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

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

Hospital humano: etnografia da humanização hospitalar na perspectiva de usuários

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

A experiência da pré-eclâmpsia vivenciada por gestantes e profissionais de saúde

The aim of this study is to understand the perceptions of pregnant women, mothers and health professional about preeclampsia and the relation between professional and patient. A qualitative approach was chosen, together with semi-structured interviews, participative observation and Test of Free Association of Words (TFAW). The data were collected in February and June 2007 at Maternidade-Escola Januário Cicco (MEJC), Natal, RN, Brazil with 61 pregnant women and 87 professionals, 20 of each group were interviewed. An interpretative and understanding perspective was used similar to that of Gadamer s hermeneutics and with the construction of themes and empirical categories. The pregnant women showed fear preeclampsia and its consequences, and to know very little about the subject and also a desire to know more. The changes that occurred with the illness were more related to the emotional order than to the healthy lifestyle they have adopted. Some lack of preparation of the basic units was observed, in order to meet and guide the pregnant women to the reference unit. Professionals knew the customers characteristics, about their fear and about their little knowledge on this illness. Nevertheless, they did not include them in the treatment. It was observed the absence of conversation over the illness between professionals and patients and also the inability of the former to deal with emotional issues. A new way of looking into the preeclampsia assistance is necessary. A way that focuses on the collective construction of intervention and approach strategies; one which includes subjective aspects in an hermeneutic perspective of health

Violência institucional no âmbito da saúde reprodutiva : a percepção de mulheres usuárias do SUS, na cidade de Natal/RN

Institutional violence ranges from the most widespread lack of access to the poor quality of services provided. It includes abuses committed by virtue of the unequal power between patients and professionals within institutions. The aim of this study was to analyze the perception of women with regard to this type of violence, in the services offered at a reproductive health facility belonging to the National Health System (SUS) in Natal, Brazil. Interdisciplinary perspective is important, in that it provides interaction and complementarity between various disciplines, favoring, in an integrated way, a thematic approach in research activities, teaching and extension, involving professionals, students and researchers in medicine, social services, psychology, nursing, anthropology and physical therapy. A quantitative/qualitative approach was used, involving a sample of 401 women, as part of a transversal observational study. In the qualitative stage, which consisted of participatory observation and semi-structured interviews, we used an intentional sample of 10 individuals. The data were analyzed using logistic regression techniques, correspondence analysis and categorical thematic content analysis, showing that the 2 questions that investigated directly the perception of institutional violence obtained affirmative response frequencies of 28.2% and 31.8%, respectively. In regard to data collected in a field diary related to participatory observation, the main complaints referred to the health providerpatient relation, translated into dissatisfaction with the interpersonal relationship and with the resolution of the specific demand that required care. From content analysis, we classified 4 categories: Access; Information; Health professionalpatient relation; and Respect/dignity. We identified 6 subcategories: Impossibility of choice; Repressed demand; Communication difficulty; Asymmetric interpersonal relations; Privacy/confidentiality; Disrespect. We concluded, therefore, that the data presented show that in the reproductive health care programs, there are indicators of institutional violence. However, it is difficult to approach this phenomenon, mainly because of the power relations involved in the patient-health care provider interaction, resulting from unawareness that determinate situations violate sexual and reproductive rights. This can be explained by sociostructural questions that reveal marked inequalities, ratified by issues related to violation of the rights of National Health System (SUS) patients

Hemiparesia congênita e adquirida na criança: interrelação entre presença de crises epilépticas, os achados eletrencefalográficos e de neuroimagem por ressonância nuclear magnética

The purpose of this paper was to study patients with congenital and acquired hemiparesis, their clinical aspects, the presence or not of epileptic seizures, and electroencephalographic (EEG) and Magnetic Resonance Imaging (MRI) findings. We analyzed the interrelation between etiology, the presence and seriousness of epileptic seizures (ES) and the possible causes of refractoriness. This is a prospective study using the clinical diagnosis of a child neurologist, who attested to the presence of unilateral motor lesions. We compared the electroencephalographic findings in patients with or without epileptic seizures, and investigated if among the former, these seizures were controlled or not, their likely etiology and risks of refractoriness. EEG background activity on the lesion and contralateral side was analyzed, in addition to the presence of concomitant epileptiform activity. Encephalon MRIs of all the patients were studied to correlate etiology and the control or not of epileptic seizures. The disorganization of bilateral EEG activity correlated with the difficult-to-control epileptic seizures. Suitably organized background activity contralateral to the lesion is a good prognosis in relation to epileptic seizures. Focal epileptogenic activity does not necessarily predispose to epileptic manifestation. The MRI is more important in determining etiology than in prognosing epileptic seizures. This study used a multidisciplinary approach involving child neurologists, a physical therapist and a neuroradiologist. This meets the criteria of multidisciplinarity of the Postgraduate Program in Health Sciences

As repercussões dos serviços hospitalares em diferentes contextos: uma análise de profissionais de saúde

This study has as general object: to verify as the health professionals that work in different hospitals evaluate the hospital services; and specific objectives: identify how health professionals evaluate the work conditions in different hospitals and verify the central nucleus and the peripheral elements of the social representations elaborated by these professionals about these institution. This is a descriptive study realized in Natal, capital of Rio Grande do Norte. Were collected 213 questionnaires. Concerning the evaluation of the health services, high averages had been verified in the philanthropic hospital, for example, quality of the customer service. At the state hospital was observed lowest ones: respect to the privacy of the patients. Similar results were found about work conditions. It was observed as central nucleus the categories Overcrowded and Humanized care, in the state and philanthropic hospital respectively, and as peripheral elements Low wages and Overcrowded. Being thus the conflicts in this scene are inevitable because of the poor structure of some public hospitals, however, these problems can be foresee and solvable if the hospital has a free expression channel accessible to all agents. The evaluation has to become integrant part of the culture of the organization, a time that this will guide the steps in direction to the best quality in the hospital assistance

STRESS: um diagnóstico dos policiais militares da cidade de Natal Brasil

Objectives: The purpose of the current study was to diagnose military police officers in Natal, Brazil as to the level and phase of stress in which they find themselves and the prevalent symptomatology (physical or mental). Methodology: Descriptive, crosscut study that investigated a sample of 264 individuals taken from a population of 3,193 military police officers of the Capital Police Command (CPC) in Natal, Brazil. The data were collected using the Lipp Stress Symptoms for Adults Inventory LSSI, and analyzed by tabulations, percentage calculations, t-test for proportions and Pearson s chi-squared test for associations between stress, symptomatology and military rank. Data collection was between June/2004 and January/2005. Results: It was found that 52.6% of the officers had symptoms of stress and 47.4% symptomatology of stress. This was distributed across all ranks, especially mid and upper-level officers as well as corporals and privates, with predominance in the resistance phase (36%) and a prevalence of psychological symptoms (76%). The only variable investigated that was related to stress was gender (P = 0.0337). Conclusions: It was concluded that there is stress among all ranks of military police officers in Natal, Brazil, especially mid and upper-level officers, corporals and privates, with a prevalence of psychological symptoms, low levels of physical symptoms and predominance in the resistance phase. It seems that stress levels do not differ significantly from those found in Brazilian men and women and do not indicate a situation of chronic fatigue

Postura sentada: a eficácia de um programa de educação para escolares

Avaliação da eficácia de um programa de educação sobre o conhecimento relacionado à postura sentada de estudantes da 1ª série do ensino fundamental, na esfera estadual, particular e municipal, em Bauru. Foram avaliados (pré-teste) 71 alunos e depois aplicado um programa de educação sobre o tema, composto de aulas expositivas, técnicas de demonstração e feedback, associado a um programa de reforço ministrado por professoras treinadas e, finalmente, a reavaliação (pós-teste) dos conhecimentos dos participantes. Foi observado que: 1) no pré-teste ocorreu diferença significativa entre as escolas, sendo que a municipal apresentou menor número de erros do que a particular e a estadual; 2) o pós-teste mostrou que houve diferença significativa sendo que as escolas municipal e particular tiveram um menor número de erros em relação a estadual; 3) em todas as escolas houve predominância da situação de erro pré-teste maior que pós-teste. A escola estadual tem resposta mais freqüente que a particular quando há aumento de erro. Conclui-se que o programa se mostrou eficaz para aumentar os conhecimentos dos escolares a respeito da postura sentada.

Soroprevalência da infecção pelo Trypanosoma cruzi no município de Caicó, RN, e caracterização genética por RAPD do parasito isolado de humanos e de triatomíneos no semiárido potiguar

Trypanosoma cruzi infection was evaluated in 390 resident individuals in different rural communities of Caicó municipality, State of Rio Grande do Norte (RN). Of 28 investigated communities the soroprevalence of T. cruzi infection was 2.8% in eight rural communities individuals. The epidemiological characteristics of seropositive shown that the age ranged from 22 to 64 years, being significantly raised from 31 years (90.9%). The female gender was predominant and low education degree. Those individuals reported that they never donated blood, but they had direct contact with triatomines bug. The isolation of the parasite was performed by blood culture and xenoculture methods to determine the genetic variability of the samples. Twenty seven T. cruzi isolates were analyzed by RAPD as genetic marker using three random primers (M13-40, gt11-F and L15996). The T. cruzi isolates showed 73.7% of shared bands considering the average obtained with the three primers, and were genetically well correlated. Using this marker it was possible to separate the populations of the parasite in three distinct groups. The first group composed by isolates obtained of triatomines and humans from four different districts (Caicó, Caraúbas, Serra Negra doNorte and Governador Dix-Sept Rosado); the second contained isolates obtained of triatomines of two different species (T. brasiliensis and P. lutzi) captured in Caraúbas and Serra Negra do Norte. The third grouped isolates obtained from humans of Angicos and Caicó municipalities. In different localities of distinct mesoregions, State of RN, a profile genetic well correlated was identified among all isolates and the presence of three distinct groups of the parasite circulating among vertebrate and invertebrate hosts

Do lixo à solidariedade : avanços e perspectivas na busca de uma nova realidade

The dissertating study about the solidarity economy has the objective to analyze the four unions responsible for the selective municipal garbage collection in Natal. It aims at verifying the consolidation of these unions as solidarity economic undertakings, revealing which progresses they have made, as well as the social and economic insertion of the garbage collectors and their process of conquering citizenship. The referred four unions had been founded and are constituted, in their majority, by collectors coming from the Cidade Nova lixão (big garbage). As it was closed in August 2004, they decided to make a union in order to collecting garbage. As what concerns the methodic and theoretic proceedings, our research has been developed with a critical perspective and a qualitative approach without discarding and quantitative one. The central analytical categories of this paper are: association, work, social exclusion and citizenship. Our research has had three articulated axis which aim was to apprehend the subject, disclosing it. The exposition of the investigative results is subdivided in four chapters. The first one approaches the main aspects of the crisis of the capital and its reflexes in the world of work. Here we deal with the question the structural unemployment coming as a result of the present economic model, the mains changes verified in the Brazilian work market, as well as levels of unemployment affecting the work market in Natal s metropolitan region. The second chapter treats of the origin, concept and revival in Brazil concerning the tradition of thought and cooperative economic organization, which has recovered the central elements of the associative thought and is nowadays studied in Latin America under the name of solidarity economy. The third chapter deals with embodiment of the collectors unions, its history, appearing and development of each union. The fourth chapter presents the relative dimensions of the analysis categories supported in the reports of institutional actors as well as the perception collectors have about the recyclable stuffs, the way they face the daily life and so on, what brings about the contradictions present in their reality. The final comments sum up the main trends and particularities of the unions researched under the light of the solidarity economy and disclose the real perspectives of social and economic insertion of these collectors and the process they follow to conquest social recognition

Associativismo nos municípios rurais: uma alternativa de desenvolvimento local em Portalegre/RN

This work aims to study the associations as mediating the process of social change and its importance for local development. The hypothesis is that associations, but bring dynamism to the smaller cities and improve the living conditions of their members, relegated to the background social sustainability, understood this as a permanent exercise of mobilization and participation in community life. The assumptions of the study are that the practice group has influenced the processes of local development in Brazilian rural municipalities through the mediation of government programs and projects aimed at combating rural poverty require social organization for their achievement. The concept of local development in this work was rescued from studies of political economy and sociology. But the concepts of collective action and partnerships advêem studies of political participation and social development of the theory of alternative or solidarity. The party consisted of an empirical case study conducted with four associations of farmers in the municipality of Portalegre-RN. Why choose qualitative study was used the technique of semi-structured interviews with the chairmen I members of associations and other actors considered essential to understanding the study (religious leaders, local political power and chairman of the union of rural workers), a total of 20 interviews, in addition to the observations of field and documentary research in records of the.ir own organizations. The survey results show that the performance of groups of farmers are key components and determinants for the production I marketing of agricultural products and for boosting the economy, as well as security for minimum levels of citizenship. Yet we are still in a space purpose of social change, which comes to confirm the initial hypothesis of this work

Gestão participativa em educação: compasso e descompasso de uma experiência de democracia no espaço escolar

This work aims at investigating the strategies of management used by State School Joaquim Jose de Medeiros, located in the city of Cruzeta - RN, as award practice of "School of Reference in Management", with a state title in 1999 at the beginning of the decade from 2000, being "Outstanding Brazil" from best management strategies nationally. In 2005, it is ranked among the best experiences of the state. It has been become complex by experiencing in that institution, but at the same time an enjoyable practice, mainly by using a social research, in a qualitative and quantitative approach, and a analysis of the institutional performance of two management practices: from 1995 to 2002 and from 2003 to 2007 . To understand the object, a investigative questionnaire was used with representatives of the school community and carried out an analysis of assessment of institutional and documents of institutional organization of the periods above in order to identify management strategies and examine the influences of the share capital, public policies , the institutional evaluation, in the process of democratic construction that has allowed achievements, highlighting Cruzeta, in the Seridó in the state of Rio Grande do Norte, semi-arid northeast, in the national and international juncture of well-successful experiences in management in institutional categories and leadership. This study becomes relevant to allow understand that the cultural practices of seridoenses that symbolize a capital generated by principles of trust, reciprocity, civic culture, as a driving force in overcoming the problems community and the conquest of democratic principles, worked for the school become a national reference in educational administration. Another aspect that made it natural that school was the collective creation of educational project with the participation and civic culture of self-evaluation as a way to understand the institutional practice and establish guidelines to improve the teaching and practice management in its many dimensions educational, social, administrative - financial and legal

Educação para a cidadania e ensino superior

El presente trabajo discute la Educación para la Ciudadanía en la Educación Superior, destacando los desafíos y las potencialidades de la Universidade do Estado do Rio Grande do Norte (UERN); que organiza su acción política y pedagógica conforme a las exigencias de la actual política educacional para este nivel de educación. Analiza la relación de ésta con la Educación Básica a partir del estudio del Proyecto Pedagógico del Curso de Ciencias Sociales discutiendo la educación para la ciudadanía y la formación ciudadana de los futuros profesores de la educación básica en consonancia con la LDB 9.394/96, con las Directrices Curriculares Nacionales para los cursos de Docencia y además para programas y políticas de orientación para la educación superior que resultaron de la conquistas de los movimientos sociales y que son propuestos por medio de las siguientes secretarías: Secretaria de Educação Continuada, Alfabetização e Diversidade (SECAD) y Secretaria de Educação Superior (SESu). La reflexión incluye el estudio de tales temáticas en el eje de temas emergentes que organizan el debate educacional, sobretodo en América Latina, y los desafíos de las universidades que actúan en el contexto de la periferia en la desconstrucción del dominio simbólico del colonialismo cultural y la construcción de la globalización alternativa y contra hegemónica a la globalización neoliberal. El estudio evidencia que la idea de ciudadanía en la sociabilización contemporánea presenta una ambigüedad política consecuente de los procesos de globalización creciente siendo necesario que la perspectiva de la educación para la ciudadanía adoptada en la formación de los profesionales de a educación sea re politizada a partir de la noción de ciudadanía colectiva y multicultural apoyada en los principios de democracia y justicia social, construida en las interfaces de la educación escolar y prácticas educativas en lo entorno social, y en los espacios políticos de organización y movilización colectiva en torno de las conquistas por los derechos civiles, sociales, políticos y culturales, y la inclusión de temas y valores emergentes en la educación que interligados e interdependientes, garanticen su efectividad

A encruzilhada da vida política em assentamentos de reforma agrária no Rio Grande do Norte

The rural settlements represent a mark in the expensive historical process of fight by the land in Brazil. At first offer basic terms of survival, through the access the land and of the fundamental supports for exploration. At the same time, have stimulated organization forms politicizes of the families who manage to work with the new challenges of the everyday. The moment that follows the land conquest, and therefore, the settlements construction while life and work project, it is crossed for objective and subjective demands, with highlight for options of agricultural production and strategies of collective action. Originally formed as representation instance legitimates of the families - front to the government and social actors - the settlers associations are private spaces for political sociability, that guided by principles participative, can lead the settlers the new conquests through indeed democratic experiences. The goal of this work is to comprehend the participation forms in the scope of these associations and the way as that translates in life best terms for the group, from the settlements experiences located in the Territories of the Citizenship Mato Grande and Açu-Mossoró, in Rio Grande do Norte's State. The theoretical conceptions that guide this analysis are concentrate on discussions about democracy and participation (Patermam, Putnam, Bodernave) and in the reflections about the rural world (Medeiros, Martins, Woodman e Woodman and Bergamansco). About methodological, different point of view strategies were developed: The direct observation, the application in locate of questionnaires to the families settlers and interviews semi-structured with the internal leaderships. With that could verify that the participation forms in the associations operate in two heartfelt: Of a side, they promote assimilation opportunities of democratic abilities accompanied of notions of social rights and redefinition of political standards; Of another, it offers indeed the possibility of the settlers lead, with relative autonomy, the political organization and her changes in direction to a way of life that wish to have in the settling

Paulo Freire e a pedagogia do oprimido: afinidades pós-coloniais

The main objective of the present research is to reflect on the affinities between post-colonial theories - analytical perspectives directed toward the discussion of colonialism and its effects on the contemporary social fabric - and Brazilian educator, Paulo Freire‟s (1921-1997) Pedagogy of the Oppressed, written at the end of the 1960‟s. The study aims to make the argument that the present reflections on the featured work is an example of a post-colonial theoretical framework, delineating a critical modus operandi of colonialism, particularly in its cultural and epistemic dimensions, delineating a problematization of the processes of cognitive domination set, above all, by the European colonization of the Latin American continent, with the formation of the modern-world-system (WALLERSTEIN, 2007), dated from the 16TH Century forward. From this stand point, and especially supported by the contributions of Boaventura de Sousa Santos on the sociology of absence, the present work accentuates Pedagogy of the Oppressed as a set of reflections that bring the possibility of a pedagogy of absence (SANTOS, 1996), having in mind that, this book deals with, the presuppositions of an educational action, which considers the plurality of knowledge and social practices by way of the establishment of a pedagogical practice of collective construction, emancipator and dialogic that arises from the encounter to the indolent reason (SANTOS, 2009) in which the silencing of the voices of the oppressed, construct their conditions of invisibility, promoting also the absence of the social questions inherent to the processes of teaching and learning. It is with this perspective, however, that post colonialism is considered a theoretical site for the affirmation and the reinvention of the Pedagogy of the Oppressed, an obligatory reference in the construction of a prudent knowledge for a decent life (SANTOS, 2006)