Rejane Maria Paiva de Menezes

Situação de trabalho dos profissionais da Estratégia Saúde da Família em Ceará-Mirim

O objetivo deste estudo foi analisar as situacoes de trabalho vivenciadas pelos profissionais da Estrategia Saude da Familia (ESF). Estudo descritivo realizado em Ceara-Mirim, Rio Grande do Norte, em 2007. A populacao constituiu-se de 190 profissionais da ESF, na qual foi aplicada um questionario com questoes fechadas. Os resultados apontaram que o conhecimento da area geografica adstrita pelos profissionais da ESF foi considerado como um aspecto positivo para a realizacao das atividades executadas por 83,2% dos profissionais, e o numero de familias acompanhadas por equipe foi considerado como uma dificuldade por 40,5%. Em relacao as condicoes de trabalho, 93,2% referiram a presenca de profissionais com perfil em saude publica, e 86,8%, indisponibilidade de equipamentos e instrumentos. Dos profissionais que trabalham exclusivamente na ESF, 74% sao agentes comunitarios de saude. O compromisso e a responsabilidade para substituir as praticas tradicionais de assistencia devem ser de todos, havendo a necessidade de interacao de fatores historicos, politicos, sociais, economicos e culturais.The purpose of this study was to analyze the work situations experienced by Family Health Strategy (FHS) professionals. This descriptive study was performed in Ceará-Mirim, Rio Grande do Norte state, in 2007. The population consisted of 190 FHS professionals, in which a questionnaire with closed-questions was applied. The results showed that 83.2% of the professionals consider that knowing the geographical area under their responsibility is a positive aspect that helps performing their activities, while 40.5% consider the number of families that each team has to follow to be a difficulty. Regarding work conditions, 93.2% reported the presence of professionals with a public health profile and 86.6% reported there is a lack of equipment and instruments. Of professionals who work exclusively with the FHS, 74% are community health agents. The commitment and responsibility to replace the traditional care practices should concern everyone, and there is a need for an interaction between historical, political, social, economic, and cultural factors.

Representações de fragilidade para idosos no contexto da estratégia saúde da família

Este estudo objetivou analisar representacoes sociais de idosos domiciliados acerca da fragilidade, conforme definicao do Ministerio da Saude, e identificar a atuacao da equipe de Saude da Familia na visao do idoso. Estudo descritivo, qualitativo e fundamentado na Teoria das Representacoes Sociais. Teve como cenario o domicilio de idosos em area adscrita de Unidade de Saude da Familia, de Natal-RN. Participaram 10 idosos, sendo a escolha intencional, considerando a saturacao das informacoes. Utilizou-se entrevista semiestruturada e observacao participante. Embora muitos apresentassem aspectos da fragilidade, a maioria dos idosos tinha dificuldade para defini-la. Com a analise de conteudo foram alcancadas seis categorias tematicas que, de modo geral, indicaram que as representacoes de fragilidade, para esses idosos, estavam relacionadas a presenca de doencas, as mudancas na vida diaria, a fraqueza e ao risco de sofrer quedas. Concluiu-se que conhecer a fragilidade e fundamental na avaliacao da saude do idoso na atencao basica.

ASSISTÊNCIA AO PARTO NORMAL NO DOMICÍLIO

This study presents the experience of an obstetric nurse and of a couple who had their third child. It focuses on care standards that value women and couples in the childbirth and delivery process. It describes the care given to a couple during the pregnancy stage and during home delivery. The experience enabled the active participation of the couple and their children in the childbirth process, which essentially provided satisfaction to the family and to the professional.This study presents the experience of an obstetric nurse and of a couple who had their third child. It focuses on care standards that value women and couples in the childbirth and delivery process. It describes the care given to a couple during the pregnancy stage and during home delivery. The experience enabled the active participation of the couple and their children in the childbirth process, which essencialy provided satisfaction to the family and to the professional.Este estudio trata de la experiencia vivida por una enfermera obstetrica con una pareja esperando su tercero hijo. Destaca los modelos asistenciales que valorizan la mujer y la pareja en el proceso del nacimiento y parto. Describe la atencion prestada a una pareja durante el proceso de la gestacion y parto realizado en la casa. Resalta que la experiencia hizo posible la participacion activa de la pareja y de los hijos en el proceso del nacimiento y parto, propiciando fundamentalmente, satisfaccion a familia y al profesional.

O ensino teórico-prático da assistência de enfermagem numa instituição de ensino: um estudo de reflexão

The study is an analysis of theory and practicum teaching of nursing care in the undergraduate program of the Federal University of Rio Grande do Norte. The objectives were to identify 1) the conceptual elements of nursing care in the program, 2) the teaching methods used, and 3) the criteria for quality evaluation of care. Professors who taught theory and practicum of nursing analysed their considerations related to the teaching and practice of nursing care expressed at discussion meetings. The results indicated a lack of internal integration, and between teaching and service characterized by 1) disarticulation of concepts, 2) lack of coherence between teaching and service and 3) lack of parameters, for the evaluation of care. Suggestions are made for collaboration of teaching and service professionals in defining their conceptual, theoretical, and practicum bases for care.

Trauma em idosos: acesso ao sistema de saúde pelo atendimento pré-hospitalar móvel

Objective: to identify the prevalence of trauma in elderly people and how they accessed the health system through pre-hospital care. Method: documentary and retrospective study at a mobile emergency care service, using a sample of 400 elderly trauma victims selected through systematic random sampling. A form validated by experts was used to collect the data. Descriptive statistical analysis was applied. The chi-square test was used to analyze the association between the variables. Results: Trauma was predominant among women (52.25%) and in the age range between 60 and 69 years (38.25%), average age 74.19 years (standard deviation±10.25). Among the mechanisms, falls (56.75%) and traffic accidents (31.25%) stood out, showing a significant relation with the pre-hospital care services (p<0.001). Circulation, airway opening, cervical control and immobilization actions were the most frequent and Basic Life Support Services (87.8%) were the most used, with trauma referral hospitals as the main destination (56.7%). Conclusion: trauma prevailed among women, victims of falls, who received pre-hospital care through basic life support services and actions and were transported to the trauma referral hospital. It is important to reorganize pre-hospital care, avoiding overcrowded hospitals and delivering better care to elderly trauma victims.Objetivo: identificar la prevalencia de trauma en ancianos y como accedieron al sistema de salud por la atencion pre-hospitalaria movil. Metodo: estudio documental y retrospectivo, llevado a como en servicio pre-hospitalario movil, con muestra de 400 ancianos victimas de trauma, seleccionados de manera aleatoria sistematica. Los datos fueron recolectados con un formulario validado por especialistas. Fue aplicado el analisis estadistico descriptivo. La prueba ji-cuadrado fue usada para analizar la asociacion entre las variables. Resultados: el trauma predomino entre las mujeres (52,25%) y en el rango de edad entre 60 y 69 anos (38,25%), promedio de 74,19 anos (desvio-estandar±10,25). Entre los mecanismos, se destacaron las caidas (56,75%) y accidentes de transito (31,25%), cuya relacion fue significativa con las unidades de atencion (p<0,001). Las acciones circulatorias, de apertura de vias aereas, con control cervical e inmovilizacion, fueron las mas efectuadas y las Unidades de Soporte Basico (87,8%) las mas accionadas, con destino principal al hospital de referencia en traumas (56,7%). Conclusion: el trauma prevalecio entre las mujeres, victimas de caida, atendidas en el ambito pre-hospitalario por unidades y acciones de soporte basico de vida, trasportadas al hospital de referencia en trauma. Es importante reorganizar la atencion pre-hospitalaria, evitando el hacinamiento de los hospitales con mejor atencion al anciano victima de trauma.

Hematopoietic Stem Cell Transplantation Based on the Transdisciplinary Care

Objetive: discuss the importance of multidisciplinary care for patients undergoing Hematopoietic Stem Cell Transplantation (HSCT) based on the transdisciplinary care. Method: This is a theoretical essay discussing. Results: Each year, about 50 million people are undergoing HSCT worldwide. This therapeutic strategy is used for some oncological, hematological or immunological, malignant and non-malignant inherited or acquired diseases. During the steps after HSCT, patients, and their families experience moments of anxiety, anguish and uncertainty that cause stress and interfere with their daily lives. The multidisciplinary team working in HSCT service provide complex and specialized care since this scenario requires specific knowledge of the area. However, they do not relieve the interweaving of new knowledge for an interdisciplinary practice that meets the patient´s health needs in this delicate moment of his life. From this perspective, health professionals of HSCT service should excel by constantly learning and dynamic interventions and sharing of knowledge in the multidisciplinary team that includes a complex and transdisciplinary care. Conclusion: This essay causes the discussion about care in HSCT based on transdisciplinary care. It should be emphasized the responsibility of each member of the multidisciplinary team for the contribution and strengthening of the patient´s quality of life. In a way, the interdisciplinary care permeates the complexity in an open perspective of approximation of the various areas of knowledge.

SIGNIFICADOS ATRIBUÍDOS POR PROFISSIONAIS DE SAÚDE AOS CUIDADOS PALIATIVOS NO CONTEXTO DA ATENÇÃO PRIMÁRIA

Objective: to understand the meanings attributed by health professionals to palliative care assistance in primary health care. Method: a qualitative research, guided by the social phenomenological dimension of Alfred Schutz. Twenty-five health professionals working in one of the three health units and a Family Health Support Center in the city of Natal / RN, Brazil, participated in this study. The fieldwork was carried out through an interview in the year 2015, and the information was analyzed according to the steps of social phenomenology researchers. Results: it was understood that health professionals were able to recognize the need of the other in the practice of palliative care assistance in primary health care. The meanings attributed by health professionals involved the need for an organized system in a health care network that favored the social relationships involved in care. This involves redefining the social attitude of health professionals, in the confrontation of culture and the curative hospital-care model, in palliative care in primary health care, through the inclusion and awareness of the family. Conclusion: the meanings attributed to palliative care in the primary health care context involve the intersubjective experience of health professionals. Based on continuous health practices in the process of interaction between professionals, health care network, patient and family, with the home context as a reality of care

Frailty Assessment and its Association with Sociodemographic and Health Characteristics in Community Elderly

Background: Frailty assessment in the elderly and its relationship to sociodemographic and health characteristics. Method: Quantitative study, descriptive and cross-sectional study, conducted between April to July 2014, at two Family Health Units in Natal, Rio Grande do Norte. The sample consisted of 203 elderly. The data collection procedure occurred through a structured interview, which used two instruments. Results: The average age of the participants was 68.59 years; among them, 83 (40.89%) did not show weakness, 45 (22.17%) were apparently vulnerable and 75 (36.94%) were frail. The weakness associated with low education, widowhood, heart disease, diabetes mellitus, osteoporosis, respiratory disease, urinary tract infection, depression, six classes of drugs (antidiabetic, antidepressant, anxiolytic, and antacid against osteoporosis) and fall episode. Conclusions: We conclude that assessment of frailty is important to detect the risk and/or embrittlement process already installed in the elderly.

Análise conceitual da gestão do cuidado em enfermagem no âmbito hospitalar

Objective To analyze the concept of nursing care management in the hospital context on the basis of the theoretical-methodological framework of Walker and Avant. Methods Elaboration of an integrative review to operationalize the analysis of the subject, extracting data from the databases Latin America and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online and the Brazilian Nursing Database, using the keywords and descriptors Care Management, Nursing and Hospital. Results The review showed that management practice by nurses focuses on bureaucratic activities and has little relationship to care. However, coordination and integration of administration and care, leadership, communication, interaction, decision-making and cooperation were identified as essential characteristics of nursing care management. Conclusion The application of this concept in nursing care management is an emerging need for the development of an administration model related to care.

Aspectos contextuais da assistência ao idoso com úlcera venosa

Aim: to analyse the contextual aspects that involve the care of elderly patients with venous ulcers. Method: theoretical and reflective study, from the context analysis framework, which presents four interactive aspects: Immediate Context, Specific, General and Metacontext. Results: in the Immediate Context, there was an approach of the elderly with venous ulcers and the search for the health professional; in the Specific Context, elements that influence in the care of the elderly with venous ulcers were described; in the General Context, aspects experienced by elderly patients with venous ulcers were considered; in Metacontext, the challenge of health professionals to promote comprehensive care to elderly with venous ulcers was discussed. Conclusion: physiological, psychological, cultural, social, economic and political aspects are involved in the care of elderly with venous ulcers, which is important for integral care to make such elderly corresposible for his own health.