RCAAP Repository

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.

The search plan of the Nursing Department of the Federal University of Ceará called: accessibility of physically and/or sensorial deficient people to health care: the object of physical conditions and communication study is to point out any architectonic obstacles making difficult or obstructing any physically deficient people (pdp) to access basic health cares and general hospitals and study the communication problems amongst such people and health caring team members. My participation in such a plan called my attention to such a theme and gave rise to this dissertation, the objects of which are to map the architectonic conditions for the physically deficient people to access any hospital cares in the city of Sobral-CE and point out any internal architectonic obstacles and also in the hospitals for the physical move of PDPs. The theoretical system of reference is based on Law No. 7,853, dated 10/24/1989, which sets up rules to ensure the exercise of individual and social rights of physically deficient people and the effective social integration thereof. Such study is quantitative and used an instrument of data collection of check-list type made by consultation under law. Four general hospitals of the city were included in such study and data collections were performed in the month of May 2004. Some of them have been documented on photos The statistic analysis found out in connection with the areas around hospitals that there no crosswalks (100%) and lowering of curb at strategic points (75%); public and private works with no fence made of planks (100%); pavements with holes and unlevellings (100%); avenues with no holes (50%); visible transit signs (75%); the way going to the institution is signaled (100%), but there are no traffic lights at strategic points (100%). Concerning access to hospitals, there is no lowering of curbs (75%); there is no parking area for PDPs signalized with the International Access Symbol (100%); there is sloping roadway (100%), flight of stairs with no handrail (50%); doors are well sized (100%); swing doors has no appropriate visors (100%); the inner features of the hospitals show that the transit areas have obstacles (100%); the pavement on the outer sloping roadways are non skid. (100%); the inner sloping roadways and stairs have handrails available (50%) but not in compliance wit the lawful standard. One of the hospitals has one floor but the other three ones have three inner stairs; counters are in accordance with legislation (80%) and the public seats as well (33%). Drinking places and telephones are not accessible (95.5%) It was concluded that there are architectonic obstacles in the way from house to hospital, in the direct access to hospital in the inner rooms thereof. The legislation in force assuring the physically deficient people to access the health care has not been complied with. This means that the public service has obviously not been aware of such legislation and has been negligent. The health caring professionals who are also responsible for assuring the citizenship of such portion of population to be exercised have been negligent as well.

Women are disturbed with symptoms of general anxiety in climacteric years/ menopause, creating a mental suffering that adversely affects their life quality. Thus, arising a demand for natural approaches such as acupuncture, which reduces the adverse effects caused by conventional drugs working as a source of self-knowledge and responsibility for individual and collective health. The aims of this study were to assess the acupuncture method as a complementary therapy in women from the Center for Psychosocial Care (CAPS - Centro de Integração Psicossocial) and to identify the intensity of their diffused complaints before and after application of acupuncture and to relate their intensity with socio-demographic factors. Experimental, mixed (single-blind and open), randomized, prospective study, which had as instruments for collecting data the Hamilton Anxiety Scale - HAMA adapted by Souza (2004), held at the Center for Psychosocial Care Prof. Frota Pinto (CAPS III). We complied with the ethical guidelines required for making this research and selected 30 women obeying the criteria of inclusion and exclusion, evaluating the HAMA-BEFORE, randomly distributed into two groups with real acupuncture (GT) and placebo acupuncture (CP), which were subjected to 10 applications once a week, moment in which we assessed the HAMA-AFTER. Fourteen women in treatment at CAPS III completed another control-group making use of medication (CM) whom also received the HAMA AFTER. The Statistical Package Social Science Program was used to process the data - SPSS, version 11.0. We used GraphPad Prism program, version 4) to generate the graphics. The results indicated that the participants between 41 and 60 years old (81.8%) are married (47.7%), concluded Junior School Elementary (47.7%) and High School grades (36.3%), are catholic (77.7%), work at home (50.0%), have no children (36.3%) or few children (43.2%) and which family incomes vary from 1 to 2 living wages (65.9%), low inactivity (31.8%), professionally unfulfilled (61.4%), careworn puberty (63.6%) life experience marked by emotional and/or physical trauma (75.0%), present the climacteric symptoms, psychophysical / menopause (52.3%) and high rate of surgical procedures (59.1%), unsatisfactory conjugal relations affect their psychosomatic lives (r = 6363, p = 0012 n = 30), and those who work at home are liable to present symptoms of anxiety, although not statistically significant (r = 6356, p = 0096 n = 30) There was no significant correlation between HAMA and other socio–demographic variables. We concluded that acupuncture reduced significantly the levels of HAMA on CP and GT groups. The effective acupuncture was lager and clinically reliable. The effective acupuncture and medication reduced the levels of anxiety among women, thence, both can be used singly or joinly. Further studies are needed involving larger, samples with regard to acupuncture, providing a better control of the most imported variables of anxiety. The knowledge acquired and produced during the systematization of acupuncture as of a viable use of health care, can be integrated in public or private institutions, at hospitals or policlinics and in a wide range of specialties

O objetivo geral foi avaliar o perfil de uso de Anticoncepcionais Orais Combinados (AOC) de baixa dose e fatores associados. Os objetivos específicos incluíram: conhecer as condições demográficas e socioeconômicas de usuárias de AOC e principais riscos reprodutivos presentes no grupo; avaliar o conhecimento de usuárias de AOC de baixa dose com relação ao uso correto, efeitos colaterais e complicações; verificar a associação entre conhecimento sobre uso correto, efeitos colaterais e complicações ao uso do AOC com Centros de Saúde da Família (CSF), idade, escolaridade, número de pessoas na família, renda familiar mensal e tempo de uso do AOC e com os tipos de conhecimento entre si e investigar o uso seguro de AOC com base nos critérios médicos de elegibilidade da Organização Mundial de Saúde (OMS). Estudo avaliativo, transversal, realizado com 264 mulheres usuárias de AOC. Os dados foram coletados por meio de entrevista, de março a julho de 2010. Foi realizada análise estatística simples e bivariada utilizando frequência absoluta e relativa, média ( ), Desvio Padrão (DP), percentis, Intervalos de Confiança (IC) e testes estatísticos não paramétricos, em que se estabeleceu significância para um valor de p < 0,05. Para avaliar o conhecimento das mulheres, foi utilizada escala tipo likert a fim de classificar o conhecimento em Nenhum; Escasso; Moderado; Substancial ou Extenso e para investigar o uso seguro foi elaborado sistema de checagem embasado nos critérios médicos de elegibilidade da OMS. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Ceará, conforme protocolo nº 04/10 e as participantes assinaram o Termo de Consentimento Livre e Esclarecido. O perfil das mulheres pesquisadas caracterizou-se por ser jovem, predominando a faixa de idade dos 20 – 28 (139; 52,7%). O tipo de união estável com parceria fixa foi referido por 222 (84,1%) mulheres. Predominou o ensino médio completo em 124 (47%) mulheres, que conviviam com uma média de 3,9 pessoas por família (DP=± 1,50) e uma renda média de 2,4 salários mínimos (DP = ±0,85). As participantes, no geral, apresentaram nível “Substancial” de conhecimento para o uso correto (mediana=4,00; IQ=1,00) e efeitos colaterais (mediana=4,00; IQ=1,00) e “Nenhum” conhecimento para complicações com o uso do AOC (Mediana=1,00; IQ=0,00). As associações estatísticas realizadas permitiram a observação de que um maior nível de conhecimento esteve relacionado a determinados Centros de Saúde da Família (p = 0,01), maior escolaridade (rho = 0, 164; p=0, 008), e condição econômica (rho =0,135; p= 0,029). Ainda assim, equívocos prevaleceram sobre uso correto,efeitos colaterais e crenças do tipo surgimento de massa no útero e infertilidade permearam a percepção das complicações referentes ao uso de AOC. Foi visto que o uso de AOC ofereceu riscos à saúde para 91 mulheres (35%). Há uma necessidade em se despender esforços a fim de assegurar uso seguro e correto dos AOC, levando em consideração as recomendações sobre práticas selecionadas para o uso desse método, bem como os critérios médicos de elegibilidade.

É fato que a problemática relacionada ao não retorno das mulheres para receber o resultado do exame preventivo tem causas multifatoriais, no entanto, partimos do pressuposto que a educação perpassa todas essas áreas e que se realizada de forma dialógica e reflexiva levará às mulheres da passividade à criticidade, de forma a serem sujeitos no processo de adoção de comportamentos saudáveis e busca pela melhoria dos serviços de prevenção do CCU. Este trabalho trata-se de um estudo experimental randomizado, cujo objetivo foi avaliar os efeitos de uma intervenção educativa sobre o exame de Papanicolaou em relação à adesão das mulheres à consulta de retorno para receber o resultado. O local selecionado para realização do estudo foi o Centro de Saúde da Família (CESAF) Aída Santos e Silva, situado no bairro Vicente Pinzon, em uma área da periferia da cidade de Fortaleza-CE. A população do estudo foi composta pelas mulheres que realizaram o exame de prevenção do CCU no referido CESAF. A coleta de dados aconteceu no período de fevereiro a julho de 2008, sendo realizada em três etapas para o grupo de intervenção (inquérito CAP, intervenção educativa e consulta de retorno), e em duas etapas para o grupo controle (inquérito CAP e consulta de retorno). Os dados foram compilados e analisados através do programa estatístico Statistical Package for the Social Sciences (SPSS) versão 13.0. Para todas as análises, um valor de p <0,05 foi considerado estatisticamente significativo. Durante a pesquisa foram realizados 261 inquéritos CAP (150 do grupo intervenção e 111 do grupo controle). No entanto, foram excluídas do estudo, 11 mulheres (09 do grupo intervenção e 02 do grupo controle) por não terem realizado o exame de Papanicolaou, o que totalizou uma amostra de 250 mulheres (141 do grupo intervenção e 109 do grupo controle). Quanto ao conhecimento sobre o Papanicolaou, apenas 40,4% foram classificadas com conhecimento adequado. Em relação à atitude e prática das mulheres frente ao exame, o percentual de adequação foi de 28% e 67,6% respectivamente. Das 230 (92%) mulheres que retornaram para a consulta no presente estudo, 173 (75,2%) compareceram na data aprazada e 57 (24,8%) após a data aprazada. Esses dados são relevantes, na medida em que permitem afirmar que somente o fato de ter consulta de retorno, como no caso do grupo controle (n = 110), a taxa de exames retidos na instituição caiu de 23,98% para 10,0%. Quando se associou a consulta de retorno à intervenção educativa (grupo intervenção/n = 140), essa taxa baixou para 6,4%. A aplicação da estratégia elaborada durante esta pesquisa demonstrou sua efetividade, na medida em que despertou o interesse das mulheres, mesmo as que eram do grupo controle, em participar da intervenção educativa e em debater sobre a problemática em questão. A eficácia da intervenção educativa aplicada durante o estudo pode ser comprovada através da diminuição da taxa de não retorno à unidade de aproximadamente 24% para 6%. Não houve diferença estatisticamente significativa entre as taxas de não retorno dos grupos controle e intervenção. O resultado desta pesquisa demonstrou que é primordial a garantia de consulta de retorno às mulheres que realizam o exame de Papanicolaou em um dia normatizado pela instituição, com flexibilidade no atendimento às mulheres que não comparecem na data aprazada, para diminuir as taxas de não retorno. Além disso, quando associada a garantia de consulta de retorno à utilização da intervenção educativa sugerida nesta pesquisa, a taxa de não retorno é bem menor, assim pode-se garantir serviço de qualidade na prevenção e controle do câncer cérvico-uterino

Adolescence is a phase of life marked by sexual maturation and accompanied by psychological and social transformations. Although visually impaired persons are subject to the same process, literature has dedicated little attention to this theme. The combination between transformations in this phase of life, the indefiniteness they are accompanied by and the visual impairment justify a study about the sexual experience of female, visually impaired adolescents inserted in society and in the school community. We interviewed five visually impaired adolescents at a Pedagogical Support Center (PSC) for blind and/or visually impaired people. Questions attempted to find out how these adolescents perceived the cause of their visual impairment, their education level, family composition and orientations, affective-sexual experience, level of knowledge about sexuality-related issues, including contraception and sexually transmitted diseases. Results revealed that visually impaired adolescents display the same sexual development characteristics as other people, although with their own properties. The lack of vision does not decrease sexual interest, but only differentiates their curiosity about this subject: they want to get to know their body and its functioning. Like all adolescents, young people who cannot see also attempt to define their identity and place in society. Moreover, they want to discover their own sexuality, find adequate means to express their sexual impulses and experience affective relationships. We found lack of knowledge about contraceptive methods and STDs, with superficial information. In order to create a health promotion culture, knowledge accessible to this population is essential. We believe that visually impaired adolescents should take their own decisions, thus practicing their rights and obligations with a view to the full exercise of citizenship

It is an integrative literature review, which aimed to search and evaluate the available evidence in the literature on perioperative care provided to patients undergoing mastectomy. To select the studies were consulted the databases PUBMED, LILACS and CINAHL and the sample consisted of seven studies. No study has been identified in the databases LILACS and CINAHL, and all seven studies were from the PUBMED. There was a prevalence of 6 studies (86%) with level of evidence 2 and 1 study (14%) with level of evidence 3. After analyzing the issues addressed in these articles, gathered in atopical category: pain management, containing the seven studies. The first study found that a dose of 600 mg of gabapentin administered 1 h before surgery produces significant postoperative analgesia after total mastectomy. The second study showed that use of EMLA in mastectomy patientsreduced the request of analgesics postoperatively and a reductionin the incidence and intensity of chronic pain. In the study 03 found no differences in the management of postoperative pain between 3.75 mg / ml and ropivacaine wound infiltration with saline prior to mastectomy. The fourth study found that preventive administration of ketoprofen intravenously (100 mg) produces greater relief of postoperative pain in patients undergoing mastectomy. The fifth study showed that administration of dexamethasone 8 mgeffectively decreases the use of analgesics in women undergoinggeneral anesthesia for mastectomy. The sixth study showed no association between the index of nitric oxide and the development of chronic postoperative pain. The seventh study found that perioperative administration of venlafaxine significantly reduces the incidence of pain syndromeafter mastectomy. The study had limitations the fact that over the 10 years studied, the only perioperative care of the mastectomy surgery in the literature was related to the pharmacological management of pain and the studies analyzed did not show an association between them, since in each was assessed a different drug, hindering consensus and recommendation regarding the use of drugs to control / minimize the pain. The evidence did not show a consensus for the perioperative care of mastectomy, because we found a diversity of use of drugs for pain control and in most studies there were differences and division of opinion. However, we noted the concern on the part of professionals to minimize / prevent pain before, during and after surgery, and nursing must be attentive to both the update of pharmacological treatments in pain management, for the development of future research related to the care of perioperative nursing.

It has been more than two decades that the world live with the HIV. Within the passing years we’ve learned a lot about ways of transmission, more efficient medical treatments, more accurate laboratory results, immunity, and so on. It’s still evident, however, the stigma experienced with the find out of the disease. That signalizes that the person is stamped and rejected. To carry a stigma means to carry a characteristic not accepted by society. Based on this fact, people live many prejudice situation and their chances of living naturally are reduced. That way, when a woman faces the positive HIV diagnostic she experiences uncertainty feelings and insecurity, those feelings lead her to a crisis moment. Taking all this into account, this work’s aim is to find out the stigmas that surround the women with HIV infection. This investigation is descriptive and exploratory and its nature is qualitative. The scenario is an infirmary of a specialized hospital in Fortaleza – CE .The research period was from December 2004 to March 2005. Ten women with positive HIV participated. The research method used was the Thematic Oral. It was used recorded semi-structured interview to collect data. The women’s reports were analyzed by creating four categories: 1) facing the diagnostic; 2) changes imposed by the disease; 3) guilt; and 4) living in social exclusion. The women were young, with scarce financial income; low scholar level and they were infected by heterosexual way. This profile coincides with the profile of the majority of infected women in Brazil. Many forms of stigma were identified. Most of them were related to the difficulty of dealing with the diagnostic, changes in the women’s lives because they tried to live better, guilt, social exclusion’s evidence and lack of family’s support. When they remembered the experience of receiving the diagnostic news, they expressed fear of death, shame, and concern with their family, abandonment, solitude, sadness and fault. Besides, they had to keep on trying not to loose their jobs. The different stigma that surround their lives don’t let them live naturally and free of any type of prejudice, and this is a right that has to be respected when we talk about women’s infected with the HIV, because they already suffer bad feelings caused by the disease. This work supported changes in the global assistance offered to infected women, emphasizing that the treatment shouldn’t concern only about biological-opportunists diseases, but should also consider the conflicts experienced by the women. That way, we search for an improvement in these women’s life quality. To defeat the stigmas and the prejudice is a task for all the professionals evolved with these women, this can be done by cultural or legal means.

A vulnerabilidade dos adolescentes brasileiros é representada por números expressivos de mortes por causas externas, alto índice de desemprego, evasão escolar, gravidez precoce, infecção por doenças sexualmente transmissíveis e envolvimento com drogas. No sentido de reverter esse quadro desfavorável, as políticas públicas apontam a necessidade de ações intersetoriais voltadas para promoção da saúde dos adolescentes nas escolas. Dentre os profissionais de saúde que poderão atuar continuamente nas escolas, tem-se o enfermeiro da Estratégia de Saúde da Família (ESF). Este estudo propõe-se a analisar o contexto dos Enfermeiros da ESF para a promoção da saúde do adolescente no cenário escolar, verificar o conhecimento dos Enfermeiros, identificar a atuação deles e identificar as condições influenciadoras para suas ações. Trata-se de um estudo transversal e exploratório, realizado com 168 enfermeiros da ESF de Fortaleza nos Centros de Saúde da Família (CSF), no período de janeiro a outubro de 2009. Aplicou-se um questionário semiestruturado. As associações entre ação, atuação e capacitação dos enfermeiros com suas características foram analisadas por meio de testes X2 ou de máximo verossimilhança, sendo considerados estatisticamente significantes aqueles com p < 5%. As questões subjetivas foram organizadas em categorias temáticas, analisando-as qualitativamente. Os aspectos éticos e legais foram respeitados. A população estudada revelou-se eminentemente feminina, em idade produtiva, residindo distante da comunidade na qual trabalham, a maioria graduada a mais de 5 anos e especialista, necessitando de cursos de formação na área estudada e com uma diversidade de recursos comunitários disponíveis para colaborar em sua atuação. O conhecimento dos enfermeiros apontou que aspectos como políticas públicas e legislações, funções do enfermeiro na saúde do adolescente, quesitos da saúde escolar e quesitos da escola promotora de saúde formam um entrelace necessário para a efetivação da promoção da saúde do adolescente. A atuação dos enfermeiros nas escolas foi considerada como uma ação de fundamental importância e viável para este profissional exercer, porém eles consideram-se pouco capacitados para seu desempenho. O espaço escolar foi ainda evidenciado como espaço de promoção da saúde e integração com o CSF e que o enfermeiro foi avaliado por 98,8% como o profissional que deve atuar no ambiente escolar. A atual conjuntura de atuação dos enfermeiros, porém, apontou a necessidade de um novo arranjo, incluindo um planejamento que permita uma maior freqüência, maior diversidade de temas, metodologias criativas, com novos parceiros e atores que atendam as reais expectativas dos adolescentes, buscando a promoção da saúde nas escolas. Foram analisados também os fatores que influenciam e repercutem na atuação dos enfermeiros nas escolas com adolescentes, fomentando reflexão crítica para a construção de uma nova realidade que realmente se concretize de maneira contínua e integrada com a comunidade escolar. A partir dos achados deste estudo, um desencadear de aspectos destaca as ações dos enfermeiros da ESF como viáveis, porém, para sua concretização, o Estado deve se apoderar de seus deveres, permitindo que a promoção da saúde escolar se concretize. Portanto, a atuação dos enfermeiros na escola trata-se de um campo promissor que aguarda o planejamento, estruturação e efetivação para a excelência esperada.

Study on the characteristics of non-verbal communication between the nurse and the blind patient, whose objectives are the following: analyzing the nurse’s non-verbal communication with the blind patient during the nursing attendance; testing the reliability index among the referees of non-verbal communication analysis; classifying the non-verbal signs, according to Hall’s referential (1986); verifying the association between the video recordings and the non-verbal communication factors; and identifying the barriers to non-verbal communication between the nurse and the blind patient. The approach adopted is exploratory, descriptive, and quantitative, aiming at gathering information for intervention and, therefore, for improvement in the quality of assistance to this clientele. The study has been developed during the period of February to April of 2005, in a reference healthcare unit, of secondary level, in the city of Fortaleza-Ce, with nurses that attended to diabetic patients, as diabetes may cause several ocular disorders, such as cataract and diabetic retinopathy. Previously, the fourteen nurses who attended to diabetic patients at the institution had been contacted. Of those, seven agreed in participating of the study, but only four made part of the study group. In what regards the selection of blind diabetic patients, it was performed at random, considering the ethical principles that govern studies with human beings. The group has been constituted, therefore, by people who went blind as a consequence of diabetes, and who were going to be attended by the nurses who were part of the study group. Five blind people integrated the study group. To the data collection, a video camera was employed, which recorded the entire nursing attendance between the nurse, the blind person and his/her companion. The instrument for data analysis to evaluate the non-verbal communication between the nurse and the blind person was elaborated according to Hall’s theoretical referential (1986), with emphasis on the proxemic theory, and received the designation Nurse - Blind Patient Non-Verbal Communication (CONVENCE). Simultaneously to the data analysis, CONVENCE was sent to three referees in order to be analyzed. To the analysis of the video recordings, three other referees were chosen, who agreed in participating in the study and that were trained according to the proposed referential. From CONVENCE, five categories were elaborated, with their respective sub-categories. Category 1: Spatial distance, with the sub-categories 1.1- distance, 1.2- posture, 1.3- axis, 1.4-contact. Category 2 – Social behavior, with the subcategories: 2.1-emblematic gestures, 2.2 illustrating gestures, 2.3 –regulating gestures. Category 3 – Facial behavior. Category 4 – Visual Code, with the subcategories: 4.1 – ocular opening, 4.2 looking direction. Category 5 – Voice volume. The training sessions and the data analysis were carried out with all the referees present in the same room and at the same time that had been preset in the beginning of the training. The video recordings were analyzed each fifteen seconds, summing up 1.131 non-verbal communication analyses. When analyzing the categories and subcategories, the main results that were observed are the following: In category 1, the subcategory minimal distance prevailed with 1.030 (91%), due to the fact that the environment were the attendance took place favored the adoption of almost exclusively that distance, either by the professional or by the patient. In this category, the subcategory 2 has shown that the sitting posture (98.3 %) almost obtained unanimity in the images that were analyzed. When addresser and addressee maintain the same posture, it means that they are attuned, sharing the same rhythm, degree of interest, and movement. Also, in this category, the subcategory 4, denominated contact, demonstrated that in 943 (83.3 %) interactions there was no contact. The most observed gesture in the subcategory ‘emblematic gestures’ was the moving of hands (762 or 67.4%). The looking direction, subcategory 4.2, deviated from the interlocutor added up 597 (52.8%) and centered in the interlocutor, 502 (44.4%). In all the video recordings, there were considerable interferences in the moment of the interaction nurse-patient. Such fact was considered a hindrance to communication. The nurse has to demonstrate interest during the interaction, and it is the look towards the patient that will favor this attention during the nursing attendance. It can be concluded, according to the data, that the nurse needs to know and to intensify the studies in non-verbal communication, and to adequate its use to the kind of patient being attended.

PEREIRA, Maria Teresa Lisboa Nobre. Resistencias femininas e ação policial: (re)pensando a função social das delegacias da mulher. 2006. 273 f. Tese (Doutorado em Sociologia) – Universidade Federal do Ceará,Departamento de Ciências Sociais, Programa de Pós- Graduação em Sociologia, Fortaleza-CE, 2006.

MARQUES, Marcelo Santos. A qualificação profissional no foco da crítica ao sistema do capital: em busca dos egressos do CEFETCE. 2009. 387f. Tese (Doutorado em Sociologia) – Universidade Federal do Ceará, Departamento de Ciências Sociais, Programa de Pós- Graduação em Sociologia, Fortaleza-CE, 2009.

O Planejamento Familiar (PF) de mulheres portadoras de Diabetes Mellitus (DM) guarda especificidades, tendo os profissionais que lidar com as particularidades deste grupo, com risco reprodutivo significativo. Portanto, são mulheres que têm indicação de Métodos Anticoncepcionais (MAC) de elevada eficácia, contra-indicação de determinados MAC em face da doença e/ou do tratamento medicamentoso para o DM, e planejamento da concepção acompanhado de adequado controle da referida patologia. O objetivo geral foi avaliar o impacto da assistência oferecida a mulheres portadoras de DM em pré-concepção e anticoncepção. Os objetivos específicos incluíram: descrever repercussões vivenciadas no processo de engravidar, gestar e parir no perfil obstétrico de mulheres portadoras de DM; identificar o conhecimento de mulheres portadoras de DM sobre cuidados a serem tomados na pré-concepção e sobre riscos maternos e fetais; verificar o conhecimento de mulheres portadoras de DM sobre MAC apropriados a essa condição e analisar a adequação do uso de MAC por mulheres vivendo com DM, tomando por base o perfil da patologia. Estudo avaliativo, transversal, realizado com 107 mulheres acompanhadas em centro de referência para DM de Fortaleza-CE. Os dados foram coletados por meio de entrevista, de março a julho de 2009. Foi realizada análise estatística simples, utilizando frequência absoluta e relativa, média (χ), desvio padrão (S) e Intervalos de Confiança (IC). As falas das mulheres foram analisadas conforme Técnica de Análise de Conteúdo proposta por Minayo. Para avaliar o impacto da assistência em pré-concepção e anticoncepção, foram elaborados os indicadores de impacto: percentual de mulheres que conhecem os MAC indicados para a condição de ser portadora de DM e estão em uso desses MAC; percentual de mulheres informadas sobre os riscos maternos e fetais do DM e sobre as medidas a serem tomadas na pré-concepção; percentual de mulheres que engravidaram e não apresentaram complicações relacionadas ao DM. Para avaliar o conhecimento das mulheres, foi utilizada escala tipo likert da Classificação dos Resultados de Enfermagem (NOC). O projeto de pesquisa foi submetido ao Comitê de Ética em Pesquisa da Universidade Federal do Ceará, segundo Resolução no. 196/96, aprovado conforme protocolo nº 27/09 e as participantes assinaram o Termo de Consentimento Livre e Esclarecido. As mulheres apresentaram média de idade de 25,7 anos, predomínio de relacionamento com parceiro fixo, renda per capita média de R$ 200,00; 90 (84,1%) tinham DM tipo 1, com média de 11,3 anos de diagnóstico. O perfil obstétrico mostrou-se marcado por repercussões possíveis de associação ao DM; 45 (42,1%) mulheres apresentaram conhecimento moderado sobre os cuidados pré-concepcionais (variou de nenhum conhecimento a conhecimento extenso) e 59 (55,1%) apresentaram conhecimento limitado em relação aos riscos maternos e fetais (variou de nenhum a conhecimento moderado); 76 (71%) desconheciam os MAC indicados para mulheres portadoras de DM (este variou de nenhum a moderado), sendo que 104 (97,2%) estavam em uso de MAC e destas 12 (11,6%) utilizavam MAC contra-indicados em detrimento do DM ou MAC que poderiam potencializar riscos. Concluiu-se que mulheres portadoras de DM necessitam de atenção anticonceptiva eficaz e de acompanhamento para monitorização do DM para que a gestação aconteça em melhor momento clínico. Destaca-se a relevante necessidade de que estes conhecimentos cheguem ao nível extenso, para garantir às mulheres portadoras de DM conhecimento e, assim, uma prática pré-concepcional e anti-anticoncepcional segura.