Pesquisa odontológica no Brasil: características da produção científica no início do século XXI

Dentistry, as a science and field of knowledge, has presented a substantial development in the last decades in the areas of research and education. The aim of this study was to evaluate the Brazilian scientific production in Dentistry, as from their methodological outlining, which characterizes the XXI Century. Five thousand two hundred and three study abstracts were evaluated, comprising works presented in the meetings of the Brazilian Society of Dentistry Research (SBPqO), during the period of 2001 to 2006. The main results identify that, as for the methodology used in the researches, there was a predominance of the studies of an individuate, interventionist and longitudinal nature; of the researches in the areas of Dentistry, Periodontology, Endodontics, Pedodontics and Collective Oral Health and experimental studies about clinical researches or with collective subjects. The inter and multidisciplinarity are pointed out in the outlining of this study, as the triad Education-Health-Research is discussed, so that they transcend in their fields of action, in the direction of the transdisciplinarity. It is concluded that, in the studied period, there was a reasonable and balanced production in Brazilian dental field

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

Avaliação da qualidade da assistência a pessoas com úlceras venosas atendidas na estratégia saúde da família

A úlcera venosa constitui importante problema de saúde pública, gera repercussão social, econômica e mudanças nos hábitos de vida, dor, sofrimento, acarretando diminuição da qualidade de vida. O estudo objetivou avaliar a assistência prestada às pessoas com úlceras venosas atendidas pela Estratégia Saúde da Família. É um estudo analítico, transversal e quantitativo, realizado com 59 pessoas com úlceras venosas, atendidas em 36 unidades da Estratégia Saúde da Família. O estudo obteve aprovação do projeto de pesquisa pelo Comitê de Ética da Universidade Federal de Alagoas. Para a coleta dos dados utilizou-se instrumento testado, entrevista, exame físico e informações dos prontuários. Os dados foram organizados em planilha do Microsoft Excel 2007, exportados e analisados em software estatístico por meio de estatística descritiva e inferencial, considerando nível de significância estatística de ρ-valor < 0,05. As pessoas com úlcera venosa eram do sexo feminino (71,2%), ≥ 60 anos (67,8%) e estavam em tratamento > 1 ano (69,5%). Possuíam tempo de lesão > 6 meses (64,4%), dor na úlcera/membro (86,4%) e leito com ≤ 30% de granulação/epitelização (78,0%). A qualidade da assistência foi ruim (< 5 aspectos positivos) em 57,6% (ρ=0,000) e os aspectos que mais interferiram foram as seguintes inadequações: profissional que acompanha/realiza curativo (ρ=0,002, coeficiente de contingência (CC) =0,458, razão de chance (RC) =13,9), produtos nos últimos 30 dias (ρ=0,038, cc=0,334, RC=7,3) e acesso a consulta com angiologista (ρ=0,041, cc=0,305, RC=4,1). Os aspectos clínicos que contribuíram para o aumento do tempo de assistência foram: tempo de lesão >6 meses (ρ<0,001), dor (ρ=0,043), recidiva (ρ<0,001); nos aspectos assistenciais: inadequação dos produtos com 83,1% (ρ=0,036). Essas características dificultaram a cicatrização tecidual, prolongando o tempo de tratamento das lesões,que podem ter contribuído para a cronicidade das úlceras

Implementação da política de assistência social em Mossoró/RN : uma avaliação a partir dos centros de referência da assistência social

The current National Policy for Social Assistance (PNAS) is the instrument that regulates the organization and procedures of social-welfare actions. Developed and approved in 2004 since the Unified Social Assistance System (ITS) was crated in 2003, it reaffirms the democratic principles of the Social Assistance Organic Law (LOAS) focusing on the universalization of social rights and equality of rights when accessing the social-welfare system. In the SUAS point of view, the PNAS highlights the information, monitoring and evaluation fields for being the best way to assure the regulation, organization and control by the Federal Government paying attention to the principles of decentralization and participation. This political-institutional rearrangement occurs through the pact among all the three federal entities. The pact deals with the implementation of the task. It says that it has to be shared between the federal autonomous entities, established by dividing responsibilities. To the cities, considered as the smallest territorial unit of the federation and closer to the population, was given the primary responsibility, which is to feed and maintain the database of SUAS NETWORK and identify families living in situations of social vulnerability. In addition to these responsibilities, the cities that have full autonomy in the management of their actions, have the responsibility to organize the basic social protection and the special social protection, that using the Center of Social Assistance Reference (CRAS) and the Center of Specialized Social Assistance Reference (CREAS), are responsible for the provision of programs, projects and services that strengthen the family and community; that promote people who are able to enjoy the benefits of the Continuing benefit of Provisions (BPC) and transfer of incomes; that hold the infringed rights on its territory; that maximize the protective role of families and strengthen its users organization. In Mossoró/RN, city classified as autonomous in the social assistance management, has five units of CRAS that, for being public utilities, are considered the main units of basic social protection, since they are responsible for the connection between the other institutions that compose the network of local social protection. Also known as Family House, the CRAS, among other programs and services, offers the Integral Attention to Families Program (PAIF), Juvenile ProJovem Program, socio-educational coexistence services programs, as well as sending people to other public policies and social-welfare services network, provides information, among others. In this large field, social workers are highlighted as keys to implement the policy of social assistance within the city, followed by psychologists and educators. They should be effective public employees, as a solution to ensure that the provision of the services are to be continued, provided to the population living around the units. However, what we can find here is inattention to the standard rules of social assistance, which not only undermines the quality of programs and services, but also the consolidation of policy on welfare as public policy of social rights

Desenvolvimento e assistência social : uma avaliação da efetividade da política de assistência social nos municípios de Assú e Mossoró (2004 -2008)

This thesis, whose title is DEVELOPMENT AND SOCIAL ASSISTANCE: AN EFFECTIVENESS EVALUATION IN SOCIAL ASSISTENCE POLICY IN THE CITIES OF ASSÚ AND MOSSORÓ/RN (2004/2008), has as main aim to evaluate effectiveness in Social Assistance Policy in the cities of Assu and Mossoró/RN, from 2004 to 2008, identifying its impacts and effects in life of its users. The methodological process for the research was composed by: a) Literature review on this theme, development of public policies; social public policies, public policy evaluation and Social Assistance Policy in Brazil; b) Documental research from Municipal Management of Social Development and Municipal Counsels of Social Assistance in the cities of Assu and Mossoró/RN about the object of this study and empirical field; c) Field Research constituted by the realization of Focal Groups with Social Assistance users and semistructured interviews with municipal managers from Assú and Mossoró. It was also taken into account participant observations in events and activities related to Social Assistance previously mentioned, considering field management and also the response to users demands. Articulating the themes of Development and Public Social Policy in Social Assistance was the theoretical purpose for this thesis. To achieve this purpose, it was performed two theoretical displacements related, at the same time, to the notion of development and to the concept of Social Assistance, which means to comprehend development as social change and improvement in users life quality, expressed in the expansion of their capacities and liberties (SEN, 1993, 2000), and the Social Assistance as an element for development. Such displacements provide a view of Public policy and Social Policies and evaluate National Policy of Social Assistance achieved in those cities. As product, this thesis presents a methodological purpose for effectiveness evaluation in Public Policy, taking into account expansion of capacities and liberties, concluding that Social Assistance Policy in Assú and Mossoró/RN, even in lesser extent had its impact and caused effective results in the life of their users and provided an expansion of their capacities and liberties, improving life quality and empowered agent condition for those subjects. The results show that this Policy has been proved to be effective, and consequently, it was considered, in this thesis, to be also an element and an allied for development

Assistência a mulher com câncer de mama em um cenro de referência no Estado da Paraíba

The assistance to women who have breast cancer is studied in a Reference Center in Paraiba and also the way this assistance is performed in a School Hospital maintained by SUS (Single Health System) is questioned. Breast cancer demands institutional organization, provision of financial, material and human resources, requiring, from the health system, effective assistance with new technologies which make it possible for the population their access to specialized medical services although it not always is able to guarantee those services nor the rights which the legislation granted them, inhibiting a proper relationship between the health professional and the patient. The theme is discussed through a transdisciplinary knowledge view and has as its theoretical referential the contribution of classical and contemporary authors from the human and social sciences and, as an empirical research strategy, the structured interview. The objectives of the research were: identify how the assistance to women with breast cancer is carried on at a Reference Center on Oncology in Campina Grande, Paraiba, identifying their difficulties and their satisfaction with the received assistance; draw up a profile of the women with breast cancer who were assisted in this Reference Center; understand their gynecological and obstetric antecedents, life styles, age group and stage of the disease when the treatment started; check their knowledge about their rights and which benefits they had received. Most women ranged between 40 and 59 years old (63%), which corresponds to the risk range of developing breast cancer. As to their occupations, 38.3% were housewives and 30.1% retired, whose family income was among those who received between less than a minimum salary and one minimum salary (58.2%). This population was mainly constituted of married women (60.2%), whose most frequent schooling was an incomplete elementary school (27.6%) and complete elementary school (24.1%), which added up to 51.6%. It was observed that the majority of the women seemed to be satisfied with the assistance received, noting that a minimum care was enough to define this satisfaction, although it is perceived that the access to the health system does not ensure the ideal attention conditions they need; it was verified that the availability of the services and the assistance itself are seen (in the local culture) as a favor and not as a right. It is also observed that only 30% of the women mentioned that they knew about their rights and the most mentioned ones were the disease assistance (13%), the medicines (13%) and the treatment (12%), which represent the most important triad to face the disease and around which the oncologic assistance most focus on. It is concluded that the condition of the users´ minimum existential of a public health unit and the condition of belonging to a lower social stratum were variables that influenced the respondents´ satisfaction in relation to the assistance received but the importance of the Reference Center for the women with breast cancer´s assistance for the whole region cannot be denied as well as the need to broaden the way the policy of the oncologic assistance in Brazil in the local realm is seen

Política de assistência social no Brasil: uma análise a partir das tipologias de políticas públicas

The study of public policy typologies is still a knowledge field which lacks more embracing and applicable studies to different sectors. On that perspective, this work, Social Assistance Policy in Brazil: an analysis from the typologies on public policy, pursues to add the relevant literature to social assistance what focus on the public policy ratings. Moreover, it concerns about a study on the the national policy of social assistance implemented by the Brazilian government from the theoretical referrence of the public policy typologies. For that reason, the referential framework of the public policies as well as the analisys of its fundamentals/principles that are indispensable for achieving a bigger goal, that is to tipify the social assistance policy based on the different public policy typologies and characterize it through the main elements which are intrinsec to the social political and economic reality of Brazil. Thus, the issue suggested for the work is: what is the profile and the political trajectory of the social assistance implemented by the Brazilian Government? How it presents, above all, the features of a distributive, focused and lawful policy, the work has been done througho the following hypothesis: the social assistance policy in Brazil has been of universal, assistance, and focusing aspects. For each of those features granted to the social assistance policy, there is a gathering of changes according to the social, political and economic moment of the country and that stands out due to the different institutions within every cyclical period. The work showed that besides the social policy has gone through meaningful changes during the last decades, even though the adoption of the Organic Law of Social Assistance and its rules, some of the mentioned characteristics still remain, as long as the State s primacy goes on being the economic policies over the dubbed social policies. Notwithstanding, the social assistance will build up itself from the materialization of the growing of the social rights related to the State, but also assuming an important role on the amplified reproducing process regarding the capitalist social relations

O município brasileiro e o direito fundamental do acesso à justiça: a prestação da assistência jurídica municipal ao necessitado

This scholarly work aims to investigate the feasibility and constitutionality of access to justice through the provision of full and free legal assistance by the Brazilian municipalities. Investigates the historical aspects of federalism in a global context, emphasizing the contributions left by American federalism. In the Brazilian context, emphasizing the importance of municipalities as federal entities and their outstanding characteristics, while addressing regional issues of federalism. Leanings to the more detailed analysis of the Brazilian municipalities, contextualizing its legal status, its independence and its constitutional powers. It is emphasized in the same way, the relevant transformations of Brazilian municipalities over the last twenty years of this Constitution of the Federative Republic of Brazil in 1988, especially the various constitutional amendments that affected the local autonomy and budgetary aspects, fiscal and skills, bringing significant changes to the municipalities. It is an approach to the concept of justice and deepening the studies on the fundamental right of access to justice in its various connotations. In this vein, it is a study on the legal advice provided in Brazil, especially the powers of the Public Defender of the States and Union, as well as the provision of such public service by Brazilian municipalities and its relevance to citizens in need. At this point, it deepens the relevance of the theme of this dissertation earning the implications of municipal performance in the provision of legal assistance provided to the needy, and the activity of the Municipal Attorney or legal counsel in conducting such a task and its implications for legal and procedural especially on the constitutionality or otherwise of the conduct of such public service, confronting the constitutional articles that are correlated with the subject. Within this context, evaluates the municipal legal assistance under the test of constitutionality, in particular the assistance given by the Executive, through the Municipal Attorney or specialized secretariats and that provided by the Legislature, although it only has the typical functions of legislating and control the municipal accounts, comes in a few municipalities in Brazil deploying sectors with the performance of legal services to the needy. At this point the thesis, one wonders if some important aspects of this activity such as political influence and patronage, very common in day-to-day municipal prosecutors and legal advisers, public employees or occupying commissioned positions within the municipal administrative structure in several municipalities throughout Brazil. Finally, there will be a conclusion as to the constitutionality of the service being done by presenting proposals and recommendations that may improve the municipal legal aid, allowing a constitutional backing to this important service is being provided in capital cities and municipalities throughout the length of Brazil

Representações sociais, relações de gênero e programas de assistência e educação à saúde da mulher no climatério em Natal/RN

Climacteric is the name of the period of the human life that it is going from the 40 years old, approximately, until the 65 years old. Though, for besides a biological phase of the woman's life, the climacteric is an object of the social world that is rendered to different apprehensions and readings on the symbolic plan. In this study, it was looked for to know the social representations, that health' professionals acting in the programs of the climacteric and the users of those same services, build in respect of that purpose. Besides, it tried to be seen that the social hegemonic representation that guides the actions and the agents' attitudes in the practices of attendance and education for the woman's health in the climacteric in the extent of the investigated institutions. The data were collected through interviews, questionnaire, focal discussion group and direct observation. The observation field was constituted by the three institutions that develop the attendance and education for the woman's health in the climacteric phase, in the city of Natal. A gender perspective was also been adopted, sought to evidence as the cognitive structures that assure the masculine power reproduction, pronounce to the social representations to build a sense to the investigated purpose. It was verified that the social representations of the climacteric are built mainly around the semantic fields old age and disease. For the health professionals, the meaning of the simbol old age carries the marks of the indentified system of the middle class employed, but also, of the feminine habitus that guides them to have an ethical and aesthetic apprehension of their own body. The climacteric, in that way, is seen as a difficult phase , a painful event that scares . For the women attended by those professionals, the sign old age means feeling emphasis from the biological climacteric aspects, in other words, the sensations and signs that forbid the body to accomplish certain linked basic life functions. Along the whole course of this thesis, it was verified that the climacteric is a complex phenomenon that needs to be faced as such. While cultural phenomenon, it is urgent to look for means to help to combat the centrality of the professional representations that face the climacteric as old age and disease, particularly in the field of health

Representações Sociais do ser idoso e suas implicações na assistência e nas práticas educativas voltadas à população idosa residente em Natal/RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

As ações político-pedagógicas do Serviço de Assistência Rural-SAR

This program resumes the history of the political-pedagogic actions on the Serviço de Assistência Rural SAR, of Natal archdiocese, and analyses the contributions of this actions on the process of rural workers organization in the social movements on the countryside. The educative actions of the RAS are happening in a permanent tension between the pedagogic project of a church in change and, a pedagogy of the groups, communities and social movements, that is centered in the cultural action, in the culture lived from its condition of citizens. This research reveals that this entity fulfilled a strategic attribution for the Natal s church on the formation of the community leaderships, at a first moment and leaderships for social movements. Before the military dictatorship, the work methodology of this entity had as priority, begin from the reality leaved by the rural workers in the expectation that these became to qualify themselves for a more citizen participation in the call development. During the military regime, the entity goes measuring theirs activities in the new context, until the moment that redefines the work line. Goes then defining regions and thematic of operation supporting the fights for land, salary campaigns, women agricultural workers organizations. The pedagogy of work has as one of its supporters the Paulo Freire s pedagogy, privileging the dialog as a source of production of knowledge from the reality leaved in a permanent transformation. The actions of this entity, with the groups and social movements, produces the necessary knowledge for the organization of the rural workers while individual and social subjects of a changing world. The process of action-reflection of the activities intended, by a creative form, a permanent production of strategies of fight of the workers. Research ever, not to make accommodate itself to the new knowledge acquired in the action-reflection it is part of the pedagogical idea of this Institution. One searched in this process of formation of the man and the woman to question the reality, to create actionreflection-action spaces on the fights for a possible transition of an ingenuous conscience for a critical conscience, in view of the transformation of the structures that oppresses them

Avaliação da qualidade da assistência aos portadores de úlceras venosas atendidos no ambulatório de um hospital universitário em Natal/RN

Study descriptive that was designed to assess the quality of care for people with venous ulcers (VUs) tended at the ambulatory of a university hospital in Natal / RN. The target population of the study was composed by 40 users bearers of venous ulcers served in the ambulatory of angiology of a university hospital in the level of tertiary education. The study received assent of the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol No. 169/06). The collect of data was performed using a form of interview and tour with collection of measures biophysiologic, for a team comprised by the researchers and an academic of nursing, in the period of three months. The data were analyzed in SPSS 14.0, using descriptive statistics and presented in the form of charts, tables and graphs. Identified a clientele of holders of VUs predominantly female, married, aged up to 59 years, low level of education and household income, from Natal, retirees or those exercising professions and occupations that require long periods standing or sitting. In relation to the characteristics of health, those surveyed had risk factors for venous disease and had UVs chronic, located in Zone 2, lost tissue in grade II and serous exudates on average quantity. The assistance to holders of UVs has been characterized by a lack of professional nurses and unavailability of products for the realization of the right curative in ambulatory and outside it; by the inadequacy of products used in VUs, for long periods of treatment without resolution, where the compressive therapy is not priority, by the lack of completeness in the levels of assistance; by monitoring the bearer of UVs only by doctors and the nurses, even with the other team of professionals in the health service; by the completion of guidelines by health professionals and the lack the standardization of conducting laboratory and specifics tests. The assistance was assessed as inadequate in aspects: reference and counter-reference (75.0%), number of consultations with angiologists last year (87.5%), documentation of the clinical findings (85.0%), use of compressive therapy in the past 30 days (77.5%), part of the team interdisciplinary (97.5%), completion of laboratory and specifics tests in the last year (100%), availability of products used in achieving the curative in ambulatory (80, 0%), and indication of products used in the conduct of dressing outside the clinic (70.0%) and appropriate in the guidelines made on the use of socks, lifting of the members and prescription of exercises regular (82.5%) and indication products used in achieving the curative in ambulatory (97.5%). We conclude that the assistance provided to holders of UV was inadequate in 80% of cases interviewed, becoming non-resolutive and assistematic

Hipertensão arterial e fatores de risco em servidores atendidos pelo departamento de assistência da Universidade Federal do Rio Grande do Norte

Systemic arterial hypertension is a multifactorial disease that contributes to the country´s high cardiovascular morbi-mortality rates. Considering that hypertension affects individuals in their most productive age while facing work and living risk factors, it is important to investigate its occurrence and predisposing factors in different occupational segments. The objective of this study was to identify the prevalence of hypertension among workers attended to in a medical service of a public university, their hypertension levels, the risk factors present, and their knowledge of the factors that influence the arterial pressure. The epidemiologic study was conducted in the Health Department of the Federal University of Rio Grande do Norte with 102 workers that sought care in the medical clinic during the months of March to May 2009. Data were collected by means of a questionnaire and measurements of systolic and diastolic arterial pressure (SAP and DAP) that were classified in stages according to the Brazilian Society of Hypertension and the degree of risk for cardiovascular events according to the criteria of the Brazilian Society for Cardiology. Data were analyzed using descriptive statistics. The workers were, on average, 54 years of age; the majority (67%) was male and had primary or middle educational level; they worked mainly in supplemental units and deanship offices conducting different functions such as security guards, administrative assistants, health auxiliaries and constructions workers; 48 (47%) of the workers identified themselves as hypertensive for 8 years on average, with the majority executing hard labor and administrative functions. Among the workers with hypertension, the number of the pressure levels classified as pre-hypertensive, stage I and II were: (12% in the SAP and 20% in the DAP); (16% in the SAP and 9% in the DAP); and (15% in the SAP and 5% in the DAP), respectively. The workers that did not identify themselves as hypertensive presented classifications with greater frequencies were: normal (16% in the SAP and 30% in the DAP); and pre-hypertensive (21% in the SAP and 16% in the DAP). The risk factors identified in more than 50% of the workers were: tobacco smoking, alcohol consumption and indices of being overweight, although physical activities are also present. Of the 48 workers diagnosed as hypertensive, those that had 5 risk factors present and limitrophic pressure levels (12%), in stage I hypertension (16%) and stage II hypertension (15¨%) were categorized as being in high risk for vascular events. The number of workers that indicated they had knowledge of the factors that influence their hypertension was less than 39% for each factor. It is concluded that there is a high prevalence of systemic arterial hypertension in the university workers, even amongst those already under treatment. They constitute a population at risk considering their age group, their work functions, and their inadequate life habits. Health care of these hypertensive workers that seek attention in the Health Department is an important aspect of the internal workers health policy in the institution. Educational interventions are recommended for the improvement of quality of life and of work in these workers

Conhecimento dos enfermeiros do Hospital Universitário Onofre Lopes sobre sistematização da assistência de Enfermagem

Nursing as a profession goes in search on quality of their care through new frameworks, trying to break postures of the health care system so fragmented in the care. To change professional practices, it is necessary to build their own knowledge grounded on Nursing Care System. The aim of this study was to analyze the influence of nurses' knowledge on care systematization in nursing in the University Hospital Natal-RN. It is an analytical descriptive study carried out at the Onofre Lopes University Hospital (HUOL), Natal-RN, 2010, the sample was composed of 40 active nurses working in hospitalization units of the hospital, the inclusion criteria were being in the monthly scale sector and agree to participate in the study. The non-participant observation and another interview were used for collecting data, statistical analysis was descriptive and inferential with reliability test, Pearson test, chi-square and Fischer, the variables that correlated were analyzed in a model Multiple logistic , calculating odds ratio. The results were: predominance of female professionals (90%), predominantly in the age range 39-46 years (37.5%), nurses who have the undergraduate degree at the Federal University of Rio Grande do Norte (80%), and who have expertise training as a minimal degree (62.5%). Among the surveyed, the knowledge showed significance with the graduation time (p = 0.018) and time working in HUOL (p = 0.036). The majority of the professionals surveyed do not know which organ is responsible for the SAE legislation (52.5%), aware of the steps needed to build the nursing diagnosis (92.5%), understand the characteristics of nursing planning (90% ). However the same professionals do not perform physical examination in patients (50.0%) did not classify the clinical findings (68.4%), and identify the problems encountered as a classification (13.2%). The planning of nursing care is carried out by verbal order of nurses (82.5%), 41% of the professionals assess only the intervention stage, in other words, the actions taken. Regarding the practical application of nursing records 53% of nurses do not realize records, 30.8% is incomplete, the other held notes (p = 0.003). The nurses know the nursing process (90% of appropriate responses), despite the actions defined by the theory are not applied in practice. Investigators believe the condition of the hospital teacher (22.5%) could positively affect the implementation of the SAE associated with the interest of professionals (20%). Of the respondents, 17.5% accept as truth the lack of facilities to assist the SAE implementation in the hospital. It was concluded that nurses know the theory that underlies the SAE and the nursing process, but do not develop the service know as well, there is need for action to boost the SAE implementation as practice of nurses in the hospital investigated

Assistência aos portadores de úlceras venosas: proposta de protocolo

Venous ulcers (VU), recurrent chronic wounds resulting from Chronic Venous Insufficiency (CVI), affect different age groups and would severely affect ambulation of patients. The lesions require treatment lasting and complex and are responsible for significant morbidity and mortality. Thus, this study aims to identify the important aspects covered in the scientific literature protocol for assisting patients with venous ulcers, identifying the issues to be proposed by the judges of the study (nurses, doctors and physiotherapists) to the protocol of care provided to patients venous ulcers and present the structure of protocol proposed by the judges of the study to assist patients with venous ulcers treated at a referral hospital of Rio Grande do Norte. This is a descriptive study using a quantitative approach, carried out at the dressings, located in the outpatient surgical clinic of the Hospital University Onofre Lopes (HUOL), located in East Sanitary District, Natal-RN. The sample consisted of 39 professionals, 30 nurses, seven doctors and two physical therapists, team members HUOL surgical clinic and other public and private institutions of Rio Grande do Norte and Jequié/Bahia. These professionals were the judges responsible for selecting the guidelines already proposed in the literature on VU protocols. Approved by the Ethics in Research HUOL (Report n.o 081/07), began the first stage of the study which consisted of reviewing the scientific literature about the relevant aspects to be included in a protocol for assisting patients with VU. These aspects were organized into a proposed questionnaire to the judges of the study. Following examination, held on the content validation with application of the Kappa (K), accepting a score higher than 0.80 and the Likert Scale, whereas rates from 4.0 to 5.0. The data collected were organized in Microsoft Excel and exported into Statistical Package for Social Sciences (SPSS) 15.0. The literature review included national and international scientific articles, thesis, dissertation and institutional protocols. Regarding the characterization of professional nurses predominated (76.1%), between 34 and 45 years (41.0%), female (79.5%), married/consensual union (46.2%), with specialization in VU care (61.5%), working in the hospital network (46.1%), with up to 5 years experience in VU (69.2%) and claiming to feel prepared to care for these injuries (92.3 %). With regard to aspects that had very good agreement (K ≥ 0.81), remained the items found in the literature with some modifications. In the analysis of the proposed evaluation items had very important, ranging from 4.1 (drug treatment) to 4.9 (patient assessment and care of the injury and the injured and perilesional skin). The proposition of the protocol is arranged in eleven items: A) Evaluation of patient and lesion, B) Registration and documentation, C) the wound and perilesional skin, D) an indication of coverage, E) Use of antibiotic and pain treatment, F) Surgical treatment of CVI, G) Drug treatment, H) Improving venous return and prevetion of recurrence, I) Referral of patients, J) Training and K) Reference and counter reference