feelings of men in the face of caring for the child. Given this, it is relevant that the Nursing team consider the various situations faced by the father in the face of prematurity of the child, with a view to minimizing antagonistic feelings and favoring a bond between the father-son dyad.

18
  • JULLIANA FERNANDES DE SENA
  • CONSTRUCTION AND VALIDATION OF EDUCATIONAL TECHNOLOGY FOR SELF-CARE OF OSTOMIZED PATIENTS

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ISABELLE KATHERINNE FERNANDES COSTA
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • MIRIAN ALVES DA SILVA
  • Data: Dec 19, 2017


  • Show Abstract
  • Living with the condition of having an ostomy causes several changes in the lives of people and their families. In this situation difficulties arise that often neither the patient nor the family is prepared to act in the face of the problem. All this generates the need to acquire new skills for self-care. Recognizing the importance of educational material with a focus on promoting the self care of ostomized patients, the present study aims to create and validate an educational booklet for this purpose. This is a methodological study that will be divided into two stages: The first one refers to a review of the literature on the subject, the preparation of educational material and a qualitative study with the ostomized patients of the Specialized Center for Rehabilitation and Enabling of Rio Grande do Norte (CERHRN), through a structured questionnaire. The second stage will consist of validation of content, appearance and suitability of the material by expert judges, as well as validation as to its organization, writing style, appearance and motivation of the booklet with the target population. The analysis of the data will be with respect to the validation of the educational booklet by the judges, the item and the instrument as a whole, which should present validation of the content with application of the Kappa Index (K) to measure the level of agreement and consistency of the judges in relation To the permanence or not of the items of the instrument, taking into account the indications of "inadequate" for them. In the analysis of the data judged by the target audience, the items with a minimum agreement level of 75% in the positive responses will be considered valid. Items with a concordance index of less than 75% will be considered worthy of change. After the suggestions made by the judges will be carried out the adequacy of the educational material, incorporating the suggestions, in order to meet the needs and expectations proposed. Educational technology will be available at ostomy care locations and provided to patients who show interest.

19
  • RENATA CLEMENTE DOS SANTOS
  • Violence and fragility in the elderly treated in a prompt care unit

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • ALEXSANDRO SILVA COURA
  • FABÍOLA DE ARAÚJO LEITE MEDEIROS
  • LUCIANE PAULA BATISTA ARAUJO DE OLIVEIRA
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Dec 21, 2017


  • Show Abstract
  • Violence against the elderly is considered a multifaceted and constantly muted phenomenon. It is understood that vulnerable and fragile elderly are more likely to become victims of violence, however, there are still few studies that seek to evidence the existence of this correlation. The objective of this study is to evaluate the correlation between the risk of violence and the frailty in the elderly attended at a Care Unit. It is a descriptive and exploratory study, with a quantitative approach. It was developed in the city of Campina Grande, in a Emergency Care Unit, after approval of the Ethics and Research Committee of the Federal University of Rio Grande do Norte under CAAE No. 69857317.2.0000.5537. The population was composed of all the elderly attending the Unit, in the months of August and September 2017. The sample of 146 elderly individuals was calculated according to the calculation of finite population with a sampling error of 0.08. We included people over 60 years old, who were in care and with physical and emotional conditions to respond to the instruments. The following were used: the sample characterization tool and the Edmonton Scales and the screening of violence against the elderly. The data collection took place after the consent of the institution, and followed the norms set forth in resolution no. 466/12 of the National Health Council and by signing the Term of Free and Informed Consent. Data were analyzed through the Statistical Package for Social Sciences (SPSS), version 20.0 through non-parametric tests. The results indicated the predominance of married and widowed elderly people, with low education (56.16%), male, up to 73 years old (53.42%), living in the city of Campina Grande (78.08%) and (64.38%) attended at the Emergency Care Unit classified in the green area of risk, being the most acute complaint, with (82.19%). Most of the elderly were classified as fragile (47.95%) and at increased risk for violence (69.86%). Through the chi-square test (X2) and fisher's exact test, and the significance level for p-value <0.05, it was observed in this study, there was a statistical relationship between the level of fragility and age, and the area of classification of care, while the risk of violence presented statistical significance for the age group. After the Spearman correlation test, with a significance level of 5%, the study demonstrated statistically significant correlation between the increase in the degree of frailty and the risk for violence in the elderly. The hypothesis of the study confirms that the fragility syndrome increases the vulnerability of the elderly being at risk of violence. In addition, it demonstrates the importance of the use of health professionals in the practice of instruments that evaluate these diseases for the purpose of early detection and to reduce their impact on the family, care services and the elderly.

Thesis
1
  • IELLEN DANTAS CAMPOS VERDES RODRIGUES
  • REALISTIC SIMULATION IN THE TEACHING-LEARNING PROCESS OF THE DIAGNOSIS OF NURSING

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • FERNANDO JOSÉ GUEDES DA SILVA JÚNIOR
  • FILADELFIA CARVALHO DE SENA
  • MARIA ALZETE DE LIMA
  • NILBA LIMA DE SOUZA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Mar 24, 2017


  • Show Abstract
  • The systematization of Nursing Assistance (SAE) emerges as a methodology for the organization of nurses&#39; work, facilitates customer care and confers scientificity on the profession, since it requires the use of theories. The Theory of Basic Human Needs, by Wanda de Aguiar Horta, consolidated the emergence of the Nursing Process (PE) in Brazil, a fundamental instrument for the implementation of SAE, which confers formal aspects to nursing care. Currently, the EP is regulated by Resolution 358/09, which provides for the SAE and its implementation. It is organized into five interdependent and recurrent stages, namely: data collection, nursing diagnosis (DE), nursing planning, implementation and evaluation. The nursing diagnoses constitute the second stage of the process, are constituted by characteristics and factors that define the health picture of the patient. It is a clinical judgment regarding the needs of the client, family and community, which guides nursing care towards efficiency, effectiveness and effectiveness of care. The task of diagnosing requires nurses critical thinking skills such as technical-scientific knowledge, analysis, logical reasoning, clinical experience, patient knowledge, discernment, among others. In order to facilitate and standardize the language used in the formulation of DE, the Systems of Classification for Nursing Practice emerge, highlighting the International Classification for Nursing Practice (CIPE) with international recognition. However, the use of classification systems and the implementation of the nursing process, in particular the construction of nursing diagnoses, still constitute challenges to be overcome in the 21st century. It is observed a lack of professionals regarding the handling skills of taxonomies and diagnostic reasoning, indispensable for the performance of ED. This implies a reformulation of teaching methods, so that learning takes place in an effective way for the student. In this context, active methodologies for teaching are emphasized, with an emphasis on realistic simulation that allows us to approach theory and practice, bringing greater satisfaction, learning, motivation, realism, confidence, improvement of techniques, reflexive thinking and transfers of competences between different realities. The purpose of this study is to evaluate the effectiveness of realistic simulation in the teaching-learning process of nursing diagnosis reasoning. This is an experimental, randomized controlled clinical trial (RCT). The research was carried out at the Nursing Department of the Federal University of Rio Grande do Norte (UFRN), Campus Natal. The study population consisted of nurses as specialists for validation of clinical cases and nursing diagnoses used in the simulation scenarios and undergraduate nursing students of the UFRN, attending the 9th period of the course, after completing the subjects of semiology and semiotechnology in Nursing care methods and models in nursing and integral health care I and II. The selection of the judges was carried out by means of a purposive, snowball and sequential sampling process among the members of the CIPE® Study Group and other study groups from Federal Universities working with the CIPE. And all the specialists who agreed to participate in the study, totaling a sample of 6 specilists, were included in the study. The sample of students was composed of 24 students, in two groups of 12 (control and intervention) respecting the control variables: age, sex, clinical experience, occupation, student profile and ARI. The data were collected in the period of March 2017, being composed by the stage of validation of the clinical cases and diagnoses, in which five priority diagnoses were validated: Immune system process impaired; Risk of Nutritional Deficit; Attitude towards health condition Impaired; Attitude regarding the management of conflicting medication; Continuity of impaired care. Next, the course &quot;Clinical Judgment and Critical-Reflective Thinking: competences for the learning of the diagnostic reasoning&quot; was carried out, which was developed in 5 steps: lecture-theoretical lecture, simulation scenario 1, 2 and 3 and evaluation of the course. The efficacy of the simulation strategy was evaluated by the correct scores in both groups after the pre and post-tests, comparing them with the diagnoses validated by the specialists. Data were organized into tables and analyzed based on absolute frequencies, measures of central tendency and dispersion, and on IVC and Kappa tests. To evaluate the independence of the study variables, the Fisher exact test was used (when the expected frequencies were lower or equal to 5. In all inferential calculations, the significance level of 5% (p &lt;0.05) will be adopted. As an ethical stance when conducting research with human beings, the study project was sent to the Nursing Department of the Federal University of Rio Grande do Norte to obtain the authorization of this institution and after its consent was sent to the Research Ethics Committee (CEP ) Of the Federal University of Rio Grande do Norte (UFRN). Regarding the subjects who agreed to participate in the study, a free and informed consent form was used, respecting resolution 466/12, which guarantees subjects anonymity and the right to withdraw from research when it is in their interest.

2
  • DIANA PAULA DE SOUZA REGO PINTO CARVALHO
  • The development of critical thinking in initial nursing education through an educational intervention.

  • Advisor : MARCOS ANTONIO FERREIRA JUNIOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ANA LUISA PETERSEN COGO
  • GREICY KELLY GOUVEIA DIAS BITTENCOURT
  • MARCOS ANTONIO FERREIRA JUNIOR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Apr 20, 2017


  • Show Abstract
  • Critical thinking requires the use of all the knowledge produced up to now, as well as searching for sources that feed the new knowledge roll and know how to direct them to practical application situations, with a unique evaluation capacity for each case. This characterizes a great challenge for the courses that are designed to develop such attributes, which lead to lifelong training. In this context, the promotion of critical thinking in undergraduate Nursing students has become one of the most imperative tasks for teaching at this level, which should be a common goal for all courses that aim to train nurses. It is hoped that the nursing professional will be able to develop the critical thinking applied to the problem of the moment, so that the care provided to the patient is adequate, regardless of the situation that presents itself and its adversities. Faced with these statements it is worth questioning whether a teaching strategy through the elaboration of Conceptual Maps associated with case studies favors the development of critical thinking in Nursing undergraduate students. To answer this question, the present study intends to compare the level of critical thinking developed between two distinct proposals of higher education in Nursing referring to the specific content of Advanced Life Support in Cardiology. It is an experimental, randomized, double-blind study with a before-after design to be carried out with undergraduate Nursing students from two public higher education institutions in different Brazilian regions. This project was submitted to the ethical assessment according to Resolution no. 466/12 of the National Health Council with favorable opinion number 752.501 and CAAE number 33917214.9.0000.5537. Data collection took place through the use of a validated and applied instrument, the California Critical Thinking Skills Test, complemented by a socioeconomic questionnaire. To reach the proposed objective and to follow the methodological rigor of the design, an Extension Course on Advanced Life Support in Cardiology was elaborated, composed of dialogic expository classes and practical activities in the laboratory lasting 40 hours. The 77 participants in the study were randomized to the Control Group (n = 38) and Intervention Group (n = 39) in which the study intervention consisted in the construction of four conceptual maps through Cmap Tools Software. This study obtained data from systematic literature reviews that suggest evidence-based practice as the teaching strategy that most favors the development of critical thinking, as measured by different measurement instruments, with emphasis on the California Critical Thinking Skills Tests. After the analysis of the tests, the average critical thinking score for the control group 15 (+/- 3.5) and for the intervention group 14.1 (+/- 3.7) in the pre-test and 14.6 (+/- 3.9) and 14.1 (+/- 3.4). There was no statistical difference for p-value of 0.05 according to the t-test. As for critical thinking skills, there was a significant increase (p-value 0.022) for the development of skill assessment in the intervention group. The study suggests that the conceptual mapping teaching strategy is useful in the refinement and development of critical thinking.

3
  • CLEA MARIA DA COSTA MORENO
  • Association of specific antibodies against Mycobacterium leprae to the risk of development of disabilities in leprosy

  • Advisor : MARCOS ANTONIO FERREIRA JUNIOR
  • COMMITTEE MEMBERS :
  • ELIZABETH BARICHELLO
  • FERNANDO DE SOUZA SILVA
  • MARCOS ANTONIO FERREIRA JUNIOR
  • SELMA MARIA BEZERRA JERONIMO
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Jun 26, 2017


  • Show Abstract
  • After twenty-six years of implementation of the use of multidrug therapy for the treatment of leprosy in Brazil, a significant number of cases are still found in health services, a condition that led the health authorities to assume it as a neglected disease. The consequences of such neglect are serious for those affected, as delays in the arrival of patients to services often already present nerve impairment, including disabilities and developed deformities. This study aims to associate antibodies specific to Mycobacterium leprae to the risk of developmental disabilities in leprosy. This is a quantitative approach, with a descriptive and analytical cross-sectional design, with an association between the presence of specific antibodies and the presence of disabilities. The subjects studied were enrolled from January 2014 to December 2015. The protocol of this research was submitted to the Ethics Committee in Research of the Federal University of Rio Grande do Norte and approved in its ethical and methodological aspects according to registration Of the CAAE no. 0042.0.051.051-09 and Opinion 2080/2012. The blood collection for the analysis of the antibodies of the cases was carried out in patients registered by the Leprosy Control Program of the dermatology departments of the Onofre Lopes University Hospital and the Giselda Trigueiro State Hospital, both of which are considered references in the state of Rio Grande do Norte for the treatment Of the disease. The results show that many actions need to be developed to control the disease, which presents a growing number of new cases. It has been found that high values in the amount of antibodies specific for the disease are strongly associated with the risk of developing disabilities, especially in males of more advanced age.

4
  • KISNA YASMIN ANDRADE ALVES
  • Written communication of health professionals in public hospitals of Rio Grande do Norte state, Brazil.

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ELIZABETH BARICHELLO
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • MARISE REIS DE FREITAS
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Aug 31, 2017


  • Show Abstract
  • The written communication is a tool that contributes to the reduction of damages to the patient, since it allows the unification of the records of the multidisciplinary team and the continuity of the assistance. The written communication is a tool that contributes to the reduction of damages to the patient, since it allows the unification of the records of the multidisciplinary team and the continuity of the assistance. As such, the present study aims to analyze the written communication of health professionals in public hospitals of Rio Grande do Norte state, Brazil. This is a subproject of the wider project entitled “Monitoring the safety indicators of patients in public hospitals of Rio Grande do Norte, Brazil”. It is a cross-sectional study with a prospective design based on the World Health Organization’s “Record review of current in-patients”. The following stages were followed: 1) a scoping review; 2) selection and training of records examiners; 3) testing of records assessment procedures (pilot study); and 4) development of a records review. To that end, we used portions of an instrument containing 10 subtopics and 92 items consisting of professional records and safe drug prescription, use and administration. The review took place between October and December 2016, at three public hospitals in Natal, Rio Grande do Norte state, Brazil, in clinical and surgical wards. Included in the sample were patients hospitalized for at least 10 days. The data were organized in a statistical package and analyzed in a descriptive way, by means of absolute and relative frequency and, Pareto Diagram. The study highlights the ethical principles established by Resolution 466/2012 of the National Health Council. The results highlight that the content of written communication comprises the elements common to the records - patient and professional identification, legible letters, use of acronyms and abbreviations Standardized, absence of erasure and beginning of writings with date and time - and elements specific to each professional category. From the medical records review, the main data on nonconformities were: 1) identification of the patient (headers) - date of birth and affiliation in the identification of the patient; 2) medical evolutions - aspects of the physical examination, personal and family history, habits and living conditions of the patient, intercurrences, laboratory and imaging results in medical evolutions; 3) nursing technician notes - life habits, presence of allergy, identification of the companion, use of medication as to type, general conditions about attitude, mood, locomotion and skin color, nutritional status and patien; 4) essential controls - unit of measurement after the vital signal; 5) nurse's notes - identification of the companion, coloration of the skin, eliminations as to consistency, odor and color; Orientation of the patient/companion; aspects about physical examination, life habits and presence of allergy; 6) common elements of written communication - legible letters, start of records with time and use of abbreviations; and 7) professional identification - category and number in the class council. It is concluded that the written communication of the health professionals in the three hospitals analyzed presents non-conformities in the patient and professional identification data, in the admission and daily records of both doctors and nursing staff. Thus, actions to improve the written communication of the professionals in the hospitals analyzed, as well as to contribute to the discussions about this subject are recommended for effective communication and safe care.

5
  • MANUELA PINTO TIBURCIO
  • REALISTIC SIMULATION AS A TEACHING-LEARNING STRATEGY IN THE TRANSFUSIONAL PROCESS

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • ANA ELZA OLIVEIRA DE MENDONCA
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • RENATA SILVA SANTOS
  • THALYTA CRISTINA MANSANO SCHLOSSER
  • Data: Dec 7, 2017


  • Show Abstract
  • Continuing education in nursing services guiding transfusion practices greatly reduces the number of events due to errors and complications. Knowledge has to be provided to the professionals the way they can understand the significance and impact of learning in your professional practice. To do this, using active methodologies, such as a realistic simulation, can be an alternative in order to make the process more interactive and efficient. The objective of the study is to evaluate the realistic simulation as a teaching-learning strategy in the acquisition of knowledge in the transfusion process for nursing professionals. Pre-and-after quasi-experimental study performed in the hospitals belonging to the Federal University o  Rio Grande do Norte (Hospital Universitário Onofre Lopes- HUOL, Maternidade Escola Januário Cicco e Hospital Ana Bezerra), in four stages: 1) Construction and validation of the instrument for the evaluation of the knowledge about the transfusion process with the judges of the research; 2) elaboration of the realistic simulation roadmap and organization of the scenarios; 3)Evaluation of the knowledge of professionals before and after the realistic simulation; 4)Evaluation of nursing professionals' satisfaction with the teaching strategy realistic simulation. It was appreciated by the Ethics and Research Committee of HUOL, with number CAAE: 58511516.0.0000.5292. For data analysis, descriptive and inferential analyzes were performed, adopting the statistical significance of p-value <0.05. The elaborated questionnaire, composed of ten multiple choice questions, presented evidence of satisfactory validity (IVC - 0.95; Kappa - 0.83). The total of 202 nursing professionals participated in the intervention, and cognitive learning increased significantly after a realistic simulation performance. Improved the gap of knowledge between pre-and post-test was evidenced in all questions and steps of the process, but mainly in those that dealt with the maximum time of infusion, storage and handling of blood components and classification of immediate and late transfusion reactions. In general, the level of satisfaction of the participants with a teaching methodology was very good, insofar as the strategy contributed to their learning and to the teaching of knowledge and skills, being considered interesting and useful for the vast majority of them. It is hoped that the study has contributed to highlight the importance of thinking about the methodology of realistic simulation as a strategy to health education actions, from technical courses, graduation to the training of professionals who are in the health area.

6
  • DALVA CEZAR DA SILVA
  • FAMILY SUPPORT AND QUALITY OF LIVING IN ELDERLY WITH VENOUS ULCERS IN THE CONTEXT OF PRIMARY HEALTH CARE 
  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • ALINE MAINO PERGOLA MARCONATO
  • ANA ELZA OLIVEIRA DE MENDONCA
  • DANIELE VIEIRA DANTAS
  • GILSON DE VASCONCELOS TORRES
  • MARIA DENISE SCHIMITH
  • Data: Dec 13, 2017


  • Show Abstract
  • The venous ulcer is the main chronic lesion of the lower limbs and has a high rate of recurrence and chronicity, thus, it demands complex health care. In different realities, from Brazil and the world, it is identified that the elderly are more affected by this type of injury and present health problems, which can cause negative changes in the quality of life. Due to the complexity and implications of this condition, Primary Health Care is indicated as a space to work the autonomy and co-responsibility of the elderly with venous ulcer and their family, in search of the improvement of the quality of life. In this sense, the objective was to evaluate the correlation of family support and quality of life of elderly patients with venous ulcer treated in Primary Health Care. Quantitative, analytical research with a cross-sectional treatment and data analysis, carried out in Santa Maria, Rio Grande do Sul, Brazil. The study included 40 elderly people attended at the health facilities, from August to December 2016. Data were collected using the following instruments: a form for socio-demographic, health, clinical and care characterization; the Charing Cross Venous Ulcer Questionnaire (CCVUQ), which assesses quality of life in people with venous ulcer, through four domains: Social Interaction, Domestic Activities, Aesthetics and Emotional Status, as well as generating a Total Score (ranging from 0 to 100 , the lower the score, the better the quality of life); and the Family Support Perception Inventory (FSPI) composed of three domains: Affective-Consistent; Family Adaptation and Autonomy. The general FSPI scores range from 0 to 84, and the higher the score the higher the perceived family support. Descriptive and inferential statistics were used to verify the distribution of the normality of the data. The Shapiro-Wilk test was used. The chi-square test, Fischer's exact test, Mann-Whitney U test was used. Spearmann correlation, considering level of statistical significance of ρ-value ≤ 0.05. The study followed the ethical precepts, was approved by the Ethics Committee in Research of the proposing University, (Process number 1,670,636 and Certificate of Presentation for Ethical Appreciation 58255016.0.0000.5346). Data on the characterization showed a prevalence of female, age 70 years or older, with a mean age of 71.90 (± 8.40) years, at least 60 years and a maximum of 87 years. Among the women, mean age was 73.26 (± 8.01) and males 70.06 (± 8.81), without partners (single, widowed or divorced), retired, with associated chronic diseases , sleep greater than six hours / day and presence of pain (n = 23, 57.5%). They reported that the health service (n = 34, 85.0%), did not use compressive therapy (n = 24, 60.0%), those who used the Unna boot = 16, 40.0%). They were oriented on lower limb elevation (n = 40, 100.0%), compressive therapies (n = 28, 70.0%) and regular exercises (n = 22, 55.0%). The CCVUQ Total Score presented a median of 43.9, for the evaluation of the general quality of life of the participants; and in the domains Social Interaction (27.9), Domestic Activities (29.9), Aesthetics (44.7) and Emotional Status (57.4). Regarding the perception of Family Support, the elderly classified as High Support. In the domains evaluated, the Affective-Consistent was 67.5%, with a mean of 33.40 (± 11.29), in the Family adaptation, the percentage of high was 45.0%, with a mean of 20.97 (± 6.42) and Autonomy was 70.0%, with an average of 14.65 (± 2.36). The sociodemographic and health variables do not present significant associations with the CCVUQ and IPSF domains. Significant associations of quality of life and family support were found with the clinical characteristics, such as relapse, current time of venous ulcer, pain and signs of infection. Also with the assistance characteristics who performs the dressing, treatment time, use of compressive therapy and number of consultations. Regarding quality of life, there was a significant difference in the clinical variable: pain in relation to domains Domestic Activities (p = 0.048), Emotional State (p = 0.034) and Total Score (p = 0.022). (P = 0.045), use of compressive therapy with Domestic Activities (p = 0.031) and number of consultations with the Social Interaction domains (p = 0.033), Domestic Activities ( p = 0.033), Emotional Status (p = 0.025) and Total Score (p = 0.030). Regarding Family Support, there were significant associations between clinical variables: relapse with Total Support (p = 0.031); time of current venous ulcer in years with Affective-Consistent (p = 0.003) and Total (0.022), pain with Autonomy domain (p = 0.041), signs of Total Support infection (p = 0.044). Among the assistance variables: Treatment time in years with the Affective-Consistent domain (p = 0.021). Use of compressive therapy with the Affective-Consistent (p = 0.002) and Total Support (p = 0.002) domains. There were negative and significant correlations of family support in quality of life in elderly patients with venous ulcer, between Affective-Consistent and the total CCVUQ score (r = -0.323, p = 0.042), the Domestic Activities domain (r = -0.350 , p = 0.027) and Emotional Status (r = -0.424, p = 0.006). Between Family Adaptation and Emotional State (r = -0.443, p = 0.004). Similarly, between Autonomy and total CCVUQ score (r = -0.514, p = 0.001), the Social Interaction domain (r = -0.362, p = 0.022), Domestic Activities (r = -0.513, p = 0.001) , Aesthetics (r = -0.478, p = 0.003) and Emotional Status (r = -0.478, p = 0.002). The quality of life of the elderly with venous ulcer was more compromised in the emotional state and Aesthetic domains. It is necessary to promote and rehabilitate the health of the elderly, focusing on family dynamics, in order to promote autonomy and social interaction to improve the quality of life. The alternative hypothesis is accepted that the family support is correlated in the quality of life in elderly patients with venous ulcer attended in Primary Attention to Health.

7
  • CICERA MARIA BRAZ DA SILVA
  • Validation of Nurse Competence Scale (NCS) to Brazilian Portuguese

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • REJANE MARIA PAIVA DE MENEZES
  • BERTHA CRUZ ENDERS
  • ROSANA LUCIA ALVES DE VILLAR
  • MARCELO VIANA DA COSTA
  • PAULO SÁVIO ANGEIRAS DE GÓES
  • Data: Dec 13, 2017


  • Show Abstract
  • Although it is common to have some doubts about the skills of the recent graduate, the process of nurses´ training requires the development of the skills necessary for their performance. The objective of this study is to validate the Nurse Competence Scale to Brazilian Portuguese. This scale evaluates nurses´ competence, consisting of 73 items, distributed in 7 categories, showing to be sensitive in the differentiation of competence levels, including the transition phase from nursing student to the nurse phase. This is a methodological study developed between September 2016 and June 2017, after the authorization of the lead author of the instrument and approval by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under opinion nº 1,766,255. The content and construct validities (dimensionality), the reliability analysis (test-retest and internal consistency) were conducted in two stages. The first stage corresponded to the cultural adaptation of the instrument, and the second stage was the verification of the psychometric qualities of the adapted scale. There were 141 undergraduate students enrolled in the Undergraduate Nursing course of Public Institutions of Higher Education in the state of Rio Grande do Norte participated in the study. The Content Validity Index was 0.99, and the Kappa coefficient was considered almost perfect. Only 13 of the 73 items on the scale presented a significant difference in the test of comparison of means during the test-retest (n = 30) for the competence level. Cronbach's total alpha at this stage was 0.97 and ranged from 0.75 to 0.92 in the categories. In the second stage, there were 111 participants participating, with a mean age of 24.2 (SD = 3.5); 84.7% were female and 95.5% had no previous experience in the Nursing area. The instrument was considered easy to fill up, with an average application time of 15 minutes, in both stages. The self-evaluation of the students was as having a good level of competence (average of 73.9), with an average of effective use of the items in practice, equal to 2, corresponding to “used occasionally”. The level of competence was higher for the Supporting Function (80.5), and lower for the Therapeutic Interventions (67.8). The analysis of correlation between the items of the scale was moderate to strong, especially the correlation between Therapeutic Interventions with Educational Functions (0.71), Diagnostic Functions (0.74) and Functions Management (0.78). The confirmatory factor analysis has shown that the adapted instrument is reasonably adjusted to the original structure proposed by the lead author. At this stage, Cronbach's alpha coefficient was higher than 0.70, except for the Support Function category (0.65). The scale validation process was reached, and the Brazilian version, called Escala de Competência do Enfermeiro was valid and reliable for the sample studied. It is believed that this scale can be used as a tool to evaluate the skills of nursing undergraduates, despite the regionality of the data. Further studies are recommended to allow a more thorough evaluation of the psychometric qualities and comparisons between research results using the Nurse Competence Scale Brazilian version.

8
  • ANA ELISA PEREIRA CHAVES
  • The Teaching of Attention to Leprosy in Undergraduate Courses in Nursing

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • FRANCISCA PATRÍCIA BARRETO DE CARVALHO
  • FRANCISCO DE SALES CLEMENTINO
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 15, 2017


  • Show Abstract
  • Leprosy is a major public health problem in Brazil. Disease control is carried out in the Unified Health System, with the Basic Units as a priority area for control actions, and Higher Education Institutions, as organizations responsible for teaching leprosy to the future health professionals. Therefore, this study aims to identify approaches to teaching leprosy care through the teaching plans and discuss the possibilities and limits related to approaches to teaching leprosy care in undergraduate nursing course (UNC) from the perspective of teachers. It is an exploratory, descriptive, quantitative-qualitative study. Documentary research was also used, using the teaching plans. The research was carried out in UNC located in the state of Paraíba. Twenty-one teachers participated in the study. Data collection occurred from September to October 2016, after approval of the Ethics and Research Committee of the Federal University of Rio Grande do Norte, CAAE: 57947916.4.0000.5537. It was used a script for surveying the teaching plans and an interview script applied to the teachers. After the data collection of the teaching plans, they were grouped in tables, and analyzed in light of the literature pertinent to the researched topic. The analysis of the empirical material was performed using IRAMUTEQ software. It has been found in the teaching plans that there is a reduced number of curricular components that deal with leprosy; the study of leprosy is carried out in the majority of UNC from the professional cycle; the content addressed does not prioritize health promotion and surveillance, and the Systematization of Nursing Care has not been a priority in the UNC. In the teachers' discourses, through the analysis of the IRAMUTEQ software, the hierarchical classification of the interviews regarding the possibilities, produced the following classes: Leprosy is a public health problem; use of new teaching methods; theoretical and practical classes; professional competence to act in the control of leprosy; opportunity of teaching in the health care network; the importance of health education and the nurse in the control of leprosy. Regarding the educational limits, the following classes were evidenced: reduced number of leprosy cases in Primary Care; reduced class time load; lack of priority in educational actions on leprosy in Primary Care; disease related to prejudice and stigma; insecurity of Primary Care professionals in the diagnosis of leprosy, and lack of support from managers in the decentralization of leprosy control actions. In view of the results found, it is necessary that the UNC fulfill their mission of working in function of a professional training that values the promotion of health and disease surveillance, with a view to contributing to the elimination of leprosy and to the improvement of the quality of life of people.

2016
Dissertations
1
  • KEZIA KATIANE MEDEIROS DA SILVA BARRETO
  • Avaliação do sono de enfermeiros nos diferentes turnos hospitalares

  • Advisor : MILVA MARIA FIGUEIREDO DE MARTINO
  • COMMITTEE MEMBERS :
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • CARLA PARADA PAZINATTO ANDREOLI
  • Data: Jan 26, 2016


  • Show Abstract
  • Objetivou-se analisar a características do padrão de sono e qualidade do sono de enfermeiros que trabalham nos turnos diurno e noturno. Trata-se de um estudo com abordagem quantitativa, de corte transversal, descritivo. O estudo foi desenvolvido no Hospital Universitário do Rio Grande do Norte. Os dados foram coletados em sua totalidade no período de janeiro a setembro de 2015, mediante os instrumentos: Índice de qualidade de sono de Pittsburgh para avaliar o padrão de sono e o Diário de sono para avaliar o ciclo vigília-sono. Após serem codificados e tabulados, foram analisados por meio do programa SPSS versão 20.0. O Estudo foi aprovado pelo Comitê de Ética em Pesquisas da Universidade Federal do Rio Grande do Norte, sob parecer nº 751.567. Para a descrição das variáveis contínuas foram utilizadas medidas de posição (média e mediana), dispersão (desvio padrão), medidas de associação (teste qui-quadrado ou de exato de Fisher) e correlação (teste de Correlação de Spearmann), para um nível de significância de 0,05. O perfil sociodemográfico da amostra mostrou um total de  (n=104) participantes, distribuído no turno diurno 64 e no turno noturno 40,  caracterizada por (90,4%) serem do sexo feminino, com faixa etária entre 24 a 45 anos correspondendo a 73% da amostra. Verificou-se a presença de diferença estatisticamente significativa, para as variáveis: laborais e hábitos de vida (setor hospitalar e ambulatorial (p=0,003), possuir mais de um trabalho (p=0,002), usar bebida estimulante (p=0,021); Padrão de Sono: tempo de cochilo p=0,003, latência do sono p=0,013), tempo total de sono (p=0,001), como se sentiu ao acordar (p=0,017), qualidade do sono noturno (p=0,001) e qualidade do sono (p=0,007) quando comparados entre os turnos diurno e o turno noturno. Concluiu-se que o trabalho em turnos alterou o padrão e a qualidade do sono dos enfermeiros dos períodos diurno e noturno.

2
  • ISABELLE CHRISTINE MARINHO DE OLIVEIRA
  • Validação de protocolo assistencial de enfermagem para detecção precoce e prevenção de infecções hospitalares a pessoas vivendo com AIDS.

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARLI TERESINHA GIMENIZ GALVÃO
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Jan 28, 2016


  • Show Abstract
  • A Síndrome da imunodeficiência adquirida (AIDS) ainda consiste em um dos grandes problemas contemporâneos de saúde pública mundial devido ao elevado número de pessoas infectadas. A presença de comorbidades e a imunossupressão nas pessoas que vivem com a AIDS, quando internadas, acarreta em maior risco de infecção hospitalar grave, o que tem levado a altas taxas de morbimortalidade. Esse aspecto exige dos profissionais, principalmente os da enfermagem, cuidados complexos e tomadas de decisão imediatas pautadas em evidências científicas. Assim, esse estudo tem como objetivo validar o conteúdo do protocolo assistencial de enfermagem para detecção precoce e prevenção de infecções hospitalares a pessoas vivendo com AIDS. Trata-se de um estudo metodológico, transversal, com abordagem quantitativa, realizado por meio de duas etapas. A primeira etapa do estudo refere-se ao desenvolvimento do protocolo fundamentado nas evidências extraídas de uma revisão integrativa da literatura e de medidas de prevenção de infecção da ANVISA. A segunda etapa, validação de conteúdo, resultou do julgamento de experts envolvidos na assistência, gerência e/ou docência. A amostra ocorreu por intencionalidade, selecionados pela analise do currículo lattes com a adaptação do sistema proposto por Fehring, totalizando 13 experts na assistência em enfermagem a pessoas com AIDS. A operacionalização ocorreu por meio de concordância entre as respostas obtidas pelo índice de validade de conteúdo (IVC) através da avaliação dos juízes em uma rodada. Os itens foram avaliados em “adequado”, “adequado com alterações” e “inadequado”, baseada em 10 requisitos: utilidade/ pertinência, consistência, clareza, objetividade, simplicidade, aplicabilidade, atual, vocabulário, precisão e sequência de instrução dos tópicos. Como resultados, a revisão mostrou os cuidados de enfermagem a pacientes com AIDS que foram abordados e agrupados nas categorias assistencial, educacional e gerencial. Quanto à validação, dos 13 juízes que avaliaram o instrumento, 84,61% são do sexo feminino, com idade média de 43 anos (±9,98), e tempo de experiência médio de 17,08 anos Na titulação profissional, 61,54% são doutores e 38,46% mestres. Na área de atuação, 69,23% são da docência, 38,46% são da assistência e 23,08% gerencial. Em relação ao protocolo, foram avaliados 20 itens, sendo 8 correspondentes ao histórico de enfermagem e 12 referentes as intervenções ao paciente com AIDS. Das 260 respostas, 58,08% foi avaliados como adequado, 41,15% adequada com alteração e apenas 0,77% das respostas foram inadequado. Dos 20 itens presentes, 18 obtiveram concordância total, (IVC =1,0) e os outros dois itens obteve IVC de 0,92. A avaliação global dos instrumentos obteve IVC de 0,99. As sugestões dos juízes foram relacionados à reformulação da redação quanto a adequação do vocabulário e informações repetidas, elaboração das frases com mais clareza, acréscimo de ações e intervenções, e inclusão de escalas para avaliação das condutas. Diante das sugestões dos juízes procurou-se reformular o buscando uma melhor compreensão e clareza dos itens que compunham o instrumento visando torná-lo aplicável. O conteúdo do protocolo foi validado, representando a base de consenso inicial para abordagem das pessoas com AIDS. O estudo obteve parecer favorável do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, CAAE de número 46209215.0.0000.5537.

3
  • MAYARA MIRNA DO NASCIMENTO COSTA
  • ACURÁCIA DOS INDICADORES CLÍNICOS DO DIAGNÓSTICO DE ENFERMAGEM FALTA DE ADESÃO EM PESSOAS VIVENDO COM AIDS.  

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • ALEXSANDRA RODRIGUES FEIJAO
  • MARLI TERESINHA GIMENIZ GALVÃO
  • Data: Jan 29, 2016


  • Show Abstract
  • No início da década de 1990, um marco importante no tratamento da Síndrome da Imunodeficiência Adquirida foi o desenvolvimento da terapia antirretroviral combinada de alta potência. O grande benefício gerado pelo uso dessa terapêutica foi o prolongamento da sobrevida das pessoas que adquiriram essa doença, uma vez que esta deixou de ser considerada fatal, tornando-se uma condição crônica. Apesar das melhorias geradas por esta terapêutica, restam ainda muitas dificuldades a serem superadas. Uma delas é a adesão do paciente ao seu tratamento, trazendo desafios aos serviços e aos profissionais de saúde. Daí advém à necessidade de se identificar precocemente o diagnóstico de enfermagem Falta de Adesão para que soluções sejam buscadas pelo enfermeiro junto ao paciente e sua família. Com essa problemática, soma-se a dificuldade do enfermeiro assistencial em inferir esse diagnóstico, especialmente na identificação de suas características definidoras. Nesse contexto, objetivou-se avaliar a acurácia dos indicadores clínicos do diagnóstico de enfermagem Falta de adesão ao tratamento antirretroviral em pessoas vivendo com a Síndrome de imunodeficiência adquirida. A pesquisa ocorreu em duas etapas. A primeira composta pela avaliação dos indicadores do diagnóstico em estudo; e a segunda, pela inferência diagnóstica realizada por enfermeiros especialistas. A primeira etapa ocorreu em um Hospital de referência no tratamento de doenças infectocontagiosas do Nordeste do Brasil, e os dados foram obtidos por meio de um instrumento para realização de anamnese e exame físico e analisado quanto à presença ou ausência dos indicadores do diagnóstico. Na segunda etapa, os dados foram encaminhados a especialistas, que julgaram a presença ou ausência do diagnóstico na clientela estudada. O projeto foi submetido ao Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, obtendo-se aprovação com o Certificado de Apresentação para Apreciação Ética (CAAE) nº 46206215.3.0000.5537. Os dados foram analisados por meio da estatística descritiva e inferencial. Utilizou-se o teste exato de Fisher, Teste qui-quadrado de Pearson e regressão logística. Já a acurácia dos indicadores clínicos foi mensurada por meio da especificidade, sensibilidade, valores preditivos, razões de verossimilhança. Como resultados, identificou-se a presença do diagnóstico Falta de adesão em 69% (n=78) dos pacientes do estudo. As características definidoras que apresentaram significância estatística na associação com o diagnóstico estudado foram: comportamento de falta de adesão, complicação relativa ao desenvolvimento, falta a compromissos agendados, falha em alcançar os resultados, e exacerbação de sintomas. A característica com maior sensibilidade foi comportamento de falta de adesão e a de maior especificidade foi exacerbação dos sintomas. A Regressão Logística demonstrou como fatores preditores para o diagnóstico faltam de adesão: comportamento de falta de adesão, falta a compromissos agendados, falha em alcançar os resultados, e exacerbação de sintomas. Foi possível concluir que a identificação de indicadores clínicos de forma acurada permitiu uma boa predição do diagnóstico de enfermagem Falta de adesão em pessoas vivendo com a Síndrome de imunodeficiência adquirida, contribuindo para que o enfermeiro desenvolva de forma precoce estratégias para a promoção da adesão ao uso dos antirretrovirais.

4
  • ILISDAYNE THALLITA SOARES DA SILVA
  • Cartografia da implementação do teste rápido anti-HIV na Estratégia de Saúde da Família

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • CECILIA NOGUEIRA VALENCA
  • MARLI TERESINHA GIMENIZ GALVÃO
  • Data: Jan 29, 2016


  • Show Abstract
  • Uma das estratégias do Ministério da Saúde para o controle da Síndrome da Imunodeficiência Adquirida no Brasil foi à ampliação do acesso ao diagnóstico da infecção pelo vírus da imunodeficiência humana por meio da oferta do teste rápido na Estratégia Saúde da Família. Esse teste deve ser realizado por profissionais de saúde devidamente capacitados, dentre eles o enfermeiro. Além disso, o Conselho Federal de Enfermagem aprovou a competência legal desse profissional nas ações relacionadas à testagem rápida. Nesse contexto, objetivou-se avaliar a implementação do teste rápido para diagnóstico do vírus da imunodeficiência humana na Estratégia de Saúde da Família na perspectiva de enfermeiros. Trata-se de uma pesquisa descritiva e exploratória com abordagem qualitativa. Os sujeitos do estudo foram 13 enfermeiros das Unidades de Saúde da Família da zona rural e urbana dos municípios da Quarta Regional de Saúde do Estado da Paraíba. Os dados foram coletados por meio de um roteiro de entrevista semiestruturada no período de março a junho de 2015 e foram analisados pelo método da cartografia simbólica de Boaventura de Sousa Santos. O projeto foi submetido ao Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, obtendo-se aprovação com o Certificado de Apresentação para Apreciação Ética nº 39639314.7.0000.5537. Os resultados revelaram que na dimensão da estrutura, identificaram-se deficiências na infraestrutura básica necessária para a implementação do teste na Estratégia Saúde da Família, especialmente aspectos relacionados à disponibilidade dos insumos de testagem. Além disso, as falas foram reveladoras quanto à qualidade da capacitação recebida pelos enfermeiros para a execução do teste, deixando lacunas no conhecimento desses profissionais. Na avaliação do processo, evidenciaram-se dificuldades vivenciadas pelos enfermeiros da região no desenvolvimento da testagem rápida, como a revelação do diagnóstico positivo para o vírus da imunodeficiência humana ao paciente e sobrecarga de atividades na Estratégia de Saúde da Família. No entanto, a inserção dos testes rápidos nas unidades de saúde da família pesquisadas apresentou como facilidades a rapidez no resultado do exame e a diminuição da resistência do paciente em fazer o teste. As falas dos entrevistados também mostraram que a oferta do teste rápido para o vírus da imunodeficiência humana é destinada prioritariamente às gestantes e para as demais clientelas apenas em eventos pontuais ou por demanda do paciente. Na etapa do aconselhamento, identificaram-se barreiras na abordagem de aspectos relacionados à sexualidade. Na região investigada, os testes são executados em dia específico conforme demanda programada. No encaminhamento de um paciente com resultado do teste positivo, observaram-se, a partir das falas dos entrevistados, diferentes fluxos e desconhecimento do serviço de referência para esse indivíduo. Concluiu-se que em relação à estrutura observou-se a necessidade de maior investimento no fornecimento dos insumos de testagem e na política de educação permanente dos enfermeiros inseridos nos serviços pesquisados. Além disso, há a necessidade de ampliação da oferta do teste para a população não gestante, interação entre as unidades e a rede de referência no estado, bem como a disponibilização do mesmo em todos os períodos de funcionamento do serviço.

5
  • FRANKLIN LEARCTON BEZERRA DE OLIVEIRA
  • A atuação do enfermeiro no combate à dengue e a Febre Chikungunya: estudo comparativo nos municípios de Parnamirim e Santa Cruz/RN.

  • Advisor : REJANE MILLIONS VIANA MENESES
  • COMMITTEE MEMBERS :
  • JOSE JAILSON DE ALMEIDA JUNIOR
  • MARCELO VIANA DA COSTA
  • REJANE MILLIONS VIANA MENESES
  • Data: Jan 29, 2016


  • Show Abstract
  • A dengue e o vírus da Febre do Chikungunya (CHIKV) são consideradas doenças de notificação compulsória transmitas por mosquitos do gênero Aedes, sendo o Aedes aegypti o principal vetor. Encontram-se amplamente distribuídas no Brasil, ocasionando um dos maiores problemas de saúde pública, devido as alterações epidemiológicas que vem ocorrendo nos últimos anos e por caracterizarem-se pela ampla distribuição em todas as regiões. O presente projeto tem como objetivo analisar a atuação dos enfermeiros das Estratégias de Saúde da Família (ESF) no controle da Dengue e Febre Chikungunya nos municípios de Parnamirim e Santa Cruz. Trata-se de pesquisa de cunho exploratório-descritivo, com abordagem quantitativa e qualitativa, que fora desenvolvida com enfermeiros dos municípios de Parnamirim e Santa Cruz. A pesquisa obteve parecer favorável do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte com o Certificado de Apresentação para Apreciação Ética (CAAE), n° 48378515.8.0000.5537. A coleta de dados foi realizada no mês de novembro e dezembro através de entrevista com questionários semiestruturados compostos por questões abertas e fechadas, organizados em três partes: o perfil dos entrevistados, o conhecimento sobre a doença e descrição das práticas realizadas. Os dados levantados foram categorizados e tabulados, utilizando o Microsoft Office Excel 2010. As tabulações do instrumento das perguntas fechadas passaram por análises, utilizando o Programa Estatístico Statistical Package for the Social Sciences (SPSS 22), e para as perguntas abertas utilizou a análise de conteúdo de Bardin. Como resultado, os enfermeiros foram questionados quanto ao agente transmissor da Dengue e Febre Chikungunya, cinco enfermeiros responderam que o agente transmissor da Dengue é o Aedes aegypti e somente um por ele e pelo Aedes albopictus; enquanto que para Febre Chikungunya, dois responderam que a doença é transmitida pelos mosquitos Aedes aegypti e Aedes albopictus e os demais somente pelo Aedes aegypti. Versando relativamente os sorotipos virais, três enfermeiros responderam que são 4 sorotipos da Dengue, dois disseram que são cinco e somente um que são dois sorotipos. Para a febre Chikungunya, um não soube responder, dois responderam que também são cinco sorotipos, dois responderam que existe somente um sorotipo e um que são dois. Todos desconhecem quais os tipos de depósitos que mais são encontrados focos do mosquito em sua região, como também desconhecem o Programa Nacional de Controle da Dengue. Os profissionais de enfermagem sabem reconhecer um caso suspeito de Dengue, mas se confundem quando tentam explicar para a Febre Chikungunya, expondo os mesmos sintomas da Dengue. Nota-se que, apesar de todos terem participado de uma capacitação sobre Febre Chikungunya e Dengue, um conhecimento bastante limitado dos enfermeiros a respeito do manejo clínico. Outra abordagem dos profissionais é uso de medicamentos para os casos sintomáticos das doenças. Destarte, conclui-se o estudo com a ausência de referências devidas que a equipe de saúde deve se apropriar para planejar ações de prevenção e controle vetorial, como treinamentos mais específicos para estes profissionais. 

6
  • ISADORA COSTA ANDRIOLA
  • Construction of the nursing diagnosis Growth Delay in adolescents

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • PAULA FERNANDA BRANDAO BATISTA DOS SANTOS
  • Data: Aug 8, 2016


  • Show Abstract
  • This study is typified as concept analysis, whose objective was to build the nursing diagnosis “Growth delay in adolescents”, based on literature. The concept analysis was performed in line with the model proposed by Walker and Avant, which is composed of eight steps, namely: concept analysis; determination of the objectives of the conceptual analysis; identification of possible uses of the concept; determination of the defining attributes; construction of a model case; construction of supplementary cases; identification of the backgrounds and consequences; besides the empirical benchmarks. The selected concept was the “Growth delay in adolescents” and the objective of the analysis was to analyze the phenomenon of growth delay in adolescents, with the purpose of subsidizing its identification in clinical practice on the part of the nursing professional. In order to operationalize the analysis, we held an integrative literature review, according to Whittermore and Knafl. The review took place in the databases: LILACS, PUBMED, CINAHL, SCOPUS, Web of Science, Science Direct, as well as in the Journal of Human Growth and Development journal. From the review, we obtained a final sample of 29 studies to be analyzed. These studies were analyzed by means of thorough reading, with a view to identifying the terms or expressions that could represent the essence of the concept, its attributes, backgrounds and consequences. The diagnostic proposal, which resulted from the conceptual analysis, showed the following definition for the growth delay in adolescents: below expected growth for individuals from 10 to 19 years of the same sex: height below the 3rd percentile or deficit in height above 2 standard deviations, which, associated with decreased growth velocity, results in the final height lower than the genetic target. The related factors were: hormonal changes; chronic malnutrition; chronic diseases; immunodeficiency/ immunosuppression; prolonged physical stress; central nervous system diseases; and genetic disorders. The defining characteristics were: low height for age; low weight for age; delayed sexual maturation; delayed pubertal growth spurt; below expected growth velocity; final height lower than the genetic target; and decreased bone mass. We found that, from the identification of attributes, backgrounds and consequences, it was possible to achieve a better understanding of the concept “Growth delay in adolescents”. The understanding of this phenomenon contributes to the advancement in the state of the art of nursing, thereby improving the identification of the delayed growth in these customers and contributing to the establishment of more effective therapeutic plans, with interventions aimed at their urgent needs.

7
  • CLARISSA MARIA BANDEIRA BEZERRA
  • Stress and Burnout syndrome in nurses of a university hospital

  • Advisor : MILVA MARIA FIGUEIREDO DE MARTINO
  • COMMITTEE MEMBERS :
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • ROSÂNGELA MARION DA SILVA
  • Data: Sep 29, 2016


  • Show Abstract
  • This study aimed to verify the level of stress and the presence of burnout syndrome in nurses in day and night shifts in the hospital. It is descriptive, observational cross-sectional with quantitative approach in a University Hospital of the Federal University of Rio Grande do Norte. The survey was conducted with a sample of 108 nurses working day and night shifts. It consisted of questionnaires for evaluation a sociodemographic data checker form of the sample, the modified Bianchi scale to quantify the level of stress and the Maslach Burnout Inventory - Human Services Survey), to identify the presence of burnout syndrome. The tabulation of the data was in spreadsheets and then tables. Continuous variables were checked for position measurements (mean and median), dispersion (standard deviation). For comparisons between the shifts with respect to the scores of the instruments we applied the Student t test and the nonparametric Mann-Whitney.Foram applied Spearman correlation test and Pearson.Adotou is a significance level of 0, 05. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in the Opinion No. 1.313.575. As for results data showed that 88.88% of the participants were female, aged 24-45 years corresponding to 84.25% of the workers, most married 47.22%. In the largest number are having another job 55.56%. Average of 12.78 years of service. 50% of participants reported physical activity and 50% did not. The score for the level of stress of the day shift was 2.35 and 2.31 of the night, being classified as average. The dimensions of Burnout for day group showed exhaustion 21.88; depersonalization 5.89; professional achievement 38.88. For the night, exhaustion 20,10; depersonalization 5.79 professional achievement 38.98. They were considered average. The values of stress and burnout as the work shift were not statistically significant. There was correlation and statically significant p-values when compared stress and the dimensions of the syndrome (p = <0.0001) (p = 0.0001) (p = 0.0003). It was concluded that the level of stress among nurses was rated as average level in day and night shifts and the three dimensions of Burnout in both rounds too, where there was absence of the syndrome. There was a statistically significant correlation between stress and the domains of burnout.

8
  • JESSICA NAIARA DE MEDEIROS ARAUJO
  • NURSING DIAGNOSIS RISK OF DRY EYE IN HOSPITALIZED PATIENTS IN INTENSIVE CARE UNIT

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ANA RAILKA DE SOUZA OLIVEIRA KUMAKURA
  • MARCOS ANTONIO FERREIRA JUNIOR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Oct 4, 2016


  • Show Abstract
  • This study aimed to evaluate the NANDA-International Nursing Diagnosis (ND) Risk of Dry Eye in patients admitted to the Intensive Care Unit (ICU). This is a cross-sectional study in adult ICU of the University Hospital Onofre Lopes. The final sample consisted of 206 patients. To collect data an instrument composed of relevant variables to sociodemographic data, clinical and risk factors of ND in study. Inference for the presence of diagnosis in patients was performed by a pair of diagnostician’s nurses with experience in diagnosis and judgment in ICU nursing care. All data collected were organized and stored in a database built in the Statistical Package for Social Sciences (SPSS) version 22.0 for testing. For the descriptive analysis, the frequencies were considered, distribution center measures and their variabilities. To compare means, applied the Student t test for independent samples. In the case of asymmetry, the Mann-Whitney test was used. For associative measurements, we used the chi-square test of Pearson and when the expected frequencies were lower than five, Fisher's test was applied. The magnitude of the association was verified by the prevalence ratio. This study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte and is funded by the National Scientific and Technological Development Council - CNPq, process n ° 444290 / 2014-1. Of the 206 patients, 52.4% were male, mean age 58.41 years and 57.6% lived in the interior of Rio Grande do Norte. Regarding education, the majority (40.3%) had incomplete primary education and 43.3% were retired. According to the type of admission, 49% were clinics, 29.1% urgency/emergency surgery and 21.8% elective surgery. Comorbidities, 59.7% had hypertension and 31.6% diabetes mellitus. 47.6% of patients had the ND in study. Thus, 52.4% have had a clinical diagnosis of ocular dryness. In the analysis by eye, 56.8% had DE, since the ocular dryness was present in 43.2% of eyes. The most prevalent risk factors were: environmental factors and treatment regimen (100%), mechanical ventilation therapy (52.4%), aging (51%), neurological damage with motor reflex sensory loss (50%), female (47.6%) and lifestyle (36.4%). Showed a statistically significant association with the presence of the studied ND in the right eye (RE) the absence of the following clinical features: hospitalization why gastrointestinal disorder, lagophthalmos in RE, lagophthalmos in the left eye (LE), the hyperemia LE, mucous secretion RE, eyelid edema RE, proptosis RE and use of anti-inflammatory. The presence of hyperemia in the RE was significant for the absence of DE in the OD. The schirmer the mean difference in the RE and LE between the presence and absence in the ND in RE also had significance. Regarding the LE, there was a statistically significant association between corneal-palpebral reflex of RE and DE risk of dry eye in RE with the ND presence in the LE. Moreover, the absence of other clinical characteristics were significant with the ND presence in the LE: hyperemia RE and LE, eyelid edema RE and LE, mucous secretion LE, neuromuscular blockers and ocular dryness in the RE and LE. Still, the schirmer of RE and LE showed significant mean differences between presence and absence in the ND in LE. Regarding the analysis of ocular dryness in the LE, the absence of certain clinical characteristics were statistically significant for the absence of dryness in the RE, to know: hospitalization why gastrointestinal disorder, lagophthalmos in RE and LE and ocular dryness in the LE. The presence of hyperemia in RE showed significance with the presence in the dryness of the RE. However, the absence of hyperemia in the LE was associated with the absence of ocular dryness in the RE, as well as the mucous secretion in the RE, eyelid edema RE, proptosis RE and use of anti-inflammatory. The ND presence in the RE and LE demonstrated association with the absence of ocular dryness in the RE. The mean difference of the schirmer in RE showed a significant relationship between the presence and absence of ocular dryness in the RE, as well as the difference of means of posts of schirmer in LE. Regarding the ocular dryness in the LE, the presence of corneal-palpebral reflex in RE and ND in RE and LE statistically showed statistically relationship with the absence of ocular dryness in LE. However, the absence of ocular hyperemia in LE, mucous secretion in LE, eyelid edema in RE and LE and the non use of neuromuscular blockers were significantly associated with the absence of ocular dryness in LE. Moreover, as in other outcomes there were significant mean differences of schirmer in RE and LE between those features or not ocular dryness in the LE. Thus, the knowledge gained has estimated relevance to ensure an action directed to the prevention of ocular dryness in ICU patients.

9
  • MILLENA FREIRE DELGADO
  • DIAGNOSIS CONSTRUCTION DELAYS NURSING IN DEVELOPMENT

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • FLÁVIA PAULA MAGALHÃES MONTEIRO
  • PAULA FERNANDA BRANDAO BATISTA DOS SANTOS
  • Data: Oct 24, 2016


  • Show Abstract
  • The adolescence is a critical stage of human development process, marked by bio-social, cognitive and psychosocial changes. These transformations are influenced by biological and social terms. Therefore, the objective of this study, build the nursing diagnosis delay in developing during the youth ages. We conducted a concept analysis, according to the reference of Walker and Avant, which was operationalized by an integrative review. The databases used were: SCOPUS, Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine and Nattional Institutes of Health, Latin American and Caribbean Health Sciences, Web of Science and Science Direct and the Journal of Human Growth and Development. The crossing of Developmental Disabilities descriptors; Growth and Development and Adolescent and keywords: Cognitive development; physical development; sexual maturation; Delay; Delay in puberty allowed to obtain an initial sample of 20 402 references that have passed thru three stages of evaluation, named:title reading and summary; consensus with the group of researchers and reading full of selected references. The final sample included a total of 51 references, which have been carefully analyzed to identify the attributes, background and concept of the consequent delay in the development of teenagers. The results show the identification of four attributes; 15 background and 16 consequential; the last one is distributed in the areas bio-social, cognitive and psychosocial. The proposed structure for the nursing diagnosis is: title - Delay in developing adolescent; dominance - 13; class - 2; definition - Development below expectations for individuals aged 10 to 19 years old, caused by delay in one or more of the following areas: cognition, behavior, social and pubertal; defining characteristics - biosocial dominance - Low self-esteem; body dissatisfaction and delayed sexual maturation; cognitive dominace - poor school performance; daily life activity harmed ; harmed verbal communication; executive function deficit and hyperactivity disorder; psychosocial dominance - externalizing behavior; internalizing behavior; difficulties expressing emotions; passive confrontation or dependence; insecurity and eating disorders; related factors -abuse of psychoactive substances , stressful home environment, maternal and neonatal obstetric conditions, malnutrition, genetic disorders, chronic illness, chronic pain, adverse effects of medication, exposure to toxic substances, infections, brain demage, social marginalization, not accepting the body changes of puberty, obesity, emotional divestment and physical trauma. Therefore, it is concluded that the delay in concept development on teenagers is extensive and involves relevant aspects that contribute for the nurses clinical practice. It is believed that further studies of this nature is an important basis for the growth of the scientific structure of nursing, supporting the development of technologies in the area.

10
  • BRUNO ARAÚJO DA SILVA DANTAS
  • ASPECTS SOCIODEMOGRAPHIC AND HEALTH RELATED QUALITY OF LIFE IN ELDERLY FAMILY HEALTH STRATEGY.

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • EULALIA MARIA CHAVES MAIA
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • GIOVANA SPOSITO
  • THALYTA CRISTINA MANSANO SCHLOSSER
  • Data: Oct 27, 2016


  • Show Abstract
  • Introduction: population aging raises many debates about the new ways of health policy for the elderly. At this stage of life, the elderly identify the perception of old age according to their degree of dependence. All these changes, when associated with the lifestyle of the elderly, are decisive factors for the vulnerability of these individuals with regard to the risks to your health and your quality of life (QOL). There is a direct relationship with the emotional, cognitive, psychological and functional. The Family Health Strategy (ESF) is the main conductor of basic care, first level of complexity of the Unified Health System (SUS), it is the Brazilian graduated system of health care. Objective: To analyze the association of sociodemographic and the elderly QOL related to the ESF. Method: analytical, cross-sectional study with a quantitative approach, performed in Igapó communities in the north of the city of Natal, Rio Grande do Norte (RN), the DNER and clinical elderly in the city of Santa Cruz-RN, Brazil from December 2015 to March 2016. The instruments used were: the questionnaire of demographic data and characteristics of pain, the Mini examination instrument Mental State Examination (MMSE) and the validated Brazilian version of the quality of life questionnaire Medical Outcomes Short- Form Health Survey (SF-36). Results: The sample consisted of 120 patients, ascribed to the FHS. Among the socio-demographic criteria, it became clear predominance of women (83.3%) and aged between 60 and 71 years of age (61.7%). In the areas of QOL, was highlighted the emotional aspects, with an average in Natal 78.3 (SD + 39.2) and Santa Cruz, 76.6 (SD + 40.8). It is also observed that these values are close to the average of the total sample in their field: 77.5 (SD 39.9). In the age group, there is a significant association between younger elderly with functional domains (M + 67.2 and ρ-value 0.032), emotional (M + 82.0 and ρ-value 0.040) and physical size ( M + 51.4 and ρ-value 0.042), all these in Santa Cruz. Considering the total sample, there was also significant between the functional domain and younger elderly. Regarding marital status seniors with company were associated significantly to functional domains (M + 69.7 and ρ-value 0.037) and emotional (M + 87.2 and ρ-value 0.043), both in Santa Cruz. Regarding the association between health aspects and QOL of the elderly, there is significance between the variable "pain in the last week", considering the absence of pain on functional areas (M + 76.7 and ρ-value 0.013 ) and emotional (M + 96.1 and ρ-value (0.019), both in Santa Cruz). The non-use of medications (M + 79.2) showed significant association with the functional domain (ρ-value 0.020) in the municipality of Santa Cruz. It is noteworthy that the functional domain had significance with most of the variables. Conclusion: this research showed that the sociodemographic and health aspects had significant association with QOL of the elderly. There is the need for planning interventions aimed to change variables.

11
  • ANDREA TAYSE DE LIMA GOMES
  • Construction and validation of graphic protocol for evaluation of safe care to the patient with multiple traumas in emergency situation

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • MARCOS ANTONIO FERREIRA JUNIOR
  • SUSANE DE FÁTIMA FERREIRA DE CASTRO
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Nov 25, 2016


  • Show Abstract
  • From 1980s the external causes suffer considerable increase so that to change the Brazilian epidemiological profile. These came to represent the second cause of death in Brazil in the overall perspective and the first in the age group between five and 39 years. Thus, the care polytrauma patient is in an emergency situation, since it is a type of lesion whose mortality rate is high due to the shocks and uncontrolled haemorrhages. This reality requires the effective and efficient application of skills and knowledge of professionals, as well as the availability of adequate structure of the emergency service, in order to provide greater security to the patient during care. Thus, it questions: how should be an evaluation graph protocol safe polytrauma patient care in an emergency situation? To answer this question, it is aimed to propose graphic protocol, valid in their content and appearance, for the evaluation of the care safe to patients with multiple traumas in emergency situation. To achieve the objective, it was necessary: summarize the scientific evidence on the safe care to patients with multiple traumas as the triad proposed by Donabedian; build graphic protocol for assessing of the structure, process and outcome of care safe; and, validate the content and appearance of the graphic protocol for assessing the structure, process and outcome of care safe to polytrauma patients in emergency situation. This is a methodological study, with mixed methods, composed by two stages, namely: 1) scoping review and focus group and 2) construction, proposition and validation of content and appearance of graph protocol. For the realization of focus group, It was used the technique of the sandplay and the humanescente vivencial pedagogy (mount-write-speak) and the research subjects were nursing professionals who work or worked in the Polytrauma sector of a Emergency Department in Natal / RN. The treatment and analysis of the speech was given by the R interface software Analyses pour Multidimensionnelles of Textes et Questionneires and the socioprofessional data were analyzed descriptively by SPSS 22.0. The study was previously submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, which was approved with seem consubstantiated No. 1053690 of April 24, 2015, with Certificate presentation for Appreciation Ethics No. 42951415.6.0000.5537. For the validation of content and appearance of the Protocol, were included 15 judges localized by the curriculum lattes based on search criteria previously established. For this purpose, it was used a Delphi technique, which was divided into two stages (Delphi I e Delphi II), and the evaluation process by means gave the provision of the Protocol and of the evaluation items in electronic formo of the google docs. The relevance of the items was judged by the result of the content validity index and Delphi consensus. After analyzing the data, it reached the validity of the graphic protocol in their appearance and content.

12
  • ARYELE RAYANA ANTUNES DE ARAÚJO
  • Analysis of risk factors of nursing diagnosis risk of infection in hospitalized cancer patients

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • BERTHA CRUZ ENDERS
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARIA LURDEMILER SABÓIA MOTA
  • Data: Nov 25, 2016


  • Show Abstract
  • The infections regarding health care represents a serious problematic of global health. Especially when it involves patients with cancer that are hospitalized, they have factors pertaining the disease, treatment and hospitalization that boosts the development of these events. Therefore, the purpose was to analyze the risk factors of the Nursing’s infection risk diagnostic on patients with cancer that are hospitalized and with an infection related to health care and according to the North American Nursing Diagnosis-International. It is about a transversal study developed inside a hospital that is reference on the field of oncology for patients of the Single Health System (SUS) in the state of Rio Grande do Norte. The handbooks of patients with age equal or above 18 years, of both gender, between the years of 2013 and 2014, which had showed infection associated with the health care during their hospitalization period were analyzed. After the samples’ calculation usage for limited populations, 110 handbooks were estimated, with five losses of non – response, consequently the sample was composed with 105 handbooks. The data gathering happened between November of 2015, to April of 2016, using an instrument composed by sociodemographic and health variables and the risk factors for infection. Sample exploratory analysis were made using frequency distributions and descriptive measures. The differences between the proportions will be verified upon the applications of the Chi – Square test and Fisher’s Exact test and the Multiple regression was evaluated using Student’s T test, all of them with significance level of 5% (p value ≤ 0,05). The study was approved on the committees of Ethics in Research of Universidade Federal do Rio Grande do Norte and the Norte Riograndense League against cancer, nº of CAAE 48374815.3.3001.5293. Regarding the sample’s characterization, it was verified a majority of adults (54.3%), with average age of 58.9 (±14.7), female (57.1%), with a companion (51.4%), that used to work (34.3%), coming from the state’s countryside (59.0%). Regarding clinical characterization, 64.8% of the patients were hospitalized by a surgical clinic. The most reported clinical manifestations on the handbooks were fever (43.8%), pain (33.3%) and constipation (26.7%). Referring the risk factors of the Nursing’s infection risk diagnostic, the most prevailing were, respectively, invasive procedure (100.0%), disrupted skin (93.3%) and inadequate peristalsis (63.8%). One observes a statistically significant association between risk factors, disrupted skin, a patient’s surgical characteristic, and the presence of free hemoglobin on the blood on patients with a non – surgical condition. Furthermore, the hospitalization’s time evaluation and the patient being a woman was significant, belonging to a non – surgical clinic and that made a previous surgery. The knowledge about the risk factors of the Nursing’s infection risk diagnostic on the studied population may direct the nursing’s team care aiming to prevent the infection related to health care and qualifies the nursing care in a way that it can systematize itself in order to make a signal for the nurses for specific needs of care for this population, in addition to suggest the development of new studies on this field.

13
  • VINICIUS LINO DE SOUZA NETO
  • DIAGNOSTICS, RESULTS AND NURSING INTERVENTIONS OF CIPE® FOR PEOPLE LIVING WITH AIDS.

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • MARIA ALZETE DE LIMA
  • MARIA MIRIAM LIMA DA NÓBREGA
  • NILBA LIMA DE SOUZA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Nov 30, 2016


  • Show Abstract
  • The Acquired Immune Deficiency Syndrome currently makes up a major challenge to research, treatment and clinical and social intervention. Given this, the nurse as health team member can make use of new technologies and realign its practice, so you can implement actions and safe interventions and quality for people living with this disease. Thus, systematization of nursing care, using a unified professional language contributes to the organization of care, addressing the priority needs of people living with AIDS, and respecting the system of values and moral beliefs of scientific expertise. In this sense, the study aimed to: identify the focus of Nursing Practice in assessing the health of people living with AIDS; elaborate diagnostics, results and nursing interventions based on ICNP® 2013 version, directed by practice focuses; and validate diagnoses, outcomes and nursing interventions of ICNP®, by specialist nurses. This is a cross-sectional study with a quantitative approach, developed in three stages: 1st: identification of nursing practice focuses for people living with AIDS; 2nd: development of diagnostics, results and nursing interventions; 3: validation and statistical analysis of the statements. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) 47380915.2.0000.5537. Data were analyzed using descriptive and inferential statistics to analyze the degree of agreement of specialist nurses adopted the Concordance Index (CI> 0.80) Compliance Validation Index (CVI> 0.80) and Binominal test (p < 0.005). As a result, they identified 146 nursing practice focuses for people living with AIDS, developing up 96 diagnostics and results without synonymy and 210 grade repetition. The statements were categorized as basic human needs, 73 were the axis of physiological needs, but 35 were validated CI> 0.80 (68.75%), IVC> 0.80 (55.42%), p <0.005 (51.66 %). With regard to psychosocial needs are elaborated 20 statements and spiritual only three, but 11 were validated IC> 0.80 (61.33%), IVC> 0.80 (59.37%), p <0.005 (64.17%). Regarding nursing interventions were developed 230 measures of which 191 have obtained validation by experts CI> 0.80 (50.17%), IVC> 0.80 (60.38%), p <0.005 (49.35%). It follows that from the practice focus was possible to elaborate diagnoses, results and nursing interventions of ICNP®. Thus, it is believed that such statements may contribute to the care of people living with AIDS, allowing the use of a special language of nursing for this clientele.

14
  • BARBARA COELI OLIVEIRA DA SILVA
  • BANK OF TERMS OF THE SPECIAL LANGUAGE OF NURSING FOR PEOPLE LIVING WITH ACQUIRED IMMUNODEFICIENCY SYNDROME.

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • CECILIA NOGUEIRA VALENCA
  • MARIA ALZETE DE LIMA
  • MARIA MIRIAM LIMA DA NÓBREGA
  • Data: Nov 30, 2016


  • Show Abstract
  • The Bank of terms of special nursing language to detect concepts that help in
    building diagnostics, results and nursing interventions. The use of the bank
    directed at people living with acquired immunodeficiency syndrome is a major
    step in identifying a specific vocabulary and can be used in nursing care,
    reinforcing systematically, their safety and quality. In this context, the objective
    was to build a database of terms of the special language of nursing for people
    living with acquired immune deficiency syndrome, using the International
    Classification for Nursing Practice version 2013. This is a methodological study
    in a referral hospital in the treatment of infectious diseases in the Northeast of
    Brazil. The research was developed in five stages: 1) extraction of the terms of
    the records and eliminating repetitions; 2) standardization of terms; 4) crossmapping
    process between extracted terms and the terms in the International
    Classification for Nursing Practice 2013 version; 5) refinement of the terms.
    Obtained approval from the Ethics Committee of the Federal University of Rio
    Grande do Norte in the opinion No. 1,177,410 and presentation of Certificate No.
    Assessment Ethics 47380915.2.0000.5537. We identified 640 terms that were
    submitted to cross-mapping process, which resulted in 315 constant and 325 not
    listed in the International Classification for Nursing Practice version 2013. With
    this study, it was possible to know the terms used by the team nursing in the care
    of people living with acquired immunodeficiency syndrome, which make it
    possible to use in the development of positive diagnoses / outcomes and nursing
    interventions, as well as the unification of the professional language of the nurse.

15
  • LAYS PINHEIRO DE MEDEIROS
  • LEVEL OF ADAPTATION OF THE OSTOMIZED PERSON UNDER THE ROY ADAPTATION MODEL: INSTRUMENT CONSTRUCTION AND VALIDATION

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARINA DE GÓES SALVETTI
  • Data: Dec 2, 2016


  • Show Abstract
  • Ostomy is an artificially created opening from the gastrointestinal tract, or urinary tract, to the abdomen, through which occurs the deviation and elimination of stool and urine. It can be permanent or temporary and is subdivided in three types: Ileostomy, colostomy and urostomy. The ostomy’s construction requires several adaptive needs that involves from physiological aspects to psychological and social demands. This way, the performance of a nurse is needed to promote the adaptation of the person with the ostomy. In order to systematize the care to people with an ostomy, aiming an effective adaptation and consequent improvement on their quality of life, the nurse may use the Roy’s Adaption Model (RAM), which is described in six stages of the nursing process. The first two form the phase of gathering data about stimuli and behaviors, which will guide the subsequent stages. Therefore, the objective on this study is to build and validate the content of the instrument entitled as “Scale of the Adaptation Level of the Person with an Ostomy (ENAE). It is about a methodological study that will be developed in two steps: the first is about the construction of the instrument’s items from the constructs’ definitions, and the second will be bases on the phase of validation by the judges. The constitutive and operational definitions were made from the literature and the validation process will be analyzed through the Content’s Validation Index (CVI). 116 judges were selected for the validation stage, of which six answered the form, showing the following characteristics:33.3% had master’s degree, 33.3% the level of specialist, 83.3% the nursing graduation on a public institution, the average time of formation was around 7.1 years, 53.8% said that they did not worked on the field of stomal therapy, the average time of care to the people with an ostomy was of 5.8 years, 61.5% mentioned an affinity as reason to work and / or make research about affairs relating to ostomy, 100% considered that it was important that the nurse knows the adaptive process of the person with an ostomy, 69.2% feel ready to help a person with an ostomy, including the adaptive needs and 92.3% knew RAM. About the item’s evaluation, 62.5% of the items allocated on physiological mode, 76.47% of the self – concept mode, 100% of the paper function mode and 71.4 of the interdependence mode showed CVI >80, being the remaining items submitted to reformulation from the suggestion made by the research’s judges. This project was approved by the Committee of Ethic in Research of Universidade Federal do Rio Grande do Norte, under report nº 421.342, CAAE  number 19866413.3.0000.5537.

16
  • MARJORIE DANTAS MEDEIROS MELO
  • ACCURACY OF NURSING DIAGNOSIS OF DEFINING CHARACTERISTICS LOW SELF-ESTEEM SITUATION FOR OSTOMY

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARINA DE GÓES SALVETTI
  • Data: Dec 2, 2016


  • Show Abstract
  • Patients with an ostomy have their changed outlook on life, mainly by negative body image due to stoma presence associated with the collection bag, the altered elimination patterns, changes in eating habits and hygiene, often resulting in diminished self-esteem, impaired sexuality and even social isolation. In view of the difficulties and complications mentioned, albeit briefly, it is clear that people with ostomy need priority be encouraged to develop self-esteem, and professional nursing through nursing process and establishing accurate diagnoses they are essential for comprehensive health care. Cross-sectional study, with exploratory and descriptive approach, aiming to analyze the accuracy of the defining characteristics of the nursing diagnosis "Low situational self-esteem" in registered ostomy people in CERHRN. The research was favorable by the Case n° 421,342 CEP-HM. Held data collection between the months of January to March 2015, through the use of two instruments: one composed of questions regarding sociodemographic and clinical aspects of patients, stoma characteristics and effluent and its complications and characteristics of self-care, and self-esteem Global Scale Rosenberg (SSRS). The sampling process was determined by convenience resulting in a total of 90 ostomy. Data were organized in electronic database by typing in the Microsoft Excel spreadsheet application. Then they were exported and performed descriptive and inferential analysis. In sociodemographic predominated 56 males (62.2%), aged from 50 years 53 (58.9%), mulatto 45 (50%), with fellow 53 (58.9%) , retired 42 (46.7%), with education to elementary school 64 (71.1%), Catholics 59 (65.6%) and income above the minimum wage 60 (66.7%). Regarding clinical and stoma aspects predominated ostomy without comorbidities 49 (54.4%), colostomists 72 (80%) with permanent  ostomy 57 (63.3%) as the main cause of making the stoma neoplasia 54 ( 60%) which did chemotherapy 45 (50%), 25 months or more stoma 48 (53.3%). The analysis related to self-care showed that 69 (76.7%) of the ostomy has full ability to perform self-care. Regarding the sociodemographic variables, there was statistical significance of self-esteem with education (p = 0.007) and a value close to significant family income with self-esteem (p = 0.091). Later, for the analysis of the accuracy of the defining characteristics of the diagnosis Low situational self-esteem nursing, a spreadsheet will be built in Microsoft Office Excel, entering the variables of the collected instruments and analyzed in SPSS version 2.0 based on sensitivity measures , specificity and post-test probabilities (positive and negative) of the defining characteristics raised in the study.

17
  • YANNA GOMES DE SOUSA
  • Workloads in nursing professionals involved in mental health services - III.

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • SORAYA MARIA DE MEDEIROS
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • SANDRA MICHELLE BESSA DE ANDRADE FERNANDES
  • FRANCISCO DE SALES CLEMENTINO
  • Data: Dec 2, 2016


  • Show Abstract
  • This study aimed to analyze the factors that contribute to generating psychic workloads and work overload of nurses inserted in CAPS III. This is an exploratory and descriptive study with a quantitative approach. Data collection was between August and September 2016, using two specific instruments: (1) semi-structured interview script, recorded in MP4 device to identify feelings of pleasure and experienced suffering in the workplace, the psychic loads and defensive strategies for suffering of coping at work and (2) Labor Impact Assessment Scale in Mental Health Services - IMPACTO-BR to evaluate the work overload. There were 46 nursing professionals interviewed who were active in CAPS III of the municipalities of Campina Grande and João Pessoa. The treatment and analysis of the speeches were carried out through the R pour Analyses Multidimensionnelles de Texteset de Questionneires Interface software (IRAMUTEQ) performing the lexical analysis for CDH. The number of the participants and the following variables were typed in command lines: professional category, sex and length of service in CAPS III. The objective was to identify whether there was a level of significance between variables with the classes of dendrograms. The data of the IMPACTO-BR Scale were organized and stored in a database built in Statistical Package for Social Science (SPSS) version 20.0. For a descriptive analysis of the IMPACTO-BR subscales the analysis of variance test (ANOVA) was carried out, and the test t Student was applied for a comparison between the subscales and the socio-demographic variables of the participants. For all statistical tests, significance level 5% was used. This study was licensing by the Ethics Committee on Research of the Federal University of Rio Grande do Norte - UFRN according to CAAE: 57947916.4.0000.5537, opinion Nº 1,675,537. Of the 46 respondents, 80.4% were female, aged 25-35 years old representing 39.1% of workers, most of them 41.3% were married. Regarding the professional category, 58.7% were nursing technicians and 41.3% were nurses. The time working in CAPS III had 67.3% working between 1 and 5 years and 54.3% working 30 hours per week. In the lexical analysis, CDH of IRAMUTEQ four dendrograms were unveiled with the following themes: the pleasure in the work environment; suffering in the work environment; psychic loads and defensive strategies used by nursing professionals. The feelings of pleasure were identified as work in nursing in mental health, the result of implemented treatment, the meaning of work and nursing care. Suffering was related to working conditions, the precariousness of material and financial resources, lack of human resources, the weakness in the mental health system and the very nature of work. Psychic charges are related to the pace of work, physical structure, women´s work, working with mental suffering patients, lack of management support, insufficient multidisciplinary team and the lack of clinical supervision. Defensive strategies used by nursing professionals were to perform physical activities, interpersonal relationships, development of leisure activity, use of psychotropic drugs, seek support in religion and critical distance. However, the habit of using psychiatric medicine has been identified as harmful to health professionals. The IMPACTO-BR Scale recorded global average score of 2.81±0.67 which results in moderate impact to work. The subscale which contributed the highest level of impact of the work was related to the emotional impact of working with 3.00±0,77. The data showed that the highest level of impact was related to the emotional impact of the work. Comparison of the subscales with the demographic variables showed evidence of a statistical difference between the emotional repercussions of work with 3,11±0.67 and physical and mental health 2.66±0.77 with gender. The female showed a high level of overload to work. There was a negative correlation in the results of work overload; It is concluded the need to conduct continuous and regular evaluations of the services surveyed to monitor the workload promoting quality of life of nursing professionals and better service to patients. It is expected that the results found in this research contribute directly to scientific production for the nursing area and Occupational Health.

18
  • DEBORA FEITOSA DE FRANCA
  • ADVERSE EVENTS RELATED TO VENTILATORY THERAPY IN HIGH RISK NEWBORNS

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • INGRID MARTINS LEITE LÚCIO
  • NILBA LIMA DE SOUZA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Dec 6, 2016


  • Show Abstract
  • In the last decades neonatal care has advanced due to the development of more effective measures for the control of respiratory insufficiency. However, the most frequent adverse events described in the literature are from ventilatory therapy, such as: mechanical ventilation pneumonia, unplanned extubation, pneumothorax and nasal septum injury. The present study aimed to analyze incidents related to respiratory therapy in high-risk newborns of a neonatal unit. It is an observational, longitudinal and prospective study carried out in a maternity unit, a reference unit in the State of Rio Grande do Norte for high-risk pregnancy and birth. The data were collected in the period from April to September 2016, after approval of the project in the Research Ethics Committee of UFRN with CAAE nº 51832415.0.0000.5537. The target population consisted of 82 newborns submitted to ventilatory therapy in the modalities: invasive mechanical ventilation, non-invasive mechanical ventilation and continuous positive airway pressure per prong nasal. The results show that the incidence of adverse events was 48.8%, most frequently unplanned extubation (34%), followed by nasal septum lesion (13%), mechanical ventilation pneumonia (7%) and Or pneumothorax (6%). Regarding the severity of the damage, most of them caused temporary damage requiring intervention or prolongation of hospitalization. The probability of occurrence of an adverse event in a neonate undergoing ventilatory therapy in the first five days of therapy exceeds 40%. There is an association between the gestational age range and the occurrence of adverse events. Newborns with gestational age less than 28 weeks are the most susceptible. The odds ratio for a newborn suffering an extreme gestational adverse event is 5.57 times greater than one term. The logistic regression results indicate an association between the congenital malformation and the occurrence of the adverse event in a general way and by type, specifically the unplanned extubation. Therefore, it is concluded that premature newborns with congenital malformations are vulnerable to the occurrence of adverse events related to ventilatory therapy. And, as an opportunity to improve care, it is recommended the construction and validation of protocols for the prevention of unplanned extubation, which meets the specificities of patients with congenital malformation, in addition to the minimum protocol for the management of extremely premature infants.

19
  • YOLE MATIAS SILVEIRA DE ASSIS
  • CONSTRUCTION AND VALIDATION OF A GRAPHIC PROTOCOL FOR THE SAFE NURSING CARE EVALUATION TO PATIENTS IN ONCOLOGICAL INTERVENTION UNITS

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ELIZABETH BARICHELLO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • QUENIA CAMILLE SOARES MARTINS
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Dec 7, 2016


  • Show Abstract
  • Its growing and highly complex incidence, cancer consists of the chronic disease with constant risk of injuries during treatment, a fact that favors the occurrence of incidents in the provision of care and proves the necessity to devote greater attention aimed at assessing the quality of care in this area. Therefore, this study aims to propose the evaluation graph protocol safe nursing care to patients in oncology inpatient units. It is a methodological study to develop and validate the graphic protocol content assessment of safe nursing care to patients in oncology inpatient units, developed in four stages: 1) literature review, to search for levels of evidence and identification of items necessary for the preparation of the instrument; 2) construction of the evaluation protocol; 3) content validation by experts - Delphi Technique; and 4) analytical procedures. The graphic evaluation protocol was drawn up in line with the elements "structure", "process" and "result" of the triad proposed by Donabedian, beyond the scientific and legal recommendations that support patient safety in oncological units. To systematize the protocol validation, it was made use of googledocs tool. As for the selection of judges analyzed the instrument in the Delphi Technique, this was intentionally through the Lattes Platform Curriculum Lattes, from inclusion and exclusion criteria predetermined. They selected 37 judges, who received the invitation letter; of these, only 13 returned with the signed consent form. For the consensus on the protocol validation, it took two rounds of the Delphi technique, in which the Delphi 1, 10 judges responded to the form, and Delphi 2, eight. After application of the Delphi technique, he proceeded to the processing of data, with further quantitative analysis, from the Content Validity Index (CVI). In the end, it was possible to get the "evaluation chart Protocol safe nursing care to patients in oncology inpatient units", endorsed in its content. It should be noted that were applied all ethical principles, involving research with human beings, with the project already approved by the Research Ethics Committee (CEP) of the Federal University of Rio Grande do Norte (UFRN), which was favorable to the CAAE No 42951515.7.0000.5537.

20
  • FÁBIO CLAUDINEY DA COSTA PEREIRA
  • Nursing work process in the care of people living with HIV/AIDS in the family health strategy

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FELISMINA ROSA PARREIRA MENDES
  • FRANCISCA PATRÍCIA BARRETO DE CARVALHO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • HYLARINA MARIA MONTENEGRO DINIZ SILVA
  • Data: Dec 12, 2016


  • Show Abstract
  • Care for the person living with the human immunodeficiency virus (HIV) or Acquired Immunodeficiency Syndrome (HIV / AIDS) (PLA), is a specificity considering that it is a complex / multifaceted object of care that requires multiple knowledge, due to the involvement Of questions that go beyond clinical knowledge and advance to social and affective demands. It is a public health problem, with an incidence rate in progression both in Rio Grande do Norte and in the city of Parnamirim. From this reality the professional nurse must exercise the care developing his work process in the various levels of health care. This context promulgates the need for an effective performance of said professional to the public cited. This study aims to analyze the work process of the nurse practitioner in the care of people living with HIV / AIDS in the family health strategy in the city of Parnamirim/RN. This is an exploratory, descriptive study of a qualitative approach of the type of case study carried out in the Family Health Strategy of the city of Parnamirim, where the nurses working in said service were interviewed through a semi-structured interview and analyzed through the thematic analysis of Bardin. The project was approved by Comitê de Ética em Pesquisa (CEP) of the Universidade Federal do Rio Grande do Norte (UFRN) in the no. 1,442,712 and CAAE: 51842215.1.0000.5537. The analysis will be by the Bardin Content Analysis method. The results showed that the majority of the interviewed population is female, between 20 and 40 years of age, with training time between 6 and 10 years and with only one working relationship. Regarding PLHA care, care is focused on promotion , Prevention and diagnosis of HIV, but there is still a great gap regarding the care of these people after the diagnosis, since this treatment is performed in the Specialized Attention Service and although it is in the same city there is no effective communication between the Services, impairing the integrality of the assistance In the health care network. PLWHA are further characterized by risk groups, which increases social stigmatization. It was concluded that there is still a great difficulty in the formation of the care network focused on PLHA care, but that studies in this sense need to be developed to provide comprehensive care to these people.

21
  • ISABELLE CAMPOS DE AZEVEDO
  • CLINICAL AND EPIDEMIOLOGICAL PROFILE AND SURVIVAL OF PATIENTS TRANSPLANTED WITH HEMATOPOIETIC STEM CELLS IN A REFERENCE SERVICE IN RIO GRANDE DO NORTE

  • Advisor : MARCOS ANTONIO FERREIRA JUNIOR
  • COMMITTEE MEMBERS :
  • MARCOS ANTONIO FERREIRA JUNIOR
  • ALLYNE FORTES VITOR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • MARIA LÚCIA IVO
  • Data: Dec 13, 2016


  • Show Abstract
  • The Stem Cell Transplantation Hematopoietic (HSCT) has been used as an alternative and effective therapy for patients with oncological diseases, hematological or immunological, malignant or not, inherited or acquired. The HSCT may occur through autologous transplantation, wherein the Cells Hematopoietic Progenitor (CHP) is collected from peripheral blood or bone marrow of the patient; allogeneic to which the donor is related or not with Human Leukocyte Antigens (HLA) the CHP and from peripheral blood, bone marrow, umbilical cord blood or placental; or syngeneic, when the donor is identical twin. This study aimed to characterize the clinical and epidemiological profile of patients who underwent HSCT in a reference service in the state of Rio Grande do Norte and estimate the overall survival of transplant patients. Is a study of retrospective cohort study with a quantitative, descriptive and analytical approach performed by collecting data from medical records of patients who underwent HSCT in a reference service in the state of Rio Grande do Norte (RN) between January 2008 and December 2015. data were collected between March and September 2016 at the Medical Archive and Statistics Service (MASS), and included analysis of recorded medical records of 272 patients who underwent HSCT in the service in question. sample were excluded 11 records that were not found. For data collection it was used an instrument that addressed the socio-demographic and clinical data of patients. Data were organized in Microsoft Excel® 2010 spreadsheet program to procedures descriptive and inferential analysis. For descriptive analysis of the data we used the Epi Info 2002 program, version 3.5.2. For a description of the sample tables were constructed containing the absolute and relative frequencies by gender and total averages and standard deviations. To calculate the likelihood of association between the characteristics analyzed and sex were used the chi-square trend, Fisher's exact test and the Mann Whitney test, according to each case. The survival estimates were calculated using the Kaplan-Meier method, when it was considered the starting point of patient entry into the study to date of the HSCT and end the last event: death, abandonment or monitoring at the time of data collection. To compare the survival rates for variables to be listed was used the statistical method of Log Rank. The survival calculations were performed using SPSS (Statistic Package for Social Sciences) version 22.0. The significance level was 0.05. The research protocol was submitted to the Research Ethics Committee (REC) of the Federal University of Rio Grande do Norte (UFRN), in accordance with Resolution no. 466/12 of the National Health Council (NHC) of the Ministry of Health, which deals with the research on human subjects to assess their ethical and methodological aspects. It was approved on July 1, 2015, in the opinion 1,132,720 and CAAE: 46202715.7.0000.5537. From the data analysis, it was observed that of the 272 patients, 53.3% were male, 46.7% were married, with an average age of 38.7 years, 78.3% lived in NB and 15% were students. Regarding the situation with HSCT service, 67.6% had completed treatment, the mean follow-up was seven months, the average time between the start of monitoring to HSCT was two months and overall survival was on average four months. As for the diagnosis leading to the HSCT, 23.5% of the patients had multiple myeloma and more antineoplastic therapies were used (100.0%), antibiotics (96.7%), antiemetics (97%), antifungals (94, 8%), antimicrobials (94.1%), proton pump inhibitors / anti-ulcer (94.4%), antivirals (91.5%), amino acids (84.9%), analgesics / antipyretics (86.4% ), antihistamine (86.4%), corticosteroids (86%), and blood therapy (84.5%). Among the comorbidities / toxicities that occurred more are the gastroenterological (93%), fever (68%), cardiovascular (53.7%), hematologic (48.1%) and respiratory (47.8%). Regarding the type of transplant, allogeneic was performed in 54.8% of patients, most MHC source used was peripheral blood (77.9%) and, among allogeneic transplants, the congener was performed in 71, 8% of cases. Among patients 9.9% had more than one HSCT and 4% had to graft versus host disease. Regarding the causes of deaths, septic shock appeared in 5.5% of cases, followed by sepsis (4.8%), multiple organ failure (4.8%) and lung infection (4%). The data presented demonstrated the epidemiological profile of patients treated with HSCT in an RN reference institution. These certainly will inform decision-making regarding the care provided in the context of HSCT. Therefore, we consider the importance of further studies on the subject in order to trace the different demographic and epidemiological profile of the Brazilian regions with regard to HSCT as a therapeutic.

22
  • SAMARA ISABELA MAIA DE OLIVEIRA
  • Notifications of Syphilis in Pregnant Women and Congenital Syphilis: An Epidemiological Analysis

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • ERIKA SIMONE GALVAO PINTO
  • JORIA VIANA GUERREIRO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • NILBA LIMA DE SOUZA
  • Data: Dec 15, 2016


  • Show Abstract
  • Syphilis is an infectious disease that remains as one of the major reporting aggravations to be addressed globally. In the maternal-infant context, it is related to deleterious effects from the vertical transmission and exposes the binomial mother and child to risks such as abortion and perinatal death. Effective actions to control the disease should be carried out in prenatal care, in a timely manner, to ensure the prevention of the congenital form of the disease. In this sense, this research aims to analyze the syphilis notification in pregnant women and congenital syphilis and the factors related to vertical transmission. This is a sectional, retrospective, documental epidemiological study of a descriptive and analytical nature carried out in the year 2016. The population was recruited from the eligibility criteria and totaled 129 reports of syphilis in pregnant women and 132 notifications for congenital syphilis in the period between June 2011 and December 2015, in the municipality of Natal / RN. Data were analyzed through descriptive and inferential statistics. The Chi-square test, the T-student test and the Fisher test were used to verify the associations between the variables of interest. The research received a favorable opinion by the Ethics Committee of the Federal University of Rio Grande do Norte under number 1,449,134 and Certificate of Presentation for Ethical Assessment 53305315.3.0000.5537. In the period under investigation, there was an increase in reported cases in the year 2012. The maternal profile points to women with a mean age of 24.7 years, browns (75.8%), urban residents (99.2%) of the municipality from Natal. The prenatal analysis identified a predominance of maternal diagnosis in the third gestational trimester (69%) and presence of non-treponemal reactive tests in (94.6%) of the women at the time of delivery. Regarding maternal treatment, only (1.6%) of these were registered with an adequate treatment scheme and (16.7%) of the partners were treated concomitantly with the pregnant women. In the children's outcomes, (78%) were registered as asymptomatic, however, this variable presented statistical significance when related to titration of the maternal non-treponemal test and to the pre-delivery treatment. In the geo-referenced spatial analysis, the predominance of cases in Quintas and Felipe Camarão’s neighborhoods, both belonging to the Western Sanitary District of the municipality investigated, was identified. The results also point to important gaps in the completion of notifications. It was concluded that the loss of diagnostic opportunity, as well as the inadequacy of maternal treatment and the low adherence to treatment by the partner were prominent factors in the occurrence of syphilis vertical transmission. The development of strategies for early detection and adherence to treatment of the disease should be adopted, with a view to strengthening care and breaking down the vertical transmission of the disease. It is important to emphasize the need for an increase in the provision of information to epidemiological surveillance in order to continue the analysis of the disease in the health context studied.

23
  • MARCELA PAULINO MOREIRA DA SILVA QUEIROZ
  • Hospital nurses: a study of the characteristics of work, stress and cardiovascular risk factors

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • Data: Dec 19, 2016


  • Show Abstract
  • Cardiovascular Diseases stand out as the leading causes of death worldwide, accounting for the most significant public health problem today. In recent decades, several studies have been made to identify the factors that increase the risk of cardiovascular disease, including in health professionals such as nurses. The aim of this study was to analyze the association between job characteristics, stress level and cardiovascular risk factors in hospital nurses. Cross-sectional study with a quantitative approach developed at the University Hospital Onofre Lopes. The study population was 256 nurses working at the institution. The sample for finite population was composed of 148 participants. The selection of participants took place through simple random sampling. For the purposes of the study it was used a semi-structured questionnaire to assess sociodemographic variables, family history, cardiovascular risk factors, work characteristics and cardiovascular risk, beyond the Stress of Bianchi Scale for assessment of stress at work. Data analysis was performed based on the statistical program Statistical Package for Social Sciences 20.0 where descriptive and bivariate analyzes were performed to associate the categorical and continuous variables. The nurses were predominantly female (85.1%); White (52%); with a mean age of 35.2 years%; training time between 5 to 10 years (42.6%). Most worked in the wards (48.6%); the afternoon shift (36.5%); with a schedule of weekly working 36 hours (45.9%); possessed another bond work (55.4%); with working time in the institution between 1 to 3 years (40.5%) and daily hours of average work 8 hours. The stress level of most of the study participants was moderate 50.7%. As for cardiovascular risk factors: 51.4% of nurses were overweight; 89.2% reported not have hypertension; 85.8% do not have diabetes; 77.7% has no dyslipidemia; 51.4% are sedentários.O cardiovascular risk by the ankle-brachial index was estimated average of 1.2. Participants with Bianchi Stress Score classified as moderate had cardiovascular risk 3.27 times higher than those with low stress Bianchi Score. Nurses who worked more than 40 hours per week gained greater cardiovascular risk than the others. In addition, we reject the hypothesis that the cardiovascular risk of nurses are equal in regard to the risk factor had to be diabetic. It is concluded that there is an association between stress, evaluated by the Bianchi Stress score, and increased cardiovascular risk, as well as the working characteristics with high cardiovascular risk. It is suggested intervention strategies for the group studied in order to reduce cardiovascular risk.

24
  • ANNE KAROLINE CANDIDO ARAUJO
  • Concept analysis of the nursing result Weight Loss Behavior in adolescents.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • SHEILA SAINT CLAIR DA SILVA TEODOSIO
  • Data: Dec 19, 2016


  • Show Abstract
  • Obesity is a chronic disease of multifactorial origin defined as the accumulation of excess fat abnormal or harmful to health. Currently, it is characterized as a public health problem worldwide and constitutes a risk factor for the development of diseases. Thus, it stands to nursing as a profession able to direct their actions and list the care directed to people with overweight and obesity. Objective of this study was to analyze the concept of weight loss behavior in adolescents. concept analysis study on the model Walker and Avant and operationalized through integrative literature review. Databases searched way: SCOPUS, CINAHL, PubMed, LILACS, WEB OF SICENICE And Sicence DIRECT with the descriptors: Behavior; Weight Loss; Obesity and Adolescent. Inclusion criteria were: full articles available on the selected databases; articles available in Portuguese, English or Spanish; articles that portray the relevant thematic review. Exclusion criteria were: reviews, abstracts, editorials, expert opinions and letters to the editor. The survey of articles occurred in the months of May to July 2016. The initial sample of 427,783 articles, and 2,129 in CINAHL, 184 in Lilacs, 229,911 in Scopus, 23,869 in Pubmed, Web of Science in 9965 and 161,725 in Science Direct. The results show that the concept developed for the behavior for weight loss is the result of actions and interventions designed to control habits and achieve goals set by health professionals. Thus, it is concluded that the concept developed for the behavior for weight loss is comprehensive and involves adolescent individual actions with family and health professionals. It is believed that research has contributed to the improvement of results in the population with overweight and obesity, as well as being essential knowledge to the scientific body of nursing science.

25
  • GLAUBER WEDER DOS SANTOS SILVA
  • Suicidal ideation, parasuicide, depression and violence against transvestites and transsexuals: analytical and transversal study.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • DULCIAN MEDEIROS DE AZEVEDO
  • EDNALDO CAVALCANTE DE ARAÚJO
  • EDU TURTE CAVADINHA
  • Data: Dec 19, 2016


  • Show Abstract
  • In the World, annually, millions of suicides and parasuicide happen, being a theme recognized as priority of Public Health. The factors for this type of death include biological, psychological and social aspects. Transvestites and transsexuals, exposed to stressful events provoked by bias and violence, may become more prone to develop a certain degree of social and psychological isolation and can contribute for the risk of suicidal ideation. This way, this research aimed to analyze the association between suicidal ideation and sociodemographic, of health-disease, depression, violence and parasuicide aspects in transvestites and transgender. It is about a study with quantitative, transversal approach, with the type being analytical, developed with four Non-Governmental Organizations of transvestites and transsexuals rights in Rio Grande do Norte. The population was composed with 58 subjects. The data gathering occurred in the period of November, 2015 to June, 2016, using three specific instruments: (1) Beck’s Suicidal Ideation Scale; (2) Beck’s Depression Inventory; and (3) Survey of sociodemographic information, of health-disease, violence and parasuicide. The data collected were organized and stores in a database constructed in the software Microsoft Office Excel® 2016 and, later, imported to the Software R version 3.3.1 for testing. For the descriptive analysis, it was considered the absolute and relative frequencies, measures of central and dispersion trend. To verify the variables associations, it was applied the Pearson’s Chi-square test and, when the prerequisites for the test were not attended, it was used Fisher’s Exact Test. A level of significance of 5% was adopted. Regarding ethical questions, the project was approved by the Committee of Ethics in Research on Human Beings of Federal University of Rio Grande do Norte, under report nº 1.314.559 from 11/09/2015. In relation to the results, about the sociodemographic characteristics, it prevailed the identity of being a transsexuals (62.1%); young subjects with an age group from 18 to 29 years (69%); single (81%); with an education level lower or equivalent to high school (77.6%); black or brown race (69%); doing prostitution activity (29.3%) or without professional occupation (17.2%); and with a monthly income of up to one minimum wage (44.8%). According to the evaluation of depressive level, these vary between minimum (41.4%). Light (31%), moderate (25.9%) and serious (1.7%). About the aspects of health – disease, 44.8%, said that they used liquid industrial silicon and were under hormonotherapy without medical supervision (67.2%). Regarding the analysis of experiences
    in the process of victimization, it was highlighted that 96.6% already had been victims of some type of violence. Among the parasuicide aspects, it is highlighted that 34.5% had at least one previous attempt of suicide. In the verification of suicide ideation’s (SI) presence, it was found that 41.4%, showed active and/or passive SI. One verifies the statistically significant association with SI with the following aspects: depression levels (p=0.0029); school violence (p=0.0122) and rejection from the family due to gender identity (p=0.0103); and parasuicide factors: and parasuicide factors: previous suicide attempt (p=0.0080); and moderate intensity or strong will to die in the last attempt (p=0.0206). There was no statistically significant association between SI and sociodemographic and of health-disease aspects. It was showed that transvestites and transgender that took part on the study had elevated tiers of SI. Therefore, the null hypothesis (H0) is rejected, and the alternative hypothesis (Hl) is accepted when affirming that there is an association between SI with depression aspects, violence and parasuicide in a group of transvestites and transgender.

26
  • ALINE DANNYELE SOUZA DE OLIVEIRA
  • CAPACITY ASSESSMENT FOR THE WORK OF NURSING PROFESSIONALS IN A UNIVERSITY HOSPITAL

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • ERIKA SIMONE GALVAO PINTO
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • JOÃO BOSCO FILHO
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 20, 2016


  • Show Abstract
  • The ability to work includes well-being in the performance of work activities and is related to the physical, emotional and mental demands arising from the work. Nurses, in the performance of hospital activities, are exposed to the impairment of their work capacity due to the complexity and volume of activities developed in an unhealthy environment in both the material and subjective sense. In this sense, this study focuses on the health of the worker, in particular on the health of the nursing team of the hospital network and has as objective to evaluate the Capacity for Work of nurses of a university hospital. This is a descriptive cross-sectional study with a quantitative approach involving 135 nurses from the Onofre Lopes University Hospital, carried out with the favorable opinion of the Research Ethics Committee of the Federal University of Rio Grande do Norte under number 1,845,951 / 16. Which governs Resolution No. 466/2012 of the National Health Council that regulates research with human beings. The data collection took place in November 2016, using as a data collection instrument a questionnaire containing two steps, one with general data of the interviewee and the other in the Brazilian version of the capacity index for work prepared by the Health Institute Occupational Therapy in Finland; Translated and adapted by researchers of the Faculty of Public Health of the University of São Carlos. The database was built in EXCEL format, version 2010. Statistica SPSS software, version 20.0 was used for descriptive tables and statistical test applications (Alpha Cronbach's test and qui-square test). It was observed that among the population of nurses who participated in the study, there were predominant adults (up to 40 years of age) (88.15%), female (81.48%), married (47.41%), Post graduation (93.33%). An average ICT score of 40.24 was found. Most of the nurses in this study had adequate ICT (81.48%), with a good or optimal classification, and only 18.52% had an inadequate ICT (low or moderate). Only one independent variable presented evidence of statistical difference that was satisfaction with the salary, other characteristics are shown tendentious as age, formation and time of bond. Because it has successfully achieved the objectives proposed by the study, it is believed that it may have contributed to the deepening of discussions on the Work Capability Index, issues related to worker health and, finally, the improvement of the use of the instrument.

27
  • LARISSA MENDONÇA TORRES ROSÁRIO
  • Experiences of the companion man facing the woman submitted to the mastectomy.

  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • FLAVIO CESAR BEZERRA DA SILVA
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • KALYANE KELLY DUARTE DE OLIVEIRA
  • Data: Dec 22, 2016


  • Show Abstract
  • Breast cancer is the most common type of cancer in the world's female population, and is responsible for the physical and emotional consequences to the lives of women and their partners. The objective of the research was to understand the experience of the women’s partner who was underwent mastectomy. This is an exploratory and descriptive research, with a qualitative approach, developed with 12 fellow men of women submitted to mastectomy, developed at the Hospital da Solidariedade and at the Centro de Oncologia e Hematologia de Mossoró, in the city of Mossoró, Rio Grande do Norte, Brasil.  According to the inclusion criteria, participants should be 18 years old or be older than this; and live with his breast cancer patient's partner, who underwent mastectomy. The information collection took place from July to October 2016, through a semi-structured interview. This was preceded by the approval of the referred hospitals, approval by the Research Ethics Committee of the Federal University of Rio Grande do Norte, with Certificate of Presentation and Ethical Appreciation nº 55191216.1.0000.5537 and opinion nº 1.618.233 as well as signing the Term of Consent Free and Clarified by the interviewees. The data were analyzed using the Content Analysis method, in the thematic analysis modality proposed by Bardin. Three categories emerged from this process: Knowledge of breast cancer and the mastectomy procedure of his lifemate, Feelings before the companion submitted to the mastectomy and Support to the woman in the difficult moments, and seven sub-categories, which were Analyzed and discussed based on the literature on the experience of the companion man before the woman submitted to the mastectomy. It was found that those interviewed, when experiencing the mastectomy of their lifemates, were inserted in a context of understanding the disease and release of feelings, and it is essential to provide support to the woman. Therefore, based on the study, it was considered the necessity of the insertion of the companions of mastectomized women in the care, because they are fundamental character to assist in the treatment of the woman. Given this, it’s relevant that the nursing team consider the different situations faced by the man during the mastectomy of his partner, having as a priority his insertion in the care process, minimizing its psychological consequences and using it as an instrument for the care of the patient. woman.

Thesis
1
  • RENATA SILVA SANTOS
  • Autocuidado apoiado aos hipertensos: Construção de um protocolo. 

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • DIEGO BONFADA
  • ERIKA SIMONE GALVAO PINTO
  • REJANE MARIA PAIVA DE MENEZES
  • SONIA MARIA SOARES
  • Data: Jan 28, 2016


  • Show Abstract
  • A hipertensão arterial é uma doença não transmissível que resulta em condições crônicas. Sua prevalência e complicação associam-se a fatores de risco como a obesidade, o sedentarismo, e a mudança de estilo de vida da população. Com isso, as ações integradas de prevenção e cuidado ocorrem prioritariamente na atenção primária à saúde, através da Estratégia de Saúde da Família. O autocuidado do indivíduo nesse processo de adoecer, precisa de apoio e orientação da equipe de saúde sobre a forma pela qual, deva realizar e/ou assumir sua própria condição de saúde. O objetivo deste estudo é propor um protocolo que norteie as ações dos profissionais da atenção primária à saúde no autocuidado apoiado aos hipertensos. Trata-se de um estudo metodológico, descritivo e quantitativo, realizado em Unidades de Saúde da Família no município de Natal, RN. Teve como população de referência hipertensos residentes em áreas adscritas dessas Unidades que caracterizaram a amostra aleatória de 287 alcançada sob fator de ajuste para população finita considerando a sua prevalência para o município de Natal, conforme dados do Vigitel. A coleta de dados, teve início após Parecer favorável  Comitê de Ética e Pesquisa sob nº 1.058.112/2015 e anuência da instituição, no período de junho e setembro de 2015, e incluiu uma fase inicial junto aos profissionais, e outra junto aos hipertensos. Foram visitadas as 41 Unidades de saúde da família e entrevistados 70 profissionais de saúde para descrever as ações realizadas junto aos hipertensos e os dados foram lançados no Excel 2010. Foi aplicado um formulário de elaboração própria junto aos hipertensos e os dados foram lançados e analisados no Software Statistical Package for Social Science, versão 20.0, A partir da realidade encontrada junto as unidades e aos hipertensos e dos aspectos teóricos discutidos no Modelo de Atenção às Crônicas e na Teoria de Enfermagem de Orem, foi construído um protocolo e este foi submetido a 31 juízes para realizar a validação de conteúdo, e foi aplicado o Índice Kappa, Índice de Verificação de Conteúdo (IVC) e a Escala de Likert. Os resultados evidenciaram que das 41 Unidades, 36 unidades realizam ações coletivas para toda a comunidade, embora essas ações não sigam diretrizes únicas e nem é rotina dos profissionais a visita domiciliar ocorrer para conhecer as condições de saúde para apoiar o autocuidado para usuários para realizar a vigilância à saúde.  26 fizeram referência a grupos de hipertensos, e 16 dessas unidades realizam reuniões sistemáticas mensais. Da caracterização dos hipertensos, 83,62% possuem mais de 49 anos, 87,11% não possuem plano de saúde, sendo acompanhamento na unidade de saúde; 81,5% recebem medicamentos da farmácia; no geral, os 287 hipertensos apresentam-se independentes em relação as atividades de vida diária, com somente 3% apresentando dependência; 80,8% não participam de atividades coletivas de educação em saúde  na unidade, e 201 hipertensos referem que procuram a unidade para renovar receita e para realizar consulta médica. Todas as etapas da avaliação do protocolo apresentaram avaliação superior a 0,83, de acordo com o IVC (máximo igual a 1), o que caracteriza que as áreas apresentadas são bastante relevantes. Dos 20 itens, 06 precisam ser adequados considerando as pontuações obtidas no Índice Kappa (menor que 0,41) e Likert (menor que 70 pontos). Estes tópicos foram revisados e adequados de acordo com a sugestão apresentada pelos validadores e a discussão literária. O protocolo foi validado em relação ao seu conteúdo, sendo assim aceito o pressuposto desta tese. Este protocolo poderá contribuir para o ordenamento das ações junto aos hipertensos na unidade e no apoio ao autocuidado que os mesmo possuem capacidade para realizá-lo em domicílio e com isso melhorar suas condições de saúde.

2
  • CLEONICE ANDREA ALVES CAVALCANTE
  • MAGNITUDE DA MORBIDADE RELACIONADA AO TRABALHO NO RIO GRANDE DO NORTE

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • CLAUDIA SANTOS MARTINIANO SOUSA
  • IRIS DO CEU CLARA COSTA
  • IZAURA LUZIA SILVERIO FREIRE
  • MARIA LUCIA AZEVEDO FERREIRA DE MACEDO
  • MARIA LÚCIA DO CARMO CRUZ ROBAZZI
  • SORAYA MARIA DE MEDEIROS
  • Data: Jan 28, 2016


  • Show Abstract
  • As doenças e agravos relacionados ao trabalho configuram-se em importante problema de Saúde Pública no Brasil e no mundo. No entanto, a realidade desses agravos ainda se constitui em uma lacuna no que diz respeito à caracterização e situação epidemiológica das mesmas, especialmente no Brasil. Diante disso, o presente estudo teve como objetivo analisar a magnitude da morbidade relacionada ao trabalho no Estado do Rio Grande do Norte, no período de 2007 a 2014. Trata-se de um estudo ecológico, quantitativo de delineamento transversal, tendo como unidade de análise os municípios do estado do Rio Grande do Norte. Os dados foram coletados a partir da base estadual do Sistema de Informações de Agravos Notificáveis (SINAN) do Centro de Referência de Saúde do Trabalhador (CEREST) da Secretaria de Estado da Saúde Pública do Rio Grande do Norte. A coleta de dados ocorreu entre março e junho de 2015, após a aprovação do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, através do Parecer N° 014/2014. A população foi representada pelo universo de casos de doenças e agravos relacionados ao trabalho que foram notificados e encerrados no sistema no período de 2007 a 2014. Os dados foram organizados em banco de dados eletrônicos do Microsoft Excel versão 2010 e exportados para o programa estatístico SPSS versão 20.0, analisados por meio da estatística descritiva e analítica, apresentados em forma de tabelas e gráficos. Para tanto, utilizou-se o Microsoft Excel 2007 e um software estatístico. Dos 10.161 casos de agravos relacionados ao trabalho notificados, destacaram-se os acidentes biológicos (52,84%) e de trabalho grave (37,49%). Quanto às doenças, destacaram-se as osteomusculares (4,82%), transtornos mentais (2,19%) e intoxicação exógena (1,97%). Houve predominância dos agravos entre homens nos acidentes graves (91,80%), transtornos mentais (70,00%) e intoxicações exógenas (52,84%). As mulheres foram mais acometidas por acidente biológico (77,50%) e doenças osteomusculares (64,10%). Entre os agravos predominou a cor parda, média de 35,86 anos de idade, baixa escolaridade e trabalhadores no mercado formal. Dentre os acidentes ocupacionais, destacaram os biológicos (n=5.369) que corresponderam a 52,84% com predomínio de casos entre os profissionais de enfermagem (48,31%). A exposição percutânea foi a mais frequente (73,05%) e as circunstâncias de ocorrência foi o descarte inadequado de perfurocortantes (45,28%), a agulha o agente mais comum (66,62%) e o material orgânico foi o sangue (72,99%). A maioria dos trabalhadores acidentados era vacinada contra HBV (68,13%), porém sem informação quanto à avaliação da resposta vacinal. A evolução dos casos predominou a situação ignorada com perda de acompanhamento do seguimento clínico. Houve ainda aumento na notificação de acidentes de trabalho grave com predominância: sexo masculino, trabalhadores entre25 a 44 anos e do acidente típico. A incapacidade temporária à evolução mais comum e a mão a parte mais atingida; a indústria extrativa e da construção civil teve o maior número de casos e o empregado registrado. Constatou-se um aumento expressivo na notificação dos agravos relacionados ao trabalho no período analisado, sobretudo os acidentes. Em relação às doenças, observou-se um aumento nos casos de doenças osteomusculares, transtornos mentais e intoxicação exógena. No entanto, o sistema de informação ainda carece de melhoria tanto na cobertura como na qualidade dos dados no sentido de demonstrar com maior fidedignidade a magnitude dos eventos para subsidiar o planejamento das ações em Saúde do Trabalhador no estado.  

3
  • LARISSA SOARES MARIZ VILAR DE MIRANDA
  • CONCEPTUALIZING NEGLIGENCE IN THE OBESE CHILDREN ATTENTION IN BASIC HEALTH CARE: MEANING OF NURSES

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • MARIA CLAUDIA MEDEIROS DANTAS DE RUBIM COSTA
  • CARLA CAMPOS MUNIZ MEDEIROS
  • FRANCISCA GEORGINA MACEDO DE SOUSA
  • Data: May 20, 2016


  • Show Abstract
  • Obesity is a major problem worldwide. In children, its care is a challenge because it requires Nursing care of the obese child is a challenge in Primary Health Care because it requires the active participation of all involved. In parallel to this concern, is the fact that obesity is a major health problem that is growing globally. In this context, the nurse can act in its prevention, identification, assessment, and treatment. Qualified practice in this area, however, requires theoretical investment. The objective of the study was to understand the meanings that nurses in Primary Health Care attribute to the care of obese children and to describe a theoretical model that explains the process. The study used the Grounded Theory method and Virginia Henderson´s theoretical/philosophical perspective. Data were collected in Primary Care Health Units, Family Health Units, and Specialized Health Services in Campina Grande, Paraiba, Brazil, during the months of April to October 2015. A total of 24 participants formed four theoretical sample groups: 11 Primary Health Care nurses, four caretakers, five health professionals, and four health service managers. Data were collected during the months of April to October 2015 by semi-structured interviews and analyzed by the constant comparison method. The analysis consisted of the initial coding, diagram and memorandum construction, axial and selective coding, and reflection of the emerging paradigm and theory. Six categories emerged from the data: Identifying processes that determined the discontinuity of care to the obese child in the health unit – causal condition; Characterizing the fragile parental co-responsibility of care to the obese child – consequence; Interacting with the multi-professional care team – intervening condition; Envisioning new perspectives for the nurse´s care and Attending to the preoccupation for new processes of nursing care – strategic actions/interactions; and Moving within the nursing care scenarios – context. The categories´ interrelations and interactions gave rise to the theoretical explicative model: The nurse worrying about the care of the obese child as a neglected area in Primary Health Care. The theoretical model provides a comprehension of the nursing care of the obese child as a web of complex relations and interactions that is permeated by the concern for the child´s health, but that is devoid of effective and continuous actions. The care surpasses individual attention and needs the shared responsibility of nurses, specialized professionals, health service managers and family. In midst of the Primary Health Care neglected area, the nurse identifies the need for care of a population that does not have priority attention in the health service units with precarious structural and human resources conditions. This reflects on the parents´ and caretakers´ lack of understanding of infantile obesity and on their distancing from the collective responsibility. It is concluded that the nursing care of the obese child configures meanings derived from the lived experience of practice and reflects intrinsic professional principles and pre-established concepts. As a whole, the meanings direct the way that care is provided, of action, and of its behavior with obese children, establishing relationships with the multiple contextual factors and the subjects, and interacting in a complex process.

4
  • SÂMARA SIRDÊNIA DUARTE DE ROSÁRIO BELMIRO
  • ESTABLISHMENT AND EVIDENCE OF VALIDATION OF A HEALTH NEEDS ASSESSMENT INSTRUMENT OF PEOPLE WITH DISABILITIES PHYSICAL, HEARING AND VISUAL

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • ALEXSANDRO SILVA COURA
  • INÁCIA SÁTIRO XAVIER DE FRANÇA
  • Data: Jun 30, 2016


  • Show Abstract
  • People with disabilities (PcD) over their history experienced situations of abandonment, denial of rights, stigma and prejudice. This therefore creates problems relating to health assistance to this audience, with limited access to services, health professionals, tests, medications, facing attitudinal and structural barriers. These factors generate health needs unmet, which causes problems for their quality of life. In this study, we consider the needs as something different from biologicist and technical demands that come to health services. In this context, the study justifies because in health is unknown specific validated instrument to assess PcD health needs, being as damaging factor to the quality of health care to this population segment, considering that identifying these needs aims at solving and quality intervention to change the health of PcD. Objective, thus , prepare and seek evidence of validity an instrument for the assessment of health needs of people with physical, hearing and visual. This is a methodological study to develop and validate the content and appearance of an evaluative instrument. Conducted with judges, professional healthcare throughout Brazil , and people with physical, hearing and visual disabilities  registered in three associations to support the disabled person in the city of Mossoro / RN , from January 2015 to May 2016. The construction and validation process follows the precepts of Pasquali , following the steps of the theoretical pole through two phases: 1) identification of constitutive and operational definitions of the construct and preparation of items comprising the instrument called Instrument Health Needs Assessment of People with hearing and Visual Disabilities , ( IANS - PcDFAV ) through an integrative literature review , in the first quarter 2015 in CINAHL, MEDLINE , LILACS and SCOPUS databases; experience of researchers ; and in taxonomy of Matsumoto and Cecilio Health Needs. 2 ) Theoretical analysis of the items , Step 1 - content validity through Delphi technique; Step 2 - semantic validation and appearance through a pilot study. The first stage was held search through Lattes platform in order to identify health professionals with expertise who acted as judges instrument. The sample consisted of 33 experts in the Delphi phase 1 and 18 for Delphi 2. In the second stage sampling was non- probabilistic for convenience with eight people with physical, hearing and visual disabilities. For the first stage of data collection was submitted, via online form to experts. We conducted the analysis adopting Content Validity Index (CVI) > 0.80 and Cronbach's Alpha > 0.70. We used the Mann -Whitney test to investigate the differences between Delphi phases 1 and 2. In step two was applied three instruments to people with physical, hearing and visual disability: the IANS - PcDFAV, DISABKIDS® Questionnaire - Overall impression and the DISABKIDS® Questionnaire - specific impressions. The analysis was given by descriptive statistics. It was considered the principles of Resolution 466/2012. In the process of validity of the content in the first round Delphi it was found that five items of dimension of demographic data, and two items of the dimension living conditions have not reached the set index in the established content of validate. In other items occurred agreement, with CVI ranging from 0.82 to 1. In the second round, after heeded the suggestions of experts, all items reached excellent levels. Presented significant differences in socio-demographic data dimensions , living conditions and in the field 1 (one) ( p> 0.05). Regarding to the average of evaluation requirements , all items had better averages in the second evaluation , with statistical significance ( p = 0.026 ) in the requirement usefulness / relevance and overall assessment of the instrument ( p = 0.031 ). Cronbach's alpha was 0.884 in phase Delphi 1 and 0,825 in phase Delphi 2. Regarding the semantic validation and appearance, the instrument was evaluated as important and the items of the instrument were considered easy to understand. The responses generated changes in the construction of the instrument items. The proposed instrument has satisfactory values of validity and reliability, serving as a guide for assessing the health needs of people with physical, hearing and visual disabilities.

5
  • ANA BEATRIZ DE ALMEIDA MEDEIROS MOURA
  • Validation of the nursing diagnosis “Pressure ulcer risk”

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • HYLARINA MARIA MONTENEGRO DINIZ SILVA
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • VIVIANE MARTINS DA SILVA
  • Data: Aug 8, 2016


  • Show Abstract
  • The objective of this study was to validate the nursing diagnosis “Pressure ulcer risk” in patients admitted to the intensive care unit. Faced with the severity, complexity and degree of dependence of the critical patients, nursing needs to assess the presence of this diagnosis to act in the prevention of risk factors and maintenance of quality in the services offered. This was a methodological study, conducted in three steps: concept analysis, content analysis by experts and clinical validation. The first step was based on the model of Walker and Avant and performed through literature review, which occurred in the months of February and March 2015. We used the databases: Scopus, Latin American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine and National Institutes of Health, and Web of Science, and the descriptors: pressure ulcer, risk factors and intensive care units, and their respective synonyms in the English language. We obtained a sample of 22 papers. After completing the concept analysis, we identified 42 backgrounds and the following essential attributes: Pressure; Pressure combined with shearing; and Tissue ischemia. In the second step, we asked the experts to give opinions about the concept analysis, by means of a focus group, composed of seven nurses, in four meetings, which were held from May to July 2015. After finishing the discussion in the focus group, we had a total of 29 backgrounds, besides the following conceptual definition for the diagnosis under study: Vulnerability of rupture of the skin integrity as a result of the tissue ischemia provoked by pressure or pressure combined with shearing. In the third step, we conducted a case-control study with the aim of assessing, in clinical practice, the accuracy of the risk factors of the nursing diagnosis identified and validated in the preceding steps. This step took place in the intensive care unit of the Onofre Lopes University Hospital, through a form. The sample was composed of 180 participants, with 90 in the case group and 90 in the control group. The research project was submitted and approved by the Research Ethics Committee of the aforementioned hospital, under Protocol number 848.997 and Presentation Certificate for Ethics Assessment number 36883714.5.0000.5292. The results show that, through the application of the hierarchical logistic regression model, a set of five risk factors and one clinical aspect must be regarded as a strong indicator of the increased risk for pressure ulcer. The risk factors were: History of pressure ulcer; Extended period of stay in the ICU; Friction, Dehydration and High Temperature. As for the clinical aspect, it was: Treatment of comorbidities. We conclude that there is a set of variables that increase the chance of occurrence of the nursing diagnosis “Pressure ulcer risk” in patients admitted to the intensive care unit. Accordingly, we believe that this study has contributed to the improvement of the diagnostic parlance, with regard to adopting preventive measures, applying more effective interventions, achieving positive results and improving the quality of the health care provided by the nursing professional.

6
  • CLAUDIA CRISTIANE FILGUEIRA MARTINS RODRIGUES
  • HOSPITAL ENVIRONMENT: Organizational Climate x Stress in the nursing team

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • MARCOS ANTONIO FERREIRA JUNIOR
  • QUENIA CAMILLE SOARES MARTINS
  • ALCIVAN NUNES VIEIRA
  • ELIANA CARDIA DE PINHO
  • Data: Aug 19, 2016


  • Show Abstract
  • Occupational stress is present in many work environments because of constant technological, productive and social changes in recent years. Thus, studies that promote worker's relationship discussion and your place of work, are important because they allow the identification of aspects of the work environment and enable a diagnosis of the main organizational needs that can lead to occupational stress. In this sense, the screen study aimed to analyze the relationship between organizational climate and the stress of nursing staff from a University Hospital. It was a cross-sectional survey with a quantitative approach. Data collection was carried out in February 2015. The study sample included 319 nursing professionals who were placed in care inpatient sectors, namely the Clinical Units and Surgery, Intensive Care, Surgical and Dialysis Center. The following instruments were used: a sociodemographic questionnaire, the Inventory Signs and Symptoms of Lipp and the evaluation scale of the organizational climate. The analyzes were the univariate and bivariate type, with 5% significance level. The study followed the ethical and legal principles governing scientific research on human subjects, the National Health Council, approved by the Research Ethics Committee, the Opinion 925,477 from December 18, 2014, under the CAAE number: 273.935.146.000 .0553-7. The results indicate that the stress was present in 22.5% of the investigated sample, wherein stood phases resistance and exhaust. The higher frequencies were found in workers with 30 years old, married, with children and who worked in the wards in the morning shift. Regarding the organizational climate, it became clear that the factor working conditions was assessed as the most satisfaction among study personnel; however the decision-making factor was scored as the most dissatisfaction. As regards the relationship between the overall organizational climate and occupational stress of the nursing team showed a statistically significant difference so that professionals who scored lower scores of the total organizational climate had expressed symptoms of occupational stress. Thus, we can say that the organizational climate that workplace influences stress responses in members of the nursing team investigated. Thus, it is concluded that the hospital environment studied in the context driving voltage reactions and wear nursing staff which reflects the signs and symptoms of stress.

7
  • FRANCISCA PATRÍCIA BARRETO DE CARVALHO
  • Leprosy Attention Policies in Rio Grande do Norte: analysis based on Health Promotion.

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • ERIKA SIMONE GALVAO PINTO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • FELISMINA ROSA PARREIRA MENDES
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • Data: Sep 6, 2016


  • Show Abstract
  • Leprosy is considered a major public health problem due to its high disabling and impairment power in individuals of the economically active age group. The Rio Grande do Norte has a high incidence of leprosy. The evaluation of quality of care of the Leprosy Control Program (HCP) was considered by the Ministry of Health from regulate to precarious, given that reveals the fragility of the measures of health surveillance in the state. The given context shows the need for a more effective action in responding to people with leprosy or with sequelae and reactions of the same in the state in order to support these individuals to face the daily difficulties generated by the disease. This study aims to analyze the aspects that compromise the performance of the Leprosy Control Program in RN. This is an analytical study and of quantitative and qualitative aspect, ie, mixed methods in order to conduct a comprehensive analysis of the research problem. It will be held in the pole-cities of each of the eight health regions of the state. The municipal coordinators of HCP and health professionals who provide care in leprosy services of these cities will be interviewed, namely, all professionals of reference services and a reference sample of professionals working in the Family Health Strategy in each city studied through scripts of interviews and a questionnaire previously established. The research project was approved under number 1011888 and CAEE No 42951615.6.0000.5537 by the Research Ethics Committee / UFRN, respecting all the requirements made by this body and the 466/12 Resolution of the National Health Council. The data were analyzed through discourse analysis and the results grounded in Health Promotion as a theoretical framework. The results are organized in three manuscripts: 1) Health evaluation: an integrative review; 2) The nurse's attention context to people with leprosy in the Family Health Strategy; 3) PCH managers of discourse analysis in newborns. The first article guided the assessment of HCP which this thesis is part and noted that reviews of health policies and programs should be learned from the following observations: as a time frame, in particular prism and from certain health conceptions. Not as an end in itself and not as absolute truth. The second article assessed the layers of the nurse's work in the context of PCH and how they influence and are influenced by it. The third article analyzes the discourse of managers PCH that distinguished the influence of bureaucratic management model and the design of attention to medical / health centralized addition to the strong influence of sanitarian / Model campaigner, although the current model is health surveillance. Met with managers over coordination under their responsibility, but without technical support, scientific and political (human and economic resources for the performance of their duties); the minority with little time to work, but most are in function for years and still not appropriated all the scientific tools and techniques needed to develop a work that promotes health and giving efficient and effective results. It realized that the PCH can improve from two initiatives: (1) professional management (2) emphasis on health promotion and teamwork (inter / multidisciplinary). Not only the PCH, but the NHS has not yet effected expressively in order to modify the model of attention to proposed health.

8
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • Construction and validation of a virtual learning object to support systematization of nursing care education to nursing technicians

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • JOSÉ CARLOS AMADO MARTINS
  • MARCOS ANTONIO FERREIRA JUNIOR
  • MARIA ISABEL DOMINGUES FERNANDES
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Sep 8, 2016


  • Show Abstract
  • The objective was to build and to validate a virtual learning object to support the Systematization of Nursing Care education to nursing technicians. This is a methodological research using a mixed approach based on the QUAL → QUAN sequential exploration strategy. The construction stages were conducted from February 2015 to March 2016. The team was composed of members of the research group from the Investigation of Care, Safety, and Technology in Health and Nursing Laboratory (LABTEC) of the Federal University of Rio Grande do Norte (UFRN), Brazil, and by faculty members of the Coimbra Nursing School (ESEnfC), Portugal, and by professionals in the area of system analysis and development. Within the framework of Instructional Design, the Analysis, Design, Development, Implementation, Evaluation (ADDIE). While pedagogical theory gives contribution to educational conceptions, the virtual learning object was designed in the light of the Theory of Meaningful Learning. The construction and validation process of the virtual learning object was designed from adaptations of the Pasquali model, following the steps: 1) theoretical procedures to identify the contents that composed the proposed teaching instrument; 2) empirical procedures, when VLO content validation was outlined by nursing experts; and 3) analytical procedures, when validation was analyzed by Delphi technique, in order to confirm or refute the validation of the VLO. Each step followed appropriate methodological procedures for the scope they were intended. The national ethical principles established by Resolution Number 466/2012 of the National Health Council were followed granting that the study proposal was considered and approved by the Research Ethics Committee, through the Opinion number 925408 of 12/18/2014, CAAE number 39640914.8.0000.5537. Thus, participant consent in each stage of the study was obtained preserving the voluntary and anonymity of subjects. The virtual learning object valid in its content is presented. It is expected to provide the virtual learning object to support the teaching of systematization of nursing care to nursing technicians for the various nursing education institutions, while a grant for the implementation of this important field to know under the conceptions of blended learning. The virtual object was developed essentially for students of nursing technical course. However, the learning is proposed and encouraged to students and nursing professionals, of any academic level.

9
  • MARIA CLEIA DE OLIVEIRA VIANA
  • Analysis of the pattern and quality of sleep with the quality of life of nurses in hospital shifts.

  • Advisor : MILVA MARIA FIGUEIREDO DE MARTINO
  • COMMITTEE MEMBERS :
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JAQUELINE GIRNOS SONATI
  • ROSÂNGELA MARION DA SILVA
  • Data: Sep 29, 2016


  • Show Abstract
  • This study aimed to analyze the quality of life and sleep patterns of nurses in hospital shifts work. This is a study with a quantitative approach, cross-sectional, descriptive. The study was conducted at the University Hospital of Rio Grande do Norte. Data were collected from January to September 2015 with the use of instruments: Questionnaire Personal and Professional Information, Pittsburgh Sleep Quality Index, form for evaluation of sleep-wake cycle - Modified by De Martino (1996), People identification Morningness and Eveningness Questionnaire by Horne & Östberg (1976) and Quality of Life Questionnaire (WHOQOL-BREF). Were interviewed 104 nurses in their work shifts. After being coded and tabulated, data were analyzed using SPSS version 20.0. For a description of nominal variables it was used the distribution in relative and absolute numbers in contingency tables and continuous variables were used measures of central tendency (mean and median), dispersion (standard deviation), Mann-Whitney test and Correlation of Spearman, and adopted significance level of p ≤ 0.05 and presented in tables, charts and figures. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in the Opinion No. 751,567.The results show a socio-demographic profile of 65.1% nurses who worked the day shift and 38.5% in the night; 90.4% female, 73% of those aged between 24 to 45 years, 65.4% worked in hospitals and 55.8% had an employment relationship. As for chronotype highlights were the indifferent (44.2%) and moderately Morning (34.6%) among those surveyed, with no significant difference between work shifts (p = 0.985). As for standard sleep features of nurses for seven consecutive days, was obtained best average scores in nurses who worked the day shift in all parameters (nap time, latency, hours overnights, sensation upon waking and sleep quality) compared to night workers, showing significant differences (p ≤ 0.05). In all indexes of quality of sleep of Pittsburgh (subjective quality, latency, duration, efficiency, disturbances, Use of medication to sleep, sleepiness and daytime disorders and overall score PSQI) indexes were better in the daytime nurses, and significantly, the duration ( p = 0.031) and overall score (p = 0.013) compared to night workers. The quality of life in all areas (Functional, Psychological, Social and Environment) and overall the day shift nurses were better than the night shift nurses, and significantly, in the social domain (p = 0.014) and overall score (p = 0.024). It was concluded that nurses who work during the day shift had standard and quality sleep and quality of better life that professionals working in the night, the null hypothesis refutes (H0) and accepts the alternative (H1) by stating that the standard and quality of sleep alters the quality of life of nurses in hospital shifts.

10
  • KESSYA DANTAS DINIZ
  • PROTOCOL ASSISTANCE FOR PATIENTS TREATED IN COMPUTED TOMOGRAPHY SERVICE

     
  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • ISABELA PINHEIRO CAVALCANTI LIMA
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARIA ALZETE DE LIMA
  • MARINA DE GÓES SALVETTI
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Dec 1, 2016


  • Show Abstract
  • The clinical protocol is characterized by being a set of information presented in a streamlined manner, which provides systematic care, and has the intention to evaluate the standardized manner the factors related to clinical, epidemiological, assists, corroborating the quality of life and patient safety. Therefore, the development of a multidisciplinary clinical protocol under the computed tomography service will contribute to a clinical evaluation needs. Thus, the study aimed to prepare and validate a clinical protocol for patients seen in the computed tomography service. This is a methodological research with a quantitative approach, carried out in two stages: the first consisted of an integrative review of literature that supported the construction of the protocol; the second was characterized by the content validation by experts using the Delphi technique. The research was initiated after approval by the Ethics Committee in Research with Human the Federal University of Rio Grande do Norte beings with Presentation Certificate for Ethics Assessment CAAE Nº. 41872215.7.0000.5537. The first phase was implemented between October and November 2015, by reviewing the literature in the MEDLINE, Scopus, Web of Science and CINAHL with the intersection of controlled descriptors: Diagnostic Imaging; Patient safety and Computed Tomography. The sample consisted of 24 articles. The results were organized into three categories: optimization, monitoring, quality and protection in relation to exposure to radiation doses; adverse reactions and kidney diseases related to the use of contrast; nursing care, management and specific cases. For the second stage, experts were selected by Lattes the National Scientific and Technological Development Council platform (CNPQ) in order to identify health professionals from Brazil who act as judges instrument. The sample was 54 specialist nurses both as Delphi 1 to Delphi 2. Statistical analysis was performed using Cronbach's alpha indices Content validity (CVI) and the Relative Index (ARI). In the first stage (Delphi 1) the average Cronbach's alpha was higher than 0.80, the IVC and ARF was 0.924. Already in Delphi 2, Cronbach's alpha arrived at 0.868, with CVI and IRA 0.934. It performed a comparison between Delphi 1 and 2, and realized that Deplhi 1 showed slightly better results in general than the Delphi 2, but in both the reliability was satisfactory. By Mann - Whitney test, there was evidence of statistical difference Delphi 1 with Delphi 2 in size utility / relevance, consistency, clarity, updating, accuracy, instructional sequence of topics and overall evaluation, which was obtained better assessment in Delphi 2 in the variables described above. Thus reached the validity of the protocol on its content.


11
  • CILENE NUNES DANTAS
  • Telenursing for the monitoring of child growth and development based on the International Classification of Nursing Practices (CIPE®)

  • Advisor : FRANCIS SOLANGE VIEIRA TOURINHO
  • COMMITTEE MEMBERS :
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • JOSE DINIZ JUNIOR
  • JOSELANY AFIO CAETANO
  • MARIA MIRIAM LIMA DA NÓBREGA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Dec 5, 2016


  • Show Abstract
  • The objective of this study was to develop a web-therapy environment applied to the nursing consultation for the monitoring of child growth and development in Primary Health Care, whose specific objectives were to construct and validate the content of a nursing history instrument for the first consultation and for the Subsequent consultation; And to propose a software (prototype) for these. It is a methodological study, composed of two stages: 1. The process of elaboration and validation of the contents of the instruments of nursing history occurred between February and July 2016 and was outlined according to the following steps: 1. Validation stage of the content of nursing history instruments: 1.1 Literature review; 1.2 Structuring of instruments for monitoring child growth and development based on literature review; 1.3 Selection of the judges to participate in the study; 1.4 Validation process of the content - adequacy of the instruments by the judges so that it can represent the content to be measured; 1.5 Validation of contents of Nursing History: Delphi Technique; And 1.6 Data analysis. Step 2: Development of the Telenfer environment (software-prototype) for the monitoring of child growth and development that occurred in the period between February and October 2016. The study followed the ethical precepts that govern the scientific research with human beings of the National Council Approved by the Ethics and Research Committee, by means of Opinion No 925.408, dated 12/18/2014, under the number CAAE 39640914.8.0000.5537. For the validation of the content of the nursing history instrument for the first consultation and subsequent for the monitoring of child growth and development, the Delphi 1 stage was used, in which eight judges evaluated the nursing history instruments, and the Delphi 2 stage And 3, six. The nursing history for the first and subsequent consultations was evaluated by the judges according to the criterion of agreement. The instruments that obtained a consensus of 80% among experts were considered valid in their content. With regard to the proposed software, the web-browsing environment was developed on a web platform and presents the previously established requirements that are related to the use cases of the system, resulting in activities that are accessible to users (user administrator and nurse) Registered in the system. It is concluded that the environment of Telenfermagem can guide the practice of the Family Health Strategy nurse and contribute to the continuity and improvement of the quality of care provided to the child, due to its theoretical basis and the use of a classified language. In addition to providing more effective communication, nurses' empowerment and greater autonomy, through the use of this technology in their work to identify the main physical, neurological and psychosocial development frameworks, as well as to detect and intervene early changes in child-family health In Primary Health Care.

12
  • JOAO EVANGELISTA DA COSTA
  • Stigmas, prejudices and myths in the search for the loyalty of blood donors and social representations

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • CLELIA ALBINO SIMPSON
  • ELIANE SANTOS CAVALCANTE
  • FERNANDO DE SOUZA SILVA
  • FRANCISCO DE SALES CLEMENTINO
  • Data: Dec 12, 2016


  • Show Abstract
  • INTRODUCTION:  The Social Representation is always a representation of an object or a subject constructed by man's relationship with the environment. One of the features of Social Representation is to transform something unknown to something known and familiar. This transformation reveals the interdependence of psychosocial reality whose structural and structural elements are characteristic of its conceptual and figurative aspect. Data from the World Health Organization and the Brazilian Ministry of Health show that the number of altruistic, loyal blood donors is insufficient to meet current needs, endangering the lives of people who depend on this therapy. MAIN OBJECTIVE: Analyze culture aspects of blood donation, stigmas, prejudices and myths in the pursuit of loyal and regular donors using the Social Representations theory. SECONDARY OBJECTIVES: Evaluate the blood donation from elderly subjects in a private transfusion service; analyze anemia as a temporary disability factor for blood donation; analyze the concept of "loyal blood donor"; verify the existence of loyal blood donors from the perspective of Social Representations. The sociodemographic and interview data were submitted to the Analyse Lexicale par Contexte d'un Ensemble de Segment de Texte (ALCESTE) and analyzed under Social Representation Theory methodologia and Central Core Theory complemented by the Bardin content analysis. METHODS: It is a quantitative and qualitative descriptive exploratory study using tools of the social representations theory. The survey was conducted in HEMOVIDA Hemotherapy Service Ltd, a private institution located in Natal, State of Rio Grande do Norte, Brazil. The data of ineligibility from 2010 to 2015 were collected from the dedicated software Hemote Plus® using its Clinical Triage module.  86 elderly donors who met the inclusion criteria (age between 67 and 69 years and donated blood between November 2012 and November 2014) were invited to make a new donation.  Fifteen scientific papers on "Loyal Blood Donor" were analyzed using Walker and Avant concept analysis and a convenience sample of 121 individuals was used to test the concept. Sociodemographic and interviews data were submitted to the software Analyse Lexicale par Contexte d'un Ensemble de Segment de Texte (ALCESTE) and analyzed using procedures of the Theory of Social Representations and Central Nucleus Theory complemented by Bardin content analysis. RESULTS: The ineligibility by anemia stands out with 51.47% among the most prevalent disabilities among female sex donors. Of the 86 invited seniors, 20 attended and of these only 8 aged above 67 years.  The concept of loyal blood donor, besides incorporating positive qualities and retaining varied presentation of similar terms, translates a semantic meaning that provokes comfortable and practical reactions in its use. Social Representation of the loyal blood donor originated four categories from the four classes generated by the software: “Society: people and others” (Class 4); “Helping the other” versus “People's life” (Class 2); “Helping the other” versus “People's life” (Class 3); “I have the opportunity but lack time to donate” (Class 1). In terms of Social Representation presents respectively the functions of orientation, knowledge, identity and justification. CONCLUSION: Ineligibility by anemia was verified in women due to menstrual blood loss, pregnancy and breastfeeding,. A low return rate of elderly donors was observed, probably due the to lack of information regarding the maximum age for blood donation and to ineligibilities due to comorbidities that are more prevalent in this age group.  The concept of “loyal blood donor” requires more studies for consolidation and to make this kind of donor more frequent in the blood stocks  replacement process. Refuting the alternative hypothesis, there are no social representations of the loyal blood donor, which is referred to the concept. It is concluded that the non loyal blood donors present the three dimensions of social representations: attitude, information and the representational field, while they are propagandized, published and not diffused in the investigated group, characterizing themselves as controversial social representations.

13
  • FABIANE ROCHA BOTARELI
  • VALIDATION OF THE NURSING DIAGNOSIS RISK OF DRY EYE IN ADULT PATIENTS HOSPITALIZED IN THE INTENSIVE CARE UNIT

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ANA RAILKA DE SOUZA OLIVEIRA KUMAKURA
  • MARCOS ANTONIO FERREIRA JUNIOR
  • ROSIMERE FERREIRA SANTANA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Dec 12, 2016


  • Show Abstract
  • The objective of this study was to validate the nursing diagnosis of dry eye risk in patients admitted to the Intensive Care Unit. It is a methodological study developed in two stages of validation of nursing diagnoses according to Lopes, Silva and Araujo (2012): construction of constitutive and operational definitions of dry eye risk factors and clinical validation of nursing diagnosis Dry eye risk. For the first step, the model of Walker and Avant (2011) was implemented through an integrative review according to Whittemore and Knalf (2005), through manual and reverse search of the references of the Analysis of concept on dry eye of Fernandes (2015) and the NANDA-I taxonomy for the diagnosis in question. The first step resulted in the constitutive and operational definitions of 15 risk factors for dry eye and subsidized the clinical validation stage. This second phase was performed at the ICU of the Onofre Lopes University Hospital operated by means of a prospective cohort study with the following steps: 1. Training of the data collection team and the diagnostic nurses; 2. Pilot study with 30 patients; 3. Data collection; 4. Inference of the diagnosticians. The sample was defined with a collection time of 7 months, which at the end was composed of 70 patients. Inclusion criteria were: age greater than or equal to 18 years, no ocular dryness at ICU admission, length of stay longer than 24 hours. Exclusion criteria: diseases of the ocular surface e topical ocular treatment. The instrument of data collection consisted of sociodemographic and clinical data; risk factors for the diagnosis in question; ocular evaluation, neurological, hemodynamic, respiratory, hydroelectrolytic evaluation; laboratory data; medications in use and the Schirmer test result. The evaluation took place daily and with a follow-up time of up to five days. The dry eye outcome was established by clinical criteria and Schirmer's test was less than 10 mm. The research was submitted and approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under opinion 918.510 and CAAE: 36079814.6.0000.5537 in accordance with Resolution 466/2012 of the National Health Council of the Ministry of Health, and in it were observed and respected the bioethical precepts governed by this dictates. Descriptive data were analyzed using simple, mean, median and standard deviation frequencies. The measures of association between the outcome variables and predictors were calculated using the Chi-square test and Fisher's exact test. For the quantitative variables, the t-Student test was used for symmetrical samples and the Wilcoxon-Mann-Whitney test. The symmetry of the sample was verified by the Kolmogorov-Smirnov test. The level of significance was 5%. The relation between exposure and outcome was obtained by Relative Risk. The calculations were performed by SPSS (Statistic Package for Social Sciences) software version 22.0. The results demonstrate that the risk factors strongly associated with dry eye in patients hospitalized in the ICU are: lagoftalmia, mechanical ventilation with elevated PEEP, chemosis, blink reflex alteration and use of systemic drugs. In addition, the criteria defined for the outcome (conjunctival hyperemia, Schirmer test less than 10 mm and mucous secretion) presented statistical significance for ocular dryness. Therefore, it is believed that this study is innovative for the advancement of knowledge on the subject and for the improvement and validation of the use of the NANDA-I taxonomy by nurses working in this scenario, in order to provide support for precise ocular evaluation, Inference of the diagnosis in question, risk prediction as adoption of measures of prevention and monitoring of complications.

14
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • Development of a program for nursing care in the prevention and control of adolescents' overweight and obesity

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CARLA CAMPOS MUNIZ MEDEIROS
  • CLAUDIA SANTOS MARTINIANO SOUSA
  • EDILMA DE OLIVEIRA COSTA
  • Data: Dec 16, 2016


  • Show Abstract
  • Overweight and obesity constitute a worldwide public health problem that has increased prevalence among adolescents. In Brazil, the Ministry of Health has designated the prevention and control of the problem to Primary Health Care.  However, no guideline instruments or programs for nursing practice with this school-based population are known. The objective was to develop a nursing care program for prevention and control of overweight and obesity among adolescents in Primary Health Care. Methodology study conducted in four public schools and four Primary Care Health Units in the city of Natal/RN. The participants were: four nurses, representing the four geographic city zones (north, south, east and west); 114 adolescents,; and 40 school teachers. A participative intervention for the prevention and control of overweight and obesity in adolescents was developed, using the six stages of Bartholomew´s Intervention Mapping framework (needs evaluation, construction of objectives for change matrices, definition of theory-based methods and strategies, program development, application planning, implementation, and evaluation). The needs were identified by an integrated review of literature, adolescent and teachers´ focal groups, and semi-structured interviews with the nurses. Data were synthesized using the collective subject discourse method.A total of 41 (36%) adolescents were identified with overweight or obesity and the main needs that emerged for discussion were: bullying, nutritional re-education, and availability of physical exercise. Next, the planner constructed performance objectives matrices, change determinants, and change objectives; these were discussed and modified with the nurses. Theinterventions emerged from the integrative review of nursing interventions with overweight and obese adolescents, and from the NIC intervention “Care for weight reduction (1280)” from the Classification of Nursing Interventions. A total of 41 (36%) adolescents were identified with overweight or obesity and the main needs that emerged for discussion were: discuss bullying, nutritional re-education, and availability of physical exercise. The result was the “School Program for More Health” with various practice strategies. Planners and participants tested and evaluated the practice strategies through implementation whichresulted in the reduction of physical exercise time, from 60 to 45 minutes per class hour. Each target group was encouraged to participate in the adoption and continuation of the Program and a bimonthly evaluation plan was constructed. It is concluded that a participative theory-based interventionthat isprocedurally mapped, and that is developed with public school adolescent students, has implications for nursing practice because of its potential to guide need-focused interventions and enhance the prevention and control of obesity in Primary Health Care. The intervention Program developed represents a scientific and technologic contribution to the advancement of nursing knowledge in health promotion theory.

15
  • TAYSSA SUELEN CORDEIRO PAULINO
  • International Classification of Practice in Nursing (CIPE®): an action research in Primary Health Care

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • FRANCISCA PATRÍCIA BARRETO DE CARVALHO
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • JOÃO BOSCO FILHO
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 20, 2016


  • Show Abstract
  • Nursing has sought to unify language through various initiatives to develop classifications for its professional practice. The International Classification for Nursing Practice (CIPE®) represents the unifying framework of all nursing practice classification systems (nursing diagnoses, interventions and results) available in the professional field that arise in response to recognized needs By profession. In this sense, the objective of the study was to implement the International Classification of Practices in Nursing in Family Health Units, analyzing its impact. An action research was carried out with the nurses of the Family Health Strategy of the Rocks. According to Thiollent, action research adds several social research techniques, enabling the collective and active construction of all the subjects involved in the problem by offering greater support in the daily activity of the professional. At the beginning, a situational diagnosis of reality was developed, which contributed to the implementation of the actions, at this stage it was evidenced the lack of knowledge of the nurses about CIPE® and the contributions that this brings to the professional practice. In this way, the actions planned and executed were: approximation with reality and exposure of the same; Wheels of conversations about the applicability and functionality of the nursing consultation through exposure-dialogued; Talk about the importance of using ICNP during the nursing consultation through group dynamics and exposure-dialogue. Thus, it can be inferred that the action-research strategy for the consolidation and applicability of CIPE® in health services constitutes a unifying framework for the nursing practice, making the nursing consultation the central axis for the consolidation of a Efficient and effective, thus contributing to the growth of the professional category.

16
  • ANA MICHELE DE FARIAS CABRAL
  • Self-Esteem and Life Quality Assessment on Children who were Separated by Leprosy in the Estate of Rio Grande do Norte 

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FELISMINA ROSA PARREIRA MENDES
  • FERNANDO DE SOUZA SILVA
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • SANDRA MARIA DA SOLIDADE GOMES SIMÕES DE OLIVEIRA TORRES
  • Data: Dec 22, 2016


  • Show Abstract
  • Leprosy is presented as one of the oldest diseases in human history with an important meaning to people’s life and community. For centuries it has been considered as an infectious and crippling disease, and it was deeply marked by stigma, prejudice and social exclusion, defined by rejection behavior of sick people and their relatives.

    In the past, a mandatory isolation of lepers generated serious social and psychological problems, culminating in their total or partial removal of their core of the family. These same children were deprived from family environment, and were taken from their families in a very ruthless way, and most of time were confined and raised in foster care/orphanages.

    The research aim is to evaluate the self-esteem and the quality of life of the children who were separated by Leprosy in the Estate of Rio Grande do Norte. Integrating a social-demographic variable, gender, age, family situation, occupation, education, religion, housing, income and number of children.

    It draws a descriptive study, with a quantitative approach on processing and analysis. The data was gathered from 60 subjects, picked up from the MORHAN Potiguar Register (Reintegration Movement of the people who were affected by Leprosy). Amongst the research tools used, there were a social-demographic survey, Rosenberg self-esteem scale and Tool SF-36.

    The following inclusion criterion were applied: people older than 18 years, living in the RN and children separated of parents infected with Leprosy and registered in the MORHAN Potiguar. The research project was approved under the number 1.047.792 and CAEE nb. 42951715.6.0000.5537 of the Research and Ethics Committee of UFRN, respecting all the requirements stated by the said Organization and by Resolution 466/12 from the National Health Committee.

    All the resulting data was tabulated in a program to be statistically analyzed. It was also taken into consideration the analysis of the inner conscience scale through Croanbach coefficient.

    Results are organized in two manuscripts: 1) Stigma and Self-Esteem: concept analysis in study about Leprosy; 2) Life quality of Children separated by Leprosy in Rio Grande do Norte. The first article goal was to analyze the conceptual relation of stigma and self-esteem of people in studies about Leprosy published by Nursery papers.

    There was a selection of 142 articles cataloged by the BDENF, of which 14 were related to “Leprosy” and “Stigma” and dated from 1994 to 2014. The analysis of the concepts of stigma and self-esteem allowed to observe that these concepts are interrelated and presented a punitive nature, which is still represented today, being also a disease perceived as demeaning, with a weakness or disadvantageous point of view.

     

    The research concept analysis was based on Walker and Avant proposal, following the 8 steps considered as essential to the analysis.

    The second article analyzed the quality of life of children separated by Leprosy in the estate of Rio Grande do Norte, and that were confronted to lack of Family, emotional and social support among others. It was noted a light predominance of female gender (51,67%) compared to male gender (48,33%).    

    Average age was 45 years old (25,42%), followed by subjects between 46 and 60 years old (37,29%) and subjects above 60 years old (37,29%). Concerning school degree, elementary school formed the majority (60%), followed by middle school (31,67%) and college (8,33%). The majority of subjects were married (51,66%), followed by single subjects (26,67%), divorced (16,67%) and widows (5%). Moreover, 40,35% had a monthly minimum wage, 49,12% had 1 to 3 minimum wages and 10,53% had more than 3 minimum wages by month. Finally, 86,67% were living in their own houses.

    When the children were drift apart from their families and started to live in foster care, they experienced a very traumatic situation, which deeply impacted their lives, suffering important lost and having to undergo difficult life arrangements.

    Opposing to these results, life development increased with age and affected positively their mental health in a way that the higher their vitality was, the better their mental health became. The studied subjects presented a low social-economic rate and acceptable standards of quality of life. All of this was evaluated highlighting their social fields, mental health and functional capacity. 

    However, there was some adversarial statistic association between the fields evaluated. Explained by the concept of resilience applied to different human life phases.

    Due to the fact hat the interviewed source formed a movement where people had the same interests, it generated empathy and may have positively interfered in the results. A bias in the selection may have taken place affecting some aspects of welfare specifically. Which could prevent a generalization of the results.

                Moreover, an emphasis on the difficulty of understanding the Instrument SF-36 may be considered as part of the study despite of all endeavors taken during the process of gathering information even that this method is the most used in the filed. External relevance is limited by the lack of different sources. 

17
  • FLAVIA ANDREIA PEREIRA SOARES DOS SANTOS
  • Autonomy of the obstetrician nurse care to minimal risk births

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • MARIA DJAIR DIAS
  • MARIA HELENA SOARES DA NOBREGA MAZZO
  • NORMÉLIA MARIA FREIRE DINIZ
  • REJANE MARIA PAIVA DE MENEZES
  • ROSINEIDE SANTANA DE BRITO
  • Data: Dec 22, 2016


  • Show Abstract
  • The new health care model in Brazil denotes the obstetrical nurse´s importance for the improvement of quality care for the pregnant or puerperal woman. However, the presence of this professional in the birthing process ocorring in the Unified Health  of System institutions is a challenge primarily because the beliefs, values, strutural and organizational conditions of the work places that model the power relations of the professional. The tensions and conflicts that result from the construction of the obstetrical nurse´s autonomy in providing care in minimal risk births within the cultural context need to explained so as to identify the enhancers and inhibitors of the process. Qualitative study with an ethnographic theoretical-methodological design based on Spradley, and conducted in three public maternities in the State of Rio Grande do Norte, Brazil. Three managers and 23 obstetrical nurses participated in the study. Data was collected during July and October in 2016 after approval from the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, reports n°1.535.089 and n°1.713.075. Information about the nurses actions were collected by participant observation, individual and focal group interviews with nurses, and registered in field notes. The collection was stopped when no new data emerged. The Atlas.ti software and Spradley´s tenets were used for data analysis conducted simultaneously. Four cover terms emerged: Obstetrical nurse´s experience in diferent hospital care contexts; Social relations and power presente in the institutional care to minimal risk births; Professional and institutional aspects related to the obstetrical nurse´s autonomy; Professional autonomy from the perspective of the obstetrical nurses. The themes were conceptualized based on Foucault´s principles about power and autonomy construction. The concepts and their relations conform a theoretical explanation of the obstetrical nurse´s autonomy contribution to the care of the minimal risk birth in the hospital cultural context. This space, the structural conditions, oranized practies, and the hospital´s cultural ambiance contribute to the dependence or autonomy of the obstetrical nurse. The institutions and the professionals develop social and power relations that enhance the concept of autonomy connected to the dominant individualistic paradigm  and dominance/submissive relations.  It is concluded that the connstructed model unveils the obstetrical nurse in the state of Rio Grande do Norte in the experience with diferent cultural contexts that influence the decision power in birthcare. The model projcts na autonomy constructed by a power/knowledge that expands and supports the nurse´s actions by na ethical value and enhances the multiprofissional work in that challenges and barriers are resolved by dialogue, not imposition. Those considerations enable to affirm that autonomy is not given but conquered by those that are aware of their role in the transformation of the práxis based on the power relations that are established with others in a perspective for joint growth.

2015
Dissertations
1
  • ROMANNINY HEVILLYN SILVA COSTA ALMINO
  • Sistematização da Assistência de Enfermagem em Pacientes com AIDS. 

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • RAFAELLA PESSOA MOREIRA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Jan 30, 2015


  • Show Abstract
  • Estudo transversal com os objetivos de: identificar os diagnósticos de enfermagem (DE), características definidoras (CD), fatores relacionados (FR) e de risco em pacientes com a Síndrome da Imunodeficiência Adquirida (AIDS) por meio da NANDA Internacional; verificar a associação entre os DE, o perfil clínico-epidemiológico, características definidoras, fatores relacionados e de risco; e propor um plano de cuidados a essa clientela, fundamentado na Sistematização da Assistência de Enfermagem e seus Sistemas de Classificação. Pesquisa realizada com 113 pacientes internados em um Hospital de Referência no tratamento de doenças infectocontagiosas no município de Natal/RN. Para a coleta de dados utilizou-se instrumentos para realização de anamnese e exame físico, no período de março a setembro de 2014. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte (CEP/UFRN) sob o parecer CAAE: 23008113.8.0000.5537/2014. A análise dos dados iniciou-se por meio do julgamento clínico e raciocínio diagnóstico. Utilizou-se frequências absoluta e relativa e testes Qui-quadradro de Pearson e Exato de Fisher para verificar as associações dos DE com as CD, FR e características sociodemográficas e clínicas a um nível de significância de 5%. Realizou-se também regressão logística para identificar os fatores preditivos dos DE mais prevalentes. Identificou-se nos participantes do estudo 57 DE estando cinco presentes em mais de 50% dos pacientes, a saber: risco de infecção (n=113/100%), conhecimento deficiente (n=91/80,5%), falta de adesão (n=78/69%), proteção ineficaz (n=68/60%) e disfunção sexual (n=61/54%). Observou-se as seguintes associações significativas entre: o DE conhecimento deficiente e local de moradia, renda familiar, tipo de exposição ao vírus da imunodeficiência adquirida, comportamentos impróprios, seguimento inadequado de instruções, verbalização do problema,  falta de interesse em aprender, interpretação errônea de informações, limitação cognitiva, falta de capacidade de recordar e de familiaridade com os recursos de informação; o diagnóstico de enfermagem falta de adesão e comportamento indicativo de falta de aderência, evidências de desenvolvimento de complicações, esquecimento, habilidade relevante para o comportamento do regime de tratamento e sistema de valores do indivíduo; o DE proteção ineficaz e deficiência da imunidade, fadiga, alteração da coagulação, distúrbios imunológicos e perfis sanguíneos anormais; o DE disfunção sexual  e déficit percebido de desejo sexual,limitações percebidas impostas pela doença e função corporal alterada. Com relação aos fatores preditivos para os DE mais prevalentes identificou-se: para o DE conhecimento deficiente - comportamentos impróprios, seguimento inadequado de instruções e verbalização do problema; para o DE falta de adesão - nível de escolaridade, participação no tratamento, habilidade relevante para o comportamento do regime de tratamento e esquecimento; para o DE proteção ineficaz – infecção oportunista atual, motivo de abandono de tratamento, deficiência da imunidade, fadiga, alteração da coagulação, distúrbios imunológicos e perfis sanguíneos anormais; para o DE disfunção sexual - renda familiar, frequência diminuída da prática sexual, uso de preservativo, déficit percebido de desejo sexual, limitações percebidas impostas pela doença e função corporal alterada. O plano de cuidados de enfermagem construído teve o caráter coletivo e enfatizou os resultados e intervenções de enfermagem para os DE mais prevalentes. Identificou-se que a ligação entre os diagnósticos, resultados e a intervenções de enfermagem favorecem a aplicação do raciocínio diagnóstico e norteiam a tomada de decisão por parte do enfermeiro, ao indicar critérios explícitos na seleção de opções de cuidado ao paciente. Conclui-se que o processo de assistir a pessoa com AIDS pode ser realizado utilizando-se os sistemas de classificação de enfermagem, com a finalidade de promover autonomia da profissão, bem como, uma assistência de qualidade a essa clientela.

2
  • EDILENE CASTRO DOS SANTOS
  • Validação de protocolo assistencial de enfermagem para o paciente em processo de terminalidade.

  • Advisor : ALEXSANDRA RODRIGUES FEIJAO
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • EDNALDO CAVALCANTE DE ARAÚJO
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Jan 30, 2015


  • Show Abstract
  • O contexto da terminalidade configura um assunto geralmente evitado embora todos tenham ciência de sua inevitabilidade. Sobretudo, não se caracteriza como uma tarefa de fácil discussão diante da sociedade, pois se vivencia com angústia os momentos da finitude. O estudo visou elaborar e validar um protocolo assistencial de enfermagem para os pacientes em terminalidade internados em Unidades de Terapia Intensiva no município de Natal-RN. Trata-se de um estudo transversal, descritivo do tipo metodológico, onde realizou-se primeiramente uma revisão integrativa da literatura. A validação resultou do julgamento de experts envolvidos na assistência e/ou docência. A amostra ocorreu por intencionalidade e os colaboradores foram selecionados através de análise de Currículo Lattes com a adaptação do sistema de pontuação proposto por Fehring num total de 11 enfermeiros mediante aprovação do Comitê de Ética em Pesquisa. Os critérios de inclusão foram enfermeiros experts em terminalidade atuantes como assistencialistas e/ou docentes das disciplinas de tanatologia, bioética ou afins. A operacionalização ocorreu por meio da concordância entre as respostas obtida pelo Índice de Validade de Conteúdo através da avaliação dos juízes em uma rodada. Como resultados, a revisão mostrou os seguintes elementos da assistência de enfermagem:  o alívio da dor, promoção de conforto, higiene, afeto, reavaliação de suporte ventilatório, hidratação, aplicação de compressas, posicionamento do paciente, toque e uso de musicoterapia; apoio psicológico e espiritual de paciente e família elencados por domínios de cuidado. Os aspectos bioéticos trataram o respeito à autonomia e dignidade dos pacientes, além da comunicação com os familiares ser deficitária. Avaliou-se 15 itens, sendo 9 correspondentes ao histórico de enfermagem e 6 referentes as intervenções de enfermagem durante o processo de enfermagem na terminalidade, onde apresentou-se favorável para 0,9 de IVC. Das 165 respostas, 67,27% mostrou-se adequado; 30,91% adequado com alterações e somente 1,82% consideração inadequado, o que atesta a validade de conteúdo em 67% das respostas elaboradas pelos juízes. Diante das sugestões dos juízes procurou-se reformular o protocolo em sua maioria buscando uma melhor compreensão e clareza dos itens que compunha o instrumento tendo em vistas a torná-lo exequível. A importância do estudo para a enfermagem de cuidados paliativos destaca-se pela uniformidade das ações no fim de vida assegurando uma assistência mais humana e de qualidade.

3
  • ANA PAULA NUNES DE LIMA FERNANDES
  • GRAVIDADE DO OLHO SECO EM PACIENTES INTERNADOS EM UNIDADE DE TERAPIA INTENSIVA: ANÁLISE DE CONCEITO E CONSTRUÇÃO DE DEFINIÇÕES

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ELIZABETH BARICHELLO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • Data: Oct 15, 2015


  • Show Abstract
  • A Síndrome do Olho Seco é uma doença multifatorial do filme lacrimal, é resultado da instabilidade da unidade funcional que produz alteração de volume, composição, ou distribuição da lágrima. Em pacientes internados em terapia intensiva, a vulnerabilidade ao olho seco pode ser potencializada por fatores de risco como ventilação mecânica, sedação, lagoftalmia  e  baixas temperaturas. O estudo tem por objeto a construção de um instrumento de avaliação da Gravidade do Olho Seco em pacientes internados em unidades de terapia intensiva com base no Sistema de Classificação Nursing Outcomes Classification. O objetivo geral deste estudo é construir um instrumento de avaliação da Gravidade do Olho Seco em pacientes internados em Unidade de Terapia Intensiva. Como objetivos específicos: Analisar o contexto da enfermagem na ocorrência do evento adverso do Olho seco em pacientes internados em UTI; Analisar o conceito de Olho seco em pacientes internados em UTI; Construir definições constitutivas, definições operacionais e magnitudes operacionais para o resultado de enfermagem Gravidade do Olho Seco em pacientes internados em UTI. Trata-se de um estudo metodológico realizado em três etapas, a saber: análise de contexto, análise de conceito, construção das definições do resultado de enfermagem. Para a primeira etapa utilizou-se o referencial metodológico de Hinds, Chaves e Cypress (1992). Para a segunda etapa foi empregado o modelo de Walker e Avant e uma revisão integrativa segundo Whitemore, Knalf (2005). Esta etapa possibilitou a identificação dos atributos do conceito, os antecedentes e os consequentes, e fundamentou a construção das definições para o resultado de enfermagem Gravidade do Olho Seco. Para a construção das definições e magnitudes operacionais, foi utilizada a Psicometria proposta por Pasquali (1999). Como resultado da análise de contexto, visualizou-se que o assunto deve ser discutido e que a enfermagem necessita atentar para a problemática das lesões oculares no intuito de criar estratégias de minimização deste evento de elevada prevalência. Mediante a revisão integrativa, foram localizados 19.853 títulos,  selecionados 215 e, a partir dos resumos, 96 artigos foram lidos na íntegra. A partir da leitura, dez foram excluídos e portanto, a amostra constitui-se de 86 artigos, utilizados para analisar o conceito e construção das definições. Os artigos selecionados foram encontrados em maior número na base de dados Scopus (55,82%), realizados nos Estados Unidos da América(39,53%), e publicados em sua maioria nos últimos 5 anos(48,82). Em relação a análise de conceito foram identificados como antecedentes:idade, lagoftalmia, fatores ambientais, uso de medicamentos, doenças sistêmicas, ventilação mecânica e cirurgias oftálmicas. Como atributos específicos: TBUT< 10segundos, teste de Schimer I <5mm, teste de Schimer II < 10mm, osmolaridade diminuída. Como consequentes: dano à superfície ocular, desconforto ocular, instabilidade visual. As definições foram construídas e acrescidos indicadores: acuidade visual reduzida, mecanismo de piscar diminuído e fadiga ocular.

4
  • GIOVANNA KARINNY PEREIRA CRUZ DE ANDRADE
  • TRANSPLANTES DE CÓRNEAS NO ESTADO DO RIO GRANDE DO NORTE: ASPECTOS EPIDEMIOLÓGICOS E CLÍNICOS

  • Advisor : MARCOS ANTONIO FERREIRA JUNIOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ELIZABETH BARICHELLO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Oct 15, 2015


  • Show Abstract
  • Objetivou-se caracterizar clínica e epidemiologicamente os pacientes em fila de espera e os transplantados com tecido corneano em um serviço de referência para transplantes de córnea no estado do Rio Grande do Norte. Trata de um estudo epidemiológico de abordagem quantitativa, de corte transversal, descritivo e analítico que incluiu todos os pacientes em fila de espera (população A) e os transplantados com tecido corneano em um serviço de referência (população B). Na população A foi realizado o censo das pessoas em lista de espera para o transplante de córnea (N=62 pacientes). Na população B a amostragem foi não probabilística e correspondeu a todos os transplantes de córnea realizados no serviço no período de 2010 a 2014 (n= 258 transplantes).  Estudo aprovado pelo Comitê de Ética em Pesquisas da Universidade Federal do Rio Grande do Norte, sob CAAE nº 37533014.8.0000.5537. Os dados foram coletados em sua totalidade no período de janeiro a abril de 2015, mediante dois instrumentos construídos para sistematizar a coleta dos dados necessários. Após serem codificados e tabulados, foram analisados por meio do programa SPSS versão 20.0. A descrição das variáveis e seus padrões de distribuição foram apresentados por frequências e medidas de tendência central, enquanto que para análise multivariada foram aplicadas medidas de magnitude de efeito (razão de prevalência) e medidas de associação (teste qui-quadrado ou de exato de Fisher), para um nível de significância de 0,05. Os resultados constituíram três artigos científicos, um de revisão integrativa de literatura e dois derivados da pesquisa de campo. Verificou-se que o perfil epidemiológico dos pacientes em fila de espera (N=62) apresenta prevalência de indivíduos com idade superior a 50 anos, sexo feminino (54,84%) e residentes da mesorregião do Leste Potiguar (66,13%). O perfil clínico dos pacientes submetidos ao transplante de córnea (n=258) foi caracterizado por (51,16%) serem do sexo masculino, com idade média de 49,33 anos e 57,75% provenientes do Leste Potiguar. O tempo médio em fila de espera foi 172,63 e 9,03 dias em transplantes eletivos e de urgência, respectivamente. A principal condição indicadora para realização do transplante foi o ceratocone. O tipo de distúrbio da córnea apresentou associação estatisticamente significativa com relação às variáveis sexo e idade, em ambos os grupos; cirurgia prévia, falência do enxerto anterior, classificação do olho e glaucoma na amostra B. Conclui-se que mediante a caracterização do perfil epidemiológico e clínico dos transplantes de córnea, torna-se possível problematizar a realidade, pontuar sobre o cuidado que deve ser ofertado e desenvolver intervenções comprometidas com as necessidades coletivas e individuais intrínsecas aos pacientes que necessitam do transplante de córnea como opção terapêutica.

5
  • SIMONE REGINA DE CARVALHO
  • Efeito do topiramato sobre o craving em usuários de crack.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • CLELIA ALBINO SIMPSON
  • GILSON DE VASCONCELOS TORRES
  • SANDRA CRISTINA PILLON
  • Data: Nov 16, 2015


  • Show Abstract
  • O estudo tem por objetivo analisar o efeito do topiramato sobre o craving em usuários de crack. Trata-se de um ensaio clínico aberto tipo crossover envolvendo usuários do Centro de Atenção Psicossocial álcool e drogas (CAPSad) do município de Parnamirim/RN, aprovado pelo CEP CAAE: 38710614.1.0000.5537, respeitada a Resolução Nº 466/2012/CNS. O estudo resultou em dois artigos científicos, um ensaio teórico e uma revisão integrativa. No ensaio teórico de Hinds, Chaves e Cypress, os contextos enfocam desde a problemática do uso individual às políticas de enfrentamento deste consumo no Brasil, ressaltando que a situação de complexidade do fenômeno requerendo estratégias de enfrentamento a partir da atenção integral ao usuário, família e sociedade. A revisão integrativa captura, dentre os 902 registros trilingui recuperados, oito estudos apresentaram esquemas terapêuticos com efeitos positivos para o craving da cocaína, a partir do uso de nove drogas diferentes. Não houveram resultados para o craving do crack. Os resultados da amostra do presente estudo foi composta predominantemente por usuários do sexo masculino, adultos e solteiros, totalizando 30 sujeitos que atenderam aos critérios de inclusão: adultos, idade a partir de 18 anos, diagnóstico do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-IV) para cocaína/crack; capacidade cognitiva preservada; assiduidade ao serviço, participar de, no mínimo, três consultas nos 12 meses anteriores à coleta dos dados; e aceitar o acompanhamento ao tratamento proposto. Os dados foram coletados no período de dezembro de 2014 a julho de 2015 e analisados por meio de estatística descritiva com o suporte do Statistical Package for Social Science (SPSS), através dos instrumentos: 1) Alcoohol, Smoking, and Substance Involvement Screening Test (ASSIST), aponta, entre outros resultados, que apenas 14% fizeram uso do crack/cocaína semanalmente durante o tratamento, enquanto 83% passaram a fazer uso diariamente ou semanalmente após o período de washout; 2) Escala de Impulsividade de Barratt, com uma média de 80,23 e 77,47 com e sem o tratamento medicamentoso, respectivamente. Uma análise a partir do teste t de Student mostram que não há diferença significativa na impulsividade com ou sem o uso do medicamento; e 3) Cocaine Craving Questionnaire-Brief (CCQ-Brief), indicando que o número de usuários com nível de intensidade do craving é expressivamente maior sem o tratamento medicamentoso (86%) do que com o tratamento (33%). A análise entre o craving e a grau de impulsividade mostram que há uma baixa correlação (Pearson) entre essas duas variáveis com medicamento (0,282986) e sem (0,154614), demonstrando que a impulsividade tem baixa
    influência sobre o resultado do tratamento medicamentoso. Conclui-se que o topiramato produz efeito positivo para redução do craving em usuários de crack e que o seu uso constitui estratégia relevante para a eficácia no tratamento de usuários de crack.

6
  • CECILIA OLIVIA PARAGUAI DE OLIVEIRA SARAIVA
  • Segurança do paciente em terapia intensiva neonatal: identificação dos incidentes e eventos adversos. 

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • FRANCISCO STÉLIO DE SOUZA
  • NILBA LIMA DE SOUZA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: Nov 20, 2015


  • Show Abstract
  • A Segurança do Paciente (SP) representa motivo de grande preocupação nos serviços de saúde por sua dimensão global. A fragilidade dos processos assistenciais predispõe a ocorrência de incidentes de segurança e eventos adversos (EAs), que na Unidade de Terapia Intensiva Neonatal (UTIN) são considerados graves e colocam em risco a vida dos recém-nascidos. O presente estudo objetivou a Identificação da ocorrência de eventos adversos nos recém-nascidos internados numa UTIN de um hospital escola. Trata-se de um estudo transversal, exploratório, de natureza descritiva, e abordagem quantitativa realizado no ano de 2015. A amostragem ocorreu de forma não probabilística envolvendo 117 RNs que atenderam aos critérios de elegibilidade. A coleta dos dados foi realizada por meio da utilização de um instrumento especifico do tipo “gatilho”, composto por eventos sentinela na UTIN, adaptado do modelo americano utilizado pela Rede Vermont-Oxford. O projeto recebeu parecer favorável pelo Comitê de Ética da Universidade Federal do Rio Grande do Norte (CEP/UFRN) com Certificado de Apresentação para Apreciação Ética (CAAE): 43894515.6.0000.5537. Foram identificados pelo menos um tipo de incidente ou EA em todos os 117 RN. Prevaleceram RNs pré-termos, com baixo peso ao nascer, filhos de mãe com DHEG. Dentre os eventos identificados destacaram-se: o controle de termorregulação inadequado (61%), distúrbios metabólicos (26%), infecções relacionadas à assistência à saúde (8%) e terapia respiratória de risco ao RN (5%). O percentual dos eventos foi diretamente proporcional à gravidade do RN e ao tempo de internação hospitalar. Assim, conclui-se, que a elevada taxa de incidentes e eventos adversos identificada na UTIN reforça a necessidade de elaboração de estratégias preventivas específicas para esse ambiente de risco.

7
  • JULIANA RAQUEL SILVA SOUZA
  • AVALIAÇÃO DA IMAGEM CORPORAL DE MULHERES SUBMETIDAS À CIRURGIA ONCOLÓGICA MAMÁRIA

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • NILBA LIMA DE SOUZA
  • ROSINEIDE SANTANA DE BRITO
  • FRANCISCO STÉLIO DE SOUZA
  • Data: Nov 20, 2015


  • Show Abstract
  • Uma das questões mais relevantes na área de saúde da mulher é o Câncer de Mama, que de acordo com as estimativas nacionais, é o segundo tipo de neoplasia que mais acomete mulheres em idade reprodutiva no Brasil. Em se tratando de conduta terapêutica, os métodos comumente utilizados são: cirurgia conservadora, que retira uma parte da glândula mamária que contém o tumor; e a mastectomia, técnica cirúrgica caracterizada pela ressecção da peça anatômica da mama. O estudo tem como objetivo geral avaliar a imagem corporal de mulheres submetidas à cirurgia oncológica mamária. Trata-se de um estudo descritivo, exploratório, transversal, com enfoque quantitativo, realizado no âmbito de uma instituição filantrópica de referência nacional em câncer. A população do estudo é composta por mulheres oncocirurgiadas de mama em tratamento na instituição. A amostra foi calculada com base na fórmula para população finita com representação de 124 sujeitos. Os dados foram coletados no período de março a maio de 2015. A mensuração da imagem corporal se deu através da escala Body Imagem After Breast Cancer Questionnaire – BIBCQ, do tipo Likert de cinco pontos, validada, traduzida para o português, e composta por 44 questões, que estão dispostas em seis escalas com domínio da autoimagem (Escala de vulnerabilidade, Escala de estigma corporal, Escala de limitações, Escala de preocupações com o corpo, Escala de transparência, Escala de preocupações com o braço). O perfil socieconômico da amostra revela a faixa etária predominante entre 40 a 59 anos (58,8%), casadas ou em união estável (59,7%), cirurgia realizada há mais de um ano (61,3%), em apenas uma mama (87,1%), do tipo mastectomia sem reconstrução (41,9%). Após mensuração da imagem corporal, o domínio “vulnerabilidade” destaca-se com maior escore de concordância na variável “preocupo-me com pequenas dores” e o domínio “preocupação com o corpo” apresenta o menor escore de discordância na questão “Estou satisfeita com a aparência do meu quadril”. A investigação possibilitou inferir que os sujeitos do estudo acentuam questões ligadas à patologia em detrimento da imagem ligada à estrutura física. Esse fato caracteriza associação com o perfil da amostra, sobretudo com o tempo de realização da cirurgia, idade e mama afetada. O estudo contribui para a apreensão das peculiaridades das mulheres oncocirurgiadas de mama e sua trajetória de reinserção, tão essencial para a práxis em Enfermagem.

8
  • ROSANE SOUSA DE ANDRADE CARVALHO
  • Qualidade de vida de pessoas com estomias intestinais.

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARINA DE GÓES SALVETTI
  • Data: Nov 23, 2015


  • Show Abstract
  • Estomia é uma abertura de origem cirúrgica, quando há necessidade de desviar, temporária ou permanentemente, o trânsito normal da alimentação e/ou eliminações. O paciente com estomia de eliminação se vê diante de modificações em sua fisiologia, surgindo também à necessidade de cuidados com a bolsa coletora. Neste estudo, objetivou-se analisar a Qualidade de Vida (QV) de pessoas vivendo com Estomias Intestinais (EI), atendidos no Centro de Reabilitação Infantil e Adulto do Rio Grande do Norte (CRI/CRA-RN).  Trata-se de um estudo analítico, com delineamento transversal e abordagem quantitativa, realizado com 89 pessoas que apresentaram EI. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte (CEP/UFRN), CAAE: 19866413.3.0000.5537. Realizou-se a coleta de dados no período de janeiro a março de 2015 e se utilizou dois instrumentos: um questionário geral adaptado abrangendo aspectos sociodemográficos, clínicos e de autocuidado e um instrumento específico de avaliação de QV de pessoas com estoma intitulado como City of Hope Quality of Life – Ostomy Questionnaire (COH-QOL-OQ), validado e adaptado para o português em 2010, composto de quatro domínios, a saber: Bem Estar Físico (BEF), Bem Estar Psicológico (BEP), Bem Estar Social (BES) e Bem Estar Espiritual (BEE). Os dados coletados foram inseridos num banco de dados na planilha do aplicativo Microsoft Excel 2007 e processados em software informatizado para as análises descritivas e inferenciais. Os resultados mostraram que 83,1% possuíam colostomia e 16,9% ileostomia. Na caracterização sociodemográfica predominaram pessoas do sexo masculino (57,3%), acima de 50 anos (57,3%), de cor parda (46,1%), com presença de companheiro/a (57,3%), aposentados/beneficiários (50,5%), renda mensal acima de um salário mínimo (68,5%) e que estudaram até o ensino fundamental (67,4%). Quanto aos aspectos clínicos, observou-se que a maior causa que culminou com a confecção do estoma foi à neoplasia (59,6%) seguida de trauma (21,3%). A amostra apresentou pessoas com estoma há mais de 6 meses (79,8%), de caráter definitivo (57,3%), em uso de equipamento peça única drenável (68,5%) de base plana (82,0%). Com relação ao autocuidado, 93,3% esvaziavam e lavavam a bolsa sozinhos (cuidados relacionados à higiene), mas apenas 75,3% fixava a nova bolsa na pele, durante a troca (cuidados relacionados à bolsa). A média dos escores de QV dos pesquisados foi de 296,2 (68,90%) para QV Geral; 74,8 (68,03%) para o BEF; 88,8 (68,38%) para o BEP; 79,7 (66,46%) para o BES e 52,7 (75,41%) para o BEE. Diante dos resultados obtidos, conclui-se que se tratou de uma amostra predominantemente adulta/idosa (entre 50 e 70 anos), com baixa escolaridade e como causa motivadora do estoma, as neoplasias. Entretanto, tais achados não repercutiram em baixos índices percentuais acerca da capacidade de realização de autocuidado nem em baixos escores de QV.

9
  • JESSICA DANTAS DE SA TINOCO
  • Validação clínica do diagnóstico de enfermagem Proteção Ineficaz em pacientes submetidos à hemodiálise

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • MARIA ALZETE DE LIMA
  • Data: Nov 24, 2015


  • Show Abstract
  • Estudo transversal de acurácia diagnóstica, com o objetivo de validar clinicamente o diagnóstico de enfermagem Proteção Ineficaz em pacientes submetidos à hemodiálise. A coleta ocorreu com 200 pacientes submetidos à hemodiálise em uma clínica no nordeste do Brasil, selecionados por conveniência, de forma consecutiva, durante os meses de março e abril de 2015. Na coleta de dados, utilizou-se um instrumento estruturado de entrevista e exame físico e o prontuário. A análise da acurácia dos indicadores clínicos do diagnóstico Proteção Ineficaz ocorreu por meio da formação de duas classes latentes de efeitos randômicos, permitindo a identificação da prevalência do diagnóstico, bem como dos valores de sensibilidade e especificidade de cada indicador clínico investigado, com os respectivos intervalos de confiança de 95%. O estudo foi aprovado pelo comitê de ética em pesquisa, com parecer sob o número 387.837 e Certificado de Apresentação para Apreciação Ética: 18486413.0.0000.5537. Os resultados indicam a prevalência de 60,2% do diagnóstico Proteção Ineficaz na clientela investigada. As características definidoras sensíveis ao diagnóstico Proteção Ineficaz foram: Fadiga, Resposta mal adaptada ao estresse e Alteração na coagulação. As específicas foram: Fadiga, Fraqueza, Disfunção do acesso vascular, Aumento do número de hospitalizações, acesso vascular infeccionado e Febre. Conclui-se que a identificação das características definidoras acuradas, por meio dos valores de sensibilidade e especificidade, permite a predição fidedigna do diagnóstico de enfermagem Proteção Ineficaz aos pacientes submetidos à hemodiálise, tornando-o válido clinicamente para a clientela estudada. Destaca-se a característica Fadiga como a que melhor prediz o diagnóstico investigado. Ademais, os achados contribuem para a prática clínica do enfermeiro, auxiliando no processo de inferência diagnóstica e no plano de intervenções de enfermagem precisas e direcionadas à realidade do paciente em hemodiálise.

10
  • MARIA DAS GRAÇAS MARIANO NUNES DE PAIVA
  • Análise de conteúdo e validação clínica do diagnóstico de enfermagem Autocontrole Ineficaz da Saúde

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • Data: Nov 24, 2015


  • Show Abstract
  • O objetivo do estudo é analisar o conteúdo e as medidas de acurácia do diagnóstico de enfermagem Autocontrole Ineficaz da Saúde em pacientes submetidos à hemodiálise. Estudo do tipo metodológico, desenvolvido em duas etapas, a saber: análise de conteúdo por juízes e acurácia dos indicadores clínicos. Na primeira etapa, 22 juízes avaliaram a definição e localização do diagnóstico, indicadores clínicos e fatores etiológicos e suas definições conceituais e empíricas. Utilizou-se o teste binomial para avaliar a concordância entre os juízes. Na segunda etapa, utilizou-se o modelo de classe latente para a inferência diagnóstica. Pesquisa aprovada pelo Comitê de ética, sob o Parecer no 387.837 e CAAE 18486413.0.0000.5537. Os resultados mostram que os juízes avaliaram como pertinentes 12 indicadores clínicos e 22 fatores etiológicos. Propuseram alteração da nomenclatura de cinco indicadores clínicos e seis fatores etiológicos e a transposição de um indicador clínico para fator etiológico e três fatores etiológicos para indicadores clínicos. Nas definições conceituais e empíricas, os juízes julgaram como não pertinentes as definições conceitual e empírica de um indicador clínico e definições conceituais de dois fatores etiológicos e definições empíricas de quatro fatores etiológicos. Ainda, foram sugeridas alterações nas definições conceitual e empírica de dois indicadores clínicos, nas definições conceituais de 12 fatores etiológicos e em definições empíricas de 11 fatores etiológicos. Os indicadores clínicos analisados na primeira etapa foram validados clinicamente em pacientes submetidos à hemodiálise. Os indicadores clínicos mais frequentes foram Alterações de exames laboratoriais (100%) e Escolhas de vida diária ineficazes para atingir metas de saúde (81%) e, três fatores etiológicos apresentaram maior frequência, são eles: Fatores sociodemográficos desfavoráveis (94,5%), Crenças (79%) e Comorbidades (77,5%). A partir do Modelo de Classe Latente, foi estimada a prevalência do diagnóstico em 66,28%. Os indicadores clínicos que apresentaram as melhores medidas de acurácia para a sensibilidade do diagnóstico de enfermagem Autocontrole Ineficaz da Saúde foram: Escolhas de vida diária ineficazes para atingir metas de saúde e Expressão de dificuldade com os regimes prescritos. Por sua vez, os indicadores clínicos Uso inadequado de medicamentos, Não Expressão de desejo de controlar a doença, Comparecimento irregular às sessões de diálise e Infecção foram mais específicos quanto ao referido diagnóstico. Não adesão ao tratamento foi o único indicador que apresentou intervalos de confiança com significância para sensibilidade e especificidade. Deste modo, o indicador clínico Não adesão ao tratamento é mais preciso e fidedigno quanto à inferência do diagnóstico de enfermagem Autocontrole Ineficaz da Saúde na clientela hemodialítica. Assim, acredita-se que o aprimoramento dos componentes do diagnóstico de enfermagem em questão, irá contribuir para a elaboração de intervenções de enfermagem mais fidedignas ao estado de saúde do indivíduo em hemodiálise, proporcionando um cuidado mais qualificado cientificamente.

11
  • KARILENA KARLLA DE AMORIM PEDROSA
  • PROTOCOLO PARA ASSISTÊNCIA DO ENFERMEIRO AO PACIENTE SÉPTICO EM TERAPIA INTENSIVA: desenvolvimento e validação de conteúdo

  • Advisor : REGIMAR CARLA MACHADO
  • COMMITTEE MEMBERS :
  • REGIMAR CARLA MACHADO
  • RODRIGO ASSIS NEVES DANTAS
  • ROSELY MORALEZ DE FIGUEIREDO
  • Data: Dec 4, 2015


  • Show Abstract
  • Tratar-se-á de um estudo metodológico, com abordagem quantitativa; baseado no referencial metodológico da técnica Delphi, com objetivo de construir e validar um protocolo clínico para assistência do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva. A proposta metodológica seguiu duas etapas: elaboração do instrumento por meio da revisão integrativa da literatura e validação de conteúdo do protocolo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, mediante o Parecer CAAE 41873314.5.0000.5537. O universo amostral foi composto por profissionais enfermeiros, considerados peritos, doutores ou mestres na área da saúde, com experiência em alta complexidade e/ ou estudos de validação de instrumento/protocolo, selecionados por meio da Plataforma Lattes. Referente à primeira etapa elaborou-se um instrumento composto pela caracterização profissional dos peritos; e baseado em evidência científica e nas diretrizes do Surviving Sepsis Campaign, contemplando três tópicos assistenciais ao paciente com sepse, a saber: Triagem para Sepse- Reconhecimento das Manifestações Clínicas; Pacote de Ressuscitação Inicial (Controle das Primeiras 6 Horas); Tratamento de Suporte. A segunda etapa caracterizou-se na validação de conteúdo do instrumento para elaboração final do protocolo, utilizando à técnica Delphi, em duas fases. No que concernem as variáveis referentes ao estudo, na 1ª fase de Delphi, 34 peritos avaliaram o instrumento composto por 18 itens, no período de maio a julho de 2015, e os dados foram analisados pela estatística descritiva (frequência, média, mediana e desvio padrão) e pelo Índice de Validade de Conteúdo (IVC), demonstrando um IVC extremamente satisfatório para 15 itens, com total de 0,79, obtendo assim, a reformulação e refinamento do conteúdo do instrumento. Na segunda fase de Delphi, entre julho e agosto de 2015, participaram 26 peritos, e utilizou-se o percentual de concordância acima de 75% para as variáveis consideradas pertinentes ao protocolo de cuidados ao paciente séptico em UTI, obtendo nesta fase, o percentual de concordância de 95%. O protocolo foi concluído com 15 itens, sendo respaldado e modificado, baseado em evidência científica, nas diretrizes internacionais e nas sugestões dos peritos. A utilização do protocolo proposto poderá contribuir para a prática clínica do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva.

12
  • GLEYCE ANY FREIRE DE LIMA CARVALHO
  • Assistência em cuidados paliativos à pessoa idosa na atenção primária a saúde

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • REJANE MARIA PAIVA DE MENEZES
  • BERTHA CRUZ ENDERS
  • MARIA CÉLIA FREITAS
  • Data: Dec 8, 2015


  • Show Abstract
  • Este estudo tem o objetivo de compreender o significado dos cuidados paliativos a pessoa idosa para profissionais de saúde que atuam na atenção primária. Estudo descritivo e de abordagem qualitativa, com base no processo de codificação e comparação constante da Teoria Fundamentada nos Dados (TFD). Realizado em um Núcleo de apoio à Saúde da Família, e mais três Unidades de Saúde da Família do bairro de Felipe Camarão, Distrito sanitário oeste, município de Natal. Dos 25 participantes, 19 são profissionais da Estratégia Saúde da Família, e 6 do Núcleo de Apoio a Saúde da Família, sendo 21 homens e 4 mulheres com experiência mínimade um ano na atenção primária à saúde.O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob CAAE nº43895815.4.0000.5537. As entrevistas individuais, realizadas entre julho a setembro de 2015. Os resultados coletados foram gravados em MP4 e transcritos para linguagem escrita, e analisados através do processo de codificação aberta, meio no qual, os conceitos foram identificados e posteriormente seguiu-se a codificação axial, onde as categorias foram desenvolvidas sistematicamente e relacionadas. Após estes procedimentos, emergiram três categorias: comportamento dos profissionais de saúde frente à assistência em cuidados paliativos na Atenção Primária, valorização da percepção subjetiva dos profissionais de saúde no cuidado a pessoa em processo de finitude e o significado desarticulado frente aos cuidados paliativos na atenção primária vivenciado entre os profissionais de saúde. Na seqüência, as categorias foram interpretadas e analisadas, mediante o referencial teórico da fenomenologia social de Alfred Schutz. Diante do comportamento dos profissionais, identificaram-se a descoberta e a profundidade das pressuposições através da estruturação e do significado em um sentido comum. Em relação à valorização da percepção subjetiva dos profissionais, percebe-se a questão da complexidade das múltiplas relações através de diversos aspectos de sua tarefa central: concentrar uma filosofia da realidade do mundo, ou seja, uma fenomenologia da atitude natural; ante o significado da desarticulação entre os profissionais de saúde e a gestão, compreende-se a realidade eminente representada pela individualidade de interesses especiais da experiência. Conclui-se que a interpretação do significado da assistência em cuidados paliativos ao idoso na atenção primária de saúde, urge inserir um novo olhar diante da atuação dos profissionais de saúde e da gestão, no que se refere às interações sociais e experiências futuras, voltadas para populações mais velhas e em situações crônicas de saúde, impingindo a necessidade de uma interação maior da equipe de saúde na atenção primária, e consequente melhoria da assistência em cuidados paliativos. 

13
  • GRACIMARY ALVES TEIXEIRA
  • Perfil de mães e o desfecho do nascimento prematuro ou termo

  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • SILVANA ALVES PEREIRA
  • BRISMARK GOES DA ROCHA
  • Data: Dec 10, 2015


  • Show Abstract
  • O nascimento ou parto prematuro, com menos de 37 semanas de gestação, é considerado um problema de saúde pública mundial, pois é tido como um dos principais fatores de risco para morbidade e mortalidade neonatal, principalmente na primeira semana de vida. O estudo teve por objetivo analisar o perfil das mães de bebês prematuros e a termo e o desfecho do nascimento. Trata-se de um estudo analítico-descritivo, seccional, com amostra de 109 mães de todos os bebês prematuros e 135 mães de bebês a termo selecionados de forma aleatória, por sorteio, ocorridos no período de abril a setembro de 2015, em uma maternidade pública. Os dados foram tabulados no Software Excel 2013 tendo sido realizado o teste do Ki-quadrado. Antes de iniciar a coleta de dados o projeto foi submetido ao Comitê de Ética e Pesquisa da Universidade Federal do Rio Grande do Norte, com parecer favorável de nº 1.047.431. Esse estudo possibilitou identificar que o perfil socioeconômico de mães de bebês prematuros e a termo apresentaram em ambos: baixo nível de escolaridade, baixa renda. Além disso, os dados apontam nos dois grupos alta prevalência de sedentarismo antes e durante a gravidez; sobrepeso a obesidade antes da gravidez em 42,22% das mães de bebês prematuros e 48,62% mães de bebês a termo; com pressão alta durante a gestação em 32,11% das mães de bebês prematuros e 17,04% das mães de bebês a termo. Outrossim, a gravidez só foi planejada em 33,33% e além disso indesejada por 21,1%  das mães de bebês prematuros, enquanto as mães de bebês a termo 40,37% planejaram a gravidez e 17,78% tiveram gravidez indesejada. No que diz respeito ao fator agravante - drogas ilícitas, houve aumento no consumo pelas mães de bebês prematuros de 3,70% antes da gravidez para 8,26% durante a gravidez; já as mães de bebês a termo, apesar de ter-se reduzido a prevalência em 6,0% entre o período antes e durante a gestação, ainda apresentou-se 3,70% do consumo durante a gestação. As intercorrências mais frequentes foram o sangramento vaginal em 43,12% das mães de bebês prematuros e 20% das mães de bebês a termo; infecção urinária em 44,95% das mães de bebês prematuros e 40% das mães de bebês a termo; gravidez estressante em 62,96% das mães de bebês prematuros e 47,41% das mães de bebês a termo. Logo, os bebês nasceram com problemas de saúde em 58,10% dos prematuros e nascimento saudável em 96,30% dos bebês a termos. Portanto, o perfil de mães com gravidez indesejada, usuária de drogas ilícitas durante a gestação, gravidez estressante, sangramento vaginal podem associar-se ao nascimento do bebê prematuro como evento desfavorável e de risco à saúde da criança.

14
  • DEYLA MOURA RAMOS
  • TRAJETÓRIA DE PESSOAS COM AIDS EM SITUAÇÃO DE VULNERABILIDADE SOCIAL: À LUZ DA HISTÓRIA ORAL DE VIDA

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • ANTONIA OLIVEIRA SILVA
  • FELISMINA ROSA PARREIRA MENDES
  • Data: Dec 16, 2015


  • Show Abstract
  • A epidemia causada pelo HIV representa fenômeno global, dinâmico e instável, cuja forma de ocorrência depende, dentre outros fatores, do comportamento humano individual e coletivo. Apesar dos benefícios alcançados em relação ao controle da doença, vivemos muitos dos “resquícios” deixados pela época de pavor que caracterizou o início da epidemia, conferindo a esta enfermidade repercussões singulares ainda nos dias de hoje. Objetivou-se narrar a trajetória de vida de portadores da Aids com vulnerabilidade inscritos na Secretaria Municipal de Assistência Social de Parnamirim/RN e sugerir a inserção das pessoas com Aids no Cadastro Único. Utilizou-se o método exploratório-descritivo, com abordagem qualitativa, tendo como referencial metodológico a História Oral de Vida. A colônia foi composta por 13 colaboradores inscritos na SEMAS em Parnamirim/RN. O instrumento da entrevista semi-estruturada contou com duas etapas, a primeira corresponde às informações que caracterizaram o colaborador e a segunda as questões norteadoras, sobre a trajetória dos entrevistados: 1. Há quanto tempo você sabe que é portador(a) do HIV? 2. Como era sua vida antes do diagnóstico positivo para o HIV? 3. O que significa ser soropositivo hoje inscrito na SEMAS? 4. O que você espera do futuro? Nas entrevistas, utilizou-se gravadores de áudio e com relação às demais informações que não puderam ser gravadas, foram registradas no diário de campo. Após aprovação pelo CEP CAAE: 30408114.5.0000.5537, respeitada a Resolução N0 466/2012/CNS, os dados foram coletados entre agosto a setembro de 2014. Os colaboradores assinaram o Termo de Consentimento Livre e Esclarecido e a Carta de Cessão. As entrevistas foram analisadas através da técnica de análise de conteúdo temática, de acordo com Bardin e dispostas em categorias. O estudo resultou em dois artigos científicos, um ensaio teórico e um artigo original. No ensaio teórico de Hinds, Chaves e Cypress obteve-se: Contexto Imediato - O cuidado de enfermagem; Contexto específico - A formação do enfermeiro e o Serviço de Assistência Especializada em HIV/Aids (SAE); Contexto geral - O cuidado em saúde e enfermagem ao portador de HIV/Aids e o Metacontexto - Processo de evolução da assistência de enfermagem. O segundo artigo mostra que em princípio, a maioria dos idosos (61,6%) afirmaram não saber o que é a Aids, mas, esta realidade logo se transformou após a realização de uma aula expositiva dialogada como instrumento de educação em saúde. Houve diferença estatisticamente significativa. Um outro artigo, ainda em construção, se baseia na análise dos relatos dos colaboradores, cujas falas emergiram de três eixos temáticos: Preconceito e discriminação no conviver com Aids; Reação frente ao diagnóstico e o processo de adesão ao tratamento antirretroviral e Enfrentamento religioso em pessoas com Aids. Concluímos, neste estudo, que a descoberta do diagnóstico positivo para Aids repercutiu drasticamente na vida dos colaboradores, mas que a aceitação da condição patológica é o ponto inicial para diminuir/amenizar o sofrimento vivenciado.

15
  • MERCIO GABRIEL DE ARAUJO
  • Vivência do adolescente e adulto jovem no puerpério da companheira

  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • CRISTYANNE SAMARA MIRANDA DE HOLANDA DA NÓBREGA
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • Data: Dec 18, 2015


  • Show Abstract
  • Tornar-se pai faz parte de um processo de inter-relações estabelecidas entre o homem e o recém-nascido. Durante essa construção, transformações e mudanças são vivenciadas e o homem necessariamente busca uma nova identidade para exercer um novo papel social, o de pai. Contudo, quando a paternidade ocorre durante a adolescência ou juventude, ela pode caracterizar-se como fator de vulnerabilidade, pois a carga de responsabilidade é capaz de desencadear problemas de ordem fisiológica e emocional. O estudo objetiva descrever a vivência do adolescente e adulto jovem sobre o período puerperal da companheira na estratégia saúde da família. Trata-se de uma pesquisa exploratória e descritiva com abordagem qualitativa realizada no município de Caicó, Rio Grande do Norte. Os participantes do estudo foram 15 homens adolescentes e adultos jovens, com idade de 10 a 24 anos. A coleta de dados ocorreu nos meses de julho a setembro de 2015 por meio de entrevista semiestruturada. Realizou-se análise de conteúdo na modalidade temática, sendo analisadas a partir da literatura pertinente. Assim, emergiram as seguintes categorias: participação do adolescente e adulto jovem no cuidado à companheira durante o pós-parto; sentimentos vivenciados pelo homem adulto jovem e adolescente no pós-parto; presença da família ampliada: (re)arranjos no contexto do pós-parto. Essa investigação revelou que os depoentes estabeleceram interações no pós-parto ao realizar o cuidado com a companheira e o recém-nascido a partir de atividades domésticas, no auxílio na rotina de cuidados com filho e ao vivenciar sentimentos ambivalentes como felicidade, anseio, dentre outros. Também, observou-se que os adolescentes e adultos jovens receberam apoio familiar, ao instituir uma relação de aproximação com os entes, diante das necessidades que emergem no período puerperal e da chegada do novo membro familiar. Diante disso, sugere-se que a estratégia saúde da família desenvolva um programa baseado na fase puerperal para este grupo populacional, de modo a receber apoio, incentivo e orientações para lidar com as novas interações presentes no período.

16
  • XÊNIA ALVES FREIRE
  • CAPACIDADE PARA TRABALHO DE ENFERMEIROS A NÍVEL DE ATENÇÃO PRIMÁRIA À SAÚDE

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • LENILDE DUARTE DE SÁ
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 18, 2015


  • Show Abstract
  • A capacidade para o trabalho é o princípio do bem-estar laboral, podendo ser entendido como a capacidade física e mental, apresentada pelo profissional para execução de suas atividades no trabalho. Na perspectiva da saúde do trabalhador, a capacidade para o trabalho decorre da inter-relação do ambiente laboral e do estilo de vida, sendo influenciada por diversos fatores, incluindo as características sócio-demográficas, estilo de vida e os aspectos intrínsecos da atividade exercida. A atualidade do presente estudo justificou-se por sua relevância cientifica e social, ao enfocar a Capacidade para o Trabalho de enfermeiros do serviço de atenção primária a saúde. Este estudo teve como objetivo avaliar a capacidade para o trabalho de enfermeiros inseridos na Estratégia Saúde da Família dos município pertencentes à sétima região de saúde do estado do Rio Grande do Norte. Trata-se de uma pesquisa descritiva, com abordagem quantitativa. Na coleta de dados foi utilizado um questionário validado denominado de Índice de Capacidade para o Trabalho. Os dados coletados foram implantados em um banco de dados eletrônico e analisados estatístisticamente, e apresentados por meio de tabelas. O projeto de pesquisa foi apreciado pela Comissão de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte - UFRN, com CAAE: 43896315.7.0000.5537, respeitando-se a normatização da Resolução Nº 466/2012 do Conselho Nacional de Saúde, referente aos aspectos éticos da pesquisa envolvendo seres humanos. Os sujeitos foram convidados a assinar o Termo de Consentimento Livre e Esclarecido – TCLE. Os resultados revelaram que os enfermeiros apresentaram capacidade para o trabalho baixa em 1,58%, moderada em 32,11%, boa em 44,21% e ótima em 22,10%. A análise múltipla, ajustada por idade, sexo, educação, idade que começou a trabalhar, tempo de serviço, capacidade atual e total de doenças, evidenciou que as variáveis que melhor explicaram a variação do ICT foram a idade, capacidade atual para o trabalho e total de doenças. A pesquisa demonstrou que o número médio do Índice de capacidade para o trabalho dos enfermeiros é de 38,76 com desvio padrão de 5,37. Foi constatado que 2,11% dos enfermeiros apresentaram baixa capacidade para o trabalho em relação a exigências físicas, 24,21% moderadamente e 43,68% boa, e 30% muito boa. De acordo com as recomendações do Instituto Finlandês de saúde Ocupacional- FIOH, para os trabalhadores que apresentarem esses escores, devem ser implementadas medidas cujo objetivo restaurar a capacidade para o trabalho que se encontre baixa, melhorar a capacidade para o trabalho moderada, apoiar a capacidade para o trabalho boa e manter a capacidade para o trabalho ótima. Portanto, recomenda-se que o ICT seja aplicado nos demais níveis de atenção à saúde, na perspectiva da realização de um diagnóstico real da situação de todos os trabalhadores do setor saúde, possibilitando a aplicação das referidas medidas tão necessárias à recuperação e promoção da saúde dos enfermeiros.

Thesis
1
  • CECILIA MARIA FARIAS DE QUEIROZ FRAZAO
  • Validação do conteúdo do diagnóstico de enfermagem Proteção ineficaz para pacientes submetidos à hemodiálise. 

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • VÂNIA PINHEIRO RAMOS
  • Data: Jan 29, 2015


  • Show Abstract
  • Estudo do tipo metodológico, com objetivo de validar o conteúdo do diagnóstico de enfermagem Proteção ineficaz em pacientes submetidos à hemodiálise. A pesquisa ocorreu em duas etapas, a saber: análise de conceito e de conteúdo por especialistas. A primeira foi operacionalizada através da revisão integrativa nas bases de dados LILACS, CINHL, PUBMED, SCOPUS e COCHRANE, com o cruzamento das palavras proteção e hemodiálise. Encontrou-se 32 artigos, nos quais foram identificados os atributos, antecedentes e consequentes. Na segunda etapa, elaborou-se um instrumento com os componentes do diagnóstico em estudo. Esse instrumento foi analisado por 22 especialistas em nefrologia e na terminologia da NANDA Internacional. O teste binomial foi utilizado para avaliar a proporção de especialistas que classificaram cada item como adequado, considerando-se o nível de significância de 5%. Elaborou-se, assim, a seguinte proposta para o diagnóstico de enfermagem proteção ineficaz em pacientes submetidos à hemodiálise: definição: a mesma apresentada na Taxonomia II da NANDA Internacional, localização: domínio segurança/proteção e classe lesão física. Os fatores relacionados são: Ausência das vacinas de rotina; Não adesão aos cuidados relacionados aos acessos vasculares; Não adesão às medidas de controle de infecção; Não adesão à dieta prescrita; Não adesão à terapia medicamentosa; Presença de comorbidades; Abuso de drogas; Distúrbios imunológicos; Extremos de idade; Perfis sanguíneos anormais; Medicamentos que reduzem a imunidade; e Efeitos colaterais e adversos relacionados ao tratamento. E características definidoras: Presença de invasores na corrente sanguínea; Distúrbios nutricionais; Aumento do número de hospitalizações; Peso seco descontrolado; Acesso vascular infeccionado; Acesso vascular inadequado; Aumento da pressão arterial sistêmica; Febre; Alteração da coagulação; Deficiência da imunidade; Fadiga; Fraqueza; Prurido; e Resposta mal adaptada ao estresse. Conclui-se, assim, que a identificação dos atributos definidores, antecedentes e consequentes aumentou a riqueza do vocabulário, possibilitando a construção de definições teóricas e empíricas para uma compreensão mais ampliada do conceito proteção. Outrossim, o estudo contribuiu para o enriquecimento do corpo de conhecimento específico da enfermagem, assim como no direcionamento da assistência do enfermeiro aos pacientes em hemodiálise.

2
  • EDILMA DE OLIVEIRA COSTA
  • A fiscalização do exercício profissional no Conselho Regional de Enfermagem do Rio Grande do Norte: um debate ético.

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • JOÃO BOSCO FILHO
  • MOEMIA GOMES DE OLIVEIRA MIRANDA
  • RAIMUNDA MEDEIROS GERMANO
  • SORAYA MARIA DE MEDEIROS
  • Data: Jan 30, 2015


  • Show Abstract
  • A presente investigação teve como objeto de estudo a história da fiscalização do exercício profissional, no Conselho Regional de Enfermagem do Rio Grande do Norte (Coren-RN). Parte do pressuposto de que a fiscalização exercida pelo Conselho constitui uma ferramenta importante para a melhoria da qualidade da assistência de enfermagem. Teve com objetivo analisar a história da fiscalização do exercício profissional da enfermagem, no Rio Grande do Norte, no período 1993-2013. Pautou-se no aporte ético-filosófico de Fourez e Vázquez. Trata-se de um estudo de natureza histórico-social, descritiva e analítica, com abordagem qualitativa, utilizando os métodos de pesquisa documental e a técnica da história oral temática. Teve como lócus da pesquisa empírica o Coren-RN, contando com sua documentação e a participação de fiscais e presidentes. A história da fiscalização foi sendo construída com base nos documentos e nas entrevistas com quem vivenciou essa trajetória.  O projeto obteve aprovação do Comitê de Ética em Pesquisa, da UFRN, conforme Parecer 562.400/2014 (CAAE: 25452113.7.0000.5537). Os resultados indicam que o Coren-RN, durante esses vinte anos, enfrentou inúmeras dificuldades, como a escassez de fiscais, a realidade precária da maioria dos serviços de saúde, a falta de qualificação dos profissionais, a ilegalidade do exercício profissional e a deficiência estrutural da instituição. Apesar disso, há que se reconhecer que o processo de fiscalização, exercido pelo Conselho, vem evoluindo ao longo desses anos. Essa evolução se expressa na ampliação do número de fiscais, na aquisição de uma nova sede e de três veículos, na criação das subseções nos municípios de Mossoró, Caicó e Pau dos Ferros, no encaminhamento dos processos éticos, entre outras conquistas. Ademais, registra-se uma maior credibilidade dos profissionais de enfermagem e de outros órgãos fiscalizadores. Em síntese, a fiscalização, como atividade-fim do Conselho, vem passando por um processo de transformação, com vistas a realizar a interlocução entre a concepção disciplinar e a pedagógica, em defesa da qualidade da assistência de enfermagem. Enfim, é um processo inacabado, em contínua construção.

3
  • ERIK CRISTÓVÃO ARAÚJO DE MELO
  • CONSTRUÇÃO DE UM AMBIENTE VIRTUAL DE APRENDIZAGEM PARA APLICAÇÃO DO PROCESSO DE ENFERMAGEM BASEADO NA NANDA INTERNATIONAL, NOC, NIC E CIPE®

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • MARIA MIRIAM LIMA DA NÓBREGA
  • MARTA LIMA BASTO
  • Data: Jan 30, 2015


  • Show Abstract
  • Este estudo objetivou construir um ambiente virtual de aprendizagem para aplicação do Processo de Enfermagem baseado na NANDA-I, NOC, NIC e CIPE®. Diante de problemas relacionados à aprendizagem do processo de enfermagem e das classificações, urge a necessidade da construção de recursos pedagógicos inovadores que modifiquem a relação entre alunos e professores. A metodologia utilizada fundamentou-se nas etapas concepção, elaboração, construção e transição, do processo de desenvolvimento de software Rational Unifield Process. A equipe envolvida no desenvolvimento deste ambiente foi composta por pesquisadores e estudantes do Grupo de Práticas Assistenciais e Epidemiológicas em Saúde e Enfermagem e do curso de Engenharia de Software da Universidade Federal do Rio Grande do Norte, com a participação das Escolas Superiores de Enfermagem de Lisboa e do Porto, Portugal. Na concepção, ocorreu a comunicação entre os pesquisadores para definição das funções, recursos e ferramentas para o processo de construção. Na elaboração, refinou-se o planejamento e ocorreu a modelagem, que resultou na criação de um diagrama e de desenhos de arquitetura que especificaram as características e as funcionalidades do software. Já na construção, realizou-se o desenvolvimento, testes unitários e integrados dos componentes das interfaces dos módulos e áreas (administrador, docente, discente e construção do PE). Em seguida foi realizada a etapa de transição, que mostrou o sistema completo e em funcionamento. Após o treinamento e utilização pelos pesquisadores nesta etapa foi possível o seu emprego na prática. Com isso, será realizada posteriormente uma avaliação do desempenho funcional, que possibilitará o incremento do software, que promoverá uma realimentação, com a correção de defeitos e mudanças necessárias. Conclui-se que este estudo possibilitou o planejamento e a construção de uma tecnologia educacional, e espera-se que a sua implementação desencadeie uma mudança substancial no aprendizado do processo de enfermagem e das classificações, com o aluno sendo agente ativo do processo de aprendizagem. Acredita-se que com o incremento do software após as avaliações, esta ferramenta cresça cada ainda mais e ajude a inserir esta metodologia e linguagem de vez no âmbito das instituições de ensino e de saúde, promovendo a mudança paradigmática tão almejada pela enfermagem.

4
  • FLAVIO CESAR BEZERRA DA SILVA
  • Construção e validação de instrumento de coleta de dados do casal grávido no âmbito da atenção básica.

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • MARIA DJAIR DIAS
  • MARIA HELENA SOARES DA NOBREGA MAZZO
  • ROSINEIDE SANTANA DE BRITO
  • RÉGIA CHRISTINA MOURA BARBOSA CASTRO
  • Data: Jul 3, 2015


  • Show Abstract
  • A pesquisa teve como objetivo construir e validar um instrumento de coleta de dados do casal grávido no âmbito da atenção básica. Considerou-se a hipótese de que o nível de concordância a partir de 70% entre as(os) participantes do painel de especialistas o validaria. O documento foi construído com base na Teoria das Necessidades Humanas de Horta ajustada por Garcia e Cubas. Trata-se de um estudo do tipo metodológico desenvolvido em quatro etapas: identificação dos indicadores empíricos relativos à gestante por meio de revisão integrativa da literatura; avaliação dos indicadores empíricos e sua relação com as necessidades humanas por grupo focal; estruturação da segunda versão do instrumento conforme a categorização dos indicadores e validação de aparência e conteúdo da terceira versão do instrumento por juízes, mediante uso da técnica Delphi. A coleta de dados da primeira etapa ocorreu de agosto a outubro de 2014 no periódico Journal of Midwifery and Women’s Health e nas bases de dados Scopus, Pubmed, Lilacs, Cinahl, Cochrane. As demais etapas foram realizadas entre os meses de novembro de 2014 a fevereiro de 2015. Para o grupo focal, contou-se com a participação de seis especialistas por meio de dois encontros. Quanto aos juízes, obteve-se uma população de 63 enfermeiras(os) e amostra final de 51 distribuídas(os) em 46 Unidades Básicas de Saúde da Secretaria Municipal de Saúde da cidade de Natal/RN, Brasil. A seleção das Unidades se deu de forma aleatória. A escolha das especialistas para o grupo focal e dos juízes participantes da técnica Delphi atendeu aos seguintes critérios de inclusão: ser enfermeira(o) com no mínimo dois anos de experiência na assistência pré-natal e lotada(o) em Unidades Básicas de Saúde do Município de Natal/RN, Brasil. A consulta a estes profissionais se deu pessoalmente nos seus locais de trabalho e ao aceitarem participar da pesquisa assinaram um Termo de Consentimento Livre e Esclarecido. A pesquisa obteve aprovação pela Comissão de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob o Protocolo nº 876.200 e Certificado de Apresentação para Apreciação Ética nº 36085514.7.0000.5537.  Para análise dos dados da primeira etapa utilizou-se a estatística descritiva e os resultados estão apresentados em forma de tabelas. Nesta etapa identificaram-se 162 indicadores empíricos e, quando relacionados com as necessidades humanas, 64 encontravam-se nas necessidades psicobiológicas, 97 nas psicossociais e um (1) nas psicoespirituais. Com relação à segunda e terceira etapas, os dados passaram por um processo de  categorização e análise pelo Índice de Validade de Conteúdo. Os indicadores obtiveram um índice de validação de 100%. Na fase de validação de aparência e conteúdo do instrumento os itens não validados foram excluídos. Os demais itens obtiveram índice acima de 70%, sendo, portanto o instrumento validado. Com a conclusão do estudo, a(o) enfermeira(o) disporá de um instrumento para coleta de dados do casal grávido na atenção básica. Além disso, o documento servirá como ferramenta para o ensino e a pesquisa em enfermagem obstétrica.

5
  • THEO DUARTE DA COSTA
  • . Avaliação do Cuidado de Enfermagem e da Segurança do Paciente em Unidades de Terapia Intensiva. 

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ELIZABETH BARICHELLO
  • LUCIA NAZARETH AMANTE
  • MARCOS ANTONIO FERREIRA JUNIOR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Oct 16, 2015


  • Show Abstract
  • A evolução tecnológica combinada à assistência em saúde proporciona o aumento nos riscos relacionados à segurança do paciente, que torna as instituições de saúde ambientes passíveis e prováveis de prejuízos no cuidado ofertado. Os setores de alta complexidade, como as Unidades de Terapia Intensiva, possuem tais características destacadas, pois esses espaços têm por objetivo cuidar de pacientes em condições clínicas graves quando o uso de aparatos tecnológicos avançados torna-se uma necessidade. Diante disso, o objetivo desse estudo foi avaliar o cuidado de enfermagem na perspectiva da segurança do paciente em Unidades de Terapia Intensiva. Trata-se de uma pesquisa avaliativa, quanti-qualitativa, que combina formas diferentes de coleta de dados, a saber: observação, aplicação de instrumento de avaliação e entrevista semiestruturada com pacientes, familiares e profissionais, avaliando, assim, a tríade estrutura-processo-resultado do cuidado em enfermagem nas Unidades de Terapia Intensiva. A coleta de dados ocorreu entre abril e julho de 2014, em Unidades de Terapia Intensiva. Para a parte quantitativa (estrutura e processos) foi utilizado a análise estatística da medida de concordância interobservador denominada Kappa (K), e para a parte qualitativa (entrevistas) a técnica de interpretação dos dados deu-se com auxílio do software Interface de R pour Analyses Multidimensionnelles de Textes et de Questionneires (IRAMUTEQ). Os resultados da análise da “estrutura” e “processos” demonstrou que a maioria dos achados se encontrava fora dos padrões de adequação, o que aponta condições precárias nas estruturas e, processos incipientes nos serviços de saúde. Os “resultados” indicam que as Unidades de Terapia Intensiva são locais seguros, contudo urgem por mudanças, principalmente na estrutura física e na disponibilidade de materiais. Portanto, aponta-se que o cuidado de Enfermagem desenvolvido nas unidades de terapia intensiva avaliadas contém falhas preocupantes com relação à segurança do paciente, o que evidencia um quadro de insegurança na assistência ofertada e a necessidade de intervenções urgentes no sentido de corrigir as não adequações apontadas, proporcionando estruturas apropriadas e implantação de protocolos e diretrizes de cuidado, para que se consolide um ambiente propicio a segurança do paciente.

6
  • FERNANDO DE SOUZA SILVA
  • Trajetória de vida de doadores renais: as histórias não ouvidas

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CLELIA ALBINO SIMPSON
  • FELISMINA ROSA PARREIRA MENDES
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • LENILDE DUARTE DE SÁ
  • MAURICIO GALVAO PEREIRA
  • Data: Dec 15, 2015


  • Show Abstract
  • O número de pessoas acometidas pela Doença Renal Crônica (DRC) aumenta a cada ano. Dentre as opções terapêuticas, o transplante renal constitui-se a escolha que promove melhor qualidade de vida aos pacientes. O transplante intervivos é uma estratégia muito utilizada, entretanto, não está totalmente esclarecida a repercussão da uninefrectomia na vida dos doadores vivos. Neste estudo buscou-se analisar, mediante a apreensão das narrativas, experiências que marcam a trajetória de vida dos doadores renais, que se submeteram a uninefrectomia com a finalidade de transplante, com o intuito de identificar eventuais interferências da doação na vida dos doadores. Trata-se de uma pesquisa exploratória e descritiva, com uma abordagem qualitativa. Utilizou-se a história oral de vida como método e técnica de apreensão e preparo analítico dos relatos. Foram entrevistados 12 doadores renais por meio da gravação de áudio dos relatos em mídia digital, no qual os colaboradores responderam às seguintes questões norteadoras: Como era sua vida antes da doação renal. Como é sua vida após a doação renal. Realizou-se a análise dos relatos por meio da análise de conteúdo de Bardin, em que os eixos temáticos nortearam as discussões. A pesquisa foi aprovada pelo comitê de ética em pesquisa do Hospital Universitário Onofre Lopes-UFRN, através da Plataforma Brasil, com CAAE 34804214.1.0000.5292. Foram respeitadas as normas preconizadas pela Resolução Nº 466/12 do Conselho Nacional de Saúde, referente aos aspectos éticos da pesquisa envolvendo seres humanos. Emergiram dos relatos os seguintes eixos temáticos: As motivações para a doação renal, a repercussão da doação renal na vida do doador e a presença divina nos desfechos terapêuticos. Concluimos que os colaboradores não reconhecem a presença de interferências negativas em seu cotidiano após o transplante, ao passo que as repercussões positivas estão latentes nos discursos, principalmente as melhorias na qualidade de vida do doador. Este fato se deve, essencialmente, devido o reconhecimento social da nobreza do ato da doação renal. O círculo de convívio social passa a ver o colaborador como uma pessoa especial, imputando-lhe capacidade inestimável de amar ao próximo.

2014
Dissertations
1
  • MARIA ISABEL DA CONCEICAO DIAS FERNANDES
  • Acurácia dos indicadores clínicos do diagnóstico de enfermagem Volume de líquidos excessivo em pacientes submetidos à hemodiálise.

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • FABIA BARBOSA DE ANDRADE
  • NIRLA GOMES GUEDES
  • VIVIANE MARTINS DA SILVA
  • Data: Jan 27, 2014


  • Show Abstract
  • Estudo transversal, com o objetivo de avaliar a acurácia dos indicadores clínicos do diagnóstico de enfermagem Volume de líquidos excessivo em pacientes submetidos à hemodiálise. Ocorreu em duas etapas, sendo a primeira composta pela avaliação dos indicadores do diagnóstico em estudo; e a segunda, a inferência diagnóstica por enfermeiros diagnosticadores. A primeira ocorreu entre os meses de dezembro de 2012 a abril de 2013, no Hospital Universitário Onofre Lopes e na Clínica de Doenças Renais, com uma amostra de 100 pacientes renais crônicos em hemodiálise. Obtiveram-se os dados mediante formulário de entrevista e exame físico, os quais foram organizados em planilhas eletrônicas e analisados quanto à presença ou ausência dos indicadores do diagnóstico Volume de líquidos excessivo. Na segunda etapa, as planilhas criadas anteriormente foram encaminhadas a três diagnosticadores, que julgaram a presença ou ausência do diagnóstico na clientela pesquisada. Essa etapa desenvolveu-se entre os meses de julho a setembro de 2013. Para a análise, utilizou-se a estatística descritiva e inferencial por meio do IBM SPSS Statistic versão 19.0 for Windows. Na análise descritiva, utilizaram-se medidas de tendência central e de dispersão. Na análise inferencial, utilizaram-se os teste de Qui-quadrado e Fisher, sendo calculadas as razões de prevalência. Posteriormente, mensurou-se a acurácia dos indicadores clínicos do referido diagnóstico por meio da especificidade, da sensibilidade, dos valores preditivos, das razões de verossimilhança e da Odds Ratio Diagnóstica. Os resultados foram organizados em tabelas e discutidos com literatura pertinente. Estudo aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob o protocolo nº 148.428 e Certificado de Apresentação para Apreciação Ética (CAAE) nº 08696212.7.0000.5537. Os resultados revelaram que o diagnóstico de enfermagem estudado esteve presente em 82% dos pacientes. Dentre as características com prevalência acima de 50% destacaram-se: azotemia, hematócrito diminuído, eletrólitos alterados, ingestão maior que o débito, ansiedade, edema, hemoglobina diminuída, oligúria e mudança na pressão arterial. Entretanto, oito apresentaram associação estatisticamente significante ao diagnóstico de enfermagem investigado: congestão pulmonar, ingesta maior que o débito, eletrólitos alterados, distensão da jugular, edema, ganho de peso, agitação e ruídos adventícios. Dentre essas, as que apresentaram maiores razões de prevalência, foram: edema e ganho de peso. As características com maior sensibilidade foram edema, eletrólitos alterados e ingesta maior que o débito e as com maior especificidade sobressaíram-se a anasarca, o ganho de peso, mudança no padrão respiratório, ruídos adventícios, congestão pulmonar, agitação e distensão da jugular. Os indicadores distensão da jugular, eletrólitos alterados, ingesta maior que o débito, pressão venosa central aumentada e edema, em conjunto foram identificados no modelo da regressão logística como os fatores preditores mais significantes. Conclui-se que a acurácia dos indicadores clínicos do diagnóstico de enfermagem Volume de líquidos excessivo em pacientes submetidos à hemodiálise auxiliará no processo de inferência do enfermeiro, principalmente no controle da volemia. Outrossim, os resultados desse estudo contribuirão também para o planejamento de estratégias para a abordagem terapêutica nesses pacientes.

2
  • ALLYNE KARLLA CUNHA GURGEL
  • Percepção de cuidadores de crianças acerca da prevenção de acidentes domésticos infantis: análise à luz do Modelo de Crenças em Saúde

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • GLAUCEA MACIEL DE FARIAS
  • NORMÉLIA MARIA FREIRE DINIZ
  • ROSINEIDE SANTANA DE BRITO
  • Data: Jan 30, 2014


  • Show Abstract
  • Esta pesquisa objetivou analisar a percepção de cuidadores domiciliares de crianças de zero a cinco anos sobre acidentes domésticos infantis e sua influência na prevenção desses eventos. Estudo exploratório e descritivo, com abordagem qualitativa, realizado junto a 20 cuidadores atendidos na Unidade de Saúde da Família do bairro de Cidade Nova, em Natal/Rio Grande do Norte, Brasil. Os participantes deveriam atender aos seguintes critérios de inclusão: ter idade igual ou superior a 18 anos, ser cuidador(a) domiciliar de pelo menos uma criança com até cinco anos e residir na área adscrita da Unidade de Saúde da Família do bairro de Cidade Nova. A coleta de dados ocorreu entre março e abril de 2013, sendo utilizado um roteiro de entrevista semiestruturado. Esta etapa foi precedida pelas anuências da diretora da instituição de saúde onde se desenvolveu a investigação; da Secretaria de Saúde do Município de Natal, bem como do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob o CAAE nº 12236013.7.0000.5537. Salienta-se que se solicitou aos entrevistados autorização formal por meio do Termo de Consentimento Livre e Esclarecido. Os dados foram tratados conforme a técnica do Discurso do Sujeito Coletivo e analisados com base em três dimensões do Modelo de Crenças em Saúde, referente às percepções de susceptibilidade aos acidentes domésticos infantis; de autoeficácia para evitar acidentes domésticos infantis e de indícios para a ação de prevenir acidentes domésticos na infância. Os resultados revelaram que todas as entrevistadas eram mulheres, as quais, em sua maioria, declararam-se mães das crianças cuidadas, com faixa etária predominante entre 18 e 30 anos, vivendo em união consensual, com ensino médio completo e desempregadas. Concernente à percepção de susceptibilidade, desvelou-se compreensão das depoentes sobre diversos tipos de acidentes, sendo estes considerados evitáveis. Para tanto, destacou-se ser essencial a vigilância constante da criança, tendo-se em vista seu alto grau de curiosidade e imaturidade. Sobre a percepção de autoeficácia, as participantes informaram adotar medidas preventivas, entretanto, relataram a vivência de quedas, queimaduras, choques elétricos e mordedura canina. Relativo ao significado atribuído aos acidentes vivenciados, realçaram-se os sentimentos de culpa e desespero, sobretudo diante dos casos interpretados como graves. Quanto à última dimensão analisada, relacionada aos indícios para a ação, a televisão sobressaiu como principal fonte de informações sobre acidentes domésticos e suas respectivas formas de prevenção, contudo, os profissionais de saúde foram citados poucas vezes como emissores de tais saberes. Conclui-se a existência de uma ampla percepção das mulheres sobre a prevenção de acidentes domésticos, porém, distribuída de modo desigual, fato que pode ter contribuído para a vivência desses episódios. A fragilidade na visualização dos profissionais de saúde, dentre eles os enfermeiros, como disseminadores dessas informações, sugere o reforço os diálogos sobre o tema e o incentivo da participação dos cuidadores como sujeitos ativos na prevenção dos acidentes domésticos infantis.

3
  • DIANA PAULA DE SOUZA REGO PINTO CARVALHO
  • A formação de conceitos no ensino de graduação em enfermagem à luz da teoria da aprendizagem significativa

  • Advisor : MARCOS ANTONIO FERREIRA JUNIOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ELIZABETH BARICHELLO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • MARIA LÚCIA IVO
  • ROSANA LUCIA ALVES DE VILLAR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Feb 6, 2014


  • Show Abstract
  • A Teoria da Aprendizagem Significativa (TAS) descrita por David Paul Ausubel oferece uma proposta para que as estratégias de ensino proporcionem ao estudante um aprendizado mais ativo, de forma mais eficaz. A projeção prática da TAS é demonstrada por meio da técnica de elaboração de mapas conceituais (MC), criada por Joseph Donald Novak, que os apresenta como estratégia, método ou recurso esquemático, que constitui um indicador para identificar a organização cognitiva do conhecimento adquirido pelos estudantes. A pesquisa foi realizada à luz da TAS em relação à aprendizagem de conceitos que envolveu estudantes do curso de graduação em Enfermagem de uma Universidade pública do estado do Rio Grande do Norte. Dessa forma, o estudo objetivou comparar a aprendizagem de conceitos dos estudantes do curso de graduação em Enfermagem, quando submetidos a formas distintas de ensino, de modo que aponta abordagens que promovam resultados mais efetivos e significativos. Trata-se de um estudo quase experimental, com análise qualitativa, realizado com estudantes do Curso de Graduação em Enfermagem da Universidade Federal do Rio Grande do Norte (UFRN), aprovado pelo Comitê de Ética em Pesquisa/UFRN, com Certificado de Apresentação para Apreciação Ética (CAAE) no. 11706412.3.0000.5537. O estudo ocorreu em dois momentos distintos e envolveu conteúdos sobre complicações de pós-operatório mediato da ferida cirúrgica, de uma mesma disciplina, com estudantes que cursavam o 5o semestre letivo do curso de graduação em Enfermagem. Para viabilização da coleta de dados, ocorrida no segundo semestre de 2013, utilizou-se à técnica de MC, para representarem o conceito de complicações de pós-operatório mediato da ferida cirúrgica, abordado em sala de aula. Os MC foram construídos em um horário diferente do horário da disciplina, com o apoio de monitores e precedido por uma breve explanação acerca da descrição e forma de elaboração e aplicação deles. Foram sujeitos deste estudo 31 alunos do curso de graduação em enfermagem, matriculados na disciplina de Atenção Integral à saúde I. Na primeira etapa, participaram da pesquisa 18 alunos, estes tiveram a intervenção de ensino baseadas na TAS, e na segunda etapa, participaram todos os estudantes, na qual ocorreu a aula prevista curricularmente com a docente responsável da disciplina, sobre o mesmo assunto. Ao final de cada encontro, os estudantes elaboraram os mapas conceituais com auxílio do SoftwareCmap Tools®. A análise dos dados foi realizada mediante a técnica de análise de conteúdos, subsidiada por um mapa conceitual “espelho”, previamente desenvolvido pelos pesquisadores, e auxílio na elaboração das categorias em que os conceitos encontrados foram classificados. O estudo descobriu que a intervenção de ensino baseada na TAS com auxílio dos MC conseguiu desenvolver nos alunos um processo de ensino aprendizagem mais expressivo do que apenas a aula curricular com o método tradicional de ensino, e ainda a associação da intervenção de ensino proposta com o método tradicional e o uso da técnica de MC estimula no aluno a capacidade de articular os diversos conhecimentos aprendidos assim como aplicá-los em situações reais.

4
  • KISNA YASMIN ANDRADE ALVES
  • Protocolo de avaliação do cuidado de enfermagem e segurança do paciente em Unidades de Terapia Intensiva.

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • ALLYNE FORTES VITOR
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • QUENIA CAMILLE SOARES MARTINS
  • ELIZABETH BARICHELLO
  • Data: Feb 7, 2014


  • Show Abstract
  • Os relatos sobre eventos adversos datam desde 1990, contemporizando-se até os dias atuais. Conceitualmente, os eventos adversos são injúrias não intencionais e sem relação com a doença de base, provocando lesões mensuráveis em pacientes, prolongamento do período de internação ou óbito. São temáticas que demandam discussões, no tocante à segurança do paciente, melhorias na qualidade do serviço e na prevenção de erros no atendimento ao paciente. Na Unidade de Terapia Intensiva, essa preocupação é ampliada, pois são setores de cuidados intensivos aos indivíduos com alterações hemodinâmicas e iminente risco de morte. Esse aspecto exige dos profissionais, principalmente os da enfermagem, cuidados complexos e tomadas de decisões imediatas. Assim, é fundamental a realização de processos avaliativos para investigar os aspectos de qualidade do cuidado de enfermagem e da segurança do paciente nesses espaços. Diante disso, objetivou-se validar o conteúdo do “Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente nas Unidades de Terapia Intensiva”. Para alcançá-lo, fez-se necessário: 1) analisar a evolução do conceito “segurança do paciente” empregado nas produções científicas, sob a visão evolucionária de Rodgers; 2) identificar os itens necessários para compor o protocolo de avaliação do cuidado de enfermagem e da segurança do paciente na Unidade de Terapia Intensiva, a partir das evidências da literatura; 3) construir um instrumento para validação de conteúdo do protocolo de avaliação do cuidado de enfermagem e da segurança do paciente na Unidade de Terapia Intensiva; e 4) descrever o conteúdo indispensável para um protocolo de avaliação do cuidado de enfermagem e da segurança do paciente na Unidade de Terapia Intensiva. Trata de um estudo metodológico, para validação de conteúdo do protocolo supracitado. Para atender os três primeiros objetivos específicos, utilizou-se a revisão integrativa da literatura no Banco de Teses da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e no portal do Centro Colaborador para a Qualidade do Cuidado e a Segurança do Paciente. O quarto objetivo específico foi concretizado pela participação de juízes na temática, localizados através dos currículos Lattes, no processo de validação de conteúdo desenvolvido em duas etapas: Delphi 1 e Delphi 2. Como instrumento, utilizou-se o formulário eletrônico do google docs. As respostas provenientes dos instrumentos de avaliação são apresentadas, mediante índice de concordância interobservador denominada Kappa (K), em tabelas e gráficos. Os resultados foram sintetizados nos artigos intitulados “A análise do conceito “segurança do paciente: a visão Evolucionária de Rodgers”, “Evidências científicas acerca da segurança do paciente na Unidade de Terapia Intensiva”; “Dispositivo tecnológico para processo de validação de conteúdo: relato de experiência”; e “Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente nas Unidades de Terapia Intensiva”. Cabe destacar que o estudo foi aprovado pelo Parecer Consubstanciado do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, nº 461.246, sob CAAE nº 19586813.2.0000.5537. Conclui-se que o protocolo, válido em seu conteúdo, constitui uma importante ferramenta de avaliação da qualidade do cuidado de enfermagem e da segurança do paciente em Unidades de Terapia Intensiva.

5
  • CAMILA AUGUSTA DA SILVA
  • O cuidado compartilhado entre mães e educadoras de um centro municipal de educação infantil: uma pesquisa-ação.

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • ALTAMIRA PEREIRA DA SILVA REICHERT
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • NEUSA COLLET
  • NILBA LIMA DE SOUZA
  • Data: Feb 20, 2014


  • Show Abstract
  • O cuidado à criança envolve a identificação e o atendimento às necessidades de modo a oferecer-lhe atenção como pessoa em contínuo processo de crescimento e desenvolvimento. Contudo, o cuidado oferecido à criança que convive em instituição escolar está permeado por conflitos que fragilizam a relação família-escola, não sendo estimulada a articulação desses atores no que refere ao cuidar da criança. Diante dessa problemática, objetivou-se analisar a construção de um pacto do cuidar entre mães e educadoras de crianças que frequentam um Centro Municipal de Educação Infantil. Trata-se de um estudo qualitativo, tendo como método a pesquisa-ação. Envolveu doze mães e oito educadoras de uma instituição de educação infantil de Cidade Nova, no município de Natal, no período de abril a novembro de 2013. Os dados foram coletados através de entrevista grupo focal, observação participante, seminários e diário de campo. Os resultados foram analisados seguindo o direcionamento da análise temática freireana. Na etapa do diagnóstico situacional, que investigou a realidade vivenciada pelas participantes do estudo, percebeu-se que as educadoras não se sentem preparadas para lidar com aspectos de saúde-doença da criança e recusam as ações de cuidado como desempenho de suas funções, interpretada como uma atitude que ultrapassa sua competência profissional. Os pais, por sua vez, apresentaram dificuldade de entendimento e clareza da sua função e relação com a instituição e executam as ações de saúde sem associá-lo à promoção e prevenção, além de realizarem com conhecimento empírico. Vista a necessidade de mudança das ações de saúde prestadas à criança, decidiu-se conjuntamente, através de uma roda de conversa, realizar capacitações sobre higiene e limpeza, medidas caseiras no cuidado à criança e primeiros socorros. Na etapa de implementação da ação coletiva as participantes consideraram as atividades úteis no cuidado prestado à criança e perceberam a importância do cuidado compartilhado para o desenvolvimento infantil. Com o desenvolvimento das capacitações, as participantes sentiram a necessidade de sistematizar as atividades prestadas à criança nos problemas de saúde e, para tanto, foram construídos, conjuntamente, protocolos e procedimentos operacionais padrão para a formalizar as ações. Na etapa de avaliação dos encontros, constatou-se que há expectativas positivas para a continuidade do cuidado em comunhão entre pais e educadores, pois foram construídas novas percepções em relação ao cuidado da criança. Percebeu-se mudança considerável nas mães assíduas ao estudo quanto ao cuidado e interesse, no entanto tornaram-se evidentes as fragilidades no processo de trabalho do CMEI, pois emergiram a dificuldade existente nos membros que compõe a instituição de educação infantil de articular o cuidado à educação. Como principal dificuldade, elenca-se o alto índice de mães faltosas e a dificuldade de articular com outros profissionais de saúde para as atividades. Considera-se que o pacto de cuidar não foi implantado integralmente, pois partilhar cuidados sugere o encontro de pais e educadores que podem ter aspectos divergentes sobre necessidades infantis e desenvolvimento, o que requer constante negociação entre as partes. Nesse sentido, constitui-se em um processo contínuo de aperfeiçoamento entre família e instituição de educação infantil.

6
  • FERNANDA CARLA MAGALHÃES
  • Práticas populares de cuidado à criança: o saber/fazer de cuidadoras.
  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • ALTAMIRA PEREIRA DA SILVA REICHERT
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • NEUSA COLLET
  • ROSINEIDE SANTANA DE BRITO
  • Data: Feb 26, 2014


  • Show Abstract
  • As práticas populares correspondem aos recursos utilizados pelas famílias, pessoas leigas e terapeutas populares, cuja apreensão do saber se constrói no cotidiano. Nesse contexto, a criança doente pode se tornar vulnerável por estar na dependência de um cuidador familiar, o qual, muitas vezes decide empregar práticas populares. Assim, o cuidado à criança deveria ser compartilhado entre cuidador e profissional de saúde. Entretanto, estes pouco sabem sobre os recursos que a família emprega ao perceber algum agravo no infante. Diante disso, a pesquisa em apreço objetivou analisar o uso de práticas populares por cuidadoras de crianças com zero a cinco anos de idade. Realizou-se um estudo exploratório e descritivo, com abordagem qualitativa, junto a 15 cuidadoras de crianças, que eram atendidas na Unidade Mista de Felipe Camarão, localizada no município de Natal, Rio Grande do Norte, Brasil. Para escolha das participantes, estas deveriam ter idade igual ou superior a 18 anos; ser cuidadora de criança(s) com até cinco anos de idade; e, residir na área adscrita da Unidade Mista de Felipe Camarão. A coleta de dados ocorreu entre os meses de setembro e outubro de 2013, por meio da entrevista em profundidade. Esta etapa foi antecedida pela anuência da Secretaria de Saúde do município de Natal; da direção da Unidade Mista de Felipe Camarão; bem como, do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, com Certificado de Apresentação e Apreciação Ética, n° 15467013.8.0000.5537. Além disso, as entrevistadas autorizaram formalmente a participação na pesquisa, através da assinatura do Termo de Consentimento Livre e Esclarecido. Os dados foram tratados conforme a técnica de Análise de Conteúdo na modalidade de análise temática, segundo Bardin. Deste processo, emergiram quatro categorias: “Tipos de práticas populares utilizadas nos cuidados com a criança”; “Fonte de informações das práticas populares”; “Resultados obtidos com as práticas populares”; “Fatores que dificultam a adoção de práticas populares”. Os resultados revelaram a utilização de práticas populares pelas cuidadoras, nos casos de adoecimento da criança, a exemplo: das preparações caseiras com plantas medicinais e da rezadeira. O ambiente familiar foi referenciado como principal espaço de aprendizado e propagação das práticas populares, as quais são influenciadas pelas relações culturais presentes nesse contexto. Quanto aos resultados obtidos com os recursos populares, as cuidadoras afirmaram ser satisfatórios, e isto desencadeia um sentimento de confiança e aceitabilidade de tais medidas. Conclui-se, que o uso de práticas populares no cuidado à criança persiste no cotidiano da maioria das famílias estudadas, apesar da hegemonia da terapia alopática. As cuidadoras afirmaram que tais práticas são eficazes e de fácil obtenção, estando asseguradas no seu contexto pela cultura popular. Além disso, os profissionais de saúde, sobretudo os enfermeiros, foram pouco citados pelas cuidadoras quanto às informações referentes aos recursos populares utilizados por elas, o que sugere a fragilidade no processo dialógico e de negociação de práticas entre ambos.
7
  • THAYSE MINOSA DOS SANTOS SILVA
  • Trajetória de profissionais da saúde de um Hospital Colônia, à luz da História Oral.

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • MARIA TERESA CICERO LAGANA
  • ANTONIA OLIVEIRA SILVA
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • Data: Feb 27, 2014


  • Show Abstract
  • A hanseníase, como problema de saúde pública, ainda persiste há bastante tempo, mesmo com tratamento há décadas. Seu processo saúde-doença é marcado por um cenário histórico de estigma, preconceito, exclusão social e por tomada de condutas autoritárias, com o intuito de extinguir a doença do meio social sob o regime do enclausuramento obrigatório do doente. Nessa perspectiva, a saúde pública brasileira do século XX adotou políticas de isolamento compulsório, que fez com que, todos aqueles que recebessem diagnóstico de hanseníase fossem isolados da sociedade e de seus familiares em hospitais colônias. Objetiva-se, com o estudo, resgatar a trajetória dos profissionais de saúde no Hospital Colônia São Francisco de Assis, em Natal/RN; Identificar como era percebida a política de asilamento compulsório imposta ao portador de hanseníase pelos profissionais de saúde; Descrever as condutas profissionais adotadas no Hospital Colônia; Recuperar informações quanto à existência, funcionamento e rotinas do Hospital e Contribuir com o projeto acervo do MORHAN. Foi utilizado o método exploratório-descritivo, com uma abordagem qualitativa, tendo como referencial metodológico a história oral temática. Obteve-se aprovação pelo CEP da Universidade Federal do Rio Grande do Norte, sob Protocolo N. 461.403 e CAAE 19476913.9.0000.5537. Entrevistaram-se, durante o período de novembro e dezembro de 2013, cinco profissionais de saúde que atuaram no hospital colônia, utilizando-se gravador de áudio e imagens para captação e registro dos depoimentos. As entrevistas foram transcritas, textualizadas, transcriadas e enviadas aos colaboradores para a etapa de conferência dos relatos. Posteriormente, A análise das histórias foi realizada a partir da proposta de análise de conteúdo de Bardin. Os resultados e a discussão estão apresentados em forma de artigo: Opinião de profissionais da enfermagem que atuaram em um hospital colônia de hanseníase, que objetivou: identificar a opinião dos profissionais de enfermagem, que atuaram em hospital colônia, sobre a vida dos doentes. Nesse artigo, três eixos temáticos foram evidenciados e discutidos a partir dos relatos dos colaboradoes: I – O processo de socialização dos internos; II – O preconceito, o estigma e a discriminação; III – A exclusão social versus inclusão social. Conclui-se que, no contexto do hospital colônia, a atuação dos profissionais de saúde contribuíram de forma significativa para que o estigma, o preconceito e a exclusão social fossem minimizados e para que a vivência dos asilados na colônia não fosse encarada de forma mais traumática.

8
  • LUCELIA MARIA CARLA PAULO DA SILVA DUARTE
  • HANSENÍASE: a implicação da educação em saúde para o autocuidado

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • REJANE MILLIONS VIANA MENESES
  • ANTONIA OLIVEIRA SILVA
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • Data: Feb 27, 2014


  • Show Abstract
  • A hanseníase é um problema de saúde em nível mundial devido principalmente ao seu potencial incapacitante. A estratégia de combate à doença adotada pelo Ministério de Saúde é o diagnóstico e tratamento precoces, prevenção e tratamento de incapacidades físicas e vigilância dos contatos domiciliares. Tudo isso fundamentado na educação em saúde como sustentáculo para compreensão do processo de adoecimento, da doença em si, sua aceitação e, principalmente, das ações de autocuidado para prevenção de sequelas. Nesse contexto, questiona-se: Qual a implicação da assistência de enfermagem focada na educação em saúde para o autocuidado em portadores de hanseníase? O objetivo geral desse estudo é avaliar os conhecimentos adquiridos pelos portadores de hanseníase sobre a doença, o tratamento e autocuidado abordados durante a consulta de enfermagem. Trata-se de um estudo exploratório-descritivo com abordagem qualitativa, realizado no Hospital Universitário Onofre Lopes. Respeitou a resolução 466/12 do Conselho Nacional de Saúde e foi aprovado pelo comitê de ética sob nº 387.769 e CAAE 17468213.0.0000.5537. Envolveu 14 portadores de hanseníase em tratamento no ambulatório de dermatologia do HUOL. Os dados foram coletados no período de 23 de setembro a 04 de novembro de 2013 por meio de entrevista semi-estruturada; e analisados a partir da analise de conteúdo de Bardin. Como resultado, as entrevistas originaram três eixos temáticos: as complicações/sequelas da hanseníase conhecidas pelos portadores da doença; as ações de autocuidado adotadas pelos portadores de hanseníase; as possíveis contribuições de um grupo de autocuidado para os portadores de hanseníase. Por fim, verificou-se a aparente superficialidade no conhecimento dos pacientes sobre as complicações da hanseníase, como também, das ações de autocuidado realizadas por eles.

9
  • ALINE GALUCIO DE OLIVEIRA RODRIGUES
  • Estágio supervisionado em enfermagem: visão de preceptores.

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • JOÃO BOSCO FILHO
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • ROSANA LUCIA ALVES DE VILLAR
  • ROSINEIDE SANTANA DE BRITO
  • Data: Mar 13, 2014


  • Show Abstract
  • O presente estudo teve como objetivo analisar a visão de preceptores de um hospital universitário acerca do estágio supervisionado em enfermagem. Trata-se de uma pesquisa de natureza descritiva, com abordagem qualitativa, desenvolvida no Hospital Universitário Onofre Lopes (HUOL), localizado em Natal-RN. A população foi composta por onze enfermeiros assistenciais que exercem a função de preceptoria de estudantes do curso de graduação em enfermagem, da Universidade Federal do Rio Grande do Norte (UFRN). Para a pesquisa empírica, realizada no período de setembro a novembro de 2013, foi utilizada a entrevista a semiestruturada, envolvendo questões direcionadas ao estágio, conforme preconizam as diretrizes curriculares nacionais, no que se refere a esse componente curricular. Contou com a anuência da instituição onde se desenvolveu o estudo e a aprovação pelo Comitê de Ética em Pesquisa da UFRN, com CAAE n° 17800613.9.0000.5537, além da assinatura do Termo de Consentimento Livre e Esclarecido pelos participantes. A análise foi realizada através da análise de conteúdo,  segundo Bardin, na modalidade temática. Desse modo,  foram definidas, a priori, quatro categorias, assim nominadas: O estágio supervisionado na visão de enfermeiros; Ser preceptor; O estágio em questão: contribuições e dificuldades; Os agentes institucionais se comunicam? Os resultados apontam que na visão dos preceptores o estágio supervisionado é uma condição sine qua non para a formação do enfermeiro, visto que prepara para a vida profissional, além de ser um momento propício para o exercício da gerência e de uma maior aproximação entre teoria e prática; estimula o preceptor a se atualizar para melhor exercer a função e, ainda, proporciona uma troca de saberes entre alunos e preceptores, contribuindo, assim, para otimizar o serviço. Apesar disso, os entrevistados assinalam a existência de um distanciamento e pouca comunicação com a instituição acadêmica. Em síntese, percebe-se que os enfermeiros compreendem a importância de sua função de preceptores e do estágio supervisionado para a formação profissional. Faz-se necessário, porém, refletir sobre os caminhos a serem trilhados no enfrentamento das dificuldades nesse processo, sobretudo, no que diz respeito à relação ensino/serviço, que, mantendo-se distanciada, fortalece a dicotomia existente entre teoria e prática.

10
  • LUCIDIO CLEBESON DE OLIVEIRA
  • Assistência de enfermagem às urgências e emergências psiquiátricas no Serviço de Atendimento Móvel de Urgência em Mossoró-RN

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • NILBA LIMA DE SOUZA
  • JACILEIDE GUIMARAES
  • FATIMA RAQUEL ROSADO MORAIS
  • SUZANA CARNEIRO DE AZEVEDO FERNANDES
  • Data: Mar 21, 2014


  • Show Abstract
  • O presente estudo tem como objetivo conhecer as concepções dos profissionais da equipe de enfermagem sobre a assistência em urgências e emergências psiquiátricas no Serviço de Atendimento Móvel de Urgência (SAMU) em Mossoró/RN, identificar as dificuldades existentes na implementação de uma assistência de emergência ao usuário em sofrimento psiquiátrico neste serviço e apontar as estratégias na busca de uma consolidação e ampliação de uma assistência integral a esse público. Trata-se de pesquisa do tipo descritiva com abordagem qualitativa e de caráter exploratório. Os sujeitos foram trabalhadores da equipe de enfermagem do SAMU do referido município. Emprega-se a entrevista semiestruturada como instrumento de coleta de dados. Contou com a anuência da instituição onde se desenvolveu o estudo e a aprovação pelo Comitê de Ética em Pesquisa da UFRN, com CAAE n° 17326513.0.0000.5537, além da assinatura do Termo de Consentimento Livre e Esclarecido pelos participantes. A análise de dados se fez por meio da Análise Temática proposta por Bardin. Desta forma, como resultado da pesquisa elaborou-se as seguintes categorias: prática mecanicista; desumanização da assistência; necessidade de qualificação, entraves para uma assistência em urgência e emergência psiquiátrica e estratégias na busca da assistência integral, o que procedeu na elaboração de dois artigos intitulados “Assistência de enfermagem às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência” e “Entraves para o atendimento às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência”. Na realidade estudada identificou-se que a assistência de enfermagem ofertada aos usuários em situação de urgência e Emergência psiquiátrica é realizada baseada principalmente na utilização de contenções químicas e físicas, assim como no transporte para o hospital geral, constantemente utilizando o acionamento de força policial, o que vai de encontro as diretrizes da Reforma Psiquiátrica e assim comprometendo a oferta de uma assistência efetiva e humanizada. Esse cenário agrava-se pela falta de um rede de serviços em saúde mental organizada, onde após o atendimento o usuário é levado a um hospital geral, tendo em vista que não existe um pronto socorro psiquiátrico ou serviço apropriado, como um Centro de Atendimento Psicossocial – CAPs III para referenciá-lo, impossibilitando assim a realização de um atendimento resolutivo e integral. Dessa forma, conclui-se que a assistência de enfermagem baseia-se no modelo biologicista e medicalocêntrico, defendido pela psiquiatria clássica e que apesar de todos os avanços da reforma psiquiátrica, ainda norteia a assistência em saúde mental, assim a falta de rede de atendimento em saúde mental organizada e hierarquizada, onde o usuário em situação de urgência e emergência psiquiátrica possa ser assistido de forma integral e as diretrizes da Reforma Psiquiátrica possam ser concretizadas na prática. 

11
  • HELOÍSA CRISTINA FERREIRA DE LIMA
  • O Ensino de Enfermagem Gerontológica na formação do  enfermeiro.

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MARIA PAIVA DE MENEZES
  • SORAYA MARIA DE MEDEIROS
  • WILMA DIAS DE FONTES
  • Data: Mar 31, 2014


  • Show Abstract
  • No atual momento das mudanças demográficas populacionais no mundo, observa-se que o setor saúde necessita de uma reestruturação de suas práticas no atendimento à pessoa idosa, de maneira a possibilitar um cuidado integral e humanizado. Nesse sentido, identifica-se a necessidade de profissionais qualificados para assistirem a pessoa idosa e, para isso, é importante que os currículos de formação do enfermeiro estejam adequados a esta realidade. O estudo tem como objetivo geral, analisar como se desenvolve o ensino do componente enfermagem gerontológica em cursos de graduação de enfermagem. Tratou-se de um estudo descritivo e exploratório, com abordagem qualitativa, realizado em duas instituições de ensino superior no Município de Natal/RN, sendo uma instituição pública e outra. A população envolvida correspondeu aos coordenadores do curso de graduação em enfermagem e professores que lecionam conteúdos de atenção à saúde do idoso, totalizando sete participantes. O instrumento de coleta de dados utilizado foi um questionário contendo questões relacionadas à caracterização sociodemográfica e profissional e ao ensino da gerontologia nos cursos de graduação em enfermagem. Os resultados foram apresentados de forma descritiva em quadros, e analisados a partir de eixos temáticos oriundos das principais questões nominados em: conhecendo os participantes da pesquisa, conhecendo o ensino do componente enfermagem gerontológica e, conhecendo os projetos pedagógicos. A análise descritiva foi do tipo comparativa, em função dos resultados incluir duas instituições de ensino, com base na Resolução n°. 03, de 7/11/2001, que dispõe sobre as diretrizes mínimas para o curso de enfermagem e nos projetos pedagógicos de ambas as instituições de ensino. Os resultados mostraram que a maioria dos participantes (cinco) eram do sexo feminino, quase todos possuem pós-graduação embora, nenhum deles declarou qualificação na área do envelhecimento ou saúde do idoso; a organização dos conteúdos do componente na matriz curricular, a carga horária teórico-prática e as estratégias metodológicas de ensino apresentaram-se de forma heterogênea e, algumas vezes divergentes em uma mesma instituição; Sobre a definição do componente  enfermagem gerontológica, identificou-se que não está bem definido ao longo do projeto pedagógico das instituições de ensino pesquisadas. Concluiu-se que, no contexto deste estudo, o ensino de enfermagem gerontológica está presente no curso de formação do enfermeiro, mas há necessidades de reavaliação e atualização com vistas a um ensino de maior abrangência e aproximado das práticas em saúde.

12
  • LIVA GURGEL GUERRA FERNANDES
  • Cultura e clima de segurança do paciente em uma maternidade escola: percepção dos profissionais de enfermagem em terapia intensiva. 

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • FATIMA RAQUEL ROSADO MORAIS
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • NILBA LIMA DE SOUZA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • SUZANA CARNEIRO DE AZEVEDO FERNANDES
  • Data: Apr 4, 2014


  • Show Abstract
  • A partir da publicação do relatório “Errar é Humano” pelo Institute of Medicine (IOM), o qual estimou que entre 44.000 a 98.000 americanos morrem anualmente em decorrência de erros da assistência à saúde, a segurança do paciente passou ganhar destaque, surgindo estudos que avaliam a cultura de segurança através da mensuração do clima de segurança. Nesse contexto, o objetivo desse estudo foi identificar a cultura de segurança percebido pelos profissionais de enfermagem que atuam nas unidades de terapia intensiva de uma maternidade escola em Natal/RN através do Questionário Atitudes de Segurança (SAQ). Tratou-se de um estudo do tipo descritivo, transversal, com abordagem quantitativa realizado nas Unidades de Terapia Intensiva Materna e Neonatal de uma maternidade escola na cidade de Natal/RN. O projeto foi submetido à Plataforma Brasil e aprovado pelo CEP/UFRN sob o número 309.540 e CAAE 16489713.7.0000.5537. Utilizou-se para a coleta de dados dois instrumentos: um questionário com a finalidade de coletar dados sócio demográficos dos sujeitos e o Questionário Atitudes de Segurança, uma adaptação transcultural para a língua portuguesa do instrumento da Organização Mundial da Saúde intitulado Safety Attitudes Questionnaire - (SAQ) Short Form 2006. Os dados coletados foram analisados quantitativamente através da organização em banco de dados eletrônicos no Microsoft Excel 2010 e exportados para planilha do SPSS (StatisticalPackage for the social sciences) versão 2.0 para serem codificados, tabulados, e analisados mediante estatística descritiva. Participaram do estudo um total de 50 profissionais de enfermagem, sendo 31 da UTI Neonatal e 19 da UTI Materna, predominantemente do sexo feminino, com idade média de 35 anos, tempo de formação médio de 10 anos e que trabalhavam na maternidade, em sua maioria, há menos de 05 anos.Como resultado, foram produzidos dois artigos. O primeiro refere-se aos dois primeiros domínios do instrumento intitulados “Clima de trabalho em equipe” e “Clima de segurança”. Os escores dos dois domínios foram ligeiramente mais elevados na UTI Materna se comparada à UTI Neonatal, porém nenhum setor atingiu o escore mínimo ideal de 75: no primeiro domínio a UTI Materna obteve média de 74,77, com medianas de 75 e 100, enquanto a UTI Neonatal atingiu média de 69,61 com medianas também de 75 e 100; enquanto no segundo domínio as médias foram de 69,35 e 66,01 para as UTIs Materna e Neonatal respectivamente, com mediana de 100 nos dois setores. O segundo artigo diz respeito ao domínio “Percepção da Gerência da Unidade e do Hospital”, que avaliou a percepção da gerência das unidades e da maternidade por parte dos profissionais. Em geral, os itens do domínio em questão também obtiveram escores aquém do mínimo ideal: 63,68 para a UTI materna e 51,02 para a neonatal, caracterizando um evidente distanciamento entre a gestão e os profissionais que atuam na assistência direta. Tais achados indicam um sinal de alerta para a instituição e apontam para a necessidade de implementar ações que visem a segurança do paciente.

13
  • KALINA SIQUEIRA DE MOURA
  • Ser cuidador de paciente com acidente vascular cerebral: histórias que não sao contadas

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MILLIONS VIANA MENESES
  • CECILIA NOGUEIRA VALENCA
  • JOÃO BOSCO FILHO
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • Data: Jun 9, 2014


  • Show Abstract
  •  

    O presente estudo objetivou compreender a vivência de ser um cuidador familiar de paciente com Acidente Vascular Cerebral (AVC). A relevância do estudo deve-se a existência comprovada de um elevado número de cuidadores de pacientes incapacitados, em decorrência do AVC, e que não vêm sendo objeto de investigação no âmbito acadêmico, conforme refere à literatura. Trata-se de uma pesquisa de natureza qualitativa, cujo fio condutor se pautou na história oral de vida, conforme a fundamentação teórica e operacional de Meihy. Assim sendo, foram evidenciadas as seguintes etapas: a comunidade de destino, composta por todos os cuidadores familiares de pacientes com AVC; a colônia, formada por cuidadores familiares de pacientes com AVC e que foram atendidos pelo Serviço de Atendimento Domiciliar (SAD) do Hospital José Pedro Bezerra (HJPB), na cidade do Natal/RN; a rede foi constituída por seis cuidadores que atendiam os critérios de inclusão, e como ponto zero o primeiro voluntário do grupo. A população foi composta por todos os cuidadores familiares atendidos pelo SAD, do HJPB tendo sido abordados através de entrevistas. Para a realização da pesquisa empírica contou com a anuência dessa instituição e aprovação do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte conforme CAAE nº 24569413.0.0000.5537 e, sobretudo, com a aquiescência dos colaboradores em participar da investigação, assinando o Termo de Consentimento Livre e Esclarecido. Do material empírico foram identificadas cinco categorias de análise: O sentido de ser cuidador; O que mudou na vida do cuidador; Os sentimentos emergem na relação do cuidar; O distanciamento de familiares e amigos; Dificuldades enfrentadas pelo cuidador. Os resultados evidenciam que a vida do cuidador passa por profundas transformações no âmbito da família bem como, em todas as esferas da vida. Para os cuidadores, assumir o cuidado de um familiar com AVC significa renúncia e doação, comprometendo, algumas vezes, os projetos individuais e da família como um todo. Além disso, ressaltam o enfrentamento de dificuldades no âmbito da assistência e humanização na saúde, informação, sobrecarga física e emocional, além de problemas de ordem financeira. Apesar de todas as adversidades que comprometem a vida do cuidador foi possível identificar atitudes de resiliência entre os cuidadores, tornando o seu fazer cotidiano menos árduo e com mais leveza. Espera-se, portanto, que essa pesquisa possa contribuir para uma melhor orientação dos profissionais junto aos cuidadores.

14
  • JOANA DARC DANTAS SOARES
  • Vivências do pai/ acompanhante no processo da hospitalização do filho

  • Advisor : JOVANKA BITTENCOURT LEITE DE CARVALHO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • FATIMA RAQUEL ROSADO MORAIS
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • LUCINEIRE LOPES DE OLIVEIRA
  • ROSINEIDE SANTANA DE BRITO
  • Data: Jul 22, 2014


  • Show Abstract
  • A presença do homem junto ao filho  hospitalizado ainda é inexpressiva  e as relações estabelecidas no âmbito hospitalar culminam em situações diversas que podem influenciar a sua vivência. O estudo objetivou analisar as vivências do pai/acompanhante do filho enfermo. Trata-se de uma pesquisa exploratória e descritiva em abordagem qualitativa, desenvolvida junto a 11 pais que acompanhavam o filho enfermo em um Hospital Pediátrico, situado na Grande Natal, Rio Grande do Norte, Brasil. Conforme os critérios de inclusão os participantes deveriam estar com idade igual ou superior a 18 anos; ter condições emocionais favoráveis para responder o questionamento, ser acompanhante do filho na faixa etária de um a cinco anos e internados em enfermarias clínicas ou cirúrgicas da referida instituição. A coleta de dados ocorreu nos meses de março e abril de 2014, por meio de entrevista semiestruturada. Antecedeu essa etapa a anuência da Secretaria de Saúde do Estado do Rio Grande do Norte, aprovação pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, com CAAE nº 22821513.1.0000.5537, como também assinatura do Termo de Consentimento Livre e Esclarecido pelos entrevistados. O tratamento dos dados ocorreu à luz da Técnica de Análise de Conteúdo na modalidade de categorias temáticas proposta por Bardin. Das falas emergiram as categorias: “Priorizando a presença na hospitalização do filho” e “Vivenciando dificuldades durante a hospitalização do filho”, as quais foram analisadas e discutidas com base na literatura sobre a criança no âmbito da “Família no contexto da hospitalização da criança” e as “Considerações sobre os cuidados  com a criança”. Constatou-se que os entrevistados ao vivenciaram a hospitalização do filho inseriram-se em um contexto de participação ativa de tarefas e compartilhamento de responsabilidades. Assim, com base no estudo considerou-se a necessidade da efetivação dos direitos do pai enquanto ente familiar na prática dos cuidados com os filhos em detrimento à questões sociais e de gênero ainda presente na sociedade contemporânea. Nesse sentido faz-se relevante que a equipe de Enfermagem considere as situações diversas enfrentadas pelo pai durante o período de internação infantil tendo como premissa à aproximação deste do processo do cuidar do infante minimizando as seqüelas advindas do afastamento da criança no âmbito familiar.

15
  • AMANDA JÉSSICA GOMES DE SOUZA
  • Associação da autoestima com a qualidade de vida de pessoas com úlcera venosa atendidas na atenção primária

  • Advisor : ISABELLE KATHERINNE FERNANDES COSTA
  • COMMITTEE MEMBERS :
  • ALEXSANDRA RODRIGUES FEIJAO
  • ALEXSANDRO SILVA COURA
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • Data: Jul 23, 2014


  • Show Abstract
  • A úlcera venosa (UV) é uma lesão crônica dos membros inferiores e devido sua elevada incidência e recorrência, implica em tratamentos longos e complexos, prejudicando a qualidade de vida(QV)  e autoestima(AE) dos paciente.  Nesse sentido, objetivou-se neste estudo analisar a associação da autoestima com a qualidade de vida de pessoas com úlcera venosa atendidas na atenção primária.  Estudo transversal, analítico, com abordagem quantitativa realizado com 44 pessoas com UV atendidas em 13 Unidades de Saúde da Família e 2 Unidades Mistas de Natal/RN. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte (UFRN), CAAE: 07556312.0.0000.5537. Realizou-se a coleta de dados de fevereiro a abril de 2014 e utilizou-se três instrumentos: um formulário estruturado abrangendo as variáveis sociodemográficas, assistenciais e clínicas, a Escala de Autoestima de Rosenberg e o SF-36. Os dados coletados foram inseridos num banco de dados e processados em software informatizado para as análises descritivas e inferenciais. Os resultados mostraram predominância de pessoas com UV do sexo feminino (65,9%), com mais de 60 anos (59,1%), casados ou em união estável (52,3%), baixa escolaridade (86,4%), sem ocupação (68,2%) e com renda inferior a um salário mínimo (81,8%). Quanto às características assistenciais observou-se que a maioria dos pacientes realizava o curativo com material adequado (72,7%), com profissional ou cuidador treinado (61,4%), não fazia uso de terapia compressiva (81,8%), tratando a lesão há mais de 6 meses(77,3%), ausência de orientações para o uso de terapia compressiva, elevação de membros inferiores e exercícios regulares (77,3%) e  consulta ao angiologista no último ano (52,3%). Quanto aos aspectos clínicos da lesão verificou-se que a maioria das lesões são recidivantes (77,3%), com mais de um ano de lesão atual (52,3%), lesões médias a grandes (54,8%), sem sinais de infecção (61,3%) e com presença de dor (79,5%). A média da AE dos pesquisados foi de 9,3 (± 5,1). A análise das relações entre a AE e as variáveis sociodemográficas, de saúde, assistenciais e clínicas mostraram que os indivíduos sem companheiro(a) (p=0,01), que não usavam terapia compressiva (p=0,04), com mais de 6 meses de tratamento (p=0,01) e com lesões maiores (p= 0,01) apresentaram AE mais baixa. As médias dos domínios e a dimensões do SF-36 foram baixos destacando-se a capacidade funcional 36,5 (± 27,6) e os aspectos físicos 15,3 (± 30,6). Verificou-se correlações significativas entre AE das pessoas com UV e os domínios e dimensões do SF-36: capacidade funcional (r= -0,432), estado geral de saúde (r= -0,415), vitalidade (r= -0,573), aspectos sociais (r= -0,517), saúde mental (r= -0,612) e dimensões saúde mental (r= -0,612) e saúde física (r= -0,473). Conclui-se que o estado civil, uso de terapia compressiva, tempo de lesão e de tratamento, tamanho do úlcera e sinais de infecção estão associados a AE de pessoas com UV e verificou-se correlação entre a AE e a QV das pessoas com UV.

16
  • ROSEMARY ALVARES DE MEDEIROS
  • O conforto do idoso em pós-operatório na perspectiva do enfermeiro.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • ANA CRISTINA ARAUJO DE ANDRADE GALVAO
  • ALEXSANDRO SILVA COURA
  • INÁCIA SÁTIRO XAVIER DE FRANÇA
  • Data: Jul 31, 2014


  • Show Abstract
  • Objetivou-se identificar o cuidado realizado pelo enfermeiro para o conforto de pacientes idosos em pós-operatório. Especificamente objetivou-se: 1) Identificar a perspectiva dos enfermeiros sobre os desconfortos nos contextos físico, psicoespiritual, ambiental e sociocultural evidenciados em idosos no pós-operatório; 2) Verificar as características definidoras e os fatores relacionados inseridos ao diagnóstico de enfermagem conforto prejudicado, identificados pelos enfermeiros no idoso em pós-operatório; 3) Identificar as intervenções de enfermagem para promoção do conforto ao idoso em pós-operatório realizadas pelos enfermeiros no seu cuidar. Trata-se de uma pesquisa exploratória, descritiva, de abordagem quantitativa, desenvolvida em um hospital universitário do Município de Natal/RN, Brasil. A população foi constituída pelos 30 enfermeiros que trabalhavam em unidades de internação cirúrgica e terapia intensiva e que prestavam atendimento à pacientes idosos em pós-operatório. Consideraram-se critérios de inclusão: ter tempo mínimo de seis meses de atividade no setor e fazer parte da escala de serviço no período da coleta dos dados. Como critérios de exclusão: estar de licença ou férias no momento da coleta de dados. Toda população formou o grupo de sujeitos do estudo. A coleta de dados foi concretizada em maio e junho de 2014 utilizando um questionário autoexplicativo, composto por quatro partes: I - Caracterização dos enfermeiros; II - Necessidades de conforto do idoso no pós-operatório; III - Diagnóstico de Enfermagem; IV - Intervenções de enfermagem. O projeto foi aprovado pelo Comitê de Ética em Pesquisa (CEP) da Universidade Federal do Rio Grande do Norte, sob CAAE25976613.7.0000.5537. Os dados foram tabulados no Statistical Package for the Social Sciences (SPSS) 20.0 e apresentados utilizando-se frequências, percentuais e medidas de tendência central. Os resultados mostram que 96,7% dos enfermeiros conceituaram conforto como sinônimo de bem-estar. Houve maior frequência do desconforto dor (100%), ruídos excessivos (56,7%), sensação de deslocamento do ambiente residencial (76,7%) e ansiedade (93,3%). Os enfermeiros evidenciaram como sinais e sintomas que caracterizam o desconforto do idoso após cirurgia, principalmente: dor (75,9%), inquietação (58,6%), sinais vitais (41,4%) e ansiedade (34,5%). O principal fator relacionado foi o efeito secundário relacionado ao tratamento (88%). As principais intervenções realizadas foram: ouvir atentamente (100%) e controle da dor (100%). Estas foram igualmente analisadas como prioritárias para esta ação de cuidado, na porcentagem de 76,7% e 66,7%, respectivamente. Conclui-se que os enfermeiros identificam os desconfortos que afetam os idosos no pós-operatório na diversidade dos contextos estudados, com uma ênfase maior aos desconfortos físicos e em especial, a dor. Além disso, possuem uma percepção ampliada sobre os possíveis sinais e sintomas apresentados pelos idosos em pós-operatório quando estão desconfortáveis, uma vez que evidenciam outras 12 características não previstas no Diagnóstico de Enfermagem Conforto prejudicado e também identificam os fatores relacionados a estes desconfortos. Entretanto, apesar de afirmarem que realizam intervenções para amenizá-los e as registrarem, estes dados não podem ser afirmados que se trata de um padrão da prática destes profissionais, uma vez que não foi realizado a observação do cuidado prestado a esta clientela nem avaliação dos prontuários.

17
  • SAMILLY MÁRJORE DANTAS LIBERATO
  •  

     Análise da adesão ao tratamento e da qualidade de vida de pessoas com úlcera venosa.

     

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARINA DE GÓES SALVETTI
  • RAIONARA CRISTINA DE ARAUJO SANTOS
  • Data: Aug 1, 2014


  • Show Abstract
  •  

     

     

    A adesão terapêutica ainda é um grande problema entre pessoas com úlceras venosas (UV), pois o tratamento é longo, dispendioso e demanda alterações no estilo de vida. Nesse contexto, este estudo tem como objetivo geral analisar a adesão ao tratamento e a qualidade de vida (QV) das pessoas com UV atendidas na atenção primária à saúde. Trata-se de um estudo analítico, transversal com abordagem quantitativa de tratamento e análise de dados. O estudo teve como cenário 13 Unidades de Saúde da Família e 02 Unidades Mistas da cidade de Natal. A população alvo foi composta por 44 pessoas com UV indicadas pelas equipes da Estratégia Saúde da Família entre fevereiro e abril de 2014. Foram utilizados três instrumentos: um instrumento de caracterização dos aspectos sociodemográficos, de saúde e da assistência, a Escala Multidimensional de Adesão Terapêutica composta pelas dimensões: estilo de vida saudável, terapia compressiva e vigilância neurovascular e o Charing Cross Venous Ulcer Questionnaire (CCVUQ) que avalia QV em pessoas com UV, composto pelos domínios: Escore Total, Interação Social, Atividades Domésticas, Estética e Estado Emocional. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, CAAE: 07556312.0.0000.5537. Os dados referentes à caracterização sociodemográfica demonstram que houve predominância do sexo feminino (65,9%), faixa etária a partir de 60 anos (59,1%) e renda de até 1 salário mínimo (81,8%). Com a caracterização de saúde, evidenciou-se que a maioria das pessoas relataram doenças crônicas associadas (63,6%), sono maior que 6 horas (81,8%), dor presente (81,8%), negando etilismo (86,4%) e tabagismo (77,3%) e apresentaram número de recidivas maior ou igual a 1 (77,3%). Relativo à adesão terapêutica verificou-se que na dimensão terapia compressiva há pior adesão. Não foram encontradas associações entre os domínios da adesão e as variáveis sociodemográficas e de saúde. Observou-se, no entanto, melhor adesão entre os indivíduos sem dor e com maior escolaridade. Quando analisadas as médias das dimensões da adesão terapêutica com as características da assistência observou-se significância estatística entre: adesão à terapia compressiva e orientação para uso de terapia compressiva (p-valor = 0,002) e orientação para exercícios regulares (p-valor = 0,026). Considerando a média do escore total do CCVUQ (média 51,47 e DP 18,33) observa-se que a QV geral dos pesquisados tem valor aproximado ao da mediana da escala (50). As médias dos domínios Interação Social (média 44,23 e DP 21,38) e Atividades Domésticas (média 45,70 e DP 23,21) foram os que revelaram melhor QV. Verificaram-se correlações fracas, porém significativas entre adesão à dimensão estilo de vida saudável e os domínios Escore Total (p-valor = 0,012), Interação Social (p-valor = 0,048), Estética (p-valor = 0,025) e Estado Emocional (0,017) do CCVUQ. A partir da análise dos dados conclui-se que entre as pessoas com UV a pior adesão refere-se à dimensão terapia compressiva. Além disso, não foi constatada significância estatística na associação entre a adesão ao tratamento e as características sociodemográficas e de saúde. Acrescenta-se que houve correlação apenas entre a dimensão estilo de vida saudável e os domínios do CCVUQ.

     

18
  • QUINIDIA LUCIA DUARTE DE ALMEIDA QUITHE DE VASCONCELOS
  • Atuação e o conhecimento dos profissionais de enfermagem quanto a morte encefálica e manuntenção do potencial doador de órgãos e tecidos para transplantes.

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARINA DE GÓES SALVETTI
  • Data: Aug 14, 2014


  • Show Abstract
  • Ao longo dos anos, o transplante de órgãos e tecidos tornou-se uma importante alternativa para o tratamento de algumas doenças consideradas em estágio terminal. Assim, para a efetivação do processo de transplante, torna-se necessário fornecer um tratamento adequado ao potencial doador de órgãos e tecidos com o intuito de prevenir disfunções orgânicas e manter o padrão hemodinâmico durante o processo de doação de órgãos e tecidos. Nesse sentido, objetivou-se analisar a atuação dos profissionais de saúde na manutenção do potencial doador de órgãos e tecidos para transplante. Trata-se de um estudo exploratório descritivo, longitudinal, prospectivo e quantitativo de tratamento e análise dos dados, sendo parte integrante da tese intitulada “Fatores determinantes da qualidade do processo de doação de órgãos e tecidos para transplantes no Estado do Rio Grande do Norte”. Foi desenvolvido na Central de Captação, Notificação e Doação de Órgãos para transplantes, Organização de Procura de Órgãos e em seis unidades hospitalares credenciadas para captação e transplante de órgãos e tecidos, em Natal-RN, entre agosto de 2010 e fevereiro de 2011, mediante aprovação do projeto de pesquisa pelo Comitê de Ética em Pesquisa, CAAE 007.0.294.000-10. A amostra probabilística sem reposição foi composta por 65 potenciais doadores. Como instrumento de coleta de dados foi utilizado um roteiro estruturado de observação não participante do tipo checklist. Os dados coletados foram exportados para o Microsoft Excel 2007, organizados, tabulados e transferidos para o Programa Estatístico SPSS versão 20.0, sendo analisados por meio da estatística descritiva e apresentados em forma de tabelas, quadro e gráficos. Predominou o sexo feminino, média de idade de 41 anos, ensino fundamental incompleto, exercendo uma atividade profissional, renda familiar de 1 a 3 salários mínimos, católicos e solteiros. Os potenciais doadores estavam internados em Unidades de Terapia Intensiva com diagnóstico de acidente vascular encefálico. Os órgãos mais doados foram o rim e o fígado. 89,2% realizaram a tipagem sanguínea, 80,0% testes hematológicos e verificação dos eletrólitos, cada. Quanto às funções, 70,8% realizaram exames para a verificação da função pulmonar, 80,0% para a função renal. Das alterações detectadas, 69,2% apresentaram hiperóxia, 66,2% leucocitose, 47,7% hipernatremia, 43,1% elevação na creatina fosfoquinase, 10,0% com sorologia positiva. Exames importantes não foram realizados. É fundamental avaliar potenciais doadores para detectar e tratar alterações, garantindo a qualidade dos órgãos e realização do transplante.

19
  • JULIA GOMES FERNANDES COSTA DE SANT ANNA
  • A psicodinâmica do trabalho de professores de ensino superior de Enfermagem de Natal/RN

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • JOÃO BOSCO FILHO
  • MAURICIO ROBERTO CAMPELO DE MACEDO
  • REJANE MARIA PAIVA DE MENEZES
  • SORAYA MARIA DE MEDEIROS
  • Data: Aug 29, 2014


  • Show Abstract
  • Esta pesquisa teve como objetivo analisar os fatores geradores de prazer e sofrimento no trabalho do professor de Ensino Superior de Enfermagem.  Trata-se de um estudo do tipo analítico, com abordagem qualitativa. Ocorreu no período de 14 a 22 de novembro de 2013 em uma instituição de ensino superior do município de Natal/RN com sete professores da graduação de enfermagem selecionados a partir dos critérios de inclusão: docentes do curso de enfermagem, enfermeiros, professores de aula teórica. Obteve parecer favorável do Comitê de Ética em Pesquisa/UFRN (CAAE nº 20727613.9.0000.5537). A coleta de dados foi realizada através da aplicação de entrevistas individuais com roteiro semi-estruturado contendo questões norteadoras relativas à organização do trabalho, reconhecimento, liberdade, desgaste e insegurança. Para a análise dos dados foi utilizada a técnica de análise de conteúdo a qual pretende superar o conteúdo manifesto da mensagem para, através da inferência, atingir uma interpretação mais profunda. Os resultados desse estudo conduziram à interpretação de duas categorias analíticas: o sofrimento e o prazer no trabalho do enfermeiro docente e suas subcategorias correspondentes. Os sujeitos identificaram como barreiras no trabalho: insuficiência de tempo remunerado, necessidade de qualificação, necessidade de dedicar-se a outras tarefas, carência de recursos humanos, carência de recursos materiais, burocracia, quantidade de alunos em sala de aula e nivelamento dos alunos.  Constatou-se por meio da análise da Psicodinâmica do Trabalho e dos resultados apresentados que o sofrimento pode emergir entre o ser humano e a organização do trabalho quando não são possíveis a negociação e a liberdade de invenções do trabalhador sobre seu labor na tentativa de adaptá-lo às suas necessidades. Quando são estreitas as margens para a adaptação desejada, é possível o surgimento do sofrimento mental, tornando o individuo fragilizado e mais susceptível ao adoecimento. Diante disso, torna-se evidente que não apenas o sofrimento, mas também o prazer origina-se de uma dinâmica interna de situações e da organização do trabalho. Situações que num dado momento aquilo que o faz sofrer pode se transformar como fonte de prazer. Assim, o prazer-sofrimento não são excludentes, confirmando o aspecto dialético do arcabouço apresentado na teoria, ainda que para a organização de trabalho seja significativo que haja o predomínio do prazer em relação ao sofrimento. Entender a influência da organização na qualidade de vida, na saúde mental e na geração de sofrimento psíquico dos trabalhadores é de suma importância para a superação e transformação das organizações de trabalho.

20
  • RAFAELE CARLA DE ARAÚJO MAIA
  • O atendimento do enfermeiro aos acidentados de trânsito terrestre.

  • Advisor : REJANE MILLIONS VIANA MENESES
  • COMMITTEE MEMBERS :
  • JOÃO BOSCO FILHO
  • REJANE MARIA PAIVA DE MENEZES
  • REJANE MILLIONS VIANA MENESES
  • RODRIGO ASSIS NEVES DANTAS
  • SORAYA MARIA DE MEDEIROS
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: Sep 30, 2014


  • Show Abstract
  • Considerada a doença do século XX, o trauma continua sendo a principal causa de mortalidade na faixa etária de um a quarenta e quatro anos no Brasil e, dentre as várias etiologias possíveis, o acidente de trânsito terrestre tem forte impacto nestas estatísticas. A essencialidade operacional do enfermeiro na organização e integração deste cenário de atendimento aos acidentados de trânsito terrestre e o reconhecimento que os instantes que sucedem o trauma são decisivos no prognóstico da vítima motivaram este estudo Assim, buscou-se avaliar o atendimento do enfermeiro aos acidentados de trânsito terrestre neste processo crucial em hospital público de referência em urgência e emergência. Trata-se de estudo avaliativo normativo com abordagem qualitativa realizado no Hospital Monsenhor Walfredo Gurgel, localizado no município de Natal/RN. A coleta de dados decorreu no mês de maio/2014 com aprovação do Comitê de Ética em Pesquisa (CAAE 27971114.9.0000.5537). A população alvo do estudo foram os enfermeiros que atuam no setor de Politrauma, atendendo aos critérios de inclusão: concordar em fazer parte do estudo voluntariamente e atuar no setor mencionado e como exclusão: profissionais alocados em outros setores (eventualmente atuando no setor) e profissionais de férias e/ou licença médica. Realizou-se entrevista semiestruturada e observação não participante para a obtenção dos dados submetidos posteriormente à técnica de Análise de Conteúdo à luz de Bardin. Identificou-se a falta de capacitação específica para o atendimento ao trauma cuja gravidade pode ser atenuada com assistência adequada e hábil. Evidenciou-se, portanto, a premência do treinamento dos enfermeiros visando à qualificação dos atendimentos às vítimas de acidentes de trânsito terrestre.

21
  • RHAYSSA DE OLIVEIRA E ARAUJO
  • Autoeficácia e qualidade de vida de pessoas com úlcera venosa atendidas na atenção primária à saúde

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MARINA DE GÓES SALVETTI
  • Data: Oct 23, 2014


  • Show Abstract
  • As úlceras venosas (UV) são resultado da insuficiência ou obstrução venosa profunda, que levam à hipertensão venosa nos membros inferiores e surgimento de lesões. Autoeficácia é a crença na habilidade de desempenhar com sucesso determinada tarefa ou de apresentar um comportamento que leve a um resultado desejável. A enfermagem necessita conhecer a relação entre autoeficácia e qualidade de vida (QV) na ocorrência das UVs, na busca de exercer o cuidado holístico. Dessa maneira, este estudo objetivou analisar a relação da autoeficácia para controle da dor e para funcionalidade com a QV de pessoas com UV na atenção primária à saúde. Trata-se de um estudo transversal, analítico, quantitativo, realizado com pessoas com UV em unidades de estratégia de saúde da família e unidades mistas de saúde em Natal/RN. Como instrumentos foram utilizados questionário de caracterização sociodemográfica e de saúde, os domínios autoeficácia para dor e autoeficácia para funcionalidade do de uma escala de autoeficácia para dor crônica e o Charing Cross Venous Ulcer Questionnaire (CCVUQ). A amostra totalizou 101 pessoas na escala de autoeficácia para funcionalidade e 89 na autoeficácia para dor, pois doze indivíduos relataram não sentir dor no momento da coleta, e por isso, foram excluídos da aplicação da escala de autoeficácia para dor. O projeto obteve parecer favorável do comitê de ética do Hospital Universitário Onofre Lopes (CAAE nº 07556312.0.0000.5537), atendendo a resolução 466/12. Houve predomínio de mulheres (66,3%), idosos (61,4%), casados ou em união estável (63,4%), baixa renda (90,1%) e escolaridade (85,1%), inativos (75,2%), doenças crônicas associadas (60,4%), mais de seis horas de sono/dia (82,2%), não etilistas/tabagistas (80,2%), lesão crônica (73,3%) e dor moderada à intensa (76,2%). A autoeficácia para dor (média 67,3 e DP 26,6) esteve menos comprometida que a autoeficácia para funcionalidade (média 59,4 DP 25,9), apresentando significância estatística (p-valor=0,011). Não foram encontradas associações significativas entre autoeficácia para controle da dor e para funcionalidade com as características sociodemográficas e de saúde. Ao se considerar a média total do CCVUQ (média 52,1 e DP 16,6), a QV dos pesquisados apresentou tendência de piora, sendo o domínio estética o mais comprometido (média 57,6 e DP 24,0), seguido de estado emocional (média 57,0 e DP 25,7), interação social (média 48,4 e DP 21,4) e atividades domésticas (média 43,6 e DP 23,3).Verificaram-se correlações negativas e significativas entre a autoeficácia para dor e o escore total do CCVUQ (r = -0,345; p = 0,001), o domínio interação social (r = -0,339; p = 0,001), atividades domésticas (r = -0,314; p = 0,003) e estado emocional (r = -0,219; p = 0,039). Da mesma maneira, entre autoeficácia para funcionalidade e o escore total do CCVUQ (r = -0,565; p < 0,001), o domínio interação social (r = -0,604; p < 0,001), atividades domésticas (r = -0,647; p < 0,001) e estado emocional (r = -0,260; p = 0,009). O domínio estética apresentou correlação negativa, porém fraca e não significativa com a autoeficácia para dor (r = -0,135; p = 0,206) e para funcionalidade (r = -0, 183; p = 0,068). O estudo evidenciou um comprometimento da autoeficácia para controle da dor e para funcionalidade e da QV em pessoas com UV, indicando a necessidade de atuação da enfermagem em estratégias para melhorar esses aspectos, contribuindo na cicatrização das lesões.

22
  • FERNANDA BEATRIZ BATISTA LIMA E SILVA
  • Análise de conceito do diagnóstico de enfermagem autocontrole ineficaz da saúde em pacientes submetidos à hemodiálise.

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • ALEXSANDRA RODRIGUES FEIJAO
  • BERTHA CRUZ ENDERS
  • ALEXSANDRO SILVA COURA
  • NIRLA GOMES GUEDES
  • Data: Nov 7, 2014


  • Show Abstract
  • O processo de validação contribui para o aumento da confiabilidade dos dados quanto processo de inferência diagnóstica na prática clínica do enfermeiro. Assim, o objetivo do trabalho foi analisar o conceito do diagnóstico de enfermagem autocontrole ineficaz da saúde em pacientes submetidos à hemodiálise. Estudo de análise de conceito, baseado no modelo Walker e Avant e operacionalizado através da revisão integrativa da literatura. As bases de dados pesquisadas foram: SCOPUS, CINAHL, PUBMED, LILACS e COCHRANE, com os descritores: Self-management, Adherence e Hemodialysis. Os critérios de inclusão estabelecidos foram: artigos publicados nos últimos 5 anos, artigos completos disponíveis gratuitamente nas bases de dados selecionadas; artigos disponíveis nos idiomas Português, Inglês ou Espanhol; e artigos que abordam o conceito autocontrole da saúde, os antecedentes e os consequentes. E os de exclusão: editoriais, cartas ao editor, teses e dissertações. O levantamento dos artigos ocorreu nos meses de janeiro a março de 2014. A amostra inicial foi de 16785 artigos, sendo 11748 na PUBMED, 4767 na Scopus,174 na CINAHL, 70 na Cochrane e 26 na LILACS. Após a aplicação dos critérios, foram selecionados 76 artigos, sendo 19 na CINAHL, 18 na PUBMED, 30 na Scopus e 9 na LILACS. Na análise dos dados, tendo em vista que o conceito buscado na literatura foi autocontrole da saúde, realizou-se a interpretação para o diagnostico autocontrole ineficaz da saúde, através da transposição para a negação dos atributos, antecedentes e consequentes identificados. Ressalta-se que termos identificados na literatura como características definidoras e fatores relacionados do diagnóstico em estudo foram acrescentados à pesquisa, mesmo não sendo possível a transposição para o termo oposto. Os resultados mostram que o conceito elaborado para o diagnóstico autocontrole ineficaz da saúde foi: Inabilidade do paciente para controlar hábitos e alcançar as metas terapêuticas acordadas com os profissionais, resultando em complicações à saúde. Foram identificados 33 antecedentes, relacionados a aspectos sociais, psicológicos e da terapêutica e 16 consequentes, envolvendo aspectos fisiológicos, sociais, psicológicos e da terapêutica. Dessa forma, percebe-se que o conceito autocontrole ineficaz da saúde é amplo, envolvendo aspectos individuais do paciente, da terapêutica e da relação entre o paciente e os profissionais. Acredita-se que esta análise de conceito contribuiu para o aprimoramento desse diagnóstico e de seus componentes. Diante disso, será possível a proposição de intervenções direcionadas à essa população especificamente. Estudos dessa natureza são base importante para o crescimento corpo científico da enfermagem, caracterizando a base teórica do conhecimento. Assim representam elementos fundamentais para subsidiar o desenvolvimento das tecnologias em enfermagem.

23
  • DÉBORAH RAQUEL CARVALHO DE OLIVEIRA
  • A prática do enfermeiro da Atenção Primária à Saúde nas consultas ao paciente com tuberculose.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ALEXSANDRO SILVA COURA
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • GREICY KELLY GOUVEIA DIAS BITTENCOURT
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Nov 11, 2014


  • Show Abstract
  • Este estudo objetivou avaliar o desenvolvimento do processo de enfermagem nas consultas de enfermagem ao paciente com tuberculose. Especificamente, identificou as ações do enfermeiro na consulta de enfermagem a pessoas com tuberculose nas unidades de atenção primária à saúde; avaliou a consulta de enfermagem ao paciente com tuberculose quanto ao desenvolvimento do processo de enfermagem; e identificou a percepção dos enfermeiros quanto à viabilização do processo de enfermagem na consulta de enfermagem ao paciente com tuberculose no âmbito da Atenção Primária à Saúde. Trata-se de um estudo do tipo descritivo com abordagem quantitativa. Foi desenvolvido com 60 enfermeiros das unidades de atenção primária à saúde do município de Natal, RN. O projeto foi encaminhado para apreciação ética, por meio do envio eletrônico à Plataforma Brasil, em respeito à normatização da Resolução Nº 466/2012 do Conselho Nacional de Saúde, referente aos aspectos éticos da pesquisa envolvendo seres humanos e foi aceito pelo Comitê de Ética em Enfermagem, com CAAE nº 31266314.9.0000.5537. Para a coleta de dados, utilizou-se um questionário estruturado, desenvolvido a partir do item “Consulta de Enfermagem”, do Protocolo de Enfermagem para o Tratamento Diretamente Observado da Tuberculose na Atenção Básica, do Ministério da Saúde, disponível para acesso livre. O instrumento foi submetido a pré-teste e continha questões referentes aos elementos que o enfermeiro utilizava durante a consulta ao paciente com tuberculose e uma questão aberta sobre a viabilidade de implantação do Processo de Enfermagem na Atenção Primária à Saúde. A coleta de dados foi realizada no período de setembro à outubro de 2014, nas unidades de saúde de trabalho de cada participante da pesquisa Os dados foram analisados por meio de recursos estatísticos, através do Programa IBM SPSS 20.0, de versão livre para uso. Para identificação das ações desenvolvidas pelo enfermeiro na consulta ao paciente com tuberculose, foi utilizada a estatística descritiva e análise referenciada em protocolos do Ministério da Saúde e conceitos teóricos de Enfermagem para o desenvolvimento da consulta de enfermagem. Observou-se um desmembramento do processo de enfermagem, uma vez que apenas alguns elementos são desenvolvidos, dentre eles, elementos da coleta de dados (anamnese e exame físico). Na anamnese o foco das ações constitui queixas (100% sempre investigam) e sintomatologia da doença (93,3% sempre investigam). Aspectos sociais e culturais são menos abordados. O exame físico do paciente é realizado de forma fragmentada, com foco sobre a mensuração do peso do paciente (96,8% realizam). O levantamento de diagnósticos de enfermagem, planejamento, implementação e avaliação do plano terapêutico não são realizados completamente no que corresponde ao processo de enfermagem. Os enfermeiros avaliaram o processo de enfermagem como uma metodologia apta a ser implementada na Atenção Primária à Saúde, uma vez ser potencial na melhoria da qualidade da assistência ofertada ao paciente com tuberculose. Os resultados encontrados permitem a reflexão de como vem se dando a prática do enfermeiro na atenção primária à saúde em suas consultas ao paciente com tuberculose. Foi possível estabelecer a não inserção do processo de enfermagem como um todo na consulta de enfermagem ao paciente com tuberculose, contrariando o que preconiza o Ministério da Saúde, além das resoluções que envolvem o direcionamento da prática da enfermagem pelos órgãos conselheiros. 

24
  • DANDARA NAYARA AZEVEDO DANTAS
  • Aplicabilidade clínica do instrumento para consulta de enfermagem na visita domiciliar as pessoas com lesão medular. 

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ALEXSANDRO SILVA COURA
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • INÁCIA SÁTIRO XAVIER DE FRANÇA
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Nov 12, 2014


  • Show Abstract
  • Os instrumentos e tecnologias são importantes para a articulação e intervenção sobre os objetos, auxiliam e asseguram a realização da assistência de enfermagem de maneira sistemática e de forma que possa atender as reais necessidades da clientela. No tocante a consulta de enfermagem às pessoas com lesão medular no âmbito do domicílio, verifica-se que esta não está sendo subsidiada por nenhum instrumento válido. Dessa forma objetiva-se com o presente estudo analisar a aplicabilidade clínica do instrumento para consulta de enfermagem na visita domiciliar as pessoas com lesão medular. Trata-se de um estudo descritivo, de abordagem quantitativa, desenvolvida entre dezembro de 2013 e junho de 2014 nas unidades de saúde do município de Natal/RN, Brasil. A população do estudo foi constituída por enfermeiros atuantes nas unidades básicas de saúde e unidades de saúde da família de Natal. Foram incluídos os profissionais que tivesse usuário com lesão medular residente em área territorial segura para realização da visita domiciliária no período de coleta de dados, que tenham recebido capacitação para utilizar o instrumento em estudo e que concordaram com a gravação em vídeo da consulta de enfermagem na visita domiciliar à pessoa com LM utilizando o instrumento do estudo. Foram excluídos os enfermeiros que estavam em licença ou afastados de suas atividades assistenciais. Foram utilizados quatro instrumentos estruturados para realização da coleta de dados. O estudo foi aprovado pelo Comitê de Ética em Pesquisa (CEP) da Universidade Federal do Rio Grande do Norte (UFRN), com o parecer nº 019/2013 e CAAE 0248.0.051.000-11. Os dados foram analisados através de estatística descritiva. Os enfermeiros eram predominantemente do sexo feminino (90,9%), brancos (63,6%), casados (45,5%), católicos (72,7%), e apresentavam em média 46,86 anos (mín.29; máx.60; ± 7,4). Quase a totalidade (95,5%) tiveram uma percepção positiva da experiência de aplicar o instrumento na prática clínica. Destes, 54,5% acharam a experiência boa ou ótima; 22,5% válida ou proveitosa ou interessante ou importante ou inovadora; 9,1% positiva e 9,1% norteadora. Um enfermeiro (4,5%) achou a experiência complicada. Quanto à viabilidade de utilização do INCEVDOP-LM na prática clínica, 63,6%dos participantes afirmaram ser viável o uso do instrumento em sua prática clínica, 27,3% asseguraram o uso apenas se for realizado alguns ajustes no instrumento e 9,1% não utilizariam esta ferramenta de investigação. Conclui-se que o instrumento norteia a consulta de enfermagem na visita domiciliar às pessoas com lesão medular e contribui para uma avaliação detalhada do indivíduo. Da forma como está descrito causou confusão em alguns profissionais quanto à alternativa que deveria assinalar. Dessa forma, acredita-se que o instrumento é passível de ser utilizado na prática clínica dos enfermeiros caso sejam realizados algumas alterações que o torne mais prático, claro, objetivo e direto e facilite a utilização por esses profissionais. Além disso, sugere-se que outros estudos sejam desenvolvidos para que possa validar clinicamente este instrumento.

25
  • ISAIANE DA SILVA CARVALHO
  • Avaliação da qualidade da assistência à mulher e ao filho durante o parto normal.

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • ROSINEIDE SANTANA DE BRITO
  • BERTHA CRUZ ENDERS
  • CLEIDE MARIA PONTES
  • Data: Nov 14, 2014


  • Show Abstract
  • O estudo objetivou avaliar a qualidade da assistência prestada à mãe e ao filho durante o parto normal em maternidades públicas de Natal-RN, Brasil. Para tanto, desenvolveu-se de um estudo transversal, com abordagem quantitativa, em duas maternidades públicas municipais que prestam assistência às parturientes de risco habitual (maternidades A e B). Participaram do estudo puérperas, cujo filho nasceu vivo, pela via transpélvica, com idade gestacional entre 37 e 42 semanas, início de trabalho de parto espontâneo ou induzido, e que apresentaram condições físicas e emocionais para responder aos questionamentos propostos. A amostra constituiu-se por 314 puérperas atendidas no período de abril a julho de 2014. O instrumento de coleta de dados foi construído com base nas recomendações da World Health Organization para a assistência ao parto normal e validado por juízes avaliadores, tendo a versão final obtido concordância ótima (k=0,96; IVC=0,99). Associado a tais recomendações, utilizou-se três indicadores para avaliar a qualidade da assistência ao parto normal: porcentagem de mulheres com trabalho de parto induzido ou submetidas à cesariana eletiva (Indicador A); porcentagem de mulheres atendidas por um profissional de saúde qualificado em trabalho de parto e parto (Indicador B); e Índice de Bologna (Indicador C). A pesquisa iniciou-se após recebimento de parecer favorável do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte sob nº 562.313 e CAAE: 25958513.0.0000.5537. Para análise das categorias relacionadas às recomendações da World Health Organization utilizou-se frequência absoluta e relativa e os testes Qui-quadradro de Pearson e Exato de Fisher compararam as diferenças observadas entre as duas maternidades. Ademais, calculou-se a porcentagem dos indicadores A e B e por meio dos resultados obtidos pelo Indicador C a qualidade foi avaliada da seguinte maneira: quanto mais próximo de 5 melhor a qualidade e quanto mais próximo de 0 pior a qualidade, sendo a mediana (2,5) utilizada para classificar a assistência em adequada ou inadequada e o teste U de Mann-Whitney para comparar as diferenças de médias obtidas. Considerou-se em todos os testes estatísticos nível de significância de 5%. Para as categorias da World Health Organization as diferenças entre as maternidades foram identificadas quanto ao oferecimento de líquidos por via oral (p=0,018), estímulo a posições não supinas (p=0,002), existência de partograma (p=0,001), apoio ou acolhimento pelos profissionais de saúde (p=0,047), infusão intravenosa (p<0,001), posição supina (<0,001), uso de ocitocina (<0,001), restrição hídrica e alimentar (p=0,002), e o fato do toque ser realizado por mais de 01 examinador (p=0,011), com piores resultados, em geral, para a maternidade B. Os indicadores A e B apresentaram percentuais de 13,09% e 100,00%, respectivamente. A média geral do Índicador C foi igual 2,07 (±0,74). Houve diferença estatisticamente significativa entre as médias das maternidades (p<0,001). Faz-se necessário a implementação de melhorias e readequação do modelo obstétrico vigente, especialmente para a maternidade B, visto nessa instituição ser evidenciada inadequação em diversos aspectos avaliados.

26
  • RAPHAEL RANIERE DE OLIVEIRA COSTA
  • A SIMULAÇÃO REALÍSTICA COMO ESTRATÉGIA DE ENSINO APRENDIZAGEM EM ENFERMAGEM

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • FRANCISCO EDILSON LEITE PINTO JUNIOR
  • JOÃO BOSCO FILHO
  • REJANE MARIA PAIVA DE MENEZES
  • REJANE MILLIONS VIANA MENESES
  • SORAYA MARIA DE MEDEIROS
  • Data: Nov 14, 2014


  • Show Abstract
  • O estudo tem por objetivo geral analisar a metodologia da simulação realística como instrumento facilitador do processo de ensino aprendizagem em enfermagem, e como objetivos específicos implantar a metodologia da simulação realística na matriz curricular da disciplina Atenção Integral a Saúde II; conhecer a percepção dos discentes da graduação em enfermagem sobre a metodologia da simulação; elencar os pontos negativos e positivos dos cenários construídos e executados na disciplina de Atenção Integral a Saúde II; e avaliar a expectativa e satisfação discente a partir do uso da simulação no contexto do componente curricular de Atenção Integral a Saúde II. Este estudo justifica-se pela possibilidade de inserir e analisar modalidades metodológicas que são utilizadas nos espaços formativos em saúde e enfermagem. Propor e averiguar conduções que vislumbrem melhorias no processo de formação é de suma relevância na perspectiva de mensurar os impactos atribuídos a novas estratégias de ensino e aprendizagem. Trata-se de um estudo descritivo com abordagem quanti-qualitativa, do tipo pesquisa-ação, que teve como foco de investigação a simulação realística no contexto da formação em saúde e enfermagem a partir da sua implantação em uma disciplina da graduação em enfermagem em uma Instituição de Ensino Superior (IES) Pública. A pesquisa foi desenvolvida na disciplina de Atenção Integral a Saúde II do Curso de Bacharelado em Enfermagem. Esta disciplina é ofertada no terceiro ano do curso objeto desse estudo, e tem a finalidade de preparar o acadêmico de enfermagem para os diversos cenários de Atenção Primária em Saúde. Obteve parecer favorável do Comitê de Ética em Pesquisa/UFRN (CAAE nº 25928714.8.0000.5537), atendendo a resolução 466/12 do Conselho Nacional de Saúde (CNS). A população do estudo foi composta por 40 sujeitos: 37 discentes e 3 docentes da disciplina. A coleta de dados aconteceu no período de fevereiro a maio de 2014 e deu-se por meio de questionários e entrevistas semiestruturados. Para tanto, seguiu-se a seguinte sequencia: identificação do uso da simulação na disciplina alvo da intervenção; consulta a docentes sobre a possibilidade de execução da pesquisa; averiguação da ementa da disciplina, objetivos, competência e habilidades; elaboração do esquema de execução da intervenção; elaboração do checklist para treinamento de habilidades; construção e execução dos cenários de simulação e avaliação dos cenários. Os dados quantitativos foram analisados a partir da estatística descritiva simples, percentual, e os qualitativos através do Discurso do Sujeito Coletivo. A simulação de alta fidelidade foi inserida no componente curricular da disciplina objeto da pesquisa, a partir do uso de paciente-padrão. Foram criados e executados 3 casos. Na visão discente, a simulação contribuiu para a síntese dos conteúdos trabalhados durante a disciplina de atenção integral a saúde II (100%), atribuindo notas entre 8 e 10 (100%) aos cenários executados. Além disso, a simulação gerou um percentual considerável de grandes expectativas para as atividades da disciplina (70,27%) e também se mostrou como uma estratégia geradora de satisfação discente (97,30%). Dos 97,30% que sinalizaram estarem bastante satisfeitos com as atividades acadêmicas proposta pela disciplina de Atenção Integral a Saúde II, 94,59% da amostra apontou a simulação como um  fator determinante para a atribuição dessa satisfação. No tocante a percepção discente sobre a estratégia da simulação, a categoria mais destacada foi à possibilidade de vivência prévia da prática (23,91%). O nervosismo foi um dos pontos negativos mais citados a partir da vivência nos cenários simulados (50,0%). O ponto positivo mais representativo (63,89%) perpassa a ideia de aproximação com a realidade da Atenção Básica. Além disso, os docentes da disciplina, no total de 3, foram capacitados na metodologia da simulação. O estudo ressaltou a contribuição da simulação realística no contexto do ensino e aprendizagem em Enfermagem e evidenciou esta estratégia enquanto mecanismo gerador de expectativa e satisfação entre discente da graduação em Enfermagem.

27
  • PATRICIA CABRAL FERREIRA
  • Nursing Activities Score: avaliação da carga de trabalho de enfermagem em Unidade de Terapia Intensiva Adulto. 

  • Advisor : REGIMAR CARLA MACHADO
  • COMMITTEE MEMBERS :
  • CÉSAR CAVALCANTI DA SILVA
  • MARIA TERESA CICERO LAGANA
  • REGIMAR CARLA MACHADO
  • Data: Nov 28, 2014


  • Show Abstract
  • O dimensionamento de recursos humanos em enfermagem é uma ferramenta gerencial essencial para suprir as necessidades da clientela e da Instituição. Quando se trata de Unidade de Terapia Intensiva, em função da gravidade dos pacientes atendidos e da tecnologia empregada que demandam um elevado quantitativo de recursos humanos especializados, existe a necessidade da utilização de instrumentos específicos para medir a carga de trabalho de enfermagem. O Nursing Activities Score é um instrumento validado para mensurar a carga de trabalho de enfermagem em Unidade de Terapia Intensiva que tem demonstrando efetividade. Trata-se de um estudo transversal, com o objetivo de avaliar a carga de trabalho de enfermagem de uma Unidade de Terapia Intensiva adulto por meio da aplicação do Nursing Activities Score. O estudo foi realizado em um hospital privado, referência em oncologia, localizado no Município de Natal/RN, após aprovação pelo Comitê de Ética em Pesquisa sob Parecer sob Parecer nº 558.799 e CAAE 24966013.7.0000.5293. Para a coleta de dados foram aplicados uma ficha de caracterização sociodemográfica do paciente; o Nursing Activities Score para identificar a carga de trabalho de enfermagem; e o instrumento de classificação de pacientes de Perroca, fornecendo dados sobre o grau de dependência dos pacientes em relação aos cuidados de enfermagem. Os dados obtidos foram analisados com o auxílio de um pacote estatístico. As variáveis categóricas foram descritas por frequência absoluta e relativa, ao passo que as numéricas por meio de mediana e intervalo interquartil. Na abordagem inferencial foram utilizados os testes Sperman, Qui-quadrado de Wald, Kruskal Wallis e Mann-Whitney, considerando-se as variáveis estatisticamente significativas aquelas com valores p< 0,05. A avaliação das médias gerais de NAS, considerando os primeiros 15 dias de internação, foi realizada por meio da análise de Estimativa de Equações Generalizadas (GEE) com ajustamento pela variável tempo de internação. A amostra constituiu-se por 40 pacientes, no período de junho a agosto de 2014. Os resultados demonstraram uma média de idade foi de 62,1 (±23,4) com predominância do sexo feminino (57,5%). O mais freqüente tipo de tratamento foi clínico (60,0%), observando-se uma média de permanência de 6,9 dias (±6,5). Em relação à procedência, a maioria dos pacientes (35%) advieram do Centro Cirúrgico. Observou-se uma mortalidade de 27,5%. Foram realizadas 277 medidas do escore NAS e de Perroca, sendo as médias de 69,8% (±24,1) e 22,7% (±4,2), respectivamente. Verificou-se a associação entre o desfecho clínico e valor do Nursing Activities Score nas 24 horas (rp 0,653, p<0,001), assim como entre o grau de depência dos pacientes e a carga de trabalho de enfermagem (rp 0,646, p<0,001). A carga de trabalho de enfermagem encontrada apresentou-se elevada no período analisado, demonstrando que os pacientes internados exigiram uma alta demanda de cuidados. Esses achados geram subsídios para o dimensionamento de pessoal e alocação de recursos humanos no setor, tendo em vista a busca por maior segurança e satisfação do paciente como resultado da assistência intensiva, bem como um ambiente de trabalho favorável à qualidade de vida dos profissionais.

28
  • LAISLA ALVES MOURA
  • Risco de quedas em idosos internados em ambiente hospitalar

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • MARCOS ANTONIO FERREIRA JUNIOR
  • RHANNA EMANUELA FONTENELE LIMA DE CARVALHO
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Dec 5, 2014


  • Show Abstract
  • As quedas, quando ocorrem em ambiente hospitalar, representam um evento adverso e ganham notória importância devido a sua maior prevalência entre idosos e às complicações geradas à evolução clínica desses pacientes. Assim, ações de promoção à saúde e prevenção de agravos tornam-se fundamentais no sentido de oferecer uma hospitalização segura a esses indivíduos. Por isso, objetivou-se caracterizar os fatores de risco de quedas e o comportamento de prevenção de quedas em idosos internados em ambiente hospitalar. Trata-se de uma pesquisa transversal com abordagem quantitativa, realizada com idosos internados nas unidades clínicas de um hospital universitário de Natal/RN/Brasil. A amostra foi delimitada estatisticamente, ao considerar as possíveis perdas e os idosos incluídos na coleta piloto, em 99 participantes, selecionados por meio de uma amostragem consecutiva e por conveniência.  Antecipadamente, este projeto foi aprovado pelo Comitê de Ética na Pesquisa, sob o parecer consubstanciado 121.028 e CAAE 07614812.6.0000.5537. A coleta foi realizada por duas enfermeiras e seis estudantes de graduação em enfermagem devidamente treinados e previamente avaliados, e ocorreu entre os meses de junho e setembro de 2013. Para tanto, utilizou-se instrumentos de anamnese e exame físico, escala de Tinetti, o Mini Mental State Examination e a escala da Nursing Outcomes Classification para avaliação do Comportamento de Prevenção de Quedas. Na análise estatística, utilizou-se os testes de Qui-quadrado, teste U de Mann-Whitney e o Coeficiente de Correlação de Pearson e considerou-se uma significância de 0,05. Conforme verificado, a fadiga (p=0,026) e uso de anticoagulantes (p=0,051) apresentaram associação com a queda nos últimos seis meses. As variáveis Hipertensão Arterial Sistêmica (0,027), deambular com ajuda (p=0,00), limitação para andar (p=0,00), limitação para tomar banho (p=0,005) e limitação para subir escada (p=0,04) apresentaram significância para o desfecho dificuldade para andar. Além desses, a dor (p=0,057), mobilidade prejudicada (p=0,00), marcha segundo Tinetti (0,04) e uso de insulina (p=0,03) também se mostraram significantes para esse desfecho. Quanto ao Comportamento de Prevenção de Quedas, conforme observado, os indicadores solicita auxílio físico para si (p=0,016), controla inquietação (p=0,001) e utiliza ações seguras durante a transferência (p=0,03) apresentaram associação com o risco de queda. Observou-se correlação forte entre marcha e equilíbrio de acordo com a escala de Tinetti (0,874) e correlação moderada entre a marcha a avaliação total do risco de quedas de Tinetti (0,806). Portanto, torna-se fundamental que a equipe de enfermagem e demais profissionais de saúde estejam atentos aos fatores de risco, em especial, aos descritos neste estudo, bem como às medidas de segurança e ao incentivo para a promoção de um comportamento seguro por parte dos pacientes. Este estudo possui cunho descritivo, sem possibilidade de constituir relação causa-efeito. Por isto, recomenda-se pesquisas longitudinais sobre o risco de quedas em idosos com intuito de estabelecer associação dos fatores de risco preditivos para o seu desenvolvimento. Percebe-se ainda a necessidade de sintetizar, comparar e implementar ações preventivas, baseadas em fortes evidências científicas para proporcionar aos idosos uma hospitalização efetivamente segura e livre de incidentes.

29
  • KÁLYA YASMINE NUNES DE LIMA
  • Processo de cuidar de crianças hospitalizadas com câncer.

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • LUCIANA MARTINS DA ROSA
  • QUENIA CAMILLE SOARES MARTINS
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Dec 8, 2014


  • Show Abstract
  • Objetivou-se compreender o processo de cuidar na percepção da criança com câncer hospitalizada. Trata-se de um estudo descritivo, de abordagem qualitativa. Os dados foram coletados entre os meses de outubro de 2013 e janeiro de 2014, através de registros fotográficos, realizados pela criança, e entrevista semiestruturada, constituída por questões referentes à identificação da idade, sexo, diagnóstico e tempo de internação e um roteiro de perguntas relacionado às fotografias reveladas. Foram incluídas oito crianças com idade entre seis e doze anos internadas na instituição hospitalar Policlínica, localizada no município de Natal/RN. Os critérios utilizados para inclusão na amostra corresponderam a: estar internada para tratamento do câncer; apresentar condições físicas favoráveis para realização da coleta de dados; aceitar participar da pesquisa e obtiver autorização do responsável através da assinatura do Termo de Consentimento Livre e Esclarecido (TCLE). Para o tratamento do material coletado, utilizou-se a Análise de Conteúdo, modalidade temática proposta por Bardin. A pesquisa seguiu os princípios éticos e legais que regem a pesquisa científica com seres humanos e realizou-se mediante aprovação do projeto no comitê de ética e pesquisa da Liga Norte Riograndense contra o Câncer com parecer 329.015 e CAAE 16097613.9.0000.5293. Para a criança, o cuidar acontece através de atividades técnicas, como a realização de procedimentos e o uso de equipamentos de proteção individual, como também, por meio do relacionamento dialógico, que favorece o estabelecimento da confiança no cuidar profissional. O cuidar, também, significa desenvolver atividades que promovam o bem estar, a diversão e o seu desenvolvimento social e cognitivo, destacando-se, assim, o lúdico durante a hospitalização, como uma ferramenta auxiliar no processo de cuidar.  Durante a internação, a criança identifica dois sujeitos responsáveis por seu cuidado, o familiar acompanhante e o profissional, sendo os profissionais de enfermagem os mais citados nos momentos de cuidado. Destaca-se, ainda, a promoção do cuidado, na percepção da criança, relacionada à infraestrutura da instituição, a limpeza do ambiente, a higiene corporal, a medicalização e a alimentação. Conclui-se que o cuidado compreendido pela criança, apesar de ainda manter relações com o modelo biomédico, aponta para uma nova perspectiva em que se devem considerar os aspectos biológicos, sociais e psicológicos do adoecer de câncer, sem desvinculá-los das etapas do desenvolvimento infantil. E, que a criança, enquanto ator social ativo desse processo, precisar ser ouvida e atendida em suas necessidades.

30
  • ADRIANA GONÇALVES DE BARROS
  • O processo de cuidar em enfermagem de um centro de tratamento oncológico.

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • LUCIANA MARTINS DA ROSA
  • QUENIA CAMILLE SOARES MARTINS
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Dec 8, 2014


  • Show Abstract
  • Objetivou-se compreender o processo de cuidar em enfermagem de uma unidade de tratamento oncológico a partir da ótica dos profissionais de enfermagem e dos pacientes. Trata-se de uma pesquisa qualitativa, do tipo exploratória e descritiva, realizada em um centro de tratamento oncológico em Natal/RN/Brasil. A coleta de dados ocorreu entre agosto de 2013 e fevereiro de 2014, sendo efetuada por meio de duas técnicas: registro fotográfico e, entrevista semi-estruturada com profissionais de enfermagem e pacientes. A população foi composta por dez profissionais de enfermagem e dez pacientes na clínica cirúrgica da referida instituição. Os critérios utilizados para inclusão dos profissionais foram: ser profissional da área de enfermagem, ser funcionário do hospital, estar inserido na escala de profissionais de enfermagem da instituição no momento da coleta de dados. Quanto aos pacientes, foram incluídos aqueles que possuíam suas capacidades cognitivas preservadas e que estavam internados e em qualquer fase do tratamento. Utilizou-se a Análise de Conteúdo, modalidade temática proposta por Bardin, para a análise do material coletado durante a entrevista semiestruturada. A pesquisa seguiu os princípios éticos e legais que regem a pesquisa científica com seres humanos, sendo realizada mediante aprovação do projeto no comitê de ética e pesquisa da Liga Norte Riograndense contra o Câncer com parecer 295.673 e CAAE 16104313.0.0000.5293. Referente aos profissionais de enfermagem, estes demonstraram visões diversas sobre o cuidado, as quais despontavam desde uma abordagem integral, acolhedora e multiprofissional, bem como tecnicista atrelado à realização de procedimentos e atendimento às prescrições. Ademais, esses sujeitos, também, apontaram que o cuidado se desvela por meio das ações de gerenciamento, na realização dos registros, no atendimento das necessidades do paciente, na humanização da assistência, na ambiência e no desenvolvimento de medidas de conforto e alívio da dor. Frente aos pacientes, destaca-se que, para eles, o cuidado acontece por meio de atitudes de carinho e aproximação do profissional, e através da realização de procedimentos, sendo mencionados como fatores de descuidado a falta de estrutura da instituição e o desconforto gerado por essa condição. Evidenciou-se, ainda, que os atores envolvidos no cuidado, na percepção de profissionais e pacientes, são representados pela equipe de enfermagem, médicos, psicólogos, nutricionistas, bem como auxiliares de cozinha e de limpeza; além do acompanhante, do próprio indivíduo enquanto responsável pelo seu cuidado e do cuidador voluntário. Nesse ensejo, conclui-se que a compreensão do cuidado na ótica dos profissionais de enfermagem e dos pacientes envolvem questões amplas que vão desde percepções de um cuidado dinâmico que abarca elementos complexos e atitudes imbuídas de significados, no qual os sujeitos envolvidos podem assumir tanto o papel de cuidadores como de seres cuidados, até um cuidado atrelado às rotinas prescritas e realização de procedimentos. Assim, os achados descritos remetem a reflexões acerca do cuidado prestado ao paciente oncológico e se este, de fato, traduz os preceitos de uma prática humanizada.

31
  • CAMILA FERNANDES DA SILVA CARVALHO
  • Concepções de mulheres com deficiência física sobre a maternidade.

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • INÁCIA SÁTIRO XAVIER DE FRANÇA
  • MARIA HELENA SOARES DA NOBREGA MAZZO
  • ROSINEIDE SANTANA DE BRITO
  • Data: Dec 8, 2014


  • Show Abstract
  • O estudo objetivou compreender a concepção de mulheres com deficiência física sobre sua capacidade de gestar, parir ou cuidar de um filho. Trata-se de uma pesquisa exploratória, descritiva com abordagem qualitativa desenvolvida em três organizações não-governamentais de Natal, Rio Grande do Norte, Brasil. A coleta de dados ocorreu no período de abril a junho de 2014, por meio de entrevista semiestruturada, utilizando-se roteiro constituído por questões sociodemográficas e uma norteadora. Obteve-se a priori anuência dos diretores das associações, aprovação do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, CAAE nº27442814.7.0000.5537 e parecer n° 618.045, assim como a autorização formal das participantes mediante a assinatura do Termo de Consentimento Livre e Esclarecido. Participaram do estudo 12 mulheres selecionadas conforme os seguintes critérios de inclusão: ter deficiência física, estar na faixa etária de 18 a 49 anos e afirmar a existência de características limitantes desde a primeira infância (0 a 3 anos). As informações obtidas nas entrevistas foram submetidas aos preceitos da análise de conteúdo segundo Bardin, de acordo com a técnica de análise temática. Desse processo, emergiram três categorias: Concebendo a maternidade diante da deficiência física; Concebendo a capacidade de ser mãe com deficiência; e Concebendo o apoio durante o ciclo gravídico-puerperal. Como referencial teórico adotou-se os princípios do Interacionismo Simbólico proposto por Blumer. A discussão foi respaldada por meio de achados literários sobre a assistência a saúde da mulher no contexto da reprodução. As entrevistadas concebem a maternidade como uma realização e acreditam na sua capacidade em gestar, parir e cuidar de um filho. Porém, o desejo pelo papel materno tende a ser influenciado por sentimentos adversos e limitações suscitadas pela deficiência, barreiras sociais e preconceitos. Referiram também a importância do suporte do companheiro, familiares e profissionais de saúde nos cuidados ao filho. Mediante esses achados, compreende-se que embora haja entraves para a realização do seu desejo, não foram suficientes para fazê-las desistir em tornar-se mãe. Portanto, se faz necessário que os profissionais da saúde, em destaque o enfermeiro, sejam capacitados para o atendimento a mulher com deficiência no âmbito da atenção à saúde reprodutiva de modo a ofertar assistência adequada às suas necessidades. 

32
  • FRANCISCO RAFAEL RIBEIRO SOARES
  • Representações sociais de familiares sobre o atendimento das emergências psiquiátricas. 

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • SANDRA APARECIDA DE ALMEIDA
  • Data: Dec 9, 2014


  • Show Abstract
  • Os movimentos reformistas no campo da saúde mental apontaram bandeiras de luta, entre as quais se destacam a priorização da produção de cuidado em saúde mental fora do ambiente manicomial, objetivando a redução dos leitos psiquiátricos, maior controle sobre a internação, coparticipação da família e o resgate da cidadania dos atores sociais envolvidos. Com a diminuição progressiva dos leitos manicomiais associada a uma série de problemas estruturais nos serviços de saúde, tem sido cada vez mais frequente a ocorrência de crises fora do ambiente hospitalar, dando à família importante papel terapêutico. Diante deste cenário, urge a necessidade de compreender a construção social do atendimento às emergências psiquiátricas, identificando os significados atribuídos pelos familiares aos aspectos constitutivos destas. O presente estudo busca responder à seguinte questão de pesquisa: quais as representações sociais de familiares sobre o atendimento das emergências psiquiátricas no município de Mossoró, Rio Grande do Norte? Objetiva-se analisar as representações sociais dos familiares acerca do atendimento das emergências psiquiátricas no município de Mossoró, Rio Grande do Norte. Trata-se de um estudo exploratório, descritivo, com abordagem mista, utilizando-se de multimétodos: para coleta, a entrevista semiestruturada e a Técnica de Associação Livre de Palavras; para a análise dos dados utilizou-se a Análise temática de Bardin e suas etapas com o suporte informacional dos softwares ALCESTE (Analyse Lexicale par Contexte d’un Ensemble de Segments de Texte) e Iramuteq (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) e do suporte teórico das representações sociais. Os sujeitos participantes do estudo, em número de 72, foram selecionados a partir dos seguintes critérios: maiores de 18 anos com grau de parentesco com usuários que sofram de algum transtorno mental e comportamental e que já tenham presenciado alguma situação de crise, resgatado pelo SAMU ou outro meio e conduzido ao hospital psiquiátrico ou pronto-socorro geral. Resultados preliminares apontam: 1. Nota prévia do projeto de pesquisa com o objetivo divulgá-lo no meio científico e garantir a propriedade intelectual do trabalho 2. A análise contextual do atendimento às emergências no locus do estudo. A reflexão sobre o fenômeno denomina o atendimento às emergências psiquiátricas como contexto imediato; os aspectos técnicos e operacionais que influenciam no atendimento, como contexto específico/geral; e as políticas de saúde mental no Brasil são identificadas como metacontexto; 3. A revisão sistemática a partir de ensaios clínicos randomizados nas bases de dados PubMed, Cochrane, Lilacs, Scielo e SCIRUS, sendo utilizados os descritores: Restrição física, Serviços de emergência psiquiátrica, Restraint, Physical e Emergency Services, Psychiatric. Somente um trabalho atendeu aos critérios do protocolo de busca: um ensaio de curta duração que registra resultados limitados sobre a proporção de pessoas que estão em restrição e isolamento. Não apresenta resultados estatisticamente significativos em relação a indicações, contraindicações e riscos da utilização da restrição física; 4. As representações sociais do atendimento às emergências psiquiátricas. Os resultados do estudo apontam a presença de cinco categorias temáticas: 1. sentimento diante da crise/atendimento; 2. pensamento e perspectivas sobre a crise/atendimento; 3. centralidade do atendimento no tripé médico-medicação-internação; 4. o pensar/agir diante do uso da restrição física e força policial; 5. periodicidade das crises. O núcleo central da representação se encontra na primeira categoria, enquanto os elementos periféricos na terceira e quinta categorias. A zona de contraste na segunda e quarta categorias. A tristeza é o elemento de maior destaque da estrutura. As representações sociais sobre o atendimento às crises psiquiátricas se encontram em um momento de transição entre os modelos hegemônico e reformista, sendo os aspectos tradicionais ainda predominantes, mas já apresentando elementos periféricos e de contraste que apontam para uma possível mudança no campo representacional.

33
  • CLARA TAVARES RANGEL
  • Perfil, opinião e atuação dos profissionais de nível médio de enfermagem dos centros de atenção psicossocial e a política de saúde mental.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • ANTONIA REGINA FERREIRA FUREGATO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • Data: Dec 10, 2014


  • Show Abstract
  • Objetivo: Caracterizar o perfil e as atividades desenvolvidas pelos profissionais de nível médio de enfermagem que prestam assistência aos usuários dos Centros de Atenção Psicossocial (CAPS) da rede de atenção à saúde mental no Estado do Rio Grande do Norte (RN). Método: Estudo descritivo, transversal, com abordagem quantitativa e qualitativa realizado no período de junho a setembro de 2014 nos 38 CAPS distribuídos pelo estado. Após aprovação do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte (CEP/UFRN) sob parecer n° 508.430 CAAE: 25851913.7.0000.5537 em 20 de dezembro de 2013 os dados foram coletados a partir de um questionário estruturado com questões fechadas e semi-abertas. A população correspondia a 75 profissionais de nível médio de enfermagem. Com os critérios de inclusão: lotação no serviço por no mínimo três meses e estar em exercício no período de coleta, a amostra resultou em 48 profissionais. A perda de 36% dos sujeitos deu-se por não responder ao questionário, afastamento, recém-lotação no serviço, férias e licença-maternidade que corresponderam aos critérios de exclusão. Os dados quantitativos foram tabulados e analisados pela estatística descritiva com o auxílio do software Statistical Package for the Social Scienses (SPSS) versão 20.0, aplicando-se o teste Qui-Quadrado e Exato de Fisher de acordo com as variáveis selecionadas para o estudo. Os dados qualitativos serão preparados e tratados para a criação de um corpus e analisados com o auxílio do suporte informacional do software Análise Lexical por Contexto de um Conjunto de Segmentos de Texto (ALCESTE)associado a análise de conteúdo de Bardin.  Resultados e Discussão:  O primeiro artigo intitulado “Perfil e atuação dos profissionais de nível médio de enfermagem dos centros de atenção psicossocial: estudo descritivo” compreende o perfil e atividades desenvolvidas pelos profissionais de nível médio que atuam nos CAPS do Estado do RN. Neste foi possível elencar diferenças significativas em relação aos dois locais de coleta (capital/interior), sugerindo explicações e alertando para a exclusão desses profissionais na elaboração do Projeto Terapêutico Singular de cada usuário. O segundo denominado “Política, prática e formação em saúde mental: a voz dos profissionais do nível médio de enfermagem” traz a opinião dos profissionais de nível médio de enfermagem sobre a política, prática e formação em saúde mental. Esses dados qualitativos originaram cinco categorias: Papéis e funções dos profissionais de nível médio de enfermagem; O “eu” na prática profissional; Necessidades acadêmicas e profissionais; A rotina nos CAPS; Insatisfação entre o dito e o feito no espaço da atuação. Conclusão: Os participantes da pesquisa são predominantemente do sexo feminino com média de 37 anos de idade, ganham até 999 reais e trabalham acima de 30h/semanais no serviço pesquisado. Realizam atendimento individual, familiar e em grupo. Diferenças estatisticamente significantes foram identificadas entre os profissionais da capital e do interior. Suas opiniões revelaram que apesar dos avanços obtidos com a reforma psiquiátrica ainda existem desafios para a sua concretização principalmente em relação aos recursos humanos. 

34
  • FERNANDA APARECIDA SOARES MALVEIRA
  • Acompanhamento de crescimento e desenvolvimento da criança: uma estratégia de acessibilidade.

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • MARIA GORETE LUCENA DE VASCONCELOS
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Dec 11, 2014


  • Show Abstract
  • O acompanhamento do crescimento e desenvolvimento consiste no eixo estruturante da assistência à criança no âmbito da atenção primária à saúde, visando contribuir para a redução da morbidade e mortalidade infantil, bem como promover um desenvolvimento saudável. Apesar de sua importância, a unidade saúde da família localizada na zona rural do município de Parazinho vivencia o problema das faltas frequentes das crianças às consultas do acompanhamento. Dessa forma, este estudo tem por objetivo analisar a participação das mães na consulta do acompanhamento do crescimento e desenvolvimento da criança na Estratégia Saúde da Família. Trata-se de um estudo exploratório, descritivo, com abordagem qualitativa, tendo como método a pesquisa-ação, desenvolvido com as mães que fazem parte do acompanhamento do crescimento e desenvolvimento da criança da área rural do município de Parazinho/RN no período de maio a outubro de 2014. A coleta de dados foi realizada utilizando as técnicas de grupo focal, observação participante e entrevista individual. Os dados foram analisados por meio da análise temática de categorização. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, sob o parecer consubstanciado 617.559 e CAAE 28598014.7.0000.5537. Na etapa do diagnóstico situacional, foram realizados dois grupos focais, onde participaram ao todo 14 mães de distintas localidades rurais. A partir das falas, percebe-se que elas possuem o entendimento suficiente a respeito do acompanhamento do crescimento e desenvolvimento da criança, referindo como um momento de aprendizagem. A enfermeira foi mencionada como profissional chave dessa ação. O principal motivo que leva as mães a abandonarem as consultas é o acesso ao serviço de saúde, devido à distância de suas residências até a unidade básica, baixa renda familiar e a escassez de transporte público para o deslocamento dos usuários. Como estratégia para solucionar esse problema, com a sugestão das próprias mães, foi criado o Acompanhamento do CD Itinerante, em que a equipe da ESF se deslocava para as localidades rurais, realizando atividades voltadas para a saúde da criança. As mães que participaram da ação aprovaram a iniciativa, apesar de apontarem como pontos negativos a pouca estrutura e privacidade nas consultas. Portanto, conclui-se que, apesar das dificuldades encontradas muitas vezes por falta de apoio da gestão e envolvimento de alguns profissionais, o acompanhamento do CD itinerante mostrou-se como uma importante ferramenta na resolução do problema do acesso aos serviços voltados para a saúde da criança, além de funcionar como um espaço para a realização da educação em saúde, passando a ser, desde então, uma atividade inerente a programação da equipe de saúde da família.

35
  • POLYANNA KEITTE FERNANDES GURGEL
  • Acompanhamento coletivo do Crescimento e Desenvolvimento infantil: participação de mães/cuidadores.

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • ALTAMIRA PEREIRA DA SILVA REICHERT
  • NILBA LIMA DE SOUZA
  • Data: Dec 11, 2014


  • Show Abstract
  • Objetivou-se analisar a participação de mães/cuidadores sob a ótica do paradigma de saúde que direciona o acompanhamento coletivo de crescimento e desenvolvimento da criança. Trata-se de uma pesquisa exploratória e descritiva, com abordagem qualitativa, realizada em duas Unidades de Saúde da Família localizadas no município de Natal/RN. Os dados foram coletados nos meses de agosto a setembro de 2014, por meio da técnica da observação participante e entrevista semiestruturada, com mães de crianças atendidas nas consultas de acompanhamento coletivo do crescimento e desenvolvimento infantil. Sendo incluído um total de 13 mães. Como critérios de inclusão foram estabelecidos: ser mãe/cuidador responsável pelo cuidado às crianças que tenha frequentado uma ou mais reunião de acompanhamento coletivo de crescimento e desenvolvimento infantil e demostrem interesse em assinar o Termo de Autorização para Gravação de Voz e o Termo de Consentimento Livre e Esclarecido, autorizando a inclusão de seu discurso nesta pesquisa. Como critérios de exclusão estabelece-se: usuários não pertencentes à área de abrangência da Unidade de Saúde da Família e que não utilizavam o Sistema Único de Saúde como principal serviço de atendimento em saúde. Para o tratamento do material coletado, foi utilizada a Análise de Conteúdo, modalidade temática proposta por Bardin. A pesquisa seguiu os princípios éticos e legais que regem a pesquisa científica com seres humanos preconizados pela resolução Nº 466/2012, do Conselho Nacional de Saúde e sua realização se ocorreumediante aprovação do projeto no comitê de ética e pesquisa da Universidade Federal do Rio Grande do Norte, que obteve aprovação pelo Parecer Consubstanciado nº 719.949, de 27 de junho de 2014, e Certificado de Apresentação para Apreciação Ética nº 32510514.7.0000.5537. Apesar de não conceituarem teoricamente, as mães demonstram que as consultas coletivas de crescimento e desenvolvimento infantil são ações direcionadas ao modelo de vigilância à saúde, uma vez que a grande maioria aponta o acompanhamento do seu filho à ações que podem ser mensuráveis. Mesmo com isso, é possível constatar a existência de ações de promoção da saúde através do relato da troca de experiência e protagonismo dos sujeitos na ação coletiva, fator facilitado pelo vínculo estabelecido entre usuários e profissionais e usuários. Nessa ação, há a indução de uma relação horizontalizada, onde busca-se aliar o saber popular ao conhecimento científico de modo a favorecer o cuidar integral da criança. No entanto, ainda é possível encontrar profissionais que direciona sua assistência apenas aos processos patológicos e deixam de criar alternativas de cuidado que englobem o todo. Além disso, ainda há um desfalque nas equipes multiprofissionais que deveriam prestar o cuidado à população infantil. Tal fator pode estar relacionado à própria formação profissional, sendo desta maneira uma questão que pode perdurar por alguns anos. Conclui-se que é necessário incorporar alternativas e modelos de atenção que subsidiem a superação das limitações e que favoreçam a saúde da população, envolvendo-a na perspectiva de uma melhor qualidade de vida e consequentemente saúde.

36
  • GRACIELA MARIA CARNEIRO MACIEL
  • AVALIAÇÃO DA FRAGILIDADE E INTERVENÇÕES DE ENFERMAGEM INDICADAS PARA IDOSOS COM RISCO DE FRAGILIDADE. 

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • REJANE MARIA PAIVA DE MENEZES
  • GILSON DE VASCONCELOS TORRES
  • ERIKA SIMONE GALVAO PINTO
  • ALEXSANDRO SILVA COURA
  • MARIA CÉLIA FREITAS
  • Data: Dec 12, 2014


  • Show Abstract
  • Objetivou-se avaliar a fragilidade e indicar intervenções de enfermagem para idosos com risco de fragilidade. Trata-se de uma pesquisa com abordagem quantitativa e delineamento transversal, realizada em duas Unidades de Saúde da Família no bairro de Felipe Camarão, distrito sanitário oeste, município de Natal. A amostra foi composta por 203 idosos que utilizaram os serviços das Unidades durante os meses de abril a julho de 2014. Os dados foram coletados, no primeiro momento, através do instrumento contendo informações sociodemográficas e de saúde. Em seguida foi aplicada a Escala de Fragilidade de Edmonton para identificar o grau de fragilidade nos idosos. Os dados obtidos foram analisados em um programa estatístico. As variáveis categóricas descritas por frequência absoluta e relativa. Na abordagem inferencial foram utilizados os testes Qui-quadrado e Fisher, considerando-se as variáveis estatisticamente significativas aquelas com valores p< 0,05. As intervenções de enfermagem foram indicadas a partir da necessidade de cada domínio da escala e de um protocolo composto por 26 intervenções, com base na Classificação das Intervenções de Enfermagem. O estudo seguiu os princípios  legais que regem a pesquisa científica com seres humanos, sendo realizada mediante aprovação do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte (UFRN), pelo n° 562.327 e CAAE: 25573313.9.0000.5537, conforme a Resolução 466/2012 do Conselho Nacional de Saúde. A maior prevalência foi do sexo feminino (73,40%), faixa etária de 60 a 69 anos (60,59%), estado conjugal casado (46,80%), renda de até um salário mínino (60,10%), aposentados (77,34%), hipertensão (67%), hábitos tabagistas (53,20%), obesidade (47,29%). Em relação ao nível de fragilidade obteve-se como resultado: não apresenta fragilidade (40,89%), aparentemente vulnerável ou em risco (22,17%), fragilidade leve (22,17%), fragilidade moderada (9,85%) e fragilidade severa (4,93%). A fragilidade foi associada ao estado conjugal (0,008), problemas no coração (0,016), diabetes mellitus (0,043), osteoporose (<0,001), problemas respiratório (0,011), infecção urinária (0,012), depressão (<0,001) e queda (0,010). As intervenções indicadas foram em relação à cognição e o estado geral de saúde como: o treinamento de memória, estimulação cognitiva e educação para saúde. Assim, a fragilidade pode está associada com problemas de saúde, levando as incapacidades, perda da autonomia e dependência funcional. Acredita-se que as intervenções de enfermagem podem prevenir e promover a saúde de modo a retardar o aparecimento da fragilidade.  

37
  • ILANA BARROS GOMES MEDEIROS
  • Acompanhamento coletivo do crescimento e desenvolvimento infantil: uma análise da prática e expansão no município de Natal/RN

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • ALTAMIRA PEREIRA DA SILVA REICHERT
  • NILBA LIMA DE SOUZA
  • Data: Dec 12, 2014


  • Show Abstract
  • O acompanhamento coletivo do Crescimento e Desenvolvimento (CD) da criança desponta como reorientação do modelo assistencial biomédico, de modo a incentivar o uso de tecnologias leves e melhorar a qualidade de vida e a satisfação dos usuários. Esta forma de cuidado constitui uma ação em construção e expansão para outras Unidades, o que a torna vulnerável a um fazer aleatório, já que não há garantia de sistematização que assegure sua legitimação. Além disso, o próprio trabalho com grupo, na rede básica, de modo geral, corre o risco de centralizar suas ações na doença, como reflexo ainda do modelo biomédico vigente. Esta realidade chama a atenção para o fato de que o acompanhamento coletivo pode estar vulnerável a estes problemas, o que demanda a necessidade de conhecer melhor a sua operacionalização. Objetivou-se analisar a prática e a expansão do acompanhamento coletivo do CD da criança em Estratégias de Saúde da Família (ESF) do município de Natal/RN, junto aos enfermeiros. Trata-se de uma pesquisa qualitativa, tendo como método a pesquisa-ação. Envolveu onze enfermeiras de quatro ESF do município de Natal, no período de abril a outubro de 2014. Os dados foram coletados através de entrevista grupo focal e observação participante, e analisados de acordo com o direcionamento da análise temática de Paulo Freire. Na etapa do diagnóstico situacional, que investigou a operacionalização do acompanhamento coletivo do CD da criança pelas enfermeiras, percebeu-se que estas buscam realizá-lo com base na organização e planejamento prévios, de forma a ser o mais qualitativo possível. Compreendem a importância desta atividade, bem como os seus benefícios, sobretudo no tocante ao emponderamento que fornece aos usuários. Entretanto, identificou-se a falta de sistematização deste acompanhamento, visto que algumas enfermeiras o realizam de modos distintos. Além disso, percebeu-se a ausência do apoio da equipe de saúde, ficando as enfermeiras responsáveis por todo o processo de trabalho do fazer coletivo, o que acaba por gerar insatisfação nas mesmas. Visto a necessidade de mudança desta realidade, decidiu-se, conjuntamente, a construção de um instrumento que norteasse e sistematizasse as ações, bem como a realização de capacitações para sensibilizar o apoio por parte das equipes. Na etapa de implementação, as enfermeiras demonstraram grande interesse pelo check-list construído através de roda de conversa, entretanto, em relação às capacitações, a pesquisadora não conseguiu implementá-las de maneira satisfatória, pois interagiu com dificuldades. Constatou-se que as enfermeiras avaliaram positivamente sua participação na pesquisa, a qual favoreceu a troca de experiências e a mudança nos pontos negativos, além de ter instigado a parceria entre os cuidadores e os profissionais. Como sugestões para o futuro, as enfermeiras elencaram o incentivo à realização de mais pesquisas nesse campo, o constante apoio da UFRN na implementação do CD coletivo para que todos os profissionais de enfermagem despertem para esta atividade e o fornecimento de uma especialização em saúde da criança. Como principais dificuldades, elenca-se o alto índice de enfermeiras faltosas nos grupos focais, o que atrasou o andamento da pesquisa; a pouca motivação de algumas participantes, bem como da diretoria de algumas ESF e a falta de participação da equipe de saúde na ação de capacitação. Assim, constata-se que pesquisas nesta área devem ser constantemente incentivadas para o seu maior aperfeiçoamento. 

38
  • MÔNICA GISELE COSTA PINHEIRO
  • História Oral Temática de familiares atingidos pelo tratamento asilar da hanseníase

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • ANTONIA OLIVEIRA SILVA
  • CLELIA ALBINO SIMPSON
  • FELISMINA ROSA PARREIRA MENDES
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • MARIA TERESA CICERO LAGANA
  • Data: Dec 12, 2014


  • Show Abstract
  • A história da hanseníase é marcada por preconceito, exclusão social, estigma, abandono e medo, por ter sido conhecida durante muito tempo como incurável e contagiosa. Além dos agravos inerentes às alterações dermatoneurológicas e consequentes incapacidades físicas, são ressaltadas as repercussão emocionais, alterações nos hábitos cotidianos e mudanças na configuração familiar. Atualmente a hanseníase é conhecida como doença negligenciada, com alta incidência e prevalência, considerada como um problema de saúde alvo de incentivos e mobilizações das políticas públicas. Ao estudar a história da hanseníase, parte-se do pressuposto de que pouco se sabe sobre as repercussões da doença do passado na vida dos familiares de ex-doentes tratados em regime asilar, assim como a visão e os sentimentos dos mesmos familiares diante da hanseníase na atualidade. Portanto, objetivou-se narrar a história de familiares de ex-doentes de hanseníase que foram tratados em hospital colônia. Os objetivos específicos são: Identificar se familiares de pacientes com hanseníase tratados em hospitais colônia eram atingidos pelo preconceito, estigma e exclusão que permeava a vida dos portadores da doença; Verificar se o tratamento de ex-doentes de hanseníase em hospitais colônia alterou a efetivação de laços familiares tais indivíduos e os membros de sua família; Averiguar qual a compreensão que familiares de ex-doentes de hanseníase tratados em hospitais colônia têm sobre a hanseníase; Promover, junto aos participantes da pesquisa, atividade de promoção da saúde sobre hanseníase. Adotou-se o estudo exploratório e descritivo, com abordagem qualitativa com suporte na História Oral de Temática como técnica e referencial metodológico. Os 52 familiares de ex-doentes de lepra que foram segregados no Hospital Colônia São Francisco de Assis, cadastrados no MORHAN-Potiguar, constituíram a colônia. A partir do ponto zero houve o recrutamento dos participantes que compuseram a rede, totalizando 10 colaboradores, de ambos os sexos e idade de 44 a 76 anos. Após aprovação pelo Comitê de Ética em Pesquisa - UFRN, sob o protocolo 650.654/2014 e CAAE 25922214.3.0000.5537, realizou-se a coleta de dados por meio de entrevista, utilizando instrumento de identificação da rede e questões abertas. As entrevistas foram gravadas, transcritas, conferidas pelos colaboradores e posteriormente transcriadas. Tratou-se as histórias, narradas pela técnica de Análise Temática de Conteúdo, segundo Bardin, emergindo três eixos temáticos: Impacto nas relações sociais (Estigma e preconceito; Exclusão social); Impacto nas relações familiares (Desagregação familiar; Restrições para visita; Compartilhamento e construção de uma nova família; Consequências familiar geradas pelo isolamento; Reconstrução do vínculo familiar); e Pensamentos frente a lepra e a hanseníase (A história no passado; A história no presente). O fato de ter um familiar doente de hanseníase segregado em hospital colônia gerou empecilhos nas relações sociais vivenciadas pelos colaboradores do estudo, que embora não tivessem a doença, foram vitimados pela exclusão social, estigma e preconceito. O internamento compulsório também gerou modificações na estrutura familiar, com distanciamento, alteração no vínculo e tentativa de reestruturação familiar. Os colaboradores também refletiram sobre política de controle da lepra no passado, assim como a adotada no presente frente à hanseníase.

39
  • MARCELLY SANTOS COSSI
  • A saúde do trabalhador na atenção básica: concepções e práticas dos enfermeiros.

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • JOÃO BOSCO FILHO
  • ROSANA LUCIA ALVES DE VILLAR
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 12, 2014


  • Show Abstract
  • O estudo tem por objetivo geral analisar as concepções e as práticas desenvolvidas pelos enfermeiros em Saúde do Trabalhador na Atenção Básica, e como objetivos específicos identificar as concepções dos enfermeiros sobre a temática da Saúde do Trabalhador; descrever as experiências vivenciadas, além de discutir as dificuldades e potencialidades dos enfermeiros na atenção à Saúde do Trabalhador na Atenção Básica. Este estudo justifica-se pela necessidade de ampliação do conhecimento sobre o desenvolvimento das atribuições dos enfermeiros da rede básica de saúde em Saúde do Trabalhador, será relevante também para a produção científica sobre essa área, além de despertar no serviço de saúde a discussão de políticas para atenção à Saúde do Trabalhador, permitindo modificar o cuidado voltado a essa classe. Trata-se de um estudo analítico de abordagem qualitativa, que visa discorrer acerca das práticas dos enfermeiros no desenvolvimento das ações voltadas aos trabalhadores e suas concepções sobre esse campo de atuação. A pesquisa foi realizada nas unidades de saúde da atenção básica dos distritos sanitários da cidade de Natal-RN: Distrito Norte I, Distrito Norte II, Distrito Oeste, Distrito Leste e Distrito Sul. Obteve parecer favorável do Comitê de Ética em Pesquisa/UFRN (CAAE nº 31265914.8.0000.5537), atendendo a resolução nº 466/12 do Conselho Nacional de Saúde (CNS). A população do estudo foi composta por 25 sujeitos, enfermeiras das unidades de saúde da Atenção Primária do município de Natal-RN. A coleta de dados aconteceu no período de agosto a outubro de 2014 e deu-se por meio de entrevistas semiestruturadas. Para tanto, seguiu-se a seguinte sequência: seleção dos entrevistados; obtenção do acordo em participar da pesquisa através da assinatura do Termo de Consentimento Livre e Esclarecido (TCLE); realização das entrevistas, que foram gravadas utilizando-se um gravador de voz, de acordo com o consentimento do entrevistado por meio da assinatura do Termo de Autorização para Gravação de Voz; transcrição das entrevistas; conferência de fidelidade da transcrição e análise. As informações obtidas foram analisadas à luz da Hermenêutica-dialética, uma abordagem que propõe uma síntese dos processos compreensivos e críticos do pensamento. Sobre as concepções das enfermeiras em relação ao conceito de Saúde do Trabalhador percebem-se ideias que corroboram a mudança do modelo de atenção à saúde. Existe um olhar voltado para a promoção da saúde e prevenção do adoecimento do trabalhador.  Entretanto, uma minoria deu maior destaque à assistência que deve ser dada ao trabalhador doente ou em processo de adoecimento decorrente do trabalho, visão esta que não deixa de fazer parte do conceito de ST, que engloba não somente ações de promoção da saúde, prevenção de agravos decorrentes do trabalho, como também ações de recuperação, reabilitação e assistência ao trabalhador vitimado, contudo guarda uma discreta aproximação com a Saúde Ocupacional e a Medicina do Trabalho. Vale destacar que, no geral, predominou entre os sujeitos uma visão de uma atuação incipiente, inexistente, deficiente, restrita, limitada ou falha das enfermeiras da Atenção Básica sobre a Saúde do Trabalhador. Três entrevistadas apresentaram uma visão diferenciada em relação aos demais sujeitos, relatando a atuação do enfermeiro da AB sobre a ST como fundamental. Quando questionadas sobre as ações realizadas na unidade em que trabalham, grande parte das enfermeiras apresentou significativa dificuldade em especificá-las, relatando que na unidade não existem ações voltadas para o trabalhador. Outras especificaram algumas ações de promoção da saúde e prevenção de doenças, assim como ações assistenciais. O estudo demonstrou que os conhecimentos e práticas dos enfermeiros sobre a Saúde do Trabalhador ainda se encontram bastante restritos, devido a diversos mecanismos colaboradores, como falta de capacitação ou de abordagem do assunto durante a vida acadêmica que, consequentemente, refletem em um olhar limitado sob essa considerável parcela da sociedade.

40
  • RAFAEL TAVARES SILVEIRA SILVA
  •  Estratégias de enfrentamento de pessoas vivendo com AIDS frente à situação da doença. 

  • Advisor : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • COMMITTEE MEMBERS :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • NILBA LIMA DE SOUZA
  • FATIMA RAQUEL ROSADO MORAIS
  • Data: Dec 16, 2014


  • Show Abstract
  •  

    A Síndrome da Imunodeficiência Adquirida (AIDS), considerada na atualidade uma doença de caráter crônico devido ao advento do tratamento com antirretrovirais (TARV), traz aos indivíduos que vivem com essa doença, dificuldades relacionadas à convivência social e à adaptação a nova condição clínica e as rotinas impostas pelo tratamento. Essa realidade causa forte impacto na vida dessas pessoas que no intuito da superar tais obstáculos utilizam estratégias de enfrentamento, o Coping. Nesse contexto, objetivou-se neste estudo caracterizar o perfil epidemiológico, clínico e de hábitos de vida de pessoas vivendo com AIDS e analisar as estratégias de enfretamento utilizadas frente à situação da doença, segundo variáveis sociodemográficas, clínicas e hábitos de vida. Trata-se de um estudo transversal com abordagem quantitativa. A amostra foi composta por 331 pessoas cadastradas no ambulatório do Hospital Giselda Trigueiro (HGT), situado em Natal/RN, que possuíam agendamento para consulta médica ambulatorial no período de janeiro a agosto de 2014. A pesquisa obteve parecer favorável do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte com o Certificado de Apresentação para Apreciação Ética (CAAE), nº 16578613.0.0000.5537. A coleta de dados foi realizada através de entrevista estruturada e do Inventário de Estratégias de Enfrentamento de Folkman e Lazarus (IEEFL). Os dados da caracterização social demonstraram a predominância de pessoas do sexo masculino (52%), com faixa etária entre 20 e 30 anos (42%), procedentes da capital (58%), com ensino fundamental incompleto (49%), de cor parda (53%), com estado civil solteiro e sem companheiro (56%), heterossexuais (79%), com renda de até um salário mínimo (68%), de religião católica (64%) e com ocupação em instituição privada (50%). Em relação aos aspectos clínicos verificou-se que a maioria realizou o primeiro exame anti-HIV há menos de cinco anos (60%), referiu como motivo para realização do exame anti-HIV os sinais e sintomas da AIDS (90%), no momento do diagnóstico apresentou co-infecção (90%), prevalecendo a Tuberculose (50%), foram internados (90%), apresentaram contagem das células CD4 abaixo de 200 células/mm3 (85%) e carga viral acima de 10.000 cópias/mL (80%). No momento da coleta dos dados da pesquisa a contagem de CD4 ficou entre 200 e 500 células/mm3 (85%), a carga viral foi modificada para não detectável (97%). Quanto ao tratamento atual, mais da metade dos usuários iniciaram o TARV há menos de cinco anos (52%), não apresentaram reações adversas e modificações no esquema inicial (62%) e não abandonaram o tratamento (70%). Em relação aos que abandonaram o tratamento, identificou-se como principal motivo as reações adversas (75%).

    No que diz respeito aos dias de atraso para retirada dos medicamentos, constatou-se que 70% relataram que atrasaram em média 29 dias, porém quando verificado os registros na farmácia foi observado um período maior de atraso entre 29 e 74 dias (50%). Relativamente aos hábitos de vida, evidenciou-se que o maior número não consumiam bebidas alcoólicas (71%), não fumavam (88%) e não usavam drogas ilícitas (92%). Sobre o usou preservativo antes do diagnóstico positivo para o HIV, 62% nunca o utilizaram e atualmente apenas 58% aderiram ao uso. No que se refere ao Coping destacaram-se escores médios maiores para os fatores de reavaliação positiva, resolução de problemas e fuga-esquiva. As mulheres e as pessoas com religião apresentaram escores médios elevados para todos os fatores. As pessoas com maior escolaridade apresentaram maiores escores médios para autocontrole, suporte social, fuga-esquiva, resolução de problemas e reavaliação positiva. Para os que referiram trabalhar, constaram-se escores médios mais elevados para autocontrole, suporte social, resolução de problemas e reavaliação positiva; para os que nunca abandonaram o tratamento, os maiores escores foram para o autocontrole, suporte social, aceitação de responsabilidades, fuga-esquiva, resolução de problemas e reavaliação positiva. O perfil da população estudada confere com as características nacionais, sugerindo feminilização, interiorização, pauperização, heterossexualização, aumento da contagem de células CD4 e redução da carga viral durante o tratamento e a manutenção de hábitos de vida saudáveis. A identificação das estratégias de enfrentamento das pessoas que vivem com AIDS, podem facilitar o planejamento da assistência, favorecendo a adaptação dessas pessoas aos estressores frente à situação da doença.

     

41
  • BHEATRIZ GONDIM LAMBERT MOREIRA
  • História oral de vida de pessoas com úlcera venosa nos serviços de atenção primária à saúde.

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • GILSON DE VASCONCELOS TORRES
  • FELISMINA ROSA PARREIRA MENDES
  • Data: Dec 17, 2014


  • Show Abstract
  • A Insuficiência Venosa Crônica (IVC) caracteriza-se como um conjunto de alterações físicas que incluem como complicação a úlcera venosa (UV), caracterizada pela perda irregular e progressiva da continuidade da pele; com maior incidência nas proeminências ósseas dos maléolos mediais de membros inferiores e de caráter recidivante, o que provoca sofrimento e ansiedade para o portador e seus familiares. A existência da UV gera dependência dos serviços de saúde, constituindo um importante problema de saúde pública, e contribui significantemente para o comprometimento da qualidade de vida, afetando os aspectos físicos, psicológicos, sociais, culturais e espirituais. O portador de UV convive com um tratamento de longa duração, não estadiável, que provoca limitações e alterações de grande impacto que repercutem na sua vida. Este estudo objetivou narrar o fenômeno de possuir uma úlcera venosa crônica, no cenário dos serviços de Atenção Básica/Estratégia de Saúde da Família no município de Natal/RN, partindo das experiências de vida de seus portadores. Trata-se de um estudo de abordagem qualitativa, exploratório-descritivo, tendo a História Oral de Vida como referencial metodológico. A partir do ponto zero houve o recrutamento dos participantes que compuseram a rede, totalizando 06 colaboradores, de ambos os sexos, e idade entre 57 e 79 anos. Após aprovação pelo Comitê de Ética em Pesquisa - UFRN, sob o protocolo 653.788/2014 e CAAE 30408014.0.0000.5537, realizou-se a coleta de dados por meio de entrevista, utilizando instrumento de identificação de coleta de dados e perguntas abertas. As entrevistas foram gravadas, transcritas, transcriadas e retornadas aos colaboradores para conferência. As narrativas foram submetidas à técnica de Análise Temática de Conteúdo, segundo Bardin, possibilitando a construção de três eixos temáticos que englobam categorias, a saber: Eixo I – Impacto da ferida nas relações humanas (Impacto nas relações sociais; Impacto nas relações familiares); Eixo II - Marcas no corpo e na alma: trajetória do ser ferido (Itinerário terapêutico nos serviços de saúde; Perdas, limitações e incapacidades), e Eixo III - Mecanismos de enfrentamento (Ressignificação do corpo ferido; Resiliência e superação). O impacto de ter UV provoca repercussões físicas, psicológicas e sociais para seus portadores. Como aspectos relacionados às mudanças ocorridas após o aparecimento da UV, os participantes da pesquisa relataram a presença de dor, limitações físicas, sofrimento psíquico, isolamento social e afetivo, incapacidade laboral, desconforto estético e dependência dos serviços de saúde; a família foi o aspecto que não apresentou modificação considerável após a ocorrência da úlcera para a maioria dos participantes, sendo uma aliada no processo terapêutico; a ressignificação do corpo e da ferida constituem o principal mecanismo de enfretamento da condição crônica. Os serviços que compões a Rede de Atenção Básica têm papel fundamental na reabilitação dos portadores, embora exista dificuldades de acesso ao tratamento adequado e necessidade de ampliação dos serviços, com capacitação permanente dos profissionais e disponibilização pelos gestores de recursos para o fortalecimento do cuidado integral da pessoa com UV nos serviços de atenção básica e de Estratégia de Saúde da Família.

42
  • ERIDA MARIA DINIZ LEITE
  • Diagnósticos de enfermagem do domínio nutrição em pacientes submetidos à hemodiálise. 

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • RAFAELLA PESSOA MOREIRA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Dec 17, 2014


  • Show Abstract
  • O estudo objetivou analisar os diagnósticos de enfermagem do domínio nutrição da NANDA Internacional em pacientes submetidos à hemodiálise. Trata-se de uma pesquisa transversal, realizada em um hospital universitário de Natal, Rio Grande do Norte com 50 pacientes submetidos à hemodiálise. O instrumento utilizado para a coleta de dados foi composto por um formulário de entrevista e um de exame físico, em formato digital, aplicados entre os meses de dezembro de 2013 a maio de 2014. A análise dos dados foi dividida em duas etapas. Na primeira etapa, as características definidoras, os fatores relacionados e de risco foram julgados quanto a sua presença pela pesquisadora, de acordo com os dados coletados. Na segunda etapa, foi realizado o julgamento diagnostico, por especialistas, sobre a presença dos diagnósticos por meio da inferência diagnóstica, baseado nos dados da primeira etapa. Os resultados foram organizados em tabelas e analisados segundo estatística descritiva e inferencial para os diagnósticos que apresentaram frequências maiores que 50%. Para as características definidoras, fatores de risco e relacionados foram analisados os que apresentaram associação estatística significante e/ou frequências maiores que 50%. O projeto foi aprovado sob o protocolo número 392.535 e com Certificado de Apresentação para Apreciação Ética número 18710613.4.00005537. Os resultados indicam uma mediana de 7 (± 1,51) diagnósticos de enfermagem do domínio nutrição por paciente. Foram identificados seis diagnósticos com frequências maiores que 50%, a saber: Risco de desequilíbrio eletrolítico, Risco de Glicemia instável, Volume de líquidos excessivo, Disposição para equilíbrio de líquidos melhorado, Disposição para Nutrição melhorada e Risco de volume de líquidos deficiente. As características definidoras, fatores de risco e relacionados apresentaram média de 34,78 (± 6,86), 15,50 (± 3,40) e mediana de 4 (± 1,93), respectivamente. Dentre as características, fatores relacionados e de risco, os que apresentaram associação estatística significante com os diagnósticos em análise foram: Ruídos respiratórios adventícios, Edema e Congestão pulmonar com o diagnóstico Volume de líquidos excessivo; Expressa desejo de aumentar o equilíbrio de líquidos com o diagnóstico de enfermagem Disposição para equilíbrio de líquidos melhorado; Alimenta-se regularmente, Atitude em relação à comida coerente com as metas de saúde, Consome alimentos adequados, Expressa conhecimento sobre escolhas alimentares saudáveis, Expressa desejo de melhorar a nutrição, Expressa conhecimento sobre escolhas saudáveis de líquidos e Segue padrão apropriado de alimentação com Disposição para nutrição melhorada. Conclui-se que os diagnósticos do domínio nutrição são prevalentes na clientela submetida à hemodiálise. Desse modo, a identificação desse resultado pode trazer reais mudanças no quadro clínico, principalmente a nível hidroeletrolítico, contribuindo na melhoria da qualidade de vida do paciente, além do avanço na prática do cuidado e possível influência nos índices de morbimortalidade. Portanto, este estudo propiciará o direcionamento dos cuidados de enfermagem às condições de saúde desses pacientes.  

43
  • ANNA LIVIA DE MEDEIROS DANTAS
  • Estudo do Domínio segunça/proteção em pacientes de unidade de Terapia Intensiva

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA CRISTINA ARAUJO DE ANDRADE GALVAO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • RAFAELLA PESSOA MOREIRA
  • Data: Dec 17, 2014


  • Show Abstract
  • O estudo objetivou analisar os diagnósticos de enfermagem do domínio segurança e proteção da NANDA Internacional presentes nos pacientes internados em Unidade de Terapia Intensiva. Trata-se de um estudo transversal, realizado no complexo de terapia intensiva de um hospital universitário no Nordeste do Brasil. A pesquisa ocorreu em duas etapas. A primeira etapa consistiu na coleta de dados, por meio deum formulário de entrevista e de exame físico, com 86 pacientes internados, durante os meses de dezembro de 2013 a maio de 2014. Planilhas foram construídas no Software Microsoft Office Excel 2010, nas quais foram assinaladas pela pesquisadora deste estudo presença ou ausência das características definidoras, fatores relacionados e fatores de risco dos 31 diagnósticos estudados. Na segunda etapa, realizada entre julho e agosto de 2014,as planilhas foram enviadas a três diagnosticadores, previamente treinados, para a realização da inferência diagnóstica. Os dados foram analisados por meio de estatística descritiva e inferencial, com auxílio do IBM SPSS Statistic versão 20.0 for Windows. O projeto recebeu parecer favorável no 440/414 e Certificado de Apresentação para Apreciação Ética no22955113.2.0000.5292.  Os resultados apontaram a presença de 29 diagnósticos de enfermagem do domínio segurança/proteção na clientela internada em Unidade de Terapia Intensiva, dentre os quais cinco estiveram presentes em 100% dos pacientes, a saber: risco de contaminação, risco de lesão, risco de quedas, risco de resposta alérgica e risco de trauma. Os diagnósticos que apresentaram frequência superior a 50% foram: risco de infecção, risco de olho seco, risco de envenenamento, risco de trauma vascular, integridade da pele prejudicada, dentição prejudicada, risco de sangramento, risco de desequilíbrio na temperatura corporal, risco de lesão por posicionamento perioperatório, integridade tissular prejudicada, risco de disfunção neurovascular periférica, risco de resposta adversa ao meio de contraste com iodo, risco de choque e risco de aspiração. Para estes diagnósticos, foram identificados 35 fatores de risco, 11 características definidoras e 3 fatores relacionados que apresentaram associação estatística significativa com os diagnósticos estudados.  Para os diagnósticos risco de contaminação, risco de lesão, risco de quedas, risco de resposta alérgica, risco de trauma, risco de infecção, risco de olho seco e risco de envenenamento não houve associação com nenhuma de suas características. Conclui-se que a maioria dos diagnósticos de enfermagem do domínio segurança/proteção apresentam-se prevalentes nos pacientes críticos, com atenção especial para os diagnósticos de risco. Ocorreu associação significativa entre esses diagnósticos e seus componentes. Destaca-se, assim, que o levantamento desse perfil contribui com pistas relevantes para a inferência dos diagnósticos de enfermagem prioritários do domínio segurança/proteção na população estudada, auxiliando a práxis da enfermagem e estimulando o conhecimento a respeito do assunto.

44
  • RHUAMA KARENINA COSTA E SILVA
  • Avaliação do ganho de peso de bebês prematuros em relação ao leite materno e do banco de leite humano.

  • Advisor : NILBA LIMA DE SOUZA
  • COMMITTEE MEMBERS :
  • FATIMA RAQUEL ROSADO MORAIS
  • NILBA LIMA DE SOUZA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Dec 17, 2014


  • Show Abstract
  • Este estudo objetivou avaliar o ganho de peso de recém-nascidos prematuros alimentados com leite materno de sua genitora com aqueles alimentados com o fornecido pelo banco de leite humano. Trata-se de uma pesquisa do tipo quantitativa, descritiva e observacional. Realizada na Unidade de Terapia Intensiva Neonatal e Alojamento Conjunto da Maternidade Escola Januário Cicco (MEJC), unidade de referência para gravidez e nascimento de risco no Rio Grande do Norte. Foram envolvidos recém-nascidos prematuros que atenderam aos seguintes critérios de inclusão: idade gestacional entre 26 a 37 semanas, internados inicialmente na UTIN, com dieta oral, por gavagem, copo e/ou sucção. Foram excluídos do estudo prematuros com dieta zero maior do que sete dias ou complicações que interferissem na avaliação do ganho de peso. A amostra foi selecionada por conveniência e constou de todos os recémnascidos hospitalizados na UTIN no período de maio a junho de 2014, com seguimento até a alta hospitalar, finalizada em agosto de 2014 e que atenderam aos critérios de inclusão do estudo. Foram admitidos 60 recémnascidos prematuros no período correspondente a coleta de dados, e destes, 40 compuseram a amostra. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da UFRN, sob CAAE nº 0699.0.000.294-11. Os dados foram analisados por meio de estatística descritiva e inferencial. Os resultados indicaram que os envolvidos no estudo nasceram de mães com média de idade 25,42 anos, com menos de nove anos de estudo 21 (52,5%), possuíam renda familiar menor que um salário mínimo 25 (62,5%). Predominou o sexo feminino 21 (52,5%), parto cesária 26 (65%), prematuridade moderada 29 (72,5%), baixo peso ao nascer 20 (50,0%). A média de peso ao nascer foi de 1.583,28g. O total de dietas foi 10.042, e média de 250,85 para cada recém-nascido, no período de 31,47 dias de hospitalização. O predomínio de oferta das dietas (50,16%) foi do Banco de Leite Humano, no entanto 52,5% dos recém-nascidos receberam dieta com maior quantidade de leite materno ordenhado. Detectouse que 37,5% dos neonatos receberam, em algum momento, leite artificial. A média de ganho de peso diário de todos os recém-nascidos foi de 1,47g, sendo que 35% teve uma média acima de 10g/dia. Do grupo de neonatos (n=25) que apresentaram ganho de peso apenas 9 (36,0%) receberam predominantemente Leite Materno Ordenhado de suas próprias mães. Conclui-se que a maioria dos recém-nascidos apresentou ganho de peso com predomínio de dietas fornecida pelo Banco de Leite Humano, mostrando a necessidade de um maior incentivo ao aleitamento materno exclusivo.

Thesis
1
  • RAIONARA CRISTINA DE ARAUJO SANTOS
  • Papéis e funções dos profissionais dos serviços e política de saúde mental em Natal (RN).

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ANTONIA REGINA FERREIRA FUREGATO
  • CLELIA ALBINO SIMPSON
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • MARIA DE OLIVEIRA FERREIRA FILHA
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • Data: Jan 31, 2014


  • Show Abstract
  • A assistência psiquiátrica e as políticas de atenção à saúde mental passaram por diversas transformações, marcadas ora por avanços, ora por retrocessos centrados no estigma, desinteresse e preconceito que ainda permeiam a sociedade e o senso comum. Este estudo objetivou analisar o processo de reforma psiquiátrica e a política de saúde mental do município de Natal (RN) a partir dos papeis e funções dos profissionais de nível superior dos serviços substitutivos em saúde mental. Trata-se de uma pesquisa analítica, transversal, com dados quantitativos e qualitativos, realizada nos sete serviços substitutivos de saúde mental de Natal (RN), entre os meses de março a agosto de 2013, após aprovação do estudo pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, parecer nº 217.808, CAAE: 10650612.8.1001.5537, em 01 de março de 2013.  A amostra de conveniência compôs-se por 65 profissionais de nível superior das equipes de saúde mental, definida a partir dos critérios de inclusão e de exclusão dos participantes. Utilizou-se um questionário com questões fechadas e semi abertas sobre o perfil socioeconômico, as políticas, as práticas e o tipo de formação dos profissionais para a atuação nos serviços de saúde mental. Tabularam-se e submeteram-se as respostas das questões fechadas do questionário no programa estatístico SPSS versão 20.0, analisando-os por meio de estatística descritiva, com a formulação de gráficos e tabelas. Para verificar o nível de significância, adotando-se p-valor<0,05, optou-se pela aplicação do teste exato de Fisher. Submeteram-se os dados das questões semi abertas ao software ALCESTE e à luz da análise de conteúdo de Bardin. O perfil dos participantes caracterizou-se por maioria do sexo feminino (78,5%), faixa etária de 36 a 55 anos (52,3%), média de 42 anos, carga horária de 40 horas semanais (61,5%), tempo de conclusão da graduação de 6 a 15 anos (57%), trabalhavam na área de saúde mental há menos de 10 anos (72%) e na instituição pesquisada há 5 anos ou menos (52%). Da amostra estudada, 86% atendiam grupos de usuários, 97% realizavam algum atendimento individual, 94% observavam o comportamento do paciente, 92% realizavam atendimento familiar, utilizando, principalmente, a abordagem cognitiva (28%). Os dados qualitativos originaram cinco categorias denominadas: Formação acadêmica e atuação em saúde mental; Ausência de capacitação e supervisão em saúde mental; Dificuldades da prática profissional nos serviços substitutivos de saúde mental; Trabalho em equipe: entre acertos e conflitos; Política Nacional de Saúde Mental: uma realidade ainda distante. Detectou-se adequabilidade dos papeis e funções dos profissionais quanto ao tempo de trabalho na área da saúde mental e na instituição pesquisada; nos atendimentos e atividades individuais (observação e registro do comportamento do paciente e das condutas terapêuticas no prontuário); na promoção de ações visando à autonomia do paciente; no atendimento em grupo de pacientes; e, em parte, à família/familiar dos portadores de transtorno mental, havendo inadequação quanto ao atendimento aos grupos de familiares. A formação especializada em saúde mental e as condições de trabalho nos serviços substitutivos apresentaram inadequação, interferindo nos papeis e funções desenvolvidos pelos profissionais nos referidos serviços. Evidenciou-se adequação nos papeis e nas funções desenvolvidas pelos profissionais nos serviços substitutivos em saúde mental, embora convivendo em seu cotidiano com inúmeras dificuldades encontradas no desenvolvimento de suas práticas profissionais frente às condições de trabalho.

2
  • DANIELE VIEIRA DANTAS
  • EVIDÊNCIAS DE VALIDAÇÃO DE UM PROTOCOLO PARA ASSISTÊNCIA ÀS PESSOAS COM ÚLCERAS VENOSAS EM SERVIÇOS DE ALTA COMPLEXIDADE


  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • ISABELLE KATHERINNE FERNANDES COSTA
  • CLELIA ALBINO SIMPSON
  • RAIONARA CRISTINA DE ARAUJO SANTOS
  • MARINA DE GÓES SALVETTI
  • MARIA KATIA GOMES
  • LUCIANA ARAUJO DOS REIS
  • Data: Jun 6, 2014


  • Show Abstract
  • As úlceras venosas são lesões resultantes da insuficiência venosa crônica, anomalias valvulares venosas e trombose venosa. Sua ocorrência vem crescendo com o aumento da expectativa de vida da população mundial. Consideram-se aspectos fundamentais na abordagem à pessoa com úlcera venosa a assistência com atuação interdisciplinar, adoção de protocolo, conhecimento específico, habilidade técnica, articulação entre os níveis de complexidade assistencial do Sistema Único de Saúde e participação ativa dos pacientes e seus familiares, em uma perspectiva holística. A construção de um protocolo assistencial para pessoas com úlcera venosa pode auxiliar os profissionais dos serviços de alta complexidade na avaliação do paciente e no estabelecimento de uma assistência de qualidade, de forma sistematizada e focada nos fatores que interferem na cicatrização da lesão. Assim, este estudo objetivou desenvolver e validar um protocolo assistencial para pessoas com úlceras venosas atendidas em serviços de alta complexidade. Trata-se de um estudo metodológico, com abordagem quantitativa, desenvolvido em três etapas: revisão da literatura, validação de conteúdo e validação clínica. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte (UFRN), CAAE: 07556312.0.0000.5537. A revisão da literatura foi realizada de agosto e setembro de 2012, tornando-se a base para a construção do protocolo. Em seguida, foi realizada a validação de conteúdo, que incluiu 53 juízes (especialistas) selecionados por meio da plataforma Lattes, para avaliar os itens do protocolo. Os juízes foram contatados por e-mail e avaliaram o protocolo via Google Docs <docs.google.com>. Após a análise dos índices obtidos nesta etapa e as sugestões dos juízes, o protocolo foi ajustado e submetido à validação clínica, no Hospital Universitário Onofre Lopes (HUOL) em Natal/RN. A validação clínica envolveu 4 juízes, que atuaram em duplas (pareados), avaliando 32 pacientes com úlceras venosas no contexto clínico de alta complexidade. Nas duas etapas, utilizou-se o índice Kappa e Índice de Validade de Conteúdo (IVC) para analisar as respostas dos juízes. Os parâmetros estabelecidos como aceitáveis para estes índices foram: Kappa ≥0,61 e IVC>0,80. Tanto na validação de conteúdo, como na validação clínica, os itens do protocolo que não atingiram índices Kappa e IVC estabelecidos foram excluídos e alguns itens foram modificados ou incluídos após sugestões. Os processos de validação de conteúdo e validação clínica permitiram o aprimoramento do protocolo para o cuidado à pessoa com úlcera venosa, proposto inicialmente. A versão inicial do protocolo, construído a partir da literatura, continha 15 categorias e 126 itens; após a validação de conteúdo, mantiveram-se as 15 categorias com redução para 91 itens; a versão final, validada clinicamente, é composta das mesmas 15 categorias, sendo 76 itens. O protocolo foi validado em seu conteúdo e no aspecto clínico, sendo assim aceitou-se a hipótese alternativa no estudo. Esse protocolo poderá contribuir para a sistematização da assistência, permitindo adequar condutas e promover maior resolutividade no tratamento da pessoa com úlcera venosa em serviços de saúde de alta complexidade. 

3
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • Conhecimentos e habilidades de acadêmicos sobre procedimentos em semiologia e semiotécnica da enfermagem

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • REJANE MILLIONS VIANA MENESES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • MARINA DE GÓES SALVETTI
  • IZAURA LUZIA SILVERIO FREIRE
  • WILMA DIAS DE FONTES
  • ANA CRISTINA DE OLIVEIRA E SILVA
  • Data: Jul 21, 2014


  • Show Abstract
  • A Disciplina de Semiologia e Semiotécnica proporciona o desenvolvimento de habilidades necessárias à prática da enfermagem e ao estudo de procedimentos teórico-práticos. Na avaliação da disciplina, torna-se fundamental observar como o estudante trabalha o conhecimento adquirido, aproveita o aprendizado, como o aplica e o progresso no uso de instrumentos e recursos, bem como sua capacidade julgamento crítico; favorecendo a concretização de uma assistência, proveniente do processo educativo eficiente. Assim, o estudo tem como objetivo geral analisar conhecimentos e habilidades de procedimentos de semiologia e semiotécnica da enfermagem (higienização simples das mãos-HSM, mensuração da pressão arterial-PA, punção venosa periférica com cateter agulhado-PVP e sondagem vesical de demora masculina-SVD) de alunos da graduação em Enfermagem da Universidade Federal do Rio Grande do Norte (UFRN). Estudo analítico com abordagem quantitativa, realizado no Departamento de Enfermagem da UFRN, em Natal/RN. A população foi composta por dois públicos alvos em diferentes etapas, sendo a primeira etapa composta por 27 juízes docentes (UFRN, UERN e UnP) responsáveis por avaliar os instrumentos de coleta de dados para validação de conteúdo dos instrumentos e, na segunda, 186 alunos da graduação em enfermagem da UFRN, matriculados do 5° ao 9° período do curso. O estudo obteve parecer favorável do CEP/HUOL (CAAE nº 0002.0.294.000-10).  A coleta de dados ocorreu em duas etapas: verificação dos conhecimentos por meio de questionários estruturados validados, com 12 questões objetivas cada; e observação da execução dos procedimentos com preenchimento das listas de verificação validadas, em laboratório de simulação. Os resultados foram analisados no programa SPSS 20.0 por meio de estatística descritiva e inferencial, utilizando-se os testes ANOVA, Wilcoxon e Friedman, adotando nível de significância estatística de p-valor < 0,05. Dos 186 alunos pesquisados, 89,8% eram do sexo feminino, com idade entre 18 a 26 anos (88,2%), solteiro/divorciado (86,6%), renda de 1 a 5 salários mínimos (74,2%). Quanto à experiência laboral, 18,3% tiveram experiência em saúde anterior a graduação; 15,6% tinham formação como técnico de enfermagem; e 10,2% trabalharam na área da saúde. Atualmente, 14,0% trabalham. A média de acertos do conhecimento nos quatro procedimentos variou de 6,2 a 8,8, sendo maior em HSM (8,6), seguida por SVD (7,8), PVP (7,4) e PA (6,7); o 6º período apresentou as piores médias sdem três dos quatro procedimentos (HSM, PA e SVD). Quanto às habilidades, o procedimento de PVP apresentou melhor média de acerto geral (21,2 ± 2,6), e a SVD masculina a média mais baixa e maior variação (27,2 ±4,4), sendo a diferença entre períodos significante (p=0,041). Verificou-se que existem diferenças significativas entre os conhecimentos e habilidades dos quatro procedimentos nos diferentes períodos da graduação em enfermagem (p<0,001, para cada procedimento). O estudo acarretará repercussão na área da saúde, colaborando na formação dos enfermeiros, melhoria do ensino e expansão das reflexões acerca do ensino de enfermagem em semiologia e semiotécnica.

4
  • KALYANE KELLY DUARTE DE OLIVEIRA
  • Atuação dos profissionais no atendimento as famílias nos Centros De Atenção Psicososial do Rio Grande do Norte

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • ANTONIA REGINA FERREIRA FUREGATO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • SANDRA APARECIDA DE ALMEIDA
  • Data: Dec 10, 2014


  • Show Abstract
  • Este estudo objetivou avaliar a atuação dos profissionais no atendimento as famílias nos Centros de Atenção Psicosocial (CAPS) do Rio Grande do Norte (RN), a partir dos papéis e funções desempenhados pelos profissionais nestes serviços. Para isso, apontou-se como objetivos específicos: Descrever o perfil e as atividades desenvolvidas pelas equipes de saúde mental nos CAPS do RN; Conhecer a opinião dos profissionais das equipes de saúde mental quanto à política, às práticas e à formação em saúde mental; Verificar a adequabilidade dos papeis e funções dos profissionais que atuam nos CAPS do RN em relação ao atendimento as famílias. Trata-se de um estudo analítico, transversal, de abordagem quantitativa e qualitativa. Coletaram-se os dados por meio de questionário, em 33 CAPS do RN, entre março e outubro de 2014, após a aprovação pelo Comitê de Ética em Pesquisa/UFRN, parecer nº217.808, CAAE: 10650612.8.1001.5537, em 1 de março de 2013. Adotou-se a amostra, definida através de critérios de inclusão e exclusão, compondo-se de 183 profissionais.  A preparação do banco de dados seguiu dois passos: 1. Preparo e tratamento dos dados das questões fechadas do instrumento de pesquisa relativas à caracterização e práticas em saúde mental dos sujeitos da pesquisa por meio do recurso informacional do Statistical Package for the Social Scienses (SPSS) Statistics versão 20.0; 2. Para verificar o nível de significância optou-se pela aplicação do teste Qui-quadrado e o Kruskal Wallis Test. Preparo e tratamento do corpus formado pelas respostas às questões abertas relativas às políticas, práticas e formação na psiquiatria por meio do software Analyse Lexicale par Contexte d’un Ensemble de Segments de Texte (ALCESTE) e categorizados conjuntamente pela técnica de Análise de Conteúdo. A análise de dados apoia-se na literatura pertinente. Explicitaram-se os resultados através de três artigos que enceram os seguintes resultados: O primeiro artigo, perfil dos participantes, caracterizou-se por predominância do sexo feminino (76,5%), na faixa etária de 40 a 58 anos (61,7%). Trabalham entre 30 e 40 horas semanais (63,5%), com atuação na saúde mental há mais de 10 anos (98,4%). A amostra estudada direciona o atendimento a grupos familiares (65,7%), predominando o atendimento em equipe entre os assistentes sociais, enfermeiros, psicólogos e terapeutas ocupacionais. O médico realiza os atendimentos sem interação com a equipe (48,6%). Sobre as dificuldades encontradas nos serviços ordenam-se em: materiais e insumos (75,1%), financeiras (78,5%) e estruturais (66,9%). O segundo artigo encerra dados qualitativos organizados em cinco categorias: Promoção da reabilitação dos usuários dos CAPS; Necessidades de capacitações; Conflitos e satisfações do trabalho em equipe; Práticas desenvolvidas nos CAPS; Dificuldades de efetivação da Política de Saúde Mental. O terceiro artigo evidencia a inadequabilidade do atendimento destinado as famílias (93,4%) e comparando-se os atendimentos as famílias e aos grupos nos CAPS os dois tipos mostram-se inadequados: família (92,63%), grupos (92,60%). Os principais dados obtidos revelam a necessidade urgente de transformação na atenção psicossocial. Evidencia-se ainda, a importância de investimentos em insumos, estrutura física e na capacitação de recursos humanos para os CAPS.

5
  • FRANCISCO DE SALES CLEMENTINO
  • AVALIAÇÃO DE ESTRUTURA, PROCESSOS DE GESTÃO E ACOLHIMENTO DOS CENTROS DE ATENÇÃO PSICOSSOCIAL DO MUNICÍPIO DE CAMPINA GRANDE, PARAÍBA.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • DANIELLE FRANKLIN DE CARVALHO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • SANDRA APARECIDA DE ALMEIDA
  • Data: Dec 11, 2014


  • Show Abstract
  • No Brasil, a Reforma Psiquiátrica organiza-se com base nos pressupostos da Reforma Sanitária e da Psiquiatria Democrática Italiana com vistas a eliminar o modelo hospitalocêntrico. Objetivo: Avaliar a estrutura e o processo de trabalho desenvolvido nos Centros de Atenção Psicossocial (CAPS), englobando a satisfação, o perfil, as condições e a sobrecarga de trabalho dos profissionais. Aprovado pela Comissão de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte (UFRN), protocolo nº 719.435, de 30/05/2014. Métodos: Estudo descritivo, com abordagem quantitativa, desenvolvido em cinco Centros de Atenção Psicossocial, a saber: 02 CAPS I, 01 CAPS II, 01 CAPS III e 01 CAPSAD, de Campina Grande-PB. A população do estudo constitui-se de todos os coordenadores dos cinco CAPS, incluindo 42 profissionais de nível superior, 71 de nível médio (técnicos e auxiliares de enfermagem, e cuidadores), e os prontuários referentes a 2.297 usuários atendidos. Para assegurar a representatividade das informações, calculou-se uma amostra aleatória estratificada com partilha proporcional, considerando-se os seguintes parâmetros: erro α de 5%, nível de confiança de 95%, poder do estudo de 80%, estimativa de proporção de 10% e o índice de proporcionalidade específico para os profissionais de nível (superior e médio) e os  prontuários. Coletou-se os dados através de questionários validados, elaborados para o estudo CAPSUL (Avaliação dos CAPS da Região Sul do Brasil), entre julho e outubro de 2014. Os questionários foram duplamente digitados e submetidos à validação no sub-programa Validate do Epi Info 3.5.4, utilizado juntamente com o SPSS, 17.0 para o processamento das análises estatísticas. Resultados: A partir da análise dos prontuários dos usuários atendidos nos CAPS, observou-se um predomínio de mulheres na faixa etária adulta. Destacou-se como psicopatologia mais frequente, à esquizofrenia. Quanto às internações antes e após o ingresso nos CAPS, registrou-se para o hospital geral 14 internações (3,5%) antes e sete (1,7%) depois, diferença não significante (p=0,612). Ressalta-se que, em hospitais psiquiátricos, após o ingresso, houve redução para o máximo de três internações. O número total reduziu de 117 (29,1%) para apenas 11 (2,7%); redução estatisticamente significante (p=0,002). Quanto às formas de contração dos profissionais de saúde, os resultados evidenciam a existência de contrato temporário. A maior proporção de insatisfação com todos os parâmetros avaliados deu-se naqueles profissionais que se consideram sobrecarregados no trabalho. Entretanto, a única diferença estatisticamente significante estava relacionada com o “grau de responsabilidade” (90,9%; p=0,04). Observou-se forte associação da insatisfação dos profissionais de saúde com fatores relacionados ao conteúdo e às condições de trabalho no CAPS, relativa às medidas de segurança, conforto e aparência dos CAPS, contato entre as equipes e usuários, e tratamento das famílias por parte das equipes. Chama à atenção que estes aspectos são aqueles que não dependem diretamente da atuação dos profissionais. Conclui-se que o fortalecimento dos CAPS requer e exige um compromisso intersetorial, a partir do nível governamental, em garantir os recursos para a operacionalização de suas ações e assegurar aos usuários e à sua família a oferta e o acesso aos serviços de saúde. 

6
  • JOAO MARIO PESSOA JUNIOR
  • PERFIS E PRÁTICAS DOS PROFISSIONAIS DE SAÚDE MENTAL NOS HOSPITAIS PSIQUIÁTRICOS DO RIO GRANDE DO NORTE

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • ANTONIA REGINA FERREIRA FUREGATO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • SANDRA APARECIDA DE ALMEIDA
  • Data: Dec 11, 2014


  • Show Abstract
  • No campo de atuação da rede de atenção psicossocial brasileira, os profissionais de saúde são considerados atores importantes no processo de transformação das politicas e práticas nos diversos serviços de saúde mental, inclusive no hospital psiquiátrico. O estudo objetiva analisar o processo de reforma psiquiátrica e a política de saúde mental no Estado do Rio Grande do Norte (RN) a partir dos perfis e práticas dos profissionais de nível superior em hospitais psiquiátricos. Trata-se de uma pesquisa transversal e descritiva, com dados quantitativos e qualitativos, realizada em dois hospitais psiquiátricos do RN. A princípio foi considerada população alvo de 95 profissionais entre os dois serviços, entretanto, considerando-se a margem de erro de 8%, taxa de não resposta e critérios de inclusão, chegou-se a um total de 60 participantes de nível superior que responderam a um questionário de questões fechadas e semiabertas sobre o perfil socioeconômico, as políticas, as práticas e a formação em saúde mental. Após tabulados, os dados obtidos através das respostas das questões fechadas do questionário foram submetidos a um software estatístico. Utilizou-se a análise estatística simples e bivariada, do tipo qui-quadrado, adotando-se o nível de significância valor p<0,05. Submeteram-se as respostas das questões semiabertas ao software ALCESTE e à análise de conteúdo de Bardin. Em respeito aos preceitos éticos de pesquisa, o projeto obteve parecer favorável pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob o nº 508.430, CAAE: 25851913.7.0000.5537. O perfil dos profissionais revelou a maioria do sexo feminino (89,7%), enfermeiras (36,7%), faixa etária de 50-59 anos (42,9%), carga horária de 40 horas semanais (52,4%), com renda de 4 a 5 salários mínimos (28,1%), tempo de conclusão da graduação de 6 a 15 anos (57%), trabalhavam na área de saúde mental de 15 a 24 anos (37,5%), 53,4% tem outro emprego, e 21,4% mencionaram ter especialização em saúde mental. Sobre as práticas desenvolvidas, 61% realizam atendimento individual sozinhos e com outro profissional, predominando-se nesse momento cuidados de anotação (71,9%), observação (70,2%), esclarecimento sobre medicação, adesão ao tratamento e família (68,4%), e, consulta em situação de crise (64,9%); no atendimento familiar, 72,2% realizam sozinhos e com outro profissional, predominando-se cuidados de anotação (61,2%), consulta em situação de crise (51%) e esclarecimento sobre medicação, adesão ao tratamento e família (68%); e, no atendimento em grupos 50,9% realizam sozinhos e com outro profissional predominando-se cuidados de observação (64,3%), anotação (59,5%), esclarecimento sobre medicação, adesão ao tratamento e família (57,1%), conforto (52,4%). Os dados qualitativos originaram quatro grandes eixos temáticos: Atuação profissional em saúde mental; Formação em saúde mental; Cenários da reforma psiquiátrica e o hospital psiquiátrico; Políticas e práticas em saúde mental: desafios para profissionais no hospital. Apesar de mudanças identificadas nos perfis e práticas dos profissionais de nível superior nos serviços de atenção à saúde mental, com a implementação de novas políticas públicas para a área, os achados do presente estudo sugerem a confluência de assimetrias e divergências na atuação das equipes nos hospitais psiquiátricos. Os cenários evidenciados circunscrevem, em parte, o descompasso político e ideológico atual do processo de reforma psiquiátrica nacional, que nega o papel da assistência realizada no ambiente hospitalar, embora não tenha avançando o suficiente com a criação e qualificação de serviços que justifiquem a extinção total dessa instituição.      

7
  • RAFAELLA LEITE FERNANDES
  • Conhecimento dos gestores da saúde mental sobre a política assistencial e assistência individual dos profissionais dos Centros de Atenção Psicossocial do Rio Grande do Norte

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • ANTONIA REGINA FERREIRA FUREGATO
  • DANIELE VIEIRA DANTAS
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • Data: Dec 12, 2014


  • Show Abstract
  • Este estudo emergiu do intuito de conhecer a realidade assistencial da saúde mental do Rio Grande do Norte diante dos avanços e desafios na pactuação de caminhos intersetoriais e da consolidação da Rede de Atenção Psicossocial (RAPS) do Estado. Definiu-se como problemática desse projeto a seguinte inquietações: 1- Qual o conhecimento dos gestores da saúde mental sobre a Política Nacional de Saúde Mental?  Nesse sentido, objetivou-se: Identificar o conhecimento dos gestores dos Centros de Atenção Psicossocial (CAPS) do RN a respeito da Política de Saúde Mental. Trata-se de um estudo de natureza analítica e descritiva e abordagem quanti-qualitativa, realizado nos CAPS do interior do RN, totalizando 33 serviços, onde 183 profissionais responderam a um questionário estruturado com questões abertas e fechadas a respeito do trabalho que desenvolvem diariamente nos serviços em que atuam; 20 coordenadores de saúde mental dos municípios e o coordenador estadual da RAPS foram entrevistados a respeito do seu conhecimento sobre a Política de Saúde Mental e a realidade enfrentada pela saúde mental do município que é responsável. Após aprovação do Comitê de Ética e Pesquisa da Universidade Federal do Rio Grande do Norte (CEP/UFRN), sob o parecer nº 508.430 CAAE: 25851913.7.0000.5537 em 20 de dezembro de 2013, os dados foram coletados de agosto a outubro de 2014 nos 26 municípios do interior do Estado que dispõem de CAPS. Os dados quantitativos foram tabulados e analisados pela estatística descritiva com o auxílio do software Statistical Package for the Social Scienses (SPSS) versão 20.0, enquanto os dados qualitativos foram preparados em um corpus e analisados com o auxílio do suporte informacional do software Analyse Lexicale par Contexte d’um Ensemble de Segments de Texte (ALCESTE) que permite fazer análises estatísticas textuais e categorização das falas dos sujeitos, que serão submetidos a análise de conteúdo de Bardin. A análise léxica das falas dos gestores dos serviços gerou 7 classes no ALCESTE, que após sucessivas leituras de aproximação de sentido formaram 5 categorias com enfoques no conhecimento dos gestores, denominadas: De volta à sociedade: protagonismo e autonomia dos usuários; Hiância entre política e prática; Entraves que afetam o serviço; Estruturação da Rede de Atenção Psicossocial; Equipe multiprofissional: atribuições e atividades. A análise das categorias revelou que o conhecimento dos gestores foi direcionado principalmente para a realidade vivenciada pelos mesmos no seu cotidiano sendo evidenciada pouca profundidade de conceitos e diretrizes políticas da assistência em saúde mental, primordial para o desenvolvimento de atividades efetivas e eficazes nos serviços.

8
  • ELIANE SANTOS CAVALCANTE
  • Trajetória de vida dos pescadores vítimas de lesão medular no litoral do Rio Grande do Norte/RN.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • ANA CRISTINA MANCUSSI E FARO
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • IZAURA LUZIA SILVERIO FREIRE
  • Data: Dec 12, 2014


  • Show Abstract
  • A lesão medular ocasiona manifestações incapacitantes permanentes, afetando a integridade anatômica, mudanças corporais e limitações funcionais pertinentes ao estado de deficiência. Objetivou-se analisar a trajetória de vida dos pescadores com lesão medular vítimas de acidente por mergulho nas praias do litoral Norte/RN. Trata-se de estudo exploratório-descritivo, com dados quantitativos, qualitativos e representacional, desenvolvido em colônias de pescadores de nove praias do litoral Norte/RN, entre outubro de 2013 a agosto de 2014, após a aprovação do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte/UFRN, parecer nº 431.891/2013, CAAE 20818913.0.0000.5537. A amostra compôs-se por pescadores acometidos por lesão medular, definida a partir dos critérios de inclusão e de exclusão dos participantes. Utilizou-se como instrumento de coleta de dados a entrevista semiestruturada. Analisaram-se os dados quantitativos por meio da estatística descritiva, apresentando-os em forma de tabelas, quadros e gráficos, utilizando o Microsolft Excel. Submeteram-se os dados das entrevistas ao software Analyse Lexicale par Contexte d`um Ensemble de Segments de Texte (ALCESTE) e à luz da análise da Teoria das Representações Sociais e Teoria do Núcleo Central. Esclarece-se e apresentam-se os resultados da pesquisa a partir de quatro artigos, seguindo recomendações normativas dos periódicos: 1. Caracterização dos pescadores artesanais atendidos em hospital naval vítimas de doença descompressiva, em análise documental. Dos 28 pescadores artesanais estudados, todos eram do sexo masculino, faixa etária de 31 a 40 anos (53,6%) e casados (35,7%). A doença descompressiva ocorreu prevalentemente no baixo verão (75,0%), litoral Norte (96,4%), tendo como principais agravos a parestesia e dor nos membros superiores (67,9%), seguido de lesão medular (57,1%) e óbitos de 25,0%. 2. Estresse e ansiedade em pescadores artesanais vítimas de lesão medular. Estudo descritivo: Dos 44 participantes, todos eram do sexo masculino, média de idades de 49,6 anos, ensino fundamental (68,2%), casados (77,3%); com sequela de paraplegia (50,0%). A maioria apresentava estresse (75,0%), encontrando-se na fase de quase exaustão (33,3%), com sintomas prevalentes de insônia (95,5%) nas últimas horas; hipertensão (97,7%) na última semana e dificuldades sexuais (95,5%) no último mês. 3. Experiências, memórias, scripts, representações sociais sobre lesão medular para pescadores vítimas de acidentes por mergulho: A análise de 10 entrevistas permitiu a construção de três categorias: Incapacidade na coordenação sensório-motora da deambulação; Ressignificação da deficiência e o sentido da dependência e Autonomia e adaptação limitante. 4. Representações sociais de pescadores artesanais vítimas de lesão medular: repercussões na trajetória de vida. A análise de 31 entrevistas sob a ótica da compreensão das Representações Sociais da lesão medular permitiu a construção de sete categorias: Tratamento: limitações e expectativas; Lesão Medular: antes e depois; Aposentadoria: uma realidade ainda distante; Deficiência: dependência, incapacidade e vulnerabilidade; Superação e autonomia; Sentimentos do eu: perdas físicas e recomeço; Vida e trabalho: impedimentos, planos e mudanças. Conclui-se esse estudo com o alcance dos objetivos, cuja temática é relevante para a saúde pública de homens pescadores. Sugere-se medidas de prevenção, promoção e recuperação da saúde do homem pescador, além das condições seguras, saudáveis e dignas como compromisso das políticas de saúde.

2013
Dissertations
1
  • ANA BEATRIZ DE ALMEIDA MEDEIROS MOURA
  • INTEGRIDADE TISSULAR DE PACIENTES COM ÚLCERAS VENOSAS: um estudo baseado na Classificação dos Resultados de Enfermagem.

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • GILSON DE VASCONCELOS TORRES
  • LUISA HELENA DE OLIVEIRA LIMA
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • Data: Feb 1, 2013


  • Show Abstract
  • A úlcera venosa é um problema epidemiológico de alta prevalência, que provoca incapacidade e dependência. Avaliar o nível de comprometimento tissular de pacientes com lesões venosas, dentro de um referencial próprio da Enfermagem, é relevante. Destarte, o objetivo deste trabalho é caracterizar o estado de saúde referente à integridade da pele dos membros inferiores de pacientes com úlcera venosa, de acordo com os indicadores do resultado Integridade tissular da Classificação dos Resultados de Enfermagem. Estudo quantitativo, transversal e descritivo, realizado em um hospital universitário de Natal-RN. A amostra foi composta por 50 participantes, selecionados através de amostragem por conveniência do tipo consecutiva. A coleta dos dados aconteceu através de um formulário de entrevista e exame físico e de um instrumento de definições operacionais para indicadores do resultado de enfermagem Integridade Tissular direcionado aos pacientes com úlcera venosa, aplicados nos meses de fevereiro a junho de 2012. A análise dos dados se deu por meio de estatística descritiva e testes não-paramétricos (teste de Spearman, Kruskal-Wallis e Mann-Whitney). O projeto foi aprovado pelo Comitê de Ética em Pesquisa sob protocolo CEP/HUOL 608/11 e Certificado de Apresentação para Apreciação Ética nº 0038.0.294.000-11. Os resultados revelam que os indicadores apresentam grau de comprometimento moderado, leve e não comprometido, quanto à mediana. Os entrevistados tinham uma média de 59,72 anos, 66% do sexo feminino, 50% aposentados e 60% com companheiro, 44% apresentavam hipertensão arterial, 26% alergias, 20% Diabetes Mellitus, 4% realizava alguma atividade física, 6% eram fumantes e 14% consumiam bebidas alcoólicas. Houve associação entre idade e hidratação (ρ=0,032) e descamação cutânea (ρ=0,026); anos de estudo e descamação cutânea (ρ=0,034); renda familiar e necrose (ρ=0,012); Índice Tornozelo/Braquial e perfusão tissular (ρ=0,044); Diabetes Mellitus e textura (ρ=0,015) e perfusão tissular (ρ=0,026); alergia e textura (ρ=0,034); atividade física e hidratação (ρ=0,034); tabagismo e espessura (ρ=0,018); e etilismo e exsudato (ρ=0,045). Conclui-se que a maioria dos indicadores avaliados nos pacientes entrevistados apresentou comprometimento, variando de leve a moderado. Os resultados deste estudo corroboram com o perfil socioeconômico, clínico e de fatores de risco da população acometida por úlceras venosas, atendida nas instituições públicas de saúde. Conclui-se que a avaliação do comprometimento tissular utilizando um sistema próprio da enfermagem e a relação deste com fatores socioeconômicos, clínicos e de risco, são ferramentas singulares no planejamento da assistência e no processo de cicatrização tecidual.
2
  • GRAYCE LOUYSE TINOCO DE CASTRO
  • ESPECIFICIDADES DO SUPORTE AVANÇADO DE VIDA NO ATENDIMENTO
    PRÉ-HOSPITALAR: MAPEANDO RISCOS, PREVENINDO ERROS 

    ATENDIMENTO PRÉ-HOSPITALAR MÓVEL: MAPEANDO RISCOS, PREVENINDO ERROS

     
  • Advisor : FRANCIS SOLANGE VIEIRA TOURINHO
  • COMMITTEE MEMBERS :
  • ARIANO JOSE FREITAS DE OLIVEIRA
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • GILSON DE VASCONCELOS TORRES
  • MARISE REIS DE FREITAS
  • ROSIANE VIANA ZUZA DINIZ
  • Data: Feb 7, 2013


  • Show Abstract
  • O cuidado com a segurança dos pacientes é importante na qualidade da assistência de enfermagem e dos cuidados de saúde. No atendimento pré-Hospitalar, estes cuidados são essenciais no local com propósito de minimizar possíveis consequências ao indivíduo, garantindo um atendimento precoce e adequado, com melhoria da morbidade e diminuição da mortalidade. Estes atendimentos igualmente associam-se a riscos significativos de even­tos adversos e erros graves, que podem ser diminuídos com a conscientização dos profissionais, organização e qualidade da gestão. Trata-se de estudo descritivo, transversal, de abordagem quantitativa, com o objetivo de identificar os riscos para a segurança do paciente no atendimento pré-hospitalar móvel sob a ótica dos enfermeiros, em uma cidade do Nordeste Brasileiro. A amostra da pesquisa foi formada por 23 enfermeiros. Os critérios de inclusão: ter no mínimo dois anos de experiência e aceitarem participar da pesquisa. A coleta de dados foi realizada em duas etapas, primeiramente coleta de fotos, através do método adaptado de análise fotográfica, e a segunda com a aplicação de questionário, dividido em duas partes:dados sócio-profissional e instrumento de pontuação de fotografia digital sobre a segurança do paciente. Encontrou-se a predominância de enfermeiros com tempo médio de trabalho no atendimento pré-hospitalar móvel de seis anos e seis meses, na faixa etária de 38 a 53 anos (69,56%) e com especialização Lato sensu (73,91%), sendo (29,41%) urgência e emergência e (29,41%) em terapia intensiva. Possuem o advanced cardicologic life suport (ACLS) (74%) e o pre hospital trauma life suport (PHTLS) (100%); conhecem a temática segurança do paciente (91,30%). Nas fotos observou-se uma maior variabilidade de categorias (riscos) onde 44% de variância emergiu na foto 01 do estudo. As fotografias 4 e 9 com médias abaixo de 5 foram classificadas como muito inseguras, enquanto que as fotos 7 e 3 com médias acima de 7, muito seguras. Dos resultados de riscos observados para a segurança do paciente no atendimento pré-hospitalar móvel emergiram cinco categorias: Organização e acondicionamento de equipamentos e materiais, rotinas e especificidades no atendimento pré-hospitalar móvel, riscos para a administração de medicamentos, para traumas e para infecção. Partindo da análise desses riscos propôs-se dez passos para a segurança do paciente no atendimento pré-hospitalar móvel: 1- Identificar o paciente; 2- Segurança relacionada à prevenção de infecção; 3- Segurança na administração de medicamentos; 4- Segurança e padronização do acondicionamento de equipamentos e materiais; 5- Atenção para as especificidades do atendimento pré-hospitalar móvel; 6- Incentivar e valorizar a participação do paciente e família; 7- Promover a comunicação com a central de regulação; 8- Prevenção de traumas e quedas; 9- Proteger a pele de lesões adicionais; 10- Compreender o benefício de todos os equipamentos da ambulância. Os múltiplos riscos e suas combinações emergidas no estudo indicam a multifatoriedade de ações a serem desenvolvidas e estimuladas, como a utilização de passos para a segurança do paciente no atendimento pré-hospitalar móvel que contribui como subsídio no gerenciamento de riscos, diminuição de erros, incapacidades e morte.

     
3
  • JOAO EVANGELISTA DA COSTA
  • TRAJETÓRIA DE VIDA DE PORTADORES DE DOENÇAS
    ONCOLÓGICAS EM USO DE TRANSFUSÕES SANGUÍNEAS NA CIDADE DE 
    NATAL/RN

    Trajetos no labirinto: História de vida dos portadores de doenças oncológicas em uso de transfusões sanguíneas na cidade de Natal/RN.

     
  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • LENILDE DUARTE DE SÁ
  • MARIA TERESA CICERO LAGANA
  • Data: Feb 18, 2013


  • Show Abstract
  • Sendo utilizado pelo homem há muito tempo e de várias formas, o sangue foi
    considerado um elemento mítico em várias culturas. Desde a antiguidade
    atribuíam a ele poderes, pois comungava do preceito geral da vida, passando a
    fazer parte do patrimônio do inconsciente coletivo humano. Atualmente, sua
    utilização não deixou de ter tanta importância, uma vez que possibilita seu uso
    em numerosas situações clínicas e cirúrgicas sendo, seu papel, determinante à
    manutenção da vida e na resposta a procedimentos terapêuticos. Nesse uso,
    cada vez mais importante do sangue e seus hemocomponentes, desperta
    atenção as transfusões que não são isentas de complicações, devendo-se
    considerar a real necessidade de sua aplicação, avaliando-se os riscos e os
    benefícios aí decorrentes. As reações transfusionais são riscos que, na maior
    parte das vezes, por ser eventos indesejados, podem ser evitadas ou
    prevenidas, por trazerem o medo e o desconforto, piorando o quadro clínico e
    provocando até mesmo a morte do usuário. Este estudo tem como objetivo
    narrar as trajetórias de vida de portadores de doenças oncológicas,
    transfundidos com componentes sanguíneos, e o impacto causado pelas
    transfusões no seu cotidiano. Utilizaremos como procedimento metodológico a
    história oral de vida (Meihy, 2011) desses portadores, realizada a partir de
    entrevistas e outras fontes documentais de natureza pessoal. A história oral,
    por ser um recurso moderno de apreensão de princípios da subjetividade,
    deixando-se entrever um sentido maior, coletivo, é destinada a colher
    testemunhos para elaboração de documentos, com finalidade de se estudar a
    sociedade. Será utilizado, para isso, um roteiro de entrevista não-estruturada a
    qual se apresenta dividida em três etapas: a pré-entrevista, a entrevista em si e
    a pós-entrevista. Na análise das histórias de vidas narradas pelos
    colaboradores utilizar-se-á a técnica de análise de conteúdo temático. O
    espaço de investigação da pesquisa será realizado no Núcleo de Hematologia
    e Hemoterapia (NHH) da Universidade Federal do Rio Grande do Norte,
    localizado na cidade de Natal-RN. A comunidade de destino será formada por
    usuários de saúde com doenças oncológicas em uso de transfusão de
    componentes sanguíneos. A colônia será formada por usuários de saúde com
    doenças oncológicas que se submeteram há pelo menos três transfusões de
    componentes sanguíneos ambulatorialmente, e a rede será formada por 12
    colaboradores com pelo menos três transfusões sanguíneas e que queiram
    participar da pesquisa. Desse modo, espera-se fazer um retrato ou perfil
    desses usuários para, com este fim, levar respostas tanto à sociedade acerca
    do papel da enfermagem, como aos próprios usuários, tornando-os
    conhecedores dos processos aí envolvidos, para que desmistifiquem os usos
    do sangue e, assim, possam atrair resultados mais positivos à hemoterapia. 

    O estudo “Trajetos no Labirinto: história de vida de portadores de doenças oncológicas em uso de transfusão sanguínea na cidade de Natal” tem a hemoterapia como procedimento primordial para se repensar a relação entre usuários de saúde oncológicos e os desdobramentos decorrentes. A hemoterapia busca suprir carências orgânicas através da hemotransfusão, que adquire função vital aos portadores de câncer por poder restabelecer o funcionamento do organismo através do aumento de componentes sanguíneos. O impacto sobre a transfusão afeta emocional e fisicamente a vida desses usuários. Objetivando refletir acerca desse impacto, o presente estudo procurou, através das narrativas de vida, resgatar suas vivências desde o diagnóstico da doença até os instantes de uso da transfusão sanguínea. Trata-se de um estudo exploratório-descritivo, em que a abordagem qualitativa utiliza o referencial teórico-metodológico da história oral de vida (MEIHY, 2011) para analisar uma colônia formada por cinco usuários de saúde com diagnóstico de câncer, com realização mínima de três transfusões sanguíneas, no ambulatório do Núcleo de Hematologia e Hemoterapia - UFRN, na cidade de Natal-RN. A rede, por sua vez, foi composta por colaboradores de ambos os sexos, sem limite de idade, que concordaram voluntariamente em participar do estudo. A coleta de dados, com aprovação do Comitê de Ética em Pesquisa (CEP), da Liga Norte Riograndense Contra o Câncer, sob parecer 001/001/2012, ocorreu por meio de entrevistas semi-estruturadas, gravadas individualmente, em contexto domiciliar, local previamente escolhido pelos colaboradores. O procedimento metodológico se deu com a transcrição das entrevistas e suas transcriações, e a análise dos relatos por meio da análise de conteúdo temático (BARDIN, 2011). Na orientação de leitura e interpretação dos relatos dos colaboradores, discutem-se três categorias de análise: o impacto no psicológico; o impacto na socialização e no grupo de pertença; o impacto do ambiente e da transfusão sanguínea no tratamento. Com base nas narrativas das histórias de vida dos colaboradores, conclui-se que as vivências e os sentimentos, a esperança e a tristeza, a dor e a fé, mesmo em face de uma doença como o câncer, trazem muito de ensinamento e aprendizagem ao profissional da saúde que deposita na humanização e na hemoterapia formas de restabelecer quadros clínicos críticos.

     
4
  • ANA MICHELE DE FARIAS CABRAL
  • História oral de vida dos filhos do Preventório/Educandário no Rio Grande do Norte: vivências a compartilhar.  

     
  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • LENILDE DUARTE DE SÁ
  • REJANE MILLIONS VIANA MENESES
  • Data: Feb 19, 2013


  • Show Abstract
  • Várias doenças marcaram a vida das pessoas e coletividades, sendo um dos principais exemplos a hanseníase, doença infecto-contagiosa, marcada pelo estigma, preconceito e exclusão social. No passado, o isolamento compulsório dos pacientes portadores de hanseníase evitou a propagação da doença causando sérios problemas sociais e psicológicos resultando no afastamento e na ruptura total ou parcial do vínculo familiar. Os filhos privados deste convívio, retirados muitas vezes de forma desumana foram confinados e criados em preventórios/educandários. Qual a história de vida dos filhos do preventório/educandário e suas inquietações? Frente ao questionamento, traçou-se como objetivo: resgatar a história de vida dos filhos de portadores de hanseníase que foram internos no preventório/educandário Osvaldo Cruz, Natal, Rio Grande do Norte. Pesquisa exploratória e descritiva, com uma abordagem qualitativa. Utilizou-se o enfoque da história oral de vida como referencial metodológico. Foram entrevistados 10 egressos do preventório/educandário Osvaldo Cruz em Natal/RN, filhos de ex-doentes comprovadamente, residentes na capital potiguar, de ambos os sexos; maior de idade; com condições cognitivas, intelectuais e emocionais preservadas. A análise das histórias obtidas a partir das entrevistas foi realizada à luz da Análise de Conteúdo, pela qual estabeleceu-se três eixos temáticos: 1. Perdas e danos: desintegração e reintegração familiar e a infância negada; 2. Inesquecível: coisas marcantes que não se esquece; 3. Expectativa em viver o novo: em busca de outros caminhos e destinos. Considera-se que a problemática vivenciada pelos filhos separados marcou profundamente as suas características afetivas e psicossociais. No entanto, eles demonstraram resiliência, buscando se reinventar e construírem novos caminhos e destinos.

     
5
  • MARIANA PEREIRA DA SILVA
  • Relações Interpessoais da equipe de enfermagem: uma ação comunicativa.

     
  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • SORAYA MARIA DE MEDEIROS
  • JACILEIDE GUIMARAES
  • RAIMUNDA MEDEIROS GERMANO
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • MOEMIA GOMES DE OLIVEIRA MIRANDA
  • Data: Feb 20, 2013


  • Show Abstract
  • O presente estudo pretendeu abordar as relações interpessoais da equipe de enfermagem sob a ótica da ação comunicativa, contribuindo para o processo de trabalho em saúde. Teve como objetivo analisar as relações interpessoais da equipe de enfermagem em seu ambiente de trabalho. Tratou-se de um estudo descritivo com abordagem qualitativa.  A coleta das informações ocorreu a partir de entrevistas individuais guiadas por um roteiro com questões abertas e semi-estruturadas. O estudo foi realizado em um hospital estadual no município de Natal/RN. Os sujeitos da pesquisa foram constituídos pelos trabalhadores da equipe de enfermagem, incluindo enfermeiros, técnicos e auxiliares de enfermagem, totalizando 16 sujeitos. A captação das informações ocorreu no mês de Abril de 2012. O projeto foi aprovado pelo Comitê de Ética em Pesquisa sob protocolo CEP/UFRN 262/11 e Certificado de Apresentação para Apreciação Ética nº 0289.0.051.000-11. A análise foi realizada a partir das categorias que emergiram da pesquisa através de um diálogo com os autores estudados no referencial teórico da teoria da ação comunicativa de Jürgen Habermas, como também as transformações do mundo do trabalho de Ricardo Antunes, e a caracterização de equipe de Marina Peduzzi. Os resultados apontam que o  relacionamento interpessoal da equipe de enfermagem é bastante conflituoso, não havendo interação entre os sujeitos envolvidos neste processo, entre si e com os demais profissionais da saúde. Elaborou-se um conceito próprio de equipe, composto por três elementos essenciais: multiplicidade de indivíduos, objetivo comum e heterogeneidade. No ambiente estudado percebeu-se a formação de equipes agrupamentos. O relacionamento interpessoal da enfermagem pode ser um fator facilitador ou conturbador do ambiente laboral, de tal forma que cause consequências positivas ou negativas tanto nos trabalhadores da saúde quanto nos doentes. Neste contexto, as entrevistadas intensificaram suas observações em relação às fragilidades que permeiam as relações da enfermagem, por se tornarem mais constantes em relação às fortalezas. As condições de trabalho sinalizaram para uma precarização evidenciada pelo constante processo de improvisação diante da falta de recursos humanos e materiais, baixa remuneração salarial, déficit no reconhecimento do trabalhador de enfermagem, desgaste físico e emocional, gerando um esgotamento do profissional. A valorização do trabalhador tornou-se também um fator marcante para esse estudo por se caracterizar um motivo de insatisfação profissional, por falta de políticas de valorização elaboradas pela instituição ou até mesmo desconhecidas pelo próprio trabalhador. A participação do trabalhador na elaboração dessas políticas despontou como relevante. As condições precárias de trabalho levam o trabalhador a um processo de insatisfação e desmotivação profissional, ocasionando o sentimento de desvalorização em seu ambiente de trabalho. Com isso, constatou-se na presente pesquisa que a ausência da comunicação conduz a situações de relacionamentos interpessoais inadequadas, criadores de um ambiente impróprio ao trabalho da equipe de enfermagem.

     
6
  • LIVIA SEMELE CAMARA BALDUINO
  • Validação de instrumentos para avaliação do conhecimento e da habilidade acerca da sondagem vesical de demora.

     
  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • EDNALDO CAVALCANTE DE ARAÚJO
  • GILSON DE VASCONCELOS TORRES
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Feb 21, 2013


  • Show Abstract
  • Este estudo teve como objetivo validar instrumentos para avaliação da habilidade e do conhecimento acerca sondagem vesical de demora (SVD). Estudo transversal, descritivo, quantitativo e metodológico realizado na Universidade Federal do Rio Grande do Norte (UFRN), Universidade do Estado do Rio Grande do Norte (UERN) e em uma universidade privada do Rio Grande do Norte. Amostra composta por 27 juízes selecionados a partir dos critérios de inclusão: enfermeiros, docentes da disciplina de semiologia e/ou semiotécnica, com mínimo de um ano de experiência nas disciplinas, ser da UFRN, UERN ou de uma universidade privada do estado e aceitar participar voluntariamente com a assinatura do Termo de Consentimento Livre Esclarecido. A pesquisa foi desenvolvida em três etapas: construção de dois instrumentos com base na literatura científica, resultando em um roteiro de observação estruturado tipo checklist composto por 36 itens e um questionário do conhecimento com 12 questões; submissão dos instrumentos aos juízes, no período de junho a setembro de 2012, os quais deveriam avaliar cada item em “adequado”, “adequado com alterações” e “inadequado”, além de fazer uma avaliação geral de cada instrumento baseada em 10 requisitos; e validação com a verificação do nível de concordância entre os juízes, através da aplicação do Índice Kappa (K) e do Índice de Validade de conteúdo (IVC). Utilizou-se o nível de consenso maior que 0,60 (bom) para o índice Kappa e maior que 0,70 para o IVC. Obteve parecer favorável do Comitê de Ética em Pesquisa/HUOL. Após serem codificados e tabulados, os dados foram analisados por meio de estatística descritiva. Dos 27 juízes que avaliaram o instrumento, 77,8% são do sexo feminino, com média de idade de 36,6 (± 9,0) anos, 63,0% atuavam na UFRN, 74,1% possuíam mestrado acadêmico e 63,0% atuavam exclusivamente na docência. A média de tempo de experiência na docência foi de 7,9 (± 8,0) anos e nas disciplinas de semiologia e/ou semiotécnica da enfermagem foi de 5,5 (± 6,7) anos. No julgamento do checklist e questionário do conhecimento, nenhuma etapa/questão foi considerada inadequada, uma vez que todas obtiveram nível de concordância dentro dos índices estabelecidos. Todas as etapas do checklist obtiveram K de bom a excelente (entre 0,60 e 1,00). Dos 36 itens, 25 tiveram K excelente (0,75 ≤ K < 1,00) e K total excelente (K = 0,83). Em relação ao IVC, todas as etapas atingiram níveis acima de 0,70 (entre 0,74 e 1,00) e o IVC total foi de 0,90. Todas as questões do questionário avaliadas separadamente (K de 0,60 a 0,93 e IVC de 0,74 a 0,96) e de forma geral (K de 0,79 a 1,00 e IVC de 0,89 a 1,00) obtiveram níveis de avaliação da validade de conteúdo dentro dos valores estabelecidos. Os instrumentos foram reformulados baseando-se nos níveis de concordância entre os juízes e em diretrizes internacionais, dissertações e artigos científicos. Os dois instrumentos mostraram-se válidos quanto ao seu conteúdo, permitindo avaliação objetiva e clara dos conhecimentos e habilidades acerca SVD, seja dos graduandos de enfermagem como também de outros estudantes e profissionais da saúde, uma vez que a utilização de medidas válidas busca a redução do risco de distorção dos resultados.

     
7
  • MANUELA PINTO TIBURCIO
  • Validação de instrumentos para avaliação da habilidade e do conhecimento acerca da medida da pressão arterial.

     
  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • EDNALDO CAVALCANTE DE ARAÚJO
  • GILSON DE VASCONCELOS TORRES
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Feb 21, 2013


  • Show Abstract
  • Este estudo teve como objetivo validar instrumentos para avaliação da habilidade e do conhecimento acerca da medida da pressão arterial (PA) entre os graduandos de enfermagem. Estudo transversal, descritivo, quantitativo e metodológico realizado na Universidade Federal do Rio Grande do Norte/UFRN, Universidade do Estado do Rio Grande do Norte/UERN e em uma universidade privada do estado. A amostra composta por 27 juízes da pesquisa selecionados a partir dos critérios de inclusão: enfermeiros, docentes da disciplina de semiologia e/ou semiotécnica, mínimo de um ano de experiência nas disciplinas, ser da UFRN, UERN ou de uma universidade privada do Rio Grande do Norte e aceitar participar voluntariamente com a assinatura do Termo de Consentimento Livre Esclarecido. A pesquisa foi desenvolvida em três etapas: construção de dois instrumentos com base na literatura científica, resultando em um roteiro de observação estruturado composto por 28 itens e um questionário do conhecimento com 12 questões; submissão dos instrumentos aos juízes, no período de junho a setembro de 2012, os quais deveriam avaliar cada item em “adequado”, “adequado com alterações” e “inadequado”, além de fazer uma avaliação geral de cada instrumento baseada em 10 requisitos; e validação com a verificação do nível de concordância entre os juízes, através da aplicação do índice Kappa e do Índice de Validade de conteúdo (IVC). Utilizou-se o nível de consenso maior que 0,61 (bom) para o índice Kappa e maior que 0,75 para o IVC. Obteve parecer favorável do Comitê de Ética em Pesquisa/HUOL. Após serem codificados e tabulados, os dados foram analisados por meio de estatística descritiva. Dos 27 juízes que avaliaram o instrumento, 77,8% são do sexo feminino, com média de idade de 36,6 (± 9,0) anos, 63,0% atuavam na UFRN, 74,1% possuíam mestrado acadêmico e 63,0% atuavam exclusivamente na docência. A média de tempo de experiência na docência foi de 7,9 (± 8,0) anos e nas disciplinas de semiologia e/ou semiotécnica da enfermagem foi de 5,5 (± 6,7) anos. No julgamento do roteiro de observação estruturado e do questionário do conhecimento acerca da medida da PA nenhum item/questão foi considerado inadequado, uma vez que todos obtiveram nível de concordância dentro dos índices estabelecidos (IVC > a 0,75 E Kappa > 0,61). Em relação ao roteiro estruturado, dos 28 itens presentes, 9 apresentaram índice de concordância perfeito (IVC=1,00; Kappa= 1,00) e outros 19 foram considerados adequados com alterações, principalmente no que diz respeito à clareza e vocabulário. No questionário do conhecimento, dentre as 12 questões que o compunham, 7 apresentaram índice de concordância perfeito e as demais foram consideradas adequadas com alterações quanto requisitos clareza, vocabulário, exequível e sequência instrucional dos tópicos. Em se tratando da avaliação geral dos instrumentos, o roteiro estruturado obteve IVC de 0,94 e Kappa de 0,89 e o questionário do conhecimento, IVC de 0,97 e Kappa de 0,94. Os dois instrumentos mostraram-se válidos quanto ao seu conteúdo, configurando-se como ferramentas objetivas e claras de avaliação dos conhecimentos e habilidades acerca da pressão arterial, seja dos graduandos de enfermagem como também de outros estudantes e profissionais da saúde, uma vez que a utilização de medidas válidas busca a redução do risco de distorção dos resultados.

     

     
8
  • SAMARA KEYLLA DANTAS BRASIL
  • ATUAÇÃO DO ENFERMEIRO NO ACOMPANHAMENTO DO CRESCIMENTO E DESENVOLVIMENTO DA CRIANÇA

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • NEUSA COLLET
  • RAIMUNDA MEDEIROS GERMANO
  • ROSINEIDE SANTANA DE BRITO
  • Data: Feb 27, 2013


  • Show Abstract
  • A assistência do enfermeiro no acompanhamento do crescimento e desenvolvimento da criança tem se caracterizado, em sua maioria, num atendimento baseado na dimensão biológica do adoecer, quando na realidade, as ações deveriam estar conjugadas na reorientação de modelo assistencial da ESF. O estudo teve como objetivo geral analisar a atuação do enfermeiro no acompanhamento do crescimento e desenvolvimento da criança e, mais especificamente, descrever a prática do enfermeiro nesta ação programática de saúde e, identificar aspectos que interferem à assistência deste profissional no acompanhamento do crescimento e desenvolvimento infantil. Trata-se de um estudo exploratório e descritivo, em uma abordagem qualitativa. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte sob parecer de nº 191/2012. A coleta de dados desenvolveu-se nas Unidades de Saúde da Família do município de Natal-RN e os participantes da pesquisa foram às enfermeiras que atuam na ESF por no mínimo dois anos, e que realizam o acompanhamento do Crescimento e Desenvolvimento da criança na unidade selecionada. Os dados foram obtidos mediante uma entrevista em profundidade. O material apreendido dos discursos foi tratado conforme o método de análise de conteúdo na modalidade de análise temática segundo Bardin. Desse processo emergiram três categorias temáticas, as quais foram analisadas à luz dos Modelos Assistenciais, do Processo de Trabalho em Saúde e de Enfermagem e dos achados literários. Os resultados elucidaram que as enfermeiras consideram a sua atuação satisfatória, pois tem favorecido na adequada adesão das mães dos menores de um ano às consultas de enfermagem, o que tem contribuído para a redução da morbidade e mortalidade infantil por doenças prevalentes, bem como o estabelecimento de vínculo entre as profissionais e genitoras. Foi evidenciado, que apesar de realizarem ações de promoção e prevenção com a utilização de tecnologias leves, as enfermeiras ainda enfatizam o cuidado nas queixas das mães e sinais e sintomas das crianças, seguido dos encaminhamentos aos profissionais da unidade ou a outros setores. Além disso, constatou que o processo de trabalho das enfermeiras enfrenta desafios quanto à estrutura organizacional dos serviços e da conjuntura social da família. Diante destas colocações, observa-se que apesar da forte interferência do modelo de saúde hegemônico na atuação das enfermeiras, é verificado que estas profissionais vêm investindo em ações de promoção e prevenção aos agravos no cuidado às crianças, com o foco no contexto familiar. Assim, as enfermeiras estão enveredando o fazer na reorientação do modelo assistencial de saúde, mediante a utilização das tecnologias relacionais, o que tem contribuído para a resolutividade do cuidado integral a população infantil.


9
  • JOSÉ EDISON RODRIGUES JUNIOR
  • Desistência ao tratamento de usuários de crack no Centro de Atenção Psicossocial em Campina Grande/PB.

  • Advisor : JACILEIDE GUIMARAES
  • COMMITTEE MEMBERS :
  • JACILEIDE GUIMARAES
  • RAIMUNDA MEDEIROS GERMANO
  • SORAYA MARIA DE MEDEIROS
  • MAURICIO ROBERTO CAMPELO DE MACEDO
  • MARCELO KIMATI DIAS
  • Data: Feb 27, 2013


  • Show Abstract
  • O presente estudo teve como objetivo geral analisar o fenômeno de desistência do acompanhamento/tratamento de usuários de crack em um CAPS AD no município de Campina Grande-PB. Trata-se de uma pesquisa exploratória, descritiva e de abordagem qualitativa, cujo marco teórico foi o enfoque histórico-dialético das políticas públicas de atenção em álcool e drogas. A coleta das informações foi realizada empregando-se a técnica de entrevista semi-estruturada, aliada ao levantamento de prontuários dos usuários de crack cadastrados no CAPS AD de Campina Grande-PB no período de 2007 a 2011. O material colhido em campo foi submetido ao método de análise temática, obtendo-se a extração das seguintes categorias e subcategorias de análise: CATEGORIA 1: Fatores de desistência do tratamento/acompanhamento no CAPS AD de Campina Grande-PB com as subcategorias 1.1. Desistências “por conta própria”, 1.2. Para assumir trabalho/emprego, 1.3. Em busca de “tratamento mais intensivo”, 1.4. Devido a recaída;  CATEGORIA 2: O tratamento/acompanhamento no CAPS AD com a subcategoria 2.1 A dependência do crack e o apoio da família como motivos que levavam a frequentar o CAPS AD; CATEGORIA 3:  Convívio com a dependência de crack sem tratamento / acompanhamento especializado com a subcategoria 3.1. Religiosidade como instrumento terapêutico. Os resultados evidenciaram uma distância entre a referência de prioridade para o tratamento comunitário e a realidade onde ainda há desinformação sobre esse tipo de tratamento e a busca da internação como solução. Os discursivos acerca do abandono do tratamento de usuários de crack fazem larga referência a importância do apoio familiar, a influência de amigos para o fenômeno da recaída e o apego à concepções religiosas. Embora os sujeitos reconheçam a qualificação do CAPS AD no tratamento, tentam por iniciativa própria ou por influência da família, dispositivos de internação. Isso nos leva a concluir que se faz necessário a reflexão e avaliação do processo de trabalho do CAPS AD à luz das transformações dinâmicas e da necessidade de respostas que o fenômeno exige.

     
10
  • ELIZABETH VASCONCELOS TRIGUEIRO
  • ENSINO DO PROCESSO DE ENFERMAGEM: SIGNIFICADOS E PERCEPÇÕES DOCENTES NA FORMAÇÃO DO ENFERMEIRO

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • MARIA VILANI CAVALCANTE GUEDES
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Feb 27, 2013


  • Show Abstract
  • A execução do processo de enfermagem por parte dos enfermeiros deve ser desenvolvida a partir da vivência acadêmica, especialmente nos cursos de graduação de enfermagem ao longo de sua formação teórico–filosófica e prática. A partir da observação da reduzida utilização do PE para planejamento da assistência durante a graduação, provavelmente, devido a um descompasso no processo de formação dos futuros enfermeiros e da inexistência de um estudo que retratasse essa situação em Natal/RN, chegou-se às seguintes questões: Qual o significado do ensino do PE para o docente enfermeiro? E, será que os docentes enfermeiros implementam o ensino do PE com estratégias e métodos que favorecem o desenvolvimento do pensamento crítico? Surgiu, então, o objetivo do estudo: Analisar o ensino do processo de enfermagem no curso de graduação de Enfermagem da Universidade Federal do Rio Grande do Norte (UFRN). Trata-se de pesquisa qualitativa com delineamento descritivo que utilizará o Interacionismo Simbólico como referencial teórico e a Análise do Conteúdo Temática como referencial metodológico. O estudo teve como cenário a UFRN, situada no município de Natal/RN, na qual é oferecido o curso de graduação em Enfermagem. Participaram do estudo trinta enfermeiros docentes que lecionam disciplinas específicas da Enfermagem. Para a coleta dos dados foram utilizados dois instrumentos, sendo um questionário contendo três partes com itens que visavam: Parte 1) Caracterização sociodemográfica, educacional e de trabalho; Parte 2) Informações sobre atuação docente; Parte 3) Informações sobre ensino da assistência de enfermagem. O segundo instrumento constou de um roteiro norteador de entrevista composto por cinco questões subjetivas no qual os participantes foram encorajados a falar livremente acerca do seu entendimento e percepção sobre o processo de enfermagem, sua utilização e ensino desse método no curso de graduação; quais as estratégias utilizadas para lecionar a assistência de enfermagem; sugestões quanto a métodos didáticos a serem utilizados na aprendizagem para que o processo de enfermagem integre os conteúdos acadêmicos, e comentários que o docente desejasse fazer acerca do ensino do processo de enfermagem durante o curso de graduação de Enfermagem. Da análise dos dados obtidos na entrevista emergiram três temas - Visão docente sobre o Processo de Enfermagem; Percepções docentes acerca do ensino do Processo de Enfermagem; Abordagem do Processo de Enfermagem na formação do enfermeiro - e seis categorias - Norteador das ações de cuidado do enfermeiro; Raciocínio clínico mental; Utilização nas ações de cuidado; Relevância do ensino; Barreiras para o ensino; Estratégias de ensino com foco nas habilidades e competências do raciocínio clínico. Desse modo, obteve-se que os participantes compreendem a relevância do processo de enfermagem como um instrumento de trabalho do enfermeiro e que a abordagem desse método durante a formação do enfermeiro proporciona o desenvolvimento de habilidades e competências para o pensamento crítico necessário às ações de cuidado. Identificaram-se as estratégias de ensino que estimulam as habilidades e competências para o desenvolvimento do raciocínio clínico, contudo todo o corpo docente deve usar códigos dotados de sentido, orientação e influência para que os discentes interajam e sejam suscitados a utilizar o processo de enfermagem.

     
11
  • RAYSSA HORACIO LOPES
  • A pessoa com tuberculose e o cuidado de si.

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • GABRIELA MARIA CAVALCANTI COSTA
  • IRIS DO CEU CLARA COSTA
  • JACILEIDE GUIMARAES
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Mar 26, 2013


  • Show Abstract
  • A tuberculose é uma doença grave,com incidência e prevalência elevadas, sendo em
    muitos países um problema de saúde pública prioritário, persistindo com alta
    importância epidemiológica. Várias ações foram desenvolvidas para o seu controle ao
    longo do tempo e, dentre estas, recomenda-se à estratégia do tratamento supervisionado
    como medida efetiva, capaz de assegurar a adesão do paciente e reduzir o abandono
    ainda marcante. Ao vislumbrar a pessoa com tuberculose é importante observar o seu
    cuidado de si, bem como as dificuldades imbricadas neste processo, visto que o mesmo
    pode estar repercutindo diretamente no processo saúde/doença. O objetivo deste estudo
    é analisar o cuidado de si da pessoa com tuberculose. Estudo do tipo descritivo e
    abordagem qualitativa, realizado no Distrito Sanitário Oeste do município de Natal, RN.
    A coleta ocorreu por meio de uma entrevista semi-estruturada orientada por questões
    relativas aos aspectos sociodemográficos e sobre a doença, tratamento, e o cuidado de
    si. A coleta das informações ocorreu entre os meses de julho a setembro de 2012 e
    atendeu aos preceitos éticos recomendados pela Resolução 196/96, sendo apreciado e
    recebendo aprovação ética pelo Comitê de Ética em Pesquisa da Universidade Federal
    do Rio Grande do Norte. Para a análise dos resultados utilizou-se a técnica de análise de
    conteúdo temática de Laurence Bardin, sob o prisma do referencial teórico-filosófico do
    cuidado de si proposto por Michel Foucault. A partir dos três eixos temáticos e dos
    dados empíricos emergiram as seguintes categorias: Cuidado de si como execução de
    prescrições; Cuidado de si como satisfação de necessidades básicas; Dificuldades para o
    cuidado de si com a alimentação; Dificuldades para o cuidado de si relativas ao
    descanso e lazer; Dificuldades para o cuidado de si relativas aos serviços de saúde;
    Dificuldades para o cuidado de si relativas a hábitos e dependências; Tuberculose como
    tristeza e infelicidade; Tuberculose como algo normal e Mudanças no cuidar de si frente
    à tuberculose.Os resultados ressaltam que cuidado de si das pessoas com tuberculose,
    nesse estudo, são relativas em grande parte, ao seguimento de prescrições e ao domínio
    da dietética. Sobre as dificuldades relacionadas a prática do cuidado de si, observa-se
    que estas estão atreladas a alimentação adequada, tempo adequado para o descanso,
    morosidade dos serviços de saúde para agendamento de consultas e exames, bem como,
    ligadas aos hábitos e dependências na vida destas pessoas os quais não são fáceis
    abandonar. Cuidar-se com tuberculose representa para alguns, como algo deveras triste,
    causando sofrimentos psicológicos, entretanto a outros surge como normalidade. As
    principais mudanças no cuidado de si ante a tuberculose são voltadas para a
    alimentação, os lugares que frequentam, os hábitos e dependências, e sobre a
    convivência com outras pessoas. Este estudo contribuiu para uma reflexão dos usuários
    com tuberculose sobre o cuidado de si, revelando aspectos que os profissionais de saúde
    devem atentar ao assistir a estas pessoas, sendo possível visualizar na correria cotidiana,
    a necessidade de um espaço e tempo para si mesmo.

12
  • DANYELLA AUGUSTO ROSENDO DA SILVA COSTA
  • Estratégias de intervenção utilizadas por enfermeiros da ESF do município de Natal/RN no controle do câncer do colo de útero.

  • Advisor : REJANE MARIE BARBOSA DAVIM
  • COMMITTEE MEMBERS :
  • FATIMA RAQUEL ROSADO MORAIS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • MARIA TERESA CICERO LAGANA
  • NILBA LIMA DE SOUZA
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MARIE BARBOSA DAVIM
  • Data: Jun 21, 2013


  • Show Abstract
  • O câncer do colo do útero (CCU) é a segunda neoplasia mais prevalente entre as mulheres brasileiras. Os elevados índices de CCU no Brasil justificam a implementação de estratégias efetivas para o controle deste, que incluem ações de promoção à saúde; prevenção primária; detecção precoce e rastreamento; tratamento e cuidados paliativos. Apesar da existência do Programa Nacional de Controle do CCU não houve redução na incidência e mortalidade dessa doença no Brasil. A Estratégia Saúde da Família (ESF) apresenta potencialidades para promover esse controle e, neste contexto, deve-se considerar que os enfermeiros têm papel central. O estudo teve por objetivo geral conhecer as estratégias de intervenções utilizadas por enfermeiros da ESF do município de Natal/RN no controle do CCU, e como específicos: analisar o conhecimento desses enfermeiros sobre o CCU, descrever as ações desenvolvidas na ESF para o controle do CCU e identificar as dificuldades enfrentadas pelos mesmos para realizá-la. Trata-se de um estudo descritivo exploratório quantitativo desenvolvido por meio de um roteiro de entrevista estruturado com 106 enfermeiros que têm experiência com o controle do CCU nas equipes de ESF de Natal/RN. A análise dos dados foi realizada por meio da estatística descritiva. Os resultados apontaram como ações desenvolvidas na ESF para o controle do CCU, coleta do exame citopatológico, atividades de educação em saúde, consulta de enfermagem, encaminhamento de casos suspeitos para o acompanhamento médico e busca ativa de mulheres com o resultado do exame alterado. Ações como formação de grupos de prevenção e promoção à saúde; ampliação da cobertura dos exames e do horário de atendimento das consultas; estabelecimento de alternativas para acabar com a demanda reprimida nas Unidades de Saúde; participação no tratamento ou processo de reabilitação de usuárias com o CCU; intervenções para o manejo da dor; alianças e parcerias com escolas, indústrias e utilização de protocolos de atendimento não foram citadas pelos enfermeiros. Com este estudo pode-se perceber que os enfermeiros praticam parcialmente ações para o CCU no município de Natal/RN. Os participantes deste estudo, quando questionados sobre o CCU, especificamente quanto aos sinais e sintomas da doença e os fatores de risco, de forma geral apresentaram lacunas importantes. Dificuldades, como a falta de material para coleta do exame preventivo; espaço físico inadequado nas Unidades de Saúde; demanda reprimida no serviço; atraso na chegada do resultado dos exames; entraves nas ações de referência e contra-referência e fatores culturais fazem com que o controle do CCU seja comprometido. Acredita-se com essa investigação ter contribuído para uma reflexão sobre a importância do papel dos enfermeiros da ESF no desenvolvimento das ações de controle do CCU, apontando os fatores que interferem nestas. É importante o envolvimento de todos os enfermeiros que compõem a ESF como conhecedores dos fatores de risco, sinais e sintomas e dos instrumentos existentes para a detecção precoce do CCU; e na busca da melhoria da qualidade das ações de promoção à saúde da mulher, contribuindo no planejamento de intervenção futuras que possam reduzir a mortalidade causada por esta doença no município de Natal/RN. 

13
  • VIRGINIA SIMONATO AGUIAR
  • O cuidador familiar de pessoa com Doença de Alzheimer: história oral de vida

  • Advisor : REJANE MILLIONS VIANA MENESES
  • COMMITTEE MEMBERS :
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MARIA PAIVA DE MENEZES
  • REJANE MILLIONS VIANA MENESES
  • Data: Jun 26, 2013


  • Show Abstract
  • O presente estudo teve por objetivo compreender os sentimentos e as dificuldades enfrentadas pelo cuidador familiar no cuidado à pessoa acometida pela Doença de Alzheimer. Como procedimento metodológico, utilizou-se a história oral de vida, proposto por Bom Meihy, seguindo, portanto, uma abordagem qualitativa. Os colaboradores desta pesquisa consistiram de cinco cuidadores familiares de pessoas acometidas pela Doença de Alzheimer, integrantes do Grupo “Cuidando de quem Cuida” existente na Unidade de Saúde de Candelária situada em Natal-RN. Após cada entrevista, realizou-se a transcrição das falas e, posteriormente, os dados transcritos foram mostrados aos entrevistados para que eles conferissem o conteúdo, o que possibilitou a realização da transcriação. A análise foi pautada nas narrativas dos colaboradores em interlocução com estudos desenvolvidos e publicados sobre o tema em questão. As falas foram organizadas em torno de cinco tópicos: a incorporação do papel de cuidador familiar; a vida antes e após assumir o papel de cuidador; sentimentos e posicionamentos do cuidador após assumir o cuidado; dificuldades no cuidado; participação do grupo como alicerce para os cuidadores. As histórias mostraram muitas dificuldades na rotina diária dos cuidadores, e também que suas participações no Grupo “Cuidando de quem Cuida” ajudam na manutenção da qualidade de suas vidas. Esse resultado abre possibilidades para a construção de novas formas de abordagem e cuidado às pessoas que desempenham o papel de cuidador familiar contribuindo para fortalecimento de subsídios que os auxiliem no melhor enfrentamento das dificuldades diárias. Com este estudo, conclui-se que ser cuidador familiar de uma pessoa acometida pela DA é uma condição sofrida, desgastante e estressante envolvendo muitas renúncias em sua vida. Considera-se a situação vivenciada pelos cuidadores familiares e as próprias pessoas acometidas pela DA uma questão de saúde pública. Dessa forma, necessita de medidas urgentes de investimentos em políticas sociais e programas de atenção e promoção da saúde das pessoas acometidas pela DA e também de seus cuidadores familiares.

14
  • PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
  • Compreensão do típico ideal de técnicos de enfermagem acerca da sistematização da assistência de enfermagem.

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • MARIA TEREZINHA ZEFERINO
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Aug 16, 2013


  • Show Abstract
  • Objetivou-se compreender o típico ideal do técnico de enfermagem acerca da sistematização da assistência de enfermagem, à luz do referencial teórico de Alfred Schutz. Trata-se de uma investigação fenomenológica compreensiva, utilizando o referencial teórico de Alfred Schutz. Para o desvelamento do fenômeno (o típico ideal do técnico de enfermagem acerca da sistematização da assistência de Enfermagem), o processo de pesquisa configurou-se a partir da proposta de princípios orientadores de uma metodologia de pesquisa com base na própria obra de Schutz, realizada por Zeferino (2010), em seu doutoramento. Para coleta de dados, utilizou-se a técnica do grupo focal, contando-se com a colaboração de treze técnicos de enfermagem atuantes em um hospital universitário norte-riograndense, que responderam positivamente ao critério de inclusão: atuar no hospital de estudo, realizando cuidados assistenciais diretos aos pacientes. Quarenta e quatro sujeitos demonstraram interesse em participar, sendo realizado um sorteio para seleção da amostra da pesquisa, composta por 14 profissionais, dos quais um não compareceu ao encontro de coleta de dados. O grupo focal, intitulado “O que eu penso acerca da sistematização da assistência de enfermagem”, aconteceu no dia 15 de fevereiro de 2013, totalizando 101 minutos. Foi realizado de acordo com a Pedagogia Vivencial Humanescente, utilizando a construção de cartazes como técnica projetiva, a partir da questão chave: “O que é sistematização da assistência de enfermagem para você?”. A fim de compreender um pouco da situação biográfica dos participantes, foi aplicado um questionário aos participantes do estudo. A partir da concordância dos sujeitos, o grupo focal foi gravado e fotografado, contando com a cooperação de um relator e de dois outros colaboradores. Foi utilizado o Microsoft Word 2010 para a realização da transcrição do encontro e o Microsoft Excel 2010 para sintetização dos resultados por meio de uma planilha. O estudo seguiu os princípios éticos e legais que regem a pesquisa científica em seres humanos, preconizados na Resolução n° 19696, sendo aprovado pelo Parecer Consubstanciado do Comitê de Ética em Pesquisa da UFRN, nº 98.424, de 31 de agosto de 2012, CAAE nº 05906912.0.0000.5537. A análise das falas dos técnicos de enfermagem, juntamente com a contemplação de seus cartazes e de suas descrições escritas, permitiu a partir dos princípios orientadores de Zeferino (2010), à luz do referencial de Alfred Schutz, desvelar o típico ideal dos técnicos de enfermagem acerca da sistematização da assistência de enfermagem, perpassando quatro eixos temáticos: tipificação do conceito da sistematização da assistência de enfermagem; benefícios, que se traduziram nos motivos-para acreditar na positividade dessa ferramenta de trabalho; problemas vivenciados, reveladores do mundo vida cotidiano dos profissionais de enfermagem; e possibilidades de melhoria. Concluiu-se que os técnicos de enfermagem desconhecem a sistematização da assistência de enfermagem. Contudo, tipificam uma percepção muito positiva acerca da mesma, em especial, com relação às melhorias que essa pode promover no cuidado.

15
  • MARIA DAS GRACAS PEREGRINO DE SOUSA SANTOS
  • Cuidado de enfermagem ao potencial doador de órgãos em morte encefálica: uma reflexão sobre a prática. 

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ALEXSANDRO SILVA COURA
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CECILIA NOGUEIRA VALENCA
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Aug 30, 2013


  • Show Abstract
  • Apesar dos avanços tecnológicos que favorecem o processo de transplante, existem problemas de eficácia do cuidado necessário para a manutenção dos órgãos dos potenciais doadores em morte encefálica, que contribuem para a não efetivação dos transplantes com órgãos e tecidos desses pacientes. Pressupõe-se que os problemas estariam relacionados às percepções e compreensões que os profissionais das unidades de internação possuem acerca dos cuidados exigidos mediante o diagnóstico de morte encefálica. O objetivo deste estudo foi identificar o significado do cuidado de enfermagem ao potencial doador de órgãos em morte encefálica para a equipe de enfermagem. Pesquisa qualitativa norteada pela teoria Ciência Ação e a metodologia da investigação crítica-reflexiva realizada com cinco enfermeiros e 19 técnicos de enfermagem do Centro de Reabilitação Operatório de um hospital público de Natal/RN. Dados foram coletados por meio da entrevista semiestruturada com reflexão individual sobre os cuidados e por meio de entrevista de grupo. A análise foi realizada de forma temática conforme Bardin. Durante a reunião de grupo os participantes foram conduzidos em uma discussão sobre a necessidade de mudanças e como proceder para realizá-las. Os resultados indicam que as ações dos profissionais são condizentes com as requeridas para manutenção do potencial doador de órgãos, ainda que os recursos materiais e humanos não sejam adequados. Essa situação conduz os profissionais a elaborar um significado do cuidado como de um labor a mais, exigindo mais do que eles podem dar. Expressam crenças e sentimentos que dizem respeito à esperança de que seu cuidar traz um bem maior, o de salvar vidas. A reflexão para uma possível mudança de ação foi difícil de realizar devido aos profissionais não conseguir se auto avaliar, o que os leva a direcionar suas sugestões de mudanças para os outros membros da equipe. Conclui-se que o cuidado realizado com estes pacientes é um cuidado difícil, evidenciado pelo sofrimento tanto pela situação de morte do ser cuidado e a dor de seus familiares, quanto pelas condições de trabalho desumanizantes, contribuindo para que eles mesmos se distanciem dos pacientes para não sofrerem tanto. Os conhecimentos imbuídos no seu agir, são de tipo científico, ético, estético e pessoal, com predominância do científico, seguido do pessoal. O estudo se mostrou relevante para a prática da enfermagem na manutenção ao potencial doador, na medida em que permitiu a identificação dos conhecimentos utilizados pela enfermagem em sua prática assistencial e a compreensão do significado dos profissionais sobre o cuidado realizado, como uma ação boa que traz satisfação quando o transplante é efetivado. Sugere-se outras experiências com a metodologia de investigação critico reflexiva e da prática reflexiva, tanto na pesquisa como no ensino de enfermagem.

16
  • MARTA BATISTA DA SILVA
  • Trajetória de vida de mulheres mastectomizadas a luz da História Oral.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • MARIA TERESA CICERO LAGANA
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • REJANE MILLIONS VIANA MENESES
  • Data: Nov 8, 2013


  • Show Abstract
  • Introdução: Uma questão de grande relevância para a saúde pública refere-se ao câncer de mama, considerado o responsável pela maior causa de morte na população feminina no mundo, inclusive no Brasil. O câncer de mama, dentre as neoplasias malignas, tem sido o responsável pelos maiores índices de mortalidade tornando-se uma das grandes preocupações no que diz respeito à saúde da mulher. Apesar de ser considerado um câncer de relativamente bom prognóstico, se diagnosticado e tratado oportunamente, as taxas de mortalidade por câncer de mama continuam elevadas no Brasil, muito provavelmente porque a doença, ainda seja diagnosticada em estágios avançados. Diante deste contexto, questiona-se: Quais as mudanças ocorridas na vida cotidiana, da mulher após diagnostico de câncer de mama? Objetivo: narrar a trajetória de mulheres mastectomizadas a luz da história oral. Métodos e Técnicas: Utilizou-se do enfoque de história oral de vida como referencial metodológico. Participaram como colaboradoras 20 mulheres integrantes do Grupo “Despertar” vinculado à Liga Norte Rio-Grandense Contra o Câncer, Natal/RN. Aprovado pelo Comitê de Ética em Pesquisa da Liga Norte-Riograndense Contra o Câncer, Protocolo n. 150/2011. Resultados: Discute-se a problemática em forma de manuscritos, inicialmente, a partir da compreensão de “Mulheres com câncer de mama submetidas à quimioterapia: assistência de enfermagem através de uma análise contextual”; seguido dos “Sentimentos e expectativas de mulheres com diagnóstico de câncer de mama: uma reflexão”; e finalmente, da “Trajetória de vida de mulheres mastectomizadas a luz do Discurso do Sujeito Coletivo (DSC)” e suas etapas: expressões-chaves, ideias centrais, discurso do sujeito coletivo. Emergiram três eixos temáticos, sustentado por suas respectivas ideias centrais, cada um referente, ao antes, durante e o depois da mastectomia: "encarar a vida de frente” - "vida normal", “separação", "mudança", "trabalho" e "filhos"; "falei com Deus" - “prevenção/cuidados”, “diagnóstico/tratamento”, “sentimentos/emoções” e “mudanças”; "reorganização com mais objetividade e experiência” - "crença”, “mudança” e “sentimentos/emoções”. Considerações Finais: Reconhecem-se o alcance do objetivo proposto e das lacunas do trabalho, embora, não o torna menos relevante do ponto de vista científico e da oralidade expressão pelas colaboradoras do estudo, além do sentido atribuído a vida depois da mastectomia. Ressalta-se a necessidade, de estudos sobre grupos de auto-ajuda voltados para as mulheres mastectomizadas e maior divulgação dos resultados, para subsidiar políticas públicas, ou simplesmente, capacitar os profissionais da saúde para um atendimento humanizado e incentivar novos grupos.

17
  • ADRIANA KARLA DE OLIVEIRA FERREIRA
  • CONCEPÇÕES DE POLICIAIS MILITARES SOBRE CUIDADOS COM SUA SAÚDE

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • CLEIDE MARIA PONTES
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • RAIMUNDA MEDEIROS GERMANO
  • ROSINEIDE SANTANA DE BRITO
  • WILMA DIAS DE FONTES
  • Data: Nov 19, 2013


  • Show Abstract
  • A ausência de cuidados do homem com a saúde representa fenômeno significativo,
    pois contribui para o aumento da morbidade e mortalidade masculina por causas
    evitáveis. Esta realidade torna-se mais relevante quando se trata do policial militar
    devido às peculiaridades do seu processo de trabalho. Visto isso, considera-se que
    os cuidados de saúde adotados por policiais militares atrelam-se ao entendimento
    que possuem sobre os agravos a saúde, o qual perpassa por concepções de gênero
    e a profissão. Isto levou ao questionamento: Como o policial militar concebe os
    cuidados com sua saúde. Objetivou-se analisar concepções de policiais militares
    sobre cuidados com sua saúde. Trata-se de um estudo exploratório e descritivo em
    abordagem qualitativa desenvolvido junto a um Batalhão Militar do Comando de
    Policiamento de Natal, Rio Grande do Norte, Brasil. A coleta de dados foi realizada
    no período de junho a julho de 2013. Antecedeu esta etapa a anuência do
    Comandante Geral da Polícia Militar do Rio Grande do Norte, sob aprovação nº
    CAAE 15449713.7.0000.5537 do Comitê de Ética em Pesquisa da Universidade
    Federal do Rio Grande do Norte e autorização formal dos entrevistados com
    assinatura do termo de consentimento livre e esclarecido, atendendo as exigências
    da Resolução 466/2012, do Conselho Nacional de Saúde no que se refere à
    pesquisa com seres humanos. Participaram do estudo 21 policiais militares, do sexo
    masculino, que trabalhavam no policiamento ostensivo, não estavam de licença
    médica e apresentaram condições psicológicas e/ou físicas favoráveis para
    responder aos questionamentos. Os dados foram coletados por meio de entrevista
    semiestruturada mediante um roteiro constituído de duas partes: a primeira contendo
    questões sócio-demográficas com vistas à caracterização dos participantes da
    pesquisa e a segunda com duas questões norteadoras relativas ao objeto de estudo.
    Os depoimentos foram tratados conforme o método de análise de conteúdo na
    modalidade de análise temática segundo Bardin. Desse processo emergiram três
    categorias: hábitos de vida de policiais militares, repercussão do trabalho na saúde
    de policiais militares e atitudes de policiais militares frente aos problemas de saúde.
    A análise dos dados foi subsidiada pelo referencial teórico do Modelo de Crenças em
    Saúde-Health Belief Model de acordo com as variáveis vulnerabilidade e barreiras.
    Para respaldar a discussão dos resultados buscou-se na literatura conhecimentos
    acerca da saúde do homem e do policial militar. Os resultados apontaram que os
    entrevistados procuram cuidar da sua saúde com práticas de exercícios físicos,
    alimentos saudáveis e preservação do sono. No entanto, vivenciam dores de coluna,
    ganho de peso, dificuldades para dormir, estresse e sofrimento psicológico. Diante
    disto, eles buscam apoio quando acometidos por agravos a saúde e reconhecem a
    necessidade de medidas de segurança durante o serviço. Portanto, percebem a sua
    condição de vulnerabilidade em decorrência de seu ofício, entretanto enfrentam
    dificuldades na adoção de práticas preventivas de agravos a saúde. Mediante os
    resultados, faz-se necessário que o enfermeiro atuante junto a este público elabore,
    implemente e acompanhe estratégias de atenção a saúde de policiais militares.

18
  • STEPHANIE BARBOSA DE MEDEIROS
  • Automedicação e guarda de medicamentos por universitários das áreas da saúde e da tecnologia.

  • Advisor : FRANCIS SOLANGE VIEIRA TOURINHO
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • MARISE REIS DE FREITAS
  • QUENIA CAMILLE SOARES MARTINS
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Nov 28, 2013


  • Show Abstract
  • O estudo teve como objetivo caracterizar nos estudantes universitáriosda área da saúde e da área tecnológica a prática da automedicação e do abastecimento doméstico de medicamentos. Trata-se de um estudo descritivo, com delineamento transversal e abordagem quantitativa, desenvolvido em uma Universidade Pública Federal do município de Natal, Rio Grande do Norte, durante os meses de agosto de 2011 a agosto de 2012. A amostra constituiu-se de 300 universitários do terceiro ano dos cursos de graduação do Centro de Ciências da Saúde e do Centro de Tecnologia, selecionados por meio de uma amostra aleatória simples. Para a análise dos dados, foi realizada a estatística descritiva e análises bivariadas aplicando o teste de Fisher e Qui-quadrado com nível adotado de significância α=5% e 10%. As variáveis que se correlacionaram com o uso da automedicação (p <0,05) foram posteriormente calculadas as razões de chance e intervalos de confiança. A prevalência dos universitários que realizaram a automedicação nos últimos 15 dias antecedentes a coleta correspondeu a 33,66% e, ao analisar cada área de conhecimento, verificou-se uma maior prevalência da automedicação nos estudantes pertencentes à área tecnológica (37,33%). A associação entre os aspectos sociodemográficos dos participantes com esta prática revelou associação significativa apenas entre as variáveis renda e automedicação (p=0,005). Os analgésicos e antipiréticos gerais (N02) se configuraram como o grupo terapêutico mais usado na automedicação (57,42%), destacando-se o acetaminofeno (28,7%), e as principais situações de saúde que motivaram esta prática relacionaram-se com a dor, principalmente as cefaleias/dores de cabeça (48,51%). Quanto à indicação dos medicamentos utilizados, a maioria dos universitários automedicou-se por conta própria. Em relação ao abastecimento domiciliar de medicamentos, a grande maioria dos participantes possuía uma farmácia caseira (88%). Ao analisar as características socioeconômicas, as variáveis “serviço médico” e “farmácia domiciliar” apresentaram associação significativa (p=0,002946). Os analgésicos e antipiréticos gerais constituíram a especialidade farmacêutica mais presente nas farmácias domiciliares, destacando-se o acetaminofeno. O principal cômodo utilizado para a armazenagem dos medicamentos foi a cozinha (36,36%), a maioria dos universitários guardava estes produtos em caixas de diferentes materiais (38,63%) e os medicamentos estocados nos domicílios da maioria dos participantes não eram de acesso fácil para crianças (75%). Esta investigação apresentou evidências que podem auxiliar significativamente futuras pesquisas, contribuindo para o conhecimento da temática e discussão sobre um importante problema de saúde pública mundial. Além de proporcionar avanços à área da enfermagem, diante da carência de estudos realizados por enfermeiros/ estudantes de enfermagem no país frente à questão.

19
  • LORENA MARA NOBREGA DE AZEVEDO
  • Enfermeiros pós-graduados: continuidades e rupturas no cotidiano profissional de hospitais universitários.

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • JOÃO BOSCO FILHO
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • ROSANA LUCIA ALVES DE VILLAR
  • SORAYA MARIA DE MEDEIROS
  • Data: Nov 28, 2013


  • Show Abstract
  • A presente pesquisa teve como objetivo analisar as transformações do cotidiano profissional do enfermeiro do hospital universitário após a realização do curso de mestrado. Trata-se de um estudo com abordagem qualitativa, realizado no Complexo Hospitalar Universitário da UFRN, composto pelo Hospital Universitário Onofre Lopes (HUOL), Maternidade Escola Januário Cicco (MEJEC), e Hospital de Pediatria Professor Heriberto Ferreira Bezerra (HOSPED) localizados em Natal-RN; e pelo Hospital Universitário Ana Bezerra (HUAB) situado em Santa Cruz-RN. A população foi composta por vinte e dois enfermeiros, com título de mestre em enfermagem, que trabalham nessas instituições. Após encaminhamento e aprovação pelo Comitê de Ética em pesquisa, conforme Parecer nº 268.498 e CAAE: 13922713.1.0000.5537, as entrevistas foram iniciadas, utilizando-se um roteiro semiestruturado, organizado em questões orientadas em conformidade com os objetivos do estudo. Do material empírico, emergiram as categorias que foram trabalhadas com base na análise de conteúdo temática, tendo como aporte teórico os estudos de Agnes Heller acerca do cotidiano e os de Paulo Freire sobre educação e mudanças, buscando a possível interlocução entre esses autores. Os resultados demonstram que o cotidiano dos enfermeiros nos hospitais universitários, após cursarem o mestrado, modifica-se a partir da própria motivação em cursá-lo e do apoio institucional recebido. As continuidades e rupturas apontadas estão distribuídas nas categorias: a inércia da cotidianidade, na qual os enfermeiros relatam a dificuldade em mudar seu cotidiano devido à rotina exaustiva e à falta de apoio; reconhecem mudanças particulares, compreendendo a formação de um olhar crítico/reflexivo/analítico, e a qualificação para o ensino e pesquisa; e as rupturas do cotidiano, que se referem às mudanças ocorridas no serviço, como a melhoria da assistência, pela implantação de resultados; e uma prática diferenciada por ter um profissional qualificado. Portanto, considera-se que a realização do mestrado contribuiu para o crescimento intelectual e profissional do enfermeiro e, consequentemente, para o serviço, no cotidiano do Complexo Hospitalar Universitário, sendo reconhecido pelos enfermeiros o compromisso com uma maior responsabilidade social. Porém, ainda são necessárias reflexões sobre maneiras de minimizar as dificuldades apontadas, como forma de incentivar essa qualificação.

20
  • ROSANA KELLY DA SILVA MEDEIROS
  • Validação de conteúdo de instrumentos sobre conhecimento e habilidade em sondagem nasogástrica.

  • Advisor : MARCOS ANTONIO FERREIRA JUNIOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • ELIZABETH BARICHELLO
  • GRAZIELLE ROBERTA FREITAS DA SILVA
  • MARCOS ANTONIO FERREIRA JUNIOR
  • MARIA LÚCIA IVO
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Nov 28, 2013


  • Show Abstract
  • Este estudo teve como objetivo verificar a validade de instrumentos sobre conhecimento e habilidade em sondagem nasogástrica. Trata-se de um estudo metodológico realizado na Universidade Federal do Rio Grande do Norte (UFRN) e na Universidade do Estado do Rio Grande do Norte (UERN). A amostra foi composta por 23 juízes da pesquisa, selecionados a partir dos critérios de inclusão: serem enfermeiros, docentes nas disciplinas de Semiologia e/ou Semiotécnica de Enfermagem, ter no mínimo um ano de experiência nestas disciplinas e ser das instituições selecionadas para o estudo. A pesquisa se desenvolveu em três etapas: (A) construção de dois instrumentos com base na revisão da literatura que resultou em um roteiro de observação da habilidade estruturado composto por 28 itens e um questionário sobre o conhecimento com 12 questões; (B) submissão dos instrumentos aos juízes, no período de junho a setembro de 2012, os quais deveriam julgar cada item como “adequado”, “adequado com alterações” ou “inadequado”, além de fazer uma avaliação geral de cada instrumento baseada em 10 requisitos adaptados do referencial teórico de Pasquali; e (C) validação com a verificação do nível de concordância entre os juízes, por meio da aplicação do Índice de Validade de Conteúdo (IVC) e do Índice Kappa. Utilizou-se o nível de consenso maior que 0,75 para o IVC e maior que 0,61 (bom) para o Índice Kappa. Estudo aprovado pelo Comitê de Ética em Pesquisa do Hospital Universitário Onofre Lopes (CEP/HUOL), sob CAAE nº 0002.0.294.000-10. Após serem codificados e tabulados, os dados foram analisados por meio de estatística descritiva. Dos 23 juízes, 87% eram do sexo feminino, com média de idade de 36,5 anos, 73,9% atuavam na UFRN, 78,3% possuíam mestrado acadêmico e 69,6% atuavam exclusivamente na docência. A média de tempo de experiência na docência foi de 7,9 anos e nas disciplinas de Semiologia e/ou Semiotécnica de Enfermagem foi de 5,6 anos. No julgamento do roteiro de observação estruturado e do questionário sobre o conhecimento, nenhum item/questão considerou-se inadequado, uma vez que todos obtiveram nível de concordância dentro dos índices estabelecidos (IVC > a 0,75 e Kappa > 0,61). Em relação ao roteiro estruturado para avaliar habilidade, dos 28 itens presentes, 13 apresentaram índice de concordância perfeito (IVC=1,00; Kappa= 1,00) e outros 15 foram considerados adequados com alterações, principalmente no que diz respeito à sequência instrucional dos tópicos, clareza e vocabulário. No questionário sobre o conhecimento, dentre as 12 questões que o compunham, 03 apresentaram índice de concordância perfeito e as demais adequadas com alterações quanto aos requisitos vocabulário, clareza, atualização e precisão. Em relação à avaliação geral dos instrumentos, o roteiro estruturado de habilidade obteve IVC de 0,95 e Kappa de 0,91 e o questionário do conhecimento, IVC de 0,94 e Kappa de 0,88. Os dois instrumentos mostraram-se válidos quanto ao seu conteúdo, e constituem ferramentas para observar a qualidade da assistência de enfermagem em relação à habilidade e conhecimento em sondagem nasogástrica. 

21
  • CAMILA DANNYELLE FERNANDES DUTRA PEREIRA
  • Segurança do Paciente no sistema de medicação: análise de enfermeiros de um hospital de ensino.

  • Advisor : FRANCIS SOLANGE VIEIRA TOURINHO
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • GRACE TEREZINHA MARCON DAL SASSO
  • QUENIA CAMILLE SOARES MARTINS
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Nov 29, 2013


  • Show Abstract
  • O estudo objetivou avaliar a Segurança do Paciente no sistema de medicação na visão dos enfermeiros de um hospital de ensino a partir de fotografias digitais. Tratou-se de um estudo descritivo e quantitativo, em um hospital de ensino no Rio Grande do Norte. A população foi composta por 42 enfermeiros das unidades de internação, dos quais 34 compuseram a amostra. Como critério de inclusão definiu-se os enfermeiros servidores públicos; e critério de exclusão os enfermeiros contratados temporariamente. A coleta dos dados utilizou o método fotográfico, através da Técnica de Análise Fotográfica de Patrícia Marck (Canadá), desenvolvida em três momentos: inicialmente foi realizada a captura aleatória das fotografias do sistema de medicação, resultando em 282 imagens; o segundo momento consistiu na seleção/tratamento das fotografias, as quais foram reduzidas a 10 imagens no Microsoft Excel 2010 (aleatórioentre); no terceiro momento, os enfermeiros responderam ao questionário dividido em perfil sócio profissional e Digital Photography Scoring Tool (composto de duas questões – “a” e “b”). Para análise da questão “a” utilizou-se a técnica de análise de conteúdo para categorização dos dados e da questão fechada “b”, o Statistical Package for the Social Scienses (20.0 - acesso livre). A Resolução nº 196/1996 do Conselho Nacional de Saúde, revisadas pela Resolução nº 466/2012, foi legalmente cumprida, respeitando os aspectos éticos das pesquisas com seres humanos (0098.0.051.294-11). O perfil sócio profissional caracterizou-se pelo predomínio: do sexo feminino; da faixa etária 34-43 anos; de profissionais com especialização; destacando-se o período de 10 a 18 anos de tempo de serviço; e enfermeiros sem outros vínculos empregatícios. Acerca do conhecimento sobre Segurança do Paciente, quase todos afirmaram conhecer este tema. Da avaliação da segurança das 10 fotografias, adaptando os escores (1 a 10) a Escala de Likert, identificou-se uma classificação distribuída em três Totalmente Inseguras (Grau 1), três Inseguras (Grau 2), três Seguras Parcialmente (Grau 3), uma Segura (Grau 4), não havendo fotografia considerada Segura Totalmente. Tratando-se da área fotografada em relação à segurança do paciente no sistema de medicação, os recortes realizados para facilitar a compreensão dos dados resultaram em categorias específicas para cada etapa considerada. Da dispensação, identificou-se: “Conferência adequada”; “Conferência inadequada”; “Identificação correta”; “Dispensação em dose unitária” e “Ambiente impróprio”, com predominância desta última categoria. Enquanto que do armazenamento: “Armazenamento adequado”; “Armazenamento inadequado”; “Risco de troca/desaparecimento” e “Higiene precária”, com destaque para o armazenamento inadequado. No preparo: “Risco de troca de medicamento/paciente”; “Espaço físico inapropriado” e “Preparo inadequado de medicamentos de uso controlado”; destacando-se a primeira categoria. Na administração dos medicamentos: “Ausência de EPI”; “Uso de EPI”; “Técnica incorreta de administração”; “Técnica correta de administração”; “Identificação correta do medicamento”; “Identificação incorreta do medicamento” e “Acesso venoso periférico sem identificação”. Através da classificação de Likert identificou-se o predomínio da insegurança no sistema de medicação na opinião dos enfermeiros. Ainda, possibilitou compreender que, apesar dos enfermeiros perceberem aspectos seguros, as categorias de maior prevalência caracterizam uma avaliação insegura. A enfermagem precisa refletir acerca da prática, identificando falhas no sistema de medicação para alcançar um cuidado adequado e seguro.

22
  • CAROLINE EVELIN NASCIMENTO KLUCZYNIK
  • Enfermagem na Atenção Primária em Saúde no screening de adolescentes com excesso de peso

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CARLA CAMPOS MUNIZ MEDEIROS
  • NEUSA COLLET
  • Data: Nov 29, 2013


  • Show Abstract
  • Uma das atividades do enfermeiro na Atenção Primária em Saúde é a assistência ao adolescente, através de atividades como o acompanhamento do crescimento, identificação e prevenção do excesso de peso. Definiu-se como objetivo desse estudo analisar o excesso de peso em adolescentes escolares e a percepção do enfermeiro das Unidades Básicas de Saúde (UBS) a essa clientela. Estudo transversal, realizado em escolas estaduais do município de Natal-RN e nas UBS responsáveis pelas escolas. A população de alunos das escolas municipais foi 27.377. Com base em procedimento estatístico para cálculo de amostras, definiu-se uma amostra estratificada de acordo com a população de alunos nos quatro distritos sanitários: 112 na Norte, 74 na Oeste, 108 na Leste e 78 na Sul, o que totalizou 372 adolescentes. Na seleção de alunos, sorteou-se oito escolas, duas por distrito, e as turmas participantes, de forma aleatória, até totalizar o tamanho das subamostras por distrito. Das oito escolas apenas quatro faziam parte de território coberto por UBS, o que definiu o número de enfermeiros a participar de uma entrevista semi-estruturada e gravada. Coletaram-se dados antropométricos e de saúde dos adolescentes por meio de um formulário e analisou-se pelo IBM SPSS 19.0. Sobre as entrevistas com os enfermeiros, as falas foram transcritas e analisadas quanto ao conteúdo. Dentre os adolescentes, identificou-se 50 com o Diagnóstico de Enfermagem (DE) excesso de peso e formaram o primeiro grupo, os demais 322 formaram o outro grupo sem o DE. Os dois grupos afirmaram praticar atividade física satisfatoriamente, entretanto apresentaram baixo consumo de alimentos saudáveis. Verificou-se associação com o consumo de alimentos de risco cardiovascular, os indivíduos com o DE tinham 4,42 vezes mais chance de consumir insatisfatoriamente embutidos, 2,13 frituras e 1,18 macarrão. Verificou-se associação com história familiar de doenças, o grupo com o DE apresentou 1,89 mais chance de possuir familiar com diabetes, 2,14 para hipertensão, 2,3 para obesidade e 1,72 para doença nos rins. Sobre à percepção das enfermeiras, elas julgaram fundamental a assistência aos adolescentes com excesso de peso, mas apontaram dificuldades, primeiramente devido a pouca procura dessa clientela pelos serviços de saúde, especialmente na APS; segundo, pelo excesso de tarefas do enfermeiro nas UBS; e por fim a baixa articulação com as escolas. Elas reconhecem o problema, mas se isentaram de condutas de maior impacto, atribuindo a outros profissionais a responsabilidade. Conclui-se que DE excesso de peso é um desvio nutricional relevante em adolescentes de escolas estaduais de Natal/RN, com frequência de 13,5%; e está relacionado ao consumo de alimentos de risco cardiovascular e história familiar de doenças.  Além disso, segundo a percepção das enfermeiras, o excesso de peso é um importante problema de saúde pública, que necessita de assistência de enfermagem, mas que elas não visualizam uma maneira de manter vínculo com o adolescente e estratégias para promover assistência de enfermagem resolutiva diante desse DE.

23
  • HILDERJANE CARLA DA SILVA
  • Trauma em idosos atendidos pelo serviço pré-hospitalar móvel. 

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • MARIA DO ROSARIO DE MENEZES
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Dec 12, 2013


  • Show Abstract
  • O objetivo deste estudo foi caracterizar a ocorrência de traumas na população idosa atendida pelo serviço pré-hospitalar móvel, no município de Natal, Rio Grande do Norte. Trata-se de um estudo descritivo, de abordagem quantitativa e delineamento transversal, cuja população foi constituída por 2.080 vítimas de trauma. A amostra, do tipo aleatória sistemática, consistiu em 400 pessoas idosas, com idade a partir de 60 anos, assistidas pelo Serviço de Atendimento Móvel de Urgência de Natal/RN, entre janeiro de 2011 a dezembro de 2012. A coleta de dados teve início após consentimento da instituição e parecer favorável de um Comitê de Ética em Pesquisa sob o nº 309.505. Procedeu-se à análise documental retrospectiva das fichas de atendimento do serviço através de um formulário de elaboração própria, validado por juízes especialistas, considerado como confiável (α>0,75) e válido (IVC=0,97) em sua clareza e relevância. Os dados foram tabulados pelo software Statistical Package for Social Science, versão 20.0. Os resultados obtidos evidenciam que as vítimas idosas possuem idade média de 74,19 anos (dp±10,25), com prevalência do sexo feminino (52,25%), acometimento por doenças crônicas, especialmente a hipertensão arterial (11%), uso médio de 2,2 medicamentos rotineiros (dp±1,53), com sinais vitais dentro dos padrões de normalidade. Os traumas prevaleceram no período diurno, na residência das vítimas, zona norte da cidade e nos fins de semana. Entre os mecanismos de trauma destacaram-se as quedas, os acidentes de trânsito e as agressões físicas, cujo tipo de trauma mais comum foi o cranioencefálico (18,75%) e principais consequências os ferimentos passivos de sutura (31%) e as fraturas fechadas (24,5%). As Unidades de Suporte Básico estiveram como as mais acionadas para o atendimento pré-hospitalar (87,8%) e o principal local de destino consistiu no hospital de referência em urgência do Estado (57,5%). Entre os procedimentos mais realizados pela equipe de enfermagem destacaram-se a imobilização com prancha rígida e colar cervical (34,5%), bem como a punção venosa periférica (19,3%), tendo como principal componente utilizado para reposição volêmica a solução fisiológica (8,3%). Houve relação significativa entre os óbitos e o mecanismo de trauma (p=0,001); mecanismo de trauma e procedimentos realizados (p≤0,001), exceto administração de medicamentos; procedimentos realizados, exceto de imobilização, e unidade destinada ao atendimento (p<0,001). Ressaltam-se os índices de pessoas idosas vítimas de trauma, o seguimento deficiente do protocolo Pre-Hospital Trauma Life Suport, a incipiência dos registros e procedimentos de enfermagem realizados. Há necessidade de um protocolo de atendimento ao trauma específico às vítimas idosas e estratégias de educação para a prevenção de eventos desta natureza.

24
  • ANA CLAUDIA CARDOZO CHAVES
  • Processo de trabalho na Estratégia Saúde da Família: potencialidades e fragilidades da atuação do enfermeiro.

     
  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • CECILIA NOGUEIRA VALENCA
  • JOSE WILLINGTON GERMANO
  • MAURICIO ROBERTO CAMPELO DE MACEDO
  • REJANE MILLIONS VIANA MENESES
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 12, 2013


  • Show Abstract
  • O presente estudo tem como objetivo analisar o processo de trabalho na Estratégia Saúde da Família, enfocando a atuação do enfermeiro e identificando aspectos que possam configurar potencialidades e fragilidades no seu desenvolvimento. Trata-se de um estudo de caso analítico e exploratório, com abordagem qualitativa e marco teórico-metodológico na Hermenêutica Dialética. Os campos empíricos selecionados para a pesquisa são as Unidades de Saúde da Família do município de Natal, RN, Brasil e como sujeitos do estudo os enfermeiros que atuam nessa Estratégia. Realizou-se a coleta de informações através de entrevista individual semiestruturada aliada à observação de campo, após aprovação no Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, conforme diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos (resolução 466/12), assegurando os devidos preceitos éticos. Projeto aprovado pelo parecer de número 398.929, CAAE 19588813.7.0000.5537. Dos 9 enfermeiros entrevistados, 8 do sexo feminino e 1 masculino, com média de idade de 52 anos, média de tempo de graduação de 27 anos e tempo médio de permanência num mesmo território da ESF de 7 anos. Verificou-se que cabe ao profissional enfermeiro na Saúde da Família o importante papel de cuidar do ser humano em seus contextos de vida, família e comunidade, produzindo condições à satisfação de suas necessidades através do agir terapêutico em saúde, utilizando para tanto instrumentos materiais (equipamentos e insumos) e imateriais (tecnologias). A potência no trabalho do enfermeiro na ESF evidencia-se na sua centralidade na equipe multiprofissional, nas ações de vigilância e na humanização em saúde, através de posturas acolhedoras e articuladoras. Também se mostram potencialidades, a cooperação no trabalho em equipe e a relativa autonomia presente no trabalho do enfermeiro. No município em questão, a vinculação profissional na ESF por concurso em regime estatutário e a adesão a programas federais que viabilizam melhorias nas condições de trabalho são aspectos considerados positivos para o trabalho. Constitui uma fragilidade no trabalho do enfermeiro na ESF a concentração de atividades, gerando sobrecarga e tornando a jornada de trabalho insuficiente para realiza-lo em plenitude. Os transtornos que ocorrem no processo de trabalho também o fragilizam, exigindo adaptações frequentes, desencadeando cansaço e estresse no trabalhador. Outros aspectos frágeis são a baixa cobertura da ESF neste município e, de maneira geral, a vulnerabilidade da ESF diante da dinâmica política nas três esferas de gestão. Considera-se necessário compreender os dilemas vivenciados no cotidiano dos enfermeiros da ESF, como parte de equipes multiprofissionais, tendo em vista a conquista real de mudanças nos processos de trabalho. Em consonância, é preciso promover a desprecarização das condições de trabalho na saúde e o bem estar dos protagonistas do trabalho no SUS.

25
  • TAYSSA SUELEN CORDEIRO PAULINO
  • CONQUISTAS E DESAFIOS DO PROCESSO DE TRABALHO DE ENFERMAGEM: o caso dos CAPS em Natal/RN.

  • Advisor : ALLYNE FORTES VITOR
  • COMMITTEE MEMBERS :
  • ALLYNE FORTES VITOR
  • EDNALDO CAVALCANTE DE ARAÚJO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • ROSANA LUCIA ALVES DE VILLAR
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Dec 12, 2013


  • Show Abstract
  • A desinstitucionalização em saúde mental preconiza a partir de diretrizes a diminuição da oferta de leitos hospitalares e consequentemente, a criação de serviços substitutivos de atenção psicossocial, principalmente, no que tange às práticas terapêuticas emancipadoras. A partir desse cenário o presente estudo tem como objetivo investigar a atualidade e os desafios do processo de trabalho da enfermagem nos CAPS III no município de Natal/RN. Trata-se de pesquisa do tipo descritiva com abordagem qualitativa e de caráter exploratório. Os sujeitos são trabalhadores da equipe de enfermagem do CAPS III Leste de Natal/RN. Este serviço possui ações voltadas para a atenção psicossocial dos sujeitos atendidos, com atendimento diário pela assistência multiprofissional, comportando a extensão de atividades de tratamento e acompanhamento, atividades laborais e culturais. Emprega-se a entrevista semiestruturada como instrumento de coleta de dados. A análise de dados se fez por meio da Análise Temática proposta por Bardin. Assim, o presente buscou trazer à discussão de como esse processo se consolida no cotidiano do serviço. Desta forma, como resultado da pesquisa foram identificados as seguintes categorias: trabalho coletivo em saúde, trabalho da enfermagem, controle social, desprecarização do trabalho e inexistência do apoio matricial o que procedeu na elaboração de dois artigos intitulados “O processo de trabalho da enfermagem em saúde mental pós-reforma psiquiátrica: o caso dos CAPSIII” e “O território do centro de atenção psicossocial: fronteiras e possibilidades do agir em saúde mental”. Diante as categorias que emergiram do discurso dos sujeitos, percebe-se que as diretrizes propostas pela Reforma Psiquiátrica Brasileira, estão aquém de serem concretizadas neste serviço. Contudo, há várias possibilidades para consolidação da mesma, como o efetivo trabalho em grupo e a utilização das redes de atenção em saúde, o apoio matricial, para que assim haja um processo de trabalho de trabalho que privilegie o sujeito e o que ele tem de constitutivo.

26
  • AMINNA KELLY ALMEIDA DE OLIVEIRA
  • Validação de instrumentos para avaliação do conhecimento e da habilidade acerca da punção venosa periférica com cateter agulhado

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • MILVA MARIA FIGUEIREDO DE MARTINO
  • MARINA DE GÓES SALVETTI
  • WILMA DIAS DE FONTES
  • Data: Dec 13, 2013


  • Show Abstract
  • Este estudo teve como objetivo validar instrumentos para avaliação da habilidade e do conhecimento acerca da punção venosa periférica com cateter agulhado. Estudo metodológico realizado na Universidade Federal do Rio Grande do Norte/UFRN, Universidade do Estado do Rio Grande do Norte/UERN. A amostra composta por 24 juízes da pesquisa selecionados a partir dos critérios de inclusão: enfermeiros, docentes das disciplinas de Semiologia e/ou Semiotécnica, mínimo de um ano de experiência nas disciplinas, ser da UFRN ou UERN. A pesquisa realizou-se em três etapas: construção de dois instrumentos com base na revisão da literatura científica, resultando em um roteiro de observação estruturado composto por 26 itens e um questionário sobre o conhecimento com 12 questões; submissão dos instrumentos aos juízes, no período de junho a setembro de 2012, os quais deveriam avaliar cada item em “adequado”, “adequado com alterações” e “inadequado”, além de fazer uma avaliação geral de cada instrumento baseada em 10 requisitos; e validação com a verificação do nível de concordância entre os juízes, através da aplicação do índice Kappa e do Índice de Validade de Conteúdo (IVC). Utilizou-se o nível de consenso maior que 0,61 (bom) para o índice Kappa e maior que 0,75 para o IVC. Obteve parecer favorável do Comitê de Ética em Pesquisa/HUOL (CAAE nº 0002.0.294.000-10). Após serem codificados e tabulados, os dados foram analisados por meio de estatística descritiva. Dos 24 juízes, 83,3% eram do sexo feminino, com média de idade de 36,6 (± 9,3) anos, 70,8% possuíam mestrado acadêmico e 75,0% atuavam exclusivamente na docência. A média de tempo de experiência na docência ficou em 7,9 (± 8,0) anos e nas disciplinas de semiologia e/ou semiotécnica da enfermagem foi de 5,5 (± 6,7) anos. No julgamento do roteiro de observação estruturado e do questionário sobre o conhecimento não houve necessidade de retirar nenhum item/questão. Em relação a lista de verificação, apenas dois, dos 26 itens do instrumento não obtiveram índice Kappa e IVC dentro dos parâmetros estabelecidos para a validade de conteúdo. Destes, sete itens apresentaram índice de concordância perfeito, dez obtiveram concordância ótima e sete tiveram índice considerado bom. Realizou-se alterações em nove itens. No questionário sobre o conhecimento, dentre as 12 questões que o compunham, todas obtiveram índice Kappa e IVC dentro dos parâmetros estabelecidos para a validade de conteúdo. Dentre elas, 11 apresentaram índice de concordância ótimo e 1 questão obteve índice de concordância bom, sendo que em 04 questões houve a necessidade de realizar alterações. Em se tratando da avaliação geral dos instrumentos, a lista de verificação obteve IVC de 0,91 e Kappa de 0,85 e o questionário do conhecimento, IVC de 0,94 e Kappa de 0,89. Os dois instrumentos mostraram-se válidos quanto ao seu conteúdo, configurando-se como ferramentas objetivas e claras de avaliação dos conhecimentos e habilidades acerca da punção venosa periférica com cateter agulhado, uma vez que a utilização de medidas válidas busca a redução do risco de distorção dos resultados.

27
  • DANYELLE LEONETTE ARAUJO DOS SANTOS
  • Trajetória de mulheres e a participação masculina no processo do aborto provocado.

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • NORMÉLIA MARIA FREIRE DINIZ
  • RAIMUNDA MEDEIROS GERMANO
  • ROSA MARIA GODOY SERPA DA FONSECA
  • ROSINEIDE SANTANA DE BRITO
  • Data: Dec 13, 2013


  • Show Abstract
  • O aborto voluntário é um fenômeno complexo devido ao estigma social imposto a este ato e às mulheres que o realizam. Por ser a gestação um evento próprio do corpo feminino, este público apresenta-se como único responsável pelas questões reprodutivas, bem como pela interrupção da gravidez, sendo a corresponsabilidade masculina excluída deste contexto. Assim, a pesquisa em apreço objetivou analisar a participação do homem no processo de decisão do aborto provocado e seu significado para a mulher. Deste modo, realizou-se uma pesquisa interpretativa, com abordagem qualitativa, junto a 19 mulheres em situação de aborto, internadas na Maternidade Escola Januário Cicco. Para seleção das participantes, estas deveriam ter idade igual ou superior a 18 anos; admitirem, livremente, a indução do aborto; apresentarem condições emocionais e/ou físicas favoráveis para responder aos questionamentos, ou seja, conscientes, sem efeitos de drogas anestésicas, ausência de sangramento abundante e dores. A coleta de dados ocorreu no período de março a agosto de 2013, por meio de entrevista em profundidade. Antecedeu esta etapa a anuência da instituição onde se desenvolveu o estudo, aprovação pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, com Certificado de Apresentação e Apreciação Ética nº 10332312.9.0000.5537. Ademais, solicitou-se às entrevistadas a assinatura do Termo de Consentimento Livre e Esclarecido. A análise dos dados ocorreu de acordo com a Teoria Fundamentada nos Dados e o Interacionismo Simbólico. Seguindo as etapas desses referenciais, elaborou-se três categorias, a saber: “Decidindo sobre a interrupção da gravidez”; “Envolvendo o parceiro no processo decisório do aborto provocado” e “Concretizando a prática abortiva”. A análise das propriedades e dimensões de tais categorias possibilitou a construção da categoria central “Vivenciando a trajetória abortiva”. Deste modo, evidenciou-se que os homens participaram do itinerário do aborto. Porém, seu envolvimento aconteceu de forma mais ativa quando havia estabilidade no relacionamento amoroso. Nestes casos, eles envolveram-se buscando informações sobre o referido ato e adquirindo o método abortivo. Em todas as etapas desta trajetória, as mulheres interagiram consigo mesma, o parceiro, a gravidez, o feto e os valores presentes no contexto sociocultural em que vivem. Portanto, conclui-se que os homens participaram da decisão feminina de abortar, mesmo quando se excluíram do processo. Pois, as atitudes deles frente a uma gravidez não planejada e indesejada levaram as participantes a refletirem sobre as dificuldades de criar um filho sem o apoio financeiro e parental do parceiro. Diante disso, entende-se ser relevante que os profissionais de saúde atuantes nos serviços de planejamento familiar, em especial o enfermeiro, ofereçam maior atenção ao público masculino, na tentativa de promover reflexões capazes de conduzi-lo a comportamentos de coparticipação junto à mulher nas questões conceptivas e contraceptivas. 

Thesis
1
  • ISABELLE KATHERINNE FERNANDES COSTA
  •  VALIDAÇÃO DE PROTOCOLO DE ATENDIMENTO PARA PESSOAS COM ÚLCERA VENOSA NA ATENÇÃO PRIMÁRIA

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • JOAO CARLOS ALCHIERI
  • EDNALDO CAVALCANTE DE ARAÚJO
  • JORDANA DE ALMEIDA NOGUEIRA
  • MARIA MÁRCIA BACHION
  • WILMA DIAS DE FONTES
  • Data: Feb 5, 2013


  • Show Abstract
  • O estudo teve como objetivo construir e validar um protocolo para assistir pessoas com úlcera venosa na atenção primária. Trata-se de um estudo longitudinal, analítico, quantitativo, do tipo metodológico realizado em três etapas: primeira etapa referente ao levantamento da literatura para subsidiar a construção do protocolo; em seguida, esses aspectos foram organizados e propostos aos juízes do estudo através de um formulário online na página do Google docs; e a terceira etapa do estudo consistiu em resubmeter o protocolo aos juízes (técnica Delphi). O estudo foi iniciado após aprovação do comitê de Ética em Pesquisa. A primeira etapa foi realizada nas bases de dados e nas páginas das secretarias de saúde e nas etapas subsequentes foi realizada uma busca ativa por meio da plataforma Lattes do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), a fim de identificar profissionais de saúde do Brasil que atuassem como juízes do instrumento e em seguida, via online, o formulário foi submetido aos juízes. A amostra de juízes da pesquisa para segunda etapa foi de 50 juízes e para a terceira etapa foram 35 juízes. A análise foi feita com índice Kappa ≥0,81 e Índice de Validade de Conteúdo (IVC)>0,80. Na primeira submissão aos juízes, as categorias que tiveram itens que não atingiram os índices Kappa e IVC estabelecidos foram: solicitação/ realização/ resultados de exames, dados sociodemográficos, anamnese, fatores de risco, verificação de dor/ sinais vitais/ pulso/ sinais de infecção/ localização da lesão/ edema e tratamento da dor. Após a remoção dos itens que não obtiveram os índices Kappa ou IVC estabelecidos, verificou-se aumento dos níveis das categorias, alcançando índices ótimos. Na etapa seguinte houve a ressubmissão do protocolo aos juízes por meio da técnica Delphi em que se verificou que das 15 categorias do protocolo 12 apresentaram melhores escores na fase Delphi 2 e as outras três categorias mantiveram os mesmos índices Kappa e IVC da fase anterior o que indica a validade e reprodutibilidade do instrumento. Quanto a média dos requisitos de avaliação do protocolo verificou-se que as notas atribuídas pelos juízes na segunda fase foram maiores em nove dos 10 itens, permanecendo a mesma em apenas um dos itens indicando  validade do instrumento perante o consenso dos juízes. Assim, aceitamos a hipótese alternativa no estudo a medida que foram obtidos na fase Delphi 2 índices de validade maiores ou iguais os da fase Delphi1, indicando a reprodutibilidade do protocolo. A formulação deste protocolo de assistência válido e reprodutível possibilitará uma reorganização e replanejamento da assistência, com padronização das ações e a continuidade da assistência às pessoas com úlcera venosa na atenção primária.

     
2
  • ALEXSANDRO SILVA COURA
  • Validação de conteúdo do instrumento para consulta de enfermagem na visita domiciliar às pessoas com lesão medular: um enfoque no autocuidado.


     
  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • FRANCISCO STÉLIO DE SOUZA
  • INÁCIA SÁTIRO XAVIER DE FRANÇA
  • LORITA MARLENA FREITAG PAGLIUCA
  • REJANE MARIA PAIVA DE MENEZES
  • ROSILENE SANTOS BAPTISTA
  • ROSINEIDE SANTANA DE BRITO
  • Data: Feb 6, 2013


  • Show Abstract
  • Objetivou-se validar o conteúdo de um Instrumento para Consulta de Enfermagem na Visita Domiciliar às Pessoas com Lesão Medular (INCEVDOP-LM), baseado no modelo conceitual da Teoria do Déficit de Autocuidado. Estudo quantitativo e de desenvolvimento metodológico, realizado com as pessoas com LM adscritas nas Unidades de Saúde da Família (USF) de Natal e com os enfermeiros dessas instituições, no período de janeiro de 2012 a janeiro 2013. O estudo foi desenvolvido em duas fases: a primeira para identificar as necessidades de autocuidado das pessoas com LM, e a segunda para desenvolver e validar o INCEVDOP-LM. Na primeira fase foi realizado o censo de pessoas com LM residentes em Natal/RN. Na segunda fase a amostragem foi não-probabilística por conveniência. Foram formados dois grupos: Primeira fase - G1: 73 pessoas com LM diagnosticadas por especialista, com paraplegia ou tetraplegia, adultas, função cognitiva preservada e adscritas a alguma USF; Segunda fase - G2: seis juizes enfermeiros, com titulação de doutor, produção científica na área de desenvolvimento de tecnologias ou assistência às pessoas com LM e publicação com qualis A2. Para coleta de dados, na primeira fase, foram realizadas visitas domiciliares as pessoas com LM e aplicados três instrumentos: Questionário I - variáveis demográficas e socioeconômicas, Escala de Avaliação da Competência para o Autocuidado (ASA) e Índice de Barthel - avaliação da capacidade funcional. Na segunda fase, a pesquisa foi desenvolvida em duas etapas: I. Construção do INCEVDOP-LM; II. Validação do INCEVDOP-LM. O instrumento foi encaminhado, juntamente com um formulário de avaliação, para apreciação dos juízes, sendo a concordância entre eles analisada por meio do teste Kappa, aceitando-se valores >0,75. Os critérios avaliados foram: organização, clareza, simplicidade, facilidade de leitura, adequação do vocabulário, objetividade, precisão, credibilidade e adequação. Considerou-se como frequência excelente de respostas positivas valores ≥90%. Utilizou-se o teste Qui-quadrado para investigar as diferenças entre as proporções observadas. Os dados foram processados no programa SPSS e apresentados por meio de tabelas e figuras com frequências absolutas, relativas e os valores dos testes. Foram considerados os princípios da Resolução 196/96. Os resultados foram apresentados por meio de 4 artigos científicos derivados da pesquisa. Verificou-se que os itens diagnósticos, intervenções e avaliação de enfermagem das facetas dos domínios Nutrição, Higiene, Eliminação, Físico, Social e Psicológico e a faceta Capacidade para realizar atividades laborais apresentaram discordância entre os juízes (k=0,02). Nos demais itens ocorreu concordância, com kappa variando de 0,72 a 1. Após a supressão dos itens com discordância entre os juízes, todos os critérios atingiram índices excelentes e não ocorreram diferenças significativas entre as proporções das respostas da avaliação dos juízes (p>0,05). Conclui-se que o instrumento apresenta validade para servir como guia para os enfermeiros na realizaçao da consulta sistematizada de enfermagem na visita domiciliar às pessoas com lesão medular, com enfoque no autocuidado, devendo passar por outros níveis de validação quando aplicado no âmbito clínico. Acredita-se que o enfermeiro com competência teórico-prática-práxis, pode contribuir para o processo educativo-integrador e de inclusão social das pessoas com LM, orientando-as para o autocuidado no atendimento das suas necessidades bio-psico-socio-espirituais.


     
3
  • CECILIA NOGUEIRA VALENCA
  • Análise dos marcos teóricos e estruturais do currículo de graduação em enfermagem no Rio Grande do Norte.

     
  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MARIA PAIVA DE MENEZES
  • SORAYA MARIA DE MEDEIROS
  • JACILEIDE GUIMARAES
  • ROSANA LUCIA ALVES DE VILLAR
  • SUZANA CARNEIRO DE AZEVEDO FERNANDES
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • MOEMIA GOMES DE OLIVEIRA MIRANDA
  • AILTON SIQUEIRA DE SOUSA FONSECA
  • Data: Apr 26, 2013


  • Show Abstract
  • Esta pesquisa teve como questão norteadora: Quais os marcos teóricos e estruturais do currículo de graduação em enfermagem das universidades públicas no estado do Rio Grande do Norte? Assim, foram objetivos deste estudo: Analisar os marcos teóricos e estruturais do currículo de graduação em enfermagem das universidades públicas no estado do Rio Grande do Norte; Identificar os marcos teóricos e os modelos de formação que orientam os marcos estruturais dos currículos dos cursos de enfermagem das universidades públicas estudadas; Analisar as concepções de formação dos currículos a partir das vozes dos coordenadores de cursos. Trata-se de um estudo qualitativo, analítico, comportando as discussões da pesquisa documental e empírica. Participaram dez docentes que atuam como coordenadores dos cursos de graduação em enfermagem ou orientadores acadêmicos, na UFRN – Campus Central em Natal e Faculdade de Ciências da Saúde (Facisa), em Santa Cruz – e na UERN – Campi Caicó, Mossoró e Pau dos Ferros. As informações coletadas por entrevista foram analisadas através da sociologia cartográfica ou cartografia simbólica de Boaventura de Sousa Santos. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da UERN, mediante o CAAE: 03610912.7.0000.5294. Todos os participantes assinaram o Termo de Consentimento Livre e Esclarecido. Os resultados e discussão foram apresentados em quatro artigos científicos. O primeiro artigo, intitulado A análise de projetos pedagógicos em enfermagem à luz da cartografia simbólica, apresenta a utilização do método cartográfico nas pesquisas e no estudo dos currículos de enfermagem. No artigo Análise dos marcos teórico-filosófico, estrutural e referencial nos currículos de enfermagem, esses marcos são conceituados nos currículos da UERN e da UFRN. Os principais desafios enfrentados na realização do estágio curricular supervisionado em enfermagem estabelecem uma reflexão sobre as dificuldades que os supervisores de estágio apresentam, principalmente, no tocante à relação ensino/serviço e à articulação teoria/prática. No último artigo são discutidas as Mudanças na formação em enfermagem a partir do perfil do egresso, que ganharam um impulso a partir das reformulações curriculares propostas pelas diretrizes curriculares nacionais. O estudo concluiu, pela análise dos marcos teóricos e estruturais dos currículos dos cursos de enfermagem das universidades públicas do Rio Grande do Norte, que existe uma intenção explícita em formar enfermeiros voltados para o sistema único de saúde e uma busca em elaborar inovadores projetos pedagógicos de curso conforme as diretrizes curriculares nacionais para a área de enfermagem. A tese defendida nesta investigação foi que os currículos das instituições públicas de ensino superior de enfermagem no estado do Rio Grande do Norte avançaram de uma formação centrada no modelo biologicista, de orientação flexneriana, para o ensino capaz de articular a saúde com as questões sociais, políticas e culturais.

4
  • IZAURA LUZIA SILVERIO FREIRE
  • Fatores associados à efetividade da doação de órgãos e tecidos para transplantes.

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • EDNALDO CAVALCANTE DE ARAÚJO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • ISABELLE KATHERINNE FERNANDES COSTA
  • LUCIANA ARAUJO DOS REIS
  • MARCOS ANTONIO FERREIRA JUNIOR
  • MARIA JULIA GUIMARÃES OLIVEIRA SOARES
  • MARINA DE GÓES SALVETTI
  • WILMA DIAS DE FONTES
  • Data: Sep 9, 2013


  • Show Abstract
  • O transplante apresenta-se como importante opção terapêutica, tanto do ponto de vista médico, quanto social ou econômico. Assim, a identificação das variáveis que podem interferir na efetividade da doação de órgãos e tecidos para transplante precisa ser investigada de maneira adequada, pois se está diante de crescente índice de doenças crônicas e degenerativas na população, que faz com que a lista de espera para transplante cresça desproporcionalmente e muitos pacientes cheguem ao óbito sem a oportunidade de realização do tratamento devido à carência de doadores. Nesse contexto, definiu-se como objetivo desse estudo avaliar os fatores associados à efetividade da doação de órgãos e tecidos para transplantes. Trata-se de pesquisa avaliativa, quantitativa, com delineamento longitudinal, desenvolvida na Central de Captação, Notificação e Doação de Órgãos para transplantes, Organização de Procura de Órgãos e em seis unidades hospitalares credenciadas para captação e transplante de órgãos e tecidos, em Natal-RN, entre agosto de 2010 e fevereiro de 2011, após a aprovação do Comitê de Ética em Pesquisa, sob o nº 414/10 e CAAE 007.0.294.000-10. A amostra probabilística com reposição foi composta de 65 potenciais doadores. Utilizou-se como instrumento de coleta de dados um roteiro estruturado de observação não participante do tipo check list. Os dados foram analisados por meio da estatística descritiva e apresentados em forma de tabelas, quadros, gráficos e figuras. Para tanto, utilizou-se o Microsoft Excel 2007 e um software estatístico. Para verificar o nível de significância optou-se pela aplicação dos testes Qui-quadrado (χ2) e Mann Whitney e para as caselas inferiores a cinco, considerou-se o teste exato de Fisher. Adotou-se como nível de significância p < 0,05. Calculou-se também a Razão de Chance (RC) entre a efetividade ou não da doação. Entre os pesquisados observou predominância de indivíduos do sexo masculino (50,8%), faixa etária até 45 anos (53,8%), média de idade de 42,3 anos, mínimo de 5 e máximo de 73 anos (± 17,32 anos). Solteiros/viúvos/divorciados (56,9%), com até o ensino fundamental (60,0%), em exercício de atividade profissional (86,2%), católicos (83,1%) e residentes na região metropolitana de Natal (52,3%). Obteve-se efetividade de doação de 27,7%. Não ocorreu significância estatística entre estrutura e a efetividade da doação, porém observaram-se inadequações nos recursos físicos (36,9%), materiais (30,8%), estrutura organizacional (29,2%) e recursos humanos (18,5%). No processo, as fases de manutenção (p= 0,004; RC=1,6), diagnóstico de morte encefálica (p= 0,032; RC=1,4), entrevista familiar (p ≤ 0,001; RC=1,9) e documentação (p= 0,001; RC=11,5) apresentaram significância estatística com a efetividade. Assim, se aceita a hipótese alternativa do estudo, na qual se evidencia que a adequação dos fatores relacionados à estrutura e processo está associada à efetividade da doação de órgãos e tecidos para transplantes. Espera-se que esses dados forneçam subsídios para o planejamento das ações relativas à doação de órgãos e tecidos e contribua para a diminuição do tempo e do sofrimento daqueles que aguardam um órgão ou tecido na fila de transplante no Brasil.

5
  • MARIA HELENA SOARES DA NOBREGA MAZZO
  • Elaboração e Validação de instrumento para consulta de enfermagem à puérpera no âmbito da atenção básica. 

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • CLÁUDIA MARIA RAMOS MEDEIROS
  • EDMÉIA DE ALMEIDA CARDOSO COELHO
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • MARIA MIRIAM LIMA DA NÓBREGA
  • ROSANA LUCIA ALVES DE VILLAR
  • ROSINEIDE SANTANA DE BRITO
  • Data: Dec 12, 2013


  • Show Abstract
  • A pesquisa teve como objetivo elaborar e validar um instrumento para sistematizar a assistência de enfermagem à puérpera no âmbito da atenção básica. O documento foi construído com base na Teoria das Necessidades Humanas Básicas de Horta, na Padronização de um Conjunto Internacional de Dados Essenciais em Enfermagem e na Nomenclatura de diagnósticos e intervenções de enfermagem desenvolvida a partir dos resultados da Classificação Internacional para as Práticas de Enfermagem. Trata-se de um estudo do tipo metodológico desenvolvido em cinco etapas: identificação dos indicadores empíricos relativos à puérpera mediante revisão integrativa da literatura; avaliação dos indicadores empíricos e sua relação com as necessidades humanas básicas por grupo focal com cinco enfermeiras especialistas; estruturação do instrumento mediante a categorização dos indicadores; validação de forma e conteúdo do instrumento pelos especialistas, por meio da técnica Delphi; e aplicação e desenvolvimento das afirmativas de diagnóstico e intervenções de enfermagem. A coleta de dados da primeira etapa ocorreu nos meses de janeiro a março de 2013 nas bases de dados Scopus, Cinahl, Pubmed, Cochrane, e no periódico Journal of Midwifery and Women’s Health. A segunda, terceira e quarta etapas se realizaram nos meses de maio a outubro de 2013. Participaram doze e sete especialistas na primeira e segunda rodada de avaliação respectivamente. A seleção dos juízes/especialistas ocorreu pela Plataforma Lattes mediante os seguintes critérios de inclusão: ser enfermeiro (a) docente e especialista em enfermagem obstétrica. A consulta a estes profissionais se deu via email e ao aceitarem participar da pesquisa assinaram um Termo de Consentimento Livre e Esclarecido. A pesquisa obteve aprovação pela Comissão de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob o protocolo nº 184.241 e Certificado de Apresentação para Apreciação Ética nº 11674112.3.0000.5537.  Para análise dos dados da primeira etapa utilizou-se a estatística descritiva e os resultados apresentados em forma de tabelas. Nesta etapa identificou-se 97 indicadores empíricos e quando relacionados com as necessidades humanas básicas, 46 desses encontravam-se nas necessidades psicobiológicas, 51 nas psicossociais e 01 nas necessidades psicoespirituais. Com relação á segunda e terceira etapas os dados passaram por um processo de  categorização e análise pelo Índice de Validade de Conteúdo. Os indicadores obtiveram um índice de validação de 100%. Na parte de avaliação da puérpera os itens não validados foram excluídos do instrumento. Os demais itens obtiveram índice acima de 70% sendo, portanto o instrumento validado.  Com a conclusão do estudo, o enfermeiro disporá de um instrumento para sistematização da assistência à puérpera na atenção básica. Além disso, o documento servirá como ferramenta para o ensino e a pesquisa em enfermagem obstétrica.

2012
Dissertations
1
  • IZABELLA BEZERRA DE LIMA
  • REPRESENTAÇÕES SOCIAIS DA HANSENÍASE: EM FOCO O ESTIGMA NO CONTEXTO DA SAÚDE MENTAL

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • REJANE MILLIONS VIANA MENESES
  • Data: Feb 16, 2012


  • Show Abstract
  • A hanseníase é uma doença infecto-contagiosa causada pelo Mycobacterium leprae, que tem preferência pelos nervos periféricos. Por isso, possui um grande potencial para provocar incapacidades físicas que podem, inclusive, evoluir para deformidades. A hanseníase também é conhecida como “lepra”, termo carregado de uma concepção que caracterizava a doença como deformante e incurável, ligada ao estigma e ao preconceito. Nesse contexto, este estudo objetiva apreender as representações sociais da hanseníase que interferem modificando as relações interpessoais do portador da hanseníase no que diz respeito ao estigma e preconceito. E como objetivos específicos: descrever as mudanças ocorridas nas atividades da vida diária do portador e família, aplicar a escala SALSA (Screening of Activity Limitation and Safety Awareness) para identificar significados; identificar o grau de participação do doente de hanseníase junto ao grupo de pertença. Trata-se de um estudo de abordagem qualitativa, exploratório-descritivo, tendo a Teoria da Representação Social como referencial metodológico. O número de sujeitos da pesquisa foi de 22, que se encontravam em tratamento com poliquimioterapia, atendidos no ambulatório de doenças infectocontagiosas do Hospital Giselda Trigueiro, localizado na cidade de Natal-RN. Os usuários foram de ambos os sexos, entre 16 a 79 anos de idade, com diagnóstico de hanseníase paucibacilar ou multibacilar, e que aceitaram participar espontaneamente do estudo. Projeto aprovado pelo Comitê de Ética do Hospital Universitário Onofre Lopes, protocolo nº 147/08, em 04 de julho de 2008, teve como instrumento de coleta de dados, um roteiro para a identificação do colaborador, a escala SALSA e a escala de Participação e uma entrevista semi-estruturada, gravada individualmente, por meio de dispositivo eletrônico, em ambiente apropriado e que não teve interferência de terceiros. A análise dos resultados obtidos a partir do questionário de Identificação, da Escala SALSA e da Escala de Participação ocorreu através da construção de tabelas e gráficos, com a utilização do Microsoft Excel Start 2010. O material gravado, transcrito e preparado, foi submetido à Análise lexical do Software Analyse Lexical par contexte d’um Ensemble de Segments de Texte (Alceste) e posteriormente á Análise de Conteúdo de Bardin. Os sujeitos da pesquisa eram em sua maioria formados por homens (14), com idade inferior a 60 anos (91%), com ensino Fundamental Incompleto (41%), em união estável ou casado (68%), e com diagnóstico de hanseníase dimorfa (41%) e tuberculoide (32%). Aplicação das escalas SALSA e de Participação mostraram baixa influencia do diagnóstico de hanseníase na vida diária dos sujeitos, assim como nas suas relações de participação na sociedade. No entanto, na análise das entrevistas, foi observado a construção de duas categorias, a primeira referente a aceitação da doenças como processo de adoecimento comum a vida humana e a segunda, como processo de adoecimento permeado por sentimento negativos, no qual o doente sente a necessidade de negar para a sociedade e muitas vezes para si, que está com hanseníase. A partir da população observada, chegou-se a identificar que a Representação Social da Hanseníase está em processo de transição, no qual, as ações de educação em saúde tem surtido efeito positivo no combate ao estigma e preconceito, mas ainda os usuários tem vivenciado esse processo de adoecimento com grande medo do preconceito, e se vê obrigado a negar a existência da doença e do tratamento.

2
  • SAMIA VALERIA OZORIO DUTRA
  •  

    Avaliação dos Fatores que Interferem na Atenção à Saúde Mental na Estratégia Saúde da Família no Município de Parnamirim/Rn

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • CLELIA ALBINO SIMPSON
  • GILSON DE VASCONCELOS TORRES
  • VIOLANTE AUGUSTA BATISTA BRAGA
  • Data: Feb 27, 2012


  • Show Abstract
  •  

    RESUMO

    O panorama geral dos transtornos mentais e comportamentais sobre a Saúde no Mundo de acordo com a Organização Mundial de Saúde (2001) ressalta o despertar da consciência crítica-reflexiva para a problemática levando em conta o real ônus e seus custos em termos humanos, sociais e econômicos. Nesta perspectiva, o presente estudo é caracterizado como uma pesquisa operacional, ou Investigação em Sistemas de Saúde (ISS), com desenho transversal de caráter descritivo quanti-qualitativo, desenvolvida em quatro etapas distintas no Município de Parnamirim/RN. Tem como objetivo geral analisar os fatores que interferem na atenção à saúde mental no contexto da estratégia saúde da família. e, específicos para cada etapa definida: descrever a estrutura organizacional da SMS e realizar o levantamento do número de casos domiciliares de transtornos mentais e comportamentais; analisar o grau de conhecimento sobre transtornos mentais e comportamentais dos membros da ESF; investigar as dificuldades apresentadas pelos os agentes comunitários de saúde com relação ao desenvolvimento de habilidades e competências no que diz respeito a percepção de possíveis transtornos mentais e comportamentais na área de abrangência e, realizar treinamento piloto para os agentes comunitários de saúde; e, recomendar propostas e sugestões de mudanças para implantação da atenção à saúde mental pela ESF. A população de estudo compõe-se dos profissionais da estratégia saúde da família integrantes das quarentas equipes do PSF do referido município, acrescido de 20% do total de pessoas com transtornos mentais e comportamentais e igual número de cuidadores familiar a partir do levantamento do total de casos atendidos pelas quarenta equipes da estratégia saúde da família, respeitado os parâmetros éticos da resolução 196/96 do Conselho Nacional de Saúde. Os dados coletados através de entrevistas e questionários serão submetidos a dois softwares: o Epi-info 6.004d para a análise dos dados quantitativos e o ALCESTE para os dados qualitativos.

     

3
  • TATIANA MARIA NOBREGA ELIAS
  • Carga de trabalho de enfermagem e infecções relacionadas à assistência à saúde em unidade de terapia intensiva.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • MARIA VILANI CAVALCANTE GUEDES
  • NILBA LIMA DE SOUZA
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Feb 29, 2012


  • Show Abstract
  • Nas últimas décadas, a busca pela qualidade assistencial vem sendo amplamente discutida pelas instituições e profissionais de saúde. Nesse contexto, compete ao enfermeiro a coordenação do processo de provimento de pessoal de enfermagem, refletindo o compromisso com a qualidade da assistência . Nesse processo, considera-se o aparecimento das Infecções Relacionadas à assistência à saúde e suas possíveis associações com a carga de trabalho em enfermagem como um valioso indicador da qualidade da assistência. Assim, a realização desta pesquisa contribui com os estudos realizados para caracterizar a demanda de trabalho de enfermagem  que favoreça uma prática assistencial segura. Este estudo objetivou identificar a associação da carga de trabalho de enfermagem com o número de casos de Pneumonia Associada à Ventilação Mecânica, Infecção do trato urinário e Infecção de cateter Venoso Central na Unidade de Terapia Intensiva. Trata-se de uma pesquisa de abordagem quantitativa, descritiva, transversal e prospectiva, realizada no Hospital Unimed, em Natal-RN. A população foi constituída por todos os pacientes submetidos a tratamento nas Unidades de Terapia Intensiva do Hospital por um período de 90 dias consecutivos em 2011. A amostra por conveniência foi compostapelos pacientes admitidos nas UTIs no período da coleta de dados, totalizando amostra de 286 pacientes. Para realização da análise dos dados, foram utilizado os softwares: Statistica 6.0, SPPS (Statistical Package for the Social Sciences) versão 17.0 (2004) e Excel 2007. Na análise descritiva, utilizaram-se Medidas de Tendência Central e Medidas de Dispersão ou Variabilidade e a utilização de testes não paramétricos. Dos 286 pacientes, 88 eram da UTI II e 198 da UTI II. Predominou o gênero masculino na UTI I (51,1%) e o feminino na UTI II (57,6%), Os pacientes da UTI I encontravam-se na faixa etária entre 61 a 80 anos (39,8%) seguido de maior do que 80 anos (39,8%). Já na UTI II, a maioria dos pacientes encontrava-se com idade entre 61 a 80 anos (38,9%) e, em seguida, os entre 41 a 60 anos (24,2%). Em relação à classe do TISS de admissão predominou a classe II nas duas UTIs (59,1%), seguido da classe III também nas duas unidades (34,6%). A maioria dos pacientes (70,6%) sai das UTIs pertencendo à classe II do TISS. Na UTI I, o número médio de formulários do TISS 28 foi de 6, já na UTI II esse valor cai para 3,2 formulários preenchidos. A média geral do TISS foi de 19,9 pontos nos pacientes da UTI I e de 17 pontos na UTI II.Sobre a média de horas necessárias para prestar a assistência de enfermagem adequada aos pacientes da UTI I, verificou-se que é de 10,7 horas; e na UTI II de 9,2 horas. Constatou-se que as horas disponibilizadas pela equipe de enfermagem foram maiores na UTI II, com valor médio de 19 horas disponíveis pela enfermagem desse setor. Na UTI I, que apresentou superior necessidade de carga horária disponibilizada, verificou-se que o valor médio foi de 12,7 horas disponíveis. Verificou-se que apenas 2,4% dos pacientes dessas unidades apresentaram Pneumonia Associada à Ventilação; 1,0% foram com infecção de cateter venoso central e de 1,4% dos pacientes apresentaram infecção do trato urinário. A infecção associada à assistência a saúde ocorre, em média, no décimo dia de internação. Na UTI II, esse valor médio se estende até o décimo segundo dia com um excesso de 2,7 horas de assistência de enfermagem, enquanto que na UTI I o valor decai para o nono dia de internação com uma deficiência de 12 horas de assistência. Conclui-se que os pacientes, em geral, apresentaram uma classificação de necessidade de cuidado semi intensivo e tem sido atendidos em sua necessidade de carga horária. Quanto a sua associação com as Infecções Relacionadas á assistência a Saúde essa análise não foi possível de ser realizada em virtude do pequeno número de notificações neste período. Sugere-se outros estudos mais aprofundados quantos aos fatores relacionados às infecções me um período maior de análise.

4
  • FERNANDA DE MEDEIROS DANTAS
  • Atenção à saúde da pessoa idosa na Estratégia Saúde da Família no município de Santo Antônio/RN: um estudo de caso.

     

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • JAMERSON VIEGAS QUEIROZ
  • LUCIA HISAKO TAKASE GONÇALVES
  • REJANE MARIA PAIVA DE MENEZES
  • REJANE MILLIONS VIANA MENESES
  • Data: Mar 30, 2012


  • Show Abstract
  • Segundo as estimativas demográficas, até o ano de 2025 o Brasil será o sexto país do mundo em número de idosos. Por essa razão, é função das políticas públicas contribuir para que as pessoas alcancem idades avançadas com melhor saúde. O atual modelo assistencial de vigilância à saúde através da Estratégia Saúde da Família (ESF) configura-se como a porta de entrada no atendimento da pessoa idosa no Sistema Único de Saúde (SUS), como também num espaço de desenvolvimento de práticas de promoção a saúde, prevenção e controle das doenças crônicas não degenerativas, a fim de evitar ou prevenir a instalação de incapacidades nessa população e melhorar sua qualidade de vida. Objetivou-se neste estudo analisar a atenção à saúde da pessoa idosa prestada pelos profissionais da ESF com vistas ao alcance de um atendimento integral. O estudo é descritivo do tipo estudo de caso com abordagem quantitativa, realizado no município de Santo Antônio/RN. A população incluiu todos os profissionais de saúde integrantes da ESF do município que aceitaram participar da pesquisa, totalizando 80 profissionais. Os dados foram coletados através de um questionário estruturado com questões abertas e fechadas sobre informações sócio demográficas, de formação profissional e as ações desenvolvidas pelos profissionais no atendimento a pessoa idosa na atenção básica de saúde. Os resultados foram analisados a partir de um banco de dados tabulados em planilha Excel, discutidos de acordo com a estatística descritiva simples, apresentados em tabelas, gráficos e quadros através de frequências, mediana e valores de tendência central. Obteve-se predomínio de profissionais de nível médio, do sexo feminino, com idade entre 30 a 34 anos, com formação profissional concluída nos últimos 10 anos, sem pós- graduação na área de geriatria ou gerontologia e maioria sem capacitação em gerontologia. Os familiares e cuidadores, considerados membros da tríade do cuidado ao idoso, na atenção primária de saúde, são os componentes da rede social de apoio mais identificados pelos profissionais (66,3%). O acesso da pessoa idosa à Unidade Básica de Saúde da Família foi considerado por 83,8% dos profissionais como o fator que mais interfere nas ações de saúde junto ao idoso. Quanto à inserção da família no cuidado, 98,8% dos profissionais consideram a família como um dos objetivos da assistência, porém 82,5% auxiliam a família a conhecer sua função e participar do cuidado junto ao idoso, embora se observe que, nenhum profissional faz uso de instrumentos de avaliação da funcionalidade  da família. Quanto às ações realizadas junto ao idoso, 91,25% realizam visita domiciliar ao idoso; 88,75% realizam o acolhimento; 77,5% conhecem os hábitos de vida, valores culturais, éticos e religiosos dos idosos, suas famílias e da comunidade; 51,25% complementam as ações através da intersetorialidade; 50% participam de grupos de vivência de idosos; 33,75% mantem a caderneta de saúde da pessoa idosa atualizados; 11,25% dos profissionais realizam o Planejamento Terapêutico Singular (PTS) e poucos realizam ações de promoção à saúde de acordo com o PTS. Identifica-se um déficit em algumas categorias profissionais na identificação de idosos frágeis e o acompanhamento dos mesmos em domicílio. Conclui-se, que a atenção à saúde da pessoa idosa desenvolvida pelos profissionais da ESF no contexto desse estudo, diverge entre as categorias profissionais; verificam-se fragilidades quanto à promoção do envelhecimento ativo e saudável e no estabelecimento de uma atenção integral e integrada a pessoa idosa. Recomenda-se a adoção de atividades de educação permanente por parte da Gestão Municipal, a priori para os profissionais da ESF na perspectiva das diretrizes da Política Nacional de Atenção à Saúde da Pessoa Idosa e posteriormente para os demais profissionais que integram a rede de atenção a saúde da pessoa idosa em todos os níveis de atenção no município para a elaboração de estratégias e práticas que promovam a melhoria da qualidade da atenção à saúde da pessoa idosa, impactando resultados efetivos e concretos em termos de produção de saúde na realidade brasileira.

5
  • MAYANA CAMILA BARBOSA GALVAO
  • VIVÊNCIA DE MULHERES EM SITUAÇÃO DE CÁRCERE PENITENCIÁRIO DURANTE O PERÍODO GESTACIONAL.

     

  • Advisor : REJANE MARIE BARBOSA DAVIM
  • COMMITTEE MEMBERS :
  • REJANE MARIE BARBOSA DAVIM
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • NORMÉLIA MARIA FREIRE DINIZ
  • Data: Apr 13, 2012


  • Show Abstract
  • O aumento gradativo da violência na sociedade brasileira vem resultando no crescimento da população carcerária ao longo dos últimos anos, bem como a proporção de mulheres em relação aos homens. A participação da mulher no crime e o papel que esta assume no seio familiar fazem com que este fenômeno represente crescente problema social. Na maioria, as detentas são jovens, em idade reprodutiva, tornando a gravidez uma situação recorrente no período em que estão cumprindo pena. Os estudos que tratam a criminalidade feminina são escassos e pouco esclarecedores quanto sua real dimensão, especialmente se direcionados as mulheres que vivenciaram a gestação nesse ambiente. Diante destas considerações, esta pesquisa teve como objetivos: identificar as características sociodemográficas e obstétricas de mulheres em situação de cárcere penitenciário que vivenciaram a gestação no Complexo Penal Dr. João Chaves na cidade de Natal no Estado do Rio Grande do Norte e descrever a vivência dessas mulheres durante o período gestacional. Trata-se de uma pesquisa descritiva de natureza qualitativa. Os dados foram obtidos por meio de entrevista estruturada junto a nove mulheres durante os meses de agosto e setembro de 2011 que atenderam aos critérios de inclusão estabelecidos previamente e organizados conforme os preceitos de análise temática segundo Bardin. Desse processo de codificação e categorização emergiu uma temática central: vivência da mulher grávida dentro de um presídio, originando três categorias: sentimentos que permeiam a mulher grávida presa; assistência a saúde a gestante encarcerada e as relações interpessoais da gestante dentro do presídio. Os dados foram analisados de acordo com a literatura disponível e o estudo revelou que as mulheres ao vivenciarem a gravidez dentro do presídio estão mais propícias a experimentarem sentimentos negativos devido a falta de estrutura do sistema para atender suas necessidades, distanciamento das relações familiares e convivência com pessoas estranhas. A assistência à saúde destinada a essas mulheres é deficitária e em muitas vezes não ocorre, colocando em risco a vida do bebê e da própria mãe, sendo esta uma realidade preocupante na saúde pública brasileira. No que diz respeito às relações interpessoais, estas foram marcadas pelo distanciamento dos familiares, principalmente devido ao fator socioeconômico, sendo uma dificuldade para o enfrentamento da gestação no presídio e registro de abuso de poder por parte de profissionais que trabalham na instituição. Por fim, espera-se que o estudo possa dar visibilidade ao tema pouco discutido na literatura e contribuir para a construção de políticas públicas específicas para tal realidade, como forma de minimizar os efeitos do encarceramento durante o período gestacional.

6
  • SIMONE KARINE DA COSTA MESQUITA
  • Abordagens pedagógicas na formação de enfermeiros: perspectivas de docentes de enfermagem.

  • Advisor : REJANE MILLIONS VIANA MENESES
  • COMMITTEE MEMBERS :
  • REJANE MILLIONS VIANA MENESES
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • WILMA DIAS DE FONTES
  • Data: Apr 20, 2012


  • Show Abstract
  • No mundo hodierno são notórias as mudanças nos aspectos social, ético, econômico e político da sociedade, as quais atingem de modo incisivo, o ensino superior, exigindo uma série de modificações e uma nova visão na formação de enfermeiros, a fim de atender as demandas do Sistema Único de Saúde. Diante disso, as instituições formadoras e os docentes são convidados a enfrentar os novos desafios e refletir sobre suas práticas, a fim de favorecer uma maior flexibilidade e capacidade de articulação, utilizando abordagens pedagógicas e metodologias inovadoras, para fazer frente às exigências de uma sociedade globalizada. O presente estudo tem como objetivo analisar a perspectiva do docente no que concernem as abordagens pedagógicas utilizadas na formação de enfermeiros e identificar as abordagens pedagógicas empregadas por docentes na formação de enfermeiros. Trata-se de uma pesquisa de campo do tipo exploratória, de abordagem quantitativa. A pesquisa foi realizada no Departamento de Enfermagem da Universidade Federal do Rio Grande do Norte – UFRN, sediada na cidade de Natal, no estado do Rio Grande do Norte. A população desta pesquisa foi composta por cinquenta e três docentes. Desta população de docentes, foi selecionada uma amostra de vinte docentes que atuam na referida Instituição. A coleta de dados ocorreu no período de agosto de 2011, através da técnica de entrevista semi-estruturada e da utilização de um questionário. Para apreensão do material empírico resultante da entrevista, será utilizada a gravação em MP3. Os dados obtidos serão analisados individualmente, em dois momentos: No primeiro momento, a análise quantitativa referente aos dados obtidos por meio da técnica de entrevista, os quais foram submetidos aos procedimentos metodológicos da análise de conteúdo proposta por Bardin. No segundo momento, análise quantitativa dos dados quantitativos coletados resultantes dos questionários aplicados aos docentes e dos dados de identificação dos participantes, os quais foram transferidos para uma planilha eletrônica do Microsoft Excel XP.Vale salientar, que foram respeitados os aspectos presentes na Resolução CNS 196/96, a qual refere os aspectos éticos e legais da pesquisa envolvendo seres humanos. Os resultados mostram que 90% dos docentes participantes da pesquisa apresentam uma compreensão adequada das abordagens pedagógicas não críticas, apenas 10% tinham um entendimento inadequado. Com relação às pedagogias críticas, 80% dos participantes da pesquisa referiram uma compreensão adequada. Porém, 70% dos docentes, apesar de terem uma compreensão adequada, relataram dificuldades durante a tentativa de implementação destas pedagogias. A maioria dos docentes, como representabilidade de 80%, consideram as pedagogias não críticas relevantes na formação do enfermeiro, como também as pedagogias críticas, sendo representada por 95% dos docentes. Com relação às características dos participantes da pesquisa, 20% eram representantes do sexo masculino; com grau de titulação de 55% com doutorado; referente ao tempo de serviço houve uma maior representatividade entre 15 a 45 anos, com 45%. Com vista a identificar as abordagens pedagógicas que norteiam suas práticas docentes na formação de enfermeiros da UFRN, revelou que as pedagogias críticas e as pedagogias não críticas estão presentes na prática de docentes da graduação em enfermagem. Isso reflete um momento de transição, visto que a presença das novas formas de ensinar já faz parte deste contexto educativo. Por fim, cabe ressaltar, a importância compreender sobre modelos educacionais que valorizam os aspectos científicos, éticos, pessoais no processo educativo. A pesquisa tem a pretensão de proporcionar aos docentes a contribuição de novas possibilidades de ação no sentido de modificar ou não seu contexto de atuação, com competências pedagógicas necessárias para conduzir o processo de ensino, em consonância com o novo paradigma pedagógico do ensino superior.

7
  • CLAUDIA CRISTIANE FILGUEIRA MARTINS RODRIGUES
  • NO CALEIDOSCÓPIO O ESTRESSE DA EQUIPE DE ENFERMAGEM DA UTI DO HUOL

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • MARIA BETTINA DE CAMARGO BUB
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Aug 3, 2012


  • Show Abstract
  • O presente estudo teve como objetivo analisar o estresse na equipe de enfermagem da terapia intensiva do Hospital Universitário Onofre Lopes. A população analisada foi constituída por trinta e oito (38) profissionais de enfermagem, entre técnicos de enfermagem e enfermeiros que atuam na UTI do referido hospital. Os dados foram coletados no período de setembro a novembro de 2011 em duas etapas distintas. A primeira, a aplicação do inventário de sinais e sintomas do estresse de Lipp (ISSL), permitiu a mensuração da fase do estresse em que cada membro da equipe se encontrava. Após isso, os dados foram tabulados em planilhas do Microsoft Excel 2010 e analisados conforme as diretrizes do inventário propostas por Lipp, 2000. Seguido essa análise, foi possível realizar a segunda etapa da pesquisa, sendo esta constituída por uma entrevista semiestruturada destinada àqueles trabalhadores que se encontravam na segunda fase do estresse, a de resistência. A análise das entrevistas foi baseada na proposta de análise do conteúdo de Bardin2004, a qual permite a criação de categorias a partir do agrupamento de ideias presentes nas falas dos entrevistados. Como resultado, obteve-se que a população estudada é de maioria feminina (78,9%), na faixa etária entre 30 e 39 anos (50%),casadas (52,3%) e com duplo vínculo empregatício (65,7%). A fase de maior predominância, segundo o inventário de Lipp, foi a de resistência ao estresse, presente em 44,7% da equipe e tendo com sintoma físico de maior predominância a sensação de desgaste físico constante, percebido em 16,8% dos participantes, e o psicológico, a irritabilidade excessiva e a sensibilidade emotiva de escores iguais a 26,3%. Quanto aos dados qualitativos, foi possível delinear três categorias e quatro subcategorias, sendo as seguintes categorias: a organização do cuidado na terapia intensiva; o excesso de trabalho dos profissionais de enfermagem e o relacionamento interpessoal da equipe de enfermagem na UTI. E como subcategorias: a organização do trabalho como fonte de pressões e cobranças; o trabalho noturno e suas consequências para a saúde desses profissionais; o corpo traduzindo os sinais e sintomas do estresse; e a comunicação deficitária entre os membros dessa equipe de trabalho. Assim, a concretização desse estudo permitiu visualizar o fenômeno do estresse na equipe de enfermagem do HUOL como um caleidoscópio de reflexões, sensações e experiências percebidas por esses profissionais em diferentes áreas de sua vida. Constatou-se, ainda, que o fortalecimento da temática estresse dos profissionais de enfermagem precisa ser instrumentalizada e estimulada em diversos espaços de discussão da enfermagem para que esses trabalhadores sejam incitados a cuidar melhor de si para, assim, cuidar da saúde do outro.

8
  • GABRIELA DE SOUSA MARTINS MELO DE ARAUJO
  • Validação de instrumentos para avaliação do conhecimento e da habilidade acerca da higienização simples das mãos

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • EDNALDO CAVALCANTE DE ARAÚJO
  • Data: Oct 26, 2012


  • Show Abstract
  • Objetivo: apresentar a construção e validação de instrumentos para avaliação do conhecimento e habilidade acerca da higienização simples das mãos. Métodos: estudo, transversal, quantitativo desenvolvido com 18 enfermeiros docentes que foram juízes da pesquisa. Desenvolvida em duas etapas: levantamento de literatura especializada para construção do check list da técnica e o questionário do conhecimento e identificação, seleção e submissão dos instrumentos para avaliação dos juízes. Realizada a validação de conteúdo com aplicação do Índice Kappa (K) para verificação do nível de concordância e nível de consistência uti­lizando como ponto de corte o índice > 0,8. O obteve parecer favorável da Comissão de Ética em Pesquisa/UFRN (CAAE nº 0002.0.294.000-10). Resultados: todos os indicadores foram aprovados, apenas o item enxágua as mãos retirando os resíduos e evita contato direto das mãos ensaboadas com a torneira (técnica) e a alternativa que corresponde ao termo higienização das mãos (conhecimento) obtiveram nível de concordância de 0,7 cada, sendo modificados de acordo com as sugestões.  Através da análise das informações fornecidas pelos juízes, verificou-se sugestões em 7 itens da técnica e 9 do conhecimento. Os comentários e sugestões foram acatados e permaneceram 14 itens de verificação da técnica da higienização das mãos e 12 da avaliação do conhecimento. Conclusão: os instrumentos elaborados podem ser considerados satisfatórios, adequados e úteis na mensuração da habilidade técnica e do conhecimento sobre a higienização simples das mãos. Demonstrando a importância de se realizar validação prévia de instrumentos de avaliação.

9
  • CECILIA MARIA FARIAS DE QUEIROZ FRAZAO
  • Diagnósticos de enfermagem em pacientes em tratamento hemodialítico: relacionado a Teoria de Roy e a NANDA Internacional.

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • GILSON DE VASCONCELOS TORRES
  • LUISA HELENA DE OLIVEIRA LIMA
  • MARCOS VENÍCIOS DE OLIVEIRA LOPES
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: Oct 26, 2012


  • Show Abstract
  • O enfermeiro no setor de nefrologia tem um importante papel na monitoração, apoio, avaliação e educação, identificando as necessidades individuais de cada cliente e proporcionando meios de prestação de serviço que visem uma melhor adaptação ao tratamento. Desta forma, torna-se fundamental a implantação do processo de enfermagem, sob o contexto de um referencial teórico. Dentre esses, destaca-se a teoria de adaptação de Roy. Destarte, objetivou-se estabelecer uma relação conceitual entre os diagnósticos de enfermagem da NANDA-Internacional e os problemas de adaptação de Roy em pacientes renais crônicos em hemodiálise. Estudo do tipo descritivo e transversal, realizado em um centro de diálise, localizado no município de Natal, Rio Grande do Norte. A população foi composta por 330 pacientes em hemodiálise, sendo a amostra de 80 pacientes, selecionados aleatoriamente, durante os meses de outubro de 2011 a fevereiro de 2012. Os critérios de inclusão foram: ser portador da doença renal crônica; estar cadastrado e submetido à hemodiálise na clínica em questão; e ser adulto (20 a 65 anos). Os instrumentos de coleta de dados foram: roteiros de entrevista e de exame físico. A análise dos dados ocorreu inicialmente através do raciocínio clínico e do julgamento diagnóstico. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte (protocolo nº 115/11), Certificado de Apresentação para Apreciação Ética (no 0139.0.051.000-111), com financiamento do Edital Universal MCT/CNPq 14/2010. Os resultados mostram que a maioria dos pacientes era do sexo masculino (55%), casados (63,7%) e residentes na região metropolitana do Natal (58,3%). A idade média foi 46,6 anos, com uma média de 8,7 anos de estudos escolares. Em relação aos diagnósticos de enfermagem, obteve-se uma média de 6,65 diagnósticos, com destaque para: Risco de Infecção (100%); Volume de líquidos excessivo (73,75%); Hipotermia (62,5%); Fadiga (51,25%). Por outro lado, a média dos problemas adaptativos foi 6,5 e os principais foram: Retenção de líquido intracelular (70%); Hipercalemia (70%); Hipotermia (63,75%) e Intolerância à atividade (50%). As relações estabelecidas entre os DE da NANDA-Internacional e os problemas adaptativos propostos por Roy foram: risco de quedas/risco de lesão e potencial para lesão; mobilidade física prejudicada e mobilidade andar e /ou coordenação restritos; déficit no autocuidado para banho e vestir-se e perda de habilidade ao autocuidado; hipotermia e hipotermia; integridade da pele prejudicada e integridade da pele prejudicada; volume de líquidos excessivo e retenção de líquido intracelular/hipercalemia/hipocalcemia/edema; nutrição desequilibrada: menos do que as necessidades corporais; constipação e constipação; dor aguda e dor aguda; dor crônica e dor crônica; Percepção sensorial perturbada: visual, auditiva e tátil e deficiência de um sentido primário: visão, audição e tátil; insônia e privação do sono; fadiga e intolerância à atividade; autocontrole ineficaz da saúde e falha no papel; disfunção sexual e disfunção sexual; baixa autoestima situacional e baixa autoestima. Conclui-se que existe uma forte semelhança entre os diagnósticos da NANDA-Internacional e os problemas adaptativos de Roy. Ademais, acredita-se que a implantação do processo de enfermagem, através da teoria de Roy e da NANDA-Internacional em pacientes renais crônicos em hemodiálise se faz necessária para subsidiar o direcionamento do planejamento da assistência, contribuindo para o fortalecimento científico da enfermagem.

10
  • ISABEL CRISTINA ARAUJO BRANDAO
  • A ATUAÇÃO DO ENFERMEIRO NA ESTRATÉGIA DE ATENÇÃO INTEGRADA ÀS DOENÇAS PREVALENTES NA INFÂNCIA

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • EDNALDO CAVALCANTE DE ARAÚJO
  • RAIMUNDA MEDEIROS GERMANO
  • ROSINEIDE SANTANA DE BRITO
  • Data: Nov 29, 2012


  • Show Abstract
  • A estratégia de Atenção Integrada as Doenças Prevalentes na Infância, desenvolvida pela Organização Mundial de Saúde e pelo Fundo das Nações Unidas para a Infância foi criada em 1994 e primeiramente introduzida nos países africanos e asiáticos. Em 1996 o Ministério da Saúde deu inicio a sua implantação no Brasil, priorizando as regiões Norte e Nordeste, onde estão localizados os maiores índices de mortalidade infantil do país. A principal meta da AIDPI é promover uma rápida e significativa redução da mortalidade na infância em decorrência de causas evitáveis, particularmente as doenças prevalentes na infância. A referida estratégia foi criada para ser desenvolvida por profissionais médicos e enfermeiros devidamente treinados. Considerando que o grupo materno infantil responde por parcela significativa da procura nos serviços de saúde, em sua maioria crianças menores de cinco, e sendo o enfermeiro o profissional de saúde que vem assumindo grande parcela da atenção prestada a esse público, convém tecer a seguinte questão de pesquisa: Como vem se dando a atuação dos enfermeiros na operacionalização da Estratégia de Atenção Integrada às Doenças Prevalentes na Infância (AIDPI)? Nesse sentido a presente pesquisa se propôs a: Analisar a atuação do enfermeiro na estratégia de Atenção Integrada às Doenças Prevalentes na Infância no município de Natal, Rio Grande do Norte, e mais especificamente: Descrever as ações que as enfermeiras prioriza no seu atendimento a criança na USF; Averiguar o entendimento das enfermeiras acerca da AIDPI; e Identificar os fatores que influenciam a atuação das enfermeiras em AIDPI. Trata-se de um estudo qualitativo com abordagem descritiva. A pesquisa empírica foi desenvolvida no município de Natal no período de março a maio de 2012. O universo foi constituído por enfermeiros da Estratégia Saúde da Família e a amostra conta com 16 sujeitos. Para a realização dessa pesquisa o projeto foi submetido à aprovação do Comitê de Ética e Pesquisa da Universidade Federal do Rio Grande do Norte, em concordância com a Resolução Nº. 196/96 do Conselho Nacional de Saúde, obtendo Parecer nº 187/2012. Os dados foram obtidos através de um questionário, para levantamento do perfil de formação das enfermeiras e de uma entrevista guiada por roteiro semi-estruturado. Os dados foram tratados à luz da análise categorial temática de Bardin e analisados através da estruturante do SUS particularmente, aquelas voltadas para atenção à saúde da criança; da literatura existente relacionada a temática AIDPI, bem como das discussões acerca dos modelos assistenciais. Os resultados permitiram identificar como temática central estudo ‘O enfermeiro no contexto da Atenção Integrada às Doenças Prevalentes na Infância’,a qual resultou no surgimento de duas categoria de análises: ‘Atuação do enfermeiro na atenção à criança’ e ‘Posição do enfermeiro em relação ao AIDPI’, seguidas de suas respectivas subcategorias. Observa-se que as enfermeiras consideram a AIDPI util, eficaz e importante para acompanhar crianças doentes dentro da lógica curativista, entretanto desconsideram o carater de promoção da saúde e prevenção de doenças da mesma. Constatou-se que as enfermeiras ainda realizam o atendimento das crinaças dentro do modelo biomédico e que essas mesmas profissionais são submetidas a condições de trabalho precarizadas e insalubres em virtude da falta de recursos humanos e materiais. Verificou-se que as profissionais não seguem os protocolos da estratégia em virtude de entraves relacionados a prescrição de medicamentos pelo enfermeiro, o ato médico, a falta de incentivo, capacitação e fiscalização por parte da gestão municipal de saúde e do Conselho Regional de Enfermagem. Por fim, foi possivel verificar que o comportamento das mães mediante a situação de saúde de seus filhos tem mudado, uma vez que elas estão mais preocupadas e engajadas em acompanharem o crescimento e desenvolvimento saudáveis de suas crianças, dentro da lógica do modelo promocional de saúde.

11
  • RENATA DE LIMA PESSOA PEREIRA
  • O ESTUDO DA MORTE NA FORMAÇÃO DO ENFERMEIRO: percepção de estudantes

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • RAIMUNDA MEDEIROS GERMANO
  • JACILEIDE GUIMARAES
  • SORAYA MARIA DE MEDEIROS
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • Data: Dec 7, 2012


  • Show Abstract
  • O presente estudo tem como objetivo compreender a percepção de estudantes de enfermagem acerca do estudo da morte no processo de formação acadêmica, desvelando sentimentos e significados gerados ao estudar essa temática. Para sua realização, o projeto foi aprovado pelo comitê de ética da UFRN, conforme Parecer nº 234/2012. Utiliza uma abordagem qualitativa, com enfoque fenomenológico, apoiando-se nas ideias do filósofo alemão Martin Heidegger. Foram entrevistados dez estudantes que responderam às seguintes questões norteadoras: em que momento de sua formação a temática morte e morrer é estudada? A que sentimentos esse tema remete? Qual o significado de estudar esse tema na formação do enfermeiro? A análise das falas mostra que a temática morte e morrer é abordada de maneira muito pontual em disciplinas diferentes, inexistindo um diálogo entre elas. Revelam o medo e angústia como sentimentos presentes ao estudar o tema; reconhecem o estudo desta temática como um momento importante de reflexão para compreender que a morte não é um fracasso da ação de cuidar, sendo uma oportunidade para entendê-la como fenômeno natural. Nessa perspectiva, podemos concluir que o discente precisa ser conduzido em seu processo de formação não o separando do seu existir no mundo-com-os-outros, mas interligando seus conceitos, entendendo seus sentimentos enquanto ser, e, dessa forma, respeitar e cuidar do homem como um ser-para-a-morte. Portanto, o grande desafio para a educação em enfermagem é criar espaços de discussão acerca da morte, entre professores e estudantes, particularmente, nas disciplinas que abordam o tema.

12
  • ANA ANGELICA REGO DE QUEIROZ
  • O CONHECIMENTO E AS ATITUDES DAS FAMÍLIAS DE PACIENTES EM TRATAMENTO DA TUBERCULOSE NA ATENÇÃO PRIMÁRIA À SAÚDE.

  • Advisor : RICARDO ALEXANDRE ARCENCIO
  • COMMITTEE MEMBERS :
  • RICARDO ALEXANDRE ARCENCIO
  • BERTHA CRUZ ENDERS
  • REJANE MARIA PAIVA DE MENEZES
  • ALINE APARECIDA MONROE
  • Data: Dec 14, 2012


  • Show Abstract
  • O Brasil vive no século XXI uma situação de saúde paradoxal, em que apesar de sua projeção econômica no cenário internacional, ainda remanescem doenças emblemáticas da pobreza, como a Tuberculose, o que atesta a hipótese de que nem sempre o desenvolvimento econômico anda pari-passu ao desenvolvimento social. A dimensão social ganha expressão importante quando se intenta investigar os desafios neste século para a redução da TB. Nesse sentido, a família vem sendo cada vez mais valorizada para a consecução deste objetivo, pelas suas responsabilidades e funções dentro de um sistema de proteção social. Desse modo, na presente investigação buscou-se analisar o conhecimento sobre TB e as atitudes das famílias de pacientes em tratamento da doença na Atenção Primária à Saúde em Natal/RN. Para tal, empreendeu-se um estudo de corte transversal, através da aplicação de questionário junto às famílias de pacientes diagnosticados de TB e em seguimento pela APS de Natal. O instrumento foi validado em uma população similar a do estudo. Os sujeitos da pesquisa foram recrutados de forma não probabilística, por conveniência, contemplando uma amostra de 50 familiares. Dentre os critérios utilizados para a inclusão dos sujeitos, foram considerados: idade acima de 18 anos, residir com o doente de TB e em Natal e disponibilidade de participação da pesquisa. A coleta de dados foi realizada pela pesquisadora e uma assistente. Procedeu-se a dupla digitação independente dos dados. Na etapa analítica, inicialmente foi conduzida a fase exploratória e univariada dos dados, com descrição das medidas de posição (média, mediana, moda) e dispersão (intervalo de confiança e desvio-padrão). Na análise bivariada, os autores efetuaram o cruzamento das variáveis dependentes e dicotômicas − conhecimento (0-Sim; 1-Não) e mudanças atitudes (0-Não; 1-Sim), com cada uma das variáveis independentes, por meio de tabelas de contingência, sendo aplicado o teste qui-quadrado e, quando necessário, o teste exato de Fisher. Nas tabelas 2x2, computou-se o odds ratio (OR) com respectivos intervalos de confiança de 95% (IC 95%). Da amostra selecionada, 43 (86%) sujeitos eram do sexo feminino, com idade média e mediana respectivamente de 46,64 e 46,50 anos; 25 (50%) possuíam o ensino fundamental. O conhecimento expresso pelos familiares sobre a TB foi considerado satisfatório. Entretanto, a falta de interesse dos familiares (54%) em procurar informações sobre a tuberculose; a forma incorreta da resposta em relação ao microrganismo causador da doença (64%); a indicação de água (62%) e alimentos contaminados (54%) como meios de disseminação da TB foi uma fragilidade identificada na investigação. Em relação ao tempo de transmissão da doença, 90% dos entrevistados indicaram não saber ou responderam errado. Das variáveis independentes investigadas, apenas duas apresentaram associação com o não conhecimento de TB, sendo elas não possuir religião (OR: 0,146; IC95% : 0,027-0,800) e renda abaixo de 1,7 salários mínimos (OR : 0,155; IC95%: 0,029-0,813), parecendo elas exercerem um efeito protetor sobre este desfecho. Quanto às mudanças de atitude, a maioria das variáveis consideradas não teve associação com significância estatística, exceto o não acesso à internet (OR: 0,212; IC95%:0,048-0,935). A maioria das atitudes foi positiva em relação ao doente de TB. Os resultados demonstram fragilidades na atenção à TB, que tem assumido um caráter mais assistencialista e individual. Os dados não somente expressam os resultados sanitários produzidos pelos serviços de saúde, mas a conjuntura política e social das famílias que são acometidas pela TB.

2011
Dissertations
1
  • ISABELLE KATHERINNE FERNANDES COSTA
  • QUALIDADE DE VIDA DE PESSOA COM ÚLCERA VENOSA: associação dos aspectos sociodemográficos, de saúde, assistência e clínicos da lesão

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • EDNALDO CAVALCANTE DE ARAÚJO
  • Data: Feb 28, 2011


  • Show Abstract
  • A Úlcera venosa (UV) é uma lesão dos membros inferiores resultante do inadequado retorno de sangue venoso nos pés ou pernas. Comuns na população adulta, causa significante impacto social e econômico devido a sua recorrência e o longo tempo decorrido entre sua abertura e cicatrização. Embora não fatais tais feridas crônicas comprometem seriamente a qualidade de vida (QV) dos doentes trazendo mudanças por vezes drásticas no âmbito familiar, social, econômico e psicológico. Nesse sentido, são diversos os aspectos que podem estar associados, influenciando a QV da pessoa com úlcera venosa. O estudo objetivou analisar a associação dos aspectos sociodemográficos e de saúde, de assistência à saúde e clínicos da lesão na QV dos portadores de UV. Estudo analítico, com delineamento transversal e abordagem quantitativa, que busca estudar a complexidade dos fatores envolvidos na alteração da QV dos portadores de UV. A coleta de dados realizou-se no ambulatório de angiologia do Hospital Universitário Onofre Lopes (HUOL), no período de 3 meses. A amostra foi de 60 portadores de UV atendidos por angiologistas no ambulatório de Clínica Cirúrgica do HUOL. O projeto obteve parecer favorável do Comitê de Ética do HUOL (n.279/09). Os resultados foram analisados no programa SPSS 15.0 através de estatística descritiva e inferencial, em seguida foram codificados, tabulados e apresentados na forma de tabelas, quadros e gráficos, com as respectivas distribuições percentuais e resultados dos testes estatísticos. Identificamos usuários com UV predominantemente do sexo feminino, idade média de 61,4 anos, baixo nível de escolaridade e de renda familiar, com profissões que exigem longos períodos em pé ou sentados, mas a maioria aposentada, desempregada ou afastada do trabalho devido à doença e com doenças crônicas associadas, em uso de produtos inadequados, curativos realizados por profissional ou cuidador sem treinamento, ausência de terapia compressiva e orientações adequadas, sem realizar elevação de membros inferiores e exercícios regulares, com tempo de lesão maior ou igual seis meses, falta de exames laboratoriais específicos, menos de 4 consultas com o angiologista por ano, sem registro no prontuário, com referência, lesões recidivantes, área de média a grande, leito da lesão com fibrina e/ou necrose, exsudato com quantidade de média a grande, sem odor e sinais de infecção, perda tecidual entre grau I e II, sem coleta de Swab ou biopsia e com presença de dor. Em geral, a QV dos pesquisados foi considerada baixa, pontuação máxima de 69 pontos. Sendo os domínios que mais influenciaram nos escores totais da QV a capacidade funcional (0,021), aspecto emocional (0,000) e aspecto social (0,080). Dos 60 pesquisados, 53,3% tiveram pontuação entre 40 a 69 pontos no SF-36, e apresentaram os escores melhores nas variáveis sociodemográficas e de saúde (ρ=0,049). Quanto às características da assistência e da lesão, os pacientes que apresentaram pontuação entre 40 e 69 pontos no SF-36 apresentaram escores melhores em tais características. Ao unir as variáveis sociodemográficas, saúde, características da assistência e da lesão verificamos que houve uma diferença significante (ρ=0,032) ao relacioná-las com o escore total da QV. Analisando separadamente os domínios do SF-36 com os escores obtidos na qualidade de vida, verificamos que os domínios que apresentaram significância estatística foram capacidade funcional (ρ= 0,035), aspecto físico (ρ= 0,019), aspecto emocional (ρ= 0,000) e saúde mental (ρ= 0,050). Dentre as características sociodemográficas estudadas, sexo e estado civil contribuíram mais para a redução da QV e entre as variáveis da assistência e da lesão, destacam-se as variáveis orientações, referencia e área da UV. Ao analisarmos o conjunto dessas cinco variáveis de acordo com o escore geral obtido na qualidade de vida, verificamos correlação significativa (ρ= 0,002), sendo 6,23 vezes maior a chance de os pacientes apresentarem melhor QV na presença desses cinco fatores positivos. Ao realizarmos o Teste de Mann Whitney U entre o conjunto das cinco variáveis sociodemográficas, saúde, clínica e assistencial, verificamos que tal conjunto também demonstrou ser significativo (ρ=0,006).  Portanto, os pacientes que apresentam essas cinco variáveis positivas tendem a ter uma melhor qualidade de vida. Diante dos resultados obtidos, rejeitamos a hipótese nula (H0) e aceitamos a hipótese alternativa (H1) proposta no estudo, pois evidenciamos que a qualidade de vida dos portadores de UV está associada aos aspectos sociodemográficos e de saúde, de assistência à saúde e dos aspectos clínicos da lesão.

2
  • CECILIA NOGUEIRA VALENCA
  • Corações e mentes desvendam o sistema
    único de saúde: visões e vivências de estudantes de enfermagem

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • JACILEIDE GUIMARAES
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: Mar 14, 2011


  • Show Abstract
  • Uma das tentativas do ministério da saúde de contribuir para tornar a saúde
    coletiva mais atraente para o estudante da área de saúde/enfermagem se trata
    do projeto de Vivências e Estágios na Realidade do SUS (VER-SUS). Portanto,
    estudar a visão de discentes sobre o ensino de enfermagem a partir de suas
    vivências no VER-SUS constitui o objeto desta investigação. Seu objetivo é
    analisar as visões e vivências de estudantes de enfermagem sobre a
    contribuição do VER-SUS na sua formação profissional. Trata-se de um estudo
    do tipo descritivo/exploratório, com abordagem qualitativa. Participaram 18
    estudantes da graduação em enfermagem da Universidade Federal do Rio
    Grande do Norte (UFRN), egressos do VER-SUS, no período de 2006/2009.
    Para a coleta de informações, foram utilizadas as técnicas de grupo focal
    orientado por um roteiro de questões, e entrevista semiestruturada, com
    questões abertas e fechadas. As informações coletadas foram analisadas
    através da técnica de análise de conteúdo, na modalidade de análise temática.
    O estudo foi aprovado pelo Comitê de Ética em Pesquisa da UFRN pelo
    parecer nº. 223/2010. A vivência e o estágio do VER-SUS contribuíram de
    forma significativa para a formação em saúde, pois ajudaram a perceber o
    papel da universidade e da formação em saúde/enfermagem em meio ao
    modelo hegemônico de formação. Nas visões e vivências dos estudantes de
    enfermagem participantes do projeto sobre o SUS foi de suma importância a
    utilização de metodologias ativas para o processo ensino/aprendizagem e os
    facilitadores atuaram como condutores da aproximação com o SUS. O estudo
    concluiu que o VER-SUS contribuiu para a formação em saúde/enfermagem,
    aproximando os estudantes da realidade da comunidade.

3
  • EDUALEIDE JEANE PEREIRA BULHOES DA NOBREGA
  • AÇÕES DE PROFISSIONAIS RELATIVAS À DISTRIBUIÇÃO DE LEITE HUMANO PASTEURIZADO: uma perspectiva de mudança

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • REJANE MARIE BARBOSA DAVIM
  • ROSINEIDE SANTANA DE BRITO
  • VALDECYR HERDY ALVES
  • Data: Mar 28, 2011


  • Show Abstract
  • A presente pesquisa tem como objetivo: Analisar as ações de profissionais médicos e equipe de enfermagem frente à necessidade do leite humano pasteurizado para o recém-nascido.É um estudo exploratório e descritivo, com abordagem qualitativa, tendo como método a pesquisa-ação. A investigação será desenvolvida numa instituição hospitalar federal, situada na capital do estado do Rio Grande do Norte, referência em atendimento a gestante, parto e puerpério de alto risco. Conta com vários setores como urgência, ginecologia, centro cirúrgico, sala de parto, enfermarias para gestantes de alto risco, puerpério de alto e baixo risco, UTI neonatal, dentre outros. A capacidade de leitos dessa maternidade para puerpério de baixo risco é de 56 leitos e para UTI neonatal 10 leitos.Farão parte do estudo, profissionais médicos, enfermeiros e técnicos de enfermagem, que atuam na UTI neonatal e alojamento conjunto. Os critérios de inclusão adotados nesse estudo são: ser médico pediatra e/ou neonatologista, enfermeiros e técnicos de enfermagem. Como critérios de exclusão: não ser profissionais das categorias já citadas, e não atuar em alojamento conjunto e UTI neonatal, como também demonstrar desinteresse pelo objeto de investigação ou qualquer outra condição que inviabilize sua participação.

4
  • JOSE EUGENIO LOPES LEITE
  • VIABILIDADE DO PROCESSO DE ENFERMAGEM NO CONTEXTO HOSPITALAR: perspectiva gerencial

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • DINÁ DE ALMEIDA LOPES MONTEIRO DA CRUZ
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • GILSON DE VASCONCELOS TORRES
  • Data: Mar 30, 2011


  • Show Abstract
  • O Processo de Enfermagem (PE) é considerado como a dinâmica das ações sistematizadas e inter-relacionadas visando à assistência do ser humano. No entanto, percebemos a falta de uso do PE nos serviços e observamos que a dificuldade de implantação do PE está relacionada à própria valorização do PE pelos enfermeiros e questões institucionais que envolvem recursos humanos e materiais. Acreditamos que o gerente, como representante de toda a assistência prestada pela enfermagem da instituição, é um personagem importante para efetivação de políticas de interesse da enfermagem, como a implantação do PE, no serviço. No entanto, a literatura é escassa quanto ao PE na perspectiva do gerente de enfermagem. O objetivo geral deste estudo é analisar a viabilidade do Processo de enfermagem no contexto hospitalar a partir das atitudes dos gerentes de enfermagem das instituições acerca desse instrumento. Realizamos uma pesquisa descritivo-exploratória, de abordagem quantitativa, com uma população de 45 gerentes de enfermagem de hospitais  atuando na rede pública estadual de Natal-RN e nas unidades hospitalares da UFRN. Foram utilizados dois instrumentos para a coleta de dados, um questionário sobre o PE, desenvolvido para propósitos deste estudo e a escala para medição de atitudes, Posições sobre o Processo de Enfermagem. A população é predominante feminina (91,0%) e relativamente experiente na prática da enfermagem (Média = 17,6 anos). No entanto, possuem pouca experiência na área gerencial (Média = 8,6 anos). Expressam ter pouco conhecimento dos termos relacionados ao PE.e pouca experiência com o PE. Possuem uma atitude favorável ao PE (Média Geral = 110,9); são favoráveis a seu desenvolvimento no serviço (88,9%) e sugeririam a sua implantação (86,7%);  48,9% indicaram pouca possibilidade de implantação no serviço e 37,8% muita possibilidade. O teste de Spearman entre a Atitude sobre o PE e a Possibilidade de implantação no serviço mostrou uma associação negativa fraca, tanto na atitude geral (-,316), quanto nos 20 itens do instrumento, com coeficientes variando entre - 0,014 a - 0,464.  A análise fatorial da escala realizada neste estudo identificou três fatores subjacentes às atitudes dos gerentes neste estudo: “relevância”, “operacionalização” e “colaboração”, com Coeficiene Alfa Cronbach de 0,955; 0,844 e 0,807, respectivamente e de 0,956 para todos os itens em conjunto, demonstrando que a escala geral e as fatoriais possuem coerência interna para uso nessa população.  Concluímos que há uma tendência, embora leve, dos profissionais com atitude favorável ter percepção negativa sobre  a possibilidade de implantação do PE no serviço. A posição favorável ao PE parece não ser suficiente para a viabilidade de implantação dessa metodologia no serviço hospitalar, sendo esse resultado desconfortável para a enfermagem.  Essa situação sugere que as dificuldades de implantação do PE estão vinculadas à outras questões, como as organizacionais. A implantação do PE em uma instituição onde não é conhecido, nem praticado, constitui a introdução de uma inovação tecnológica e de trabalho que envolve múltiplos requisitos, entre eles a adesão das pessoas à inovação proposta. Isso demanda não só tempo, mas um processo com estratégias especificas para a difusão do conhecimento acerca do método, bem como os ajustes institucionais e de recursos humanos necessários. Nesse processo o envolvimento de todos os profissionais da instituição é necessário. Essa situação retoma as discussões de autonomia profissional, limites e perspectivas da ação e influência do enfermeiro no contexto hospitalar, (re) definição de papeis, delimitação (ou consenso) do objeto de estudo ou do(s) processo(s) de trabalho, entre outras.

5
  • MARIA DA GUIA FELICIANO DA SILVA
  • Registro de enfermagem no prontuário em um Hospital Universitário: Uma busca pela humanização do cuidado

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • MOEMIA GOMES DE OLIVEIRA MIRANDA
  • RAIMUNDA MEDEIROS GERMANO
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: Mar 31, 2011


  • Show Abstract
  • O objetivo do presente estudo é analisar a visão de enfermeiros acerca dos registros de enfermagem no prontuário, na perspectiva do registro do cuidado humanizado. Trata-se de um estudo de caso, de abordagem qualitativa. Para sua realização foi solicitada e concedida autorização da direção do Hospital Universitário Onofre Lopes (HUOL), bem como do Comitê de Ética em Pesquisa, da UFRN, conforme Parecer 422/10. Durante a coleta de dados foram feitas entrevistas com 20 enfermeiros da Instituição. A análise do material coletado foi realizada a partir do referencial teórico de Minayo para análise temática do conteúdo, ancorada em autores que trabalham com os temas, registros de enfermagem e humanização da assistência. A partir do material empírico foi construída uma grelha de análise, sendo identificadas  quatro categorias, assim nominadas: “Lendo e aprendendo com o que se registra”; “os registros de enfermagem e a qualidade da assistência”; “a essência dos registros de enfermagem” e a “intenção e gesto sobre o registro dos aspectos subjetivos do paciente”. Os resultados apontam  que os registros são incipientes, mesmo em se tratando dos procedimentos realizados com o paciente; comumente não informam acerca dos aspectos que tratam das subjetividades que o envolvem; e admitem que os registros não representam um parâmetro para avaliar a qualidade da assistência, pelo menos naquela instituição. Em síntese, os participantes da pesquisa reconhecem a importância da valorização da subjetividade do paciente em seu tratamento, no entanto, confessam negligenciar este aspecto tão significativo para uma assistência integral, humanizada e de qualidade.

6
  • MARIA GORETE PEREIRA DE ARAUJO
  • PERFIL DA ATUAÇÃO DO ENFERMEIRO NA REDE BÁSICA DE SAÚDE FRENTE À GESTANTE COM INFECÇÃO DO TRATO URINÁRIO.

  • Advisor : REJANE MARIE BARBOSA DAVIM
  • COMMITTEE MEMBERS :
  • FATIMA RAQUEL ROSADO MORAIS
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MARIE BARBOSA DAVIM
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: May 30, 2011


  • Show Abstract
  • A infecção do trato urinário (ITU) constitui uma das principais causas de consulta médica, perdendo apenas para as infecções respiratórias.  Sua  importância na gravidez  se deve  em função da  morbimortalidade materno-infantil, representando a segunda causa de morbidade obstétrica e a terceira intercorrência clínica mais comum na gestação acometendo de 10 a 12% das gestantes. Também está associada ao aborto, trabalho de parto prematuro (TPP) e infecção ovular. O objetivo desta pesquisa é identificar a atuação do enfermeiro na rede básica de saúde frente à gestante com infecção do trato urinário. Estudo descritivo exploratório, com abordagem quantitativa. Os dados serão coletados por meio de um formulário de entrevista. A população a ser estudada será enfermeiros que atuam nas Unidades de Saúde da Família que pertencem aos Distritos Leste e Oeste de Natal, capital do Rio Grande do Norte(RN), estando constituídos por 24 unidades. A importância da pesquisa se deve a alta incidência de ITU em gestantes admitidas em uma maternidade pública de referência para o Rio Grande do Norte. Os resultados serão tratados por meio de estatística descritiva, computados, ordenados e apresentados sob a forma de tabelas, figuras e quadros, sendo discutidos e analisados, levando-se em consideração o levantamento da literatura acerca do assunto.

7
  • SILVIA XIMENES OLIVEIRA
  • Qualidade de vida em gestantes no contexto da Estratégia Saúde da Família.

  • Advisor : REJANE MARIE BARBOSA DAVIM
  • COMMITTEE MEMBERS :
  • FATIMA RAQUEL ROSADO MORAIS
  • REJANE MARIE BARBOSA DAVIM
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • ROSINEIDE SANTANA DE BRITO
  • Data: May 31, 2011


  • Show Abstract
  • A gravidez como processo na vida da mulher determina intensas transformações biológicas, psíquicas, relacionais e socioculturais para preparação da maternidade. Por sua capacidade modificadora e, em detrimento destes fatores, observa-se que as alterações físicas, sociais e emocionais vividas pelas mulheres durante a gestação podem influenciar na sua qualidade de vida, especialmente relacionada à saúde. Teve-se como objetivos desta pesquisa verificar a qualidade de vida de gestantes no contexto da Estratégia Saúde da Família de um município da Paraíba, com vista à: caracterizar os aspectos sociodemográficos, hábitos de vida, obstétricos e assistenciais das gestantes e caracterizar os domínios da qualidade de vida das mulheres grávidas segundo o questionário WHOQOL-bref. Trata-se de um estudo descritivo do tipo transversal exploratório e descritivo com abordagem quantitativa. A população foi composta por 120 gestantes atendidas na atenção básica do município de Sousa-PB. A coleta de dados ocorreu num período de dois meses pela própria mestranda e dois acadêmicos de enfermagem aplicando-se um formulário referente às características sociodemográficas, assistenciais e obstétricas e do instrumento WHOQOL-bref. Os dados coletados foram organizados em um banco de dados eletrônico do aplicativo Microsoft Excel, codificados, tabulados e apresentados em forma de tabelas, quadros e figuras com suas respectivas distribuições percentuais. Das pesquisadas, predominou a faixa etária de 20 a 25 anos, católicas, com companheiro fixo, baixa escolaridade, sem vínculo empregatício, renda salarial de 01 salário mínimo. Quanto aos dados obstétricos e assistenciais, quase a totalidade, nunca havia abortado e referiram à assistência recebida como ótima. As queixas mais frequentes foram: dor nas costas em baixo ventre. Quanto à qualidade de vida segundo o WHOQOL-bref, as insatisfações que predominaram nos domínios foram: no domínio físico, dor e desconforto, sono, repouso, energia e fadiga. No domínio psicológico: imagem corporal e aparência, memória, concentração e sentimentos negativos. No domínio relações sociais, a atividade sexual e no domínio meio ambiente, as facetas com maior insatisfação pontuaram: recursos financeiros, oportunidade de lazer e transporte. Conclui-se que a qualidade de vida das usuárias entrevistadas foi considerada insatisfatória para estas facetas, denotando que a assistência a este público alvo deve ser realizada de forma integral e holística, de forma a contemplar as facetas afetadas para uma melhoria da qualidade de vida das gestantes assistidas na atenção básica.  

     

8
  • JOCELLY DE ARAUJO FERREIRA
  • Comunicação dos enfermeiros com usuários do gênero masculino: um estudo representacional.

  • Advisor : REJANE MILLIONS VIANA MENESES
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • REJANE MILLIONS VIANA MENESES
  • WILMA DIAS DE FONTES
  • Data: Aug 2, 2011


  • Show Abstract
  • A comunicação é vista como função vital. Por meio dela, os indivíduos e organizações se relacionam entre si, com o meio ambiente e com as próprias partes do seu grupo, influenciando-se mutuamente ao transformar fatos em informações. O usuário do gênero masculino faz parte de um grupo de pacientes cuja política de saúde ainda está em desenvolvimento. Tal fato pode gerar insegurança no enfermeiro em estabelecer um processo que promova a prevenção da doença, promoção e/ou recuperação da saúde desse usuário. Visando a essa elucidação, a presente pesquisa teve o objetivo geral de analisar as representações sociais da comunicação entre os enfermeiros e os usuários do gênero masculino, na atenção básica de saúde. A fim de alcançar o objetivo suscitado, este estudo foi de cunho descritivo, exploratório e com abordagem qualitativa. Baseou-se no referencial teórico-metodológico das representações sociais de Serge Moscovici e Denise Jodelet. O projeto obteve, mediante o Parecer nº. 649/10, aprovação do Comitê de Ética e Pesquisa do HULW. Durante a coleta de dados, utilizou-se um roteiro semiestruturado e um diário de campo nas entrevistas com os 24 enfermeiros das unidades básicas de saúde do bairro de Mangabeira- Distrito Sanitário III, no município de João Pessoa (PB). Os resultados foram analisados por meio da técnica de Análise de Conteúdo, segundo Bardin (2007).Classificaram-se os sujeitos da pesquisa e identificaram-se três categorias e cinco núcleos das ideias centrais. As categorias identificadas: o apreender das RS da comunicação dos enfermeiros com os usuários do gênero masculino, a identificação dos fatores que influem na efetivação da comunicação dos enfermeiros com os usuários do gênero masculino e a investigação sobre as estratégias utilizadas pelos enfermeiros para a elucidação da comunicação com os usuários do gênero masculino. Os núcleos das ideias centrais encontrados: as representações sociais da comunicação dos enfermeiros com os usuários do gênero masculino são exteriorizadas como difícil, diferente, árdua, sem técnica (conhecimento) específica, apresentando um sentido dúbio em relação a sua ação terapêutica; os fatores apreciados como positivos nessa comunicação estavam pautados no vínculo entre profissional e usuário, no olhar detalhista e não mecanicista, nas ações preventivas, na dinamicidade do atendimento, acessibilidade, cuidados participativos, humanização e qualificação no atendimento. Já os fatores atendidos como negativos durante a referida comunicação, firmaram-se nas diferenças comportamentais dos homens, na feminização dos enfermeiros, na falta de capacitação para os profissionais em relação ao tema, condutas prescritivas e nos preconceitos (inquietações) socioculturais. Outro núcleo coligado consolidou-se nas estratégias empregadas para a ocorrência dessa comunicação. Diante desses resultados, percebeu-se a importância das representações sociais para a consagração de uma linguagem única, no entendimento consensual da realidade sobre a comunicação do enfermeiro com o usuário do gênero masculino e na determinação de mudanças no comportamento do enfermeiro e do usuário, para o estabelecimento de estratégias mais eficazes para a obtenção de uma comunicação terapêutica, entre eles.

     

9
  • RANE CRISTINA PEREIRA ANGELICO
  • Qualidade da assistência e o conhecimento sobre o direito a saúde das pessoas com úlcera venosa crônica

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • LUCIANA ARAUJO DOS REIS
  • THAIZA TEIXEIRA XAVIER NOBRE
  • Data: Sep 30, 2011


  • Show Abstract
  • O estudo teve como objetivo analisar a qualidade da assistência e o conhecimento do direito à saúde dos usuários com úlcera venosa (UV) crônica no Sistema Único de Saúde (SUS). Trata-se de um estudo descritivo transversal, com abordagem quantitativa, realizado no Hospital Universitário Onofre Lopes (HUOL), especificamente no ambulatório da Clínica Cirúrgica. O estudo obteve parecer favorável do Comitê de Ética em Pesquisa do HUOL (CAAE nº 0148.0.051.000-10). A amostra por acessibilidade foi composta por 30 pessoas com UV atendidas no ambulatório de Clínica Cirúrgica do HUOL. Para coleta de dados foi utilizado um questionário estruturado composto de duas partes: características sociodemográficas, de saúde, da assistência e da evolução clínica da UV; e conhecimento dos usuários acerca dos direitos à saúde. Os resultados foram processados no programa SPSS 15.0 e analisados por estatística descritiva. Diante das caracterizações sociodemográficas e de saúde apresentadas, identificamos uma clientela de usuários com UV predominantemente feminina (76,7%), com faixa etária a partir de 60 anos (66,7%), casado/união estável (60,0%), baixo nível de escolaridade (83,3%), renda familiar (73,3%), desempregados e com doenças crônicas associadas (53,3%), sono maior ou igual a 6 horas (76,7%) e não eram etilistas ou tabagistas (93,3%). Em relação às condições clínicas, foram evidenciadas presença de uma ou mais recidivas (73,3%), predomínio de granulação / epitelização no leito da UV (60,0%), exsudato serossanguinolento (43,3%), em quantidade média / grande (60,0%), sem predomínio de presença ou ausência de odor (50,0%), totalidade dos pacientes com perda tecidual em grau III/grau IV, ausência de sinais de infecção (73,3%) e presença de dor intensa (50,0%). Nos últimos 30 dias o principal local de realização do curativo foi o HUOL (100 %), a principal terapia compressiva utilizada era a bota de unna (60%) e na impossibilidade de se realizar os curativos na unidade eram os próprios pacientes que fazia a troca em domicílio (40,0%). A maioria dos pesquisados considerou como boa a qualidade da assistência (56,7%), mostrou-se satisfeita com o atendimento do SUS (76,7%), afirmou ter conhecimento sobre seus direitos (70,0%), mas ao mesmo tempo desconheciam o significado da sigla SUS (90,0%) e classificaram o seu nível de obtenção de informações como inadequado (70,0%). Percebemos que os usuários designaram como boa a qualidade da assistência e demonstraram conhecimento inadequado sobre seus direitos à saúde nos SUS, porém mostraram interesse em adquirir mais informações. Os direitos básicos ao ingresso no SUS encontram-se constitucionalmente garantidos e necessitam ser divulgados de modo a torná-los conhecidos da população, para que assim possa ser implementada e garantida uma assistência de maior resolutividade no tratamento deste tipo de lesão.

10
  • LUCIANA EDUARDO FERNANDES SARAIVA
  • Qualidade de vida do servidor da Universidade Federal do Rio Grande do Norte em condição crônica de saúde.

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • LUCIANA ARAUJO DOS REIS
  • THAIZA TEIXEIRA XAVIER NOBRE
  • Data: Sep 30, 2011


  • Show Abstract
  • Estudo descritivo, transversal, com dados prospectivos e abordagem quantitativa que objetivou avaliar a qualidade de vida (QV) dos servidores da Universidade Federal do Rio Grande do Norte em condições crônicas de saúde (CCS). A coleta de dados realizou-se no ambulatório do Departamento de Assistência ao Servidor (DAS) da Pró-Reitoria de Recursos Humanos, após aprovação pelo comitê de ética do HUOL (CAAE nº 0046.0.294.000.10) com duração de três meses, através de aplicação de formulário de caracterização sociodemográfico, saúde, ambiental e laboral, questionário Medical Outcome Study 36-Item Short Form (SF-36). A amostra foi composta por acessibilidade, totalizando 215 servidores, sendo 153 ativos e 62 inativos em condição crônica de saúde, usuários do DAS. Os resultados foram analisados no programa SPSS 15.0 através da estatística descritiva e inferencial, apresentados em forma de tabela, quadros e figuras. Identificamos servidores predominantemente do sexo masculino, menores que 60 anos, casados ou em união estável, católicos, cor parda, da capital e residente em moradia própria. Quanto aos aspectos laborais, predominou servidores ativos, com cargos de nível intermediário e médio, pequena proporção de docentes. A CCS mais freqüência foi a doença crônica não transmissível - DCNT (95,8%), cujo principal diagnóstico foi \a hipertensão arterial, a depressão correspondeu ao diagnóstico mais presentes no transtorno mental persistente - TMP. A QV dos servidores foi considerada boa com pontuação média 72,5 no escore total, sendo os domínios mais afetados aspectos físicos (59,1), estado geral de saúde (66,2), dor no corpo (66,3) e aspecto funcional (72,0). A dimensão saúde mental (76,5) apresentou melhores média do que a dimensão saúde física (68,0). Verificamos que a diminuição dos escores de QV esta estatisticamente significante relacionada ao maior número de CCS (ρ<0,001), não havendo significância estatística com relação a situação funcional (p=0,259). Os técnicos administrativos de nível elementar, básico, médio e docente apresentaram piores escores de QV. Ao analisarmos a correlação das CCS, com os domínios e dimensões do SF-36 verificamos significância estatística, correlação fraca e negativa nos domínios aspecto funcional (ρ=0,002; r=-0,207), aspectos físicos (ρ=0,007; r=-0,183), vitalidade (ρ=0,002; r=-0,213), função social (ρ=0,000; r=-0,313), aspectos emocionais (ρ=0,000; r=-0,293), saúde mental (ρ=0,000; r=-0,238), dimensão saúde física (ρ=0,002; r=-0,210) e dimensão saúde mental (ρ=0,000; r=-0,298). A presença do TMP, isolado ou em conjunto, contribuiu para os menores escores SF-36, sendo a variação das médias dos domínios significante exceto para dor no corpo, aspecto geral de saúde e aspectos físicos. Ao correlacionarmos as categorias de CCS, com a QV, identificamos correlação fraca (r≤-0,376), e significante (ρ≤0,011), relacionada principalmente as DCNT, TMP e DCNT+TMP, afetando os domínios saúde mental, função social, aspectos emocionais, vitalidade, aspecto funcional.Diante dos resultados obtidos concluímos, que as a qualidade de vida dos servidores é influência pelas sua CCS. Destarte inferimos que presença da CCS repercute negativamente na qualidade de vida, conduzindo os servidores ativos e inativos ao comprometimento geral de suas atividades diária de vida e trabalho ao longo dos anos em decorrência da morbidade acometida principalmente relacionada com DCNT e TMP.

11
  • THEO DUARTE DA COSTA
  • O PROCESSO DE CUIDAR EM UNIDADE DE TERAPIA INTENSIVA

  • Advisor : VIVIANE EUZEBIA PEREIRA SANTOS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • LUCIA NAZARETH AMANTE
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Oct 10, 2011


  • Show Abstract
  • O ambiente da Unidade de Terapia Intensiva (UTI) é referido comumente como um local onde o cuidar está intrinsecamente ligado à alta tecnologia. O cuidar na UTI transforma o paciente em um sujeito passivo, sendo sua complexidade deixada à parte e, por vezes, compreendida em uma perspectiva reducionista. Com isso, fazemse necessários estudos voltados para o processo cuidar a partir de um resgate histórico, trazendo a perspectiva de uma assistência mais centralizada no ser humano. Desta forma, este estudo teve como objetivo analisar o processo de cuidar em Enfermagem de uma unidade de terapia intensiva a partir da ótica do profissional, do familiar e dos pacientes. O estudo caracteriza-se a partir de uma abordagem metodológica qualitativa do tipo descritivo-exploratória. Os atores participantes foram os profissionais de Enfermagem, os pacientes e os familiares de uma unidade de terapia intensiva de Mossoró/RN. Os dados foram obtidos através de entrevistas e observação das atividades realizadas pelos profissionais da Enfermagem, bem como seus registros no prontuário. A análise dos dados foi dividida em tópicos e subtópicos representativos das fases e formas que delinearam a coleta. A análise e a discussão das entrevistas basearam-se na proposta de Bardin, em que criamos categorias a partir de um processo de classificação e agrupamento segundo critérios devidamente definidos. A observação dos registros de Enfermagem teve como ênfase observar o que é descrito nessas anotações, bem como sua coerência com sua prática e a resolução 358/2009 do COFEN. A análise demonstrou que a equipe de Enfermagem ainda realiza um trabalho centrado em atividades mecanizadas e técnico-burocráticas da instituição que parecem se sobrepor às necessidades dos pacientes. Em uma visão geral, o cuidado realizado pelos profissionais ocorre de forma fragmentada ou insipiente, porém existe uma assistência que envolve outros aspectos além do fazer técnico-curativo, considerando importante a atenção que é fornecida à família e ao paciente, focalizada na preocupação da Enfermagem em não direcionar suas ações somente à realização de procedimentos. Contudo, o processo de humanizar nem sempre se finaliza com um envolvimento entre profissional e paciente, o que descaracteriza o verdadeiro sentido do cuidar humano. Os registros também evidenciaram uma tendência em focar o cuidar em uma linha positivista, em que, na maioria das vezes, os fatores da doença e a obrigação de atender à produtividade se sobrepuseram aos demais aspectos relevantes para uma compreensão holística de cuidar. Em relação à resolução COFEN nº 358/2009, que norteia uma sistematização da assistência de Enfermagem, confirma-se uma visão tecnicista, fragmentada e superficial do paciente, bem como uma fragilidade da assistência, causada pelo desconhecimento e despreparo de toda a equipe. A visão do cuidar que acontece nesse espaço demonstra uma realidade com uma dialética entre o que se propõe em uma Enfermagem humanizada e o que acontece nesse espaço de atuação. Além disso, mostrou-se um cotidiano repleto de considerações importantes, que se apresentam na prática do profissional, em suas concepções e também naquelas pessoas que foram partícipes do processo.

12
  • ELISANDRA DE ARAUJO SALDANHA
  • Diagnósticos de enfermagem em pacientes no pós-operatório imediato de prostatectomia de um hospital universitário de Natal-RN

  • Advisor : ANA LUISA BRANDAO DE CARVALHO LIRA
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • GILSON DE VASCONCELOS TORRES
  • VIVIANE MARTINS DA SILVA
  • Data: Nov 4, 2011


  • Show Abstract
  • O estabelecimento dos diagnósticos de enfermagem em pacientes prostatectomizados é um instrumento de extrema importância, pois proporciona uma linguagem própria da profissão, facilitando a comunicação entre os profissionais e o paciente. Objetivou-se nesse estudo analisar a distribuição dos diagnósticos de enfermagem presentes em pacientes no pós-operatório imediato de prostatectomia. Estudo do tipo transversal, de caráter exploratório e descritivo, realizado na clínica cirúrgica do Hospital Universitário Onofre Lopes, localizado no município de Natal-RN. A amostra do estudo foi composta por 50 pacientes, que atenderam aos seguintes critérios de inclusão, a saber: ter diagnóstico médico de hiperplasia prostática benigna ou neoplasia prostática; ter realizado cirurgia de próstata no serviço; encontrar-se no pós-operatório imediato no momento da coleta de dados. Os critérios de exclusão foram: não estar em condições físicas e mentais adequadas para participar da pesquisa; doença vascular encefálica, pulmonar, hepática avançada, cardiopatia, coronariopatia ou doença periférica extensa. Os instrumentos de coleta de dados foram: o roteiro de entrevista e o de exame físico. O período de coleta deu-se entre os períodos de novembro de 2010 a abril de 2011. Os dados foram organizados em duas etapas: o processo diagnóstico e a construção do banco. O projeto foi aprovado pelo Comitê de Ética da Universidade Federal do Rio Grande do Norte. Os resultados mostraram que a maioria dos homens eram provenientes do interior do estado, viviam com suas companheiras, tinham uma média de 67,78 anos, eram aposentados, com baixa escolaridade, católicos e não realizavam exames de prevenção da próstata. Os pacientes apresentaram uma média de 9,82 diagnósticos de enfermagem, 23,88 características definidoras e 21,28 fatores relacionados por paciente. Foram identificados 32 diagnósticos de enfermagem, dos quais 8 encontravam-se acima do percentil 75, são eles: Risco de quedas, Deambulação prejudicada, Risco de infecção, Déficit no autocuidado para banho, higiene íntima e vestir-se, Risco de volume de líquidos deficiente e Dor aguda. Os seis primeiros DE presentes nos pacientes entrevistados estavam presentes em todos os prostatectomizados, não sendo possível aplicar nenhum teste estatístico. Os demais apresentaram associação com suas respectivas características definidoras e fatores relacionados ou de risco. Conclui-se que os diagnósticos identificados nesse estudo contribuem para o delineamento da assistência de enfermagem aos pacientes prostatectomizados no pós-operatório, permitindo a implementações de ações de enfermagem eficazes para a resolução dos problemas identificados.

13
  • RAIMUNDO VALDOCI DE MELO JUNIOR
  • Redução de Danos e o saber-fazer de profissionais de um CAPS ad em Natal-RN.

  • Advisor : JACILEIDE GUIMARAES
  • COMMITTEE MEMBERS :
  • ANA KARENINA DE MELO ARRAES AMORIM
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JACILEIDE GUIMARAES
  • MARCELO KIMATI DIAS
  • Data: Nov 14, 2011


  • Show Abstract
  • O presente estudo teve como objetivo geral analisar como os profissionais de um CAPS ad do município de Natal-RN concebem o saber-fazer no que se refere à Política de Redução de Danos (PRD) em álcool e outras drogas. Para o seu alcance, pretendeu-se: 1) Verificar as possibilidades e limites da implementação da PRD em um CAPS ad do município de Natal-RN; 2) Relacionar o conhecimento dos profissionais de um CAPS ad de Natal quanto à Política de Redução de Danos; 3) Enumerar as ações programáticas à PRD na referida instituição. A pesquisa configurou-se como exploratória, descritiva e de abordagem qualitativa, norteada pelos conceitos de biopoder e do cuidado de si propostos por Michel Foucault. A coleta dos dados foi realizada entre os meses de junho e julho de 2011 empregando-se a técnica do grupo focal. Em seguida, o material recolhido em campo foi analisado utilizando-se como método a análise de conteúdo de Minayo. Os resultados evidenciaram uma aproximação conceitual e prática entre a estratégia da redução de danos e o saber-fazer dos profissionais do CAPS ad. Os modelos discursivos acerca do uso de drogas, com destaque para o modelo jurídico-moral, ainda possui espaço significativo no cotidiano desses profissionais sendo amplificado pela natureza de algumas demandas que chegam até esses ou pelo próprio discurso instituído. Os sujeitos reconhecem a necessidade de práticas menos proibitivas e mais socializadoras, identificando-as com a lógica da Redução de Danos (RD) sendo perceptível uma compreensão coerente e fundamentada pela maioria dos profissionais acerca da RD. Visões distorcidas e reducionistas acerca da RD pelos profissionais, como considerar apenas a função instrumentalizadora dessa estratégia (distribuição de insumos), configuram-se como uma das maiores barreiras a sua implementação.  Há um número reduzido de atividades programáticas no interior desse CAPS ad que guardam relação com a estratégia da RD o que dificulta uma apropriação mais efetiva por parte da equipe de trabalho. Os processos de trabalho e as posturas adotadas pelos profissionais do CAPS ad nos últimos tempos demonstram que muitas de suas práticas e concepções foram modificadas em detrimento das novas necessidades que as demandas atendidas lhes trouxeram. Por consequência, a noção do cuidado de si descortina-se, fazendo-se necessária a valorização do papel desempenhado por esses agentes do cuidado, a sua contribuição individual e coletiva.

14
  • MAGNA MARIA PEREIRA DA SILVA
  • CONTROLE DA NEOPLASIA MALIGNA DO COLO DE ÚTERO: A RESOLUTIVIDADE NA ATENÇÃO BÁSICA.

  • Advisor : MARIA TERESA CICERO LAGANA
  • COMMITTEE MEMBERS :
  • ANA FATIMA CARVALHO FERNANDES
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • MARIA TERESA CICERO LAGANA
  • ROSINEIDE SANTANA DE BRITO
  • Data: Nov 18, 2011


  • Show Abstract
  • Estudo quantitativo realizado por meio de pesquisa descritiva, transversal e retrospectiva, utilizando procedimentos técnicos de consulta documental a fontes secundárias e inquérito domiciliar com aplicação de formulário de entrevistas face a face, após parecer favorável nº 039/2011 do Comitê de Ética em Pesquisa com Seres Humanos da Universidade Federal do Rio Grande do Norte. O objetivo dessa pesquisa foi analisar ar a resolutividade do controle da neoplasia maligna do colo de útero na área 47 da Unidade de Saúde da Família Nova Natal II. A neoplasia maligna do colo de útero é o segundo tipo de câncer mais frequente entre as mulheres no mundo. No Brasil o rastreamento para detecção e tratamento precoces da doença tem sido efetuado precariamente e o seguimento, para reduzir a mortalidade, não tem sido executado. De um total de 1170 mulheres pertencentes à área 47, que se submeteu a rastreamento por meio do exame de Papanicolau, no período de 2005 a 2010, elegeu-se uma amostra de 38 mulheres com resultado positivo de alterações cervicais, maiores de 18 anos. A análise do cálculo da frequência de variáveis sociodemográficas e clínico-epidemiológicas selecionadas com os resultados das alterações cervicais, utilizando-se o teste de X2 e adotando como nível de significância p<0,05 não mostrou significância estatística. A faixa etária predominante foi de 25 a 64 anos (68,9%); a maioria parda (60,5%); com escolaridade predominante até o ensino fundamental (57,9%); a maioria casada ou em convivência marital (68,4%) e donas de casa (68,4%); com início precoce da atividade sexual (86,8%), a minoria fumante (13,2%), com um parceiro sexual (36,8%). No momento da entrevista, 42,1% das mulheres verbalizou queixa de corrimento, enquanto apenas 2,6% referiu sangramento. Em relação à ocorrência de DSTs (inclusive HPV), 10,5% das mulheres declarou ser portadora. Verbalizaram o uso de contraceptivos orais, 32,3% das mulheres, por 2 a 4 anos (44,4%). Quanto ao resultado do último exame preventivo realizado, prevaleceu a metaplasia escamosa imatura (55,3%), seguido de lesão intra-epitelial de baixo grau (compreendendo efeito citopatológico pelo HPV e neoplasia intra-epitelial cervical grau I) (31,6%); lesão intra-epitelial de alto grau (compreendendo neoplasias intra-epiteliais cervicais de grau II e III) (7,9%); células atípicas escamosas de significado indeterminado, possivelmente não neoplásicas, (5,3%). Não foi observado carcinoma de células escamosas e adenocarcinoma. A maioria das mulheres recebeu informações sobre o seguimento que deveria ser realizado após o resultado do último exame preventivo (55,3%), mas, quanto a realizar o seguimento, a maior parte das mulheres não referiu tê-lo feito (55,3%). O seguimento do grupo de mulheres analisadas, com diferentes graus de alterações cervicais, somente deveria ser finalizado com a alta por cura, estabelecido em citologias consecutivas negativas, meta que não está sendo atingida na área 47 da Unidade de Saúde da Família Nova Natal II.

15
  • VIVIANNE RAFAELLE CORREIA DOS SANTOS
  • EDUCAÇÃO EM SAÚDE SOBRE O RISCO DE ADOECER EM HANSENÍASE: estratégia na educação básica, Parnamirim/RN

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • REJANE MILLIONS VIANA MENESES
  • RICARDO ALEXANDRE ARCENCIO
  • Data: Nov 24, 2011


  • Show Abstract
  • A hanseníase é uma doença milenar que ainda figura como um problema de saúde pública no mundo, principalmente nos países considerados em desenvolvimento. Dentre estes, o Brasil é um dos que ainda apresenta áreas de grande endemicidade. A doença se mantém alta entre os menores de 15 anos. Nesse grupo, o índice nacional alcança 0,6 a cada 10 mil habitantes e chega a 2 nas regiões Norte e Centro-Oeste. Por isso, o plano do Ministério da Saúde consiste em priorizar o combate à doença nas áreas críticas, oferecendo diagnóstico precoce e tratamento oportuno, especialmente aos pacientes com menos de 15 anos. Esta pesquisa teve como objetivos identificar o conhecimento dos estudantes de três escolas da educação básica de Parnamirim/RN sobre o risco de adoecer em hanseníase e realizar educação em saúde sobre o tema para estes. Estudo do tipo exploratório – descritivo e de natureza quanti-qualitativa composto de duas etapas: questionário e educação em saúde sobre hanseníase. O estudo foi aprovado pelo Comitê de Ética em Pesquisa (CEP) da UFRN por meio do parecer de n.° 204 de 2009. Os dados obtidos foram organizados, categorizados, digitados e submetidos ao programa Microsoft Office - Excel para análise quantitativa com percentagem simples e apresentados em forma de gráficos. Além disso, foi feita uma análise de conteúdo de acordo com Bardin (1977) para a questão aberta/qualitativa do questionário antes e depois da educação em saúde em hanseníase. Quanto à identificação dos sujeitos da pesquisa, houve maior quantidade de alunos: do 1º ano do ensino médio, de faixa etária de 11 até 15 anos, do turno vespertino, do gênero feminino, de cor da pele branca, residentes no município de Parnamirim, cada estudante convivendo com 4 pessoas, não responderam em relação à profissão do pai, para a profissão da mãe responderam dona de casa e com faixa de renda da família de 1 a menos de 4 salários mínimos. Os resultados dos questionários aplicados antes e após a realização da educação em saúde em hanseníase mostraram que nas respostas aos mesmos antes da educação em saúde os alunos detinham pouco conhecimento a respeito da hanseníase e que, nas respostas aos questionários após a educação em saúde, a maioria dos alunos sabia responder corretamente aos questionamentos feitos a respeito da doença, os quais abordavam o que é a doença, como ela é transmitida, o que ela causa nas pessoas acometidas, onde procurar ajuda em caso de suspeita de hanseníase, a necessidade de as pessoas que convivem com o doente de hanseníase também procurarem ajuda e se os alunos sabiam se a doença tem cura ou não. Além desses resultados, foi feita uma análise de conteúdo antes e após a realização da educação em saúde. Os seguintes eixos temáticos foram encontrados antes da educação em saúde: cura, medo e
    preconceito. Após a educação em saúde os eixos temáticos foram cura, efetividade da educação em saúde e exclusão social no passado. Dessa maneira, a realização dessa pesquisa alcançou seus objetivos propostos e apresentou em seus resultados a efetividade da educação em saúde em hanseníase na educação básica de Parnamirim/RN. Estes resultados enfatizam, assim, a importância do apoderamento do conhecimento por parte da população em geral, e, neste caso, dos estudantes de escolas públicas com o intuito de a própria sociedade detectar precocemente casos de hanseníase em suas comunidades, a fim de iniciar o tratamento o mais rápido possível, prevenir incapacidades, além de diminuir o estigma em torno da doença e quebrar a cadeia epidemiológica de transmissão da mesma.

16
  • MABEL MARIA MARQUES PEREIRA
  • À beira do leito: sentimentos de pacientes durante a passagem de plantão em Unidade de Terapia Intensiva.

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • RAIMUNDA MEDEIROS GERMANO
  • GLAUCEA MACIEL DE FARIAS
  • ROSANA LUCIA ALVES DE VILLAR
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • Data: Nov 30, 2011


  • Show Abstract
  • O presente estudo tem como objetivo compreender os sentimentos de pacientes internados na Unidade de Terapia Intensiva (UTI) que vivenciam uma passagem de plantão à beira do leito. A passagem de plantão constitui uma das rotinas utilizadas pela enfermagem no seu processo de trabalho e de grande significação para o paciente; por isso mesmo, merece uma análise cuidadosa na busca de seu aperfeiçoamento para o aprimoramento da assistência de enfermagem. Trata-se de um estudo descritivo exploratório, de natureza qualitativa.  A coleta de informações foi realizada através de entrevista semiestruturada, nos meses de agosto e setembro de 2011, após autorização do Comitê de Ética, da Universidade Federal do Rio Grande do Norte, conforme Parecer 290/2011. A análise, pautada nos depoimentos dos pacientes, tomou a humanização como o fio condutor da investigação, apoiada em autores que tratam sobre o tema e na teoria da dádiva de Marcel Mauss que se assenta na tríade: dar-receber-retribuir. Os resultados apontam que a passagem de plantão à beira do leito embora não tenha se configurado, pelo teor das falas dos pacientes entrevistados, como um momento que tenha gerado medo e ansiedade, pôde-se depreender pelas expressões de silêncio, lágrimas e outras sinalizações, durante as entrevistas, o quão difícil é vivenciar essa experiência. Mesmo assim, apesar dessa aparente tranquilidade, revelaram incerteza e apreensão diante das falas dos profissionais, por ocasião da visita à beira do leito, particularmente, quando se referiam ao seu estado de saúde e de seus vizinhos. Por outro lado, a indiferença em relação à participação do paciente, no momento da visita, expressando uma atitude de cunho meramente técnico, desumaniza a ação do cuidar, essência da enfermagem. E, por tudo que apreendemos dos pacientes, acerca da visita à beira do leito, bem como da própria UTI, podemos inferir que há sofrimento para eles. No entanto, vamos compreender suas revelações e sentimentos buscando apoio na teoria da dádiva de Mauss: o paciente recebe o presente (cuidado) e, imbuído de um sentimento de gratidão, o retribui em forma de elogios e gentilezas. Justamente por isso, precisamos aguçar nossa sensibilidade para lidar com a condição humana, em toda a sua vulnerabilidade.

17
  • SÂMARA SIRDÊNIA DUARTE DE ROSÁRIO BELMIRO
  • Inclusão da criança com deficiência na Estratégia de Saúde da Família

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • BERTHA CRUZ ENDERS
  • INÁCIA SÁTIRO XAVIER DE FRANÇA
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Dec 1, 2011


  • Show Abstract
  • A Estratégia de Saúde da Família (ESF) é um campo importante para o desenvolvimento de assistência à saúde da criança com deficiência (CcD). Porém, na maioria das situações esta assistência é pautada no modelo médico da deficiência, com ênfase nas queixas e problemas, baseada em práticas curativistas e individuais que não consideram o sujeito como ser ativo do processo. Diante do exposto, objetivamos analisar a mudança do processo de trabalho da equipe da ESF na atenção à criança com deficiência, a partir de ações de sensibilização. Trata-se de um estudo qualitativo, tendo como método a pesquisa-ação. Foram envolvidos treze profissionais de saúde das duas equipes da ESF da área de abrangência da Unidade de Saúde da Família Dr. Chico Porto (UBSFCP) no município de Mossoró, no período de março a agosto de 2011. Os dados foram analisados seguindo o direcionamento da análise temática freireana. No diagnóstico situacional da realidade atual de assistência as CcD na referida UBSFCP, através da observação participante e aplicação de entrevista semi-estruturada junto aos profissionais, percebemos que apesar destes realizarem algumas ações assistenciais para a CcD, na prática poucas são empregadas no sentido da inclusão e acessibilidade. O acompanhamento da CcD é feito através de consultas individuais por cada profissional da equipe, visitas domiciliares quando possível, ambos pautadas nas queixas e problemas, com pouca resolubilidade nas ações empregadas. Visto a necessidade de mudança no modelo de atendimento e necessidade de capacitação como apontado pelos profissionais na entrevista realizada, decidimos em seguida construir a proposta de capacitação sugerida pela equipe multiprofissional e elaboramos coletivamente a realização deste momento em todas as suas fases. Na etapa de implementação da capacita (ação) contemplamos aspectos referentes à situação atual no Brasil e em Mossoró (Leis, políticas e assistência a saúde) para as CcD e Assistência à CcD e a sua família na ESF nos dois primeiros momentos do primeiro de capacita (ação). No segundo dia discutimos a assistência especializada a CcD contribuição da Associação Pais e Amigos dos Excepcionais de Mossoró e em um segundo momento foi realizada uma oficina que discutia a sensibilização para inclusão da CcD nas ações da ESF. Todos estes momentos foram debatidos e construídos coletivamente. Na avaliação, constatamos que a capacita (ação) permitiu aos profissionais a compreensão de novos entendimentos sobre a pessoa com deficiência, sobre as formas de incluir, de orientar, de cuidar, de assistir e, principalmente, de ter uma nova visão sobre a assistência a saúde da CcD, ampliando a assistência para além dos aspectos clínicos e reconhecendo os aspectos educacionais, dos direitos e deveres de cidadãos e a inclusão dessas crianças da área nos espaços sociais. Como dificuldades, nos deparamos com a necessidade de alguns profissionais se ausentarem para comparecerem a outro emprego, resolver problemas pessoais, e pouca ou nenhuma participação. Assim, durante esta pesquisa-ação, fez com que os sujeitos conseguissem perceber a importância da realização de sua prática para a qualidade vida dele e daquele que ele cuida.

18
  • ISABEL KAROLYNE FERNANDES COSTA
  • Riscos ocupacionais e acidentes de trabalho em um Serviço de Atendimento Móvel de Urgência do Rio Grande do Norte.

  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • JACILEIDE GUIMARAES
  • MARIA ALVES BARBOSA
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Dec 2, 2011


  • Show Abstract
  • Estudo exploratório, descritivo, quantitativo e dados prospectivos, realizado no Serviço de Atendimento Móvel de Urgência da Região Metropolitana de Natal/RN, com vistas a identificar o conhecimento da equipe multiprofissional acerca das normas de precauções padrão e segurança do trabalhador; identificar os riscos ocupacionais peculiares às atividades desenvolvidas nesse serviço; caracterizar os acidentes de trabalho (AT) e conhecer os procedimentos adotados após cada AT. A população constou de 162 profissionais e os dados foram coletados entre os meses de novembro e dezembro de 2010. Quanto à caracterização pessoal e profissional, dos 162 profissionais, 12,96% eram médicos; 6,79%, enfermeiros; 33,95%, técnicos de enfermagem; 46,29%, condutores; 74,70% do sexo masculino; 43,21% tinham entre 31 e 40 anos; 69,33% residiam em Natal/RN; 50,00% possuíam o ensino médio completo; 58,64% casados; 69,75% tinham filhos; 46,91% tinham entre 1 e 4 anos de formação; 61,73% possuíam cursos de atualização; 59,25% estavam com de 3 a 4 anos de serviço; 54,32%, com de 1 a 4 anos de experiência na urgência; 44,44% recebiam de 1 a 2 salários; 78,40% recebiam insalubridade; 67,28% atuavam na USB; 83,95% tinham jornada no SAMU Metropolitano de 31 a 40 horas semanais; 52,47% possuíam outro vínculo empregatício. Quanto ao conhecimento sobre normas de precauções padrão, segurança e riscos ocupacionais, 99,38% sabiam o que era AT; 62,96% deram respostas incompletas; 74,07% conheciam as normas de AT; 46,67% adquiriram esse conhecimento em palestras; 53,09% conheciam os EPIs; 71,60% deram respostas incorretas sobre a importância das PPs; 45,06% nunca receberam intervenção educativa sobre essa temática; 89,51% disseram serem muito importantes as intervenções educativas na prevenção de ATs; 90,12%, apontaram como muito importante este tema no ambiente de trabalho; 27,00% sugeriram a orientação sobre o tema no próprio local de trabalho; dentre os riscos físicos, 34,57% consideraram os ruídos como o mais importante; dos riscos químicos, 78,40% escolheram os gases e fumaça; dos riscos biológicos, 48,77% citaram o contato com o sangue; dos riscos mecânicos, 80,86% disseram que eram os acidentes de transporte; dos riscos ergonômicos, 40,12% afirmaram ser a tensão/estresse no atendimento aos pacientes graves, psiquiátricos e agressivos; e houve uma média de 4,5 para o sentimento de segurança no ambiente de trabalho. Em relação aos dados sobre os ATs ocorridos, 31,48% sofreram pelo menos um evento acidentário; 72,55% não notificaram; 60,98% responderam que não existia rotina para notificação; 56,86% estavam realizando o transporte de pacientes; 49,02% se acidentaram na USB/UR; 60,78% aconteceram durante o dia; 96,08% dos profissionais estavam em escala de trabalho normal (plantão 24hs); 31,37% sofreram contusão; 58,82% lesões nos membros/cintura pélvica; 43,14% foram acidentes de transporte. Quanto à evolução do AT, 62,75% não precisaram de afastamento do trabalho; 76,47% não tiveram sequelas; 88,24% não precisaram de reabilitação; nenhum profissional precisou mudar de ocupação. E, por meio da regressão logística univariada, evidenciou-se que os enfermeiros e o sexo masculino eram fatores de risco para a ocorrência de AT. Concluímos que havia lacunas no conhecimento da equipe no que concerne aos AT, enfatizando-se a necessidade da educação permanente em biossegurança no serviço.

19
  • KALYANE KELLY DUARTE DE OLIVEIRA
  • ENTRE O SOL E A LIBERDADE IMPERA A VIOLÊNCIA: formação de redes para a ação a partir da Estratégia Saúde da Família

     

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • GLAUCEA MACIEL DE FARIAS
  • RAIMUNDA MEDEIROS GERMANO
  • NEUSA COLLET
  • Data: Dec 5, 2011


  • Show Abstract
  • A pesquisa teve como objetivo analisar a construção coletiva de uma rede de serviços municipais para prevenção e tratamento às crianças vítimas de violência a partir das Unidades Básicas de Saúde da Família em Mossoró/RN. A pesquisa é de abordagem qualitativa e foi desenvolvida na forma de pesquisa-ação. A população foi constituída por representantes de instituições de direitos da criança e profissionais da atenção básica. Os dados foram coletados através de questionários, seminários e entrevista semi-estruturada. Os resultados foram analisados a partir dos dados coletados através do questionário de avaliação do material elaborado, palestras dialogadas e nas avaliações com a equipe e apresentados de acordo com os achados da pesquisa. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da UFRN com protocolo de nº 158/2010, CAAE: 0176.0.051.000-10. No diagnóstico situacional os participantes responderam um questionário para caracterização e em seguida foi lançada a questão norteadora do grupo focal Enquanto profissional da ESF qual a sua percepção frente à violência contra a criança? Percebeu-se o medo e o desconhecimento por parte dos profissionais da unidade de como prevenir e encaminhar os casos de violência contra a criança e o adolescente existentes na área de cobertura da unidade e, ainda percebeu-se que os profissionais se sentiam vítimas da violência ocupacional, diante das proporções que a violência alcançou na área da unidade. Vista a necessidade de mudança das estratégias para trabalhar o combate a violência, planejamos no grupo focal realizar oficina para preenchimento da ficha de notificação, capacitação para proteção contra a violência ocupacional; e reunião com outros órgãos responsáveis pala proteção da criança e do adolescente para traçar o fluxograma das vítimas na rede de proteção. No momento seguinte de capacitação para preenchimento da ficha de notificação os profissionais mostraram-se interessados em aprender e utilizar esse instrumento de combate a violência. No terceiro encontro na Unidade, a reunião com representantes do conselho tutelar, os profissionais da unidade demonstraram o interesse em se articular com o órgão para denunciar e combater a violência contra a criança e o adolescente. Devido às dificuldades na estrutura física da unidade não foi possível dar continuidade a pesquisa e a todos os momentos planejados, sendo então finalizada a coleta de dados com a realização de entrevistas com os profissionais participantes, a fim de avaliar os encontros realizados. Diante disso, considera-se que a pesquisa-ação também teve seus objetivos alcançados, pois houve envolvimento da equipe na construção coletiva de uma proposta de mudança nas práticas de prevenção e encaminhamento da violência contra a criança e o adolescente. Esse envolvimento foi favorecido pelo uso dos princípios freirianos durante o desenrolar do estudo.  No entanto, admite-se que a rede não foi implantada integralmente, pois sabe-se que ela se constitui em um processo contínuo de aperfeiçoamento e deve continuar em evolução junto à equipe da unidade.

20
  • MIRNA CRISTINA DA SILVA FREITAS
  • Violência contra a mulher: estudo de caso em uma instituição de ensino.

  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • MATILDE MEIRE DE MIRANDA CADETE
  • RAIMUNDA MEDEIROS GERMANO
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: Dec 7, 2011


  • Show Abstract
  • Pesquisa do tipo estudo de caso, com abordagem quantitativa e dados prospectivos, desenvolvido entre dezembro de 2010 a fevereiro de 2011, com o objetivo de identificar o perfil das mulheres participantes do estudo; caracterizar os atos de violência ocorridos quanto ao tipo, frequência, local de ocorrência e agressor; analisar as medidas adotadas após a ocorrência dos atos de violência e as principais conseqüências nas vítimas. A população constou de 285 trabalhadoras de uma instituição de ensino superior do Rio Grande do Norte. Os resultados mostraram que 99 (34,74%) têm entre 51 a 60 anos de idade, 78 (27,37%) de 41 a 50 e 62 (21,75%) entre 20 e 30 anos; consideram-se de cor branca, 162 (56,84%); Têm ensino superior completo, 171 (60,00%) e destas 97 (56,73%) afirmaram possuir alguma pós-graduação; são casadas, 141 (49,47%) e possuem de zero a um filho, 148 (51,93%); residem na Zona Sul do município de Natal, 146 (51,23%); possuem uma renda mensal de três a cinco salários mínimos, 171 (60,00%) e são em sua maioria Técnicos nas Ciências Administrativas 152 (53,33%); 77 (27,02%) afirmaram ter sofrido violência; 60 (62,50%) episódios de agressão verbais, 26 (27,08%) de assédio moral, 05 (5,21%) de agressão física e 05 (5,21%) assédio sexual; 05 (100,00%) agressões físicas foram produzidas pelo esposo ou companheiro das vítimas, e os colegas de trabalho se outra profissão foram os responsáveis por 18 (30,00%) agressões verbal, 15 (57,69%) assédios moral e 03 (60,00%) assédios sexuais; 02 (40,00%) das vítimas de agressão física e 18 (30,00%) de agressão verbal sofreram violência apenas uma vez; 10 (38,46%) de assédio moral e 02 (40,00%) de assédio sexual vivenciaram quatro vezes ou mais; 05 (100,00%) agressões físicas ocorreram no ambiente doméstico, e o local de trabalho destacou-se com 36 (60,00%) agressões verbais, 22 (84,62%) assédios morais e 04 (80,00%) assédios sexuais; 35 (36,46%) contou para colegas de trabalho e 31 (32,29%) para familiares e amigos; em 75 (78,13%) dos casos não houve intervenção, 07 (7,29) não souberam responde se algo havia sido realizado e 14 (14,58%) informaram ter havido intervenção, destas, 09 (64,29%) foram tomadas pela chefia das vítimas; 26 (32,10%) não notificaram o fato por considerarem que não seriam tomadas providências; 62 (80,52%) sentiram estresse; 5 (1,76%) das mulheres se afastaram do trabalho após o episódio de violência, contabilizando 198 dias de absenteísmo. Chegamos a conclusão que existe um alto índice de violência contra a mulher, mesmo quando estas possuem um bom nível socioeconômico, e nesse sentido é de fundamenta importância a criação de novas propostas de controle de casos aperfeiçoamento dos profissionais de saúde, em especial o enfermeiro, para que abordem as pacientes com um olhar mais investigativo, e que, ao identificar um caso de violência, esteja instruído quanto os caminhos a serem seguidos para a notificação fornecendo simultaneamente suporte psicológico à vítima.

21
  • KAROLINA DE MOURA MANSO DA ROCHA
  • ATUAÇÃO DA ESCOLA FRENTE À VIOLÊNCIA: ESTUDO COMPARATIVO ENTRE DUAS INSTITUIÇOES DE ENSINO.

  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • MATILDE MEIRE DE MIRANDA CADETE
  • RAIMUNDA MEDEIROS GERMANO
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: Dec 8, 2011


  • Show Abstract
  • Trata-se de um estudo descritivo, exploratório, comparativo com abordagem quantitativa, cujo objetivo geral foi analisar a violência na escola de forma comparativa no contexto de duas instituições de ensino em Natal/RN. Os específicos foram identificar os tipos de manifestações da violência nos contextos da escola pública e particular; identificar a postura da direção, professores e funcionários da escola durante e após a ocorrência de manifestações de violência no ambiente escolar; identificar medidas de prevenção da violência no âmbito das escolas. Os resultados mostram que dos 121 participantes 68 (56,20%) eram do sexo feminino e 53 (43,80%) masculino, 38 (31,40%) tinham entre 40 e 49 anos, 85 (70,2%) residiam na Zona Sul da cidade de Natal (RN), 46 (38,02%) especialização, 68 (56,20%) eram católicos, 63 (52,07%)  casados; 41 (33,88%) recebiam entre 03 e 05 salários mínimos e 68 (56,20%) eram professores; 51 (42,15%) funcionários e 02 (01,65%) diretores; 46 (38,02%) profissionais possuíam entre 05 e 14 anos e 11 meses de experiência no ensino 70 (57,85%) menos de cinco anos de serviço na instituição; 68 (56,20%) trabalhavam entre 20 horas e 40 horas por semana, 81 (16,30%) atuavam no 9º ano do ensino fundamental II. Quanto ao dimensionamento da violência, 111 (91,74%) entrevistados presenciaram episódios deste evento na instituição que trabalham; 100 (82,64%) presenciaram a violência verbal; 87 (71,90%) ligaram para os pais quando acontecia algum evento violento que causava lesão aos alunos, 66 (54,55%) acreditaram que a violência familiar é o principal motivo para os jovens praticaram o bullying, 44 (38,98%) observaram os episódios de bullying diariamente; 64 (52,89%) o evento acontecer no pátio. Das 37 vitimas de violência na escola, 22 (59,45%) sofreram agressão verbal; 18 (48,65%) sofreram violência uma vez por semana, 36 (97,30%) foram agredidos por alunos, 104 (85,95%) conseguem diferenciar os atos mal comportamento do  bullying; 28 (23,14%) separaram os envolvidos e comunicaram verbalmente a coordenação; 23 (19,00%) afirmaram que as coordenações das escolas conversaram com os pais a respeito da conduta agressiva do aluno. No tocante as ações realizadas para minimizar o bullying, 69 (57,02%) profissionais participaram de algum processo educativo, 47 (38,84%) o processo educativo foi em outra instituição, 49 (71,01%) fizeram cursos com duração de 12 a 24 horas; 59 (48,76%) afirmam que a interação com os pais e familiares foi a ação mais estimulada pela escola para tentar minimizar e prevenir o evento; 116 (95,87%) participaram de reuniões nas instituições pesquisadas; 58 (50,00%) responderam que as reuniões aconteciam bimestralmente e 121 (100,00%) afirmaram não ter nenhum curso de atualização sobre violência na escola nas escolas pesquisadas. Concluímos que a violência na escola vem se expressando em qualquer classe social e que os profissionais estão pouco preparados para lidarem com a situação. Assim esperamos que os profissionais da educação, através da leitura do nosso estudo, possam perceber que a violência na escola acontece em qualquer instituição prejudicando a vida de todos que compõem o universo educacional. É de extrema relevância que estes profissionais procurem se capacitar sempre para que através do conhecimento possam criar estratégias de prevenção e minimização do bullying  que mudem a realidade do seu ambiente de trabalho.

22
  • MARIA CONCEBIDA DA CUNHA GARCIA
  • Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • JORDANA DE ALMEIDA NOGUEIRA
  • REJANE MARIA PAIVA DE MENEZES
  • RICARDO ALEXANDRE ARCENCIO
  • Data: Dec 8, 2011


  • Show Abstract
  • A tuberculose (TB) é um dos principais agravos à saúde a ser enfrentado em âmbito global.  No Brasil, a responsabilidade pelas ações de diagnóstico e controle desta doença foi transferida aos municípios, no âmbito da Atenção Primária à Saúde (APS), visando melhorias nos indicadores epidemiológicos, impondo reorientação da prática das equipes de saúde da família e requerendo metodologias que analisem em que medida os componentes da APS estão sendo alcançados. Destarte, este estudo tem o objetivo de analisar o desempenho dos serviços de APS do município de Natal-RN para o diagnóstico e controle da TB, sob a perspectiva dos profissionais de saúde (médicos e enfermeiros). O estudo é descritivo, de corte transversal e quantitativo. A coleta de dados foi realizada de março a julho de 2011, e envolveu 121 profissionais de saúde, que atuam em 52 unidades de saúde (USF, UBS e Unidades Mistas). O instrumento de coleta é estruturado, baseado no Primary Care Assessment Tool (PCAT), validado e adaptado para avaliar a atenção a TB no Brasil, e inclui questões referentes aos componentes Estrutura e Processo dos serviços de saúde. Para análise quantitativa, construíram-se indicadores, cujos padrões de respostas são seguidos de acordo com a escala de Likert, entre um e cinco, que significou o grau de relação de preferência (ou concordância) das afirmações. Os valores entre 1 e 3 foram considerados insatisfatórios para o indicador; entre 3 e menores que 4, regulares e, entre 4 e 5, satisfatórios. No tocante aos insumos e equipamentos, as unidades apresentaram condições satisfatórias, para formulário (=4,26), consulta médica (=4,02) e cesta básica (=4,24); condição regular, para pote (=3,56) e condições insatisfatórias para vale transporte (=1,50) e realização da baciloscopia (=2,42) e raioX (=1,07). Em relação às ações, observou-se desenvolvimento satisfatório para aquelas centradas no indivíduo doente. As ações voltadas para o âmbito coletivo, como a busca de sintomáticos respiratórios (SR), controle de comunicantes e orientações para comunidade variou de regular a insatisfatórias (=3,16 -=1,34). Quanto a capacitação, 94,2% receberam treinamentos para identificar SR. No que se refere ao tempo para o diagnóstico, a mediana do tempo decorrido entre a identificação do SR e o início do tratamento foi de 22 dias. Em relação às dificuldades enfrentadas pelos profissionais para o diagnóstico da TB, 56,2% referiram que estas estão relacionadas somente aos serviços de saúde, com destaque para deficiência na retaguarda laboratorial e na referência para os serviços especializados, o déficit de recursos humanos e materiais e a baixa realização de busca ativa. Os profissionais percebem o desempenho das ações de diagnóstico e controle da TB, permeados por limitações e entraves de caráter organizacionais e operacionais de diversas dimensões, emergindo a necessidade de articulação efetiva dos diversos setores e atores-chaves da atenção à TB, para adoção de novas estratégias intersetoriais que visem a ampliação da capacidade de resposta da APS, promovendo o melhor desempenho na prestação dos serviços ao usuário, família e comunidade, e assegurando ações efetivas e resolutivas as necessidades deste grupo populacional.

23
  • DÉBORAH KAROLLYNE RIBEIRO RAMOS LIMA
  • Reinternações psiquiátricas no Rio Grande do Norte: implicações e impacto das novas estratégias de atenção à saúde mental.

  • Advisor : JACILEIDE GUIMARAES
  • COMMITTEE MEMBERS :
  • JACILEIDE GUIMARAES
  • MAURICIO ROBERTO CAMPELO DE MACEDO
  • RAIMUNDA MEDEIROS GERMANO
  • ROZEMERE CARDOSO DE SOUZA
  • Data: Dec 8, 2011


  • Show Abstract
  • A Reforma Psiquiátrica brasileira pautada sobre o ideário de desinstitucionalização da assistência, traduzido na ênfase no tratamento de base comunitária/territorial e na inclusão social do sofredor psíquico, promoveu avanços significativos na reestruturação da psiquiatria. No cenário do Estado do Rio Grande do Norte, podemos enumerar como avanços da Reforma Psiquiátrica brasileira a expansão da rede de atenção à saúde mental e a implementação de estratégias que, em conjunto, visam favorecer a atenção psicossocial do indivíduo em sofrimento psíquico e reduzir os índices de rienternações psiquiátricas no Estado. Diante do panorama atual da saúde mental no Brasil nos empenhamos em responder ao seguinte questionamento: qual o impacto da ampliação dos dispositivos substitutivos no fenômeno da porta giratória na realidade da atenção à saúde mental do Rio Grande do Norte? Assim, o presente estudo teve como objetivo analisar a ocorrência do fenômeno da porta giratória à luz das novas estratégias de atenção à saúde mental no RN. Trata-se de uma pesquisa qualitativa do tipo exploratório-descritiva, norteada por um arcabouço teórico de enfoque crítico-dialético sobre a Reforma Psiquiátrica brasileira e tendo a história oral temática como método de coleta de informações. O cenário da pesquisa foi o Hospital João Machado, referência estadual para o atendimento em psiquiatria no Estado do Rio Grande do Norte e os sujeitos da pesquisa foram 20 profissionais da instituição. A coleta das informações foi iniciada após a liberação do Comitê de Ética em Pesquisa da UFRN através do parecer no 216/2011 e CAEE no 0021.0.051.000-11 e realizada mediante a utilização de observação direta e de entrevista semi-estruturada. A operacionalização das informações suscitou o surgimento de duas categorias e cinco subcategorias de análise. CATEGORIA 1) A atualidade da Rede de Atenção à Saúde Mental no RN, com as subcategorias: 1.1 Impacto da rede de saúde mental no fenômeno da porta giratória no RN; 1.2 Implicações dos novos serviços de saúde mental na assistência aos usuários do HJM; 1.3 Problemáticas que permeiam a rede de saúde mental do RN. CATEGORIA 2) Principais causas da porta giratória no RN, com as subcategorias: 2.1 Problemática familiar e 2.2 desassistência pós-alta. Em síntese, concluímos que a ampliação da rede saúde mental contribuiu para a redução das reinternações psiquiátricas no RN. No entanto, vimos que os dispositivos territoriais de saúde mental não são os únicos responsáveis pela perpetuação do fenômeno da porta giratória. Fatores como a problemática familiar e a desarticulação de assistência pós-alta influenciam nas internações e reinternações psiquiátricas na realidade estadual. Estudar a porta giratória da assistência psiquiátrica e as novas estratégias de atenção à saúde mental nos permitiu a aproximação com os avanços e desafios trazidos pela Reforma Psiquiátrica brasileira e pela desinstitucionalização no âmbito estadual, apontando para a necessidade de novas discussões e estratégias de resolubilidade da atenção psicossocial.

24
  • ILLA DANTAS CIRINO
  • A EFETIVIDADE DAS AÇÕES DAS EQUIPES DE SAÚDE DA ATENÇÃO BÁSICA NO CONTROLE DA TUBERCULOSE: a visão do doente

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • ERIKA SIMONE GALVAO PINTO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Dec 9, 2011


  • Show Abstract
  • A tuberculose é uma doença de grande repercussão no contexto mundial atual. No Brasil, o controle da doença foi direcionado para a Atenção primária à saúde, em virtude da determinação do Ministério da Saúde de descentralizar as ações de saúde para a Atenção Básica. Dessa forma, desde então as ações de diagnóstico, controle e tratamento da doença devem acontecer nesse contexto, porém, ainda existem muitos entraves que podem dificultar a realização dessas determinações. Assim, este estudo tem o objetivo analisar o desenvolvimento das ações de controle de tuberculose desenvolvidas nos serviços de Atenção Primária à Saúde, a partir da visão do doente. O estudo é descritivo, de corte transversal e quantitativo. A população é constituída por 517 doentes de tuberculose em tratamento nas Unidades de Atenção Primária à Saúde no município de Natal-RN. O instrumento de coleta é estruturado, baseado no The Primary Care Assessment Tool (PCAT), validado no Brasil e adaptado para avaliar a atenção a TB no Brasil, com modificações. Tal instrumento foi dividido em blocos: o primeiro correspondeu às informações sócio-demográficas do doente de TB e o segundo a efetividade dos serviços de saúde que atuam nas ações de controle, diagnóstico e tratamento de TB, e inclui questões relacionadas às dimensões da atenção primária: acesso, vínculo, elenco de serviços, coordenação da atenção, orientação à comunidade e enfoque na família. Para análise quantitativa, construíram-se indicadores para cada item do instrumento. Os padrões de respostas são seguidos de acordo com a escala de Likert, à qual se atribuiu um valor entre um e cinco que significou o grau de relação de preferência (ou concordância) das afirmações. Os valores entre 1 e 3 foram considerados insatisfatórios para o indicador; entre 3 e menores que 4, regulares e, entre 4 e 5, satisfatórios. Os resultados indicam que 62,37% dos doentes são homens, 27,96% com faixa etária de 41 a 50 anos, sendo 34,41% desempregados, de baixa escolaridade e baixa renda familiar. Verificou-se que os serviços hospitalares de referência são a porta de entrada para o doente (59,14%), e também os locais de diagnóstico da doença (72,04%). Sobre o acesso, as condições encontradas são satisfatórias quanto: ao número de vezes que precisam buscá-lo até o atendimento ao problema de saúde, à marcação e à facilidade para conseguir consulta no SS, à realização do atendimento sem prejuízos ao comparecimento do indivíduo ao trabalho e, às facilidades referentes à proximidade entre a residência e os serviços; foram consideradas insatisfatórias as condições relacionadas ao deslocamento até o SS, e sobre horário e dias de funcionamento dos serviços. No que se refere ao elenco de serviços, foram satisfatórias e regulares as ações relacionadas à solicitação de exames até a sua viabilização no primeiro SS, à disponibilização de pote para realização de baciloscopia e de medicamentos para o tratamento, além da realização de consultas de controle e recebimento de informações sobre a doença e o tratamento realizado; considerou-se ainda, insatisfatória a realização de atendimento domiciliar ao doente de TB por parte do SS que atua como porta de entrada, de realização do TDO, de visitas domiciliares durante o tratamento, de oferta de auxílio-transporte ao doente e de existência de grupos para doentes de TB. Em relação à coordenação da atenção, resultou em regular a ação de encaminhamento do doente a outros SS para obtenção de exames; e como insatisfatório o encaminhamento para obtenção de medicamentos. Já as relações de vínculo, entre doente e equipe de saúde foram consideradas em maioria satisfatórias ou regulares. Quanto ao enfoque familiar e comunitário, foi satisfatório apenas o indicador referente aos questionamentos dos profissionais ao doente sobre a existência de sintomáticos respiratórios na família. Considera-se que há necessidade de maior compromisso dos entes governamentais para com os incentivos obrigatórios ao controle da TB, assim como a disponibilização dos insumos necessários e, a capacitação dos recursos humanos que atuam na APS na contínua busca de fortalecimento da atenção primária, como lugar do mais amplo acolhimento às necessidades de contato do usuário com as ações e os profissionais de saúde. Recomenda-se a adoção de mecanismos de gestão possíveis de ampliar a capacidade resolutiva da APS, promovendo a efetividade na prestação dos serviços ao usuário e assegurando a atenção efetiva à saúde da população.

25
  • SUENIA SILVA DE MESQUITA XAVIER
  • A roda da vida: revelações de uma paciente em hemodiálise.

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • GLAUCEA MACIEL DE FARIAS
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Dec 9, 2011


  • Show Abstract
  • Reconstruir, a partir da escuta, a trajetória de vida de uma paciente renal crônica, submetida ao tratamento hemodialítico, constitui o objetivo desta investigação. Como procedimento metodológico, trabalhamos com a história oral de vida, conforme Meihy, dentro de uma abordagem qualitativa. Para isto, tivemos a aprovação do Comitê de Ética em Pesquisa, do Hospital Universitário Onofre Lopes (HUOL), sob protocolo de nº. 591/2011. Como instrumento de abordagem da paciente, fizemos entrevistas com questões abertas, realizadas na casa da paciente. Foram cinco encontros, nos quais escutamos sua história, experiências e formas de enfrentamento, durante sua trajetória de adoecimento e tratamento.  A análise foi pautada nas narrativas da colaboradora, ancorada em estudos que tratam da história oral, da subjetividade humana, com destaque para a resiliência, conforme assinala Cyrulnik. Sua história nos leva a concluir que, apesar das adversidades da vida e do sofrimento, existe, no ser humano, a força de navegar nas torrentes e conseguir ser feliz. Essa é a lição que nos lega a colaboradora deste estudo.

26
  • ELAINE MEIRELES CASTRO MAIA
  • ASSISTÊNCIA DE ENFERMAGEM E O RISCO DE DESENVOLVIMENTO DE ÚLCERAS DE PRESSÃO MEDIDA PELA ESCALA DE BRADEN EM PACIENTES DE UNIDADE DE TERAPIA INTENSIVA

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • THAIZA TEIXEIRA XAVIER NOBRE
  • WILMA DIAS DE FONTES
  • Data: Dec 9, 2011


  • Show Abstract
  • A problemática frente à incidência de UP no ambiente hospitalar especialmente na UTI, embora seja evento antigo e freqüente se observado em nossa prática profissional, é fato pouco notificado e com escassos estudos acerca. Observa-se uma tendência em investir em condutas terapêuticas e em estudos para produção de novas coberturas sofisticadas. Poucos, porém, são os investimentos em pesquisas sobre medidas preventivas com intuito evitar ou pelo menos retardar o desenvolvimento das lesões. Nesse sentido, o estudo teve como objetivo avaliar a influência da assistência de enfermagem na capacidade preditiva da escala de Braden para o desenvolvimento de úlceras de pressão em pacientes de Unidade de Terapia Intensiva. Trata-se de um estudo descritivo longitudinal de abordagem quantitativa. O projeto obteve parecer favorável do Comitê de Ética do HUOL (n.486/10). A coleta de dados realizou-se em um no Hospital da Unimed Natal, num período de seis meses em 2011. A amostra foi de 32 pacientes internados na UTI por mais de quatro dias. Os resultados foram processados no programa SPSS 15.0 por estatística descritiva e inferencial. Identificamos que, apenas 9,4% de nossa amostra desenvolveu UP, sendo predominantemente do sexo masculino, idosos com faixa etária acima de 60 anos, de raça branca, com hipótese diagnóstica no momento da internação de sepse, eram pacientes clínicos, que apresentaram instabilidade hemodinâmica, utilizando tubo endotraqueal, sonda enteral, sonda vesical de demora e tinham valores de albumina e hemoglobina abaixo do normal, apresentaram um maior tempo de internamento, maior tempo de uso de TOT, de SNE, de SVD, maior tempo de uso de sedação de dreno e eram todos de risco para o desenvolvimento de UP segundo escores de Braden. 66,7% das lesões desenvolvidas localizavam-se na região sacral, limitando-se a grau I e, todos os pacientes que as desenvolveram eram considerados graves, uma vez que 100,0% deles evoluíram a óbito. Pequena foi a diferençadas médias dos escores de Braden entre os pacientes com UP e os sem UP, 11,9+2,4 contra 12,4+2,6 com p=0,627. Os aspectos clínicos dos pacientes do estudo foram determinantes para o desenvolvimento de UP, uma vez que, estes achados foram significantes estatisticamente através do teste de Mann-Whitney, e adequação das condutas de enfermagem foi decisiva para a prevenção de úlceras por pressão em pacientes críticos, já que, muitos eram aqueles classificados como de risco (28) e poucos os que desenvolveram lesões (03).

27
  • JANILE BERNARDO PEREIRA DE OLIVEIRA MACEDO
  • Concepções de homens quanto a influência de uma gravidez sobre outra.

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • NILBA LIMA DE SOUZA
  • NORMÉLIA MARIA FREIRE DINIZ
  • ROSINEIDE SANTANA DE BRITO
  • Data: Dec 9, 2011


  • Show Abstract
  • O processo de reprodução humana é caracterizado por experiências singulares que afetam o homem e a mulher de forma diferenciada. O homem que vivencia o processo gestatório de sua companheira, mesmo não sofrendo as modificações gravídicas, enfrenta transformações relacionadas ao papel que desempenha junto à mulher gestante. Tal vivência é entremeada por significados diversos que dependem tanto da forma como ele concebe a gestação de sua companheira, como da experiência com gestações anteriores. Sendo assim, torna-se imprescindível reconhecer as concepções masculinas acerca das repercussões que uma gravidez conduz nas experiências seguintes, a fim de promover uma atenção em saúde direcionada para as necessidades apresentadas pelo homem, favorecer seu envolvimento e responsabilização no processo gestatório de sua companheira. Com base no exposto, objetivou-se compreender a concepção de homens, que vivenciam a gestação de sua companheira, acerca da influência de uma gravidez anterior sobre as demais. Para tal foi realizado uma pesquisa qualitativa por meio de entrevista semi-estruturada com homens que vivenciaram duas ou mais gestações de sua companheira com intervalo de no máximo cinco anos entre tais experiências. Cumpre ressaltar que as entrevistas ocorreram após parecer favorável de no 045/2011, emitido pelo Comitê de Ética e Pesquisa da Universidade Federal do Rio Grande do Norte. Os dados foram coletados por amostragem teórica e analisados, seguindo as etapas da Teoria Fundamentada nos Dados, sob a ótica proposta pelo Interacionismo Simbólico. Seguindo o percurso dos referenciais adotados, foram elaboradas três categorias: Sentimentos vivenciados pelo homem diante da gestação da companheira, Expectativas do homem diante da gestação da companheira e Repercussões da vivência de uma gravidez anterior sobre a seguinte. A análise das propriedades e dimensões de tais categorias suscitou à construção da teoria Influências de uma gravidez sobre a outra. Assim evidenciou-se que a gravidez anterior influencia nos sentimentos do homem diante de uma nova gestação, nas suas expectativas, principalmente quanto ao sexo do segundo filho, bem como em suas atitudes e comportamentos diante da companheira, do primogênito e do recém-nascido. Revelou-se que em todos esses aspectos ocorreram processos interativos do homem consigo mesmo, com sua companheira e com o contexto social no qual estava inserido. Assim sendo, conclui-se que a interação que o homem estabelece com a experiência anterior conduz a determinação de seus sentimentos e ações frente ao advento de uma nova gravidez. Diante disso, compreende-se que o entendimento sobre tal assunto é imprescindível para fundamentar ações do enfermeiro voltadas à inserção do homem no processo de gravidez, por meio da compreensão das repercussões de vivências anteriores na sua experiência com as demais gestações. Essa compreensão possibilitará uma dinâmica familiar favorável à adaptações requeridas em processos gestatórios seguintes, centrada na satisfação e valorização de seus membros.

28
  • LUZIA KELLY ALVES DA SILVA NASCIMENTO
  • ENSINO DO PROCESSO DE ENFERMAGEM: visão dos discentes de graduação de Natal-RN

  • Advisor : FRANCIS SOLANGE VIEIRA TOURINHO
  • COMMITTEE MEMBERS :
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • MARCOS ANTONIO FERREIRA JUNIOR
  • MARIA MIRIAM LIMA DA NÓBREGA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • Data: Dec 13, 2011


  • Show Abstract
  • O processo de enfermagem (PE) é o meio sistematizado de oferecer cuidados humanizados objetivando atingir resultados esperados. Vem crescendo a preocupação das instituições de saúde e de ensino em elaborar estratégias de implementação do mesmo. O objetivo desta pesquisa foi saber a visão dos discentes do último ano dos cursos de graduação de enfermagem de Natal/RN, sobre o ensino do processo de enfermagem (PE). Trata-se de um estudo descritivo e exploratório do tipo quanti-qualitativo, realizado em cinco instituições de ensino do curso de graduação em enfermagem do município de Natal- RN em 2011. A amostra foi composta de 48 discentes dos penúltimos e últimos períodos dos cursos de enfermagem.  A coleta dos dados foi realizada através de questionário on line com perguntas abertas e fechadas via SurveyMonkey®.  Foi utilizada para os dados quantitativos a estatística descritiva através do programa Microsoft Office Excel e para os dados qualitativos, a análise foi através da técnica de Análise de Conteúdo de Bardin. Os resultados apontaram uma predominância de discentes do sexo feminino (81,25%) com idade entre 21- 39 anos (75%) e cursando o oitavo período do curso (75%). Quanto à opinião dos discentes sobre o PE foi relatado que são ações sistematizadas embasadas em conhecimento científico e estabelecido por etapas e é um instrumento que promove a melhoria da qualidade da assistência de enfermagem, refletindo na prática e na promoção do bem-estar do cliente. Em relação ao ensino do PE os discentes (45,83%) disseram que o conhecimento do docente sobre o tema é bom; 81,25% relataram que os professores utilizam uma metodologia de ensino tradicional com componentes problematizadores e 45,83% respondeu que é abordado em disciplinas específicas de forma isolada a partir do eixo profissional.  A fase do PE que os discentes de enfermagem têm mais dificuldades de apreensão é a implementação, sendo citada 22 vezes (29,7%). Em relação às dificuldades dos discentes, nos campos de estágio supervisionados, em aplicar o PE foi relatado por 83,5% que os entraves estavam relacionados a não implementação na prática, sobrecarga de trabalho e falta de crença do enfermeiro no PE. As estratégias de integração docente-assistencial descrita quanto aos campos de estágio foram: a capacitação dos enfermeiros, para que possam contribuir com a universidade na implementação no serviço e ensino; e a necessidade das universidades focarem, de forma contínua no decorrer do curso, o PE envolvendo e estimulando os docentes nesse processo. Esses resultados mostram que o PE para os discentes de enfermagem é uma metodologia de trabalho da profissão que precisa ser implementada efetivamente na realidade prática para que o seu ensino se torne efetivo e os futuros profissionais possam trazer contribuições reais na realização de ações sistematizadas com vista à melhoria da qualidade da assistência e das ações da enfermagem. Espera-se que esse estudo possa contribuir trazendo algumas estratégias para facilitar a integração entre teoria e prática no ensino do PE e estimular uma discussão sobre o tema nas Escolas de Enfermagem onde a pesquisa foi realizada junto aos coordenadores, docentes e discentes.

29
  • JAQUELINE MIRANDA BARROS SILVA
  • Aconselhamento em HIV/Aids: ações e reflexões dos profissionais do Centro de Testagem e Aconselhamento (CTA).

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • BERTHA CRUZ ENDERS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • MARIA MIRIAM LIMA DA NÓBREGA
  • Data: Dec 13, 2011


  • Show Abstract
  • O aconselhamento em HIV/Aids consiste numa estratégia de prevenção pela qual é possível aumentar o diagnóstico do HIV e iniciar o mais precoce o tratamento. O aconselhamento tem como pilares o apoio emocional, apoio educativo e avaliação de riscos que visam à adoção de práticas seguras e responsabilidade do sujeito enquanto agente da sua saúde. O aconselhamento reforça os meios de prevenção e tratamento, atuando tanto na atenção primária quanto na secundária. Para que esses resultados sejam alcançados torna-se necessário que os profissionais de saúde compreendam o aconselhamento como um momento ímpar, por estimular a reflexão crítica do usuário no tocante ao seu papel enquanto sujeito ativo nesse processo. Este estudo teve como objetivo analisar o aconselhamento em HIV/Aids realizado pelos profissionais do Centro de Testagem e Aconselhamento (CTA) enquanto momento de reflexão e educação. Trata-se de um estudo exploratório descritivo com abordagem qualitativa e delineamento de investigação crítica reflexiva, com base nos princípios da Ciência Ação. Participaram desta pesquisa todos os profissionais, totalizando oito, que atuam no aconselhamento no CTA de João Pessoa/PB. Os dados foram coletados por meio da observação não-participativa e entrevista semi-estruturada com enfoque crítico reflexivo e analisados segundo os aportes da metodologia crítico reflexiva e discutidos à luz da pedagogia de Paulo Freire e autores pertinentes. Observou-se que a maioria dos profissionais compreende a filosofia de trabalho do CTA como sendo o diagnóstico e a prevenção associada à utilização e demonstração do preservativo. Contudo, ao observarmos as suas ações durante os aconselhamentos essas idéias não se concretizam. Temas educativos não foram abordados e o preservativo não foi oferecido em nenhum dos atendimentos. As ações centraram-se no acolhimento de informações e no preenchimento dos formulários necessários ao atendimento, com diálogo estanque e com pouca abertura para o usuário expor, ou completar, os seus pensamentos e necessidades. Os profissionais citaram as condições facilitadoras para o aconselhamento, a interação da equipe e estrutura física. Focalizaram as dificuldades do baixo grau de instrução dos usuários, a demanda de atendimentos e outros aspectos da organização de serviço, e o descompromisso dos aconselhadores quanto às faltas e atrasos. Ao refletir sobre as ações observadas nos aconselhamentos, à maioria dos profissionais reconheceu que precisam modificar algumas ações do atendimento para incorporação dos princípios educativos na realização de uma prevenção mais ampla e se mostraram dispostos a trabalhar nessa perspectiva. Conclui-se que, embora os profissionais expressem idéias condizentes com os propósitos do CTA, estas são limitadas enquanto apropriação do significado de prevenção em HIV/Aids. Na medida em que expressam uma compreensão e agem de forma diferente na realização das ações durante o aconselhamento, demonstram a desarticulação entre as teorias em uso e as teorias propostas, conforme os aportes da teoria da ciência-ação. O aconselhamento enquanto prática educativa não se concretiza nos aconselhamentos e a orientação para uma reflexão não é oportunizada no atendimento. Esses achados sugerem a necessidade de inserir o processo de reflexão na realização das ações de aconselhamento, de forma que estas sejam pautadas na prática reflexiva, objetivando a transformação do seu modo de pensar e agir para uma perspectiva educacional com vistas a uma assistência mais democrática e integral.

30
  • SILVANA HELENA NEVES DE MEDEIROS JERONIMO
  • O atendimento à pessoa idosa com doença crônica não transmissível (DCNT) em serviço de média complexidade.

     

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • JAMERSON VIEGAS QUEIROZ
  • REJANE MARIA PAIVA DE MENEZES
  • WILMA DIAS DE FONTES
  • Data: Dec 15, 2011


  • Show Abstract
  • O processo de transição demográfica e epidemiológica causado pela diminuição dos índices de natalidade e mortalidade e modificação do perfil de morbimortalidade, é representado pelo aumento da população idosa e das doenças crônicas não transmissíveis. Doenças essas, caracterizadas por etiologia múltipla, fatores de risco, período longo de latência, curso prolongado, origem não infecciosa e associação com deficiências e incapacidades funcionais. Desse modo, a pessoa idosa com doença crônica não transmissível, encontra-se em prioridade por tratar-se de um grupo vulnerável para o acometimento das comorbidades no envelhecimento, com aumento da procura e gastos nos serviços de saúde. O objetivo desse estudo é analisar o atendimento da pessoa idosa com Doença Crônica Não Transmissível em serviços de média complexidade como contribuição para a melhoria do atendimento no município de Natal-RN. Estudo descritivo e exploratório, com abordagem quantitativa, realizado no Centro Especializado de Atenção a Saúde do Idoso e no Hospital dos Pescadores. A população foi de 4180 e uma amostra de 124 idosos com idade igual ou acima de 60 anos, atendidos nesses serviços de média complexidade. O instrumento, um formulário estruturado, adaptado do questionário de monitoramento para fatores de risco e proteção para doença crônica do Ministério da Saúde. Na coleta de dados usou-se a entrevista acompanhada de formulário contendo dados sociodemográficos, hábitos e condição de saúde e o atendimento nos serviços de saúde. Os resultados foram processados no programa Statistical Package for the Social Science, versão 18.0, analisados através da estatística simples. Identificou-se que a maioria dos idosos é do sexo feminino, com predomínio entre 70 a 74 anos, casados, cor parda e católicos; mais da metade tem ensino fundamental incompleto; renda familiar entre 1 a 2 salário mínimo e reside com a família. Quanto aos hábitos de vida, (94,4%) consumiam frango e (97,6%) frutas; observa-se haver redução do tabagismo, do alcoolismo e da atividade física com o aumento da idade; 58,1% possuem insônia e 18,5% utilizam remédios para dormir. Os idosos (51,6%), referem utilizar os serviços quando adoece, buscando a atenção primária no primeiro momento (30,6%); 52% não receberam encaminhamento e a procura é por livre demanda (38.7%). A morbidade mais referida é a hipertensão, seguida das doenças musculoesqueléticas. Sobre as dificuldades na procura pelos serviços de saúde, a demora no atendimento e as filas foram citadas pelos idosos. Quase todos relatam não haver atividades de promoção à saúde nesses serviços e referem receber orientação individual sobre as Doenças Crônicas. Quase sempre, os profissionais de saúde que os atendem, em sua maioria são médicos seguidos dos enfermeiros. Mediante os resultados apresentados, considera-se que os serviços de saúde de média complexidade precisam exercer de forma mais contínua, a interlocução com os demais níveis de atenção e enfocar no atendimento as ações de promoção e prevenção à saúde. Recomenda-se também, a necessidade de qualificação dos profissionais para o atendimento a pessoa idosa e a implantação de protocolos pela equipe multiprofissional de saúde de modo a proporcionar melhor atendimento e continuidade do tratamento à pessoa idosa com doenças crônicas não transmissíveis.

31
  • ANA DULCE BATISTA DOS SANTOS
  • PROMOÇÃO DA SAÚDE DA CRIANÇA EM UM CENTRO DE EDUCAÇÃO INFANTIL: a inserção da equipe da estratégia saúde da família

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • FRANCISCA MÁRCIA PEREIRA LINHARES
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: Dec 16, 2011


  • Show Abstract
  • A articulação entre as equipes da estratégia saúde da família (ESF) e o Centro Municipal de Educação Infantil (CMEI) desponta como uma maneira de assegurar a vigilância e promoção à saúde das crianças, ao ingressarem no ambiente de creche/pré-escola, que representa um local expositor a doenças transmissíveis e repercute no afastamento da criança do serviço de saúde. Por essa necessidade, traçou-se como objetivo: Analisar a assistência a criança, desenvolvida pela equipe da estratégia saúde da família, na promoção a saúde da criança, atendida em um CMEI, numa articulação UBSF, CMEI para a construção de uma proposta de atenção as necessidades de saúde da criança no CMEI. Traçamos assim, como objetivos específicos: Identificar diante da realidade, a necessidade de ações de saúde (preventivas, promocionais e curativas) pela equipe da ESF, para a criança de 2 a 5 anos, no CMEI; Estruturar uma proposta de atenção as necessidades de saúde da população infantil do CMEI; Avaliar os resultados obtidos durante a pesquisa-ação; Descrever as etapas percorridas para a construção do plano de atenção a saúde da criança no CMEI. Trata-se de um descritivo, de natureza qualitativa, do tipo pesquisa-ação. Será desenvolvido em um CMEI e na UBSF do bairro de Cidade Nova, Natal-RN. A população foi constituída pelos profissionais da equipe da ESF e do CMEI. Para a obtenção dos dados utilizamos diversas técnicas como a entrevista individual, grupo focal, observação participante com registro fotográfico e anotações diárias, e a avaliação dos encontros. A análise dos dados ocorreu por meio da análise de conteúdo e das idéias teóricas de Paulo Freire (1987). Na etapa de diagnóstico situacional buscou-se investigar a realidade vivenciada pelos sujeitos da ESF e CMEI quanto a saúde da criança. As categorias desta etapa abrangiam: a realidade das equipes da saúde da família na atenção a saúde da criança no CMEI identificando as ações que já vinham sendo desenvolvidas pela ESF no CMEI; o funcionamento do CMEI e sua rotina de atividades; o papel do CMEI no cuidado a criança; o cotidiano da ESF, quanto ao cuidado à saúde da criança de 2 a 5 anos envolvendo as diversas dificuldades enfrentadas pela ESF; dificuldades enfrentadas no cotidiano do CMEI para o cuidado a criança de 2 a 5 anos. Com a problematização e conscientização alcançadas pelos sujeitos surgiram às categorias: papel da articulação ESF e CMEI para o enfrentamento das dificuldades; e ações de saúde a serem desenvolvidas que subsidiaram a etapa de planejamento da pesquisa-ação. Na etapa de desenvolvimento dos seminários e execução das ações foram desenvolvidas as atividades anteriormente sugeridas pelos sujeitos que compreenderam: ações educativas com os trabalhadores do CMEI; ações de atenção a saúde das crianças; e ações educativas com os pais. A etapa de avaliação aconteceu durante toda a pesquisa-ação implicando diversos rearranjos emergiu a categoria percepção dos sujeitos diante das ações desenvolvidas e perspectivas de continuidade das ações. Diante de todo o percurso da pesquisa-ação pode-se inferir que a articulação ESF e CMEI é uma iniciativa necessária diante da atual situação dos serviços de saúde para a promoção de uma atenção integral a saúde da criança, mas que as equipes da ESF ainda não dispõem de condições material e de pessoal para desenvolver ações que ultrapassem os limites das UBSF, sendo necessário para isso o fortalecimento das articulações principalmente com a universidade.

32
  • VANNUCIA KARLA DE MEDEIROS NOBREGA
  • REPRESENTAÇÕES SOCIAIS DO COMPORTAMENTO AGRESSIVO DO HOMEM SOB A ÓTICA DA MULHER VITIMIZADA

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • EDNALDO CAVALCANTE DE ARAÚJO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • ROSINEIDE SANTANA DE BRITO
  • Data: Dec 16, 2011


  • Show Abstract
  • Objetivamos com esse estudo apreender as representações sociais do comportamento agressivo do homem na ocorrência de violência intrafamiliar, sob a ótica da mulher vitimizada. Trata-se de um estudo de caráter descritivo, exploratório e representacional, cuja abordagem metodológica se insere na categoria qualitativa. Considerando a complexidade da temática violência, as condições biopsíquicas e sociais da mulher que sofreu a violência, o referencial de busca e direcionamento tomados por elas como tentativa de quebrar o ciclo no âmbito familiar, optamos, após visita in loco, pelo Centro de Referencia a Mulher Cidadã (CRMC) como cenário de investigação, Natal – RN. Os critérios de seleção das participantes foram: mulheres que viveram/vivem situações de violência intrafamiliar; com vinculo afetivo ou de parentesco com o agressor; estejam em condições psicológicas e emocionais adequadas à realidade; que estejam sob proteção ou atendidas pelo serviço acima relacionado. Adotamos um enfoque multimetodológico a partir dos seguintes instrumentos de coleta: o questionário, o Desenho-estória (DE) e, em caráter complementar, o diário de campo. Dessa forma, foi possível caracterizar as mulheres investigadas, seus agressores e a violência sofrida, bem como, categorizar os discursos do corpus “homens”, gerado pelo ALCESTE. Para analise dos dados textuais, optamos pelo uso do software ALCESTE conjugado a análise de edição e leitura flutuante. Foram investigadas 20 mulheres vítimas de violência intrafamiliar, cujo autor das agressões era o marido/ companheiro. Identificamos que 70% (n=14) dos homens com comportamento agressivo apresentam igualmente histórico familiar de violência e relações familiares fragilizadas. No tangente às condições físicas e emocionais do agressor na hora da violência, 50% (n=10) desses homens, independente do uso do álcool, apresentavam frequentemente comportamento briguento e/ou nervoso, impaciência e humor imprevisível, frente a uma contrariedade, preocupação ou aborrecimento. Quanto a natureza da violência, observamos que as mulheres foram vítimas de todos os tipos de violência, todavia, a psicológica, prevaleceu em 100% dos casos. O corpus “homens” gerou três classes, cujo foco são respectivamente: renuncia, denuncia e violência/ agressão. Sendo possível assim categorizá-las: Categoria 1: “Fui esquecendo de mim”. O sonho que te deixa míope; Categoria 2: “Escrevendo uma nova história”. Quando a mulher resolve denunciar; Categoria 3: “Eu não sei explicar, só sei sentir”. A violência e suas significações. Dessa forma, evidenciamos que as representações sociais do comportamento agressivo do homem, a partir da mulher vitimizada, estão ancoradas nas concepções de doença, como vício ou psicopatias; dos constructos familiares em que os homens estão inseridos e em um caso especifico, proveniente da concepção/gestação, contribuindo para a construção de um ser violento. Esperamos que esse estudo contribua na construção de políticas públicas de saúde voltadas para o homem, com vistas a equidade de gênero, de forma que possa envolvê-los ativamente na diminuição e interrupção do ciclo de violência.

33
  • JOAO MARIO PESSOA JUNIOR
  •  

    Trajetória do Hospital-dia Dr. Elger Nunes: um recorte histórico da psiquiatria e saúde mental no Rio Grande do Norte.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • LENILDE DUARTE DE SÁ
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Dec 19, 2011


  • Show Abstract
  • No Brasil, a rede de saúde mental proposta pela Reforma Psiquiátrica insere os serviços intermediários e substitutivos, na busca pela aproximação ou ressocialização do portador de transtorno mental e comportamental junto à comunidade.  Adotou-se, entre outros serviços, o Centro de Atenção Psicossocial, Residência Terapêutica, Lar Abrigado, Hospital-dia, Leito Psiquiátrico em Hospital Geral. Nesse contexto, o Estado do Rio Grande do Norte, implantou o Hospital-Dia Dr. Elger Nunes (HDEN) em Natal/RN no ano de 1996, primeiro e único serviço público psiquiátrico intermediário nessa modalidade, ligado à Secretaria Estadual de Saúde Pública. No HDEN acontecia um trabalho terapêutico multi e interdisciplinar, além de ser palco de práticas disciplinares e projetos de extensão de cursos em graduação de Instituições de Ensino Superior na capital. Entretanto, com o processo de municipalização dos serviços locais, o HDEN foi extinto por ato administrativo estadual em 2006, deixando prejuízo para as atividades prestadas aos usuários, as práticas disciplinares e as atividades extensionistas. Partindo dessa ruptura, objetivou-se narrar a trajetória do Hospital-Dia Dr. Elger Nunes através dos profissionais da equipe multidisciplinar e dos professores que o utilizaram como campo de práticas disciplinares. Caracteriza-se como estudo documental e qualitativo, respaldado na técnica da história oral temática, seguindo as fases: autorização do depoente, gravação da entrevista, transcrição, a textualização e a transcriação do material. Utilizaram-se documentos, portarias inerentes, relatórios gerais de atividades; somada a realização de entrevistas a quinze colaboradores que utilizaram esse serviço, sendo treze profissionais da equipe multidisciplinar e dois docentes da graduação da área da saúde, Enfermagem e Medicina. As histórias coletadas foram organizadas conforme a técnica escolhida associada respeitada respeitando-se suas etapas e para a preparação do corpus o qual será submetido ao programa informático ALCESTE, priorizando o tom vital para a formação das categorias e classes elegida por ele, estruturada a partir de três eixos temáticos: no primeiro sub-eixo destacou-se a rede de atenção psicossocial em Natal e no RN: avanços e desafios, referindo-se os avanços e entraves dos serviços substitutivos na atual rede municipal; no segundo sub-eixo refletiu-se sobre o Hospital Dr. João Machado: o serviço “portas abertas”; no terceiro eixo ocupou-se do debate em torno da atenção básica: “o nó da questão!”, mencionou-se sobre a falta de articulação existente entre a rede de serviços básicos com os de atenção psicossocial, marcada pelo despreparo de seus profissionais atuantes no atendimento ao portador de transtorno mental e comportamental. Ademais, a trajetória do Hospital-Dia Dr. Elger Nunes propicia o reconhecimento das bases históricas traçadas na constituição da rede de serviços substitutivos presente no atual cenário de atenção psicossocial do município de Natal/RN. Adensa-se ainda o trajeto das políticas públicas em saúde mental vividas na Reforma potiguar, onde se espera, através desse estudo, suscitar novas discussões em torno da construção do modelo de atenção psicossocial, circunscritos pela rememorização das histórias de um serviço intermediário com reflexos sobre os desafios do processo nacional de Reforma Psiquiátrica.

34
  • REGINA CELIA DAMASCENO
  • A TERAPIA COMUNITÁRIA INTEGRATIVA: construção de um espaço de escuta para os trabalhadores da saúde da atenção básica

  • Advisor : ROSANA LUCIA ALVES DE VILLAR
  • COMMITTEE MEMBERS :
  • JACILEIDE GUIMARAES
  • RAIMUNDA MEDEIROS GERMANO
  • ROSANA LUCIA ALVES DE VILLAR
  • SUZANA CARNEIRO DE AZEVEDO FERNANDES
  • Data: Dec 19, 2011


  • Show Abstract
  • Esta pesquisa aborda a Terapia Comunitária Integrativa (TCI) como ferramenta de
    criação de espaços de encontros entre os profissionais da saúde, na qual cada um
    pode acolher o outro e ser acolhido. Objetivou-se analisar a referida terapia como
    abordagem terapêutica e espaço de escuta e fala dos profissionais da saúde,
    identificando os sofrimentos decorrentes do contexto das relações de trabalho e as
    repercussões das vivências terapêuticas na visão dos participantes. Para a sua
    operacionalização foi desenvolvida como uma pesquisa ação, envolvendo várias
    etapas, cujo campo de investigação foram as rodas de TCI com trabalhadores das
    Unidades da Estratégia Saúde da Família dos Distritos Sanitários Norte I e II do
    município de Natal-RN, utilizando uma abordagem qualitativa. A interpretação dos
    dados obtidos, fundamentada na análise de conteúdo proposta por Bardin,
    evidenciou a TCI como espaço de diálogo e de partilha, com repercussões nas
    relações de trabalho e expansões para além das rodas, alcançando as relações
    familiares e sociais, contribuindo para criação de vínculos e formação de redes
    solidárias. Na visão dos participantes foi reconhecida como uma experiência que
    otimizou a socialização, promoveu a atenuação de sofrimentos e potencializou o
    bem estar. Diante dos achados, infere-se que TCI pode ser considerada uma
    ferramenta viável para o acolhimento e cuidado humanizado dos trabalhadores da
    saúde.

35
  • FERNANDO DE SOUZA SILVA
  • Histórial oral de vida de pacientes transplantados renais: novos caminhos a trilhar

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • LENILDE DUARTE DE SÁ
  • MARIA TERESA CICERO LAGANA
  • Data: Dec 19, 2011


  • Show Abstract
  • As possibilidades terapêuticas para a Insuficiência Renal Crônica (IRC) estão intimamente relacionadas à condição biológica e social, e nesta perspectiva o transplante renal é considerado a melhor opção, por proporcionar melhor qualidade de vida. Este estudo objetivou apreender, por meio do resgate da história oral de vida dos pacientes transplantados renais, as experiências vivenciadas desde o diagnóstico da doença renal à convivência com a atual modalidade terapêutica. Trata-se de um estudo de abordagem qualitativa, exploratório-descritivo, tendo a história oral de vida como técnica e referencial metodológico. A colônia foi formada com os dez primeiros pacientes transplantados renais do Rio Grande do Norte, atendidos no ambulatório da Nefrologia no Hospital Universitário Onofre Lopes-UFRN, localizado na cidade de Natal-RN. A rede foi composta por colaboradores de ambos os sexos, na faixa etária entre 21 e 56 anos de idade, submetidos há mais de um ano ao transplante renal e que, em alguns casos, juntamente de seus familiares, aceitaram voluntariamente participar do estudo. Foi excluído o primeiro colaborador entrevistado por este não desejar participar mais do estudo. Após aprovação pelo Comitê de Ética em Pesquisa (CEP) da UFRN, realizamos a coleta de dados, por meio de uma entrevista semi-estruturada, gravada individualmente, em ambiente escolhido pelos colaboradores. Realizamos a transcrição das entrevistas e posteriormente retornamos aos entrevistados para que os mesmos fizessem a conferência, o que nos possibilitou realizar a transcriação, após leituras consecutivas. Analisamos os relatos por meio da análise de conteúdo de Bardin. Norteando a análise dos relatos dos colaboradores, encontramos três eixos temáticos: Impacto nas relações sociais, Impacto na condição social e Comportamento frente a doença e tratamento. Concluímos neste estudo que a perda da função renal repercutiu drasticamente na vida dos colaboradores, mas que a aceitação da condição patológica emergiu, principalmente pelo apoio da família e na crença em Deus. O transplante renal foi visto como a oportunidade para uma nova vida, porém, para que alcancem uma melhoria na qualidade de vida, outras questões devem ser otimizadas, como a garantia de direitos constitucionais, o resgate da cidadania e a oferta de maior apoio dos profissionais da saúde, família e sociedade para o enfrentamento dos problemas gerados pela doença renal crônica e seus tratamentos.

36
  • HENIA RAMALHO DE MELO ESTACIO
  • BIOSSEGURANÇA E A SAÚDE DO TRABALHADOR NA ASSISTÊNCIA A PACIENTES EM TRATAMENTO ONCO-HEMATOLÓGICO

     

     

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • SORAYA MARIA DE MEDEIROS
  • RAIMUNDA MEDEIROS GERMANO
  • IRIS DO CEU CLARA COSTA
  • LENILDE DUARTE DE SÁ
  • Data: Dec 20, 2011


  • Show Abstract
  • INTRODUÇÃO: Nos últimos anos, a biossegurança vem possibilitando um novo olhar, no qual são baseadas as concepções do processo saúde e doença, bem como as necessidades humanas. Essa nova visão está voltada para a vigilância em saúde, essa referenciada, especificamente neste estudo na saúde do trabalhador, a qual é essencial para prevenção e controle das epidemias e surtos de agravos e doenças emergentes e reemergentes. O presente estudo pretende mostrar a importância das medidas de biossegurança para os trabalhadores em saúde, evidenciando-as através das concepções no seu cotidiano de trabalho. Direcionam-se também para o uso das medidas de biossegurança na assistência a pacientes em tratamento onco-hematológico, devido à susceptibilidade dessa clientela as infecções. Foram realizadas buscas nas bases de dados, como: Lilacs, Scielo, Medline, sites (Portal de Saúde e Ministério do Trabalho, Risco Biológico e Controle de Infecção Hospitalar) dentre outros. Constataram-se, poucos artigos fazendo referência as concepções dos trabalhadores frente às medidas de biossegurança. Visto também a escassez de literatura que focaliza uma clientela em tratamento onco-hematológico. OBJETIVOS: Analisar as concepções dos trabalhadores em saúde frente a prática de biossegurança a pacientes em tratamento onco-hematológico, em uma instituição especializada em oncologia em Natal/RN. METODOLOGIA: A pesquisa é exploratória descritiva com abordagem qualitativa, utilizando-se a técnica de História oral temática, justificando o uso da mesma pela possibilidade de analisar as concepções dos profissionais de saúde frente às medidas de biossegurança. A análise das entrevistas foi realizada pela técnica da história oral temática, que é um recurso moderno usado para elaboração de documentos, arquivamento e estudos referentes à experiência social de pessoas e de grupo. O estudo foi realizado na Liga Contra o Câncer, Natal/RN, especificamente na unidade, Hospital Luiz Antônio. A população que será estudada é profissional de saúde de diversas categorias, que trabalham na clínica onco-hematológica. As entrevistas estruturadas foram realizadas nos três turnos de trabalho, em face das perspectivas de ampliação das possibilidades de análise das concepções de biossegurança. CONSIDERAÇÕES FINAIS: Constata-se com as análises das informações, que a biossegurança foi dita pelos colaboradores como benefícios imensuráveis na segurança é saúde do trabalhador, e tendo como pontos fortes na compreensão deles, a excelência da assistência e a segurança na redução dos riscos de doenças ocupacionais e infecções decorrentes de suas atividades laborais.

     

     

37
  • RAIMUNDA MARIA DE MELO
  • Percepção de homens/companheiros acerca da sua presença no nascimento do filho.

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • CLEIDE MARIA PONTES
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • ROSINEIDE SANTANA DE BRITO
  • Data: Dec 22, 2011


  • Show Abstract
  • Diante do reconhecimento da importância do acompanhante no parto, o estudo teve como objetivo analisar a percepção de homens quanto à sua presença na sala de parto durante o nascimento de seu filho. Trata-se de uma pesquisa do tipo exploratório e descritivo de natureza qualitativa. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte sob protocolo de nº 041/11. A coleta dos dados foi realizada no Hospital Universitário Ana Bezerra em Santa Cruz/RN, Brasil. Participaram da pesquisa homens/companheiros que estiveram presente na sala de parto no momento do nascimento do filho. A coleta de dados ocorreu entre os meses de junho a agosto de 2011, por meio de entrevista semiestruturada, após aquiescência da direção da instituição e assinatura do Termo de Consentimento Livre e Esclarecido pelos entrevistados. Os depoimentos foram tratados de acordo com a análise de conteúdo segundo Bardin. Por meio da leitura exaustiva dos depoimentos foram identificadas as unidades de registro que passando por um processo de codificação e categorização deram origem a três categorias temáticas e seis subcategorias: importância da presença do homem na sala de parto; considerações do homem acerca do processo parturitivo e conhecimentos do homem relativos ao trabalho de parto e nascimento. A análise dos resultados teve como base os princípios do interacionismo simbólico segundo Blumer. Os resultados apontam que a unanimidade dos participantes expressou a importância do homem estar presente em sala de parto e acompanhar o nascimento de seu filho, com isso, recomendaram a presença de outros homens durante o processo da parturição de suas respectivas companheiras. Os depoentes afirmaram que a sua presença na sala de parto os levou a ter uma nova visão sobre a mulher. Ao acompanhá-la durante o trabalho de parto e parto os depoentes compreenderam esses períodos como algo que conduz a companheira a sofrimento físico e por envolver-se com a parturição passaram também a sentir os desconfortos oriundos do trabalho de parto. Portanto, em uma abordagem interacionista os entrevistados perceberam a sua presença na sala de parto como momento importante para a mulher, criança e para ele próprio. Mediante os resultados se faz necessário valorizar a presença do companheiro no contexto parturitivo, pois é o acompanhante ideal para a parturiente, visto que a sua presença em sala de parto garante o estabelecimento da interação com a mulher no momento em que ela mais precisa de apoio e de cuidados.

2010
Dissertations
1
  • JOHNY CARLOS DE QUEIROZ
  • Articulação ensino/serviço na visão dos discentes de enfermagem.

  • Advisor : ROSALBA PESSOA DE SOUZA TIMOTEO
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MILLIONS VIANA MENESES
  • Data: Apr 6, 2010


  • Show Abstract
  • O estudo visou compreender a repercussão da articulação ensino/serviço entre a Faculdade de enfermagem da Universidade do Estado do Rio Grande do Norte (FAEN/UERN) e os serviços de saúde da cidade de Mossoró/RN na aprendizagem dos discentes. Para tanto, buscou-se resgatar e reelaborar as trajetórias vivenciadas pelos discentes concluintes do ano de 2009 do curso de graduação em enfermagem. Foi utilizado como instrumento norteador questionário com perguntas abertas e fechadas para subsidiar a coleta. A análise dos dados foi realizada à luz dos preceitos propostos por Bardin. A pesquisa revelou uma visível necessidade da construção de vínculos com o envolvimento dos discentes nos serviços e dos profissionais inseridos na academia, de modo que o conhecimento possa ser construído coletivamente e as dificuldades serem amenizadas.

2
  • ANTONIA LÍRIA FEITOSA NOGUEIRA ALVINO
  • . O LÚDICO NA PROMOÇÃO DA SAÚDE NO TRÂNSITO: uma contribuição da enfermagem.

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • JACILEIDE GUIMARAES
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • Data: May 24, 2010


  • Show Abstract
  • RESUMO

    Trata-se de um estudo sobre a contribuição da enfermagem na prmoção da saúde no trânsito, utilizando o lúdico como estratégia de intervenção. Para tanto, buscou-se a construção de um material educativo impresso baseado nos princípios do trânsito solidário apresentados pelo DENATRAN, em 2005. A pesquisa se justifica pelo aporte teórico que está poderá proporcionar à saúde no trânsito, sobretudo no sentido de proteção aos indivíduos em seus deslocamentos; Ademais, este trabalho poderá contribuir com a enfermagem como ciência, especialmente no desenvolvimento de conceitos e teorias que corroboram a forma transcultural de prestar cuidados. Sobre cuidado transcultural, este foi proposto por Leininger (1991) através da Teoria da Diversidade e Universalidade do Cuidado Cultural, referência que alicerça esta pesquisa e liberta a enfermagem da assistência direta tradicional exclusiva, enquanto acomoda outras compreensões do ‘cuidar’. A decisão pelo lúdico baseou-se nos estudos de Huizinga (2008) e em sua defesa de que a ludicidade facilita a aceitação humana às propostas educativas. Neste sentido, defendendo a construção de um material educativo impresso como uma forma de produção de cuidado, adotamos a Pesquisa Ativa de Jüngen Habermas para compor nosso percurso metodológico. Através desse método trabalhamos o ‘existente’ e o ‘vivido’ na tentativa de aproximar os atores que compõem o trânsito, em especial as crianças. Finalmente, após a produção do material educativo impresso, a cartilha, denominação dada ao produto final, passou por especialistas de órgãos públicos federais e estaduais que fizeram sua validação como instrumento educativo. Acreditamos que esta pesquisa produziu um cuidado com ação ampliada para a coletividade, desdobrando a contribuição da enfermagem pré-hospitalar para além da assistência direta individual.

3
  • THIAGO ENGGLE DE ARAÚJO ALVES
  • O TRABALHO EM SAÚDE COMO ESPAÇO PEDAGÓGICO: desafios e possibilidades

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • JACILEIDE GUIMARAES
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • SORAYA MARIA DE MEDEIROS
  • Data: May 26, 2010


  • Show Abstract
  • As transformações em curso na sociedade brasileira, decorrentes das mudanças técnico-organizacionais no mundo do trabalho, estão fazendo ressurgir, com muita ênfase, acalorados debates relativos a temas e problemas que nos remetem às relações entre trabalho, qualificação e educação. Diante disso, este estudo encontra-se inserido no âmbito da articulação entre educação e trabalho, apontando para o trabalho como princípio educativo na perspectiva de Antonio Gramsci. Este estudo tem por objetivos discutir as interfaces entre educação e trabalho no cotidiano de equipes de saúde e conhecer as atividades desenvolvidas por equipes de saúde relacionadas com os processos de aprendizagem no e com o trabalho para analisar as possibilidades e os desafios de transformar os espaços de trabalho em saúde em ambientes de aprendizado permanente. Trata-se de um estudo de caso de caráter descritivo, exploratório, de abordagem qualitativa e desenvolvido a partir de entrevistas semi-estruturadas com os profissionais da equipe de saúde da Unidade de Terapia Intensiva da Casa de Saúde Dix-Sept Rosado em Mossoró/RN, os quais responderam questões abertas sobre a articulação entre educação e trabalho. As entrevistas foram realizadas durante o mês de janeiro de 2010, sendo as mesmas gravadas, transcritas e analisadas, culminando com a produção de novos conhecimentos sobre o tema. Entende-se que trabalho e educação são atividades eminentemente humanas; logo, somente o ser humano trabalha e educa. Diante das falas dos participantes da pesquisa, conclui-se que todos os processos de trabalho em saúde são momentos de aprendizado. Este acontece por meio de novas demandas impostas pelo cotidiano dos serviços, pela interação com a equipe multiprofissional, pela participação em atividades educativas e estudo individual. Percebeu-se que a instituição em estudo não promove cursos relacionados à Terapia Intensiva e que existem entraves à realização de atividades educativas no e com o trabalho, tais como: excesso de carga horária de trabalho, impossibilidade de liberação do funcionário para participação em eventos, má remuneração, o que leva o trabalhador a ter mais de um vínculo empregatício, rejeição à aquisição de novos conhecimentos por parte de alguns trabalhadores e falta de estrutura física  e incentivos para realização de atividades. Deve-se transformar as situações diárias em aprendizagem, analisando reflexivamente os problemas da prática e valorizando o próprio processo de trabalho no seu contexto intrínseco. Conclui-se que lidar com a teia de relações entre os processos educacionais e os processos de produção de serviços de saúde, desvendando os meandros do mundo do trabalho e da educação nesse setor são exigências a cada dia mais presentes na agenda dos trabalhadores e gestores do Sistema Único de Saúde. A análise permanente dessa problemática torna-se um exercício indispensável para o bom desempenho de suas responsabilidades. Considera-se que aproximar a educação da vida cotidiana é fruto do reconhecimento do potencial educativo da situação de trabalho.

4
  • DANIELE VIEIRA DANTAS
  • Assistência aos portadores de úlceras venosas: proposta de um protocolo

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • EDNALDO CAVALCANTE DE ARAÚJO
  • Data: Sep 3, 2010


  • Show Abstract
  • As úlceras venosas (UV), feridas crônicas que resultam da IVC, acometem pessoas de diferentes faixas etárias, com índices elevados de recidiva (66% dos casos), e repercutem de forma severa na deambulação dos portadores. As lesões apresentam tratamento duradouro e complexo, são causa de hospitalização prolongada, sendo responsáveis por morbidade e mortalidade significativas. Este estudo tem como objetivos identificar os aspectos relevantes da literatura científica contemplados em protocolo para assistência aos portadores de úlceras venosas; identificar os aspectos a serem propostos pelos juízes do estudo (angiologistas, enfermeiros e fisioterapeutas) para o protocolo de assistência aos portadores de úlceras venosas atendidos em um hospital de referência do Rio Grande do Norte; apresentar estrutura de protocolo proposta pelos juízes do estudo (angiologistas, enfermeiros e fisioterapeutas) para assistência aos portadores de úlceras venosas atendidos em um hospital de referência do Rio Grande do Norte; propor um protocolo de assistência aos portadores de úlceras venosas atendidos em um hospital de referência do Rio Grande do Norte. Trata-se de um estudo descritivo, com abordagem quantitativa, com 40 profissionais, sendo 7 angiologistas e 1 enfermeiro integrante da equipe de clínica cirúrgica do Hospital Universitário Onofre Lopes, 29 enfermeiros especialistas em dermatologia e de reconhecida experiência no tratamento de UV, além de 3 fisioterapeutas que desenvolvem assistência a pessoas com lesões venosas. Esses profissionais foram os juízes responsáveis por selecionar as diretrizes já propostas na literatura, além de acrescentar outros aspectos a serem incorporados no protocolo. A primeira etapa do estudo consistiu na realização de revisão de literatura científica acerca dos aspectos relevantes a serem contemplados em protocolo. Em seguida, esses aspectos foram organizados e propostos aos juízes do estudo (angiologistas, enfermeiros e fisioterapeutas) através de um instrumento de coleta de dados, questionário estruturado do tipo check list. Após as críticas e sugestões, foi feita a validação de conteúdo, com aplicação do Índice Kappa (K) para verificação no nível de concordância e nível de consistência (fidedignidade) dos juízes. Como critério de aceitação foi estabelecido uma concordância superior a 80% entre os juízes, correspondendo a um bom e ótimo nível de concordância. Os dados coletados foram organizados no Excel e exportados para Statistical Package for Social Science (SPSS) 15.0, para cálculo de média e desvio padrão e aplicação do índice Kappa (K), os dados estão apresentados na forma de tabelas, quadros e gráficos. O levantamento da literatura identificou alguns itens importantes para composição do protocolo como: A) Avaliação do paciente e da lesão (AGUIAR et al, 2005; BORGES, 2005; NATAL, 2008), B) Registro e documentação (BORGES, 2005), C) Cuidado com a ferida e a pele perilesional (BORGES, 2005), D) Indicação de cobertura (BORGES, 2005), E) Uso de antibiótico e tratamento da dor (AGUIAR et al, 2005; BORGES, 2005),  F) Tratamento Cirúrgico da IVC (AGUIAR et al., 2005), G) Tratamento medicamentoso (AGUIAR et al, 2005), H) Melhoria do retorno venoso e prevenção de recidiva (BORGES, 2005), I) Encaminhamento dos pacientes (BORGES, 2005), J) Capacitação profissional (BORGES, 2005) e K) Referência e contra-referência (DEODATO, 2007). Quanto ao grau de importância dos itens (A a K) as médias variaram de bom nos aspectos E) Uso de antibiótico e tratamento da dor (4,4), F) Tratamento cirúrgico da IVC (4,2), G) Tratamento medicamentoso (4,1), I) Encaminhamento dos pacientes (4,3) e K) Referência e contra-referência (4,5) a ótimo A) Avaliação do paciente e da lesão (4,9), B) Registro e documentação (4,7), C) Cuidado com a ferida e a pele perilesional (4,9), D) Indicação de cobertura (4,6), H) Melhoria do retorno venoso e prevenção de recidiva (4,8) e J) capacitação profissional (4,9). O apanhado realizado na literatura permitiu a elaboração de diretrizes atuais na assistência a pessoas com úlceras venosas. Além disso, a partir do julgamento dos itens de composição do protocolo pelos juízes pode-se destacar possíveis avanços e retrocessos no tratamento dessas lesões. Após a análise dos dados foi elaborada uma nova proposta de protocolo mantendo os itens com índice Kappa (K) acima de 0,8. Esta nova proposta será encaminhada aos profissionais juízes para implementação e validação na continuidade deste estudo.

5
  • RAMON EVANGELISTA DOS ANJOS PAIVA
  • A busca de sintomáticos respiratórios de tuberculose na prática e perspectiva do Agente Comunitário de Saúde no município de Natal

  • Advisor : RICARDO ALEXANDRE ARCENCIO
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • CLELIA ALBINO SIMPSON
  • JORDANA DE ALMEIDA NOGUEIRA
  • RICARDO ALEXANDRE ARCENCIO
  • Data: Sep 24, 2010


  • Show Abstract
  • O estudo em questão trata da importância da busca do sintomático respiratório de tuberculose na prática e perspectiva do agente comunitário de saúde no município de Natal-RN. Vale ressaltar que uma das prioridades nas políticas de saúde refere-se ao diagnóstico precoce da doença, nas visitas domiciliares dos Agentes Comunitários de Saúde (ACS), em que se espera oportunamente a identificação dos Sintomáticos Respiratórios e a orientação para coleta e a distribuição de pote de escarro pelo ACS, priorizando os comunicantes de casos bacilíferos de TB. Sendo esta ação de suma relevância no controle da TB, pela redução efetiva da carga da doença nas diferentes comunidades. O objetivo da pesquisa é analisar a busca de sintomáticos respiratórios de tuberculose na prática e perspectiva do Agente Comunitário de Saúde no município de Natal. Trata-se de um estudo de corte transversal, sendo realizado inquérito com os ACS do município de Natal/RN. A população do estudo será constituída por ACS do município de Natal/RN, que atuam nas Unidades Básicas de Saúde e Unidades Saúde da Família compondo um universo de aproximadamente 646. A amostragem seguiu a forma probabilística aleatória, estratificada por distritos, para o cálculo do tamanho da amostra de ACS estratificada por distrito, utilizou-se a equação de Bolfarine e Bussab calculou-se um n= 108. O instrumento de coleta de dados consiste do questionário Primary care Assesment Toll, (PCAT). sendo adaptado para atenção à TB por Ruffino-Netto e Villa (2009). O questionário tem como marco teórico os atributos da atenção primária, uma vez que os sistemas de saúde que baseiam-se nestes atributos apresentam-se com melhor desempenho. RESULTADOS: A amostra de ACS foi composta de 87% do sexo feminino. Quanto ao grau de formação se percebeu que 58% concluíram o ensino médio. Em relação ao tempo de exercício da profissão de ACS, tivemos uma média de 120 meses (IC 95% 111,9 – 129,5. Quanto ao local pesquisado, foi verificado que 90% eram USF. A média encontrada de acompanhamento de casos foi de 2 casos de TB desde o início da carreira profissional do ACS e nos últimos três anos essa média se apresenta de 1 caso acompanhado.Os ACS obtiveram índices satisfatórios quanto ao elo de confiança com o usuário, assim como o acesso as suas residências. Possuindo um caráter investigativo na busca por sintomático respiratória (BSR). A recusa por parte do usuário a coleta, também foi exposta como não sendo um obstáculo para esse profissional. O Qual se sente preparado para orientar quanto a coleta de exame. No que refere ao acesso do usuário, a utilização de transporte motorizado para se deslocar à unidade não foi percebido, apenas, um ponto que na percepção dos ACS enfrenta dificuldade é o tempo de atendimento, muitas vezes longo.O ACS ainda colocam que a entrega de solicitação de pedidos é baixa, assim como o acompanhamento dos casos de TB. Todas as unidades possuem um profissional que responde pelo PNCT. O município de Natal se caracterizaram por possuir níveis satisfatórios de potes para a coleta de escarro, no entanto, um ponto que merece atenção por parte dos gestores é o local de acondicionamento do escarro coletado até o momento que o laboratório busque essa amostra ou até a análise da amostra. Quanto aos motivos na percepção do ACS que leva o usuário a recusar a coleta, o medo de confrontamento do resultado foi um dos maiores motivos que levam o usuário a recusar a coleta do escarro, seguido do Alcoolismo. A ausência de catarro também foi verificada como um dos motivos que levam o usuário a recusarem a coleta do exame. Dentre os motivos, no item “outros”, para a refuta da coleta do escarro, o sentimento de vergonha mereceu destaque. Podemos então trazer alguns pontos para serem discuticos, entre eles o elo com o usuário já é discutido na literatura, que para uma melhor efetivação da BSR é necessário que o ACS construa um elo de confiança com usuário, item no qual se conseguiu ser satisfatórios em todos os distritos do município de Natal, mas para esse elo existir, o contato é primordial, logo, a partir do momento que não é possível dialogar com o usuário, não se pode construir essa ligação.
    No que tange a suspeita de TB, todos os ACS responderam que sempre suspeitam de TB quando o usuário apresenta tosse, porém em todos os distritos foram verificados a baixa entrega de solicitações de pedidos de baciloscopia. Em pesquisa de Ignotti et al. (2007) visualizou-se uma diferença de 67% entre ESF e Centro de Referência na solicitação da baciloscopia de escarro no diagnóstico, em que os autores reconhecem a perda da qualidade da atenção à TB, depois da descentralização da atenção à TB para a ESF. Logo, é percebido níveis insatisfatórios de entrega de solicitações de baciloscopia.Analisando os níveis organizacionais, todos os distritos possuem o pote de escarro em níveis satisfatórios, mas isso não é suficiente, Nogueira (2007) refere que apesar de parecer um simples procedimento, a BSR no controle da TB, caracteriza-se na prática como uma ação complexa vai além das habilidades técnicas e o contato com a família rompe com o cartesianismo. BSR é papel do ACS, onde o mesmo realiza as visitas diárias nos domicílios e deve realizar a busca ativa, mas essa busca cabe a todos os profissionais. Na atual pesquisa os ACS se mostraram capacitados para essa busca e esse item foi satisfatório. A descoberta precoce da tuberculose é um dos pilares da cura dos doentes, logo se deve dar o real valor a tal prática. Conclui-se portanto que a busca por sintomáticos respiratórios ainda encontra bastantes empecilhos nos equipamentos de saúde, sendo o ACS é o vetor mais importante nesse processo pela característica do seu processo de trabalho, mas, não é o único ator importante nessa construção, sendo prioridade em seu processo de trabalho a BSR. O município deve fornecer todas as ferramentas necessárias para o fortalecimento da BSR. Essa pesquisa destaca o papel gerencial do enfermeiro, o qual responde pelas ações de controle da TB na grande maioria das unidades investigadas. Então, é necessário que a academia forme profissionais capacitados para funções gerenciais.

6
  • ANGELICA TERESA NASCIMENTO DE MEDEIROS
  • Relações de trabalho da enfermagem no contexto hospitalar a partir das competências profissionais de seus membros. 

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • ABIGAIL MOURA
  • BERTHA CRUZ ENDERS
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Oct 4, 2010


  • Show Abstract
  • O presente estudo faz uma análise das relações de trabalho na equipe de enfermagem a partir das atribuições/competências de seus membros, como contribuição para o entendimento do processo de trabalho em enfermagem. Teve como objetivos identificar as competências dos membros da equipe de enfermagem através da visão de enfermeiros, técnicos e auxiliares de enfermagem, além de tentar detectar estratégias para melhorar a assistência prestada ao paciente. Trata-se de um estudo descritivo e analítico com abordagem qualitativa, fundamentado em princípios teórico-metodológicos do Interacionismo Simbólico. Teve como cenário o local de trabalho dos participantes, sendo este um Hospital Público de Referência para o SUS, localizado no distrito sanitário leste do Município de Natal/RN. Participaram do estudo 19 profissionais de enfermagem, dos quais, 07 eram enfermeiros e 12 eram técnicos de enfermagem. Como procedimento de coleta, utilizou-se de uma entrevista não-estruturada acompanhada de formulário, a qual foi gravada e posteriormente transcrita. Para a análise dos resultados, utilizou-se a análise de conteúdo, a qual fez emergir categorias temáticas relevantes que foram analisadas tendo por base os referenciais teóricos desse estudo, bem como a teoria interacionista. O estudo obedeceu aos preceitos éticos da Resolução nº. 196/96, com parecer favorável do Comitê de Ética e Pesquisa da UFRN. Os resultados obtidos indicam que para os profissionais a Enfermagem é uma profissão, fortemente atrelada ao processo de cuidar e que recentemente vem adquirindo status de ciência. No que se refere às funções do enfermeiro, no processo de trabalho em enfermagem, os profissionais relacionaram as categorias gerenciar/administrar como sendo as principais atividades desenvolvidas por esses profissionais, além da categoria de ensino e da prestação de assistência em cuidados de enfermagem complexos. Com relação às funções dos auxiliares e técnicos de enfermagem, notou-se que na opinião dos profissionais, não existe mais uma distinção entre as atribuições dessas categorias. Os entrevistados foram unânimes em relatar que a esses profissionais está atribuído o cuidado direto ao paciente, através da realização de cuidados de enfermagem mais simples. E por fim, no que tange às relações de trabalho entre os membros da equipe de enfermagem, para a maioria dos entrevistados tais relações são conflituosas, desarmônicas e no geral, não existe união entre as categorias que compõem o processo de trabalho em enfermagem. Diante desses achados considera-se que a importância de se conhecer o significado de enfermagem atribuído por estes profissionais, bem como as suas competências pode servir de base para a identificação dos problemas, cuja a origem pode se localizar nas relações de poder, desvios de funções, distanciamento entre concepção (saber) e execução (fazer) do trabalho, além da perda da globalidade das atividades realizadas no processo de trabalho em enfermagem.

7
  • LUCIANA MELO RIBEIRO ROSSITER PINHEIRO
  • CONHECIMENTO DO ENFERMEIRO SOBRE AS AÇÕES DE VIGILÂNCIA EPIDEMIOLÓGICA NO HOSPITAL UNIVERSITÁRIO ONOFRE LOPES, NATAL, RN.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • JACILEIDE GUIMARAES
  • LETÍCIA FORTES LEGAY
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Oct 7, 2010


  • Show Abstract
  • Trata-se de um estudo descritivo exploratório com abordagem quantitativa, com objetivo de verificar o conhecimento dos enfermeiros sobre as ações de vigilância epidemiológica no Hospital Universitário Onofre Lopes (HUOL), no Município de Natal, Estado do Rio Grande do Norte. O estudo foi desenvolvido com 63 enfermeiros do referido hospital e os dados foram coletados através de um questionário. Todos os dados foram analisados através de estatística descritiva. Os resultados foram organizados e discutidos em quatro seções: conhecimento dos enfermeiros sobre vigilância epidemiológica hospitalar; procedimentos do profissional enfermeiro mediante as doenças de notificação compulsória; dificuldades dos enfermeiros para registrar as doenças de notificação compulsória e as sugestões de estratégias para articular o serviço de vigilância epidemiológica com as práticas assistenciais dos enfermeiros. Os resultados mostram que (55,55%) dos enfermeiros conhecem a principal ação de vigilância epidemiológica, a notificação compulsória de doença, e que (42,86%) notificam ao Núcleo Hospitalar de Epidemiologia, enquanto (57,14%) não destinam as informações para esse serviço. A maior parte dos enfermeiros revela dificuldades para realizar notificação por desconhecerem o fluxo de notificação; pelo serviço de vigilância não funcionar 24 horas e por indefinição diagnóstica das doenças. As sugestões de estratégias para melhorar a qualidade da informação epidemiológica estão voltadas para capacitação do enfermeiro em vigilância epidemiológica hospitalar; trabalho em parceria com o núcleo de vigilância; divulgação das informações sobre vigilância e realização de busca ativa diária. Concluí-se que a maioria dos enfermeiros não notifica ao Núcleo de Vigilância as Doenças de Notificação Compulsória e não se percebe a incorporação dos valores da integralidade entre a VE hospitalar com todos os enfermeiros, posto que este princípio norteia ações dos serviços de saúde fundamentadas no diálogo, na escuta, no comprometimento ético, compartilhamento de saberes entre os profissionais dos diversos serviços e respeito quanto ao trabalho do outro profissional. Assim, a lacuna da integralidade nas ações dos enfermeiros estudados, bem como no serviço de VE não mobiliza o potencial desses serviços para mudanças, no sentido de realização de práticas voltadas para um modelo de atenção integral que articula ações preventivas e curativas, proposto e desejado pelo SUS. Mediante as dificuldades apresentadas torna-se importante recomendar processos educativos com estratégia de transformação das práticas, além de proposta de ações à luz do princípio da integralidade possibilitando respostas ágeis e efetivas, conforme propósito da VE hospitalar mediante as urgências e emergências epidemiológicas atuais.
    Palavras

8
  • ALINE CRISTIANE DE MOURA MATIAS
  • O CLIMA ORGANIZACIONAL E A SATISFAÇÃO LABORAL: uma realidade dos Núcleos Hospitalares de Epidemiologia de Natal/RN

    

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • JACILEIDE GUIMARAES
  • REJANE MARIA PAIVA DE MENEZES
  • LETÍCIA FORTES LEGAY
  • Data: Oct 8, 2010


  • Show Abstract
  • O Núcleo Hospitalar de Epidemiologia (NHE) constitui em uma organização que apresenta um clima organizacional específico, o qual contribui para o nível de satisfação laboral dos profissionais que nele atuam. Este estudo consiste em um trabalho descritivo, com abordagem quantitativa, que teve por objetivo identificar a relação entre o clima organizacional nos NHE regulamentados na Cidade do Natal/RN e a satisfação laboral dos profissionais que neles trabalham, sob a perspectiva dos aportes teóricos acerca do Desenvolvimento Organizacional. A pesquisa foi desenvolvida em 13 hospitais com características mantenedoras diversas, 9 públicos, 3 filantrópicos e 1 privado. Os dados foram coletados, através do instrumento “Organização hospitalar: aspectos inerentes ao clima e a satisfação laboral”, junto a 33 profissionais nomeados e atuantes nos NHE. O estudo recebeu parecer favorável dos Comitês de Ética em Pesquisa do Hospital de Pediatria Professor Heriberto Ferreira Bezerra, da Liga Norte Riograndense Contra o Câncer e da Universidade Federal do Rio Grande do Norte. Os dados obtidos foram organizados e tratados com estatística descritiva simples. Constatou-se que dos 33 pesquisados, 93,9% eram do sexo feminino, tinham uma média de 40 anos de idade, com um tempo de atuação entre 1 e 2 anos (84,9%). Além disso, 45,5% dos profissionais do setor eram enfermeiros. Identificou-se que os profissionais que atuam no NHE percebem e vivenciam o seu ambiente de trabalho como uma estrutura organizacional em desenvolvimento. Verificou-se que, com exceção dos aspectos “vida profissional”, “nível sócio-cultural” e “cultura organizacional, os demais fatores internos e externos ao NHE não apresentam forte expressão na conformação de um clima organizacional favorável ao desenvolvimento do setor. Constatou-se que 70% dos participantes percebem o clima organizacional como favorável ao progresso do setor. Com relação ao nível de satisfação laboral, os respondentes sentem-se bastante satisfeitos com a estrutura organizacional. Portanto, os resultados desta pesquisa são sugestivos de que existe algum fator que esteja de sobremaneira contribuindo para que o clima organizacional saudável do setor estimule os membros das equipes do NHE a apresentarem comportamentos que os identificam como atores comprometidos e satisfeitos com o trabalho desenvolvido, mesmo diante de todas os entraves para realização da Vigilância Epidemiológica. Com isso, sugere-se a realização de estudos que busquem verificar de que forma a cultura organizacional, enquanto fator interno expressivo, influencia o estabelecimento do clima organizacional do NHE e, por conseguinte, o nível de satisfação laboral e bem-estar individual dos membros de sua equipe.

9
  • ARIELI RODRIGUES NÓBREGA
  • TRAJETÓRIA DE VIDA DE EX-PORTADORES DE HANSENÍASE COM HISTÓRICO ASILAR

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • REJANE MILLIONS VIANA MENESES
  • LENILDE DUARTE DE SÁ
  • Data: Oct 22, 2010


  • Show Abstract
  •  

    RESUMO

     

    A hanseníase, apesar dos significativos avanços no que concerne seu diagnóstico, controle e tratamento, ainda hoje apresenta uma carga incomensurável de estigma em conseqüência, principalmente, da construção sócio-histórica marcada pelo preconceito e o isolamento dos doentes, traduzidos pelo sofrimento, abandono e problemas psicossociais. Destarte, o estudo objetivou resgatar a trajetória de vida de ex-portadores de hanseníase com histórico asilar; recuperar as histórias da trajetória de vida desses ex-portadores e, identificar os fatores comuns a essas histórias de vida. Trata-se de um estudo exploratório-descritivo, com abordagem qualitativa, utilizando-se como referencial metodológico a história oral de vida. A colônia do estudo escolhida através de uma amostragem não-probabilística por bola de neve foi formada por doze ex-portadores de hanseníase que foram asilados no Hospital Colônia São Francisco de Assis, locado no município de Natal (RN). A rede foi composta por colaboradores independentes do sexo e sem idade limite máximo, que viveram no Hospital Colônia por um período mínimo de seis meses e, que concordarem em participar livremente do estudo. Foram excluídos da rede colaboradores portadores de necessidades físicas (audição) ou mentais e, que não concordarem em participar do estudo. Como instrumento de coleta de dados utilizou-se uma entrevista semi-estruturada, gravada individualmente em contexto domiciliar dos colaboradores, residentes nos bairros Felipe Camarão, Km 6 e Jardim Américo, mais precisamente no Conjunto Nova Vida, todos situados no referido município. Os dados foram analisados segundo a técnica de análise temática de conteúdo proposta por Bardin. Vale ressaltar que o estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte sob parecer de nº 016/2010. Após sucessivas e cuidadosas leituras das histórias de vida foram identificados cinco eixos temáticos norteadores da análise dos dados, quais sejam, preconceito, crise, exclusão social, estigma e paradoxo. Dessa forma, percebe-se que a prática do confinamento compulsório dos enfermos em instituições asilares concomitante a imagem mítica do leproso como ser repulsivo e deformado, contribuiu para solidificação histórica do estigma em torno da doença e do doente, despertando na sociedade e na família atitudes e sentimentos de exclusão, preconceito e medo. Ademais, observa-se nas histórias de vidas dos colaboradores relatos marcantes de sofrimento, rejeição, revolta e, crises existenciais que repercutem até os dias atuais, interferindo negativamente a reintegração social e familiar desses indivíduos. Com isso, vê-se a necessidade dos gestores e profissionais locais da saúde repensarem as estratégias de reabilitação social do doente e ex-doente de hanseníase visando à supressão de uma estigmatização injusta e nociva enraizada na imagem e história de vida desses indivíduos.

10
  • MARIA NEYRIAN DE FATIMA FERNANDES
  • Representações sociais do cuidado transcultural para enfermeiros da saúde indígena

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • ANTONIA OLIVEIRA SILVA
  • BERTHA CRUZ ENDERS
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • Data: Oct 26, 2010


  • Show Abstract
  • A realização deste estudo surgiu a partir da experiência como enfermeira na saúde indígena, ao observar que muitos profissionais oriundos das mais diversas regiões do Brasil optam por esta área de atuação. Era notória a dificuldade que o enfermeiro tinha em fixar-se por muito tempo em um único local de serviço. Provavelmente porque o cuidado de saúde na área indígena acontece a partir de um confronto de culturas diversas, pois traz o profissional, de um lado, com todo o seu conhecimento acadêmico e cultura própria e, do outro lado, o índio com seus ritos, usos e costumes peculiares. Neste contexto, o enfermeiro deve definir e negociar a realidade através de representações simbólicas da vida, para em seguida questionar a nova realidade. Este estudo busca apreender as representações sociais sobre a saúde indígena para os profissionais enfermeiros. Conhecer as representações sociais dos enfermeiros inseridos na atenção a saúde indígena, é importante para evitar possíveis conflitos, choques, dificuldades e incongruência da assistência nesse contexto. Trata-se de um estudo descritivo e analítico que visa apreender as representações sociais do cuidado transcultural na saúde indígena para profissionais enfermeiros. A coleta de dados foi realizada através de entrevista não-estruturada guiada por um roteiro contendo quatro perguntas e elaboração de um desenho que fosse relacionado ao cuidado do enfermeiro na saúde indígena. A pesquisa contou com a participação voluntária de 17 enfermeiros do Distrito Sanitário Indígena de Manaus, no estado do Amazonas. Para o tratamento dos dados foi utilizada a Técnica de Análise do Discurso do Sujeito Coletivo, sendo os resultados apresentados em três momentos: caracterização dos participantes do estudo; discussão dos eixos temáticos predominantes nos discursos; representação social do cuidado de enfermagem através de infográficos. A análise revelou que o cuidado na saúde indígena é desafiador porque o indígena e seu mundo são percebidos e processados de acordo com a lente cultural dos enfermeiros, levando ao surgimento de alguns estranhamentos e dificuldades de adaptação, principalmente nos primeiros contatos. O trabalho de representar é essencial em atenuar as estranhezas iniciais e ajudar o enfermeiro a situar-se melhor no novo universo.  Contudo, insatisfação salarial, preconceitos, condições precárias de trabalho e o despreparo para atuar com os povos indígenas interferem na prestação do cuidado. Reconhece-se que a assimilação, a compreensão do sistema de saúde indígena e o uso dos conhecimentos dessas práticas são elementos essenciais para o desenvolvimento de estratégias que podem melhorar o acesso e a qualidade do cuidado aos povos indígenas. Ressalta-se a necessidade urgente do preparo e treinamento desses profissionais para uma atuação mais eficaz com os povos indígenas.

11
  • TARCIANA SAMPAIO COSTA
  • AÇÕES DOS AGENTES COMUNITÁRIOS DE SAÚDE DIANTE DO USUÁRIO DA ESTRATÉGIA SAÚDE DA FAMÍLIA COM ESTADOS DEPRESSIVOS NO MUNICÍPIO DE ABAIARA-CE-BR

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • FRANCISCA LUCÉLIA RIBEIRO DE FARIAS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • Data: Oct 26, 2010


  • Show Abstract
  • A assistência pública a saúde brasileira perpassa por duas Reformas, a Sanitária e a Psiquiátrica. Ambas estão permeadas pela visão holística do ser, garantindo assistência nos três níveis: primária, secundária e terciária. Neste sentido, a assistência a saúde mental deve ser prestada desde os cuidados preventivos até os que exigem maior aparato tecnológico e conseqüente investimento financeiro, prevalecendo, outrossim, a prevenção e socialização do portador, bem como a desistitucionalização deste. Destaca-se, pois, que se observa lacunas na prestação deste serviço e programas como o Programa de Agentes Comunitários de Saúde (PACS)/ Estratégia Saúde da Família (ESF), além de ampliarem a cobertura de serviços, têm possibilitado reorientações do sistema no sentido da integralidade, universalização e eqüidade. Contudo, nem sempre a Atenção Básica apresenta condições para dar conta a sua articulação com a saúde mental. Neste sentido, a intervenção conjunta da equipe em saúde mental e a ESF pode oferecer diversos benefícios à população, pois proporcionam além da assistência e acompanhamento aos portadores de transtorno mental, orientações para prevenir tais transtornos e, dessa forma, obtém resultados significativos, inclusive em casos de depressão, abrangendo a saúde mental em seu contexto ampliado, e neste, vislumbra-se resultados ainda maiores. Para tanto, pretende-se avaliar relatos dos agentes comunitários de saúde sobre atenção em saúde mental a partir de queixas de estados depressivos em um Município de pequeno porte. Este estudo será do tipo quanti-qualitativo e realizar-se-á no município de Abaiara-CE, onde aplicar-se-á entrevistas com os agentes comunitários de saúde e usuários cadastrados na Estratégia Saúde da Família do referido local, previsto para os meses de março e abril de 2010.

12
  • RAIONARA CRISTINA DE ARAUJO SANTOS
  • Transito de Saberes na saúde da Familia e no programa de educação pelo trabalho e para a saúde: estudo representacional

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • CLELIA ALBINO SIMPSON
  • MARIA TERESA CICERO LAGANA
  • ANTONIA REGINA FERREIRA FUREGATO
  • Data: Oct 27, 2010


  • Show Abstract
  • A Estratégia de Saúde da Família (ESF) emerge como uma possibilidade de reestruturação dos serviços e de novas práticas de intervenção na atenção à saúde, requerendo profissionais capacitados para atuarem nesse âmbito. Para tal, foi instituído o Programa de Educação pelo Trabalho e para a Saúde (PET-Saúde), visando integrar ações ensino-serviço, tomando como foco a ESF. Com base nisso, definiu-se como objetivo desse trabalho apreender a representação social do enfermeiro, médico e odontólogo (preceptores do projeto PET-Saúde Natal – RN) sobre a ESF, enquanto campo de prática dos mesmos. Estudo descritivo-exploratório, de abordagem qualitativa, realizado nas 11 Unidades de Saúde da Família (USF) que integram o PET-Saúde Natal (RN). A população era composta por 49 profissionais que compunham as equipes básicas de nível superior das USFs vinculadas ao referido projeto. A amostra consistiu em 05 enfermeiros, 05 médicos e 05 odontólogos, perfazendo um total de 15 sujeitos. Os dados foram coletados através de três instrumentos: o desenho-estória com tema, a entrevista individual semi-estruturada e o diário de campo. Os dados referentes à identificação dos sujeitos foram digitados e tabulados pelo software Microsoft Excel versão 2007. A análise e interpretação dos desenhos deram-se pela significação atribuída ao recurso gráfico a partir do título e das palavras evocadas pelos sujeitos, tendo como termo indutor a palavra ESF. As estórias e entrevistas transcritas e digitadas foram submetidas à leitura/escuta flutuante do material e, posteriormente, à análise léxica do ALCESTE. Terminado o processo de submissão do ALCESTE o material discursivo foi analisado e discutido mediante o recurso técnico-metodológico da Teoria das Representações Sociais e da Teoria do Núcleo Central. A maioria dos profissionais eram do gênero feminino, com idade entre 46 e 52 anos, casados, com renda mínima de 6 salários mínimos, tempo de formado variando entre 22 a 29 anos e tempo de trabalho na ESF variando de 7 a 11 anos. A partir do sistema de classificação do ALCESTE foram elegidas as categorias identificadas por: Categoria 1 – ESF: relações e território; Categoria 2 – Formação e desenho do vínculo; Categoria 3 – Processos de trabalho na ESF; Categoria 4 – Articulação ensino-serviço; Categoria 5 – Atenção à saúde e prevenção de doenças. Nesse sentido, infere-se que a ESF consiste num ambiente rico em diversidades, experiências e relações, que possui diversas potencialidades tais como o estabelecimento de vínculo entre profissional-comunidade, o conhecimento, por parte daquele, do seu território de atuação e práticas de trabalho em equipe, mas que também apresenta algumas fragilidades como precárias condições de trabalho, falta de participação popular e de apoio da gestão. Com isso, ressalta-se a importância da formação de profissionais aptos para a atuação em tal estratégia, destacando-se, para isso, o projeto PET-Saúde cuja importância reside na integração ensino-serviço-comunidade, proporcionando a formação de um novo profissional, com habilidades e competências para desenvolver um bom trabalho junto ao indivíduo-família-comunidade.

13
  • RAFAELLA LEITE FERNANDES
  •  

     

    A PALAVRA CANTADA NOS ESPAÇOS INTERSUBJETIVOS DO CENTRO DE ATENÇÃO PSISOSSOCIAL

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • CLELIA ALBINO SIMPSON
  • JACILEIDE GUIMARAES
  • ANTONIA REGINA FERREIRA FUREGATO
  • Data: Oct 28, 2010


  • Show Abstract
  •  

     

     

    O cuidado em psiquiatria ao longo da história vem passando por constantes mudanças. A Reforma Psiquiátrica Brasileira, baseada nos moldes da desinstitucionalização, tem como um dos principais serviços substitutivos dos hospitais psiquiátricos, os CAPS, Centros de Atenção Psicossocial, que destina suas terapia a partir de um projeto terapêutico a fim de restituir a autonomia e resgatar a dignidade dos usuários. Para isso utiliza de várias modalidades terapêuticas, dentre elas as oficinas terapêuticas que trabalham a escrita, a arte, música, poesia, dentre outros. Este estudo teve como objetivo apreender as contribuições da oficina de música desenvolvida no CAPS II Oeste do município de Natal/RN, a partir dos relatos dos participantes da oficina, por meio da técnica de grupo focal. É um trabalho descritivo exploratório com abordagem qualitativa. O material discursivo proveniente das oficinas foi transcrito e submetido ao recurso informacional do ALCESTE (Analyse Lexicale par Contexte d’um Ensemble de Segments de Texte) e analisado com base na Teoria das Representações Sociais e na Teoria do Núcleo Central. Participaram da pesquisa um total de 16 usuários, onde durante quatro oficinas de música sob a supervisão da pesquisadora, relataram os sentimentos e sensações evocados de cada momento. A partir do sistema de classificação do ALCESTE foram elegidas categorias identificadas por: Categoria 1 – Experiência da Palavra Cantada na Família; Categoria 2 – Experiências e Aproximações Musicais; e Categoria 3 – Sentimentos e emoções evocados pela música.

14
  • WERUSKA ALCOFORADO COSTA
  • AVALIAÇÃO DA DOR ONCOLÓGICA: ESTUDO COMPARATIVO EM PACIENTES INTERNADOS EM UM HOSPITAL DE REFERÊNCIA EM NATAL/RN

  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • MARIA MIRIAM LIMA DA NÓBREGA
  • RAIMUNDA MEDEIROS GERMANO
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: Nov 4, 2010


  • Show Abstract
  •  

    Trata-se de um estudo de caráter quase experimental, com dados prospectivos, comparativo e abordagem quantitativa, com os objetivos de identificar a efetividade do instrumento unidimensional (Escala de Estimativa Numérica) e o multidimensional (Questionário para dor de McGill) utilizados simultaneamente para avaliar um grupo de pacientes com dor oncológica (Grupo Experimental); identificar a efetividade do instrumento unidimensional (Escala de Estimativa Numérica) para avaliar um grupo de pacientes com dor oncológica (Grupo Controle); identificar a resolutividade da dor de acordo com a medicação prescrita, considerando o resultado das escalas de avaliação, e compará-la entre os dois grupos de pacientes estudados. Acredita-se que este estudo poderá contribuir para subsidiar a prática dos profissionais envolvidos na prestação dos cuidados ao paciente oncológico. Espera-se também que o estudo sobre o câncer nas suas várias esferas, possa ser introduzido no ensino da graduação em enfermagem, despertando assim, tanto o interesse dos futuros profissionais para essa abordagem como sobre o conhecimento da avaliação da dor nesses pacientes. Como resultado desse conhecimento sobre o cuidar, o paciente tenha melhor qualidade de vida e ou uma morte com dignidade.

15
  • EUNICE FERNANDES DA SILVA
  • VALORIZAÇÃO DO SERVIDOR NO PROGRAMA NACIONAL DE HUMANIZAÇÃO:

    Estudo em um Hospital Universitário

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • JACILEIDE GUIMARAES
  • LENILDE DUARTE DE SÁ
  • LORE FORTES
  • SORAYA MARIA DE MEDEIROS
  • Data: Nov 5, 2010


  • Show Abstract
  • A Política Nacional de Humanização compreende que a humanização envolve a valorização dos diferentes sujeitos implicados no processo de produção de saúde que são:  usuários, trabalhadores e gestores.  Sendo esta política norteada por valores de autonomia e o protagonismo dos sujeitos, a co-responsabilidade entre eles, o estabelecimento de vínculos solidários e a participação coletiva no processo de gestão (PNH, 2004).

    Como objetivo do trabalho: analisar as possibilidades e desafios da valorização dos servidores de saúde de acordo com a Política Nacional de Humanização, no hospital de Pediatria da Universidade Federal do Rio Grande do Norte (UFRN).  

16
  • FATIMA HARYANNY GOMES RUFINO
  •  

    Avaliação da dor pós-operatória: análise em pacientes submetidos a cirurgias abdominais em um hospital universitário de Natal/RN

     

    Trata-se de um estudo do tipo exploratório descritivo, com abordagem quantitativa. Os objetivos são avaliar a dor dos pacientes submetidos a cirurgias abdominais de um hospital universitário com vistas à: identificar a localização e a intensidade dolorosa mensurada pela Escala de Estimativa Numérica, analisar a dor nas dimensões sensorial-discriminativa, motivacional-afetiva e a cognitivo-avaliativa, utilizando o Questionário para dor McGill no pós-operatório de pacientes submetidos a cirurgias abdominais, relacionar o processo álgico com a idade, sexo, religião, diagnóstico e tipo de cirurgia e identificar a efetividade da medicação utilizada no alívio da dor pós-operatória. Acredita-se que este estudo poderá contribuir para subsidiar a prática dos profissionais envolvidos na prestação dos cuidados ao paciente com dor pós-operatória. Espera-se que os resultados possam ser introduzidos no ensino da graduação em enfermagem, despertando o interesse dos futuros profissionais para o tema, e dessa forma, esse conhecimento sobre o cuidar, refletirá numa melhor qualidade de vida e menor sofrimento dos pacientes.

  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • MARIA MIRIAM LIMA DA NÓBREGA
  • RAIMUNDA MEDEIROS GERMANO
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: Nov 5, 2010


  • Show Abstract
  • Trata-se de um estudo do tipo exploratório descritivo, com abordagem quantitativa. Os objetivos são avaliar a dor dos pacientes submetidos a cirurgias abdominais de um hospital universitário com vistas à: identificar a localização e a intensidade dolorosa mensurada pela Escala de Estimativa Numérica, analisar a dor nas dimensões sensorial-discriminativa, motivacional-afetiva e a cognitivo-avaliativa, utilizando o Questionário para dor McGill no pós-operatório de pacientes submetidos a cirurgias abdominais, relacionar o processo álgico com a idade, sexo, religião, diagnóstico e tipo de cirurgia e identificar a efetividade da medicação utilizada no alívio da dor pós-operatória. Acredita-se que este estudo poderá contribuir para subsidiar a prática dos profissionais envolvidos na prestação dos cuidados ao paciente com dor pós-operatória. Espera-se que os resultados possam ser introduzidos no ensino da graduação em enfermagem, despertando o interesse dos futuros profissionais para o tema, e dessa forma, esse conhecimento sobre o cuidar, refletirá numa melhor qualidade de vida e menor sofrimento dos pacientes.

17
  • DIEGO BONFADA
  • SERVIÇO DE ATENDIMENTO MÓVEL DE URGÊNCIA (SAMU) E A ASSISTÊNCIA ÀS URGÊNCIAS PSIQUIÁTRICAS

  • Advisor : JACILEIDE GUIMARAES
  • COMMITTEE MEMBERS :
  • JACILEIDE GUIMARAES
  • SORAYA MARIA DE MEDEIROS
  • MAURICIO ROBERTO CAMPELO DE MACEDO
  • MARCELO KIMATI DIAS
  • Data: Nov 8, 2010


  • Show Abstract
  • O objetivo desse trabalho, caracterizado como uma pesquisa aplicada, de abordagem qualitativa, exploratória e do tipo estudo de caso, foi analisar as concepções e práticas dos profissionais de saúde do SAMU de Natal-RN sobre o atendimento às urgências psiquiátricas. As informações foram coletadas entre os meses de março e abril de 2010, por meio de entrevistas semi-estruturadas realizadas com 24 profissionais de saúde lotados no SAMU-Natal e da utilização da técnica da observação direta, feita na sala de regulação médica da instituição. Tanto o número de profissionais participantes nas entrevistas quanto o tempo de realização das observações foram determinados pelo método da saturação na coleta de informações em pesquisas qualitativas. As entrevistas e observações foram transcritas e submetidas à técnica da análise de conteúdo, mais especificamente, da análise temática, o que possibilitou o alcance de níveis mais profundos, que ultrapassaram o que foi simplesmente manifesto nas falas, atingindo a relação entre as categorias e estruturas sociais do problema de pesquisa. Diante disso, foram construídas três categorias de análise, a saber: concepções e conceitos de urgência psiquiátrica dos profissionais de saúde do SAMU–Natal; a assistência às urgências psiquiátricas no SAMU-Natal; e a Reforma Psiquiátrica brasileira sob o olhar dos profissionais de saúde do SAMU de Natal-RN. A reflexão sobre as informações analisadas revelaram discussões a respeito do estigma e preconceito sobre a doença mental, bem como, apontaram para alguns entraves que prejudicam a assistência ao sujeito em sofrimento mental no SAMU-Natal. As concepções sobre o sujeito em crise psíquica dos profissionais de saúde entrevistados envolvem os conceitos de imprevisibilidade, agressividade e do risco, elementos estigmatizantes e historicamente associados à ideologia da periculosidade social e necessidade de segregação do doente mental. O predomínio dessas concepções, no discurso dos profissionais de saúde, tem reflexos identificáveis na assistência prestada pelo SAMU-Natal às demandas psiquiátricas, na qual se destacam: a solicitação indiscriminada da polícia militar durante as intervenções em crise psíquica, a negligência com as ocorrências que envolvem pacientes de saúde mental, bem como, a prática assistencial repetitiva e direcionada à contenção física, medicação e ao transporte para hospital psiquiátrico. Associado a isso, os profissionais demonstraram compreensões deturpadas e reducionistas da Reforma Psiquiátrica brasileira e, em sua maioria, não deram credibilidade ao atual modelo de atenção à saúde mental pautado no tratamento psicossocial, remetendo suas falas à necessidade de internamento dos pacientes psiquiátricos. Nesse sentido, percebemos que o modelo hospitalocêntrico e excludente concebido pela psiquiatria clássica ainda permanece vivo no ideário desses profissionais como referência para a assistência às urgências psiquiátricas. Portanto, a pesquisa revelou uma série de elementos que nos fazem pensar a respeito dos desafios que o setor saúde e a sociedade ainda precisam enfrentar para concretizar os princípios e diretrizes da Reforma Psiquiátrica brasileira.

18
  • RAFAELA COSTA DE MEDEIROS
  • ACIDENTES DE TRABALHO: ANÁLISE EM PROFISSIONAIS DE ENFERMAGEM QUE ATUAM NAS UNIDADES DE TERAPIA INTENSIVA E URGÊNCIA-NATAL/RN.

     

  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • JACILEIDE GUIMARAES
  • MARIA ALVES BARBOSA
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Nov 8, 2010


  • Show Abstract
  •  

    Trata-se de um estudo do tipo descritivo-exploratório com abordagem quantitativa, com os objetivos de caracterizar os Acidentes de Trabalho, sofridos pelos profissionais da equipe de enfermagem, nas Unidades de Terapia Intensiva e de Urgência e Emergência em Hospital de referência-Natal/RN; identificar os fatores que contribuem para os acidentes de trabalho, sofridos pelos profissionais da equipe de enfermagem; identificar o conhecimento dos profissionais da saúde com relação aos riscos para os acidentes de trabalho e conhecer os procedimento adotados após cada acidente de trabalho. Acredita-se que este estudo poderá contribuir para a caracterização da demanda de acidentes de trabalho da equipe de enfermagem em um Hospital público de Natal, bem como contribuir no apoio à formulação e implementação de medidas de proteção e promoção e prevenção da saúde dos trabalhadores de enfermagem.

19
  • FABIANE ROCHA BOTARELI
  • O CONHECIMENTO DO ENFERMEIRO SOBRE O PROCESSO DE CUIDAR A VITIMA DE TRAUMATISMO CRANIOENCEFALICO

  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • RAIMUNDA MEDEIROS GERMANO
  • MARIA ALVES BARBOSA
  • Data: Nov 9, 2010


  • Show Abstract
  • T

    Introdução: o crescimento das causas externas (CEs), nos quais incluem-se os acidentes e violências, tornaram-se um problema de Saúde Pública dada a alta demanda nos serviços de saúde, comprometendo a qualidade de vida das vítimas e seus familiares e resultando em possibilidade de sequelas, muitas delas irreversíveis (MARTINS; ANDRADE, 2005; MELLO-JORGE; LAURENTTI, 1997). Nos Brasil, estes eventos configuram-se em índices elevados de vítimas fatais, assim como grande número de incapacitados para o exercício de qualquer atividade (DENATRAN, 2002). Das CEs, os acidentes de trânsito (ATs) tem sido a principal causa de morte e ocupando a terceira causa geral de morte no Brasil (BRASIL, 2007). Com relação à caracterização das vítimas de ATs, estas apresentam lesões únicas ou múltiplas, que variam de intensidade e localização corpórea. Quando gravemente feridos, estes indivíduos caracterizam-se como politraumatizados, destacando o traumatismo cranioencefálico (TCE) como a lesão mais freqüente e principal causa de morte nestes eventos (KOIZUMI, 2000). Neste contexto, o TCE constitui fator agravante e incerto de recuperação dada à vulnerabilidade e capacidade limitada de reabilitação do sistema nervoso central. Sendo assim, as vítimas podem apresentar deficiências e incapacidades temporárias ou permanentes, interferindo na capacidade do indivíduo em desempenhar suas funções (HORA; SOUZA, 2005). Nesta perspectiva, a gravidade da lesão é determinada nas primeiras horas após o trauma, sendo de extrema importância a avaliação da gravidade do trauma de forma rápida e precisa e a condução adequada de manobras para a manutenção da vida da vítima no local do evento, com continuidade no âmbito hospitalar (PALVELQUEIRES et al., 1997). Sendo assim, torna-se imprescindível, na condição de profissionais dos serviços de urgência pré e intra-hospitalar, o conhecimento da avaliação da gravidade do trauma, bem como do processo de cuidar a estas vítimas, de forma a minimizar as sequelas e promover a reabilitação. Com esta pesquisa, esperamos que ao identificar o conhecimento do enfermeiro sobre o processo de cuidar ao paciente com TCE e a utilização da Escala de Coma de Glasgow (ECGl), possamos contribuir na melhoria da qualidade da assistência à vítima e seus familiares, minimizar esses agravos e suas consequências. Objetivos: identificar o conhecimento do enfermeiro acerca do processo de cuidar do paciente vítima de TCE nas fases pré-hospitalar e hospitalar e verificar o conhecimento do enfermeiro sobre a utilização da ECGI e sua importância para avaliar a gravidade do TCE e o nível de consciência dessas vítimas. Metodologia: trata-se de um estudo descritivo, exploratório, de abordagem quantitativa. A pesquisa será desenvolvida no Complexo Hospital Walfredo Gurgel, com 44 enfermeiros que atuam nos setores de reanimação, politrauma, neurologia, observação clínica, centro de recuperação operatória, unidade de terapia intensiva e semi-intensiva adulto e unidade de terapia intensiva pediátrica. Será utilizado um instrumento do tipo questionário com dados sobre a caracterização sócio-demográfica, formação profissional, informações sobre a utilização da Escala de Coma de Glasgow e ações desenvolvidas nas fases pré-hospitalar e hospitalar de acordo com sequência de prioridade no processo de cuidar dos pacientes com TCE. Considerações: Pelo fato dos agravos ocasionados pelo TCE poderem ser minimizados por um atendimento baseado no conhecimento teórico e experiência prática, espera-se com este estudo uma aproximação da realidade do nível de conhecimento do enfermeiro sobre o processo de cuidar a essas vítimas.  Desta forma, os dados obtidos fornecerão estratégias de educação continuada para atuação desses profissionais, baseando-se na importância do conhecimento teórico e prático deste processo, a fim de minimizar as iatrogenias, prestar assistência de qualidade e favorecer a recuperação e reabilitação desses pacientes.

20
  • NEYSE PATRÍCIA DO NASCIMENTO MENDES
  • CONHECIMENTO DOS ENFERMEIROS DO HUOL SOBRE SISTEMATIZAÇÃO DA ASSISTÊNCIA DE ENFERMAGEM

  • Advisor : FRANCIS SOLANGE VIEIRA TOURINHO
  • COMMITTEE MEMBERS :
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • ANA LUISA BRANDAO DE CARVALHO LIRA
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • MARIA MIRIAM LIMA DA NÓBREGA
  • Data: Nov 19, 2010


  • Show Abstract
  • A enfermagem como categoria profissional segue em busca da qualidade de sua assistência através de novos modelos de trabalho, procurando romper com posturas de ações fragmentadas. Para mudança de práticas profissionais, faz-se necessário a construção de conhecimento próprio com base na Sistematização da Assistência de Enfermagem. O objetivo do estudo foi analisar a influencia do conhecimento dos enfermeiros sobre sistematização da assistência de Enfermagem no Hospital Universitário Natal-RN. O estudo descritivo analítico, foi realizado no  Hospital Universitário Onofre Lopes (HUOL), Natal–RN,2010, a amostra foi composta de 40 enfermeiros ativos que trabalham nas unidades de internação do hospital, os critérios de inclusão foram estar na escala mensal dos setores escolhidos e concordar em fazer parte do estudo. Foi utilizado um instrumento de observação não participante e outro de entrevista para a coleta de dados, o tratamento estatístico foi descritivo e inferencial com teste de confiabilidade, teste de Pearson, qui-quadrado e Fischer, as variáveis que se correlacionaram foram analisadas segundo um modelo de regressão logística múltipla, calculando razão de chance (odds ratio). Os resultados encontrados foram: predominância de profissionais do sexo feminino (90%), idade predominante no intervalo de 39 a 46 anos (37.5%), enfermeiros que concluíram curso de graduação na Universidade Federal do Rio Grande do Norte (80%), e que possuem especialização como formação mínima (62.5%). Entre os pesquisados o conhecimento demonstrou significância em relação tempo de formação (p=0,018) e tempo  de trabalha no HUOL (p=0,036). A maioria dos profissionais investigados não sabe qual o órgão responsável pela legislação da SAE (52.5%), tem conhecimento dos passos necessários para a construção do diagnóstico de enfermagem (92,5%), compreendem as características do planejamento de enfermagem (90%,), Entretanto os mesmos profissionais não realizam exame físico nos pacientes (50.0%), não classificam os achados clínicos (68.4%), e identificam os problemas encontrados como classificação (13.2%). O planejamento da assistência de enfermagem é realizado por ordem verbal dos enfermeiros (82.5%), 41% dos profissionais realizam avaliação de apenas da etapa de intervenção, ou seja, das ações executadas. Referente à aplicação prática da evolução de enfermagem 53% dos enfermeiros não realizam evolução, 30.8% faz de maneira incompleta, os demais realizam anotações (p=0,003). Os enfermeiros conhecem o processo de enfermagem (90% de adequação nas respostas), não obstante as ações definidas pela teoria não são aplicadas na prática. Os investigados acreditam que a condição de hospital escola (22.5%) possa interferir positivamente na implantação da SAE, associados ao interesse dos profissionais (20%). Dos entrevistados, 17.5% aceitam como verdade a inexistência de facilidades que auxiliem na implantação da SAE no hospital. Conclui-se que os enfermeiros conhecem a teoria que embasa a SAE e o processo de enfermagem, no entanto não desenvolvem a assistência conforme conhecem, assim, há necessidade de ações que impulsione a implantação da SAE como prática dos enfermeiros no hospital investigado.

     

21
  • LORRAINY DA CRUZ SOLANO
  • O corpo como matriz pedagógica.

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • RAIMUNDA MEDEIROS GERMANO
  • JACILEIDE GUIMARAES
  • SORAYA MARIA DE MEDEIROS
  • AILTON SIQUEIRA DE SOUSA FONSECA
  • Data: Dec 1, 2010


  • Show Abstract
  • A conjuntura contemporânea alicerçada no saber capitalístico conflui para a
    inconsciência corporal que nos faz ver, sentir, saborear, ouvir, ser em/aos pedaços.
    A razão descorporificada legitima e legisla modos de ser e de viver socialmente e
    tem como desdobramento a desumanização das relações humanas, causando dor e
    sofrimento. O objetivo deste trabalho é discutir o corpo como matriz pedagógica
    mediante elementos imagísticos/artísticos: música, pintura e literatura. As metáforas
    levam a um auto conhecimento da subjetividade humana e nos aproxima do
    caleidoscópio do saber sensível e possibilitam aprender a aprender com as infinitas
    combinações de imagens, conhecimentos, sentimentos e visões de mundo. A
    música Memória da Pele vem na voz de Maria Betânia falar das lembranças que não
    são minhas, mas estão em mim tatuadas na memória da pele, cantando as
    recordações de um amor vivido de quem tenta esquecer racionalmente, mas que o
    corpo teima em lembrar. É uma senha para pensar no que somos. O conto de
    Clarice Lispector, intitulado Miss Algrave, narra a história de vida de uma mulher
    solteira e virgem, e seu encontro com um extraterrestre chamado Ixtlan. Até então,
    ela que vivia como se todos os dias fossem uma segunda-feira, se viu seduzida pelo
    prazer em ter um corpo em contato com outro corpo, o que lhe permitiu também dar
    visibilidade aos corpos dos outros. Tinha repúdio pela imoralidade que os corpos dos
    outros e o seu transpiravam. A descoberta do corpo traz lições importantes para a
    enfermagem, envolvendo o nosso e os outros corpos. A tela cama voadora ou o
    Hospital Henry Ford, de Frida Kahlo, é nossa última metáfora. A experiência
    traumática do aborto é mostrada nessa tela através da pintura da artista nua em
    cima de uma cama de hospital. Essa tela nos convida a refletir sobre nosso processo
    de trabalho. Precisamos pensar na multidimensionalidade do ser e aceitar o convite
    da arte, para que a leveza nos confronte com o peso imposto pelo ideário
    hegemônico. Acredito não ser uma única visão, mas as muitas visões que devam
    fundamentar os saberes e fazeres da enfermagem; o que importa é que sejam eles
    tecidos no diálogo, na democracia, na condição de protagonismo dos sujeitos
    envolvidos nesse processo, na errância e incerteza, na religação, na solidariedade,
    na pluralidade. Para tanto, o corpo deve ser o grande pedagogo capaz de ser olhado
    não como uma tapeçaria vista pelo direito, como vê o saber lógico, mas vista pelo
    avesso em suas tramas singulares, irregulares, descontínuas.

22
  • MARILIA FERNANDES GONZAGA DE SOUZA
  • IMPLEMENTAÇÃO DA SISTEMATIZAÇÃO DA ASSISTÊNCIA DE ENFERMAGEM (sae) EM UM HOSPITAL PEDIÁTRICO DE ENSINO: um trabalho em equipe.

    

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • MARIA MIRIAM LIMA DA NÓBREGA
  • ROSINEIDE SANTANA DE BRITO
  • Data: Dec 3, 2010


  • Show Abstract
  • A busca incessante do enfermeiro em qualificar a assistência de enfermagem, faz da Sistematização da Assistência de Enfermagem (SAE) um tema atual de discussão em todo o país, não apenas no intuito de atender às exigências legais de sua prática, mas especialmente pelos benefícios esperados com sua aplicação. Neste sentido, este estudo teve uma abordagem qualitativa, desenvolvida através de uma pesquisa-ação, em um hospital pediátrico de ensino, conjuntamente com a equipe de enfermagem. O objetivo geral foi analisar a mudança nas práticas de enfermagem em um hospital pediátrico de ensino, a partir da construção e implementação da SAE pela equipe de enfermagem.  Os resultados tiveram a análise temática segundo Freire (2003) e foram divulgados na forma de relatórios. Para atingir tais objetivos iniciou-se por passos pré-pesquisa com a revisão nos prontuários da instituição e uma abordagem com os gestores. Para o diagnóstico situacional das práticas de enfermagem sem a sistematização, seguiu-se as etapas da pesquisa com aplicação de um questionário com a equipe de enfermagem e um grupo focal com os enfermeiros. Estes passos subsidiaram a etapa de implementação da SAE, na qual foram desenvolvidas ações paralelas, tais como o grupo focal com os enfermeiros sobre o histórico de enfermagem, a capacitação com a equipe de enfermagem sobre a SAE, a elaboração, aplicação e re-elaboração de impressos e as discussões em pequenos grupos. A análise das mudanças ocorridas após a pesquisa se deu através de uma entrevista individual com os enfermeiros para a avaliação dos resultados obtidos. A revisão de prontuários confirmou o déficit nos registros realizados pelo enfermeiro no prontuário, o que reforçou a necessidade de implementação da SAE, argumento apresentado na reunião com os gestores que prontamente acataram a pesquisa. Os questionários e o grupo focal com os enfermeiros revelaram um processo de trabalho de enfermagem sem sistematização, demonstrando lacunas nas práticas, mas também foram relatadas expectativas de melhorias na qualidade da assistência a partir da SAE, fornecendo-se dados para a elaboração dos passos seguintes. Os impressos foram gradativamente utilizados e modificados, a medida que a equipe compreendeu a SAE e seus objetivos através da capacitação. A avaliação final apontou para a implementação parcial das etapas da SAE, tendo sido institucionalizado o histórico e a evolução de enfermagem, além de relatadas dificuldades com o diagnóstico e a prescrição de enfermagem, representando esta última em uma quebra de paradigma. Este estudo contribuiu para mudança na concepção da SAE pela equipe de enfermeiros na instituição, tendo sido revelado através da introdução de novas práticas no processo de trabalho de enfermagem como a realização do exame físico do paciente, a entrevista na admissão do cliente ao serviço e o acompanhamento diário pelo enfermeiro através da evolução de enfermagem. Espera-se que novas ações para a continuidade das atividades da SAE sejam desenvolvidas por esta equipe e que as etapas desenvolvidas nesta pesquisa, possam ser adaptadas a outros serviços para que estes avançem na sistematização.    

23
  • PALMYRA SAYONARA DE GÓIS
  • A precarização do trabalho do enfermeiro na estratégia saúde da família: contribuição ao debate.

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • JOSE WILLINGTON GERMANO
  • MOEMIA GOMES DE OLIVEIRA MIRANDA
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 16, 2010


  • Show Abstract
  •  

    O estudo faz uma análise do trabalho do enfermeiro da Estratégia Saúde da Família, desvelando o significado do trabalho e do trabalho precarizado para esse enfermeiro. Objetiva analisar as formas de precarização do trabalho do enfermeiro da ESF do município de Pau dos Ferros, região do Alto Oeste Potiguar. Trata-se de um estudo de abordagem qualitativa com análise das categorias que emergiram da pesquisa através do diálogo com os autores estudados no referencial teórico do sentido do trabalho humano, do mundo do trabalho atual e a precarização do trabalho em saúde. Utilizou-se a metodologia da história oral temática e a entrevista semi-estruturadas com perguntas geradoras como instrumento de coleta de informações. Participaram 07 enfermeiros da ESF daquele município. Houve predomínio do sexo feminino, com estado civil casado, com faixa etária entre 29 e 47 anos, inseridos como enfermeiros na ESF de 1 a 9 anos. Todos referem satisfação com o trabalho. Emergiram 02 principais significados do trabalho, prevalecendo à concepção de trabalho como fonte de realização humana e prática transformadora da realidade, com o sentido de realização de uma ação pelo indivíduo que promove e sofre mudança. Compreendem o trabalho precarizado não somente como ausência de vínculos trabalhistas e proteção social, diferentemente do pensamento do Ministério da Saúde, semelhante à concepção do estudo, a precarização compreendida ainda como ausência de participação dos trabalhadores nos espaços de gestão do trabalho e autogestão do trabalho e ausência das condições estruturais e infra-estruturais onde o processo de trabalho se realiza. Evidenciou-se que a totalidade dos enfermeiros entrevistados se inseriu na ESF através de concurso público e referem ter direitos trabalhistas assegurados. Não compreendem sob qual regime jurídico são regidos. A realidade pesquisada não tem um PCCS-SUS ou política de desprecarização do trabalho do enfermeiro da ESF. Concluiu-se que o município apresenta avanços e retrocessos em relação à precarização do trabalho do enfermeiro da ESF. O trabalho coletivo em saúde é um desafio na realidade pesquisada e a política de desprecarização do trabalho da gestão da educação e do trabalho não foi evidenciada. Apesar da realização do concurso público esses profissionais apresentam um grau de precarização do trabalho, com o acúmulo gradual de responsabilidades, alguma falta de condições de trabalho em aspectos estruturais, infra-estruturais e meios e instrumentos. 

24
  • FLAVIA ANDREIA PEREIRA SOARES DOS SANTOS
  • Revisão pós-parto: significado atribuído pela puérpera.

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • NORMÉLIA MARIA FREIRE DINIZ
  • RAIMUNDA MEDEIROS GERMANO
  • ROSINEIDE SANTANA DE BRITO
  • Data: Dec 16, 2010


  • Show Abstract
  • A consulta à mulher durante o puerpério deve acontecer entre o sétimo ao décimo dia, e com quarenta e dois dias após o nascimento da criança, visando diminuir a incidência de  morbidade e mortalidade materna e neonatal . No entanto, a efetivação dessa assistência no nível primário de atenção à saúde, ainda não foi conseguida, principalmente no quadragésimo segundo dia de puerpério. Frente  essa realidade, a pesquisa teve como objetivo compreender as concepções da mulher acerca da consulta pós-parto. Trata-se de um estudo exploratório e descritivo em uma abordagem qualitativa, desenvolvido no município de Lajes/RN-Brasil, com mulheres adscritas das quatro equipes que compõem a Estratégia Saúde da Família. Os dados foram obtidos por meio de entrevista semiestrurada junto a 15 mulheres que atenderam aos  seguintes critérios de inclusão: ser adscrita  na área de abrangência de quatro equipes da Estratégias Saúde da Família; residir no município em estudo; apresentar faculdades mentais preservadas; ter sido inscrita no Programa de Humanização do Pré-Natal e Nascimento, e que estivessem, no máximo, com sessenta dias pós-parto. As informações coletadas foram organizadas conforme os preceitos de análise de conteúdo segundo Bardin. Assim sendo, identificou-se os núcleos de sentidos, em seguida o processo de codificação e categorização,  originando 03 categorias: prevenção de complicações puerperais;  sentimentos relacionados às mudanças de vida após o parto e cuidados pós-parto, e uma temática central Vivência da mulher no puerpério. A análise dos dados seguiu os principio do Interacionismo Simbólico, conforme Blumer, como referencial teórico metodológico.  O estudo revelou que para as   participantes da investigação, o puerpério é um período de muitas mudanças biológicas, sociais e psicológicas. Diante disso, demonstram-se preocupadas com o aparecimento de complicações. Os significados atribuídos ao puerpério  relativos à prevenção de complicações estavam diretamente relacionados ao repouso e a realização da consulta puerperal. Percebeu-se que as entrevistada cumpriram rigorosamente o repouso por imposição de familiares, porém isso não aconteceu com a revisão pós-parto, pois, pequenos números de puérpera se submeteram a esse procedimento. A interação das entrevistadas com as pessoas do seu convívio habitual, bem como os sentimentos que premiaram o pós-parto foram decisivos para considerarem ou não, a consulta puerperal significativa.  As depoentes vivenciaram  a fase puerperal sob  influência do contexto no qual estavam inseridas. De acordo com os resultados obtidos há necessidades de outros estudos  sobre  o assunto.  Além disso, novas medidas no âmbito da Estratégia de Saúde da Familiar devem ser implementadas na perspectiva da adesão  das puérperas a consulta pós-parto.

25
  • ISABELLE PINHEIRO DE MACEDO
  • Acompanhando o crescimento e o desenvolvimento da criança: intervenção integrada entre enfermagem e família.

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • NEUSA COLLET
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: Dec 17, 2010


  • Show Abstract
  • O acompanhamento do crescimento e desenvolvimento (CD) da criança, é o eixo norteador das ações básicas em saúde voltadas ao público infantil, atuando no âmbito da vigilância à saúde e inferindo positivamente nos índices de morbimortalidade infantil, que ainda hoje são uma preocupação no mundo e no Brasil. Porém, na maioria das vezes, esta prática é desenvolvida pautada no modelo biomédico de atendimento, individualizado, com ênfase nas queixas e medicalização, além da passividade dos usuários. Diante desta problemática, objetivamos desenvolver o acompanhamento do CD da criança em uma Unidade de Saúde da Família (USF), através de uma abordagem coletiva de atendimento junto à equipe de saúde, em especial aos enfermeiros, e cuidadores. Trata-se de um estudo descritivo exploratório, com abordagem qualitativa, tendo como método a pesquisa-ação. Foi aprovado previamente pelo comitê de ética em pesquisa da Universidade Federal do Rio Grande do Norte sob parecer 201/2009. Envolveu as quatro enfermeiras e vinte e seis cuidadores de crianças da área de abrangência da USF de Cidade Nova, no período de fevereiro a julho de 2010. Como técnicas de coleta de dados utilizaram-se a observação participante, aplicação de entrevistas e questionários, grupo de avaliação e diário de campo. Os dados foram analisados seguindo o direcionamento da análise temática por categorização freiriana. No diagnostico situacional, percebemos que apesar das enfermeiras terem um conhecimento atrelado ao paradigma de promoção à saúde, na prática o acompanhamento da criança é feito através de consultas individuais em sala ambulatorial, pautado nas queixas trazidas pelos cuidadores, com pouca resolubilidade nas ações empregadas. Visto a necessidade de mudança no modelo de atendimento, apresentamos a proposta de acompanhamento coletivo do CD das crianças à equipe multiprofissional que compõe a referida USF, discutindo a participação das categorias profissionais e planejando coletivamente as ações. O acompanhamento coletivo das crianças contemplou a execução pelos cuidadores, sob supervisão das enfermeiras e facilitadoras, da anamnese e exame físico, registro dos dados encontrados na caderneta da criança e discussão dos achados clínicos. Favoreceu, assim, o processo de aprendizagem e a troca de experiências. Como dificuldades, nos deparamos com o alto índice de faltosos (53,8%), falta de motivação e passividade dos usuários, pouca participação de outros profissionais de saúde e envolvimento das enfermeiras com outras atividades no momento do atendimento. Constatamos ainda um forte enraizamento do modelo clínico individual no modo de pensar e agir das enfermeiras e dos cuidadores.

26
  • RENATA SILVA SANTOS
  • O CUIDAR DE ENFERMAGEM E DA FAMÍLIA À

    PESSOA IDOSA NO DOMICÍLIO: Uma abordagem etnográfica

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • REJANE MARIA PAIVA DE MENEZES
  • BERTHA CRUZ ENDERS
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MARIA DO ROSARIO DE MENEZES
  • Data: Dec 20, 2010


  • Show Abstract
  • INTRODUÇÃO: O envelhecimento é um processo multidimensional que envolve entre outros os aspectos físico-biológicos, sociais, econômicos e psicológicos. Ao avaliar essa fase da vida dentro de uma visão social e cultural, percebe-se que ser idoso ou não varia com as concepções culturais, sendo necessário investigar as variações que atuam no processo e rege o fenômeno sociocultural da realidade em que se está inserido (FERICGLA, 1992).  Kalache, Veras e Ramos (1987) mostram que a população idosa mundial aumentou e que esse processo tende a se intensificar. Estima-se que até em 2050 existam cerca de dois bilhões de pessoas com mais de 60 anos no mundo, e a maioria delas vivendo em países em desenvolvimento. No Brasil, acredita-se que existam, atualmente, cerca de 17,6 milhões de idosos (BRASIL, 2006). A normatização e legislação brasileira de amparo ao idoso em relação à saúde iniciaram-se a partir da Constituição Federal de 1988 e da Lei 8080 que regulamenta o Sistema Único de Saúde (SUS) em 1990, em seus vários níveis de complexidade: atenção básica, média e alta complexidade. Para auxiliar nessa prestação dos serviços na atenção básica de saúde é importante observar as condições sociais, culturais, econômicas e de saúde dos idosos e seus familiares. Nesse sentido, a visita ao domicílio e a avaliação deste idoso em sem ambiente doméstico torna-se fundamental para acompanhar o cuidar prestado e o quanto esse processo irá interferir no sistema de saúde, na família e na qualidade de vida dos idosos. Neste contexto, o enfermeiro como integrante da Equipe de Saúde da Família, presta assistência à saúde do idoso no domicílio. OBJETIVO: Analisar o cuidado de enfermagem e dos familiares à pessoa idosa no domicílio com vistas à compreensão dos aspectos sociais e culturais. METODOLOGIA: Estudo do tipo descritivo e de abordagem qualitativa, norteados por princípios teórico-metodológicos da etnografia com vistas ao estudo da influência dos aspectos culturais e sociais na assistência da família e do enfermeiro à idosos em domicílio. Foi realizado no município de Santana do Matos, RN, tendo como participantes, idosos, familiares e enfermeiros da equipe da ESF, definidos a partir da população do município e obtendo-se uma amostra intencional de 25 participantes: 6 enfermeiras, 10 idosos e 9 grupos familiares. Para a coleta de informações, utilizou-se observação, entrevista, diário de campo e grupo focal. ANÁLISE E RESULTADOS: Os resultados foram apresentados em forma de narrativa descritiva, na perspectiva dos conceitos de Boris Cyrulnik, com análise interpretativa cultural de Geertz (1989), na busca dos significados e símbolos próprios da cultura da velhice de idosos e dos seus familiares, sobre cuidados que são realizados, tanto pela família, como pelos enfermeiros em domicílio. Observou-se que a família e o cuidador, dentro de sua realidade social e cultural, precisam ser mais compreendidos pela equipe de saúde para ser melhor orientados e capacitados na realização do cuidar de forma adequada. Por sua vez, os profissionais de saúde, em especial o enfermeiro, enfrentam dificuldades para realizar o cuidado ao idoso no domicílio como a grande demanda de atribuições na unidade de saúde como consultas e atendimentos; falta de transporte até os domicílios; extensão territorial do município e das áreas assistidas; número de pessoas atendidas por cada equipe; falta de compreensão dos profissionais de saúde quanto à importância da visita domiciliária na atenção básica. Entendem a necessidade de realizar ações de promoção em saúde, prevenção de agravos e de educação em saúde, além de reconhecerem a importância de uma melhor formação acadêmica para atuar nessa perspectiva e contribuírem para as mudanças necessárias na prática dos cuidados ao idoso em domicílio.

27
  • MARIA COELI CARDOSO VIANA AZEVEDO
  • Identificação de crianças e adolescentes com suspeita de câncer: uma proposta de intervenção.

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • PATRICIA NEYVA DA COSTA PINHEIRO
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Dec 28, 2010


  • Show Abstract
  • Ao contrário do câncer no adulto, em que as células geralmente originam-se de tecido epitelial e que está ligado a fatores ambientais, os tumores malignos na infância são, na sua maioria, de origem embrionária e apresentam uma fase de rápida proliferação. Quando não iniciado o tratamento quimioterápico nesta fase, o tumor aumenta de tamanho, diminuindo sua velocidade de crescimento, diminuindo a resposta aos quimioterápicos. O câncer infantil representa a segunda causa de mortalidade entre crianças e adolescentes de um a dezenove anos, no Brasil. Seu impacto por doenças torna-se significativamente importante para saúde pública, já que a primeira causa está relacionada aos acidentes e à violência. Muitas crianças ainda são encaminhadas aos centros de alta complexidade para tratamento oncológico com a doença em estágio avançado. A demora ao ser encaminhado para diagnóstico pode ser da família, da dificuldade do acesso ao setor saúde, das características da doença e desconhecimento da equipe de saúde quanto à temática de câncer infantil. Diante desta problemática, objetivamos analisar o desempenho das equipes de saúde na identificação da criança e adolescente, sintomáticos de câncer, na atenção primária, por meio da metodologia pedagógica de ensino-aprendizagem, seminários, descrevendo a atuação do grupo e discutindo as atividades desenvolvidas após os treinamentos. Trata-se de um estudo qualitativo, tendo como método a pesquisa-ação. Envolveu trinta e sete profissionais de saúde que prestam atenção à crianças e adolescentes na USF Felipe Camarão II, na casa de apoio à criança com câncer e no Hospital de Pediatria/UFRN, durante o período de março à dezembro de 2010. Os dados foram analisados simultaneamente a avaliação das ações, seguindo o direcionamento da análise das ideias freireanas, tendo como referencial teórico a atenção primária à saúde. O diagnóstico situacional da realidade atual quanto ao conhecimento da equipe de saúde direcionado para identificação precoce de sinais e sintomas levantada por meio da problematização apresentou temas geradores como: a resistência para a mudança; a conscientização para a necessidade de apreenção de saberes; o conhecimento prévio por meio da mídia; fragmentação da rede de assistência, interferindo no funcionamento do sistema de referência e contra referência; o estigma da morte dentre outros. Esses temas geradores viabilizaram a escolha do conteúdo para elaboração de quatro seminários, como implementação de ação coletiva para discussão problematizadora. O processo ensino-aprendizagem permitiu aos participantes do estudo a conscientização do problema e agir por meio do conhecimento adquirido, interferindo na diminuição do intervalo de tempo entre a identificação de sinais e sintomas de câncer e o início do tratamento especializado. Como dificuldades, nos deparamos com o diagnóstico de câncer associado a terminalidade, e a dificuldade de acesso à exames laboratoriais e de imagem, necessários para o diagnóstico de neoplasias. Assim, constatamos que quando a equipe é envolvida, conscientemente, no processo de educação desde a identificação da situação problema, pode ocorrer mudanças significativas no fazer cotidiano por meio da concientização do ser. Entretanto, percebemos também que aquisição de conhecimento e interesse da equipe não são suficientes, já que para haver eficácia do atendimento é necessário uma organização da rede de atenção oncológica no estado no Rio Grande do Norte.

2009
Dissertations
1
  • KATIA REGINA BARROS RIBEIRO
  • O sofrimento do paciente na UTI: escutando a sua experiência
  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • GLAUCEA MACIEL DE FARIAS
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Feb 19, 2009


  • Show Abstract
  • O sofrimento do paciente na UTI: escutando a sua experiência
2
  • NEUMA MARIA DA SILVA
  • AVALIAÇÃO DA CAPACIDADE PARA O TRABALHO DO SERVIDOR PÚBLICO:
    um estudo de caso em uma instituição federal de ensino superior

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • GEOVANIA DA SILVA TOSCANO
  • JACILEIDE GUIMARAES
  • MOISES ALBERTO CALLE AGUIRRE
  • ROSINEIDE SANTANA DE BRITO
  • SORAYA MARIA DE MEDEIROS
  • Data: Feb 27, 2009


  • Show Abstract
  • A capacidade para o trabalho, considerada como resultante de um processo
    dinâmico entre recursos do indivíduo em relação ao seu trabalho, sofre influência de
    diversos fatores, como aspectos sociodemográficos, estilo de vida, processo de
    envelhecimento e exigências do trabalho. Tendo como objetivo analisar a
    capacidade para o trabalho em uma população de servidores públicos, o estudo
    transversal analisou 132 servidores públicos voluntários, do setor de infra-estrutura,
    em uma instituição federal de ensino superior do estado do Rio Grande do Norte,
    nordeste, Brasil. Os dados foram coletados através de um questionário denominado
    Índice de Capacidade para o Trabalho – ICT. A análise das variáveis foi feita através
    da estatística descritiva por meio das médias, desvios-padrão, mediana valores
    mínimos e máximos dos escores das variáveis quantitativas. A análise conjunta das
    variáveis foi feita por meio de regressão linear múltipla. Os Servidores apresentaram
    capacidade para o trabalho baixa 11 (8,33%), moderada 31 (23,48%), boa 54
    (40,91%), e Ótima 28 (21,21%). A análise múltipla, ajustada por idade, sexo,
    educação, idade que começou a trabalhar, tempo de serviço, capacidade atual e
    total de doenças, evidenciou que as variáveis que melhor explicaram a variação do
    ICT foram a idade, capacidade atual e total de doenças. A pesquisa demonstrou que
    75% dos servidores apresentaram ICT abaixo de 43 pontos - Capacidade baixa,
    moderada ou boa e que apenas 25% dos servidores entrevistados apresentaram o
    ICT acima de 43 pontos - ótima capacidade para o trabalho. De acordo com as
    recomendações do Instituto Finlandês de Saúde Ocupacional - FIOH, para os
    servidores que apresentarem esses escores devem ser implementadas medidas
    cujo objetivo será: restaurar a capacidade para o trabalho que se encontre baixa,
    melhorar a capacidade para trabalho moderada, apoiar a capacidade para o trabalho
    bom e manter a capacidade para o trabalho ótimo. Portanto, recomendamos que o
    ICT seja aplicado nas demais instituições federais de ensino superior da federação,
    na perspectiva da realização de um diagnóstico real da situação de todos os seus
    servidores, possibilitando a aplicação das referidas medidas tão necessárias à
    recuperação e promoção da saúde de seus colaboradores.

3
  • JONAS SAMI ALBUQUERQUE DE OLIVEIRA
  • Análise da contribuição de estagiários remunerados na força de trabalho em enfermagem

  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • JOAO CARLOS ALCHIERI
  • RAIMUNDA MEDEIROS GERMANO
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • SORAYA MARIA DE MEDEIROS
  • Data: Jun 26, 2009


  • Show Abstract
  • O presente estudo faz uma análise de estágios não obrigatórios e remunerados em
    enfermagem, como contribuição para o processo de trabalho em saúde e aprendizagem dos
    estudantes de cursos técnicos em enfermagem. Teve como objetivo examinar a contribuição
    de bolsistas de nível médio de enfermagem na força de trabalho em um Hospital de Ensino
    em Natal/RN. Trata-se de uma investigação quantitativa/qualitativa, com uso de estatística
    descritiva e análise realizada a partir das categorias que emergiram da pesquisa através de
    um diálogo com os autores estudados no referencial teórico do atual mundo do trabalho,
    força de trabalho, estágio não obrigatório remunerado e trabalho em turnos e noturno. Os
    colaboradores desta pesquisa, foram 105 (73,43%) técnicos de enfermagem, bolsistas de
    nível médio que realizam estágio remunerado no hospital. Houve predomínio do sexo
    feminino com 90 (85,70%), com média de idade de 29,71 anos, 62 (59,00%) solteiros, 57
    (54,30%) não referiram ter filhos, 100 (95,23%) bolsistas com nível médio completo, 78,10%
    tiveram experiência profissional antes de sua inserção no estágio remunerado, 73 (69,50%)
    referiram gostar da área, motivo da escolha do curso técnico de enfermagem. Sobre a
    conclusão do curso técnico, 83 (79,00%) afirmaram ter sido entre 2005 e 2008, e sobre o
    tempo de estágio na instituição, 38 (36,20%) têm entre um e seis meses. Quanto à
    aprendizagem, 74 (70,50%) referiram aprender com os técnicos de enfermagem e todos
    realizam cursos de especialização ou aperfeiçoamento para ter o vínculo com a escola e
    poder estagiar. Esses cursos foram tidos como de baixa qualidade, o que justifica os 54
    (51,40%) bolsistas que disseram que o rendimento nos estudos é bom e 75 (71,40%)
    conseguem conciliar com o estágio sem problemas. Quanto à remuneração em forma de
    bolsa, 71 (67,60%) referiram que ajudavam na continuidade dos estudos, pois esse valor
    tem principalmente esse propósito de custear os estudos. Sobre o estágio não obrigatório, a
    ABEn-RN afirmou que não existe uma relação de acompanhamento dessa modalidade de
    estágio, posto que nunca houve essa preocupação, uma vez que os estágios obrigatórios
    tomam muito do esforço, nas reuniões. E o COREN-RN não fiscaliza essa forma de
    contrato. Constatou-se na presente pesquisa que há a contribuição da força de trabalho de
    bolsistas de nível médio de enfermagem na instituição pesquisada. Submetidos às
    circunstâncias de trabalho estabelecidas pela instituição, representando a carência de
    recursos humanos, de materiais, de condições de trabalho, inserção no trabalho em turnos e
    noturno, pode-se afirmar que esta situação é irregular no contexto dos bolsistas, além de
    determinante fator de riscos para suas vidas e saúde. Além disso, para que os bolsistas se
    mantenham na qualidade de estagiário na instituição, são obrigados a realizar cursos de
    aperfeiçoamento ou especialização de técnicos de enfermagem, em escolas referidas como
    de péssima qualidade.

4
  • PATRICIA DE CASSIA BEZERRA FONSECA
  • INFECÇÃO DO TRATO URINÁRIO ASSOCIADA AO CONHECIMENTO E AO PROCEDIMENTO DE SONDAGEM VESICAL PELA EQUIPE DE ENFERMAGEM NUMA UNIDADE DE TERAPIA INTENSIVA

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • GILSON DE VASCONCELOS TORRES
  • RAIMUNDA MEDEIROS GERMANO
  • WILMA DIAS DE FONTES
  • Data: Sep 29, 2009


  • Show Abstract
  • RESUMO

    FONSECA, Patrícia de Cássia Bezerra. Infecção do trato urinário associada ao conhecimento e ao procedimento de sondagem vesical pela equipe de enfermagem numa unidade de terapia intensiva. Natal, 2009. Xxxxp. Dissertação (Mestrado em Enfermagem) – Departamento de Enfermagem, Universidade Federal do Rio Grande do Norte, 2009.

    Estudo descritivo prospectivo, exploratório, de abordagem quantitativa e observacional não participante, que teve como objetivo geral analisar a relação entre o conhecimento dos profissionais de enfermagem e as condutas assumidas por eles durante a inserção e manipulação da sonda vesical de demora e suas interferências na ocorrência de infecção do trato urinário, realizado na UTI do Hospital Universitário Onofre Lopes em Natal/RN. A amostra pesquisada foi composta por 38 profissionais da equipe de enfermagem, sendo cinco (5) enfermeiros e 38 técnicos de enfermagem, deles 28 eram terceirizados (FUNPEC e bolsistas do IEL) e 10 servidores da UFRN. A coleta de dados foi realizada através de dois instrumentos, o primeiro utilizado na observação procedimentos de inserção e de manipulação da SVD e sistema de drenagem urinário e o segundo, com a aplicação de um questionário o qual abordou dados de caracterização dos pesquisados, conhecimentos e conduta na inserção e manipulação do referido procedimento. Os resultados foram tabulados no Excel e analisados utilizando estatística descritiva e inferencial, através do programa estatístico SPSS, versão 15.0. Obtivemos como resultados a predominância de funcionários com vínculo institucional terceirizado – IEL e FUNPEC - (64,3%), do sexo feminino (p = 0,654), na faixa etária de 21 a 35 anos (p = 0,055), com nível médio de escolaridade (p = 0,001). Deles, 11,6% são enfermeiros e 88,4% técnicos de enfermagem. Ressaltamos a importância do que foi encontrado quanto ao conhecimento e conduta na execução da lavagem das mãos, a maioria dos profissionais refere que deve ser realizada antes e após todo procedimento (81,4%), mas que na prática vimos dados discordantes, onde 40,3% dos profissionais o fazem adequadamente. Na categoria de técnico de enfermagem, as condutas com maior ocorrência de inadequação, em ordem decrescente, foram: a lavagem das mãos (56%), a higienização do meato urinário (17,8%) e o posicionamento da bolsa coletora acima do nível da bexiga (1,6%). A partir dos resultados, vimos que os enfermeiros erraram menos, no item escolha do diâmetro da SVD, houve 66,7% de inadequação quanto à inserção da SVD em pacientes do sexo masculino. Em se tratando da lavagem das mãos, obtivemos 57,1% de inadequações observadas no procedimento de inserção da SVD, nos demais itens do procedimento, a predominância foi de passos adequados. Concluimos este estudo quando correlacionarmos a ocorrência das infecções urinárias diagnosticadas nos pacientes pesquisados com o total de inadequações, tempo de permanência com uso de SVD e na UTI, vimos que a possibilidade de um paciente adquirir este tipo de infecção está duas vezes e meia maior em pacientes que obtiveram maior número de inadequações e passaram muito tempo em uso do cateter e internados na UTI. Importante ressaltar que a responsabilidade quanto ao uso da SVD está nos profissionais de saúde, principalmente a equipe de enfermagem por estar ligada diretamente em sua execução, especialmente em pacientes que necessitam de cuidados intensivos, de tal maneira que possa assegurar ao paciente a melhora de sua patologia de base, minimizando os riscos do surgimento de complicações infecciosas secundárias, possíveis de serem evitadas.

5
  • MAURA VANESSA SILVA SOBREIRA
  • Repercussões da Terapia Comunitária no Processo de Trabalho na Estratégia de Saúde da Família

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • MARIA DE OLIVEIRA FERREIRA FILHA
  • Data: Oct 13, 2009


  • Show Abstract
  • RESUMO

    A Terapia Comunitária (TC) constitui-se em uma prática de efeito terapêutico, podendo ser também considerada como uma tecnologia leve de cuidado de procedimento terapêutico grupal, cuja finalidade é a promoção da saúde, a prevenção do adoecimento, desenvolvida no âmbito da atenção primária em saúde mental. Assim buscou-se apreender as representações sociais dos profissionais de saúde que atuam com a Terapia Comunitária, sobre a utilização desta na Estratégia Saúde da Família (ESF) do município de João Pessoa. Trata-se de uma pesquisa de campo com abordagem qualitativa, na perspectiva moscoviciana da Teoria das Representações Sociais, realizado com sete profissionais da ESF, terapeutas comunitários do Distrito Sanitário II através da realização de dois encontros de grupo focal no mês de abril de 2009, onde foram realizadas rodas de TC. Utilizou-se como técnica de análise o discurso do sujeito coletivo, sendo os dados apresentados, através de gráficos, quadros, mapas, figuras e infográficos e dispostos em três momentos: Sujeitos do estudo, caracterizando os participantes do estudo; Representações Sociais do Terapeuta Comunitário, apresentando e discutindo as representações sociais pelos terapeutas comunitários estudados sobre a TC; e Repercussões da Terapia Comunitária na Estratégia de Saúde da Família, discutindo as percepções dos participantes da pesquisa sobre mudanças na ESF. Alguns significados foram atribuídos à TC pelos terapeutas estudados advindos das falas, músicas e desenhos construídos, e que, apresentados através de esquema ilustrativo, demonstraram a relação entre as representações: vida, escuta, fé/luz, mudança, transformação. A teia, símbolo da TC, apareceu nas imagens construídas pelos representantes do estudo e representa a formação de vínculos que permite a construção de redes de apoio social, que fortalecem a convivência na comunidade. No estudo, revelaram-se pelos profissionais os significados que possuem sobre as mudanças no processo de trabalho a partir da implantação da TC, sendo evidenciados que a mudança deu-se no âmbito de uma postura mais acolhedora por parte dos profissionais; a relação entre os membros das equipes não teve mudanças significativas, explicadas pela pouca adesão dos membros das equipes à TC; na relação frente ao usuário, o vínculo foi fortalecido, sendo esse fortalecimento associado ao papel do terapeuta comunitário. Reconhece-se, dessa forma, o caráter transformador da TC na construção de vínculos com os usuários, necessitando, todavia, que seja visualizada pela equipe como oferta terapêutica da equipe e não do profissional terapeuta. Portanto, a TC por ser um fenômeno novo nos serviços de saúde e na comunidade de pertencimento, insere-se como uma novidade que repercute na construção de uma representação polêmica. Mesmo assim, como algo do tempo curto pode contribuir com a reorganização da rede de cuidados em saúde mental, em consonância com o novo modelo de atenção à saúde mental defendido pela Reforma Psiquiátrica.

     

6
  • FRANCISCA PATRÍCIA BARRETO DE CARVALHO
  • A Morte na concepção de estudantes de enfermagem.

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • GILSON DE VASCONCELOS TORRES
  • ROSINEIDE SANTANA DE BRITO
  • RAIMUNDA MAGALHÃES DA SILVA
  • Data: Oct 23, 2009


  • Show Abstract
  • Compreender o significado da morte para o estudante de enfermagem constitui o objeto desta pesquisa. A motivação para sua realização decorreu de minhas dificuldades como pessoa e, particularmente, como docente, diante de estudantes de enfermagem, em lidar com a morte no dia-a-dia do hospital, durante o curso de graduação. A morte se tornou este mal desconhecido que se agiganta diante dos homens e os desestabiliza, causando, muitas vezes, transtornos mentais irreversíveis quando se deparam com perdas familiares. Por isso mesmo, justifica-se estudá-la pela possibilidade de nos fazer refletir sobre o nosso modo de levar a vida e de tratar os seres humanos na perspectiva da finitude. Teve como objetivo compreender o significado da morte  para estudantes de enfermagem. Com esse propósito, pautou-se na seguinte pergunta norteadora: Qual o significado da morte para você como estudante de enfermagem? Nessa perspectiva, o estudo desenvolveu-se dentro de uma dimensão qualitativa de abordagem fenomenológica. Para sua realização foram entrevistados dez estudantes durante mês de julho de 2009.  Emergiram destas entrevistas uma diversidade de sentimentos como medo, angústia, insegurança, fracasso, tristeza, conforme a experiência sensível de cada um. Para compreender as unidades de significado que emergiram do material empírico e que constituem a essência da presente investigação, foram fundamentais os estudos de Heidegger que tratam acerca da morte em uma perspectiva fenomenológica, além de autores como Bicudo, D’Assunção, Dastur, Morin, Boff, Kübler-Ross, Boemer, dentre outros. A partir da compreensão do fenômeno estudado, podemos afirmar que a morte produz nestes estudantes sentimentos conflitantes que os conduzem à auto-proteção, esta compreendida, muitas vezes, como um afastamento do outro, diante da proximidade da morte. No entanto, mostraram-se sensíveis e receptivos à abordagem da morte dentro de outras dimensões, para além dos aspectos eminentemente técnicos, apontando para uma mudança de paradigmas que tem como fermento a própria vontade de mudar.   Além disso, a pesquisa evidencia as fragilidades na formação do enfermeiro no que concerne à compreensão do ser humano em sua totalidade e finitude e a necessidade de superá-las.

7
  • FRANCISCO DE SALES CLEMENTINO
  • Tuberculose: conhecimentos, representações
    sociais e experiências da doença na visão do portador.
  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • JORDANA DE ALMEIDA NOGUEIRA
  • RICARDO ALEXANDRE ARCENCIO
  • Data: Oct 28, 2009


  • Show Abstract
  • A tuberculose, considerada uma das mais antigas doenças que acometem a humanidade, cujos registros datam desde o ano 3900 antes de Cristo, atualmente constitui-se, no cenário mundial, como um grave problema de saúde pública, reflexo da má distribuição de renda e conseqüente precariedade das condições de vida, dentre outros fatores. Nesse sentido, desenvolveu-se um estudo exploratório e descritivo, com o objetivo de analisar as representações sociais da tuberculose pelos usuários das Unidades de Saúde da Família do Município de Campina Grande-PB, frente à descentralização das ações de controle da doença. Entrevistou-se 34 doentes de Tuberculose que realizaram tratamento no período de 2007 a 2008. A faixa etária dos entrevistados variou entre 10 e 60 anos, com predomínio dos 36 aos 60 (58,8%, n=20); em seguida, adulto jovem e adulto (21- 35 anos), com 11 (32,3%) respondentes e, em menor freqüência, a faixa correspondente a crianças e adolescentes (11-20 anos), com 03 (8,8%) participantes. Os dados foram coletados através de entrevista semi-estruturada. As questões norteadoras foram elaboradas com base nas recomendações operacionais propostas pela Estratégia DOTS, a saber: acesso aos exames laboratoriais; garantia de medicamentos; tratamento diretamente observado. Além disso, foram consideradas as experiências do usuário nas relações familiares e com os diferentes grupos sociais. A análise do material discursivo foi submetida ao software Analyse Lexicale par Context d’un Ensemble de Segments de Texte - ALCESTE 4.7. A interpretação dos dados apontou cinco categorias temáticas em que estão organizadas as representações sociais relacionadas aos doentes de tuberculose atendidos na estratégia DOTS: 1) A acessibilidade sobre o atendimento nos serviços de saúde; 2) A doença entendida pelos usuários; 3) A mudança de funcionamento na vida produtiva; 4) Os sinais e sintomas de estar doente com tuberculose; 5) Os rearranjos e mecanismos de enfrentamento. O Núcleo Central evidenciou a compreensão da tuberculose como uma doença transmissível que pode ser prevenida através de práticas educativas, promoção da saúde, busca ativa de sintomáticos respiratórios, controle dos comunicantes; mecanismos que devem estar incorporados à rotina de atividades de todos os membros das equipes de saúde da família. Os Elementos Intermediários, ancorados no cotidiano, e experiências individuais dos doentes de tuberculose, apontam questões relacionadas a atitudes e crenças circundadas pelo preconceito, levando ao isolamento, bem como à restrição dos relacionamentos interpessoais. Os Elementos Periféricos foram constituídos por temas cercados por sentimentos de indignação do doente de tuberculose frente às barreiras encontradas nas Unidades Básicas de Saúde da Família durante o tratamento. Estes elementos denotam um conteúdo negativo da representação quanto à acessibilidade, a saber: estrutura inadequada dos serviços de saúde; distância para o Centro de Referência (Centro de Saúde), o que dificulta a continuidade do atendimento; demora no agendamento e resultados dos exames; limitação dos serviços em responder a outras demandas (médico, dentista, entre outras). Espera-se contribuir para a construção de uma nova perspectiva da questão saúde entre os diferentes agentes que fazem as instituições assistenciais e de formação de profissionais, seja em âmbito central ou local.

8
  • HAMILTON LEANDRO PINTO DE ANDRADE
  • A ORGANIZAÇÃO DO DOTS EM UM DISTRITO SANITÁRIO DE NATAL/RN, 2009

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • CLELIA ALBINO SIMPSON
  • JORDANA DE ALMEIDA NOGUEIRA
  • RICARDO ALEXANDRE ARCENCIO
  • Data: Oct 28, 2009


  • Show Abstract
  •  

    RESUMO

     

    A Tuberculose é uma doença antiga que persiste como problema sério de Saúde Pública, necessitando de uma urgente atenção. Os avanços no seu conhecimento e na tecnologia disponível para controlá-la não tem sido suficientes para impactar significativamente em sua morbi-mortalidade, principalmente nos países em desenvolvimento. Para possibilitar a adesão dos pacientes com TB ao tratamento, prevenindo o abandono deste por garantir o uso correto dos medicamentos foi sugerido o DOTS (Directly Observed Treatment - Short course) ou Tratamento de Curta Duração Diretamente Observável. O presente estudo tem como foco a incorporação de dois componentes técnicos do DOTS na Estratégia de Saúde da Família, sendo eles a Busca Ativa de Sintomáticos Respiratórios (BSR) e Tratamento Supervisionado (TS). O Distrito Sanitário Oeste foi considerado o mais indicado para ser o foco do estudo, pois pressupõe-se  que aqueles locais que estiverem melhor estruturados forneceriam melhores informações acerca da situação da estratégia no município. Tem por objetivo analisar a organização do DOTS quanto à Busca Ativa dos sintomáticos respiratórios e Tratamento Supervisionado em Equipes de Saúde da Família pertencentes a um Distrito Sanitário localizado na cidade de Natal, RN. Estudo descritivo-exploratório com abordagem quantitativa que envolveu profissionais da saúde de 11 Unidades de Saúde da Família, Distrito Sanitário Oeste, Natal, Rio Grande do Norte. Foram entrevistados 62 profissionais quanto à categoria profissional, envolvimento deles na estratégia DOTS, contribuições dos gestores para a sustentabilidade da estratégia, Ações de Busca Ativa de Sintomáticos Respiratórios, diagnóstico e Tratamento Supervisionado dos casos de TB e Dificuldades e facilidades para a sustentabilidade da Estratégia DOTS. Conclui-se que as ações realizadas pelos profissionais da ESF do Distrito Sanitário Oeste se organizam mais no Tratamento Supervisionado, fato esse observado nas suas percepções acerca do DOTS.

9
  • FLAVIO CESAR BEZERRA DA SILVA
  • EXPERIENCIANDO A AUSÊNCIA DO COMPANHEIRO NAS CONSULTAS DE
    PRÉ-NATAL

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • MARIA DE FATIMA ABRAHAO TAVARES
  • MARIA MIRIAM LIMA DA NÓBREGA
  • RAIMUNDA MEDEIROS GERMANO
  • ROSINEIDE SANTANA DE BRITO
  • Data: Oct 29, 2009


  • Show Abstract
  • RESUMO
    A pesquisa teve como objetivo geral compreender o significado atribuído por gestantes
    acerca da ausência do companheiro nas consultas de pré-natal. Trata-se de um estudo
    exploratório e descritivo em uma abordagem qualitativa, desenvolvido no Centro de
    Saúde de Jardim Lola no Município de São Gonçalo do Amarante/RN. Participaram da
    investigação 20 gestantes cadastradas no programa de pré-natal, com idade igual ou
    superior a 18 anos, apresentando orientação das faculdades mentais e que conviviam
    sob o mesmo teto com o companheiro. Os dados foram coletados no período de março
    a maio de 2009, através de entrevista semiestruturada. A análise se processou segundo
    a teoria fundamentada nos dados (Grounded Theory) e o interacionismo simbólico
    (Simbolic Interactionism), como referenciais teórico-metodológicos. Para respaldar as
    discussões foram utilizados achados literários envolvendo aspectos políticos da
    humanização na assistência à saúde da mulher, bem como a relação de gênero no
    contexto familiar. Seguindo o percurso dos referenciais adotados, foram originadas as
    seguintes categorias secundárias: ¨Percebendo a participação do companheiro durante
    o pré-natal¨, ¨Expressando sentimentos durante o pré-natal¨ e ¨Revelando atitudes
    durante o pré-natal¨. Estas, quando tiveram suas propriedades e dimensões
    analisadas, suscitaram na categoria central ¨Experienciando a ausência do
    companheiro nas consultas de pré-natal¨. A construção dessa teoria leva a considerar
    que as gestantes entendem a ausência do companheiro, atribuindo esse fato ao mesmo
    trabalhar nos horários dos atendimentos de pré-natal ou a não gostar de frequentar
    instituições de saúde. Entretanto, isto não significa dizer que a sua presença do mesmo
    esteja descartada, pois o desejo de tê-lo nas consultas de pré-natal foi mencionado pela
    grande maioria das entrevistadas. Assim sendo, ter o companheiro ausente nesse
    momento leva as mulheres a experienciar anseios, sentimentos, atitudes, percepções e
    expectativas frente ao fenômeno estudado. Diante dessa realidade, pode-se concluir
    que a ausência do companheiro nas consultas de pré-natal predispõe as gestantes ao
    fortalecimento dos desconfortos advindos da gravidez e, consequentemente, vai de
    encontro ao bem-estar das grávidas, além de velar a possibilidade de desajuste
    conjugal. Essa situação requer dos profissionais de enfermagem medidas que
    viabilizem a inclusão do parceiro no cotidiano do atendimento pré-natal, na perspectiva
    da humanização da assistência.

10
  • KELIANNY PINHEIRO BEZERRA
  • Atuação dos enfermeiros na Estratégia de Saúde da Família frente
    à violência física e negligência contra a criança

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • JACILEIDE GUIMARAES
  • NEUSA COLLET
  • RICARDO ALEXANDRE ARCENCIO
  • Data: Oct 29, 2009


  • Show Abstract
  • RESUMO
    A violência intrafamiliar contra a criança assumiu importância no contexto da saúde
    pública devido aos danos e sequelas gerados na vida das crianças e à necessidade
    crescente de investimento em recursos físicos e humanos para o atendimento a
    essa demanda. Neste sentido, acredita-se que medidas de intervenção capazes de
    prevenir tais eventos se configuram como estratégias primordiais para evitar os
    corolários gerados pela violência. Diante desta problemática, o presente estudo teve
    como objetivo analisar a atuação dos enfermeiros inseridos na Estratégia de Saúde
    da Família com vistas a identificar ações prevenção da violência intrafamiliar contra
    a criança. Trata-se de uma pesquisa descritiva e exploratória de cunho qualitativo.
    As informações foram analisadas com base na análise de conteúdo modalidade
    temática proposta por Bardin. A pesquisa foi desenvolvida no Município de Mossoró-
    RN e teve como participantes 14 enfermeiros atuantes na Estratégia de Saúde da
    Família em Unidades de Saúde da Família do referido município. O instrumento para
    coleta de informações foi um questionário semi-estruturado, contendo perguntas
    abertas respondidas pelos próprios participantes. Evidenciou-se com o estudo que
    os enfermeiros acreditam na educação em saúde como principal instrumento para o
    enfrentamento da violência intrafamiliar contra a criança, desenvolvendo-a, porém,
    na sua forma positivista e verticalizada. As ações de promoção à saúde efetivadas
    pela equipe no seu cotidiano limitam-se às atividades educativas e são
    desenvolvidas no momento em que se notificam os casos de violência intrafamiliar
    contra a criança. Como barreiras para a atuação emergiram o medo de represálias
    do agente agressor, a sobrecarga de trabalho, a falta de apoio dos gestores e a
    dificuldade para a materialização da interdisciplinaridade, intersetorialidade e
    integralidade da atenção.

11
  • LUIZ ALVES MORAIS FILHO
  • Violência ocupacional contra profissionais de saúde em um hospital de urgência. Natal/RN 2009

  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • GLAUCEA MACIEL DE FARIAS
  • MARIA MIRIAM LIMA DA NÓBREGA
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Oct 29, 2009


  • Show Abstract
  • RESUMO

     

     

    Estudo exploratório descritivo, com abordagem quantitativa, desenvolvido entre abril e maio de 2009, com o objetivo de identificar os tipos de violência ocupacional, sofrida pelos profissionais da equipe de enfermagem e médica, nos últimos 12 meses, em um serviço de urgência hospitalar, em Natal/RN; identificar os setores da urgência onde ocorreram os episódios de violência ocupacional; caracterizar os agressores de cada tipo de violência ocupacional; conhecer os procedimentos adotados após cada ato violento sofrido pelos profissionais da equipe de enfermagem e médica, e conhecer as consequências da violência sofrida pelos profissionais da equipe de enfermagem e médica. A amostra constou de 26 enfermeiros, 95 auxiliares/técnicos de enfermagem e 124 médicos, totalizando 245 profissionais. Os resultados mostraram que 50,61% dos profissionais eram mulheres, entre 41 e 45 anos (22,45%); com pós-graduação(51,43%), casadas (60,82%); 21,22% tinham entre 16 e 20 anos tanto de experiência na profissão como de experiência na urgência; carga horária semanal de trabalho de 40 horas (86,12%); e trabalham tanto no turno diurno como no noturno (70,21%); 27,35% consideram que a violência faz parte da sua profissão e os acompanhantes como importante fator de risco (86,53%); não sabiam informar se no hospital havia um procedimento estabelecido, específico, para o relato de violência ocupacional (45,71%); 73,06% sofreram violência ocupacional nos 12 meses; 70,20% agressão verbal, 24,08% assédio moral, 6,12% agressão física, e 3,67% assédio sexual; 66,67% dos pacientes participaram da violência física; os acompanhantes, do assédio verbal (58,14%); e a equipe de saúde do assédio moral (69,49%); diante dos episódios de violência, 37,65% dos profissionais, contaram o fato para colegas de trabalho; 57,25% tiveram como consequência o estresse;  em 4,71% dos episódios os profissionais precisaram ausentar-se do trabalho, resultando em 75 dias de absenteísmo relacionado a violência ocupacional. Concluímos que houve um alto índice de violência ocupacional na população investigada, sendo a agressão verbal e o assédio moral os tipos de violência mais frequentes. Os fatores relacionados à violência ocupacional foram muito diversos e por esta razão, as ações voltadas para o enfrentamento desse problema não devem estar limitadas apenas ao ambiente de trabalho. A educação deverá ser uma das ações mais eficazes para evitar ou minimizar a ocorrência desses eventos.

     

12
  • RITA DE CÁSSIA DANTAS
  • HISTÓRIAS DE VIDAS DE USUÁRIOS DE PSICOFÁRMACOS: O DESAFIO DO CUIDAR EM ENFERMAGEM.

  • Advisor : CLELIA ALBINO SIMPSON
  • COMMITTEE MEMBERS :
  • ANTONIA OLIVEIRA SILVA
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • REJANE MILLIONS VIANA MENESES
  • Data: Oct 29, 2009


  • Show Abstract
  • Estudo de abordagem qualitativa, através da metodologia história oral, na modalidade história oral de vida, o qual teve como objetivos: narrar as histórias de vidas de usuários de medicamentos psicofármacos por tempo prolongado, na Unidade de Saúde da Família Santarém (USF Santarém), Natal-RN-Brasil; identificar as possíveis causas que influenciam e desencadeiam, respectivamente, o uso de psicofármacos por tempo prolongado; buscar um maior conhecimento sobre essa problemática de saúde pública; contribuir com o planejamento e desenvolvimento dos cuidados de enfermagem, aos usuários de medicamentos psicofármacos por tempo prolongado, bem como na Atenção à Saúde Mental, de forma integral, na perspectiva da Estratégia Saúde da Família. Utilizou-se, como cenário de pesquisa, a área de abrangência de uma equipe de saúde da família, da USF Santarém, pertencente ao Distrito Sanitário Norte II, da Secretaria Municipal de Saúde, no município de Natal-RN-BR. Foram entrevistados oito colaboradores que utilizam psicofármacos por tempo prolongado, os quais se dispuseram a narrar as suas histórias de vidas, as quais foram analisadas através da utilização da modalidade temática, visto que o estudo encontra-se centrado no tema da utilização de medicamentos psicofármacos por tempo prolongado. Os eixos temáticos crise, preconceito e cuidado, definidos através da categorização dos elementos comuns, encontrados por intermédio das sucessivas e cuidadosas leituras das narrativas, foram utilizados para a análise dessas histórias de vidas.

13
  • ROSANGELA DINIZ CAVALCANTE
  • . O projeto pedagógico de enfermagem e o Sistema Único de Saúde: a visão de discentes

  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • JACILEIDE GUIMARAES
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • SORAYA MARIA DE MEDEIROS
  • Data: Oct 29, 2009


  • Show Abstract
  • RESUMO

     

    A presente investigação tem como objetivo analisar, na visão de discentes, o projeto pedagógico do curso de graduação de enfermagem, da UFRN, e sua articulação com o SUS, na tentativa de compreender os desafios que permeiam o processo ensino/aprendizagem da enfermagem. Trata-se de um estudo com abordagem qualitativa que utilizou a técnica de grupo focal como instrumento para coleta do material empírico. Foram realizadas três reuniões, nas quais contamos com a colaboração de 23 estudantes concluintes do oitavo período do semestre letivo 2009.1. Para a análise das informações, utilizamos um aporte teórico fundamentada nas diretrizes curriculares e princípios básicos do SUS, fazendo a analogia dos resultados encontrados com a metáfora da mitologia grega, o fio de Ariadne, mantendo o diálogo com autores que discutem a educação como prática transformadora.  Dessa forma, a tessitura do fio foi constituída por cinco teias temáticas: articulação do projeto pedagógico com o SUS; relação ensino/serviço e teoria/prática; transdisciplinaridade ou interdisciplinaridade; abordagens didáticas/metodológicas e relacionais; e co-participação do discente no projeto pedagógico.  De acordo com as discussões, encontramos várias dificuldades no processo ensinar/aprender da graduação de enfermagem na UFRN para fortalecimento do SUS, entre elas: desarticulação das instituições de ensino com os serviços, profissionais, gestores e comunidade; dicotomia persistente entre teoria/prática; realidade dos serviços como campo de aprendizagem e o processo de trabalho em saúde; postura adotada por profissionais, docentes e outros sujeitos inseridos no processo de formação em saúde; fragmentação e descontextualização do ensino com as práticas em saúde e enfermagem; uso excessivo de metodologias muito ilustrativas e pouco problematizadoras; dificuldade e fragilidade na convivência entre professores e entre professores/alunos, no que diz respeito à aceitação das diferenças; ausência de participação de discentes no processo de avaliação e condução do projeto pedagógico em curso. Neste sentido, compreendemos a necessidade de autorreflexão do agir pedagógico e condução coletiva da proposta pedagógica do curso, na perspectiva de concretização do SUS. Desse modo, torna-se necessário o apoio em práticas motivadas pelo diálogo polifônico e no exercício da simbiose e autopoiese dos sujeitos/atores co-responsáveis pelo processo permanente de aprendizagem para a vida.

14
  • SELDA GOMES DE SOUSA ALVES
  • A prática do acolhimento à pessoa idosa na Atenção Basica: Uma estratégia de humanização

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • CLELIA ALBINO SIMPSON
  • CARLOS BEZERRA DE LIMA
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Oct 29, 2009


  • Show Abstract
  • RESUMO

     

    O envelhecimento da população já é um fato, antes considerado um fenômeno, hoje, faz parte da realidade da maioria das sociedades no mundo. O presente estudo tem como objetivo analisar a prática do acolhimento desenvolvida pela equipe multidisciplinar para a pessoa idosa na Estratégia de Saúde da Família. Trata-se de uma investigação descritiva e exploratória, desenvolvida mediante abordagem quantitativa. A população deste estudo constituiu-se de dezenove equipes que trabalham na ESF inseridas na zona urbana do município de Sousa-PB, compreendendo um total de 133 profissionais integrantes das equipes da ESF. A coleta de dados foi realizada através de um questionário contendo questões fechadas, referente aos dados sócio-demográficos e, questões abertas específicas O procedimento de coleta de sados teve início após autorização e aprovação do projeto pelo Comitê de Ética e Pesquisa da UEPB. Os principais resultados indicam que os profissionais de Saúde do município de Sousa, PB, que participaram desse estudo constituíram-se num total de 76, de uma população total de 133 que atualmente trabalham nas Unidades de Saúde da Família na região urbana do município. Dentre estes, 20% são enfermeiros, seguido dos odontólogos  em 6%;  35% são ACS, seguidos de perto pelos técnicos de enfermagem que se apresentaram nesse estudo com 19%. A idade dos entrevistados encontra-se na faixa etárias entre, 21 e 30 anos, em 43%. A maioria são do sexo feminino com um total de 84%. Já de acordo com o estado civil, o maior percentual refere-se aos casados, com 34%. Se tratando do salário, o médico tem o de maior de 12 salários, seguido de 04 a 06 salários pelos enfermeiros e odontólogos. Os participantes apresentam o maior percentual de tempo de formado com 33% referente de 1 a 3 anos de formação. E por fim, a variável tempo de atuação, se destacaram 39% dos participantes com 08 a 11 anos. Com relação de como se processa a recepção e atendimento a pessoa na ESF, podemos observar que, o atendimento prioritário foi destaque com 27% dos participantes, seguido de um atendimento atencioso com 26%. Já em relação as ações que são desenvolvidas diariamente na ESF, estas estão voltadas para o HIPERDIA com 40%, seguida de ações pautadas em orientações com 27%.  De acordo com 13% dos participantes algumas ações são realizadas de acordo com a necessidade de cada idoso, e 9% através de visitas domiciliares. Foi-lhes perguntado como o acolhimento era facilitado na UBS, 35% relataram que é através da atenção que é dispensada ao idoso, e por fim, como este era dificultado, em sua maioria com 37% não quiseram responder, seguidos da falta de compreensão com 26%. Com este estudo foi possível concluir que a prática desenvolvida pelos profissionais da ESF do município de Sousa, PB com a pessoa idosa, é caracterizada por uma assistência pautada no aspecto clínico, pouco focalizado nas ações que permeiam a Política Nacional de Humanização.

15
  • FRANCISCA MARTA DE LIMA COSTA SOUZA
  • Ações de detecção precoce do câncer de mama realizadas por profissionais da Estratégia Saúde da Família

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • GILSON DE VASCONCELOS TORRES
  • RAIMUNDA MAGALHÃES DA SILVA
  • ROSINEIDE SANTANA DE BRITO
  • Data: Oct 30, 2009


  • Show Abstract
  • Trata-se de um estudo descritivo exploratório com abordagem quantitativa, que teve como objetivo identificar as ações de detecção precoce do câncer de mama realizadas por profissionais da Estratégia Saúde da Família na região Trairi, no Estado do Rio Grande do Norte. A pesquisa foi desenvolvida nos nove municípios dessa região. Os dados foram coletados através de um questionário junto a 52 profissionais da Estratégia Saúde da Família, sendo 30 enfermeiros e 22 médicos. A análise foi realizada por meio de estatística descritiva. Os resultados foram organizados e discutidos em três grandes itens: conhecimento dos profissionais sobre a detecção precoce do câncer de mama; ações de detecção precoce do câncer de mama e dificuldades vivenciadas pelos profissionais no rastreamento do câncer de mama. Os resultados indicam que estes profissionais em geral, possuem experiência na área de atuação, todos eles (100%) têm algum conhecimento sobre os sinais e sintomas do câncer de mama e que a maioria (96,2%) desenvolve ações de rastreamento conforme orientações do Ministério da Saúde. No entanto, um grupo considerável de profissionais (55,8%) enfrenta dificuldades nas condutas de rastreamento em seu ambientes de trabalho. As dificuldades variam, de empecilhos de ordem pessoal à de acesso, como a indisponibilidade de cotas para exames de rastreamento. Concluímos que a maioria dos profissionais executa as ações de rastreamento do câncer de mama em seus ambientes de trabalho conforma preconizado pelo Ministério da Saúde, embora haja dificuldades de acesso e de conclusão dos exames de mamografia e ultrasonografia, essenciais na detecção precoce. Entendemos que os profissionais refletem um conhecimento das ações de prevenção secundária, embora não  haja um envolvimento completo nas medidas  de detecção precoce do câncer de mama, devido ao bloqueio no processo de vigilância em saúde imposto pela situação de disponibilidade de cotas. Assim, concluímos que as ações de detecção precoce de câncer de mama no contexto da ESF na região do Trairi estão sendo desenvolvidas em parte, apesar das dificuldades vivenciadas. Há necessidade de medidas que possam mediar esses empecilhos e que  permitam os profissionais efetivar suas ações de prevenção secundária com relação ao câncer de mama junto à população feminina em risco na região. Sugerimos a realização de treinamentos e capacitações dos profissionais para a realização das ações de rastreamento de forma plena e uma ampla discussão da nova legislação que viabiliza o exame mamográfico para mulheres acima de 40 anos, faixa etária em risco para esta patologia.  Acreditamos que tal perspectiva de trabalho do enfermeiro na detecção precoce de alterações mamaria através de ações de rastreamento, juntamente com o conhecimento científico de vigilância em saúde e sobre câncer de mama, aproximará o enfermeiro, como membro da equipe saúde da família, da atenção integral à mulher que tanto almeja.

16
  • LUCIA DE FATIMA DA COSTA
  • HIPERTENSÃO ARTERIAL E FATORES DE RISCO EM SERVIDORES ATENDIDOS PELO DEPARTAMENTO DE ASSISTÊNCIA DA UNIVERSIDADE FEDERAL DO RIO GRANDE DO NORTE

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • GLAUCEA MACIEL DE FARIAS
  • RAIMUNDA MAGALHÃES DA SILVA
  • SORAYA MARIA DE MEDEIROS
  • Data: Oct 30, 2009


  • Show Abstract
  • RESUMO

    A hipertensão arterial sistêmica (HAS) é uma doença multifatorial que contribui para uma elevada morbimortalidade cardiovascular, em todo o país. Considerando que a HAS afeta indivíduos em idade produtiva, quando enfrentam fatores de risco no trabalho e nos hábitos de vida, torna-se essencial conhecer a ocorrência da hipertensão e os fatores que predispõem os trabalhadores dos diversos segmentos ocupacionais a essa doença. Objetivou-se, neste estudo, identificar a prevalência da HAS em servidores atendidos em um serviço de saúde de uma universidade pública, as variações de níveis pressóricos, os fatores de risco presentes e o conhecimento que esses servidores possuem sobre os fatores que influenciam a elevação da pressão arterial. A pesquisa epidemiológica foi realizada no Departamento de Atendimento ao Servidor (DAS) da Universidade Federal do Rio Grande do Norte (UFRN), com 102 servidores atendidos na clinica médica no período de março a maio de 2009. Os dados foram coletados por meio de um questionário e pela aferição dos níveis pressóricos arteriais sistólicos e diastólicos (PAS e PAD). As aferições foram classificadas em estágios de hipertensão, segundo os parâmetros da Sociedade Brasileira de Hipertensão (SBH), e quanto ao risco cardiovascular que indicavam, com base nos critérios da Sociedade Brasileira de Cardiologia (SBC). Os dados foram analisados utilizando técnicas de estatística descritiva. Os servidores tinham, em média, 54 anos de idade; a maioria era do sexo masculino (67%) e com escolaridade de nível fundamental ou médio (76%); trabalhavam principalmente nas unidades suplementares e nas pró-reitorias; exerciam diversas funções, com predominância de vigilância, assistência administrativa, como auxiliares nos setores de saúde e em obras estruturais. Identificou-se que 47% (48) dos servidores se autorreferiram como portadores de hipertensão por oito anos em média, a maioria exercendo funções braçais e administrativas.  Entre os trabalhadores com hipertensão autorreferida, observaram-se percentuais de trabalhadores com níveis pressóricos nas classificações de pré-hipertenso (12% no PAS e 20% no PAD), em estágio I de hipertensão (16% no PAS e 9% no PAS) e no estágio II da doença (15% no PAS e 5% no PAD).  As aferições dos não portadores foram classificada em: normal (16% no PAS e 30% no PAD) e pré-hipertenso (21% no PAS e 16% no PAD). Os fatores de risco identificados em mais de 50% dos sujeitos foram: tabagismo, etilismo e sobrepeso, embora houvesse indícios de alguns hábitos positivos para combater o sedentarismo. Dos 48 servidores com diagnostico de hipertensão que tiveram 5 cinco fatores de risco presentes e níveis pressóricos limítrofes (12%), em estágio I e II foram categorizados como de alto risco vascular, respectivamente, 16% e 15%. Nos servidores que indicaram ter conhecimento dos fatores que influenciam a elevação de sua pressão arterial, o percentual informado foi menor do que 39% para cada fator de risco citado. Conclui-se que havia uma alta prevalência de HAS entre os servidores atendidos no Departamento; que todos os servidores apresentavam comportamentos de risco; que os níveis pressóricos eram elevados, mesmo naqueles que se encontravam em tratamento, revelando baixa adesão à terapêutica.  Trata-se de uma população em risco, quando se considera a faixa etária do grupo, as funções que exercem e os hábitos de vida inadequados que possuem. A atenção à saúde dos servidores com hipertensão na UFRN e que procuram o serviço do DAS se apresenta como uma ação essencial no cumprimento da política de saúde do trabalhador da instituição e do país. Sugere-se a realização de intervenções educativas que resultem em melhoria da qualidade de vida e trabalho desses servidores.

17
  • RODRIGO ASSIS NEVES DANTAS
  • A VIOLÊNCIA NO CONTEXTO DE UM SERVIÇO DE URGÊNCIA: análise do processo de cuidar na visão das vítimas e profissionais de saúde em Natal/RN.

  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GLAUCEA MACIEL DE FARIAS
  • MARIA MIRIAM LIMA DA NÓBREGA
  • RAIMUNDA MEDEIROS GERMANO
  • RICARDO ALEXANDRE ARCENCIO
  • Data: Oct 30, 2009


  • Show Abstract
  • RESUMO

     

    Estudo exploratório descritivo, com abordagem quantitativa e dados prospectivos, realizado no Pronto Socorro Clóvis Sarinho (PSCS), em Natal/RN, com vistas a analisar o cuidado prestado pela equipe de enfermagem e médica, às vítimas de violência atendidas em um hospital de urgência em Natal/RN; identificar na visão das vítimas o cuidado prestado pela equipe de enfermagem e médica; comparar os dados observados durante o processo de cuidar com a visão da vítima sobre o cuidado prestado pela equipe de enfermagem e médica; identificar o conhecimento existente sobre violência e o processo de cuidar às vítimas e sua relação com o preconceito; identificar os obstáculos e as perspectivas de prevenção durante o processo de cuidar às vítimas nos serviços de urgência. A população contou de 97 médicos, 16 enfermeiros, 75 técnicos e auxiliares de enfermagem e 365 vítimas de violência, com dados coletados de abril a maio de 2009. Dos 188 profissionais, 52,1% são do sexo feminino; 32% tinham entre 41 e 50 anos; 99,5% haviam cuidado de alguma vítima de violência; 90,4% afirmaram já ter cuidado de paciente custodiado; dentre estes, 17,3% sentiram preconceito; 55,3% afirmaram que não cuidam de uma vítima agredida diferente de uma agressora, porém 44,7% afirmaram que sim; 86,7% acham seu local de trabalho inseguro; 61,7% negaram a existência de algum obstáculo e 38,3% afirmaram a existência de obstáculo; dentre estes, 26,1% referiram-se ao espaço físico inadequado; 37,8% acham que o reforço na segurança e a capacitação dos profissionais, são as principais soluções. Das 365 vítimas de violência pesquisadas, 82,2% foram agredidas; do sexo masculino (69,6%); tinham entre 18 a 24 anos de idade (24,9%); procedentes da Grande Natal (89,9%); em 19,7% o evento ocorreu no sábado; no horário noturno (48,8%); vítima de agressão física (61,4%); produzida por força corporal (27,7%); 24,4% sofreram lesões na cabeça e pescoço; 57% haviam usado alguma droga, destes, predominando o álcool (75%). Das 621 observações feitas durante o processo de cuidar das vítimas, quando comparadas ao relato das vítimas agredidas, houve diferença estatística, ao nível de significância de 5%, em relação ao acolhimento, presença de resistência por parte dos profissionais, questionamento sobre o evento violento, fornecimento de orientações, interação com o paciente e entendimento de ser bem atendido, e resolutividade do atendimento. Nas comparações entre o observado e o relato das vítimas agressoras, houve diferença estatística, quanto à presença de resistência por parte dos profissionais, realização dos procedimentos necessários e quanto a interação com o paciente e entendimento de ser bem atendido e 58,1% das vítimas relataram que a equipe de enfermagem foi a que melhor atendeu. Concluímos que os profissionais já haviam cuidado de pacientes agressores, reconhecem a importância de conhecer como se deu o evento e adquiriram esse preparo em suas práticas. O cuidado durante as observações e no relato das vítimas, este sofre interferência dos sentimentos de medo ou preconceito em relação as vítimas agressoras e isto foi percebido por elas. Os obstáculos mais referidos que dificultam a assistência, foram: o espaço físico inadequado, o déficit de materiais e o despreparo dos profissionais. Como soluções desses problemas, citaram o reforço na segurança e capacitação dos profissionais.

18
  • WALKIRIA GOMES DA NOBREGA
  • Qualidade de vida dos portadores de úlceras venosas atendidos no ambulatório de um hospital universitário en Natal

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • CARLOS BEZERRA DE LIMA
  • GILSON DE VASCONCELOS TORRES
  • JOAO CARLOS ALCHIERI
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Oct 30, 2009


  • Show Abstract
  • Estudo transversal e descritivo que objetiva analisar a qualidade de vida (QV) de pessoas com úlcera venosa (UV) atendidos no ambulatório de um hospital universitário em Natal/RN. A população alvo do estudo sera composta por 50 pacientes com UV atendidos no ambulatório de angiologia de um hospital universitário de ensino no nível terciário. O estudo obteve parecer favorável do Comitê de Ética da Universidade Federal do Rio Grande do Norte (Protocolo nº 279/09). A coleta de dados sera realizada num período de dois meses pela própria mestranda e uma acadêmica de enfermagem, por meio da aplicação de um formulário referente as características sócio-demográfica, clínico, de saúde e assistencial,  e dos instrumentos WHOQOL-bref e WHOQOL-old. Os dados serão analisados no SPSS 15.0, através de estatística descritiva e inferencial apresentados na forma de tabelas, quadros e gráficos.

19
  • OSVALDO DE GOES BAY JUNIOR
  • O Processo de Trabalho e a Composição Técnica do Trabalho do Enfermeiro no cuidado à Saúde da Criança em Unidades de Saúde da Família

  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • NEUSA COLLET
  • RAIMUNDA MEDEIROS GERMANO
  • SORAYA MARIA DE MEDEIROS
  • Data: Nov 30, 2009


  • Show Abstract
  • Com a trajetória que os problemas referentes à criança estão tomando em nossa sociedade, principalmente aos referentes à morbimortalidade infantil, além do processo de descentralização da saúde e a implementação da Estratégia de Saúde da Família nos municípios, em que tem aumentado consideravelmente a atuação dos trabalhadores de enfermagem na Atenção Básica à Saúde, esses fatores vem proporcionando reflexões sobre o cuidado que o Enfermeiro dispensa à Saúde dessas crianças. A fim de verificar como está organizado o processo de trabalho do Enfermeiro no cuidado à criança em USF’s, as dificuldades encontradas na dinâmica do trabalho, esta pesquisa tem como objetivo analisar o processo de trabalho dos Enfermeiros no cuidado à Saúde da Criança nas USF’s, com ênfase nas tecnologias utilizadas na produção desse cuidado. Trata-se de uma pesquisa exploratória e descritiva com abordagem qualitativa, fundamentada no referencial teórico sobre Processo de Trabalho e Composição Técnica do Trabalho. Foram entrevistadas 11 Enfermeiras que exerciam suas funções a mais de 01 em suas USF. Os dados foram coletados através de entrevista semi-estruturada. As questões norteadoras foram elaboradas com base no Referencial Teórico utilizado. Para análise dos resultados, utilizamos o referencial de Bardin (1977) de análise de conteúdo, além de nos reportarmos a análise temática proposta por Minayo (2008). Em determinadas situações utilizamos o programa SPSS 15.0 para Windows. Os resultados apontam que o processo de trabalho do enfermeiro no cuidado à saúde da criança, está centrado no caráter preventivo, cujo foco das ações são as crianças sadias, que procuram o serviço para o acompanhamento do Crescimento e Desenvolvimento, seguindo as rotinas e os protocolos preconizados pelo Ministério da Saúde, com vistas a manutenção da saúde dessa criança. Ao analisar os dados pelo referencial teórico da Composição Técnica do Trabalho pode se constatar que os núcleos tecnológicos utilizados estão voltados para as Tecnologias leve-duras e duras, em que a razão entre Trabalho Morto e Trabalho Vivo, há a prevalência do primeiro em relação ao segundo, podendo ser sugestivo para o aparecimento de problemas relacionados à adesão das mães/cuidadoras ao acompanhamento do CD, devido ao caráter prescritivo e normalizador das ações; e da forte influência externas com relação ao cuidado, orientando condutas consideradas incorretas. Entretanto, os resultados mostraram a presença de “linhas de fuga”, que confirma o autogoverno que os profissionais de saúde têm no cotidiano do trabalho, como afirma Merhy. Essas “linhas de fuga” expressa à própria execução do Trabalho Vivo em ato, pautado pelo uso das tecnologias leves, contudo, não se caracterizou um processo de transição tecnológica para tecnologias leves e tecnologias leve-duras. Portanto, entendemos que para se dar resposta a situação levantado por Macinko et al. E, até ter uma maior resolutividade aos problemas relacionados à criança. O Enfermeiro tem que reorganizar o seu processo de trabalho centrado no trabalho vivo em ato.

20
  • PATRICIA SUERDA DE OLIVEIRA MACIEL
  • O homem na Estratégia de Saúde da Família

  • Advisor : ROSINEIDE SANTANA DE BRITO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • MARIA DJAIR DIAS
  • RAIMUNDA MEDEIROS GERMANO
  • ROSINEIDE SANTANA DE BRITO
  • Data: Nov 30, 2009


  • Show Abstract
  • A pesquisa terá como objetivo geral compreender a percepção dos homens sobre a atenção a sua saúde em uma unidade de saúde da família.Trata-se de um estudo exploratório  e  descritivo  em  uma  abordagem  qualitativa, que será desenvolvido  no  Centro  de Saúde de Dr Vulpiano Cavalcante no Município de Parnamirim/RN. Participarão da investigação 12 homens cadastrados no programa da Estratégia de saúde da família-ESF, na faixa-etária de 20 a 59 anos e que residem na área de abrangência de uma das equipes da ESF da unidade acima referida.  Os dados serão coletados no período de julho a agosto de 2009, por meio de entrevista semiestruturada, as quais, após a transcrição sofrerão um processo de identificação das unidades de sentido, codificação e categorização seguindo os preceitos da análise de conteúdo segundo Bardin.

21
  • EURIDES ARAUJO BEZERRA DE MACEDO
  • Custo-Efetividade da terapia compressiva no processo de cicatrização de ulceras venosas

  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • CARLOS BEZERRA DE LIMA
  • FRANCIS SOLANGE VIEIRA TOURINHO
  • GILSON DE VASCONCELOS TORRES
  • REJANE MILLIONS VIANA MENESES
  • Data: Dec 11, 2009


  • Show Abstract
  • Estudo analítico de intervenção do tipo terapêutico não randomizado com controle intragrupo, com o objetivo de analisar o custo-efetividade da terapia compressiva com bota de Unna manipulada em relação à terapia convencional no processo de cicatrização de úlceras venosas (UV) de pacientes atendidos em ambulatório. A população alvo do estudo sera composta por portadores de UV atendidos por angiologistas no ambulatório de Clínica Cirúrgica do Hospital Universitário Onofre Lopes (HUOL), com amostra de 18 pacientes. Obteve parecer favorável do Comitê de Ética em Pesquisa do HUOL (Protocolo nº 276/09). A coleta de dados sera realizada num período de quatro meses pela própria mestranda e 34 acadêmicos de enfermagem, por meio da aplicação do instrumento de pesquisa na admissão dos pacientes ao estudo e nas dez avaliações subseqüentes, realizadas no momento das trocas da bota de Unna semanais, por um período máximo de 10 semanas. Os dados serão analisados no SPSS 15.0, através de estatística descritiva e inferencial, e apresentados na forma de tabelas, quadros e gráficos.

2008
Dissertations
1
  • ERIKA SIMONE GALVAO PINTO
  • DIFICULDADES E/OU FACILIDADES VIVENCIADAS PELOS PROFISSIONAIS QUE COMPÕEM A ESTRATÉGIA DE SAÚDE DA FAMÍLIA

  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • REJANE MARIA PAIVA DE MENEZES
  • BERTHA CRUZ ENDERS
  • GILSON DE VASCONCELOS TORRES
  • TEREZA CRISTINA SCATENA VILLA
  • Data: Mar 31, 2008


  • Show Abstract
  • Estudo descritivo, quantitativo, com o objetivo de analisar as facilidades e dificuldades vivenciadas pelos profissionais da Estratégia de Saúde da Família (ESF) do Município de Ceará-Mirim, RN. A população incluiu 190 profissionais de saúde que integram as equipes de saúde da família e a coleta de dados ocorreu no local de trabalho após reunião com a aplicação de um questionário. Os resultados foram organizados em planilha excel, com análise estatística descritiva em tabelas, gráficos e quadros através de freqüências, médias e desvio padrão. Há predominância do sexo feminino (n=137) e índices maiores em quase todas as profissões, e maior média de idade (38,9% e DP= 7,8) e renda salarial (média = 10) na categoria médica. Quanto às atividades mais desenvolvidas, para médicos e enfermeiros são as ações do cuidado em saúde na Unidade, higiene bucal para os odontólogos, imunização para os auxiliares de enfermagem (Aux. Enf.) reunião educativa para os auxiliares de consultório dentário (ACD), e visita domiciliar para os agentes comunitários de saúde (ACS). Sobre as facilidades do trabalho, 93,2% referiram ser a presença de profissionais com perfil em saúde sública; quanto às dificuldades, 86,8% dos profissionais citaram à indisponibilidade de material, seguidas da faixa salarial referida por enfermeiros (80,9%), odontólogos (80,0%), médicos (73,3%), ACS (83,1%) e Aux. e Enf. (90,5%). Em relação às condições de trabalho, a indisponibilidade de materiais foi a mais citada com exceção dos odontólogos que referiram a melhoria salarial. Identifica-se ainda, entre essas dificuldades: a disponibilidade de medicamentos considerada como grau um de empecilho pelos ACS e pelo médico, a modalidade de vínculo contratual em grau dois citada pelo ACD e o odontólogo; e em grau três, a faixa salarial citada pelos odontólogos e auxiliares de enfermagem. Conclui-se, que às dificuldades e facilidades enfrentadas pelos profissionais da ESF são divergentes entre si. Para os médicos e enfermeiros, cujas ações em saúde centralizam-se no atendimento aos grupos específicos, ao indivíduo e a família, as suas dificuldades relacionam-se a indisponibilidade de materiais. Para os odontólogos, cujas ações mais citadas foram aplicação tópica de flúor e escovação supervisionada, sua dificuldade maior é a faixa salarial. Quanto ao aux. de enf., ACD e ACS para todos eles, a indisponibilidade de materiais tem dificultado a realização das suas atividades na ESF.

2
  • JANMILLI DA COSTA DANTAS SANTIAGO
  • CONDUTAS DE PROFISSIONAIS QUE REALIZAM A CONSULTA PRÉ-NATAL NA ESTRATÉGIA SAÚDE DA FAMÍLIA QUANTO À DETECÇÃO, TRATAMENTO E ACOMPANHAMENTO DA GESTANTE COM SÍFILIS
  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • BERTHA CRUZ ENDERS
  • MARIA DJAIR DIAS
  • ROSINEIDE SANTANA DE BRITO
  • Data: Apr 17, 2008


  • Show Abstract
  • Estudo descritivo exploratório com abordagem quantitativa, que tem como objetivo de verificar atendimento das recomendações do MS para a detecção, tratamento e acompanhamento da gestante com sífilis nas condutas assistenciais realizadas pelos profissionais que atuam na consulta pré-natal na ESF nos municípios da região Trairi no Estado do Rio Grande do Norte. A pesquisa foi desenvolvida nos nove municípios desta região. Os dados foram coletados através de um questionário, em uma população de 53 profissionais, sendo 30 enfermeiros e 23 médicos. Para a análise de dados, utilizamos freqüências absolutas e percentuais. Os resultados da análise dos dados foram organizados em três grandes itens: conhecimento dos profissionais sobre a sintomatologia da sífilis e suas ações de detecção, na gestante; ações dos profissionais no tratamento da sífilis na gestante; ações dos profissionais no acompanhamento de uma gestante com sífilis. Identificamos, nas afirmativas desses profissionais, que 81,2% têm conhecimentos sobre a sintomatologia da sífilis na gestante; 79,2% solicitam o VDRL em períodos adequados e em torno de 50% efetuam o tratamento conforme o orientado pelo Ministério da Saúde; para acompanhamento da gestante infectada,79,2% solicitam o VDRL mensal, 69,8% explicam a doença à gestante e 20,7% garantem a realização do acolhimento a essa mulher. Concluímos que as ações de alguns profissionais divergem do recomendado pelo Ministério da Saúde e que necessitam de um melhor embasamento científico para realizar tais ações.
3
  • MARIA DE LOURDES COSTA DA SILVA
  • Interação entre a equipe de enfermagem e a gestante com diagnóstico de pré-eclâmpsia
  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • RAIMUNDA MEDEIROS GERMANO
  • ROSINEIDE SANTANA DE BRITO
  • MARIA DJAIR DIAS
  • Data: Apr 17, 2008


  • Show Abstract
  • Trata-se de um estudo exploratório descritivo com abordagem qualitativa, tendo como objetivo analisar a percepção da equipe de enfermagem e das gestantes hospitalizadas, com pré-eclâmpsia, sobre o processo de interação durante a realização dos cuidados. A coleta dos dados foi realizada através de entrevista semi- estruturada junto a 20 profissionais de enfermagem, que atuam na enfermaria de alto risco, e 10 gestantes com diagnóstico de pré-eclâmpsia. As informações originadas dos depoimentos foram tratadas, conforme o método de análise de conteúdo, na modalidade de análise temática. Desse processo, em relação aos profissionais, surgiram três categorias que descrevem como estes percebem a sua interação com a gestante no cuidado: reconhecimento das necessidades da gestante hospitalizada, compreensão da mulher com pré-eclâmpsia e apresentação às gestantes, das dificuldades no processo de interação. No que diz respeito emergiram três categorias: percepção das especificidades do cuidado, ausência de informação/acolhimento/vínculo e percepção do processo de interação. O significado das falas foi interpretado à luz dos princípios do Interacionismo Simbólico. Os resultados mostraram que tanto os profissionais quanto as gestantes percebem haver uma interação limitada entre eles, sendo necessário refletir sobre esta realidade nas instituições de saúde e no ensino de enfermagem.
4
  • MARIA DE FATIMA MEDEIROS SALDANHA
  • A migração do cuidado em saúde:do hospital para o domicílio
  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • SORAYA MARIA DE MEDEIROS
  • RAIMUNDA MEDEIROS GERMANO
  • ROSINEIDE SANTANA DE BRITO
  • Data: Apr 18, 2008


  • Show Abstract
  • A migração do cuidado em saúde:do hospital para o domicílio
5
  • WANESSA CRISTINA TOMAZ DOS SANTOS BARROS
  • AVALIAÇÃO DA GRAVIDADE DO TRAUMA EM CONDUTORES DE MOTOCICLETA VÍTIMAS DE ACIDENTE DE TRÂNSITO NO RIO GRANDE DO NORTE
  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • GLAUCEA MACIEL DE FARIAS
  • MARIA SUMIE KOIZUMI
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Apr 23, 2008


  • Show Abstract
  • Estudo exploratório descritivo, prospectivo, com abordagem quantitativa, realizado no Complexo Hospitalar Monsenhor Walfredo Gurgel (HMWG), Natal/RN, com o objetivo de identificar as lesões por região corpórea e natureza das lesões em condutores vítimas de acidentes de motocicleta, avaliar a gravidade das lesões e do trauma desses condutores e identificar a existência de associação entre a gravidade da lesão, do trauma e algumas características do acidente. A população constou de 371 condutores de motocicleta, com dados coletados de outubro a dezembro de 2007. Utilizamos como instrumento a Abbreviated Injury Scale (AIS), Injury Severity Score (ISS) e Escala de Coma de Glasgow (ECGl). Os resultados mostram que quanto à caracterização, houve predominância do sexo masculino (88,40%), entre 18 e 24 anos (39,90%), procedentes da grande Natal (55,79%), com ensino fundamental (51,48%), católicos (75,78%), casados (47,98%). 23,18% exercem atividades ligadas ao comércio e 75,20% possuem renda de ate 2 salários mínimos. Quanto às características do acidente, o turno predominante foi o vespertino (46,36%), admitidos em até 1 hora após o evento (50,67%), transportados por ambulâncias do interior, colegas e familiares (51,21%), 25,34% foram acidentados no domingo; 53,91% sofreram quedas e capotamentos; dentre as colisões destacou-se aquelas entre moto-carro (28,03%); 52,6% eram habilitados e destes, 50,76% tinham no máximo 1 ano de habilitação; 65,50% disseram não ter sofrido acidentes anteriores; estar usando capacete no momento do acidente, 65,77%, não utilizou droga (57,41%) e dos que usaram, o álcool foi a mais consumida (98,10%). A pontuação mais baixa avaliada pela ECGl (3 a 8), foram atribuídas aos condutores acidentados no sábado (10,13%), aqueles que não utilizavam capacete (14,29%) e as vítimas de colisão moto-pedestre/ animal (13,33%). As regiões corpóreas mais atingidas tiveram AIS entre 1 e 3 (95,76%) e foram assim distribuídas: superfície externa (39,90%) e cabeça/pescoço (33,20%). Quanto a gravidade do trauma, os escores ,mais altos (ISS > 25) ocorreram entre os que consumiram álcool (30,73%), sofreram queda ou capotamento (48,98%) e aqueles que foram atendidos 3h ou mais após o acidente (50%). Concluímos que para os condutores de motocicleta vítimas de acidente, a idade, sexo, dia da semana, tipo de acidente, uso de drogas e o não uso de capacete, tempo transcorrido entre o evento e o atendimento hospitalar, sinalizam tanto para o risco de ocorrência desses eventos, quanto para maior gravidade das lesões e do trauma.
6
  • CRISTIANE DA SILVA RAMOS MARINHO
  • CARACTERIZAÇÃO DO ACIDENTE DE TRÂNSITO E GRAVIDADE DO TRAUMA: um estudo em vítimas de um Hospital de Urgência em Natal/RN
  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • GLAUCEA MACIEL DE FARIAS
  • MARIA SUMIE KOIZUMI
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Apr 24, 2008


  • Show Abstract
  • Estudo exploratório descritivo, com abordagem quantitativa e dados prospectivos realizado no Complexo Hospitalar Monsenhor Walfredo Gurgel (HMWG), Natal/RN, com vistas a classificar o tipo de veículo a motor envolvido no acidente, a qualidade do usuário da via pública e as lesões mais freqüentes; avaliar a gravidade do trauma em vítimas de acidente trânsito; caracterizar a gravidade do trauma e das lesões e o tipo de veículo a motor envolvido. A população constou de 605 vítimas de acidentes de trânsito, com dados coletados de outubro a dezembro de 2007. Utilizamos com suporte na avaliação da gravidade das lesões e do trauma a Escala de Coma Glasgow (ECGl) e o Condensed Abbreviated Injury Scale (CAIS) e o Injure Severity Score. Os resultados mostram que 82,8% das vítimas eram do sexo masculino; 78,4% tinham entre 18 e 38 anos; prevaleceram as vítimas advindas do Interior do Estado (43,1%); 24,3% da população possuíam o nível de médio completo; 23,1% trabalhavam no comércio e em atividades auxiliares; a maioria (74,9%) era católica; 48,8% eram casada/união consensual; 76,2% ganhavam no máximo dois salários mínimos mensais; o domingo foi o dia com maior número de acidentes (25,1%); 47,4% foram atendidas com menos de 1h após o evento; a motocicleta isoladamente, foi responsável por 53,2% dos acidentes; 42,3% foram atendidas pelo SAMU; 61,8% eram vítimas de colisão; mais da metade (53,4%) utilizaram equipamento de proteção individual; 49,4% usavam o capacete e 4,0%, o cinto de segurança; 61,3% eram condutores de moto; 43,3% dos acidentes aconteceram no turno da tarde; dos 395 condutores, 55,2% possuíam habilitação, e destes 50,7% tinham entre 1 e 5 anos de habilitação; 90,7% das vítimas tinham ECGl entre 13 e 15 pontos na hora da avaliação; a região corpórea mais atingida foi a superfície externa (35,9%); 38,8% das lesões foram do tipo leve e moderada (AIS 1 e AIS 2); 83,2% apresentaram trauma leve (ISS entre 1 e 15 pontos). Diante dos resultados podemos concluir que a presença de alguns fatores de risco,quando associados à direção de veículos, contribuempara o agravamento das lesões e do trauma decorrentes dos AT’s, como: sexo, idade, dia da semana, intervalo de tempo entre o acidente e o atendimento à vítima, a ingestão de drogas, tipo de acidente, qualidade do usuário da via pública, uso de EPI, turno do dia, região corpórea atingida e o tipo de veículo a motor envolvido.
7
  • LAURIANA MEDEIROS COSTA SANTOS
  • A aprendizagem na convivência: O estágio curricular na estratégia saúde da família
  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • FRANCISCO DE ASSIS PEREIRA
  • JOSINEIDE SILVEIRA DE OLIVEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • Data: Apr 28, 2008


  • Show Abstract
  • Trata-se de uma pesquisa analítica de cunho qualitativo, com o objetivo de analisar o processo de aprendizagem de estudantes do Curso de Enfermagem da UFRN em Estágio Curricular Supervisionado (ECS) na Estratégia de Saúde da Família (ESF), tendo como fio condutor a aprendizagem na convivência. Para isto, foi apresentado um resgate histórico desta atividade acadêmica no ensino de enfermagem, assim como foi discutida a relevância da ESF como cenário da formação profissional em saúde. Para a investigação empírica, foram entrevistados dez estudantes do oitavo período do curso, que estagiavam em unidades de saúde da família do Distrito Sanitário Oeste de Natal/RN. O aporte referencial teve como pressuposto epistemológico as idéias do educador Humberto Maturana, o qual demonstrou que a aprendizagem na natureza e também entre seres humanos acontece dentro das relações dialógicas de convivência, nas quais é essencial a aceitação do outro, a afetividade (o amor) e o diálogo, como estímulos à aprendizagem. As falas dos estudantes foram sendo incorporadas às categorias analíticas, definidas à priori. Ficou demonstrado que o estudante vivenciou uma aprendizagem significativa, estimulada por todos aqueles que compartilharam da convivência, a saber: enfermeiro/preceptor, docente/supervisor, equipe de saúde da família e comunidade. Neste processo, foram comuns vários sentimentos, como a alegria, a satisfação, a autoconfiança, a afetividade, assim como, em um sentido oposto, a tristeza, a indignação, a sensação de impotência e o medo. O aprendizado do relacionamento interpessoal foi apresentado como o mais relevante da experiência acadêmica, dando conta, portanto, da importância da afetividade no processo de aprendizagem, conforme assinala Maturana. Recomenda-se que o ensino de enfermagem continue priorizando as unidades de saúde da família como cenário educativo na Atenção Básica, observando-se a importância de inserir os estudantes em ambientes acolhedores, de forma que a aprendizagem possa ser estimulada.
8
  • LUCILA CORSINO DE PAIVA
  • Úlcera de pressão em pacientes internados em um hospital universitário em Natal/RN: Condições predisponentes e fatores de risco
  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • RAIMUNDA MEDEIROS GERMANO
  • WILMA DIAS DE FONTES
  • Data: Apr 29, 2008


  • Show Abstract
  • As úlceras de pressão (UP), denominadas também úlcera de decúbito, são definidas como lesões causadas pela constante pressão exercida sobre um determinado ponto do corpo, ocasionando comprometimento do aporte sanguíneo com diminuição ou interrupção da irrigação tissular, ocasionando oclusão de vasos e capilares, isquemia e morte celular. Trata-se de um estudo descritivo com delineamento longitudinal, tipo painel, com abordagem quantitativa que objetivou analisar a associação existente entre condições predisponentes (CP), fatores intrínsecos (FI) e fatores extrínsecos (FE) com a ocorrência de UP, em pacientes internados em Unidade de Terapia Intensiva (UTI), enfermarias de clínicas médica, cirúrgica e neurologia de um hospital universitário. A população do estudo foi composta por todos os pacientes que estiveram acamados durante o período de dezembro de 2007 a fevereiro de 2008. O estudo foi aprovado pelo Comitê de Ética do HUOL/UFRN (no 135/07). A coleta de dados realizou-se por meio de um formulário estruturado de observação, dados dos prontuários e exame físico da pele dos pacientes. Os resultados foram organizados no programa SPSS 15.0, tabulados, categorizados e analisados por meio de estatística descritiva e inferencial. Dos 30 pacientes pesquisados, 43,3% encontravam-se internados na enfermaria de clínica médica e clínica cirúrgica, 20,0% na UTI, 20,0% na UTI/enfermaria e 16,7% na neurologia, sendo o tempo de internação nessas unidades de 7 a 18 dias (63,3%) e de 19 a 30 dias (36,7%), com predominância do sexo feminino e faixa etária ≥ 60 anos (60,0%). Foram diagnosticadas 19 UP em 43,3% dos pacientes acompanhados, 38,5% com uma UP entre 7 a 18 dias e 46,2% com duas ou mais entre 19 a 30 dias de internação, mostrando relação significativa (ρ-valor = 0,029) entre tempo de internação e o número de UP. Verificou-se associação de 35,7% das CP (cardio-respiratórias, hematológicas, metabólicas e psicogênicas), FI (faixa etária, edema, alteração na umidade da pele e alteração da temperatura corporal) e FE (tipo de colchão e força de pressão do corpo) no conjunto dos pacientes pesquisados, estatisticamente significante (ρ-valor = 0,001), entre as médias dos escores nos pacientes com e sem UP, com razão de chance de 12,0 de desenvolvimento de UP e existência de moderada correlação (r = 0,618) na presença dessa associação. Os resultados denotam a influência da multiplicidade de fatores e condições na ocorrência de UP, o que nos remete a refletir acerca da assistência voltada para prevenção e diminuição dessas lesões o que irá favorecer a redução do tempo de internamento, sofrimento físico e psicológico, bem como a possibilidade de melhora do estado clínico do paciente.
9
  • CLEA MARIA DA COSTA MORENO
  • Avaliação do treinamento de clínica em hanseníase e sua contribuição para o aumento da detecção da doença no Estado do Rio Grande do Norte
  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • CLELIA ALBINO SIMPSON
  • JORDANA DE ALMEIDA NOGUEIRA
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • Data: Apr 30, 2008


  • Show Abstract
  • A hanseníase é considerada um grave problema de saúde pública, pois de acordo com dados do Ministério da Saúde no ano de 2006, o Brasil posicionou-se em 2º lugar no mundo, em número de casos da doença. A Região Norte figura como a que mais apresenta casos. No Rio Grande do Norte, a hanseníase já é considerada eliminada, pois possui menos de 1 caso/10.000 habitantes, segundo dados da carta de eliminação de 2005. No Estado, treinamentos de clínica em hanseníase tem sido oferecidos pela Coordenação do Programa de Controle da Hanseníase do Rio Grande do Norte (PCH-RN) desde 1997, com o apoio da organização não governamental britânica The Leprosy Relief Association (LRA), sem nenhuma avaliação ter sido realizada. O objetivo deste estudo foi avaliar o impacto do treinamento de clínica em hanseníase e sua contribuição para a detecção da doença no Estado do Rio Grande do Norte. Para avaliar os treinamentos, foi escolhida a análise da intervenção. O estudo foi desenvolvido em sete municípios, os quais são as sedes das regionais de saúde, atualmente designadas como Unidades Regionais de Saúde Pública (URSAPs), que são: São José de Mipibu – URSAP I, Mossoró – URSAP II, João Câmara – URSAP III, Caicó – URSAP IV, Santa Cruz – URSAP V, Pau dos Ferros – URSAP VI e em Natal, a capital do Estado, que se localiza na região metropolitana. Foram realizadas entrevistas com médicos e enfermeiros do Programa de Saúde da Família (PSF), questionando as percepções desses profissionais sobre a implementação do treinamento de clínica em hanseníase, viabilizado através do Programa de Controle da Hanseníase do Estado do Rio Grande do Norte. Os profissionais avaliaram a própria prática e o treinamento. Apresentaram uma avaliação positiva e ofereceram sugestões para os próximos treinamentos. De acordo com os resultados deste estudo, há necessidade da educação permanente. Tanto os dados oficiais sobre a doença apresentados pela Secretaria de Saúde do Estado, quanto as respostas obtidas nas entrevistas, indicam que o caminho para o controle da hanseníase, é o da educação em saúde.
10
  • DULCIAN MEDEIROS DE AZEVEDO
  • ESTUDO REPRESENTACIONAL DA PARTICIPAÇÃO FAMILIAR NAS ATIVIDADES DOS CENTROS DE ATENÇÃO PSICOSSOCIAL NO MUNICÍPIO DE NATAL-RN
  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • Data: Apr 30, 2008


  • Show Abstract
  • Apreender as representações sociais dos familiares de usuários dos Centros de Atenção Psicossocial (CAPS) do Município de Natal-RN, a respeito de sua participação nas atividades desses serviços, foi o objetivo deste estudo. O instrumento de pesquisa utilizado foi entrevista semi-estruturada, dirigida a 28 familiares de usuários dos CAPS II Leste e Oeste e CAPSad Leste e Norte, que participavam do Grupo Terapêutico de Familiares, da Reunião de Familiares, da Assembléia de Usuários, Técnicos e Familiares, segundo a agenda terapêutica de cada serviço de saúde, no período de agosto a novembro de 2007. Os dados obtidos na identificação dos familiares e usuários foram caracterizados com o auxílio de tabelas e quadros em valores absolutos e/ou percentuais. O material discursivo, proveniente do roteiro das entrevistas, foi submetido ao recurso informacional do ALCESTE (Analyse Lexicale par Contexte d’un Ensemble de Segments de Texte) e analisado com base na Teoria das Representações Sociais e na Teoria do Núcleo Central. A maioria dos familiares foram mulheres, casadas, com idade superior a 50 anos, que participavam há mais de dois anos das atividades nos CAPS, e uma convivência superior a 11 anos com o usuário. A partir do sistema de classificação do ALCESTE foram elegidas categorias identificadas por: Categoria 1, Tratamento - Melhoras e Expectativas; Categoria 2, Convivência – Usuário Antes e Depois; Categoria 3, Atividades – Importância, Contradições e Sugestões; Categoria 4, Orientações – Psicofarmacologia e Medicalização; Categoria 5, Família - Participação e Atividades; e Categoria 6, Condições Terapêuticas – Agradecimentos, Sugestões e Vulnerabilidade. A representação social dos familiares ancora no desejo por mudanças, identificando que é preciso promover mudanças pela continuidade das atividades terapêuticas e superação das inconsistências detectadas, objetivada pelo reforço e pela estabilidade das melhorias nas condições de vida e saúde dos usuários, vivenciadas no tratamento dos CAPS. O núcleo central correspondeu a mudanças positivas nas condições de saúde e de vida dos usuários, já os elementos periféricos foram constituídos pelas condutas familiares antes e durante o tratamento, e, pelas expectativas de mudanças nas atividades, especialmente as oficinas. Apesar dessa participação familiar ser considerada importante, ainda não reúne condições para promover a inserção do familiar, sob um ponto de vista emancipador, capaz de suscitar no sujeito o desejo da autonomia, da iniciativa, do crescimento individual e coletivo, de um envolvimento mais próximo e ativo nas atividades terapêuticas, nas oficinas e nas discussões.
11
  • KESSYA DANTAS DINIZ
  • Atuação de técnicos de enfermagem junto ao recém-nascido com dor em uma unidade de terapia intensiva neonatal.
  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • BERTHA CRUZ ENDERS
  • GILSON DE VASCONCELOS TORRES
  • NEUSA COLLET
  • Data: Apr 30, 2008


  • Show Abstract
  • A dor é uma experiência sensitiva e emocional desagradável associada ou relacionada à lesão real ou potencial dos tecidos. É considerada uma sensação individual e subjetiva e de um modo geral, muito se tem descrito na literatura a seu respeito na fase neonatal. Este estudo teve caráter descritivo-exploratório com uma abordagem qualitativa e objetivou compreender a atuação de técnicos de enfermagem que trabalham com recém-nascidos internados em UTIN, buscando descrever a percepção dos técnicos sobre a dor, identificar os parâmetros utilizados para a detecção e avaliação da dor tentando descrever as ações da equipe a respeito da dor no RN em UTIN. Os participantes são nove técnicas de enfermagem da UTIN da Maternidade Escola Januário Cicco em Natal-RN, que trabalham na assistência direta a recém-nascidos na UTIN, no turno matutino, que se dispuseram a participar da pesquisa. A coleta dos dados foi realizada através de uma entrevista estruturada em três questões, observação não participativa com um roteiro estruturado, utilização do prontuário e a passagem de plantão como forma se obtenção de dados. O início da coleta se deu logo após o parecer favorável do Comitê de Ética/ UFRN no mês de Novembro de 2007. As falas foram transcritas e os dados lidos até a obtenção de categorias. A análise do conteúdo se deu sob a óptica de Bardin. Emergiram três principais categorias de significância: Percebendo a dor no RN; Cuidando do RN com dor; Registrando a dor no RN. Os técnicos de enfermagem identificam a dor no RN, na sua maior parte, de forma empírica, utilizando sinais de alterações comportamentais ou fisiológicas de forma isolada, dando pouca ênfase para contexto que o RN está inserido. Constatou-se que as atitudes citadas pelas participantes da pesquisa diante do RN com dor são em sua maioria, ações não-farmacológicas como a sucção não nutritiva, um posicionamento adequado e medidas de conforto, no entanto, as ações farmacológicas também foram relatadas. Foi verificada ainda a ausência, de registros de enfermagem no prontuário do relato de dor e ações para minimizá-las, bem como, nos prontuários e durante a passagem de plantão. Com este estudo buscou-se compreender a atuação dos técnicos de enfermagem, contribuir com subsídios para a prática dos profissionais envolvidos nos cuidados a essa faixa etária, e também na busca de uma assistência humanizada ao RN. Palavras-Chaves: Enfermagem. Recém-nascido. Dor.
12
  • MARIA CLEIA DE OLIVEIRA VIANA
  • O acolhimento no ambulatório de um hospital universitário na visão de usuário
  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MILLIONS VIANA MENESES
  • WILMA DIAS DE FONTES
  • Data: Apr 30, 2008


  • Show Abstract
  • O presente estudo de abordagem quantitativa / qualitativa tem como objetivo analisar a assistência ambulatorial no Hospital Universitário Onofre Lopes (HUOL), tendo, como fio condutor, o acolhimento do usuário. Com este propósito foram convidados e entrevistados 20 usuários. Além das entrevistas, realizadas em um espaço de 45 dias, neste mesmo lapso de tempo foi utilizado um diário de campo para anotações das observações mais significativas. Na análise, traçamos o perfil sociodemográfico do grupo e identificamos suas principais queixas, dificuldades e sugestões. Para isto, construímos gráficos, quadros e figuras, além de destacarmos seus depoimentos, como recurso para melhor compreensão dos aspectos subjetivos. O referencial teórico constou de documentos do Ministério da Saúde acerca do acolhimento e da humanização, bem como dos estudos de Merhy, Franco, Pinheiro, Matumoto Mariotti, Teixeira, entre outros. Os resultados apontam o ambulatório do HUOL como um espaço privilegiado e de credibilidade, onde os usuários encontram, comumente, respostas para seus problemas. No entanto, estes mesmos usuários foram unânimes em afirmar as dificuldades que enfrentam para a obtenção de consultas, desde a unidade básica, até chegar ao hospital. Referindo-se ao atendimento, embora sintam-se satisfeitos quanto à assistência recebida, elencam uma série de problemas, de ordem estrutural e de relacionamento: falta de sinalização visual, de informação, de cadeira de rodas, de higiene, de salas de espera que ofereçam algum conforto, além da desatenção de alguns profissionais. Em síntese, o estudo, ora empreendido, não nos permite afirmar que exista, na realidade estudada, o acolhimento, em seu sentido pleno; no entanto, o HUOL, como hospital-escola, dispõe de todo um potencial para realizá-lo.
13
  • SANDRA MARIA DA SOLIDADE GOMES SIMÕES DE OLIVEIRA TORRES
  • Conhecimento dos adolescentes sobre métodos contraceptivos: pesquisa ação em uma unidade do programa saúde da família de Natal
  • Advisor : AKEMI IWATA MONTEIRO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • NEUSA COLLET
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MILLIONS VIANA MENESES
  • Data: Apr 30, 2008


  • Show Abstract
  • Estudo descritivo com abordagem qualitativa, do tipo pesquisa ação, que objetivou analisar a mudança do conhecimento sobre métodos contraceptivos investidos a um grupo de adolescentes atendidos na Unidade Saúde da Família de Igapó no município de Natal/RN, após consentimento institucional e parecer favorável do Comitê de Ética da Universidade Federal do Rio Grande do Norte (Protocolo nº 131/07). Foram pesquisados 16 adolescentes de ambos os sexos com faixa etária variando de 11 a 16 anos. Foram utilizados dois questionários estruturados, sendo um no diagnóstico inicial e outro durante as sete reuniões do grupo focal, além das anotações de campo e transcrições das discussões das reuniões. A coleta de dados foi realizada no período de dois meses por uma equipe composta por uma enfermeira, coordenadora da pesquisa, uma odontóloga, uma auxiliar de enfermagem, uma agente comunitário de saúde e uma acadêmica de enfermagem. Os dados quanti-qualitativos foram organizados, codificados e categorizados em planilha no Excel, sendo realizada análise tipo temática das falas dos participantes do estudo. Os resultados foram apresentados na forma de quadros, gráfico, fotos, desenhos e recortes das falas. A estratégia educativa desenvolvida em grupo focal permitiu aos adolescentes, discutir, trocar idéias e opiniões sobre os diferentes métodos contraceptivos proporcionando ampliação no conhecimento de todos contraceptivos discutidos, principalmente, nos naturais e cirúrgicos, que foram menos referidos no início do estudo. Dentre as vantagens dos métodos contraceptivos elencadas pelos adolescentes destacaram-se evitar DSTs e gravidez no uso do método de barreira camisinha. Já as desvantagens mais freqüentes apontadas pelos pesquisados com o uso incorreto dos métodos de barreira, destacaram-se engravidar e adquirir DST’s, não prevenir DST’s nos hormonais, naturais e cirúrgicos. Os adolescentes apresentaram coerência entre as vantagens e desvantagens e os tipos de métodos contraceptivos, demonstrando uma ampliação no conhecimento entre os pesquisados. Pode-se afirmar que de um modo geral os pesquisados apresentaram um bom entendimento sobre o uso dos diferentes métodos contraceptivos. No geral os participantes do estudo avaliaram positivamente em todos os critérios utilizados para qualificar as reuniões no grupo focal. A estratégia de ação do grupo focal deve ser incentivada pelos profissionais que atuam junto aos adolescentes, uma vez que estes preferem conviver em grupos, sendo uma característica da adolescência.
14
  • CRISTIANE RIBEIRO DE MELO LINO
  • Uma intervenção educativa para os profissionais de saúde na prevenção de pneumonia associada à ventilação mecânica
  • Advisor : GLAUCEA MACIEL DE FARIAS
  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • GLAUCEA MACIEL DE FARIAS
  • KATIA GRILLO PADILHA
  • Data: May 29, 2008


  • Show Abstract
  • Estudo quase-experimental, com abordagem quantitativa, delineamento tempo-série e dados prospectivos, realizado no Hospital do Coração de Natal, objetivando verificar a existência de diferença entre a assistência prestada pelos profissionais de saúde aos pacientes sob ventilação mecânica (VM) internados na UTI, antes e após uma intervenção educativa. A população foi de 31 profissionais, com dados coletados entre 05 de novembro de 2007 e 27 de março de 2008. Os resultados mostram uma população jovem, entre 20 e 30 anos de idade, do sexo feminino, ensino nível médio completo, na maioria, técnicos de enfermagem, trabalhando entre 05 e 09 anos na profissão, e 01 e 04 anos em UTI; a maioria nunca realizou treinamento acerca da prevenção de PAV; dos que realizaram, participaram em eventos da instituição com duração entre 12 e 24 horas. Quanto à intubação endotraqueal, o teste do cuff com seringa estéril sofreu modificação positiva, após a intervenção educativa, aumentando de 75,0% para 100,0%; o fio guia estéril foi usado em 75,0% das ocasiões antes e em 100,0% após. Sobre a aspiração endotraqueal, não foi explicado ao paciente sobre esse procedimento em 72,7% das situações antes, mas foi em 56,7% das vezes após; a higienização das mãos não foi realizada previamente em 68,5% das vezes antes, mas foi em 63,3% após; a máscara foi utilizada em 74,2% das oportunidades antes e em 76,7% após; o cateter de aspiração tinha o tamanho adequado em 98,9% das observações antes e em 100,0% após; a gaze usada estava estéril em 95,7% antes e em 100,0% após; o ventilador foi conectado ao paciente durante os intervalos da aspiração em 94,4% das oportunidades antes e em 100,0% após; o ambu estava limpo e protegido em 76,1% das situações antes e em 85,7% após; o cateter de aspiração foi descartado após o uso em 98,9% das oportunidades antes e em 100,0% após; a extensão de látex foi limpa em 86,5% das observações antes e em 93,3% após; a FIO foi retornada ao valor inicial em 32,9% das vezes antes e em 12,0% após; a higienização das mãos ao término do procedimento foi feita em 71,9% das situações antes e em 73,3% após; as anotações referentes à aspiração foram feitas em 70,8% das observações antes e em 86,7% após. Quanto aos dispositivos, a troca diária dos frascos aspiradores não foi obedecida em 84,6% das oportunidades antes e em 71,0% após; a troca diária da extensão de látex não foi realizada em 93,6% das vezes antes e em 87,1% após; o ambu não foi trocado em 50,0% das observações, embora estivesse sujo e/ou desprotegido antes, mas em 75,8% das oportunidades esse dispositivo foi trocado após; a nebulização não foi preparada com fluídos não estéreis e/ou manipulada assepticamente em 65,2% das ocasiões antes; entretanto em 71,7% das vezes foram realizados após; os nebulizadores não foram trocados em 65,2% das situações antes, mas foram em 60,9% após. Acerca dos circuitos do VM, o condensado acumulado nos circuitos foi descartado em 55,0% das vezes antes e em 64,0% após; o preenchimento do umidificador com água, não foi feito em 78,4% das vezes em que possuía líquidos remanescentes antes e em 90,2% após; os circuitos do VM foram trocados em 97,0% das oportunidades em que apresentavam sujidade visível ou estavam defeituosos antes e em 98,4% após. Quanto à mudança de decúbito, em 51,3% das vezes antes foi realizada e em 78,2% após; a cabeceira do leito do paciente foi mantida elevada em 95,5% das observações antes e em 98,2% após. Sobre a fisioterapia, a dieta enteral não foi interrompida antes das manobras fisioterápicas em 94,9% das situações antes e em 90,0% após; os materiais usados durante a fisioterapia não estavam desinfetados e/ou estéreis em 69,6% das observações antes, mas estavam em 60,0% após. Quanto à nutrição enteral, o teste da sonda antes de iniciar a dieta enteral ou de administrar medicamentos não foi realizado em nenhuma das oportunidades antes, entretanto foi em 15,2% após; a motilidade intestinal e aferição do conteúdo (residual) gástrico não foram verificadas em nenhuma das observações, mas foi em 15,2%, após. Concluímos que, em 05 dos 07 procedimentos avaliados em relação à VM, houve melhora significativa na qualidade da assistência prestada quando comparados ao momento anterior à intervenção educativa.
15
  • JOSE JAILSON DE ALMEIDA JUNIOR
  • Relatos de uma vivência interdisciplinar: educação, saúde e cidadania
  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • ANTONIO MEDEIROS JUNIOR
  • GEOVANIA DA SILVA TOSCANO
  • RAIMUNDA MEDEIROS GERMANO
  • SORAYA MARIA DE MEDEIROS
  • Data: Oct 31, 2008


  • Show Abstract
  • O presente estudo aborda a interdisciplinaridade na perspectiva da formação para o Sistema Único de Saúde (SUS) na ótica de estudantes da área da saúde da Universidade Federal do Rio Grande do Norte (UFRN) egressos da disciplina Saúde e Cidadania (SACI). Ressalta, igualmente, a importância do compromisso com as políticas sociais e, em particular, com aquelas voltadas para a área da saúde. Trata-se de um estudo de caso com abordagem qualitativa. Realizou-se o levantamento dos dados através de pesquisa documental, a partir de 14 portfólios de aprendizagem, que são registros semanais dos estudantes da respectiva disciplina, correspondendo aos semestres 2005.2 a 2007.2. Da análise empreendida, inferiu-se que a metodologia problematizadora, utilizada pela referida disciplina, possibilita aos estudantes compreender que a aprendizagem não se limita aos restritos muros universitários. Ela situa a saúde partindo de uma realidade social concreta e complexa possibilitando aos estudantes um diálogo interdisciplinar na busca da transformação desta realidade. Significa uma oportunidade de interagir com a dinâmica da sociedade no seu espaço de ações, desenvolvendo uma relação de solidariedade na formação do cidadão. Por outro lado, ficou evidente o sentido da interdisciplinaridade vivenciada e reconhecida pelos estudantes de diversas profissões que integram a disciplina. Desse modo, a SACI na perspectiva de construção do SUS, ajuda a formar um novo profissional, mais comprometido com a promoção e com um trabalho coletivo em saúde.
16
  • ILDONE FORTE DE MORAIS
  • Saúde da Família: uma estratégia de mudança no processo de produção dos serviços de saúde
  • Advisor : RAIMUNDA MEDEIROS GERMANO
  • COMMITTEE MEMBERS :
  • CLELIA ALBINO SIMPSON
  • JORDANA DE ALMEIDA NOGUEIRA
  • RAIMUNDA MEDEIROS GERMANO
  • SORAYA MARIA DE MEDEIROS
  • Data: Nov 27, 2008


  • Show Abstract
  • O presente estudo tem como objetivo analisar, na visão de enfermeiros, as mudanças no processo de produção dos serviços de saúde, após a implantação do Programa Saúde da Família (PSF). Trata-se de uma investigação de natureza qualitativa, que utiliza entrevistas semi-estruturadas como principal ferramenta de abordagem empírica. Foram entrevistadas seis enfermeiras da cidade de Caicó-RN, que trabalhavam na atenção básica, antes da implantação do PSF, e continuam trabalhando. Pela análise empreendida, as principais mudanças verificadas no processo de produção dos serviços de saúde com a implantação do PSF, no contexto da atenção básica, foram: a adscrição e vínculos com a comunidade; acolhimento e humanização do atendimento; diminuição das internações hospitalares; fortalecimento da prevenção de agravos e promoção da saúde; melhoria dos indicadores de saúde; enfim, ações que sinalizam para a realização dos princípios da integralidade, eqüidade e universalidade, conforme preconiza o Sistemaùnico de Saúde (SUS). No entanto, apesar dos aspectos positivos identificados, o PSF apresenta algumas fragilidades, tais como: a dificuldade do trabalho coletivo; descompasso entre a formação dos profissionais e as exigências do modelo de saúde atual; alta rotatividade dos profissionais de saúde e precarização do trabalho. Além disso, foram apontadas algumas estratégias que podem ser utilizadas para melhor orientação do processo de produção dos serviços de saúde, como a intersetorialidade, educação permanente, desprecarização do trabalho e melhoria na condução da gestão dos serviços de saúde. Assim, concluímos que o PSF apresenta mudanças significativas no processo de produção dos serviços de saúde para a consolidação do SUS, embora esteja inserido em um contexto de adversidades que podem ser superadas através da luta coletiva dos distintos atores sociais.
17
  • GYSELLA ROSE PRADO DE CARVALHO
  • O QUE SEI E O QUE NÃO SEI SOBRE O MEU TRABALHO? ESTUDO REPRESENTACIONAL SOBRE O SOFRIMENTO PSÍQUICO DO PONTO DE VISTA DO PROFISSIONAL ENFERMEIRO EM AMBIENTE HOSPITALAR.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • CLELIA ALBINO SIMPSON
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • ROSALINA APARECIDA PARTEZANI RODRIGUES
  • Data: Dec 22, 2008


  • Show Abstract
  • O QUE SEI E O QUE NÃO SEI SOBRE O MEU TRABALHO? ESTUDO REPRESENTACIONAL SOBRE O SOFRIMENTO PSÍQUICO DO PONTO DE VISTA DO PROFISSIONAL ENFERMEIRO EM AMBIENTE HOSPITALAR.

18
  • LUCIANE PAULA BATISTA ARAUJO DE OLIVEIRA
  • A fragilidade e suas representações para idosos domiciliados no contexto da estratégia de saúde da família
  • Advisor : REJANE MARIA PAIVA DE MENEZES
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • REJANE MARIA PAIVA DE MENEZES
  • ROSALINA APARECIDA PARTEZANI RODRIGUES
  • Data: Dec 22, 2008


  • Show Abstract
  • A fragilidade e suas representações para idosos domiciliados no contexto da estratégia de saúde da família
19
  • SENEI DA ROCHA HENRIQUE
  • HABILIDADES DE VIDA FRENTE A SEXUALIDADE DO ADOLESCENTE: UM ESTUDO REPRESENTACIONAL.

  • Advisor : FRANCISCO ARNOLDO NUNES DE MIRANDA
  • COMMITTEE MEMBERS :
  • ANTONIA OLIVEIRA SILVA
  • BERTHA CRUZ ENDERS
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • REJANE MILLIONS VIANA MENESES
  • Data: Dec 22, 2008


  • Show Abstract
  • Observando o processo de adolescer e as inquietações relacionadas à vivência da sexualidade, este estudo trata de uma pesquisa descritiva, exploratória e representacional. O objeto configura a maneira como o adolescente representa socialmente sua sexualidade e como a vivencia. Desse modo, objetivamos apreender as representações sociais do adolescente sobre sua sexualidade, a partir das habilidades de vida. Traçarmos como objetivos específicos: 1- Descrever valores, tabus e preconceitos em relação à sexualidade na adolescência; 2-Identificar o conhecimento sobre o uso dos métodos contraceptivos, DSTs e as condições de risco; 3- Identificar as habilidades dos adolescentes no que concerne à vivência da sexualidade. Para tanto, utilizamos para a coleta de dados entrevista semiestruturada e entrevista grupo focal. Participaram do estudo 13 adolescentes, sendo sete do gênero feminino e seis do gênero masculino, estando estes frequentando a Educação de Jovens e Adultos (E.J.A) de duas escolas do Município de Jandaíra, localizado no Rio Grande do Norte, situado na região do Mato Grande, a 120km de Natal, sendo uma escola municipal e outra estadual. Como resultados, observamos a coexistência de diversas dúvidas sobre sexualidade, ocorrência de gravidez devido ao uso inadequado de pílulas anticoncepcionais, conhecimento mínimo sobre os métodos contraceptivos, pouca ou nenhuma procura dos serviços de saúde, possivelmente devido a tabus culturais, escassez ou inexistência de diálogo intrafamiliar sobre questões referentes à sexualidade, déficit de autocuidado, dentre outros fatores. Preocupantemente, além destes, os adolescentes de ambos os gêneros demonstraram pouco conhecimento sobre DSTs, apesar de reconhecerem a importância da camisinha na prevenção da gonorreia e aids. Percebemos a necessidade de serem trabalhadas as habilidades de vida, onde a cognitiva pode ser intensificada por intermédio da disponibilidade de mais informações a partir da visão que o adolescente tem de seu próprio corpo para, então, discutir questões referentes a sexualidade. Quanto à habilidade social, é fundamental a participação dos pais no contexto escolar, para que juntamente com professores e profissionais de saúde possam construir ressignificações sobre fatores de proteção para a saúde dos adolescentes, fortalecendo assim o dialogo familiar, o qual exerce forte influência na tomada de posição dos adolescentes. Por fim, a habilidade no controle de emoções deve ser reforçada quando da participação dos adolescentes, já que são exemplos multiplicadores de informações e participação em ações diversas junto ao setor saúde e ao setor educação. Para tanto, consideramos primordial o desenvolvimento de ações intersetoriais entre saúde e educação, com vistas à promoção da saúde do adolescente por entendermos que o profissional enfermeiro exerce forte influência sobre a articulação dessas atividades.

20
  • MAISA ARANTES DA SILVA
  • Atuação dos profissionais de enfermagem durante o processo transfusional na UTI de um hospital universitário
  • Advisor : GILSON DE VASCONCELOS TORRES
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • GILSON DE VASCONCELOS TORRES
  • RAIMUNDA MEDEIROS GERMANO
  • WILMA DIAS DE FONTES
  • Data: Dec 23, 2008


  • Show Abstract
  • Estudo descritivo prospectivo, com abordagem quantitativa, que objetivou analisar a relação entre o conhecimento dos profissionais de enfermagem e as condutas assistenciais prestadas, durante o processo transfusional, aos pacientes na UTI de um hospital universitário em Natal-RN. A amostra foi composta por 27 profissionais da equipe de enfermagem (5 enfermeiros e 22 técnicos de enfermagem), escalados para a UTI durante o período da coleta de dados, coleta esta realizada por meio de questionário e formulário de observação estruturados, além da consulta ao prontuário. Esses resultados foram organizados no programa SPSS 15.0, tabulados, categorizados e analisados por meio de estatística descritiva e inferencial. Os resultados mostram uma população jovem, na faixa etária entre 21 e 32 anos (63,0%), do sexo feminino (85,2%). Dentre os pesquisados houve predominância de bolsistas, em sua maioria técnicos de enfermagem (ρ= 0,006), os quais possuem pouco tempo de experiência, até 2 anos (ρ= 0,008), não conhecem a RDC no 153 (ρ= 0,019), realizaram o maior número de condutas assistenciais na hemotransfusão (ρ= 0,018), a não participação de treinamentos e a falta de informação sobre o processo transfusional não resultaram em diferenças significativas. Quanto aos funcionários, destacaram-se apenas o tempo de experiência superior a 2 anos, a realização de menor número de procedimentos e se sentirem informados sobre a hemotransfusão. Em relação às condutas durante o processo transfusional, constatamos que, na maioria, as condutas observadas, tanto dos bolsistas como dos funcionários foram inadequados, com predominância nos primeiros, tanto na realização das condutas quanto na inadequação. As médias das condutas inadequadas, predominantemente desenvolvidas pelos bolsistas, foram maiores em todas as etapas em relação às condutas adequadas. Analisando o conhecimento sobre o processo transfusional, os bolsistas foram os que apresentaram os menores escores de conhecimento nas três etapas. Quanto à relação existente entre as condutas assistenciais e o conhecimento, verificamos que em todas as etapas do processo transfusional as médias de conhecimentos inadequados foram superiores, tendo diferença significativa nas etapas pré-transfusional (ρ= 0,012). Ao analisarmos a média de condutas desenvolvidas, verificamos que nas condutas inadequadas foram significativamente maiores (ρ= 0,031) nos pesquisados que apresentaram conhecimentos inadequados. Quanto à frequência total de procedimentos realizados, verificamos uma predominância significativa (ρ= 0,049) de condutas inadequadas (88,9%), das quais 81,5% foram desenvolvidas por profissionais que tiveram conhecimento inadequado, apresentando moderada correlação (r = 0,516) e razão de chance de 2,750 vezes de desenvolvimento de condutas inadequadas nos profissionais com conhecimentos inadequados. Concluímos que os profissionais pesquisados, principalmente os técnicos de enfermagem bolsistas, apresentaram deficiências graves no tocante ao desenvolvimento das condutas e conhecimento sobre o processo transfusional, denotando a inadequação para desenvolver essa terapêutica. Diante do exposto, aceitamos a hipótese alternativa proposta no estudo, pois evidenciamos que a adequação do conhecimento sobre o processo transfusional influenciou nas condutas adequadas implementadas pela equipe de enfermagem na UTI.
21
  • ARIANE ROSE SOUZA DE MACEDO OLIVEIRA
  • Atenção à criança na estratégia saúde da família: óbito infantil como referência para análise de qualidade
  • Advisor : ROSALBA PESSOA DE SOUZA TIMOTEO
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • BERTHA CRUZ ENDERS
  • NEUSA COLLET
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • Data: Dec 29, 2008


  • Show Abstract
  • Atenção à criança na estratégia saúde da família: óbito infantil como referência para análise de qualidade
22
  • FRANCISCA IDANESIA DA SILVA
  • Entre flores e espinhos: a atuação do técnico em enfermagem na estratégia saúde da família
  • Advisor : ROSALBA PESSOA DE SOUZA TIMOTEO
  • COMMITTEE MEMBERS :
  • JACILEIDE GUIMARAES
  • LENILDE DUARTE DE SÁ
  • RAIMUNDA MEDEIROS GERMANO
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • Data: Dec 29, 2008


  • Show Abstract
  • Entre flores e espinhos: a atuação do técnico em enfermagem na estratégia saúde da família
23
  • NEYLA IVANETE GOMES DE FARIAS ALVES BILA
  • A banalização da injustiça social no cotidiano de trabalho: a propósito da violência no trabalho e ameaça à saúde do trabalhador
  • Advisor : SORAYA MARIA DE MEDEIROS
  • COMMITTEE MEMBERS :
  • JACILEIDE GUIMARAES
  • LENILDE DUARTE DE SÁ
  • RAIMUNDA MEDEIROS GERMANO
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 29, 2008


  • Show Abstract
  • Analisa os fatores que desencadeiam violência pela banalização dos problemas e das questões da saúde dos trabalhadores em uma instituição pública federal, em Natal/RN. Analisa as transformações no mundo do trabalho, com seus determinantes políticos, sociais e econômicos e sua relação com a saúde do trabalhador. Aborda a violência no ambiente de trabalho e suas implicações na saúde do trabalhador, enfocando a banalização dos problemas enfrentados por esses trabalhadores como uma forma de violência no e com o trabalho. Foi utilizada metodologia analítica com abordagem qualitativa, através da técnica de coleta e análise de informações segundo a história oral temática, com gravações consentidas de narrativas pessoais, através da entrevista individual com roteiro emi-estruturado. Na análise dos resultados foram construídas as categorias empíricas: o cotidiano no ambiente de trabalho e sua influência na profissão e na vida dos trabalhadores; a violência presente no ambiente de trabalho e suas conseqüências na vida e na saúde dos trabalhadores; a banalização da injustiça social, a propósito da violência contra o trabalhador e sonhos divisados, a propósito da contribuição da enfermagem. Os resultados revelam que o cotidiano de trabalho desses trabalhadores, apresentam condição ambiental e organizacional insalubres, caracterizada pela insegurança física e técnica; falta e desqualificação de recursos instrumentais e humanos; sobrecarga e complexidade do serviço; má distribuição das tarefas e pressão por prazo e produtividade, gerando tensão, conflito e ansiedade relacionados com os usuários, colegas, superiores, e com a tarefa. No ambiente de trabalho foram identificadas a violência externa, caracterizada por agressão física e verbal, sofrimento psíquico e desvalorização do trabalhador e interna, caracterizada por assédio moral, assédio psicológico, e violência estrutural ocupacional. Essas formas de violência trazem conseqüências à vida, explicitadas por fatores de ordem profissional, econômica e moral, e à saúde, por fatores de ordem biológica, mental e emocional. A banalização da injustiça social no cotidiano de trabalho foi discutida nos aspectos da banalização dos problemas e das condições de trabalho, da banalização da saúde, e da banalização da qualificação e valorização profissional. As expectativas dos trabalhadores apontaram para a necessidade de: condições de trabalho seguras; treinamentos e assistência técnica; política de atenção a saúde física, mental e social para os trabalhadores, extensiva à família. Conclui-se que as condições ambientais e organizacionais dos trabalhadores pesquisados, não oferecem segurança física e técnica de que os trabalhadores necessitam para a execução de suas atividades, nem oferecem conforto e bem-estar físico e psíquico. A política que vem sendo utilizada pela instituição, aponta para a desvalorização e desumanização destes, acarretando sentimento de insatisfação, frustração e indignação com respeito a instituição e ao trabalho, acarretando sofrimento e adoecimento físico e mental. Constatou-se que a forma mais cruel de violência presente no ambiente de trabalho é a banalização da injustiça social diante dos problemas e saúde desses trabalhadores, gerando padecimento lento e morte simbólica de seus sonhos e de suas vidas. Portanto faz-se necessário a implementação de uma política que promova segurança, saúde, educação integral, valorização e humanização desses trabalhadores.
24
  • ERICA LOUISE DE SOUZA FERNANDES BEZERRA
  • VIVÊNCIAS DE DOCENTES DE ENFERMAGEM NO ENSINO DO CUIDAR

  • Advisor : ROSALBA PESSOA DE SOUZA TIMOTEO
  • COMMITTEE MEMBERS :
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • BERTHA CRUZ ENDERS
  • RAIMUNDA MEDEIROS GERMANO
  • GEOVANIA DA SILVA TOSCANO
  • Data: Dec 30, 2008


  • Show Abstract
  • O cuidar, em uma perspectiva global, aparece nas principais discussões como o fenômeno que deverá permear os pensamentos, a percepção e os valores necessários para a mudança que levará à superação de uma crise paradigmática. O cuidado profissional foi atribuído, no decorrer da história, à Enfermagem. Sua evolução histórica e a articulação com os processos sociais, políticos e científicos colocam-na em lugar de destaque, no que diz respeito ao bem-estar humano, não objetivando apenas curar, mas confortar, complementar as capacidades debilitadas e potencializar as capacidades presentes, aliviando a dor, ou seja, cuidando. O Ensino do Cuidar em Enfermagem sofreu grandes influências do modelo biomédico, sendo assim, a educação em Enfermagem tem sido criticada por se valer de modelos pedagógicos incapazes de promover o crescimento dos sujeitos, mantendo-o passivo diante de seus processos de vida, mostrando fragilidades, atitudes e comportamentos questionáveis, dissonâncias, surgindo a iminência de um ato de cuidar e educar que precisa ser considerado como um agir dialético e intersubjetivo. O objetivo desta pesquisa é compreender a experiência vivida dos docentes de Enfermagem no Ensino do Cuidar, a fim de refletir sobre a inserção da Enfermagem no atual contexto mundial, desvelando a dialética do Ensino do Cuidar e as mudanças paradigmáticas no setor saúde. Trata-se de uma pesquisa de cunho fenomenológico que utilizou a análise do fenômeno situado, para obter as unidades de significado do discurso dos docentes de Enfermagem sobre sua experiência vivida no Ensino do Cuidar. Este estudo permitiu que os docentes de Enfermagem pudessem compartilhar as suas vivências, sentidos e informações sobre o interior de sua ação pedagógica exaltando a interpretação, que surge intencionalmente na consciência, enfatizando a experiência pura do ser-docente, incluindo emoções e afetividades no ensino do cuidar. Na construção dos resultados, três momentos foram desvelados para discussão: o Cuidar Multidimensional; o Cuidar como Prática Profissional; e o Ensino do Cuidar. Os discursos mostraram-se ricos, complexos e por vezes paradoxais. A compreensão de um ensino sensível, que, algumas vezes, chega a se preocupar em resgatar a ternura e a humanidade, vai de encontro ao outros discursos permeados de fragilidades, inconstâncias, tecnificações, que explicitaram falta de preparo pedagógico. O ensino do cuidar precisa adotar uma concepção de ensino/aprendizagem e utilizar metodologias que possam conduzir a uma ação libertadora, capaz de romper com amarras tradicionais e com preconceitos ou hábitos de vida pouco saudáveis, favorecendo a utilização de métodos que promovam o educar pela via do sensível, destacando aspectos que contribuem para esse fim, como a intuição, a emoção, a criação, a percepção e a sensibilidade. Neste sentido, considera-se importante aprofundar questões que possibilitem a criação de estratégias assistenciais e educacionais com a visão do ser humano em sua totalidade, pois se percebe que a abordagem terapêutica precisa ser mais ampla, passando pelo indivíduo, família e suas relações sociais.

25
  • VIVIANE LIMA DE SENA
  • O PROCESSO DE ALIMENTAÇÃO DO SISTEMA-HIPERDIA: ESTUDO DE CASO COM OS PROFISSIONAIS NO MUNICÍPIO DE NATAL.

  • Advisor : BERTHA CRUZ ENDERS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • GILSON DE VASCONCELOS TORRES
  • REJANE MARIA PAIVA DE MENEZES
  • Data: Dec 30, 2008


  • Show Abstract
  • O PROCESSO DE ALIMENTAÇÃO DO SISTEMA-HIPERDIA: ESTUDO DE CASO COM OS PROFISSIONAIS NO MUNICÍPIO DE NATAL.

2007
Dissertations
1
  • MEINE SIOMARA ALCANTARA
  • Envelhecer Entre Pássaros e Anjos: Um Ensaio Etnografico sobre o Processo Saúde Doença dp Idoso Contexto Familiar
  • COMMITTEE MEMBERS :
  • REJANE MARIA PAIVA DE MENEZES
  • BERTHA CRUZ ENDERS
  • RAIMUNDA MEDEIROS GERMANO
  • Data: Feb 7, 2007


  • Show Abstract
  • Estudo, do tipo descritivo, guiado por princípios etnográficos, que objetivaram analisar o idoso no contexto familiar, em seu processo de saúde e envelhecimento, no bairro de Felipe Camarão, localizado na região administrativa Oeste do município de Natal/RN, cidade do Nordeste do Brasil. Os participantes do estudo são idosos com idades entre 61 e 84 anos, residentes nesse bairro, cuja maioria, é constituída por migrantes da região rural do Estado, aposentados, incluindo viúvos e casados, com baixa escolaridade. Para a coleta das informações, utilizou-se a entrevista semi-estruturada, a observação participante e o diário de campo, efetivando-se , na sua maioria, nos domicílios e na Unidade de Saúde da Família, no período de março a outubro de 2006. Para a discussão dos resultados, utilizou-se a análise de conteúdo temática e o programa ALCESTE (Análise Léxica por Contexto de um Conjunto de Segmentos de Texto), através do qual emergiram dois corpus: o corpus I: Família e os idosos, e o corpus II, O idoso e a velhice na sociedade. A análise dos resultados permitiu concluir que a família, também utilizada pelas políticas públicas, como estratégia das suas práticas em saúde, é um suporte de apoio necessário para o cidadão idoso em seu processo de envelhecimento e de saúde. Os contextos familiares dos idosos permitiram identificar a existência de condições sociais mínimas de vida, e de novos re-arranjos das famílias atuais, através da convivência plurigeracional e da presença atuante da mulher idosa, como mantenedora dessa família; das relações de conflitos entre seus membros, num nível suportável de convivência. Diferentes concepções sobre a velhice e a pessoa idosa, originam desencontros e divergências, contudo, o apoio e a ajuda para resolução dos problemas e a atenção à saúde são provenientes dos familiares. Porém, nota-se que a solidão é algo presente no cotidiano desses idosos. Sobre a atenção à saúde, em nível de atenção básica, percebe-se haver ainda várias lacunas, principalmente no tocante às ações de promoção e prevenção, merecendo maior sensibilização e empenho por parte das instituições locais de saúde.
2
  • MARIA CLAUDIA MEDEIROS DANTAS DE RUBIM COSTA
  • VIVENDO O BEM ESTAR DO DESCONHECIDO:EXPERIÊNCIA DA MULHER COM A PRESENÇA DO ACOMPANHANTE NO PROCESSO DE PARTO
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • ROSINEIDE SANTANA DE BRITO
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • Data: Aug 31, 2007


  • Show Abstract
  • VIVENDO O BEM ESTAR DO DESCONHECIDO:EXPERIÊNCIA DA MULHER COM A PRESENÇA DO ACOMPANHANTE NO PROCESSO DE PARTO
3
  • MARIA JACQUELINE ABRANTES GADELHA
  • Beirando a vida, driblando os problemas:estratégias de bem viver
  • COMMITTEE MEMBERS :
  • RAIMUNDA MEDEIROS GERMANO
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 14, 2007


  • Show Abstract
  • O presente estudo tem por objetivo analisar as estratégias utilizadas pelas famílias em situação de risco e vulnerabilidade, adscritas à Estratégia Saúde da Família (ESF), no enfrentamento de seus problemas cotidianos. Trata-se de uma investigação de natureza qualitativa que utiliza a entrevista como principal ferramenta da abordagem empírica. Foram entrevistadas dez mulheres da localidade do Panatis, zona Norte, do município de Natal-RN, cujas famílias vivenciam carências de condições socioeconômicas básicas. As entrevistas ocorreram entre os meses de abril a junho de 2007. Os depoimentos revelam a existência de um misto de improvisações e criatividades usadas como estratégias para a superação das privações e necessidades vividas no cotidiano. Depreendemos, igualmente, que estas famílias buscam soluções para os problemas por meio da religiosidade e do sistema de reciprocidade da dádiva, como recurso para obtenção de reconhecimento pessoal e apoio nas adversidades. Os resultados apontam, ainda, a ESF como uma das estratégias utilizadas por essas famílias na busca de atenção e de cuidado. Nessa perspectiva, a ESF evidencia-se como um espaço de escuta e de construção de vínculos que se consolidam nas visitas domiciliares, nos grupos organizados, nas festas e passeios promovidos junto à comunidade, reinserindo o contato e o apoio entre as pessoas e sinalizando para uma via de saída do abandono e do isolamento. Detentoras de um saber construído a partir das suas experiências de vida, as participantes do estudo nos induzem a inferir ser necessário ampliar os espaços, que lhes permitam expressar significados, valores e vivências, e a considerar o adoecimento como um processo que incorpora outras dimensões da vida, além da física. Como profissionais de saúde, precisamos estar atentos às diversas e criativas habilidades de atuação no cotidiano dessas famílias, para que possamos, junto a elas, reinventar um novo jeito de fazer saúde.
4
  • PRISCILA BRIGOLINI PORFIRIO FERREIRA
  • O PROCESSO DE CUIDAR DO ENFERMEIRO EM UNIDADE DE TERAPIA INTENSIVA: UMA ANÁLISE DOS CONHECIMENTOS UTILIZADOS
  • COMMITTEE MEMBERS :
  • BERTHA CRUZ ENDERS
  • RAIMUNDA MEDEIROS GERMANO
  • GLAUCEA MACIEL DE FARIAS
  • Data: Dec 14, 2007


  • Show Abstract
  • O cuidado sempre esteve presente na história humana e é considerado uma característica fundamental na área da enfermagem. No contexto da Unidade de Terapia Intensiva (UTI), ele se concretiza em meio a um ambiente repleto de fatores estressantes, aparelhagens múltiplas, distanciamento social e desconforto. A vivência da prática em UTI expõe uma realidade em que, geralmente, há falta de uma assistência planejada e sistematizada, todavia, nota-se a existência de algum saber utilizado pelos profissionais. Apoiados nessa premissa, alvitramos identificar que conhecimentos os enfermeiros utilizam para efetuar sua assistência em UTI. Acreditamos que para essa identificação, e determinação, de como esses saberes se caracterizam e se apresentam na prática é essencial uma análise reflexiva e, portanto, utilizamos como metodologia o processo investigatório de Kim (1999), com base nos preceitos da Ciência da Ação de Argyris et al. (1985) sob uma abordagem qualitativa. O levantamento dos dados transcorreu mediante observação não-participativa e entrevista semi-estruturada, numa perspectiva de reflexão com oito enfermeiros intensivistas de um hospital público. O estudo nos possibilitou detectar, como resultados, não somente que os enfermeiros utilizam conhecimentos e padrões de saber adquiridos ou construídos, mas também identificá-los como: científico, filosófico, tácito, popular, religioso, empírico, pessoal, ético e estético. O conhecimento científico destaca-se entre os outros no processo de cuidar, sugerindo, assim, o aporte científico adquirido por esses profissionais para possibilitar uma assistência especializada e direcionada ao tratamento intensivo. A presente análise contribui para a Ciência de Enfermagem no sentido de proporcionar a elaboração de idéias e construtos derivados da própria prática. A concepção da realidade da prática extrapola os limites de teorias, técnicas e fatos conhecidos, o que exalta a necessidade de um processo de reflexão na ação para a compreensão dos conhecimentos envolvidos na elaboração de um cuidado de excelência.
5
  • VILANI MEDEIROS DE ARAUJO NUNES
  • Qualidade de vida na perspectiva de idosos institucionalizados no município de Natal/RN
  • COMMITTEE MEMBERS :
  • REJANE MARIA PAIVA DE MENEZES
  • GILSON DE VASCONCELOS TORRES
  • MARIA JOSEFINA DA SILVA
  • Data: Dec 14, 2007


  • Show Abstract
  • Estudo descritivo e exploratório, de natureza quantitativa, com o propósito de avaliar a Qualidade de Vida (QV) de idosos residentes em Instituição de Longa Permanência (ILP) segundo sua própria percepção. Foi realizado em seis Instituições Públicas de Longa Permanência para Idosos, no Município de Natal – RN, no período de julho a agosto de 2007. Para a coleta dos dados, foi utilizada a entrevista estruturada, guiada por dois formulários: o primeiro contendo questões acerca dos aspectos sócio-demográficos e o segundo, o WHOQUOL-OLD, elaborado pela Organização Mundial de Saúde, para avaliar a qualidade de vida em pessoas idosas. A população de referência foi de 266 idosos, e uma amostra aleatória simples, de 43 idosos, 28 mulheres e 15 homens, que correspondem a 30%. Os resultados indicaram haver predominância de mulheres idosas (65,1%) e média de idade de 76.6 anos, predominância da religião católica (44,2 %) e solteiros sem filhos (32,6%). Quanto à escolaridade e à procedência, (41,9% não alfabetizados) e 67,4%, procedentes da zona rural. O tempo de residência na instituição foi de 1 a 5 anos para 69,8% dos idosos, com 37,2% deles residindo na instituição por não ter outra opção de moradia. A maioria dos idosos informou fazer uso de medicamentos, sendo que, 51,3% afirmaram tomar anti-hipertensivos. Quanto aos aspectos da QV, referentes às facetas sensorial, autonomia, atividades passadas, presentes e futuras, participação social, morte e morrer e intimidade, do WHOQOL-OLD, observou-se um escore médio total de 52,9% (escala de 0 a 100), com tendência à neutralidade, denotando que os idosos, desse estudo, avaliaram sua QV como nem satisfatória, nem insatisfatória, Dentre as facetas do instrumento de QV, destaca-se a sensorial que obteve a maior média dos escores (68,1%), revelando que os idosos referem-se como “satisfeitos” na situação em que se encontram, não apresentando deficiência significativa. Destacou-se, também, a faceta autonomia, que se refere à independência e à capacidade de tomar decisões e que obteve a menor média dos escores (40,7%), mostrando a insatisfação dos idosos quanto a este quesito. A avaliação dos idosos relativa às demais facetas foram: participação social (48,2%); atividades passadas, presentes e futuras (44,6%); e intimidade (50,6%), todas percebidas como nem insatisfatórias nem satisfatórias.Na faceta morte e morrer os idosos declaram-se satisfeitos, com escore médio 65,5%. A análise da confiabilidade do WHOQOL-OLD pelo Alpha de Cronbach teve como valor total 0,57, nos 24 itens que englobam o instrumento, atestando confiabilidade interna regular do instrumento, em nossa realidade, provavelmente devido às diferenças existentes entre as regiões sul e nordeste e pela ampla diversidade sócio-cultural. Consideramos que os idosos nesse estudo, tenderam a perceber sua QV de forma neutra, considerando-a como nem insatisfatória, nem satisfatória, resultado provavelmente, relacionado à resignação com o destino, caracterizado no momento, pela finitude da vida, sentimento muito comum entre os idosos ou talvez até por uma acomodação, muitas vezes acompanhada por desânimo, presente no cotidiano de muito deles. Palavras-Chave: Qualidade de Vida. Idoso. Instituições de Longa Permanência para Idosos.
6
  • LAIANE MEDEIROS RIBEIRO
  • COMMITTEE MEMBERS :
  • RAIMUNDA MEDEIROS GERMANO
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 18, 2007


  • Show Abstract
  • SAÚDE MENTAL E ENFERMAGEM:EM BUSCA DA INTEGRALIDADE NA ESTRATÉGIA SAÚDE DA FAMÍLIA
7
  • MARIA BETANIA MACIEL DA SILVA
  • GRITOS DE SILÊNCIO: na voz dos familiares cuidadores de portadores da doença de Alzheimer.
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • MARIA DE OLIVEIRA FERREIRA FILHA
  • RAIMUNDA MEDEIROS GERMANO
  • SORAYA MARIA DE MEDEIROS
  • Data: Dec 18, 2007


  • Show Abstract
  • O presente trabalho trata-se de uma investigação em torno do cuidado vivenciado pelos familiares de portadores de doença de Alzheimer no domicílio. Justifica-se desenvolver este estudo pela necessidade de conhecer como os familiares cuidadores vêm desempenhando o papel de cuidador e quais os caminhos construídos por eles para a realização do cuidar de um familiar portador de DA. Trata-se, portanto, de um estudo de natureza analítica e abordagem qualitativa, tendo como norteador a história oral temática. Para sua realização, o trabalho teve como colaboradores nove familiares cuidadores de portadores de doença de Alzheimer que participam do grupo de familiares cuidadores de portadores de doença de Alzheimer, no bairro de Candelária, Natal /RN. Os depoimentos foram obtidos através da entrevista semi estruturada, as quais foram agendadas previamente e contou com o consentimento dos familiares cuidadores. Nesse sentido, a análise foi realizada partindo da literatura existente sobre o assunto. A partir da agregação das informações, foram definidos três eixos temáticos norteadores, e destas, as subcategorias de análise. O primeiro eixo temático enfoca o movimento de rito de passagem, quando o familiar torna-se cuidador de um portador de DA. A segunda categoria aborda as formas de ajuda que o familiar cuidador busca, na perspectiva de promover o cuidado do seu ente querido e de si próprio. Constatou-se que entre essas formas de ajuda, o familiar portador precisa contar com uma rede de suporte, envolvendo os serviços de saúde, com equipes multiprofissionais, bem como com uma melhor articulação entre os familiares e colaboradores. A dimensão da fé e da espiritualidade também foi observada como aspecto importante no processo de suporte emocional para estes familiares. No terceiro eixo temático, foram analisadas as perspectivas de lutas e conquistas na busca pelo direito à saúde e qualidade de vida dos portadores de DA e seus familiares cuidadores, contemplando inclusive, seus sonhos e suas esperanças
8
  • LUCIANA FERNANDA LUCENA MENDES
  • VIVENDO E APRENDENDO NO AMBIENTE HOSPITALAR:PERCEPÇÕES DE CRIANÇAS SOBRE A CRIANÇA
  • COMMITTEE MEMBERS :
  • RAIMUNDA MEDEIROS GERMANO
  • AKEMI IWATA MONTEIRO
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • Data: Dec 20, 2007


  • Show Abstract
  • VIVENDO E APRENDENDO NO AMBIENTE HOSPITALAR:PERCEPÇÕES DE CRIANÇAS SOBRE A CRIANÇA
9
  • LUCIANA FERNANDA LUCENA MENDES
  • VIVENDO E APRENDENDO NO AMBIENTE HOSPITALAR:PERCEPÇÕES DE CRIANÇAS SOBRE A CRIANÇA
  • COMMITTEE MEMBERS :
  • RAIMUNDA MEDEIROS GERMANO
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • AKEMI IWATA MONTEIRO
  • Data: Dec 20, 2007


  • Show Abstract
  • O presente estudo focaliza a criança no ambiente hospitalar. Tem como objetivos descrever a percepção de crianças sobre sua doença e hospitalização e identificar suas principais dificuldades com o tratamento. Trata-se de um estudo de natureza qualitativa, tendo como aporte teórico/metodológico o método criativo e sensível desenvolvido por Cabral (1998); os estudos de Piaget, Vygotsky e Wallon que abordam o desenvolvimento infantil; e os de Pinto et al. (2005), Collet (2004), Chiattone (2003), Silva (2002), Lima et al. (1999) que tratam acerca da criança hospitalizada. Para sua realização, foram entrevistadas 13 crianças, na faixa etária de 7 a 12 anos, de uma instituição hospitalar pública, da cidade de Natal/RN, especializada em atendimento pediátrico. Como critério para participação deste estudo, as crianças teriam que ter mais de três dias de internação e plenas condições físicas e emocionais para interagirem com a pesquisadora, por ocasião da entrevista. A análise se processou a partir do estudo do material empírico que constou de entrevistas e um diário de campo onde eram anotadas as reações, expressões e gestos das crianças. Os resultados demonstram a existência de alguma compreensão, por parte destas crianças, sobre sua doença, tendo nos pais seus principais informantes. Elas aceitam o hospital pela necessidade de tratamento, mas reconhecem que a vida fica diferente, principalmente, pelos limites resultantes da doença e do próprio hospital. As principais dificuldades com o tratamento são: a inexistência de atividades recreativas no ambiente hospitalar à noite e nos finais de semana, a ausência dos familiares, principalmente, os irmãos, e a falta de explicação dos profissionais de saúde durante a realização de alguns procedimentos. Concluímos que as crianças percebem a doença e o ambiente hospitalar como algo que muda o ritmo de suas vidas e lhes causam transtornos, medos e apreensões. Sugerimos, portanto, que os profissionais que trabalham com crianças hospitalizadas devam receber uma formação especial para lidar com elas e seus pais, visando diminuir medos e angústias; respondendo às suas dúvidas, e, ainda, orientando os pais quanto ao tratamento de seu filho durante e após a alta. O ambiente hospitalar deve ser também alegre, colorido, com sala destinada à brinquedoteca, coordenada por pessoas preparadas para tal fim.
10
  • LÍBNE LIDIANNE DA ROCHA E NÓBREGA
  • PRATICA DO ENFERMEIRO DO PROGRAMA SAÚDE DA FAMÍLIA - PSF NA PROMOÇÃO DA SAÚDE DO ADOLESCENTE
  • COMMITTEE MEMBERS :
  • AKEMI IWATA MONTEIRO
  • SORAYA MARIA DE MEDEIROS
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • Data: Dec 20, 2007


  • Show Abstract
  • A atenção à saúde do adolescente, baseada no paradigma flexneriano, necessita ser superada. A partir da Conferência Internacional de Ottawa (1986), a literatura vem elaborando a discussão de que a promoção da saúde, baseada no paradigma de produção social em saúde, sugere uma concepção sanitária que visa superar as práticas assistenciais tradicionais. O Programa Saúde da Família - PSF aspira a transmutar o modelo de assistência vigente, sendo o enfermeiro elemento essencial ao trabalho desenvolvido no programa. Ante este contexto, objetivando-se analisar a prática do enfermeiro do PSF para a promoção da saúde do adolescente, elaborou-se uma pesquisa descritiva de abordagem metodológica quantitativa com a inclusão de dados qualitativos. Foram realizadas entrevistas com 9 enfermeiros de 3 Unidades Saúde da Família – USF de Mossoró-RN e aplicados questionários com 74 adolescentes com idade entre 15 e 19 anos, de escolas públicas das adjacências das USF onde atuam esses enfermeiros. As descrições quantitativas foram transformadas em tabelas, quadros e gráficos a partir do programa Excel (Microsoft) e as qualitativas foram trabalhadas através da técnica de análise de conteúdo de Bardin (2004). A análise foi realizada, utilizando-se o referencial de promoção da saúde trazido pelo estudo. Os resultados mostram que os problemas mais comuns que acontecem com os adolescentes são as drogas (33,8%), a gravidez (27,0%) e problemas político-sócio-econômico-culturais (24,3%). Os adolescentes constituem demanda espontânea e raramente buscam as USF. São tímidas as ações dos enfermeiros, palestras e grupos, frente aos macro-problemas apresentados pelos adolescentes, além de verticalizadas e irregulares. Os enfermeiros conhecem a promoção da saúde genericamente, não explicitando como operacionalizá-la a partir de sua prática cotidiana. Concluiu-se que a prática do enfermeiro do PSF ainda não se volta à promoção da saúde do adolescente, sendo necessária a programação de módulos sobre a temática para a capacitação contínua de equipes, profissionais das USF, assim como de professores e demais funcionários das escolas, dando espaço à participação de acadêmicos. As discussões devem ser socializadas junto à comunidade para se discutir possibilidades de enfrentamento dos problemas, que também requisitam mudanças sócio-estruturais. Esta pesquisa pode contribuir como trabalho-diagnóstico, no qual se conheceu a realidade assistencial do enfermeiro do PSF a um grupo específico
11
  • ETENIGER MARCELA FERNANDES DE OLIVEIRA
  • Vivência do homem no puerpério
  • COMMITTEE MEMBERS :
  • ROSINEIDE SANTANA DE BRITO
  • AKEMI IWATA MONTEIRO
  • BERTHA CRUZ ENDERS
  • NORMÉLIA MARIA FREIRE DINIZ
  • Data: Dec 21, 2007


  • Show Abstract
  • Após o nascimento de um filho, ou seja, durante o pós-parto da companheira, o exercício da paternidade, a paternagem, o relacionamento conjugal e sexual, assim como, a definição do papel masculino são aspectos passíveis de mudanças, ainda veladas, que podem contribuir tanto para o fortalecimento dos laços familiares como para o empobrecimento conjugal. Assim sendo, o estudo em apreço teve por objetivo compreender a vivência do homem durante o puerpério de sua companheira, partindo do pressuposto que, nesse período, ele interage e participa de acordo com seu entendimento acerca do pós-parto, vivenciando diferentes situações junto à parceira, família e meio social. Trata-se de uma pesquisa do tipo descritiva-exploratória, em uma abordagem qualitativa, desenvolvida junto a 15 homens que coabitam com suas esposas e as mesmas estavam no período puerperal. Os dados foram coletados através de entrevista semi-estruturada, tratados de acordo com a técnica de análise de conteúdo conforme Bardin e analisados a luz dos princípios do Interacionismo Simbólico, segundo Blumer. Desse processo emergiram três temas – ações de cuidado em ambiente doméstico, significados atribuídos ao puerpério, emoções emergidas durante o pós-parto – e sete categorias – cuidando da companheira e da criança, provendo o sustento da família, momento de descanso, realização da paternidade, sentimento de alegria, sentimento de preocupação, sentimento de exclusão. Desse modo, obtivemos que os entrevistados experienciam o pós-parto cuidando de sua companheira e filho, como também, provendo o sustento da família. Além disso, atribuíram significados ao puerpério considerando-o um período de descanso, para a companheira, e de realização da paternidade. Por fim, mesmo sentindo-se excluídos, expressaram alegria e preocupação com o futuro do filho em virtude da insegurança pela qual passa a atual conjuntura social do país.
12
  • ONIELE OLIVEIRA DAS NEVES
  • Avaliação da qualidade da assistência dos portadores de úlceras venosas atendidas no ambulatório de um hospital universitário em Natal/RN.

  • COMMITTEE MEMBERS :
  • GILSON DE VASCONCELOS TORRES
  • GLAUCEA MACIEL DE FARIAS
  • RAIMUNDA MEDEIROS GERMANO
  • ELINE LIMA BORGES
  • Data: Dec 27, 2007


  • Show Abstract
  • Estudo descritivo que objetivou avaliar a qualidade da assistŒncia aos portadores de œlceras venosas (UVs) atendidos no ambulatrio de um hospital universitürio em Natal/RN. A populaÑo alvo do estudo foi composta por 40 usuürios portadores de œlceras venosas atendidos no ambulatrio de angiologia de um hospital universitürio de ensino no n=vel terciürio. O estudo obteve parecer favorüvel do ComitŒ de õtica da Universidade Federal do Rio Grande do Norte (Protocolo n– 169/06). A coleta de dados foi realizada por meio de um formulürio com roteiro de entrevista e coleta de medidas biofisiolgicas, por uma equipe composta pelos pesquisadores e uma acadŒmica de enfermagem, no per=odo de trŒs meses. Os dados foram analisados no SPSS 14,0, por meio de estat=stica descritiva e apresentados na forma de tabelas, quadros e grüficos. Identificamos uma clientela de portadores de UVs predominantemente feminina, casada, faixa etüria de atª 59 anos, baixo n=vel de escolaridade e renda familiar, procedentes de Natal, aposentados ou que exerciam profissies e ocupaies que exigem longos per=odos em pª ou sentado. Em relaÑo Às caracter=sticas de saœde, os pesquisados apresentaram fatores de risco de doena venosa e apresentavam UVs crnicas, localizadas na zona 2, perda tecidual em grau II e exsudato seroso em mªdia quantidade. A assistŒncia aos portadores de UVs foi caracterizada pela falta de profissionais enfermeiros e indisponibilidade de produtos para a realizaÑo correta do curativo no ambulatrio e fora dele; pela inadequaÑo de produtos utilizados nas UVs; por longos per=odos de tratamento sem resolutividade, onde a terapia compressiva nÑo ª prioritüria; pela ausŒncia de integralidade entre os n=veis de assistŒncia; pelo acompanhamento do portador de UVs apenas pelo mªdico e pela enfermagem, mesmo tendo os outros profissionais da equipe de saœde presentes no servio; pela realizaÑo de orientaies pelos profissionais de saœde e pela falta de padronizaÑo na realizaÑo de exames laboratoriais e espec=ficos. A assistŒncia foi avaliada como inadequada nos aspectos: referŒncia e contra-referŒncia (75,0%), nœmero de consultas com angiologista no œltimo ano (87,5%), documentaÑo dos achados cl=nicos (85,0%), uso de terapia compressiva nos œltimos 30 dias (77,5%), participaÑo da equipe interdisciplinar (97,5%), realizaÑo de exames laboratoriais e espec=ficos no œltimo ano (100%), disponibilidade de produtos usados na realizaÑo dos curativos no ambulatrio (80,0%), e indicaÑo de produtos usados na realizaÑo dos curativos fora do ambulatrio (70,0%); e adequada nas orientaies realizadas quanto ao uso de meias, elevaÑo dos membros e prescriÑo de exerc=cios regulares (82,5%) e indicaÑo de produtos usados na realizaÑo dos curativos no ambulatrio (97,5%). Conclu=mos que a assistŒncia prestada aos portadores de UV foi inadequada em 80% dos casos entrevistados, tornando-se nÑo-resolutiva e assistemütica.

13
  • ROBERTA KALINY DE SOUZA COSTA
  • A FORMAÇÃO ACADÊMICA DO ENFERMEIRO PARA O SUS NA PERCEPÇÃO DE ADOLESCENTES E DISCENTES DA FACULDADE DE ENFERMAGEM/UERN
  • COMMITTEE MEMBERS :
  • FRANCISCO ARNOLDO NUNES DE MIRANDA
  • GILSON DE VASCONCELOS TORRES
  • Data: Dec 28, 2007


  • Show Abstract
  • A FORMAÇÃO ACADÊMICA DO ENFERMEIRO PARA O SUS NA PERCEPÇÃO DE ADOLESCENTES E DISCENTES DA FACULDADE DE ENFERMAGEM/UERN
14
  • SELMA SUELY DA SILVA OLIVEIRA
  • Hospital de Pediatria da UFRN: resgatando memórias na construção da história
  • COMMITTEE MEMBERS :
  • MARIA ELIZETE GUIMARAES CARVALHO
  • RAIMUNDA MEDEIROS GERMANO
  • REJANE MILLIONS VIANA MENESES
  • ROSALBA PESSOA DE SOUZA TIMOTEO
  • Data: Dec 28, 2007


  • Show Abstract
  • Trata-se de um estudo de enfoque histórico, exploratório e descritivo visando resgatar a origem e trajetória do Hospital de Pediatria da UFRN e a inserção da enfermagem no mesmo. Este foi realizado a partir dos registros existentes e dos depoimentos colhidos dos profissionais - médicos, enfermeiras, parteira, auxiliar de enfermagem e psicóloga. Estabeleceu-se uma rede de informantes qualificados, partindo do marco zero, a qual foi configurada pelas referências dos entrevistados. O tratamento e a análise aconteceram com base nas fontes orais coletadas tomando o contexto em que foram vivenciadas para compreendê-las e interpretá-las. Utilizou-se a oralidade na construção de uma história em que as informações, baseadas no tema central, foram desdobradas em sub-temas que emergiram do conjunto dos discursos: o cenário da história, do sonho à realidade e a enfermagem na construção da história, temas que constituíram o corpo do trabalho. Nesse processo, identificou-se vultos de grande relevância para a organização da assistência à criança norte-rio-grandense, que deram origem ao sistema de atenção à saúde da população infantil. Percebeu-se a intencionalidade de se criar instituições de saúde voltadas para a educação de uma geração para o futuro. Observou-se a mudança desse olhar educacional, a partir da criação da Faculdade de Medicina de Natal e, conseqüentemente a estruturação de um hospital pediátrico voltado para o ensino médico. Evidenciou-se a contribuição da enfermagem na construção de uma assistência de qualidade à criança, apesar dos escassos recursos, precária condições de trabalho, jornadas excessivas e baixa qualificação profissional. Observou-se a mudança do perfil da categoria, a partir da inserção das enfermeiras no serviço e com elas, novas mentalidades, processos inovadores e postura profissional. Constatou-se a distinta relação que se estabelece entre o pensar/fazer do médico e da enfermagem, o primeiro relacionado à idealização, projeção e prescrição, e o segundo localizado na concretização e na realização de algo que não se projetou nem idealizou, podendo ser geradora de insatisfação e sofrimento. Enfim, confirmou-se que a riqueza da história oral decorre da possibilidade dos sujeitos construírem a história, a partir das suas interpretações dos fatos e relações entre o geral e o particular.
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