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.

Terapia comunitária integrativa: construção de um espaço de escuta para os trabalhadores na atenção básica da saúde

This research, which appears in the form of a dissertation, entitled: Integrative Therapy Community: construction of a listening space to health care workers in primary care, addresses the Integrative Community Therapy (ICT) as a tool to create meeting spaces between health professionals where they can be receptive among one another. With the completion of this study aimed to analyze the ICT as a therapeutic approach and space of listening and speaking for health professionals cited here in order to identify their anxieties, doubts, worries and uncertainties arising from the context of labor relations and the impact of therapeutic experiences under the view of the participants. It was developed as an action-science research, involving several steps. The field of research was the ICT meetings of workers from the units under the Family Health Strategy of Northern Health Districts I and II of the city of Natal, using a qualitative approach. The interpretation of data collected was based on content analysis proposed by Bardin. Finally, this study showed the ICT as a space for dialogue and sharing, with repercussions on labor relations and expansions beyond the ICT meetings, reaching out to family and social relationships, contributing to creating bonds and solidarity networks. Under the view of the participants it was recognized as an experience that optimized the socialization, promoting the alleviation of suffering and increasing the well-being. Based on the study findings, it is inferred that ICT can be considered a viable tool for the receptiveness and humanized care of health care workers.

No caleidoscópio o estresse da equipe de enfermagem da UTI de um Hospital Universitário em Natal-RN

This study aimed to analyze stress on nursing staff of intensive care at the Teaching Hospital Onofre Lopes. The study sample consisted of thirty-eight (38) nursing professionals, including technicians and nurses working in the ICU of the hospital Data were collected between September to November 2011 in two stages.The first was the application of the Lipp Stress Symptoms Inventory (LSSI), which allowed us to measure the stress phase in which each team member was. After that, data were tabulated in Microsoft Excel spreadsheets and analyzed according to the 2010 inventory guidelines proposed by the author. After this analysis it was possible to complete the second phase of the research, which consisted of a semi-structured interview designed for those workers who were in the second phase of stress, resistance. Data analysis was based on Bardin 2004 content analysis, enabling the creation of categories based on grouping the ideas present in the interviewees' statements. It was found that the study population was mostly female (78.9%) aged from 30 to 39 years (50%), married (52.3%) and with dual-employment (65.7%). The most predominant phase, according to the Lipp inventory, was the stress resistance, present in 44.7% of the team and having as most predominant physical symptoms the constant feeling of physical exhaustion, verified in 16.8% of the participants, and psychological, the excessive irritability and emotional sensitivity in 26.3%. Regarding the qualitative data it was possible to establish three categories and four subcategories, with the following categories: the stressors of the workplace, overwork and the interpersonal relationships of the nursing staff in the ICU. And as subcategories: Routine care in the ICU; Pressures and Individual Charges; double journey: professional reflections on daily life, the night shift nursing staff and the body suffers, the manifestations of stress; deficient communication between team members. Thus, this study allowed the visualization of the stress phenomenon on nursing staff of the Teaching Hospital Onofre Lopes as a kaleidoscope of thoughts, feelings and experiences perceived by these professionals in different areas of their lives. It was also verified that the strengthening of the stress theme among nursing professionals need to be exploited and stimulated in several nursing areas of discussion so these workers are encouraged to take better care of themselves so they can take care of others health

Carga de trabalho de enfermagem e infecções relacionadas à assistência à saúde na unidade de terapia intensiva

In recent decades, the search for quality care has been widely discussed by the institutions and health professionals. In this context, it is the nurse coordinator of the process of providing nursing staff, reflecting the commitment to quality of care. In this process, it is the appearance of Infections Related to health care and its potential association with the workload in nursing as a valuable indicator of quality of care. Thus, this research contributes to studies to characterize the demand of nursing work to promote a safe healthcare practice. This study aimed to identify the association of nursing workload with the number of cases of Ventilator-Associated Pneumonia, urinary tract infection and central venous catheter infection in the intensive care unit. This is a quantitative research approach, descriptive, cross-sectional and prospective, held at Unimed Hospital in Natal-RN. The study population consisted of all patients treated in the Intensive Care Unit, Hospital for a period of 90 consecutive days in 2011. The convenience sample was compostapelos patients admitted to the ICU during the period of data collection, a total sample of 286 patients. To perform the data analysis software were used: Statistica 6.0, SPPS (Statistical Package for Social Sciences) version 17.0 (2004) and Excel 2007. In the descriptive analysis, we used Measures of Central Tendency and Measures of Dispersion or Variability and the use of nonparametric tests. Of the 286 patients, 88 were from the ICU and 198 ICU II II. Males predominated in the ICU I (51.1%) and female ICU II (57.6%) patients in the ICU I were aged 61-80 years (39.8%) followed by greater than 80 years (39.8%). In the ICU II, most of the patients were aged 61-80 years (38.9%) and then from 41 to 60 years (24.2%). In relation to the class of TISS inlet predominant class II in the two ICUs (59.1%), followed by Class III also in the two units (34.6%). Most patients (70.6%) out of the ICUs belonging to class II TISS. In the ICU I, the average number of forms of the TISS 28 was 6, has in ICU II this value drops to 3.2 forms. The overall mean was 19.9 TISS points in ICU patients I and ICU II.the 17 points in the average hours required to provide adequate nursing care to patients in the ICU I found that is 10 , 7 hours, and the ICU II 9.2 hours. It was found that the time provided by the nursing staff were higher in ICU II, with an average of 19 hours available for nurses in this sector. In the ICU I, which showed higher need of available hours, it was found that the mean value of 12.7 available hours. It was found that only 2.4% of patients had these units Ventilator-Associated Pneumonia, 1.0% were infected central venous catheter and 1.4% of patients had urinary tract infection. Infection associated with health care occurs, on average, on the tenth day of hospitalization. In the ICU II, this average value extends to the twelfth day with an excess of 2.7 hours of nursing care while in ICU I value decays to the ninth day of hospitalization with a deficiency of 12-hour assistance. It is concluded that patients generally showed a need for classification of semi-intensive care and has been assisted in their need to load. As for his association with the Related Infections Health will assist this analysis could not be performed due to the small number of notifications in this period. It is suggested further study how other factors related to infections me a longer period of analysis

Assistência de enfermagem e o risco para úlceras de pressão medido pela Escala de Braden em unidade de terapia intensiva

The problem facing the incidence of pressure ulcers (UP) in the hospital environment especially in the intensive care unit (ICU), although it is an old and frequent event in our professional practice, it is not notified in the researches as much as it should be. We observed a tendency to invest in therapeutical and in studies about the production of sophisticated new bandages. Few, however, are the investments in research on preventive measures in order to prevent or at least slow down the development of lesions. In this sense, the study aimed to analyze the correlation between nursing care and the risk of developing UP measured by the Braden scale in ICU patients. This is a descriptive study of longitudinal quantitative approach. The project obtained a favourable opinion from the Ethics Committee of HUOL (no 486/10). Data collection was carried out in the Hospital of Unimed in Natal during six months in 2011. The sample was of 32 patients hospitalized in ICU for over four days. The results were processed in SPSS 15.0 for descriptive statistics and inferential statistics. We identified that, only 9.4% of our sample developed UP, being predominantly male, elderly people aged above 60 years, Caucasian, with diagnostic hypothesis at the time of hospitalization of sepsis, were clinical patients, who presented hemodynamic instability, using orotracheal tube (TOT), enteral probe (SNE), vesical probe delay (SVD) and had values of albumin and hemoglobin levels below normal. In addition, these patients had a longer hospital stay, longer usage of TOT, SNE, SVD, increased use of sedation and drain than those who did not develop UP and were all at risk for developing these injuries second Braden scores. 66.7% of the lesions developed were located in the sacral region, limiting the degree I and all patients that developed were considered serious, 100.0% of them have evolved since the death. Small were the differences between the averages of Braden scores between patients with and without UP, 11,9+2,4 against 12,4+2,6 with p = 0.627. The clinical aspects of the patients in the study were instrumental in the development of UP, once, these findings were statistically significant through the Mann-Whitney test, and appropriateness of nursing conduct was decisive for the prevention of pressure ulcers in critical patients, since many were those classified as at risk (28) and few who have developed lesions (03)

Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

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

Limonologia e qualidade ambiental de um corpo lêntico receptor de efluentes tratados da indústria de petróleo

Environmental pollution has become a subject of public interest throughout the world. Not only have developed countries been affected by environmental problems but also the developing nations have started to suffer from the serious impacts of pollution. Within this context it is necessary to collect simplified environmental data to assist in the management of water resources by the appropriate authorities. These data are obtained through an environmental index that allows a space-time comparison of points distributed in the same aquatic body, or between different water bodies, for physico-chemical and bacteriological parameters. The aim of this present study was to determine the environmental status of the Lagoa de Baixo at Guamaré/RN, where a production unit of PETROBRAS RN/CE is located. For this purpose the Water Quality Index (WQI) was used in both an add and multiply form, the Trophic State Index (TSI) and the Environmental Quality Quotient (EQQ), as well as determining the concentrations of metals. The average values obtained for the WQI, in its two forms were 68,67 and 62,76 respectively which were inside the good qualification. According to the TSI the lagoon showed characteristics of a middle trophic state, and an impact level of regular as determined by the EQQ

Tatuagem da palavra : educação sentimental do corpo no corpus poético de Maria Teresa Horta

While looking to the body and finding it engraved by cultural, imaginary and power-related texts through a discourse embodied in itself, this research proposes a new vertiginous approach to it by analyzing the following works: Poesia completa II, more specifically, Educação sentimental, and Novas cartas portuguesas. Such transgressive and performatic works are from Maria Teresa Horta (1937-), Portuguese writer, who proposes a new education by a renewed language: a sentimental education spawned from the erotic element. Starting from the deconstruction of the view over the spoiled body and exposed in Novas cartas portuguesas, from the poetic texts in Educação sentimental, as well as in remaining ones in Poesia completa II, Horta disassembles and reassembles the body, giving a new meaning to the symbols that surround us and our experiences. Other than proposing to all, men and women, such new meaning of the behavior and current practices models, Horta s education allows, through a performance action, the construction of a stage for female identity, free from the phallic influence. A new identity, able to handle all holy and profane characteristics of women, discarding the chromatic lens of sin. Horta s poetry emerges as a new proposal of literary labor

As construções adverbiais em mente: análise funcionalista e implicações para o ensino de língua materna

This research aims at investigating the constructions with adverbials in ly, based on the view of contemporaneous linguistic functionalism, such as proposed by Givón, Hopper, Thompson, Traugott, Furtado da Cunha, as well as the cognitivist notion of language, through construction grammar support upon the patterns of Goldberg and the prototypes theory. The cognitive functional approach adopted here considers the change as a proper and inherent phenomenon of language and understands the linguistic phenomenon as resulting from effective use of language. Another aspect to be considered to the realization of this study is the fact that the formation adjective + ly is a word construction mechanism really productive, which generates interests on linguistic description. In a particular way, our leading objective is to exam the constructions with adverbials in ly in the context of language in use, in its oral and written forms, looking for to apprehend the meaning multiple manifestations forged in the use. Bearing this in mind, we worked with data from the Corpus Discurso & Gramática (Natal). There are, in the data, adverbs ended in ly that take the signification of mode, as foreseen in traditional models, but there are also other significations, for instance, the modalizador in its different manifestations. The results show that this adverb is a linguistic mark that carries in its constitution the multissêmico and multifunctional character, which interferes extremely in the ordination of this category, assuming a position sometimes pre-verbal, sometimes post-verbal. Other aspect observed refers to the relationship between the adverb and the verb, with emphasis on the compatibility or restriction between them, option which is related to the semantic aspect. The data in analysis legitimate the use in different constructions with adverb ended in ly in various genres, as follows: personal experience narrative, retold narrative, local description, proceeding account, opinion account, both in oral as in written language

Ana Cristina Cesar: um corpo de crítica

La présente thèse est une approche critique de la production littéraire de l écrivain carioca Ana Cristina Cesar. Aussi bien dans la poésie que dans son oeuvre critique, Ana Cristina Cesar a mis en évidence la question de l écriture comme le principal dilème de son projet comme écrivain. En face d autant de registres, soit en forme de poèmes, texte critique ou lettres, la question de l écriture est, dans l ensemble de son oeuvre, formulée à partir d une interpénétration entre la littérature et la vie. Considérant le problème de l écriture comme partie d un projet de l être écrivain pour Ana Cristina Cesar, nous affirmons que l intérêt de notre recherche se dirige vers l analyse des manières selon lesquelles ce problème parcourt son écriture et dévient une question métalinguistique dans sa création. Nous partons de la réflexion sur l écriture dans son oeuvre pour relever la question principale de notre proposition de travail avec son texte: Qu est-ce que c est, après tout, écrire pour Ana Cristina Cesar et comment cela se formule-t-il dans la production des rôles qu elle exerce en tant que poète, critique et professeur? Parmi les principaux objectifs qui guident cette recherche sont: promouvoir un dialogue avec les textes de l auteur, où se présente le problème de l écrire, à travers une réflexion sur le parcours de son activité intellectuelle, pour elle imprégné de questions sur l écriture féminine et la production marginale; et enquêter les manières dont cette réflexion s articule dans les fonctions qu elle développe comme poète, critique et professeur et les rélations qu elle établi avec la littérature de son époque. En outre, nous discuterons l importance de son oeuvre dans la littérature marginale, ce qui possibilite aussi une évaluation de cette production dans la littérature brésilienne

Casal nacional: significações do corpo e do figurino no telejornalismo

The main objective of this study is to investigate the meanings of body and costume as essential components of television journalists aesthetic discourse, as exemplified by the presenters of Jornal Nacional, from Rede Globo. The study is inspired on the paths proposed by semiotics, and combines this approach with other techniques of scientific investigation to identify the meanings of this non-verbal communication form. For that, this work uses the concept of communication proposed by the Palo Alto School s authors, more specifically the concept of Watzlawick et al. (2005), which understands communication like relation and inherent of human beings. The precepts of complex thought and the hologramatic principle of Morin (1990), which value the union and the need to connect the knowledge of elements or parts to that of the systems these parts constitute, is also present in the thinking that guides the work. Throughout the chapters, we elucidate our understanding of body and television as media, and fashion and television journalism as languages. This work approaches a televisual history of Jornal Nacional in order to better understand the aesthetic proposed by television news over time, its presenters and costumes. The elements that are part of the televisual language s expression and content are addressed so that we can better understand the importance of body and presenters costume in this context. Finally, we conduct an analysis of the meanings of television journalism presenters body and costume through their stereotypes, their integration into the fashion cycle and also into the televisual analysis of the most important costume elements of Jornal Nacional s presenter couple: colors, models and accessories. We thus seek to strengthen the understanding of the wardrobe inseparable from the body as communication and detail some of their production understanding processes. The women historical role in brazilian television journalism, as well as masculinization of TV journalism environment are important elements to contextualize televisual language thinking in contemporary society. The investigation covers the origins, concepts, proposals, stereotypes, prejudices, reproductions, naturalizations and reinterpretation of the body and the costume of the presenters through time and the relationship between body, fashion and communication

O corpo no pensamento de Epicuro: limites e possibilidades

The theme that fits the perspective of this thesis comes from the interest of treating, in the Epicurean corpus, about the importance of the body and its manners of realization for understanding the thought of Epicurus of Samos. Based on the inferences contained in the texts that remained from Epicurus, we did an analysis of the aspects that characterize Epicurism as a thought that makes repeated references to the body as an instance of sensitivity. It was necessary, therefore, to discuss how the body is linked to the possibility of thought, and how the latter can be admitted as a body element. It is further understood that the atomistic physics converges to the idea that asserts natural phenomena as likely to be contained and explained by the observations that come from the senses which are manifested through the body. For this reason, it was also pertinent to reflect on the admission of the body as a key element for the interpretation of Epicurean thought, even under the constitution of language. The Epicurean construction about body image was also used for the interpretation and questioning of the dynamics that define the relationships between individuals, characterizing the koinonía of the garden through the notion of corporeal unity. It was defined, therefore, that the characterization of the action field of individuals who lived in the Epicurean garden revolves around the use of logos, with the dialogues coming from the exercise of philosophy for therapeutic purposes, which were able to introduce a specific mode of political action marked by the absence of strange interests of the notion of philía

Deus, mente e mundo: sobre os conceitos de complicatio, imago e explicatio a partir do diálogo de mente de nicolau de cusa

This work deals with the way how the three themes of traditional metaphysics, namely, God, man, and the world, are rethought through the philosophical speculation of German cardinal Nicholas of Cusa (1401-1464). Due to the comprehensiveness of this subject, our dissertation had as a starting point and constant reference the book that the philosopher wrote in 1450, Idiota. De mente, the second written work that makes up the series of the Idiota (Idiotae libri), whose discussion is developed around the theme of the human mind. From the dialogue of the mind we have built our reflection on some issues and theoretical foundations presented in Idiota. De sapientia and De docta ignorantia, extending it to little more than that. According to Nicholas of Cusa, the human mind, in its creative character in the image of the divine mind, transcends the purely functional considerations commonly assigned to it, that is, those that regard its cognitive nature and epistemological role. In addition to these aspects, Cusanus understands the humana mens as a point of articulation of two other main themes of his metaphysics: God and the world. In this context, through the concepts of complicatioexplicatio and imago, as well as with the intercession between the themes of man as imago Dei and the reason of the microcosm, we present here an introduction to Cusan metaphysics