Helena Eri Shimizu

Acidentes de trabalho com trabalhadores de enfermagem

O objetivo deste estudo foi o de identificar e analisar acidentes e as cargas de trabalho a que estao expostos os trabalhadores de enfermagem no desenvolvimento de suas atividades. Trata-se de um estudo de caso, do tipo descritivo e exploratorio, desenvolvido em um hospital de ensino do Distrito Federal. Foi realizado levantamento dos acidentes de trabalho registrados no SESMT e CCIH no periodo de janeiro de 1998 a dezembro de 2002 e identificadas essas cargas de trabalho. Constatou-se que os trabalhadores sofreram 76 acidentes de trabalho, dentre quais, 83,95% foram causados por materiais perfurocortantes, 8,64% por quedas, 6,17% por exposicoes a fluidos biologicos e 1,24% por contusoes. A diversidade e simultaneidade de cargas de trabalho contribuiram para a ocorrencia desses acidentes.The objective of this study was to identify and analyze work accidents as well the activities in which the nursing workers are exposed to. This is a study case, descriptive and exploratory, developed in a University Hospital in the Brazilian Federal District. It was done a survey on work accidents registered in SESMT and CCIH, from January 1998 to December 2002 and is was also identified work activities related to these accidents. We could noticed that the workers suffered 76 accidents. From those accidents 83.95% happened due to sharpened materials; 8.64% due to falls; 6.17% due to exposition to biological fluids and 1.24% due to injuries. The diversity and simultaneity of the work activities contribute to the occurrence of the work accidents.

O significado da mudança no modo de vida da pessoa com estomia intestinal definitiva

La finalidad del estudio fue identificar y analizar las principales modificaciones que ocurren en el modo de vivir del portador de ostomia intestinal definitiva asi como las principales estrategias desarrolladas para enfrentar la situacion de ser ostomizado. El metodo utilizado fue la historia oral de vida topica conseguida a partir de diez entrevistas semiestructuradas con los portadores de ostomia intestinal definitiva. Se utilizo la tecnica de analisis de contenido, especificamente la tematica. Del analisis emergieron cinco temas: La experiencia de depararse con las senales y sintomas de la enfermedad y necesidad de realizacion de la ostomia; el aprendizaje de la convivencia con la ostomia, el equipo colector y la busqueda de alternativas para suplemento del uso de equipo colector; el enfrentamiento de los cambios en el modo de alimentarse, vestirse y vivir la sexualidad; la busqueda por la reinsercion social, el desafio de enfrentar la muerte y la busqueda de perspectivas futuras; el armado de una red de apoyo social: creencias religiosas y espirituales, la familia y la asociacion de los ostomizados.The research aims to identify and analyze the main modifications that affect the way of life of an ostomate, and strategies developed to face the situation of having an ostomy. The method used was oral history of topic life. Ten semi-structured interviews were conducted with permanent ostomates. For data analysis, the method used was thematic content analysis. Five themes emerged from the analysis of the interviews: the experience of signs and symptoms and the need for an ostomy; learning to live with an ostomy, the pouching system, and the search for alternatives to replace the usage of the pouching system; facing the changes caused by an ostomy in terms of feeding, clothing and sex life; the search for social reintegration, the challenge of facing death, and the search for future perspectives; the search for a social support network: religious and spiritual beliefs, family and the ostomates association.

As dimensões do cuidado pré-natal na consulta de enfermagem

This study aimed at analyzing the social representation of pregnant women about pregnancy, regarding care provided in nursing consultations during the prenatal period. A qualitative study conducted by semi-structured interviews, with fifteen pregnant women at the nursing consultations of the prenatal program regarding the care provided, analyzed by the ALCEST software. Three thematic axes were identified: the experience of pregnancy, constituted by the classes: the impact and the changes due to pregnancy; the orientations provided about pregnancy, with the classes: perception of the nursing consultation and family planning; and the approaches baby care, with the classes: how to take care of the new-born and how to assure good breastfeeding. A nursing consultation covers different dimensions psychosocial to pregnancy and to the newborn.

Como os trabalhadores de enfermagem enfrentam o processo de morrer

Este estudio tuvo como objetivos identificar y analizar las representaciones y sentimientos vividos y los mecanismos de defensa y estrategias desarrollados por los trabajadores de enfermeria en el proceso de enfrentar la muerte de pacientes. Se trata de um estudio cualitativo que utiliza la Teoria de las Representaciones Sociales. Fueron realizadas entrevistas semiestructuradas con cuatro tecnicos y doce auxiliares de enfermeria que trabajan en Centros de Cuidados Intensivos. La tecnica utilizada para el analisis de datos fue la de analisis de contenido, exactamente el analisis tematico. Los resultados muestran que los trabajadores de enfermeria sufren terriblemente al cuidar de los pacientes que estan en proceso de morir. Para enfrentar el sufrimiento cotidiano utilizan diversas estrategias y mecanismos de defensa, tanto individuales como colectivos, tales como la negacion, la creacion de nuevas rutinas, el alejamiento.

A relevância da Rede de Apoio ao estomizado

The purpose of the study was to learn about the social support stomized patients turn to, as well as their benefits in facing the changes a new way of life incur in. The methodological reference was oral history of topic lives. Ten half-structured interviews have been conducted with subjects with definitive intestinal ostomy It was used the technique of content analysis, which provided us with three important supporting networks: religious and spiritual beliefs, family and the Ostomy Association. Those networks worked as pillars that minimized the suffering of stomized patients. Health care professionals must value those supporting networks so as to enhance the lives of stomized patients.O estudo teve como objetivo conhecer o apoio social utilizado pelas pessoas estomizadas, bem como os seus beneficios para o enfrentamento das mudancas ocorridas no novo modo de vida. O referencial metodologico foi a historia oral de vida topica. Foram realizadas dez entrevistas semi-estruturadas com portadores de estomia intestinal definitiva. Utilizou-se a tecnica de analise de conteudo, especificamente, a tematica, de onde emergiram tres importantes redes de apoio, as crencas religiosas e espirituais, a familia e a Associacao dos Ostomizados. Essas redes funcionam como suportes para minimizar o sofrimento das pessoas estomizadas. Os profissionais de saude devem valorizar essas redes de apoio a fim de trabalhar a melhoria da qualidade de vida dos estomizados.

O processo de trabalho na Estratégia Saúde da Família e suas repercussões no processo saúde-doença

This study analyzes the perceptions that health workers engaged in the Family Heath Strategy (FHS) of the Federal District (FD) have of their own work process and its repercussions on the health-illness process. It is a cross-sectional descriptive survey carried out with a sample of 243 FHS/FD workers: 139 community health agents, 47 nursing assistants, 41 nurses, and 11 doctors. Four previously validated scales were used (Evaluation of Work Context, Human Cost at Work, Pain and Pleasure, Work Inventory and Risk of illness). The results revealed a highly Taylorised type of work process management typified by a sharp work distinction between formulators and performers, highly repetitive work tasks, performance supervision and very weak formal communication between the various hierarchical levels. These factors have seriously impaired the re-regulation of the work process by confronting current objective and subjective realities with pre-existing norms. In conclusion, the Taylorised work processes, the precarious working conditions and the specific difficulties associated with providing care to families and communities in their own territories are highly stressful and debilitating and underscore the need for improved management of the respective work processes.

As representações dos técnicos e auxiliares de enfermagem acerca do trabalho em equipe na Unidade de Terapia Intensiva

Este estudo tem por objetivos explicitar e analisar as representacoes dos tecnicos e auxiliares de enfermagem acerca do trabalho em equipe em UTI. Foi utilizada a abordagem qualitativa e, como referencial teorico metodologico, a Teoria das Representacoes Sociais. O material empirico constou de entrevistas com quatro tecnicos e doze auxiliares de enfermagem que atuam nas UTIs de Clinica Medica, Cirurgica e Pediatrica. Na analise dos dados, foi utilizada a tecnica de analise de conteudo, na modalidade de analise tematica. Os resultados evidenciaram que os trabalhadores de enfermagem mantem interacao conflituosa, indicando a necessidade de adocao de modelos de gerenciamento de pessoal mais eficientes que contemplem a gestao de conflitos entre as equipes de enfermagem.This study aims to explain and analyze the representations of nursing auxiliaries and technicians about team work at an intensive-care unit. The qualitative approach was used and the Theory of Social Representations was adopted as a theoretical-methodological reference framework. The empirical material was obtained from interviews with four technicians and twelve nursing auxiliaries working at the intensive care units of Medical, Surgical and Pediatric Clinics. The information obtained was analyzed by means of the content analysis technique, following the thematic analysis mode. Results indicated conflicting interaction among nursing workers, highlighting the need to implement more efficient staff management models that focus on conflict management actions among different nursing teams.

As práticas desenvolvidas no Programa Saúde da Família contribuem para transformar o modelo de atenção à saúde

El estudio tiene por objetivo identificar y analizar las principales practicas desarrolladas en la atencion primaria. Se trata de un estudio de caso de caracter cualitativo centrado en la Unidad del Programa de la salud de la Familia del municipio de Sebastiao, DF. Los datos se obtuvieron por medio de una entrevista semi-estructurada con los trabajadores de un equipo basico, asi como atraves de la observacion del proceso de trabajo. El estudio concluye que, si bien se desarrollan diversas practicas, otras practicas orientadas hacia la promocion en la salud se hacen necesarias para el alcance del modelo de atencion.This study aimed to identify and analyze the main primary health care practices developed in the Family Health Care Program. Qualitative case study was carried out in the region of São Sebastião, DF. Data were collected through semi-structured interviews with team workers and observation of the work process. The author concluded that diverse basic practices are developed in primary health care, but others practices focused in health care promotion are necessary in order to transform the health care model.

Atividades desenvolvidas pelos enfermeiros nas unidades de internação de um hospital-escola

The purpose of this study was to identify and analyze tasks performed by nurses at inpatient units in a large general hospital in Brasilia, Federal District, which also functions as a training hospital. A quantitative, exploratory, descriptive study was carried out and involved a total of 612 hours of direct observation of the activities performed by 18 nurses at the General Medicine, Surgical, Pediatric and Maternity units. The tasks observed were classified as: administration, nursing care delivery, education and related to information system. Nurses dedicate a large part of their time to administrative tasks, followed by tasks related to nursing care delivery and information system, performing almost no educative tasks.The purpose of this study was to identify and analyze tasks performed by nurses at inpatient units in a large general hospital in Brasilia, Federal District, which also functions as a training hospital. A quantitative, exploratory, descriptive study was carried out and involved a total of 612 hours of direct observation of the activities performed by 18 nurses at the General Medicine, Surgical, Pediatric and Maternity units. The tasks observed were classified as: administration, nursing care delivery, education and related to information system. Nurses dedicate a large part of their time to administrative tasks, followed by tasks related to nursing care delivery and information system, performing almost no educative tasks.

A gestão do SUS e as práticas de monitoramento e avaliação: possibilidades e desafios para a construção de uma agenda estratégica

This paper deals with the challenges involved in institutionalizing Monitoring and Evaluation practices within the scope of management of the Brazilian Unified Health System (SUS), based on the creation of a strategic agenda. This is structured around actions by the Federal Administration, from the perspective of defining the scope of the federative relationship. A summarized literature review is thus presented, placing into context the current SUS management process, which is based on the Pact for Health as well as theoretical and operational aspects inherent to monitoring and evaluation practices. The approach related to the strategic agenda highlights the creation of mechanisms that underpin the political and institutional decision, namely the creation of financial incentives and the development of technical mechanisms. These include organizational strategies for qualifying management teams and conducting studies and research and the dissemination of strategic information. These processes are based on the concept of providing for the management specificities in the different spheres of management based on a broad cooperation process involving teaching and research institutions and international organizations as well as the managers themselves.