A satisfação dos clientes internos e o comprometimento organizacional: um estudo à luz do modelo ASH nas indústrias alimentícias no RN

Currently the organizations are passing for continuous cycles of changes due to necessity of survival in the work market. The administration of the future points a way to the organizations of today and tomorrow, the search of the competitiveness from loyalty and motivation of its staff. Of this form, the model of the Auditoria do Sistema Humano (ASH), developed for Spanish researchers and that now it is being applied in Brazil, contemplates a series of dimensions about Human Resources management quality in the companies and the organizational effectiveness, such as the environment where the company is inserted, the strategies, the organizational drawing, the psychological and psychosocial processes, e the reached results. In this direction, the present research analyzed the factors of job satisfaction and organizational commitment, making, also, a relation of causality between the same ones. The quantitative-descriptive research had as population the employees of twenty three nourishing industries of the State of Rio Grande do Norte (Brazil), registered in the Federacy of the Industries of the state. The collection of the data occurred for the months of October of 2005 and March of 2006, by means of the application of questionnaire of model ASH. The sample was composed for 197 employees, however it was observed presence of five outliers, that they had been excluded from the analysis of the data. To extract the dimensions of the satisfaction and the commitment and identification the factorial analysis was used, with extraction method of principal components, rotation Varimax and normalization Kaiser. The gotten dimensions had been evaluated with the calculation of the coefficient Alpha of Cronbach. The factorial analysis of the pointers of the organizational commitment and identification had extracted ten factors. Of these, four had gotten significance of the analyses inside: affective commitment, values commitment, continuance commitment and necessity commitment. The result of the analysis of the pointers of job satisfaction indicated four factors: extrinsic, motivations, relation with the friends and auto-accomplishment. To deal with the data the relation between job satisfaction and organizational commitment it was used technique of multiple regression. The correlation between commitment and satisfaction was satisfactory, detaching the affective commitment with bigger index of correlation, followed of the affective one

Avaliação das pressões respiratórias máximas em crianças e adolescentes da grande Natal: elaboração de uma equação preditiva

The human respiratory system was so designed that would allow efficient ventilation, regardless of variations in the external environment that may hinder the act of breathing, such an act involves dozens of variables, among them we find the respiratory depression, which is nothing more than respiratory muscle strength. The pressures are widely used in several cases: Neuro-muscular; evolution of pulmonary dysfunction and a predictor for discontinuation of mechanical ventilation. Therefore it was proposed to carry out evaluations of these respiratory pressures for children and adolescents aged 10 to 16 years and propose a predictive equation that involves the anthropometric variables age (A, years), body mass (BM, kilograms) and height (H, meters) with maximal respiratory pressures (maximum inspiratory and expiratory pressure). Evaluations were performed in this age group of students in public and private schools of the Grande Natal , measurements were performed using the analogue manometer, were children and adolescents and their parents gave informed consent. 517 samples were taken, and 250 for males (M), 255 for females (F) and 12 were excluded according to our exclusion criteria. The sample was subdivided into three age groups (10-11, 12-13 and 14 to 16 years old). It was found through the student s t test (p ≤ 0.05) for all variables studied, children and male adolescents had higher means than females, except for the MC. For the correlation between the variables found significant correlation (p <0.05) among all the variables when analyzed as pairs except between MIP and height for females. The development of predictive equations (for p ≤ 0.05) based on three types of strategies adopted were restricted to two association between anthropometric variables isolated, resulting in: for males: MIP = -32.29 + (-2.11*A) + (-0.52*BM), MIP = 9.99 + (-0.36*BM) + (-49.40*H); MEP = 18.54 + 3.53*A + 0, 42*BM, MEP = -33.37 + 2.78*A + 52.18* H, MEP = -17.39 + 0.33*BM + 55.04*H; and, for females we find: MEP = 24.32 + 2.59 * A + 0.24*BM

Saúde bucal de idosos institucionalizados no Brasil

O propósito dessa investigação foi o de estudar as situações objetivas e de auto-percepção em saúde bucal de idosos residentes em Instituições de Longa Permanência de Idosos (ILPIS) distribuídos em 11 municípios pertencentes as 5 regiões geográficas do Brasil. Metodologia: Trata-se de estudo seccional através de um censo com idosos institucionalizados no Brasil. Foram avaliados 1192 indivíduos, residentes em 36 Instituições de Longa Permanência de Idosos (ILPIS), distribuídas em 11 municípios. Deste universo, 587 (49,2%) responderam ao GOHAI. Foi aplicado questionário com questões subjetivas e sobre o comportamento em saúde bucal, além de levantamento epidemiológico seguindo critérios da Organização Mundial da Saúde (OMS). Foram realizados os testes de Mann-Whitney, Kruskal-Wallis, Exato de Fisher, Qui-quadrado e Regressão logística múltipla. Resultados: A idade média foi de 74,98 (+ 9,5). Destes, 51,4% (302) eram do sexo masculino e 152 (25,9) apresentavam alguma dependência. A média do CPOD foi de 28,8 (+ 5,5) e 54,5% (320) dos idosos eram edêntulos. Constatouse que 54,2% (318) e 74,1% (435) não usam nenhum tipo de prótese superior e inferior, respectivamente. O CPI e PIP mostraram que 64,4% (378) apresentaram todos os sextantes excluídos. O GOHAI mostrou que 75% (440) dos indivíduos apresentava auto-percepção positiva em saúde bucal. As variáveis última visita ao dentista (RP ajust=4,058; IC=1,526-10,789), presença de problemas gengivais (RP ajust=5,703; IC=1,754-18,544) e opinião sobre os dentes, as gengivas ou prótese (RP ajust=19,514; IC=5,075-75,041) permaneceram significativas no modelo após regressão logística múltipla. Conclusões: Observou-se predomínio da auto-percepção positiva em saúde bucal em detrimento das precárias condições bucais. Assim, para a população institucionalizada, o presente estudo recomenda a aplicação de levantamentos epidemiológicos e de auto-percepção para assegurar adequado planejamento nas ações de saúde bucal

Emprego dos ácidos graxos de cadeia curta na colite de derivação fecal : estudo em ratos Wistar

Diversion colitis is a chronic inflammatory process affecting the dysfunctional colon, after a colostomy. It is postulated that nutritional deficiency of the colonic epithelium by the absence of short-chain fatty acids (SCFA) is one of the factors responsible for the appearance of DC and that their employment could reverse the morphological changes of the mucosa. The treatment of choice for fecal diversion colitis (DC) is the reconstruction of the intestinal tract, although they suggested therapeutic options using enemas. This study evaluates the effect of SCFA in atrophy and inflammation in excluded colonic segments before and after the installation DC. Forty Wistar rats were divided into four groups (n = 10 for each group), submitted colostomy with distal colon exclusion. Two control groups (A1 and B1) received rectally administered physiological saline, whereas two experimental groups (A2 and B2) received rectally administered short-chain fatty-acids. The A groups were prophylactically treated (5th to 40th days postoperatively), whereas the B groups were therapeutically treated (after postoperative day 40), for 07 days. Histological sections stained with HE were used for histological analysis of the thickness of the colonic mucosa excluded (t- Student p ≤0.05). Inflammatory reaction of the lamina propria and mucosa were measured with scores previously established (Mann Whitney p ≤ 0.05). There was a significant thickness recovery of the colonic mucosa in group B2 animals (p = 0.0001), which also exhibited a significant reduction in the number of eosinophilic polymorphonuclear cells in the lamina propria (p = 0.0126) and in the intestinal lumen (p = 0.0256). Group A2 did not prevent the mucosal atrophy and significant increases in the numbers of lymphocytes (p=0.0006) and 50 eosinophilic polymorphonuclear cells in the lamina propria of the mucosa (p = 0.0022). Therapeutic use of short-chain fatty-acids significantly reduced eosinophilic polymorphonuclear cell numbers in the intestinal wall and in the colonic lumen; it also reversed the atrophy of the colonic mucosa. Prophylactic use did not impede the development of mucosal atrophy

Avaliação dos efeitos da atividade física na prevenção do estresse oxidativo e do câncer de mama

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Juventude e vulnerabilidade social :no contexto intra-urbano de Natal, RN

The use of the term social vulnerability in the study of the reproduction of the social inequalities in Brazil, still, is recent. The social vulnerability is linked to the indicators of social risk. The work approaches the youth's social vulnerability and your relationship with the education, considering the youth a, among other groups socially excluded, vulnerable, in the Brazilian metropolises. It is guided by the methodological theoretical formulations on this thematic one developed by the Rede Metrópoles in the ambit of the project, " Observatory of the Metropolises: territory, social cohesion and democratic governability ( Project Millennium CNPq) and your unfoldings in the Natal group. Empirically, forehead a methodological proposal - still in construction - and it accomplishes a " pilot " study for the city of Natal with base in the data of the Census of IBGE 2000, that proposes mensurar the importance of the social characteristics of the neighborhood on the considered youths' educational acting those that are in the strip from 15 to 24 years. It considers that the youths' educational " earnings as being influenced not only for the social context of the family, also, for your space location in the city - social context of the neighborhood. With base in the results can verify that the youths of the city of Natal present situations of social vulnerability so much in the ambit of the family as expresses in the social space of the neighborhood. Such vulnerability are verified in the low educational indexes, in the high unemployment rates and in the presented social conditions of the researched areas. The youths, residents of those neighborhoods, they are considered vulnerable socially because original of a precarious source of " assets " and opportunities. There is in Natal a low " structure of assets and opportunities " - accessible to the youth

Inclusão digital: a inserção das tecnologias informacionais nas escolas públicas da RMNatal

This study aims to determine the influence of Digital Inclusion in school performance of students from public high school in the metropolitan area of Natal, through the use of computers in a pedagogical and Internet use.Throughout the paper we try to answer the question: The pedagogical use of computers connected to the Internet contributes to improving the academic performance of students in public schools in the RMNatal? To answer the research question, we focus on the database INEP on the infrastructure of schools and the bank rates of school performance. For both technical procedures performed to obtain the relationship between Internet and School Performance. Then the School Settings have been configured for Digital Inclusion and made crosses with the approval rates, distortion and failure. The survey results indicate that according to the classification established in: Included in School Settings, School Settings deficit, Adverse Environments School and School Settings Deleted, which has prevailed in the metropolitan area of Natal are the schools that are provided outside.

A reestruturação produtiva e as novas formas de organização do trabalho: a experiência do transporte alternativo no município de Belém/PA

The study made in this thesis analyzes the new form of work organization at the urban collective transportation sector, so called Altemative Transportation which is a new form of public transportation that appears in the Brazilian urban context by the mid ninety' s, this work is made by independent or sub-contracted workers, usually organized in cooperatives . It reflects the investigation of new forms of precarious work, unformal which has been expanding in the urban transportation sector. Thus, discusses non regulation of the services sector problem the ways of survival of exc1uded workers from the formal work market mainly afier the capital productive restructure. It has as privileged area of investigation, the sector policy of urban transportation that make field of the main nets of political articulations that define the dynamic of the urban space. It is known that the urban collective transportation allows the access to the production, circulation and general consumption being necessary to the mobility of the resident population, mainly to those with low purchasing capacity. It becomes a field of empirical investigation at the Belem municipal, located at the Amazonic region - north Brazil. The main points dealed on this research start from concrete relations from the daily life of workers that deve1op their activity on the altemative transport mediated with theoretical references needed for understanding and interpretation of the studied reality. The investigation strategies were built from the abstract (theorical knowledge produced for the reality analyze) in concrete by the investigation quantitative-qualitative from this area of urban policy, making up possible the formation of a references chart to the analyses of the studied subject. Rescue his historicity, from characterization of the urban space of the metropolitan region of Belem passing true the forms of organization and urban services performances while essential production and reproduction element of the social relations. Identifies the main individuals that historically have been participating in the construction of the municipality transport policy and the ways of expression of the local political strength relations. Outstand the State paper on the net of established relations near the local power, as well as outstand the importance of social sciences in the understanding of urban policies in the transportation area, trying to bring input to the academicals -scientific debate .The above e1ected and mentioned points in this study are crucial for a critical reflection of the transportation policies. That relation is not given, but historically built at the power relation chart that makes up this unique area of the urban policies

O pedagogo como agente de transformação social para além dos muros escolares

This thesis concerns the problem about the pedagogue actuation in the social education into no scholars places. It search to understand the context and the social pedagogue role to his praxis and formation that enlarger the possibilities of the social educative practices into no scholars places. In this direction, we developed an investigation about the actuation of the pedagogues-educators in Natal city, in the 2007-2010 periods, into Municipal Secretary of the Labor and Social Assistance (SEMTAS). Considering that pedagogues are regularly attached in social educators profession as municipals public employees, we re the objective to evaluate their role into the social executed in the no scholars places, with the focus in the environmental dimensions of theirs work s places, pedagogical organization, institutional management and the professional formation. It privileged in this research the Specialized Reference Center of Social Assistance II (CREAS II), the Passages Houses I, II and III, the Social-Educative Measures in Open Environment Execution Program of Natal city (PENSEMA) and the Pitimbú Educational Center (CEDUC-Pitimbú). To realize this study it developed a research with qualitative nature by critic ethnography approach privileging those information collected with the social pedagogue-educators of the mentioned places. Through the methodological procedures adopted; beyond the bibliographical review we remarked the documental research, the semi-structured interview, the questionnaires-routes and the field observations. The analytical results revealed that the politics to the social education in Brazil historically came been dimensioned by the fight of social movements demanding the fundamental rights to the excluded people; that the SEMTAS politics of social education present a relative basic social protection to the excluded children and young people specially into law view; that the politics of social education in Natal city it s close of the logic of sanitarian attention about the disadvantaged groups; that the conceptual, methodological and formatives fragilities needs to the social pedagogues-educators praxis into non scholars places made difficult the operation capacity of a educative proposition anchored in a institutional action guided by the idea of emancipator education; that the SEMTAS take face several difficulties to developed a web assistance as preview in the reception proposition elaborated by the social pedagogues-educators. However in despite the tensions we remarked the value of this potentiality to the non scholar social education in her attempt to constitute herself in a legitimate space to the pedagogue professional actuation. In despite the obstacles to work and formation quotidian, across those non scholar spaces in the municipalities institutes to the social politics, it demonstrated personal sensibility and professional creativity in learning mediations and educative action to the children and younger derived from exclusion process and the social iniquities

Navegando nas ondas dos saberes do ser: uma conversa com a sexualidade à luz da corporeidade.

This study aimed to provide a continuing education towards raising teachers for reflection and effective sexual education within the school environment as a possible route of self-education and training of teachers of elementary school. More specifically aim to facilitate through the Continuing Education to discuss the knowledge of the body and knowledge of human sexuality, presenting them as core knowledge in the integral formation of individuals and promote discussion of a Human-centered education Teaching in a vocational training and human .In this sense, we dialogue with the human teaching preconized by Arroyo (2002, 2004) along with the humanization (hominization) of the individuals through education, under Freire´s perspective of the being more (2003) as well as his ideas, Pineau´s (2003) and Josso´s (2004) about the educational practice understanding as a way to build up the autonomy of the individuals who we intend to educate. We defend the inclusion of the body as an essential learning element according to the principles of corporeity presented by Assman (2001), whose comprehension is that every learning experience has a corporal inscription. Furthermore, the knowledge about human sexuality cannot be excluded from this process since the sexuality is inherent of individuals and is constructed and reconstructed during their existence. Our view of the world and of man is supported by the knowledge of the complexity (Morim, 2004) trying to surpass the mechanist view that sees them through the duality view, fragmenting them. For the discussion and construction of knowledge that search for the confluence of these knowledges about the being and the educational practice, aiming at the individual integral formation starting from the process of self-formation/self-knowledge, we´ve directed our research-action-formation having as compass the theoretical-methodological postulate of the research-action (Barbier, 2002; Morin, 2004; Thiollent, 2004) because it makes the participation of all the involved people in the process of resolution or surpassing of problem solving possible. We´ve used the continuing formation as a way of access for data collection, applying a questionnaire with open questions for the ones involved in the research. Based on the findings it´s been possible to infer that for the teaching formation it is necessary the inclusion of the Human sexuality and corporeity theme, so that the teacher can surpass the biological view of sexuality and also the expansion of the mechanist view of the body. To do so, we suggest that the teaching formation happens supported by the teaching capacitation and formation according to Maturana (2004), bringing teaching knowledges (Tardiff, 2002), which contribute effectively for the responsibility to educate people for life.

História das mulheres idosas do Grupo Aurora da Vida Campina Grande-PB (1940-1950)

La recherche intitulée l Histoire des femmes agées du group Aurore de La Vie: Campina Grande-PB (1940-1950) a surgit comme consequence de mon observation sur les interêts de femmes en retrouner à l école aprés qu elles étaient arrivées aux soixante ans, um moment de la vie que malgré son importance est encore considerée par trop de gens comme des moments d être seul jusqu à la fin de la vie. Alors, nous avons formulé la question la plus importante de ce travail: Quel est l histoire de l éducation des femmes agées du group Aurore de La Vie, dans le période de son education d enfant? Un group de 25 femmes qui ont étudié le projet Digna, on a fait une seletion de treize agées, entre 65 et 80 ans, qui s appellent: Perpétua, Florinda, Benta, Ambrósia, Celestine, Cordélia, Circe, Filomena, Desdêmona, Dorotéia, Ofelia, Martítius e Nausica. Beaucoup d intelectuels nous ont aidé avec la base theórico-methodologique et nous ont presenté l histoire des excludées comment une histoire en construction. Parmis ces intelectuelles on rencontre Chartier, Halbwachs, Elias, Perrot, Bosi, Bezerra, Morais et Machado. Pendant notre recherche nous avons employés des narrations, des entrevues, des questions ouvertes ou les femmes puissent parler sur l histoire de leur vie. Nous avons regardé aussi le fiche des agées, le arquive de La Secretarie Municipale de Assistence Social (SEMAS) du Hôtel de Ville de Campina Grande-PB. Nous avons aussi étudié sur la legislation relié à la tematique de la Constituition Brésilienne dans l estatute et dans la Politique Nacional de l age. Notre étude nous a donné des analises sur les themas: pauvresse, travail, sourvenirs, jeux e aussi punitions scolaires. Nous sommes arrivés à la conclusion qu à l époque de son enfance, l éducation formale était déjá determinée pour le mariage, la pró-création la famille. Enfim toujours dédans de la maison excludées du reste du monde. Nous avons compris que pesquiser cet object d étude est un contribut avec l histoire des excludées en cassant le silence des femmes lesqueles on été ignorées par presque toute la prodution historiographique

Vivência do homem no puerpério

After the birth of a child, during the post-partum period, the exercise of fatherhood, the sexual relationships either marital or sexual as well as the definition of the male role are all aspects that can change. These changes are guarded and can contribute to strengthen the familiar bond or deprive it. Thus, this study aims to understand the male experience during the partner s puerperal period. In this period, the male interacts and participates according to his understanding of the post-partum period. The male experiences different situations with his partner, family and social environment. This research is descriptive-exploratory and has a qualitative approach. It was developed with 15 men that live with their live with their partners during the puerperal period. The data was collected through a semi-structured interview. These data was treated according to content analysis proposed by Bardin. These were analyzed through Symbolic Interacionism according to Blumer. Thus, three themes emergedshares of care in the home environment, meanings attributed to the puerperium, emotions emerged during the post-partum - the seven subcategories-taking care of the wife and child, supporting the family, moment to rest, fulfillment through fatherhood, sense of joy, feeling of concern and sense of exclusion. It was seen that the subjects experience post-partum mainly by taking care of their partner and child and providing support of the family. Besides the mentioned aspects, there was meaning attributed to the puerperal period, considering it a period of rest for the partner and above all, fatherhood. Thus, even understanding that it is excluded, the subjects expressed joy and worriness towards the child s future, related to the insecurity in which the country goes through in current conjuncture

Trajetória de vida de ex-portadores de hanseníase com histórico asilar

Hansen's disease, despite significant advances regarding the diagnosis, treatment and control still carries an immense burden of stigma as a result, mainly of its socio-historical marked by prejudice and isolation of patients, translated by suffering, abandonment and psychosocial problems. Thus, the study set out to rescue the life stories of former leprosy patients with a leprosarium history; recovering the life trajectory stories of these former patients and to identify common factors to these life stories. Exploratory-descriptive study with a qualitative approach, using the Life History Research Methodology. The sample was composed by twelve former leprosy patients who lived while undergone treatment in the Colony Hospital St. Francisco de Assis, located in Natal, Rio Grande do Norte. The network was composed without considering sex and age limit, patients that lived in the Colony Hospital for at least six months and who agree to participate freely in the study. The subjects with special physical needs (hearing) or mental disabilities and those who do not agree to participate were excluded. A semi-structured interview was used to data collection, the interviews were recorded in the household context of individual, residents in neighborhoods Felipe Camarão, Km 6 and Jardim America, more precisely at Nova Vida village, all located in that district. The data collected were subjected to the technique of thematic content analysis. This study had obtained an appropriate consent of the UFRN Research Ethics Committee under the protocol No. 016/2010. After extensive and careful readings of life stories we identified three themes that guided the data analysis: behavioral stages, social exclusion and, stigma and prejudice. Thus, it is clear that the practice of compulsory confinement of patients in nursing homes and the mythical image of Hansen's disease as being ugly and deformed, contributed to solidifying the historical stigma surrounding the disease and its patients, raising in society and family attitudes and feelings of exclusion, prejudice and fear. Moreover, there are remarkable stories in the lives of these interviewed reporting suffering, denials, anger that reverberate to this day, affecting negatively the social and family reintegration of these individuals. As a result, we see the need for managers and local health professionals, especially nurses, rethink existing strategies for social rehabilitation of the patient and ex-leprosy patient aiming to suppression unjust and harmful stigma rooted in image and stories of these individuals

Elaboração e validação de instrumento para consulta de enfermagem à puérpera no âmbito da atenção básica

A pesquisa teve como objetivo elaborar e validar um instrumento para sistematizar a assistência de enfermagem à puérpera no âmbito da atenção básica. O documento foi construído com base na Teoria das Necessidades Humanas Básicas de Horta, na Padronização de um Conjunto Internacional de Dados Essenciais em Enfermagem e na Nomenclatura de diagnósticos e intervenções de enfermagem desenvolvida a partir dos resultados da Classificação Internacional para as Práticas de Enfermagem. Trata-se de um estudo do tipo metodológico desenvolvido em cinco etapas: identificação dos indicadores empíricos relativos à puérpera mediante revisão integrativa da literatura; avaliação dos indicadores empíricos e sua relação com as necessidades humanas básicas por grupo focal com cinco enfermeiras especialistas; estruturação do instrumento mediante a categorização dos indicadores; validação de forma e conteúdo do instrumento pelos especialistas, por meio da técnica Delphi; e aplicação e desenvolvimento das afirmativas de diagnóstico e intervenções de enfermagem. A coleta de dados da primeira etapa ocorreu nos meses de janeiro a março de 2013 nas bases de dados Scopus, Cinahl, Pubmed, Cochrane, e no periódico Journal of Midwifery and Women s Health. A segunda, terceira e quarta etapas se realizaram nos meses de maio a outubro de 2013. Participaram doze e sete especialistas na primeira e segunda rodada de avaliação respectivamente. A seleção dos especialistas ocorreu pela Plataforma Lattes mediante os seguintes critérios de inclusão: ser enfermeiro (a) docente e especialista em enfermagem obstétrica. A consulta a estes profissionais se deu via email e, ao aceitarem participar da pesquisa, assinaram um Termo de Consentimento Livre e Esclarecido. A pesquisa obteve aprovação da Comissão de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob o protocolo nº 184.241 e Certificado de Apresentação para Apreciação Ética nº 11674112.3.0000.5537. Para análise dos dados da primeira etapa, utilizou-se a estatística descritiva e os resultados apresentados em forma de tabelas. Nesta etapa, identificou-se 97 indicadores empíricos e, quando relacionados com as necessidades humanas básicas, 46 desses encontravam-se nas necessidades psicobiológicas, 51 nas psicossociais e 01 nas necessidades psicoespirituais. Com relação à segunda e terceira etapas, os dados passaram por um processo de categorização e análise pelo Índice de Validade de Conteúdo. Os indicadores obtiveram um índice de validação de 100%. Na parte de avaliação da puérpera, os itens não validados foram excluídos do instrumento. Os demais itens obtiveram índice acima de 70%, sendo, portanto, o instrumento validado. O instrumento para a consulta de enfermagem é constituído de dados de identificação da puérpera, dados de avaliação das necessidades humanas da puérpera e itens do cuidado de enfermagem. Na versão final foram selecionados 73 Diagnósticos de Enfermagem e 155 Intervenções de Enfermagem a partir da categorização dos indicadores empíricos validados na segunda e terceira etapas do estudo. Com a conclusão do estudo, o enfermeiro disporá de um instrumento para sistematização da assistência à puérpera na atenção básica. Além disso, o documento servirá como ferramenta para o ensino e a pesquisa em enfermagem obstétrica

Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity