998 resultados para Participação do Paciente
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The object of analysis of this work is the implementation of the election of director in the State School August 11, situated in the city of Umarizal, State of Rio Grande do Norte, period 2005-2008. The understanding of the politics concerning the school democratization, triggered in Brazilian society in the 1990s, requires taking into consideration the changes occurring in recent decades in the national and international, which impressed significant changes in the role and functions of the state. The election of a director is part of the policy of administrative decentralization and educational reform that focuses on the democratization of the management of public education with the involvement of social actors in decisions within the educational institutions as a way to address the problems that hinder the actions management education, especially school management. To better understand this process of political democratization of school management developed our analysis seeking to answer the following questions: implementation of direct election for a director ensures democratic management in schools? What are the ramifications for the school, caused by direct election on the school autonomy and participation of the subjects in school processes? From these questions, we set as standard for analysis of democratic management in schools of two dimensions: participation and autonomy within the school. For this we take as a theoretical and methodological literature: Pateman (1992); Rousseau (2010); Bourdieu (2007), Castoriadis (1991); Macpherson (1978); Marx; Engels (2007), among others dealing with participation, autonomy, decision power and election of director, and guidelines dealing with the democratization of school management. As data collection procedure, we use the semi-structured interviews and analysis of meeting minutes of the School Council and the Minutes of the final results of elections, to understand the empirical aspects of the implementation of the election of a director. The survey results indicate some progress and setbacks regarding the participation of subjects from issues relating to the school's educational project. Also underline the political interference as a factor crystallizer the centralization of power in the figure of the director as well as the advancement of the spaces that nurture the mobilization of political debate on the democratization of management. About the extent of autonomy observed that social actors to relate predominantly to the power of decision and the involvement of subjects in the school's actions
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This project was based on an implemented investigation of the institutional self-evaluation at Municipal Emmanuel Bezerra school, located at the west zone of Natal capital in Rio Grande do Norte state, where school individuals were analysed in interaction. A qualitative research was taken under the use of several pieces of information and collected out of several sources, such as: managing, docent and administrative staff interviews; present school legislation, political pedagogical project, scholar regiment as well as the 2013 action plans documental analyses; and the literature review focused in books and articles which treats of evaluation, State Evaluator and the public educational politics in order to promote the dialogue between school theory and reality. The institutional evaluation has been the theme debated through several studies. However, with its major focus on the evaluation systems and High Education aiming to raise competition having implying the reaching of educational quality as justification under liberal view. Notwithstanding, over the controlling function of the educational results and competition trigger amongst the educational institutions to the accruement of the received resources, it is believed that this institutional evaluation, however the system, can assist in the educational services improvement offered to the local public, when endeavoured to the purpose of supporting human development. Having the obtained data, the self-evaluation process implemented at the concerned school, the conceptions which permeate the school environment as well as the community joining given in this object lesson, was described and analysed as dialoguing with the political pedagogical project and comprehending the constitution in a democratic management
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This research aims to study the participation of mothers in the School Council of the Centro Municipal de Educação Infantil Amor de Mãe. The goal is to understand the relationship among concepts that mothers have and their practices as advisors. The historical-philosophical approach taken along the research permitted working with real people and not those derived or idealized ones. It searched an approximation of the mode of being and living of the councilor mothers in their homes, and the concepts and practices in the School Council. It was inspired by ethnographic researches to describe data, habits, cultural practices, meanings and values of people involved. As sources of research, we used: interviews with mothers and school staff; documentary and photographic collection of CMEI Amor de Mãe; local and national legislation; notebooks of the National Program for the Strengthening of School Council (2004); data bank of dissertations and theses of the Post-Graduate Program in Education of the UFRN dealing with democratic management and the relationship school and family. The study indicates the existence of a narrative of the school community that shows mothers as "missing" or "passive" and a practice that point out to how people participate actively in the school routine. This contradiction reveals the existence of a historically constructed school mindset that is rooted in a model of family and school that differs from the reality found in CMEI Amor de Mãe and how families served by CMEI Amor de Mãe organize themselves. It is recommended that the school community and families reorganize the conceptions that guide their practices in educating and caring for children with whom they live and work to make progress together in managing this process
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To investigate the relationship that exists among the educational participation of the school board and the teacher's professional development, starting from the analysis teachers of a public institution who teaches daily in the city of Natal. We focused the possible relationships between the teacher's action and their professional development, which includes the participation of the School board, considered by us as a collective space. To accomplish this research we used Interviews (KAUFMANN, 1996; SILVA, 2002) to analyze the nine participants, who are teachers' of the school board, and their oral speeches, considered as main references of our study. While trying to understand the reasons that led the teachers to choose her/his educational profession, we noticed the difficulty of recognition of the job of lecturing as a profession. This fact comes as an obstacle to the perspective of the teachers' professional development. In what he/she refers to the forms of the teachers' participation in the board and their meanings, we noticed in first place that the feeling of it belongs one of the decisive factors it can be considered actively for the teacher to announce of the actions colegiadas. This for them to want and they believe that that is the best road for if they develop better while professionals and consequently to improve the situation of the school. In second place we noticed that the school board represents, a place of articulation of the equality among all the ones that form the school community. So, we tried to understand how they happened to the collective actions in the school, how the teachers presented them in spite of what they know, how a collective action should be presented in the elements of fragility of that process that inhibit the development of the overall action. Finally, we questioned the elements that would contribute to the educational professional development; we noticed that the teachers present the competence, the ethics and professional valorization, as factors that contributed at the present time to their educational professional development
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This study board the FUNDEF social control council implementation in Parnamirim/RN city, concerning their representatives participation in the accompaniment (decision power) in resort, in front of governmental politics of decentralization, unleashed in 90´s, seen in decentralization process needs the society participation in decisions of educative institutions and represent an efficient way of solve the problems difficult the educational management actions. For this, the council creation of Brazil manager configure, since the 80´s, detaching, and the single characterizing, in actual context. The objective is raise pertinent questions of thematic of representatives members participation of collegiate organs, evidencing the decision power of these, in public resource control. The theory-methodological referential the literature treat the participation and power decision of FUNDEF social control decision, such as politics directrix that rules this council. It utilizes as proceeding of collecting data the semi-structured interview and analyze of meeting register to understand the empirics of council implantation in this city, in view of that the electoral process configured in 2003, showed as a innovation, because the counselor is indicated by the local public power representatives (in this case the education municipal secretary). The research result show the representatives have difficult, to accompany the FUNDEF resources amount, particularly in concern in the financial resources (ratio) over plus. Finally, emphasize the importance of democratization in the relations between the state and civil society, elucidating and exciting reflections a: democratic participation in control of public recourses for education, educational management and civil society mobilization in access of public and cultural cash which the citizen has rights
Vivências de familiares do paciente internado em unidade de terapia intensiva: estudo fenomenológico
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This study originated from my concerns as critical care nurse, regarding the lived experience of the family member of the patient that is hospitalized in the intensive care unit - ICU. The purpose of the study was to comprehend the experience of the family members while having a loved one interned in an ICU, and to identify the common elements of the phenomenon, based on the descriptions of their experiences. Considering that the object of study involves subjective and social questions, the study was conducted using some fundamental ideas of descriptive phenomenology as a referential and the situated phenomenon as suggested by Martins and Bicudo (1989). Ten (10) family members of patients that were interned in the ICU of private hospital in Natal, RN were interviewed using the following leading question: What is it like to have a member of your family interned in the ICU? Five thematic structural categories emerged from the comprehensive analysis of the interviews: Fear of the family member s death; Lack of humanization; Social isolation; Confidence in the ICU; and Overload to the personal life. The description of the phenomenon enabled a new look at how the care team relates to the family members of the patients interned in the ICU, providing some guidance on how to construct a humanized care that involves the family and that is based on affective human relations. This involves a rethinking of the care provided by team to the family and stimulates the reformulation of personal and social attitudes, and of hospital organizational norms
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Comprehending social representations of users relatives of Psychosocial Care Centers (CAPS) from Natal-RN, about their participation in the activities of these services, was the purpose of this study. The research instrument used was a semi-structured interview, led to 28 relatives of users of East and West CAPS II, East and North CAPS-ad, involved in the Relative Therapeutic Group, in Relative Meeting, in the Assembly of Users, Technicians and Relatives, according to the therapeutic schedule of each health services, between August to November 2007. Data obtained in family and users identification were characterized with the aid of charts and boards in absolute and/or percentage values. The discursive material from the guide from interviews was submitted to the informational resource ALCESTE (Analyse Lexicale par Contexte d'un Ensemble of Segments of Texte), and analyzed on the basis of the Theory of Social Representations and Central Nucleus Theory. Most of the relatives were women, married, aged over 50 years, who participated for more than two years in CAPS activities, and a coexistence of more than 11 years with the user. From the classification system of ALCESTE were selected categories, identified by: Category 1, Treatment Improvements and Expectations; Category 2, Living User Before and After; Category 3, Activities Relevance, Contradictions and Suggestions; Category 4, Guidelines -- Psychopharmacology and Medicalization; Category 5, Family Participation and Activities; and Category 6, Therapeutic Conditions Thanks, Tips and Vulnerability. The social representation of the family exists in the desire for change, identifying that we need to promote change by the continuity of therapeutic activities and overcome the detected inconsistencies, targeted by strengthening and by the stability of improvements in living and health conditions of users, experienced in CAPS treatment. The central nucleus had corresponded to positive changes in health and living conditions of users, and the peripheral elements were constituted by family conducts before and during treatment, and the expectations of changes in activities, especially in workshops. Despite this family participation be considered important, it still does not meet conditions to promote the inclusion of family, under an emancipating point of view, capable of causing in subject the hope for autonomy, initiative, individual and collective growths, a closer and active involvement in therapeutic activities, in workshops and discussions
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In tertiary care, the Intensive Care Unit (ICU) is nowadays one of the most complex settings in providing care to critically ill patients and could make the difference in favor of life. Nevertheless, the stigma of death which pervades the imagination when the ICU is mentioned and the excessive importance placed on machines rather than on the human being end up by causing distress to some extent. As the purpose of this investigation is to understand the distress caused to a patient in an ICU, it has been grounded on the following question: What kind of distress does a patient go through during his/her experience in an ICU? This study has, therefore, an analytical and reflexive character embedded in a qualitative dimension of a phenomenological approach based on narratives. To this purpose, five patients were interviewed from November to December 2008. Out of the empirical material gathered from these narratives we were able to identify several factors that cause distress to ICU patients. Among them were: the certainty that they are critically ill and fear death, a closed room, too much lighting, a typical loneliness arising from being isolated from family members and dear ones, lack of communication with the professional staff, and noise; besides having to undergo therapeutic procedures. In summary, although the ICU is seen as a place of distress, in many aspects and in accord with this research, such distress can and should be relieved. On the other hand, being near to death leads them to a redefinition of life, said the patients.
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Estudo de caráter exploratório e descritivo, de abordagem quantitativa, realizado num hospital de urgência hospitalar referência em traumatologia, em Natal/RN, com o objetivo de identificar o conhecimento do enfermeiro a respeito da ECGl para avaliação do nível de consciência e do processo de cuidar na fase pré-hospitalar e hospitalar às vítimas de TCE. A população constou de 44 enfermeiros e os dados foram coletados entre abril e maio de 2010. Os resultados mostram que, 35 (79,5%) dos enfermeiros eram do sexo feminino; 17 (38,64%) estavam na faixa etária entre 24 a 30 anos e 12 (27,27%) entre 51 a 60 anos; 25(56,82%) solteiros, 30 (68,18%) católicos e 25 (56,82%) sem filhos; 40 (90,90%) eram formados por instituições públicas, 18 (40,92%) tinham tempo de serviço na enfermagem acima de 21 anos e 14 (31,82%) até quatro anos; 18 (40,91%) estavam alocados nas UTIs e 13 (29,55%) atuavam em mais de um setor e 20 (65,90%) possuíam especialização. Dos que estavam mais especializados, 18 (40,92%) tinham tempo de serviço até quatro anos e 08 (34,48%) acima de 21 anos. Todos relataram ter prestado assistência às vítimas de TCE e 36 (81,82%) sentiam-se preparados; 35 (46,67%) adquiriram essas informações na prática e apenas 8 (10,67%) na graduação. Em relação a opinião dos pesquisados sobre os empecilhos que dificultam esta assistência, 23 (23,01%) relataram déficit de recursos humanos e 19 (20,65%) despreparo da equipe de enfermagem, estrutura física inadequada e recursos materiais precários. Como propostas de solução para os problemas, 26 (47,27%) sugeriram reforma na gestão e 13 (23,63%) referiram educação continuada. Em relação a ECGl, 40 (90,1%) afirmaram conhecê-la, 33 (82,50%) a utilizavam, 32 (80%) conheciam sua finalidade, 25 (62,5%) acertaram os indicadores fisiológicos e 36 (90%) classificaram corretamente a gravidade do TCE. Dos enfermeiros que utilizam a ECGl, 23 (92%) conheciam seus indicadores e classificação e 20 (60,61%) utilizavam uma vez por plantão. Em relação às dificuldades no manejo da ECGl, 11 (21,58%) não tinham nenhum problema; 10 (19,60%) citaram a falta de tempo e com o mesmo percentual responderam interpretação da resposta verbal nos pacientes intubados. Quanto ao conhecimento dos enfermeiros na descrição do processo de cuidar, 31 (70,45%) das respostas da fase pré e 35 (79,55%) da hospitalar não possuíam etapas importantes, sendo consideradas como incorretas. Quanto à afirmativa dos enfermeiros em estar, e realmente estar preparados para esta assistência, detectamos que daqueles que disseram estar preparados, apenas 12 (33,33%) acertaram todos os passos do atendimento pré hospitalar e 6 (16,67%) no atendimento hospitalar. Concluímos que diante dos resultados obtidos, os enfermeiros conhecem a ECGl, no entanto, necessitam de capacitação para sua melhor compreensão e utilização. Quanto ao conhecimento do processo de cuidar aos pacientes com TCE, é necessário modificar urgente esta realidade, especialmente na atenção às ações desenvolvidas pelo enfermeiro no âmbito hospitalar, onde as consequências das lesões secundárias, muitas delas evitadas com diagnóstico precoce e intervenções imediatas, podem acarretar incapacidades permanentes e prejudicar a qualidade de vida desses indivíduos
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Reconstruct, from listening, the life histories of a chronic renal patient, submitted to hemodialysis, is the objective of this investigation. How methodological procedure,we worked with oral history of life, ,according Meihy, within a qualitative approach. For this, we had the approval of the Ethics Committee in Research of Hospital Universitário Onofre Lopes (HUOL), under protocol no 591/2011. As instrument to approach the patient, we did interviews with open questions, conducted in the patient's house. There were five meetings, in which we hear his story, experiences and ways of coping during their course of illness and treatment. The analysis was based on the collaborator's narratives, anchored in studies dealing with oral history, of human subjectivity, highlighting the resilience, as indicated Cyrulnik. Her story leads us to conclude that despite the adversities of life and suffering, there is in humans, the strength to navigate the streams and be happy. This is the lesson that leaves us the collaborator this study.
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Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs
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This study aimed to identify and describe the factors related to Patient Safety in a medication system according to the nurses analysis in a teaching hospital from the photographic analysis method. This was a cross-sectional, descriptive study with mixed approach in a teaching hospital in Rio Grande do Norte. The population consisted of 42 nurses from inpatient units, of which 34 composed the study sample. As eligibility criteria, we defined nurses from public service and nurses who agreed to participate. Ethical determinations were observed, the study was submitted to the Ethics and Research of the University Hospital Onofre Lopes, obtaining the assent with ethical assessment certificate (CAAE 0098.0.051.294-11). For data collection, we used the photographic method (Photographic Analysis Technique) by Patricia Marck (Canada). It was developed in two phases: at first, we randomly captured photos from the medication system, resulting in 282 images; then we selected/processed the photographs, which were reduced to 10 images in Microsoft Excel 2010; in the second phase, the nurses answered the questionnaire divided into socio-professional profile and Digital Photography Scoring Tool (questions a and b ). For analysis of the question a , we used the content analysis technique, and for b , we used the Statistical Package for the Social Sciences 20.0 (temporary license). The socio-professional profile revealed the predominance of females; age group 34-43 years; professionals with specialization; 10-18 years of length of service; and nurses working exclusively in the hospital and who know the Patient Safety. The photographic analysis in relation to Patient Safety resulted in specific categories for each stage of the medication system. Regarding disposal, we identified Proper verification ; Improper verification ; Correct identification ; Disposal in single doses ; and Improper Environment , with predominance of that last category. As for storage: Proper storage ; Improper storage ; Risk of exchange/disappearance ; and Poor hygiene , with special reference to improper storage. In preparation: Risk of exchanging medication/patient ; Inappropriate physical space ; and Inadequate 9 preparation of controlled drugs , highlighting the first category. In drug administration: Lack of Personal Protective Equipment ; Use of Personal Protective Equipment ; Improper administration technique ; Proper administration technique ; Correct drug identification ; Incorrect drug identification ; and Peripheral venous access without identification . From the safety assessment of 10 photographs, by adapting the scores (1-10) to the Likert Scale, we identified three Totally Unsafe (Level 1), three Unsafe (Level 2), three Partially Safe (Level 3), one Safe (Level 4), and no photograph considered Totally Safe. This study identified the prevalence of unsafety in the medication system in the nurses opinion. We were also able to understand that, although nurses identify safety aspects, the most prevalent categories characterize an unsafe assessment. Nursing needs to reflect on its practice, identifying gaps in the medication system in order to achieve a proper and safe care
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
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Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Questionário Atitudes de Segurança , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety
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The question of participation has been debated in Brazil since the 1980 decade in search a better way to take care of poulation s demand. More specificaly after the democratic open (1985) begins to be thought ways to make population participates of decisions related to alocation of public resources. The characteristic of participates actualy doesn t exist, population to be carried through is, at top, consulted, and the fact population participates stays restrict to some technics interests at the projects, mainly of public politics of local development. Observe that this implementation happens through a process and that has its limits (pass) that could be surpassed through strategies made to that. This dissertation shows results of a research about participative practices in city of Serrinha between 1997 and 2004, showing through a study of the case of Serrinha what was the process used to carry through these pratices in a moment and local considered model of this application. The analyses were developed through a model of research elaborated by the author based on large literature respects the ideal process to implant a participative public politics. The present research had a qualitative boarding, being explorative and descritive nature. The researcher (author of this dissertation) carried through all the research phases, including the transcriptions of interviews that were recorded with a digital voice recorder. Before the analysis of these data was verified that despite the public manager (former-mayor) had had a real interest in implant a process of local development in city, he was not able to forsee the correct process to do it. Two high faults were made. The first was the intention to have as tool a development plan, what locked up to make this plan was the booster of supossed participative pratice and no the ideal model that would be a plan generate by popular initiative. The second one was absence of a critical education project for the population that should be the fisrt step to carry through a politc like that