O cuidar de enfermagem e da família à pessoa idosa no domicílio: uma abordagem etnográfica

O envelhecimento é um processo multidimensional que envolve entre outros os aspectos físico-biológicos, sociais, econômicos e psicológicos. Ao avaliar essa fase da vida dentro de uma visão social e cultural, percebe-se que ser idoso ou não varia com as concepções culturais, sendo necessário investigar as variações que atuam no processo e rege o fenômeno sociocultural da realidade em que se está inserido. Com o aumento da população idosa mundial, esse processo tende a se intensificar. Estima-se que até em 2050 existam cerca de dois bilhões de pessoas com mais de 60 anos no mundo, e a maioria delas vivendo em países em desenvolvimento. No Brasil, acredita-se que existam, atualmente, cerca de 20 milhões de idosos. A normatização e legislação brasileira de amparo ao idoso em relação à saúde iniciaram-se a partir da Constituição Federal de 1988 e da Lei 8080 que regulamenta o Sistema Único de Saúde em 1990, em seus níveis de complexidade: atenção básica, média e alta complexidade. Para auxiliar nessa prestação dos serviços na atenção básica de saúde é importante observar as condições sociais, culturais, econômicas e de saúde dos idosos e seus familiares. Nesse sentido, a visita ao domicílio e a avaliação deste idoso em seu ambiente doméstico torna-se fundamental para acompanhar o cuidar prestado e o quanto esse processo irá interferir no sistema de saúde, na família e na qualidade de vida dos idosos. Neste contexto, o enfermeiro como integrante da Equipe de Saúde da Família, presta assistência à saúde do idoso no domicílio. Nesse sentido, o objetivo do estudo é analisar o cuidado de enfermagem e da família à pessoa idosa no domicílio com vistas à identificação das influências socioculturais. Trata-se de um estudo do tipo descritivo e de abordagem qualitativa, norteados por princípios teórico-metodológicos da etnografia com vistas ao estudo da influência dos aspectos culturais e sociais na assistência da família e do enfermeiro à idosos em domicílio. Foi realizado no município de Santana do Matos, RN, tendo como participantes, idosos, familiares e enfermeiros da equipe da ESF, definidos a partir da população do município e obtendo-se uma amostra intencional de 25 participantes: 6 enfermeiras, 10 idosos e 9 grupos familiares. Para a coleta de informações, utilizou-se observação, entrevista, diário de campo e grupo focal. Os resultados foram apresentados em forma de narrativa descritiva, na perspectiva dos conceitos de Boris Cyrulnik, com análise interpretativa cultural de Geertz, na busca dos significados e símbolos próprios da cultura da velhice de idosos e dos seus familiares, sobre cuidados que são realizados, tanto pela família, como pelos enfermeiros em domicílio. Observou-se que a família e o cuidador, dentro de sua realidade social e cultural, precisam ser mais compreendidos pela equipe de saúde para ser melhor orientados e capacitados na realização do cuidar de forma adequada. Por sua vez, os profissionais de saúde, em especial o enfermeiro, enfrentam dificuldades para realizar o cuidado ao idoso no domicílio como a grande demanda de atribuições na unidade de saúde como consultas e atendimentos; falta de transporte até os domicílios; extensão territorial do município e das áreas assistidas; número de pessoas atendidas por cada equipe; falta de compreensão dos profissionais de saúde quanto à importância da visita domiciliária na atenção básica. Entendem a necessidade de realizar ações de promoção em saúde, prevenção de agravos e de educação em saúde, além de reconhecerem a importância de uma melhor formação acadêmica para atuar nessa perspectiva e contribuírem para as mudanças necessárias na prática dos cuidados ao idoso em domicílio

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Fatores condicionantes da utilização da Internet na compra de serviços de viagens e turismo: estudo com turistas brasileiros em visita à Natal-RN

In today s global society, companies have become even more competitive with the abundance of information that prospective clients have available to them. This way the tourist services has appropriate the distribution using electronics ways as information for doing acquirement services. This work, shows the adopted provision of on-line tourist services does have suited apportionment for factors and buy decisions. The method used is a survey applied to the tourists, at international airport Augusto Severo, no matter why the visit reason to Natal city, at all, they were 210 people, being the chief variables evaluated the tourist perception of facility, utility, benefits, amenity and pleasure from the Internet s use, under the terms at the tourists experiences from the WEB about to acquisitions and researches. The results acquaint that the younger tourists or less experts tourists, in visit to Natal, demonstrated greater bias to the Internet s use than the other people. By the way women have a larger representation as a consumer from the WEB and finally, people along greater study tends to adopt. The work s contribution provides greater knowledge for the tourism executives about how might use the Internet, as well as bring forward a scene propitious for the on-line diffuseness service

Cargos comissionados da administração pública direta do Rio Grande do Norte: análise comparativa entre o perfil profissional dos cargos comissionados com vínculo funcional e sem vínculo funcional

The professional profile of public administrators in Brazil is changing very rapidly in recent years, seeking to meet the principle of efficiency by public agencies at all levels. The admission of the permanent government employee under the Public Administration is by competition, however, commissioned positions are free appointment of managers, which allows effective participation of external experts according to their respective standards and norms. In this context, this dissertation seeks to understand the main characteristics of the profile of the occupants of commissioned positions in Direct Public Administration of the State of Rio Grande do Norte, noting the differences between those with functional link with the have nots. For this study, by data collection and content analysis, a mapping of the administrative structure of the Government of the State of Rio Grande do Norte was done, i.e., the organization of the Executive Branch, which is regulated by the Complementary Law no. 163/1999 and its amendments, which consists of 53 (fifty three) entities, these 29 (twenty nine) are agencies of the direct administration and the remaining 24 (twenty four) comprises the indirect administration. With the collected data, analysis on the number of commissioned positions of each organ of the State of Rio Grande do Norte and information on education, age, length of service, gender and functional link with the direct administration was carried out. Data were available from SEARH in June/2013, when they totaled 58,733 (fifty-eight thousand seven hundred thirty-three) servers, these 2.15% (two point fifteen percent) occupy commissioned positions, corresponding to 1,262 commissioned positions under the Direct Administration, below the national average of 4% (four percent). Of total commissioned positions 64.7% (sixty-four point seven percent) have no functional link with the direct administration, while only 35.3% (thirty -five point three percent) have functional link. It was noticed that there are no clear and specific criteria for the appointments of commissioned positions in the State. They occur freely, as provided in the State Constitution. Another conclusion is the importance of Public Administration define and improve their capacity, competence and efficiency in the delivery of public services. For that it is necessary to invest in their workforce composed of permanent employees and commissioned positions to define the appropriate professional profile

Diagnóstico do usuário no aprimoramento dos serviços de tecnologia da informação: um projeto de intervenção para o Ministério Público do Estado do Rio Grande do Norte

The information tecnology (IT) has, over the years, gaining prominence as a strategic element and competitive edge in organizations, public or private. In the judiciary, with the implementation of actions related to Judiciário Eletrônico, information technology (IT), definitely earns its status as a strategic element and significantly raises the level of dependence of the organs of their services and products. Increasingly, the quality of services provided by IT has direct impact on the quality of services provided by the agency as a whole. The Ministério Público do Estado do Rio Grande do Norte (MPRN) deployments shares of Electronic Government, along with an administrative reform, beyond these issues raised, caused a large increase in institutional demand for products and services provided by the Diretoria de Tecnologia da Informação (DTI), a sector responsible for the provision of IT services. Taking as starting point strategic goal set by MPRN to reach a 85% level of user satisfaction in four years, we seek to propose a method that assists in meeting the goal, respecting the capacity constraints of the IT sector. To achieve the proposed objective, we conducted a work in two distinct and complementary stages. In the first step we conducted a case study in MPRN, in which, through an internal and external diagnosis of DTI, accomplished by an action of internal consulting and one research of the user satisfaction, we seek to identify opportunities of change seeking to raise the quality perceived of the services provided by the DTI , from the viewpoint of their customers. The situational report, drawn from the data collected, fostered changes in DTI, which were then evaluated with the managers. In the second stage, with the results obtained in the initial process, empirical observation, evaluation of side projects of quality improvement in the sector, and validation with the managers, of the initial model, we developed an improved process, gazing beyond the identification of gaps in service a strategy for the selection of best management practices and deployment of these, in a incremental and adaptive way, allowing the application of the process in organs with little staff allocated to the provision of information technology services

Os Centros de Especialidades Odontológicas como suporte da atenção básica: uma avaliação na perspectiva da integralidade

The public dental services in Brazil were limited, practically, to the basic care, so that the specialized services acted, up to 2002, no more than 3,5% of the total of clinical procedures. That lower offer reveals the difficulty of continuity of the attention, that is, the comprehensiveness in the assistance, particulary, the reference and counter-reference system. Brasil Sorridente search to supply those needs when proposing Speciality Dental's Centers(CEOs Centros de Especialidades Odontológicas, Brazil) to compose the services of average complexity. In 2005, Ministry of Health enabled the three CEOs of Natal, located in the North II, East and West Sanitary Districts. This investigation evaluated the implantation of these CEOs, as support of the family health care teams, in the perspective of organization of the services in assistencial nets in Natal/RN. It was a study of evaluation, with qualitative approach and some quantitative data as contribution. Dentists, users and managers were interviewed to identify and to understand their perceptions, relationships and experiences in the daily of the services. The conceptual base that orientated the investigation was the principle of comprehensiveness, in its operational sense of the hierarchization in health attention levels. The collection of data was done with documental research, direct observation and semi-structured interview. The analysis was accomplished by triangulation of the extracted content from the used techniques and sources of interviewed groups depositions, looking for theoretical-conceptual support in specific bibliography. The results pointed aspects that go away from the comprehensiveness like: low resolution of problems in the basic net; little valorization of the space in the health units; traditional models of access to health services, insufficient offer for some specialties, compromising the reference and counter-reference system; practices centered in procedures in the CEO; bureaucratic directions from basic care to the specialized service; disintegrated and disjointed system among levels of attention; disrespect to the municipal protocol. On the other hand, there is an approach of compreensiveness in situations like: increase of the access and covering in the Family Health Strategy (ESF Estratégia Saúde da Família, Brazil); larger approach between professional and user; tendency to the quantitative and qualitative growth of specialized actions; punctual initiatives of relationships among levels; existence of protocol to guide professionals

As organizações não-governamentais (ONGs) de atenção à criança e ao adolescente em Natal/RN: contribuição na garantia de direitos?

In contemporaneousness watches in Brazil the emergence of a "new" relationship between State and society based on partnership, which will allow the growing playacting organizations "non-profit" and "public interest" in the management of social public policies. In that sense, as part of a logic of global restructuring of the Capital, under the aegis of the neoliberal project, starting from the years of 1990, an administration model is had in favor of the market that looks for to minimize the actions of the State, reinforcing the outsourcing of the social public politics, and consequently, debilitating rights legally conquered. In that way, with this study it was pursued as general objective to apprehend the actions developed by Non-governmental Organizations NGOs in the child's area and of the adolescent in Natal / RN, verifying in that measured, these contribute to the warranty of rights or they reproduce practices of welfare work, and as specific objectives: to identify the group of the actions developed by NGOs in the child's area and of the adolescent in Natal / RN; to analyze the practice of NGOs of the point of view of the human resources, of the administration, of the financing, of the user's participation in the decision processes, as well as the quality of the services and the continuity of the actions of these organizations; and to apprehend the relationship between the researched organizations and users in the process of implantation of the actions, in order to identify the perspective that guide the practice of NGOs is going in the direction of contributing in the warranty of rights or in the reinforcement to the welfare work. In summary the results showed two trends in the actions of the NGOs, in the direction of the provision of services, which still unfurls in two perspectives of handouts. The other trend will give priority to the defense of rights of children and adolescents, with actions of political impact strengthen the promotion of public policies state, thus contributing to guarantee rights

A Construção/reconstrução das competências profissionais do assistente social diante da gestão do serviço social da indústria SESI a partir dos anos 90

L´étude du processus de construction / reconstruction des compétences de l´assistant social sous la gestion du SESI (Service Social de l´ Industrie), Natal/RN, dès la moitié des années 90 a réaffirmer la perspective que ce processus est le résultat de déterminations macrosociétaires qui sont présents, particulièrement au Brésil, aussi que, la façon par laquelle l´assistant social, le professionnel inscrit dans la division sociale et technique du travail, fait développer son perfectionement technique et intelectuel dans un milieu de nouvelles structures productives qui éxigent un nouveau profil du professionnel face à la crise du capital et de l´État. Cette recherche, de nature qualitative et quantitative, a eu lieu par de combinaisons de recherche bibliographique et empirique. Les sujets ont été huit assistants sociaux et six travailleurs administratifs du SESI, Natal/RN. Les donnés ont été obtenus par des interviews semi-structrées. On a analisé les changements qui sont arrivés dans les gestions du SESI et les compétences qui sont éxigées de l´assistant social ; l´influence du milieu socio-occupationel sur l´action professionnelle et sur le processus de construction/reconstruction de compétences; l´agrandissement de demandes institutionnelles pour l´assistant social par rapport à la prestation de services ; aussi que la constatation de l´importance de ce professionnel, sa hardiesse, mais aussi quelques limites et défis affrontés face à la qualification stimulé par le SESI, en amenant le professionnel dans un processus contradictoire de qualification et disqualification professionelle

Câncer de mama: vivência das usuárias dos serviços prestados pela Liga Norte Riograndense Contra o Câncer

This study is about the users' experiences of the services offered by League Against Câncer that are in treatment of breast cancer, focusing on how the health/illness process develops. It is distinguished, in this context, the National Politics of Health, approaching the sprouting, implantation and consolidation process of the Unified Health System and its shocks on the installment of health services to the low-income population as a legit right from Citizen Constitution. It has as an objective to analyze how the social-economic extract of these women intervenes with such process, the aspects who involve the cancer while a pathology, approaching the signals, symptoms, forms of prevention, diagnosis, among other aspects that configure themselves as important points to the understanding of these experiences, since the diagnosis, treatment and control phases. The research was carried out with 25 women, between the months of January and February of year of 2005. The used technique was the scriptstructured interview, whose universe was defined through intentional sample. The following distinguishes as a result of the research: The majority of the women has its origins on the interior of the state, possesses a familiar income from one to three minimum wages and didn't make any kind of prevention before diagnosis, currently make treatment, beyond other aspects. It becomes necessary posterior studies on this social problematic, with respect to the personal, professional, familiar and social daily behavior of these women. It is worth mentioning that the role of the social assistant in the developed work with these women, understanding all the impediments associated with such experiences, as well as giving information about the rights of the patients with cancer, conquered through the years

Modelo geral das atividades da empresa

O modelo evidencia que as atividades de qualquer tipo de empresa, inclusive a de serviços, podem ser organizadas em quatro grupos (produção, atendimento, apoio e planejamento) e que essa organização é aplicável à empresa como um todo, a qualquer órgão (departamento, seção) e a qualquer célula de trabalho, inclusive a constituída por apenas um funcionário. O modelo, por mergulhar, como nenhum outro, nas profundezas da empresa, complementa outros modelos (Tavistock, Katz & Kahn, Kast & Rosenzweig). A comparação com o modelo da Cadeia de Valores de Porter e as vantagens apontadas no texto permitem concluir que o modelo é bastante adequado para a proposição de mudanças na empresa que melhorem sua posição competitiva.

Estresse, qualidade de vida e percepção de suporte familiar em porteiros

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

O comitê gestor da internet no Brasil: gestão, segurança e comunicação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A qualidade dos serviços educacionais e a proteção do código de defesa do consumidor

Pós-graduação em Direito - FCHS

As obrigações decorrentes das relações de trabalho face à Emenda Constitucional n. 45 que deu nova redação ao art. 114

Pós-graduação em Direito - FCHS

Negociação coletiva no setor público

Pós-graduação em Direito - FCHS