A motivação e o significado do trabalho de bancários: estudo comparativo entre dois momentos do processo de reestruturação produtiva

This master s dissertation deals with motivation and the meaning of work amongst bank employees. This is done considering a cognitive perception. Work is understood here under a social and subjective comprehension, once it deals with significance attribution. Motivation is the process that rules choice of the different possibilities of individual behavior, all of which according to the Expectation Theory. This study aims to analyze the implications of the productive restructure, since it is related to technological innovation, organizational changes and management, in motivation and work significance. Thus, the objective of the research is to verify motivational differences and the meaning of work amongst bank employees. This is done in two distinct moments of the productive restructure of bank employees in Natal-RN. The research is divided in two parts. In the first one, changes that occurred in banks between 1999 until 2005 were identified by the means of interviews with 7 bank managers. The analyzed perspective was training intensifying, quality emphasis of customer attendance, the use of automation/technology, staff stabilization, change in staff profile, work intensification, etc. In the second study the Inventory of Motivation and Work Meaning was applied. Thus, questions related to work focus, social demographic data, in 187 bank employees were dealt with. The collected data was compared to data from previous work. It was observed that productive restructure has a reflection in the meaning of work increasing self-expression, economical reward, and responsibility in work conditions. All of the item mention beforehand maintain the level of inhumanness and consummation and respond as being the characteristics of the real work environment. On the other hand, bank employees value less justice, self-expression and more the survival perspective, implying instrumental values to work. As for motivation, it is increased among bank employees. These employees have greater expectations that their work produce results since they believe in their interference in work results

Gestão educativa gerencial: superação do modelo burocrático?

The study discusses the changes in public management and their impacts on the educational field from the adoption of the flexible model production. It is based on the assumption that the changes incontemporary societies were influenced by the need to reorganize the capital that, in crisis, tried to overcome the Taylor/Ford production model, by implementing a more agile, more flexible one to meet the current demands of the market. For the implementation of the new public management, the Latin American countries started to use strategies based on the business model and the criteria of efficiency, effectiveness and productivity. This new management paradigm advocated replacing the bureaucratic model of management by a decentralized model, with focus on customer service. These guidelines have a broad impact on the educational management and were disseminated by international organizations. Studies show that the management model has been unable to overcome the bureaucratic model of management that existed within the school, which is found in the transformation of a bureaucratic flexibility, consistent with the new model of production.

Os significados de ludoterapia para as protagonistas do processo: crianças em atendimento

The ludic therapy in a Phenomenological-Existential perspective is conceived as a psychotherapeutic process in which, the listening and talking, mediated by playing activities, allow the child to deal with their grief/suffering. This study is based on the need to broaden the understanding of this modality of clinical intervention by emphasizing the speech of the protagonists in the process: children in therapy. The objective was to understand the ludic therapy from the children s perspective, knowing the meanings assigned to the therapeutic process, to the psychologist and to the involvement of the children in clinical consultations. The main ideas that underlie this research are presented in three theoretical chapters covering, respectively, the suffering of children and the demand for psychotherapy, the Phenomenological-Existential clinical psychology, and the psychotherapy for children, in Brazil, under this theoretical-methodological approach. The study was qualitative, on a phenomenological basis, and included six children as participants, aged between six and ten years, undergoing ludic therapy for at least six months, and referred by their own therapists. In the research s corpus construction, individual meetings were held and mediated by tools to support expressiveness (ludic and pictures/figures boxes), added by the storytelling of an incomplete story about a child s visit to the therapy session, and the request for the elaboration of a message to be passed to a child who will go to see a psychologist. The analysis of the data was based on a variant of the phenomenological method proposed by Amedeo Giorgi. The results reveal a lack of knowledge by the children about the psychologist s activities. Thus, the children develop fantasies about this intervention modality because of lack of information. These observations are consistent with the historical meanings assigned to clinical psychology, involving ideas of normality and guilt. The meanings associated with the motives for a referral to a psychologist highlight the conflict "be a problem versus having a problem" and an elitist conception of clinical psychology. Children understand the characteristics of the therapeutic process, such as the specifics of the therapist-client relationship and the notion of freedom. They also demonstrate remarkable pleasure in the therapeutic process. Finally, it was concluded that the meanings attributed to the ludic therapy by the children are consistent with that proposed in the literature about the children s psychotherapy process in the Phenomenological-Existential perspective. Moreover, the relevance of both the children s experience in the therapeutic setting and the meanings of these proceedings understood by the children are highlighted by the listening to the protagonists in the ludic therapeutic process. The comprehension of these aspects and their transference from the clients experience to the reflective field, promote advances in the understanding of child psychotherapy and indicate the need for further studies with children using this approach.

Escuta clínica e atitude fenomenológica no atendimento à pessoa surda: reflexões sobre um processo psicoterápico

Psychology uses listening as a work resource. When it comes to psychotherapy, listening establishes communication and makes psychologist-client dialogue easier. This qualitative research aims to discuss the clinic listening in phenomenological attitude in existential-phenomenological psychotherapy with deaf people. This perspective is based on the thinking of German philosopher Martin Heidegger, who considers humane a being-with and being-in-the-world, always unveiling meanings. Regarding the deaf people, Libras is currently the natural language of Brazilian deaf people. In this new language configuration, communication occurs in a visual-spatial modality. Thus, listening and speech gain new dimensions, demanding different ways of understanding in the field of psychotherapy. To the development of this research, we present excerpts from therapeutic sessions narratives with a deaf client, interpreted in the light of Heidegger s hermeneutics. We consider that it is possible for the psychotherapist to listen to deaf people in phenomenological attitude. Such position, which does not naturalize and limit the humane, helps so that the clients do not feel responsible for their existence and can hermeneutically converse in their language. In this context, the psychologist must be qualified to conduct the treatment in Libras. We hope that this research can, somehow, fill the existing gap of the scientific production about such theme in the field of Psychology and, mainly, instigate discussion in the context of Psychology courses on the importance and need to qualify psychologists for the management of clinical practice with deaf people

Contribuições ao estudo de modelagem de equações estruturais na avaliação da satisfação do cliente de serviços de comunicações móveis

No mercado de telecomunicações as transformações tecnológicas das últimas décadas aliaram-se a um cenário formado por empresas de alta tecnologia que caracterizam o setor de comunicações móveis pessoais em todo mundo. Neste contexto, as empresas deste setor preocupam-se cada vez mais com a competitividade, oferta de serviços, área de atendimento, demanda reprimida e a lealdade do cliente. Estudos de comportamento do consumidor pesquisam a satisfação e lealdade de clientes como fatores básicos para relações bem sucedidas e duradouras com as empresas. A complexidade das relações entre variáveis na avaliação da satisfação do cliente em comunicações móveis pode ser adequadamente pesquisada com a utilização de métodos estatísticos multivariados. Essa tese analisou as relações causais envolvendo os antecedentes e consequentes associados à satisfação do cliente, no segmento de comunicações móveis, bem como desenvolveu e validou um modelo comportamental do cliente no uso deste serviço, buscando explicar as relações entre os construtos envolvidos: satisfação, qualidade dos serviços, valor percebido, imagem da marca, lealdade e reclamação. Foi estabelecida uma ampla base teórica para avaliar a importância estratégica do modelo que relaciona a influência na satisfação do serviço com as percepções dos clientes e avaliada a precisão deste modelo, por meio de uma análise comparativa a utilização de três métodos de estimação dos seus parâmetros, MLE, GLS, e ULS, com o emprego de modelagem de equações estruturais. Foram feitas aplicações em análises de dados, sendo testada e avaliada empiricamente, a influência do gênero na satisfação do cliente deste setor, além de uma segmentação de mercado utilizando mapas auto-organizáveis e a correspondente validação deste processo, com modelagem de equações estruturais.Os resultados do estudo empírico produziram uma boa qualidade de ajustamento para o modelo teórico proposto, com evidências do estabelecimento de uma adequada capacidade explicativa e preditiva, destacando-se a relevância da relação causal entre a satisfação e lealdade, em consonância com diversos estudos realizados para os mercados de comunicações móveis.

Humanização do atendimento à criança na atenção básica: visão dos profissionais

Objetivou-se compreender a humanização do atendimento à criança na Atenção Básica na visão dos profissionais. Estudo qualitativo, realizado em uma Unidade de Saúde da Família de Natal-RN, Brasil. Dezesseis profissionais responderam a um formulário contendo questões referentes ao atendimento à criança, à humanização e às práticas realizadas para humanizar o atendimento. Os dados foram categorizados por temas e analisados a partir dos princípios da Política Nacional de Humanização. Para os profissionais, humanizar o atendimento envolve acolher, escutar, aconselhar sobre o que está sendo realizado com a criança, valorizar a família, e tornar o sujeito ativo no atendimento, mesmo que de forma incipiente. A maioria dos profissionais descreveu atendimento que valorizava parte dos princípios da política de humanização, mesmo com dificuldades para implementá-los na rotina. Requer, portanto, estímulos e atualização dos profissionais para uma postura autocrítica sobre o atendimento

Representações sociais dos trabalhadores de saúde da atenção básica sobre envelhecimento e o atendimento ao idoso

This study aims to identify the social representations built on senior care health workers of Primary Care. This is an exploratory research within the subsidized social representations held in 100 Basic Health Units in the city of João Pessoa-PB, with a sample of n= 204 workers of both sexes, who agreed to participate. To collect the data used to set an interview in two parts: the first looked at the Test of Free Association of Words using the inductive stimulus "senior care". The interviews were analyzed with the help of a software for quantitative analysis of textual data ALCESTE (version 2010). The results were interpreted from the theoretical framework of social representations. The study included 178 women (87.25%) and 26 men (12.75%), working in Family Health Units in the city of João Pessoa, the majority are aged between 40-49 years of age ( 28.92%), and have higher education with 81.86%. The results of Alceste link to the term inducer six (6) where the hierarchical classes representing senior care workers as synonymous with care and attention, showing situations neglect of the elderly, for that patience is required to promote the increase of disease prevention and living with the elderly to generate humanization in health services. It is considered that the social representations of health workers on assistance to the elderly may support modeling of strategic actions in health services with health promotion programs for large groups, able to modify practices and behavior in elder care and strengthening the policy was directed at the elderly

Dimensões da satisfação do paciente geriátrico com a assistência fisioterapêutica

Introdução: Os idosos constituem os maiores consumidores dos serviços de saúde, especialmente os de reabilitação, tornando imprescindível a avaliação da qualidade da assistência fisioterapêutica prestada. A satisfação do paciente tem sido considerada uma das melhores e mais eficazes formas de avaliar o cuidado e direcionar o provedor do serviço para suprir as necessidades e expectativas do paciente-cliente. O objetivo deste estudo foi investigar os principais aspectos (preditores) que contribuem para a satisfação do paciente geriátrico com o tratamento fisioterapêutico ambulatorial. Métodos: Trata-se de um estudo com enfoque epidemiológico, transversal e descritivo de cunho exploratório. Foi utilizado o instrumento de avaliação da satisfação do paciente com a fisioterapia, desenvolvido e validado para a população brasileira por Mendonça em 2007, com uma escala de satisfação do paciente composta por 23 itens. Os dados foram coletados na sala de espera de 29 clínicas de Fisioterapia da rede privada da capital do RN/Brasil e a amostra selecionada de forma não-probabilística constou de 221 pacientes com idade superior a 60 anos, que realizaram entre 5 e 60 sessões de fisioterapia onde os dados foram coletados, deveriam ser usuários de plano de saúde e ter condições cognitivas preservadas. Resultados: A análise fatorial indicou a existência de quatro fatores com autovalor maior que 1: interação pacienteterapeuta (7 itens) α = 0,901; acesso e atendimento de recepcionista e pessoal de apoio (8 itens) α = 0,888; ambiente físico e satisfação global (5 itens) α = 0,835; e conveniência (3 itens) α = 0,711. Os itens com maiores escores de satisfação completa foram os contemplados nos aspectos de interação paciente-terapeuta, especialmente o respeito e a gentileza do fisioterapeuta. As associações realizadas através do teste do Qui-quadrado e regressão logística binária entre a satisfação do paciente e as variáveis sócio-demográficas, percepção do estado de saúde e capacidade funcional demonstraram que a satisfação do paciente idoso associa significativamente com o sexo e estado civil. Os achados revelam que as mulheres mostram-se mais satisfeitas com a fisioterapia. Conclusão: Os aspectos interpessoais demonstraram ser preditores relevantes para assistência fisioterapêutica satisfatória, especialmente na população idosa que requer atenção além do suporte puramente técnico

Políticas públicas de atendimento à criança: desafio da ação articulada no Projeto Belém Criança (2001-2004)

Public politics of Service to the Child: The Challenge of the Action Articulated in the Project Belém Criança (2001-2004) if it constitutes in a study on the politics directed toward the children of 0 the 6 years. It has as objective to analyze the configuration of the politics of integral attention to the child, evidencing the form as the same ones they had been redimensioned by the neoliberal ideas and by the lines of direction of the international organisms. The work has like empiric reference the project Belém Criança, developed by county of Belém from a partnership with the Deep of United Nations for Infancy (UNICEF), in the period of 2001 and 2004. The project intends to develop an articulated action among the several county departments which offer assistance to the children looking for to rationalize the resources and to optimize the services. Amongst the methodological procedures that materialized the research distinguished: The bibliographical review and documental allowed to analyze the contextualization of the public politics and, between them, the social politics of attendance to the child; the historical revolution this attendance; the paper of the UNICEF how articulator of the politics in municipal scope; and the paper of county how executer these politics. Still it was utilized, the half-structuralized interview, Having like subjects: the representative of the UNICEF in Belém, the municipal co-managers and actors of community in which the project was implemented. The result of the analyzes review that, historically, the politics destined to the child they had been being dimensioned having like support the fight of social movements vindictive for publics politic which guarantee the fundamentals rights these citizen. Although legal dimension of current politics of attendance to the child, to assume a vision of completeness and the guarantee of the rights, it still has a great exaggeration between the speech and the practical one. Actually, the same one are elaborate inside the neoliberal optics, with ruled actions by the beginning in combat to the poverty, implanted with low costs and with practice which to lead to the excessive fragmentation, generating inadequate actions and punctual programs which don t guarantee the social quality of the attendance. This perspective was evidenced to the most of the actors which the Project Belém Criança don t constitute itself a real public politic toward the child of 0 the 6 years, although present innovating aspects, how the mobilization and participation. It was demonstrated yet, in the participant s depositions of the research, that the bureau had numberless of difficulty to develop the action preview in the project, it has seen the great complexity of articulation between the several organism responsible by politics of attendance

O atendimento educacional especializado no processo de inclusão escolar, na rede municipal de ensino de Mossoró/RN

This dissertation aims to analyze the specialized educational services(AEE, Portuguese) implemented in four municipal schools of Mossoró/RN, with attention to the process of collaboration between regular classroom teachers and multifunctional resource classroom teachers. We use as theoretical reference the works of Vygotsky and others authors that write about education and collaboration. To accomplish the research we chose a qualitative approach, using as a methodological resources: study of cases, bibliographical, documental and field research. For the field research we make observations in regular and multifunctional classrooms. We produce group intervieus with regular and multifunctional teachers. From the analysis performed we identify that the concepts and the practices of teachers in regular classrooms changes, with integrationist predominance. The AEE s teachers had more inclusive conceptions and greater investment in continuing education than the regular classroom teachers. The practices of regular classroom teachers are more traditional, what makes the learning process more difficult for the students, even more for the students with disabilities and pervasive developmental disorders. Teachers of AEE was more interactive and creative, however, the attention to the students was more individual. In three of the four schools surveyed stand out the efforts of the teachers of specialist classroom to collaborate with regular school teachers, by notes, e-mails, phone calls and resource sharing. In one of the four was noted a good collaborative interactive between the AEE teachers and the regular school teachers. The school with the worst improvement was that in which the actions of the teachers of the AEE were limited to actions in multifunctional resource classroom. The resistance to these professionals was identified in the statements of the regular classroom teachers. Another issue raised was the lack of time for teachers to conduct AEE actions that contribute to the process of school students, because their working hours is restricted to the opposite turn in school. Transport difficulties for the students to attend the resource classroom multifunctional and the lack of dialogue with the health sector was challenges for the four schools. The families were with a practically constant interest to interact with the AEE teachers in the four schools. Thus, we believe that the presence of AEE school can make contributions to the educational process, however, it is necessary more attention to the collaborative process between teachers and the school community

Satisfação da equipe de enfermagem do serviço de atendimento móvel às urgências (SAMU) no ambiente de trabalho

Descriptive exploratory study, prospective with quantitative approach, performed on the Medical Regulation Central of SAMU/Natal, aiming to identify the level of professional satisfaction of the members of the nursing team working at SAMU/Natal; and verify the degree of importance attributed by the professionals to each of the components Professional Satisfaction: autonomy, interaction, professional status , work requirements, organizational rules and remuneration. The population was of 60 professionals, with data collected from january to february 2005. We used an instrument translated and validated by Lino (1999) to the portuguese language, the Professional Satisfaction Rate (PSR). The results demonstrate that there was a slight predominance of the female gender (54,9%); aged between 36 and 45 years old (60,8%); married (58,8%), 82,4% with children, 30,8% aged between 05 and 09. Regarding formation, we observed that 78,4% were nursing technicians and 21,6% nurses, formed for 11 to 15 years (17,5%). From the 11 nurses, 09 (81,8%) informed they have specialization, 29,4% of the team has been working for 11 to 15 years on the urgency area, 58.8% works for more than 02 years on SAMU, 72,6% of the team members have fixed work schedules. There was homogeneity on the work shifts: 41,2% on the day shift and 53% on the night shift. Regarding the reason to be working on SAMU, 64% chose to work in the service, and among these 76,3% predominantly perform direct care to the patients, 96,1% like and are satisfied to work in the service. Regarding the remuneration, 90,9% informed they receive 05 to 10 minimum wages; 70% of the technicians informed they receive -2 to 05 minumum wages, 50,1% informed they receive no additional benefit. The analysis of PSR through Cronbach s Alpha Coeficient resulted on the value of 0,94 and through Kendall s Tau Coeficient on 0,87, demonstrating to be a trustworthy instrument to measure the level of professional satisfaction of the SAMU nursing team, in our environment. As for the level of importance attributed to the components of professional satisfaction, we indentified that the nursing team considered the Autonomy component as the most important, followed by the component Remuneration, Interaction, Work Requirements, Work Requirements, Organizational Rules and Professional Status . Regarding the current level of professional satisfaction, we identified they were most satisfied with the Professional Status , Autonomy, Interaction, Remuneration, Work Requirements and Organizational Rules. The real professional satisfaction level, calculated through statistics, however, tells these professionals are more satisfied with Autonomy, Remuneration, Interaction, Work Requirements, professional Status and Organizational Rules. The PSR in our work was of 8,6, indicating the SAMU Natal nursing team has little satisfaction on their work environment

Serviço de atendimento móvel de urgência (SAMU) e a assistência às urgências psiquiátricas

The objective of this work which is characterized as an applied research, with a qualitative exploratory approach and has case study character has been the analysis of the conceptions and dealings of health professionals of SAMU in Natal RN about the attendance of psychiatric urgencies. The information was collected between the months of March and April of 2010, by means of semi-structured interviews, performed with 24 health professionals integrating of SAMU-Natal as well as the usage of direct observation technique, performed in the institution's medical regulation room. Both the number of professionals involved in the interviews and the bringing about of the observations, were determined by saturation methods in qualitative research's information collecting. The interviews and observations were transcribed and submitted to contents analysis technique , more specifically, to thematic analysis, which made possible to reach the deepest levels, that go beyond what has simply been manifest in the speech of the interviewed, getting to the relations among the categories and social structures of the issue of the research. Keeping this in mind, three analysis categories have been built, namely: conceptions and concepts of psychiatric urgencies shared by health professionals in SAMU-Natal; attendances to psychiatric urgencies in SAMU-Natal; and the Brazilian Psychiatric Reformation under the view of the SAMU-Natal's health professionals. Reflection about the analyzed information revealed discussions pertaining to the stigma and prejudice on mental illness, and also, pointed out to some hindrances which impair the attendance to individuals in mental suffering in SAMU-Natal. The interviewed health professionals' conceptions on the individual in psychical crisis involve concepts of unpredictability, aggressiveness and risk, stigmatizing elements and historically associated to the social hazard ideology and need for mentally sicks' segregation. The predominance of these conceptions, seen in health professionals speech, had identifiable reflexes on assistance to psychiatric demands performed by SAMU-Natal, namely: indiscriminate request for military police's presence during psychic crisis intervention, neglect about occasions that involve mental health patients, as well as repetitive assisting practice directed on physical contention, and transportation to psychiatric hospital. Associated to it, the professionals have shown distorted and reductionist understanding about Brazilian Psychiatric Reformation, and, in the majority, haven't lent credibility to present model of attention to mental health, based on psycho-social treatment, pointing their speech to a need for psychiatric patient's internment. In this sense, we notice that the hospital-centered and excluding model conceived by classical psychiatry still remains alive in these health professionals' mentality as a reference to psychiatric urgency's assistance. Therefore, the research revealed a sequence of elements, that make us think about the challenges that health sector and society must face to realize Brazilian Psychiatric Reformation's principles and guidelines

Riscos ocupacionais e acidentes de trabalho em um serviço de atendimento móvel de urgência do Rio Grande do Norte

Exploratory, descriptive and quantitative study with prospective data, performed in the Mobile Emergency Care Service in the metropolitan region of Natal/RN, in order to identify the knowledge of the multidisciplinary team about the rules of standard precautions and worker safety, to identify occupational hazards peculiar to the activities of this service; characterize work-related accidents (WRA) and know the procedures adopted after each WRA. The population consisted of 162 professionals and data were collected between the months of November and December 2010. As for personal and professional characteristics, of the 162 professional, 12,96% were physicians; 6,79%, nurses; 33,95%, nursing technicians, 46,29%, conductors; 74,70% were male; 43,21% were between 31 and 40 years old; 69,33% lived in Natal/RN, 50,00% had completed high school; 58,64% were married; 69,75% had children, 46,91% were between 1 and 4 years of training; 61,73% had improvement courses; 59,25% had 3 to 4 years of service; 54,32%, with 1-4 years experience in emergency; 44,44% received 1-2 minimum wages; 78,40% received insalubrity premium; 67,28% worked in Basic Support Unit (BSU); 83,95% had journey on SAMU Metropolitano of 31-40 hours per week; 52,47% had other employments. As for knowledge of rules of standard precautions, safety and occupational hazards, 99,38% knew what it was WRA; 62,96% gave incomplete answers; 74,07% knew the rules of prevent WRA; 46,67% acquired this knowledge in lectures; 53,09% knew Personal Protective Equipment (PPE); 71,60% gave incorrect answers about the importance of standard precautions; 45,06% never received an educational intervention on this issue; 89,51% said that educational interventions in the prevention of WRA are very important; 90,12% pointed out this as a very important issue in the workplace; 27,00% suggested guidance on the topic in the workplace; regarding the physical hazards, 34,57% considered noise as the most important; about chemical hazards, 78,40% chose the gases and smoke; for biological hazards, 48,77% reported contact with the blood; for mechanical hazards, 80,86% said that were transport accidents; about ergonomic risks, 40,12% say it is the tension/stress in the care of critically ill, psychiatric and aggressive patients; and there was an average of 4,5 to the feeling of safety in the workplace. Regarding the data on the WRAs occurred, 31,48% experienced at least one accident event; 72,55% did not notify it; 60,98% answered that there was no routine for notification; 56,86% were performing patient transportation; 49,02% were hurt in the Basic Support Unit/Rescue Unit (BSU/RH); 60,78% occurred during the day; 96,08% of professionals were in normal work schedule (24 hours on duty); 31,37% had contusion; 58.82% had damage to members/pelvic girdle; 43,14% had traffic accidents. About the evolution of the WRA, 62,75% did not have to take time away from work; 76,47% had no sequelae; 88,24% did not require rehabilitation; no professional had a change of occupation. And by means of univariate logistic regression, showed that the nurses and male sex were risk factors for the occurrence of WRA. We conclude that there were gaps in the knowledge of staff regarding WRA, emphasizing the need for continuing education in biosafety in the service.

Atendimento Pré-hospitalar Móvel. Mapeando Riscos e Prevenindo Erros

The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death

Assistência de enfermagem às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência em Mossoró-RN

This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice