Teoria do déficit de autocuidado análise da sua importância e aplicabilidade na prática de enfermagem

submeter a teoria do déficit de autocuidado de Orem a uma reflexão crítica. Metodologia: estudo teórico sobre os aspectos Importância e Aplicabilidade contidos no Modelo de Análise Crítica de Chinn e Kramer para análise crítica da teoria do déficit de autocuidado. Desenvolvido no período de outubro a dezembro de 2008. Resultados: o posicionamento da teoria do déficit de autocuidado está essencialmente relacionado à filosofia da enfermagem e demonstra potencial para influenciar ações de enfermagem, em especial relativas à educação para o autocuidado em pacientes portadores de cardiopatia isquêmica. Conclusões: a enfermagem, mediante a teoria do déficit de autocuidado, pode oferecer condições mais saudáveis e de maior autonomia ao indivíduo portador de cardiopatia isquêmica

Avaliação do desempenho funcional de crianças com paralisia cerebral de acordo com níveis de comprometimento motor

Contextualization: Several studies have examined the mobility of this group of children, however little is known about the impact of motor function in activities of daily living, considering the seriousness of their neuromotor damage. Objective: Identify the functional differences of children with Cerebral Palsy with different levels of motor dysfunction and correlate these differences with the areas of mobility, self-care and social function in functional ability and caregiver´s assistance of these children. Methods: An l analytical cross-section search was developed, which were part 70 children / families aged from 4 to 7.5 years, in the Rehabilitation Center for Children. As tools were used the Pediatric Evaluation Disability Inventory (PEDI) and the Gross Motor Function Classification System (GMFCS). Data analysis was performed by ANOVA and Pearson's correlation tests. Results: The results show the functional variability of children CP in different severity levels of motor disfunction This variation was observed in the areas of mobility, self-care and social function. The results also showed a strong correlation between the domains mobility and self-care, mobility and social function. Conclusions: The variability shown by the children with CP, suggests the use of PEDI and GMFCS as this association appears to increase the understanding of how the gross motor functions are related to activities of daily living, describing the best commitments and their degree of impact on functional activities. This correlation demonstrates how mobility is crucial to evaluate the performance and guide the therapeutic practice, to develop the children´s potencial, and guide the caregiver in stimulation

Atividades educativas aos portadores de periodontite crônica: escuta e troca de saberes no autocuidado em saúde bucal

This research aimed at evaluating oral health education activities for Periodontitis carriers, emphasizing the motivation for self-care and understanding the cultural aspects involved. This was a qualitative and quantitative study. Based on the qualitative referential, 20 interviews were done, in which differences between scientific and popular explicative models of the health-illness process were verified, besides the increased knowledge and motivation in relation to the use of preventive measures and also the fails in the understanding of the chronic character of periodontitis, enhancing frustration and guilty feelings in the patients. Two groups were structured: intervention and control. The intervention group was submitted to clinical attendance and education activities, while the control group undergone the traditional clinical attendance only. The sample consisted of 51 participants of intervention group and 47 of control group. Structured interviews were conducted at the beginning and at the end of the treatment in order to evaluate the knowledge and motivation for self-care in both groups. For comparison between the previous and post moments in both groups, there were applied McNemar tests with a probability of p < 0.05. In intervention group there was an increase in knowledge related to the name, the causes and related factors of the disease (p < 0.05). In control group there wasn t a rise in the understanding of the diseases chronic character, unlike in intervention group. However, in what concerns self-care, a greatest frequency in medium and high scores was observed in both groups. By this study, it is conclude that there is a common sense knowledge about the importance of preventive techniques and poor oral health as causing periodontitis; clinical interventions for bearers of chronic Periodontitis do not add values to the patients, regarding the illness, its causes and its chronic character; popular beliefs stay in their imagination, and the patients have a increased motivational capacity for self-care

A arte de si: uma análise da ascese nas comunidades alternativas

In this research, we studied alternative communities that promote self-care practices, as well as environmental and community care.We problematized if there are ascetical practices in these communities - understanding asceticism from Ortega (2008) and Foucault (2006, 2009, 1998), which would be a transition from one type of subjectivity to another one to be achieved through exercises on itself, in other words, the ascetic oscillates between a refused identity to another to be drawn by an art that focuses itlself.This research was conducted through the analysis of files, observations of daily practices and interviews with open questions in order to achieve reflections and thoughts of the residents of alternative communities.For our study, we chose the Alternative Community of Campina, located in the Capon Valley/Bahia; Sabiaguaba community, located in Fortaleza-CE; and the National Meeting of Alternative Communities (ENCA). The research points to ways of living that create new subjectivities, in which the subject feels responsible for taking care of themselves, others and the environment

Uma análise sociodemográfica dos cuidadores formais de idosos institucionalizados no município de Natal/RN, 2012

The aging population and individual have been the subject of a multitude of studies nowadays. This is probably due to the impact of this phenomenon in various sectors of society, like social security, social assistance and public health. The process of aging of the individual imply the demand for specific services, considering the limitations and vulnerabilities of the individual at that stage of life cycle. The growth of the elderly contingent in the last decades raises challenges for policymakers, the family and also for the society at large. In this scenario, long-stay institutions for the elderly (LSIEs) appear as an option to aid and support the elderly and their family, assisting in all or part in the activities of daily living and self-care. Inside these LSIEs we find the professional responsible for the direct care of the elderly, the formal caregiver. In this context, this dissertation presents two main objectives: an analysis of the phenomenon of population aging in a given brazilian municipality Natal / RN, based on the Demographic Censuses of 2000 e 2010; and a social, demographic and economic characterization of the Formal caregiver for the institutionalized elderly in the municipality, evaluating aspects of his quality of life and also analyzing the institutions where they are inserted. Furthermore, we intend to identify demographic, socioeconomic and quality of life factors that are correlated with caregivers quitting the job. The data used in the second part of this work comes from the research project named Long-Stay Institutions for Elderly: abandonment or a family need? . This survey interviewed 92 caregivers in eleven LSIEs in Natal/RN. In the data treatment logistic regressions, cluster analysis and statistical tests were used. The survey revealed that aging in Natal is more pronounced in the older, more traditional districts: Petrópolis, Lagoa Seca and Tirol. It also allowed a broad characterization of the formal caregivers in LSIEs. Most of these professionals are female. The educational level is predominantly complete high school and more. Most caregivers reported being married or in union, or have ever been in a union. Family monthly income is under three times the minimum wage. The mean age is of 37.4 years. The mean time of work as a caregiver was 5.93 years. The associations showed that being woman, not being single, having caregiving training and physical limitations (regarding quality of life) are related to wanting to quit the caregiving job. As for the characterization of the LSIEs, it was found that the philanthropic ones are older and have most (62.5%) of the institutionalized elderly. The institutions managers gave social interaction and affinity with the elderly as the main criteria with which to evaluate and hire caregivers. It is intended with this study to contribute to improving the quality of life of the elderly and their caregiver, providing information on aspects of institutionalization of elderly both in the philanthropic and particular institutions, in Natal/RN; this dissertation may also be used as a starting point for later works

O homem na estratégia de saúde da família

The research aimed to understand the general perception of men about their health care in a health unit família. This is an exploratory and descriptive qualitative approach, developed at the Center for Health Dr Vulpiano Cavalcante in the City of Parnamirim / RN. Participated in the investigation 12 men enrolled in the Estratégia de Saúde da Família ESF (Family Health Strategy), in the age-group 20 to 59 years lived in the catchment area of one of the ESF teams unit above. Data were collected from July to August 2009, through structured interviews, which, after transcription have undergone a process of identifying meaning units, coded and categorized according to the precepts of content analysis according to Bardin. Following in the footsteps of this method, originated the following themes: "Revealing what motivates men to seek assistance in the Estratégia de Saúde da Família," "Expressing knowledge of the Estratégia de Saúde da Família ", "an opinion about the care health and relationship with the ESF. The analysis was processed according to the principles of symbolic interactionism as Blumer. To support the discussions were used literary themes about man in the context of public health policies and the man in the family and the influences of gender. These, when they had their properties and dimensions analyzed, raised the central category Man on the Estratégia de Saúde da Família . The results show that respondents have limited knowledge about the ESF, your actions turn to use the service when no obligation arising from discomforts and accuracy of care. Moreover, delivering the opinion of the care with your health, even need, but recognizing that do not perform self-care. Given this reality, we can conclude that the perception of the man about his health in the ESF permeates gender issues that influence their behavior toward disease prevention and health promotion. This situation requires that the professionals and managers of health initiatives for the inclusion of man in the actions of the ESF assistance starting from the understanding of their conceptions of health care.

Diagnósticos de enfermagem em pacientes no pós-operatório imediato de prostatectomia de um Hospital Universitário de Natal-RN

The characterization of the nursing diagnoses in prostatectomized patients is important to provide an unique nursing language, facilitating the communication between professionals and patients. The objective of this study was to analyze the nursing diagnoses of patients in the immediate prostatectomy postoperative period. This is a cross-sectional and descriptive study, developed at the surgical-clinic of Onofre Lopes University Hospital, in the Natal City RN - Brazil. The sample was composed of 50 patients included by the criteria: have presented a diagnosis of a benign prostatic hyperplasia or a prostate cancer, have been subjected to a prostate surgery at the mentioned hospital, and have been in the immediate postoperative period at the moment of the data collection. The exclusion criteria were: haven t been in an appropriate physical and mental condition, have presented a brain vascular disease, a lung disease, an advanced liver disease, a heart disease or a extensive coronary artery disease. The data collection instruments were: the script of an interview and physical examination. The data collection period was between November 2010 and April 2011. The data were organized in two phases: the diagnostic process and the construction of the database. The project was approved by the Ethics Committee of the Federal University of Rio Grande do Norte The results showed that most patients came from the countryside, was living with partners, had an average of 67.78 years, was pensionerthose with low schooling, Catholic and often did not perform preventive examinations of prostatic disease. The patients showed an average of 9.48 nursing diagnoses, defining characteristics 21.70 and 20.72 related or risk factors per patient. We identified 30 nursing diagnoses, of which 7 were above the 75 percentile: Risk of falls, Impaired ambulation, Risk of infection, Self-care deficit bath / hygiene and dress up and Risk for deficient fluid volume. The top six nursing diagnoses were in all patients, and therefore could not apply any statistical test. The others ND were associated with their defining characteristics and related or risk factors. We conclude that the nursing diagnoses identified in this study contribute to the progress of the nursing care to the prostatectomized patients in post-surgery period, allowing the deployment of nursing actions for the effective resolution of identified problems

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.

Validação de conteúdo do instrumento para consulta de enfermagem na visita domiciliar às pessoas com lesão medular: um enfoque no autocuidado

This study aimed to validate the contents of an Instrument for Nursing Consultation in the Home Visit of people with Spinal Cord Injury (INCEVDOP-LM), based on the Self-Care Deficit Theory. The methodological development study was conducted with spinal cord injured (SCI) people ascribed in the Family Health Units the city of Natal/RN/Brazil, and with the nurses of these institutions. The study was conducted from Januray 2012 to January 2013 in two phases: the first aimed to identify the need for self-care of persons with SCI, and the second to develop and validate the INCEVDOP-LM. The first phase consisted of a census study of people with SCI living in Natal/RN. In the second phase, a non-probabilistic convencience sample of subjects was selected to form two groups: First stage - Group 1 of the first stage was comprised by 73 adults with SCI diagnosed with paraplegia or tetraplegia, with cognitive function preserved and that were registered to some family health unit; Group 2 of the Second phase was composed of six experts that were nurses with doctoral formation, scientific experience in the area of technology development or assistance to persons with SCI, and with publications in periodicals Qualis A2. Data collection of the first phase was conducted through home visits of people with SCI that responded three instruments: Questionnaire I (comprised of demographic and socioeconomic variables), The Competency Rating Scale for Self-care (ASA) and the Barthel Index (an instrument for evaluation of functional capacity). The research for the second phase was conducted in two stages: I-construction of the INCEVDOP LM; II-validation of the INCEVDOP-LM. The instrument and an evaluation form were forwarded to the experts for the validation. The correlations between the responses were analyzed by the Kappa test, with accepting values of>0.75. The evaluation criteria were: organization, clarity, simplicity, readability, appropriateness of vocabulary, objectivity, accuracy, reliability and suitability and the positive responses with frequency values of≥90% were considered excellent. The chi-square test was used to investigate the differences between proportions. The study attended to the principles of Human Rights CNS Resolution 196/96. Results were reported by means of four articles derived from the study. The findings indicate that the items that showed disagreement among experts (k=0.02) were diagnoses, interventions and evaluation of the nursing features pertaining to the domains of Nutrition, Hygiene, Elimination, Physical, Social and Psychological, and of the Ability to perform work activities feature. Agreement among the experts were reported for the other items, with kappa ranging from 0.72 to 1. After removing items with disagreement, all criteria achieved excellent rates and no significant differences were observed between the proportions of responses of evaluation of experts (p>0.05). We conclude that the instrument shows validity to serve as a guide for nurses to conduct a systematic consultation during the home visit to people with spinal cord injury, with emphasis on self-care. The instrument must go through other levels of validation when applied in the clinical setting

Diagnósticos de enfermagem em pacientes submetidos à hemodiálise: semelhanças entre o modelo de adaptação e a NANDA internacional

The nurses in the hemodialysis has an important role in the nursing process implementation, in the context of a theoretical referential. Among the nursing theories, highlights the Roy´s adaptations model, who considers a person as an holistic adaptive system that aims to adapt customers to different living conditions. Thus, it is believed that the Roy´s nursing process will guide nursing care to patients on dialysis. Therefore, the study aimed to analyze the nursing diagnosis present in patients with chronic kidney disease on hemodialysis based on the theoretical model of Roy and NANDA-International. Descriptive and cros-sectional study, performed at a dialysis center in a city in northeastern Brazil. Sample of 178 patients and consecutive sampling by convenience. Data collection ocurred from October/2011 until February/2012, through interview and physical examination forms. Data analysis was initiated by clinical reasoning, diagnosis judgment and similarity relation. Then, the data were entered into SPSS program, 16.0 version, generating descriptive statistics. The project was approved by the Ethics Research Committee (protocol nº 115/11) with a Presentation Certificate for Ethics Appreciation (in 0139.0.051.000-111) and was funded by the Universal edict MCT / CNPq 14/2010. The results revealed that most patients were male (52.2%), married (62.9%) and residents in the Natal´s metropolitan region (54.5%). The mean age was 46.6 years and the years of study, 8,5. Regarding nursing diagnosis obtained an average of 6.6, especially: Risk of Infection (100%), excessive fluid volume (99.4%) and hypothermia (61.8%). On the other hand the adaptive problems average was 6.4, and the most common: intracellular fluid retention (99.4%); Hyperkalemia (64.6%); Hypothermia (61.8%) and edema (53.9%). Were established 20 similarity relations between the NANDA-International nursing diagnosis and adaptive problems of Roy, namely: risk of falls / injury risk and potential for injury, impaired physical mobility and walking mobility and / or restricted coordination, dressing self-care deficit and loss of self-care ability; hypothermia and hypothermia; impaired skin integrity and impaired skin integrity; excessive fluid volume and intracellular fluid retention / Hyperkalemia / Hypocalcemia / edema; imbalanced nutrition: less than body requirements and Nutrition less than the body's needs; constipation and constipation, acute pain and acute pain, chronic pain and chronic pain, sensorial perception disturbed: visual, tactile and auditory disabilities and a primary sense: sight, hearing and tactile; sleep deprivation and insomnia, fatigue and intolerance to activities; ineffective self health and fails in the role; sexual dysfunction and sexual dysfunction; situational low self-esteem and low self-esteem, and diarrhea and diarrhea. We conclude that there is similarity between the typologies and was required a model´s analysis, because they present different ways to establish the nursing diagnosis. Moreover, the nursing process use, under the context of a theory and a classification system, subsidizes the care and contributes to the strengthening of nursing science

A pessoa com tuberculose e o cuidado de si

Tuberculosis is a serious disease with high incidence and prevalence, and in many countries a priority public health problem, with persisting high epidemiological significance. Seeing the person with tuberculosis it is important to observe his/her self care, as well as the difficulties intertwined in this process, since it can be directly impacting the health/disease process. The aim of this study was to analyze the self care of people with tuberculosis. Descriptive study with qualitative approach, conducted in West Sanitary District of the city of Natal, RN. Data collection occurred through a semi-structured interview guided by questions concerning sociodemographic and about the disease, treatment, and self care, between the months of July to September 2012 and met the ethical precepts of research with human beings. To analyze the results we used the technique of thematic content analysis of Laurence Bardin, through the prism of the theoretical-philosophical self care discussed by Michel Foucault. From the analysis emerged two categories, the first being, Meaning of tuberculosis, with subcategories: tuberculosis as sadness and unhappiness and tuberculosis as a normal issue, and the second, Beware yourself to tuberculosis, which had subcategories: self care as attention to the health care of oneself as satisfaction of basic needs and difficulties to self care. Tuberculosis represents for some people, something really sad, causing psychological suffering, however the other presents as normal. Self care of persons with tuberculosis in this study are related in great part to seek health care and the satisfaction of basic needs. About the difficulties related to the practice of self-care, it is observed that these are tied to food, time for rest, slowness of health services for scheduling appointments and tests, as well as related habits and dependencies in the lives of these people. This study contributed to a reflection of the users with tuberculosis and self care, revealing aspects that healthcare professionals should pay attention to watch these people, being able to see everyday on the run, the need for a space and time for oneself

Hanseníase: a implicação da educação em saúde para o autocuidado

A hanseníase é um problema de saúde em nível mundial devido principalmente ao seu potencial incapacitante. A estratégia de combate à doença adotada pelo Ministério de Saúde é o diagnóstico e tratamento precoces, prevenção e tratamento de incapacidades físicas e vigilância dos contatos domiciliares. Tudo isso fundamentado na educação em saúde como sustentáculo para compreensão do processo de adoecimento, da doença em si, sua aceitação e, principalmente, das ações de autocuidado para prevenção de sequelas. Nesse contexto, questiona-se: Qual a implicação da assistência de enfermagem focada na educação em saúde para o autocuidado em portadores de hanseníase? O objetivo geral desse estudo é avaliar os conhecimentos adquiridos pelos portadores de hanseníase sobre a doença, o tratamento e autocuidado abordados durante a consulta de enfermagem. Trata-se de um estudo exploratório-descritivo com abordagem qualitativa, realizado no Hospital Universitário Onofre Lopes. Respeitou a resolução 466/12 do Conselho Nacional de Saúde e foi aprovado pelo comitê de ética sob nº 387.769 e CAAE 17468213.0.0000.5537. Envolveu 14 portadores de hanseníase em tratamento no ambulatório de dermatologia do HUOL. Os dados foram coletados no período de 23 de setembro a 04 de novembro de 2013 por meio de entrevista semi-estruturada; e analisados a partir da analise de conteúdo de Bardin. Os resultados e discussões são apresentados através de um artigo, o qual atende os objetivos propostos, denominado O autocuidado realizado por portadores de hanseníase . Esse objetivou identificar as ações de autocuidado de portadores de hanseníase em uma unidade de referência a partir de três eixos temáticos emersos dos discursos dos sujeitos: 1.as complicações/sequelas da hanseníase conhecidas pelos portadores da doença; 2. as ações de autocuidado adotadas pelos portadores de hanseníase; 3. as possíveis contribuições de um grupo de autocuidado para os portadores de hanseníase. Constou-se aparente superficialidade no conhecimento dos pacientes sobre as complicações da hanseníase, como também, das ações de autocuidado realizadas por eles. Verificou-se também a importância da assistência de enfermagem ao portador de hanseníase, tanto na atenção primária, quanto nos demais níveis de complexidade 11 da assistência. Considera-se que o enfermeiro é um potencial colaborador da educação em saúde como alicerce para o controle e eliminação da hanseníase

Ética e clínica na atenção psicossocial: contribuições da psicanálise de Freud e Lacan

O objetivo central é discutir a possibilidade de uma ética pertinente ao conjunto de ações atualmente realizadas sob o enfoque da Atenção Psicossocial no campo da Saúde Mental Coletiva. Utilizando o método do ensaio, partirei da análise de algumas proposições importantes sobre a ética na Saúde Mental, presentes na literatura recente, e da experiência de vários anos no campo da Atenção Psicossocial como trabalhador, como assessor clínico-institucional do Ministério da Saúde e como formador de psicoterapeutas. Duas vertentes de análise são consideradas: éticas disciplinares, chamadas éticas da psiquiatria, incluindo uma tentativa importante de complementá-las criticamente sob o enfoque da ética do cuidado, e éticas fundadas em concepções psicanalíticas do sujeito e seu sofrimento, que destacam as dimensões do sujeito como entre social e como entre subjetivo ou entre sentido. Com base nas diretrizes do Sistema Único de Saúde e na psicanálise do campo freudiano, procura-se fundamentar a ética da Clínica na Atenção Psicossocial como ética do cuidar-se - base necessária para a construção do protagonismo dos sujeitos do sofrimento na produção do sentido necessário à superação do sofrimento e demais impasses que motivaram a procura de ajuda, e para a possibilidade de seu reposicionamento no entre social e no entre sentido; componentes da saúde em sintonia com a subjetividade singularizada referenciada nos Ideais socioculturais e no devir desejante. Demonstra-se que essa ética exige dos trabalhadores do campo a superação dialética dos modos de produção de saúde e subjetividade em sintonia com o Modo Capitalista de Produção e seus derivados autoritários.