Caracterização das intervenções em grupo na rede básica de saúde em Natal-RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Conhecimento sobre energia eólica: um estudo exploratório a partir das redes semânticas naturais de estudantes da cidade de Natal

The human being has a fundamental role in issues concerning scarcity of energy resources as well as in the success of technologies which favor the use of renewable sources, such as wind energy. But what does wind energy mean for people? What are the psychological meanings concerning this term? Aiming to answer these questions, the general objective of this dissertation was to identify and to analyze the knowledge about wind energy taking into account a network of psychological meanings. One hundred and ninety one (191) university students from Natal-RN participated in the study, being male the majority (53%); aged between 17 and 51 years old (M=23.3 years; SD=5.7). Participants responded to self reports using the Natural Semantic Networks (NSW) technique, as well as to several sociodemographic questions. The results showed a consistent, positive and useful general semantic network. In this semantic network, knowledge about wind energy was represented by words that correspond to the appeal of (pro) environmental stance (e.g., clean and nature), that evinced both the technological aspect (e.g., force) and the economic aspect (e.g., economy). Results from different groups were also analyzed. The first set of groups (non-environemental and environmental) was divided considering the course (e.g., ecology and economy). The second set of groups(non-caretaker and caretaker) was divided based on the practice of environmental care expressed. Subtle differences were observed in the semantic networks of caretakers, who emphasized environment, an attribute not mentioned by non-caretakes. This indicates a construction of knowledge that is influenced by the presence or absence of the environmental commitment. Such findings may be useful in the construction of instruments for surveys and in the development of public and educational policies. Additionally, they may assist the media towards a more objective performance concerning wind energy

A CRONIFICAÇÃO NOS SERVIÇOS SUBSTITUTIVOS NA REDE DE SAÚDE MENTAL DE NATAL/RN

Brazilian Psychiatry Reform, through Psychosocial Care Strategy, has intended to build insane people care practices from community care services which contemplates the subjects complete lives. However, to change the traditional care ways demands the facing of a series of epistemological, political and cultural obstacles. One of the current challenges deals with patients aggravation processes, with management ways, with devices and with professionals, as well as with the assistance network. The purpose of this thesis was to investigate how these aggravation processes has been constituted in Natal mental healthcare network, understanding its effects in the work teams and patients. Theoretical and methodological perspective used was Institutional analysis was, subsidizing the usage of concept-tools as the implication analysis, selfmanagement and self-analysis, and restitution. The research was carried out at the Natal East Sanitary District Mental Healthcare Clinic, with the participation of technicians and patients. The research procedures were: literature and document research on the attendance and the analyzed theme; attendance registers analysis; participating observation of the institutional routine for three months and field log entries; talking groups, one with the team and one with the patients. Two main discussion points are shown: 1. The mental healthcare clinic organization logic and the intersector politics; 2. The work and management processes developed at the mental healthcare clinic. The analysis show diversity in the attended demands in the service, which has favored the patients aggravation, this device and the substitute network processes. The work processes are apart from the political sphere and from the managements processes. In this sense, we show the need to reevaluate the clinic device as well as the management models adopted in the Brazilian Psychiatry Reform context

Evidências de validade do Millon Behavioral Medicine Diagnostic: avaliação de indicadores de adesão ao tratamento em pacientes com hipertensão

Systemic Arterial Hypertension – SAH – is defined as the syndrome which its main feature is the presence of high tensional levels, associated with alterations of functional or structural levels in the organs that it strikes. Its specific causes are not very well bounded and have an asymptomatic character. Due to its chronicity it requires adherence to the treatment plan in a systematic and permanent manner, implicating in lifestyle changes, combined or not with the use of medication. The personality inventories have been largely used in the lineation of indicative traits of difficulties with the adherence to the treatment. In this sense, developed by Theodore Millon, the Millon Behavioural Medicine Diagnostic – MBMD is an instrument made from the consensus among healthcare professionals, aiming at identifying psychological factors that may compromise medical treatment so that they can be conducted in a way to enable a better adherence. Objective: evaluation of the evidence of validity of the Millon Behavioural Medicine Diagnostic – MBMD for a public of patients with hypertension, aiming at investigating the indicators implicated in the adherence or not to the anti-hypertensive treatment. Method: there was a group of 200 participants in a university hospital in the city of Natal/RN, males and females, ranging from 20 to 70 years old. An interview protocol was administered in order to obtain information about socio-demographic data, clinical history, healthcare habits and way of conducting treatment, and after, the administration of the MBMD followed. Results: by means of Factor Analysis it was verified that the organization proposed by the factors is favorable and it adjusts to the theory, allowing the visualization of other underlying constructs to the scales, with adequate adjustment indexes and satisfactory Cronbach’s alpha indicators. Besides, the MBMD revealed itself sensitive to the intragroup differences relative to the sex, age, schooling, marital status, profession, income, SAH history, diagnostic time, medication use, comorbidity presence, hyposodic diet, social support and adherence criteria variables. The utilization of such instrument in the evaluation of the adherence to the anti-hypertensive treatment show, therefore, indicators of validity.

Investigando o cuidado em equipe de enfermagem em uma UBS da cidade do Natal-RN

On the health area, care is seen as an important concept for professionals. Recently there is a trend, the epistemological point of view, to think carefully as category allowing discuss and re (thinking) practices of humane health care. The objective of this study is to investigate the understanding of care in nursing staff in a Basic Health Unit (BHU) in the city of Natal. The participants were two nurses and two nursing technicians working on the BHU of Guarapes district, located on the west side of Natal - RN. As Theoretical support for data interpretation, was used the concept of care taking, using Heidegger’s theories as reference, through Ayre’s ideas. This is a qualitative research using autobiographical as a methodology. The methodological strategy approach used were focus group and individual interviews. The data were discussed by three angles: knowledge (concepts and theories behind the practical model), technical (the way to do), and ethics (values that bases practices) by hermeneutics Gadamer's dialectic. The results showed the necessity to expand the discussion on care, in practice the understanding of care seems to get narrower concerns with technical success by professionals. The care, as a meeting between beings, the desired humanized care, seems to be understood in parts in theory, but also distances itself from reality in professional practice.

Perfil desenvolvimental das funções executivas em crianças de 05 a 08 anos da cidade de Natal - RN

This study aimed to establish the developmental profile of executives components in typical child development. This is a correlational cross-sectional study of predominantly quantitative. The instruments for data collection are the subtests included in the NEPSY-II Attention and Executive Functioning domain. Eighty children between 5 and 8 years of age, of both genders, students from public and private schools in the city of Natal were evaluated. The sample was divided into six-month intervals for subsequent analysis of strategies and types of errors. Analysis of variance (univariate and multivariate) and Tukey and Games-Howell post hoc tests were conducted to verify the effect of age on test performance. Subsequent correlations indicate the strength and direction of the relationship between variables. Were identified two peaks of development in the six-month interval adopted for the skills of selective attention and inhibitory control. The results indicate that there’s no significant influence of sex and type of school on the performance of the sample. The performance of preschool children (5 and 6 years) was lower than the other subgroups in most tests. Highlights the role of autoregulation discourse among preschool children during activities of greater executive demand and the abstraction resource as a resolution strategy between the older. Were identified similar development trajectories among selective attention abilities and inhibitory control. In general, there is a decrease in the number of mistakes and increase of success with the age progression. Future longitudinal research can extend the age range encompassed in this study, investigating the developmental course of executive abilities.

Histórias de adoção tardia: considerações a partir da analítica existencial heideggeriana

Adoption establishes a filiation status, resulting from a legal act, which attributes to the child and parents the rights and obligations associated with such condition, being legally irrevocable. Nevertheless, in practice there are adoptions that do not concretize and the child returns to justice during or even after the legal process is closed. Late adoption is the denomination of the adoption of children over two years and it is still permeated by myths and stigmas, leading to a frequent return of the child to justice in these cases. The late adoption involves a process of building a unique relationship with a child whose backstory is commonly marked by the dissolution of the relationship with the family of origin, due to violation of rights and, in some cases, the experience of institutional care. Given such a scenario, this research, based on the Existential Analytic proposed by Martin Heidegger, seeks to understand the experience of mothers and children in the process of late adoption, in order to obtain subsidies to psychological attention in this context. This is a qualitative, phenomenological study with a comprehensive focus. The participants were two mothers and two children who have gone through late adoption for about two years. The procedures of data generation contemplated narrative interviews with mothers and individual meetings with children, in which ludic resources were used as mediators of expression (free drawings, unfinished children's story and "Story-Drawings" on late adoption). The procedures were audiotaped and transcribed. Data analysis was grounded in Heidegger's hermeneutics. The late adoption process, permeated by historical, social and cultural determinants and the web of meanings that create the historical singularity of each person involved have proved to be complex as seen in the narratives. The construction of the meanings of parenthood and filiation has been developing in the families in the study, from the experience of being-with-the-other, caring and dwelling in their peculiar modes of expression. The family of origin and the adoptive family mingle and differentiate by means of the experience of children, especially because of the existence of biological siblings. Data point to the importance of psychological care to family core in late adoption processes

Evidências de validade do Millon Behavioral Medicine Diagnostic na avaliação de aderência terapêutica em pacientes com insuficiência cardíaca crônica

Chronic heart failure (CHF) is the final common pathway of most diseases affecting the heart, being responsible for a high level of mortality and hospitalization, as well as significant reduction in quality of life of those affected. Interventions that claim to optimize patient adherence to their medical regimen, and improve self-care behavior, have proven effective in preventing unplanned admissions and improves the outcome for patients, however, studies have shown the problem of non-adherence, and some psychological instruments have been used to show that traces indicate difficulties with treatment adherence. Having shown this, the aim of this work is to evaluate the evidence of validity of the Millon Behavioral Medicine Diagnostic (MBMD) in a population of patients with CHF. The study included individuals with CHF, males and females, between the age of 18 and 85 years, treated in a reference hospital in the city of NatalRN. A total of 120 patients answered, in addition to the MBMD, another questionnaire structured with sociodemographic aspects and clinical itens. The results indicated that the parameter of the MBMD reliability was satisfactory the most of extracted factors, and some scale. In terms of the population studied, we could verify that the disease was more prevalent in men, but women had the highest average in indicators related to negative health habits and depressed mood. Younger pacients and those who had no partner had the highest averages in groups of items that dealt with feelings of sadness and discouragement. Hasn’t been observed differences related to negative health habits and problematic adherence among patients in different functional classes. More studies in this research line, with a larger population and from other regions of the country, are needed in order to expand the data presented here

Estratégias de cuidados por familiares de portadores de transtornos mentais severos residentes na zona rural do alto sertão paraibano

In the current configuration of the Brazilian Psychiatric Reform, family plays a key role in mental health care: shared responsibility and active participation in the process of rehabilitation of people with severe mental disorders. It´s considered that the family member who cares can help users in their daily tasks and articulating trajectories, networks and ways to potentiate social connections. This research was motivaded by interest in the subject and by the lack of research and studies about this reality in rural areas. This study aimed to identify ways of mental health care by relatives of severe mental disorder patients living in rural zone located at sertão of Paraiba. Methodologically was made a work with qualitative research structured in two moments. In the first one, was held a Documentary Research in CAPS II in order to identify: a) users living in rural that had a history of at least one psychiatric hospitalization, b) users who no longer use the reference service (CAPS II) for at least one year. The second stage consisted by home visits and semi-structured interviews with eleven families in rural areas. Results pointed out a profile composed by 56 users: 56 women and 26 men aged between 50 and 64 years, unmarried, without study, farmers and housewives, living six miles from CAPS II and carriers with severe mental disorders. Strategies and resources used by the families for mental health care were: religion, work, medication and help from relatives, neighbors and community. Factors related to non-use of substitute services were lack of internment in CAPS II and lack of money and transportation. The hospital, the house arrest, the police aid and religion were strategies used by family members as support to psychiatric crises. The data pointed to non-solving of care offered by psychosocial support network and the importance of redirecting practices aligned to the asylum model in favor of psychosocial strategies that aimed at rehabilitation and community participation in mental health care

A relação entre transtorno da insônia e funções executivas em adultos

The insomnia disorder is defined as a difficulty initiating or maintaining sleep or waking up earlier than expected unable to return to sleep, followed by a feeling of nonrestorative and poor quality sleep, present for at least three months, with consequences on daytime functioning. Studies have shown that insomnia affects cognitive function, especially executive functions. However, researches that sought to investigate the relationship between primary insomnia and executive functioning were quite inconsistent from a methodological point of view, especially in regard to the variability of the used methods, the heterogeneity of diagnostic criteria for insomnia and the control of sleep altering drugs. In this sense, the present study aimed to investigate the relationship between insomnia and executive functions in adults. The participants were 29 people, from both genders, aged 20-55 years old. Participants were divided into three groups, one composed of 10 people with primary insomnia who used sleep medication (GIM), nine people with primary insomnia who did not use medication (GInM) and 10 healthy people who composed the control group (CG). The research was conducted in two stages. The first one involved a diagnostic evaluation for insomnia disorder through a clinical interview and the application of the following protocols: the Athens Insomnia Scale, the Insomnia Severity Index, Sleep Journal (for 14 days), Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Test, depression and anxiety Beck inventories, and Lipp’s Iventory of stress symptoms for adults. After this stage, the evaluation of executive functions was performed by applying a battery of neuropsychological tests composed by the following tests: Wisconsin, Stoop Test, Colored trails Test, the Tower of London Test, Iowa Gambling Task (IGT) and WAIS III subtest digit span, which measured selective attention, inhibitory control, cognitive flexibility, planning, problem solving, decision making and working memory, respectively. The results showed that insomniacs (GIM and GInM) showed higher sleep latency, shorter sleep duration and lower sleep efficiency compared to the CG. In regard to the performance in executive functions, no statistically significant difference between groups was observed in the evaluated modalities. However, the data show evidence that, compared to GInM and GC, the performance of GIM was lower on tasks that required quick responses and changes in attention focus. On the other hand, GInM, when compared to GIM and GC, showed a better performance on tasks involving cognitive flexibility. Furthermore, impaired sleep measures were correlated with the worst performance of insomniacs in all components evaluated. In conclusion, people with the insomnia disorder showed a performance similar to healthy people’s in components of the executive functioning. Thus, one can infer that there is a relationship between primary insomnia and executive functions in adults.

Travestis na atenção primária: o cuidado em saúde na cidade de Natal

Among the deviant a heteronormative ideal, transvestites are the ones that suffer abuse and discrimination. Have been found that health services often present themselves as places that maintains and reproduce such discrimination, which makes transvestites only sought medical care in the latter case. Based on the guidelines of the SUS and the National Humanization Policy as well as the inclusion and leadership of the users, we conducted a qualitative study seeking to understand the experience of transvestites in seeking health care within primary care in Natal-RN. We use as techno-methodological instruments in depth interview and workshop with use of "scenes". For interpretative analysis of the narratives we use to Hermeneutics-Dialectic. From the dialogue with the narrative we come to the following themes: 1) Understanding the meaning of being a transvestite; 2) The experience transvestite in search of health; 3) Transvestites and humanized health care. In the first point they reveal the daily struggle of transvestites between prejudice and the search for respect, as well as the meanings of being a transvestite, who appeared as: Being gay, being feminine, not transsexual and accept themselves as they are. In the second axis, expressed difficulties in access to and use of health services: the embarrassment by not using the social name; fear of going out during the day; the association of transvestites to HIV; and pain caused by discrimination from health professionals. It was also possible to identify simple demands such as illnesses from day to day, the demand for hormone therapy, which involves treatment needs as well as the vital need to have their rights XVII respected. The third axis, for the range of a humanized care identified that the respectful gaze guarantee their dignity and their right to health in a humane way, but it identified some necessary changes: Training of professionals, dialogue with the social movement, publicity campaigns and rapprochement with the transvestite. Finally, it is expected that the research will contribute to the field of knowledge know-how in health care transvestites, inside and outside of the university

O Centro de Referência da Assistência Social e a Psicanálise: efeitos de uma escuta singularizada

This paper emerged from an experience of 18 months in the CRAS – Reference Center for Social Assistance – which aroused a question about the listening of the singularity in the professional practice of Psi in the context of social assistance. The literature review revealed, on the one hand, a series of studies that aim to a discussion about of the process of professional integration of psychologists in the field of social welfare, proposing and / or analyzing practices directed towards the psychosocial assistance directed to the group and for the assurance of rights, forming citizen subjects. On the other hand, supported by a psychoanalytic perspective, we found studies that point to the importance of the singularity listening considering the subjectivity and symbolic resources of those who seek help in Basic Assistance Service. In this perspective, we aim to analyze, in a posteriori, the effects of offering a singularized listening in the context of CRAS and discuss its implications for the Psi professional practice in social institution. This is a theoretical and clinical research, based on Freudian and Lacanian psychoanalysis, in which two cases, placed as investigation boosters, are analyzed in the light of the concept of the subject. We conclude that a singularized listening allowed a significant sliding and the consequent repositioning of the subject, in each case, front to their suffering. The effects collected allowed us to affirm the importance of a singular listening in the treatment of the demands that appear within the institutional framework

Significado do trabalho para trabalhadores da construção civil

The meaning of work is a construct that has been studied more systematically from the 80s, through various approaches and in different occupational categories. This dissertation aims to describe and discuss the meanings of work for construction workers. This is an empirical study whose research supports herself in the Model Attributes Meaning of Work and its respective instrument for measuring the Meaning of Work Inventory (STI). The research involved 402 workers in the construction industry sector in the two capitals of the Brazilian Northeast, with a mean age of 35.8 years (SD = 11.4). To collect the data, besides the IST, the Working Conditions Questionnaire and sociodemographic data were also used. Data were organized and analyzed using the SPSS program. The study used data analysis techniques to Smallest Space Analisys (SSA), descriptive statistics, correlation and analysis of variance. There was evidence of validity of the STI which was structured into five types of value attributes (what work should be), and seven types of descriptive attributes (what is working). The results showed that the work has high centrality and profiling for participants after the family, the most important aspect in the lives of workers. Aspects of personal and economic growth were more emphasized in definition of what the work should be and responsibility and effort were characteristics that best described the reality of work.

Interação social e envelhecimento ativo: um estudo em duas praças de Natal/RN

In view of the evident increase in the population group of people over 60 years old, the aging process has raised important discussions on social, political and economical planning that recommend that the increase in longevity must be followed by autonomy and well-being. Faced to these demands, the literature reports that physical activity is a key strategy to promote better living conditions for the elderly. Studies about personenvironment are making efforts to understand the socio physical environment role to encourage old people to make activities in many different environments. Among these, the urban public open space has been reported by many researches as a promising alternative in order to adopt a less sedentary life style. Based on these considerations, this study proposed to investigate the relationship between the social environment support elements and social interaction of seniors in public squares in the city of Natal, RN, using a multimethodological approach that included a experts panel, environmental characteristics analysis of 252 squares, case studies containing collective and individual interviews with elderly users and the spatial representation of their social interactions. The association between physical activities with the socialization practiced by them was identified as the main motivation for their presence in these places. The results indicate that the relationship between the socio-environmental characteristics (concept developed in this study) and the socio-spatial behaviors that include the spatial appropriation, spatial arrangements and interpersonal distances, helps to promote social interactions in carrying out activities, which, according to the assumptions Active Ageing Program, enable the maintenance of an active way of life, with important implications for health, wellness and quality of life in old age

O processo de inserção dos psicólogos na assistência social em Natal/RN no período de 1972-2003

Since the rules of the National Social Assistance (PNAS) and the Unified Social Assistance System (SUAS) in 2004/2005 the psychologist action as an essential professional teams in the services offered in this field. Althoug, there are indications of psychologists who worked on the assistence prior this time. This insertion had not systematized in the literature, not allowing the establishment of records of this linear trajectory. The objective of this paper is investigate the entrance and a psychologist working in social care services in Natal / RN , as well as the activities undertaken by them in the period 1972-2003 . This temporal boundary is justified because Natal initiate to have a psychologist from 1972 to 2003 was immediately prior to the landmarks of the 2004/2005 year. The research was divided into two stages: documentary and oral history. The first was through the consultation of 86 monographs of the Sector Documentation Social Service Department of the Federal University of Rio Grande do Norte , its intend identify what were the services that characterized the health care field and evidence of the presence of psychologists in these spaces. In the second stage, interviews with psychologists who worked 13 trailers to social assistance in order to investigate its performance, activities undertaken, the insertion process in the area, among other things were done. The material analysis was based on themes from a historical perspective. The results point to three major areas of integration of psychologists : in child exceptionality in which psychologists were linked to Brazilian Legion Social Assistance (LBA); the field of the minor through the State Foundation for the Well Being of Minors (center), and occupying positions of management and coordination in some welfare programs.