Atividades profissionais da enfermagem no contexto hospitalar: influências nas relações de trabalho

The present study is based on an analysis of professional work relationships in the nursing team from the task/skills of its members as a contribution to understanding the work process in nursing. It is aimed to identify the skills of the nursing team members through the vision of nurses, technicians and nursing assistants, thus it attempts to find strategies to improve the health assistance to patients. It is a descriptive and analytical study with a qualitative approach grounded in theoretical and methodological framework of Symbolic Interactionism. The research was carried out in the participant work place, a Public Hospital of Reference for the SUS, located in the eastern health district of Natal/RN. Nineteen nursing professionals participated in the study, which seven was nurse and twelve nursing technician. As procedure to collect data we used an unstructured interview accompanied by a standard topic guide which was recorded and later transcribed. The content analysis was chosen as the main methodology to analyze the discussion, which gave rise to thematic categories that were considered relevant based on the theoretical framework of this study, and the interactionist theory. This study was in accordance with the ethical principles of the Resolution nº. 196/96, it has obtained an appropriate consent of the UFRN Research Ethics Committee. The results indicate that the professionals seen the nursing as a profession strongly attached to the health care process and as a profession that acquired a scientific status very recently. Regarding to the nursing functions in the work process in nursing, the professionals they identified the manage/administer category as the main activities developed by these professionals, thus the education and complex care in nursing categories. Concerning to the technicians and nursing assistants functions, it was figured out in the professional s opinion that there is not distinction among the attribution of these categories. The interviewed were unanimous in report that these professionals are more involved in direct patient health care through performance of basic duties in nursing care. Finally, with regard to the work relationship among nursing team members, the majority of those interviewed see this relationship as disharmony and quarrelsome and in general, there is not bond between categories that comprise the process of work in nursing. On the basis of our results we consider the importance of knowing the meaning of nursing given by these professionals; also their skills could be useful as basis to identify problems, which source could be detected in the power relationship, deviations of functions, gap between design (knowledge) and performance (doing) work, besides the loss of the global activities view in the process of nursing work

Serviço de atendimento móvel de urgência (SAMU) e a assistência às urgências psiquiátricas

The objective of this work which is characterized as an applied research, with a qualitative exploratory approach and has case study character has been the analysis of the conceptions and dealings of health professionals of SAMU in Natal RN about the attendance of psychiatric urgencies. The information was collected between the months of March and April of 2010, by means of semi-structured interviews, performed with 24 health professionals integrating of SAMU-Natal as well as the usage of direct observation technique, performed in the institution's medical regulation room. Both the number of professionals involved in the interviews and the bringing about of the observations, were determined by saturation methods in qualitative research's information collecting. The interviews and observations were transcribed and submitted to contents analysis technique , more specifically, to thematic analysis, which made possible to reach the deepest levels, that go beyond what has simply been manifest in the speech of the interviewed, getting to the relations among the categories and social structures of the issue of the research. Keeping this in mind, three analysis categories have been built, namely: conceptions and concepts of psychiatric urgencies shared by health professionals in SAMU-Natal; attendances to psychiatric urgencies in SAMU-Natal; and the Brazilian Psychiatric Reformation under the view of the SAMU-Natal's health professionals. Reflection about the analyzed information revealed discussions pertaining to the stigma and prejudice on mental illness, and also, pointed out to some hindrances which impair the attendance to individuals in mental suffering in SAMU-Natal. The interviewed health professionals' conceptions on the individual in psychical crisis involve concepts of unpredictability, aggressiveness and risk, stigmatizing elements and historically associated to the social hazard ideology and need for mentally sicks' segregation. The predominance of these conceptions, seen in health professionals speech, had identifiable reflexes on assistance to psychiatric demands performed by SAMU-Natal, namely: indiscriminate request for military police's presence during psychic crisis intervention, neglect about occasions that involve mental health patients, as well as repetitive assisting practice directed on physical contention, and transportation to psychiatric hospital. Associated to it, the professionals have shown distorted and reductionist understanding about Brazilian Psychiatric Reformation, and, in the majority, haven't lent credibility to present model of attention to mental health, based on psycho-social treatment, pointing their speech to a need for psychiatric patient's internment. In this sense, we notice that the hospital-centered and excluding model conceived by classical psychiatry still remains alive in these health professionals' mentality as a reference to psychiatric urgency's assistance. Therefore, the research revealed a sequence of elements, that make us think about the challenges that health sector and society must face to realize Brazilian Psychiatric Reformation's principles and guidelines

Valorização do servidor no Programa Nacional de Humanização: estudo em um hospital universitário

It is at the work environment where value of the health professional is realized, according to the National Humanization Policy (PNH) from a Pediatric Hospital connected to an institution of higher education. Among the guiding principles of PNH it is highlighted the commitment to the democratization of labor relations and enhancement of health professionals, stimulating the continuing education process. For this research, a qualitative approach was chosen, using a semistructured interview as a tool to collect data. In a perspective of identifying the appreciation and humanization into interpersonal relations between workers, information from the theory of communicative action of Habermas was analyzed, considering cultural values goes beyond the practice in action, where the prospects of moral arguments in the universal truisms of life pervade original cultural moral, cognitive and expressive, imbued on ethics. This reasearch had the collaboration 29 employees with a regular contract labor to a teaching hospital in Natal, Brazil. The data was obtained through interviews which all participants signed a consent term. After data analysis the results shows the existance of a satisfaction of all workers on performing duties. The workers perceive its role valorization through kudos received as a consequence of a work done, others believe that it occurs when the institution or the group itself is concerned to enhance the work. Thus, in general, they feel valued. Regarding the interpersonal relationship, the most highlighted point was the fact that in the employees versus general directors item, respondents indicated the existence of a distance between these two categories, which can affect a participatory management. Therefore, the results of this study showed the necessity to develop actions that provide a healthy work environment. The joint guidelines of the PNH and the Employee Health Care Policy, represent some directions with some similarities in their purpose to the theory of communicative action, where there is a mutual respect, tolerance and coexistence of differences, considering the constructive conflict among health workers within the perspective of communication and interaction among individuals

Atuação da escola frente à violência: estudo comparativo entre duas instituiçoes de ensino

It is a descriptive, exploratory study, quantitative comparative approach, whose general objective was to analyze the violence at school in a comparative way in the context of two schools in Natal / RN. The specifics were to identify the types of manifestations of violence in the contexts of public and private schools, to identify the position of the leadership, teachers and school staff during and after the occurrence of manifestations of violence in the school environment, to identify measures to prevent violence within of schools. The results show that 68 of the 121 participants (56.20%) were female and 53 (43.80%) were male, 38 (31.40%) were between 40 and 49, 85 (70.2%) lived in the south of Natal (RN), 46 (38.02%) specialization, 68 (56.20%) were Catholic, 63 (52.07%) married, 41 (33.88%) received between 03 and 05 and 68 minimum wages (56.20%) were teachers, 51 (42.15%) 02 employees (01,65%) and directors, 46 (38.02%) providers had between 05 and 14 years and 11 months experience in teaching 70 (57.85%) less than five years in the job, 68 (56.20%) worked between 20 hours and 40 hours per week, 81 (16.30%) worked in the 9th grade of elementary school II. As for the sizing of violence, 111 (91.74%) respondents witnessed episodes of this event who work in the institution, 100 (82.64%) witnessed verbal violence, 87 (71.90%) called for parents when some event happenedviolent that it caused injury to students, 66 (54.55%) believed that family violence is the main reason for young people practiced bullying, 44 (38.98%) reported daily episodes of bullying, 64 (52.89% ) the event happens in the courtyard. Of the 37 victims of violence at school, 22 (59.45%) suffered verbal abuse, 18 (48.65%) experienced violence once a week, 36 (97.30%) were attacked by students, 104 (85.95 %) are able to differentiate the bad acts of bullying behavior, 28 (23.14%) separated the involved coordination and communicated verbally, 23 (19.00%) stated that the coordination of schools talked with parents about the aggressive behavior of the student. Regarding the actions taken to minimize bullying, 69 (57.02%) participated in any professional education process, 47 (38.84%) was the educational process at another institution, 49 (71.01%) took courses lasting 12 to 24 hours, 59 (48.76%) stated that interaction with parents and family was the most stimulated by the school to try to minimize and prevent the event and 116 (95.87%) participated in meetings at the institutions surveyed , 58 (50.00%) responded that the meetings took place every two months and 121 (100.00%) reported having no refresher course on school violence in the schools surveyed. We conclude that violence in schools has been expressed in any social class and that professionals are poorly prepared to deal with the situation. So we hope that education professionals through the reading of our study may realize that school violence takes place in any institution affecting the lives of all who make up the educational universe. It is extremely important that these professionals always seek to empower through knowledge so that they can develop strategies to prevent and minimize the bullying to change the reality of the workplace

Riscos ocupacionais e acidentes de trabalho em um serviço de atendimento móvel de urgência do Rio Grande do Norte

Exploratory, descriptive and quantitative study with prospective data, performed in the Mobile Emergency Care Service in the metropolitan region of Natal/RN, in order to identify the knowledge of the multidisciplinary team about the rules of standard precautions and worker safety, to identify occupational hazards peculiar to the activities of this service; characterize work-related accidents (WRA) and know the procedures adopted after each WRA. The population consisted of 162 professionals and data were collected between the months of November and December 2010. As for personal and professional characteristics, of the 162 professional, 12,96% were physicians; 6,79%, nurses; 33,95%, nursing technicians, 46,29%, conductors; 74,70% were male; 43,21% were between 31 and 40 years old; 69,33% lived in Natal/RN, 50,00% had completed high school; 58,64% were married; 69,75% had children, 46,91% were between 1 and 4 years of training; 61,73% had improvement courses; 59,25% had 3 to 4 years of service; 54,32%, with 1-4 years experience in emergency; 44,44% received 1-2 minimum wages; 78,40% received insalubrity premium; 67,28% worked in Basic Support Unit (BSU); 83,95% had journey on SAMU Metropolitano of 31-40 hours per week; 52,47% had other employments. As for knowledge of rules of standard precautions, safety and occupational hazards, 99,38% knew what it was WRA; 62,96% gave incomplete answers; 74,07% knew the rules of prevent WRA; 46,67% acquired this knowledge in lectures; 53,09% knew Personal Protective Equipment (PPE); 71,60% gave incorrect answers about the importance of standard precautions; 45,06% never received an educational intervention on this issue; 89,51% said that educational interventions in the prevention of WRA are very important; 90,12% pointed out this as a very important issue in the workplace; 27,00% suggested guidance on the topic in the workplace; regarding the physical hazards, 34,57% considered noise as the most important; about chemical hazards, 78,40% chose the gases and smoke; for biological hazards, 48,77% reported contact with the blood; for mechanical hazards, 80,86% said that were transport accidents; about ergonomic risks, 40,12% say it is the tension/stress in the care of critically ill, psychiatric and aggressive patients; and there was an average of 4,5 to the feeling of safety in the workplace. Regarding the data on the WRAs occurred, 31,48% experienced at least one accident event; 72,55% did not notify it; 60,98% answered that there was no routine for notification; 56,86% were performing patient transportation; 49,02% were hurt in the Basic Support Unit/Rescue Unit (BSU/RH); 60,78% occurred during the day; 96,08% of professionals were in normal work schedule (24 hours on duty); 31,37% had contusion; 58.82% had damage to members/pelvic girdle; 43,14% had traffic accidents. About the evolution of the WRA, 62,75% did not have to take time away from work; 76,47% had no sequelae; 88,24% did not require rehabilitation; no professional had a change of occupation. And by means of univariate logistic regression, showed that the nurses and male sex were risk factors for the occurrence of WRA. We conclude that there were gaps in the knowledge of staff regarding WRA, emphasizing the need for continuing education in biosafety in the service.

Trajetória do hospital dia Dr. Elger nunes: um recorte histórico da psiquiatria e saúde mental no Rio Grande do Norte

In Brazil, the mental health network proposed by the Psychiatric Reform inserts the intermediate and replacement services in the pursuit of alignment or resocialization of patients with mental and behavioral disorder in the community. Was adopted, among other services, the Center for Psychosocial Care, Home Therapy, Sheltered Home, Day Hospital and psychiatric beds in general hospital. In this context, the State of Rio Grande do Norte implanted the Day Hospital Dr. Elger Nunes (HDEN) in Natal / RN in 1996, linked to State Department of Public Health. At HDEN happened a multi and interdisciplinary therapeutic work, besides being the scene of disciplinary practices, and extension projects for graduate courses in Higher Education Institutions in the city. However, with the process of decentralization of local services, the hospital was terminated by an administrative state act in 2006, leaving damage to the activities provided to users, disciplinary practices and extension activities. From this breakdown, the objective was to narrate the trajectory of HDEN through a multidisciplinary team of professionals and teachers who used it as a field of disciplinary practices. It is characterized as a documental and qualitative, backed in the technique of thematic oral history, following the phases: authorization of the interviewee, interview recording, transcription, textualization and transcreation of the material obtained. We used documents, ordinances, general reports of activities, among others, plus interviews to fifteen employees who used this service, being thirteen part of the multidisciplinary team of professionals and two graduation professors of health care area, nursing and medicine. The stories collected were organized according to the technique chosen, respecting its steps. In preparing the body subjected to ALCESTE computer program, priority was given to the vital tone for the formation of categories and classes elected by the program, structured in three thematic areas. In the first axis, called Trajectory of HDEN, were recalled the beginning of its activities, the steps of that time, their activities, and its actors - users, families, professionals, and teaching practices. The second axis has dealt with the process of extinction of HDEN, rescuing the feelings of employees, the main reasons given at the time and immediate postextinction scenario. And the third axis revealed in an articulated form the situation of mental health in Natal / RN, listing to the challenges and prospects for the psychosocial care, starting from the trajectory of HDEN with emphasis on activities. Moreover, the trajectory of HDEN provides recognition of the historical basis outlined in the constitution of the network of substitute services present in the current scenario of psychosocial care in the city of Natal and in RN.

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

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.

Viabilidade do processo de enfermagem no contexto hospitalar

The Nursing Process (NP) is considered as the dynamics of the systemized and inter-related actions of human care. We believe that the nursing manager, as the representative of all the nursing care provided in the hospital setting, is an important agent for the implementation of institutional policies, such as the NP, in the service. However, there is little information in the literature about the NP in the perspective of the nurse manager. The objective of this study was to analyze the viability of the Nursing Process in the hospital context based on the attitudes of the nurse managers toward the Process. We conducted a descriptive-exploratory research study, of quantitative approach, with a population of 45 nurse managers that worked in the state hospitals located in Natal, RN and in the university hospitals of the UFRN. Two instruments were used for the collection of data: a nursing process questionnaire, constructed for use in this study, and the scale for the measurement of the attitudes titled Positions on the Nursing Process. The population is predominantly feminine (91,0%) and have relative nursing practice experience (Mean=17,6 years). However, they have little experience in management (Mean=8,6 years). They express little knowledge of the PE nursing terms and little experience with the Process. They have a positive atitude toward the NP (Mean = 110,9); are favorable to its developement in the service (86,7%); 48,9% indicated little possibility of institutionalization in the service and 37,8% indicated large possibility. The Spearman test for association between the variables of attitude about the NP and the possibility of its institutionalization demonstrated a weak negative association in the total individual scores of the attitudes (-,316) as in the 20 itens of the instrument, with coefficients varying from 0,014 to 0,464. Factorial analysis of the instrument identified three underlying factors to the attitudes of the managers in this study: relevance, operationalization and collaboration, with Cronbach Alpha coeficients of 0,955, 0,844 and 0,807, respectively, and 0,956 for the whole instrument, indicating that the scale and its factorial subscales have internal consistency. We conclude that there is a weak tendency for the managers with a favorable attitude to have a negative perception about the possibility of institutionalization of the NP in the service. The favorable position does not appear to be sufficient for the viability of this methodology in the hospital sector, results that is worrisome for nursing. This situation suggests that the difficulties with the institution of the NP in the hospitals may be related to other factors, including the organizational conditions. We believe that the institucionalization of the NP in a servisse where it is not known and not practiced, constitutes the introduction of an innovative work technology that involves many demands, among them the adherence of the persons to the proposed innovation. This demands time and the institutional adjustments and the human resources necessary. In this process, the involvement of the health professional of the institution is necessary. This situation brings to light the discussions of professional autonomy, the action limits and perspectives, the redefinition of roles, delimiation (or consensus) of the objects of study and of the work processes, among others.

A inserção da equipe da Estratégia Saúde da Família em um Centro Municipal de Educação Infantil na promoção da saúde da criança

The joint enters the teams of the Strategy Health of Family (ESF) and the Municipal Center of Infantile education (CMEI) blunts as a form to assure the monitoring and promotion to the health of the children of 2 the 5 years when entering the day-care center environment/daily pay-school. It was traced as objective: To analyze the actions developed for the team of the Strategy Health of the Family in the promotion the health of the child, taken care of in a CMEI. Description-exploratory is to a study, qualitative nature, the type research-action. Developed in a CMEI and the USF of the quarter of New City, Natal-RN. The population was constituted by the professionals of the team of the ESF and the CMEI and parents. During the stages of the research-action diverse techniques had been used as the individually interview and in group, focal group, comment participant, and daily of field. The analysis of the data occurred by means of the content analysis, in the thematic modality, proposal for Bardin (1977) and description of the stages of the research-action. In the stage of situational diagnosis that it investigates the reality lived deeply for the citizens of ESF and CMEI how much to the health of the child seven categories had emerged that they enclosed: the context of the attention child in the CMEI identifying the actions that already came being developed for the ESF in the CMEI; the functioning of the CMEI and its routine of activities; the paper of the CMEI in the care the child; the daily one of the ESF, how much to the care to the health of the child of 2 the 5 years involving the diverse difficulties faced for the ESF; difficulties faced in daily of the CMEI for the care the child of 2 the 5 years; paper of joint ESF and CMEI for the confrontation of the difficulties; e action of health to be developed that they had subsidized the stage of planning of the research-action. During the stages of planning and implementation of the actions the actions of education in health with professionals of the CMEI and parents had been materialize and the actions of direct attention the health of the child. In the stage of evaluation of the actions for the involved citizens one searched to ahead understand the perception of the actions developed and perspective of continuity of the actions, through 4 boarded subjects for the citizens. For all the passage of the research-action it can be inferred that joint ESF and CMEI is a necessary initiative ahead of the current situation of the services of health for the promotion of an integral attention the health of the child, but that the teams of the ESF not yet make use of material conditions and staff enough to develop actions that exceed the limits of the USF, being necessary for this the reinforcement of the joints mainly with the Federal University of the Rio Grande of the North.

Representações sociais do comportamento agressivo do homem sob a ótica da mulher em situação de violência

We aim to understand the social representations of man's aggressive behavior from the perspective of women in situations of domestic violence. This is a descriptive, exploratory and representational study, whose methodological approach falls into the qualitative category. We chose as a scenario for research, by the Reference Center for Citizen Women (CRMC), Natal / RN. The criteria for selection of participants were women who lived/live in situations of domestic violence, with affective or relationship bonding with the assailant, in psychological and emotional positions appropriated to the reality; that are being protected or assisted by the service listed above; whose aggressor is male. We adopted as data collection instruments: questionnaire, Drawing-Story (DE) and a field diary. For analysis of textual data, we decided to use the ALCESTE software conjugated to editing analyze and initial reading. Were investigated 20 women victims of domestic violence, whose author of the attacks was the husband/partner. We identified, from the respondents, that 70% (n = 14) of men with aggressive behavior also had a family history of violence and fragile family relationships. About the physical and emotional condition of the assailant at the time of violence, 50% (n = 10) of these men, regardless the use of alcohol, had often quarrelsome and/or nervous behavior, impatient and unpredictable humor facing a setback, worry or annoyance. Regarding the nature of violence, we observed that women were victims of all types of violence, however, the psychological prevailed in 100% of cases. The corpus "Men" has three classes, whose focuses are, respectively: resignation, denounce and violence/aggression, being possible categorizing them as well: Category 1: The imprisonment of women; Category 2: Violence and its meanings; Category 3: Breaking the violent cycle. We show that the social representations of man s aggressive behavior, from the women in situations of violence, are anchored in the social roles of men in family and society, becoming a dominant model of masculinity. It is aimed, on one hand, from the reproduction of what is already known and/or experienced by male aggressors in the family, as repetitions of behavior. And on the other, present themselves as a state of illness, addiction or psychopathy

História oral de vida de pacientes transplantados renais: novos caminhos a trilhar

The therapeutic possibilities for chronic renal failure closely are related to the biological and social condition, and in this perspective the renal transplant is considered the best option, for providing quality of life better. This study it objectified to apprehend, by means of the rescue of the verbal history of life of the kidney transplant patients, the experiences lived since the diagnosis of the renal to the current with the current therapeutic modality. One is about a study of qualitative boarding, exploratory and descriptive, having the verbal history of life as a technique and method. The colony was formed with the ten first kidney transplant patients of the Rio Grande of the North, taken care of in the clinic of the Nephrology in the University Hospital Onofre Lopes-UFRN, located in the city of Christmas-RN. The net was composed for collaborators of both the sex, in the age band between 21 and 56 years of age, submitted it more than has one year to the renal transplant and that, in some cases, together of its familiar ones, they had voluntarily accepted to participate of the study. The first collaborator interviewed for this was excluded not to desire to participate the study more than. After approval for the Committee of Ethics in Search of the UFRN, we carry through the collection of data, by means of a halfstructuralized interview, recorded individually, in environment chosen for the collaborators. We carry through the transcription of the interviews and later we return to the interviewed ones so that the same ones made the conference, what it made possible in them to carry through the transcriation, after consecutive readings. We analyze the stories by means of the analysis of content of Bardin. Guiding the analysis of the stories of the collaborators, we find three axles thematic: Impact in the social relations, Impact in the social condition and Behavior front the illness and treatment. We conclude in this study that the loss of the renal function reed-echo drastically in the life of the collaborators, but that the acceptance of the pathological condition emerged, mainly for the support of the family and in the belief in God. The renal transplant was seen as the chance for a new life, however, so that they reach an improvement in the quality of life, other questions must be optimized, as the guarantee of constitutional laws, the rescue of the citizenship and offer of bigger support of the professionals of the health, family and society for the confrontation of the problems generated for the chronic renal illness and its treatments

Biossegurança e a saúde do trabalhador na assistência a pacientes em tratamento onco-hematológico

In recent years, the biosafety has been made possible a new look which are based the conceptions of health and illness process, as well as human needs. This new vision is focused on health vigilance that is referenced specifically in this study to the worker s health. The health of workers is essential for the prevention and control of epidemics and outbreaks of diseases as well as emerging and reemerging diseases. The present study wants to show the importance of biosafety measures for health workers, showing them through the concepts in their daily work. It is also to direct the use of biosafety measures in the care of oncology and hematology patients care, because of its infection susceptibility. OBJECTIVES: To analyze the conceptions of health workers in the biosafety pratice to the patients in oncological and hematological treatment in an oncological institution in Natal / RN, as well as make a socio-demographic profile of these workers and to know their difficulties to adequate biosafety measures. METODOLOGIA: The research is exploratory descriptive with qualitative approach, using the technique of oral history. The use of this technique is justified for the possibility of analyze the conceptions of health workers in the face of biosafety measures. From the definition of analysis categories that have emerged in the study. The categories were: daily work, education, occupational risk and onco-hematological care. The research population was the health workers who provide care to patients in oncological and hematological treatment. The study was conducted in the League against Cancer, in Natal / RN, specifically in the unit Luiz Antonio Hospital. Data collections were conducted from June to August of 2011 and were interviewed sixteen employees who assist in oncology and hematology. Structured interviews were conducted in three shifts, given the prospects of expanding the possibilities of analysis of the biosafety concepts. After data collection, the interviews were analyzed qualitatively by the technique of oral history. This genre, thematic oral history is a modern resource used for preparation of documents, files and studies concerning the social experience of people and groups with the construction of a script prior to the interview moment (MEIHY, 2002). ANALYSIS OF INFORMATION: It was made a reflection about the concepts and practices of professionals who take care of patients in oncology and hematology as well as its relation to biosafety measures. The speech of employees revealed that the adoption has been very supportive of these standards, although some have been highlighted gaps in the understanding of employees in relation to biosafety and the proposed categories. CONCLUSION: The analysis of information showed that biosafety has been cited by employees as an immeasurable benefit to safety and occupational health. And the strengths marks in their understanding were: the excellence of care and safety in occupational diseases risk reduction and infections resulting from their work activities, despite some difficulties in adopting appropriate biosafety standards

Atuação do enfermeiro na rede básica de saúde frente a gestante com infecção do trato urinário

The Urinary Tract Infection (UTI) in pregnancy is important as a consequence of the high incidence during the gestation. It is the third most common clinical complication in pregnancy affecting 10-12% of women whether prevalence is increasing in the first trimester of pregnancy, it may also contribute to maternal and infant mortality. Due the relevance for the results of obstetric and neonatal complications from UTI, these complications must be prevented, because it can lead to health hazards to pregnant women and newborns, producing a direct effect on morbidity and perinatal mortality. On this basis, it was defined as objectives of this research the identification of the profile of nurses from the Family Health Strategy (FHS) in the East and West Health Districts from the city of Natal / RN before the women with UTI and to verify the nurse performance during prenatal consultations. This is an exploratory study with a quantitative approach using a sample of 40 nurses active workers during this survey, it was approved by the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte Protocol n0 232/10 P-CEP/UFRN and opinion n0 080/2011. The tool for data collection was a structured interview. The data collected were organized into an electronic database application Microsoft ® Excel 2007, exported and analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0, and coded, tabulated and presented through tables and charts into their respective percentage distributions, using the descriptive and inferential statistical analysis, chi-square test and significance level of 5% (distribution in relative and absolute frequencies) in the independent variables. Therefore, it was observed from these results that the longer action of nurses in the FHS from the East and Weast health districts of the city of Natal/RN contributed to the development of a greater number of activities to control the incidence of UTI in women who are attended in the prenatal care service, proven by significance in statistics

Validação de conteúdo do instrumento para consulta de enfermagem na visita domiciliar às pessoas com lesão medular: um enfoque no autocuidado

This study aimed to validate the contents of an Instrument for Nursing Consultation in the Home Visit of people with Spinal Cord Injury (INCEVDOP-LM), based on the Self-Care Deficit Theory. The methodological development study was conducted with spinal cord injured (SCI) people ascribed in the Family Health Units the city of Natal/RN/Brazil, and with the nurses of these institutions. The study was conducted from Januray 2012 to January 2013 in two phases: the first aimed to identify the need for self-care of persons with SCI, and the second to develop and validate the INCEVDOP-LM. The first phase consisted of a census study of people with SCI living in Natal/RN. In the second phase, a non-probabilistic convencience sample of subjects was selected to form two groups: First stage - Group 1 of the first stage was comprised by 73 adults with SCI diagnosed with paraplegia or tetraplegia, with cognitive function preserved and that were registered to some family health unit; Group 2 of the Second phase was composed of six experts that were nurses with doctoral formation, scientific experience in the area of technology development or assistance to persons with SCI, and with publications in periodicals Qualis A2. Data collection of the first phase was conducted through home visits of people with SCI that responded three instruments: Questionnaire I (comprised of demographic and socioeconomic variables), The Competency Rating Scale for Self-care (ASA) and the Barthel Index (an instrument for evaluation of functional capacity). The research for the second phase was conducted in two stages: I-construction of the INCEVDOP LM; II-validation of the INCEVDOP-LM. The instrument and an evaluation form were forwarded to the experts for the validation. The correlations between the responses were analyzed by the Kappa test, with accepting values of>0.75. The evaluation criteria were: organization, clarity, simplicity, readability, appropriateness of vocabulary, objectivity, accuracy, reliability and suitability and the positive responses with frequency values of≥90% were considered excellent. The chi-square test was used to investigate the differences between proportions. The study attended to the principles of Human Rights CNS Resolution 196/96. Results were reported by means of four articles derived from the study. The findings indicate that the items that showed disagreement among experts (k=0.02) were diagnoses, interventions and evaluation of the nursing features pertaining to the domains of Nutrition, Hygiene, Elimination, Physical, Social and Psychological, and of the Ability to perform work activities feature. Agreement among the experts were reported for the other items, with kappa ranging from 0.72 to 1. After removing items with disagreement, all criteria achieved excellent rates and no significant differences were observed between the proportions of responses of evaluation of experts (p>0.05). We conclude that the instrument shows validity to serve as a guide for nurses to conduct a systematic consultation during the home visit to people with spinal cord injury, with emphasis on self-care. The instrument must go through other levels of validation when applied in the clinical setting