Dimensões da satisfação do paciente geriátrico com a assistência fisioterapêutica

Introdução: Os idosos constituem os maiores consumidores dos serviços de saúde, especialmente os de reabilitação, tornando imprescindível a avaliação da qualidade da assistência fisioterapêutica prestada. A satisfação do paciente tem sido considerada uma das melhores e mais eficazes formas de avaliar o cuidado e direcionar o provedor do serviço para suprir as necessidades e expectativas do paciente-cliente. O objetivo deste estudo foi investigar os principais aspectos (preditores) que contribuem para a satisfação do paciente geriátrico com o tratamento fisioterapêutico ambulatorial. Métodos: Trata-se de um estudo com enfoque epidemiológico, transversal e descritivo de cunho exploratório. Foi utilizado o instrumento de avaliação da satisfação do paciente com a fisioterapia, desenvolvido e validado para a população brasileira por Mendonça em 2007, com uma escala de satisfação do paciente composta por 23 itens. Os dados foram coletados na sala de espera de 29 clínicas de Fisioterapia da rede privada da capital do RN/Brasil e a amostra selecionada de forma não-probabilística constou de 221 pacientes com idade superior a 60 anos, que realizaram entre 5 e 60 sessões de fisioterapia onde os dados foram coletados, deveriam ser usuários de plano de saúde e ter condições cognitivas preservadas. Resultados: A análise fatorial indicou a existência de quatro fatores com autovalor maior que 1: interação pacienteterapeuta (7 itens) α = 0,901; acesso e atendimento de recepcionista e pessoal de apoio (8 itens) α = 0,888; ambiente físico e satisfação global (5 itens) α = 0,835; e conveniência (3 itens) α = 0,711. Os itens com maiores escores de satisfação completa foram os contemplados nos aspectos de interação paciente-terapeuta, especialmente o respeito e a gentileza do fisioterapeuta. As associações realizadas através do teste do Qui-quadrado e regressão logística binária entre a satisfação do paciente e as variáveis sócio-demográficas, percepção do estado de saúde e capacidade funcional demonstraram que a satisfação do paciente idoso associa significativamente com o sexo e estado civil. Os achados revelam que as mulheres mostram-se mais satisfeitas com a fisioterapia. Conclusão: Os aspectos interpessoais demonstraram ser preditores relevantes para assistência fisioterapêutica satisfatória, especialmente na população idosa que requer atenção além do suporte puramente técnico

O tratamento ortodôntico em uma perspectiva a longo prazo: avaliação da estabilidade oclusal e do grau de satisfação dos pacientes

This study aimed to evaluate factors associated to orthodontic treatment stability and patient satisfaction in the long-term. A total of 209 patients (88 class I and 121 class II) treated with straight wire fixed appliance were selected at least 5 years post treatment. Six hundred twenty seven dental casts were examined with the PAR Index at pretreatment (T1), end of treatment (T2), and at long-term follow up (T3, mean 8.5 years post treatment). At T3, a Dental Impact on Daily Living questionnaire was used to assess patient satisfaction with the dentition in the long-term. Friedman test and multiple regression analysis were used to evaluate changes among the time points and factors associated with stability and patient satisfaction. Predictive factors used to exam the occlusion were: PAR Index at T1 and T2, age at T1, the amount of time without retainer, length of Hawley retainer wear, length of follow-up, sex, extraction and third molar status. To assess patient satisfaction were considered: changes produced by the orthodontic treatment (PAR T2-T1), post treatment stability (PAR T3), age at the start of treatment (T1), length of treatment (T2-T1), gender, and extraction. Orthodontic treatment produced a significant improvement of 94.2% in the PAR Index (T2-T1), but this change was not associated with the level of satisfaction when the patient was questioned at T3. No significant change was observed between T2 and T3. However, when the sample was divided according to the level of finalization (PAR T2), it was observed that well-finished patients experienced some deterioration (P<.001), whereas the less well-finished ones showed some improvement (P<.05). Even with the deterioration, the well-finished patients still had a better PAR Index at T3 compared to the less well-finished ones (PAR T2- T3). Regression analysis showed that PAR Index at T1 and T2, age at T1, and length of retainer wear had a slight association with occlusal stability (R2 = 0.27). Patient satisfaction was significantly associated only with PAR Index at T3 (r2=0.125, P<.0001). We can conclude that, even thought orthodontic treatment is quite stable, not so well-finished treatments tend to show some improvement and well-finished ones deteriorate some in the long-term. Despite of that, well-finished patients still have better occlusal characteristics. Patient satisfaction is not related to the result of orthodontic treatment; nevertheless, there is a slight association with dentition in the long-term

Avaliação do conhecimento e de habilidades clínicas em saúde sexual e reprodutiva na graduação de medicina

No Brasil, a despeito das conquistas obtidas a partir da implantação do Sistema Único de Saúde e dos avanços legais e institucionais na atenção a diversos problemas relacionados ao gênero, a incorporação de temas relacionados aos direitos humanos, sexuais e reprodutivos no contexto da formação profissional em saúde permanece deficiente. Este trabalho teve como objetivos avaliar a inserção da temática saúde sexual e reprodutiva no currículo do curso de graduação em Medicina, por meio do emprego de avaliações de conteúdo cognitivo, procedimental e atitudinal. Trata-se de estudo de intervenção educacional envolvendo alunos do internato do curso de Medicina da UFRN. Foram utilizados os seguintes métodos avaliativos: prova escrita, exame clínico objetivo estruturado (OSCE) e Mini-CEX. Como variáveis explicativas foram consideradas o sexo, idade e participação prévia no componente curricular optativo Saúde Reprodutiva . A avaliação do processo constou da aplicação de questionários de satisfação e entrevistas acerca dos métodos avaliativos utilizados. Considerando os três métodos avaliativos empregados, 183 estudantes participaram do estudo, com média de idade de 24,5 ± 2,2 anos, sendo 52,5% do sexo masculino e 47,5% do sexo feminino. No contexto geral, observamos concordância entre os desempenhos dos estudantes nas avaliações de conteúdo cognitivo, procedimental e atitudinal. A participação dos estudantes no componente curricular eletivo Saúde Reprodutiva mostrou-se associada com melhor desempenho em algumas dimensões da avaliação cognitiva e na avaliação com o Mini-CEX, em relação às competências de anamnese, profissionalismo e qualidades humanísticas, relação médico paciente e desempenho global. A análise da fidedignidade entre os avaliadores na avaliação com o método OSCE mostrou-se adequada (alfa de Cronbach superior a 70%) em relação ao desempenho global e aos aspectos técnicos das competências avaliadas, observando-se baixa confiabilidade na avaliação da comunicação médico-paciente. O presente trabalho constitui-se numa experiência educacional inovadora e pioneira no âmbito da educação médica brasileira no que tange à inserção da temática de saúde sexual e reprodutiva na graduação, sugerindo-se um impacto positivo da iniciativa na formação do médico generalista na UFRN. A avaliação de conhecimentos, habilidades e atitudes em saúde sexual e reprodutiva na graduação de Medicina mostrou-se factível, com alta concordância entre os diferentes métodos empregados. Os métodos OSCE e Mini-CEX podem ser aplicados ao contexto da saúde sexual e reprodutiva, possibilitando a avaliação de competências clínicas relevantes para a formação do médico generalista e que habitualmente não são contempladas nas avaliações rotineiramente realizadas na graduação

Diferenças de gênero na produção de associações livres de palavras através do ciclo sono-vigília

Although several studies, have shown differences in cognitive performance between men and women, it not yet known whether these differences occur in tasks involving free association of words (WA). Studies across the sleep-wake cycle (SWC) suggest that rapid eye movement sleep (REM) favors semantic flexibility, in comparison with pre-sleep waking (Pre-WK), slow-wave sleep (SWS) and post-sleep waking (Post-WK). The present work has two aims: (1) to evaluate the semantic distances of word pairs produced by AP, comparing men and women, (2) to evaluate semantic distance in word pairs produced by free association across the SWC in young adults of both sexes. To achieve aim (1), we applied a task of WA in 68 adult volunteers during waking (52 women and 16 men). The WA task consisted of writing the first word that came to mind after viewing another word offered as a stimulus (root Word). To achieve aim (2), we performed polysomnography to identify specific stages of the SWC. The experimental subjects were then awakened (if they were asleep) and were immediately given a WA task. The task was administered to 2 groups of 10 subjects each (G1 and G2). G1 subjects were stimulated with the same set of root words after waking from various states of SWC, while G2 subjects received sets of different root words at each state of the SWC. In the absence of a Portuguese corpus suitable for the measurement of semantic distances, the words collected in our experiments were translated to English, and semantically quantified within a systematic and representative corpus of that language (Wordnet). This procedure removed the polysemies typical of Portuguese, but preserved the semantic macrostructure common to both languages. During waking, we found that semantic distances are significantly lower in WA produced by women, in comparison with the distances observed in men. Through the SWC, there were no statistically significant differences in G1. In G2 women, we detected a significant increase of semantic distances upon being awakened from SWS. In contrast, G2 men showed a significant increase in semantic distances upon being awakened from REM. The results of the first experiment are consistent with the notion that women have a more concrete reasoning than men. The results of the second experiment indicate that men awakened from REM present more flexibility in word association than when being awakened from other states. In contrast, women showed more flexible word association after being awakened from SWS, in compared with other states. The results indicate that the cognitive flexibility attributed to different states of the SWC shows gender dependency

Satisfação do paciente com a fisioterapia :tradução, adequação cultura e validação de um instrumento de medida

The measurement of patient satisfaction can provide information about the success of the care provider in reaching the values and meeting the expectations of the patient. The purpose of this study was to translate into the Portuguese language and to culturally customize to the Brazilian population the instrument to measure patient satisfaction with physical therapy elaborated by Goldstein et al. The study sample was made up of 279 patients who were undergoing physical therapy treatment at 39 different private clinics in a middle-sized town in northeastern Brazil. For the translation of the survey instrument, the back-translation technique was employed, in association with the bilingual method. The reliability and validity of the Brazilian version of the instrument were both assessed. Reliability analysis, carried out with the computation of Cronbach alpha coefficients, showed that the measures obtained with the instrument have a high degree of internal consistency. The aspects dealing with the patient therapist relationship are the most important predictors of satisfaction, followed by those dealing with courtesy, privacy, and practical aspects such as efficiency of the facility in the patient admissions process, setting up of appointments, and waiting time in waiting room. Items dealing with aspects such as location of the facility and availability of parking facilities may underestimate the reliability of the instrument. This study translated, culturally customized, and validated an instrument to measure patient satisfaction with physical therapy originally developed in English. By so doing, this study has made this instrument available to the Brazilian society, and it has rendered it a useful parameter that can be utilized in our country in the field of physical therapy

The Beatles: ensaio sobre a ética do amor

The thesis intends to discuss the ethics by the way of love. So, it uses as a mention the musical work and the set of attitudes of the group that changed the way of thinking across the 20th Century mass-comm, entering a new way of thinking about the World: The Beatles. Analyzing the lyrics and the writing of the songs was searched the comprehension of he intrinsic love message at the Ethics it expresses. At the musical art of The Beatles political messages had been announced in a time that the World sought a Ethic way beyond the several declared war and the Cold War. Taking the Edgar Morin works as a base, O método 6, Ética (2005), it sought to understand the idea who permeates the human relations: the good, the possible, the necessary. Another works used as a cognitive base were Meus demônios (2003), Cultura de massas no Século XX: neurose (2005), Cultura de massas no Século XX (2006), The Beatles Anthology (2000) and Many years from now (2000). Holding the Ethics idea showed by Morin were established imaginary lines that perpass the behavior of the group known in the entire World understood till nowadays as tolerance, comprehension, peace, love and endurance messengers. The Beatles operate during the sixties a musical reborn, which allowed to the people the discussion and the reflexion about the World and the human being new behavior,endurance but acting with tolerance. Permeating the basic study, we find the Beatles way, the group origin, the fast walk till success, the spiritual choice, who guide their behavior and the end of the band. The music used as a masscomp instrument passes by the condition of a simple way of communicating. It deeply action feeds feelings, allows transcendence and is showed as target of human being transformation. The Ethics in music passes by the ideological barriers and becomes to comprehension with a clear synthony for the man, cause the polyphony and the new musical order establish the messages worldwide

Banheiros Públicos: Os bastidores das práticas sexuais

This dissertation tries to describe the interactions called pegações in the homosexual milieu that exist in the public bathrooms in UFRN. They used for sexual practices by some of their users. The participating observation made it possible a discription concerning how the interactions occur among the bathrooms users. We researched the flert process that happens around the place, the poses they strike, the approach, until they get to the sexual practice. We also traced their route through the most used bathrooms. We associated the research the messages written on the doors and cabins that are means of contact among the users. So we tried to interpret the meanings of the interactions that exist in the public bathrooms in UFRN

Os trabalhos de amor e outras mandingas: A experiência mágico-religiosa em terreiros de umbanda

The following text addresses the magical-religious experience carried on by many individuals when they seek to solve their love, financial and health problems by means of white magic spells done by pais-de-santo e mães-de-santo (saint s father and saint s mother) from umbanda. The rites through which this seek can be detected are free love spells, troublesolving spells, and healing spell. The concept of experience, here understood as the thing which gives sense to the sense, has been the main guiding idea of the reflections here enclosed. People who seek the umbandista spells as a way of solving their daily afflictions have the opportunity of living a rich magical-religious experience in which several dimensions intersect. Among these dimensions I decided to study the performance, the knowhow and the subjetivity. Each one gave rise to the opportunity of studying a range of other themes, such as the corporeity, the gestuality, vocality, the world knowledge, the science, the secret, the emotions and the moral. The ethnographic research was carried on in the yards which are named after Dona Luiza, Pai Gledson, Pai Salviano and Dona Terezinha umbanda, all of them situated in the town of Limoeiro do Norte, Ceará

O amor em mal-estar : a insustentável leveza da domideologia

The discourse about love, in the Western modern world, is an effect of the power that constructs bodies that matter, paraphrasing Butler, which represents a performative reiterarion of the domination drive, forming and ego of love through the imposition of a cultural super-ego. The domination, a real process of social constraint, is concomitant to its ideological secret, which lead us to the expression domideology , inspired by Sousa Filho, to determine the unconscious domination of the ideological discourse, Through a critical analysis of the bases of Freudian discourse about love, we question, inspired by Foucault, the sexual nature of the drive, to put it in a place insecure of critics to the substance metaphysics expression used by Nietzsche. In our point of view, the domination drive is a critical tool for the individual to think about, as interpellated by the love domideology , making believe the only interpretation of the social interchange is love, nuclear element of our modern Western love complex

O amor em tempos de internet: as expectativas amorosas na rede social Badoo

This research aims to examine the phenomenon of sexual relations by observing the Social Network Badoo. As a means to achieve this objective, qualitative in-depth interviews were conducted online. The main question is to understand how the amorous expectations in the liquid modernity are configured. Added to that, there is as analysis categories the insight about relationships and the love experiences provided by the use of the Social Network Badoo. There are three initial hypotheses: 1) a time of transition is experienced, in which the liquid love in the proposed terms by Bauman (2004) was gaining ground and, as consequence, the relationships would be presenting themselves shorter, more open and with another interactive proposals for the relations. 2) The consuming practices of the liquid modernity can interpellate the relational practices molding them according to your logic. 3) It is assumed that the reasoning, inherent to the market, of the use followed by the disposal settles itself in the social behavior and this practice is accentuated by technology, through the use of the internet for the establishment of romantic relationships.the empirical analysis shows that both the vision on relationships as the amorous expectations in liquid modernity have as references the model of solid loving relationship, inherent to the traditional modernity. However it also demonstrates that the romantic experiences and practices refer to the liquid relationship model. Therefore, from these statements it is argued that there is in liquid modernity the cohabitation of the liquid and solid models of romantic relationships. In summary, this research aims to understand the contemporary love relationships across the spectrum of relationships that develop on the Internet Social Network: Badoo

A educação da mulher em Lima Barreto

Lima Barreto has built an educational conception of women in his fictional productions despite nuances inciting scholars to debate his writings and label him as misogynist and philogynist. Thus, the objective of this study is to comprehend, through signs present in his literary works, how women used to be educated in early twentieth century to accomplish the historical differences in gender relations. The main reason for this extract is the periodicity of his publications that started in 1900 by means of chronicles in newspapers and ended in 1922 after his death. For this, we identified codes and rules forged in the social processes to be assimilated by children through diverse institutions, aiming to incite the production of behaviors and social practices represented by the existence men and women in an ever changing society. Gender relations are analyzed within a society for their configuration concept by Nobert Elias (1970) as interdependence bonds among individuals. An investigative method proposed by Ginzburg (1989) was the most adequate to conduct the research on the work of Lima Barreto because it enables us to reconstruct the education concept for women. The dramas and novels analyzed point out the construction of categories such as women education, family, love and seduction revealing the engagement of Lima Barreto with the social problems of the period investigated. It was concluded that gender differentiation has come from family education which kept men and women in opposing sides giving them a marriage perspective that, after consummated, would bring frustration to women causing them to adopt confronting practices against domination strategies through celibacy or adultery. This research constitutes a reflection based on determined representations like justice, respect and duties that were the ideas defended by Lima Barreto in his writings, concerning both broader situations in social life and particular gender relations

Cecília Meireles e a lírica pedagógica em Criança meu amor (1924)

The research Cecília Meireles and the Pedagogical Lyric in Children My Love (1924) consists in a critical analysis, a cultural and historical approach to the pedagogical intentionalities and to the social and educational functionalities expressed in the childish literary work of the poetess and educator Cecília Meireles (1901-1964), in Brazil, during the first decades of XX century. The author s conceptions of the literary art, the philosophical and educational foundations, the Christian and liberal ideologies and values pertinent to her work for children and the relations between her texts and the ideals of the Brazilian intellectuals to effect changes in the every day life based on the child formation and on the teaching feminization process were examined in the work. This paper shows a content analysis with the intention of offering signification to the work Children My Love (1924) according to the investigation of specific categories: child, motherhood and schooling; through the exploration of synonymous and bipolar key-words found in Cecília s documents: child/adult, teacher/mother; school/home, ignorance/intelligence. The research intends to understand how the author articulates, in her informal pedagogical action in Children s Literature, science, literary and Christian faith knowledge, in order to expand her social and educational ideal concentrated in children, guided by the maternal hand and aimed at constructing a New Man, New Civilization and a New Social Order

As condições de trabalho e a satisfação profissional: dimensões do profissionalismo docente no ensino médio

The dissertation is developed in the Research Base of Teacher Training and Professionalization of Universidade Federal do Rio Grande do Norte as a way to discuss the professionalization of High School teachers in Natal. It is a study linked to the research The context of teaching practice and professionalism: the case of high school teachers and sponsored by CNPq, with the objective of characterizing working conditions and job satisfaction as dimensions to the teacher professionalism in high schools. In this study we prioritized the focus on professionalization in national and international discussions, which combines the aspects of teaching in its historical, social, political and economical path, in order to reflect about its evolutional elements in the hierarchy of professions and establish a relation to high school teaching. To develop this relation we elaborated some questions that are considered relevant, such as: How does the high school teacher evaluate his/her working conditions to his/her professional practice? What level of satisfaction does the high school teacher have regarding his/her professional practice? What expectations does the high school teacher have in relation to his/her professional development? The answers to those questions were according to the high school teachers considerations shown in the questionnaire, which was structured with open and closed questions. These questions gave better adequacy to the teachers evaluations about their working place and the situations they experience in their working conditions, provoking job satisfaction and expectations for professional growth. The description of the teachers perception about working conditions, job satisfaction and expectation of professional development can explain the distinct factors that characterize these categories in the working context, although the conclusive results, in general, do not show a direct relationship between the categories studied. Some factors that teachers attribute as causes of bigger difficulties in working conditions and work activity itself are: working time, salary, professional status, school s infrastructure, and school s social context. These factors are similarly related to the degree of job satisfaction, without showing interference in the professional expectations

A participação das mães no conselho escolar do CMEI Amor de Mãe

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