999 resultados para Dano ao paciente


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The measurement of patient satisfaction can provide information about the success of the care provider in reaching the values and meeting the expectations of the patient. The purpose of this study was to translate into the Portuguese language and to culturally customize to the Brazilian population the instrument to measure patient satisfaction with physical therapy elaborated by Goldstein et al. The study sample was made up of 279 patients who were undergoing physical therapy treatment at 39 different private clinics in a middle-sized town in northeastern Brazil. For the translation of the survey instrument, the back-translation technique was employed, in association with the bilingual method. The reliability and validity of the Brazilian version of the instrument were both assessed. Reliability analysis, carried out with the computation of Cronbach alpha coefficients, showed that the measures obtained with the instrument have a high degree of internal consistency. The aspects dealing with the patient therapist relationship are the most important predictors of satisfaction, followed by those dealing with courtesy, privacy, and practical aspects such as efficiency of the facility in the patient admissions process, setting up of appointments, and waiting time in waiting room. Items dealing with aspects such as location of the facility and availability of parking facilities may underestimate the reliability of the instrument. This study translated, culturally customized, and validated an instrument to measure patient satisfaction with physical therapy originally developed in English. By so doing, this study has made this instrument available to the Brazilian society, and it has rendered it a useful parameter that can be utilized in our country in the field of physical therapy

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The demands brought by a society doomed to the constant production of global risks, which whose effects are not immediately noticed effects are not perceived immediately, claim from the Law a new Theory about the Risk, that would offer a broad environmental protection, at the same time it would still be compatible with the idea of economic efficiency, required by the Modern Industry. The expansion of the methods and technologies regarding the exploitation and production of oil causes the constant expansion of the exploitable boundaries, especially in ultra-deep waters with the Pre-salt layer, in Brazil, or the still incipient research about the polymetallic nodules and other mineral sources in international waters, like the Atlântico Sudoeste, by the Programme on Ocean Science in Relation do Non Living Resources (OSNLR), a global study performed in partnership with the Intergovernmental Oceanographic Commission, from UNESCO (IOC UNESCO) and also with the Division of Ocean Affairs and Law of the Sea (UNDOALOS). Thus, we aim to analyze the correlation, and possible collisions between the right to a balanced environment and the free exercise of economic activity and the occurrence of environmental damages from the perspective of the exploitation activities of oil and other natural resources in international waters, specifically in the Area, from the constitutional principle of sustainable development and its legitimacy by the environmental international protection. Therefore, this study also aims to evaluate the legal framework for exploration and production of oil in international waters, particularly in the Area, and appraise how the constitutional instruments and mechanisms for environmental protection can impact on the international environmental protection system in order to ensure the present and future generations an ecologically balanced environment, laid down in Article 225 of the Brazilian Constitution, even with so many risks posed by the activities of exploitation and production of oil in international waters. In the meantime, we intend to also intend to investigate the possibility of future liability for environmental damage in order to ensure that constitutional principle and, consequently, and try to define the concept of environmental damage and its implications on the constitutional principle of environmental protection. Given all that was in summary, this work aims to contribute to the evolution of the new Theory of Environmental Risk, turning the law into something more than a punitive or corrective element in this society, but into a legal risk management, that may be triggered even before the consolidation of the damage

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O presente trabalho teve como objetivo avaliar a influência da adubação da cultura do sorgo Sorghum bicolor (L.) Moench, na biologia da broca da cana-de-açúcar Diatraea saccharalis (Fabr., 1794) (Lepidoptera: Pyralidae). Para isso foi utilizado sorgo da cultivar Rubi-Asgrow, plantado em vasos utilizando-se diferentes doses de fertilizantes e mantidos em casa-de-vegetação. Os tratamentos utilizados (doses de NK) foram: N1 = 0-200 ppm; N2 = 50-200 ppm; N3 = 100-200 ppm; N4 = 200-200 ppm; N5 = 400-200 ppm; K1 = 200-0 ppm; K2 = 200-50 ppm; K3 = 200-100 ppm; K4 = 200-200 ppm; e K5 = 200-400 ppm. de modo geral, pode-se concluir que doses de 50 a 200 ppm de N promoveram o desenvolvimento normal das larvas de D. saccharalis, sendo que as menores porcentagens de dano foram verificadas nas menores doses; para o potássio, quanto maior a dose, menor foi o dano causado pelas lagartas, apesar de favorecer o desenvolvimento da mesma.

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The present work aimed at learning the population dynamic of Triozoida limbata (Enderlein, 1918) (Hemiptera: Psyllidae) in a guava orchard submitted to the minimum use of insecticide in Jaboticabal - SP. For the study of population fluctuation and the evolution of damage from the psillid we analyzed 20 plants of the orchard biweekly, during the period from March 2005 to June 2006. For each plant we evaluated 10 leaves containing the symptom of the attack from the psillid. The evaluated parameters were the number of nymphs and the percentage of damage caused in the leaves, in accordance with a scale of notes. These parameters were analyzed in histograms and correlated to the meteorological factors. The population density of the psillid increased considerably with the approach of the spring and presented a positive correlation with the temperature. The level of damage of the psillid accompanied the population density of the pest. According to the data found in this work we may conclude that the increase of the temperature causes an increase in the population density of T. limbata and the largest population densities from psillid occur in the months of September to November and the smallest densities occur between the months of May and July.

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A estimulação transcraniana por corrente contínua (ETCC) é uma técnica não invasiva que apresenta características anti-fadigante e analgésica. Com o objetivo de testar seus efeitos sobre a diminuição da força e do aparecimento da dor muscular de início tardio (DMIT), apresentados após um evento de dano muscular induzido pelo exercício (DMIE), foi utilizado um estudo clínico de caráter experimental, controlado, randomizado e duplo-cego. A amostra foi composta por 24 jovens do sexo masculino, aparentemente saudáveis (19,7±1,8 anos; 23,6±3,65 IMC), os quais foram alocada, de forma aleatória e estratificada, nos seguintes grupos: G1: grupo controle; G2: grupo de estimulação após o dano e G3: grupo com estimulação antes e após o dano muscular. Os dados foram submetidos à estatística descritiva e análise de variância ANOVA, adotando-se um nível de significância de 5%. O aumento nos níveis séricos de CK (56.18%) e LDH (24,15%) comprovou a ocorrência do DMIE. Em contrapartida, após a análise de variância para comparação dos tratamentos aplicados, pode-se observar que não houve diferenças significativas nos níveis de CK (p= 0,3514) e força muscular (p= 0,9702). A DMIT transcorreu como esperado, mas sem diferença significativa entre os grupos (p= 0,4861). Estes dados demonstraram que a ETCC não foi capaz de modular a DMIT e a diminuição da força muscular após o DMIE em jovens aparentemente saudáveis

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This study originated from my concerns as critical care nurse, regarding the lived experience of the family member of the patient that is hospitalized in the intensive care unit - ICU. The purpose of the study was to comprehend the experience of the family members while having a loved one interned in an ICU, and to identify the common elements of the phenomenon, based on the descriptions of their experiences. Considering that the object of study involves subjective and social questions, the study was conducted using some fundamental ideas of descriptive phenomenology as a referential and the situated phenomenon as suggested by Martins and Bicudo (1989). Ten (10) family members of patients that were interned in the ICU of private hospital in Natal, RN were interviewed using the following leading question: What is it like to have a member of your family interned in the ICU? Five thematic structural categories emerged from the comprehensive analysis of the interviews: Fear of the family member s death; Lack of humanization; Social isolation; Confidence in the ICU; and Overload to the personal life. The description of the phenomenon enabled a new look at how the care team relates to the family members of the patients interned in the ICU, providing some guidance on how to construct a humanized care that involves the family and that is based on affective human relations. This involves a rethinking of the care provided by team to the family and stimulates the reformulation of personal and social attitudes, and of hospital organizational norms

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In tertiary care, the Intensive Care Unit (ICU) is nowadays one of the most complex settings in providing care to critically ill patients and could make the difference in favor of life. Nevertheless, the stigma of death which pervades the imagination when the ICU is mentioned and the excessive importance placed on machines rather than on the human being end up by causing distress to some extent. As the purpose of this investigation is to understand the distress caused to a patient in an ICU, it has been grounded on the following question: What kind of distress does a patient go through during his/her experience in an ICU? This study has, therefore, an analytical and reflexive character embedded in a qualitative dimension of a phenomenological approach based on narratives. To this purpose, five patients were interviewed from November to December 2008. Out of the empirical material gathered from these narratives we were able to identify several factors that cause distress to ICU patients. Among them were: the certainty that they are critically ill and fear death, a closed room, too much lighting, a typical loneliness arising from being isolated from family members and dear ones, lack of communication with the professional staff, and noise; besides having to undergo therapeutic procedures. In summary, although the ICU is seen as a place of distress, in many aspects and in accord with this research, such distress can and should be relieved. On the other hand, being near to death leads them to a redefinition of life, said the patients.

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Estudo de caráter exploratório e descritivo, de abordagem quantitativa, realizado num hospital de urgência hospitalar referência em traumatologia, em Natal/RN, com o objetivo de identificar o conhecimento do enfermeiro a respeito da ECGl para avaliação do nível de consciência e do processo de cuidar na fase pré-hospitalar e hospitalar às vítimas de TCE. A população constou de 44 enfermeiros e os dados foram coletados entre abril e maio de 2010. Os resultados mostram que, 35 (79,5%) dos enfermeiros eram do sexo feminino; 17 (38,64%) estavam na faixa etária entre 24 a 30 anos e 12 (27,27%) entre 51 a 60 anos; 25(56,82%) solteiros, 30 (68,18%) católicos e 25 (56,82%) sem filhos; 40 (90,90%) eram formados por instituições públicas, 18 (40,92%) tinham tempo de serviço na enfermagem acima de 21 anos e 14 (31,82%) até quatro anos; 18 (40,91%) estavam alocados nas UTIs e 13 (29,55%) atuavam em mais de um setor e 20 (65,90%) possuíam especialização. Dos que estavam mais especializados, 18 (40,92%) tinham tempo de serviço até quatro anos e 08 (34,48%) acima de 21 anos. Todos relataram ter prestado assistência às vítimas de TCE e 36 (81,82%) sentiam-se preparados; 35 (46,67%) adquiriram essas informações na prática e apenas 8 (10,67%) na graduação. Em relação a opinião dos pesquisados sobre os empecilhos que dificultam esta assistência, 23 (23,01%) relataram déficit de recursos humanos e 19 (20,65%) despreparo da equipe de enfermagem, estrutura física inadequada e recursos materiais precários. Como propostas de solução para os problemas, 26 (47,27%) sugeriram reforma na gestão e 13 (23,63%) referiram educação continuada. Em relação a ECGl, 40 (90,1%) afirmaram conhecê-la, 33 (82,50%) a utilizavam, 32 (80%) conheciam sua finalidade, 25 (62,5%) acertaram os indicadores fisiológicos e 36 (90%) classificaram corretamente a gravidade do TCE. Dos enfermeiros que utilizam a ECGl, 23 (92%) conheciam seus indicadores e classificação e 20 (60,61%) utilizavam uma vez por plantão. Em relação às dificuldades no manejo da ECGl, 11 (21,58%) não tinham nenhum problema; 10 (19,60%) citaram a falta de tempo e com o mesmo percentual responderam interpretação da resposta verbal nos pacientes intubados. Quanto ao conhecimento dos enfermeiros na descrição do processo de cuidar, 31 (70,45%) das respostas da fase pré e 35 (79,55%) da hospitalar não possuíam etapas importantes, sendo consideradas como incorretas. Quanto à afirmativa dos enfermeiros em estar, e realmente estar preparados para esta assistência, detectamos que daqueles que disseram estar preparados, apenas 12 (33,33%) acertaram todos os passos do atendimento pré hospitalar e 6 (16,67%) no atendimento hospitalar. Concluímos que diante dos resultados obtidos, os enfermeiros conhecem a ECGl, no entanto, necessitam de capacitação para sua melhor compreensão e utilização. Quanto ao conhecimento do processo de cuidar aos pacientes com TCE, é necessário modificar urgente esta realidade, especialmente na atenção às ações desenvolvidas pelo enfermeiro no âmbito hospitalar, onde as consequências das lesões secundárias, muitas delas evitadas com diagnóstico precoce e intervenções imediatas, podem acarretar incapacidades permanentes e prejudicar a qualidade de vida desses indivíduos

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Reconstruct, from listening, the life histories of a chronic renal patient, submitted to hemodialysis, is the objective of this investigation. How methodological procedure,we worked with oral history of life, ,according Meihy, within a qualitative approach. For this, we had the approval of the Ethics Committee in Research of Hospital Universitário Onofre Lopes (HUOL), under protocol no 591/2011. As instrument to approach the patient, we did interviews with open questions, conducted in the patient's house. There were five meetings, in which we hear his story, experiences and ways of coping during their course of illness and treatment. The analysis was based on the collaborator's narratives, anchored in studies dealing with oral history, of human subjectivity, highlighting the resilience, as indicated Cyrulnik. Her story leads us to conclude that despite the adversities of life and suffering, there is in humans, the strength to navigate the streams and be happy. This is the lesson that leaves us the collaborator this study.

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This study aimed to identify and describe the factors related to Patient Safety in a medication system according to the nurses analysis in a teaching hospital from the photographic analysis method. This was a cross-sectional, descriptive study with mixed approach in a teaching hospital in Rio Grande do Norte. The population consisted of 42 nurses from inpatient units, of which 34 composed the study sample. As eligibility criteria, we defined nurses from public service and nurses who agreed to participate. Ethical determinations were observed, the study was submitted to the Ethics and Research of the University Hospital Onofre Lopes, obtaining the assent with ethical assessment certificate (CAAE 0098.0.051.294-11). For data collection, we used the photographic method (Photographic Analysis Technique) by Patricia Marck (Canada). It was developed in two phases: at first, we randomly captured photos from the medication system, resulting in 282 images; then we selected/processed the photographs, which were reduced to 10 images in Microsoft Excel 2010; in the second phase, the nurses answered the questionnaire divided into socio-professional profile and Digital Photography Scoring Tool (questions a and b ). For analysis of the question a , we used the content analysis technique, and for b , we used the Statistical Package for the Social Sciences 20.0 (temporary license). The socio-professional profile revealed the predominance of females; age group 34-43 years; professionals with specialization; 10-18 years of length of service; and nurses working exclusively in the hospital and who know the Patient Safety. The photographic analysis in relation to Patient Safety resulted in specific categories for each stage of the medication system. Regarding disposal, we identified Proper verification ; Improper verification ; Correct identification ; Disposal in single doses ; and Improper Environment , with predominance of that last category. As for storage: Proper storage ; Improper storage ; Risk of exchange/disappearance ; and Poor hygiene , with special reference to improper storage. In preparation: Risk of exchanging medication/patient ; Inappropriate physical space ; and Inadequate 9 preparation of controlled drugs , highlighting the first category. In drug administration: Lack of Personal Protective Equipment ; Use of Personal Protective Equipment ; Improper administration technique ; Proper administration technique ; Correct drug identification ; Incorrect drug identification ; and Peripheral venous access without identification . From the safety assessment of 10 photographs, by adapting the scores (1-10) to the Likert Scale, we identified three Totally Unsafe (Level 1), three Unsafe (Level 2), three Partially Safe (Level 3), one Safe (Level 4), and no photograph considered Totally Safe. This study identified the prevalence of unsafety in the medication system in the nurses opinion. We were also able to understand that, although nurses identify safety aspects, the most prevalent categories characterize an unsafe assessment. Nursing needs to reflect on its practice, identifying gaps in the medication system in order to achieve a proper and safe care

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The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

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Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Questionário Atitudes de Segurança , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety

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Exercise-induced muscle damage mainly affects individuals who returned to physical activity after a time without practicing it or had some kind of exhaustive exercise, particularly eccentric exercise. To evaluate the effect of cryotherapy and laser therapy in response to muscle damage induced by eccentric exercise on the biceps muscle. This was a randomized clinical trial consisting of 60 female subjects. All subjects initially underwent an evaluation consisting of perimetry, measurement of pain sensation (via algometry and visual analogue scale), electromyography and dynamometry. Then the subjects performed an exercise protocol on the isokinetic dynamometer consisting of 2 sets of 10 eccentric elbow flexors contraction at 60 °/s. Completed this protocol, an intervention was held according to a previously random group distribution: control group (no intervention), cryotherapy group and laser therapy group. Finally, subjects were re-evaluated immediately and 48 hours after the intervention protocol, except for Visual Analogue Scale (VAS), which was also evaluated 24 hours after exercise. The circumference of the limb, the pain sensation (VAS and algometry), the muscle activation amplitude (via Root Mean Square - RMS), median frequency, peak torque normalized per body weight, average peak torque, power and work were analyzed. The median frequency immediately after the intervention protocol on the cryotherapy group was the only variable that showed inter and intra-group differences; the remaining variables showed only intragroup differences. The perimetry values did not change immediately after the protocol on the groups which underwent cryotherapy and laser therapy, however, there was an increase after 48 hours; algometry values decreased in all groups for 48 hours and the VAS values increased 24 and 48 hours also for all groups. Regarding RMS no significant change was observed. For dynamometry, peak torque normalized per body weight and average peak torque had a similar behavior, with a reduction in the post protocol that has remained after 48 hours. For the power and work, a decrease was observed immediately after the protocol with a further reduction after 48 hours. Cryotherapy and laser therapy does not alter the muscle damage response, except for the perimetry values immediately after exercise.

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This work deals with an analysis related to the social worker s practice in the oncology area. It aims to identify demands, work conditions as well as current challenges related to this profession. It considers the specificities of breast cancer and relates it to political decisions in the health sector considering the concept of contemporary capitalism. The study analyzes professional action and the demands presented by breast cancer patients who are currently in treatment in Hospital Dr. Luiz Antônio em Natal-Rio Grande do Norte-Brazil. The methodological procedures considered of documental analysis, semi-structured interviews (with two social workers that work with fifteen breast cancer patients) as well as participant observation; which was done counting with my own professional practice in the oncology area. Thus, the research also discusses the breast cancer issue in the life of the users considering their social-economical, cultural and political determinants. Factors such as age in which the diagnosis was known, the relation user/social workers, number of children, rights of the oncology patient, place where he/she lives, education, civil status, (re)insertion of the professional in the work field, perception of self-esteem and bio-psycho-social representation of breast cancer in the lives of these women, all of which were dealt with in this research

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JUSTIFICATIVA E OBJETIVOS: A deficiência do fator XI é uma doença hematológica rara na população. A hemofilia C (deficiência do fator XI) ocorre em ambos os sexos e normalmente não apresenta qualquer sintomatologia, podendo manifestar-se apenas como hemorragia pós-cirúrgica. É uma doença autossômica recessiva, homozigótica ou heterozigótica, e sua gravidade depende dos níveis de fator XI. O objetivo desse relato foi apresentar a estratégia anestésica em paciente portadora de hemofilia C. RELATO do CASO: Paciente com 32 anos, gesta I/para 0, 39 semanas de gestação programada para cesariana eletiva. Paciente portadora de deficiência de fator XI. Exame clínico e laboratorial sem alterações. Conforme orientação do hematologista, no dia da cesárea a paciente usou prometazina 25 mg; hidrocortisona 500 mg, devido a reações transfusionais prévias, e plasma 10 mL-1.kg-1 num total de 700 mL. Após 2 horas foi submetida ao bloqueio subaracnóideo sob monitorização de rotina. Hidratação com RL 2000 mL. Procedimento anestésico-cirúrgico sem intercorrências. A paciente evoluiu no pós-operatório sem intercorrências, sendo que no 3º DPO fez uso de plasma fresco congelado (PFC) 10.mL-1.kg-1 com o objetivo de evitar sangramento pós cirúrgico tardio. CONCLUSÕES: O objetivo do caso foi apresentar o protocolo anestésico para pacientes portadores de hemofilia C e alertar para a necessidade de investigação em caso de antecedente de sangramento pós-operatório, quando um estudo da coagulação deve ser realizado antes de qualquer procedimento invasivo e, se um TTPA prolongado for encontrado, torna-se imperativo pesquisar a deficiência desse fator.