A violência no contexto de um serviço de urgência: análise do processo de cuidar na visão das vítimas e profissionais de saúde em Natal/RN

Exploratory descriptive study, with a quantitative approach and prospective data, performed in Pronto Socorro Clóvis Sarinho (PSCS), in Natal/RN, aiming to analyze care given by the nursing and medical staff to victims of violence attended to in an emergency hospital in Natal/RN; to identify care given by the nursing and medical staff as viewed by the victims; to compare data observed during the process of care with the victim s view on the care given by the nursing and medical staff; to identify the existing knowledge on violence and the process of caring for victims and its relation with prejudice; to identify obstacles and perspectives for prevention during the process of caring for victims in the emergency services. The population consisted of 97 physicians, 16 nurses, 75 nursing technicians and assistants and 365 victims of violence, with data collected from April to May 2009. Out of 188 professionals, 52.1% are female; 32% were aged 41 to 50; 99.5% had given care to a victim of violence; 90.4% reported to have given care to patients under custody; among these, 17.3% felt prejudice; 55.3% stated they don t provide different care for assaulted victims and assailants, however 44.7% stated they do; 86.7% feel their workplace is unsafe; 61.7% denied the existence of any obstacle and 38.3% reported the existence of obstacles; among these, 26.1% referred to inadequate facilities; 37.8% believe reinforcing security and professional training are the main solutions. Among the 365 researched violence victims, 82.2% were assaulted; male (69.6%); aged 18 to 24 (24.9%); hailing from the Greater Natal area (89.9%); on 19.7% the event happened on Saturday; during the night (48.8%); victim of physical assault (61.4%); produced by body force (27.7%); 24.4% were injured in the head and neck. 57% had used some drug, among which alcohol was predominant (75.5%). On 621 observations performed during the victim care process, when compared to the report of assaulted victims, there was a statistical difference, at 5% significance level, regarding reception, resistance from the professionals, questioning about the violent event, providing of guidance, interaction with the patient and the understanding of receiving proper care, and care resolution. In comparisons involving the observed and the assailant victims reports, there was a statistical difference regarding the resence of resistance from the professionals, performance of necessary procedures and the nteraction with the patient and the understanding of receiving proper care and 58.1% reported the nursing team was the one that provided the best care. We conclude that professionals had lready given care to assailant patients, acknowledge the importance of knowing how the vent took place and acquired this preparation during their practice. The most often referred bstacles that hinder assistance were: inadequate facilities, material deficit and lack of rofessional preparation. As solutions for these problems, they cited the reinforcement of ecurity and professional training

Histórias de vidas de Usuários de psicofármacos: o desafio do cuidar para a enfermagem

Study of qualitative approach using the oral history methodology, in modality oral history of life, which aimed to: tell the stories of lives of users of psychotropic drugs for prolonged period of time, in Family Health Unit Santarém (FHU Santarém), Natal-RN-Brazil; identify possible causes which influence and trigger, respectively, use of psychotropic for prolonged period of time; search for greater knowledge about this problem of public health; contribute with the planning and development of nursing cares, to users of psychotropic drugs for prolonged period of time, as well as in Mental Health Care, integrally, in perspective of Family Health Strategy (FHS). It was used as a baseline survey, the coverage area of family health team, from FHU Santarém, which belongs to Health District North II, from Municipal Health Secretariat, in Natal-RN-BR. Eight employees who use psychotropic drugs for prolonged period of time were interviewed. They volunteered to narrate their life stories, which were analyzed by using the thematic modality, since the study is focused on the question of the use of psychotropic drugs for prolonged period of time. The thematic axis crisis, prejudice and care, defined by the categorization of common elements, found through successive and careful readings of narratives, were used to analyze these stories of lives. The study found that users of psychotropic drugs for prolonged period of time are affected by mental health crisis, feeling need to be heard, as well as the existence of social prejudice towards people with mental disorders, and non-completion of development of managed care, by the family health team, and particularly, the nursing care to people suffering from mental disorders and users of psychotropic drugs for prolonged period of time. It is proposed that, in the search of development and planning of nursing care to users of psychotropic drugs for prolonged period of time, and in mental health care, integrally, in FHS, the nurse can think and make a drawing about manners of performing nursing care to this clientele through the use of consultation of nursing, conducting home visits, collective construction of spaces for listening and socialization, which can be used as possible paths for the construction of such care

Conhecimento do enfermeiro sobre o processo de cuidar do paciente com traumatismo cranioencefálico

Estudo de caráter exploratório e descritivo, de abordagem quantitativa, realizado num hospital de urgência hospitalar referência em traumatologia, em Natal/RN, com o objetivo de identificar o conhecimento do enfermeiro a respeito da ECGl para avaliação do nível de consciência e do processo de cuidar na fase pré-hospitalar e hospitalar às vítimas de TCE. A população constou de 44 enfermeiros e os dados foram coletados entre abril e maio de 2010. Os resultados mostram que, 35 (79,5%) dos enfermeiros eram do sexo feminino; 17 (38,64%) estavam na faixa etária entre 24 a 30 anos e 12 (27,27%) entre 51 a 60 anos; 25(56,82%) solteiros, 30 (68,18%) católicos e 25 (56,82%) sem filhos; 40 (90,90%) eram formados por instituições públicas, 18 (40,92%) tinham tempo de serviço na enfermagem acima de 21 anos e 14 (31,82%) até quatro anos; 18 (40,91%) estavam alocados nas UTIs e 13 (29,55%) atuavam em mais de um setor e 20 (65,90%) possuíam especialização. Dos que estavam mais especializados, 18 (40,92%) tinham tempo de serviço até quatro anos e 08 (34,48%) acima de 21 anos. Todos relataram ter prestado assistência às vítimas de TCE e 36 (81,82%) sentiam-se preparados; 35 (46,67%) adquiriram essas informações na prática e apenas 8 (10,67%) na graduação. Em relação a opinião dos pesquisados sobre os empecilhos que dificultam esta assistência, 23 (23,01%) relataram déficit de recursos humanos e 19 (20,65%) despreparo da equipe de enfermagem, estrutura física inadequada e recursos materiais precários. Como propostas de solução para os problemas, 26 (47,27%) sugeriram reforma na gestão e 13 (23,63%) referiram educação continuada. Em relação a ECGl, 40 (90,1%) afirmaram conhecê-la, 33 (82,50%) a utilizavam, 32 (80%) conheciam sua finalidade, 25 (62,5%) acertaram os indicadores fisiológicos e 36 (90%) classificaram corretamente a gravidade do TCE. Dos enfermeiros que utilizam a ECGl, 23 (92%) conheciam seus indicadores e classificação e 20 (60,61%) utilizavam uma vez por plantão. Em relação às dificuldades no manejo da ECGl, 11 (21,58%) não tinham nenhum problema; 10 (19,60%) citaram a falta de tempo e com o mesmo percentual responderam interpretação da resposta verbal nos pacientes intubados. Quanto ao conhecimento dos enfermeiros na descrição do processo de cuidar, 31 (70,45%) das respostas da fase pré e 35 (79,55%) da hospitalar não possuíam etapas importantes, sendo consideradas como incorretas. Quanto à afirmativa dos enfermeiros em estar, e realmente estar preparados para esta assistência, detectamos que daqueles que disseram estar preparados, apenas 12 (33,33%) acertaram todos os passos do atendimento pré hospitalar e 6 (16,67%) no atendimento hospitalar. Concluímos que diante dos resultados obtidos, os enfermeiros conhecem a ECGl, no entanto, necessitam de capacitação para sua melhor compreensão e utilização. Quanto ao conhecimento do processo de cuidar aos pacientes com TCE, é necessário modificar urgente esta realidade, especialmente na atenção às ações desenvolvidas pelo enfermeiro no âmbito hospitalar, onde as consequências das lesões secundárias, muitas delas evitadas com diagnóstico precoce e intervenções imediatas, podem acarretar incapacidades permanentes e prejudicar a qualidade de vida desses indivíduos

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

Representações sociais sobre a prática do cuidado para enfermeiros da saúde indígena: um estudo transcultural

The desire to research on this subject arisen from the experience as nursing in the indigenous health, where I observed that many professionals from all regions of Brazil chose to work within this zone. It was notorious the nurse s difficult to settle in only one place for a long length of time. Probably due to health care in indigenous zones happens from a cultural confront. This confront materialize because both sides are imbued with their own culture: in one hand the nurse professional with its scientific knownledgment on the other the indigenous with their rituals and peculiars habits. In this context nurses should delineate and negotiate the reality through symbolic representations of life, and then make questions on the new reality. In this way, this study set out with the aim of apprehends the nurse s social representations of transcultural care in indigenous health. This knownledgment is important to avoid possible conflicts, shocks, difficulties and health care incongruence within this context. The data collect was carried out on a range of non structured interview guided by a pre-elaborated questionnaire with four questions and a hand drawing related to nurse s health care in the indigenous health. This research had a sample of 17 nurses from the Indigenous Sanitary District of Manaus in the Amazon State. To interpret data we used the Discourse of the Collective Subject, which findings were presented in three chapters: characterization of participants, discussion on themes prevalent in discourse; social representation of nursing care through infographics. The analysis revealed that the care in the indigenous health is challenging because the native people imbued in its world are perceived and processed according to the nurse s cultural lens, leading to materialize of some strangeness and adaptation difficulties, especially in the first contacts. The Social Representation on nursing practice, in many cases, is projected and contrived on the basis of scattered believes and on perception derived from common sense. The findings shows that representions are essential to mitigating the initial strangeness and help nurses to better situate themselves in the new universe. The nurse s practice in the indigenous health care should merge into each other. From the Social Representations is possible to perceive that assimilation, also comprehension on indigenous health system and its traditional knowledge are important to developing strategies to improve access and quality of care for indigenous peoples. After analysis the nurse s discourses and drawings, it is possible to represent the nurse s practice in the indigenous health as anthropophagism, since nurses should literally consuming its patients culture, digesting it and seize it as means to provide culturally congruent care. We highlight the urgent need for preparation and training of professionals to work more effectively with indigenous peoples

À beira do leito : sentimentos de pacientes durante a passagem de plantão em Unidade de Terapia Intensiva

This study aims to understand the feelings of patients admitted to the Intensive Care Unit (ICU) that experienced a change of shift at the bedside. The change of shift is one of the routines used by nursing in their work process and of great significance for the patient; therefore, deserves careful analysis in seeking to perfect themselves for the improvement of nursing care. It is a descriptive research, with a qualitative approach. The collection of information was performed using semi-structured interview, in August and September of 2011, after authorization from the Ethics Committee of the Federal University of Rio Grande do Norte, as opinion 290/2011. The analysis, based on interviews of patients, took the humanization as the thread of investigation backed by authors who deal on the subject and the theory of the gift of Marcel Mauss that sits on drug give-receive-return. The results indicate that the change of shift at the bedside but has not configured, the content of the speech of patients interviewed, as a moment that has generated fear and anxiety, could be deduced by the expression of silence, tears and other signs during interviews, how hard it is to live this experience. Nevertheless, despite this apparent tranquility, revealed uncertainty and apprehension face the speech of professional, during the visit at the bedside, particularly when referring to their health and their neighbors. On the other hand, the indifference to the participation of the patient at the time of the visit, expressing an attitude of merely technical nature, dehumanizes the act of taking care, the essence of nursing. And, for all the patients that we understand, about the visit to the bedside, as well as the ICU, we can infer that there is suffering for them. However, we understand your feelings and revelations seeking support in the theory of Mauss's gift: the patient receives the gift (care), and imbued with a feeling of gratitude, the rewards in the form of compliments and courtesies. Precisely for this reason, we need to sharpen our sensitivity to deal about the human condition in all its vulnerability.

A roda da vida: revelações de uma paciente em hemodiálise.

Reconstruct, from listening, the life histories of a chronic renal patient, submitted to hemodialysis, is the objective of this investigation. How methodological procedure,we worked with oral history of life, ,according Meihy, within a qualitative approach. For this, we had the approval of the Ethics Committee in Research of Hospital Universitário Onofre Lopes (HUOL), under protocol no 591/2011. As instrument to approach the patient, we did interviews with open questions, conducted in the patient's house. There were five meetings, in which we hear his story, experiences and ways of coping during their course of illness and treatment. The analysis was based on the collaborator's narratives, anchored in studies dealing with oral history, of human subjectivity, highlighting the resilience, as indicated Cyrulnik. Her story leads us to conclude that despite the adversities of life and suffering, there is in humans, the strength to navigate the streams and be happy. This is the lesson that leaves us the collaborator this study.

Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

A pessoa com tuberculose e o cuidado de si

Tuberculosis is a serious disease with high incidence and prevalence, and in many countries a priority public health problem, with persisting high epidemiological significance. Seeing the person with tuberculosis it is important to observe his/her self care, as well as the difficulties intertwined in this process, since it can be directly impacting the health/disease process. The aim of this study was to analyze the self care of people with tuberculosis. Descriptive study with qualitative approach, conducted in West Sanitary District of the city of Natal, RN. Data collection occurred through a semi-structured interview guided by questions concerning sociodemographic and about the disease, treatment, and self care, between the months of July to September 2012 and met the ethical precepts of research with human beings. To analyze the results we used the technique of thematic content analysis of Laurence Bardin, through the prism of the theoretical-philosophical self care discussed by Michel Foucault. From the analysis emerged two categories, the first being, Meaning of tuberculosis, with subcategories: tuberculosis as sadness and unhappiness and tuberculosis as a normal issue, and the second, Beware yourself to tuberculosis, which had subcategories: self care as attention to the health care of oneself as satisfaction of basic needs and difficulties to self care. Tuberculosis represents for some people, something really sad, causing psychological suffering, however the other presents as normal. Self care of persons with tuberculosis in this study are related in great part to seek health care and the satisfaction of basic needs. About the difficulties related to the practice of self-care, it is observed that these are tied to food, time for rest, slowness of health services for scheduling appointments and tests, as well as related habits and dependencies in the lives of these people. This study contributed to a reflection of the users with tuberculosis and self care, revealing aspects that healthcare professionals should pay attention to watch these people, being able to see everyday on the run, the need for a space and time for oneself

Cuidado de enfermagem ao potencial doador de órgãos em morte encefálica: uma reflexão sobre a prática

Despite of the technological advances that favor the transplant process, there are issues of effectiveness of care necessary for the maintenance of potential organ donors with brain death, which contribute to the no realization of transplants of organs and tissues of these patients. It is presupposed that the problems could be related to perceptions and understandings that the professionals of the units of internment have about the care required by the diagnosis of brain death. The aim of this study was to understand the meaning of the nursing care of the potential organ donor with brain death to the nursing staff. Descriptive study with qualitative approach guided by Action Science Theory and the critic-reflexive research methodology accomplished with five nurses and 19 nursing technicians from Operative Rehabilitation Center in a public hospital at Natal / RN, Brazil, between March and May 2013. Data were collected through semi-structured interviews with individual reflection about the care and through group interview, after approval by the Ethics and Research Committee, CAAE No.: 04255612.7.0000.5537. The analysis was performed in a thematic way according to Bardin. During the group meeting the participants were driven in a discussion about the need for change and how to perform them. The results indicate that the professionals actions are consistent with those required for maintenance of potential organ donors, although the material and human resources are not adequate. That situation leads the professionals to develop a meaning of care as one labor more, demanding more than they can give. They express beliefs and feelings concerning the hope that their care brings a greater good that is to save lives. The reflection for a possible change of action was difficult to accomplish due to professionals not to be able to self evaluate, what lead to direct your changes suggestions for other team members. It is concluded that the care provided to these patients is a difficult care, evidenced by suffering both death situation of the person cared and pain of their families, as the dehumanizing conditions of work, helping themselves to keep distance from patients to not suffer so much. The knowledge impregnated in their act, are scientific, ethical, aesthetic and personal kind with a predominance of the scientific followed by the personal. The study was also relevant to the practice of nursing in maintaining the potential donor, in that it allowed the identification of the knowledge used by nurses in their care practice and the meaning understanding of the professionals on the care provided, as a good action that brings satisfaction when the transplanting is executed. Other experiences are suggested with the critic-reflexive research methodology, both in research as in teaching nursing

O cuidado compartilhado entre mães e educadoras de um centro municipal de educação infantil: uma pesquisa-ação

O cuidado à criança envolve a identificação e o atendimento às necessidades de modo a oferecer-lhe atenção como pessoa em contínuo processo de crescimento e desenvolvimento. Contudo, o cuidado oferecido à criança que convive em instituição escolar está permeado por conflitos que fragilizam a relação família-escola, não sendo estimulada a articulação desses atores no que refere ao cuidar da criança. Diante dessa problemática, objetivou-se analisar a construção de um pacto do cuidar entre mães e educadoras de crianças que frequentam um Centro Municipal de Educação Infantil. Trata-se de um estudo qualitativo, tendo como método a pesquisa-ação. Envolveu doze mães e oito educadoras de uma instituição de educação infantil de Cidade Nova, no município de Natal, no período de abril a novembro de 2013. Os dados foram coletados através de entrevista grupo focal, observação participante, seminários e diário de campo. Os resultados foram analisados seguindo o direcionamento da análise temática freireana. Na etapa do diagnóstico situacional, que investigou a realidade vivenciada pelas participantes do estudo, percebeu-se que as educadoras não se sentem preparadas para lidar com aspectos de saúde-doença da criança e recusam as ações de cuidado como desempenho de suas funções, interpretada como uma atitude que ultrapassa sua competência profissional. Os pais, por sua vez, apresentaram dificuldade de entendimento e clareza da sua função e relação com a instituição e executam as ações de saúde sem associá-lo à promoção e prevenção, além de realizarem com conhecimento empírico. Vista a necessidade de mudança das ações de saúde prestadas à criança, decidiu-se conjuntamente, através de uma roda de conversa, realizar capacitações sobre higiene e limpeza, medidas caseiras no cuidado à criança e primeiros socorros. Na etapa de implementação da ação coletiva as participantes consideraram as atividades úteis no cuidado prestado à criança e perceberam a importância do cuidado compartilhado para o desenvolvimento infantil. Com o desenvolvimento das capacitações, as participantes sentiram a necessidade de sistematizar as atividades prestadas à criança nos problemas de saúde e, para tanto, foram construídos, conjuntamente, protocolos e procedimentos operacionais padrão para a formalizar as ações. Na etapa de avaliação dos encontros, constatou-se que há expectativas positivas para a continuidade do cuidado em comunhão entre pais e educadores, pois foram construídas novas percepções em relação ao cuidado da criança. Percebeu-se mudança considerável nas mães assíduas ao estudo quanto ao cuidado e interesse, no entanto tornaram-se evidentes as fragilidades no processo de trabalho do CMEI, pois emergiram a dificuldade existente nos membros que compõe a instituição de educação infantil de articular o cuidado à educação. Como principal dificuldade, elenca-se o alto índice de mães faltosas e a dificuldade de articular com outros profissionais de saúde para as atividades. Considera-se que o pacto de cuidar não foi implantado integralmente, pois partilhar cuidados sugere o encontro de pais e educadores que podem ter aspectos divergentes sobre necessidades infantis e desenvolvimento, o que requer constante negociação entre as partes. Nesse sentido, constitui-se em um processo contínuo de aperfeiçoamento entre família e instituição de educação infantil

Práticas populares de cuidado à criança: o saber/fazer de cuidadoras

Popular practices correspond to the resources used by households, lay people and popular therapists, whose perception of knowledge is constructed in the everyday. In this context, the sick child can become vulnerable to be dependent on a family caregiver, who often decide to employ popular practices. Thus, the child care should be shared between carer and health professional. However, they know little about the resources that the family uses to detect a grievance in infant. Therefore, the present research aimed to analyse the use of popular practices by caregivers of children with zero to five years old. We conducted an exploratory and descriptive study with a qualitative approach, together with 15 caregivers of children who were treated at the Joint Unit Felipe Shrimp, located in Natal, Rio Grande do Norte, Brazil. To select the participants, they should be age and above 18 years; be caregivers of children up to five years of age; and reside in the area ascribed the Joint Unit Felipe Shrimp. The data collection took place between September and October 2013, through in depth interview. This step was preceded by the approval of the Health Department of the city of Natal; the direction of the Joint Unit Felipe Shrimp; as well as, the Committee on Ethics in Research from the Federal University of Rio Grande do Norte with Certificate of Presentation and Consideration Ethics, No 15467013.8.0000.5537. Furthermore, the interviewees formally authorized their participation in the research by signing the consent form. The data were treated according to the technique of content analysis in the form of thematic analysis according to Bardin. This process, four categories emerged: "Types of popular practices used in the care of the child"; "Source of information of popular practices"; "Results obtained with popular practices"; "Factors that hinder the adoption of common practices." The results showed the use of popular practices by caregivers in the case of illness to children such as the homemade preparations with medicinal plants and folk healers. The family environment was referenced as the main learning space and spread of popular practices, which are influenced by cultural relations present in this context. As to the results obtained with popular features, the caregivers said to be satisfactory, and this triggers a feeling of confidence and acceptability of such measures. It is concluded that the use of popular practices in child care persists in everyday most of the participants, despite the hegemony of allopathic therapy. The caregivers stated that such practices are effective and easy to obtain, being secured in context by popular culture. In addition, health professionals, especially nurses, were seldom mentioned by the caregivers as to the information concerning popular resources used by them, which suggests the weakness in dialogic process of negotiating practices between both of them

Clima e cultura de segurança do paciente em uma maternidade escola: percepção dos profissionais de enfermagem em terapia intensiva

Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Questionário Atitudes de Segurança , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety

Vivência do enfermeiro no cuidado humano na Unidade de Terapia Intensiva adulto

The purpose of the study was to understand the nurse s experience with human care in the Adult Intensive Care Unit (ICU). The objective was to describe the nurse s experience in caring for patients in the ICU and to analyze the nurse s perception of the care provided. The study is a descriptive inquiry of qualitative nature with a phenomenological approach. We interviewed eight nurses, 26 and 43 years of age, that provide care in the ICU of a private hospital in Natal/RN, during the manths of July and August of 2006. We analyzed the data acording to the method of Colaizzi. Four categories emerged from the data: The search for the maintenance of life, The technicalbureaucratic activities, The recognition of the patient s individuality, and the expression of the nurse s feelings.The analysis allowed us to describe the lived experience of the nurse s care the ICU and to comprehend the structural elements of this experience. The results showed that the nurse s experience presents itself as a process of the several actions and feelings that occur while the social relations between the patient and the nurse develop. Finally, we understand that although the study shows an experience based on a biological model of health, these nurses possess an initial idea on how to reach humanized care in its essence, needing, however, of an institutional policy that favors this practice, an educational formation that prepares her to recognize her field of work as a place of continuous learning and an understanding of the health model as an ally in the search of humanized care

Investigação histórica na formação de professores de matemática: um estudo centrado no conceito de função

In this study we analyzed the development of a teaching experience, involving students with a bachelor s degree in mathematics from UFRN, based on the history of mathematics and mathematical investigations with the aim of contributing to the improvement of the teaching-learning of mathematics. The historical investigation tasks were planned and applied in the classroom, focusing on functional thought. The results obtained during the experience were described and evaluated based on authors who support the assumption of investigation and history as an alternative to the learning of mathematics. We emphasize that the material of analysis consisted of a work diary, audio recordings, questionnaires with testimony of the students involved, and, in addition, the assessment of the teacher of that subject. With regard to the mathematical content, the study was restricted to the concept of function, forms of representation and notation. It was evident that students showed great improvement with regard to the necessary formalization of the mathematical contents which were focused on, and to the active involvement of the students at different stages of the study. We can affirm that the completed study certainly represents significant contributions to an approach in the teaching-learning of functional thought