Programa de Pós-graduação em Enfermagem e Saúde
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Navegando Programa de Pós-graduação em Enfermagem e Saúde por Por Orientador "BACHION, Maria Marcia"
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Item Diagnósticos de enfermagem da NANDA identificados em pessoas com lesão medular mediante abordagem baseada na teoria do déficit de autocuidado(Universidade Federal de Goiás, 2007-02-23) BRITO, Maria Auxiliadora Gomes de Mello; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635The nursery role next to people with acute spinal cord injury is of great reaching, and it requires knowledge from the professionals faced to the features of that population. The nursing diagnosis (ND) knowledge that occurs on that group of people can help on more efficient introducing of nursing systems. Facing the exposed above, it emerges the need of knowing the diagnosis profile of that population. It is about a descriptive study of the quantitative approaching and aims: 1 - to analyze the nursing diagnosis profile of North American Nursing Diagnosis Association (NANDA), identified next to acute spinal cord injury carriers using Orem Model. 2 To analyze the relation of identified nursing diagnosis numbers with the variables: age, sex, income, marital status and level of scholarship of the person with acute spinal cord injury, etiology, level and extent of the injury, lead time of the injury, existence of a daycare, sex and degree of kinship of the daycare. 3 to analyze the relation of the identified nursing diagnosis with those variables. To the data collection, it was made interviews, physical exam and consulting to the patient files. In the ND developing it was realized the process of rational thought process proposed by Helland and the Taxonomy II of NANDA. 30 patients with acute spinal cord injury participated on the sample, independent from the gender, attended in the ambulatory of triage of a rehabilitation center of Goiás state, from November 2005 to December 2006, who agreed to take part in the research signing the informed consent , 73.3% of the patients were male, the medium age was 32.6 years old (± 10,29). The average time of the injury was 162 days (±369,9), 28 of the cases presented traumatic injury, and 16 presented complete spinal cord injury. From these ones, 16.7% were not literate. The familiar income varied from 0 to 5 minimum wages. 61 different nursing diagnoses were found, with a sum of 734 happenings, and the average was 24.46 ND per person. The most affected requirement of universal long term care was the one about prevention of dangerous to the life function and to the well- being of humans, with 20 ND and 318 happenings. The number of identified nursing diagnosis didn t present any link with the variables age, sex, income, marital status and scholarship of the person with acute spinal cord injury, etiology, level and extent of the injury, lead time of the injury, existence of the daycare, sex and degree of kinship of the daycare, to the studied sample. The variables with highest number of association with ND were: level of the injury that presented association statistically meaningful with ND impaired walking (p = 0.009); useless control of the therapeutic regime (p = 0.034); lack of care about feeding (p = 0.0006); lack of care about oral hygiene (p = 0.004); impaired physical mobility (p = 0.034); ineffective protection (p = 0.014); and risk for impaired home maintenance (p = 0.015), and the variable extent of the injury that presented association statistically meaningful with ND impaired walking (p = 0.007); sexual dysfunction (p = 0.005), intestinal incontinent (p = 0.033); total urinary incontinent (p = 0.0006); infection (p= 0.024); tissue integrity impaired (p = 0.16); ineffective protection (p = 0.0004); risk for peripheral neurovascular dysfunction (p = 0.002) and risk for musculoskeletal inactivity (p = 0.015). We hope the results of this research can contribute to the grounding of professional practice and to a better nursing assistance to acute spinal cord injury patients.Item Integridade da pele de área perilesional prejudicada e integridade tissular prejudicada relacionada à circulação alterada em pessoas com úlceras vasculogênicas(Universidade Federal de Goiás, 2010-03-05) MALAQUIAS, Suelen Gomes; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635Vasculogenic ulcers represent a public health problem that requires an interdisciplinary approach emphasizing nursing. The focus of nursing on caring when this disease is present should be on diagnoses impaired tissue integrity and impaired perilesional skin integrity , among others. Despite the high number of bandages made to the outpatient units of the Goiania Department of Health, the nursing staff has not conducted systematic approach and evaluation. The aim of this study was to analyze the occurrence of impaired tissue integrity related to altered circulation and impaired perilesional skin integrity in patients with vasculogenic ulcers treated in primary health units in Goiania, Goias, Brazil. The association between the related factors and defining characteristics of these diagnoses with social, demographic and individual clinical variables were also investigated. A cross sectional observational clinical study in municipal health units that operate 24 hours a day was conducted from February to August 2009. From the population of 67 individuals with vasculogenic ulcers who were being treated in the network, 42 participants were included in the study. Interviews, physical examinations, planigraphy, digital photography of the wound, and analyses of patient records were used in data collection. Descriptive statistical procedures were performed for data analysis. To analyze the relationship between each related factor (RF) and the defining characteristics (DC) with social, demographic and clinical variables, the X2 test was used, and for the association of the number of RFs and the DC of the diagnoses and the variables of interest, the Mann-Whitney and Kruskal-Wallis tests were used, for which p �� 0.05 was adopted. The study was approved by the UFG Research Ethics Committee (protocol 032/2008). Participants were predominately males (73.8%), age �� 50 years old. All (100%) showed impaired tissue integrity, highlighting the RFs: impaired circulation (100%), of venous origin (90.5%), knowledge deficit (100%), and chemical irritants (95.2%). In relation to the DC, granulation tissue and/or epithelialization (a new proposal for inclusion), destroyed tissue (95.2%), and damaged tissue (76.2%) were identified. All (100%) had impaired perilesional skin integrity, and the RF impaired circulation and changes in pigmentation were also found in 100% of the cases studied. The inclusion of the RF knowledge deficit was found in 100% of the participants. Impaired tissue integrity presented association between the gender of the participants and the temperature extremes (p=0.001). For the impaired perilesional skin integrity, there was association between gender and the exudation (p=0.049), mechanical factors (p=0.049), impaired physical mobility (p=0.032), bony prominences (p=0.034), extreme age (p=0.035), developmental factors (p=0.035), and hyperthermia (p=0.003). There was a statistically significant association for the number of RFs of the impaired perilesional skin integrity in relation to the current work situation (p=0.020). The significant occurrence of impaired perilesional skin integrity signalizes the importance of expanded evaluation by the professionals. The results indicate the presence of RFs that are highly sensitive to nursing interventions, such as knowledge deficit. The association of RFs and CDs with social, demographic and clinical variables indicates the need for differentiated nursing interventions in relation to the gender of patients.Item Percepção sensorial perturbada (tátil) nos pés de pessoas com diabetes tipo 2, em atendimento ambulatorial(Universidade Federal de Goiás, 2010-03-31) MILHOMEM, Alyne Coelho Moreira; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635Attention to health in individuals with diabetes reaches better outcomes when carried out by multidisciplinary teams, in which nursing is inserted. Follow up may be favored by the use of terminology specific to the area, namely, North America Nursing Diagnosis Association taxonomy, which presents nursing diagnosis (ND) disturbed sensory perception , which seems to describe the human response of decreased sensibility in the feet of patients with diabetes. Diabetes complications may lead to decreased tactile sensory perception in the extremities. It can lead to complications such as ulcerations and amputation of limbs, causing increased morbidity and mortality. Despite this fact, Nursing studies under the perspective of identifying disturbed sensory (tactile) perception in the feet for care of individuals with diabetes are scarce. This study aimed at assessing the occurrence of ND disturbed sensory (tactile) perception in the feet in individuals with type 2 diabetes. This is a transversal observational clinic study, carried out in the endocrinology laboratory at a school hospital in the municipality of Goiânia-GO, from May to October in 2009. Data was collected through clinical assessment and reports using standard questionnaire. The 55 individuals assessed consisted of 36 (65.5%) female and 19 (35.5%) male with average age of 59.4 (+/- 10.6 years, Diabetes diagnosis time of 14 years on average, ranging from 1 to 32 years. We identified that 61.8% of the participants showed some kind of complication due to the disease, and 43.6% reported having had previous ulcers in their feet. The median for glycosylated hemoglobin among participants was 8.4%, being 80.9% had values higher than the recommended ones. The found median for capillary glycemia was 240.0 mg/dL, being 83.6% of all participants showed higher values than the recommended ones. Forty-seven individuals (85.5%) showed disturbed sensory (tactile) perception in the feet . Concerning related factors, all have presented biochemical imbalance, 78.7% psychological stress, 21.8% altered transmission and reception, and 21.3% electrolytic imbalance. Concerning defining characteristics, all presented changes in the usual response to stimuli and changes in sensorial acuity and 83.0% sensorial distortions. There was no statistically significant association between ND studied with social demographic and morbidity variables. The outcomes indicate that this phenomenon deserves special attention from nurses, due to its high prevalence and severity of complications. This study also evidences the usefulness of permanence and refining this diagnosis in the NANDA taxonomy.Item Diagnóstico de enfermagem identificados em famílias em situação de acompanhamento hospitalar utilizando o modelo Calgary(Universidade Federal de Goiás, 2006-12-19) MONTEFUSCO, Selma Rodrigues Alves; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635Family is a natural group that, through the times, has developed interaction standards, that they constitute the familiar structure, that, in turn, governs the functioning of its members, delineating its gamma of behaviors and facilitating its interaction. In accordance with Wright; Leahey (2002) the nursing has the commitment to include the families in the cares of health. Many evidences exist that the family assumes one meaning special for well-being and the health of its members, thus the nurses must consider the family of the patients as integrant part of the unit of care. Front to the displayed one, immerges the necessity to evaluate and to intervine together to the family of the people during the process of hospitalization, independent of which is its alteration of health. We know that an evaluation model does not exist that contemplates all the phenomena of the family. However, the Wrights; Leahey (2002) cite the necessity of the adoption of a clear conceptual structure, or map of the family. This encourages the synthesis of data, in order to be identified to the forces and the problems of the family, constituting a plan of useful and systemize treatment. The Calgary model involves evaluation (MCAF) and Intervention (MCIF) in the Family and constitutes the multidimensional one structure that possesss three main categories: structural, of development and functionary. These subcategories allow that the evaluation of each family is differentiated. Nor all the subcategories need to be evaluated in a first meeting with the family and some never will need to be evaluated. This study the June of 2006 through descriptive study has the objective to analyze the disgnostic profile of nursing identified in families of patients interned in the medical clinic of a hospital school during the period of January. They had been enclosed families who were following patient in the period for collection of data that had agreed to participating by means of signature of the term of free and clarified assent. The patient and its familiar ones had been taken as participant unit of the research. The findings had been argued focusing the disgnostic headings, related factors and characteristic defining to the light of the Model Calgary de Evaluation and Intervention 12 disgnostic of nursing,being 75% Reals and 25% of risk had been found. They had not been detected disgnostic of well-being the disgnostic average for family was of four, being that we had a family with 07 (seven) disgnostic ones and one with 02 (two). The ones that had gotten greater frequency had been: Tension Due to the Paper of Cuidador, gift in 100% of the families; in second, Harmed, present Verbal Communication in 75%, and together in third, Interrupted Maintenance of the Harmed Home and Familiar Processes, gifts in 66% of the families. The nurses need to be intent to the families who are on its cares, fitting to them to develop strategies shared with all the team to multidiscipline to protect the families in relation to these occurrences, to prevent that the adoecimento of a familiar one has taken the abalos greaters in the structure and functioning of the families. To make the evaluation of the families allows to identify to the difficulties for which these families passes, allowing a acurada intervention more on the part of the professionals.Item Revisão sistemática da literatura sobre produtos usados no tratamento de feridas(Universidade Federal de Goiás, 2006-03-02) PEREIRA, Angela Lima; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635Every day an increasing volume of publications has been produced being necessary that these information are analyzed in order to make their application useful becoming the produced knowledge more easily used The systematic review of literature answers the necessity to synthesize the produced knowledge and to separate the excellent studies to the determined clinical question A great diversity of products for the treatment of wounds exists During practical ours we live deeply the difficulty of the professionals in deciding which is the best treatment which product will have greater effectiveness and associating the studies developed concerning the treatment of wounds to the practical clinic In order to contribute for the theoretical recital of taking care of nursing in the treatment of wounds we believe to be necessary to investigate in the scientific literature of the health area which are the best evidences gotten concerning the treatment of wounds The results of this research will be able to direct the assistance and education of nursing concerning the thematic one as well as generating new questions of research Thus we consider as objective to identify and to analyze scientific evidences concerning some products used in the treatment of wounds in human beings in published scientific articles in the languages Portuguese English or Spanish the 2004 enter the years of 1995 in the following database of the Virtual Library of Health (VLH): ADOLEC BDENF MEDCARIB MEDLINE This study is about the research of Systematic Revision of Literature Defined the object of the study tests of relevance had been elaborated (TR) After that by means of consultation to the DECs there had been adopted to unitermos and carried through search in literature in VLH The preliminary election of the references and summaries gotten in the search in database was carried through by means of the application of TRI for one of the researches considering criteria of inclusion and exclusion previously determined. Later TRII was applied to the references and summaries of articles and after that to articles in the complete one for two research of independent form To enclosed articles in this phase TRII was applied for two researchers of independent form and requested evaluation of two consultants for analysis of articles in which had disagreement between the researchers The decision of the consultants about the inclusion or exclusion of articles was sovereign Finally the enclosed articles had been submitted to the script of extraction of information of each article was constructed and later the general map of evidences identified for the diverse uses of the studied products was elaborated The total amount of joined article references was of 2906 With the application of the TRI it had a total of 1234 exclusions and 1672 inclusions The application of TRII resulted in a total of 1413 exclusions and 159 inclusions It was note possible to apply TRII in 100 articles for not having been joined in the national territory TR III resulted in 142 exclusions and 17 inclusions The joined evidences denote positive effect of the use of these products; being the majority of them classified them as evidence IB or either strong recommended for implementation in the studied circumstancesItem Análise da implementação de uma abordagem de cuidar de enfermagem junto à mulher no ciclo gravídico-puerperal: uma aproximação do Modelo de Orem, sistemas de classificação da prática de enfermagem e diretrizes de humanização do parto(Universidade Federal de Goiás, 2004-12-14) PEREIRA, Sandra Valeria Martins; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635Item Úlceras venosas: caracterização e tratamento em usuários atendidos nas salas de curativos da rede municipal de saúde de Goiânia-GO(Universidade Federal de Goiás, 2011-01-28) SANT\'ANA, Sílvia Maria Soares Carvalho; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635The venous ulcer is a public health problem according to the number of people affected and because of its chronic character, being the main cause of ulcers of the lower limbs. The injuries alter domestic activities, work and leisure activities, doing it necessary to the acting of a multidisciplinary team, which includes the nurse as a professional who, every day, assesses the health of the person, carrying out the curative, runs educational actions and makes referrals. The care of this population is realized, in mostly, on basic health units, yet the polls are usually conducted in reporting units, which contributes to know only part of the affected population. We aimed to analyze the socioeconomic, demographic and clinical profile of people with venous ulcers treated in curative rooms of the municipal health network and to analyze the treatment performed on the units and at home. We conducted a clinical study, observational, descriptive, cross-sectional with quantitative approach, involving people with venous ulcers, users of the curative rooms of the municipal health network of Goiânia, Goiás. Data collection was conducted from October 2009 to July 2010. It occurred through interviews, physical examination, application of evaluation scale of healing, refers to diagnostic procedures for amending the venous circulation of lower limbs and photography of the lesion, using a standardized guide. The 58 (100%) subjects tested ranged in age from 28 to 79, 39 (67.2%) were male, 42 (72.4%) were up to five years of study, 39 (67.2%) were working, 28 (48.3%) were in economy class "D". It was observed that 21 (36.2%) had hypertension, 10 (17.2%) diabetes, 30 (51.7%) higher body mass index, 39 (67.2%) spent most of the day sitting or lying. The lower limbs had varicose veins, reticular veins or telangiectasia (87.9%), hyperpigmentation (84.8%), edema (83.3%), lipodermatosclerosis (53.0%), eczema (51.5%) and pain (60.6%). Approximately half of the lesions were recurrent, people had a predominantly affected limb with a single lesion, with more than one-year duration; areas of lesions were greater than 24cm2, predominantly in the slough bed and a large amount of exudates, indicating a state of healing impaired. The borders were circled, regular, adhered and elevated; the perilesional skin showed fine texture (75.5%), shiny, scaly, with hyperthermia and hyperemia. The treatment occurred with the accompanying professional of technician or nursing assistant, nurse and doctor (56.9%), four people (7.0%) only with the technician. The product used in treatment was, mainly, based on essential fatty acid, four (6.9%) people used Unna s boot and three (5.1%), drug therapy. The majority (67.2%) was also curative at home, and in 17 (29.3%) cases, cleaning carried out with water. The results of this study indicate a population with poor socioeconomic conditions, presenting chronic disease with lesions characteristically deteriorated; pointing to needs of treatment, those consider the people in their entirety, which involves actions planned and ongoing, systemic and local impact.Item Diagnósticos de enfermagem identificados em puérperas no período imediato e tardio no contexto da comunidade(Universidade Federal de Goiás, 2008-07-16) VIEIRA, Flaviana; SALGE, Ana Karina Marques; http://lattes.cnpq.br/7766918925030041; BACHION, Maria Marcia; http://lattes.cnpq.br/8503907944360635The puerperium occurs concomitant to the efetive exercise of maternity, in which a woman experiences profounds changes, within biological and in psychological and socio-cultural. The planned assistance, with the lifting of data, identification of human responses to problems or events from the life cycle in individual aspects, considering the context in which this woman is embedded is crucial during the post-partum phase. Studies with focus on nursing diagnosis (ND) identified in the puerperium have been made eminently at the hospital's context. This survey aimed to analyze the occurrence of 26 diagnosis of nursing care in the interest of immediate and late puerperium in the context of the community. This is a descriptive study of quantitative approach, carried out between February and May 2008. For the data gathering has been prepared an instrument from the defining characteristics and related factors / risk factors of diagnosis of interest, the NANDA Taxonomy II, version 2007-2008. The data gathering has included procedures for interview, physical examination and observation. A researcher conducted the fieldwork, completed the roadmap for collection and noted the diagnosis inference. Two experts reviewed the material for analysis of evidence about the presence of diagnosis reported. In the analysis was adopted procedures of descriptive statistics and inferential (Mann-Whitney, chi-square and its variants, P ≤ 0.05). It was even used Segment analysis, considering the typology of diagnosis made. Participated in the sample 40 puerperium during immediate and late periods, belonging to the team's area of coverage of family health team in the east region, after having been read and signed the term of free and informed consent. The socio-demographic characteristics of the participants were: predominant age group between 21 to 25 years (37.5%); brown color that self (65%), marital status or married with stable partner (82.5%); incomplete primary education (47.5%), 60% with housing itself; family income was, predominantly, from 1 to 2 (32.5%) or 3 to 4 (42.5%) minimum wage; family income over the male figure, since 55% of puerperium reported as occupying housewives. In this sample 65% had caesarian childbirth, the majority (70%) had up to two children, 80% began prenatal care in the first trimester of pregnancy, 80% performed at least 6 consultations, 90% had to full-term child; 32.5% claimed to have had urinary tract infection during pregnancy. Has been identified in this sample the occurrence of 24 of the 26 ND studied. Besides evidence of two new ND. The number of ND ranged from 08 to 16 in each puerperal woman, with an average of 13, totaling 521 ND, with 266 real diagnosis, 168-risk and 87 welfare or health promotion. In examining the relationship between the diagnosis of nursing and socio-demographic variables and obstetric (chi-square and its variants) was found a significant association for the diagnosis of breastfeeding interrupted and type of housing (p = 0.028); risk of breastfeeding interrupted and type of housing (p = 0.028); impaired tissue integrity and type of delivery (p = 0.011); risk for impaired integrity skin and number queries from prenatal (p = 0.020); impaired integrity skin and household income (p = 0.043)/number queries from prenatal (p = 0.032); altered nutrition: less than body requirements and housing (p = 0.001)/self that color (p = 0.021)/parity (p = 0.020); provision for improved nutrition and that self color (p = 0.044); altered nutrition: more than body requirements and type of housing (p = 0.001); acute pain and family income (p = 0.032)/self that color (p = 0.032 )/days of postpartum (p = 0.013)/type of delivery (p = 0.002); risk of constipation and type of delivery (p = 0.017); situational low self-esteem and family income (p=0,022). In examining the relationship between the number of diagnosis identified and the variables of interest, were not significantly different (Mann-Whitney). In the analysis of segments were found two cluster, which prevailed in the first segment more ND real and potential, than those related to psychological and social aspects. The characteristics of the two subgroups are presented descriptively. It was concluded that the diagnoses initially predicted were found in postpartum period at early and late period's, representing more human responses than those that have traditionally been exploited in monitoring the puerperal period, and is necessary to review the approach of nursing in this area under the education, assistance, research and public policies.