Izaura Luzia Silvério Freire

Alterações fisiológicas da morte encefálica em potenciais doadores de órgãos e tecidos para transplantes

Resumen El objetivo del estudio fue describir los cambios fisiológicos de la muerte cerebral en los potenciales donadores de órganos y tejidos para trasplante. Investigación exploratoria, descriptiva, con datos prospectivos y enfoque cuantitativo, hecho en las unidades de emergencia y de cuidados intensivos de adultos de un hospital de Pernambuco en el periodo de abril a octubre de 2011. La población fue formada por 32 potenciales donadores de órganos y tejidos para trasplante. Después de la aprobación en el Comité Ético de Investigación, los datos han sido recogidos, tabulados y analizados mediante estadística descriptiva por el programa informático SPSS 15.0, siendo presentados en forma de tablas. Los cambios fisiológicos fueron: hipotensión (100%), hipotermia (75,0%), hipernatremia (62,5%), diabetes insípida (37,5%), infección (25,0%), hipertensión ar terial (9,4%) y la úlcera de córnea (3,1%). Se cree que el conocimiento de estos cambios permite al equipo de atención de la salud dirigir sus acciones al potencial donador de acuerdo a sus necesidades y así mantener los órganos/tejidos viables para el trasplante. Palabras-clave: Enfermería. Obtención de Tejidos y Órganos. Muerte Encefálica. Enfermeira. Especialista em terapia intensiva pelo Hospital da Restauração/Recife. NatalRN. Brasil. Email: sarahgabrielfreire@gmail.com; Enfermeira. Professora Mestre da Escola de Enfermagem da Universidade Federal do Rio Grande do Norte/UFRN. Doutoranda do Programa de Pós-Graduação em Enfermagem/UFRN. Membro do Grupo de Pesquisa Incubadora de Procedimentos de Enfermagem/UFRN. Natal-RN. Brasil. Email: izaurafreire@hotmail.com; Enfermeira. Professora Mestre da Escola de Enfermagem da Universidade Federal do Rio Grande do Norte/UFRN. Membro do Grupo de Pesquisa Saúde e Sociedade da Escola de Enfermagem/UFRN. Natal-RN. Brasil. Email: jujales@hotmail.com; Acadêmica de Enfermagem da Universidade Federal do Rio Grande do Norte/ UFRN. Membro do Grupo de Pesquisa Incubadora de Procedimentos de Enfermagem/UFRN. Natal-RN. Brasil. Email: quinidia@hotmail.com; Enfermeiro. Professor Pós-Doutor do Departamento de Enfermagem e do Programa de Pós-Graduação em Enfermagem da Universidade Federal do Rio Grande do Norte/UFRN. Coordenador do Grupo de Pesquisa Incubadora de Procedimentos de Enfermagem/UFRN. Natal-RN. Brasil. Email: gilsonvtorres@hotmail.com. PESQUISA RESEARCH INVESTIGACIÓN The objective was to describe the physiologic changes of brain death in potential donors of organs and tissues for transplantation. Exploratory descriptive study with prospective data and quantitative approach carried out in emergency and intensive care units hospital adult, in the period from April to October 2011. The population consisted of 32 potential donors of organs and tissues for transplantation. After approval of Ethics Committee, data were collected, tabulated and analyzed by descriptive statistics by SPSS 15.0 software and presented in tables. Physiological changes were: hypotension (100%), hypothermia (75%), hypernatremia (62,5%), diabetes insipidus (37,5%), hyperglycemia (32,3%), infection (25,0%), hypertension (9,4%) and corneal ulcer (3,1%). It was found that knowledge of these changes allows the team of health care to direct the potential donors according to their needs and thus keep the organ/tissue viable for transplant.

Facilitating aspects and barriers in the effectiveness of donation of organs and tissues

This study aims to ascertain the influence of the structure and process on the effectiveness of donation of organs and tissues. It is an evaluative, longitudinal study, with a quantitative approach, undertaken in six hospitals of Natal-RN, with 65 potential donors. The data collection instrument was a structured script of non-participant observation. The data were analyzed using descriptive statistics and the application of the Chi-squared, Fisher, and Mann Whitney tests. The effectiveness of donation was 27.7%. No significant difference occurred between structure and effectiveness of donation, however, inadequacies were observed in the physical resources (36.9%), material resources (30.8%), organizational structure (29.2%), and human resources (18.5%). In the process, the phases of maintenance (p=0.004), diagnosis of brain death (p=0.032), family interview (p≤0.001) and documentation (p=0.001) presented significant differences with effectiveness. The adequacy of the factors related to the structure and process is associated with the effectiveness of the donation. Improvement of these indices depends on the speed with which the process is conducted, in addition to the adequate structure.

FACILITADORES E BARREIRAS NA EFETIVIDADE DA DOAÇÃO DE ÓRGÃOS E TECIDOS

This study aims to ascertain the influence of the structure and process on the effectiveness of donation of organs and tissues. It is an evaluative, longitudinal study, with a quantitative approach, undertaken in six hospitals of Natal-RN, with 65 potential donors. The data collection instrument was a structured script of non-participant observation. The data were analyzed using descriptive statistics and the application of the Chi-squared, Fisher, and Mann Whitney tests. The effectiveness of donation was 27.7%. No significant difference occurred between structure and effectiveness of donation, however, inadequacies were observed in the physical resources (36.9%), material resources (30.8%), organizational structure (29.2%), and human resources (18.5%). In the process, the phases of maintenance (p=0.004), diagnosis of brain death (p=0.032), family interview (p≤0.001) and documentation (p=0.001) presented significant differences with effectiveness. The adequacy of the factors related to the structure and process is associated with the effectiveness of the donation. Improvement of these indices depends on the speed with which the process is conducted, in addition to the adequate structure.

Physiological changes of brain death in potential donors of organs and tissues for transplantation

Resumen El objetivo del estudio fue describir los cambios fisiológicos de la muerte cerebral en los potenciales donadores de órganos y tejidos para trasplante. Investigación exploratoria, descriptiva, con datos prospectivos y enfoque cuantitativo, hecho en las unidades de emergencia y de cuidados intensivos de adultos de un hospital de Pernambuco en el periodo de abril a octubre de 2011. La población fue formada por 32 potenciales donadores de órganos y tejidos para trasplante. Después de la aprobación en el Comité Ético de Investigación, los datos han sido recogidos, tabulados y analizados mediante estadística descriptiva por el programa informático SPSS 15.0, siendo presentados en forma de tablas. Los cambios fisiológicos fueron: hipotensión (100%), hipotermia (75,0%), hipernatremia (62,5%), diabetes insípida (37,5%), infección (25,0%), hipertensión ar terial (9,4%) y la úlcera de córnea (3,1%). Se cree que el conocimiento de estos cambios permite al equipo de atención de la salud dirigir sus acciones al potencial donador de acuerdo a sus necesidades y así mantener los órganos/tejidos viables para el trasplante. Palabras-clave: Enfermería. Obtención de Tejidos y Órganos. Muerte Encefálica. Enfermeira. Especialista em terapia intensiva pelo Hospital da Restauração/Recife. NatalRN. Brasil. Email: sarahgabrielfreire@gmail.com; Enfermeira. Professora Mestre da Escola de Enfermagem da Universidade Federal do Rio Grande do Norte/UFRN. Doutoranda do Programa de Pós-Graduação em Enfermagem/UFRN. Membro do Grupo de Pesquisa Incubadora de Procedimentos de Enfermagem/UFRN. Natal-RN. Brasil. Email: izaurafreire@hotmail.com; Enfermeira. Professora Mestre da Escola de Enfermagem da Universidade Federal do Rio Grande do Norte/UFRN. Membro do Grupo de Pesquisa Saúde e Sociedade da Escola de Enfermagem/UFRN. Natal-RN. Brasil. Email: jujales@hotmail.com; Acadêmica de Enfermagem da Universidade Federal do Rio Grande do Norte/ UFRN. Membro do Grupo de Pesquisa Incubadora de Procedimentos de Enfermagem/UFRN. Natal-RN. Brasil. Email: quinidia@hotmail.com; Enfermeiro. Professor Pós-Doutor do Departamento de Enfermagem e do Programa de Pós-Graduação em Enfermagem da Universidade Federal do Rio Grande do Norte/UFRN. Coordenador do Grupo de Pesquisa Incubadora de Procedimentos de Enfermagem/UFRN. Natal-RN. Brasil. Email: gilsonvtorres@hotmail.com. PESQUISA RESEARCH INVESTIGACIÓN The objective was to describe the physiologic changes of brain death in potential donors of organs and tissues for transplantation. Exploratory descriptive study with prospective data and quantitative approach carried out in emergency and intensive care units hospital adult, in the period from April to October 2011. The population consisted of 32 potential donors of organs and tissues for transplantation. After approval of Ethics Committee, data were collected, tabulated and analyzed by descriptive statistics by SPSS 15.0 software and presented in tables. Physiological changes were: hypotension (100%), hypothermia (75%), hypernatremia (62,5%), diabetes insipidus (37,5%), hyperglycemia (32,3%), infection (25,0%), hypertension (9,4%) and corneal ulcer (3,1%). It was found that knowledge of these changes allows the team of health care to direct the potential donors according to their needs and thus keep the organ/tissue viable for transplant.

Representações sociais de pescadores com lesão medular: repercussões e trajetória de vida

Objective: analyze social representations in the life trajectory of artisanal fishermen with spinal cord injury caused by diving on the north coast of Rio Grande do Norte. Method: a descriptive, qualitative study was conducted with 31 fishermen between October 2013 and August 2014, using a semi-structured interview. A lexicographic analysis and descending hierarchical classification of texts were performed (with software ALCESTE), in the perspective of the social representations. Results: social representations of fishermen with spinal cord injury presented experiences with physical limitations and expectations regarding retirement, which appeared as a distant reality from the requirements in Brazilian labor laws. Conclusion: measures are required for the promotion, prevention and rehabilitation of the health of fishermen with spinal cord injury, as well as safe and decent fishing conditions, with the commitment of health authorities.

[Harnessing of corneas captured and processed for transplantation in an ocular tissue bank of North-eastern Brazil].

The aim of this study was to describe the harnessing of corneas captured and processed for transplantation in an ocular tissue bank in north-eastern Brazil.This was a transverse and retrospective study, with a sample group of 612 individuals whose corneas were do- nated and captured between January/2007 and July/2012. This study was approved by the Research Ethics Committee under number 007.0.294.000-10, and research was based on an instrument consisting of social, demographic and clinical data of the donors. Of the 1209 corneas captured, 868 were used and 341 were discarded. Of the 612 donors, the corneas of 597 (97.5%) were captured from both eyes, being that 423 (70.9%) of these corneas were used. Further studies are required on the reasons for discarding corneas and clarifications as to the conduct of professionals when processing corneas, considering the increase in the quantity of donors and the elevated number of discarded ocular tissue.

Perfil de pacientes em lista de espera para transplante renal

Aim: to identify the profile of patients on the waiting list for kidney transplantation. Method: descriptive and quantitative study performed from May 2010 to May 2012, with 55 patients followed at the outpatient unit of nephrology in Natal/RN, Brazil. Results: of those surveyed, 63,6% were males, 39,9 (±12,2) years median age, coming from the country (56,4%), married (60,0%), with children (50,9%). Elementary School was the predominant level of schooling (41,8%) and the majority of patients (89,1%) did not exercise any working activity. Most had monthly income up to two minimum wages (67,3%). The majority of patients in the unique waiting list were submitted to hemodialysis (98,2%), were hypertensive (81,8%) and with an average registration time of 1,9 (±1,9) years. Conclusion: to know the profile of patients is essential to plan health actions, in order to minimize the morbidity and mortality on the waiting list.

SPINAL CORD INJURY DUE TO DIVING ACCIDENTS AND STRESS AMONG ARTISANAL FISHERS

Objective: to analyze the presence and symptoms of stress among artisanal fishers who are victims of spinal cord injury. Method: this descriptive, cross-sectional and quantitative study was conducted with a non-probabilistic sample of 44 fishers, victims of spinal cord injury on the beaches of the northern coast of Rio Grande do Norte, Brazil. Data were collected using an inventory designed for adults addressing the presence and symptoms of stress, and a form addressing the participants’ sociodemographic and clinical variables. Descriptive analysis considered the participants’ scores. Results: all fishers were male, aged 23.87 ± 20.9 years old on average; time since the accident that caused the injury was 33.3 ± 19.31 years on average; the level of injury most frequently affected was the thoracic spine (41.8%), of which the main sequel was paraplegia (50.0%). The findings reveal stress compatible with the exhaustion phase (25.0%), followed by the resistance phase (13.6%), with the main symptoms including: insomnia, tachycardia, hypertension, and sexual problems, among others. Conclusion: the stress identified among the fishers was in the exhaustion phase and physical symptoms predominated. A spinal cord injury impacts the victim’s social, occupational and family context, leading to the emergence of stress. DESCRIPTORS: Psychological stress. Decompression sickness. Spinal cord injuries. Mental Health. Nursing. LESÃO MEDULAR POR MERGULHO E ESTRESSE EM PESCADORES ARTESANAIS

Caracterização sociodemográfica e epidemiológica dos doadores de córneas do banco de tecidos oculares do Rio Grande do Norte

Morte encefalica; Bancos de tecidos; Doadores de tecidos; Transplante de cornea; Enfermagem.

Facilitadores y barreras en la eficacia de la donación de órganos y tejidos

This study aims to ascertain the influence of the structure and process on the effectiveness of donation of organs and tissues. It is an evaluative, longitudinal study, with a quantitative approach, undertaken in six hospitals of Natal-RN, with 65 potential donors. The data collection instrument was a structured script of non-participant observation. The data were analyzed using descriptive statistics and the application of the Chi-squared, Fisher, and Mann Whitney tests. The effectiveness of donation was 27.7%. No significant difference occurred between structure and effectiveness of donation, however, inadequacies were observed in the physical resources (36.9%), material resources (30.8%), organizational structure (29.2%), and human resources (18.5%). In the process, the phases of maintenance (p=0.004), diagnosis of brain death (p=0.032), family interview (p≤0.001) and documentation (p=0.001) presented significant differences with effectiveness. The adequacy of the factors related to the structure and process is associated with the effectiveness of the donation. Improvement of these indices depends on the speed with which the process is conducted, in addition to the adequate structure.