Vivências de docentes de enfermagem no ensino do cuidar

Care, in a global perspective, appears in the main quarrels as the necessary phenomenon that will have to permeate the thoughts, the perception and values for the change that will lead to the overcoming of a paradigmatic crisis. The professional care was attributed, in elapsing of history, to the Nursing. Its historical evolution and articulation with the social processes, political and scientific in prominence place, in what it says respect to human well-being, not objectifying to cure, but to comfort, to complement the weak capacities and to the establishment the present capacities, alleviating pain, in other words, caring. The Teaching of care in Nursing, suffered great influences of the biomedical model, being like this, the education in Nursing has been criticized for if being valid pedagogical models incapable to promote the growth of the subjects, keeping it passive before your life processes, showing fragilities, attitudes and questionable behaviors, dissonances, appearing the imminence of an act of to care and to educate that needs to be considered as dialectical and intersubjective act. The objective of this research is to understand the lived experience of the nursing teachers in the Teaching of Care, in order to reflect about the insert of Nursing in the current world context, watching the dialetics of the Teaching of care and the paradigm changes in the section health. It is a phenomenological research that used the analysis of the located phenomenon, to obtain the units of meaning of the speech Nursing teachers about your experience lived in the Teaching of care. This study allowed the Nursing teachers could share your existences, senses and information on the interior of your pedagogic action exalting the interpretation, which appears intentionally in the conscience, emphasizing the pure experience of the be-professor, including emotions and affectivities in the teaching of care. In the construction of the results, three moments were devoted for discussion: Multidimensional Care; Care as Professional Practice; and the Teaching of care. The speeches had revealed rich, complex and for paradoxical times. The understanding of a sensitive teaching, that sometimes, arrives if to worry in rescuing the tenderness and the humanity, it is running into the other permeated speeches of fragilities, inconstancies, technifying, that showed lacks of pedagogic preparation. The Teaching of care needs to adopt a conception of education/learning and to use methodologies that can lead to an action liberating, capable to breach with traditional mooring cables and preconceptions or little healthful habits of life, favoring the use of methods that promote educating for the way of the sensitive, detaching aspects that they contribute for this end, as the intuition, the emotion, the creation, the perception and the sensibility. In this direction, it is considered important to deepen subjects that make possible the creation of care strategies and educational with the human being vision in your totality, therefore if it perceives that the necessary therapeutical boarding to be ampler, passing for the social individual, family and its relations

Satisfação da equipe de enfermagem do serviço de atendimento móvel às urgências (SAMU) no ambiente de trabalho

Descriptive exploratory study, prospective with quantitative approach, performed on the Medical Regulation Central of SAMU/Natal, aiming to identify the level of professional satisfaction of the members of the nursing team working at SAMU/Natal; and verify the degree of importance attributed by the professionals to each of the components Professional Satisfaction: autonomy, interaction, professional status , work requirements, organizational rules and remuneration. The population was of 60 professionals, with data collected from january to february 2005. We used an instrument translated and validated by Lino (1999) to the portuguese language, the Professional Satisfaction Rate (PSR). The results demonstrate that there was a slight predominance of the female gender (54,9%); aged between 36 and 45 years old (60,8%); married (58,8%), 82,4% with children, 30,8% aged between 05 and 09. Regarding formation, we observed that 78,4% were nursing technicians and 21,6% nurses, formed for 11 to 15 years (17,5%). From the 11 nurses, 09 (81,8%) informed they have specialization, 29,4% of the team has been working for 11 to 15 years on the urgency area, 58.8% works for more than 02 years on SAMU, 72,6% of the team members have fixed work schedules. There was homogeneity on the work shifts: 41,2% on the day shift and 53% on the night shift. Regarding the reason to be working on SAMU, 64% chose to work in the service, and among these 76,3% predominantly perform direct care to the patients, 96,1% like and are satisfied to work in the service. Regarding the remuneration, 90,9% informed they receive 05 to 10 minimum wages; 70% of the technicians informed they receive -2 to 05 minumum wages, 50,1% informed they receive no additional benefit. The analysis of PSR through Cronbach s Alpha Coeficient resulted on the value of 0,94 and through Kendall s Tau Coeficient on 0,87, demonstrating to be a trustworthy instrument to measure the level of professional satisfaction of the SAMU nursing team, in our environment. As for the level of importance attributed to the components of professional satisfaction, we indentified that the nursing team considered the Autonomy component as the most important, followed by the component Remuneration, Interaction, Work Requirements, Work Requirements, Organizational Rules and Professional Status . Regarding the current level of professional satisfaction, we identified they were most satisfied with the Professional Status , Autonomy, Interaction, Remuneration, Work Requirements and Organizational Rules. The real professional satisfaction level, calculated through statistics, however, tells these professionals are more satisfied with Autonomy, Remuneration, Interaction, Work Requirements, professional Status and Organizational Rules. The PSR in our work was of 8,6, indicating the SAMU Natal nursing team has little satisfaction on their work environment

Sofrimento psíquico: representações sociais dos enfermeiros em ambiente hospitalar

We believe that the dissatisfaction arising from the lack of belief in the possibilities of change in the workplace, which cause difficulties to achieve professional results in the professional psychological distress that currently fits into the context of mental health. This is a qualitative, descriptive and representational research aiming to discover how the professional nurses represent the very psychological distress from work in the hospital environment. Aided and supported by specific objectives of identifying factors that generates this suffering and strategies for defense and confronting these professionals in the hospital. 22 nurses participated in this research, officials of the University Hospital Onofre Lopes, located in the city of Natal / RN, with length of service in the institution more than one year and less than five, and they accepted, by signing the Term of Free and Informed Consent, participate in the study. We use plurimethodological approach: a questionnaire, a semi-structured interview and the design-story with a theme adapted from Trinca with the support of the Theory of Social Representations and that nurses do in their psychological distress of the Central Core. We reviewed the data from the results generated by the ALCESTE software, based on hierarchical categorization downward, leading seven classes used as categories: Work process: completeness vs. incompleteness; labor contradiction of the nurse; qualitative aspects of interpersonal relationships; hospital surveillance: Challenges, muteness and neglect; Expectations, conflicts and feelings in the work process; Leisure: the other side of the work process, and Suffering generating aspects of in the work process. We consider the analysis of quarters generated by the program, which SLQ houses in the central core of the representations; the SRQ and the DLQ the intermediaries elements and the DRQ the peripheral elements that nurses do in their psychological distress. We analytically adequate results in the three belonging dimensions of social representations: the Subjectivity, the Intersubjectivity and Trans-subjectivity. We infer that the interpersonal relationship, the extra work, the deviation in the role of nurse show themself as the factors responsible for psychological distress of it. In that sense, the central core of SR of this profession is based on the level of trans-subjectivity and understood as a Social Representation controversy

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

Trânsito de saberes e campo representacional na visão dos profissionais da saúde da família e do programa de educação pelo trabalho e para a saúde

The Family Health Strategy (ESF) is emerging as a possible restructuring of services and new practices of intervention in health care; it requires skilled professionals to work with that framework. Within this purpose, we established the Education Programme for Work and Health (PET-Saúde), in order to integrate teaching and service activities, focusing on primary care. On this basis, the aim of this work is to apprehend the social representation of nurse, doctor and dentist (Project PET-Natal Health RN preceptors) on the ESF, while practice field of them. It is a descriptive and exploratory study, with a qualitative approach, carried out in 07 Family Health Units (USF) included in the PET-Saúde Natal (RN). The population was composed of 35 professional components of the primary care team with bachelor's degree of the USF linked to this project. The sample was composed of 05 nurses, 05 physicians and 05 dentists, for a total of 15 subjects. Data were collected through three instruments: the drawing-themed story, a semi-structured individual interviews and field diary. The data relating to the identification of the subjects were entered and tabulated by the Microsoft Excel software 2007 version. The drawing analysis and interpretation is given by the significance attributed to the resource chart from title and keywords assigned by the subjects, considering the ESF as an inductive term. The stories and interviews were transcribed and typed and then subjected to read/listen the material and a lexical analysis through Alceste. After this process, the discursive material was analyzed and discussed by theoretical and methodological feature of the Social Representations theory. The majority of health professionals were female, aged between 46 and 52 years old, married, income less than six minimum wage, time since graduation ranged from 22 to 29 years and working time in the ESF range from 02 to 11 years. From the classification system ALCESTE were selected categories identified by: Category 1 - ESF: relations and territory; Category 2 - Training and bond profile; Category 3 - Working process in the ESF; Category 4 - Articulation between teaching and service; Category 5 - Health care and disease prevention. The representational field construction, while a process, followed the logic of structural cores in existing categories. In this sense, it is clear that the ESF is an environment rich in diversity, experience and relationships with potential such as the relationship "very subject-subject" and the link established between professional-community, but also has some weaknesses such as poor working conditions, lack of popular participation and management support, thus difficulties in the achievement of teamwork. Being essential to that end, the teaching-service aimed at the formation of a new health professional able to work in the ESF. In this research, the training of the representational field encountered a diversity of structural cores, or thoughts on training, about the ESF because of the greater emphasis on the here and now of the interaction between health professionals, the ESF, the community, PET Health-UFRN and students, emphasizing that such proposals are still considered as concepts in the context of recent health and that, therefore, are not fully realized in the social imaginary

A palavra cantada nos espaços intersubjetivos de um centro de atenção psisossocial do município do Natal/RN

The psychiatric care and mental health are undergoing constant change over the History. The Brazilian Psychiatric Reform, which brings up the deinstitutionalization as a structuring in the restorative care process. The Reform has as one of the mainly substitutive services the Centers for Psychosocial Care (CAPS), which work from the Singular Therapeutic Project (PTS) in order to restore the autonomy and restore the dignity of users. The therapeutic workshop is some of the resources used and work several kinds of activities as: writing, handcraft, music, poetry, and so forth. This study set up to apprehend the social representations of helping of the music workshop carried out in the CAPS II east of Natal/RN, from the reports given by the participants of the workshop, using the focal group as technique. This is a descriptive exploratory study with a qualitative approach. A total of 16 users participated in four musical therapeutic workshops from April to May 2010. The study was approved by the Ethics and Research Committee of UFRN. The discursive material from the workshop was submitted to the informational resource of Analyse Lexicale par Contexte d um Ensemble de Segments de Texte, ALCESTE, and analyzed based on the Theory of Representations and the Central Core Theory. The majority of subjects were men (62.5%), single (62.5%), aged 40-49 years (37.6%) and elementary school level (56.2 %). The reports were transcribed and submitted to the classification system of ALCESTE, which elected the following categories: Category 1 - Experience in the Word Family Sung, Category 2 - Musical Experiences and Approaches, and Category 3 - Feelings and emotions evoked by music. The representation of these individuals is anchored in the experience they have with the CAPS, lived and socialized by common sense, through this particular social group workshop objectified in music therapy as a therapeutic modality enjoyable. The central core revealed the intrinsic relationship between users and the music, establishing a relationship of openness to use the same while its therapeutic use in workshops of substitute services for mental health. Peripherals elements issues are related to listen, share and experience music in the family. Intermediary Elements relate to the feelings and emotions evoked by music, given her close relationship with it. It was found in the study that music can be construed as an artifact of good therapeutic responsiveness to users, configuring it as an invigorating and enjoyable therapy, confirming the need for continuity of this activity, as well as its expansion into the service

Acidentes de Trabalho : análise em profissionais de enfermagem que atuam nas unidades de terapia intensiva e urgência Natal/RN

It is a descriptive-exploratory research, with a quantitative approach, aiming to characterize typical occupational accident suffered by the professionals from nursery group, in the Intensive Care Units and Emergency in a hospital in Natal-RN, trying to identify the factors that contribute to those accidents; to identify some information taken by those professionals related to the accident risks; to know the procedures taken after each accident. This sample is composed by 176 professionals that are 44 nurses and 132 nursing technicians/auxiliaries, collected from March to April 2010. The results related to the personal characterization of the nursery group showed that 31 (18.61%) are between the 36-40 years of age; 148 (84.09%) females and 96 (55.68%) had finished High School. Related to the professional characterization, 53 (30.11%) are nurses, and 123 (69.88%) nursing technicians and auxiliaries; 44 (25.00%) are working as nurses, and 132 (75.00%) as nursing technicians and auxiliaries; 45 (25.56%) are working in the nursery area between 15 to 20 years and 11 months; 53 (30.11%) are in this institution between 10 to 14 years and 11 months; 79 (44.88%) work in the ICU; 55 (31.25%) are working in this area from 1 to 4 years and 11 months; 110 (62.50%) like to work in this area; 161 (91.47%) work 30 to 40 hours per week; 90 (51,13%) have another employment. Related to knowledge about typical occupational accident, 167 (94.88%) said they know about it; 96 (54.54%) know the accident rules; 103 (58.52%) think it is important to talk about this subject in the nursery courses; 92 (52.27%) said this subject is important to be discussed in the work and 372 (87.73%) think education is necessary to reduce accident. Related to the data about accidents, 104 (59.09%) have suffered typical occupational accident, among them 69 (39.20%) have suffered it once; 47 (36.19%) did not register any accident; 60 (57.69%) were caring some patient during the accident; 47 (45.19%) of them occurred in the ICU; 50 (48.07%) professionals were working during the night period; 69 (66.34%) have suffered perforation; 86 (82.69%) had upper limbs affected; 64 (61.53%) were affected by needle; about the reason of the accident, 89 (60.54%) said it occurred due to carelessness. Related to the accident evolution, 88 (85.57%) did not need to remain off work after accident; 13 (81.25%) remained off work during 15 days; 87 (83.65%) had no sequelae and for 101 (97.11%) it was not necessary rehabilitation. We conclude that typical occupational accident can occur with young workers who admit a knowledge about the subject, however they do almost nothing to prevent it. We believe this research has contributed to the characterization of this kind of accident suffered by the nursery group of a public hospital in Natal, and it can stimulate the creation and reformulation of personal protection against typical occupational accident suffered by nursery professionals

Acompanhando o crescimento e o desenvolvimento da criança : uma intervenção integrada entre enfermagem e família

The accompanying the growth and development of the child is the guiding line of basic health measures directed at this public, acting within the scope of health monitoring and inferring positively in the rate of infant morbidity and mortality, which are still a preoccupation worldwide and in Brazil. However, mostly, this practice is based on the biomedical model of care, individualized, with emphasis on the medicalization and complaints, favoring the passivity of users. Given this issue, aim to develop accompanying the growth and development of the child in a Basic Unit Family Health, through a collective approach of medical care next to a health team, especially nurses and caregivers. This is a qualitative study, with the research-action method. Involved the four nurses and twenty-six of children's caregivers of the area of Basic Unit Family Health of Cidade Nova, in Natal, in the period from February to July 2010. The results were analyzed following the direction of the thematic analysis of Freire. In the situation analysis of the current reality of the accompanying the growth and development the children in the Basic Unit Family Health, through participant observation and applying a questionnaire to the nurses, we realize that despite these professionals have a knowledge tied to the paradigm of health promotion, in practice the monitoring of child is done through individual consultations in outpatient room, based on complaints brought by caregivers, with little solvability in actions employed. Given the need for change in medical care model, we decided jointly, in the focal group, for the collective monitoring of children's the growth and development, featuring then this proposal to the multidisciplinary team, discussing the participation of professional categories and planned collectively the actions. In the implementation stage of collective action, we contemplate the execution by the caregivers of anamnesis and physical examination, recording data in the Child Health Handbook and discussion of clinical findings, under the supervision of nurses and facilitators. In the evaluation, we found that this collective accompanying strategy allowed to caregivers learn new knowledge, exchange experiences, assistance in home care, beyond reduce the waiting time for medical care and creating opportunity of more time for debate about the children‟s health situation, differing of ambulatory care. As difficulties, we face with a high rate of defaulters (53.8%), lack of motivation and passivity of the users, little participation of other health professionals and nurses' involvement in other activities, technical and bureaucratic in the moment of care. Thus, we note also a strong rooting of individual clinical model on the way of thinking and acting of nurses and caregivers

Corações e mentes desvendam o Sistema Único de Saúde : visões e vivências de estudantes de enfermagem

One of the Ministry of Health s attempts at contributing to making collective health more appealing to health students is the Experience and In-Service Training within the Reality of the Unified Health Service Project (VER-SUS). Hence, the object of this investigation is to survey learners views on the teaching of nursing based in the experiences they have lived through in the VER-SUS. Its purpose is to analyze the views and lived-through experiences of nursing students on how the VER-SUS contributed to their professional education. This is a study of the descriptiveexploratory type with a qualitative approach. Eighteen undergraduate students from the nursing program at the Federal University of Rio Grande do Norte (UFRN), former VER-SUS participants, took part in this study, from 2006 to 2009. Information was collected using focus group techniques guided by a set of questions and semistructured interview with open and closed questions. The information collected was analyzed using content analysis technique, of the thematic analysis type. The UFRN Research Ethics Committee approved of the survey pursuant to Report Opinion number 223/2010 and CAAE number 0105.0.051.000-10. Lived-through experiences and in-service training gathered from the VER-SUS have contributed meaningfully to health education, as they helped understand the role of the university and of a health and nursing education within the hegemonic model of education. According to the views and lived-through experiences of nursing students who took part in the SUS project it was extremely relevant to use active methodologies in the teaching-learning process and have the facilitators act as liaisons for the SUS. It follows from this study that the VER-SUS does contribute to a health-nursing education and brings the students close to the reality of the community

Registro de enfermagem no prontuário em um hospital universitário: uma busca pela humanização do cuidado

T he aim of this study is to analyze the view of nurses about nursing records in the patient chart, in perspective of the record of humanized care. This is a case study, with qualitative approach. For its achievement, was sought and granted authorization from the direction of the Hospital Universitário Onofre Lopes (HUOL) and the Ethics Committee in Research of HUOL as Statement No. 422/10. During data collection, interviews were conducted with 20 nurses of the institution. The data analysis was based on the theoretical framework of Minayo to thematic content analysis, grounded in authors who work with themes, nursing records and quality care. With the empirical material, we constructed a framework of analysis, which was identified four categories thus nominated, "Reading and learning from those who register," "nursing records and quality of care," "the essence of nursing records" and "intention and action on the record of the subjective aspects of the patient." The results show that the records are insufficient, even in the case of the procedures performed with the patients often do not inform about the aspects that deal with the subjectivity that surround it, and admit that the records do not represent a parameter for evaluating the quality of care at least at that institution. In summary, the respondents recognize the importance of valuing subjectivity of the patient in their treatment, yet admit to neglect this aspect as significant for comprehensive health care, humane and quality

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

O cuidar de enfermagem e da família à pessoa idosa no domicílio: uma abordagem etnográfica

O envelhecimento é um processo multidimensional que envolve entre outros os aspectos físico-biológicos, sociais, econômicos e psicológicos. Ao avaliar essa fase da vida dentro de uma visão social e cultural, percebe-se que ser idoso ou não varia com as concepções culturais, sendo necessário investigar as variações que atuam no processo e rege o fenômeno sociocultural da realidade em que se está inserido. Com o aumento da população idosa mundial, esse processo tende a se intensificar. Estima-se que até em 2050 existam cerca de dois bilhões de pessoas com mais de 60 anos no mundo, e a maioria delas vivendo em países em desenvolvimento. No Brasil, acredita-se que existam, atualmente, cerca de 20 milhões de idosos. A normatização e legislação brasileira de amparo ao idoso em relação à saúde iniciaram-se a partir da Constituição Federal de 1988 e da Lei 8080 que regulamenta o Sistema Único de Saúde em 1990, em seus níveis de complexidade: atenção básica, média e alta complexidade. Para auxiliar nessa prestação dos serviços na atenção básica de saúde é importante observar as condições sociais, culturais, econômicas e de saúde dos idosos e seus familiares. Nesse sentido, a visita ao domicílio e a avaliação deste idoso em seu ambiente doméstico torna-se fundamental para acompanhar o cuidar prestado e o quanto esse processo irá interferir no sistema de saúde, na família e na qualidade de vida dos idosos. Neste contexto, o enfermeiro como integrante da Equipe de Saúde da Família, presta assistência à saúde do idoso no domicílio. Nesse sentido, o objetivo do estudo é analisar o cuidado de enfermagem e da família à pessoa idosa no domicílio com vistas à identificação das influências socioculturais. Trata-se de um estudo do tipo descritivo e de abordagem qualitativa, norteados por princípios teórico-metodológicos da etnografia com vistas ao estudo da influência dos aspectos culturais e sociais na assistência da família e do enfermeiro à idosos em domicílio. Foi realizado no município de Santana do Matos, RN, tendo como participantes, idosos, familiares e enfermeiros da equipe da ESF, definidos a partir da população do município e obtendo-se uma amostra intencional de 25 participantes: 6 enfermeiras, 10 idosos e 9 grupos familiares. Para a coleta de informações, utilizou-se observação, entrevista, diário de campo e grupo focal. Os resultados foram apresentados em forma de narrativa descritiva, na perspectiva dos conceitos de Boris Cyrulnik, com análise interpretativa cultural de Geertz, na busca dos significados e símbolos próprios da cultura da velhice de idosos e dos seus familiares, sobre cuidados que são realizados, tanto pela família, como pelos enfermeiros em domicílio. Observou-se que a família e o cuidador, dentro de sua realidade social e cultural, precisam ser mais compreendidos pela equipe de saúde para ser melhor orientados e capacitados na realização do cuidar de forma adequada. Por sua vez, os profissionais de saúde, em especial o enfermeiro, enfrentam dificuldades para realizar o cuidado ao idoso no domicílio como a grande demanda de atribuições na unidade de saúde como consultas e atendimentos; falta de transporte até os domicílios; extensão territorial do município e das áreas assistidas; número de pessoas atendidas por cada equipe; falta de compreensão dos profissionais de saúde quanto à importância da visita domiciliária na atenção básica. Entendem a necessidade de realizar ações de promoção em saúde, prevenção de agravos e de educação em saúde, além de reconhecerem a importância de uma melhor formação acadêmica para atuar nessa perspectiva e contribuírem para as mudanças necessárias na prática dos cuidados ao idoso em domicílio

Diagnósticos de enfermagem em pacientes no pós-operatório imediato de prostatectomia de um Hospital Universitário de Natal-RN

The characterization of the nursing diagnoses in prostatectomized patients is important to provide an unique nursing language, facilitating the communication between professionals and patients. The objective of this study was to analyze the nursing diagnoses of patients in the immediate prostatectomy postoperative period. This is a cross-sectional and descriptive study, developed at the surgical-clinic of Onofre Lopes University Hospital, in the Natal City RN - Brazil. The sample was composed of 50 patients included by the criteria: have presented a diagnosis of a benign prostatic hyperplasia or a prostate cancer, have been subjected to a prostate surgery at the mentioned hospital, and have been in the immediate postoperative period at the moment of the data collection. The exclusion criteria were: haven t been in an appropriate physical and mental condition, have presented a brain vascular disease, a lung disease, an advanced liver disease, a heart disease or a extensive coronary artery disease. The data collection instruments were: the script of an interview and physical examination. The data collection period was between November 2010 and April 2011. The data were organized in two phases: the diagnostic process and the construction of the database. The project was approved by the Ethics Committee of the Federal University of Rio Grande do Norte The results showed that most patients came from the countryside, was living with partners, had an average of 67.78 years, was pensionerthose with low schooling, Catholic and often did not perform preventive examinations of prostatic disease. The patients showed an average of 9.48 nursing diagnoses, defining characteristics 21.70 and 20.72 related or risk factors per patient. We identified 30 nursing diagnoses, of which 7 were above the 75 percentile: Risk of falls, Impaired ambulation, Risk of infection, Self-care deficit bath / hygiene and dress up and Risk for deficient fluid volume. The top six nursing diagnoses were in all patients, and therefore could not apply any statistical test. The others ND were associated with their defining characteristics and related or risk factors. We conclude that the nursing diagnoses identified in this study contribute to the progress of the nursing care to the prostatectomized patients in post-surgery period, allowing the deployment of nursing actions for the effective resolution of identified problems

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.

Concepções de homens quanto a influência de uma gravidez sobre outra

O processo de reprodução humana é caracterizado por experiências singulares que afetam o homem e a mulher de forma diferenciada. O homem que vivencia o processo gestatório de sua companheira, mesmo não sofrendo as modificações gravídicas, enfrenta transformações relacionadas ao papel que desempenha junto à mulher gestante. Tal vivência é entremeada por significados diversos que dependem tanto da forma como ele concebe a gestação de sua companheira, como da experiência com gestações anteriores. Sendo assim, torna-se imprescindível reconhecer as concepções masculinas acerca das repercussões que uma gravidez conduz nas experiências seguintes, a fim de promover uma atenção em saúde direcionada para as necessidades apresentadas pelo homem, favorecer seu envolvimento e responsabilização no processo gestatório de sua companheira. Com base no exposto, objetivou-se compreender a concepção de homens, que vivenciam a gestação de sua companheira, acerca da influência de uma gravidez anterior sobre as demais. Para tal foi realizado uma pesquisa qualitativa por meio de entrevista semi-estruturada com homens que vivenciaram duas ou mais gestações de sua companheira com intervalo de no máximo cinco anos entre tais experiências. Cumpre ressaltar que as entrevistas ocorreram após parecer favorável de no 045/2011, emitido pelo Comitê de Ética e Pesquisa da Universidade Federal do Rio Grande do Norte. Os dados foram coletados por amostragem teórica e analisados, seguindo as etapas da Teoria Fundamentada nos Dados, sob a ótica proposta pelo Interacionismo Simbólico. Seguindo o percurso dos referenciais adotados, foram elaboradas três categorias: Sentimentos vivenciados pelo homem diante da gestação da companheira, Expectativas do homem diante da gestação da companheira e Repercussões da vivência de uma gravidez anterior sobre a seguinte. A análise das propriedades e dimensões de tais categorias suscitou à construção da teoria Influências de uma gravidez sobre a outra. Assim evidenciou-se que a gravidez anterior influencia nos sentimentos do homem diante de uma nova gestação, nas suas expectativas, principalmente quanto ao sexo do segundo filho, bem como em suas atitudes e comportamentos diante da companheira, do primogênito e do recém-nascido. Revelou-se que em todos esses aspectos ocorreram processos interativos do homem consigo mesmo, com sua companheira e com o contexto social no qual estava inserido. Assim sendo, conclui-se que a interação que o homem estabelece com a experiência anterior conduz a determinação de seus sentimentos e ações frente ao advento de uma nova gravidez. Diante disso, compreende-se que o entendimento sobre tal assunto é imprescindível para fundamentar ações do enfermeiro voltadas à inserção do homem no processo de gravidez, por meio da compreensão das repercussões de vivências anteriores na sua experiência com as demais gestações. Essa compreensão possibilitará uma dinâmica familiar favorável à adaptações requeridas em processos gestatórios seguintes, centrada na satisfação e valorização de seus membros.