Cursos de mestrado acadêmico na área de enfermagem: análise da carga horária

OBJETIVO: identificar, entre os cursos de Mestrado Acadêmico dos programas de pós-graduação em enfermagem brasileiros, analisados por ocasião da avaliação trienal (2007-2009) da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, a carga horária informada pelos programas para a formação de mestre. MÉTODO: trata-se de estudo descritivo, quantitativo, documental, com dados coletados em julho de 2010, mediante consulta aos relatórios da citada Coordenação, no quesito "Propostas dos Programas", dos Cadernos de Indicadores, disponíveis na web. RESULTADOS: foram encontradas discrepâncias entre as cargas horárias dos 32 cursos de Mestrado Acadêmico das diversas regiões do Brasil, sendo que a menor carga horária foi de 315 horas e a maior de 1.530 horas. CONCLUSÕES: há necessidade de maior discussão acerca da carga horária necessária à formação das competências e habilidades para o perfil desejado do egresso. O estudo propicia avanços no conhecimento da enfermagem, pois não foram identificadas investigações pregressas que tratem de tal tema. Espera-se que os cursos de Mestrado Acadêmico de enfermagem percebam-se nesse processo e revejam suas decisões pedagógicas, à luz dos novos modelos de formação/capacitação dos profissionais de enfermagem, centrados na ciência, tecnologia e inovação na área.

Relationship among social support, treatment adherence and metabolic control of diabetes mellitus patients

This cross-sectional and quantitative study aimed to analyze the relationship among social support, adherence to non-pharmacological (diet and physical exercise) and pharmacological treatments (insulin and/or oral anti-diabetic medication) and clinical and metabolic control of 162 type 2 diabetes mellitus patients. Data were collected through instruments validated for Brazil. Social support was directly correlated with treatment adherence. Adherence to non-pharmacological treatment was inversely correlated with body mass index, and medication adherence was inversely correlated with diastolic blood pressure. There were no associations between social support and clinical and metabolic control variables. Findings indicate that social support can be useful to achieve treatment adherence. Studies with other designs should be developed to broaden the analysis of relations between social support and other variables.

Reliability and validity of spirituality questionnaire by Parsian and Dunning in the Spanish version

The aim of this methodological study was to translate, culturally adapt and assess the internal consistency and validity of the Spanish version of the "Spirituality Questionnaire". The sample comprised 204 young people between 18 and 25 years of age from two universities in Bogota. Cronbach's Alpha was used for reliability, while groups of experts and young people were used for construct validity. The reliability score of the total instrument was 0.88. The overall index of content validity corresponded to 0.90. Exploratory factor analysis showed that four factors explain 52.60% of the variance. The originally proposed theoretical model was confirmed and, in two dimensions, a different structure was proposed. In conclusion, the instrument "Spirituality Questionnaire" by Parsian and Dunning is reliable and valid in the Spanish version.

Family health team knowledge concerning the health needs of people with tuberculosis

The purposes of the study were to get to know conceptions on tuberculosis and health needs and to describe the care provided to people with tuberculosis, according to health professionals' perspective. Qualitative study developed at family health units in Capao Redondo, Sao Paulo. The data were collected through open interviews in January 2010 and submitted to discourse analysis, resulting in three categories: meanings attributed to tuberculosis and health needs and care characteristics. The conceptions regarding the disease are supported by the multi-causal theory of the health-disease process. The care is characterized by interventions that go beyond the biological dimension. The precarious living conditions define the needs of most people with tuberculosis, and can be more important to the ill than the very diagnosis of the disease, influencing treatment adherence, and should gain relevance in care.

Quedas em idosos e sua relação com a capacidade funcional

OBJETIVO: determinar a prevalência de quedas em idosos e sua relação com a capacidade funcional. MÉTODO: trata-se de estudo epidemiológico transversal de base populacional, com uma amostra por conglomerado de duplo estágio de 240 sujeitos, com idade acima de 60 anos, de ambos os sexos, residentes em Ribeirão Preto, SP. Os dados foram coletados entre novembro de 2010 e fevereiro de 2011 e utilizaram-se os questionários: perfil social, avaliação de quedas, Medida de Independência Funcional e Escala de Lawton e Brody. Foi adotado o nível de significância de 0,05. Para a identificação da ocorrência das quedas e sua relação com a capacidade funcional, foram utilizadas razão de prevalência e de chances de prevalência e regressão logística múltipla. RESULTADOS: a média de idade foi de 73,5 anos (±8,4), 25% com 80 anos ou mais, predomínio do sexo feminino; 48,8% estudaram de 1 a 4 anos. Média de 1,33 quedas (±0,472); com maior prevalência em mulheres e idosos mais jovens; o local mais frequente foi o quintal e o banheiro. Houve forte correlação entre o nível de independência funcional e as atividades instrumentais com a idade, e não houve relação entre os idosos que sofreram queda e as variáveis sexo e idade. CONCLUSÃO: houve predomínio de mulheres que sofreram quedas relacionadas à independência funcional, podendo-se prevenir com estratégias de promoção à saúde ao idoso, política essa para oferecer condição de vida à pessoa no processo de envelhecer.

Evaluation of the vulnerability of families assisted in Primary Care in Brazil

Objective: to characterize the profiles of families in the area covered by a Primary Health Center and to identify those in a vulnerable situation. Method: this is an epidemiological, observational, cross-sectional and quantitative study. 320 home visits were made, defined by a random sample of the areas covered by the Urban Center 1 in the city of Sao Sebastiao, in Brazil's Federal District. A structured questionnaire was used for data collection, elaborated based on the Family Development Index (FDI). Results: there was a predominance of young families, women, and low levels of schooling. The FDI permitted the identification of families in situations of "high" and "very high" vulnerability. The most critical dimensions were: "access to knowledge" and "access to work". Conclusion: the study indicated the importance of greater investments in the areas of education, work and income, and highlighted the need for the use of a wider concept of vulnerability by the health services.

Fatigue in colorectal cancer patients: prevalence and associated factors

This study identified the prevalence and prevalence and predictors of fatigue in colorectal cancer (CRC) patients. Cross-sectional study with 157 adult CRC outpatients (age 60 +/- 11.7 years; 54% male; cancer stage IV 44.8%). The Piper Fatigue Scale-revised was used to assess fatigue scores. Socio-demographic, clinical, depression, performance status, pain and sleep disturbance data were assessed. Associations between fatigue and these data were analyzed through logistic regression models. Fatigue was reported by 26.8% patients. Logistic regression identified three predictors: depression (OR: 4.2; 95%CI 1.68-10.39), performance status (OR: 3.2; 95%CI 1.37-7.51) and sleep disturbance (OR: 3.2; 95%CI 1.30-8.09). When all predictors were present, the probability of fatigue occurrence was 80%; when none were present, the probability was 8%. The model's specificity and sensitivity were 81.9% and 58.6%, respectively. Through the assessment of depression, performance status and sleep disturbance, the probability of fatigue occurrence can be estimated, and preventive and treatment strategies can be rapidly implemented in clinical practice.

Costs of most frequent nursing activities in highly dependent hospitalized patients

This quantitative study aimed to identify the costs of the most frequent nursing activities in highly dependent hospitalized patients at a medical clinic. The non-probabilistic convenience sample corresponded to 607 observations regarding oral feeding activities (OF), blood pressure verification (BP)/heart rate (HR), body temperature checking (BTC), performance of intimate hygiene and management of feeding probe. The costs identified corresponded to R$2.40 (SD+/-2.64) for OF feeding; R$1.26 (SD+/-0.48) to verify the BP/HR; R$1.17 (SD+/-0.46) for BTC; R$15.59 (SD+/-8.62) to perform intimate hygiene and R$5.95 (SD+/-2.13) for management of feeding probe. This study will facilitate cost management, with a view to avoiding waste related to unnecessary resource consumption and establish a correlation between costs and care delivery results. Supported by Pro-Reitoria de Pesquisa, Universidade de Sao Paulo, Brazil.

Tuberculose: limites e potencialidades do tratamento supervisionado

Objetivou-se analisar potencialidades e limites da estratégia do tratamento supervisionado (DOTS) para a tuberculose, sob a percepção de usuários em tratamento e de trabalhadores de saúde de uma supervisão técnica de saúde do município de São Paulo. Entrevistaram-se 4 usuários e 17 profissionais de saúde de nove unidades básicas de saúde, entre abril e junho de 2006, após consentimento livre e esclarecido. Os depoimentos foram decodificados segundo a técnica de análise de discurso. Adotou-se a teoria da determinação social do processo saúde/doença como referencial teórico. Foram potencialidades: criação de vínculo entre profissional/usuário e incentivos ao tratamento, o que favorece a adesão. Foram limites: restrito envolvimento dos profissionais no DOTS e conciliar horário de trabalho do usuário com a supervisão. Reitera-se que a adesão ao tratamento transcende o âmbito biológico, sendo fundamental que os trabalhadores de saúde reconheçam os usuários como portadores de necessidades, não se restringindo apenas à supervisão da tomada de medicamentos.

Impact of a participatory program to reduce noise in a Neonatal Unit

This study evaluated the impact of a participatory program to reduce noise in a neonatal intermediate care unit of a university hospital. A time-series quasi-experimental design was used, in which sound pressure levels were measured before and after the intervention was implemented using the Quest-400 dosimeter. Non-parametric statistical tests were used to compare noise with the level of significance fixed at 5%. Results showed significant reduction of sound pressure levels in the neonatal unit after the intervention program was implemented (p<0.0001). The average Leq before the intervention was 62.5dBA and was reduced to 58.8dBA after the intervention. A reduction of 7.1dBA in the average Lmax(from 104.8 to 87.7dBA) and of 30.6dBA in the average Lpeak(from 138.1 to 107.5dBA) was observed. The program was proven to be effective in significantly reducing noise levels in the neonatal unit, although levels were still more intense than recommended.

Incidence of gastric extubation of users in a home care program of a university hospital

This quantitative, prospective study, aimed to characterize the profile of users and caregivers and to measure the incidence of gastric extubation, identifying the type and the reasons for the extubation of these users in a Home Care Program of a university hospital. The population consisted of 37 subjects and the date were collected from April to August 2010. For the analysis, descriptive statistics, test of significance of 5% and calculation of indicators were adopted. It was found that 51.4% of the users were female, 67.5% in the age group >= 60 years and 67.6% presented neurological diseases. Regarding the caregivers 89.2% were female and their mean age was 50.6 years. The incidence of extubation, considering 100 days of intubation, corresponded to 1.08, with 0.26 planned and 0.82 unplanned (p=0.009). These results allowed the rates to be calculated of the extubation of patients with gastric intubation for nutritional support in domicile care, providing support in establishing care and management goals for the continuous improvement of quality.

Work and Inter-subjectivity: a theoretical reflection on its dialectics in the field of health and nursing

This theoretical reflection intends to show the inter-subjective relationship that takes place in health and nursing practices under the following theoretical perspectives: Institutional Analysis, Psychodynamics of Labor and the Theory of Communicative Action, with an emphasis on the latter. Linking these concepts to the Marxist approach to work in the field of health emerges from recognizing the need for its continuous reconstruction-in this case, with a view to understand the interaction and communication intrinsic to work in action. The theory of Communicative Action seeks to consider these two inextricable dimensions: work as productive action and as interaction. The first corresponds to instrumental action based on technical rules with a production-guided rationale. The second refers to the interaction that takes place as communicative action and seeks understanding among subjects. We assume that adopting this theoretical perspective in the analysis of health and nursing practices opens new possibilities for clarifying its social and historical process and inter-subjective connections.

Work organization and the health of bank employees

The Brazilian banking sector has undergone an intense restructuring process and taken a leading position in the incorporation of new technologies and organizational innovations. Computerization in the industry, in association with forms of work organization, has resulted in changes that reflect on the workers' health. Based on the theoretical and methodological frameworks of historical and dialectical materialism, this qualitative study investigates the work conditions of bank employees in order to identify the extent to which changes in work organization interfere with these workers' health. Data were collected through interviews held with 11 bank employees. In addition to physical sickening due to occupational diseases directly related to work intensification, the results also show an increased incidence of mental suffering and a feeling of loss of professional identity. Work-related frustration, instability and concerns related to psychological pressure resulting from the need to achieve goals predominated in the reports.

Nursing care practices at an outpatient care center from an integrative perspective

Aim: to analyze nursing care practices at a Specialized Outpatient Care Center from the perspective of an integrative health care activity. Method: Interviews with 24 nursing professionals were undertaken. For data analysis, Thematic Content Analysis as proposed by Bardin was applied, resulting in the following themes: the team size and its commitment to health care; professional practices and activity of the nursing team. Results: The size of the nursing team was considered insufficient, which compromises the quality of care and results in work overload and dissatisfaction of the nursing professionals. On the other hand, they were satisfied with the tasks performed day-to-day and related integrality to individual care, considered it essential and usually practiced it daily. Conclusion: It is considered that the nursing team has the potential and commitment to develop their care practice combined with the integrative perspective, and therefore providing quality health care to the population.

Nursing care time and quality indicators for adult intensive care: correlation analysis

The objective of this quantitative, correlational and descriptive study was to analyze the time the nursing staff spends to assist patients in Adult Intensive Care Units, as well as to verify its correlation with quality care indicators. The average length of time spent on care and the quality care indicators were identified by consulting management instruments the nursing head of the Unit employs. The average hours of nursing care delivered to patients remained stable, but lower than official Brazilian agencies' indications. The correlation between time of nursing care and the incidence of accidental extubation indicator indicated that it decreases with increasing nursing care delivered by nurses. The results of this investigation showed the influence of nursing care time, provided by nurses, in the outcome of care delivery.