Programa de Pós-graduação em Enfermagem e Saúde
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Item Competências de enfermeiros recém-graduados para gestão: desafios para a formação profissional(Universidade Federal de Goiás, 2023-03-17) Almeida, Daniel Ribeiro de; Santos, Patrícia Tavares dos; http://lattes.cnpq.br/8052298165888796; Ribeiro, Luana Cássia Miranda; http://lattes.cnpq.br/1727326201446926; Ribeiro, Luana Cássia Miranda; Medeiros, Marcelo; Pascon, Daniela MioriHistóricamente, las enfermeras han asumido cargos de gestión en las unidades de salud, pues desde su origen, la enfermería, a través de las damas enfermeras de la época de Florence Nightingale, ha tenido la preocupación de asegurar la organización y administración de los servicios de salud. En consonancia con esto, la formación de enfermeros incorpora en su estructura curricular horas específicas para disciplinas relacionadas con la gestión, siendo una de las pocas graduaciones en el área de la salud con esta especificidad. Por lo tanto, existe la necesidad de una mayor inversión en la formación de enfermeras gestoras, respondiendo a las demandas del mercado laboral y evidenciando las lagunas existentes en el desarrollo de habilidades directivas desde la graduación hasta la práctica profesional. OBJETIVO: Describir las percepciones de las enfermeras en sus primeros cuatro años de trabajo sobre las competencias para el ejercicio de la gestión sanitaria. METODOLOGÍA: Estudio descriptivo-exploratorio con abordaje cualitativo, realizado con 14 enfermeros recién graduados de una universidad pública de Goiás. A coleta foi realizada nos meses de agosto e setembro de 2022 utilizando um roteiro semiestruturado composto por sete perguntas abertas para descrição da percepção desses enfermeiros sobre as competências para a gestão. El análisis se realizó mediante el método de análisis de contenido de Bardin y, posteriormente, mediante la clasificación jerárquica descendente, el análisis de similitud, el análisis fatorial de correlación y el muestreo de palabras mediante el software IRaMuTeQ. RESULTADOS: La mayoría de las enfermeras ocupaban puestos asistenciales, con más de dos años de formación y un tiempo de desempeño equivalente al de su formación. Enumeraron las competencias directivas adquiridas durante la graduación: comunicación, gestión de conflictos, liderazgo, trabajo en equipo, relaciones interpersonales, gestión de flujos asistenciales, gestión de recursos humanos, financieros y materiales, toma de decisiones, gestión del tiempo, formación continuada y asistencia, de acuerdo con las Directrices Curriculares Nacionales de Enfermería (DCN/ENF). Durante su desempeño profesional adquirieron las competencias de gestión de conflictos, toma de decisiones, delegación de funciones y negociación, que se sumaron a las adquiridas antes de acceder al mercado laboral. Estas competencias fueron adquiridas durante el curso de graduación, que tuvo como diferencial una estructura curricular con asignaturas específicamente centradas en cuestiones de gestión de enfermería, con una gran carga de trabajo práctico que, según ellas, desencadenó una mayor adquisición de estas competencias, la participación en actividades extracurriculares, además de que la estructura del curso fue percibida como un ejemplo en términos de formación de enfermeras gestoras. Los participantes sugirieron puntos de mejora en la matriz curricular como la inserción de nuevas materias obligatorias como seguridad del paciente, inserción de simulación realista como estrategia para el desarrollo de competencias actitudinales y aproximación con campos de pasantía en el sector privado. CONSIDERACIONES FINALES: Los participantes de este estudio relataron un conjunto de competencias de gestión desarrolladas durante la graduación que van más allá de las exigidas en la ENF-DCN y señalaron contribuciones para la mejora de las matrices curriculares de los cursos de pregrado en enfermería. Se espera que otros estudios puedan ser desarrollados en otros contextos, como instituciones de enseñanza privada.Item Qualidade da assistência especializada a pessoas com diabetes mellitus e hipertensão arterial segundo o Chronic Care Model(Universidade Federal de Goiás, 2022-04-27) Borges, Dalma Alves Pereira; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Vitorino, Priscila Valverde de Oliveira; Zanini, Claudia Regina de Oliveira; Rezende, Marina Aleixo DinizINTRODUCTION: Support for self-management of chronic conditions and health literacy are essential elements in the development of person-centered services. The use of integrated care models that focus on the person, and not just on the specific disease, represent a viable solution for effective care. The Chronic Care Model is a model that is based on the relationship between motivated and informed users and the proactive and prepared health team. However, there is evidence of gaps in the attention and care that should be provided in the care of chronic conditions, especially in hypertension and diabetes. OBJECTIVE: To characterize the quality of care provided and the health literacy conditions reported by people with arterial hypertension and diabetes mellitus in a secondary care service. METHODS: Crosssectional study, carried out in an outpatient clinic that is a reference in the care of arterial hypertension, in a large Brazilian center, where diabetes is prevalent morbidity. Eighty-two people with diabetes mellitus and arterial hypertension were evaluated, with a follow-up of at least five years and ten consultations. Sociodemographic and clinical data were obtained through a nursing consultation. The Patient Assessment of Care for Chronic Conditions - PACIC questionnaire was applied, with 20 questions and five scales. Higher scores (> 3.0) indicate a perception of greater involvement in self-management and support. Three scales from the Brazilian version of the Health Literacy Questionnaire - HLQ-Br were also used. The score of each scale indicates the person's strengths and weaknesses in relation to their health literacy. Internal consistency was evaluated; Mann-Whitney test, Spearman test and significance of 5% were applied. RESULTS: The mean age of the participants was 68.98±8.79 years, female (82.93%), with a median of 4 years of study (IQR 3 - 8). Most parents (70.73%) did not study. Less than half of the users had controlled values of glycated hemoglobin - HbA1c (34.15%) and blood pressure (36.59%). The Cronbach alpha of PACIC was 0.85 and that of HLQ-Br was 0.75. There was a positive correlation between the time of diagnosis of diabetes and HbA1c. The overall PACIC score was 3.4 (IQR 2.8-3.8) out of a high of 5.0. The highest score was evidenced on the scale of care/decision-making model (4.3) and the lowest on the scale of coordination of care/follow-up (2.8). Support for selfmanagement is assessed by the treatment adherence scores (3.0), problem-solving / follow-up contextualization (3.0), and goal setting (3.8). Those with ≥ 4 years of schooling had higher scores for Attention Coordination / Follow-up (p=0.039). Participants whose parents had some schooling had higher scores for Adherence to treatment (p=0.038), Coordination of care / Follow-up (p=0.042) and general PACIC (p=0.026). Lower scores were identified among participants who did not have HbA1c control, on the Goal Setting scale (p=0.003). Health literacy showed mean scores of 4.07 ± 0.87 on the Ability to interact with the team scale; 3.02±1.31 in Understanding the information and 2.84±1.25 in Finding good information. Male users had higher scores for interacting with professionals, finding information and understanding information (p=0.039, p=0.00 and p=0.003). Those with ≥ to 4 years of schooling had higher scores for Finding and Understanding information (p=0.002 and p< 0.001), as well as those whose parents had some schooling (p=0.036 and p=0.037). Those who were overweight had a higher score for Understanding the information (p= 0.040). There was a positive correlation between the time of diagnosis of diabetes and HbA1c and no correlation was identified between the general value of PACIC and the HLQ-Br scales. CONCLUSIONS: The quality of care was considered high according to the general PACIC, and moderate in terms of the person's participation in decision-making and the contextualization of the treatment plan. Weakness was identified in the dependence on other people to be able to access and understand written information, but the ease of involvement with professionals can favor the use of communication strategies to improve health self-management.Item Análise do aleitamento materno durante a pandemia do SARS-CoV-2: estudo de coorte(Universidade Federal de Goiás, 2022-06-13) Silva, Aline Gabriele Ribeiro da; Guimarães, Janaína Valadares; http://lattes.cnpq.br/0986934969522024; Vieira, Flaviana Vely Mendonça; http://lattes.cnpq.br/5199507174724803; Vieira, Flaviana Vely Mendonça; Aredes, Natalia Del’ Angelo; Evangelista, Danielle RosaINTRODUCTION: COVID-19 is a new disease, and at first there was not much information about its vertical transmission. Subsequently, molecular studies have indicated that breast milk and placenta are not means of transmission of the disease (KARIMI-ZARCHI et al., 2020). Thus, the safety of breastfeeding was confirmed, and its continuity was encouraged (RCOG, 2021). The emergence of this new virus has brought several uncertainties about the repercussions on maternal and child health, as well as challenges for institutions to adapt to new care protocols and health professionals to adapt to new demands. OBJECTIVE: To analyze breastfeeding from birth to hospital discharge of newborns of women exposed to the pandemic by SARSCoV-2. METHODS: This is a prospective cohort study, in a secondary database, patient records and indicator records. The sample consisted of 225 binomials (mother and NB) who had their delivery/birth between April 1, 2020, and August 30, 2021, within the hospital institution. 67 had a delivery under suspicion or confirmation for COVID19 and 158 without suspicion. The continuous variables were described from position and dispersion measurements as mean, standard deviation and quartiles. Categorical variables were described by means of absolute frequencies and percentages. For the analysis of the factors associated with AM in the first hour of life, during hospitalization and hospital discharge, a generalized linear model (Poisson family) was performed. The results of the regression model were presented Adjusted Relative Risk (RRaj), 95% CI. The analyses were performed using the Software SPSS version 28, being considered a significance level of 5%. RESULTS: The participants had a mean age of 25 years (± 6.4), and the mean number of prenatal consultations was 6.5 (±2.9). Referring to neonatal characteristics, 91.6% were born at term. Newborns born to women without suspicion for COVID-19 are twice as likely to breastfeed in the first hour of life (RR: 2.04; CI95%: 1.05 to 3.94; p= 0.035). The NB who made skin-to-skin contact with their mother at birth have twice the opportunity of breastfeeding in the first hour of life (RR: 1.92; CI95%:1.07 to 3.43; p=0.028). From the bivariate regression, we performed multivariate regression for the following variables: full-term gestational age of the NB, women without suspicion or confirmation for COVID-19 at hospitalization, type of vaginal delivery and complications with NB during hospitalization. Newborns who exclusively breastfeed during hospitalization have 1.6 times more opportunity to be exclusively breastfed at hospital discharge (RR: 1.62; CI95%:1.11 to 2.35; p=0.012). CONCLUSION: Women without suspicion for COVID-19 are more likely to breastfeed in the first hour of life and maintain exclusive breastfeeding during hospitalization. Exclusive breastfeeding at hospital discharge is influenced by breastfeeding during hospitalization.