Cuidado de enfermagem ao potencial doador de órgãos em morte encefálica: uma reflexão sobre a prática

Despite of the technological advances that favor the transplant process, there are issues of effectiveness of care necessary for the maintenance of potential organ donors with brain death, which contribute to the no realization of transplants of organs and tissues of these patients. It is presupposed that the problems could be related to perceptions and understandings that the professionals of the units of internment have about the care required by the diagnosis of brain death. The aim of this study was to understand the meaning of the nursing care of the potential organ donor with brain death to the nursing staff. Descriptive study with qualitative approach guided by Action Science Theory and the critic-reflexive research methodology accomplished with five nurses and 19 nursing technicians from Operative Rehabilitation Center in a public hospital at Natal / RN, Brazil, between March and May 2013. Data were collected through semi-structured interviews with individual reflection about the care and through group interview, after approval by the Ethics and Research Committee, CAAE No.: 04255612.7.0000.5537. The analysis was performed in a thematic way according to Bardin. During the group meeting the participants were driven in a discussion about the need for change and how to perform them. The results indicate that the professionals actions are consistent with those required for maintenance of potential organ donors, although the material and human resources are not adequate. That situation leads the professionals to develop a meaning of care as one labor more, demanding more than they can give. They express beliefs and feelings concerning the hope that their care brings a greater good that is to save lives. The reflection for a possible change of action was difficult to accomplish due to professionals not to be able to self evaluate, what lead to direct your changes suggestions for other team members. It is concluded that the care provided to these patients is a difficult care, evidenced by suffering both death situation of the person cared and pain of their families, as the dehumanizing conditions of work, helping themselves to keep distance from patients to not suffer so much. The knowledge impregnated in their act, are scientific, ethical, aesthetic and personal kind with a predominance of the scientific followed by the personal. The study was also relevant to the practice of nursing in maintaining the potential donor, in that it allowed the identification of the knowledge used by nurses in their care practice and the meaning understanding of the professionals on the care provided, as a good action that brings satisfaction when the transplanting is executed. Other experiences are suggested with the critic-reflexive research methodology, both in research as in teaching nursing

Assistência de enfermagem às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência em Mossoró-RN

This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice

Nascimento de um filho :o significado para o pai

Qualitative study on the meaning of a child s birth to the father. Its general purpose was to comprehend the significance the man attaches to his child s birth and its specific objectives were to identify the man s feelings with regard to his child s birth as well as to verify his attitude toward a child s birth. The study was founded on the theoretical reference system about the man in the gravid-puerperal cycle and the humanization of the assistance. The data were obtained through semistructured interview performed with men accompanying their children s birth whose wives were in the immediate puerperium. This stage occurred in two maternity hospitals in Natal-RN, both of which adopt the principle of safe notherhood in the attendance of women in the process of parturition. The material apprehended from the statements was treated in conformity with the content analysis method in the mode of thematic analysis according to Bardin. Three thematic categories emerged from this process: the father s attitude toward his child s birth, the father s feelings in respect of his child s birth, and the informations received by the father in the course of his child s birth. The speech content was analyzed in accordance with the principles of symbolic interactionism according to Blumer. The results showed that the husbands interact with their respective wives and respond with attitudes of care, help, support, and encouragement within the principles of humanization intermingled with feelings of happiness, restlessness, and suffering leading them to appraise and exalt their consorts. Besides, we verified that the father s attitudes and feelings in the delivery room in the light of symbolic interactionism tend to be influenced by the interaction between him and the attending professionals

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.

Um breve estudo acerca do cotidiano do trabalho de produtores rurais: intoxicações por agrotóxicos e subnotificação

Pesquisas na área da Saúde no Trabalho têm revelado a preocupação com os agravos à saúde de trabalhadores rurais decorrentes da utilização de defensivos agrícolas. Diante disso, este estudo objetivou conhecer o cotidiano de trabalho de produtores rurais de uma cooperativa agrícola localizada no interior do estado de São Paulo, bem como avaliar a exposição deles quando da utilização de agrotóxicos no desenvolvimento de suas atividades. Esperamos, com base nos resultados, estar contribuindo com discussões sobre o tema relacionado à saúde dos trabalhadores no contexto considerado. Para coleta de dados, utilizamos entrevistas semi-estruturadas, aplicadas de formas individual e coletiva. Participaram do estudo cinqüenta produtores rurais que desenvolvem atividades nas lavouras de café, soja, trigo e milho. Os dados foram agrupados em cinco categorias e analisados qualitativamente. Os resultados expõem as características da atividade agrícola na região, a utilização dos equipamentos de proteção individual, as técnicas no uso dos agrotóxicos, o sofrimento psíquico e a produção rural e maneiras de lidar com as situações de intoxicação e alertar os órgãos competentes para o problema da subnotificação.

Helena de Machado de Assis; Imagens literárias e a retórica da morte da nação inconclusa

Helena is the romance of perishable and discontinuous title character denominator of a dialectic that does not consume and build the narrative by sequential fragmentation combined with episodic frame. The novel is a lightning stroke to the romantic literary project. Therefore, this study aims to find "objective" elements of the novel that would constitute a conception of literary nation proposed by Machado de Assis, as in classical writing, where women are engaged as a metaphor for the nation by a non-cultural heroism, as the example of the Greek myth of Helena, where the feminine represents a mythical image of the nation. The paper's theoretical conception of the history of Walter Benjamin, that is, that is constructed as an allegorical appeal, the conclusions about the disciplinary society of nineteenth century of Michel Foucault, the construction of the nation as a subtle game to remember and forget of Wander Miranda and the rhetoric of death and loss reflected in the speeches of the cultural heritage of José Reginaldo Santos Gonçalves, which allow you to analyze the work permeated by subjectivity and existential conflicts by Machado, who has it arranged in dialectic with the avant-garde literary romanticism and realism. In this relationship with the Greek myth of Helen, explained that characters with the nickname of Helena in Machado's work are not uncommon. As in classical Helena, Machado s Helena uses three rhetorical are the cause of the seizure of the nation. In this game of remembering and forgetting, in the daily plebiscite, Machado draw ideal images that forged our mythical past and commitment to the future. The suffering love of Helena is suffering from failure of the nation which would have led the author to the use of allegorical language, seeking a balance in the chaos generated by the opposition between cruelty and pity widespread view in an area where only left the character's confession guilt for the death. It is a simulacrum of unfinished nation, the space for the game of remembering and forgetting, while the rhetoric of negotiation of our Brazilianness

As Noites Mussetianas na Lírica Castroalvina

Ce mémoire de master a comme objectif étudier l influence du recueil Les Nuits d Alfred de Musset dans la poésie de Castro Alves. Nous allons procéder à une analyse textuelle des poèmes A volta da primavera , Murmúrios da tarde et Adeus à partir de la transposition des thèmes traités par le poète français dans La nuit d août , La nuit de mai et La nuit d octobre . A traves l intertextualité manifestée par des épigraphes de ces poèmes mussetiens, nous trouvons des ressemblances et dissemblances éventuelles qui assurent d un rapport entre ces deux auteurs. Le lyrisme romantique d orientation mélancolique établit des liens entre des poètes qui ont un concep cyclique du sentiment amoureux: de la naissance à la mort, et de celle-ci à la renaissance. La femme, qui se trouve liée aux événements naturels, change le paysage, sa présence étant une raison raison de joie et son absence, une souffrance. La nature évoquée et ses saisons servent de décor vivant aux penchants d états d esprit parmi les amants. Alors, nous verront dans le premier poème castroalvino l euphorie des noces printanières; La mélancolie éprouvée au déclin du jour et ses soupirs évanescents dans le deuxième poème; et dans le dernier, le deuil fermé d un amant qui resiste à accomplir le deuil de l objet d amour

Nietzsche e Rosset: alegria, impulso à criação

Understood in a project of transvaluation of values, the joy is one of the central themes of the thought of Friedrich Nietzsche and Clément Rosset. Opposed to the dogmatic philosophy that moralize and robs your strength to think of it as "happiness", evaluated, in short, a target linked to virtue and rationality these thinkers propose a perspective that makes the joy of point to an instance extraterrestrial and back to the earth, to the body. In this vein, beyond the oppositions of values constitutive of metaphysics dogmatic, the joy and suffering are conceived as elements that are not mutually exclusive, they are complementary as foundations of a gaia(ta) science, based in laughter and friendship. Contents of a tragic wisdom that leads to an unconditional fidelity to the real (expressed in formulas of amor fati Nietzsche and unrestricted approval of existence Rosset), the joy is then interview as vital impulse, the force majeure, the strength plastic encourages artistic creation: the joy of children playing

Psicologia e profissão: neurose profissional e a atuação do psicólogo organizacional frente à questão

Este artigo pretende fazer um levantamento bibliográfico sobre a neurose profissional, cujos sintomas são entendidos como a expressão simbólica de um conflito psíquico que se desenvolve a partir de uma situação organizacional ou profissional determinada. O diagnóstico é formado a partir das queixas mencionadas, da história de trabalho e da análise da situação de trabalho atual. Entende-se que condições estressantes de trabalho, associadas ao contexto social de desemprego e competitividade, contribuem para o aparecimento de doenças mentais como a neurose profissional. As formas de tratamento para essa doença, além da psicoterapia individual, envolvem a ação integrada de uma equipe multiprofissional capacitada para lidar com o sofrimento psíquico do trabalhador e com os aspectos sociais e de intervenção nos ambientes de trabalho. Ressalta-se a carência de literatura sobre o tema estudado e a importância de se ampliar a discussão sobre os fatores de risco no trabalho, os determinantes psíquicos para o desenvolvimento da neurose profissional e o papel do psicólogo no contexto de prevenção e promoção da saúde mental.

Nervos: rede de discursos e práticas de cuidado na atenção básica no município de Natal/RN

The Primary Health Care and one of its main strategies, the Family Health Strategy (ESF), are framed as the gateway to the Public Health System (SUS). Thus, most of the incident and prevalent health problems in the population attended should be solved at this level of care, including psychological suffering, and the so-called complaint of nerves. Nerves and nervous denote a complexity that is not always well comprehended by health workers, in such a way that the care to this kind of problem is usually inadequate. In this line of thought, the general objective of this study is to analyze the network of discourses and the care to the psychological suffering, expressed as nerves, in SUS daily Primary Health Care. Besides and more specifically, it aims at identifying the principles and guidelines of the Primary Health Care in mental health; to investigate health workers positioning before psychological suffering and complaints of nerves, and also analyze different actions and practices of care carried out in different Health Units towards complaints like nerves. Institutional Ethnography was the theoreticalmethodological perspective adopted for the work. This approach seeks to understand and analyze the institutional relationships in a particular context considering sociostructural influences and power relations, as well as daily discourses and practices. Based on interviews with health professionals, informal conversations and observations in six Health Units with ESF teams from different sanitary districts in Natal/RN, it was possible to check that the index of complaint of nerves is high. The referral to psychologists and psychiatrists, as well as the prescription of psychotropic drugs appear as the most common intervention at this level of care. In general, the participants complain that they have poor specialized knowledge about the theme of mental health. They face the problem of bad work conditions and the lack of institutional support, which make actions of illnesses prevention and health promotion even more difficult. Besides, there are different ongoing practices such as meetings for hypertensive and aged people, walk, visit, round-table discussions and community therapy. However, not all of these actions are aimed at the care of psychological suffering. It is observed that the Matrix Support, which is a methodological strategy of supervision and follow up forcases of mental health, hasn t been totally implemented in the municipal system, although it is a tool that has been used by psychologists in some Health Units in the city. It was also verified that the health care practices to the problem of nerves strongly depend on the professional s commitment with the PSF guidelines and on mental health policies, in addition to continued support, when available, from other professional who works as matrix supporter

Masculinidade a prova: um estudo de inspiração fenomenologico - hermeneutico sobre a infertilidade masculina

Culturally, childbearing is understood as a situation that subjects will experience at some point in their lives, especially people who are married or have a similar affectionate relationship. Thus, to realize the inability to meet such a fate seems to be a natural cultural trigger of suffering, frustration and feelings of inadequacy and helplessness. Specifically for men, infertility is closely related to loss of masculinity, virility. He fails in his role as a male. This study sought to understand the impact that infertility have on the existence of a man who receives such a diagnosis, both in self-image as in their marital, sexual and professional roles. This study sets up as a hermeneutic phenomenological research based on the ideas of the philosopher Martin Heidegger. Participants were seven heterosexual, married and infertile men. Two interviews were conducted. The analysis of the material included both the material of the narratives, as the affectation of the researcher when interacting with the participants and their narratives, through phenomenological-hermeneutic interpretation. The results corroborate the literature that states the difficulty of the men, immersed in a context that defines them as virile, powerful and invulnerable to worry about issues related to health and disease. The possibility of any condition that impairs the reproductive capacity exceeds the acceptable limits of daily life for these men, not being recognized as a model of masculinity present in the condition in which they recognize. This leads to questions about their masculinity, role in the marital relationship and their existence. Thus, to recognize themselves as infertile surpass a medical diagnosis and is associated with the construction of meaning for their existence from the approximation with the infertility condition, which helps in redirecting their choices, restoring the project to be self and allowing further recognition as men. In the marital relationship, doing what they can to ensure, theirs happiness. Through these actions, they remain playing the role of family provider, showing that they are able to protect their wives and taking in assisted reproduction or adoption of children viable alternatives to fulfill the desire to leave a legacy and give a child to their wives and to society. Another result observed, refers to the ontological condition of care that characterizes the human being. The ways in which men are treated socially demonstrates a type of care that focuses on the development of characteristics such as strength, virility and determination but does not allow them to cope with the suffering of emotionally difficult situations, such as the diagnosis of infertility. At the end, the study gives rise to reflections on the need to provide a 12 space for men and their expressions of suffering, as well as to recognize their ability to overcome the painful and difficult situations

Do útero à adoção: a experiência de mulheres férteis que adotaram uma criança

Even with all changes and ruptures related to the social roles that woman had performed, the literature had confirmed that the motherhood still configures it like one of the main roles that she hopes to play in some moment of her life. When the woman did not get pregnant or take ahead a pregnancy, some women find in adoption an alternative to play this role. This research aimed to understand the experience of being mother for adoption in the case of fertile women, but whose partner is infertile. Supported by existential-phenomenological theory, used it the narrative, how methodological instrument. Participated five women, whose adoption process followed the legal ways in the Youngness and Infancy Judgeship of Natal/RN. The results showed that in the selfish training, the woman to see herself how whose role principal is to generate children, although, she think that is natural her participation in others activities go out home too. In male infertile case is a tendency that the woman strikes the infertile status too. The adoption is an alternative to fulfill her desire of being a mother and, meanwhile, please her husband and guarantee the continuity of her love relationship. Through motherly care, the woman discover herself as a mother, what brings a new meaning for her live, independent of to generate a child. Though, exit frustration, sometimes, in association with suffering, on account of the pregnancy and childbirth absence. The end of the research suggests reflections that to become fulfilled herself as mother, the woman does not need, necessarily, to generate a child, being the maternity one of the uncountable possibilities that are shown, and that she can choose, or not, accomplish it

Compreendendo a experiência de pessoas portadoras de transtorno mental: histórias de vidas severinas repletas de possibilidades

This study aims to understand the experience of people suffering from mental disorder. The patients are enrolled in a mental health ambulatory clinic in the city of Natal (RN). Mental disorders are growing rapidly in the contemporary world and are a source of intense mental suffering. Besides patients being strongly marked by a history of isolation and prejudice, they have been the target of real atrocities committed in the name of preservation of a supposed normality. The understanding and treatment of this disorder is influenced by cultural and historical inferences, depending on the period in which it is experienced. Semi-directed Interviews were conducted with a group of users, with the emphasis on giving voice to their uniqueness and individuality, highlighting how each one perceives his or her own experience. These were recorded and later transcribed by identifying the core of meanings. The results were analyzed under the gaze of the Humanist Phenomenology Existential perspective, which aims to unravel the phenomenon, without truths from volatility, highlighting the existence of the mental disorder as a way of living, being permeated by suffering mental and influenced by social problems, assuming contours very particular to each individual. Some progress has been perceived, even by users, with respect to the change of paradigm in the way of care, but still there is a consistent emphasis on medical and drug use. The changes point to the need for offering services to replace the asylum hospital model, and in addition to accept the bearer of mental disorder as a citizen, a bearer of rights who should be accepted and respected by society. Despite the pain expressed and its close liaison with suicide, their reports are full of perspectives and attitudes of confrontation facing life, pointing to new possibilities to be, recreating itself

O médico diante da morte na urgência e emergência:reflexões sobre o ser médico

The literature pointed that the way which people deal with death have been changing along centuries, and nowadays what is realized it is that, each time more, the human being have difficulties to deal with death. Due to the fact that the main function of the physician is to save their patients lives; responsibility that is aggravated by the necessity of to take decisions quickly, once he need to deal with the unexpected situations of the urgency and emergency, many times these professional have to face of impotency and fail situations, when he lose a patient. The main goal of this study was to understand the experience of physicians that work in the urgency and emergency, in front of death. These questioning it justified by the fact of the physicians do not have, many times, a space to express their suffering and anguish about the issues related to death in their work routine, despite lifedeath question to be often present their everyday. It is still possible to verify in the literature, an appointment of the necessity of to include in the curriculum of Medicine courses, subjects that approach such questions. The method used was based on the existential-phenomenological perspective, using as instrument the participant observation, to the intent of understand the routine in the urgency and emergency context, and semi-structured interview. It was interviewed six physicians that work in the urgency and emergency of the most important hospital of public health system of Natal-RN. The results showed that the physicians reported pleasure in work in the urgency and emergency, despite of they presented stress and the difficulties that they deal with in the public system. Despite of the fact that the death to be considered as a phenomenon that make part of the physician s routine, sometimes, deals with these one is more difficult. Many times losses generate an impotency and guilty feeling, as well as questionings about their performance during the attempts to save lives. We verified, from this study, the importance of the existence of some kind of intervention in the emergency, in order to the physicians can elaborate the questions about death and die emerged in their work. We consider yet that this study corroborates and reiterates the discussions concerning the importance of this thematic to be approached in a more effective way, during the academic formation of these professionals, as well as, the importance of a larger investment from the part of Government in the urgency and emergency sector, in order to propitiate to these professionals a work that brings less harmful for their health

Moradores crônicos de hospital psiquiátrico: um desafio à desinstitucionalização

The existence of chronic inhabitants in the psychiatric hospitals imposes a challenge to the Psychiatric Reform, that proposes things such as the gradual and progressive way to extinct mental institutions, once the permanence of the hospital in the system is only necessary because there is not a net of well structured substitute services capable of receiving that demand. This work considered relevant to deepen the knowledge about those people who passes their lives jailed by the walls of psychiatric hospitals and compose significant part of the world population. It also aimed to investigate the problem relative to the condition of being an inhabitant of a psychiatric hospital the Dr. João Machado Hospital (HJM), in the city of Natal/RN. The paper used different points of view (patients , families and professionals ) to define the profile of the inhabitants, to identify the possibility of insertion in substituting social equipment, to know the expectations of the inhabitants and their relatives regarding to the exit of the life shelter, to investigate the demands related to the net of cares social support for making feasible the discharge and to identify the difficulties that are involved in the exit of the chronic inhabitant of the hospital. There were defined three methodological phases: delineation of the identification, socio-economic and clinical profile of the inhabitants of the HJM; semi-structured interviews with professionals; and open interviews with inhabitants and family. It concluded that the psychiatric institutionalization contributes to the generation of chronic inhabitants in the psychiatric hospitals. Among the professionals, it was detached the defense of desospitalization, but an existence of devices of the asylum model. The relatives showed a resistance to participate in the care and the inhabitants exposed their desire to leave the hospital, as well like the wish of permanence. It was considered important: the construction of an extra-hospital net that enables to desinstitutionalization; the qualification of the technical; orientation to the family, stimulating its participation in the process of caring; give freedom to the individuals in mental suffering, enabling them to be ahead of their lives and express their desires and opinions; the implementation of an extended clinic that is capable of building new possibilities; and a subjectivity guided by the social enclosure