RCAAP Repository

MELLO, Marcos Paulo Campos Cavalcanti de. Quando os assentados chegaram: tempo e experiência social no MST. 2011. 169f. Dissertação (Mestrado em Sociologia) – Universidade Federal do Ceará, Departamento de Ciências Sociais, Programa de Pós-Graduação em Sociologia, Fortaleza-CE, 2011.

A utilização de recursos tecnológicos na área da saúde e da enfermagem vem sendo cada vez mais presente na realidade prática. Essas ferramentas são desenvolvidas e aplicadas no meio assistencial, assim como no meio acadêmico por enfermeiros e por discentes. Diante desta nova realidade, é exigido dos enfermeiros preparo, conhecimento e domínio da tecnologia para adequar-se a estas novas tendências de ações em enfermagem, sem, contudo, afastar-se da essência do cuidado ou distanciar a relação existente entre professor e aluno. Dentre as práticas do enfermeiro, cita-se a atenção em planejamento familiar e anticoncepção. Passando pelos aspectos tecnológicos e assistenciais, torna-se oportuno articular o uso de tecnologia, educação e enfermagem em planejamento familiar, desenvolvendo uma hipermídia educacional. Assim, objetivou-se construir uma hipermídia educacional em planejamento familiar, com ênfase à contracepção. O desenvolvimento deste estudo foi baseado na teoria da interação social de Vygostsky. O estudo é do tipo de desenvolvimento, ou seja, a construção e desenvolvimento de softwares e outras estratégias tecnológicas que são implementadas no ambiente educacional ou assistencial. A construção da hipermídia ocorreu no período de maio a outubro de 2009. Em seguida, foi realizada avaliação por juízes especialistas em planejamento familiar-contracepção e em tecnologia. Após análise pelos juízes, foram implementadas as sugestões e correções, as quais resultaram na última versão do hipermídia. O desenvolvimento foi baseado na proposta de Falkembach (2005), que cita como fases de concepção e desenvolvimento de uma hipermídia: o planejamento; a modelagem, que consistiu na elaboração do roteiro de aulas; implementação, que consistiu na criação do curso no Ambiente Virtual de Aprendizagem (AVA) Solar e na avaliação. Esta ocorreu por meio de avaliação de especialistas técnicos e em conteúdo, selecionados com base em critérios de produtividade e experiência na área relacionada. Feita a avaliação, foram realizadas as alterações sugerias, resultando em uma última versão da hipermídia. Foram seguidos os aspectos éticos. Os juízes validaram a hipermídia em termos técnicos e termos de conteúdo ao atribuírem valoração que classificou a hipermídia como adequada a ser utilizada junto a acadêmicos de enfermagem. A hipermídia mostrou-se como uma ferramenta a ser utilizada no processo ensino-aprendizagem relacionado a temática planejamento familiar em contracepção. A criação e utilização dos recursos em tecnologia vêm se mostrando cada vez mais úteis e eficientes, sendo sua aplicação na prática docente ou assistencial algo cada vez mais explorado na enfermagem e, mais precisamente no ambiente de ensino. A criação destes recursos na enfermagem se faz de grande importância para a elevação da profissão e da qualidade da assistência.

Two decades after the beginning of the AIDS epidemic, it has been observed how one generation of children has been affected by HIV. They experience a childhood marked by their parent’s becoming ill, by being orphans and by the stigma caused by the illness. Some of these children whether they are the virus’ bearer or not have to be taken to institutions. Thus, living in an institution is, most of the times, the most viable option for the children. It was intended to analyze how children who were born exposed to HIV live inserted in support houses/orphanages in Fortaleza, Ceará. The option chosen was the articulation of the research with the qualitative and quantitative approach which was used to provide elements of the way the case study should follow. The modality of thematic oral history research was also used. The population used was composed of 24 children exposed to HIV on birth that live in full or part-time system in two institutions (support house and orphanage). The study was carried out during the first semester of 2010, in Fortaleza-Ceará, Northeastern region of Brazil. Two institutions registered in a public organ and which function as reference institutions in the state of Ceará, are responsible by the children’s care of children exposed to HIV on birth or infected during their lives. Both took part in the study: the “Casa do Sol Nascente” [House of Rising Sun (full-time permanence)] and the “Centro de Convivência Madre Regina” [Social Center Madre Regina (semi-full permanence)]. To collect the data were used: interviews semi-structured to collect epidemiologic, clinical and social data of the children and their parents; primary data obtained from the children’s health registers; life stories produced by the people in charge of the institutions and by the mothers and reports of prejudice situations experienced by the children. For the quantitative analysis, the institutions were compared by means of distribution of bivariad frequencies. It was observed that the children have access to the items indispensable for their adequate growth and development, facing, however, important markers of vulnerability. The differences between the two institutions were most of the time attributed to the mother’s presence in the care dedicated to the children of the semi-full time institutions. An inter-sectional work should be suggested and a full-time care according to the needs characteristic of each institution, each family and each child, in a more humanized resolute practice as a way of promoting life.

A educação é condição-chave para a consciência ambiental, ou seja, faz despertar nas pessoas a responsabilidade com a natureza e preocupação com novas relações comprometidas com o meio ambiente. Neste contexto, esta investigação se propôs realizar uma pesquisa-ação, na qual o enfermeiro insere-se na escola efetuando ações relacionadas à educação ambiental num espaço de debate e crescimento coletivo com adolescentes. Objetivou-se promover um espaço crítico-reflexivo acerca da saúde ambiental junto ao adolescente. Trata-se de um estudo descritivo-exploratório, com abordagem qualitativa, realizado na Escola de Ensino Fundamental Manoel Pereira de Brito, pertencente à rede municipal de ensino, com sede em Bolso, no Município de São Gonçalo do Amarante- Ceará, a qual localiza-se nas proximidades da proposta de implantação de uma usina termelétrica a carvão mineral. A população do estudo foi composta por um grupo com dezessete adolescentes. O período da investigação aconteceu de janeiro a setembro de 2009. Os instrumentos e procedimentos que foram utilizados foi observação, diário de campo, gravador e abordagem grupal. No primeiro encontro, foi utilizado o desenho estória com tema, tomando o seguinte eixo norteador: O que você entende como saúde ambiental? Logo depois, fora apresentado pelos participantes o relato da estória do desenho. No segundo encontro, foi solicitado aos jovens que tirassem fotografias da sua região adjacente para descobrirmos na percepção deles o que seria saúde ambiental para que, posteriormente, essas imagens fossem desencadeadoras da discussão, caracterizando-se como fichas de cultura. No terceiro encontro, foi elaborada letras de músicas, paródias ou poemas pelos alunos, sendo um produto das discussões no que se relaciona à saúde ambiental. O quarto encontro foi elaborado a partir da avaliação do terceiro, com a finalidade de formular no quinto encontro um folheto educativo. Então, foi proposta uma ação grupal de reflexão de itens importantes que deveriam estar presentes neste folheto educativo. E, por fim, o quinto encontro, que foi o seguimento do quarto, sendo um processo avaliativo final, no qual os adolescentes fizeram um folheto sobre saúde ambiental, contextualizado a comunidade local. A análise dos dados foi baseada nas práticas discursivas das narrativas realizadas pelos participantes. O estudo foi submetido à apreciação do Comitê de Ética em Pesquisa da Universidade Federal do Ceará e aprovado na reunião do dia 19 de dezembro de 2008, número do protocolo 252/08. Nessa pesquisa-ação, constatou-se que o enfermeiro pode ser um educador ambiental, inserir-se nesse espaço para proporcionar aos grupos discussões contextualizadas à realidade deles, favorecendo reflexões sobre relações comprometidas com o socio-ambiental. Na pesquisa em enfermagem, é necessário utilizar diferentes métodos de coleta para explorar a técnica grupal, pois permite uma troca mútua pelo estabelecimento do diálogo. O cuidado de enfermagem na saúde ambiental é escasso, contudo, é uma área que precisa de intervenção, e o enfermeiro pode inserir-se por meio da promoção da saúde em prol do bem-estar ecológico e, consequentemente, humano.

Qualitative study having as subject, the communication between mothers and adolescent daughters in the family context. Objectives 1. Know, based on experience with mothers of adolescents, their views and experiences on issues related to gender, sexuality and reproduction, the dialogue between mothers and daughters. 2. Identify the mothers´ difficulties/ potentialities, with support in their lived experiences.3. Discover the processes of communication between mothers and daughters, made collectively through dialogue, negotiation and argumentation.4. Propose the practice of Health Education as a mediator of communication between mothers and daughters in the family context. Methodology: The social agents of the research were seven mothers of female adolescents, participants from non-governmental organization Acartes, residents in the District of Pirambu in Fortaleza-CE. The theoretical framework used was the Theory of Diversity and Universality of the Care of Madeleine Leininger. Data collection followed the model Observation-Participation Reflection, proposed by Leininger; semi-structured interviews and eleven meetings with the group, addressing the stages of development of the daughters: birth, childhood, puberty and adolescence. The project was submitted and approved by the Ethics Committee of the UFC under Protocol No 17/08. Results: social and cultural factors in the community contribute to the vision of sexuality of women and make difficult the dialogue with their daughters. The early pregnancy is a factor in their story of life, and when they project this fact to their daughters, the pregnancy has already occurred, or report that their daughters are likely to become pregnant early. That experience, the fruit of social development, creates barriers, which, alone, women can not overcome, and what happens is the continuation of a cycle in which the relationship of non-dialogue between mother and daughter are reproduced over the generations. In this reality, many times women, placed in a particular cultural background, have little or no degree of motivation of the family or community. When they remember their experiences of adolescence, feelings such as fear and shame are reported in adulthood and relate these feelings as still present in their lives. In relation to dialogue with their daughters, the argument is used by the pregnancy issue, linking it to the future of these barriers in life. For STD, are little discussed as an argument for prevention, not on explaining signs and symptoms, making the vision of adolescents at the preventive issue. The TV is seen as an area that provides the reasoning and negotiation. Conclusions: The study may prompt a renewed vision in the field of sexual and reproductive health in the family, which considers the relational dimension of sexuality, sex and reproduction, aiming to contribute to the promotion of the dialogue between mother and daughter. The intervention of the nurse as part of the team of Health of the Family through the Health Education helps to improve self-esteem and perception of the women´s world, encouraging them to a greater degree of autonomy and power to decide about questions related to sexuality. The reflection of the experiences through the memories of the life cycle can encourage them to think about new projects for their lives and shows that even with difficulties, the dialogue between mothers and daughters can occur, whereas it is never too late to learn

Infants in the Neonatal Intensive Care Unit (NICU) often get skin lesions on account of the many stressful procedures they are exposed to. This prospective, quantitative and descriptive study was carried out at a public health facility in Fortaleza (Northeastern Brazil) from March to May 2007, in order to investigate skin lesion patterns in infants in the NICU setting. The study population consisted of 137 hospitalized infants. Informed written consent was obtained from the infants’ caretakers. The data collection instrument registered skin lesions through direct observation during bathing, change of diapers, catheters and eye patches and during removal of semi-permeable membranes, elastic adhesive bandages and/or micropores, electrodes and hydrocolloid dressings applied to the skin during punction, among other procedures. Eighty percent of the infants were premature, 63% were male, 61% were caesarean births, 40% presented first-minute apgar scores of 7-10, 49% were diagnosed with moderate prematurity, 74% were full-term, 39% had low birth weight and 44% measured 41–47cm. Thirty-six infants had skin lesions (total 51 lesions) in the form of bruises (46%), erythema (18%), excoriation (12%), ecchymosis (10), pustulas (6%), scaling (4%), myelomeningocele (2%) or gastroschisis (2%). The lesions were inflicted while the infants were being treated with intravenous hydration (84%), antibiotics (78%), mechanical ventilation (53%), phototherapy (33%), parenteral nutrition (27%), blood transfusion (8%), oxygen hood (8%), nasal cpap (6%) or circulating oxygen (4%), or were in a heated incubator (86%), transport incubator (10%) or heated crib (4%). Lesions were observed most often on limbs (52%), torso (24%), head (16%) and other sites (8%). The causes identified were arterial puncture (32%), leaking (14%), contact dermatitis (14%), vein puncture (8%), impetigo (4%), undetermined (4%), congenital malformation (4%), removal of the caul (4%), removal of adhesive bandage (4%), skin dryness (4%), infection (2%), removal of hypoallergenic tape (2%) and birth traumatism (2%). Forty percent of lesions measured < 1cm2 and 68% measured 1-2cm. Most were well defined (38%) and/or localized (92%). Infants with lesions presented prematurity (92%), syndrome of respiratory distress (43%), asphyxia (24%), full-term delivery (8%); risk of infection (6%), risk of hypoglycemia (6%), gastroschisis (2%) or myelomeningocele (2%). Most (47%) weighed 550-999g at birth, with lesions occurring at 455-999g in 47%. Most were newborn (84%) and lesions appeared before the seventh day of life in 47% of cases. Among the parameters lesion type, diagnosis, PN, IG and prematurity, only the latter presented a statistically significant association (p=0.496, by the Fisher-Freeman-Halton test). The study shows the importance of providing the newborn with good-quality holistic nursing care with a view to the special needs of this patient population.

The chronic renal disease is considered a progressive pathology and an important public health problem. In Brazil, the number of patients undergoing any of the different dialysis modalities keeps growing. During the dialysis sessions, countless complications may occur, such as arterial hypotension, which occurs in 25% of the sessions. This study was aimed to screen the representation by gender within the chronic renal disease patient population with hypotension episodes during hemodialysis. The study was carried out between March and May 2009, using a descriptive, exploratory, quantitative and qualitative methodology based on the Social Representation Theory. The study was done at a hemodialysis clinic in the City of Fortaleza serving the state-run health service (SUS), over a population of 50 chronic renal patients suffering from arterial hypotension episodes during dialysis. Data were obtained from the patients´ clinical history by a multi-method approach, a free association of words with inducing stimuli, narrative interviews and collages. Data obtained from the clinical histories and from the free association of words were organized in Excel spreadsheets, while the qualitative data, i.e. the interview and collage, were organized by narrative lines (Spink) and the expression technique, respectively. All legal and ethics norms were followed pursuant to Resolution 196/96, which regulates the research on human beings. The results show a dominance of women, an age range of over 60 years, illiterate, married, catholic, retired, patients with a family income of about one minimum wage, residents of the capital city, mainly with HAS and DM as the cause for dialysis. They evoked 200 words, chosen regarding the central core and periphery. 30 patients were interviewed and were classified in 7 categories. Finally, 45 patients used the collage and were classified into 13 categories. We noticed that the social representations are more pessimistic and negative in men. They associated AH to sweating, fear, bad sight and death, and reported that after the initiation of treatment the limitations imposed by the illness made their daily life more difficult. They also reported changes in previously developed activities and associated the illness limitations to a lack of freedom, prison and fire. The social representations of women were expressed in a more cautious and sentimental way. They associated AH to sweating, fear, bad sight and pain. They reported positive attitudes, dealt well with the condition, and mentioned religious aspects and future plans as tools to face and overcome the illness. Shared images related to the difficulties related to the new dietary habits were common, yet highlighting their ability to come to terms with it. We concluded that many things can be done for chronic renal patients as well as for the professionals taking care of them. By knowing the particularities of each individual, it would be possible to apply healthcare promotion principles aimed to improve the patients´ quality of life.

Adolescence is characterized by the need of knowing more about themselves and the world, with special reference to sexuality and sex. However, this sexual experimentation is related to the social and cultural environment in which these adolescents are inserted. So, being the habit of watching soap operas a cultural and social habit presented by adolescents, we can assume that soap operas can influence the sexual behavior of adolescents. Thus, the objective was to investigate the influence of soap operas in the sexual behavior of adolescents concerning the vulnerability to HIV infection. This is a case-control study of quantitative approach carried out in seven high schools from the public state net of Fortaleza-CE. The study population was composed of male adolescents who were regularly enrolled in these high schools. The sample was selected through the application of inclusion and exclusion criteria on the use of condoms during sexual intercourse. We used the matching method for each case and control groups with 67 male adolescents with age equivalents. Two questionnaires were applied for data collection, from August to November 2010. For data analysis we used the SPSS version 16.0. The research project was approved by the Ethics Committee under protocol Nº. 71/10 and the free and informed consent was applied before the questionnaires. Adolescents had a mean age of 16.79 years, single, studying in the 2nd year of high school, no job, family income up to three minimum wages. 45 adolescents in the case group were living with up to two people working, while 49 in the control group lived more than two people working (p=0.061). Adolescents of both groups started their sex life, on average, at 14.44 years old (p=0.847). Three teenagers in the case group were "dating" the current sexual partner compared to 11 in the control group, and 20 adolescents had a girlfriend in the case group compared to 26 in the control group (p=0.651). Five teenagers in the case group presented more than one sexual partner in comparison to 10 in the other group (p=0.025). The reasons curiosity (p=0.038) and attraction (p=0.038) were the ones that most encouraged the teenagers to begin their sexual life. Teenagers in the control group (38) watched more soap operas from Rede Globo than the case group (27) (p=0.057). The soap opera "Malhação" was the most watched by adolescents in the control group (19) than in the case group (9) (p=0.034). 15 adolescents in the control group compared to the five in the case group showed that the soap opera influenced their sexual behavior (p=0.062). It was concluded that although teenagers present the same socioeconomic level and go the same type of school, the soap opera contributed to the practice by adolescents in the control group of the following risk behaviors: having more than one sexual partner, not use condoms in all sexual intercourse with girlfriends and "dates", which increased their vulnerability to HIV infection.

A assistência de enfermagem à criança portadora de cardiopatia congênita com ênfase na investigação de dados antropométricos é recomendada precocemente, pois significantes atrasos no peso e comprimento devido ao comprometimento hemodinâmico relacionam-se intimamente aos problemas nutricionais. Buscou-se avaliar o estado nutricional de crianças menores de 2 anos de idade, portadoras de cardiopatias congênitas, mediante estudo antropométrico, caracterizar os dados sociodemográficos, história alimentar e antecedentes perinatais, analisar os percentis e escore Z de peso/comprimento, peso/idade, comprimento/idade, circunferência braquial, índice de massa corporal/idade e verificar os preditores de alteração dos parâmetros antropométricos, dos percentis e escore Z nessas crianças. Estudo transversal e observacional desenvolvido em duas instituições de saúde ambulatorial e hospitalar, referências em doenças cardíacas. A coleta de dados ocorreu de janeiro a junho de 2009, utilizando formulário estruturado em dados: identificação da criança, sociodemográficos, antecedentes perinatais, diagnóstico patológico, registro alimentar atual e medidas antropométricas. Respeitaram-se todos os aspectos éticos e avaliaram-se 132 crianças predominantemente de Fortaleza-CE, do sexo masculino, com mediana de idade até 8,5 meses e portadoras de cardiopatias congênitas acianóticas, tipo comunicação interatrial, em acompanhamento ambulatorial, no período pré-operatório. Conforme os achados, a maioria de crianças era desprovida financeiramente; as mães haviam cursado até nove anos de estudo, restritas às atividades do lar, e dividiam com os companheiros os cuidados do filho. A maior parte das crianças consumia fórmulas lácteas infantis acrescentadas de complementos alimentares. Segundo os antecedentes perinatais, evidenciaram-se mães com até dois filhos e aproximadamente 27 anos de idade no nascimento do filho cardiopata, alimentação adequada durante o período gestacional, assinalado por intercorrências: infecções do trato urinário, sangramentos transvaginais, dores, ameaça de aborto, hiperêmese gravídica, hipertensão arterial, rubéola, anemia ferropriva, diabetes gestacional, anorexia e edema. Metade das mães realizou até seis consultas de pré-natal. Grande parcela das crianças nasceu de parto cesáreo e foi classificada como RN a termo, com elevados escores de Apgar. Com referência à antropometria, tiveram valores de peso e comprimento adequados ao nascer e outras medidas obtidas no momento do estudo consideradas dentro do padrão de normalidade. Os percentis e escores Z predominantes no estudo concentraram-se dentro da faixa de normalidade nutricional. No entanto, os valores de escores Z apresentaram variações negativas com desvio para a esquerda, portanto, mesmo incluídas na faixa nutricional adequada, as crianças estão em risco iminente de desenvolver alterações nutricionais e seus valores de escores Z ainda são discrepantes em relação às crianças sadias. Na análise de fatores preditores, a ocorrência de desnutrição imediata e desnutrição aguda está relacionada à diminuição do valor da prega cutânea subescapular e a ocorrência de desnutrição imediata refere-se ao elevado escore de Apgar no primeiro minuto. Além disso, a desnutrição crônica relacionou-se às crianças do sexo feminino com idades maiores. Por fim, em face da magnitude do defeito cardíaco e sua profunda repercussão no estado nutricional da criança, estudos podem aperfeiçoar o conhecimento do enfermeiro e subsidiar o acompanhamento do crescimento que possibilite melhor prognóstico dessas crianças em diferentes contextos da saúde.

Based on quarterly data for the period 1994.1-2005.3 of the 74 main types of stocks negotiated in Brazil, and making use of stochastic factor estimation technique proposed by AIF(2005) it was aimed to estimate the return rate for what would be a risk free rate in Brazil. The estimates obtained from the stochastic discount factor estimation shown to be very consistent with tests of assets pricing, even for those non-sampled points. Moreover, was veri ed a correlation of 0,69 between the estimated return risk free rate and the SELIC rate. In spite of such strong relationship, the rate obtained from the estimador proposed by AIF (2005) was below that of SELIC, although the decreasing pattern of gap between those rates allows supporting the argument that the stability of brazilian economy, and the correspondent reduction in the so called Brazil risk contributed with the spread paid for by the country. Nonetheless, given the relationship between the stochastic factor estimation and the marginal tax of substitution over time stated by modern theory of assets pricing, the high values attached for the rates free from risk still allow inferring that the overvalued interest rates in the brazilian market reveals the investors behavior in the national nancial market.

Na maioria dos países, em todo o mundo, os sistemas previdenciários baseados nos regimes de repartição simples apresentam dificuldades de financiamento, motivados principalmente pela modificação da composição etária da população. No Brasil, o déficit fiscal do governo vem sendo pressionado nos últimos anos pelo peso dos inativos no orçamento dos governos. A implementação de reformas em direção a sistemas privados de aposentadoria tem sido um dos caminhos perseguidos pelos países, na América Latina, nesses últimos anos. Um dos elementos importantes que motivam estas reformas é a possibilidade de geração de poupança interna que estas economias passam a apresentar quando da reforma desses sistemas. Este artigo discute como os sistemas previdenciários podem afetar a atividade econômica em termos de acumulação de capital, distorção no mercado de trabalho e seus efeitos sobre o bem-estar dos indivíduos de diversas gerações.

SCHAUMANN, Gustavo Pucci. Gestão da qualidade e sua relação com a satisfação e o comprometimento no trabalho de servidores técnico-administrativos. 2010. 144f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2010.

CHAVES, Hamilton Viana. Estratégias de mediação e construção compartilhada de conhecimentos entre surdos. 2006. 129 f. Dissertação (Mestrado em Psicologia) – Universidade Federal do Ceará, Departamento de Psicologia, Programa de Pós-Graduação em Psicologia, Fortaleza-CE, 2006.

Os enfermeiros têm responsabilidade específica, junto aos pacientes com riscos de lesão de pele, pois são eles que, em diversas situações, iniciam e controlam o cuidado da ferida. De forma particular, as úlceras venosas são lesões crônicas que acarretam prejuízos significativos. Assim, a Classificação dos Resultados de Enfermagem (NOC) pode ser um instrumento relevante, a fim de avaliar o estado de saúde referente aos aspectos da pele e circulação em pacientes com esta alteração. O estudo teve como objetivo caracterizar o estado de saúde referente à integridade e perfusão tissular dos membros inferiores de portadores de úlceras venosas com base nos indicadores da NOC. O estudo é transversal exploratório e descritivo. A população constituiu-se de pacientes com úlceras venosas e a amostra obteve 49 indivíduos. A coleta de dados deu-se por meio de um formulário fechado e exame físico, em um ambulatório situado na região metropolitana em Maracanaú.- CE. Todos os itens do instrumento foram descritos baseados na NOC e literatura. Utilizou-se o programa estatístico SPSS versão 13.0, para armazenamento e avaliação dos dados. O projeto obedeceu aos aspectos da Resolução196/96. Os achados da amostra mostraram predominância do sexo feminino com idade acima de 60 anos. A maioria dos participantes eram aposentados ou pensionistas e viviam com companheiros. A hipertensão arterial sistêmica assumiu destaque entre as demais co-morbidades. O índice tornozelo-braquial, de forma geral, assumiu um valor normal; 75% dos sujeitos eram obesos. As caracteristicas mais presentes das úlceras venosas foram bordas irregulares, exsudato seroso e em pouca quantidade, tecido de granulação e extensa área da ferida. A geléia de metronidazol foi muito utilizada nos curativos. Entre os indicadores operacionais que mostraram-se mais comprometidos estão crescimento de pêlos e edema periférico. Os Resultados de Enfermagem Integridade e Perfusão Tissular apresentaram moderado comprometimento. A variável idade mostrou ter relação inversa com a Integridade Tissular. Evidenciou-se que a presença de doença cardíaca exerce influência sobre o resultado integridade tissular, assim como a presença da hipertensão arterial sistêmica interfere negativamente na perfusão tissular. A variável pressão arterial diastólica mostrou correlação negativa com o resultado perfusão tissular. Foi possível desenvolver parâmetros de classificação para os indicadores propostos pela NOC e verificar sua aplicabilidade. Um instrumento clínico com termos claros e bem definidos pode ser um guia para dispor eficazmente os recursos físicos e humanos.

The performance of the nurse in the consultations to carriers of hypertension, carrying through specific actions and systemize interventions, has increasing importance because, not rare, the customer lacks of interventions that run away from the ability of one alone professional. It was had as objective to identify registered interventions of nursing in handbooks of taken care of carriers of hypertension in a reference service; to detect the frequency of the register of the interventions; to analyze, on the basis of the Plan of Reorganization of the attention to the Hypertension and Diabetes Mellitus (2001) and in the Brazilian Lines of direction of Hypertension (2006), the interventions with a frequency equal or bigger the five times in the registers; e to mapear the found interventions, according to International Classification for Nursing Pratice, version 1.0. It was carried through in the city of Fortaleza, in a unit of health of reference in hypertension and diabetes mellitus, for the state Ceará. Universe consisting of 3.606 registered in cadastre handbooks of July of 2003 the July of 2005, in a total of 704 handbooks with register of the diagnosis of hypertension. Amongst these, 175 handbooks had taken care of to the inclusion criteria: to be handbook of carrying patient of the diagnosis of arterial or primary hypertension, without other disease, as neoplasias, hematology, neuro-psychiatric, bones, metabolic and renals illnesses; to be registered in cadastre, and in validity since July of 2003; independent of sex and age and, to have register of, at least, a nursing consultation. The data had been collected in handbooks for the analysis of the registers of the carried through consultations of nursing of December of 2005 the February of 2006. A form was used that had as axle the questions necessary to reach the considered objectives. In 175 handbooks, it had register of 259 consultations of nursing (average: 1,48). In all had registers of interventions, in a total of 10 actions of nursing and 972 registers of interventions, with a average of 3,7 interventions for consultation. The actions presented had been: to verify (819), to guide (71), to direct (65), to teach (7), to keep (5), to stimulate (1), to acquire knowledge (1), to prevent (1), to request (1) and to watch (1). In the action to verify interventions had been distinguished that had occurred with a frequency equal or bigger the five times: blood pressure (257), weight (217), glicemy (212), height (86); following itself for the referring interventions to direct: cardiologist (18), dentist (12), nutrition (10), ophthalmologist (8) and nephrologist (7) and to guide: to diminish weight (9), diet (8), orientation (5); to keep: cares (5). It was observed that the registered intervention more registered was verification of the arterial pressure (257), however it being characterized as a specific action and essential in the consultation of nursing to the carrier of hypertension, it was not presented in all consultations. This fact seems to indicate, the occurrence of sub-registers for the nurses, what it represents damage for the systematic evaluation of the customer and accompaniment of the effectiveness of its therapeutical one. One concludes that the analysis of registers of nursing consultations made possible to identify to interventions and action of nursing parallel with the interventions related in ICNP 1. However, sub-registers can be occurring, making with that the quantitative one of interventions is inferior to that face to the specific of the analyzed consultations could expect.

Como gerente de Enfermagem, vivenciando a realidade da sala de recuperação pós-anestésica e unidade de terapia intensiva pós-operatória, percebeu-se que as condições de trabalho são geradoras de sofrimento físico e psíquico. O cuidado de Enfermagem, em dois setores, com características diferentes, requer conhecimento para desenvolvimento de habilidades, atitudes e perfil de competência profissional, exigências para atuar na alta complexidade. Objetivou-se analisar sentimentos e reações dos profissionais de Enfermagem no trabalho; identificar fatores relacionados ao trabalho que influenciam na saúde física e mental dos profissionais de Enfermagem; identificar fatores relacionados ao ambiente que influenciam no desempenho profissional e proporcionar espaço para verbalização dos sentimentos e reações dos profissionais de Enfermagem no trabalho. Trata-se de um estudo descritivo, de caráter qualitativo, com referencial teórico à luz de estudiosos como Dejours (2007), Lunardi Filho et al. (2001). Foi realizado no período de julho a setembro de 2008, em um hospital público na cidade de Fortaleza, Ceará - Brasil. Participaram do estudo dez enfermeiras e 12 técnicos de Enfermagem. Os critérios de inclusão foram: profissionais de Enfermagem cujas escalas de serviço coincidiram com a coleta de dados e aqueles que aceitaram participar. Foram considerados como critérios de exclusão: profissionais que estivessem de licenças prolongadas e férias. Obedecendo a Resolução, 196/96 que trata das pesquisas em seres humanos, o projeto foi encaminhado ao Comitê de Ética em Pesquisa da instituição e submetido à aprovação, sob Protocolo nº. 037.06.08. Todos os participantes assinaram o Termo de Consentimento Livre e Esclarecido. Os instrumentos de coleta das informações utilizados foram entrevistas individuais, com roteiro semiestruturado e encontros grupais. As informações apreendidas nas entrevistas individuais foram categorizadas em - Significado do trabalho na SRPA e UTI pós-operatória; Fatores que influenciam na saúde física e mental dos profissionais de Enfermagem; e Fatores relacionados ao ambiente que influenciam no desempenho profissional. Em todos os encontros grupais foi realizada a pergunta norteadora: Como você está se sentindo? As respostas que emergiram foram categorizadas em sofrimento físico, sofrimento psíquico dos profissionais de Enfermagem e estratégias defensivas utilizadas pelos profissionais de Enfermagem, sendo analisadas à luz da análise de conteúdo de Bardin (1977). O estudo demonstrou a importância da valorização dos profissionais de Enfermagem, alertando aos gestores para as estratégias defensivas contra o adoecimento físico e psíquico no trabalho. Além de sensibilizar o profissional para o cuidado a si mesmo, pois ao se cuidar, poderá cuidar melhor do outro. Consideramos, neste estudo, que os momentos de paradas, durante a jornada de trabalho, reduziram o sofrimento das pessoas que compartilharam reações e sentimentos. Os encontros grupais permitiram momentos de reflexão, integração e relaxamento para os profissionais de Enfermagem.

SILVA, Gelson Aguiar

The familiar cuidador of the aged dependent very starts to be focus of the attention in health recently. It was objectified, in this study to know the abilities and abilities developed for the nurse in the attendance to the familiar cuidador of the aged dependent in the domicile. To take care of adequately of these patients also demands deep preparation scientific technician of the professionals who carry through visits domiciliary the aged dependents, as well as planning of educative interventions, medicaments accomplishment of procedures and treatments. This diversification comes generating reflections and questionings between the professionals whom they visit and they take care of aged in domiciles. What one searchs in this study is, from the social reality of the nurses who work with assistance, internment and domiciliary visit. To know the construction of the care excused to aged and its cuidador. The work, in function of its objective and intention implies the use of methodology of qualitative cut. The population of the study consisted of integrant nurses of the Strategy Health of Family (ESF), of the Program of Domiciliary Attendance (PAD) and Home Care. For 8 (eight) nurses of ESF and 8 (eight) of the too much public and private institutions had been in such a way chosen totalizing 16 nurses. For collection of data associate to an individual interview opted itself to the technique of Focal Groupe (GF) as complementary instrument. Amongst the qualitative techniques, we opt to the Speech of Collective Citizen (DSC) gotten through the analysis of the interviews carried through with nurses citizens of the research according to LEFÉVRE and LEFÉVRE, to believing to be this the best option for the considered study. The ideas central offices had been: it guides and it trains on the care with the aged one, the cuidador as nursing technology, the cuidador is not important, the cuidador is not focus of the attention, the family guided in the care to the aged one, the cuidador needs more than well-taken care of that the proper sick person, the cuidador is also aged, does not exist availability of time for assistance to the cuidador, the assistance is given in accordance with to the complaints and necessity of qualification for a quality assistance. The content of the speeches does not leave doubts of that it has necessity of get up the actions of nursing based in scientific knowledge, rules and creation of instruments domiciliary assistance in the public institutions. Initiating for the ESF, that will work in concurrence with the Program of Domiciliary Internment (PID) implanted in the hospital institutions of the municipal and state public nets.

Exclusive to The Lactation Amenorrhea (LAM) is a contraceptive method (MAC) natural, with efficiency of 98% by the sixth month of life. Currently, promotion of MAC is available in the country carried out by teams of the Family Health Program (FHP), particularly by nurses, who must do it in neutral, respecting the free choice of users. The aim of this study was to analyze knowledge and performance of nurses of the PSF on the LAM. The specific objectives were: To identify personal experiences of nurses (parents or mothers) in relation to breastfeeding and LAM; To assess knowledge and confidence of nurses related to LAM; To identify promotion of LAM by the perception of nurses and how the acceptance of LAM by the customer; To know opportunities and strategies used by nurses to promote LAM; To show results of the practice of nurses with respect to the monitoring of users of LAM. It was a field study, cross, held from February to July 2008, the Regional Executive Secretariats (SER) I, III, IV and V of Fortaleza-CE, with 137 nurses. Data collection occurred in the Basic Health Units using the interview. There were the nurses, accounting for 121 (88.3%) participants, who had a mean age of 35.1 years. Slightly more than half, 70 (51.1%) reported having children, and of those, 61 (92.4%) reported having experienced exclusive breastfeeding, which had an average of 4.38 months. However, only 12 (19.6%) nurses said they had adopted the LAM, even considering its practicality and its benefits. Only 2 (1.5%) nurses know how to LAM contraceptive option. As the self-assessment of knowledge on the subject, 34 (24.8%) nurses rated their knowledge as excellent or good, 80 (58.4%) good, 20 (14.6%) as regular and 3 (2, 2%) inadequate. Most, 88 (64.2%), know the effectiveness of LAM and only 5 (3.7%) reported the efficacy correct. Even with 65 (47.4%) of nurses discrediting the effectiveness of LAM and only 19 (13.9%) being knowledgeable of the three requirements for optimal operation of the method, 112 (81.8%) said guide for women on the use of it. The acceptance of women occurs in part, to the extent that seeking complementary method to continue use of LAM. The guidance is provided by nurses at different times, related to the pregnancy-puerperal period (prenatal, postpartum and child care) and outside, in the consultations for family planning and, in most cases, adopted the individual approach. The students, 59 (52.7%) nurses accompanied users of LAM. The average time of use by customers is 3 to 4 months, and the return to work and the introduction of other foods to the infant diet the main reasons for discontinuation of LAM. The oral combination was the MAC of succession of LAM. It is therefore the need to improve knowledge of nurses of the PSF over the area of care, since in such circumstances the promotion of LAM is compromised, affecting the adherence of women to the method and the effectiveness of it.

The modern systems of measurement, protection, command, control and supervision (MPCCS) have contributed in a meaningful way to increase the security and reliability of the power systems. The most important part of this multifunctional system is the protection system, which has as the main goal to maintain the power system integrity when it is under a disturbance, assuring the people‟s safety as well as the continuation of the services to the part of the system not involved in the disturbance. For this, the protection system must fulfill some basic requirements such as: proper selectivity and coordination, prompt response, sensitivity to protect the largest zone as possible and reliability. In a system protection, one component takes on a prominent position, given its functional importance: the digital protection relay. It is in this device where the necessary adjustments are configured for proper operation of the protection scheme of a given electrical power system. The digital relays are devices that have several protection functions, with multiple levels of settings, measurements, oscillography, supervision, control and communication. Besides all these features, the digital relays have multiple groups of settings that can be previously configured and switched among them, according to operational needs. The changing of setting group in a relay is a very important resource at a protection system, extensively used by protection sectors of companies in the power sector, allowing the optimization of the protection system setting, making it compatible to a new topology taken on by the system after a fault or an intentional removal of some system component. Nowadays this procedure is performed manually, making it vulnerable to human errors that might occur as a consequence of an outage, with serious effect in the system performance indices. In this sense this work presents a system, based on Colored Petri Nets, able to automatically change the setting groups of a protection system when the power network topology changes. This system monitors in real time the status of the circuit breakers in order to take the decision whether a meaningful change in the network topology has taken place. If so, a command is automatically sent to the relays to change the active group setting so as to maintain a suitable coordination of the protection system.