Humanização hospitalar, ambiente físico e relações assistenciais :a percepção de arquitetos especialistas

The creation of the Humanization Program of Hospital Care and the increasing number of academic works and journal articles that discuss more humane practices in the health care services express the emphasis given to the theme in Brazil. In these discussions, however, it is not usual to find reference to architecture as a relevant factor in the humanization of hospitals, even though it is known that the physical structure of the building may help the recovering of the patients; elements such as gardens, the use of colors and open spaces may soften the impact caused by the hospital routine on patients. Considering the contribution the architectural project may bring to the humanization of hospitals, the aim of this study was to verify how the architects perceive the hospital humanization process. Besides having searched for subsides in informal interviews with health professionals, in visits to hospitals and in related seminars, the study was based on semi-structured interviews with architects of Natal, Rio Grande do Norte, who are specialists in this kind of projects. The content analysis of the interviews showed that physical space and attendance are essential to the humanization process. Those professionals see two humanization tendencies: while private hospitals have the structural physical appearance considered as humanized, public hospitals emphasize the humanization in attendance, fact that illustrates the contradictions in Brazilian health system. The interviewees consider the post-occupancy evaluation of the building as a learning exercise that contributes to new projects, but surprisingly they do not mention the patients opinion as part of it. Two annoying facts have emerged from the interviews, as also seen in preliminary stages of the study: rare are the works that focus on the person-environment relationship, and the definition of humanized hospital environments is still broad and inaccurate. This suggests the need of new studies in order to better understand how the two factors shown in this study attendance and physical space interact towards a true hospital humanization

Políticas públicas para a juventude: uma análise do Projovem Adolescente sob a perspectiva dos participantes

A partir dos diagnósticos das vulnerabilidades da condição juvenil contemporânea, as Políticas Públicas de Juventude tem ganhado maior força e um lugar mais definido nas pautas das demandas e conquistas sociais. Faz-se necessário, então, direcionar atenção para estas Políticas Públicas, a fim de promover uma reflexão sobre como ocorre a execução destas junto ao seu público alvo. Esta dissertação centraliza sua análise no Projovem Adolescente (PJA), uma das modalidades Programa Nacional de Inclusão de Jovens PROJOVEM que se destina ao atendimento de jovens com específica faixa etária entre 15 a 17 anos, com caráter assistencial e socioeducativo. Desta forma, o objetivo geral deste estudo foi discutir as ações do Projovem Adolescente no que diz respeito ao processo socioeducativo, a partir da perspectiva dos adolescentes participantes da cidade de Natal/RN. E, especificamente, objetivou-se: investigar de que maneira os adolescentes avaliam as atividades das quais participam, considerando se suas expectativas coincidem com as propostas do serviço; averiguar a participação dos adolescentes na elaboração, execução e avaliação das ações socioeducativas do serviço; bem como compreender as motivações que contribuem para a inserção e permanência ou evasão dos adolescentes no PJA. Para tanto foram realizados três grupos focais com adolescentes participantes do Projovem Adolescente, em diferentes núcleos do serviço, no município de Natal/RN. Cada grupo focal contou com dois encontros, em que primeiramente foram debatidos aspectos da participação nas ações socioeducativas e, num segundo encontro foram realizadas oficinas de produção de fanzines. A análise qualitativa dos dados foi realizada a partir da perspectiva teórica do materialismo histórico-dialético, utilizando-se como método de análise o Método Comparativo Constante, baseado na Teoria Fundamentada, que busca compreender o significado do fenômeno sob a perspectiva dos participantes. Os resultados foram apresentados divididos em eixos de análise os quais versaram sobre: as concepções dos jovens sobre adolescência e juventude; e a participação nas ações socioeducativas do PJA, destacando-se as características positivas e negativas apontadas pelos participantes, a relação dos jovens com o trabalho e as possibilidades e contribuições do PJA em seus contextos de vida. Em vista da análise empreendida, é possível constatar que a concepção dos participantes sobre a própria vivência da adolescência e juventude se encontra marcada pela absorção de determinadas imagens socialmente atribuídas aos jovens, como a que considera a juventude enquanto etapa de preparação para o mundo adulto. A participação nas ações socioeducativas, por sua vez, foi, de uma maneira geral, avaliada positivamente pelos participantes, não obstante esta avaliação, os jovens apresentaram uma visão muito crítica sobre a execução do serviço no município de Natal, relatando conhecer bem as dificuldades de ordem da gestão, bem como as contradições e limitações nas ações do serviço. Compreende-se a perspectiva da inclusão social no contexto neoliberal em que são implementadas as políticas sociais, contudo acredita-se que dar voz aos jovens participantes contribuiu para proporcionar uma reflexão sobre o modo como as políticas sociais, através do Projovem Adolescente tem atingido seu público, considerando as questões e perspectivas apresentadas pelos jovens como ferramentas a serviço das juventudes na construção de políticas democráticas e efetivas

Sofrimento solitário, mal-estar compartilhado :um estudo sobre a doença dos nervos

Nerves has been perceived as generalized suffering with multiple complaints, such as pain and other physical sensations, usually followed by symptoms of anxiety and/or depression. Even after medications have been prescribed, mainly psychotropic drugs to reduce these symptoms, exams aiming to discover the causes of the disorders, and a significant referral to health services, the problem tends to get progressively worse. The objective of this study is to characterize the diseases of clients who complain of nerves at the Unidade Mista de Felipe Camarão, Natal/RN, through in depth interviews, allowing for the clarification of ideas, beliefs and the meanings attributed to nerves by that person; to identify the symptoms and to know how they interfere in daily activities; to investigate the causes attributed to the problem and their relation to the biographical and psychosocial context of the patient. Thirteen women, health service clients, aged 30 to 59 years old, participated in the research. It was observed that they perceive, feel and act in unique ways with relation to symptoms, as well as to the attributed explanations and treatments given, showing the influence of life conditions, family context and their own subjectivity. Daily concerns and overwhelming responsibilities in the domestic environment, which usually stem from their precarious survival conditions, as well as marital conflicts motivated by the inequity of gender relations, contribute to trigger this type of suffering. The methodology of the research itself proved to be crucial to the comprehension and understanding of the meanings attributed to the complaints as well as to the argumenting process and the redefinition of the illness experience. Therefore, the importance of interdisciplinary intervention must be emphasize and specially the role of listening as relevant intervention resource

A Água nossa de cada dia: percepção, uso e predisposições comportamentais de alunos do ensino médio de Natal, Rio Grande do Norte

Although water scarcity is recognized as one of the main world-wide problems to be faced by human kind, ecologically unsustainable patterns of behavior still persist. Thus, the objective of this study was to analyze pro-environmental behavior related to water, as well as meanings associated to it by high school students of Federal Center of Technological Education of Rio Grande do Norte, in Natal. The convenience sample was composed by 315 students, 146 women and 169 men, who answered a questionnaire about use and perception of water, containing indicators of proenvironmentalism, environmental care, sustainable development, time perspective, externalities and collectivism, besides socio-demographic items. According to participants, water is synonymous of life, even though the relationship they present with it is ambiguous, much more functional than ecological; they consider it a finite resource, an indispensable life patrimony, however there was no coherence between such conceptions and the self-reported behaviors of water use. Results indicated three important predictors of pro-environmental behavior: sex of respondent, New Ecological Paradigm Scale and telephone/address left for eventual contact to participate in future environmental campaigns. They may be used in additional studies for theoretical development, or to assist in the planning of programs of environmental education, aimed at the inhibition of the effects of a culture of consumption and of an utilitarian perception of water, extending individual and collective efforts towards the preservation of common resources as water

Suporte ao uso de álcool e drogas na atenção primária: um estudo com equipes de Natal/RN

National surveys indicate that 6.8 % of the brazilian population is dependent on alcohol and 1 % dependent on illicit drugs, representing a significant portion of the population affected by this issue . Primary Care becomes instrumental in expanding the coverage of this demand and in reducing unnecessary referrals for specialized care. This study aimed to investigate the responsiveness and institutional support of Primary Care Teams in relation to the demands of alcohol and drugs users. The research was conducted in a Family Health Unit in West Sanitary District of Natal City. With quantitative and qualitative nature, our study consisted of two stages. At first, we performed a mapping of alcohol and other drugs abusive use in a sample of the population assisted by Family Heath Teams, using sociodemographic questionnaire and ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). 406 questionnaires were completed. Of these questionnaires, 27.8% are men and 72.2% women, of which 56% are between 20 and 39 years-old, they are housewives, have a stable relationship and are consumers of tobacco (37.6%), marijuana (13%) and especially alcohol (57%). In second stage, two Conversation Circles with Family Health Teams and the referential Family Health Support Center were formed to discuss the data of the mapping realized in the previous phase. The circles, which had participation of 20 of the 37 professional teams from Family Health and 2 from Family Health Support Center, showed a lack of professional training in the subject; inability of the healthcare network in the user embracement; belief of professionals that nothing can be done when matter is alcohol and drugs; and referencing as the only care action performed by teams. Thus we point out the need to support an approach on issues of alcohol and drugs which consider gender issues, investing in Harm Reduction Policy as a possibility of working in this context for recognizing each user in their uniqueness and strategizing with them to promote health in a broad and contextualized way

A percepção de suporte organizacional dos novos servidores da Universidade Federal do Rio Grande do Norte

This work deals with organizational support perception-OSP. This is done considering staff global beliefs, value of their contributions, care and well being related of individuals in an organization. These issues has been have been present in many researches since the 80s. It is important to analyze this matter considering all the changes that occurred nationally and internationally in the academic environment, characterized as being diversified in academic and managerial level. This occurs especially in Brazil since Federal Universities and their agents have suffered impact and restructuring. The research has emphasized the technical-managerial as well as professor staff level at Universidade Federal do Rio Grande do Norte aiming to deal with their unsatisfaction upon social political support. Thus, there was participation of 259 staff that were admitted from 2003 to 2005 in many sectors and units of the university. These subjects were submitted to a social and demographical query through an application of a scale of organizational support perception-OSP. Descriptive and multivariate analysis was done considering factors (management style of higher command), material support, wages, work overload, social support at work and ascending levels). Results show that there a hierarchy of the analyzed factors, the factor social support at work as being the first one with 3,31%, the factor management style of the higher command in second with 3,30%, then followed by the factor social support at work with 2,92%, in a sequence the factor material support, factor overload with 2,49% in the fourth position, and in the fifth place, the factor ascending with an average of 2,33% and in last the factor wages with 2,20%. It is concluded that the factors related to the more positive attributions of the OSP (social support at work), in a sequence material support opposing from the most negative factors of the OSP (wages, overload, ascending) reveal a reality that points out that the OSP is very much related to the individualized actions of the members of the organization (leader-member-group) rather than on structure and institutionalized actions carried out at UFRN

O significado do trabalho entre os jovens na transição de estudante universitário a profissional

The present study analyses the variability of the meaning of the work among young people on the transition from university to professional life, divided according to: university levels, knowledge area and graduation course. A hundred seventeen young people answered the questionaries structured on the components of the meaning of work. Semi-structured interviews were also made with parts of the sample about the themes related to the meaning of work on this way the information of the questionaries became complete. The answers of the interviews were studied through the analysis of the thematic contents. The results of such analysis and the answers of the questionaries were registered on the data base SPSS for Windows. The results of the statistic analysis made indicated that: (1) the centrality of work and the articulations among stronger spheres do not present variability according to level, area or course; (2) the course makes more difference values factors and descriptives factors than area and level; (3) the hierarchy of values presents variability according to area and the descriptive hierarchy presents variability according to course; (4) the level makes more difference specific attributes of the meaning of the work than area and course; (5) the standards of the meaning of work do not present variability according to level, area and course, but present variability according to type of the work market evaluation and planning the future work. In summary, the meaning of work present variability according to level, area and course of the young people, when studied in facets, except for the work centrality

Violência sob o olhar do adolescente autor de Ato Infracional: reflexões fenomenologicas

O envolvimento de jovens com a violência nos últimos anos, no Brasil, tem aumentado significativamente, bem como o número de adolescentes cumprindo medidas socioeducativas com restrição de liberdade. Entretanto, a literatura mostra a produção incipiente de estudos que abordam o jovem infrator a partir da sua própria experiência. Com base nessas evidências, esta pesquisa teve como objetivo compreender como adolescentes autores de atos infracionais experienciam a violência, sejam como agentes, espectadores ou vítimas, sob a ótica da Analítica Existencial, de Martin Heidegger. Trata-se de uma pesquisa qualitativa, de inspiração fenomenológico-hermenêutica, tendo sido utilizada a narrativa como recurso metodológico. Foram realizadas entrevistas semiestruturadas, com dois adolescentes de 16 e 17 anos, egressos de medida socioeducativa de restrição de liberdade. A interpretação das narrativas foi feita a partir dos sentidos que emergiram na experiência relatada e do diálogo entre algumas noções heideggerianas como ser-no-mundo, cuidado e impessoalidade. Os relatos mostraram que a violência está presente desde a infância desses adolescentes, tendo sido presenciada na própria família. Para eles, o comportamento violento representa uma forma de impor respeito e admiração. As experiências podem ser interpretadas como uma expressão das relações entre o ser adolescente e o mundo que caracteriza o seu contexto de vida. Assim, as noções de cuidado, no modo de ocupação, e impessoalidade, são vistas como presentes nas experiências narradas. Por hora, o que apresentamos foi nossa compreensão dessas experiências únicas de ser adolescentes num contexto de violência, mostrando peculiaridades de duas crianças que não queriam ser um problema social, mas lançados num mundo inóspito e cruel, na qual nos absorve para as tramas mais sutis de ser, misturando significações e sentidos num espectro fluido que é o viver. Por fim, esperamos que esta pesquisa possa acrescentar não só aos estudos sobre a violência de jovens, mas também ressaltar a importância de se compreender a violência pelo olhar daqueles que a vivenciam

Adaptação transcultural para o Português/Brasil do instrumento vulnerability to abuse screening scale (VASS)

Esse trabalho objetivou promover a adaptação transcultural para o Brasil da VASS. Os passos para adaptação transcultural seguirão a proposta de operacionalização alicerçado na apreciação de diferentes tipos de equivalência: a conceitual e de itens, a semântica e a de mensuração. Para alcançar as duas primeiras etapas utilizou-se as técnicas de tradução e retrotradução associada ao procedimento intitulado Painel de Especialistas. Para o pré-teste e verificação de equivalência de mensuração, aplicou-se o questionário com uma população de 30 e 66 idosos, respectivamente. Para as análises dos resultados foi utilizada a estatística descritiva e inferencial, em especial o KR-20, teste T de student, correlação de Pearson e ANOVA univariada, bem como o método kappa de Fleiss para verificação do índice de confiabilidade. Verificou-se que o conceito utilizado para construção do instrumento, bem como seus itens se mostram adequados à investigação do fenômeno. Evidenciou-se boa equivalência semântica entre os itens das retrotraduções e do instrumento original, especialmente quanto aos resultados de T1 R1. Os juízes optaram pelo uso de 11 itens de T1 à versão-síntese. A equivalência operacional mostrou-se satisfatória. Em geral, os resultados apresentados mostraram-se aceitáveis. Quanto à etapa da equivalência de mensuração, verificou-se que a idade dos participantes variou entre 60 a 84 anos, prevalecendo respondentes idosas (n = 38), representando 57,6% da amostra estudada. O valor do KR-20 para o escore geral do instrumento foi de 0,688 (IC95%: 0,670). Os valores encontrados para as quatro dimensões propostas pelos autores do estudo inicial do instrumento foram 0,528, 0,289, 0,552 e 0,303, respectivamente. Apenas os valores de consistência interna das subescalas Vulnerabilidade e Coerção mostraram-se aproximados aos encontrados no estudo original, a saber, 0,550 e 0,390, respectivamente. Verificou-se que com a retirada dos itens nº 04, nº 06 e nº 10, houve aumento do índice de consistência interna da escala total. Já quanto aos valores da consistência interna das subescalas, percebeu-se que apenas com a retirada dos itens nº 09, referente à escala que dimensiona o Desânimo, e nº 12, item da subescala Coerção, é que houve acréscimo nesses valores. Destaca-se que esses são resultados preliminares, uma vez que após a verificação da adequabilidade e de padrões psicométricos iniciais acerca do uso do instrumento para a população idosa, ainda há de se dar continuidade à etapa concernente à verificação de propriedades psicométricas robustas do instrumento, que indiquem, por exemplo, evidências de fidedignidade em situação de teste-reteste, validade de constructo e de critério, se possível e aplicável. A principal limitação do estudo é a falta de um instrumento padrão-ouro para testar a fidedignidade, sensibilidade e especificidade do instrumento em questão. Apesar desta limitação, a adaptação transcultural e a verificação de propriedades psicométricas preliminares do instrumento de uma medida de autorrelato que afere indicativo de violência doméstica contra o idoso tem sua relevância e foi satisfatória

O fazer do psicólogo no núcleo de apoio à saúde da família

The Brazilian Ministry of Health regulated in 2008 the Family Health Support Nucleus (FHSN) as a device for support and complementarity to the Family Health Strategy. The FHSN, through the matrix support, potentiates the Family Health teams on dealing with a great variety of demands and activities that are under their responsibilities. It is structured in teams of professionals from various health specialties, among which is the mental health. In preliminary studies we noticed that the psychologists have been the main representatives of mental health professionals at the FHSN from Rio Grande do Norte (RN-Brazil). On this scenario, this study intends to problematize the professional practice of the psychologists who work at the FHSN teams in RN, regarding how their work is done, discussing it under the perspective of collective health and the directions for the basic health care on Brazilian s health system. Still as a goal, in more specific ways: identify the forms of professional insertion of the psychologists in this field; characterize the work done by the psychologist at the FHSN (developed activities); and produce an analysis of the characteristics and limits of those actions, from theoretical and methodological references based on Marxian ontology. Were performed semistructured interviews with psychologists working in the oldest FHSN teams form RN. We conducted the analysis of the material following the blocks of information: determinants of the psychologist entry at the services, training for current practice; operation of FHSN; activities performed by FHSN team and the psychologist; joint actions; and limits of psychology practice in the FHSN. An important result, we observed the little articulation of practicing between the psychology and other professionals and teams, further indicating the prevalence of the traditional medical model (individual and outpatient) as guidance of their performance instead of the matrix logic that is the foundation of the proposed action for the FHSN. We also emphasize the potential of psychologists actions at the FHSN on contributing to the achievement of comprehensive care

O psicólogo e os serviços de acolhimento institucional para crianças e adolescentes

The Shelters are responsible for caring for children and adolescents whose families or guardians are temporarily unable to fulfill his role as care and protection. The activities to be developed by psychologists in these services are greatly important for the elaboration and development of political- pedagogical project of the same, and for reasons pertaining to the present and future of children and adolescents received judgments. The psychologist puts up the challenge of contributing to a better care of children, also cooperating with the implementation of the new care standards of childcare. The aim of this study was to investigate the role of the professional psychologist in assistance to children and adolescents in 13 Shelters in the Metropolitan Region of Natal/RN. For both set out to make visits to the institutions to know how it is organized the field work of the psychologist, his routine work and activities developed. Nine psychologists interviewed according to a semi-structured interview script. The data analysis is supported by the theoretical aspects of dialectical materialism historical and theme content analysis was used. Results were presented from three angles: psychologists and institutional framework; activities, resources and methods of work; psychologists and legal frameworks of the Institutional Hospitality. The study points out the recent entry of the psychologist in Shelters, combined with considerable turnover of these professionals. This work has been organized through the Individualized Service Plan, prioritizing the return to family of origin. Moreover, in general, perform joints with the service network, reporting, individual consultations and follow-adoption processes . Staff members, however, feel a lack of specific and continuing training on special protection, including due to the distance between the proposed theory and practice. It was thus observed a movement of psychologists distance themselves from welfare or repressive practices, however the structural difficulties of services and lack of continuing education appear to limit the development of a performance focused on the transformation of the reality of children and adolescents treated and their families

Caracterização de aspectos da cognição social, habilidades sociais e funções executivas de crianças diagnosticadas com transtorno autista e transtorno de asperger

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

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

Gênero, trabalho e saúde mental entre trabalhadoras rurais assentadas na região do Mato Grande Potiguar

The lack of studies aimed at the mental health of the rural population, the social, economic, familial and emotional impact that mental disorders produce and the vulnerability that women have in this context, lead us to believe in the need to investigate the mental health demands of female rural workers, in order to subsidize the development of more effective and culturally sensitive public health programs and policies that take into account the specificities of this population. The present study aims to investigate the prevalence of common mental disorders (CMD) and the possible factors associated with the emergence of such disorders among women living in a rural settlement in Rio Grande do Norte. This survey has a quantitative and qualitative character with an ethnographic approach. As methodological strategies, we made use of an adapted version of the socio-demographic and environmental questionnaire prepared by The Department of Geology/UFRN s Strategic Analysis Laboratory to evaluate the quality of life of the families from the rural settlement and the mental health screening test Self-Reporting Questionnaire (SRQ-20) to identify the prevalence of CMD in adult women from the community. Complementing the role of methodological tools, we use the participant observation and semi-structured interviews with women who presented positive hypothesis of CMD attempting to comprehend the crossings that build the subjective experience of being a woman in this context. The results point to the high prevalence of CMD (43.6%) and suggest the link between poverty, lack of social support, unequal gender relations and the occurrence of CMD. We also verified that the settled women do not access the health network to address issues relating to mental health and that the only recourse of care offered by primary health care is the prescription of anxiolytic medication. In this context, the religiosity and the work are the most important strategies for mental health support among women

A inclusão escolar da subjetividade do professor à constituição de um lugar de aluno

The move to include students with special needs (NEE) in the schools presents a paradigm that raises continual discussion about how to implement this proposal. Considering that learning is built from the weaving of socially constructed knowledge and the field of knowledge concerning subjectivity, this research explores the difficulties that occur with the later in the process of inclusion in the schools. Admittedly, the promise implicit in the school does not guarantee that the student learn, but the envisioning of this learning, when the student s educator discredits him, is such that the person is then not taken on as an actual student, being excluded from the transmission of knowledge, even within the school. The project implemented at the Instituto Educacional Casa Escola IECE, for the last three years, shows us that the possibility and sustainability of this envisioning is intimately linked to the subjectivity of the educator, as well as how one relates to the institutional culture. We question then, how this perspective is formed in the educator this perspective capable of denying the offer of a place as student, allowing him to advance while learning. With this in mind, we explore the paradoxical elements present in the paradigm of inclusion, as well as analyzing theoretically, through the body of conceptual psychoanalysis, the process of subjective constitution. We intend to bring to light how this process coincides with the construction of the educator s perspective of exemption from teaching the special needs students. We question, through the formative functions of subjective structuring (The Mirror Stage and the Oedipus Complex), how to form a perspective capable of promoting inclusion of special needs students in educators. Finally, we show how it is possible to bring to light, with the concepts of the I ideal and the ideal I, the subjective difficulties in the practicing instructor