Vivências de familiares do paciente internado em unidade de terapia intensiva: estudo fenomenológico

This study originated from my concerns as critical care nurse, regarding the lived experience of the family member of the patient that is hospitalized in the intensive care unit - ICU. The purpose of the study was to comprehend the experience of the family members while having a loved one interned in an ICU, and to identify the common elements of the phenomenon, based on the descriptions of their experiences. Considering that the object of study involves subjective and social questions, the study was conducted using some fundamental ideas of descriptive phenomenology as a referential and the situated phenomenon as suggested by Martins and Bicudo (1989). Ten (10) family members of patients that were interned in the ICU of private hospital in Natal, RN were interviewed using the following leading question: What is it like to have a member of your family interned in the ICU? Five thematic structural categories emerged from the comprehensive analysis of the interviews: Fear of the family member s death; Lack of humanization; Social isolation; Confidence in the ICU; and Overload to the personal life. The description of the phenomenon enabled a new look at how the care team relates to the family members of the patients interned in the ICU, providing some guidance on how to construct a humanized care that involves the family and that is based on affective human relations. This involves a rethinking of the care provided by team to the family and stimulates the reformulation of personal and social attitudes, and of hospital organizational norms

Em busca do conhecimento da equipe de enfermagem na sua prática assistencial às vítimas de traumatismo raquimedular

The great demand of accidents resulting in victims with rachi-medullar traumatism (RMT) and the need for indetifying how they are being assisted, led us to proceed with this investigation. It had as its goal to identify and analyze the knowledge of nurses and nurse assistents regarding the nursing assistance to these patients. It consists of a descriptive exploratory study, with a quantitative method and prospective data. For its execution, 193 subjects were interviewed, 37 of them nurses and 157 nurse assistents in 02 hospitals of the metropolitan zone of Natal. The results reveal that the subjects are not coherent when questioned whether they are prepared to assist victim of RMT and the content described by order of piority regarding the steps followed in the assistance of these victims, both in the pre-hospital and hospital care. Thus, we observe that only 06 nurses and 07 assistents, described correctly all the steps necessary to pre-hospital care and only 01 nurse and 02 assistents registered all the steps in the correct sequence regarding the hospital care. We conclude that, in face of the obtained results, we can urgently modify this reality, improving the nursing staff and giving them better work conditions

A ontologia da cor na fenomenologia estética bachelardiana

La philosophie de Gaston Bachelard se fonde sur une tension ontologique, qui comprend tant la Science que la poétique, et au cours de cette recherche, se développe par la compréhension de la possibilité d envisager une ontologie de la couleur, expression de Bachelard ci tée en «Le Droit de Rêver». Nous suivons, donc, face au dialogue ent re la science et la poésie tout en établissant des paramèt res afin d élucider, d un côté, la couleur conceptuelle de la science qui ne matise pas seulement les objets par le biais de l expérience chimico-physique, mais établit aussi dans la relat ion ent re l observateur et l objet une compréhension de l existence de la couleur invisible, celle qui habite l imagination créatrice et apparaît comme un type d ontologie de la couleur. Dans ce sens, la couleur est une image qui naît dans la conscience de l homme, comme un produit direct de l âme dans son actualité même. Ainsi, la couleur serait dans l imagination créative une image autogène desti tuée de substantialité

A incorporação da saúde bucal no programa saúde da família do Rio Grande do Norte: investigando a possibilidade de conversão do modelo assistencial

The Health Family Program (HFP) was founded in the 1990s with the objective of changing the health care model through a restructuring of primary care. Oral health was officially incorporated into HFP mainly through the efforts of dental professionals, and was seen as a way to break from oral health care models based on curative, technical biological and inequity methods. Despite the fast expansion of HFP oral health teams, it is essential to ask if changes are really occurring in the oral health model of municipalities. Therefore, the purpose of this study is to evaluate the incorporation of oral health teams into the Health Family Program by analyzing the factors that may interfere positively or negatively in the implementation of this strategy and consequently in the process of changing oral health care models in the National Health System in the state of Rio Grande do Norte, Brazil. This evaluation involves three dimensions: access, work organization and strategies of planning. For this purpose,19 municipalities, geographically distributed according to Regional Public Health Units (RPHU), were randomly selected. The data collection instruments used were: structured interview of supervisors and dentists, structured observation, documental research and data from national health data banks. It was possible to identify critical points that may be impeding the implementation of oral health into HFP, such as, low incomes, no legal employment contract, difficulty in referring patients for high-complexity procedures, in developing intersectoral actions and program strategies such as epidemiologic diagnosis and evaluation of the new actions. The majority of municipalities showed little or no improvement in oral health care after incorporating the new model into HFP. All of them had failures in most of the aspects mentioned above. Furthermore, these municipalities are similar in other areas, such as low educational levels in children from 7 to 14 years of age, high child mortality rates and wide social inequalities. On the other hand, the five municipalities that had improved oral health, according to the categories analyzed, offered better living conditions to the population, with higher life expectancy, low infant mortality rates, per capita income among the highest in the state as well as high Human Development Index (HDI) means. Therefore, it is possible to conclude that public policies that include aspects beyond the health sector are decisive for a real change in health care models

Saúde bucal no Programa Saúde da Família: uma avaliação do modelo assistencial

O objetivo deste estudo foi avaliar a incorporação da saúde bucal no Programa Saúde da Família no Rio Grande do Norte, com base na análise de fatores capazes de interferir no processo de mudança dos modelos assistenciais em saúde bucal. Esta avaliação tomou como referência três dimensões: o acesso, a organização do trabalho e as estratégias de programação. Foram sorteados 19 municípios no estado. Os instrumentos de coleta foram a entrevista estruturada aplicada a gestores e dentistas, a observação estruturada e a pesquisa documental. Foi possível identificar precariedade nas relações de trabalho e dificuldades no referenciamento para média e alta complexidade, na intersetorialidade, no diagnóstico epidemiológico e na avaliação das ações. A maioria dos municípios apresentou pouco ou nenhum avanço no modelo assistencial em saúde bucal. Os municípios que demonstraram avanços apresentaram alta expectativa de vida ao nascer, baixas taxas de mortalidade infantil, valores per capita entre os mais altos do Estado e altos valores de IDH-M. Concluiu-se que políticas públicas que contemplam aspectos além dos pertinentes ao setor saúde são decisivas para uma real mudança nos modelos assistenciais.

Saúde bucal no Programa Saúde da Família: uma avaliação do modelo assistencial

O objetivo deste estudo foi avaliar a incorporação da saúde bucal no Programa Saúde da Família no Rio Grande do Norte, com base na análise de fatores capazes de interferir no processo de mudança dos modelos assistenciais em saúde bucal. Esta avaliação tomou como referência três dimensões: o acesso, a organização do trabalho e as estratégias de programação. Foram sorteados 19 municípios no estado. Os instrumentos de coleta foram a entrevista estruturada aplicada a gestores e dentistas, a observação estruturada e a pesquisa documental. Foi possível identificar precariedade nas relações de trabalho e dificuldades no referenciamento para média e alta complexidade, na intersetorialidade, no diagnóstico epidemiológico e na avaliação das ações. A maioria dos municípios apresentou pouco ou nenhum avanço no modelo assistencial em saúde bucal. Os municípios que demonstraram avanços apresentaram alta expectativa de vida ao nascer, baixas taxas de mortalidade infantil, valores per capita entre os mais altos do Estado e altos valores de IDH-M. Concluiu-se que políticas públicas que contemplam aspectos além dos pertinentes ao setor saúde são decisivas para uma real mudança nos modelos assistenciais.

A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”

Fenômeno vivido por familiares de pacientes internados em unidade de terapia intensiva

COMASSETTO, Isabel, ENDERS, Bertha Cruz. Fenômeno vivido por familiares de pacientes internados em Unidade de Terapia Intensiva. Revista Gaúcha de Enfermagem., Porto Alegre(RS), v.30,n., p.46-53. Mar. 2009. Disponivel em: < http://www.seer.ufrgs.br/index.php/RevistaGauchadeEnfermagem/search/results>.

BURNOUT: analisando a síndrome do ramo das indústrias alimentícias do Rio Grande do Norte

This paper aims to verify the Burnout´s possibilities of incidence, finding the creating dimensions and comparing with the socio-demographics characteristics of the researched professionals. This quantitative-descriptive search has a population of 197 workers of 23 nourishing companies in Rio Grande do Norte. This population is predominantly male, younger than 28 years old, single, relatively instructed (57,07% with complete high school) and having just started their current job since 79% of the interviewees are in the company less than six years. The AUDITORIA DO SISTEMA HUMANO (ASH) model, utilized for investigation and developed for the Spaniards Quijano and Navarro in 1999, has several dimensions about human resources management and the organizational effectiveness, but only makes part of the research in 19 questions Burnout referring. It was used factorial analyses with extraction method, varimax rotation and Kaiser normalization with the intuition to define the creating dimensions of the syndrome, they were evaluated with Cronbach Alpha coefficient after extraction. The dimensions found through the factorial analyses were: emotional exhaustion, physical exhaustion and vitality. The accumulated explanation value reached 65,30% of total variation. The data socio-demographics don t justify the syndrome appearance, because the T test and ANOVA showed irrelevant values. It has been also observed that the founded dimensions were different of the Maslach sociopsychological perspective (emotional exhaustion, depersonalization and low professional realization) allowing comparison with others researches and the possibility to develop new ones with workers from different assistance areas. These new researches are important, since the syndrome refers to chronic labor stress consequences and any professional is favorable to Burnout, harmful to the company as to the collaborators

Projeto do complexo ambulatorial do Hospital Universitário João de Barros Barreto visando a critérios de sustentabilidade

The purpose of this dissertation is the architectural project of the ambulatory complex of the Federal University of Pará in Belém. It is a health care establishment whose focus is sustainability, energy efficiency and humanization. This design went through the application of architectural concepts, the study of references (theorical and empirical ones), planning, examining the terrain and its conditions and the preliminay design and resulted in a preliminary architecture blueprint. The empirical research is based on the main building of the Hospital Universitário João de Barros Barreto in Belém, Hospital Sarah Kubitschek of Fortaleza (Architect João Filgueiras de Lima - Lelé) and Hospital e Maternity São Luiz of São Paulo (Architect Siegbert Zanettini). Part of the planning is based on the method "Problem Seeking of Pena and Parshal (2001)". During the development process I sought to incorporate sustainability criterias, energy efficiency and humanization. In relation to sustainability the dissertation focuses on the utilization of rainwater for non-potable usage

Paisagem, um patrimônio esquecido: subsídios para a construção de uma metodologia de valoração e proteção do cenário natural litorâneo

The so-called "residential tourism" came to intensify the previous occupation of the coastal zones, characterized by traditional beach houses, and brought significant consequences for their spatial configuration, and especially for its scenic value of the landscape. Although there is the intention to regulate the activities of enterprising groups by some legal instruments to control the use and occupation of land, and to contain some negative effects, the actions of government are still inefficient in trying to follow the implications on the landscape from the accelerated growth of the real estate and touristic sectors. Supported in the speech of economic development and income generation, public managers prioritize areas to attract tourists to the detriment of preserving important physical attributes of the natural environment that contribute significantly to the quality of life. The result can be noticed in the use of natural elements as one of the major components in the land valorization, and in the immediate attraction of investors and enterprising. Therefore, the objective of this work is to contribute to the debate on the landscape preservation a little detailed thematic in view of their relevance in the current context - by indicating subsidies to the creation of a methodology for the evaluation and protection of coastal zones that may assist the government in creating new instruments, and better prepare it in control of the occupation of these areas. For such, was followed two ways to analysis: the indirect method and the direct method. The first is grounded in the evaluation of landscape attributes, which is based on the work of Raquel Tardin (2008) and Eduardo Cuesta, Encarnación Algarra and Isabel Pastor (2001). The second, based on the research of Leticia and Carlos Hardt (2010) and on the concepts of phenomenology - expressed by Antonio Christofoletti (1985) and Yi-Fu Tuan (1983) - considers the population perspective on the quality of the natural scenery. Developed through cartographic materials, photographic collections and quantitative tables, this dissertation utilized as a case study the beaches of Barra de Tabatinga and Camurupim, located in the city of Nísia Floresta/RN. Despite already being sighted spaces of advanced stage of landscape degradation in these locations, areas of remarkable scenic value can still be found, what reinforce the urgency in adopting preservationists actions. The absence of laws focused on the management and protection of the landscape singularities associated with the inefficiency of the government to invigilate the land occupation in coastal zones, encourage the excessive action of the real estate-tourism, and consequently make the government the main responsible for the environmental and landscape impacts in these areas - by its omission or by their connivance. Therefore, the legislation permeates this entire process and constitutes itself as the most effective way to guarantee the right to the landscape to present and future generations. Are also pointed some important considerations to build a methodology, especially concerning possibilities of improvements and adaptations of its applicability in each case

Sobre a constituição do sujeito: uma análise comparativa entre a psicologia sócio-sociologia do conhecimento de berger e luckmann

This study investigated how the process of the constitution of the subject is interpreted in the formulations of the founders of socio-historical psychology (Lev S. Vigotski, Alexei N. Leontiev and Alexander R. Luria) and in the sociology of knowledge of Peter Berger and Thomas Luckmann. These two theoretical perspectives, despite having different philosophical formulations as ontological and epistemological intentions (socio-historical psychology, historical dialectical materialism; the sociology of Berger and Luckmann and phenomenology) arrive, however, at the same basic conclusion about the social nature of the subject. The objective of the study, therefore, was that of identifying the differences and convergences between the two perspectives and then, try to determine the possibility of a theoretical synthesis between them in relation to the constitution of the subject. At the same time, we intended to analyse the implications of this possible synthesis in order to comprehend the manner in which the ideology functions in human societies as thought by Louis Althusser and Alípio de Sousa Filho. We arrived at the conclusion that, despite being incompatible from the ontological and epistemological points of view, a synthesis is possible between socio-historical psychology and the sociology of knowledge of Berger and Luckmann in relation to the conception of society and the comprehension of the process of the constitution of the subject. Starting from the philosophical intentions of socio-historical psychology, it is possible to incorporate, enriching points such as: Berger s and Luckmann sconception of society and the interpretation of the process of constitution of the subject. This possible synthesis, when interpreted in light of the reflections of Althusser and Sousa Filho on the phenomenon of ideology in human societies, is constituted in a real unveiling of the concrete provisos by which the ideology acts in human societies in order to transform biological examples of the human species in specific social subjects

O impacto do programa do leite na vda familiar dos beneficiários do Rio Grande do Norte - Natal

This present study aims to identify and evaluate the impacts caused by the state Programa do Leite in the familiar life of the ones that get this benefit in Natal, from 2003 to 2008. The interviews were done in the four areas of the city and show the high level of poverty of the ones registered in the benefit. The introduction of the families in the program changed their habits. The study also shows the fragility of the poor population inside social welfare works like this one. Some of these programs become permanent by the politicians and by the lack of economic independence of the ones that get the benefit, causing much more dependence of these people on the social program

Atenção ao usuário em um centro de referência HIV/Aids: perspectiva de profissionais e usuários

We study the health care focused on care in an intercessor and dialogical relationship with the User, which involves the construction of therapeutic projects essential to the quality of the treatment of the user in health services, and it is necessary individual and collective actions. It is intended to acknowledge and analyze the perception of social subjects, users and professionals on the treatment given to a user of a Specialized Outpatient Service (Serviço Ambulatorial Especializado SAE) in STD/HIV/AIDS state reference in Natal, RN. The study is structured in a transdisciplinary vision of science and knowledge, theoretical and methodological principles that give meaning to the expression of the institutional features of care and health care reconnecting them to the social context. As a research strategy we seek the expressions of 56 subjects of social research, which agreed to participate in the sample, from a symbolic map of the attention, coupled with the techniques of observation and semi-structured interview. For the analysis of the results, five categories of analysis were established: the meaning of the service, care perception, process of communication and interaction, treatment perception and organization and evaluation of the service. It is argued that the attention and care are developed in a technical health care assistance to the disease, focusing on attention based on treatment, on diagnostic and drug therapy of antiretroviral drugs, reflecting the traditional biomedical paradigm of attention to the disease. This is also the mode of organization of practical actions in daily SAE: the therapy proves to be fragmented in several specialties, vertical and feeds the same model, generating tension and overload for professionals; showing impersonal care focused on structured and informative technology, unrelated to an interactive dialogic. From the speech of the subjects, the SAE is understood as the place of confrontation with the disease, but also enables greater elaboration of the illness by meeting their peers. Living with HIV and AIDS is living with concern, apprehension and fear, but mainly with the stigma, prejudice and exclusion, which require that the disease is kept in secret. There is a movement of forces and power, expressed in the knowledge-power of those who dominate the technical and administrative capabilities, devices that concentrate the maintenance of the medicalization of care, rapid consultations and with little attention, making it difficult to interact with and listen to, combined with structural failures, organizational and inadequate management of the service. We conclude that there are dimensions that are not considered in the internal dynamics of the care service multiple forms, characterized by care conflicting models, marked by individual interventions related to the disease. The subject is not considered together with his speech as technical discourse is imposed and care production based on material technology is observed

O compromisso político do serviço prestado pela Fundação Bradesco na cidade de João Pessoa

In this work we have analyzed the political commitment of the social assistance sponsored by the Bradesco Foundation in João Pessoa. This Foundation is a private institution of public interest that provides social assistance to low income populations all over Brazil. This kind of work is one of the oldest management initiatives in what is actually referred to as managers` social responsibility. This thesis assumes that managers who are in fact socially responsible should guide their actions by the principles of social democracy, so that everyone can enjoy citizens` social freedom, and guarantee their rights as well as the political awareness of social actors. Analysis of documents and a qualitative approach have been applied to the pedagogical Project of the Foundation, as well as phenomenology to study the social profile of their students. The analysis of the pedagogical project as well as the students` standpoint towards life reveals that the Bradesco Foundation is indeed committed to the social efficacy of its students. The educational proposal of the organization includes those elements that are required for teenagers` education envisaging participative citizenship. The teenagers` speech reveals that they have developed the project identity, being therefore able to take part in the process of political transformation of our time. The results indicate that the Bradesco Foundation not only guarantees some of the basic social rights for the healthy development of those who attend their courses, but also sponsors a high level education providing both a technical and a political formation