O médico diante da morte na urgência e emergência:reflexões sobre o ser médico

The literature pointed that the way which people deal with death have been changing along centuries, and nowadays what is realized it is that, each time more, the human being have difficulties to deal with death. Due to the fact that the main function of the physician is to save their patients lives; responsibility that is aggravated by the necessity of to take decisions quickly, once he need to deal with the unexpected situations of the urgency and emergency, many times these professional have to face of impotency and fail situations, when he lose a patient. The main goal of this study was to understand the experience of physicians that work in the urgency and emergency, in front of death. These questioning it justified by the fact of the physicians do not have, many times, a space to express their suffering and anguish about the issues related to death in their work routine, despite lifedeath question to be often present their everyday. It is still possible to verify in the literature, an appointment of the necessity of to include in the curriculum of Medicine courses, subjects that approach such questions. The method used was based on the existential-phenomenological perspective, using as instrument the participant observation, to the intent of understand the routine in the urgency and emergency context, and semi-structured interview. It was interviewed six physicians that work in the urgency and emergency of the most important hospital of public health system of Natal-RN. The results showed that the physicians reported pleasure in work in the urgency and emergency, despite of they presented stress and the difficulties that they deal with in the public system. Despite of the fact that the death to be considered as a phenomenon that make part of the physician s routine, sometimes, deals with these one is more difficult. Many times losses generate an impotency and guilty feeling, as well as questionings about their performance during the attempts to save lives. We verified, from this study, the importance of the existence of some kind of intervention in the emergency, in order to the physicians can elaborate the questions about death and die emerged in their work. We consider yet that this study corroborates and reiterates the discussions concerning the importance of this thematic to be approached in a more effective way, during the academic formation of these professionals, as well as, the importance of a larger investment from the part of Government in the urgency and emergency sector, in order to propitiate to these professionals a work that brings less harmful for their health

A auto-estima da criança que sofre violência física pela família

This research investigates the self-esteem of children who suffered physical violence by family members. Seven children took part in the research: three boys and four girls, aged between six and twelve years old. The analysis were done from the constructed data obtained from: semi-structured interview, activities about human feelings, activities that included facial expressions, unfinished phrases, Pinocchio s story, a drawing of a family and a drawing of their own family. Data were analyzed from the Content Analysis. The Thematic Units were: violence, intrafamily violence, and self-esteem. The synthesis of the categories studied evidenced that the physical violence and the psychological violence present in the lives of children affect the positive development of their self-concept and, consequently, of their self-esteem. Among the results, we emphasize some negative feelings that are present in children s lives such as fear, a sense of guilt, and sadness, arising out of the situations of violence they have experienced

O aborto provocado como uma possibilidade na existência da mulher: reflexões fenomenológico-existenciais

Abortion is a very controversial and stigmatized subject, target of many criticism and discussions, mainly regarding to the legal, bioethical and religious aspects involved. In Brazil, abortion is considered a serious public health problem, being the major cause of maternal death due to its criminalization. The woman who causes an abortion is not up looked by society, since motherhood, culturally and historically, was imposed as a destination. Our main goal is to understand, from the existential-phenomenological perspective, the unique experience of the woman who induced the abortion This study is an offshoot of a larger study from USP in partnership with UFRN. Our participants were women who checked in on a maternity hospital in Natal with a miscarriage diagnosis and, among them, those who reported having induced abortion. Altogether, five women were interviewed. The used method was a phenomenological hermeneutics. The research revealed that the experience of abortion is a possibility that permeates women s life, being understood as a choice. This choice pervaded by much suffering, once it goes against everything that women are culturally taught and meant to be. The feeling more surfacing in this experiment, confirming the literature review, was blame. Abortion was also shown as an experience of helplessness and loneliness, due to lack of support from family and the partner. It was also revealed that abortion was made, mainly, by the desire of going along with future projects, including the prosecute of motherhood in the therms of what they consider ideal to a son s arrival, meaning, a family formation grounded on a stable relationship. Regarding the care provided by health professionals to these women, there is the need of restructuring the operating logic of SUS, so that women have the right to health in a integrate manner. This experience also made women reconsider the meanings they had towards abortion, and their life projects

Relação amorosa e tentativa de suicídio na adolescência : uma questão de (des)amor

Suicide rates have been rising all over the world. In Rio Grande do Norte state, a study carried out by Dutra (1999) investigated suicide rates among youngsters and found that in 1997 alone 244 cases of suicide attempt were registered. The author took an interest in studying this phenomenon among adolescents after reviewing Dutra s study and the technical literature on suicide. In addition to that, another topic caught her attention and raised new research questions: suicide attempts motivated by love, i.e., the end of a relationship, the fantasy of being abandoned by a partner. These have made the author to question how love manifested itself among adolescents and how it could become a reason for adolescents to give up their lives. Based on the data she analyzed and the research questions she developed, her research objective was to understand how adolescents who have attempted suicide because of love-related reasons have gone through this experience. The theoretical reference for the research was the Client-centered Therapy and more specifically, the construct self , according to Carl Rogers. The methodological strategy was inspired by the existential-phenomenological strategy. It used the narrative as a research instrument, inspired by the work of Walter Benjamim (1994) which was developed into a research strategy by Schmidt (1990). Four youngsters (three male and one female) have participated in this study. They have attempted suicide for love-related reasons during dolescence, when they were 12 to 18 years old. The interviews were recorded on cassette tapes, transcribed and literalized into narratives. The understanding of the narratives was based on the meanings that emerged from the youngsters speeches, as well as from the moments that touched the author. These moments highlighted the meaning of the experience of giving up life and the experience of love-based relationship as experienced by the youngsters. The study detected, among the adolescents who were interviewed, the existence of impulsiveness related to the suicide attempt. Also, the majority of the interviewees came from unstructured family backgrounds and had lost of one of their parents or had to face their parents divorce. The suicide was attempted by these youngsters through the ingestion of medicines. The research also revealed that the youngsters had regretted attempting suicide and felt guilty about it. With regards to their self-evaluation, the author observed that the youngsters had low self-esteem, negative perceptions about themselves and distorted views of themselves. These findings helped the author to reflect on the close relationship between the construct self and the suicide attempt. She also observed that a few factors, i.e., family context, education, social and cultural values, have influenced the way the youngsters perceived themselves . The results of this research confirm the idea that we have to understand the suicide attempt as a multi-determined phenomenon. This study contributed to the analysis and reflection on the factors that contribute to suicide attempts thus providing a foundation for the development of public health programs and policies to deal with this topic

A experiência de depressão na contemporaneidade: uma compreensão fenomenológico-existencial

The depression is one of the most common forms of getting ill nowaday. Due to the increase in incidence of depression cases registered worldwide, this theme has been the subject of important studies, especially regarding the symptomatological description and biological etiology of the disease. This research had the objective to understand the unique experience of depression experienced by people who recognize themselves in depression, under the focus of existential phenomenology of Martin Heidegger. To reach the proposed objective, individuals narratives interviews were conducted with four participants, starting from the triggering question, "from your experience, how is for you to being depressed?". The survey revealed that depression affects the whole person and is related to stressful life contexts. Depression was narrated as an experience of disempowerment and lack of self esteem and personal worth. The collaborators of the research referred to the depression from sad, angry, bored and pessimistic mood. The time is experienced as a restriction to the projective opening towards the possibilities of being in which the future is seen as catastrophic and the past lived as debt and guilt. The corporeality, in depression is experienced through the weight, fatigue and pains for no reason. The space is lived from the notion of fall and collapse. We also realized the desire for isolation and avoidance of social contact. Suicide is desired and represents the end of the suffering in life. The depression has proved, still, very stigmatized, because it is discredited and misunderstood. The stigma also addressed to the experience of hospitalization and the unsuitability to the socially imposed standards of beauty, which generates enough suffering to the depressed person. The medication was described based on its positive effects, as a balance and suffering reducer, but also as a producer of dependence. Were also identified according to the collaborators, traces of selfdemand, ordenality and being-for-others, characteristic of typus melancholicus. This study contributes to an understanding of the depression that goes beyond the merely biological perspective and symptomatology of the pathology. The investigation of the depressive experience, through the lens of Heidegger's phenomenology, showed us the phenomenon of the depression in their singularity, complexity and multiple meanings, showing the close relationship between the formation of the depression and the context of personal and social life of the participants

O processo de readaptação funcional e suas implicações no gerenciamento em enfermagem

Hoje há maior interesse pelo trabalhador da saúde. A preocupação com o processo de readaptação funcional foi a proposta desta investigação. O objetivo foi compreender a vivência dos sujeitos nos processos de readaptação funcional, em uma instituição hospitalar pública. No estudo, qualitativo, foram realizadas entrevistas para apreensão da vivência do profissional de enfermagem quanto ao processo de readaptação funcional, analisadas utilizando a Análise de Conteúdo, proposta por Bardin. Os resultados evidenciam a problemática do processo de trabalho em enfermagem nas categorias organização do trabalho , trabalho em equipe , afastamento e readaptação funcional e gerenciamento da equipe , gerando sugestões para a melhoria dos processos de trabalho. O processo de readaptação funcional gera individual, profissional e socialmente sentimento de incompetência e culpa no trabalhador. Importantes reflexões e mudanças de atitude são urgentes e necessárias, subsidiando o gerenciamento da equipe que implicará em melhoria na assistência prestada à população.

Representação de gestantes tabagistas sobre o uso do cigarro: estudo realizado em hospital do interior paulista

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Sentimentos e percepções de puérperas com relação à assistência prestada pelo serviço materno-infantil de um hospital universitário

OBJETIVOS: avaliar percepções e sentimentos de puérperas adultas e adolescentes, relacionados ao filho e a assistência materno-infantil, em hospital universitário de nível terciário. MÉTODOS: estudo transversal, envolvendo 180 puérperas, no Alojamento Conjunto (AC) e no Berçário Interno (BI) do Hospital das Clínicas da Faculdade de Medicina de Botucatu , entrevistadas no segundo e terceiro dia pós-parto e distribuídas em três grupos: adultas primíparas, adultas multíparas e adolescentes. Para comparação entre grupos e locais de internação utilizou-se o chi2 ou teste de Fisher. RESULTADOS: ultrasom obstétrico e cardiotocografia tiveram impacto positivo na emoção materna. Houve pouca diferença entre os grupos quanto aos sentimentos antes e após o parto, sendo felicidade, amor, responsabilidade, ansiedade e medo os mais freqüentes. A culpa predominou nas adolescentes do BI. As percepções relacionadas ao filho, a avaliação da assistência e equipe, não diferiram entre adultas e adolescentes. Nas duas enfermarias o relacionamento entre mães e cuidadores foi bom, as mães mostraram-se satisfeitas com a equipe e a assistência, mas o aleitamento materno foi pouco valorizado e poucas mães conheciam o médico. CONCLUSÕES: está ocorrendo um processo de humanização na assistência materno-infantil deste hospital universitário, mas alguns aspectos precisam ser melhorados, especialmente a valorização do aleitamento materno e a individualização no contato médico-paciente.

Tratamento do transtorno de pânico com terapia psicodramática de grupo

INTRODUÇÃO/OBJETIVOS: Há poucos trabalhos publicados sobre psicoterapia grupal para pacientes com transtorno de pânico (TP); além disso, esses estudos geralmente são restritos a abordagens cognitivo-comportamentais. O objetivo deste trabalho é relatar uma experiência de atendimento psicoterápico psicodramático grupal para portadores de TP, iniciada em 1996 na Faculdade de Medicina de Botucatu/Unesp, e discutir aspectos psicodinâmicos desse transtorno. MÉTODOS: Atende-se uma média de oito a dez pacientes em sessões mensais de duas horas de duração, nas quais se utilizam técnicas psicodramáticas. O uso associado de psicofármacos é a regra. A temática é aberta, centrando-se tanto em aspectos próprios do TP (sintomas mais comuns; peregrinação em serviços médicos até o diagnóstico; preocupações hipocondríacas; limitações e dependência; reações dos familiares; estratégias de exposição e enfrentamento; efeitos e reações dos medicamentos) quanto em problemas individuais específicos. RESULTADOS: A abordagem psicodramática favorece a identificação e a elaboração de aspectos psicodinâmicos. Entre estes, destacaram-se os sentimentos de desamparo e seus desdobramentos: insegurança; fragilidade e medo; raiva e culpa; sentimentos de desamor e rejeição; vergonha e inferioridade; isolamento e dificuldade de pedir ajuda; dificuldade de identificar e de expressar sentimentos - manifestados somaticamente -; e dificuldade de assumir o papel de cuidador e outras responsabilidades. CONCLUSÕES: Aspectos valiosos para o tratamento do TP, como apoio mútuo, companheirismo, confiança, modelo e estímulo, são favorecidos pelo contexto grupal homogêneo. O compartilhar de experiências e sofrimentos comuns propiciou rápida coesão e suporte grupal, melhora da capacidade de expressar sentimentos e da auto-estima e o aprimoramento de papéis sociais. Além da melhora dos sintomas, possibilitou-se a melhor compreensão e elaboração destes, que passam a ser integrados significativamente no contexto existencial.

Armadilhas cognitivas: o caso das omissões na gênese dos acidentes de trabalho

Neste artigo discute-se o tema das omissões na gênese de acidentes do trabalho, tendo como referência contribuições de James Reason. Os autores descrevem três acidentes de trabalho ocorridos em atividades de manutenção, e nos quais a omissão de passos na execução da atividade foi apontada como causa nas análises efetuadas pelas empresas, acarretando atribuição de culpa aos acidentados. Nos três casos, a análise efetuada pelos autores revelou que, na seqüência de passos da atividade havia presença simultânea de pelo menos quatro das características apontadas por Reason como geradoras de omissões, caracterizando as denominadas armadilhas cognitivas.

Transtorno mental: dificuldades enfrentadas pela família

Utilizando uma metodologia qualitativa (entrevistas abertas, desenho-estória e análise temática) identificamos e analisamos 4 categorias (descompasso temporal, culpa, conflitos e perdas) presentes no discurso de mães (e uma irmã) de pacientes psiquiátricos do Núcleo de Atenção Psicossocial (NAPS) de Ribeirão Preto/SP, e avaliamos sua importância conforme o objetivo de se entender a dinâmica da relação entre serviço de saúde mental, paciente psiquiátrico e sua família.

Uma educação para além do bem e do mal: o limiar da experiência educativa de um móbile solto no furacão

Pós-graduação em Educação - IBRC

Sanção expiatória versus sanção por reciprocidade: estudo exploratório em dez classes de educação infantil. -

Pós-graduação em Educação - IBRC

Percepções de profissionais que atuam em unidade de terapia intensiva sobre a ocorrência de infecções relacionadas à assistência

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Apontamentos sobre a história constitutiva dos saberes crimino-penais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)