Adesão ao regime terapêutico na pessoa com enfarte agudo do miócardio: contributo dos enfermeiros no internamento hospita

RESUMO: O Enfarte Agudo do Miocárdio (EAM) representa um dos principais problemas de saúde pública em Portugal. A rápida intervenção nos factores de risco determinantes da saúde cardíaca pode ter um impacto positivo em vários indicadores de saúde. O objectivo final dessa intervenção passa por capacitar a pessoa, para que, autonomamente, adopte um conjunto de comportamentos de saúde, baseados em estilos de vida protectores da saúde cardíaca, que favorecem positivamente o processo de reabilitação. Esta procura e aquisição do comportamento de saúde, adesão ao regime terapêutico, deve ser desenvolvido em parceria com os profissionais de saúde. O hospital representa a porta de entrada da pessoa com EAM no sistema de saúde. É neste contacto que se inicia uma intervenção de sensibilização e promoção da adesão ao regime terapêutico. Sendo os enfermeiros um grupo profissional que estabelece uma relação continua com a pessoa, importa conhecer um conjunto de dimensões do desempenho dos enfermeiros na promoção da adesão ao regime terapêutico. Breve referência ao desenho de estudo. Foram incluídas no estudo 143 enfermeiros de 9 serviços hospitalares da Região de Saúde de Lisboa e Vale do Tejo. Os dados foram obtidos através de um questionário auto-preenchido. Os dados mostraram que a população de enfermeiros é jovem (M= 30,5: dp= 8,0), 49% têm uma idade £ 26 anos e apresenta pouca experiência profissional (M=7,7; dp= 7,6), 48,2% exerce a profissão há menos de 3 anos. A antiguidade no serviço actual é reduzida (M= 4,7; dp= 4,6), 48,9% estão no serviço há menos de 2 anos. Os enfermeiros acreditam que deviam intervir com mais frequência nos factores de risco fisiológicos e comportamentais que nos factores psicossociais e ambientais; a confiança que têm nas capacidades para intervir nos factores de risco fisiológicos e comportamentais é maior que nos factores psicossociais e ambientais e no último ano, intervieram mais frequentemente nos factores de risco fisiológicos e comportamentais que nos psicossociais e ambientais. O “ensaio” da validação da escala de Will scale de Anderson et al (2004), sobre a capacidade de intervenção na saúde cardíaca, mostrou que o teste de Esfericidade de Bartlett e Medida de adequação da amostragem de Kaiser-Meyer- Olkin (KMO) permitiram a realização da análise factorial em componentes principais (AFCP). Da AFCP emergiram 16 factores, os mesmos que no estudo original de Anderson et al (2004), que revelaram boa consistência interna, com valores de alpha de Cronbach que variaram entre 0,71 a 0,98. Os resultados revelam a necessidade de sensibilizar os enfermeiros para valorizar a intervenção no âmbito dos factores de risco psicossociais e ambientais para promover a adesão ao regime terapêutico. Sugerem ainda que a intervenção baseada na evidência pode ser potenciada de forma a melhorar as práticas de cuidados dos enfermeiros. ABSTRACT: Myocardial infarction (MI) is one of the most important problems in public health in Portugal. A prompt intervention in cardiac health determinants means a positive impact in health outcomes, individually and collectively. The main purpose of this intervention lays on patient’s empowerment so he or she becomes able to choose healthy behaviours, based on heart health protective life styles, and therefore to manage his/hers therapeutic regime. This search and acquisition of health behaviours leading to therapeutic regime adherence may positively have an influence on the whole rehabilitation process and it must be developed in partnership with health workers. MI patients’ first contact with the Health System usually happens at the Hospital. Here the first steps are taken to start an intervention in order to promote therapeutic regime adherence. Nurses are a group of health workers who establish a unique and continuous relation with patients, so it matters to have knowledge of their performance skills that can actually promote a healthy behaviours and increase therapeutic regime adherence. Short Study design The study sample includes 143 nurses working on 9 different hospital wards, belonging to the Lisboa and Tejo’s Valley Health Region, in the district of Lisbon. Data were collected trough a self-administered questionnaire. It revealed that the nurses sample is a young population (M=30,5; dp=8,0), 49% of whom are aged less than 26 years old and has little professional experience (M=7,7; dp= 7,6); 48,2% work has nurses for less than 3 years. There’s a low percentage of seniority (M=4,7; dp=4,6), 48,9% of nurses work in these wards for less than 2 years. Nurses believe they should have intervene more frequently in physiological and behaviour risk factors than in psychological, social and environmental factors; they have greater confidence in their ability to intervene in physiological and behaviour risk factors than to intervene in psychological, social and environmental factors. In last year they took interventions more frequently in physiological and behaviour risk factors than in the other health determinants. The Scale Validation “essay” on Will Scale (Anderson et al, 2004), about heart health intervention capacity, revealed that the Bartlett’s test sphericity and the Kaiser-Meyer- Olkin’s (KMO) appropriate sample measure allowed the factorial analysis on main components (FAMC). From FAMC emerged 16 factors, the same number found on Anderson’s et al (2004) study, revealing good internal consistence, with Cronbach’s alpha values that varied between 0,71 and 0,98. The results point a need for nurses to attribute bigger value to other health determinants intervention - such as psychological, social and environmental determinants - so they’ll take part in promoting therapeutic regime adherence. The results also suggest t

Análise do comportamento higrotérmico de soluções construtivas de paredes em regime variável

Dissertação apresentada na Faculdade de Ciências Tecnologia da Universidade Nova de Lisboa para obtenção do grau Mestre em Engenharia Civil – Perfil Construção

A importância da segurança no trabalho no novo regime do contrato de trabalho em funções públicas

Apresentação realizada no Colóquio Internacional de Segurança e Higiene Ocupacional, que decorreu em Guimarães, em 5 e 6 de fevereiro de 2009.

O novo regime de contrato de trabalho em funções públicas e riscos psicossociais emergentes

Apresentação realizada no 3º Encontro Nacional de Riscos, Segurança e Fiabilidade em Lisboa, de 3-5 de novembro de 2009.

O regime fiscal cooperativo – análise crítica e desafios

Dissertação de Mestrado apresentada ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Contabilidade e Finanças, sob orientação de Doutora Deolinda Meira e Doutora Nina Aguiar

A medicina paliativa como medicina de proximidade. Suspensão dos julgamentos gerais e acção médica em regime de familiaridade

Dissertação apresentada para cumprimento dos requisitos necessários à obtenção do grau de Doutor em Sociologia, na especialidade de Sociologia da Cultura, do Conhecimento e da Educação.

Expatriates recruitment and selection for long-term international assignments in portuguese companies

Long-term international assignments’ increase requires more attention being paid for the preparation of these foreign assignments, especially on the recruitment and selection process of expatriates. This article explores how the recruitment and selection process of expatriates is developed in Portuguese companies, examining the main criteria on recruitment and selection of expatriates’ decision to send international assignments. The paper is based on qualitative case studies of companies located in Portugal. The data were collected through semi-structured interviews of 42 expatriates and 18 organisational representatives as well from nine Portuguese companies. The findings show that the most important criteria are: (1) trust from managers, (2) years in service, (3) previous technical and language competences, (4) organisational knowledge and, (5) availability. Based on the findings, the article discusses in detail the main theoretical and managerial implications. Suggestions for further research are also presented.

The influence of pre-departure training on expatriate adjustment: an empirical investigation with portuguese international assignees

This chapter examines the cross-cultural influence of training on the adjustment of international assignees. We focus on the pre-departure training (PDT) before an international assignment. It is an important topic because in the globalized world of today more and more expatriations are needed. The absence of PDT may generate the failure of the expatriation experience. Companies may neglect PDT due to cost reduction practices and ignorance of the need for it. Data were collected through semi-structured interviews to 42 Portuguese international assignees and 18 organizational representatives from nine Portuguese companies. The results suggest that companies should develop PDT programs, particularly when the cultural distance to the host country is bigger and when there is no previous experience of expatriation to that country in the company. The study is original because it details in depth the methods of PDT, its problems, and consequences. Some limitations linked to the research design and detailed in the conclusion should be overcome in future studies.

Privatization in an international mixed duopoly with environmental taxes

We study the effects of environmental and trade policies in an international duopoly serving two countries, with pollution abatement. This analysis is done in both mixed and privatized markets. The model has two stages: First, governments choose environmental taxes and import tariffs, simultaneously; then, the firms compete in the market by choosing output levels for the domestic market and to export and also abatement levels.

Contribuição da produção em regime especial na garantia do abastecimento de energia elétrica e o impacto no planeamento da rede

Esta dissertação apresenta um estudo sobre a garantia de fornecimento de energia elétrica por parte dos produtores em regime especial com tecnologia cogeração e o impacto que estes traduzem na fase de planeamento da rede. Este trabalho foi realizado na Energias de Portugal - Distribuição (EDP-D) na direção de planeamento da rede (DPL). Para este estudo foi utilizado o caso de uma subestação com dezoito produtores em regime especial agregados à sua rede, em que dezasseis desses produtores são cogeração. A proposta de estudo para o caso concreto, passa pela análise das condições de funcionamento da subestação e apurar se a mesma necessita de alguma reformulação, tendo em vista as cargas a satisfazer atuais e possível incremento de carga futura. Considerando que a subestação está inserida num ambiente industrial e atendendo que existem diversos produtores de energia elétrica nas imediações da subestação. Para a resolução da garantia do fornecimento de energia por parte da cogeração, estudou-se a possibilidade de prever a energia produzida por estes produtores, através dos seguintes modelos de previsão: árvore de regressão, árvore de regressão com aplicação bagging e uma rede neuronal (unidirecional). Com a implementação destes modelos pretende-se estimar qual a potência que se pode esperar na garantia de abastecimento da carga, prevenindo maior solicitação de potência por parte da subestação. A metodologia utilizada baseia-se em simulações computacionais.

China's space program : a new tool for PRC "soft power" in international relations?

When China launched an anti-satellite (ASAT) weapon in January 2007 to destroy one of its inactive weather satellites, most reactions from academics and U.S. space experts focused on a potential military “space race” between the United States and China. Overlooked, however, is China’s growing role as global competitor on the non-military side of space. China’s space program goes far beyond military counterspace applications and manifests manned space aspirations, including lunar exploration. Its pursuit of both commercial and scientific international space ventures constitutes a small, yet growing, percentage of the global space launch and related satellite service industry. It also highlights China’s willingness to cooperate with nations far away from Asia for political and strategic purposes. These partnerships may constitute a challenge to the United States and enhance China’s “soft power” among key American allies and even in some regions traditionally dominated by U.S. influence (e.g., Latin America and Africa). Thus, an appropriate U.S. response may not lie in a “hard power” counterspace effort but instead in a revival of U.S. space outreach of the past, as well as implementation of more business-friendly export control policies.

Estudo experimental de escoamentos em regime uniforme e não uniforme em canais de secção composta

Dissertação apresentada para obtenção do grau de Mestre em Engenharia Civil

As Características Teocráticas do Regime Político Iraniano e a Respectiva Influência na Formulação da Política Externa do País

Dissertação apresentada para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Ciência Política e Relações Internacionais – variante de Relações Internacionais

Expatriates’ influence on knowledge sharing: an empirical study with International portuguese companies

Despite the abundant literature in knowledge management, few empirical studies have explored knowledge management in connection with international assignees. This phenomenon has a special relevance in the Portuguese context, since (a) there are no empirical studies concerning this issue that involves international Portuguese companies; (b) the national business reality is incipient as far as internationalisation is concerned, and; (c) the organisational and national culture presents characteristics that are distinctive from the most highly studied contexts (e.g., Asia, USA, Scandinavian countries, Spain, France, The Netherlands, Germany, England and Russia). We examine the role of expatriates in transfer and knowledge sharing within the Portuguese companies with operations abroad. We focus specifically on expatriates’ role on knowledge sharing connected to international Portuguese companies and our findings take into account organizational representatives’ and expatriates’ perspectives. Using a comparative case study approach, we examine how three main dimensions influence the role of expatriates in knowledge sharing among headquarters and their subsidiaries (types of international assignment, reasons for using expatriation and international assignment characteristics). Data were collected using semi‐structured interviews to 30 Portuguese repatriates and 14 organizational representatives from seven Portuguese companies. The findings suggest that the reasons that lead Portuguese companies to expatriating employees are connected to: (1) business expansion needs; (2) control of international operations and; (3) transfer and knowledge sharing. Our study also shows that Portuguese companies use international assignments in order to positively respond to the increasingly decaying domestic market in the economic areas in which they operate. Evidence also reveals that expatriation is seen as a strategy to fulfill main organizational objectives through their expatriates (e.g., business internationalization, improvement of the coordination and control level of the units/subsidiaries abroad, replication of aspects of the home base, development and incorporation of new organizational techniques and processes). We also conclude that Portuguese companies have developed an International Human Resources Management strategy, based on an ethnocentric approach, typically associated with companies in early stages of internationalization, i.e., the authority and decision making are centered in the home base. Expatriates have a central role in transmitting culture and technical knowledge from company’s headquarters to the company’s branches. Based on the findings, the article will discuss in detail the main theoretical and managerial implications. Suggestions for further research will also be presented.