Rafael Celestino da Silva

A TECNOLOGIA EM SAÚDE: UMA PERSPECTIVA PSICOSSOCIOLÓGICA APLICADA AO CUIDADO DE ENFERMAGEM

Resumen This study has a purpose of demonstrating the social relevance of technology as a phenomenon in the health care related to psychossociological knowledge. The technology can determine the way of life of the society, leading the man to develop feelings and behaviors of adoration, fear, approach and distancing. The phenomenon of the use of the technology in health, integrates thoughts and discussions, leading to circulation of the information among professionals; and then, producing knowledge as a foundation to the action of the health staff. The presence of technological resources in care environments generates restlessness, feelings and behaviors related to representations about an object, in this case, the technology in health. These representations produce different ways of care. The understanding of the technology in health care, based in a psychossociological approach, is useful to the knowledge of elements that builds social representations that are created to understand the ways of care.Resumen This study has a purpose of demonstrating the social relevance of technology as a phenomenon in the health care related to psychossociological knowledge. The technology can determine the way of life of the society, leading the man to develop feelings and behaviors of adoration, fear, approach and distancing. The phenomenon of the use of the technology in health, integrates thoughts and discussions, leading to circulation of the information among professionals; and then, producing knowledge as a foundation to the action of the health staff. The presence of technological resources in care environments generates restlessness, feelings and behaviors related to representations about an object, in this case, the technology in health. These representations produce different ways of care. The understanding of the technology in health care, based in a psychossociological approach, is useful to the knowledge of elements that builds social representations that are created to understand the ways of care.

Características dos enfermeiros de uma unidade tecnológica: implicações para o cuidado de enfermagem

The purpose was to describe characteristics of formation and qualification of the nurses of a unit of intensive cares, and to argue its implications in the nursing assistance, how much to the use of technologies. Descriptive-exploratory study, with accomplishment of half-structuralized interview. Citizens: twenty and four operating nurses in cardio-intensive unit. Predominance of women with two years acting in the sector and course of specialization. Great part did not participate of courses for manuscript of technologies, six had not chosen the sector and eleven are inexperienced. It had balance in the time of professional formation. The professional profile must be considered to work in the sectors of intensive cares. Not to take care of this profile can bring risks to the customers.The purpose was to describe characteristics of formation and qualification of the nurses of a unit of intensive cares, and to argue its implications in the nursing assistance, how much to the use of technologies. Descriptive-exploratory study, with accomplishment of half-structuralized interview. Citizens: twenty and four operating nurses in cardio-intensive unit. Predominance of women with two years acting in the sector and course of specialization. Great part did not participate of courses for manuscript of technologies, six had not chosen the sector and eleven are inexperienced. It had balance in the time of professional formation. The professional profile must be considered to work in the sectors of intensive cares. Not to take care of this profile can bring risks to the customers

O adolescente e as drogas: conseqüências para a saúde

Pesquisa Documental. Objetivos: identificar a frequencia do uso/abuso de drogas pelos adolescentes escolares de instituicao de ensino medio; e analisar as consequencias do uso/abuso de drogas para a saude do adolescente. Fontes: dois relatorios de pesquisas realizadas com esses adolescentes, no segundo semestre de 2006 e primeiro semestre de 2007. O estudo evidenciou o consumo do alcool como de grande destaque entre os pesquisados e mostrou, ainda, que aproximadamente 6% da populacao em estudo ja teve contato com drogas ilicitas. Alem disso, constatou-se que o enfermeiro se apresenta como ator estrategico nas acoes direcionadas para este tema, no sentido de buscar abordagens que ampliem o olhar e as possibilidades de intervencao, sobretudo no nivel de prevencao e promocao a saude.Resumen

Representações socias dos enfermeiros sobre a tecnologia no ambiente da terapia intensiva

El objetivo del estudio es identificar las representaciones sociales de los enfermeros novatos y veteranos sobre la tecnologia propia a los ambientes de cuidados intensivos y analizar sus influencias en el cuidado al cliente. Investigacion cualitativa descriptiva con 24 enfermeros de una unidad de terapia intensiva cardiologica. Se utilizo la Teoria de las Representaciones Sociales, la entrevista semiestructurada y el analisis tematico de contenido. Las representaciones sociales sobre la tecnologia se forman articuladas a la gravedad y riesgo de muerte del cliente, por lo que se requiere cuidados diferenciados y especiales. Por ello, el profesional debe tener caracteristicas peculiares para laborar en ese sector. No hay diferencias en las representaciones sociales de los novatos y los veteranos, pero la inexperiencia de los novatos diferencia sus acciones. Se concluye que son necesarias estrategias que lleven los enfermeros a (re)interpretar la tecnologia, y politicas de asignacion de los enfermeros por especialidades y preferencias por los sectores de actuacion.The objective of this study is to identify the social representations of novice and veteran nurses concerning proper technology for intensive care environments and to analyze their influences on client care. It is a qualitative-descriptive study involving 24 cardio-intensive unit nurses. The Social Representations Theory, the semi-structured interview, and thematic content analysis were used. Social representations concerning technology are formed articulated to the gravity and risk of client death, which requires differentiated and special care. Therefore, the professional must have peculiar characteristics to perform in this sector. There are not differences in novice and veteran social representations, but the inexperience of novices differentiates their actions. One concludes that strategies that lead nurses to reinterpret the technology, as well as allocation policies for specialties and preferences of the nurses for the performance sectors are necessary. DESCRIPTORS: Biomedical technology. Nursing care. Nursing. Intensive care units. Psychology, social. LAS REPRESENTACIONES SOCIALES DE LOS ENFERMEROS SOBRE LA TECNOLOGÍA EN EL AMBIENTE DE TERAPIA INTENSIVA RESUMEN: El objetivo del estudio es identificar las representaciones sociales de los enfermeros novatos y veteranos sobre la tecnología propia a los ambientes de cuidados intensivos y analizar sus influencias en el cuidado al cliente. Investigación cualitativa descriptiva con 24 enfermeros de una unidad de terapia intensiva cardiológica. Se utilizó la Teoría de las Representaciones Sociales, la entrevista semiestructurada y el análisis temático de contenido. Las representaciones sociales sobre la tecnología se forman articuladas a la gravedad y riesgo de muerte del cliente, por lo que se requiere cuidados diferenciados y especiales. Por ello, el profesional debe tener características peculiares para laborar en ese sector. No hay diferencias en las representaciones sociales de los novatos y los veteranos, pero la inexperiencia de los novatos diferencia sus acciones. Se concluye que son necesarias estrategias que lleven los enfermeros a (re) interpretar la tecnología, y políticas de asignación de los enfermeros por especialidades y preferencias por los sectores de actuación. DESCRIPTORES: Tecnología biomédica. Atención de enfermería. Enfermería. Unidades de terapia intensiva. Psicología social.

Intensive care nurses' practice related to experience and shift worked.

OBJECTIVE To analyse the social representations of nurses about intensive care practices comparing the variables 1) time since graduation and 2) shift worked. METHOD Qualitative field research using social representation theory. Individual interviews were conducted and lexical analysis was applied. STUDY SETTING Intensive Care Unit of a federal hospital with 21 clinical nurses. FINDINGS Day shift nurses are more pragmatic and operationally oriented because they deal directly with the general functioning of the unit. Less experienced nurses face difficulties dealing with intensive care contexts, but have a critical view of their practices, while more experienced nurses apply practical knowledge in their decision-making and actions. CONCLUSION The relationship of proximity or distance from patients, mediated by technology, is related to the domains of knowledge that are required to manage technology and to the role technology plays in intensive care.

A dimensão da ação nas representações sociais da tecnologia no cuidado de enfermagem

Se objetiva identificar las maneras de actuar de los enfermeros frente al cuidado del cliente portador de aparatos tecnologicos, a partir de sus representaciones sociales sobre la tecnologia. El referencial teorico fue la teoria de las representaciones sociales. Investigacion cualitativa, con realizacion de entrevistas, observacion sistematica y analisis de contenido tematico. Sujetos: once enfermeros novatos y trece veteranos. Los resultados mostraron la existencia de dos lineas conductoras de la accion del enfermero junto al cliente que se utiliza de los aparatos tecnologicos: la del cuidado tecnologico, en el cual existe una accion que articula el saber tecnologico y los saberes inherentes al cuidado de enfermeria; y la de la accion tecnologica, en que el profesional actua orientado solamente teniendo en cuenta la maquina. Se concluye que la tecnologia puede estar orientando la formacion de determinados estilos de cuidar en la enfermeria.Resumen Se objetiva identificar las maneras de actuar de los enfermeros frente al cuidado del cliente portador de aparatos tecnológicos, a partir de sus representaciones sociales sobre la tecnología. El referencial teórico fue la teoría de las representaciones sociales. Investigación cualitativa, con realización de entrevistas, observación sistemática y análisis de contenido temático. Sujetos: once enfermeros novatos y trece veteranos. Los resultados mostraron la existencia de dos líneas conductoras de la acción del enfermero junto al cliente que se utiliza de los aparatos tecnológicos: la del cuidado tecnológico, en el cual existe una acción que articula el saber tecnológico y los saberes inherentes al cuidado de enfermería; y la de la acción tecnológica, en que el profesional actúa orientado solamente teniendo en cuenta la máquina. Se concluye que la tecnología puede estar orientando la formación de determinados estilos de cuidar en la enfermería. Palabras clave: Tecnología biomédica. Unidades de Terapia Intensiva. Enfermería. Cuidados de Enfermería. Psicología social 1Mestre em Enfermagem. Professor do Curso de Graduação em Enfermagem da Universidade Castelo Branco. Aluno do Curso de Doutorado da Escola de Enfermagem Anna Nery. Membro do Núcleo de Pesquisa de Fundamentos do Cuidado de Enfermagem. Rio de Janeiro, RJ. Brasil. E-mail: rafaenfer@yahoo.com.br,2Doutora em Enfermagem. Professora Titular do Departamento de Enfermagem Fundamental da Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro. Coordenadora Geral de Pós-graduação e Pesquisa. Membro do Núcleo de Pesquisa de Fundamentos do Cuidado de Enfermagem. Rio de Janeiro, RJ. Brasil. E-mail:marciadeaf@ibest.com.br PESQUISA RESEARCH INVESTIGACIÓN It aims to identify the nurses’ ways of acting when taking care of customer carrying technological devices, from its social representations on the technology. It was used as a reference the theory of the social representations. It’s a qualitative research, with the accomplishment of interviews, systematic comment and thematic analysis of the content. Subjects: eleven inexperienced nurses and thir teen veterans. The results showed the existence of two conducting lines of the nurse action regarding the customer that uses the technological devices: the technological care, which there is an action that manages the technological and the inherent knowledge to the care of nursing; and the technological action, where the professional acts only guided by the machine. It is concluded that the technology may be directing the formation of certain care styles in the nursing.

The practice of intensive care nursing: alliance among technique, technology and humanization

A qualitative, field research study whose aim was to characterize the specific practice of intensive care nursing. Observation and interviews were conducted with 21 nurses in an intensive care unit. The results evidenced eight characteristics of this care, which included subjectivity and objectivity, translated into: interaction, dialogue, humanistic principles, vigilance, knowledge, and mastery of machinery. Because of this practice, subjectivity is not always expressed in a clear way, and objectivity requires training of nurses to perform intensive care. It is concluded that the practice of intensive care nursing combines technique, technology and humanization, which underlie the nursing care performed at the unit.Investigacion de campo, cualitativa, cuyo objetivo fue caracterizar la clinica de la atencion de enfermeria especifica del cuidado intensivo. Se realizaron la observacion y la entrevista con 21 enfermeros de una unidad de cuidados intensivos. Los resultados evidenciaron ocho caracteristicas de esta clinica, que abarcan la subjetividad y la objetividad, traducidas en: interaccion, dialogo, principios humanisticos, vigilancia, conocimiento y dominio de las maquinas. En razon de esta clinica, la subjetividad no siempre se expresa de manera clara y la objetividad exige capacitacion de los enfermeros para la atencion en cuidados intensivos. Se concluye que la clinica de la atencion de enfermeria en los cuidados intensivos compromete tecnica, tecnologia y humanizacion, que fundamentan la atencion de enfermeria que se realiza dentro.A qualitative, field research study whose aim was to characterize the specific practice of intensive care nursing. Observation and interviews were conducted with 21 nurses in an intensive care unit. The results evidenced eight characteristics of this care, which included subjectivity and objectivity, translated into: interaction, dialogue, humanistic principles, vigilance, knowledge, and mastery of machinery. Because of this practice, subjectivity is not always expressed in a clear way, and objectivity requires training of nurses to perform intensive care. It is concluded that the practice of intensive care nursing combines technique, technology and humanization, which underlie the nursing care performed at the unit.

Discursos de enfermeiros sobre humanização na Unidade de Terapia Intensiva

Pesquisa qualitativa, cujo objetivo foi identificar elementos da pratica dos enfermeiros de terapia intensiva que dificultam a implementacao da humanizacao da assistencia, analisando-os a luz da Politica Nacional de Humanizacao. Realizaram-se entrevista semiestruturada com 22 enfermeiros de uma unidade de terapia intensiva e analise tematica de conteudo. O usuario, a familia e a equipe integram a pratica cotidiana de cuidados, mas os dispositivos da humanizacao contidos na Politica, como visita aberta, ambiencia, acolhimento, interacao com a equipe multiprofissional, oficinas e grupos de trabalho, nao sao efetivamente implementados para eles. Ha dificuldades que indicam necessidade de investimentos na formacao e na gestao institucional e do cuidado, de modo que a politica de humanizacao seja efetivamente implantada na unidade de terapia intensiva.Resumen Investigación cualitativa, cuyo objetivo fue identificar elementos de la práctica de los enfermeros de terapia intensiva que dificultan la implementación de la humanización del cuidado, analizándolos a la luz de la Política Nacional de Humanización. Se realizó entrevista semi-estructurada con 22 enfermeros de una unidad de terapia intensiva y análisis temático de contenido. El usuario, la familia y el equipo integran la práctica cotidiana de atención, pero los dispositivos de la humanización contenidos en la Política como visita abierta, ambiente, acogimiento, interacción con el equipo multiprofesional, oficinas y grupos de trabajo no son efectivamente implementados junto a estos. Hay dificultades que indican necesidad de inversiones en la formación y en la gestión institucional y de la atención, de manera que la política de humanización sea efectivamente implantada en la Unidad de Terapia Intensiva. Palabras claves: Unidades de Terapia Intensiva. Enfermería. Atencion de Enfermería. Humanización de la Atención. 1Enfermeira. Aluna do Curso de Mestrado do Programa de Pós-Graduação em Enfermagem da Escola de Enfermagem Anna Nery, da Universidade Federal do Rio de Janeiro (EEAN-UFRJ). Rio de Janeiro – RJ. Brasil. E-mail: fernanda23_dasilva@yahoo.com.br; 2Enfermeira. Aluna do Curso de Mestrado do Programa de Pós-Graduação em Enfermagem da Escola de Enfermagem Anna Nery, da Universidade Federal do Rio de Janeiro (EEAN-UFRJ). Membro do Núcleo de Pesquisa de Fundamentos do Cuidado de Enfermagem (Nuclearte). Rio de Janeiro – RJ. Brasil. E-mail: zizimoraes@hotmail.com; 3Doutor em Enfermagem, Membro do Nuclear te. Rio de Janeiro – RJ. Brasil. Email: rafaenfer@yahoo.com.br; 4Doutora em Enfermagem. Professora Titular do Depar tamento de Enfermagem Fundamental da EEAN-UFRJ. Membro do Nuclear te. Pesquisadora 1D do CNPq. Rio de Janeiro – RJ. Brasil. Email:marciadeaf@ibest.com.br PESQUISA RESEARCH INVESTIGACIÓN Qualitative research whose aim was to identify elements of the practice of intensive care nurses that difficult the implementation of the humanization of care, analyzing them according to the National Policy of Humanization. It was carried out semistructured interviews with twenty-two nurses from an intensive care unit and theme analysis of content. The user, family and the team integrate everyday practice of care, but the rules of the Humanization contained in Policy as visit open, ambience, welcome, interaction with the multidisciplinary team, workshops and group of work aren’t effectively implemented. There are difficulties that indicate the need to invest in training and institutional management, and in care, so that the humanization policy can be effectively implemented in the intensive care unit.

Clínica do cuidado de enfermagem na terapia intensiva: aliança entre técnica, tecnologia e humanização

A qualitative, field research study whose aim was to characterize the specific practice of intensive care nursing. Observation and interviews were conducted with 21 nurses in an intensive care unit. The results evidenced eight characteristics of this care, which included subjectivity and objectivity, translated into: interaction, dialogue, humanistic principles, vigilance, knowledge, and mastery of machinery. Because of this practice, subjectivity is not always expressed in a clear way, and objectivity requires training of nurses to perform intensive care. It is concluded that the practice of intensive care nursing combines technique, technology and humanization, which underlie the nursing care performed at the unit.Investigacion de campo, cualitativa, cuyo objetivo fue caracterizar la clinica de la atencion de enfermeria especifica del cuidado intensivo. Se realizaron la observacion y la entrevista con 21 enfermeros de una unidad de cuidados intensivos. Los resultados evidenciaron ocho caracteristicas de esta clinica, que abarcan la subjetividad y la objetividad, traducidas en: interaccion, dialogo, principios humanisticos, vigilancia, conocimiento y dominio de las maquinas. En razon de esta clinica, la subjetividad no siempre se expresa de manera clara y la objetividad exige capacitacion de los enfermeros para la atencion en cuidados intensivos. Se concluye que la clinica de la atencion de enfermeria en los cuidados intensivos compromete tecnica, tecnologia y humanizacion, que fundamentan la atencion de enfermeria que se realiza dentro.A qualitative, field research study whose aim was to characterize the specific practice of intensive care nursing. Observation and interviews were conducted with 21 nurses in an intensive care unit. The results evidenced eight characteristics of this care, which included subjectivity and objectivity, translated into: interaction, dialogue, humanistic principles, vigilance, knowledge, and mastery of machinery. Because of this practice, subjectivity is not always expressed in a clear way, and objectivity requires training of nurses to perform intensive care. It is concluded that the practice of intensive care nursing combines technique, technology and humanization, which underlie the nursing care performed at the unit.

Construindo o roteiro de entrevista na pesquisa em representações sociais: como, por que, para que

Resumen Bibliographic revision about the building of a script of interview applied to research in social representations field, from the survey of elements that are essential to its elaboration. A search was held on a vir tual data base and at a sectorial library; selection of reference books and indexed publications; selective and analytical reading. The questions, going from the private and concrete to the general and abstract, should emerge information, images, beliefs, opinions; approach aspects of the practical daily lives of the individuals, besides characterizing it to understand the group in the individual and the individual in the group, as well as to catch the mute zone of the representation. It is concluded that the way the data are collected leads and interferes on getting the representations. Therefore, this study provides theoreticalmethodological subsidies, and indicates the impor tance of epistemological vigilance in the researches of this area.Resumen Bibliographic revision about the building of a script of interview applied to research in social representations field, from the survey of elements that are essential to its elaboration. A search was held on a virtual data base and at a sectorial library; selection of reference books and indexed publications; selective and analytical reading. The questions, going from the private and concrete to the general and abstract, should emerge information, images, beliefs, opinions; approach aspects of the practical daily lives of the individuals, besides characterizing it to understand the group in the individual and the individual in the group, as well as to catch the mute zone of the representation. It is concluded that the way the data are collected leads and interferes on getting the representations. Therefore, this study provides theoreticalmethodological subsidies, and indicates the impor tance of epistemological vigilance in the researches of this area.