Validação do instrumento dos indicadores observáveis da qualidade do cuidado em instituições de longa permanência para idosos

The Nursing Homes are an important alternative care in the world, but Brazil still has no valid instrument to monitor the quality these institutions. In the United States, the Observable Indicators of Nursing Home Care Quality Instrument (OIQ) is used to assess the quality of Nursing Home care using 30 indicators of structure (2 dimensions) and process (5 dimensions) related to quality person-centered care. The present study aimed at cross-culturally adapting the OIQ in order to evaluate the quality of Nursing Home care in Brazil. Conceptual and item equivalence were determined to assess the relevance and viability of OIQ in the Brazilian context, using the Content Validity Index (CVI) and a group of specialists composed of 10 participants directly involved in the object of study. Next, operational, idiomatic and semantic equivalence were carried out concurrently. This consisted of 5 phases: (1) two translations and (2) their respective back translations; (3) formal appraisal of referential and general meaning; (4) review by a second group of specialists; (5) application of the pretest at three Nursing Homes by different social entities: health professionals, sanitary surveillance regulators and potential consumers. Measurement equivalence was evaluated by the Cronbach’s alpha test to verify the internal consistency of the instrument. To measure inter-evaluator agreement, the General Agreement Index (ICG) and Kappa coefficient were used. Timely compliance and 95% Confidence Interval of indicators, dimensions and total construct were estimated. The CVI obtained high results for both relevance (95.3%) and viability (94.3%) in the Brazilian context. With respect to referential meaning, similarity was observed, ranging between 90-100% for the first back translation and 70-100% for the second. In relation to general meaning, version 1 was better, classified as “unchanged” in 80% of the items, whereas in version 2 it was only 47%. In the pretest, the OIQ was easy to understand and apply. The following outcomes were obtained: a high Cronbach’s alpha (0.93), satisfactory ICG (75%) and substantial agreement between the pairs of evaluators (health professionals, regulators from the Superintendency of Sanitary Surveillance –SUVISA-, and potential consumers), according to the Kappa coefficient (0.65). It´s possible take the operational equivalence held since it preserved the original layout in the Brazilian version from the maintenance in application mode, response options, number of items, statements and scores. The performance of nursing homes obtained approximate average scores of 87, a variation 55-111 considering a range from 30 to 150 points. The worst outcomes were related to process indicators with a mean of 2.8 per item, while structure was 3.75 on a scale of 1 to 5. The lowest score was obtained for the care dimension (mean 2). The OIQ version was deemed to be a valid and reliable instrument in the Brazilian context. It is recommended that health professionals, regulators and potential consumers adopt it to access and monitor the quality of Nursing Home care and demonstrating opportunities for improvement.

Características dos programas de residência médica em cardiologia do estado do Rio Grande do Norte

The present study had as goal to evaluate Rio Grande do Norte state’s medical residency programs (MRP) in Cardiology. It’s a descriptive study, including a documental analysis of the program’s accreditation processes (PAP) of cardiology’s medical residency in Rio Grande do Norte state in 2014 and the analysis of the resident’s perception about his professional education as a specialist in Cardiology. Beside the documental analysis of the PAPs, it was applied a semi-structured questionnaire with closed questions Likert style and open questions to all the current and former residents of the MRPs analyzed. Two MRPs in Cardiology were identified in Rio Grande do Norte state, one hosted in a public institution and the other in a private institution. The documental analysis showed a greater amount of preceptors with a good level of ownership on the public institution in comparison with the private one, as well as a bigger number of publications, participation in congresses and in book’s publications. The private institution presents a better Urgency’s infrastructure, with emergency room and cardiologic ICU. It IS clear that the residents are aware of how a good residency must work, as well as the strengths and fragilities of their own residences. Most of Onofre Lopes Universitary Hospital’s residents point out as a strength the organization, participation and quality of the preceptors, practice activities and scientific debates, great amount of patients and the visits and debates with the preceptors on the sickrooms. As the greatest fragilities, they emphasize the lack of a urgency service of their own and a specialized ICU. In Coração Hospital of Natal (HCor), it is listed as weak points the theoretic scheduling and the few ambulatory practices. As positive aspects, they report the preceptors, the agility on the execution of exams, a good number of serious patients and procedures. In both residences, it is seen a certain difficulty in accepting the important and mandatory items imposed by the rules of the Medical Residences’ National Committee, such as: biostatistics, bioethics, medical ethic, epidemiology and research methodology. Besides that, the residents recognize that both hospitals have a good infrastructure and technological support, especially in imaging methods. The evaluation of PRMCs identifies the strengths of each program and the aspects to be improved in both programs. It also allowed the observation of difficulties in accepting some regulations contained in the CNRM resolution by the resident, such as participation in activities such as biostatistics, epidemiology and research methodology as well as the improvement needs of specific technical training, such as in emergency care. Thus, our results make possible to develop strategies for continued improvement of PRMC in RN state. In addition, it enabled the preparation of the resident’s manual in cardiology, containing even a breakdown of resident evaluation system, which could serve as a model for other residency programs.

Avaliação das características de carcaça e perfil dos ácidos graxos em suínos na fase de terminação, alimentados com dietas contendo farelo de bagaço de caju

Provide healthier meat to consumers of pig farmers has required an adjustment of nutrition and feed management. Nutrition is a primary factor in defining the qualitative aspects of pork, because through it we can modify the fatty acid profile. The objective of this study was to analyze the effects of adding bran bagasse cashew (FBC) in diets for finishing pigs, on carcass traits and meat quality. 20 crossbred barrows with an average initial weight of 57.93 ± 3.67 kg / BW were used Diets were formulated based on corn and soybean meal containing vegetable oil, commercial core and different levels of inclusion of the bran bagasse cashew ( 0.0, 7.5 % , 15.0 % , 22.5 % and 30.0 % ) . The experimental design was a randomized block with 5 treatments and 4 replications. Quantitative, qualitative, fatty acid profile of the longissimus muscle and fat area parameters were evaluated. It was observed that with the inclusion of FBC, the parameters of carcass yield, backfat thickness, fat area had a negative linear effect relationship and meat / fat positive effect. Regarding the profile of fatty acids in fat area, the content of linoleic fatty acid level of 30 % of FBC was 18.2 % higher ( P < 0.05 ) at the level of 0.0 % and the arachidonic level of 22.5 % was higher than 33.3 % and 37.5 % at levels of 0.0 % and 15.0 % ( FBC ) respectively. It is concluded that finishing pigs may be food diets containing up to 30 % of FBC, improving the quality of housing for lower fat deposition and modification in the fatty acid profile.

Proposta de um processador multithreading com características de previsibilidade

The real-time embedded systems design requires precise control of the passage of time in the computation performed by the modules and communication between them. Generally, these systems consist of several modules, each designed for a specific task and restricted communication with other modules in order to obtain the required timing. This strategy, called federated architecture, is already becoming unviable in front of the current demands of cost, required performance and quality of embedded system. To address this problem, it has been proposed the use of integrated architectures that consist of one or few circuits performing multiple tasks in parallel in a more efficient manner and with reduced costs. However, one has to ensure that the integrated architecture has temporal composability, ie the ability to design each task temporally isolated from the others in order to maintain the individual characteristics of each task. The Precision Timed Machines are an integrated architecture approach that makes use of multithreaded processors to ensure temporal composability. Thus, this work presents the implementation of a Precision Machine Timed named Hivek-RT. This processor which is a VLIW supporting Simultaneous Multithreading is capable of efficiently execute real-time tasks when compared to a traditional processor. In addition to the efficient implementation, the proposed architecture facilitates the implementation real-time tasks from a programming point of view.

Os impactos na qualidade da água e do solo de um manancial tropical do semiárido devido ao uso e ocupação e evento de seca extrema

Human activities alter soil features, causing the deterioration of its quality. Land use and occupation in drainage basins of water supply reservoirs can change the environmental soil quality and, thus, lead to the expansion of the soil potential of being a diffuse pollution source. In the Brazilian semiarid region, the soils are generally shallow with high susceptibility to erosion, favoring the sediment and nutrients input into the superficial waterbodies, contributing to the eutrophication process. Moreover, this region has high temperatures and high evapotranspiration rates, that are generally higher than the precipitation rates, causing a negative hydric balance and big volume losses by evaporation. The water volume reduction increases the nutrients’ concentration and, therefore, exacerbates the eutrophication process, deteriorating the water quality. Thereby, we hypothesized that the eutrophication process of semiarid reservoirs is intensified both by the extreme climatic events of prolonged drought, and by the diffuse pollution due to the basin land use and occupation. The study aimed to test whether the land use and occupation activities of the basin and the severe drought events intensify the eutrophication process of a semiarid tropical reservoir. To verify the influence of human activities carried out in the water supply of drainage basin on the soil quality and the eutrophication process, we conducted the mapping of the kind of use and occupation, as well the calculation of erosion for each activity and the soil quality evaluation of the riparian zone and water quality of the water supply. For the water analyses, the samplings were carried out monthly in the deeper point, near dam. For the soil, deformed composite samples were taken for the physical and chemical attributes analysis, according to the identified land use and occupation classes. The results showed that extreme droughts drastically reduces the water volume and elevates the nutrients concentration, contributing, thus, to a bigger degradation of water quality. Furthermore, we verified that human activities in the drainage basin promote the diffuse pollution, by increasing the soil susceptibility to erosion and nutrients contents. Summarizing, our results support the investigated hypothesis that activities of land use and occupation and extreme drought generate a combined effect that provide the intensification of eutrophication process of semiarid reservoirs.

Qualidade de vida de pessoas com estomias intestinais

Ostomy is an open surgical origin, when it is necessary to deviate temporarily or permanently, the normal transit of food and / or deletions. The patient with ostomy disposal is faced with changes in their physiology, also emerging on the need to care collection bag. This study aimed to analyze the quality of life (QOL) of people living with ostomy Intestinal (EI), who attended the Pediatric and Adult Rehabilitation Center of Rio Grande do Norte (CRI / CRA-RN). It is an analytical study with cross-sectional design and quantitative approach, accomplished with 89 people who had EI. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), CAAE: 19866413.3.0000.5537. Held data collection in the period January-March 2015 using two instruments: an adapted general questionnaire covering socio-demographic, clinical and self-care and a specific instrument for assessing QOL of people with stoma titled as City of Hope Quality of Life - Ostomy Questionnaire (COH-QOL-Q), validated and adapted to Portuguese in 2010, composed of four areas, namely: Welfare Body (BEF), Welfare Psychological (BEP), Welfare (BES ) and Spiritual Well-Being (BEE). The collected data were entered into a database in Microsoft Excel 2007 spreadsheet application and processed in computerized software for descriptive and inferential analysis. The results showed that 83.1% had a colostomy and ileostomy 16.9%. Sociodemographic characteristics prevailed in males (57.3%), over 50 (57.3%), mulatto (46.1%), with presence of companion / a (57.3%), retired / beneficiaries (50.5%), monthly income above the minimum wage (68.5%) and who have studied up to elementary school (67.4%). Regarding clinical aspects, it was observed that the main cause that led to the making of the stoma was the neoplasm (59.6%) followed by trauma (21.3%). The sample showed people with stoma for more than six months (79.8%) of permanently (57.3%), in use sink equipment piece drainable (68.5%) of flat base (82.0%). With respect to self-care, 93.3% emptied and washed the bag alone (care related to hygiene) and 75.3% fixed the new exchange on the skin during the exchange (care related to the stock). Patients with more than six months of ostomy and had no partner (a) had higher averages of self-care related hygiene and purse. The average of respondents QoL scores was 68.90% for General QOL; 68.03% for the BEF; 68.38% for the BEP; 66.46% for BES and 75.41% for BEE. Among the aspects that influenced QOL included: physical strength, pain, suffering and gases (physical domain); appearance, care of the stoma and adaptation to new condition (psychological domain); isolation, interference in personal relationships and social activities (social domain) and going to church or synagogue, spiritual activities and positive change after ostomy (spiritual realm). Based on these results, it is concluded that this was a predominantly adult sample / elderly (between 50 and 70 years), with low education and the cause motivating the stoma, neoplasms. However, such findings did not pass at low percentage levels on the self-care capacity to deliver even at low QOL scores.

Qualidade de vida de pessoas com estomias intestinais

Ostomy is an open surgical origin, when it is necessary to deviate temporarily or permanently, the normal transit of food and / or deletions. The patient with ostomy disposal is faced with changes in their physiology, also emerging on the need to care collection bag. This study aimed to analyze the quality of life (QOL) of people living with ostomy Intestinal (EI), who attended the Pediatric and Adult Rehabilitation Center of Rio Grande do Norte (CRI / CRA-RN). It is an analytical study with cross-sectional design and quantitative approach, accomplished with 89 people who had EI. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), CAAE: 19866413.3.0000.5537. Held data collection in the period January-March 2015 using two instruments: an adapted general questionnaire covering socio-demographic, clinical and self-care and a specific instrument for assessing QOL of people with stoma titled as City of Hope Quality of Life - Ostomy Questionnaire (COH-QOL-Q), validated and adapted to Portuguese in 2010, composed of four areas, namely: Welfare Body (BEF), Welfare Psychological (BEP), Welfare (BES ) and Spiritual Well-Being (BEE). The collected data were entered into a database in Microsoft Excel 2007 spreadsheet application and processed in computerized software for descriptive and inferential analysis. The results showed that 83.1% had a colostomy and ileostomy 16.9%. Sociodemographic characteristics prevailed in males (57.3%), over 50 (57.3%), mulatto (46.1%), with presence of companion / a (57.3%), retired / beneficiaries (50.5%), monthly income above the minimum wage (68.5%) and who have studied up to elementary school (67.4%). Regarding clinical aspects, it was observed that the main cause that led to the making of the stoma was the neoplasm (59.6%) followed by trauma (21.3%). The sample showed people with stoma for more than six months (79.8%) of permanently (57.3%), in use sink equipment piece drainable (68.5%) of flat base (82.0%). With respect to self-care, 93.3% emptied and washed the bag alone (care related to hygiene) and 75.3% fixed the new exchange on the skin during the exchange (care related to the stock). Patients with more than six months of ostomy and had no partner (a) had higher averages of self-care related hygiene and purse. The average of respondents QoL scores was 68.90% for General QOL; 68.03% for the BEF; 68.38% for the BEP; 66.46% for BES and 75.41% for BEE. Among the aspects that influenced QOL included: physical strength, pain, suffering and gases (physical domain); appearance, care of the stoma and adaptation to new condition (psychological domain); isolation, interference in personal relationships and social activities (social domain) and going to church or synagogue, spiritual activities and positive change after ostomy (spiritual realm). Based on these results, it is concluded that this was a predominantly adult sample / elderly (between 50 and 70 years), with low education and the cause motivating the stoma, neoplasms. However, such findings did not pass at low percentage levels on the self-care capacity to deliver even at low QOL scores.

Controle de mobilidade infraestruturado e orientado à qualidade para maximização de admissões em sistemas WiNeMO: uma abordagem definida por software

The spread of wireless networks and growing proliferation of mobile devices require the development of mobility control mechanisms to support the different demands of traffic in different network conditions. A major obstacle to developing this kind of technology is the complexity involved in handling all the information about the large number of Moving Objects (MO), as well as the entire signaling overhead required to manage these procedures in the network. Despite several initiatives have been proposed by the scientific community to address this issue they have not proved to be effective since they depend on the particular request of the MO that is responsible for triggering the mobility process. Moreover, they are often only guided by wireless medium statistics, such as Received Signal Strength Indicator (RSSI) of the candidate Point of Attachment (PoA). Thus, this work seeks to develop, evaluate and validate a sophisticated communication infrastructure for Wireless Networking for Moving Objects (WiNeMO) systems by making use of the flexibility provided by the Software-Defined Networking (SDN) paradigm, where network functions are easily and efficiently deployed by integrating OpenFlow and IEEE 802.21 standards. For purposes of benchmarking, the analysis was conducted in the control and data planes aspects, which demonstrate that the proposal significantly outperforms typical IPbased SDN and QoS-enabled capabilities, by allowing the network to handle the multimedia traffic with optimal Quality of Service (QoS) transport and acceptable Quality of Experience (QoE) over time.

Avaliação multidimensional da qualidade de vida em idosos: um estudo no Curimataú ocidental paraibano

The fast growth of the elderly population is a reality throughout the world and has become one of the greatest challenges for contemporary public health. When considering the increased life expectancy and the aging as a multidimensional phenomenon, one should highlight the need to investigate if the increase of longevity is associated with satisfactory levels of Quality of Life (QOL). This study has the objective of assessing the QOL of elderly people from the Paraíba’s Western Curimataú microregion, explained by its health and living conditions. This is a cross-sectional and observational study with quantitative design held with 444 elderly people from five cities: Barra de Santa Rosa, Cuité, Nova Floresta, Remígio e Sossego. In order to obtain information, the following instruments were used: I) Questionnaire for collection data related to the elderly population, for sociodemographic, clinical and behavioral characteristics; and II) WHOQOL-Old questionnaire, with a view to measuring and assessing QOL. Data were processed on the IBM-SPSS Statistics 20.0 software by means of the ANOVA (one-way), Student’s t, Mann-Whitney, Kruskal-Wallis and Pearson’s correlation tests, with p-values<0,05 accepted as being statistically significant. The results indicate a good global QOL (ETT=65,69%), with better assessment by elderly men, aged between 60 and 74 years, married, living with partner and children, without caregiver, physical activity practitioners, with up to one health problem before an aspect of multimorbidity and with very good and/or good assessment of basic needs. The self-reported stress showed a negative significant correlation before the global QOL, where the greater the perception of stress, the worse the assessment of QOL. In the faceted assessment of QOL, the Sensory Operation showed the best performance (ETF= 68,86%) and the Social Participation (SP) the worst (ETF=60,37%). In the multiple linear regression model, SP is singly responsible for 51,8% (R2=0,518) of explanation of the global QOL. In the intercorrelation among the WHOQOL-Old facets, only Death and Dying did not reveal significance. The harmony highlighted among the facets raises the need to ensure a comprehensive health care for the elderly population, especially in understanding the social participation as an intrinsic part of the QOL and that it requires the re-discussion and reconstruction of individual and collective, family and community, political and government actions. Hence, guaranteeing an active, healthy and participatory aging, with QOL, is the major challenge.

Avaliação multidimensional da qualidade de vida em idosos: um estudo no Curimataú ocidental paraibano

The fast growth of the elderly population is a reality throughout the world and has become one of the greatest challenges for contemporary public health. When considering the increased life expectancy and the aging as a multidimensional phenomenon, one should highlight the need to investigate if the increase of longevity is associated with satisfactory levels of Quality of Life (QOL). This study has the objective of assessing the QOL of elderly people from the Paraíba’s Western Curimataú microregion, explained by its health and living conditions. This is a cross-sectional and observational study with quantitative design held with 444 elderly people from five cities: Barra de Santa Rosa, Cuité, Nova Floresta, Remígio e Sossego. In order to obtain information, the following instruments were used: I) Questionnaire for collection data related to the elderly population, for sociodemographic, clinical and behavioral characteristics; and II) WHOQOL-Old questionnaire, with a view to measuring and assessing QOL. Data were processed on the IBM-SPSS Statistics 20.0 software by means of the ANOVA (one-way), Student’s t, Mann-Whitney, Kruskal-Wallis and Pearson’s correlation tests, with p-values<0,05 accepted as being statistically significant. The results indicate a good global QOL (ETT=65,69%), with better assessment by elderly men, aged between 60 and 74 years, married, living with partner and children, without caregiver, physical activity practitioners, with up to one health problem before an aspect of multimorbidity and with very good and/or good assessment of basic needs. The self-reported stress showed a negative significant correlation before the global QOL, where the greater the perception of stress, the worse the assessment of QOL. In the faceted assessment of QOL, the Sensory Operation showed the best performance (ETF= 68,86%) and the Social Participation (SP) the worst (ETF=60,37%). In the multiple linear regression model, SP is singly responsible for 51,8% (R2=0,518) of explanation of the global QOL. In the intercorrelation among the WHOQOL-Old facets, only Death and Dying did not reveal significance. The harmony highlighted among the facets raises the need to ensure a comprehensive health care for the elderly population, especially in understanding the social participation as an intrinsic part of the QOL and that it requires the re-discussion and reconstruction of individual and collective, family and community, political and government actions. Hence, guaranteeing an active, healthy and participatory aging, with QOL, is the major challenge.

Estudo da injeção de água e gás em um reservatório com características do pré-sal brasileiro

The pre-salt province is composed by large amounts of light oil and with good quality, a reality that puts Brazil in a strategic position facing the great demand for energy worldwide. In this province are the largest discoveries in the world in the last ten years; areas as Libra, Franco and Lula field, everyone containing volumes greater than 8 billion recoverable oil barrels. To develop and optimize the production of these fields, a study was done for choosing the improved oil recovery methods. The main motivations were the presence of carbon dioxide (CO2) as a contaminant and the strategic decision of do not discard it, combined with high GOR (gas-oil ratio) of the reservoir fluid. The method should take advantage of the unique abundant resources: seawater and produced gas. This way, the process of matching these resources in the water alterning gas injection (WAG) became a good option. In this master’s dissertation, it was developed a reservoir model with average characteristics of the Brazilian pre-salt, where was applied the improved oil recovery method of water alternating gas. The production of this reservoir was analyzed by parameters as: the first fluid injected in the injection process, position of the injection wells completion, injection water and gas rate and cycle time. The results showed a good performance of the method, with up to 26% of gains in the recovery factor regarding the primary recovery, since the application of water injection and gas, individually, was not able to overcome 10 % of gain. The most influential parameter found in the results was the cycle time, with higher recovery factor values obtained with the use of shorter times.

Cidades saudáveis e qualidade de vida em Uberlândia (MG): aportes metodológicos para um processo em construção

The current study includes theoretical and methodological reflections on the quality of life in the city of Uberlândia, Minas Gerais. It started from the thought that the quality of life is multifactorial and is permanently under construction and the main objective of analyzing it as one of the componets of Healthy Cities's moviment. The theoretical research focused on the concepts of healthy cities, quality of life, health, sustainability, well-being, happiness, indexes and indicators. From the use of multiple search strategies, documentary and on field of quantitative and qualitative character, this research of exploratory descriptive nature can offers a contribution to the studies on the quality of life in cities. It is proposed that the studies startes to work with some concept, like some notions os life quality adequated for some paticular reality, whose notions can approach concepts already established as health. This step is important on the exploratory researches. The studies may include aspects of objective analysis, subjective or both. The objective dimension, which is most common approach, are traditionally considered variables and indicators related to: the urban infrastructure (health, education, leisure, security, mobility), dwelling (quantitative and qualitative dwlling deficit), the urban structure (density and mix uses), socioeconomic characteristics (age, income, education), urban infrastructure (sanitation, communication), governance (social mobilization and participation). To focus on the subjective dimension, most recent and unusual, it is proposed to consider the (dis)satisfaction, the personal assessment in relation to the objective aspects. In conclusion, being intrinsically related to the health, the quality of life also has a number of determinants, and the ideal of the reach of quality of life depends on the action of all citizens based on the recognition of networks and territories, in a interescalar perspective and intersectoral. Therefore, emphasis in given on the potential of tools, such as the observatories, to monitor and intervent in reality, aiming in a building process of healthy cities.

O impacto da gestão do conhecimento na gestão da qualidade total nas empresas distinguidas como PME líder em 2012

Num ambiente economicamente instável, as organizações devem criar condições para vingarem no mercado onde se inserem. A aposta das empresas em fatores diferenciadores como a Gestão do Conhecimento e a Gestão da Qualidade Total torna-se cada vez mais evidente. De acordo com a literatura, a Gestão do Conhecimento e a Gestão da Qualidade Total têm características análogas, na medida em que se baseiam nos recursos humanos, na partilha de conhecimentos e na satisfação dos clientes, estando por isso relacionadas. Como forma de verificar a importância que as organizações atribuem a estes conceitos, avançou-se com o presente estudo que incidiu nas Pequenas e Médias Empresas que foram distinguidas como PME líder em 2012. O principal objetivo desta investigação é analisar a influência que a Gestão do Conhecimento exerce na Gestão da Qualidade Total nas PME que se destacaram em 2012 como líderes. Os resultados obtidos indicam que a Gestão do Conhecimento está associada positivamente com a Gestão da Qualidade Total. Apesar de esta conclusão ir ao encontro da teoria, a generalização deverá ser feita com alguma precaução, tendo em conta que a amostra é pouco representativa da população. Importa ainda realçar que a Gestão do Conhecimento e a Gestão da Qualidade Total são conceitos que não se podem dissociar uma vez que ambos criam valor organizacional

A enfermagem e a promoção da qualidade de vida dos portadores de esquizofrenia: perceção dos enfermerios

A Esquizofrenia é uma doença crónica que afeta aproximadamente 1% da população mundial sendo uma das doenças mais incapacitantes da psiquiatria com um maior efeito nos indivíduos e nas suas famílias com influencia negativa sobre a qualidade de vida dos mesmos. O enfermeiro na assistência ao utente portador de esquizofrenia tem a funçao de ajudar a minimizar os sintomas e a prevenir as recaídas ajudando a ter uma vida mais adaptada a patologia, contribuindo assim, para uma melhor qualidade de vida do utente bem como das suas famílias. Neste estudo delineou-se como objetivo geral, identificar qual a percepção dos profissionais de saúde sobre a importância do enfermeiro na promoção da qualidade de vida dos portadores de esquizofrenia. Para o estudo da temática optou-se por um estudo qualitativo, descritivo e exploratório com uma abordagem fenomenológica, sendo que o método de recolha de informações foi a entrevista. O público-alvo deste estudo foi constituído por dez (10) profissionais que trabalham na área de saúde mental, sendo cinco (5) enfermeiros e 5 (cinco) profissionais do Centro de Acolhimento do Doente Mental (CADM). Os resultados deste estudo comprovam a devida importância do enfermeiro na promoção da qualidade de vida do portador de esquizofrenia, embora constatou-se uma falta de motivação por parte dos profissionais, uma vez que nos seus discursos realçam um certo esquecimento/abandono por parte das entidades competentes, visto que estes não dão a devida importancia do que se trata numa enfermaría de crise. Nota-se ainda, que essa dificuldade em implementar os cuidados de enfermagem é também influenciada pelo fato dos enfermeiros não serem inteiramente capacitados para lidar com os portadores da esquizofrenia, devido as características dessa doença mental.

Homo e Heterossexuais: o papel das memórias de vergonha, das memórias precoces de calor e segurança, e qualidade de vinculação ao pai, à mãe e ao par amoroso

As experiências precoces de vergonha, na infância e adolescência, cujas memórias assumem características traumáticas, e de centralidade para a identidade, estão associadas a maior propensão para a vergonha e psicopatologia na adultez. O presente estudo visou clarificar o impacto das características traumáticas e da centralidade, das memórias de vergonha, e das memórias precoces de calor e segurança, na qualidade de vinculação aos pais e ao par amoroso, apreciando a orientação sexual. Nesse sentido, 123 sujeitos, homossexuais masculinos (N = 53) e heterossexuais masculinos e femininos (N = 70), completaram a bateria de questionários de autorresposta, para avaliar as caraterísticas traumáticas e a centralidade das memórias de vergonha, as memórias precoces de calor e segurança, a qualidade de vinculação ao pai, à mãe e ao par amoroso, recolhidos a partir de amostra de conveniência não aleatória da população geral. Os resultados mostram que os homossexuais, comparativamente com os heterossexuais, apresentam níveis mais elevados de caraterísticas traumáticas e de centralidade para a identidade, das memórias de vergonha, a par de níveis inferiores de memórias precoces positivas. As caraterísticas traumáticas e de centralidade, das memórias de vergonha, surgem associadas, com intensidade tendencialmente superior nos homossexuais, à restrição da aquisição de autonomia, conferida pelo pai, à sua desvalorização e à ansiedade de separação materna. O vínculo inseguro, aos progenitores, perpetua-se à adultez e ao par amoroso. Relativamente aos heterossexuais, apurámos que o laço emocional e a ansiedade de separação e dependência, paterna e materna, surgem associados a maior confiança e menor evitamento, respetivamente, ao par amoroso. Paralelamente, a ansiedade de separação e dependência materna surge, ainda, associada a maior dependência daquela figura. Este estudo conclui que as experiências precoces de vergonha, na infância e adolescência, podem funcionar como memórias com caraterísticas traumáticas e autobiográficas, constituir marcos de referência centrais no que concerne à identidade e história de vida, sobretudo em homossexuais, com atribuição de significado a outras experiências de vida, nomeadamente no que respeita à vinculação ao par romântico. / Early experiences of shame, in childhood and adolescence, whose memories assume traumatic characteristics, and centrality to identity, are associated with greater propensity to shame and psychopathology in adulthood. The present study aimed to clarify the impact of traumatic features and centrality to identity of shame memories, and of early memories of warmth and safety, on quality of attachment to parents and the loving couple`s bond, considering sexual orientation. Accordingly, 123 subjects, male homosexuals (N = 53) and male and female (N = 70) heterosexuals, completed the battery of self-report questionnaires, to assess trauma characteristics and centrality of shame memories, early memories of warmth and safeness, quality of attachment to the father, mother and loving couple, collected from a non-random convenience sample from general population. The results point that homosexual men, compared with heterosexuals, show higher levels of traumatic characteristics and centrality to identity of shame memories, along with lower levels of early positive memories. Traumatic characteristics and centrality of shame memories arise associated, tendentiously with higher intensity in homosexuals, to restriction of autonomy`s acquisition, conferred by the father, his devaluation and maternal separation anxiety. The unsecured bond, to parents, perpetuates into adulthood and loving couple. Regarding heterosexuals, we found that emotional bond and separation anxiety and dependency, paternal and maternal, arise associated with greater confidence, and less avoidance, respectively, to the loving couple. Further, separation anxiety and mother`s dependency also appears associated with greater dependency to that figure. This study concludes that early experiences of shame, in childhood and adolescence, might function as memories with traumatic and autobiographical characteristics, produce landmarks of central reference regarding identity and life`s history, particularly in homosexual, with attribution of meaning to other life experiences, particularly in the linking to the romantic couple.