Atuação do enfermeiro na estratégia de atenção integrada às doenças prevalentes na infância

This study aimed to describe nurses' actions in the strategy of Integrated Management of Childhood Illness in the city of Natal, Rio Grande do Norte. This is a qualitative study with descriptive approach. The universe consisted of nurses from the Family Health Strategy, totaling 16 participants. For the research project was submitted for approval by the Ethics Committee of the Universidade Federal do Rio Grande do Norte, obtaining Opinion No. 187/2012. Data were obtained in two ways: a questionnaire survey to profile the training of nurses and an interview guided by a structured interview. Interviews were treated in the light of analysis of thematic category Bardin. The results showed the central thematic study "Integrated Management of Childhood Illness in the context of nursing activities" category and three analyzes: "Understanding the Integrated Management of Childhood Illness", "Difficulties invibializam use IMCI "and" Working conditions for nurses in the Integrated Management of Childhood Illness. " It is observed that nurses consider the Integrated Management of Childhood Illness useful, effective and important to keep sick children within the logic curative. However disregard the character of health promotion and disease prevention thereof. It was found that the participants still hold the attendance of crinaças within the biomedical model and that these same professionals are subjected to increasingly precarious working conditions and unhealthy due to lack of human and material resources. It was found that the interviewees do not follow the protocols of strategy because of barriers related to prescription medications by nurses, the medical, the lack of incentives, training and supervision by the municipal health and the Regional Nursing Council

Integridade tissular de pacientes com úlceras venosas: um estudo baseado na Classificação dos Resultados de Enfermagem

The venous ulcer is an epidemiological problem of high prevalence, causing disability and dependence. Assess the tissue impairment level of patients with venous lesions, within a nursing referential, is relevant for the implementation of a directed assistance to specific clientele. Thus, this work aims to characterize the health status regarding the integrity the lower limbs skin of patients with venous ulcers, according to the of tissue integrity outcome indicators from the Nursing Outcomes Classification. A cross-sectional study conducted in a university hospital in Natal - Rio Grande do Norte. The sample consisted of 50 participants, selected through consecutive sampling. Data collection occurred through a interview and physical examination form and a operational definitions tool for indicators of the nursing Tissue Integrity outcome directed to patients with venous ulcer, applied from February to June 2012. Data analysis was done by descriptive statistics and nonparametric tests (Spearman, Kruskal-Wallis and Mann-Whitney tests). The project was approved by the Research Ethics Committee with protocol 608/11 and Presentation Certificate to Ethical Consideration No. 0038.0.294.000-11. The results were presented using three scientific articles derivatives of research. It was found that the indicators show moderate impairment, light and not impaired, as the median. The respondents had an average of 59.72 years, 66% female, 50% were retired, 60% with a partner, 44% had arterial hypertension, 26% allergies, 20% diabetes mellitus, 96% were sedentary, 14% drank alcohol and 6% were smokers. There was a statistically significant correlation of low intensity between age and hydration (p=0.032; rs=-0.304) and skin desquamation (p=0.026; rs=-0.316), family income and necrosis (p=0.012; rs=-0.353); Ankle Brachial Index and tissue perfusion (p=0,044; rs=-0,329); Diabetes Mellitus and texture (p=0.015) and tissue perfusion (p=0.026); allergy and texture (p=0.034), physical activity and hydration (p=0.034), smoking and thickness (p=0.018), and alcohol consumption and exudate (p=0.045). We conclude that the patients had light to moderate impairment, indicating a good state of health on the integrity of the skin of the lower limbs, according to the indicators of the outcome of tissue integrity Classification Nursing Outcomes valued in the present study. It is believed that the evaluation of impairment tissue using a self-nursing system and its relation with socioeconomic, clinical and risk factors are unique tools in the care planning and in the wound healing

Atuação do enfermeiro no acompanhamento do crescimento e desenvolvimento da criança

The nurses assistance in monitoring the growth and development of children has been characterized mostly a service based on the biological dimension of illness, when in reality, the actions should be combined in the reorientation of care model of the Family Health Strategy. Thus, the research aimed to examine the role of nurses in the growth and development of children. This is an exploratory and descriptive, qualitative approach. The project was approved by the Ethics Committee of the Universidade Federal do Rio Grande do Norte under Opinion No. 191/2012. Data collection was developed in the Health Units from the city of Natal, RN, Brazil. Survey participants were nurses who worked in the Family Health Strategy for at least two years and who performed the monitoring of child growth and development in the health unit selected. Data were collected through an in-depth interview, and seized material from speeches was treated as categorical thematic analysis proposed by Bardin. This process revealed three themes, which were analyzed in the light of Relief Models and Process Work in Health and Nursing and discussed based on the findings literary. The results elucidated that nurses consider their performance satisfactory as it has favored the accession of mothers of children under one year nursing visits, contributing to the reduction of morbidity and mortality due to prevalent diseases, as well as the establishment of a connection between the professionals and mothers. It was shown that despite having a promotion and prevention with the use of lightweight technologies, the nurses also emphasized the care of mothers in complaints and signs and symptoms of children, followed by referrals to professionals in the unit or to other sectors. Furthermore, we found that the process of working nurses face challenges regarding the organizational structure of services and social situation of the family. Given these statements, it is observed that despite the strong interference from hegemonic health model in the performance of nurses, it is found that these professionals have been investing in promotion and prevention to injuries to children in care, with a focus on family context. Thus, nurses are embarking on making the reorientation of health care through the use of relational technologies, which has contributed to solving the integral care to the pediatric population

Percepção do pai sobre sua presença no nascimento do filho

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Segredos da alma: a dádiva da assistência de Enfermagem

The present study is an analysis of interpersonal relationships between the nursing staff and the patients under their care. Its objectives are to analyze ties/links that may possibly exist in such relationships and to describe, based on the experience of the patients, how they are received by the nursing staff, and what is the extent of their reliability on the nursing staff within the hospital. This investigation is analytical in nature and qualitative in approach, having as its leading thought Marcel Mauss s gift-exchange theory. The study involved eighteen in-patients, eight of them from government institutions, at a large hospital school and ten others from a private specialty hospital; both in the city of Natal, state of Rio Grande do Norte, Brazil. Data were collected between January and March 2006. Results point to ties being created between the nursing staff and patients irrespective of their social status, involving especially the development of friendship and reliability. We have noticed that in both services the interpersonal relationship is associated with the circulation of the symbolic goods mentioned in the patients discourse, such as attention, loving care and concern, among others, marking the formation of ties during hospital stay. Likewise, reliability is also present in close relationship with the technical competence of the professional. Patient hospitality is associated with the manner in which the patients were treated on being admitted to the hospital, although they also refer to hospitality at later moments, during the course of their treatment. Finally, we are in a position to say that there are ties/links between in-patients and nursing staff, irrespective of the patient s social status and class divide. It is thus evident that the antiutilitarian symbolism of gift to give, receive, give back -, which shapes the setting of social ties also takes place in today s utilitarian, individualistic and competitive societies. Thus, human beings whose existence is dependent on mutual relationships try to save their humanity, especially those who are fragile and dependent as is the case of the hospital in-patient

Relações interpessoais no ambiente de trabalho da equipe de enfermagem: uma ação comunicativa

The current study strives to address the interpersonal relationships of the nursing team from the perspective of the communicative action, by contributing to the health work process. It aims to analyze the interpersonal relationships of the nursing team in its work environment. This is a descriptive study with a qualitative approach. Data collection wal held from interviews, guided by a script with open questions. The study was conducted at a state hospital in the city of Natal/RN/Brazil. The research subjects were the workers of the nursing team, including nurses, nursing technicians and nursing assistants, totaling 16 subjects. The capture of information was performed in April 2012. The project was approved by the Ethics Research Committee, under CEP/UFRN protocol n. º 262/11 and Certificate of Presentation for Ethical Consideration n. º 0289.0.051.000-11. The analysis was performed from the categories that emerged from the research through a dialogue with the authors studied in the theoretical framework of the Theory of communicative action , by Jürgen Habermas, as well as The changing in the world of work, by Ricardo Antunes, and Characterization of the team , by Marina Peduzzi. The outocomes point out that the interpersonal relationship of the nursing team is very troubled, with no interaction among the individuals involved in this process, among themselves and with other health professionals. We have developed a particular concept about team, which is comprised of three essential elements: multiplicity of individuals, common objective and heterogeneity. In the studied environment, it was realized the existence of grouping teams. The interpersonal relationship of the nursing can be a facilitator or an obstacle in the workplace in such a way that causes positive or negative consequences, both to the health workers, and to the sicks. In this context, the interviewees have intensified their viewpoints with regard to the weaknesses that permeate the nursing relationship, by pointing them more frequently than the strengths. The work conditions have signaled a failing situation, which is evidenced by the constant improvisation process before the lack of human and material resources, low wages, deficit in recognizing the nursing worker, and physical and emotional wear, by creating a professional exhaustion. The devaluation of the worker also became a strong factor for this study, because it was characterized a reason of job dissatisfaction, due to the lack of valuation policies, which should be prepared by the institution or, even, they are unknown by the worker itself. The worker participation in the design of these policies has emerged as a relevant factor. The poor work conditions lead the worker to a process of professional demotivation and dissatisfaction, by causing the feeling of devaluation within its work environment. Hence, it was found in this research that the lack of communication leads to situations of inadequate interpersonal relationships, which are creators of an unsuitable environment for the performance of the nursing team

Compreensão do típico ideal de técnicos de enfermagem acerca da sistematização da assistência de enfermagem

This study aimed to understand the typical ideal of the nursing technician about the systematization of nursing care in the light of the theoretical framework of Alfred Schutz. It is a comprehensive phenomenological research, using the theoretical framework of Alfred Schutz. For the unveiling of the phenomenon (the typical ideal of the nursing technician about the systematization of nursing care), the search process was configured from the proposed guiding principles for a research methodology based on the work itself of Schutz held by Zeferino (2010) in his PhD. For data collection, we used the focus group technique, counting on the collaboration of thirteen practical nurses working in a university hospital in Rio Grande do Norte, who responded positively to the inclusion criteria: working in the study hospital, performing care direct to patients. Forty-four subjects showed interest in participating, being held a draw for selection of the research sample, consisting of 14 professionals, one of whom did not attend the gathering of data collection. The focus group, entitled "What I think about the systematization of nursing care", took place on February 15th, 2013, totaling 101 minutes. It was performed according to the Experiential Education Humanescent using building posters as projective technique, from the key question: "What is the systematization of nursing care for you?". In order to understand some of the biographical situation of the participants, a questionnaire was administered to study participants. From the agreement of the subjects, the focus group was recorded and photographed with the cooperation of one reporter and two other employees. We used Microsoft Word 2010 to perform the transcript of the meeting and Microsoft Excel 2010 for synthesizing the results via a spreadsheet. The study followed the ethical and legal principles that govern scientific research on humans, recommended in Resolution nº 196/96, it was approved by Opinion Embodied Ethics Committee in Research of UFRN (Federal University of Rio Grande do Norte), nº 98 424, of August 31th, 2012, CAAE No. 05906912.0.0000.5537. The analysis of the nursing staff speeches, along with the contemplation of their posters and their written descriptions, allowed from the guiding principles of Zeferino (2010), in light of the reference of Alfred Schutz, unveiling the typical ideal of nursing technicians about the systematization of nursing care, passing four themes: typing of the concept of systematization of nursing care; benefits, which resulted in the reasons to believe in the positivity of this working tool; experienced problems, revealing the world of everyday life of nursing professionals, and possibilities for improvement. It was concluded that the nursing technicians are unaware of the systematization of nursing care. However, they typify a very positive perception about the same, especially with regard to improvements that may foster care

A intenção e o gesto :ações gerenciais de enfermeiros em espaços hospitalares

The present study analyses the supervisory practice of the nurse in the hospital environment. It has, as its main objective identify the use of planning, supervision and evaluation, as managerial instruments in the daily nursing practice. It tries also to identify the importance given to these instruments in their supervisory actions and the difficulties encountered in their use. It deals with an exploratory and analytical investigation with a qualitative approach having as its main point of analysis the principles of strategic planning. In order for it to be done 10 nurses were interviewed, distributed in three public hospitals in the city of Natal/RN. The results show that, although the nurses recognize the importance of the managerial instruments, they do not put them into practice in an effective and systematic way. They justify it because of the existence of personal, professional and institutional difficulties. On the other hand we could conclude from what they say that there is the desire to overcome the eminently burocratic vision of the management. Thus, they express a feeling for change and point in the direction of looking for ways that will contribute to innovate this practice

Trajetória de vida de mulheres mastectomizadas integrantes de um grupo de auto ajuda a luz da História Oral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Conquistas e desafios do processo de trabalho de enfermagem: o caso dos CAPS em Natal/RN

The Brazilian Psychiatric Reform proposes creating linkages / interactions of the mentally ill with civil society , through promoting citizenship and assistance to the mentally ill. The deinstitutionalization of mental health advocates from the guidelines decreased supply of hospital beds and consequently the creation of substitute services for psychosocial care, especially with regard to therapeutic practices emancipatory. From this scenario, the present study aims to investigate the relevance and challenges of the process of nursing work in CAPS III in Natal / RN. It is descriptive research with a qualitative and exploratory. The subjects are employees of the nursing team in CAPS III East of Natal / RN. This service has actions for the psychosocial care of the subjects treated with daily multidisciplinary care by behaving the length of treatment and follow-up activities, industrial and cultural activities. Employ the semi-structured interview as a tool for data collection. The data analysis was done by means of thematic analysis proposed by Bardin. Thus, this sought to bring to the discussion of how this process is consolidated in the daily service. Thus, purposed to contribute to the debate on deinstitutionalization in psychosocial care as a guideline in the process of mental health nursing work in a CAPSIII, Natal / RN

A formação de conceitos no ensino de graduação em enfermagem à luz da teoria da aprendizagem significativa

The Theory of Meaningful Learning (TML) described by David Paul Ausubel offers a proposal for the teaching strategies to provide a more active and effective student learning. The projection of the TML practice is demonstrated through the development of concept maps (CM) technique, created by Joseph Donald Novak, which presents as a strategy, method or schematic feature, which is an indicator to identify the cognitive organization of the knowledge acquired by students. The survey was conducted in the light of TML in relation to learning concepts involving students of undergraduate nursing in a public university in the state of Rio Grande do Norte. Thus, the study aimed to compare the concept learning of students of undergraduate nursing, when subjected to different forms of education, to point approaches that promote more effective and meaningful results. It was a quasi - experimental study with a qualitative analysis, conducted with students of the Undergraduate Nursing of the Universidade Federal do Rio Grande do Norte (UFRN), approved by the Research Ethics Committee/UFRN Certification of Presention for Ethics Appreciation (CPEA) in 11706412.3.0000.5537. The study took place at two different times and involved content on complications mediate postoperative surgical wound in the same discipline with students who attended the 5th semester of the degree course in Nursing. For the viability of data collection, in the second half of 2013, we used the technique of CM, to represent the concept of complications mediate postoperative surgical wound covered in the classroom. CM were built at a different time from that of the discipline, with the support of tutors and preceded by a brief description and explanation about the form of preparation and application. In this study were subjected, 31 students of undergraduate nursing, registered in the discipline of Integral Attention to health I. In the first stage, 18 students participated in the survey, they had the teaching intervention based on TML, and in the second stage, all students participated in the lesson provided curriculum with the responsible teacher of the subject, on the same issue occurred. At the end of each meeting, the students 11 developed concept maps with the aid of software Cmap Tools®. Data analysis happened upon the technique of content analysis, supported by a conceptual map "glass", previously developed by researchers and aid in the preparation of the categories in which the concepts found were classified. The study found that the teaching intervention based on TML with the help of CM, managed to develop in students a more expressive teaching learning process than just classroom curriculum with the traditional teaching method, and also that the association between the intervention motion teaching with the traditional method and the use of the technique of CM encourages the student the ability to articulate the various acquired knowledge as well as apply them in real situations

Trajetória de mulheres e a participação masculina no processo de aborto provocado

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Acurácia dos indicadores clínicos do diagnóstico de enfermagem volume de líquidos excessivo em pacientes submetidos à hemodiálise

Trasnversal study, with the objective of evaluating the accuracy of clinical indicators of nursing diagnosis excessive fluid volume in patients undergoing hemodialysis. The study occurred in two stages, the first consisted of the evaluation of the diagnostic indicators in study; and the second, the diagnostic inference conducted by nurse diagnosticians. The first stage occurred from december 2012 to april 2013, in a University Hospital and a Hemodialysis Clinic in Northeastern of Brazil, with a sample of 100 chronic renal failure patients on hemodialysis. The data were selected through an interview form and a physical examination, organized into spreadsheets and analyzed as to the presence or absence of the indicators of diagnosis excessive fluid volume. In the second step, the spreadsheets were sent to three nurses diagnosticians, who judged the presence or absence of diagnosis in the clientele searched. This step was conducted from july to september 2013. For analysis of the data, we used descriptive and inferential statistics. In the descriptive analysis, we used measures of central tendency and dispersion. In inferential analysis, we used the tests Chi- square, Fisher and prevalence ratios. The accuracy of the clinical indicators pertaining to the diagnosis were measured as to the specificity, sensitivity, predictive values, likelihood ratios and Diagnostic Odds Ratio. Also developed a logistic regression. The results were organized in tables and discussed with literature. This study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, with Presentation Certificate for Ethics Appreciation nº 08696212.7.0000.5537. The results revealed that the diagnosis studied was present in 82% of patients. The characteristics with prevalence above 50 % that stood out were: azotemia, decreased hematocrit, electrolyte imbalance, intake exceeds output, anxiety, edema, decreased hemoglobin, oliguria and blood pressure changes. Eight defining characteristics were presented statistically significant association with the nursing diagnosis investigated: pulmonary congestion, intake exceeds output, electrolytes imbalance, jugular vein distension, edema, weight gain over short period of time, agitation and adventitious breath sounds. Among these, the 10 characteristics which showed higher prevalence ratios were: edema and weight gain over short period of time. The features with the highest sensitivity were edema, electrolytes imbalance and intake exceeds output and the standing out with greater specificity were: anasarca, weight gain over short period of time, change in respiratory pattern, adventitious breath sounds, pulmonary congestion, agitation and jugular vein distension. The indicators jugular vein distension, electrolytes imbalance, intake exceeds output, increased central venous pressure and edema, together, were identified in the logistic regression model as the most significant predictors. It is concluded that the identification of accurate clinical indicators allow a good prediction of the nursing diagnosis of excessive fluid volume in patients undergoing hemodialysis in order to assist the nurse in the inference process, which will contribute to the success of patient care. In addition, nurses will consider for diagnostic inference not only his clinical experience, but also scientific evidence of the occurrence of excessive fluid volume, contributing to the control of volemia in these patients

Assistência de enfermagem às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência em Mossoró-RN

This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice

O ensino de enfermagem gerontológica na formação do enfermeiro

At the current time of demographic changes in the world , it is observed that the health sector requires restructuring of its practices in caring for the elderly , in order to enable a comprehensive and humane care . In this sense, we identify the need for qualified professionals to assist the elderly and, therefore , it is important that training curricula are adequate to this reality . The study aims to analyze how it develops teaching gerontological nursing component in undergraduate nursing . This is a descriptive , exploratory study with a qualitative approach, in two higher education institutions in the city of Natal / RN . The population involved corresponded to the coordinators of graduate courses in nursing and teachers who teach content of health care for the elderly, a total of seven participants . The data collection instruments were used: a questionnaire containing questions related to the characterization of the participants and the teaching of gerontological nursing in undergraduate courses in nursing and a form with items of analysis for pedagogical projects . The results were presented descriptively in tables and analyzed from coming themes of the main themes of the instruments defined in: knowledge about the research participants , knowledge of teaching gerontological nursing component and knowledge of pedagogical projects , discussed under Resolution paragraph . 03 of 7/11/2001 , which establishes standards for the nursing program , the educational projects of educational institutions , the Theoretical Donald Shoon and thematically relevant literature . The results indicate that the majority of participants were female (four), all have graduate though , none of them stated in the qualification of aging or elderly health area; the organization of the contents of the component in the curriculum, workload theoretical- methodological and practical teaching strategies presented was heterogeneous and sometimes diverging at the same institution . On the definition of gerontological nursing component was identified that is not well defined along the pedagogical design of educational institutions surveyed . It was concluded that in the context of this study , teaching gerontological nursing is present in the course of nursing education, but needs reevaluation and updating in order to teach a wider range of driving and health practices