Comportamento de parâmetros fisiológicos de homens e mulheres em condições de estresse laboral submetidos à técnica Watsu

The physiological variations of parameters in situations of laboral stress can function like indicator in the sprouting of disorder. Those conditions have led researchers to investigate alternatives that can favor the quality of life in persons under stress laboral. The present research had as objectives investigate the physiological behavior of parameters (blood pressure, heart hat and respiratory hat) of men and women in condition of stress laboral submitted to the technique Watsu. It was used a experimental methodology with a group formed by men and women in reproductive age, that work as salesclerk in a supermarket net in Natal/RN. The seven individuals selected were submitted to the three phases of the study (dependent groups), that consisted of the phase 1 of obtaining from the measure basal (control 1), in the phase 2 of immersion in the water (control 2), and phase 3 from the application the technique Watsu (experimental phase). It was verified that during the phase basal (condition 1) the physiological parameters (BPS, BPD, HH and RH) of both sexes evaluated showed the medium values of the women (average±detour-standard: BSP = 104.1±7.92; BPD = 70.83 ±7.92; HH = 77.58 ±3.87; RH = 19.83 ±2.58) similar those presented by the men (BPS = 118.75 ±7.55; BPD = 75.00 ±9.91; HH = 71.75 ±14.95; RH = 16.62 ±3.99). The evaluation of those parameters before and after immersion of the volunteers in the water (condition 2) showed a significant reduction (W = 3.0: p≤0.05) barely for the values of BPS presented by the sex females after immersion. In the men group, all of the physiological parameters analyzed did not vary significantly. Regarding the profile of those variables before and after application of the watsu (condition 3), was verified a significant increase (W= 0,0: p≤0.05) for the BPS one and SABP in the women. The Men did not show significant variation for all of the physiological parameters. Faced with the results presented, we are able to conclude that the systolic and diastolic blood pressures were the physiological parameters that are on influence from the Technique Watsu, only for the kind females

Influência da técnica de fabricação e dos materiais sobre o ajuste da interface pilar/implante em infraestruturas implantossuportadas

The aim of this study was to compare the misfit vertical, horizontal and passivity of zirconia and cobalt-chromium frameworks fabricated for CAD / CAM technology and conventional method of casting. Sixteen frameworks in one-piece, were obtained from a metallic matrix containing three Brånemark compatible implants with regular platform (Titamax Cortical Ti, Neodent). Eight frameworks were fabricated by CAD / CAM system (NeoShape, Neodent): four in zirconia (ZirCAD) and four cobalt-chromium (CoCrcad). Eight other frameworks were obtained by conventional casting method: four cobalt-chromium with UCLA abutment premachined Co-Cr (CoCrUCci) and four cobalt-chromium with UCLA abutment castable (CoCrUCc). The fit vertical, horizontal and passivity by one-screw test were measured using scanning electron microscopy with magnification of 250x. Initially evaluated the passivity by one-screw test and subsequently to assess the vertical and horizontal misfit, tightened all the screws with a torque of 20 Ncm. Mean, standard deviation, minimum and maximum values were calculated for each group. Measurements of horizontal misfit were transformed into cumulative frequency for categorization of the variable and the group later comparison groups. To evaluate the existence of quantitative differences between the groups tested for vertical misfit and passivity, we used the Kruskal-Wallis test. The Mann-Whitney test was used to compare group to group statistical differences (p <0.05). Were observed the respective mean and standard deviation for vertical misfit and passivity in micrometers: ZirCAD (5.9 ± 3.6, 107.2 ± 36), CoCrcad (1.2 ± 2.2, 107.5 ± 26 ), CoCrUCci (11.8 ± 9.8, 124.7 ± 74), CoCrUCc (12.9 ± 11.0, 108.8 ± 85). There were statistical differences in measures of vertical misfit (p = 0.000). The Mann-Whitney test revealed statistical differences (p <0.05) between all groups except between CoCrUCci and CoCrUCc (p = 0.619). No statistical difference was observed for the passivity. In relation to the horizontal misfit groups ZirCAD and CoCrcad did not show best values in relation to CoCrUCci and CoCrUCc. Based on the results it can be concluded that frameworks fabricated by CAD / CAM technology had better values of vertical fit than those manufactured by the casting method, nevertheless, the passivity was not influenced by manufacturing technique and material used. The horizontal fit obtained by frameworks manufactured by CAD / CAM was not superior to those manufactured by casting. A lower variability in vertical adjustment and passivity was observed when frameworks were fabricated by CAD / CAM technology

Ensino superior em Turismo: uma análise da relação dos cursos acadêmicos de Turismo da cidade do Natal-RN e o mercado de trabalho na percepção dos egressos dos anos de 2009 e 2010

The process of development of any area is closely linked to teaching and research, and in Tourism it is not different. Thus, in this area in which service is one of the factors intrinsically related to its success , it is observed the need for people with deep and critical training in the various aspects of this activity acting in this sector. However, we can see the existence of some differences between what is offered by the academy from what is required by the market. Therefore, the objective of this research is to verify the relationship between higher education in Tourism and labor market through the perception of the bachelor in this area, graduated in Natal-RN, since it is the tourismologist who makes the link between this two fields. To know the perception of these tourismologists, it was necessary to apply a questionnaire to those ones graduated in the years 2009 and 2010. In accordance with the aim of this study, this research was exploratory-descriptive. Related to the technical procedures, it was a documentary, literature and field research. To have it analyzed, some qualitative and quantitative techniques were applied according to our specific objectives and the types of data collected, such as: content analysis, factorial analysis to synthesize the information and identify the basic dimensions that represent the different variables studied, the standard deviation to verify the variation of the responses in some items and the correlation technique that allows the analysis of the relationship between two variables. In response to the objectives proposed here, we could finally conclude that: the syllabuses of these courses are too general and the graduates themselves consider them so. It was diagnosed that the graduates 1) are mostly female, 2) a very small part of them is working in the area that they are graduated in, and 3) not all of them receive satisfactory wages which contributes to having a negative view of their degree course. Moreover, the educational institution where they studied was not a decisive factor to get a job. It was still diagnosed that most part of them do not have positive perceptions when thinking about the future of their careers as bachelors in Tourism. Many of them, including, if it was possible to change something in their careers so far, they could have chosen another college degree. It was found that, although there is a negative perception about their professional future, almost half of them believe that the course met the needs of the market. However, those ones that are not working have a more positive point of view related to the applicability of higher education. On the other hand, the other ones who already worked in this area have a more negative perception about it and do not believe that the course meets the market's needs. In summary, this study allowed the understanding of the existence of some gaps that exist between higher education in Tourism and the market needs, professionally speaking, thus contributing to the spreading of ideas on that subject for teachers, researchers and the current and future students of the area.

Conhecimento sobre ergonomia no âmbito acadêmico: um estudo com alunos e professores de odontologia

OBJETIVO: As doenças osteomusculares são as afecções ocupacionais mais prevalentes em cirurgiões-dentistas. Nosso propósito: 1) investigar os conhecimentos, aplicabilidades clínicas dos princípios ergonômicos em discentes e docentes em atividades clínicas de uma universidade pública 2) pesquisar a incidência de sintomatologias dolorosas no pescoço, ombros, parte superior e inferior das costas, cotovelos, quadris, coxas, joelhos, tornozelos e pés no universo de alunos em estágios clínicos. 3) incitar discussões de normas e diretrizes ergonômicas na universidade. MÉTODOS: Esse estudo investigou o universo de alunos matriculados em disciplinas clínicas (148) e respectivos professores (30) do curso de odontologia da Universidade Federal do Rio Grande do Norte, Natal-RN a respeito dos princípios ergonômicos utilizados na rotina clínica. Paralelamente foi pesquisada a incidência de sintomatologia dolorosa nos alunos por intermédio do questionário nórdico e a partir dos resultados foi mensurado o índice de severidade dos sintomas em alunos. The Nordic Musculoskeletal Questionnaire (NMQ) é um instrumento de diagnóstico, proposto para padronizar a mensuração de relatos de sintomas osteomusculares. A análise dos dados foi através do programa SPSS-Statistical Package for the Social Sciences, versão 17.0 realizada analítica e descritivamente, com determinação das médias (x), desvio-padrão para variáveis quantitativas, freqüências simples e relativas para as variáveis categóricas, além da estatística de associação entre grupos (teste t) e a análise de associação do quiquadrado com nível de significância 5% entre as variáveis (Person). As respostas das questões abertas foram codificadas e transformadas em freqüências, descritas posteriormente. RESULTADOS: A aplicabilidade de medidas ergonômicas nas clínicas universitárias não foi evidenciada pelo universo de discentes e docentes. Quanto ao relato de sintomas osteomusculares o sexo feminino foi o mais acometido qualquer que seja o nível acadêmico cursado. As regiões anatômicas de maior grau de severidade de relatos dos sintomas foram: pescoço, parte inferior das costas, punhos, mãos e ombros, com significância etatística p<0,001. CONCLUSÃO: Em função dos achados os autores apresentam um protocolo de intervenção clínica baseado nos determinantes ergonômicos da Associação internacional de ergonomia (EAI) como medida de prevenção da saúde ocupacional dos futuros cirurgiões-dentistas ainda em processo de formação nas clínicas odontológicas das universidades.

Processos aleatórios não-markovianos: perfis de memória

One of the mechanisms responsible for the anomalous diffusion is the existence of long-range temporal correlations, for example, Fractional Brownian Motion and walk models according to Elephant memory and Alzheimer profiles, whereas in the latter two cases the walker can always "remember" of his first steps. The question to be elucidated, and the was the main motivation of our work, is if memory of the historic initial is condition for observation anomalous diffusion (in this case, superdiffusion). We give a conclusive answer, by studying a non-Markovian model in which the walkers memory of the past, at time t, is given by a Gaussian centered at time t=2 and standard deviation t which grows linearly as the walker ages. For large widths of we find that the model behaves similarly to the Elephant model; In the opposite limit (! 0), although the walker forget the early days, we observed similar results to the Alzheimer walk model, in particular the presence of amnestically induced persistence, characterized by certain log-periodic oscillations. We conclude that the memory of earlier times is not a necessary condition for the generating of superdiffusion nor the amnestically induced persistence and can appear even in profiles of memory that forgets the initial steps, like the Gausssian memory profile investigated here.

Alterações dos parâmetros climáticos no município de Apodi-RN, antes e após a construção da barragem Santa Cruz do Apodi, e formação do lago

Este trabalho teve como objetivo principal analisar as mudanças ocorridas no clima local onde o município de Apodi/RN está inserido, em virtude da construção da Barragem Santa Cruz do Apodi. Foram utilizadas para o tratamento dos dados climáticos precipitação pluviométrica, umidade relativa do ar e temperatura técnicas estatísticas como Desvio Padrão, Teste T, Coeficiente de Variação e Média aritmética, além do modelo matemático. Para o balanço hídrico foi aplicado o método de Thornthwait (1948), considerando dois períodos em análise: o anterior e posterior a construção da Barragem Santa Cruz do Apodi, respectivamente 1995 e 2005. os resultados obtidos permitiram inferir que a hipótese inicial levantada se confirma, ou seja, a construção da Barragem Santa Cruz do Apodi, está influenciando diretamente numa alteração no que concerne à condição atmosférica local, especialmente no parâmetro umidade relativa do ar. Quanto ao balanço hídrico, observou-se a predominância do déficit hídrico especialmente entre os meses de junho a janeiro, período de estiagem; um excedente ocorrente entre os meses de maio e junho, conseqüente do período chuvoso; e uma reposição hídrica antecedendo e sucedendo este período, chuvoso, ou seja, compreendendo os meses de fevereiro a junho. Todas as considerações e análises poderão contribuir para o planejamento de abastecimento d´água, a irrigação, auxílio na previsão de enchentes e estiagens, bem como o manejo do uso da água subterrânea

Monitoramento da qualidade das ásguas de chuvas conforme a atuação dos sistemas sinóticos na cidade de Natal/RN

Acid rain is a major assault on the environment, a consequence of burning fossil fuels and industrial pollutants the basis of sulfur dioxide released into the atmosphere. The objective of this research was to monitor and analyze changes in water quality of rain in the city of Natal, seeking to investigate the influence of quality on a local, regional and global, in addition to possible effects of this quality in the local landscape. Data collection was performed from December 2005 to December 2007. We used techniques of nefanálise in identifying systems sinóticos, field research in the search for possible effects of acid rain on the landscape, and collect and analyze data of precipitation and its degree of acidity. Used descriptive statistics (standard deviation and coefficient of variation) used to monitor the behavior of chemical precipitation, and monitoring of errors in measurements of pH, level of confidence, Normalized distribution of Gauss, confidence intervals, analysis of variance ANOVA were also used. Main results presented as a variation of pH between 5,021 and 6,836, with an average standard deviation of 5,958 and 0,402, showing that the average may represent the sample. Thus, we can infer that, according to the CONAMA Resolution 357 (the index for fresh water acidity should be between 6.0 and 9.0), the precipitation of Natal / RN is slightly acidic. It appears that the intertropical convergence zone figures showed the most acidic among the systems analyzed sinóticos, taking its average value of pH of 5,617, which means an acid value now, with a standard deviation of 0,235 and the coefficient of variation of 4,183% which shows that the average may represent the sample. Already in field research and found several places that suffer strongly the action of acid rain. However, the results are original and need further investigation, including the use of new methodologies

Relação entre desempenho funcional e indicadores de doença arterial obstrutiva periférica em idosas

The presence of peripheral arterial disease (PAD) increases the risk and vulnerability to adverse clinical outcomes in the elderly. Like this, we investigated the relationship between functional performance and indicators of PAD in elderly women. METHODS: Cross-sectional study in which 54 elderly were assessed by questionnaire mini mental state examination, Short Phisical Performance Battery (SPPB), ankle-brachial index (ABI), human activity profile (HAP) and Edinburgh questionnaire. Statistical analysis was performed using ANOVA, t test and Pearson correlation. We considered p <0.05 as significance level. RESULTS: The mean age SPPB and ABI were 69.2 (± 6.9) years, SPPB 9.42 (± 2.55) and ABI 1.04 (± 0.14). The prevalence of PAD was 16.3%. There was a significant correlation between ABI and gait speed (r = 0.75, p = 0.001) and between PAH with SPPB (p = 0.001). CONCLUSIONS: It is suggested that the decline in functional performance in older, expressed in gait velocity component of the SPPB, is related to the presence of PAD

Determinação de CD, PB, e TL em água produzida por HR-CS GF AAS após extração em ponto nuvem

Produced water is a major problem associated with the crude oil extraction activity. The monitoring of the levels of metals in the waste is constant and requires the use of sensitive analytical techniques. However, the determination of trace elements can often require a pre-concentration step. The objective of this study was to develop a simple and rapid analytical method for the extraction and pre-concentration based on extraction phenomenon cloud point for the determination of Cd, Pb and Tl in produced water samples by spectrometry of high resolution Absorption source continues and atomization graphite furnace. The Box Behnken design was used to obtain the optimal condition of extraction of analytes. The factors were evaluated: concentration of complexing agent (o,o-dietilditilfosfato ammonium, DDTP), the concentration of hydrochloric acid and concentration of surfactant (Triton X -114). The optimal condition obtained through extraction was: 0,6% m v-1 DDTP, HCl 0,3 mol L-1 and 0,2% m v-1 of Triton X - 114 for Pb; 0,7% m v-1 DDTP, HCl 0,8 mol L-1 and 0,2% m v-1 Triton X-114 for Cd. For Tl was evidenced that best extraction condition occurs with no DDTP, the extraction conditions were HCl 1,0 mol L-1 e 1,0% m v-1 de Triton X - 114. The limits of detection for the proposed method were 0,005 µg L-1 , 0,03 µg L-1 and 0,09 µg L-1 to Cd, Pb and Tl, Respectively. Enrichment factors Were greater than 10 times. The method was applied to the water produced in the Potiguar basin, and addition and recovery tests were performed, and values were between 81% and 120%. The precision was expressed with relative standard deviation (RSD) is less than 5%

Desempenho de analistas sell-side no mercado de ações brasileiro

The purpose of this study was to analyze the behavior of Sell-Side analysts and analysts propose a classification, considering the performance of the price forecasts and recom- mendations (sell-hold-buy) in the Brazilian stock market. For this, the first step was to analyze the consensus of analysts to understand the importance of this collective interven- tion in the market; the second was to analyze the analysts individually to understand how improve their analysis in time. Third was to understand how are the main methods of ranking used in markets. Finally, propose a form of classification that reflects the previous aspects discussed. To investigate the hypotheses proposed in the study were used linear models for panel to capture elements in time. The data of price forecasts and analyst recommendations individually and consensus, in the period 2005-2013 were obtained from Bloomberg R ○ . The main results were: (i) superior performance of consensus recommen- dations, compared with the individual analyzes; (ii) associating the number of analysts issuing recommendations with improved accuracy allows supposing that this number may be associated with increased consensus strength and hence accuracy; (iii) the anchoring effect of the analysts consensus revisions makes his predictions are biased, overvaluating the assets; (iv) analysts need to have greater caution in times of economic turbulence, noting also foreign markets such as the USA. For these may result changes in bias between optimism and pessimism; (v) effects due to changes in bias, as increased pessimism can cause excessive increase in purchase recommendations number. In this case, analysts can should be more cautious in analysis, mainly for consistency between recommendation and the expected price; (vi) the experience of the analyst with the asset economic sector and the asset contributes to the improvement of forecasts, however, the overall experience showed opposite evidence; (vii) the optimism associated with the overall experience, over time, shows a similar behavior to an excess of confidence, which could cause reduction of accuracy; (viii) the conflicting effect of general experience between the accuracy and the observed return shows evidence that, over time, the analyst has effects similar to the endowment bias on assets, which would result in a conflict analysis of recommendations and forecasts ; (ix) despite the focus on fewer sectors contribute to the quality of accuracy, the same does not occur with the focus on assets. So it is possible that analysts may have economies of scale when cover more assets within the same industry; and finally, (x) was possible to develop a proposal for classification analysts to consider both returns and the consistency of these predictions, called Analysis coefficient. This ranking resulted better results, considering the return / standard deviation.

A motivação de licenciandos em música sob a perspectiva da teoria da autodeterminação

This research had as main aim to verify the motivational quality of music students at four public universities in the Northeast of Brazil, based on the Self-Determination Theory (SDT). This perspective was proposed by Edward Deci and Richard Ryan (1985, 2000, 2008a, 2008b), and considers the qualitative aspects of motivation. It defends that the individuals have a natural tendency to self-regulation; it adopts the concept of internalizations through a continuum of self-determination conceived in the mini-theory of organismic integration. The research presents a descriptive, exploratory and correlational approach. To collect data, it was submitted a self-report questionnaire, based on the Academic Motivational Scale, translated and validated by Guimarães and Bzuneck (2008), which allow us to verify the motivation types according to a selfdeterminational continuum. According to this application, the instrument has shown evidence of satisfactory validity, with a good internal consistence and correlations from weak to moderate scale. The obtained data were collected from 380 music students, analyzed through a descriptive and inferential statistics, considering a few procedures: frequencies, averages, standard deviation, factorial analysis, internal consistence analysis through Cronbach Alpha, Pearson’s correlational analysis and variance analysis. The analyzed data show that high averages in the evaluation of self-determined motivation and low evaluation in demotivation and less autonomy motivation. Many students revealed strong intention to conclude the course. It was identified less autonomous motivation and more motivation among the students with intention to work in other areas, some of them concluded the final training process in Music Course, and say that they are in this course because they had no other option. We conclude that those graduated in Music Course, represented in this sample, show a good motivational quality. But after a few time there is a tendency in decreasing autonomous motivation because of some requirements of an academic course. In this sense, the courses must create strategies to maintain a self-determined behavior so that students can realize their autonomous motivation, identifying its importance, value and meaning along the Course.

Ferramenta para avaliação e inferência de parâmetros de redes industriais sem fio

Wireless sensor networks (WSN) have gained ground in the industrial environment, due to the possibility of connecting points of information that were inaccessible to wired networks. However, there are several challenges in the implementation and acceptance of this technology in the industrial environment, one of them the guaranteed availability of information, which can be influenced by various parameters, such as path stability and power consumption of the field device. As such, in this work was developed a tool to evaluate and infer parameters of wireless industrial networks based on the WirelessHART and ISA 100.11a protocols. The tool allows quantitative evaluation, qualitative evaluation and evaluation by inference during a given time of the operating network. The quantitative and qualitative evaluation are based on own definitions of parameters, such as the parameter of stability, or based on descriptive statistics, such as mean, standard deviation and box plots. In the evaluation by inference uses the intelligent technique artificial neural networks to infer some network parameters such as battery life. Finally, it displays the results of use the tool in different scenarios networks, as topologies star and mesh, in order to attest to the importance of tool in evaluation of the behavior of these networks, but also support possible changes or maintenance of the system.

Avaliação da toxicidade subcrônica e reprodutiva do extrato seco de pericarpo de passiflora edulis variedade flavicarpa degener em ratos

The pericarp of Passiflora edulis var. flavicarpa Degener is now being investigated for medicine purposes. There are no reports about it toxicity. The aim of the present study was investigate the sub chronic toxicity in male rats and reproductive toxicity in pregnant rats and exposed fetuses of an extract obtained by infusion of the pericarp in water (1:3 m/v;100o C, 10 min). The extract composition was evaluated by tube reactions and thin lawyer chromatography (TLC). Adult male rats (n=8) were treated with 300 mg/kg of the extract, by gavage, during 30 days and pregnant rats (n=7) from gestation day 0 to day 20. Control received tap water (1 mL). Water and food intakes and body weight gain were recorded. At day 29 of treatment the sexual behavior of the males was analyzed and then half of males from each group received cyclophosphamide (50 mg/kg, i.p.) to (anti)genotoxic assessment in bone marrow. At day 30, males were anesthesized for parameters collection. At day 20 of gestation, the dams were anesthesized for reproductive performance evaluation. The fetal analysis was conducted by visceral and skeletal. Phytochemical analysis revealed the presence of flavonoids, unspecific alkaloids, phenols and triterpenic compounds. Statistical analysis revealed absence of significant differences between experimental and control. This study suggest that the aqueous extract obtained from pericarp of P. edulis var. flavicarpa Degener was not able to promote toxic effects in rats. Cytotoxicity was evaluated with the PCE/NCE ratio (NCE=normochromatic erythrocytes). Statistical analysis (mean ± SEM) revealed absence of changes in the frequency of MNPCE (negative control: 3.26±0.42; positive control: 11.72±1.02; negative experimental: 4.02±0.13; positive experimental: 10.47±0.87) or cytotoxicity (negative control: 0.37±0.08; positive control: 0.23±0.05; negative experimental: 0.37±0.07; positive experimental: 0.23±0.02). This study suggests that the extracts showed no (anti)genotoxic and no cytotoxic activities under the experimental conditions.

Protocolo para assistência do enfermeiro ao paciente séptico em terapia intensiva: construção e validação de conteúdo

Tratar-se-á de um estudo metodológico, com abordagem quantitativa; baseado no referencial metodológico da técnica Delphi, com objetivo de construir e validar um protocolo clínico para assistência do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva. A proposta metodológica seguiu duas etapas: elaboração do instrumento por meio da revisão integrativa da literatura e validação de conteúdo do protocolo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, mediante o Parecer CAAE 41873314.5.0000.5537. O universo amostral foi composto por profissionais enfermeiros, considerados peritos, doutores ou mestres na área da saúde, com experiência em alta complexidade e/ ou estudos de validação de instrumento/protocolo, selecionados por meio da Plataforma Lattes. Referente à primeira etapa elaborou-se um instrumento composto pela caracterização profissional dos peritos; e baseado em evidência científica e nas diretrizes do Surviving Sepsis Campaign, contemplando três tópicos assistenciais ao paciente com sepse, a saber: Triagem para Sepse- Reconhecimento das Manifestações Clínicas; Pacote de Ressuscitação Inicial (Controle das Primeiras 6 Horas); Tratamento de Suporte. A segunda etapa caracterizou-se na validação de conteúdo do instrumento para elaboração final do protocolo, utilizando à técnica Delphi, em duas fases. No que concernem as variáveis referentes ao estudo, na 1ª fase de Delphi, 34 peritos avaliaram o instrumento composto por 18 itens, no período de maio a julho de 2015, e os dados foram analisados pela estatística descritiva (frequência, média, mediana e desvio padrão) e pelo Índice de Validade de Conteúdo (IVC), demonstrando um IVC extremamente satisfatório para 15 itens, com total de 0,79, obtendo assim, a reformulação e refinamento do conteúdo do instrumento. Na segunda fase de Delphi, entre julho e agosto de 2015, participaram 26 peritos, e utilizou-se o percentual de concordância acima de 75% para as variáveis consideradas pertinentes ao protocolo de cuidados ao paciente séptico em UTI, obtendo nesta fase, o percentual de concordância de 95%. O protocolo foi concluído com 15 itens, sendo respaldado e modificado, baseado em evidência científica, nas diretrizes internacionais e nas sugestões dos peritos. A utilização do protocolo proposto poderá contribuir para a prática clínica do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva.

Protocolo para assistência do enfermeiro ao paciente séptico em terapia intensiva: construção e validação de conteúdo

Tratar-se-á de um estudo metodológico, com abordagem quantitativa; baseado no referencial metodológico da técnica Delphi, com objetivo de construir e validar um protocolo clínico para assistência do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva. A proposta metodológica seguiu duas etapas: elaboração do instrumento por meio da revisão integrativa da literatura e validação de conteúdo do protocolo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, mediante o Parecer CAAE 41873314.5.0000.5537. O universo amostral foi composto por profissionais enfermeiros, considerados peritos, doutores ou mestres na área da saúde, com experiência em alta complexidade e/ ou estudos de validação de instrumento/protocolo, selecionados por meio da Plataforma Lattes. Referente à primeira etapa elaborou-se um instrumento composto pela caracterização profissional dos peritos; e baseado em evidência científica e nas diretrizes do Surviving Sepsis Campaign, contemplando três tópicos assistenciais ao paciente com sepse, a saber: Triagem para Sepse- Reconhecimento das Manifestações Clínicas; Pacote de Ressuscitação Inicial (Controle das Primeiras 6 Horas); Tratamento de Suporte. A segunda etapa caracterizou-se na validação de conteúdo do instrumento para elaboração final do protocolo, utilizando à técnica Delphi, em duas fases. No que concernem as variáveis referentes ao estudo, na 1ª fase de Delphi, 34 peritos avaliaram o instrumento composto por 18 itens, no período de maio a julho de 2015, e os dados foram analisados pela estatística descritiva (frequência, média, mediana e desvio padrão) e pelo Índice de Validade de Conteúdo (IVC), demonstrando um IVC extremamente satisfatório para 15 itens, com total de 0,79, obtendo assim, a reformulação e refinamento do conteúdo do instrumento. Na segunda fase de Delphi, entre julho e agosto de 2015, participaram 26 peritos, e utilizou-se o percentual de concordância acima de 75% para as variáveis consideradas pertinentes ao protocolo de cuidados ao paciente séptico em UTI, obtendo nesta fase, o percentual de concordância de 95%. O protocolo foi concluído com 15 itens, sendo respaldado e modificado, baseado em evidência científica, nas diretrizes internacionais e nas sugestões dos peritos. A utilização do protocolo proposto poderá contribuir para a prática clínica do enfermeiro ao paciente séptico na Unidade de Terapia Intensiva.