Percepção dos usuários sobre o programa de saúde da família : um contributo para a reflexão

A Estratégia Saúde da Família apresenta-se como uma possibilidade de reestruturação da atenção primária, a partir de um conjunto de ações conjugadas em sintonia com os princípios de intersetorialidade, descentralização, equidade, coresponsabilidade e priorização de grupos populacionais com maior risco de adoecerem ou morrerem. Assim, este estudo objetivou caracterizar a percepção dos usuários da Unidade Básica de Saúde da Família (UBSF) sobre o Programa Saúde da Família (PSF). Trata-se de um estudo qualitativo desenvolvido na USF Barra de Sirinhaém, do Estado de Pernanbuco. Para tanto, contou-se com a participação de 54 usuárias do sexo feminino. Estas responderam a um formulário sócio-demográfico e um roteiro de entrevista semi-diretiva. Os discursos foram submetidos a análise de conteúdo à luz da literatura pertinente. Os principais resultados mostraram que a percepção das usuárias acerca do Programa de Saúde Familiar é de que este ainda funciona com abordagem curativa, mas que possuem maior acessibilidade e construíram um vínculo mais efetivo com os profissionais de saúde. Diante do exposto infere-se que a estratégia de saúde da família ainda não se concretiza pela dificuldade das pessoas entenderem a filosofia do programa, ainda polarizarem uma visão hospitalocêntrica da saúde e revelaram um certo alheamento da compreensão do significado do PSF. Palavras-chave: Estratégia Saúde da Família; Percepção; Assistência à Saúde.

Problemas éticos identificados por enfermeiros na relação com usuários em situação crítica

O artigo apresenta os resultados da análise das questões éticas identificadas por enfermeiros perante usuários em situação crítica, de risco iminente de morte, e cuja sobrevivência depende de métodos avançados de vigilância, monitorização e terapêutica. As principais preocupações éticas dizem respeito à informação ao cliente, ao acompanhamento em fim de vida, à responsabilidade profissional em intervenções interdependentes; as temáticas reportam à decisão da pessoa (consentimento/recusa de proposta terapêutica), dilemas na informação, atuação nos processos de morrer e decisão de não tentar reanimar, respeito pelos direitos humanos em contextos desfavoráveis. Destacamos as dimensões do sentido de responsabilidade, da influência da consciência moral nas decisões, da deliberação de proteger o Outro em risco e da vivência de episódios profissionais de superação; finalmente, identificamos fatores mediadores na gestão das dificuldades éticas.

O PERFIL DOS USUÁRIOS DA COMUNICAÇÃO MEDIADA POR COMPUTADOR UMA ABORDAGEM PSICOLÓGICA

A Comunicação Mediada por Computador (CMC) é entendida como o relacionamento interpessoal via Internet. Este modo de comunicação atinge usuários que visam interagir e conhecer pessoas sem o limite da distância. Atualmente está sendo objeto de estudos interdisciplinares que se interessam pelas influências da CMC no comportamento de seus usuários. Trata-se de um estudo caracterizado como exploratório baseado em dados coletados através de uma pesquisa bibliográfica. Seu objetivo é refletir sobre os efeitos gerados pela difusão da CMC sobre o perfil de seus usuários, além de apresentar as contribuições da Psicologia frente aos questionamentos provindos da utilização da CMC e discutir as ambivalências (ganhos e perdas) de seu uso no comportamento de seus usuários. Percebe-se que os internautas estão transformando a forma de interação social em um ambiente desprovido de limites espaço-temporais. Portanto, este trabalho estuda as novas formas de interação, e busca compreender esse novo homem, pois, se a tecnologia traz mudanças, o indivíduo muda junto com ela. Portanto, ao acompanhar todas essas transformações que têm influenciado o homem e suas novas formas de relacionamento, estão motivando o surgimento de novas formas de contribuição da Psicologia ao estudo da CMC.

DROGAS E ALUNOS USUÁRIOS DE DROGAS NA ESCOLA: ESTUDO DE REPRESENTAÇÕES SOCIAIS DE PROFESSORES DO ENSINO MÉDIO DA REDE ESTADUAL DE SÃO PAULO

Este estudo apresenta uma discussão a respeito de drogas e de alunos usuários de drogas na escola, explorando as Representações Sociais manifestadas por professores que atuam na Rede Estadual de São Paulo, no ensino Médio. O estudo resgata aspectos históricos e sociais que influenciaram representações sociais sobre drogas em diferentes contextos da sociedade, na perspectiva de buscar compreender a maneira como atualmente elas se apresentam. Discute aspectos conceituais da Teoria das Representações Sociais a partir de Moscovici, considerando contribuições de Jodelet, e outros autores. Os dados coletados por meio de questionários e entrevistas foram analisados com o auxílio de dois softwares, o ALCESTE para análise lexical e o EVOC para análise de associação de palavras ou expressões, em articulação com uma análise de conteúdo clássica sugerida por Maria Laura Puglisi Barbosa Franco. O resultado identificou que as representações sociais sobre drogas na escola e alunos usuários estão ancoradas no modo como a grande mídia trata o tema, de forma alarmista e sensacionalista, influenciando grande parte dos professores que associa drogas na escola à violência. Verificou-se ainda que objetivação do aluno usuário de drogas é simbolizada como doença e que o grupo pesquisado segue as representações sociais há muito tempo estruturadas na sociedade, tendo a normalidade como sinônimo de saúde e a drogadição como condição desviante, decorrente de patologias. Assim, espera-se estar contribuindo para a reflexão sobre o uso e abuso de drogas nas escolas, um tema indispensável e que precisa ser enfrentado para construir-se uma via que leve a uma Educação justa e democrática.(AU)

Usuários de crack, instituições e modos de subjetivação: estudo das práticas e da eficácia terapêutica em uma comunidade terapêutica religiosa (RN)

This anthropological research has as main goal to grasp the meanings and perceptions - mode of subjectivity - of crack users in relation to the proposals of Therapeutic Communities (TC) of religious character. The work emphasizes the analysis of Therapeutic Communities of Rio Grande do Norte state, studying a particular organization, called Anzóis da Dor. I intend to analyze qualitative data, focusing on an analysis of the discursive content of speeches and the observation of social interaction, which results in an ethnographic text characterized by a dense description. In relation to the dissertation’s specific goals, we seek to present a general overview of the emergence and development of Therapeutic Communities – encompassing general and local considerations - and pointing out to the dynamics of religious healing systems of these institutions, besides the principles that guide them. In methodological terms, I conducted the partial mapping of therapeutic communities located in Rio Grande do Norte state; interviews with Therapeutic Communities coordinators, visits, participant observation in one of these institutions as well as some interviews with crack users and people close to these social agents in relation to the Therapeutic Communities and the treatment offered by them

Acolhimento prescrito x real: uma análise sobre as relações entre trabalhadores e usuários na estratégia saúde da família

User embracement has been proposed as a tool that contributes to humanize the nursing, to increase the users’ access to the services, to ensure the resolvability of claims, to organize the services and promote the strengthening of the links between them and the health professionals. In the city of Recife, this practice has been fomented by the municipal government and its implementation is guided by normative acts, with evaluation matrices and proposition of goals, based on a model created by the public administration. This study intended to analyze the relation between the prescribed user embracement and the real one and their interferences with the relations of reciprocity between workers and users in the health units of basic attention in Recife. Four units of the Family Health Strategy at the Sanitary District IV of the city of Recife – PE were taken as an investigation field. The investigation had a qualitative character, so, Interviews were performed involving professionals and users whose speeches were recorded by the voice digital mode and literally transcript. The obtained speeches were analyzed mostly through the Discourse of the Collective Subject methodological approach, being also used, but on a smaller scale, the technique of thematic analysis, in the dialogic way, with theoretical contributions and official documents related to the theme. The results pointed that in most of the health units the professionals execute the proposed protocols and consider that these have a positive influence for the working process in user embracement, however, factors such as the excessive demand, the physical structure of the units, little resolvability of the reference network, singularities of the units, among others, have appeared, hampering the accomplishment of the prescribed, creating, thus, a negative influence on the working process of the user embracement. The reciprocal relations have also suffered the influences of these factors, which made difficult, therefore, the circulation of gift. Meanwhile, other factors such as access, resolvability, sheltering attitude and responsabilization, potentiated the reciprocal exchange between professionals and users. The findings demand the prescriptive acts and the reciprocal relations of the user embracement to be directly influenced by the singularities present in each community, by the human variabilities and by factors connected to the structure and working process, so it shall be operated with caution in order to provide a real user embracement with quality

Avaliação da usabilidade e da arquitetura da informação do site do Instituto do Cérebro da UFRN: um estudo de caso com base nas opiniões dos usuários da instituição

The objective of the current piece of research presents was draw up a list of recommendations for the site of the Instituto do Cérebro da Universidade Federal do Rio Grande do Norte, with an emphasis on fault identification in usability and information architecture, through the application of design techniques with users of the institution. From the use of the following techniques: Cardsorting, applied to a group of six people as target public, such as professor, administrative technicians and graduate student of the institution; Interviews, carried out with the director of the Instituto do Cérebro, secretaries of the undergraduate and graduate courses; Cooperative Evaluation applied in two ways: in group and individually. The evaluation in group was fulfilled in four sessions that occurred with a group composed of six people who are part of the technical staff of the Instituto do Cérebro. In the Individual Cooperative Evaluation, eight users (graduate students and administrative technicians of the Instituto do Cérebro da UFRN) performed tasks which are frequently fulfilled by users from the public target in the site of the Instituto do Cérebro. After each session of the Individual Cooperative Evaluation, a questionnaire of the user´s satisfaction was used about his or her perception in regard to the site usability and utility of the mentioned institute site. Therefore, it was concluded that, by means of the analysis of the results and the triangulation of the obtained data in each one of the techniques applied with the users, in the present piece of research, problems were verified, among others; all related to the unsuitable use of the interface elements, navigation, labeling of some menu terms, and still, the lack of search space and integration with the social networks – besides the lack, positioning and inappropriate formatting of information that would be of high relevance to the users. Finally, a list of recommendations is presented and this can be used in a future interface redesign with the goal to improve the information architecture and the usability of the site of the Instituto do Cérebro da Universidade Federal do Rio Grande do Norte.

Fatores que influenciam a predisposição dos usuários em aderir a uma política de segurança da informação

The information constitutes one of the most valuable strategic assets for the organization. However, the organizational environment in which it is inserted is very complex and heterogeneous, making emerging issues relevant to the Governance of information technology (IT) and Information Security. Academic Studies and market surveys indicate that the origin of most accidents with the information assets is the behavior of people organization itself rather than external attacks. Taking as a basis the promotion of a culture of safety among users and ensuring the protection of information in their properties of confidentiality, integrity and availability, organizations must establish its Information Security Policy (PSI). This policy is to formalise the guidelines in relation to the security of corporate information resources, in order to avoid that the asset vulnerabilities are exploited by threats and can bring negative consequences to the business. But, for the PSI being effective, it is required that the user have readiness to accept and follow the procedures and safety standards. In the light of this context, the present study aims to investigate what are the motivators extrinsic and intrinsic that affect the willingness of the user to be in accordance with the organization's security policies. The theoretical framework addresses issues related to IT Governance, Information Security, Theory of deterrence, Motivation and Behavior Pro-social. It was created a theoretical model based on the studies of Herath and Rao (2009) and D'Arcy, Hovav and Galletta (2009) that are based on General Deterrence Theory and propose the following influencing factors in compliance with the Policy: Severity of Punishment, Certainty of Detection, Peer Behaviour, Normative Beliefs, Perceived Effectiveness and Moral Commitment. The research used a quantitative approach, descriptive. The data were collected through a questionnaire with 18 variables with a Likert scale of five points representing the influencing factors proposed by the theory. The sample was composed of 391 students entering the courses from the Center for Applied Social Sciences of the Universidade Federal do Rio Grande do Norte. For the data analysis, were adopted the techniques of Exploratory Factor Analysis, Analysis of Cluster hierarchical and nonhierarchical, Logistic Regression and Multiple Linear Regression. As main results, it is noteworthy that the factor severity of punishment is what contributes the most to the theoretical model and also influences the division of the sample between users more predisposed and less prone. As practical implication, the research model applied allows organizations to provide users less prone and, with them, to carry out actions of awareness and training directed and write Security Policies more effective.

Acolhimento na estratégia saúde da família: o que dizem os usuários?

The objective of the National Humanization Policy (NHP) is to humanize relations between professionals and users. It is guided by the proposal of expanded clinic and proposes the embracement as a strategy for its existence. The embracement requires qualified hearing, the provision of adequate technologies and the establishment of relations for better solving health problems of users. The objective of this study was to evaluate user satisfaction of the Family Health Strategy (FHS) regarding the embracement from the perspective of qualified hearing and improved relations in the city of Recife- PE. In this quantitative, qualitative, evaluative and cross-sectional study, 297 users of the services offered by the FHS were interviewed in six health districts of the city. For data collection, the Satisfaction Rating Scale of users with Mental Health Services - Satis-BR- abbreviated and adapted to the subject embracement was used. Quantitative data were analyzed by using the software Statistical Package for Social Science (SPSS) 17.0, calculating the absolute and relative frequencies. Qualitative data were analyzed by content analysis of Bardin with the elaboration of thematic categories. The results indicate that most users are satisfied with the embracement offered by the teams. About 66% reported being very or fairly heard by professionals; 80.2% reported to have obtained some or much help when searched for embracement; 64.6% indicated that the embracement is friendly or very friendly. Regarding ambience, 55.9% of users demonstrated indifference and dissatisfaction with comfort and appearance; regarding general facilities of the service, 69.4% reported as regular to awful. Three thematic categories were revealed by the speeches: satisfaction with embracement, dissatisfaction with the ambience, and suggestions for improvements in embracement and service. This study contributed to the understanding that both the hearing and relations are present in the embracement of the city and also to demonstrate that the ambience is a possible weakness in the opinion of the users.

Percepção da equipe de saúde, discentes e usuários sobre a comunicação com indivíduos surdos na atenção primária

The study aimed to identify in the professionals and students of health courses that work in a health Basic Unit in the city of Natal/RN their perceptions of the care of deaf patients, and with the population's needs with hearing loss in relation to health care. This is a cross-sectional, exploratory, descriptive study, conducted between April to July 2014, with a population composed of 21 health professionals, 17 students and 8 deaf users. For data collection, we used a structured questionnaire with open and closed questions applied to groups composed of health professionals (doctors, dentists, nurses and health workers) and students of medical schools, nursing, physical education, nutrition and social service. The professionals/students answered a semi-structured questionnaire with open and closed questions concerning the possible difficulties the care of the deaf and hearing impaired. Data collection with deaf users was conducted through filmed interview for the Brazilian Sign Language (Libras) could be interpreted as to the Portuguese by the researcher. With the latter it was conducted a survey of their reactions when looking for a care in the health service. Regarding the profile of identification of the subjects, it was analyzed by simple descriptive statistics (absolute and relative frequencies). The open questions were analyzed through the content analysis technique which allowed the categorization process preserving all the points raised in the discussion so that the lines were representative of the whole. When asked about the professionals and students attitude used to communicate with deaf patients possible the following categories emerged: the "writing", the "gestures" and the "third party assistance". With regard of the deaf, when asked about their experiences in seeking care in health, the elucidated categories were: "quality of care to the hearing impaired", "communication with the hearing impaired adequacy" and "dependence on third parties." The closed questions were measured and adapted to the 5 degrees of variation Likert Scale, which comprised three of these issues: degree of difficulty in communication to meet a patient with hearing loss (minimum to great difficulty); feeling of comfort while using sign language (minimum to severe discomfort); and knowledge of the Law 10.436, which provides for the Brazilian Sign Language (Libras) (low knowledge to entirely clear). The data collected with professionals and students revealed some misunderstanding and discomfort in health care for deaf patients, reality also evidenced in the opinion of the deaf participants. This study revealed problems in communication, resulting in negative consequences in serving this population. This diagnosis may be relevant to public policy development and curriculum guidelines essential to the training of health professionals, inclusion and improving assistance to deaf.

Efeito do topiramato sobre o craving em usuários de crack

The study aims to analyze the effects of topiramato on the craving of crack users. It is an open crossover clinical trial involving users from the Psychosocial Care Center for Alcohol and Drugs (CAPSad) in city of Parnamirim, RN, approved by the CEP CAAE: 38710614.1.0000.5537, respecting the norms of the resolution n. 466/2012/CNS. The study produced preliminary two scientific papers: a theoretical essay and an integrative review, as a way of seeking the state of art. The first paper was based in the theoretical framework of Hinds, Chaves and Cypress, which focuses different contexts, from the issues of individual use to the coping policies in Brazil, highlighting that the situation and the complexity of the phenome requires coping strategies for the full attention to the user, family and society. As a result of the integrative review, among the 902 retrieved records, eight of them presented therapeutic schemes with positive effects for the craving of cocaine. They used nine different drugs. It is important to spot out that there was no result for the craving of crack. The data collection was conducted from December 2014 to July 2015 and has as sample predominantly single males. The sample was composed of 30 subjects who met the inclusion criteria: adults, age from 18 years, diagnosis of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for cocaine/crack; cognitive capacity preserved; attendance to the service, participated at least three visits in the 12 months prior to data collection; and accepted to be monitored in the proposed treatment. Data was analyzed using descriptive statistics from the Statistical Package of Support for Social Sciences (SPSS) on the instruments: 1) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), pointing out, among other results, that only 14% used crack/cocaine weekly during treatment, while 83% used daily or weekly after the washout period; 2) Barratt Impulsiveness Scale, with an average of 80.23 and 77.47 with and without drug treatment, respectively. An analysis from the Student t test show no significant differences in impulsivity with or without the drug; and 3) Cocaine-Craving Questionnaire-Brief (CCK-B), indicating that the number of users with craving intensity level is significantly higher without drug treatment (86%) than with treatment (33%). The analysis between craving and level of impulsivity showed that there is a low correlation (Pearson) between these two variables during treatment and after the washout, demonstrating that impulsivity has low influence on the outcome of drug therapy. As conclusion, it was noted that the topiramate produces positive effect on reducing the craving for crack users and their use is a relevant strategy for efficacy in the treatment of crack users.

Efeito do topiramato sobre o craving em usuários de crack

The study aims to analyze the effects of topiramato on the craving of crack users. It is an open crossover clinical trial involving users from the Psychosocial Care Center for Alcohol and Drugs (CAPSad) in city of Parnamirim, RN, approved by the CEP CAAE: 38710614.1.0000.5537, respecting the norms of the resolution n. 466/2012/CNS. The study produced preliminary two scientific papers: a theoretical essay and an integrative review, as a way of seeking the state of art. The first paper was based in the theoretical framework of Hinds, Chaves and Cypress, which focuses different contexts, from the issues of individual use to the coping policies in Brazil, highlighting that the situation and the complexity of the phenome requires coping strategies for the full attention to the user, family and society. As a result of the integrative review, among the 902 retrieved records, eight of them presented therapeutic schemes with positive effects for the craving of cocaine. They used nine different drugs. It is important to spot out that there was no result for the craving of crack. The data collection was conducted from December 2014 to July 2015 and has as sample predominantly single males. The sample was composed of 30 subjects who met the inclusion criteria: adults, age from 18 years, diagnosis of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for cocaine/crack; cognitive capacity preserved; attendance to the service, participated at least three visits in the 12 months prior to data collection; and accepted to be monitored in the proposed treatment. Data was analyzed using descriptive statistics from the Statistical Package of Support for Social Sciences (SPSS) on the instruments: 1) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), pointing out, among other results, that only 14% used crack/cocaine weekly during treatment, while 83% used daily or weekly after the washout period; 2) Barratt Impulsiveness Scale, with an average of 80.23 and 77.47 with and without drug treatment, respectively. An analysis from the Student t test show no significant differences in impulsivity with or without the drug; and 3) Cocaine-Craving Questionnaire-Brief (CCK-B), indicating that the number of users with craving intensity level is significantly higher without drug treatment (86%) than with treatment (33%). The analysis between craving and level of impulsivity showed that there is a low correlation (Pearson) between these two variables during treatment and after the washout, demonstrating that impulsivity has low influence on the outcome of drug therapy. As conclusion, it was noted that the topiramate produces positive effect on reducing the craving for crack users and their use is a relevant strategy for efficacy in the treatment of crack users.

Educação bilíngue para surdos : um estudo acerca de práticas de letramento crítico com alunos surdos usuários da Língua Brasileira de Sinais

At a time when the issue of the inclusion of hearing-impaired students in regular schools has been discussed, it becomes necessary to reflect upon the relevance of a recurrent educational process in schools specialized in education for the hearing-impaired: the bilingual schools. Such institutions, still scarce in Brazil, offer an oriented and specialized education to hearing-impaired children and adolescents, since they have the Brazilian Sign Language as a language of instruction in all subjects, and the Portuguese written language as an additional language, which gives them the bilingual status. This research aims to investigate how the practices developed in my Portuguese classes in a bilingual school have contributed to the development of student‟s literacy, specifically the Critical Literacy (STREET, 1985, 1990, 1998), in two classes of hearing-impaired students enrolled in the final grades of elementary school. It is a qualitative, ethnographic research, which uses the triangulation system for analyzing data: (i) the pedagogical sequences; (ii) the students‟ activities and (iii) the teacher‟s and students‟ written accounts registered as field notes. Through the intersection of the data, this work evaluates whether students have achieved some level of Critical Literacy, and what kind of collaboration and/or activity is relevant during this process. This research is justified by the need to evaluate practices at bilingual schools that, although supported by current law in Brazil, are still a minority whose work is still not acknowledged or valued. The results show that activities using real texts of different genres can contribute to the development of Critical Literacy, and also to dynamic classes, with discussions about relevant topics to society in Sign Language. Also, activities that encourage students to do research and that provide to the hearing-impaired student, the understanding of the real usefulness of Portuguese as an instrument for the social inclusion of the hearing-impaired providing opportunities for them to change their social position can collaborate to this process.

WEBJORNALISMO COLABORATIVO - A PRESENÇA DOS USUÁRIOS NO CONTEÚDO INFORMATIVO DO PORTAL R7

Este estudo procura verificar como ocorre a colaboração dos usuários no conteúdo informativo do Portal R7, a partir da nova configuração da internet, a web 2.0, criada em 2004. O termo web 2.0 surgiu para qualificar uma segunda geração de comunidades e serviços, em um ambiente de interação e participação que engloba diversas linguagens. Com o crescimento da adesão à tecnologia digital, algumas barreiras que limitavam a colaboração nos conteúdos informativos foram superadas e o ambiente comunicacional tornou-se um espaço de intercâmbio para experiências e práticas do cotidiano. Nesse cenário, os internautas passam a ter uma relação mais aproximativa nos processos midiáticos presentes no suporte digital, no qual o cidadão pode se expressar, ter maior visibilidade e se relacionar a partir do momento em que ele produz, publica e compartilha qualquer tipo de conteúdo, seja de caráter informativo ou de entretenimento. A revisão bibliográfica abrangeu autores como Ciro Marcondes Filho, José Marques de Melo, Nelson Traquina, Alex Primo, Ana Brambilla, Marcelo Träsel, Raquel Recuero, Polyana Ferrari, Squirra, entre outros. O método de investigação utilizado é o qualitativo, por meio de uma pesquisa exploratória descritiva, do tipo estudo de caso. Os instrumentos para a investigação foram a observação direta assistemática e a entrevista semiestruturada (ou semiaberta). O principal resultado obtido é que o webjornalismo colaborativo no Portal R7 é prioritariamente induzido pelas redes sociais, especialmente o Facebook e o Twitter, inspirado no “call for action”, como estratégia para chamar à colaboração. As práticas jornalísticas estão intrinsicamente dependentes da ação do usuário, sendo que o jornalista agrega às práticas de checagem uma nova etapa, a de relacionamento com o usuário do Portal, para agregar e fidelizar a audiência, valorizando a colaboração em todas as etapas de produção.