Repositório RCAAP

A identificação dos principais diagnósticos de enfermagem presentes nos pacientes com Angina Instável contribui para o conhecimento do perfil de respostas humanas destes pacientes, colaborando para o planejamento de intervenções mais adequadas, viabilizando a sistematização da assistência de enfermagem. O objetivo deste estudo foi analisar o perfil de diagnósticos de enfermagem apresentado por pessoas com Angina Instável internadas em um hospital especializado em doenças cardíacas. A população foi composta pelos clientes portadores do diagnóstico de Angina Instável, sob atendimento nesse hospital. Trata-se de estudo descritivo do tipo transversal, com abordagem de análise quantitativa. Foram avaliados 57 pacientes com Angina Instável, no período de janeiro a outubro de 2006. O instrumento de coleta foi um formulário preenchido durante entrevista e exame físico. Estes pacientes são predominantemente do sexo masculino, com média de idade de 61 anos, sem companheiro, originários do interior do estado do Ceará e procedentes da capital do estado. Têm renda familiar próxima a 650 reais, tendo estudado por volta de quatro anos, pertencentes à religião católica e a maioria está aposentada. O tempo de internamento desses pacientes até a coleta dos dados foi de, em média, cinco dias e estavam, em sua maioria, no primeiro episódio de Angina Instável. Verificamos que as principais características clínicas de base foram: Hipertensão Arterial, Fumo, Cateterismo cardíaco anterior e Menopausa. A média da Relação Cintura-Quadril desses indivíduos estava dentro do risco considerado alto, independente do sexo e da idade e a maior parte dos pacientes estava acima do peso ideal para a altura e a compleição corporal. Constatamos que esses pacientes apresentavam em média, cinco diagnósticos de enfermagem, doze características definidoras, quatro fatores relacionados, e sete fatores de risco. Examinamos que os diagnósticos de enfermagem mais freqüentes eram decorrentes do quadro anginoso ou favoreciam seu surgimento, sendo o diagnóstico de Risco de quedas o mais presente. Os fatores relacionados mais presentes eram relacionados aos diagnósticos de Dor aguda, Intolerância à atividade, Padrão de sono perturbado e Estilo de vida sedentário. Neste estudo tivemos a oportunidade de identificar aspectos do cuidado ao paciente anginoso possíveis de serem aprimorados, por meio da análise dos diagnósticos de enfermagem. Isso pode contribuir para conscientizar e incentivar a enfermagem na execução de mais estudos científicos não só com relação à Angina Instável, mas também alusivos a outras doenças isquêmicas miocárdicas, além de nortear a assistência de enfermagem à população.

Sexually Transmitted Diseases (STD) are considered an occupational risk for prostitutes, and they can be prevented with the use of condom. A conscientization about its importance through health education is necessary, as it is the most efficient strategy in STD/Aids prevention, what will bring changes in behavior, values and attitudes. In face of all this problematic situation of prostitution and its relation with STD, we got interested in understanding the work carried out by the prostitutes from the Association of Prostitutes from Ceará - APROCE concerning STD/Aids prevention. In this context, this study objectified to analyze the educational work carried out by the prostitutes from APROCE concerning STD and Aids prevention, and to verify if this Health Education estimulates reflexion, criticism and behavior change, or if it is only an information provider. This way, we awakened to the relation between the object of study and the theoretical approach based on Paulo Freire’s reflexions, considering that “change”, together with “conscientization”, is a “theme generator” of Paulo Freire’s theoretical practice. It is a qualitative research inspired in Paulo Freire’s theory and practice, and analyzed according to the Critical Theory. The data were grouped according to the stages they were collected: Observing Social Educators and Dialoguing with Social Educators. Later, the second part was divided in two categories: the profile and the dialogue with social educators. In the dialogue with social educators their feelings about the work done were identified, as well as the main difficulties; the facilitator points; how they perceive their results; and the most and least important points of their work. Therefore, we can conclude that being aware of the importance of STD and Aids prevention and changing behavior are not easy tasks because many factors interfere in prostitutes’ lives. The Health Education strategies used by the Association are not estimulating reflexion, criticism and behavior change as expected, but it has given a great step, as they provide information and condom to prostitutes. And, as it is an action that has happened for some years, many women have already changed behavior. More efficient strategies and projects must be carried out so that conscientization and change happen in a shorter period of time. For the obtention of this aim, Health Education methodological strategies in STD/Aids prevention for prostitutes were elaborated

VALENTIM, Farley Janusio Rebouças. Havia um CAPS no meio do caminho: adoecimento mental, narrativa e produção de sentido. 2011. 143 f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2011.

Given the greater vulnerability to acquisition of Sexually Transmitted Diseases (STD)/HIV by women prisoners, decided to develop the study. It is an evaluative study of type Knowledge, Attitude and Practice (KAP) held in a female prison in the state of Ceará, with the following objectives: Assess the knowledge, attitude and practice regarding the use of prisoners male and female condoms as a measure prevention of STD/HIV; Verify the sociodemographic, sexual, reproductive and lifestyle habits of prisoners; Investigate vulnerability factors in prisoners; Associate predictor variables with the knowledge, attitude and practice of male and female condoms by prisoners; Compare the knowledge and attitude to the practice of male and female condoms by prisoners. Search with quantitative approach, involving a sample of 155 prisoners. Data collection was conducted from January to March 2010. The instrument included data on sociodemographics, sexual, reproductive and lifestyle habits. Then we applied the KAP survey about condoms, adapted from research Brenna et al. (2001). The data were compiled, stored and associated in the Statistical Package for Social Sciences (SPSS) version 17.0. The chi-square test was used as statistical tool. The sociodemographic profile pointed to a majority of young Brazilian, single, low education level and family income, trapped for drug trafficking. The history of sexual precocity revealed the occurrence of first sexual intercourse, stability and little variety of sexual partners. However, drug use, be male or female prisoner, and has tattoos/ piercings were the principal characteristics of the partnerships. The homo/ bisexuality and prostitution was attended by about 35%. STDs acquired before or after the arrest showed low percentages, 13.5% and 5.8% respectively. Only 15% were granted the right to conjugal visits. Smoking habits, alcoholism, and illicit drug use were presented in more than 60% of women. Knowledge about condoms proved to be superficial. Although they had heard of and/ or correctly knew the reasons for use, 120 (77.4%) couldn’t report three necessary cares for the proper use of male condoms and 143 (92.3%) females. Were diagnosed less favorable attitudes about the use of female and during oral sex. The practice proper condom had little representation, particularly females. Homosexuality, gender issues, lack of knowledge and access difficulties represented obstacles. The attitude was significantly associated with the variables age and age of first sexual intercourse. The proper use of condoms and the history of prostitution were statistically associated. The components of the KAP didn’t showed statistical associations between them. Therefore, knowledge and attitudes weren’ot adequate enough to ensure appropriate practices. Possible clarifications are in the context of difficulties in negotiating the use of the partners, restricting access and the "illegality" that occur in homosexual relations. Strengthening the autonomy of individuals, as the essence of the educational process, and consider the knowledge and opinions, should bring together the contexts of environmental vulnerability, social, cultural and emotional.

The nursing diagnoses identification in renal transplant patients is an adequate and important instrument, because it provides an own nursing language, facilitates the communication between the professional and the patient and defines the nurse competence working scope. This study aimed to analyze the nursing diagnoses distribution presents in renal transplanted patients of an academic hospital of Fortaleza. The population was formed by the renal transplanted who are accompanied in the renal transplant ambulatory of this hospital. It was a cross-sectional study of exploratory and descriptive character. Fifty eight renal transplant patients were evaluated between months of december/04 and april/05. The data collection instruments were: an interview script and a physical exam. The results show the masculine sex predominance, with age average about 40 years, the majority being married, with average about 2 children. The origin was of the countryside cities of the Ceará or of other country states, they had familiar income of four minimum wages on an average, they did not use any contraceptive method. The majority was retired, with low education, catholic, without alcoholic drink and tobacco use. They had a medium duration of 52 dialysis months, mostly the hemodilysis. The most had as renal graft donor a corpse and average six year and half of transplant. Were identified 39 nursing diagnoses, 10 of which above of percentil 75, with the presence of six domains of the 12 investigated. Regarding the associations among nursing diagnoses, we find relation between sleep Pattern disturbed and sexual Dysfunction, sleep Pattern disturbed and ineffective sexuality Patterns, sexual Dysfunction and ineffective sexuality Patterns. In the diagnoses disturbed sensory Perception: visual and disturbed sensory Perception: auditory were found media differences with the age and time of dialysis respectively. The first diagnosis manifested itself in renal transplanted patients with more advanced age. The second diagnosis was present in patients with larger time of dialysis. We realize that the nursing diagnoses study provided us a larger knowledge of these patients’ reality, contributing for a possible implementation of effective nursing actions for the resolution of the identified problems. This can contribute to guide the nursing assistance to the renal transplanted and to provide a better life quality to this clientele.

A dor é frequente em crianças com paralisia cerebral (PC), sendo provável que a lesão altere a capacidade de compreender e comunicar a dor. Objetivamos compreender a vivência da mãe/cuidadora frente à dor da criança com paralisia cerebral. Estudo descritivo, qualitativo realizado no Núcleo de Tratamento e Estimulação Precoce (NUTEP) com 21 mães/cuidadoras de crianças com diagnóstico de PC tetraparética espástica, selecionadas a partir de uma amostra não-probabilística intencional por saturação de dados, durante o mês de novembro de 2010. Utilizamos, como suporte metodológico, a Teoria de Enfermagem Humanística, seguindo as fases da enfermagem fenomenológica de Paterson e Zderad: preparação da enfermeira para vir-a-conhecer; a enfermeira conhece intuitivamente o outro; a enfermeira conhece cientificamente o outro; a enfermeira sintetiza de forma complementar as realidades conhecidas e a sucessão interna da enfermeira a partir de muitos para um único paradoxal. Para a coleta de dados, preparamo-nos previamente através de leituras, introspecção, ambientação no local do estudo e interação com as mães. Em seguida, efetivamos a coleta de dados através da observação participante e da entrevista semi-estruturada, registrada por gravador. Para a análise, realizamos leituras exaustivas dos depoimentos, seguidas de leitura analítica para síntese e comparação das realidades conhecidas a partir das quais emergiram as seguintes categorias: reações da criança com paralisia cerebral tetraparética espástica à dor: o chamado de ajuda; a singularidade do diálogo da criança com paralisia cerebral tetraparética espástica; reações das mães à dor da criança tetraparética espástica e ausência de dor na criança com paralisia cerebral tetraparética espástica. As principais reações à dor evidenciadas por relatos das mães/cuidadoras foram irritação, agitação, choro, testa franzida, mudanças no movimento e no tônus muscular da criança. Percebemos que a comunicação não verbal da criança no momento da dor expressa as manifestações comportamentais, enquanto que a comunicação verbal através do autorrelato complementa as alterações comportamentais com base na confirmação da presença de dor e suas características. As mães/cuidadoras reagem, identificando se realmente a dor está presente na criança, bem como procurando sua localização. Para tanto, realizam a observação, o toque, avaliam as mudanças de comportamento, alterações nas expressões faciais e questionam a criança onde é a fonte da dor, quando esta consegue indicar ou comunicar-se verbalmente e para aliviar a dor oferecem medicamentos, promovem massagem, fornecem conforto, carinho e contato, e quando não percebem melhora procuram a opinião e ajuda médica. A maioria das mães/cuidadoras expressou que se sentem com vontade de chorar, preocupadas, tristes, angustiadas, desesperadas, nervosas e, em geral, descrevem o momento em que seu filho está com dor como horrível, sendo uma das piores situações vivenciadas no cuidado. Assim, concluímos que a vivência materna frente à dor da criança com paralisia cerebral tetraparética espástica se estabelece por meio da interação contínua entre a díade mãe-criança, quando ocorre identificação das reações comportamentais e vocalizações, caracterizando a comunicação, e da realização de medidas de alívio farmacológicas e não-farmacológicas, envolvidas por sentimentos da mãe que perpassam a preocupação, medo, angústia e culpa.

To study the burden of the caregivers of the patients affected by stroke contributes to the improvement of nursing care by making it more skilled and geared to the needs of this population. The objective was to evaluate the main burden of family caregivers of the patients with stroke. Cross-sectional study was conducted from January to April 2010. It was carried out in Fortaleza-Ceará, Brazil, in 2010, at Home Care Program. Established themselves as inclusion criteria: be the principal family caregiver and pursue such activity for at least two months. Caregivers who were unable to give information about the health-disease patients, and caregivers of stroke patients who had mental disorders, and other neurological diseases, were alcoholics or drug addicts were excluded. We interviewed 61 caregivers in relation to demographic data, activities performed, presence of pain, assessment of financial expenditures, the presence of psychiatric symptoms through Self Report Questionnaire (SRQ-20), cognitive evaluation by Mini-Mental State Examination (MMSE) and evaluation of the burden of care for the Caregiver Burden Scale (CBS). Patients were asked about the sociodemographic, health history, degree of dependence in the Activities of the Daily Living (basic and instrumental) and cognitive evaluation (MMSE) and anthropometric evaluation was performed. The data were compiled in the Excel software and analyzed through the SPSS program, version 15.0. The level of significance considered was 5% (p<0.05). All the ethical recommendations were fulfilled. It was found that most caregivers were female (93.4%), married (52.5%) and daughters of the patient with stroke (50.8%), they had not another occupation (82%), they had family support to engage in the activity of caring and had good schooling. The caregivers exerted on the caregiver for at least 27 months and 18 hours per day devoted to his family. Patients were primarily female (59%), elderly, bedridden, with a low educational level, other events of stroke, highly dependent, low cognitive level (95.1%). Depending on the observed, the caregivers had health problems such as hypertension, diabetes mellitus, dyslipidemia and osteoporosis. Many caregivers complained of pain after engaging in this activity. Others presented with psychological distress (44.3%). As for the activities performed, they understood, above all, self-care activities. Besides taking care of the patients, they took care of children or grandchildren. Changes in daily routine and emotional status were reported. Despite the above problems, it was observed that caregivers performed the care, especially for pleasure (70.5%). In relation to the burden it was found an average of 2.36 (± 0.59) on CBS, superior national and international studies. That burden suffered higher impact when the caregivers have higher scores on the SRQ-20, in the absence of a secondary caregiver, and when the caregivers reported that they had noticed any change in their body and health, and when the patient was taking several medications daily. The findings underscore the need for nursing staff to act not only with patients affected by stroke, but also on prevention and health promotion and their caregivers who are burdened.

BERTINI , Fátima Maria Araújo. Centro da cidade de Fortaleza, lugar das transformações: o idoso e os afetos implicados. 2006. 183f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2006.

The prevalence of type 2 mellitus diabetes has increased worldwide, mostly in children and adolescents. The objective was investigating the prevalence of risk factors for type 2 mellitus diabetes in adolescents from public state schools in the city of Fortaleza-Ce. From February to March, 2006 a transversal study was carried through with 720 individuals from both genders between the ages of 14 and 19, enrolled in twelve state schools. A form was used to record identification data, socio-demographical features, food habits, physical activity and leisure practice, in addition to the measurement of weight, height, capillary glucose and arterial pressure. Results highlighted that 59.3% were girls, 10.3% were overweight, 2.6% were obese, 75.3% were sedentary, 91.1% had a family income not higher than 3 minimum wages, 8.3% presented capillary glucose with doubtful rates and 42.1% elevated arterial pressure levels. Food consumption of four or more times a week was statistically significant in rice (95.8%; p=0.0001), bread (85.8%; p= 0.0001), beans (75%; p= 0.0001) and meat (60.6%; p= 0.0001); besides that, 92.7% had from three to six meals a day. From the sample stating there was diabetes in the family, 13.6% mentioned the parents as diabetes carriers. Women practiced less physical activity than men (p= 0.000) and presented a higher percentage of doubtful glucose (p=0.004), but they had a smaller relative number of elevated arterial pressure (p=0.000); regarding overweight / obesity there was a statistically significant association with gender (p=0.840). Overweight was higher between the ages of 14 to 15 (11.1%, p=0.003) and obesity between the ages of 16 to 17(3.3%, p=0.003). Whereas sedentariness was also higher between the ages of 16 to 17 (80.8%, p=0.049). As observed, capillary glucose had no association in a statistically significant manner, with age (p= 0.453%). The risk factors association for type 2 mellitus diabetes (overweight, sedentariness, capillary glucose and elevated pressure levels) was mostly found in girls between the ages of 16 to 17.

JESUINO, Filipe de Menezes. O delírio paranóico nos sistemas de Freud e Jung: contribuições mútuas e contrastes. 2008. 177 f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2008.

Pregnant women’s access to a decent, humanized and qualified service is not only a right, but a women’s necessity. The Health Department expresses and makes official through regulations, the intention of investing in attention to pregnancy, childbirth and post-delivery, establishing the Program of Humanization in Prenatal and Birth (PHPN). It is an unprecedented program, as a deep search in literature did not identify any other program like PHPN. Besides, it is a proposal of intervention for a country that is in process of development; it offers directives for the different instances of assistance; it describes the minimum conditions for the attention with financial incentive connected to the execution of such conditions; and it suggests an information system (SISPRENATAL), with offers the local administrator to monitor progress and challenges and to correct imperfections. In this context, it was decided to carry out the present study which had as a general objective to evaluate the quality of prenatal assistance in Ceará from the implementation of PHPN on. The specific objectives were to evaluate process indicators of PHPN generator in the SISPRENATAL in the State; to analyze specific aspects of the nurse’s performance in the prenatal attention, informed in the SISPRENATAL; and to identify the financial income produced by PHPN to the state of Ceará. The study was characterized as exploratory and descriptive and its universe was the Health System of Ceará. Part of the data was collected in the Information Department of the Health State Secretariat through a search in the Prenatal Information System (SISPRENATAL). The other part was collected in the Coordination of Control and Evaluation of the same Secretariat. The process indicators served as supplementary information to analyze the quality of prenatal assistance in Ceará, between June, 2001 and August, 2006. Throughout these six years 691.001 live born infants (NV) were notified in the SISPRENATAL. However, only 312.507 registrations of pregnant women were notified, that is, 44,4% of NV, including pregnant women with pregnancy age until 120 days from 2001 to 2003, and from then on women with all pregnancy ages. It was observed a continuous increase in the indicators of pregnant women’s early registration (<120 days) in the program, from 88,3%, in 2001, to 96,4%, in 2006. In the evaluation of all conditions determined in Component I of PHPN, together, which defines a better quality of prenatal assistance, the percentage reached 15,67% of registered pregnant women. This result was about 50% superior to the result found in the Country, considering that the conclusion of this indicator in national level was about 10,12% in the same period. It was demonstrated that nurses act extensively in prenatal assistance of basic health units of the State, because 95% of pregnant women’s registration and 88% of post-delivery service were carried out by this professional. Concerning the financial aspect, when we verify the difference of the value of the actions which were carried out and informed at the BPA of the municipalities but were not approved, we have a State total value of R$ 323.040,00. It is noticeable by this value the possible lack of interest or even the lack of Knowledge that governors have when solving problems that produce the disapproval of information and block the collection of resources, what decreases the possibility of greater progress in this area. In conclusion, it was possible to notice through this study that it is necessary to intensify the discussions among professionals, governors and community about progress and challenges in each municipality, in each area of PSF, in other to promote a visualization of several necessities in prenatal assistance and look for possible and effective solutions. It is unacceptable that the area of care which is so necessary and considered many times a priority by public policies suffer because of negligence and absence of basic guarantees like the realization of essential lab exams, anti-tetanus immunization and post-delivery service. This is a reality detected in Ceará and also described in the national scenery. We have to recognize the active role of the nurse in this area of care and that it is urgent that governors of the municipality appropriate the financing process of PHPN and minimize missed opportunities to obtain financial resources for the Health Local System.

PINHEIRO , Francisco Pablo Huascar Aragão. A arte e a brincadeira e suas interfaces com a dramatização em psicologia comunitária: um estudo de processos de mediação simbólica. 2008. 110f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2008.

CASTRO, Geísa Sombra de. Diálogos e vivências sobre arte e identidade com jovens do Bom Jardim. 2009. 264f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2009.

This study objectifies to evince the process of precarization of labor that autonomous workers from the tourism sector– operators of transport and tourism - in the city of Fortaleza face and their relation with stress at work, emphasizing the coping strategies these professionals are using in the execution of their activities. Our reflection is based on the theoretical referential of Social Psychology, together with stress theories in articulation with socio-historical aspects involved in the phenomena. Methodologically, we used a qualitative approach, recognizing the relevance for the object of analysis. The study was dividedin two moments: in the first, it was used the Inventary of Stress Symptoms for Adults by Lipp (2000) –ISSL, aiming the identification of the level of stress in the respondents.15 workers took part in this stage. The data analysis was carried out according to the correction criteria of the inventory. In the second part, we used the interview. 7 workers participated and the criterion of choice was those who presented stress in their inventories. The analysis of the qualitative material was done through content analysis.The articulation between the precarization process and the development of coping strategies identified in the group studied highlights the necessity to deepen the analysis of the effects of intense transformation of labor reality on the workers.

PINHEIRO, Glícia Rodrigues. Afetividade e ambiente hospitalar: construção de significados pelo paciente oncológico com dor. 2009. 157f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2009.

Newborn infants that have impaired lung function because of prematurity or any other diagnosis that interferes in the respiratory system, usually need some type of oxigenotherapy. The objectives of this study were to evaluate physiological parameters (RR, HR, Pulse, SpO2) in neonates submitted to oxigenotherapy in a Neonatal Intensive Care Unit (NICU) during the execution of some painful procedures carried out by nurses (orotracheal suction, upper airway suction, blood collectium to gasometry, insertion of a Peripherally Inserted Central Catheter – PICC - and withdrawing of curative). For this purpose, it was developed a before and after longitudinal and quantitative study in a Neonatal Intensive Care Unit of a public institution of reference in the city of Fortaleza-Ceara, in the period of December 2008 to June 2009. The sample was composed of 125 clinically stable newborns hospitalized in high-risk beds with at least six hours of life, and submitted to some type of oxigenotherapy for at least six hours. The data collecting was accomplished by systematic observation and the data were recorded in research forms that contained some independent variables, such as painful procedures carried out by nurses and some dependent variables such as the physiological parameters, like RR, HR and others that were visualized in the cardiac monitor during the procedures (pulse, SpO2). Additionally to these variables, it was studied both characteristics of the newborns regarding the birth conditions (birth weight, gender, type of labour, Apgar score, capurro) and regarding the period of hospitalization in the NICU (date and time of hospitalization, date and type of oxigenotherapy when the baby was admitted in the NICU, oxigenotheray modality and newborn weight at the time of the data collection, accommodation, diet and medication). These data were obtained through the medical charts, with the purpose of correlating them to those variables. The results showed that 92,8% of the neonates were preterm infants and 7,3% were term infants. Regarding the type of labor, 56,8% of the babies were delivered by caesarean section and 43,2% of them born by vaginal labor. According to the weight of the babies under the study, 92,0% weighted below 2500g while only 7,2% were above 2500g. The most common diagnostic hypotheses founded were prematurity (93,6%) and Respiratory Distress Syndrome - RDS (52,8%). The evaluation of the physiological parameters of the four procedures accessed in this study showed some variations (p<0,05) of RR and HR in the newborns using hood and CPAP, and variation of pulse (p<0,05) for the newborns in hood, CPAP and MV; however, the SpO2 was the only parameter that did not suffer any significant variation (p>0,05) regarding the suction of either orotracheal tube or upper airway. Concerning the gasometry, variations were found (p<0,05) in all physiological parameters; nevertheless, the alterations related to this procedure were different for each oxigenotherapy modality, occurring changes in HR, pulse and SpO2 in newborn using hood, and alterations in RR and pulse in neonates under MV; however, regarding the insertion of a PICC and the withdrawing of curative, no statistically significance alterations were found (p>0,05). It is proposed to the nurses to develop interventions that can keep the variations of the parameters of RR, HR, pulse and SpO2 in normal levels during the execution of these procedures.

Esta pesquisa aborda a prática desenvolvida nos Centros de Atenção Psicossocial Álcool e outras Drogas (CAPS AD), com enfoque no saber-fazer das equipes multiprofissionais neles atuantes. O objetivo geral do estudo foi analisar os CAPS AD como dispositivos de atenção ao usuário de droga com base nos preceitos das políticas atuais sobre drogas. Os serviços foram caracterizados quanto a sua estrutura física e recursos humanos. Investigaram-se as concepções e percepções dos profissionais relacionadas à problemática do consumo de droga na atualidade, assim como as ações e práticas desenvolvidas por eles nos CAPS AD. Trata-se de uma pesquisa exploratória e descritiva desenvolvida em quatro CAPS AD, distribuídos na cidade de Fortaleza-CE. Os sujeitos envolvidos no estudo foram os profissionais de nível superior, que compunham as equipes multiprofissionais e os coordenadores técnicos de cada instituição. Utilizou-se um roteiro de entrevista semiestruturada com perguntas contemplando aspectos inerentes às características sociodemográficas dos sujeitos, suas formações profissionais e experiências em saúde mental. Alguns questionamentos também visaram o conhecimento das práticas desenvolvidas nos serviços e do uso dos recursos e dispositivos presentes nas comunidades e na suposta rede de atenção e apoio ao usuário de álcool e outras drogas. A observação sistemática e o diário de campo foram utilizados também na coleta de dados, já que se pretendeu saber como estavam organizados e distribuídos os recursos físicos e humanos de cada instituição, assim como suas dinâmicas de funcionamento. Os dados quantitativos foram organizados em quadros e os qualitativos de acordo com o método de análise de conteúdo proposto por Bardin, sendo analisados e discutidos com base na literatura recente. Os aspectos éticos e legais da pesquisa foram respeitados conforme as normas da Resolução 196/96 do Conselho Nacional de Saúde, que regulamenta a pesquisa envolvendo seres humanos. Ao findar do estudo, percebeu-se a consciência dos profissionais em relação à importância da problemática das drogas nos dias atuais, bem como das articulações entre os diversos espaços voltados à assistência ao usuário de droga. No entanto, muitas das ações ainda são centradas no CAPS AD, constatando-se o predomínio de práticas ambulatoriais em detrimento das comunitárias e o esforço de alguns profissionais para reabilitar e reinserir socialmente os usuários dos serviços, embora considerem o preconceito da sociedade como uma grande barreira a ser superada. A apreensão dos discursos dos profissionais acerca da prática junto ao usuário de droga traz à tona uma realidade nova, de construção de serviços desta natureza, destacando alguns avanços e muitos desafios a serem enfrentados para mudar o cenário de atenção a esta população. Para que isto ocorra, necessários se fazem a união de esforços e de ações interdisciplinares e intersetoriais. O campo estudado mostra-se rico e carente de outros estudos.

The breast cancer has been established as a serious public health problem, not only by the growing number of cases diagnosed each year, but also by the financial investment that is required for diagnosis and treatment. The objective of this study was to evaluate actions for early detection and risk factors for breast cancer in women at a Basic Health Unit, Fortaleza, Ceará. It was conducted a cross-sectional study, descriptive and analytical, with a quantitative approach, on shares of early detection and risk factors to the breast cancer. The research was developed in a Basic Unit of Family Health, Fortaleza, Ceará, in the period from March to November of 2008. The population was based on the amount of annual gynecological attendances made by nurses, for a total of 1920. The sample was 320 women. It was used as technique for data collection a semi-structured interview and as instrument, the semi-structured form. For the analysis was used the chi-square test with the aid of SPSS version 15.0 in order to measure the association of variables, at 5% level of significance. The following results were obtained: the average age of interviewed women was 37, had family income below a minimum wage 139 (43.44%) of them; studied between 11 and 15 years of study, 192 (60%) of the total; reported first episode menstrual, aged over twelve years, 206 (64.38%); only 64 (20%) had entered the menopause and 238 (74.38%) had their first pregnancy, aged below 30 years of age; on breastfeeding, 210 (65.63%) breastfed their children; it was found that 177 (55.31%) make use contraceptive oral; had family history of breast cancer, 71 (22.19 %); affirm the habit of smoking 62 (19.38%); said drink alcohol 89 (27.81%). It was inferred that 252 (78.75%) know the BSE. The Clinical examination of the breasts is performed by 246 (76.87%) of respondents. It was observed that 46 (44.23%) reported perform mammography annually. It was detected that the years of study influenced on practice of BSE. However, there was a lack of association between the time of study and implementation of BCE and knowledge of mammography. As the range of income, this variable was associated only with the knowledge of the BSE and the mammography. It is noteworthy from the results of the research, that even with the technology developed in recent decades for the control of breast cancer, can not ignore the many factors that make the etiology of this neoplasm. Hence the need for greater effectiveness in detecting breast cancer, and early recognition of its risk factors

INTRODUCTION: Brazilian children and adolescents are considered to be the most vulnerable part of population, due to their exposition to social aggravating elements that poverty and lack of access to basic services as education health, sports, leisure and professionalization increase. Social context is a very significant factor to adolescent`s education as a subject who embraces values and attitudes. Living at Brazilian country areas is a determining factor for his/her social vulnerability. It is necessary to know social context to develop purposes and actions that can positively influence adolescents` health. Photography is often used within research in Health subject area as a mean of knowledge/interpretation of subjects` life reality. This research considers that, through photography, it is possible to know country adolescents` point of view, by engaging a group critical reflection process on images and themes. OBJECTIVES: Analyzing country adolescents’ points of views, based on Paulo Freire`s conscience process, identifying primary problems in community health. METHODOLOGY: Community-Based Participatory Research (CBPR) study, with qualitative approach, based on Paulo Freire’s Critical Education and on documentary photography. Twenty-six students participated in the study. Data collection followed Wang and Buris’ photovoice method, and engaged in fifteen group meetings, country adolescents argued on health problems that affect them. Each participant received a photo camera, captured images from their community and reflected on their pictures. Results were organized within themes and categories through participatory analysis. RESULTS: The amount of girls (21) was higher than the amount of boys (5), as well as the age 12 to 13 years-old (16) was more prevalent. Familiar life living was with parents overall (24) and with grandparents (2). Family was often reported to be the basis for everything. Feeling on health was reported in two opposite sides: adolescent was or very healthy or very sick in Carapió community. Themes for photos represented their main concerns on country community social questions: nature, education, leisure, health, feeding, and tobacco and alcohol consummation. 131 images were selected to critical reflection. Written reports highlighted the importance of nature on country adolescents` health, as well as poverty and the lack of resources in community`s health unit. Adolescents concluded photovoice project with the exposition “Reality in Image”, within the country community, where population, media and managers were engaged. In different moments Freire`s three levels of conscience were experienced, always endless, and the conscience process succeeded from lenses to reality. CONCLUSION: Photovoice is considered a positive educational strategy for health, that engaged adolescents in community`s collective health matter and empowered teens` voice as protagonists of their own history. Country adolescents health point of view is specific, his/her culture influences his/her action and thoughts. Therefore, adolescent health care programs shall consider differences between rural and urban areas. There are some challenges to overcome, above all the ones concerning to political power rupture, which shall break common sense wild spreading within country communities. This research recommends new studies on this methodology in Brazil.

NOBRE, Maria Cristina de Queiroz. Modernização do atraso: a hegemonia burguesa do CIC e a alianças eleitorais da "Era Tasso" . 2008. 324 f. Tese (Doutorado em Sociologia) – Universidade Federal do Ceará, Departamento de Ciências Sociais, Programa de Pós- Graduação em Sociologia, Fortaleza-CE, 2008.