Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

Adaptação e validação da escala de motivação à prática de atividades físicas

The study of the motivation to practice physical activities is relevant once through this it is possible to develop intervention strategies for sedentary population. In this way, the present dissertation aimed to adapt and validate for the Brazilian context the Motives for Physical Activity Measure Revised (MPAM-R). It was investigated yet the relation of some socio-demographic variables (age, gender, Body Mass Index - BMI, types of physical activity; way to practice and time of practice) and the participants means in the motives studied. The physical activity (PA) is defined as any bodily movement produced by skeletal muscles resulting in energy expenditure above the basal level. However, in the present study it was considered motivation for two types of PA: the physical exercises and sports. The Self-Determination Theory (SDT) underlay this research, once it has been used in the sportive context, beyond the facto of it was used as theoretical base to the development of MPAM-R. To attain the proposed goals, it was accomplished translations to Portuguese of the original English scale. Next, was carried out the semantic analysis and the judge analysis. For the empirical analysis of items, participated 309 practitioner of PA, classified in physical exercises practitioners and sports practitioners, with ages between 16 and 74 years, distributed equally by sex. They answered the final version in Portuguese of the MPAM-R and socio-demographic questions. The data was collected in Natal/RN, where the researcher approached people in some places where the PA is practiced, following she communicated that their involvement will be spontaneous and their responses will be confidential. The obtained results pointed the confirmation of the existence of five factors in the final version of the instrument, that was composed by 26 items that presented the following statistics indexes: x² (289) = 757.75, p < 0.000, x²/DF = 2.62, with GFI of 0.83, AGFI of 0.80 and RMSEA of 0.07. The reliability (Cronbach Alpha) of the complete instrument was 0.90, and the indexes of each factor were considered satisfactory too: Enjoyment (α = 0.88), Health (α = 0.84), Appearance (α = 0.79), Competence (α = 0.85) and Social (α = 0.75). It was observed that, in general, the main motive presented by the participants to practice PA was Health. It was verified yet, that women and aged had a higher mean in the Health factor; among the exercise practitioners was found a higher mean in the Appearance factor; and a higher mean in the Social factor was found among those that practice PA with accompaniment. It was concluded that the MPAM-R presented satisfactory psychometric parameters, became it useful in futures researches. Moreover, proposed the accomplishment of new studies that considered others variables to the intent of the better understanding of motivation to practice physical activity

A experiência de adolescentes portadores de diabetes Mellitus Tipo 1: seus significados e sentido

Worldwide, the diabetes mellitus is considered a serious problem of public health; it also involves high costs for its treatment and its complications. Even though the onset of diabetes mellitus type 1 is on 5% to 10% of the diabetic population, it is the most aggressive type of anifestation; furthermore, it is the commonest chronic disease in childhood and adolescence. Such data show the importance of understanding the development of this disease from the moment the individual perceives it, according to their experience, observing the complexity of the phenomenon thoroughly. This study aimed to comprehend the experience of the adolescent with onset of diabetes mellitus type 1 in order to learn how these young individuals perceive and reason their place in the world when they experience this illness. The methodological strategy was based on qualitative research of phenomenological inspiration. We applied the main ideas of heideggerian ontology and some concepts of existential phenomenological psychology to guide our reflexive path. The participants were 10 young individuals (06 female and 04 male), ages between 15 and 18, under treatment in the city of Recife, Pernambuco. The methodological resource was the narrative, which allowed us access to the adolescents experience. The comprehension of the reports was based on the heideggerian hermeneutics, whose priority is the interpretation of the meaning expressed by the participants speech. The results showed that factors such as social, family, economic and cultural context greatly influence the perception and the way the individuals deal with, perceive and reason their experience. We noticed that the diabetes type 1 may often represent a limitation, but it does not make it impossible to be part of the world with others. The data show a significant affective ambivalence regarding the content more directly related to the disease. This demonstrates the unique way which each one gives meaning and reasons their condition of existence. This research points out the need to understand the complexity of this phenomenon in a more complete manner, considering the adolescent in their timely and historical context. We believe we can encourage thinking that may become actions which are more fit to the reality researched regarding all the parties involved with the subject, such as health professionals, adolescents, family, support programs and public health policies

A doença como ponto de mutação :os processos de significação em mulheres portadores de lúpus eritematoso sistêmico

Systemic lupus erythematous (SLE) is a chronic and auto-immune disease that can affect several systems of one´s body, including the nervous system, causing several clinical evidences, which can put in risk the person´s life. Although the illness could manifest itself at any age or sex, studies indicate higher incidence among women. Its etiology points to the combination of genetic, hormonal and environmental factors. Due to the disease´s complexity, it is evident that it affects all the person´s life as a whole and not only its organic dimension. It is believed that the signification attributed to all the process of sickening influences its treatment, as well as the person´s capacity to cope with the difficulties and implicit profits involved in the process.In this study, eight women who were affected by SLE were interviewed, with the aim of examining carefully the processes of signification as well as the generation of meanings which permeate these women´s sickening processes. The analysis of their speeches evidences distinct forms of giving meaning to the process, regardless of the time of the diagnosis. The fact that the disease is incurable was shocking to all the participants, and it demanded changes in their lives, in order to detain a relative control of their condition. The majority of the participants were able to deal with these modifications, since strategies have been created to face the difficulties and thus to preserve their social life, without damaging their health. However, some of the participants did not obtain strenght to cope with the disease, eventually developing a depressive state. It is observed that not only SLE has innumerable ways of manifestation, but the experience of the illness is very subjective and dynamic. There are also several ways of expressing this experience, according to the implications in the social, cultural and economic context where the participants are inserted. This ratifies the necessity of a interdisciplinary approach to embrace SLE complexity. (310 words, 1.610 characters)

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

Implicações socioambientais da construção de um parque eólico no município de Rio de Fogo-RN

The purpose of this study was to investigate the social-environmental implications of the first large scale wind farm recently built in Brazil (2006), Parque Eólico de Rio do Fogo (PERF), to the nearby communities. The research was base on the adjustment of the DIS/BCN tool to analyze social impact and it was linked to the multi-method approach. Applying the autophotography strategy, cameras were given to five children from the district of Zumbi, the nearest location to PERF, and they were asked to individually photograph the six places they liked the most and the six places they liked the least in their community. Then, these children were interviewed individually and collectively about the photographs. Adult locals in Zumbi, residents of Zumbi/Rio do Fogo settlement, members of the State and Municipal government and representatives of the PERF were also interviewed with the aid of some of the pictures taken by the children and others that might trigger something to say, as a strategy called sample function. The five children presented positive image towards PERF; all of them chose to photograph it as one of places they liked. Adult population of Zumbi presented positive visual evaluation towards PERF. A small number of the interviewees were aware of the environmental and social benefits of wind energy production. Residents did not participate of the decision making process regarding PERF. They approved the project, especially because of the jobs provided during construction. Nowadays, PERF is something apart from their lives because it no longer provides jobs or any other interaction between the facility and the locals. Residents relate to the land, not with the facility. However, there is no evidence of rejection towards PERF, it is simply seen as something neutral to their lives. The low levels of education, traditional lack of social commitment and citizenship, and the experience accumulated by PERF´s planners and builders in other countries, may be contributing points to the fact that Zumbi residents did not oppose to PERF. It is clear that the country needs a legislation which seriously considers the psycho-social dimension involved in the implementation of wind farms

Publicação e avaliação de periódicos científicos: paradoxos da classificação Qualis em Psicologia

Recently, Brazilian scientific production has increased greatly, due to demands for productivity from scientific agencies. However, this high increases requires a more qualified production, since it s essential that publications are relevant and original. In the psychological field, the assessment scientific journals of the CAPES/ANPEPP Commission had a strong effect on the scientific community and raised questions about the chosen evaluation method. Considering this impact, the aim of this research is a meta-analysis on the assessment of Psychological journals by CAPES to update the Qualis database. For this research, Psychology scientific editors (38 questionnaires were applied by e-mail) were consulted, also 5 librarians who work with scientific journals assessment (semi-structured interviews) and 8 members who acted as referees in the CAPES/ANPEPP Commission (open questions were sent by e-mail). The results are shown through 3 analysis: general evaluation of the Qualis process (including the Assessment Committee constitution), evaluation criteria used in the process and the effect of the evaluation on the scientific community (changes on the editing scene included). Some important points emerged: disagreement among different actors about the suitability of this evaluation model; the recognition of the improvement of scientific journals, mainly toward normalization and diffusion; the verification that the model does not point the quality of the journal, i.e., the content of the scientific articles published in the journal; the disagreement with the criteria used, seemed necessary and useful but needed to be discussed and cleared between the scientific community. Despite these points, the scientific journals evaluation still is the main method to assure quality for Psychology publications

Em defesa da reforma psiquiátrica :por um amanhã que há de renascer sem pedir licença

Insanity was victim of several arbitrary acts perpetrated on behalf of the science. Psychiatric reform constitues an important movement which has attempted to rescue dignity and humanity in the treatment of mental disorder patients. Some countries have advanced in the implement of substutive models that work on the construction of a new social place for madness. The model of attention to mental health in Brazil has also suffered extensive modifications due to the wearing out of the psychiatric hospital model. In Santos, a town in the State of Sao Paulo, we have found a landmark in the development of an anti internment politics, through the creation of a dail care service, including psychosocial assistance. It is in this context that it has been founded in Natal, Rio Grande do Norte, the NAPS and CAPS ( Nucleus and Centres of Psychosocial Attention), municipal strategies that put into effect the law # 10.216/2001, which estabilishes the gradual extinction of psychiatric hospitals. This work has the purpose of carrying out a study about the historical process of psychiatric reform implantation in the State of Rio Grande do Norte, emphasizing the actors involved in process, their trajectory, achievements, improvements, and the movement s perspectives of achieving the ideal of reinstating mental disorder patients. In order to accomplish this purpose, it was necessary to understand the process occurred at the Municipal Secretary s Office for Health, since 1992, for it was the impelling experience towards the reflections about the psychiatric reform in the State of Rio Grande do Norte. The instruments used for this work were documentary analysis, through reports, legislation and handbooks, as well as the staments of people involved in this process. Through the statements analysis, we attempted to estabilish the social actors identity, their perception, emphasizing congruences and incongruences concerning the history of psychiatric reform in the State of Rio Grande do Norte. It is also analyzed the contribution of Psychology in this process, which has become a protagonist in the struggle for the rights of mental disorder patients

Validade e confiabilidade da versão informatizada do inventário Million de estilos de personalidade

Currently, several psychological and non-psychological tests can be found in publishes without standardization on procedures set in different psychological areas, like intelligence, emotional states, attitudes, social skills, vocation, preferences and others. The computerized psychological testing is a extension of traditional testing psychological practices. However, it has own psychometrics qualities, either by its matching in a computerized environment or by the extension that can be developed in it. The current research, developed from a necessity to study process of validity and reliability on a computerized test, drew a methodological structure to provide parallel applications in numerous kinds of operational groups, evaluating the influences of the time and approach in the computerization process. This validity refers to normative values groups, reproducibility in computerized applications process and data processing. Not every psychological test can be computerized. Therefore, our need to find a good test, with quality and plausible properties to transform in computerized application, leaded us to use The Millon Personality Inventory, created by Theodore Millon. This Inventory assesses personality according to 12 bipolarities distributed in 24 factors, distributed in categories motivational styles, cognitive targets and interpersonal relations. This instrument doesn t diagnose pathological features, but test normal and non adaptive aspects in human personality, comparing with Theodore Millon theory of personality. In oder to support this research in a Brazilian context in psychological testing, we discuss the theme, evaluating the advantages and disadvantages of such practices. Also we discuss the current forms in computerization of psychological testing and the main specific criteria in this psychometric specialized area of knowledge. The test was on-line, hosted in the site http://www.planetapsi.com, during the years of 2007 and 2008, which was available a questionnaire to describe social characteristics before test. A report was generated from the data entry of each user. An application of this test was conducted in a linear way through a national coverage in all Brazil regions, getting 1508 applications. Were organized nine groups, reaching 180 applications in test and retest subject, where three periods of time and three forms of retests for studies of on-line tests were separated. Parallel to this, we organized multi-application session offline group, 20 subjects who received tests by email. The subjects of this study were generally distributed by the five Brazilian regions, and were noticed about the test via the Internet. The performance application in traditional and on-line tested groups subsidies us to conclude that on-line application provides significantly consistency in all criteria for validity studied and justifies its use. The on-line test results were related not only among themselves but were similar to those data of tests done on pencil and paper (0,82). The retests results demonstrated correlation, between 0,92 and, 1 while multisessions had a good correlation in these comparisons. Moreover, were assessed the adequacy of operational criteria used, such as security, the performance of users, the environmental characteristics, the organization of the database, operational costs and limitations in this on-line inventory. In all these five items, there were excellent performances, concluding, also, that it s possible a self-applied psychometric test. The results of this work are a guide to question and establish of methodologies studies for computerization psychological testing software in the country

Infância na publicidade: um estudo sobre o trabalho de crianças na publicidade na cidade de Natal-RN

In Brazilian scene the child labor is a serious and relevant theme regarding issues that involve infancy, arousing the interest and concerning of public and private institutions, and organized civil society. Thus, the child labor is forbidden by the law, considered that the child worker have a distinguished life experience, especially because it is demanded them the early mature of some skill, generating implications on their physical, emotional, cognitive, social and psychological development. Observing those issues, we proposed think the child labor, over and above those considered the worst forms of one and more found in literature, what lead us to think the child labor in the advertising. In that way, this research aimed to investigate the insertion and development conditions of children who work in advertisements, and the possible effects on their lives in the face of that insertion. Participated of this study: three advertising agencies, six video producers companies, one child model s agent and five children with their respective families. Those children were four boys and two girls, with ages between seven and eleven years old, which one that have accomplished four or more advertisements, in Natal city, Rio Grande do Norte. Based on social-historical perspective, we used the semi-structured interview as methodological instrument, which underlays the comprehension of the data obtained in field research processes. This study revealed that when children are inserted in the advertising activities they are submitted to irregular and adverse work situations, what occurs in others productive activities mentioned in the literature. The data still exposed that the family is the main responsible to the children insertion in the advertisement work; moreover, there is an ambiguousness of wishes in relation of that activity. On the other hand, we realized that the legal content concerning to the child labor forbidding, carries contradictory aspects in face of the ECA s 149 article, that one, under some conditions, allows that a child take part in the activities of advertising context. This highlights the necessity of a rigorous evaluation of the children insertion in the advertising, in order to ensure the whole children and adolescents protection. This study put in evidence the complexity that involves the child labor in this context, mainly, due to the exposition and manipulation of the childish image on the media. Besides, we understand that the discussion on this subject should be stimulated and, therefore, enlarged this on over and above those considered the worst forms of child labor

Inserção e atuação profissional do psicólogo no campo das políticas sociais no Rio Grande do Norte

Since the first years of the regulation of Psychology as a profession in Brazil, it has been carried out studies on the academic graduation, practice, workplace and the social commitment of the category. Despite the diversity of goals and propositions, these studies show that psychologists have been significantly inserted into the social policies field, implying changes in the profession. Since the 1980s, researches in Rio Grande do Norte corroborate the results of national studies. The aim of this paper is to study the insertion and professional career of psychologists in the social policies field in Rio Grande do Norte. In order to accomplish the final results of this paper, it was developed an exploratory research, with the use of a questionnaire, comprised of four parts: general data, academic graduation, complementary graduation and professional experience. The results show three groups of information: characterization, insertion and professional performance. It has been verified expressive insertion of psychologists into the social policies field (41%). The socio-demographic and graduation characteristics are not different from those shown by literature: women, young, from families with an average of 7 to 15 minimum wages. Most of them graduated from public institutions and with post-graduation studies in clinical area. The professionals studied seem to be in worse working conditions compared to the rest of the category, which are also in unfavorable conditions, especially the psychologists who work in social assistance institutions, which present greater problems in its structure. The activities developed do not show anything new, reserving conservative practices instead of effective innovations, emphasizing the discussion on the profession for not considering demands presented to the psychologists in the social policies field. With unique scenario, the eproduction of liberal values corroborates classic performance standards; an unpolitical and uncritical practice is diffused. It is then reconsidered the importance of critical studies that organize goals to the category, with the aim of political transformation concerning the current scenario.

Crianças no pátio escolar :a utilização dos espaços e o comportamento infantil no recreio

The interest for understanding the relationship of the child with its environment has increased in the whole world during the last few years. Several researchers, using Environmental Psychology as basis, have analyzed the implications of this relation for the child development and the organization of playful spaces. Being a place where children spend a great part of their time and develop many intellectual and social abilities, the school becomes one of the main focus of this research. This study investigated different sectors of the outdoor area of NEI -UFRN, during the recreation time, in which the use of space and the interaction between children were analyzed, through the observation of the child behavior (place-centered and individual-centered mapping). The results had disclosed that the school s outdoor area and its equipments presents a great range of choices possible to the children, however its occupation is not uniform: there are areas very used and others almost without use. Generally, this heterogeneity happens again in relation to the distribution of the interaction states in the sectors, the friendly associative behavior being the most present. The observation of children behaviors favored a better understanding of the use of the spaces, and contributed for discussion about the environment what these users really need for a healthy development, including differences in related to gender, age and daytime. In spite of the studied outdoor areas being vast, pleasant and varied, it needs a better distribution of its equipments and a plan that allows greater children participation in the place organization

A Relação entre a saúde organizacional e a Síndrome de Burnout

We studied about the organizational health and the syndrome of burnout in professionals of the education and health field, with the objective of establishing a connection between those two constructs. This research was realized in three public schools and in three hospitals, two publics and one from the military. We obtained 168 valid questionnaires for investigation about the syndrome of burnout, being 83 in the hospitals and 85 in the schools, among the questionnaires given in those two organizations. Worked with accidental sample, although it was decided the professional proportions, with the objective of reproducing the population characteristics. In the schools the sample was planned with the teachers. In the hospitals the sample was planned with doctors, nurses and nurse assistants, nutritionists, psychologists, dentists and social assistants. To assure the syndrome of burnout, it was used the Maslach Burnout Inventory (MBI), followed with social demographic information. We used semi-structured interviews, based in the indicators, with the organizations key persons, directors, coordinators, and people involved in the human resources department, for research about the organizational health. Only among the hospitals were found significant statistics differences between the scores of factors and the incidence of burnout. Besides that, it was observed as well that it is possible to establish a connection between the organizational health and the syndrome of burnout, this research main objective

Infâncias :o lugar do lúdico nas tramas do trabalho infantil

Considering infancy as the socio-historic construction required from the researcher, not only gives problems to the natural character of the human development, that for a long period in the history of psychology has sown to be predominant, but before anything assumes the position in which the vision of the social condition, i.e., for the contexts of the insertion of the human being, is predominant. In this sense, it is not possible to talk about infancy in the singular, once the different developmental contexts enable different forms of immersion in the daily experiences, amongst which this research focuses on the experience of the ludic. According to various theories of development amongst which we emphasize the socio-historic, this element brings important contributions in the processes of the human being constitution. From the legal aspect this recognition is present in the Code of Practice of the Child and Adolescent which considers playing to be a right of the child. However, the childhood of many children have this aspect affected by many factors. It is in the context of this discussion that we developed this research which has as its objective investigate how children in a working environment experience playing on a daily basis. Four children, girls, took part in this research, who develop activities in the process of the usage of cashew nuts. We used interviews, observations, photographs and drawings. The perspective of analysis which guided this task is based on socio-historic and discursive studies. In this way, the elements which constitute the child s discourse, formed from the corpus were: be a child, the ludic culture, the work in the child s life and the perspective of future and change. The participants discourse showed to be conflicting, contradictory, arisen from a specific ideological formation. In the children s daily routine it was possible to verify that there is an existence of a rich ludic culture, even if it is lived in few moments of the day in consequence of the workload

O adolescente em conflito com a lei e a escola: criminalização e inclusão perversa

This study aims to identify the relation between adolescents in conflict with the penal law, who were convicted to assisted freedom (a socio-educative measure applied by the Juvenile Justice system as a sanction to adolescent offenders), and the school. The research was developed in the Community-based Assisted Freedom Program of Pastoral do Menor , in Fortaleza (capital city of Ceará State, Brazil). The study has engaged 21 adolescents, eight program professionals, three members of the Center for Defense of Child Rights in Ceará, five teachers and eight school principals and education managers from the schools attended by the adolescents in the neighborhoods of Pirambu, Tancredo Neves, Jardim Iracema e Bom Jardim. It intends, based on dialectical and historical method, to define the investigated adolescents as persons with a very singular insertion into the social structures of neoliberal capitalism. Their adolescence is subject to consumerism appeals, to the limits imposed by these appeals and to perverse ways of insertion in the system, such as criminalization, segregation and marginalization. It reveals that the school attended by the adolescents reproduces such conditions of insertion. At the same time, these conditions are elements of identity, by which the adolescents are characterized.