Cuidados de enfermagem ao paciente em pós-operatório de prostatectomia: revisão integrativa

Este estudo trata-se de revisão integrativa da literatura com objetivo de sintetizar o conhecimento produzido em artigos sobre os cuidados de enfermagem aos pacientes em pós-operatório de prostatectomia. Para seleção dos artigos foram consultadas cinco bases de dados – SCOPUS, CINAHL, PUBMED, LILACS e Cochrane – sendo incluídos dezenove artigos. Os resultados mostram estudos que se enquadram nos níveis II, IV, V, VI e VII de evidência, a maioria realizada nos Estados Unidos durante os anos de 1999 a 2011. Os cuidados de enfermagem identificados foram agrupados em seis categorias: acompanhamento psicológico, orientações pós-operatórias, tratamento da disfunção erétil, tratamento da incontinência urinária, tratamento da dor e tratamento da hiponatremia. Conclui-se que os estudos com maior nível de evidência identificado recomendam cuidados de enfermagem centrados no acompanhamento psicológico, nas orientações do período pós-operatório e no tratamento da disfunção erétil. Destaca-se ainda que tais recomendações concentram-se, sobretudo, nas ações de apoio emocional e educativo

A teoria de Callista Roy, a nanda-i e o cuidado ao paciente prostatectomizado

Trata-se de um estudo descritivo de caso clínico, com abordagem qualitativa, o qual possui como objetivo estabelecer relações entre os diagnósticos de enfermagem da NANDA-I e os problemas de adaptação segundo o Modelo Teórico de Roy em um paciente prostatectomizado. A coleta de dados ocorreu em um hospital universitário localizado na cidade de Natal-RN, no mês de janeiro de 2011, por meio de um roteiro de entrevista e exame físico. Os diagnósticos que apresentaram relações entre a NANDA-I e o Modelo de Roy foram: dor, ansiedade, constipação, sono, atividade, volume de líquido e infecção. Conclui-se que grande parte dos problemas adaptativos segundo o Modelo de Roy, manifestados pelos pacientes no pós-operatório de prostatectomia, possuem semelhança com os diagnósticos da NANDA-I

Processo de enfermagem aplicado a um paciente com síndrome de marfan associado a aneurisma aórtico

Trata-se de um caso clínico que teve como objetivo traçar diagnósticos, intervenções e resultados de enfermagem em um paciente com Síndrome de Marfan internado na unidade de terapia intensiva no pós-operatório de correção de aneurisma de aorta. Foi desenvolvido em um Hospital Universitário, localizado no município de Natal-Brasil, em abril de 2011. Entre os principais diagnósticos de enfermagem identificados, destaca-se: Débito Cardíaco Diminuído; Risco de Infecção; Dor Aguda; Risco de Glicemia Instável; Integridade da Pele Prejudicada e Ansiedade. Percebeu-se que a aplicação do processo de enfermagem neste paciente contribuiu para delimitar o campo de atuação específico da enfermagem, bem como identificar os cuidados prioritários, contribuindo para uma melhoria na qualidade da assistência

Hiperidrose compensatória após simpatectomia toracoscópica: características, incidência e influência na satisfação do paciente

Hyperhidrosis is an idiopathic condition characterized by excessive sweating. Symptoms generally begin in childhood or early adolescence, and rarely improve with age. The excessive localized sweating generally occurs either spontaneously, or in association with stressful or emotionally charged situations. This prospective study aimed to investigate predictive factors for compensatory hyperhidrosis after thoracoscopic sympathicotomy. From 2000 to 2002, 80 patients (53 female and 27 male) underwent hyperhidrosis surgery. The patients, ranging from 12 to 56 years old, were studied and followed-up for 42.51 ±5.98 months. A satisfaction grading using a visual analogue scale -VAS (0 = not at all satisfied, and 10 = fully satisfied) was used. The surgical procedure was performed bilaterally on the second ganglion (T2) for facial hyperhidrosis, on the third and fourth ganglia (T3 and T4) for axillary hyperhidrosis, and on the third ganglion (T3) for palmar hyperhidrosis. The results showed that, 68 patients (85%) presented with compensatory sweating (CS), which was classified as mild (33.8%), moderate (33.8%) and severe (32.4%). Considering the final surgical results, 70 patients (87.5%) were satisfied with the outcome of the operation, while 10 patients (12.5%) were dissatisfied. Degrees of satisfaction varied according to sex, age, BMI and extent of denervation. Moreover, the compensatory hyperhidrosis was more severe in abdomen and back than in legs. In conclusion, although CS is a frequent adverse effect of sympathicotomy, the degree of patient satisfaction was high. Some factors were related to the occurrence and severity of CS and the most adequate patients to be submitted to this operation are young adult women whose BMI is less than 24.9

Seleção de categorias da Classificação Internacional de Funcionalidade, Incapacidade e Saúde para avaliação do paciente com acidente vascular cerebral em reabilitação

Stroke represents the first cause of disabilities among adults. Although different professions work together in treatment of stroke patients, all they use different terminologies for the description of the patients problems and it can constitute an impediment in the communication between the staff members. Thus, the multidisciplinary and interdisciplinary work would be facilitated if using a reference common tool, as the new International Classification of Functioning, Disability and Health (ICF). However, the ICF is very extensive and complex and due to its complexity, it has been evidenced the necessity to select its categories to become it more practical. The aim of the study was to investigate which categories of the ICF are more suitable to evaluate and to describe the stroke patient in the view of teachers and municipal public health professionals. It was a descriptive research, which involved 5 professors and 11 professionals of Physiotherapy that have worked at the health public area in Natal / RN. It was used the Delphi Technique in 3 rounds and the Likert Scale to select the categories among the ICF components. As result, from the 362 IFC categories, 94 were selected. The selected categories correspond to rehabilitative characteristics of Stroke patients in the universe of the Physiotherapy performance. The methodology applied was suitable to the studied object emphasizing the necessity of future studies for validation of the chosen categories

As repercussões dos serviços hospitalares em diferentes contextos: uma análise de profissionais de saúde

This study has as general object: to verify as the health professionals that work in different hospitals evaluate the hospital services; and specific objectives: identify how health professionals evaluate the work conditions in different hospitals and verify the central nucleus and the peripheral elements of the social representations elaborated by these professionals about these institution. This is a descriptive study realized in Natal, capital of Rio Grande do Norte. Were collected 213 questionnaires. Concerning the evaluation of the health services, high averages had been verified in the philanthropic hospital, for example, quality of the customer service. At the state hospital was observed lowest ones: respect to the privacy of the patients. Similar results were found about work conditions. It was observed as central nucleus the categories Overcrowded and Humanized care, in the state and philanthropic hospital respectively, and as peripheral elements Low wages and Overcrowded. Being thus the conflicts in this scene are inevitable because of the poor structure of some public hospitals, however, these problems can be foresee and solvable if the hospital has a free expression channel accessible to all agents. The evaluation has to become integrant part of the culture of the organization, a time that this will guide the steps in direction to the best quality in the hospital assistance

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

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

Atividades educativas aos portadores de periodontite crônica: escuta e troca de saberes no autocuidado em saúde bucal

This research aimed at evaluating oral health education activities for Periodontitis carriers, emphasizing the motivation for self-care and understanding the cultural aspects involved. This was a qualitative and quantitative study. Based on the qualitative referential, 20 interviews were done, in which differences between scientific and popular explicative models of the health-illness process were verified, besides the increased knowledge and motivation in relation to the use of preventive measures and also the fails in the understanding of the chronic character of periodontitis, enhancing frustration and guilty feelings in the patients. Two groups were structured: intervention and control. The intervention group was submitted to clinical attendance and education activities, while the control group undergone the traditional clinical attendance only. The sample consisted of 51 participants of intervention group and 47 of control group. Structured interviews were conducted at the beginning and at the end of the treatment in order to evaluate the knowledge and motivation for self-care in both groups. For comparison between the previous and post moments in both groups, there were applied McNemar tests with a probability of p < 0.05. In intervention group there was an increase in knowledge related to the name, the causes and related factors of the disease (p < 0.05). In control group there wasn t a rise in the understanding of the diseases chronic character, unlike in intervention group. However, in what concerns self-care, a greatest frequency in medium and high scores was observed in both groups. By this study, it is conclude that there is a common sense knowledge about the importance of preventive techniques and poor oral health as causing periodontitis; clinical interventions for bearers of chronic Periodontitis do not add values to the patients, regarding the illness, its causes and its chronic character; popular beliefs stay in their imagination, and the patients have a increased motivational capacity for self-care

Cartografia da percepção de mês e profissionais sobre a atenção a saúde de crianças/adolescentes soropositivos no município de Natal

This study had as objective to identify to the perception of mothers and professionals of health on the attention to the health of HIV-Positive children/adolescents in the city of Natal-RN. It is a descriptive-exploratory study with quantitative and qualitative approach, carried through in the Giselda Trigueiro Hospital and in the State and Municipal Health Councils in Natal - RN, from march to december of 2005. The sample was composed by 56 participants, 33 mothers of children who use specialized assistance and 23 professionals. Data collection occurred with the application of a half-structuralized interview. Quantitative data were analyzed through descriptive statistics and qualitative data were submitted to content analysis. Prevailing categories in relation to the cartography of the attention to seropositive children and adolescents in Natal were: Organization and dynamics of the attention; Institutional management and human development; Control and prevention; other contexts of attention; relationship/communication team-patient and organization and functioning of the services. The profile epidemiologist of the children, adolescents and of the people/mothers, who take care of them with HIV/Aids, followed the evolution of the epidemic in the country and the world. It was verified that mothers need care and information; however they make a positive evaluation of the attendance they receive. It was also observed many gaps in the services of assistance, in which the researched group was attended, beyond imperfections in the communication between health professionals and users. The professionals recognize the advances that the politics represent for the assistance of people with Aids; however feel themselves limited by the precariousness of the system and the partner-economic conditions of the people. According to these data, it can be verified great challenges to go through in the context of integrality of the assistance to HIV positive children and adolescents in the city of Natal and in the improvement of the communication in the institution of reference

Satisfação do paciente com a fisioterapia :tradução, adequação cultura e validação de um instrumento de medida

The measurement of patient satisfaction can provide information about the success of the care provider in reaching the values and meeting the expectations of the patient. The purpose of this study was to translate into the Portuguese language and to culturally customize to the Brazilian population the instrument to measure patient satisfaction with physical therapy elaborated by Goldstein et al. The study sample was made up of 279 patients who were undergoing physical therapy treatment at 39 different private clinics in a middle-sized town in northeastern Brazil. For the translation of the survey instrument, the back-translation technique was employed, in association with the bilingual method. The reliability and validity of the Brazilian version of the instrument were both assessed. Reliability analysis, carried out with the computation of Cronbach alpha coefficients, showed that the measures obtained with the instrument have a high degree of internal consistency. The aspects dealing with the patient therapist relationship are the most important predictors of satisfaction, followed by those dealing with courtesy, privacy, and practical aspects such as efficiency of the facility in the patient admissions process, setting up of appointments, and waiting time in waiting room. Items dealing with aspects such as location of the facility and availability of parking facilities may underestimate the reliability of the instrument. This study translated, culturally customized, and validated an instrument to measure patient satisfaction with physical therapy originally developed in English. By so doing, this study has made this instrument available to the Brazilian society, and it has rendered it a useful parameter that can be utilized in our country in the field of physical therapy

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

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

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

Dimensões didática, afetiva e formativa de docência que tecem as representações sociais entre licenciandos da UFPI

This study intends to analyze the social representation of teaching for students of first years of undergraduate courses in Education, Letters and Biology. The field of this research was the Federal University of Piaui - Campus of Picos in 2009. To reach the objective proposed above, was used the theory of social representations to the seizure of the elements which constitute such representations according to Moscovici and colleagues, considering the contribution of Abric with his Theory of Central Nucleus and Wagner with the Theory of Sociogenesis. Data were collected in two phases: first, through the Technique of Free Association of Words (TFAW) of which 100 subjects evoked representations of their teaching through the inductor terms 'to teach', 'student' and 'teacher'. For those data we used the EVOC software that promoted to detect the elements of the core and to conclude that the social representation of teaching is one of the work performed by a master / teacher who transmits, directed to an apprentice who learns, confined to the school involving the student with all his virtues to be smart, interested and dedicated, and teacher to be friend, wise bearer of knowledge and also intelligent. Then, using the Multiple Classification Procedure (MCP) only 10 subjects made ratings of 25 more evoked words in the first phase, for the analysis of data from the MPC with the use of the SPSS software we used Multidimensional Statistical Analysis (MSA) for the Free Classification we found three dimensions of Social Representation of Teaching: The Didactic, that focuses on teacher and student being superimposed, meaning the inseparability of these elements, the Affective, which presents the elements inherent in teachers with love as the strong point of this dimension, and the Formative, that is as ambiguous as ambivalent because it sees the teacher as a professional directed to help students get an education; for Directed Classification with Similarity Structure Analysis (SSA), we learn that teaching is a profession that materializes in the classroom, which is extremely true because the action happens in this teaching space, supposing a caring, loving, cheerful, capable, apt, patient, partner, responsible, dedicated, committed educator, who has wisdom and knows how to teach and help students through dialogue to there study and learning. All of it s necessary to occur the result of teaching, which is education in a disciplinary manner. The results point to a very traditional social representation of what is the role of teachers, the role of students and the role of the relationship itself between teaching and learning through the act of teaching. With this statement, we can confirm that the structure of Social Representation of Teaching for the investigated subjects reflects the sociogenetic conditions that engendered them, and that these conditions permeate their structural organization, in particular time-context in which social representation was captured

Um estudo sobre o estágio supervisionado na formação inicial de professores de matemática na Bahia

This work arose from our concerns with the issues of teacher training for early childhood education. From the difficulties encountered as a novice teacher in elementary, we deem important to research training needs of these professionals. Thus, we define the objective of this research to investigate the training needs of novice teachers teaching Early Childhood Education/Elementary school. Our work fits in Educational Research Qualitative Approach, and its construction procedures of the semistructured interview data and document analysis. Our empirical field was made up of schools in the metropolitan region of Natal / RN, offering kindergarten / elementary school. The subjects are five teachers who act as holder of the elementary school class and have 0-3 years of teaching practice, characterizing the second Huberman (2007) as novice teachers. Data analysis, based on principles of content analysis, three themes emerged: Beginner Teaching Professor in Early Childhood Education / Preschool; Reasons explaining the difficulties Faculty / Formative Needs Teaching and Training in Early Childhood Education / Elementary school, from the Training Needs Analysis, with their respective categories, subcategories, contributing to our understanding of the subject matter. The entry into the profession is marked by mixed feelings of euphoria and fear, where there seems to be a "clash" with reality. The difficulties are related to the planning / execution of activities, meet the individual needs of learning and assessment of children. As a strategy to overcome the difficulties the teachers exercise the action-reflection-action in their practices and seek continuous updates in the theoretical and methodological framework of early childhood education. The reasons that define these difficulties may be related to the teacher, school, family, and students of these institutions. In experiencing these difficulties has outlined the need for teacher training, among which stand out studies on ethics in teaching with children, the concept of children and their childhoods, peculiarities of teaching / learning in preschool, toys and legal determinations on early childhood education, multi-language and expressions in early childhood education, specific content areas of knowledge, among others. Furthermore, studies on the theoretical as Piaget, Vigotsky, Maria Carmen Barbosa and Emily Smith. For these professionals to be a professional early childhood education is: like children, be patient and careful, have specific theoretical and practical training for teachers in kindergarten, being able to improvise with seriousness and competence and get updates on continuing education. The surveys, together with the authors and teachers, to confirm our understanding that the training needs of beginners may be related to shortcomings in the initial and continuing education

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

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