Assistência de enfermagem e o risco para úlceras de pressão medido pela Escala de Braden em unidade de terapia intensiva

The problem facing the incidence of pressure ulcers (UP) in the hospital environment especially in the intensive care unit (ICU), although it is an old and frequent event in our professional practice, it is not notified in the researches as much as it should be. We observed a tendency to invest in therapeutical and in studies about the production of sophisticated new bandages. Few, however, are the investments in research on preventive measures in order to prevent or at least slow down the development of lesions. In this sense, the study aimed to analyze the correlation between nursing care and the risk of developing UP measured by the Braden scale in ICU patients. This is a descriptive study of longitudinal quantitative approach. The project obtained a favourable opinion from the Ethics Committee of HUOL (no 486/10). Data collection was carried out in the Hospital of Unimed in Natal during six months in 2011. The sample was of 32 patients hospitalized in ICU for over four days. The results were processed in SPSS 15.0 for descriptive statistics and inferential statistics. We identified that, only 9.4% of our sample developed UP, being predominantly male, elderly people aged above 60 years, Caucasian, with diagnostic hypothesis at the time of hospitalization of sepsis, were clinical patients, who presented hemodynamic instability, using orotracheal tube (TOT), enteral probe (SNE), vesical probe delay (SVD) and had values of albumin and hemoglobin levels below normal. In addition, these patients had a longer hospital stay, longer usage of TOT, SNE, SVD, increased use of sedation and drain than those who did not develop UP and were all at risk for developing these injuries second Braden scores. 66.7% of the lesions developed were located in the sacral region, limiting the degree I and all patients that developed were considered serious, 100.0% of them have evolved since the death. Small were the differences between the averages of Braden scores between patients with and without UP, 11,9+2,4 against 12,4+2,6 with p = 0.627. The clinical aspects of the patients in the study were instrumental in the development of UP, once, these findings were statistically significant through the Mann-Whitney test, and appropriateness of nursing conduct was decisive for the prevention of pressure ulcers in critical patients, since many were those classified as at risk (28) and few who have developed lesions (03)

Vivências compartilhadas de filhos separados pela hanseníase no RN a luz da história oral de vida

Several epidemics marked the lives of individuals and communities in all historical periods, and a prime example is leprosy, infectious disease marked by stigma, prejudice and social exclusion. In the past, the compulsory isolation of patients with leprosy caused serious social and psychological problems, resulting in the separation and the partial or total disruption of the family relationship. Children deprived of this living, removed often inhumanely, were kept and bred in preventoriums / educational establishments. This study aimed to: rescue the oral history of life of the children of leprosy patients that were built in preventorium Osvaldo Cruz, Natal, Rio Grande do Norte; develop a contextual analysis about these children; know the life trajectory of children of leprosy patients institutionalized in preventoriums / educational establishments; produce a documentary on the history of life of children of parents separated by leprosy; forming MORHAN of Rio Grande do Norte state; and implement the I Meeting of MORHAN of Rio Grande do Norte state. This is an exploratory and descriptive study, with a qualitative approach, approved by the ERC No. 024/024/2012 Liga Norteriograndense Contra o Câncer. We used the contributions of the method and technique of oral history of life as methodological reference. We interviewed 10 individuals egress from preventorium Osvaldo Cruz in Natal/RN, sons of former patients proven to be residents in the city, of both sexes, older than 18, with cognitive, intellectual and emotional conditions preserved. The analysis of the histories obtained from collaborators was performed in the light of Thematic Content Analysis. The results and discussions are presented through two articles which meet the proposed objectives. The first, called Contextual Analysis on the children of leprosy patients in preventoriums aimed to record the phenomenon of children of leprosy patients in preventorium through four contextual levels, which identified the need to broaden the debate on public policy in the field of leprosy as a way to enable more effective measures to propagate in the search for harm reduction and direct consequences resulting from stigma and marginalization around patients and their healthy children, egress from preventoriums. The second, Leprosy and the denial of history: the story of separated children , aimed to know the life trajectory of children of leprosy patients who were institutionalized in preventoriums / educational establishments. In this article, we discuss the research question through the establishment of three main themes: 1. Losses and damages: disintegration and reintegration into the family and denied childhood; 2. Unforgettable: remarkable things you do not forget; and 3. Expectancy in living new situations: in search of other paths and destinations. These thematic axis highlighted the negative implications for the lives of the subjects, arising from the separation of their parents, leprosy patients at the time of compulsory isolation; however, has also been shown that this separation was not decisive in their life histories, once they have succeeded in providing a new sense of these experiences and lead their lives with dignity and fortitude. It was concluded that these children demonstrated resilience as form of defense and fighting stigma and prejudice, being able to reinvent themselves and build new paths and destinations

Segredos da alma: a dádiva da assistência de Enfermagem

The present study is an analysis of interpersonal relationships between the nursing staff and the patients under their care. Its objectives are to analyze ties/links that may possibly exist in such relationships and to describe, based on the experience of the patients, how they are received by the nursing staff, and what is the extent of their reliability on the nursing staff within the hospital. This investigation is analytical in nature and qualitative in approach, having as its leading thought Marcel Mauss s gift-exchange theory. The study involved eighteen in-patients, eight of them from government institutions, at a large hospital school and ten others from a private specialty hospital; both in the city of Natal, state of Rio Grande do Norte, Brazil. Data were collected between January and March 2006. Results point to ties being created between the nursing staff and patients irrespective of their social status, involving especially the development of friendship and reliability. We have noticed that in both services the interpersonal relationship is associated with the circulation of the symbolic goods mentioned in the patients discourse, such as attention, loving care and concern, among others, marking the formation of ties during hospital stay. Likewise, reliability is also present in close relationship with the technical competence of the professional. Patient hospitality is associated with the manner in which the patients were treated on being admitted to the hospital, although they also refer to hospitality at later moments, during the course of their treatment. Finally, we are in a position to say that there are ties/links between in-patients and nursing staff, irrespective of the patient s social status and class divide. It is thus evident that the antiutilitarian symbolism of gift to give, receive, give back -, which shapes the setting of social ties also takes place in today s utilitarian, individualistic and competitive societies. Thus, human beings whose existence is dependent on mutual relationships try to save their humanity, especially those who are fragile and dependent as is the case of the hospital in-patient

Compreensão do típico ideal de técnicos de enfermagem acerca da sistematização da assistência de enfermagem

This study aimed to understand the typical ideal of the nursing technician about the systematization of nursing care in the light of the theoretical framework of Alfred Schutz. It is a comprehensive phenomenological research, using the theoretical framework of Alfred Schutz. For the unveiling of the phenomenon (the typical ideal of the nursing technician about the systematization of nursing care), the search process was configured from the proposed guiding principles for a research methodology based on the work itself of Schutz held by Zeferino (2010) in his PhD. For data collection, we used the focus group technique, counting on the collaboration of thirteen practical nurses working in a university hospital in Rio Grande do Norte, who responded positively to the inclusion criteria: working in the study hospital, performing care direct to patients. Forty-four subjects showed interest in participating, being held a draw for selection of the research sample, consisting of 14 professionals, one of whom did not attend the gathering of data collection. The focus group, entitled "What I think about the systematization of nursing care", took place on February 15th, 2013, totaling 101 minutes. It was performed according to the Experiential Education Humanescent using building posters as projective technique, from the key question: "What is the systematization of nursing care for you?". In order to understand some of the biographical situation of the participants, a questionnaire was administered to study participants. From the agreement of the subjects, the focus group was recorded and photographed with the cooperation of one reporter and two other employees. We used Microsoft Word 2010 to perform the transcript of the meeting and Microsoft Excel 2010 for synthesizing the results via a spreadsheet. The study followed the ethical and legal principles that govern scientific research on humans, recommended in Resolution nº 196/96, it was approved by Opinion Embodied Ethics Committee in Research of UFRN (Federal University of Rio Grande do Norte), nº 98 424, of August 31th, 2012, CAAE No. 05906912.0.0000.5537. The analysis of the nursing staff speeches, along with the contemplation of their posters and their written descriptions, allowed from the guiding principles of Zeferino (2010), in light of the reference of Alfred Schutz, unveiling the typical ideal of nursing technicians about the systematization of nursing care, passing four themes: typing of the concept of systematization of nursing care; benefits, which resulted in the reasons to believe in the positivity of this working tool; experienced problems, revealing the world of everyday life of nursing professionals, and possibilities for improvement. It was concluded that the nursing technicians are unaware of the systematization of nursing care. However, they typify a very positive perception about the same, especially with regard to improvements that may foster care

Assistência de enfermagem às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência em Mossoró-RN

This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice

Avaliação da assistência à saúde dos portadores de úlceras venosas atendidos no programa saúde da família do município de Natal/RN

Descriptive research aimed at evaluating the assistance offered to patients with venous ulcers, on lower limbs, attended by the Family Health Program (FHP) team, from the municipality of Natal/RN. The target population was composed of 74 patients with venous ulcers (VU), attended by the FHP teams in the 31 FHUs. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (protocol n.55/05). The data collection was performed in patients homes and in the FHUs, through structured interviews and physical examinations of patients with VU and non-participant observation during the changing of wound dressings in these Units and in users homes. The data was organized into an Excel electronic table and transported into the SPSS 14.0 program, for descriptive analysis on 2x2 contingency tables and inferential (Qui-Square χ2, Spearman Correlation, Binomial Proportion Test and p-value <0.05). The prevalence of VU (0.36/1000) in the target population (over 20 years of age) was greater than in the population registered in FHP (0.25/1000). We detected a greater prevalence in the age area of over 60 years (2.22/1000), with 2.98/1000 for females and 1.3/1000 for males (p-value=0.008). The sociodemographical and health characteristics of patients with VU revealed predominance of females (74.5%), elders over 60 years of age (67.6%), with fundamental education (74.3%), family earnings of up to 2 minimum wages (68.9%), retired (90.5%), ortostatic position (23.0%), inadequate sleep (59,9%), presence of CVI (100.0%), hypertension (44.6%) and diabetes (25.7%). As for the time of existence of the VU, 64.9% had over 1 year, and 35.1% less than 1 year), with predominance of one wound (67.6%). The changing of wound dressings is performed mostly at home, in and inadequate way, especially with incorrect cleaning techniques, likewise incorrect use of products and substances, and reduced participation of the FHP team on the evaluation and application of the dressing and choosing of products and substances. The compressive therapy is not part of therapeutic conducts for treatment in the FHUs. As for the evaluation of assistance to patients with VU, 90.5% were inadequate and only 9.5% adequate. The main inadequacy factors were the absence of: diagnosis (47.3%), consultation with and angiologist (63.5%), compressive treatment (100.0%), adequate optical therapy (98.62%), adequate dressing kit (70.3%), training for the changing of dressings (67.6%), following by the FHP team (51.4%) and performed exams (55.4%). We ve concluded that patients with VU mostly present now socioeconomical level and associated chronic diseases. Considering that assistance offered by FHP is non-systematic, fragmented, with no diagnosis planning, continual evaluation and evolution, we qualify the assistance as inadequate and with low level of solution, directly interfering on the maintenance of the VUs chronic state

Assistência de ar e volumes de aplicação na deposição de calda e no controle do arroz vermelho (Oryza sativa L.)

O trabalho teve como objetivo avaliar o efeito da assistência de ar junto à barra pulverizadora e de três volumes de pulverização na dessecação e deposição da calda em arroz vermelho, sob cultivo de nabo forrageiro, em áreas de recuperação de várzeas, utilizando o herbicida paraquat e o corante Azul Brilhante, respectivamente. Os volumes de pulverização foram 100; 200 e 300 L ha-1 da solução aquosa, contendo corante alimentício (1.500 mg L-1). Com ou sem a assistência de ar junto à barra, foram utilizadas pontas de pulverização de jato plano tipo AXI 110015 à pressão de 117,3 kPa, AXI 11002 e AXI 11003 a 276 kPa. A avaliação da deposição da pulverização deu-se em folhas de plantas de arroz vermelho. Os maiores volumes (200 e 300 L ha-1) pulverizados com a assistência de ar junto à barra pulverizadora proporcionaram maiores depósitos do corante em relação ao volume de 100 L ha-1. Não foram constatadas diferenças na deposição do corante para os volumes pulverizados, sem a assistência de ar junto à barra, tampouco entre os volumes de 200 e 300 L ha-1 com a assistência de ar junto à barra. As maiores percentagens de controle do arroz vermelho foram obtidas com a assistência de ar junto à barra, independentemente do volume pulverizado, equivalendo-se ao controle obtido com 300 L ha-1, sem o uso dessa tecnologia.

Adjuvantes e assistência de ar em pulverizador de barras sobre a deposição da calda e controle de Phakopsora pachyrhizi (Sydow & Sydow)

Com o intuito de melhorar a cobertura da pulverização e diminuir as perdas na produtividade da cultura da soja, o estudo objetivou avaliar o efeito da adição de adjuvantes à calda combinado ou não ao uso da assistência de ar sobre a deposição da pulverização, controle de Phakopsora pachyrhizi H. Sydow & P. Sydow, perdas de produção (peso de 1000 grãos) e produtividade da cultura (kg ha-1). Dois experimentos a campo foram conduzidos na cultura da soja, variedade Conquista, safra agrícola 2008/09. Um deles no delineamento em blocos ao acaso com três doses de adjuvantes associados a um marcador cúprico combinadas a dois níveis de ar na barra de pulverização (0 e 29 km h-1), totalizando 6 tratamentos e 4 repetições. Outro experimento foi instalado no mesmo local do anterior. O delineamento experimental utilizado foi o de blocos ao acaso com 7 tratamentos: fungicida e dois adjuvantes associados ao fungicida, combinados a dois níveis de ar na barra de pulverização (0 e 29 km h-1), mais testemunha, e 4 repetições. Após a pulverização do fungicida piraclostrobina + epoxiconazole com diferentes tecnologias, procedeu-se a avaliação da severidade da doença através da estimativa da área abaixo da curva de progresso da doença (AACPD) e da produtividade da cultura da soja. A assistência de ar na velocidade máxima gerada pelo ventilador (29 km h-1), combinada ao fungicida piraclostrobina + epoxiconazole mais o adjuvante organosiliconado Silwet L-77 contribuiu para melhor controle da ferrugem asiática, proporcionando incremento na produtividade e no peso de 1000 grãos.

Deposição e perdas da calda em feijoeiro em aplicação com assistência de ar na barra pulverizadora

Com o objetivo de avaliar a influência da assistência de ar na deposição da calda de pulverização, em plantas de feijoeiro (Phaseolus vulgaris) aos 26 dias após a emergência (DAE), com pontas de pulverização de jato cônico vazio (JA-0,5 e JA-1) e jato plano (AXI-110015), e volumes de calda, foi realizado um experimento em delineamento inteiramente casualizado, utilizando como traçador o íon cobre. Alvos coletores (papel de filtro com 3 x 3 cm) foram afixados nas superfícies adaxial e abaxial de folíolos posicionados nas partes superior e inferior das plantas. Para aplicar a solução traçadora, utilizou-se pulverizador com barras de 14 metros, com e sem assistência de ar, volumes de 60 e 100 L.ha-1, e velocidade do ar correspondente a 50% da rotação máxima do ventilador. Após a aplicação, os coletores foram lavados individualmente em solução extratora de ácido nítrico a 1,0 mol.L-1, e a quantificação dos depósitos através de espectrofotometria. A assistência de ar não influenciou na deposição da calda tanto a 60 quanto a 100 L.ha-1. O maior volume proporcionou maiores depósitos, sendo constatadas elevadas perdas para o solo (mais de 60%).

Assistência de ar em barra de pulverização no controle da ferrugem asiática da soja

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Dessecação da aveia-preta (Avena strigosa Schreb) com herbicida de contato, em presença ou não de assistência de ar junto à barra do pulverizador, em diferentes volumes de calda

A tecnologia de aplicação dos produtos fitossanitários na agricultura pode ser aprimorada mediante a redução dos desperdícios. Com o objetivo de contribuir com tal avanço tecnológico, avaliou-se a eficácia de um herbicida com ação de contato, aplicado em pós-emergência com pulverizadores sem e com assistência de ar junto à barra, em diferentes volumes de calda. O experimento foi instalado no município de Ponta Grossa - PR, com a dessecação de aveia-preta (Avena strigosa Schreb) implantada em sistema de plantio direto sob a palha. Empregou-se a mistura herbicida formulada (SC) de dicloreto de paraquate (400 g ha-1) + diuron (200 g ha-1). O delineamento experimental utilizado foi o de blocos casualizados (DBC), em esquema fatorial 2 (pulverizador sem e com assistência de ar) x 5 (volumes de calda: 0; 100; 200; 300 e 400 L ha-1), com quatro repetições. A avaliação do efeito da dessecação se deu por meio da escala proposta pela Asociación Latinoamericana de Malezas (ALAM). A interação entre os fatores foi significativa, obtendo-se suficiência na dessecação a partir de 200 e 100 L ha-1, sem e com assistência de ar na barra, respectivamente.

Para uma crítica da razão socioeducativa em entidades assistenciais

Buscou-se cartografar as instituições de assistência social que atendem à infância e à adolescência consideradas em situação de risco pessoal e social, em um município do interior do estado de São Paulo, utilizando o instrumental da análise institucional. O papel de membro do Conselho Municipal dos Direitos da Criança e do Adolescente e do Conselho Municipal de Assistência Social facultou a realização de uma análise documental nos arquivos desses Conselhos, relativa às entidades assistenciais cadastradas, tais como organizações governamentais, organizações não-governamentais e outros estabelecimentos filantrópicos. Os resultados indicam que, no universo da Assistência Social, a constelação criança/adolescente orbita em torno do astro-rei socioeducativo. Todas as atividades desenvolvidas nas entidades parecem recobertas por esse significantemestre, que conota dimensões pedagógicas e terapêuticas, educativas e corretivas, de vigilância e de prevenção, promovendo controle e normalização.

Tipos e consequências da violência sexual sofrida por estudantes do interior paulista na infância e/ou adolescência

Discutem-se os tipos de Violência Sexual (VS) sofridos na infância e/ou adolescência e suas vicissitudes, nas trajetórias sexuais de 236 adolescentes, de ambos os sexos, cursando o Ensino Médio no interior do Oeste Paulista que declararam ter sofrido um ou mais tipos de violência sexual. Dentre esses tipos, destacamos a Violência Doméstica Sexual (VDS), aqui definida como intrafamiliar. Nesse caso, observamos que, dentre os 236 adolescentes com histórico de VDS, 94 (39.8%) declararam ter pensado em suicídio e 39 (16.5%) disseram ter tentado, sendo que 35 (89.7%) deles se declararam heterossexuais (27 [77.1%] do sexo feminino) e 4 não-heterossexuais (3 bissexuais e 1 outro, sendo todos do sexo feminino). A maioria das vítimas finda por relatar o ocorrido aos amigos e responsáveis, mas pouco ou nada é feito, em termos de medidas protetivas a elas.

Infância - memórias: cenários - personas

Infância is undoubtedly memory, high qual ity l iterature, reputable, as the story moves between f ict ion and reality. Personal and social history, wi th such a sense of reality, causing the reader to prof it f rom the honesty and the sinceri ty producing, in this work, remarkable results in a constancy of cl ippings, f rame -by-f rame. Memory and obl ivion are this work guidance. We aim to denounce the relat ionship between the chi ld and violence, and as it is a memorialist ic text , we see the importance of f ict ion for this type of narrat ive to be sustained. I aim thereby show the tone of this report humanizing memories, its deep and decisive meaning, through the memories concepts by Le Gof f , by Seligmann-Silva and by Ecléa Bosi. I t is also through the theories of Jeanne Marie Ganegbin that I just ify the concept of remembering and forget t ing, and also it is also according the concepts of Eliane Zagury that I give support to the importance of autobiography as a a mean of expressing the reported memor ies. Final ly, in Infância, there is no room for fantasy. The lyricism that overwhelms, throughout each chapter, commands the author's imaginat ion. The need to invent gives way to the need to test ify, to denounce. And this t ransit ion occurs gradually, slow as Gra c il ia n o s c h i ld li f e , d u e to such humiliat ion and submission

Das cinzas aos mafuás: infância e morte na lírica de Manuel Bandeira

Cet article étudie la poésie de l'enfance et de la mort de Manuel Bandeira, à partir de la relation entre l'expérience, le langage et le sens, afin de mettre en place une nouvelle perspective sur ce thème, qui sert de guide et structure son Estrela da vida inteira (1966). Pour cela, il faut introduire la notion de lyrique, discutée par Theodor Adorno, pendant la conférence Lírica e sociedade (1958), à promouvoir la compréhension du poète, comme c'est le cas de Bandeira, implique son art par le biais de la dimension négative face à une situation de fétichisation des choses, afin d'appréhender des expériences qui constituent la substance de la vie et l'essence de la poésie. À cette perspective de lyrique s ajoutent les concepts de l'enfance et de la mort, exploités par Giorgio Agamben, dans les oeuvres Infância e história (2005) et A linguagem e a morte (2006), étant largement favorables à la compréhension de la poétique de l'enfance chez Manuel Bandeira, comme une sorte de discours qui récupère l'idée d'expérience dans l actualité, en marquant la limite entre une expérience muette et une expérience de la langue, de même, la mort apporte des implications relatives à la négativité, comme une brèche par laquelle l'auteur explore la signification de sa lyrique et la«dénoue» des incrustations du monde réifié, pour être dans la défense du langage non contaminé par le clôturée qui entravent la conservation de la créature et la donnée originaire des choses . Cela culmine l aboutissement de la thèse, la conclusion d être la négativité la voie qui explicite, dans l oeuvre bandeirienne, la culture brésilienne non comme une totalité positivée dans une ethnie, classe ou nation, mais comme un langage qui reconstruit, avec lyrisme, le coloré mosaïque qui est le Brésil