Avaliação da efetividade de estratégias não farmacológicas para o alívio da dor de parturientes na fase ativa do período de dilatação no trabalho de parto

This study was aim to evaluate the effectiveness of strategies non pharmacological for the relief of the intensity of the parturient pain in the phase activates of the dilation period in the labor. Is a clinic rehearse of the type therapeutic intervention before and after" with a quantitative approach, accomplished in the Humanized Unit of Childbirth of the Maternity Januário Cicco School of the Federal University of Rio Grande do Norte, in Natal/RN, whit 130 parturient, being 30 in the pre-test of the strategies and 100 in the application of the strategies non pharmacological combined (breathing exercises, muscular relaxation and lombossacral massage) and isolated (shower bath in a normal temperature). We used the visual analogical scale to evaluate the intensity of the pain of the study parturient before and after" to the application of the strategies in the phases of acceleration, maximum inclination and desaceleration in the phase activates of dilation period in the labor. The principal results showed that the majority of the study parturient was between 20 to 30 years old (60%); with incomplete fundamental teaching (85%); family income until 2 minimum wages (74%); 78% had a companion and these, 44% were the own husband. The oxytocin was administered in the parturient during the phase activates of the labor in 81% of the cases and only 15% these women didn´t reciev anything medication. We verified significant relief (ρ=0.000) of intensity of the pain of the study parturient after application of the strategies non pharmacological combined and isolated. We concluded that the strategies non pharmacological combined and isolated were effective in the relief of the pain of the study parturient in the phase activates de labor

A saúde psíquica de quem faz saúde: uma análise crítica sobre a humanização direcionada ao profissional de saúde

It is noticeable that pressure, tension and overwork are frequent in health professionals routine. The work related to the ward area demands deep attention and surveillance. Because of that, it is essential to have a specific look at the humanization directed at health professionals, considering that taking care of other human beings is the essence of their job. This study has analyzed the psychic health levels, as well as the stress health professionals are submitted to, providing a debate about the humanization in 06 public hospitals (03 of them awarded by actions of humanization, and 03 not awarded) in Rio Grande do Norte state, Brazil. A study with 126 active health professionals (doctors, nurses, psychologists, nutritionists and social workers) in ward areas in their respective institutions was carried out. The thesis presented, with multi-disciplinary characteristic, counted on the support of statisticians (to calculate samples and data analysis), psychologists, social workers and administrators (linked to the human resources sector in each hospital). A cross-sectional study was performed, taking into consideration both quantitative and qualitative factors. The tools used for that were a semistructured questionnaire with socio-demographic characteristics, work and humanization; Lipp's Stress Symptoms Inventory for Adults (ISSL), and the Goldberg s General Health Questionnaire (QSG). The workers are predominantly women (84,9%), married (54,8%), between 46 and 55 years old (40,5%), working in the same institution for more than 20 years (22,2%), and between 16 and 20 years (20,6%), respectively. They work 40 hours a week (71,4%) and have multiple jobs (61,9%). Although most of these individuals global psychic health is in a good level, there are a significant number of people that is gradually getting worse concerning psychic stress (F1) showed by QSG (54,7%), and stress showed by ISSL(42,1%). Observing the categories, nurses (41,5%). Nutritionists (20,8%), doctors and social workers (18,9%), were among the most affected. About general health (F6), 63% of the awarded hospitals and 70% of the not awarded ones, presented good health levels (ranging from 5 to 50%). It was also noticed that, in the groups mentioned above, 25 and 20% respectively, were inserted in scores between 55 to 90%, what means that they are in worsening phase. The fact that the hospital is awarded or well recognized doesn t interfere in health professionals stress level and in their psychic health. Through what was heard from these individuals, it was possible to verify that they know little about humanization, once few of them identify or know that the service they offer is in an adoption process by Ministerial Policies. It was also detected the necessity of developing actions aimed at worker s health. Such results showed the importance of have more investments in programs that are directed to workers well-being, because they deal with other people s health and it is known that it is difficult for them to offer high-quality assistance if there are not suitable physical, psychological and material conditions to help them develop their jobs. As a warning, it is fair to say that investments in actions that provide humanized care to health professionals, mainly concerning preventive care for their health and life quality in their work

Hospital humano: etnografia da humanização hospitalar na perspectiva de usuários

This ethnographic work studies the experiences of patients admitted in public (PUH) and private (PRH) hospitals in the Brazilian northeastern region. 28 adult patients of different clinics participated in the study. Data were analyzed by the patient path method, consisting in a combination of complemented and articulated techniques free observation, participating observation, ethnographic interview and patient testimonials collected prospectively during the patients admissions, from their arrival and until their discharge. The analysis was carried out according to the Thematic Categories Analysis Technique and the data were interpreted pursuant to medical anthropology, healthcare humanization and healthcare promotion theoretical references. The ethical principles of Resolution 196/96 were followed. The human hospital, as revealed by the patient, highlights the significance of subjectivity. 225 (54.7%) out of 411 mentioned concepts were collected in a public hospital (PUH) and 186 (45.3%) in a private institution (PRH). The results show that the patient at the PUH and PRH ethnoevaluates different aspects of the healthcare professionals´ human and technical competence, the hospital´s functioning structure, the access to and the ethics in the financial management, and develops overcoming strategies for his stay at the hospital. This ethnoevaluation is mediated by different factors, namely: social and economic status, personality, religiosity, ironic speech, somber diagnosis and satisfied needs, prior hospital experiences and the conditions under which the interview was carried out. A pedagogic proposal for the hospital humanization must include structural, managerial and organizational changes of the offered services and use active methodologies aimed to the political resolution of problematic situations at work and the inclusion of affective and subjective factors, and become as well a tool for the collective learning. This study shows the importance for the user´s ethnoevaluation to be incorporated into the hospital management and care as a guideline in the decision making and clinical action, thus promoting practices that shall lead to a decent and humanized care. The multidisciplinary nature of this study allowed a wide understanding of the user´s perspective as a socially critical ethnoevaluator

Significados e percepções de puérperas sobre as síndromes hipertensivas da gravidez e parto prematuro

Hypertensive syndromes in pregnancy (HSP) are configured as one of the major complications in the pregnancy and postpartum period and can lead premature newborn and subsequent hospitalization of the newborn to the Neonatal Intensive Care Unit (NICU). This study aimed to analyze the perceptions, meanings and feelings of mothers on the hypertensive syndromes in pregnancy and premature obstetric labor. The research was qualitative and has a theoretical methodological the Social Representations Theory(SRT) in the approach to the Central Nucleus Theory. The study included 70 women, mean age 29 years, predominantly school to high school, most of them married or in consensual union, primiparous and prevalence of cesarean delivery occurred between 32 and 37 weeks of pregnancy.The data were collected from may to december 2008 in the Maternity School Januário Cicco in Natal , and obtained through the following instruments for data collection: questionnaire including questions about socio-demographic status; the Free Words Association Test (FWAT) and and verbalized mental image construction used three stimuli: such as pregnancy with high blood pressure, preterm birth and NICU, and interview with the following guiding question: what it meant for you to have a pregnancy with high blood pressure and consequently the birth of a premature baby? Data analysis was performed using multi-method obtained from the data processing by EVOC (Ensemble Programmes Permettant L 'Analyze des Évocations) and ALCESTE (Analyse Lexicale par Contexte d'un Ensemble de Segment de Texte) and thematic analysis in categories. The results will be presented in four thematic units under the following representative universes: HSP, prematurity as a result of HSP, NICU and the social representations of mothers on the hypertensive disorder of pregnancy sequenced premature birth and hospitalization of the child in the NICU. The results obtained by multimethod analyses showed similar constructions and point to death as the central nucleus and negative aspects, coping strategies, need of care, knowledge about the disease, fragility and meanings of the NICU as peripheral elements. It is considered that the perceptions, meanings and feelings of puerperal women in relation to HSPs and to premature delivery are a negative social representation, with representational elements that may have influenced the adverse effects on the disease and its consequences. We suggest action on the peripheral elements of this representation, with adequate orientation, early diagnosis, effective conduct, receptive attitude on the part of the team, health promotion measures and effective public policies, in order to improve the care provided to puerperal women, making them feel welcome and minimizing their suffering

A Humanização e a Formação Médica na Perspectiva dos Estudantes de Medicina da Universidade Federal do Rio Grande do Norte

The aim of this study is to understand the perception of medical students at the Federal University of Rio Grande do Norte (UFRN) about humanization in the context of their medical formation, using a qualitative approach. The focus group and participant observation techniques were used, involving a multidisciplinary team composed of professionals from the areas of anthropology and psychology, as well as professors from the medical course, who studied two groups of nine students in their final year. The data were analyzed using the categorical thematic content analysis technique, from which emerged three categories: student/patient relationship, teaching/learning and student/professor relationship. The first allows us to identify that student-patient contact is an essential experience for adopting a more humanized view of the disease process. The second category shows that unqualified professors in the pedagogic practices inherent to the teaching profession and the theory the practical dichotomy hinder the autonomous and holistic formation of knowledge. Similarly, the lack of practices outside the academic environment and the absence of multiprofessional stimulation interfere in the construction of an integral view of the individual. From the third category, the student/professor relationship, emerge two opposing subcategories (professor model and assymetric relationships), which reflect the importance of the professor`s ethical humanist position, as opposed to an authoritarian attitude, to form the professional attitude of the student. The results point important aspects of the medical formation that may open a discussion about humanization, in the context of new national curricular guidelines

Síndrome metabólica e fatores associados: estudo comparativo com mulheres que apresentaram pré-eclâmpsia e gravidez normal, acompanhadas cinco anos após o parto

Preeclampsia is defined as an extremely serious complication of the pregnancy-puerperium cycle with delayed emergence of cardiovascular risk factors, including metabolic syndrome. The research aimed estimate the prevalences of metabolic syndrome and associated factors in women with preeclampsia and normal pregnancy followed five years after childbirth. This is a cross-sectional observational study using a quantitative approach, conducted at a maternity school in the city of Natal in Rio Grande do Norte state. The sample was composed of 70 women with previous preeclampsia and 75 normal selected by simple random probability sampling. Subjects were analyzed for sociodemographic, obstetric, clinical, anthropometric and biochemical parameters. International Diabetes Federation criteria were adopted to diagnose metabol ic syndrome. The Kolmogorov-Smirnov, Mann-Whitney, Student s t, Pearson s chi-squared, and Fisher s exact tests, in addition to simple logistic regression, were used for data analysis, at a 5% significance level (p ≤ 0.05). Statistical tests demonstrated elevated body mass index (p = 0.001), predominance of family history of diabetes mellitus (p = 0.022) and significantly higher prevalence of metabolic syndrome in the preeclampsia group (37.1%) when compared to normal (22.7%) (p = 0.042). Intergroup comparison showed a high number of metabolic syndrome components in women with previous preeclampsia. Altered systolic and diastolic blood pressure (p < 0.001) was the most prevalent, followed by low concentrations of high-density lipoproteins (p = 0.049), and hyperglycemia (p=0.030). There was a predominance of the metabolic syndrome in women with schooling 0-9 years (42.4%) (p = 0.005), body mass index above 30Kg.m 2 (52.3%) (p < 0.001), uric acid high (62.5%) (p = 0.050 and family history of hypertension (38.5%) (p< 0.001). Multivariate analysis of the data showed that the body mass index above 30 kg.m2, education level less than 10 years of study (p < 0.001) and family history of hypertension (p = 0.002) remained associated with the metabolic syndrome after multivariate analysis of the data. It is considered Women with previous preeclampsia exhibited high prevalence of metabolic syndrome and their individual components in relation to normal, especially, altered systolic and diastolic blood pressure, low concentrations of high-density lipoproteins and hyperglycemia. The factors associated to this ou tcome were obesity, less than 10 years of schooling, and family history of hypertension. Overall, this study identified young women with a history of PE exposed to a higher cardiovascular risk than normal

O parto dos caminhos: Formação dos Sindicatos Rurais no Rio Grande do Norte (1960 - 1964)

The present work treats the movements dedicated to reinvidication per land and social rights for the field works, among 1960 and 1964. Trying to understand this question in the Rio Grande do Norte it is necessary to consider the connection between the catholic church and the rural syndicates besides the influence of the Brazilian communist party, and still other social movements and the state. The structures politics local, national and international, had considerable importance to the organization rural potiguares workers. The rural potiguares syndicate appear in 1961 - after a hard organization work starting of the Service of Rural Assistance - and expand itself through state until the middle of 1962. Soon the first big conflicts an important manifestation are perceive, indirectly referring to a increasing movement's performance. The Favoring Progresses chains co quested a biggest influence in the politics destiny of the Rio Grande do Norte, in front of integration among syndicates, educational projects, and favoring progress's politics. But the military coup hired that the hope overflow the field

A política de humanização e a estratégia saúde da família: visões e vivências

This study approaches the topic of humanization in health that involves the set of policies implemented by the Ministry of Health in Brazil. Its aims are directed towards a reflection on the guiding theoretical and organizing axes of the National Humanization Policy (NHP) and their repercussions on municipal health policy of Natal, Brazil; an analysis of the results of the policy at the local level; knowledge of the views and experiences of the humanization agents in the daily work process and identification of the main challenges of the policy. The empirical field of investigation was the Family Health Strategy (FHS) of the city of Natal. The assumption of the study is that the FHS has produced local experiences with potentialities that must not be wasted, in which there are difficulties and discrepancies between the real and proposed model. The contradictions and challenges in the social and political context of Brazil in the early XXI century and their consequences in the field of health reflect anti-utilitarian aspects anchored strongly in the theoretical concepts of Boaventura de Sousa Santos about the sociology of privations and emergencies as well as of the work of translating. The predominantly qualitative approach collects some complementary quantitative data. The study procedures used were the following: bibliographic research; documental research; interviews; and direct observation. Interpretation of the information obtained was based on documental analysis and on the symbolic cartography of the social representations. Cartographic evidence suggests that practices still take place under dehumanizing conditions that compromise the quality of care given. However, there is a movement aimed at changing the work process that has been strengthening the link and widening the measures developed, incorporating new directions in diversity, integrality and solidarity. The map drawn shows a reality manifested by explicit intentions in a political agenda, by concrete solutions marked by an assortment of difficulties and expressed in the words of the agents and by latent clues identified in successful local experiences, posing many challenges for the consolidation of the proposed changes

Prática do acolhimento à pessoa idosa na atenção básica: uma estratégia de humanização

The aging of the population already is a fact, before considered a phenomenon, today, is part of the reality of the majority of the societies in the world. The present study it has as objective to analyze the practical one of the shelter developed for the team to multidiscipline for the elderly in the Strategy of Health of the Family. One is about a descriptive and exploratória inquiry, developed by means of quantitative boarding. The population of this study consisted of nineteen teams that work in the inserted ESF in the urban zone of the city of Sousa-PB, understanding a complete of 133 professionals. The collection of date was carried through through a questionnaire contends closed questions, referring to the partner-demographic date e, specific open questions. The main results indicate that the professionals of Health of the city of Sousa, PB, that had participated of this study had consisted in a complete of 76. Amongst these, 20% are nurses, followed of the odontólogos in 6%; 35% are ACS and technician of nursing with 19%. The age of the interviewed ones meets in the age band enters, 21 and 30 years, in 43%. The majority is of the feminine sex with a 84% total. Already in accordance with civil state 34% is married. If treating to the wage, the doctor has of greater of 12 wages. The participants present the percentile greater of formed time of with referring 33% of 1 the 3 years of formation. E finally, the changeable time of performance, if had detached 39% of the participants with 08 the 11 years. With regard to as if it processes the reception and attendance to the person in the ESF, we can observe that, with priority attendance was prominence with 27% of the participants, followed of a considerate attendance with 26%. Already in relation to the actions that are developed daily in the ESF, these they are come back toward the HIPERDIA with 40%, followed of actions ruled in orientation with 27%. Some actions they are carried through in accordance with the aged necessity of each (13%) and through visits domiciliary (9%). It was asked to them as the shelter was facilitated in the UBS, these had told that it is through the attention that is excused the aged one (35%), and finally, as this made it difficult age, in its majority with 37% they had not wanted to answer, followed of the lack of understanding with 26%. With this study it was possible to conclude that the practical one developed for the professionals of the ESF of the city of Sousa, PB with the elderly, is characterized by an assistance ruled in the clinical aspect, little focused in the actions that to permeate the PNH

Registro de enfermagem no prontuário em um hospital universitário: uma busca pela humanização do cuidado

T he aim of this study is to analyze the view of nurses about nursing records in the patient chart, in perspective of the record of humanized care. This is a case study, with qualitative approach. For its achievement, was sought and granted authorization from the direction of the Hospital Universitário Onofre Lopes (HUOL) and the Ethics Committee in Research of HUOL as Statement No. 422/10. During data collection, interviews were conducted with 20 nurses of the institution. The data analysis was based on the theoretical framework of Minayo to thematic content analysis, grounded in authors who work with themes, nursing records and quality care. With the empirical material, we constructed a framework of analysis, which was identified four categories thus nominated, "Reading and learning from those who register," "nursing records and quality of care," "the essence of nursing records" and "intention and action on the record of the subjective aspects of the patient." The results show that the records are insufficient, even in the case of the procedures performed with the patients often do not inform about the aspects that deal with the subjectivity that surround it, and admit that the records do not represent a parameter for evaluating the quality of care at least at that institution. In summary, the respondents recognize the importance of valuing subjectivity of the patient in their treatment, yet admit to neglect this aspect as significant for comprehensive health care, humane and quality

Valorização do servidor no Programa Nacional de Humanização: estudo em um hospital universitário

It is at the work environment where value of the health professional is realized, according to the National Humanization Policy (PNH) from a Pediatric Hospital connected to an institution of higher education. Among the guiding principles of PNH it is highlighted the commitment to the democratization of labor relations and enhancement of health professionals, stimulating the continuing education process. For this research, a qualitative approach was chosen, using a semistructured interview as a tool to collect data. In a perspective of identifying the appreciation and humanization into interpersonal relations between workers, information from the theory of communicative action of Habermas was analyzed, considering cultural values goes beyond the practice in action, where the prospects of moral arguments in the universal truisms of life pervade original cultural moral, cognitive and expressive, imbued on ethics. This reasearch had the collaboration 29 employees with a regular contract labor to a teaching hospital in Natal, Brazil. The data was obtained through interviews which all participants signed a consent term. After data analysis the results shows the existance of a satisfaction of all workers on performing duties. The workers perceive its role valorization through kudos received as a consequence of a work done, others believe that it occurs when the institution or the group itself is concerned to enhance the work. Thus, in general, they feel valued. Regarding the interpersonal relationship, the most highlighted point was the fact that in the employees versus general directors item, respondents indicated the existence of a distance between these two categories, which can affect a participatory management. Therefore, the results of this study showed the necessity to develop actions that provide a healthy work environment. The joint guidelines of the PNH and the Employee Health Care Policy, represent some directions with some similarities in their purpose to the theory of communicative action, where there is a mutual respect, tolerance and coexistence of differences, considering the constructive conflict among health workers within the perspective of communication and interaction among individuals

Percepção do pai sobre sua presença no nascimento do filho

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Nascimento de um filho :o significado para o pai

Qualitative study on the meaning of a child s birth to the father. Its general purpose was to comprehend the significance the man attaches to his child s birth and its specific objectives were to identify the man s feelings with regard to his child s birth as well as to verify his attitude toward a child s birth. The study was founded on the theoretical reference system about the man in the gravid-puerperal cycle and the humanization of the assistance. The data were obtained through semistructured interview performed with men accompanying their children s birth whose wives were in the immediate puerperium. This stage occurred in two maternity hospitals in Natal-RN, both of which adopt the principle of safe notherhood in the attendance of women in the process of parturition. The material apprehended from the statements was treated in conformity with the content analysis method in the mode of thematic analysis according to Bardin. Three thematic categories emerged from this process: the father s attitude toward his child s birth, the father s feelings in respect of his child s birth, and the informations received by the father in the course of his child s birth. The speech content was analyzed in accordance with the principles of symbolic interactionism according to Blumer. The results showed that the husbands interact with their respective wives and respond with attitudes of care, help, support, and encouragement within the principles of humanization intermingled with feelings of happiness, restlessness, and suffering leading them to appraise and exalt their consorts. Besides, we verified that the father s attitudes and feelings in the delivery room in the light of symbolic interactionism tend to be influenced by the interaction between him and the attending professionals

Avaliação de características de crescimento pós-desmama de animais Nelore puros e cruzados no estado do Mato Grosso do Sul

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeito da seleção para peso pós-desmama sobre indicadores da eficiência produtiva de vacas da raça Nelore

O objetivo deste estudo foi avaliar indicadores da eficiência produtiva de vacas Nelore selecionadas para peso pós-desmama, enfocados nas relações peso bezerro e peso da vaca, nos rebanhos controle (NeC), não-selecionados para peso pós-desmama, seleção (NeS) e tradicional (NeT). As análises envolveram 3929 e 3906 pesos dos bezerros aos 120 (P120) e 210 (P210) dias de idade, respectivamente. Os pesos das vacas àquelas idades também foram considerados, obtendo-se 3824 (PV120) e 3777 (PV210) registros, respectivamente, para 120 e 210 dias. A análise incluiu 183, 375 e 554 vacas dos rebanhos NeC, NeS e NeT, respectivamente. Para as análises utilizou-se o procedimento GLM/SAS, em modelos que incluíram os efeitos fixos de rebanho, ano e mês de nascimento, sexo do bezerro, idade da vaca ao parto e as interações rebanho x ano de nascimento e ano x mês de nascimento. Todos os efeitos foram significativos. Os resultados mostraram respostas correlacionadas positivas na seleção para peso pós-desmama nos pesos dos bezerros e, em menor magnitude, no peso das vacas. As relações peso bezerro e peso da vaca apresentaram valores médios ajustados de 249,0±2,1; 253,7±1,6; e 255,8±1,2 g/kg para R120 e 362,9±2,8; 368,5±2,1; e 374,6±1,7 para NeC, NeS e NeT em R210, respectivamente, indicando que, nas duas idades, os rebanhos NeS e NeT produziram mais quilogramas de bezerro por quilogramas de vaca, quando comparados ao NeC.