Fernanda Carneiro Mussi

Refletindo sobre pressupostos para o cuidar/cuidado na educação em saúde da pessoa hipertensa

Hypertension has high prevalence and mortality. Preventing and controlling this disease poses a challenge, which implies in considering the educational process as a necessary tool for care. The study had the purpose to reflect on the assumptions for care in the healthcare education of hypertensive people. It was observed that the assumptions for caring, in the process of healthcare education, are based on considering the person instead of the sick body, and in comprehending caring while being capable of investing in the clinic of the individual, favoring spaces for sensitive listening and welcoming, comprehension of suffering, the meaning of falling ill and caring for the self. We expect this reflection to contribute for the implementation and enhancement of new forms of caring in the programs of hypertension, comprehending the human being as someone destined to have freedom, happiness and full satisfaction.Hypertension has high prevalence and mortality. Preventing and controlling this disease poses a challenge, which implies in considering the educational process as a necessary tool for care. The study had the purpose to reflect on the assumptions for care in the healthcare education of hypertensive people. It was observed that the assumptions for caring, in the process of healthcare education, are based on considering the person instead of the sick body, and in comprehending caring while being capable of investing in the clinic of the individual, favoring spaces for sensitive listening and welcoming, comprehension of suffering, the meaning of falling ill and caring for the self. We expect this reflection to contribute for the implementation and enhancement of new forms of caring in the programs of hypertension, comprehending the human being as someone destined to have freedom, happiness and full satisfaction.

Entraves no acesso à atenção médica: vivências de pessoas com infarto agudo do miocárdio

OBJETIVO: Analisar o caminho percorrido por homens e mulheres que sofreram infarto agudo do miocardio ate conseguirem atencao medica. Conhecer essa trajetoria pode permitir a tomada de decisoes que resultem em atendimento precoce e eficiente nos primeiros minutos apos o inicio dos sintomas, reduzindo a morbi-mortalidade. METODOS: Foram entrevistadas 43 mulheres e 54 homens que sofreram infarto com dor. Os dados foram submetidos a analise de conteudo e inferencia estatistica. RESULTADOS:A mediana de idade para os homens foi 55,3 e para as mulheres 61,5 anos. Predominou para os sexos a baixa escolaridade, inatividade profissional e ocorrencia do infarto no domicilio. Os homens tinham renda familiar maior (p=0,005) e viviam mais em companhia de alguem (p=0,001). Somente 7% das mulheres utilizaram ambulância. Dois tercos da amostra procuraram o hospital como primeiro local de atendimento, mas apenas 33% conseguiram internacao. Assim, 67% dos sujeitos perambularam por ate cinco servicos ate conseguirem a hospitalizacao. As principais razoes para nao admissao hospitalar foram falta de recursos, negacao de atendimento e encaminhamento medico para casa. O local procurado para atendimento, numero de atendimentos recebidos ate a hospitalizacao e a acao medica nao foram associados ao sexo (p=NS). CONCLUSAO: Homens e mulheres optaram por meios de transporte e locais de atendimento inadequados e o sistema de saude nao parece preparado para atende-los. Estes achados convidam a reflexao sobre a importância e os alvos dos programas da educacao para saude e a qualidade da assistencia ao infarto.

O infarto e a ruptura com o cotidiano: possível atuação da enfermagem na prevenção

Este articulo presenta una propuesta de actuacion de la enfermera en la prevencion del infarto agudo de miocardio (IAM), con base en una investigacion desarrollada para una tesis de doctorado, con el objetivo de conocer la experiencia de conforto en la perspectiva de pacientes, acudiendo al Interaccionismo Simbolico y a la metodologia de la Teoria Fundamentada en los datos. En dos hospitales paulistas, fueron realizadas 13 entrevistas con individuos del sexo masculino que sufrieron IAM. Fue posible captar las situaciones definidas por ellos como de conforto o de desconforto. Este texto enfoca la primera fase de la experiencia vivenciada por hombres infartados, donde el principal desconforto es la ruptura con el cotidiano provocada por el aparecimiento de sintomas o por la irrupcion del infarto, examinando las posibilidades de intervencion de la enfermera en la prevencion primaria y secundaria.This proposal for Nursing action to prevent acute myocardial infarction (AMI) draws on a doctoral thesis research carried out to investigate the experience of comfort and discomfort in the patients perspective, by means of the Symbolic Interactionism approach and the Grounded Theory methodology. Data collected by means of interviews with 13 men who had suffered AMI, at two hospitals in São Paulo, Brazil, allowed us to point out what they define as comfortable or uncomfortable. This article focuses on the first phase of these mens experience, when the main discomfort is the break with everyday life, brought about by the onset of symptoms or by the stroke itself, and discusses possibilities for Nursing action in primary and secondary AMI prevention.Este artigo apresenta uma proposta de atuacao da Enfermagem na prevencao do infarto agudo do miocardio (IAM), com base em pesquisa desenvolvida para tese de doutorado que investigou a experiencia de conforto na perspectiva de pacientes, recorrendo ao Interacionismo Simbolico e a metodologia da Teoria Fundamentada nos Dados. Entrevistas com 13 homens que sofreram IAM, realizadas em dois hospitais paulistas, permitiram captar as situacoes por eles definidas como de conforto ou desconforto. Este texto focaliza a primeira fase da experiencia vivenciada por homens infartados, na qual o principal desconforto e a ruptura com o cotidiano, provocada pelo aparecimento de sintomas ou pela irrupcao do infarto, examinando as possibilidades de intervencao da enfermagem na prevencao primaria e secundaria.

Conforto na perspectiva de familiares de pessoas internadas em Unidade de Terapia Intensiva

This study aimed at understanding the meaning of comfort to the families of people in intensive care units. It consists of a qualitative study carried out in the intensive care unit of a hospital in Salvador-Bahia. Fourteen family members were interviewed. The authors utilized the theoretical principles of symbolic interactionism and the technique of qualitative data analysis. Results indicated that the categories Safety, Receptiveness, Information, Proximity, Social and Spiritual Support, Convenience and Integration expressed the meaning of comfort, which was comprised of reliability in terms of technical-scientific competence and a supportive and sensitive attitude of the team, chance of recovery, access to information and the opportunity to be close to the patient, support of people in their social life, spiritual sources and the environmental structure of the hospital, preservation of self-care and routine activities. It was concluded that the family is important as objects and subjects of the actions in healthcare and must be the focus in public health policies and programs in Brazil. DESCRIPTORS: Family. Health care. Family nursing.

O alivio da dor de pacientes no pós-operatório na perspectiva de Enfermeiros de um centro de terapia intensiva

The objective of the present study was to identify how nurses releave the post-operative patients pain in the Intensive Care Unit of a general hospital, situated in São Paulo city concil. Participated of this study 14 nurses between 20 and 40 years, and 78,6% were females and 42,9% had 1 to 5 years of professional performance. The data were collected through halfestructured recordered interview and qualitativelly analysed, applying the stages proposed by Bardin(1) . Two categories were found : appraisement of pain and conducts to releave pain. The results displayed that the nurses used as the medicinal therapeutics as the complementaries to pain relief an considered the appraisement of this pain as initial conduct to set up a way to comfort, prevention and relief.

A implantação do Projeto de atendimento Móvel de Urgência em Salvador/BA: panorama e desafios

The goal of this study was to describe the implementation of the emergency ambulance service of Salvador, Bahia (SAMU-192). The Ministry of Health provided the legal basis and regulations for its implementation. The main purpose of this service is the provision of free primary level healthcare to individuals, with clinical, surgical, traumatic and psychiatric aggravations that cause suffering, sequels or death and occur outside the hospital environment. The specific goals of SAMU-192 was to grant free healthcare to urgency and emergency situations, under the hierarchy and regulations of the Single Health System (SUS) of the Brazilian government, assuring that public resources will be available and integrated to the complementary healthcare network. Investments for the installation of the service were agreed on in the city and with federal and state management commissions. To turn SAMU-192 into reality, several challenges need to be accomplished, including community education, professional qualification and evaluation of human and material resources so as to provide basic emergency care with the appropriate quality.O estudo objetivou relatar a experiencia na implantacao e estruturacao do projeto do Servico Movel de Urgencia (SAMU-192), em Salvador, cujas bases legais foram portarias do Ministerio da Saude e a Norma Operacional de Assistencia a Saude 02/2002. O servico tem como finalidade prestar assistencia gratuita ao individuo, em um primeiro nivel de atencao, com agravos de natureza clinica, cirurgica, traumatica e psiquiatrica que acarretam sofrimento, sequelas ou morte e ocorrem fora do ambiente hospitalar. O objetivo especifico foi garantir o atendimento as situacoes de urgencia e emergencia por meio do SAMU-192, regulado, hierarquizado e integrado ao Sistema Unico de Saude, assegurando recursos publicos inclusive integrados a rede complementar de assistencia. Despesas para sua instalacao foram pactuadas no municipio e em comissoes intergestoras federal e estadual. Os desafios do servico incluem educacao comunitaria, capacitacao profissional, avaliacao de recursos humanos e materiais, na dinâmica e qualidade da atencao.

Conforto: revisão de literatura

A autora apresenta uma revisao de literatura sobre o tema conforto. Retrata analiticamente a concepcao, as definicoes encontradas e os estudos que focaram o conforto sob a perspectiva dos sujeitos. Destaca algumas lacunas existentes nesta area do conhecimento e sugere aspectos importantes a serem considerados no desenvolvimento de pesquisas.

Reflecting about assumptions for care in the healthcare education for hypertensive people

Hypertension has high prevalence and mortality. Preventing and controlling this disease poses a challenge, which implies in considering the educational process as a necessary tool for care. The study had the purpose to reflect on the assumptions for care in the healthcare education of hypertensive people. It was observed that the assumptions for caring, in the process of healthcare education, are based on considering the person instead of the sick body, and in comprehending caring while being capable of investing in the clinic of the individual, favoring spaces for sensitive listening and welcoming, comprehension of suffering, the meaning of falling ill and caring for the self. We expect this reflection to contribute for the implementation and enhancement of new forms of caring in the programs of hypertension, comprehending the human being as someone destined to have freedom, happiness and full satisfaction.Hypertension has high prevalence and mortality. Preventing and controlling this disease poses a challenge, which implies in considering the educational process as a necessary tool for care. The study had the purpose to reflect on the assumptions for care in the healthcare education of hypertensive people. It was observed that the assumptions for caring, in the process of healthcare education, are based on considering the person instead of the sick body, and in comprehending caring while being capable of investing in the clinic of the individual, favoring spaces for sensitive listening and welcoming, comprehension of suffering, the meaning of falling ill and caring for the self. We expect this reflection to contribute for the implementation and enhancement of new forms of caring in the programs of hypertension, comprehending the human being as someone destined to have freedom, happiness and full satisfaction.

Conforto e lógica hospitalar: análise a partir da evolução histórica do conceito conforto na enfermagem

Analysis of nursing literature from the beginning of the nursing practice until now shows that comfort is viewed as the aim of nursing care and that it is also regarded as a critical concept in the history of nursing. Therefore, this study was undertaken in order to analyse the theoretical concepts of comfort during the nursing history as well as its defining factors in an attempt to clarify the meaning of comfort as a theoretical concept and its impact in nowadays practice and teaching of nursing.

Os significados da palavra conforto segundo a perspectiva do paciente com infarto agudo do miocárdio

This investigation included 25 male adult patients with Acute Myocardial Infarction admitted in a Coronary Disease Unit located in the Municipality of Sao Paulo, Brazil. It aimed at identifying the meaning those patients give to the word comfort. Data collection was carried using a specific form and manually processed; answers to open questions were treated using the BARDINs content analysis method and the results were basically analysed in absolute numbers and percentages and organized in tables and figures. Comfort was expressed by several ways, from material and financial conditions, enjoyment of personal interactions, sense of physical, psychological, and spiritual well-being to normal functioning which means recovery expectations, disease-freedom and capacity to perform usual activities. Material and financial conditions (29,4%) and personal interactions (21,6%) were emphasized. In addition to the conclusions directly related to the objective, the results showed that: (a) viewing the multidimensional aspects related to comfort, it should not be exclusively considered as dependent of nursing care; (b) various indicators identified suggested that the same meaning for comfort was expressed or described in most varied ways.O estudo objetivou identificar o significado da palavra conforto conferido por pacientes com infarto agudo do miocardio, do sexo masculino, internados numa Unidade Coronariana do municipio de Sao Paulo. A coleta de dados foi realizada por meio de formulario especifico. As respostas as questoes abertas foram tratadas utilizando-se o metodo de analise de conteudo de BARDIN, e os resultados basicamente analisados sob a forma de numeros absolutos percentuais. O conforto enquanto significado foi expressado com varios sentidos, relacionando-se com as condicoes materiais ou financeiras (29,4%), o desfrutar das interacoes pessoais (21,6%), as sensacoes de bem-estar psicologico (13,7%), fisico (11,8%) e espiritual (9,8%), o funcionar normalmente (13,7%), isto e, Ter expectativas de recuperacao, estar livre de doencas e poder desempenhar as atividades habituais. UNITERMOS: conforto, assistencia de enfermagem