O concreto e o simbólico no cotidiano da educação em saúde: práticas, representações e processo identitário dos agentes comunitários de saúde de João Pessoa PB

The present study is about an etnographic research based on the Theory of Social Representation and its complementary approach, the Theory of Central Core based on the bourdiesianos concepts of field and habitus , concerning that these concepts, articulated to the constructed social representation, may contribute to the study of social identities. Its aim is to acknowledge which identity references community health agents (CHA), agents from Community Health Agent Program (CHAP) and Family Health Program (FHP) from João Pessoa PB and which social representation is constructed by them towards health education. The study had the participation of 119 CHAs, from which 90,3 % were female and 9,7% were male. Since the identity is also built by the representation of others towards the group, 63 professionals of the FHP group (16 nurses, 16 nursing assistents, 12 doctors, 9 dentists, 6 dentistry office assistents, 4 coordinators, 1 psicologist and 1 receptionist) and 1 nurse from CHAP took part of the study, oficial documents from the Health Ministry were analyzed, verbal information from its representatives were also taken into consideration, as well as reports from the many benefitiaries of the CHA, CHAP and FHP. For data collecting, we used the combination of (a) Direct Observation and Participant Observation of the functioning micro-areas of the CHA at the Family Health Units, and the Union of the Agents; (b) Free-Association of words and expressions to stimulate the CHA , Health Education and Health ; (c) Questionnaire; (d) Interviews. The interviews were submitted to a thematic analysis of its topic. The free-association was analyzed taking in consideration the vèrgesiana proposal (a combination of the frequency and average order of evocation) which treatment enabled the identification of the central and peripheral systems of social representation towards health education and the community health agent. A test of central refutation, associated to the analysis of the indicated evocations as the most important, provided empirical evidence of social representation towards health education as orientation , prevention and hygiene , as well as the identity of CHA as supervisor , friend , help , important , and the link between the community and the Family Health Staff. Other professionals from CHAP, FHP and the Health Ministry share all of these representational contents, especially the concepts of friend and link , also shared by the community. A habitus towards the community health agents was identified, as a representation based on trust and friendship, which gives the professional a great importance towards the daily inconsistencies faced by the community

Dificuldades e/ou facilidades vivenciadas pelos profissionais que compõem a Estratégia de Saúde da Família

Descriptive and quantitative study, with the objective of review the positive and negative aspects experienced by professionals working in the Family Health Strategy (ESF) of Ceará-Mirim town, at Rio Grande do Norte state. The population included 190 healthcare professionals that integrate the family healthcare staff and the data-collection occurred in a meeting at their workplace, with the implementation of a questionnaire. Results were organized in Microsoft Excel spreadsheet software, with descriptive statistical analysis in tables, graphs and tables through frequencies, averages values and standard deviations. There is a predominance of females (n = 137) and higher rates in almost all professions, and higher average age (38.9%, SD = 7.8) and income wage (average = 10) in the medical category. Regarding the more developed activities, for physicians and nurses are the healthcare actions in the Unit, the oral hygiene for dentists, the immunization for auxiliary nurses (Aux-N), educational meeting for the dental office assistants (ACD), and home visitations to community-based health workers (ACS). About the easiness of work, 93.2% said to be presence of professionals with a personal profile in public healthcare; about the difficulties, 86.8% of professionals cited the unavailability of material, followed by salary range reported by nurses (80.9% ), dentists (80.0%), physicians (73.3%), ACS (83.1%), and Aux-N (90.5%). In relation to working conditions, the unavailability of materials was the most mentioned, with the exception of dentists who reported improvement in wages. We still identify among these difficulties: the drugs availability regarded as first grade obstacle by ACS and physicians, the type of contracts in second grade cited by the ACD and dentists and, in third grade, the salary range cited by dentists and auxiliary nurses. It is concluded that the difficulties and easiness faced by ESF professionals are divergent among themselves. For physicians and nurses, whose healthcare actions become directed to specific groups, the individual and the family, their difficulties relate to the unavailability of materials. For dentists, whose actions more quoted were topical application of fluoride and supervised toothbrush, their greatest difficulty is the salary range. As to the Aux-N, ACD and ACS, for all of them the unavailability of materials has hindered the implementation of their activities in ESF

Infecção do trato urinário associada à sondagem vesical numa unidade de terapia intensiva

A descriptive, quantitative approach and non-participant observation study, which was aimed at analyzing the association between knowledge and practice of inclusion and maintenance of urinary catheter by nursing professionals in the occurrence of urinary tract infection, performed in the ICU of Onofre Lopes University Hospital in Natal / RN. The original sample was composed of 42 nursing staff professional, five (5) nurses and 37 nursing technicians, 27 of them were outsourced (FUNPEC and IEL fellows) and 10 servers UFRN. Data collection was performed using two instruments, the first observation procedures used in the insertion and manipulation of indwelling urinary catheter (IUC) and the second with a questionnaire that addressed the characterization data of respondents, knowledge and conduct the insertion and manipulation of the IUC. The results were tabulated in Microsoft Excel and analyzed using SPSS software, version 15.0. We found the prevalence of institutional staff members on outsourcing - IEL and FUNPEC - (64.3%) were female (69.0%), aged 21 to 35 years (59.5%) and with mid-level education (88.1%). As to knowledge, we found that the nurses had levels of good to excellent and the nursing technicians, to regulate the poor. The nurses made a mistake when choosing IUC (40.0%) and washing hands (30.0%) and technicians on hand washing (74.4%) and the contents of the tray (34.7%). In relation to the conduct of insertion of IUC, the nurses made a mistake when choosing SVD (66.7%) and washing hands (57.1%). Regarding the handling of IUC/drainage system, the technicians were wrong more about washing their hands (56.0%). Analyzing the misconduct to the categorization of knowledge, we saw that the nursing staff who had missed more had inadequate knowledge (ρ = 0.001). At the end we found the risk of a patient to acquire UTI is higher in two and a half times when there is a large number of mismatches, patient spends more time using the IUC and hospitalized in the ICU. As regards the study hypotheses, we accept the alternative hypothesis and reject the null hypothesis proposed at the start of this research, where the number of gaps in knowledge and behavior increases the incidence of urinary tract infection.

Prática do acolhimento à pessoa idosa na atenção básica: uma estratégia de humanização

The aging of the population already is a fact, before considered a phenomenon, today, is part of the reality of the majority of the societies in the world. The present study it has as objective to analyze the practical one of the shelter developed for the team to multidiscipline for the elderly in the Strategy of Health of the Family. One is about a descriptive and exploratória inquiry, developed by means of quantitative boarding. The population of this study consisted of nineteen teams that work in the inserted ESF in the urban zone of the city of Sousa-PB, understanding a complete of 133 professionals. The collection of date was carried through through a questionnaire contends closed questions, referring to the partner-demographic date e, specific open questions. The main results indicate that the professionals of Health of the city of Sousa, PB, that had participated of this study had consisted in a complete of 76. Amongst these, 20% are nurses, followed of the odontólogos in 6%; 35% are ACS and technician of nursing with 19%. The age of the interviewed ones meets in the age band enters, 21 and 30 years, in 43%. The majority is of the feminine sex with a 84% total. Already in accordance with civil state 34% is married. If treating to the wage, the doctor has of greater of 12 wages. The participants present the percentile greater of formed time of with referring 33% of 1 the 3 years of formation. E finally, the changeable time of performance, if had detached 39% of the participants with 08 the 11 years. With regard to as if it processes the reception and attendance to the person in the ESF, we can observe that, with priority attendance was prominence with 27% of the participants, followed of a considerate attendance with 26%. Already in relation to the actions that are developed daily in the ESF, these they are come back toward the HIPERDIA with 40%, followed of actions ruled in orientation with 27%. Some actions they are carried through in accordance with the aged necessity of each (13%) and through visits domiciliary (9%). It was asked to them as the shelter was facilitated in the UBS, these had told that it is through the attention that is excused the aged one (35%), and finally, as this made it difficult age, in its majority with 37% they had not wanted to answer, followed of the lack of understanding with 26%. With this study it was possible to conclude that the practical one developed for the professionals of the ESF of the city of Sousa, PB with the elderly, is characterized by an assistance ruled in the clinical aspect, little focused in the actions that to permeate the PNH

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

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

A busca de sintomáticos respiratórios de tuberculose na prática e perspectiva do agente comunitário de saúde nos distritos sanitários de Natal

The objective of this work - which is characterized analyze the search for symptomatic tuberculosis in practice and perspective of the Community Health Agent (ACS) in the districts of Natal. Methods: This is a cross-sectional study. The study population was 646 professionals, and conducted a probabilistic random sampling, stratified by districts. The data were collected from one instrument to collect data based on Primary Care Assesment Toll (PCAT) and analyzed by descriptive statistics. The sample consisted of ACS was 87% female. Among the study participants 58% completed high school and 120 months of exercise training (95% CI 111.9 to 129.5) on average. 90% were USF. The average follow-up of cases found were 2 cases of TB since the beginning of the career of the ACS and the last three years the average is presented in a case accompanied. The ACS received satisfactory ratings on the bond of trust with the user, so as access to homes in the community. The ACS reported for denying the fear of being positive result was the biggest reason for not performing the sputum. All units have a professional that responds to the Tuberculosis Control Program. Regarding the structural capacity of primary care settings for the diagnosis of TB, we observed satisfactory levels in different districts of pots for sputum collection, however, a point that deserves attention from managers is lack of materials for packaging sputum. Fear of positive result was one of the reasons for the refusal of sputum collection, followed by alcoholism. With regard to TB suspects, all responded that ACS always suspect when the user has TB coughs, but in all districts were noticed at low delivery of requests for applications for smear. BSR in TB control, is characterized in practice as a complex action goes beyond technical expertise and contact with the family that breaks with the Cartesian. The BSR is part of the ACS can perform them from the daily visits. We conclude that the ACS is difficult to achieve. This practice should not be the privilege of this actor, but the entire team of primary care. We must rethink the practices of TB care, seeing the health surveillance while aegis of the working process of primary care teams for early diagnosis and thereby reduce TB in communities

Educação em saúde em hanseníase: estratégia na educação básica, Parnamirim/RN

Leprosy is an ancient disease that still stands as a public health problem worldwide, especially in the considered developing countries. Of these, Brazil still has large areas of endemicity. The disease remains high among those younger than 15 years old. In this group, the national index achieves 0.6 every 10 000 inhabitants and reaches 2 in the North and Midwest of Brazil. Therefore, the plan of the Ministry of Health is to prioritize the fight against disease in critical areas, providing early diagnosis and timely treatment, especially for patients under 15 years old. This research aimed to: identify the knowledge of students from three schools of basic education in Parnamirim/RN about the risk of getting ill in leprosy; conduct them health education on this topic. An exploratory-descriptive study with quantitative and qualitative nature. Data collection consists of two steps: questionnaire and health education on leprosy. The study was approved by the Research Ethics Committee (REC) of UFRN through the opinion nº 204/2009. Quantitative data obtained were organized, categorized, typed and submitted to the Microsoft Office - Excel for quantitative analysis with simple percentage. Qualitative data were subjected to a content analysis according to Bardin. The sample consisted of 164 students of basic education, most of which is: 1st year of high school, from 11 to 15 years, in the afternoon shift, female gender, skin color white and residents in the municipality of Parnamirim/RN. Still, each student living with four people curiously did not respond in relation to occupation of the father. But the same answered their mother as a housewife and a family income of one to less than four minimum wages. There have been significant results compared the performance of health education in leprosy. Initially, students possessed little knowledge about leprosy. Subsequent to health education, most knew the answer about the disease, transmission, cause, where to get help in case of suspicion of leprosy and the need for the people who lives with leprosy patients to also seek for help, the understanding about if it is treatable or not. Content analysis has established the following themes: axis I, what I do not know about leprosy: cure, fear and prejudice. Axis II, what I know about leprosy, we identified: cure, effectiveness of health education and social exclusion in the past. It is considered the scope of the proposed objectives by matching the effectiveness of health education on leprosy in basic education in Parnamirim/RN; emphasizes, therefore, the importance of understanding the knowledge of public school students. It is expected of them to detect early cases of leprosy in their communities; encourage adherence to treatment as quickly as possible; prevent disability; reduce the stigma surrounding the disease.

Entre o sol e a liberdade impera a violência: formação de redes para a ação a partir da estratégia saúde da família

The research aimed to analyze the feasibility of forming a network of municipal services to prevent and treat child victims of violence from the Basic Health Units in the Family Mossoró / RN. The research is a qualitative approach and was developed in the form of action research. The population was composed of representatives of institutions of the child and primary care professionals. Data were collected through questionnaires, workshops and semi-structured interview. The results were analyzed from data collected through the questionnaire designed to assess the material, lectures, dialogues and assessments with the team and presented in accordance with the findings of the research. The study was approved by the Ethics in Research UFRN with protocol No. 158/2010, CAAE: 0176.0.051.000-10. Situational diagnosis in the participants answered a questionnaire to characterize and then launched the guiding question of the focus group FHS While professional what your perception towards violence against children? It was felt the fear and ignorance on the part of the unit staff on how to prevent and to refer cases of violence against children and adolescents in the area of coverage of the unit and also realized that the professionals felt victims of occupational violence before the violence has reached proportions that the area of the unit. Mind the need to change strategies to work to combat violence, we plan to conduct focus group workshop to complete the questionnaire, training for protection against occupational violence, and meeting with other bodies responsible visor protecting children and adolescents to draw the flowchart of the victims in safety net. The next moment training to fill the notification form professionals were interested in learning and use this tool to combat violence. At the third meeting in Unity, meeting with representatives of the Child Protection Council, the professional unit showed interest in interacting with the agency to expose and combat violence against children and adolescents. Due to difficulties in the physical structure of the unit was not possible to continue the research and planned every moment, and then completed the data collection with interviews with the participating professionals, to assess the meetings. Therefore, it is considered that action research has also achieved its goals because the team was involved in the collective construction of a proposed change in the practices of referral and prevention of violence against children and adolescents. This involvement was favored using the principles Freirian during the course of the study. However, it is assumed that the network was not fully implemented because it is known that it is in a continual process of improvement and must continue evolving with the unit team.

Redução de danos e o saber-fazer de profissionais de um CAPS ad em Natal-RN

The present study had as a main objective to analyze how the professionals at a CAPS ad unit in Natal-RN conceive the knowledge-practice process with regard to the Harm Reduction Policy (HRP) towards alcohol and other drugs. For the accomplishment of this proposal, it was intended: 1) Verifying the possibilities and limits of the HRP implementation at a CAPS ad unit in Natal-RN; 2) Relating the professionals knowledge at a CAPS ad unit in Natal in regard to the Harm Reduction Policy; 3) Enumerating the HRP programmatic actions at the institution. The research had exploratory, descriptive and qualitative approach aspects, guided by the concepts of biopower and self care proposed by Michel Foucault. Data collection occurred in June and July 2011, in which the focal group technique was used. After that, collect field material was analyzed through the content analysis method proposed by Minayo. The results showed some conceptual and practical approach between the harm reduction strategy and the knowledge-practice of the professionals at this CAPS ad unit. The discursive models about drug usage, especially the moral-legal model, still have a significant role in the daily lives of these professionals, being amplified by some demands of their jobs or even through the instituted discourse. The individuals recognize the need for less prohibited practices and more socializing ones, identifying them with the Harm Reduction (HR) logic, when there is a coherent and well-founded understanding about HR among the professionals. Distorted and reductionist views about HR as considering the simple instrumental function of this strategy (distribution of basic supplies) among the professionals, represent one of the main barriers for its implementation. There are few programmatic activities that are related to the RD strategy at this CAPS ad unit which makes a more effective appropriation by the working team difficult to reach. The working processes and the postures adopted by this CAP ad unit professionals have been showing that many of their practices and conceptions were modified to the detriment of new necessities emerged from the demands. Consequently, the self care notion is revealed which brings the need for the valorization of these care agents roles, that is, their collective and individual contribution.

Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

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

Qualidade da assistência e o conhecimento sobre o direito à saúde das pessoas com úlcera venosa crônica

The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE nº 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury

Fatores associados à efetividade da doação de órgãos e tecidos para transplantes

The transplantation of organs and tissues presents itself as an important therapeutic option, both from a medical standpoint, the social or economic. Thus, the identification of variables that can interfere in the effectiveness of organs and tissues donation for transplantation needs to be investigated adequately, because it stands before increasing index of chronic and degenerative diseases in the population, what makes the waiting list for transplantation grow disproportionately and patients come to death without the opportunity of realization the treatment due to a lack of donors. In this context, has defined as objective of this study evaluate the factors associated with the effectiveness of organs and tissues donation for transplantation. It is a evaluative research, quantitative, prospective, with longitudinal design, developed at Central of Catchment, Notification and organ donation for transplant, Organ Procurement Organization and in six accredited hospitals to collect and transplantation of organs and tissues, in Natal/RN, between august 2010 and february 2011, after the approval of the Research Ethics Committee, under No. 414/10 and CAAE 007.0.294.000-10. The probabilistic sample without replacement was composed of 65 potential donors. It was used as an instrument of data collection a structured script non-participant observation of checklist type. Data were analyzed using descriptive statistics and presented in tables, charts, graphs and figures. For this, was used Microsoft Excel 2007 and statistical program SPSS version 20.0. To check the level of significance was chosen by applying the chi-square test (χ2) and Mann Whitney and caselas for less than five, it is considered the Fisher exact test. It was adopted as the significance level p-value <0.05. Among the surveyed it was observed that most of the individuals were male (50,8%), in the age group 45 years (53,8%), mean age of 42,3 years, minimum 5 and maximum 73 years (± 17,32 years). Single / widowers / divorced (56,9%), with up to completed elementary school (60,0%) in the exercise of professional activity (86,2%), catholic (83,1%) and residents in metropolitan region of Natal (52,3%). Was obtained donation effectiveness of 27,7%. There was no statistical significance between structure and effectiveness of the donation, but were observed inadequacies in physical resources (36,9%), materials (30,8%), organizational structure (29,2%) and human resources (18,5%). In the process, the maintenance phase (p= 0.004), diagnosis of brain death (p= 0.032), family interview (p≤ 0.001) and documentation (p= 0.001) presented statistical significance with effectiveness. Thus, it is accepts the alternative hypothesis of the study, in which is evidenced that the adequacy of the factors related to structure and process is associated to effectiveness of organs and tissues donation for transplantation. In this way, the effectiveness of organ and tissue donation ends in an essential way the rapidity and accuracy with which the donation process is conducted, requiring appropriate structure, with appropriate physical and material resources and skilled human resources to optimize the reduction of time and the suffering of those waiting for an organ or tissue transplant queued in Brazil

O trabalho do enfermeiro de um hospital pediátrico de ensino e o SUS: desafios a enfrentar

This study analyzes the point of view of nurses working at a pediatric teaching hospital on their work process within the scope of the Brazilian unified healthcare system SUS, in order to identify factors that interfere with its development and find out how work relations are taking place between nurses, other nursing professionals and the multidisciplinary staff. It is a descriptive and analytical study, qualitative in nature, which starts with a consideration of a nurse s current practices and moves on to reflect on a perspective of transformation aiming at rethinking their work process pursuant to the principles of SUS. In order to attain these objectives, we decided on using the focal group as a data-collecting technique, which took place from November to December 2005, by using as instruments a questionnaire for the characterization of the persons being researched and a discussion outline. Theoretical support has approached transformations in the world of work, placing it in the context of healthcare and nursing and has tried, specifically, to understand the work process of a nurse engaged in the production of health services. Therefore, the discourse analysis of participants, in the light of theoretical support, has evinced an ambiguity inasmuch as though identified as such in their work process, nurses are also fulfilling multiple functions in health services. Through this study it has also been possible to identify several factors that interfere with the work of these professionals, including poor working conditions and excessive hiring of high school graduate interns as an attempt to make up for a meager nursing workforce, as well as reveal the possibilities brought about by the SUS in retargeting its professional practice to interdisciplinarity and integrality

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