Construção e evidências de validação de instrumentos de pesquisa para avaliação da assistência nos centros de atenção psicossocial

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES

Atuação dos profissionais no atendimento às famílias nos centros de atenção psicossocial

This study aimed to evaluate the work of professionals to care for families in Psychosocial Care Centers ( C APS) of Rio Grande do Norte ( RN), from the roles and functions performed by these professional services. For this, it was pointed out the following objectives: To describe the profile and the activities conducted by mental health teams in the RN CAPS ; Know the opinion of professionals in the mental health teams of the poli ti c , practices and training in mental health; Check the suitability of the roles and functions of professionals working in the RN CAPS in relation to care for families . This is an analytic al cross - sectional study of quantitative and qualitative approach . Data were c ollected through a questionnaire in 33 CAPS RN, between March and October 2014 , after being approved by the Research Ethics Committee / UFRN , opinion nº217.808 , CAAE : 10650612.8. 1001.5537 , on March 1 2013. T he sample was adopted , defined by inclusion and exclusion criteria , and is composed of 183 professionals. The database preparation followed two steps: 1. Preparation and processing of data of closed questions of the questionnai re concerning the characterization and practices in mental health research subjects through informational resource Statistical Package for Social Scienses (SPSS) Statistics version 20.0 ; 2. To check the significance level was chosen by applying the chi - squ are test. Preparation and treatment of the corpus formed by the answers to open questions relating to the policies, practices and training in psychiatry through Analyse lexicale pair Contexte software d' un Ensemble of Segments of Texte ( ALCESTE) together a nd categorized by content analysis technique , Bardin (2004) . The data analysis is supported in the literature . It m ade explicit the results through three articles waxing the following results. In the first, participants profile was characterized by a predo minance of females (76.5 %), aged 40 - 58 years ( 61.7 %). They work between 30 and 40 hours per week (63.5 %), working in mental health for over 10 years ( 98.4%). The sample directs the care of family groups ( 65.7%), predominantly the care team of social worke rs, nurses, psychologists and occupational therapists . The doctor performs emergency care without interaction with the staff (48.6%) . On the difficulties encountered in services are ranked in : materials and supplies ( 75.1%), financial ( 78.5%) and structura l ( 66.9%). The second article contains qualitative data organized into five categories : Promoting the rehabilitation of users of CAPS ; Needs training ; Conflicts and satisfactions of teamwork ; Practices developed in CAPS ; Effective difficulties of Mental He alth Policy . The third article highlights the inadequacy of care for families ( 93.4%) and comparing the care families and groups in CAPS both types show to be inadequate : family ( 92.63%), groups ( 92, 60%). The main data obtained reveal the urgent need for transformation in psychosocial care . It shows also the importance of investments in inputs, physical structure and training of human resources for the CAPS.

Referência e contra referência em saúde bucal: regulação do acesso aos centros de especialidades odontológicas

Objective Based on the system of reference and counter-reference and comprehensiveness in oral health care, we aimed to examine ways of refering users to Specialized Dental Care Centers (SDCC) and the interface between them and Primary Care. Methods This is a cross-sectional study carried out with users and dentists of SDCC in a metropolitan region of Northeast of Brazil. Analyses were descriptive, and the association test was done with chi-square. Results Six forms of entry to specialized service were identified: free demand (13.8 %) and reference by the Primary Care dentist (63.2 %) were most frequent. Users referred by the basic health unit dentist had more interest in making a counter-reference than the others (p<0.001, PR=4.65, 95 % CI: 2.74 to 7.91), while individuals without this referral had 1.49 times more difficulty obtaining care (95 % CI: 1.02 to 2.17). Referral procedures are a decisive factor for counter-references. However, the high demand for primary care services and the short supply these services can offer in the face of needs make SDCC performance difficult. Conclusion The analysis of oral health practices from the perspective of network modeling points to the service's need to establish protocols for regulation in a bid to improve access to and the quality of care provided.

Referência e contra referência em saúde bucal: regulação do acesso aos centros de especialidades odontológicas

Objective Based on the system of reference and counter-reference and comprehensiveness in oral health care, we aimed to examine ways of refering users to Specialized Dental Care Centers (SDCC) and the interface between them and Primary Care. Methods This is a cross-sectional study carried out with users and dentists of SDCC in a metropolitan region of Northeast of Brazil. Analyses were descriptive, and the association test was done with chi-square. Results Six forms of entry to specialized service were identified: free demand (13.8 %) and reference by the Primary Care dentist (63.2 %) were most frequent. Users referred by the basic health unit dentist had more interest in making a counter-reference than the others (p<0.001, PR=4.65, 95 % CI: 2.74 to 7.91), while individuals without this referral had 1.49 times more difficulty obtaining care (95 % CI: 1.02 to 2.17). Referral procedures are a decisive factor for counter-references. However, the high demand for primary care services and the short supply these services can offer in the face of needs make SDCC performance difficult. Conclusion The analysis of oral health practices from the perspective of network modeling points to the service's need to establish protocols for regulation in a bid to improve access to and the quality of care provided.

Promoção da saúde e trabalho: um ensaio analítico

CAVALCANTE,Cleonice Andréa Alves, NÓBREGA, Jussara Azevedo Bezerra da, ENDERS,Bertha Cruz, MEDERIROS, Soraya Maria de. Promoção da saúde e trabalho: um ensaio analítico. Revista Eletrônica de Enfermagem. v.10,n.1 p.241-248.2008. Disponível em :.

Paradigms that guide the models of attention to the health in Brazil: an analytic essay

SILVA, Flávio César Bezerra da ; COSTA, Francisca Marta de Lima; ANDRADE, Hamilton Leandro Pinto de; FREIRE, Lúcia de Fátima; MACIEL, Patrícia Suerda de Oliveira; ENDERS, Bertha Cruz ; MENEZES, Rejane Maria Paiva de. Paradigms that guide the models of attention to the health in Brazil: an analytic essay. Revista de Enfermagem UFPE On Line., Recife, v.3,n.4, p.460-65. out/dez. 2009. Disponível em < http://www.ufpe.br/revistaenfermagem/index.php/revista/search/results >.

Investigação e gerenciamento de áreas contaminadas por postos revendedores de combustíveis em Natal

Activities that have fuel subterranean storage system are considered potentially polluting fuels by CONAMA Resolution 273, due to the possibility of leak, outpouring and overflow of fuel into the ground. Being even more worrying when contaminate groundwater for public supply, as the case of Natal City. For this reason, the Public Ministry/RN, in partnership with UFRN, developed the project environmental suitability of Gas stations in Natal, of which 36% showed evidence of contamination. This paper describes the four stages of the management of contaminated areas: preliminary assessment of environmental liabilities, detailed confirmatory investigation of the contamination, risk analysis to human health (RBCA), as well as the remediation plan of degraded areas. Therefore it is presented a case study. For the area investigated has been proposed a mathematical method to estimate the volume of LNAPL by a free CAD software (ScketchUp) and compare it with the partition method for grid area. Were also performed 3D graphics designs of feathers contamination. Research results showed that passive benzene contamination in groundwater was 2791.77 μg/L, when the maximum allowed by CONAMA Resolution 420 is 5 μg/L which is the potability standards. The individual and cumulative risks were calculated from 4.4 x10-3, both above the limits of 1.0 x10-5 or by RBCA 1.0 x10-6 by the Public Ministry/RN. Corrective action points that remediation of dissolved phase benzene is expected to reach a concentration of 25 μg/L, based on carcinogenic risk for ingestion of groundwater by residents residential, diverging legislation. According to the proposed model, the volume of LNAPL using the ScketchUp was 17.59 m3, while by the grid partitioning method was 14.02 m3. Because of the low recovery, the expected removal of LNAPL is 11 years, if the multiphase extraction system installed in the enterprise is not optimized

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

Moradores crônicos de hospital psiquiátrico: um desafio à desinstitucionalização

The existence of chronic inhabitants in the psychiatric hospitals imposes a challenge to the Psychiatric Reform, that proposes things such as the gradual and progressive way to extinct mental institutions, once the permanence of the hospital in the system is only necessary because there is not a net of well structured substitute services capable of receiving that demand. This work considered relevant to deepen the knowledge about those people who passes their lives jailed by the walls of psychiatric hospitals and compose significant part of the world population. It also aimed to investigate the problem relative to the condition of being an inhabitant of a psychiatric hospital the Dr. João Machado Hospital (HJM), in the city of Natal/RN. The paper used different points of view (patients , families and professionals ) to define the profile of the inhabitants, to identify the possibility of insertion in substituting social equipment, to know the expectations of the inhabitants and their relatives regarding to the exit of the life shelter, to investigate the demands related to the net of cares social support for making feasible the discharge and to identify the difficulties that are involved in the exit of the chronic inhabitant of the hospital. There were defined three methodological phases: delineation of the identification, socio-economic and clinical profile of the inhabitants of the HJM; semi-structured interviews with professionals; and open interviews with inhabitants and family. It concluded that the psychiatric institutionalization contributes to the generation of chronic inhabitants in the psychiatric hospitals. Among the professionals, it was detached the defense of desospitalization, but an existence of devices of the asylum model. The relatives showed a resistance to participate in the care and the inhabitants exposed their desire to leave the hospital, as well like the wish of permanence. It was considered important: the construction of an extra-hospital net that enables to desinstitutionalization; the qualification of the technical; orientation to the family, stimulating its participation in the process of caring; give freedom to the individuals in mental suffering, enabling them to be ahead of their lives and express their desires and opinions; the implementation of an extended clinic that is capable of building new possibilities; and a subjectivity guided by the social enclosure

Cuidados paliativos e ser-para-morte: reflexões sobre um atendimento psicológico

Death is a theme that fascinates, though at the same time, frightens and uneasy the human being, despite the finitude being present at our daily lives. In each historical time, death has been represented in a peculiar way, from familiar death (at Middle Ages), to interdicted death (at contemporary times). Through this path it‟s possible to recognize several attitudes and stages front of death and the process of dying as possibilities of coping and the understanding of these occurrences. In other hand, the palliative care proposal came as a humanized attention, front of the human finitude, recognizing death as a part of the vital cycle. The Brazilian reality, in this context, still faces a lot of political, economic and social barriers that makes difficult the consolidation of palliative care at the death process in the Brazilian Health Care policies. Currently, according to the Brazilian Palliative Care Association, Brazil presents an average of 40 services with this proposal. Such data portray our inexpressive condition in relation to these cares when considering the territorial extension and population of our country. Considering this scenario is relevant think about death and the process of dying at contemporary times, at a health context in which palliative care, when trying to humanize the process of dying, bring to light the issue of human finitude and the beingtowards- death, as thought by the philosopher Martin Heidegger. According to him, the human being (Dasein) is constituted as a being-towards-death, once death is its most own potentiality-for-bein and its last possibility to be lived. In view of the ideas presented, the proposed study appears as a qualitative research of existential-phenomenological inspiration and aims to understand the experience of being-toward-death from the psychological care to a person out of possibilities of cure living on palliative cares. The psychological care happened at the patient‟s home, understanding the clinical process of being-with-the-other from the written reports of the psychology/researcher, by the accompanying sessions, configured as an experience report. These reports are focused on the experiences lived by the patient, as well as apprehended by the psychologist at the intersubjectivity relation and its own experience with Dasein and, therefore, being-toward-death. The reports were hermeneutically interpreted, from the senses that emerged in this process, considering the notion of being-toward-death proposed by Heidegger. Furthermore, it was important to dialogue with other authors that approached the studied theme. It is perceived, through brief and meaningful reflections about the clinical treatments started, that the experience of illness with no possibilities of cure makes the Dasein revises feelings and experiences that were marked at the temporality and historicity of existence. It is a stage of life in which the cultural dimension and the common sense of finitude, often gains ground in the human condition, taken in its ordinary sense, unlike the way it has been thought from an ontological and existential perspective of death. Thus, there are singulars and revealing paths in the palliative care scenery as possible ways for authenticity of being-toward-death

O trabalho dos assistentes sociais no âmbito hospitalar: as particularidades da sua inserção no Hospital Universitário Onofre Lopes (HUOL), em Natal/RN/

This study aimed to analyze the work of social workers at the Hospital Universitário Onofre Lopes (HUOL), with the analytical approach the contracting process with the HUOL with the National Health System (SUS), which is set from 2004. Thus, this study sought in times of state reform, restructuring and tension between enlargement / reduction of social and labor rights, understanding the limits and possibilities of social work in HUOL, analyzing how these determinations bounce in the practice of social workers included in the collective process of health work. From a theoretical and methodological historical and dialectical materialism, we conducted literature search, in which developed book report and readings of texts, articles, books that focus on the central categories of the study, namely: Work, Social Work, Health, Health Reform , Project ethical and professional politician. Operationalized also a documentary research, on the Brazilian Public Health Policy, (SUS) and of the Education, as well as research field in which we conducted interviews with 11 social workers, employees packed the HUOL. We conclude that social workers did not participate in the discussion process of contracting the HUOL with the Municipal Health Secretariat of Natal, RN, manager of health and full resetting of user access, via reference setting - counter-referral services provided by the hospital brought the main demands on Social Work guidance regarding the functionality of SUS, and the social intervention in the struggle to guarantee such access. However, the data show that the expansion of demands that require the intervention of the social worker at HUOL is not associated with quantitative growth of these professionals need. Such conditions inflect the possibilities of materialization of the professional ethical-political project, even though that these professionals worry and seek the intellectual improvement, quality of service and to guarantee the social rights of users in the professional practice everyday

O Serviço Social e a exclusão/inclusão social dos portadores de HIV/AIDS :demandas e desafios nos hospitais públicos

This research presents the labors developed by the Social Service unto socially excluded HIV/Aids positives at public hospitals in Rio Grande do Norte (RN). It purposes to identify and to analyze the demands brought by the holder onto the Social Service professional as well as the challenges the latter face to minister to the former. It privileges, from the methodological viewpoint, the qualitative and quantitative analysis with the application of questionnaires, direct observation, semi-structured interviews and bibliographic references. Data were collected from 12 (twelve) social assistants who work at Giselda Trigueiro Hospital in Natal (7) and Rafael Fernandes Hospital in Mossoró (5). The central hypothesis that guided this study is that the social inclusion/exclusion process experienced by the HIV/Aids positive on society implies a demand for the Social Service that is inserted in the public health context (specially in HIV-referred public hospitals), whose agents, however, when attempting to answer those demands, meet obstacles due to both the precariousness of public health services and the social complexity that concerns the HIV/Aids epidemic. Results point out that, de facto, the HIV/Aids epidemic, because of the social exclusion/inclusion process to which the holder is subject results a demand for the social agents at hospitals. Demands rise principally from the patient s life condition, considering the increasing pauperization in the epidemic context. As to what it is concerned, social assistants, responding to the needs, come across concrete twofold challenges: the illness in itself, for all social, negative aspects that make part of quotidian life of holders; and the precarious state of the public health service in RN State, since that working conditions are unsatisfactory

As múltiplas dimensões da garantia dos direitos do paciente idoso internado: o caso de uma instituição hospitalar pública no município de Natal/RN

In the context of current capitalist society, marked by the logic that restricts the human person their status as workforce, in order to generate profits, old age is often treated as an underprivileged life stage. This reality becomes more intense considering the sharp aging process that affects brazilian society is accompanied by the country's entry into a globalized world and tensioned by the dictates of capital. Thus, despite the increasing development of policies to strengthen the guarantee of elderly rights, it is necessary to establish effective strategies of these measures to ensure a higher quality of life to these subjects. Therefore, it is necessary to develop studies that problematize the issue of the elderly, which represent a growing portion of the population, and hence have more visible demands, including in health. With the increase in the elderly population in Brazil it is possible to realize the country is going through a demographic transition and epidemiological changes that contribute to change the landscape of health care of the elderly, especially the hospitalization. Thus, this study aimed to analyze the multiple aspects of ensuring the rights of elderly patients admitted to the State Hospital Dr. Ruy Pereira dos Santos (HRPS), located in Natal / RN, whose most patients are elderly. Specifically sought to understand the aging process, its social consequences and the vulnerability to which it is exposed, especially during the disease situation; understand the process of construction of the Brazilian public health and their actions for older people; learn the expressions of citizenship formation in Brazil with regard to policies for older people; and investigate the design of health professionals about the guarantee of the right of hospitalized elderly. Starting from an integrated coordinated theoretical and practical possibilities, a qualitative research and literature character, documentary and field was held. For this, there were four semi-structured interviews with health research locus Hospital professionals - namely, two social workers, a doctor and a nurse - as well as life stories with the hospitalized elderly patients, one in each deck the said Hospital, totaling three. The results pointed to the difficulty of health policy become effective as law and stressed one historical scenario violation of the rights of elderly hospitalized patients, which persists due to the precarious situation and the difficulty of effective implementation of the Unified Health System (SUS ) and other public policies to that end.

Paradigms that guide the models of attention to the health in Brazil: an analytic essay

SILVA, Flávio César Bezerra da ; COSTA, Francisca Marta de Lima; ANDRADE, Hamilton Leandro Pinto de; FREIRE, Lúcia de Fátima; MACIEL, Patrícia Suerda de Oliveira; ENDERS, Bertha Cruz ; MENEZES, Rejane Maria Paiva de. Paradigms that guide the models of attention to the health in Brazil: an analytic essay. Revista de Enfermagem UFPE On Line., Recife, v.3,n.4, p.460-65. out/dez. 2009. Disponível em < http://www.ufpe.br/revistaenfermagem/index.php/revista/search/results >.

Investigação e gerenciamento de áreas contaminadas por postos revendedores de combustíveis em Natal

Activities that have fuel subterranean storage system are considered potentially polluting fuels by CONAMA Resolution 273, due to the possibility of leak, outpouring and overflow of fuel into the ground. Being even more worrying when contaminate groundwater for public supply, as the case of Natal City. For this reason, the Public Ministry/RN, in partnership with UFRN, developed the project environmental suitability of Gas stations in Natal, of which 36% showed evidence of contamination. This paper describes the four stages of the management of contaminated areas: preliminary assessment of environmental liabilities, detailed confirmatory investigation of the contamination, risk analysis to human health (RBCA), as well as the remediation plan of degraded areas. Therefore it is presented a case study. For the area investigated has been proposed a mathematical method to estimate the volume of LNAPL by a free CAD software (ScketchUp) and compare it with the partition method for grid area. Were also performed 3D graphics designs of feathers contamination. Research results showed that passive benzene contamination in groundwater was 2791.77 μg/L, when the maximum allowed by CONAMA Resolution 420 is 5 μg/L which is the potability standards. The individual and cumulative risks were calculated from 4.4 x10-3, both above the limits of 1.0 x10-5 or by RBCA 1.0 x10-6 by the Public Ministry/RN. Corrective action points that remediation of dissolved phase benzene is expected to reach a concentration of 25 μg/L, based on carcinogenic risk for ingestion of groundwater by residents residential, diverging legislation. According to the proposed model, the volume of LNAPL using the ScketchUp was 17.59 m3, while by the grid partitioning method was 14.02 m3. Because of the low recovery, the expected removal of LNAPL is 11 years, if the multiphase extraction system installed in the enterprise is not optimized