Contexto de trabalho e Síndrome de Burnout na equipe de enfermagem da Estratégia Saúde da Família

Objetivo: Verificar a relação entre o contexto de trabalho e a Síndrome de Burnout dos profissionais de enfermagem da Estratégia Saúde da Família de um município mineiro. Método: Estudo seccional, de abordagem quantitativa. O grupo de estudo foi composto por 50 profissionais de enfermagem que responderam o questionário de caracterização sociodemográfica e profissional, Escala de Avaliação de Contexto de Trabalho (EACT) e Inventário da Síndrome de Burnout. Foram utilizadas análises exploratória e bivariada, considerando nível de significância de 5%. Resultados: A dimensão Exaustão Emocional apresentou correlações significativas com todos os fatores da EACT; Despersonalização apresentou diferença com as Relações Socioprofissionais e Organização do Trabalho; Diminuição da Realização Pessoal correlacionou-se com Organização do Trabalho. Conclusão: Quanto pior sejam as condições e organização do trabalho e as relações socioprofissionais, maior a possibilidade de insatisfação, desenvolvimento de atitudes de insensibilidade, adoecimento e exaustão emocional do profissional de enfermagem da atenção primária.

Um olhar sobre o desenvolvimento das crianças em idade pré-escolar - Uma perspectiva da intervenção do enfermeiro

Relatório de Estágio apresentado para a obtenção do grau de Mestre em Enfermagem de Saúde da Criança e do Jovem

Atitude dos estudantes de enfermagem ao cuidar a pessoa com dor

Introdução: Cuidar da pessoa com dor é imprescindível à excelência dos cuidados de enfermagem. Refletindo sobre a natureza desses cuidados pelos estudantes, é possível promover atitudes de abertura ao sofrimento, para que como futuros profissionais respondam à necessidade de alívio. O comportamento humano é intencional, reflete preferências e para o prever podemos simplesmente examinar atitudes. Objectivo: Estimar a validade e confiabilidade da escala e analisar a atitude dos estudantes de enfermagem ao cuidar da pessoa com dor. Material e Método: Estudo analítico, correlacional e transversal, realizado com 255 estudantes da ESSV. Os dados recolhidos através de questionário autoaplicado que integra a escala: Atitude dos Estudantes de Enfermagem ao Cuidar a Pessoa com Dor. Resultados: Após o estudo psicométrico, a escala apresenta 17 itens e 2 fatores, fator 1 “Aptidão Terapêutico-Curativa” e fator 2 “Aptidão Centrada na Pessoa”. Os estudantes apresentam uma média de idade de 21.91 anos, 77.3% do sexo feminino, maioritariamente solteiros e 40.8% frequentam o 4º ano. Todos avaliam a dor nos ensinos clínicos, 86.4% com a EN e 94.9% conjuga intervenções farmacológicas e não farmacológicas, mais de 55% emprega a diminuição do ruído e luminosidade, aplicação do frio e massagem, havendo 87.5% que usa posicionamentos. Os do sexo masculino que aplicam exercícios de relaxamento e os do sexo feminino com idade ≥21 anos, do 3º ano, apresentam uma atitude mais adequada. Conclusão: A formação no tema dor ao longo do curso é preponderante no desenvolvimento de competências, mas também na aquisição de conhecimento e promoção de atitudes. Palavras chave: Estudantes de Enfermagem, Atitude; Dor; Cuidar.

Intervenções de enfermagem na prevenção da pneumonia associada à ventilação mecânica

Relatório de Trabalho de Projeto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Enfermagem Médico-cirúrgica

Avaliação por pares em contexto de ensino clínico em enfermagem

Introdução: A avaliação/feedback por pares em contexto de ensino clinico define-se como um processo benéfico no que concerne ao desenvolvimento de competências melhorando os resultados de aprendizagem dos estudantes. A implementação da mesma, centrada no estudante surge numa configuração inovadora no ensino, alterando o paradigma tradicional de avaliação transportando o estudante para o ativo no que diz respeito ao ensino-aprendizagem. Esta promove ao estudante autonomia; aumenta a sua auto confiança e auto estima; aumenta a sua capacidade crítica e melhora as suas competências para o futuro profissional. Não implementada devidamente pode gerar conflitos entre os estudantes. Objetivo: Identificar qual o contributo da avaliação por pares para o desenvolvimento de competências nos estudantes do 1º Ciclo de Estudos do Curso de Licenciatura em Enfermagem em Contexto de Ensino Clínico. Metodologia: Estudo qualitativo, tendo por base o focus group, a perceção da avaliação por pares de 11 estudantes do 3º ano do 1º Ciclo de Estudos do Curso de Licenciatura em Enfermagem da ESEnfCVPOA e respetiva aquisição de competências pelos estudantes e aplicabilidade em contexto de ensino clínico. Resultados: Verificou-se que se adquire uma série de competências tais como autonomia e responsabilidade, com foco na auto-regulação através de pensamento crítico e reflexivo, de forma a promover a sua evolução enquanto estudante de enfermagem. Esta teria de ser bem implementada de modo a que o feedback fosse benéfico, para desenvolver as suas competências profissionais. Conclusão: O estudo sugere que a avaliação por pares em contexto de ensino clínico desenvolve competências no estudante.

Cuidados de enfermagem ao cliente internado na UCPA submetido a cateterização vesical

Relatório de Trabalho de Projeto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Enfermagem Médico-Cirúrgica

Efeitos da Implementação da Sistematização da Assistência de Enfermagem nos Enfermeiros de uma Instituição de Saúde Pública

O presente estudo teve como objetivos investigar a opinião do enfermeiro sobre a Sistematização da Assistência de Enfermagem, verificar os efeitos da Sistematização da Assistência de Enfermagem na organização do trabalho do enfermeiro e identificar se a Implementação da Sistematização da Assistência de Enfermagem causa sofrimento psíquico nesses profissionais. Trata-se de uma pesquisa qualitativa, realizada com 22 enfermeiros que atuam em uma instituição pública de saúde do grande ABCD, no Estado de São Paulo. Foram utilizadas entrevistas semi-estruturadas, por meio de gravação dos depoimentos. A análise dos dados foi realizada buscando apreender os conteúdos representacionais sobre os efeitos da Implementação da Sistematização da Assistência de Enfermagem nos Enfermeiros. As categorias de análise sobre a influência da SAE nos sujeitos foram: a)conhecimento sobre a SAE: tem conhecimento e tem pouco conhecimento; b)opinião sobre a SAE: favorável e parcialmente favorável; c)desenvolvimento da SAE no contexto do trabalho: ocorre parcialmente e não ocorre; d)influência da Implementação da SAE no desempenho das tarefas: afeta e não afeta; e)ocorrência de sofrimento psíquico na Implementação da SAE : há e não há expressões diretas de sofrimento psíquico. Os dados revelaram que os efeitos da Implementação da Sistematização da Assistência de Enfermagem nos Enfermeiros causam sofrimento psíquico, resultantes das condições de trabalho inadequadas para promover a Sistematização da Assistência de Enfermagem.

A INFLUÊNCIA DAS PRÁTICAS PEDAGÓGICAS DOCENTES E DAS BARREIRAS DISCENTES SOBRE O DESENVOLVIMENTO DA CRIATIVIDADE DO FUTURO ADMINISTRADOR

As empresas que almejam garantir e melhorar sua posição dentro de em um mercado cada vez mais competitivo precisam estar sempre atualizadas e em constante evolução. Na busca contínua por essa evolução, investem em projetos de Pesquisa & Desenvolvimento (P&D) e em seu capital humano para promover a criatividade e a inovação organizacional. As pessoas têm papel fundamental no desenvolvimento da inovação, mas para que isso possa florescer de forma constante é preciso comprometimento e criatividade para a geração de ideias. Criatividade é pensar o novo; inovação é fazer acontecer. Porém, encontrar pessoas com essas qualidades nem sempre é tarefa fácil e muitas vezes é preciso estimular essas habilidades e características para que se tornem efetivamente criativas. Os cursos de graduação podem ser uma importante ferramenta para trabalhar esses aspectos, características e habilidades, usando métodos e práticas de ensino que auxiliem no desenvolvimento da criatividade, pois o ambiente ensino-aprendizagem pesa significativamente na formação das pessoas. O objetivo deste estudo é de identificar quais fatores têm maior influência sobre o desenvolvimento da criatividade em um curso de graduação em administração, analisando a influência das práticas pedagógicas dos docentes e as barreiras internas dos discentes. O referencial teórico se baseia principalmente nos trabalhos de Alencar, Fleith, Torrance e Wechsler. A pesquisa transversal de abordagem quantitativa teve como público-alvo os alunos do curso de Administração de uma universidade confessional da Grande São Paulo, que responderam 465 questionários compostos de três escalas. Para as práticas docentes foi adaptada a escala de Práticas Docentes em relação à Criatividade. Para as barreiras internas foi adaptada a escala de Barreiras da Criatividade Pessoal. Para a análise da percepção do desenvolvimento da criatividade foi construída e validada uma escala baseada no referencial de características de uma pessoa criativa. As análises estatísticas descritivas e fatoriais exploratórias foram realizadas no software Statistical Package for the Social Sciences (SPSS), enquanto as análises fatoriais confirmatórias e a mensuração da influência das práticas pedagógicas e das barreiras internas sobre a percepção do desenvolvimento da criatividade foram realizadas por modelagem de equação estrutural utilizando o algoritmo Partial Least Squares (PLS), no software Smart PLS 2.0. Os resultados apontaram que as práticas pedagógicas e as barreiras internas dos discentes explicam 40% da percepção de desenvolvimento da criatividade, sendo as práticas pedagógicas que exercem maior influencia. A pesquisa também apontou que o tipo de temática e o período em que o aluno está cursando não têm influência sobre nenhum dos três construtos, somente o professor influencia as práticas pedagógicas.

Análise de conceito do diagnóstico de enfermagem autocontrole ineficaz da saúde em pacientes submetidos à hemodiálise

The concept analysis process carefully examines the description and uses of a word or term, enabling the standardization of language, in addition to providing representation to the profession, and facilitate the work of taxonomies. The aim of the study was to analyze the concept of nursing diagnosis ineffective self-health in patients undergoing hemodialysis. Study concept analysis, based on Walker and Avant model and operationalized through integrative literature review. The databases searched were: SCOPUS, CINAHL, PUBMED, LILACS and COCHRANE, with descriptors: Selfmanagement, Adherence and Hemodialysis. The inclusion criteria were: articles published in the last five years, complete articles are available free in selected databases; articles available in Portuguese, English or Spanish; and articles that address the self-concept of health, the antecedents and the consequent. And Exclusion: editorials, letters to the editor, theses and dissertations. The survey of the articles occurred in the months from January to March 2014. The initial sample of 16785 articles, with 11748 in PUBMED, 4767 in Scopus, 174 in CINAHL, the Cochrane 70 and 26 in LILACS. After applying the criteria, 76 articles were selected, 19 in CINAHL, 18 in PUBMED, 30 in Scopus, and 9 in LILACS. In analyzing the data, given that the concept was sought in the literature was self-health, was held interpretation to ineffective self-health diagnosis through the transposition in the denial of the attributes, antecedents and consequences identified. It is noteworthy that the terms identified in the literature as defining characteristics and related factors of the diagnosis under study were added to the survey, not even the transposition into opposite term is possible. The results show that the concept developed for the inefficient self-health diagnosis was: the patient's inability to control habits and achieve the negotiated with professionals therapeutic targets, resulting in health complications. 33 antecedents relating to social, psychological and therapeutic aspects and 16 consequential, involving physiological, social, psychological and therapeutic aspects were identified. Thus, it is concluded that the ineffective self-health concept is broad and involves individual patient factors and the therapeutic relationship between patient and professionals. It is believed that the study contributed to the improvement of diagnosis in renal clientele, besides being an important base for the growth of the scientific body of nursing, subsidizing the development of own technology area

Construção de um ambiente virtual de aprendizagem para aplicação do processo de enfermagem baseado na Nanda International, NOC, NIC e CIPE®

This study aimed to build a virtual learning environment for application of the nursing process based on the NANDA-I, NOC, NIC and ICNP® . Faced with problems related to learning of the nursing process and classifications, there is an urgent need to develop innovative teaching resources that modify the relationship between students and teachers. The methodology was based on the steps inception, development, construction and transition, and the software development process Rational Process Unifield. The team involved in the development of this environment was composed by researchers and students of The Care and Epidemiological Practice in Health and Nursing and Group of the Software Engineering curse of the Federal University Rio Grande do Norte, with the participation of the Lisbon and Porto Schools of Nursing, in Portugal. In the inception stage the inter research communication was in order to define the functions, features and tools for the construction process. In the preparation, step the planning and modeling occurred, which resulted in the creation of a diagram and a architectural drawings that specify the features and functionality of the software. The development, unit testing and integrated in interfaces of the modules and areas (administrator, teacher, student, and construction of the NP). Then the transition step was performed, which showed complete and functioning system, as well as the training and use by researchers with its use in practice. In conclusion, this study allowed for the planning and the construction of an educational technology, and it is expected that its implementation will trigger a substantial change in the learning of the nursing process and classifications, with the student being active agent of the learning process. Later, an assessment will be made of functional performance, which will enable the software development, with a feedback, correction of defects and necessary changes. It is believed that the software increment after the reviews, this tool grow further and help insert this methodology and every language under the educational and health institutions, promoting paradigmatic desired change by nursing.

Acompanhamento do crescimento e desenvolvimento da criança: a participação das mães da área rural

The accompaniment of growth and development is the central thrust of child care in primary health care in order to contribute to the reduction of infant morbidity and mortality and promote healthy development. Despite its importance, the family health unit located in rural Parazinhocounty experiences the problem of frequent absences of children to follow-up consultations. Thus, this study aims to analyze the participation of mothers in the accompaniment of growth and development of children in the Family Health Strategy. This is an exploratory, descriptive study with a qualitative approach with the method action research, developed with mothers who are part of the monitoring of the growth and development of children in the rural area of the municipality of Parazinho/RN from May to October 2014. Data collection was performed using the focus group techniques, participant observation and individual interviews. Data were analyzed using thematic analysis of categorization. The study was approved by the Research Ethics Committee, under the opinion embodied 617,559 and CAAE 28598014.7.0000.5537. In step situation analysis, were conducted two focus groups, attended by a total of 14 mothers of different rural locations. From the speeches, one realizes that they have a satisfactory understanding of the monitoring of the growth and development of the childwas a learning moment. The nurse was mentioned as key professional that actionof accompaniment. The main reason that mothers to abandon consultations is access to health services, due to the distance from their homes to the basic unit, the shortage of public transport for the movement of users and delay between the service and the back home. As a strategy to try to tackle these problems, at the suggestion of their mothers was created Monitoring of Growth and Development Itinerant, where the FHS team moved to rural locations, performing activities related to children's health. Mothers who participated in the action approved the initiative as improving access and care of health needs, despite indicate dissatisfaction as the poor infrastructure and little privacy in consultations. Therefore, it is concluded that, despite the difficulties encountered often for lack of management support and involvement of some professionals, the monitoring of growth and development itinerant proved to be an important tool in solving the problem of access to services oriented to the health of child, in addition to functioning as a space for the realization of health education, becoming, since then, an activity inherent in family health team schedule.

Acompanhamento coletivo do crescimento e desenvolvimento infantil: participação de mães/cuidadores

This study aimed to analyze the participation of mothers/caregivers from the perspective of the health care model that directs the collective monitoring of child growth and development. This is an exploratory and descriptive research with qualitative approach, carried out in two Family Health Units located in the city of Natal/RN. Data were collected between August and September 2014, through participant observation and semi-structured interview technique, with mothers of infants seen at follow-up visits collective child growth and development. A total of 13 mothers were included who met the following inclusion criteria: being a mother/caregiver responsible for the care of children who have attended one or more meeting of collective monitoring of child growth and development. Exclusion criteria was established: users outside the area covered by the Health Unit Family and who did not use the National Health System as the primary health care service. For the treatment of the collected material, the content analysis was used, thematic Bardin. The study followed the ethical and legal principles governing the scientific research on human subjects recommended by Resolution nº. 466/2012 of the National Health Council and its realization occurred with the approval of the project in the Research Ethics Committee of the Federal University of Rio Grande do North, which was approved by Opinion Embodied nº. 719 949, of June 27, 2014, and Certificate Presentation of Findings Ethics No 32510514.7.0000.5537. Although not conceptualize theoretically mothers demonstrated that collective consultations of child growth and development are actions aimed at health surveillance model, since most pointed monitoring your child to actions that can be measured. Even with that, it was established the existence of health promotion actions by reporting the exchange of experience and leadership of the subjects in collective action, factor facilitated by the link established between users and professionals and users. In this action there is the induction of permanent horizontal relationship where we seek to combine popular knowledge to scientific knowledge in order to promote the integral care for the child. However, it is still possible to find professionals who directs its assistance only to pathological processes and fail to create comprehensive care alternatives. In addition, there is still embezzlement in multi that should provide care to the child population. This factor may be related to their professional training, and thus an issue that can last for a few years. We conclude that it is necessary to incorporate alternatives and models of care that support overcoming limitations and enhancing the health of the population, involving it in the prospect of a better quality of life and therefore health.

Acurácia dos indicadores clínicos do diagnóstico de enfermagem falta de adesão em pessoas vivendo com AIDS

In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

Acurácia dos indicadores clínicos do diagnóstico de enfermagem falta de adesão em pessoas vivendo com AIDS

In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.