Vivência do enfermeiro no cuidado humano na Unidade de Terapia Intensiva adulto

The purpose of the study was to understand the nurse s experience with human care in the Adult Intensive Care Unit (ICU). The objective was to describe the nurse s experience in caring for patients in the ICU and to analyze the nurse s perception of the care provided. The study is a descriptive inquiry of qualitative nature with a phenomenological approach. We interviewed eight nurses, 26 and 43 years of age, that provide care in the ICU of a private hospital in Natal/RN, during the manths of July and August of 2006. We analyzed the data acording to the method of Colaizzi. Four categories emerged from the data: The search for the maintenance of life, The technicalbureaucratic activities, The recognition of the patient s individuality, and the expression of the nurse s feelings.The analysis allowed us to describe the lived experience of the nurse s care the ICU and to comprehend the structural elements of this experience. The results showed that the nurse s experience presents itself as a process of the several actions and feelings that occur while the social relations between the patient and the nurse develop. Finally, we understand that although the study shows an experience based on a biological model of health, these nurses possess an initial idea on how to reach humanized care in its essence, needing, however, of an institutional policy that favors this practice, an educational formation that prepares her to recognize her field of work as a place of continuous learning and an understanding of the health model as an ally in the search of humanized care

O PAPEL DO CETICISMO NA FILOSOFIA DO JOVEM HEGEL

Ce travail veut montrer que le scepticisme n‟est pas q‟un des principaux défis pour la philosophie moderne jusqu‟a la déflagration da la Reforme Protestante, la redecouverte et la traduction des textes de Sexte Empirique. La reception de ce scepticisme n‟est q‟un des principaux facteurs qui determinent le noveau fondament da la philosophie moderne avec base dans la subjectivité. Dans ce contexte d‟un nouveau fondament de la philosophie sous la base de la subjectivité, Hegel aborde le problème du scepticisme. La pensé developpé par Hegel dans période de Jena (1801-1807), principalement dans l‟écrit de la Differance parmi les philosophies de Fichte e Schelling, et dans les articles du Journal Critic de Philosophie, Relation du scepticisme avec la philosophie et Foi et Savoir, part du dialogue avec la philosophie d‟idealisme allemand, qui est le point plus haut du subjectivisme dans la philosophie developpé à partir du retour du scepticisme. Hegel essaye à travès l‟interpretation et la superation du scepticisme, établir une nouvelle base pour la philosophie. Alors, le scepticisme, dans cette période de la philosophie d‟Hegel, a la function d‟être la negativité propre à la authentique philosophie qui anéante le point de vue des les philosophies de la subjectivité. Cette manière comme Hegel intégre la scepticisme à sa philosophie, a son point plus haut dans la Phénoménologie de l Esprit. La figure du scepticisme parfait présenté dans l‟introduction de la Phénoménologie de l Esprit a la function de faire le passage du point de vue des philosophies de la subjectivité au point de vue espéculatif da la raison

O cuidado e a ética do cuidado: um diálogo entre Leonardo Boff, Carol Gilligam e Nel Noddings

To elucidate the important contribution of care ethics in improving human relations and social intimates, this work reveals the fragility and lack of ethics on the formation of a just society, equal, peaceful and caring. To this end, we study on the moral development of men and women, warning of the natural differences between the sexes, which change for both the way of seeing life and live it - which does not imply inferiority to some genres. From this study it is clear that the natural care is innate to humans, it provides a tendency to act for the good of all life forms and nature as a whole. But it is evident here a greater sensitivity of women to such care because they possess perception and more emotion than men, which make them more participatory and involved in relationships. This greater openness to care found in women, due in part to the strong and lasting relationship with their mothers. Thus is revealed the power that women have to positively change the direction of human relationships, providing careful with your example, protective and caring, the awakening of a new and comprehensive ethics - opens to the truth, and features especially for affections. Therefore, the care ethics arises from the life experiences of women and aims, through them, to join the men's morality in order to bring out the relevant fact of interdependence between human beings, of human fragility and the need for relationships to the fullness of life

Saúde física e emocional de cuidadores da cidade de Santa Cruz-RN: perfil epidemiológico e fatores associados

Taking care for an impaired elderly is a hard and costly task that could affect directly the caregiver health. The purpose of this study was to evaluate the physical and mental health of elderly caregivers from the city of Santa Cruz-RN and analyze the potential correlated factors through an observational analytic design of a crosssectional. A multidimensional questionnaire was used to evaluation of the social demographics characteristics and those related to the care activity, as well as the caregivers´ physical and mental health. It was realized a descriptive analyze using frequency distribution and measures of the central tendency and dispersion to description of the caregivers. To verify the magnitude of the association between the variables was used the bivariate analysis through the Pearson and Spearman correlations and qui-square test. To evaluation of the association of the correlated factors to the adverse outcome with the caregivers´ physical and mental health was made a multivariate analysis by logistic binary regression and multiple linear regression models. The final sample was constituted by 304 persons, mostly women with a mean age of 50.3 ±16.8 years. The principal factors related to the physical health were age, stress and life satisfaction. Be a male caregiver, caring for a little while the elderly with cognitive deficit and not been spouse were related to worse mental health. Have worse physical health, high stress, depressive symptomatology, burden and low levels of satisfaction were also related to the mental health. After adjust through multiple linear regression was observed R2 values of R2=0,21 for Stress, R2 =0,17 for Depressive Symptomatology, R2 =0,21 for Burden and R2 =0,16 for Satisfaction. The attainment of the factors associated with caregiver´s health can help in the elaboration of specifics politics witch the goal is the integral attention to the elderly and his caregiver. The inability of continuous taking care could result in adverse outcomes such as institutionalization, impairment and death

Perfil hormonal anual de machos e fêmeas adultos de saguis (callithrix jacchus)

Many behavioral and biological variables of animals are expressed in the form of biological rhytms, down by the Circadian Timing System, that synchronize them with the environment from external stimuli such as light. One of them is the secretion profile of most circulating hormones regulated by the hypothalamuspirtuitary axis, which controls functions essential for the survival and reproduction of organisms. The sagüi, Callithrix jacchus, one of the most studied species about their endocrine physiology, is an appropriate subject for evaluating the profile of plasma prolactin and cortisol of adult males and females born in captivity throughout the year. Three male and two adult femelas were housed individually and subjected to natural environmental conditions over two years. Blood samples were used to measure the circulating levels of both hormones by methods radioimmunoassay (RIA) and immunoassay (ELISA), respectively. The analysis during the year of the plasmatic values of both hormones test was performed by ANOVA for repeated measures, the correlation of Spearman, and the test of Friedman and Student's t-test. The levels of prolactin in plasma were higher during the months in which there is a greater incidence of births of baby in the colony, possibly serving for modulating the expression of the behavior of parental care in both sexes. The plasma cortisol showed a lift in anticipation of the station with the highest birth rate and may be associated with the preparation of individual participation in caring for the baby, and also with the establishment of emotional bond between reproductive partners. Thus, this study shows that, despite the variations observed in the environment in which the animals live, plasma levels of prolactin and cortisol vary little throughout the year.

Cuidado ao filhote de boto cinza, Sotalia guianensis (van Benédén, 1864)

In some species parental care is vital to survival. Many studies have reported various parental care behaviours in cetaceans. In Sotalia guianensis, some behaviours have been already described and linked to parental care. However, many aspects are still unknown and all these information might be important for the species conservation. The aim of the present study was minimize these gaps, showing the options involved in the marine tucuxi parental care. The observations took place in Enseada do Curral, located in Pipa, Tibal do Sul, Rio Grande do Norte Coast. Between January and December of 2005 the local population of tucuxi was observed during 42 days. The methods used were Focal Animal and Ad Libitum. The results suggest that calves are present in the bay all year long. Groups with calves had a mean of 6,9 animals, allowing the animals to participate in different activities in the group besides caring. The calves created different associations, being usually followed by an adult. In groups, the calves stay mainly in the centre, which offers them protection. Calves remained next to the adults tail, facilitating breastfeeding. The calves most noticeable activities were those in the surface and the behaviour frequencies decreased, in general, in the presence of human swimmers and boats, what could be considered a threat to the animals. Adults shared positions when caring for calves, suggesting allomaternal care; food transfer from adults to calves was observed, which might be related to diet acquisition; three non-described behaviours were seen, indicating a diversified behavioural repertoire for this species

Não há você sem mim: histórias de mulheres sobreviventes de uma tentativa de homicídio

The murder-suicide (H / S) has been defined as a shocking crime in which a person takes the life of another and then kills himself within 24 hours. Set up as a gender violence, because men are in majority, the killers and the women victims. This study aims to understand the meanings of the experience of a H / S, from women who have survived this act. This study sets up as a hermeneutic phenomenological research, based on Heidegger`s ontology. We interviewed three survivors of H / S, whose narratives allowed to approach the senses present in their lives. The interviews were transcribed and interpreted in accordance with the hermeneutic circle, as proposed by Martin Heidegger. From the interviews of research participants perceive that these women have built their senses in stocks, represented the family foundation and the presence of a husband and children. This project that moved their lives toward the construction of modes-of-being. We noticed the presence of historicity constructing meanings for the existence of these women. We found reports of an experience of loving relationships characterized by strong jealousy, with the presence of fantasies of betrayal, and marked by a careful affective relationship that put them in the position of object possession of his companions. Reflect that such caring restricted their existence being-for-husband. So the senses that moved their stocks, which aimed his ways existential, was the creation of a family, a reference to their lives, to live a love, and care for the children. Therefore, beyond the already known aspects in studies on violence against women, which made these women continue to choose this relationship was the sense that they had for their existence. It is hoped that this study will contribute to the construction of a new look on violence against women, taking as a basis the Heideggerian hermeneutic phenomenology

Moradores crônicos de hospital psiquiátrico: um desafio à desinstitucionalização

The existence of chronic inhabitants in the psychiatric hospitals imposes a challenge to the Psychiatric Reform, that proposes things such as the gradual and progressive way to extinct mental institutions, once the permanence of the hospital in the system is only necessary because there is not a net of well structured substitute services capable of receiving that demand. This work considered relevant to deepen the knowledge about those people who passes their lives jailed by the walls of psychiatric hospitals and compose significant part of the world population. It also aimed to investigate the problem relative to the condition of being an inhabitant of a psychiatric hospital the Dr. João Machado Hospital (HJM), in the city of Natal/RN. The paper used different points of view (patients , families and professionals ) to define the profile of the inhabitants, to identify the possibility of insertion in substituting social equipment, to know the expectations of the inhabitants and their relatives regarding to the exit of the life shelter, to investigate the demands related to the net of cares social support for making feasible the discharge and to identify the difficulties that are involved in the exit of the chronic inhabitant of the hospital. There were defined three methodological phases: delineation of the identification, socio-economic and clinical profile of the inhabitants of the HJM; semi-structured interviews with professionals; and open interviews with inhabitants and family. It concluded that the psychiatric institutionalization contributes to the generation of chronic inhabitants in the psychiatric hospitals. Among the professionals, it was detached the defense of desospitalization, but an existence of devices of the asylum model. The relatives showed a resistance to participate in the care and the inhabitants exposed their desire to leave the hospital, as well like the wish of permanence. It was considered important: the construction of an extra-hospital net that enables to desinstitutionalization; the qualification of the technical; orientation to the family, stimulating its participation in the process of caring; give freedom to the individuals in mental suffering, enabling them to be ahead of their lives and express their desires and opinions; the implementation of an extended clinic that is capable of building new possibilities; and a subjectivity guided by the social enclosure

Ser-no-mundo com a criança portadora de câncer compreendendo a experiência de psicólogos nos serviços de oncologia pediátrica de Natal-RN

Cancer goes on to be a frightening disease by humanity, simetimes,it is considered as death, suffering and stigma synonym. Occurring at childhood, this meaning seems to acquire a more intense conotation, having in view of the perplexity and godliness feeling in the presence of the precocity of events, nearly always associated to the death. A psychologist co-existence with the cancer children is going acquiring, thus, a permeated sense by incognitas , fears and fantasy, which raised us the following question: how does the psychologist that answers children with cancer lives this experience? Therefore, the aim this research was to understand this co-existence experience. Our theoretical perspective comes from an existencial fenomenology and, more specifically, the Humanistic Approach and Martin Heidegger Existencial Ontology. The metodology is qualitative of phenomenological character. The access instrument to the experience was the narrative, such as purpose by Walter Benjamin. They were carried out nine semi-open interviews with psychologists who work on pediatric oncology services of Natal-RN city. Such interviews were recorded in cassette, transcripted and later, re-educated. These interviews were recorded, transcribed and later on edited with the help of the interviewee and turned into a text. The narrative comprehension was carried out on Heidegger Existencial Ontology, on dada exaustive reading and the clipping of indicative passages of experience sense of being psychologist on this area. The research suggests that the experience is oriented of clinic kowing-doing, being crossed by implications of key thematics which indicate the care as central ontologic element that orientates the way as these professionals come being in the world in association with the clientèle. Besides, the caring experience of these children acquire the sense of true living experience, since the cancer undoes the immortality illusion, launching the psychologist to his/her condition of being to the death and with that, calling him/her the authenticity. Is is only not dealt with to experience the anguish and the death imminence, but above all, re-meaning them in favour of a continual learning, of quality answering , besides other possibilities. Working with child cancer brings news perspectives and world views, making the psychologist a more human people and sensitive to the distracted needs. And we believe that, regardless of area which actuates, being psychologist is a particular way which choose to be citizen. Is is a project that will be delimited by society, history and culture and after all, by us like human being. Therefore, we understand that the results this research suggest the discussed thematic deepening on this intervention field in order to new sense possibilities can arise giving origin to other reflections about the clinical practice, the professional formation in Psychology and other possible developments

O oncologista clínico diante da morte: implicações para a produção do cuidado

It is undeniable that all the extraordinary technological advances in contemporary society have increased the severe patients expectation and quality of life, especially cancer patients. On the other hand, it is easily verifiable by many researches that it was not possible to advance in the same proportion in caring for the human experience of death. Much is said about the anguish of a man facing death, of cancer patients in terminal stage, about their families, and very little about the feelings, anxieties and ways of coping with the medical professional who deals with this situation, specifically the clinical oncologist. Little is known about the experience of the doctor who has learned to take death as an enemy to be defeated, and increasingly is compelled to live at length with his advertisement. However, we started to watch in recent years a growing interest of researchers in this issue. This study seeks to add to this interest in order to understand the experience of clinical oncologists that accompany dying patients, the meanings they attach to death, ways of coping and the implications for providing care. This is a qualitative study in which was used as a tool for data collection an in-depth interview with the projective using script and scenes. Gadameriana Hermeneutics was used for analysis and interpretation of narratives. The subjects were 10 clinical oncologists who work at two institutions from cancer treatments in the state of Rio Grande do Norte, chosen from a variation in the time working in the specialty (minimum of one year, even old ones). However, you can bring some initial results for the dialogue. It was found that the death is still a topic that causes many difficulties in the daily lives of these professionals, the choice for oncology involves dealing with death without preparation in medical education; being close to the patient in the final moment, supporting the family, coping with own pain of loss and the inability to heal. These are central elements of the narratives. We also have investment in medical training and continuing education in setting up a demand that permeates the discourse of participants. Being able to listen to the subjective world of clinical oncologists will support the work not only for them as other professionals who deal with patients with advanced cancer, providing evidence to understand to what extent the meanings attributed to its know-how before patients on the verge of death interfere with the production of care and allow identify coping strategies in everyday life of these professionals that hinder or facilitate coping with death, promote or preclude the care with others and with themselves. It is hoped that research can contribute to the field of knowledge about the know-how in clinical oncology and their terminal-care-death oncologist-patient relationships, bringing runways capable of promoting a better quality of care in the production of all involved in this process: professionals, patients and families

Os agentes funerários e a morte: o cuidado presente diante da vida ausente

The present time is marked by the art of escape from death, which has become synonymous with failure, its exposure has become intolerable and the care of the dead body were assigned to third parties who market this practice through services and products that shape the market undertaker. In this context, in which death is an object of study, has arisen funeral officers, as professionals dealing with a dead body, with the pain of relatives and their reactions, often being the first to have contact with the death scene. As professionals in the health area, the morticians also deal with death. The first attempt to prevent the arrival of death, funeral officers already has begun their work routine from there. Death and its surrounding part of their profession. What about those professionals whose work demands as a feared and denied by society? This study aims to understand the intents, meanings and implications for the mortician to deal with death in their daily work in order to focus renewed attention to the care of these professionals. To this end, it was carried out a qualitative research grounded in the theoretical framework of Gadamerian hermeneutics for production and interpretation of narratives. It was used two methodological strategies for data collection: in-depth interview with script and workshop with the use of "scenes". Research participants were nine morticians funeral of two funeral agencies of the city of Natal. It was possible to detect the presence of the social imaginary of interdiction on the theme of death from living with feelings of his presence daily, from the need of respondents to naturalize their contacts with death, a requirement of their office to deal with the difficulties of manipulating body fluids and odors, sometimes in a state of decomposition; allied to wishes to achieve the goal of delivering to family-customers a "embellished" body for the final farewell. Being a mortician, in addition to not being a professional motivation, involves facing difficulties related to heavy routine work, low salaries, unprofitable work materials and equipments, besides having to deal with the social gaze that devalues the profession. In turn, they also deal with the pain coming especially from contact with family members, either when they are targets of these feelings of anger, whether they identify with the pain of the bereaved ones. On the other hand, when the recognition and gratitude of the families occur, they find meaning and beauty in their profession of caring for the dead body. The present study by giving voice to morticians has become possible to understand better their profession, the pain that surrounds and care needs of these workers. Finally, it has argued that the mortician may be recognized as a care professional for the way exercising caution with the dead body and their families.

As fontes de desgaste físico e emocional e a Síndrome de Burnout no setor de transporte coletivo urbano de Natal

Recognizing the importance the workplace has on mental health of the individual, the objective of this study was to investigate the relationship between the burnout syndrome and the sources of physical and emotional wear which permeate the work conditions of the urban public transport system of the city of Natal. Although existent in international literature, research on burnout in the professional transport category and studies directed to this category are not a tradition in Brazil. The research was carried out using 412 drivers and money-changers of two transport companies of Natal. To collect the data, two questionnaires and a semi-structured interview were used. The first instrument, developed and validated during the research, investigated the sources of wear and the second, the syndrome of burnout. As its main results, two sources of empirical wear were identified as follows: (1) the Conflict of Values and the Lack of Justice at the Workplace, (2) Union and Reward. Besides these, it was observed that there is an incidence of the syndrome of burnout among the drivers and money-changers of urban transport by bus, not only in the caring occupations studied before in Natal and Brazil and that this incidence is related to the sources of wear which permeate the work conditions of these professionals

O psicólogo e os serviços de acolhimento institucional para crianças e adolescentes

The Shelters are responsible for caring for children and adolescents whose families or guardians are temporarily unable to fulfill his role as care and protection. The activities to be developed by psychologists in these services are greatly important for the elaboration and development of political- pedagogical project of the same, and for reasons pertaining to the present and future of children and adolescents received judgments. The psychologist puts up the challenge of contributing to a better care of children, also cooperating with the implementation of the new care standards of childcare. The aim of this study was to investigate the role of the professional psychologist in assistance to children and adolescents in 13 Shelters in the Metropolitan Region of Natal/RN. For both set out to make visits to the institutions to know how it is organized the field work of the psychologist, his routine work and activities developed. Nine psychologists interviewed according to a semi-structured interview script. The data analysis is supported by the theoretical aspects of dialectical materialism historical and theme content analysis was used. Results were presented from three angles: psychologists and institutional framework; activities, resources and methods of work; psychologists and legal frameworks of the Institutional Hospitality. The study points out the recent entry of the psychologist in Shelters, combined with considerable turnover of these professionals. This work has been organized through the Individualized Service Plan, prioritizing the return to family of origin. Moreover, in general, perform joints with the service network, reporting, individual consultations and follow-adoption processes . Staff members, however, feel a lack of specific and continuing training on special protection, including due to the distance between the proposed theory and practice. It was thus observed a movement of psychologists distance themselves from welfare or repressive practices, however the structural difficulties of services and lack of continuing education appear to limit the development of a performance focused on the transformation of the reality of children and adolescents treated and their families

O Serviço Residencial Terapêutico: cartografias de um híbrido no contexto da desinstitucionalização em saúde mental

This thesis seeks to uphold the idea that the therapeutic residential service, as hybrid device and recent process of deinstitutionalization in mental health, works as a problem producer while it also indicates challenges and potentialities in this process, the attention on mental health and on its own care production. To that end, we work with the prospect map with which we approach reality as the subjectivities production field which transformations and intensities are the major thought propellants. From this perspective, it was possible to produce three "purpose maps" from meetings with actors and groups involved with the TRS and the theoretical study carried out. On the first map we mapped the conditions of possibility of this device and its design in the midst of the process of institutionalization and health policies. We indicate on it the TRS configuration as a hybrid and we hassled its proposition as a means of "social rehabilitation" that can work as a social homogeneity mechanism. On a second map, we cartographied mental captures through images and ways historically built from madness presented in the biopolitical contemporary game and we indicated that the resistance to such catches should be built on a politic daily basis as important vectors of the institutionalization process in mental health. Finally, on a third map we mapped the carefulness produced in the TRS, by analyzing the transition psychiatric hospital - TRS and the caregivers´ team work. On this mapping, the care, for the weakness in the coresponsibility field, is reveled crossed by mental, disciplinary and normality elements, but it is also built in resistance born from links in the intersubjective field of the caring work. We conclude, then, that the TRS power and the deinstitutionalization process itself were in building and strengthening affective labor micro political networks of life and liberty producers

Tratamento do Centro de Atenção Psicossocial para usuários de álcool e outras drogas CAPSad II Leste Natal/RN : uma avaliação da efetividade

The treatment for abusive users of alcohol and other drugs suffered significant modifications until arriving to the psychosocial model that is used by Centro de Atenção Psicossocial CAPSad II Eastern Natal/RN (Psychosocial Support Center). That model appears starting from Brazilian sanitary and psychiatric reforms which are expressed in the principles and propositions of Sistema Único de Saúde SUS (Unique System of Health). The Psychiatric Reform meant a rupture with the mental hospital and hospital centered treatment pattern which was destined to the abusive users of alcohol and other drugs. The new proposal offers the universalization, democratization, regionalization and completeness of the actions in the field of mental health. It gathers a strictly interdisciplinary health staff. The purpose of this study is to evaluate the effectiveness of the treatment for abusive users of alcohol and other drugs offered by CAPSad II Eastern Natal/RN. The evaluation used, as priority, the qualitative social research through an evaluating study starting from the non-experimental model. The methodological process used different instruments of data collection: bibliographical and documental researches, systematic observations at CAPSad II Eastern Natal/RN and, mainly, the semistructured interviews (21) that were accomplished with the professionals, users and relatives of CAPSad II Eastern Natal/RN. The investigation showed the effectiveness of the service and, therefore, CAPSad II Eastern Natal/RN constitute itself as the main confronting strategy to the mental hospital and hospital centered treatment pattern of caring the abusive users of alcohol and other drugs