Mestrado em Enfermagem e Saúde (FEN)

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    Absenteísmo entre trabalhadores de enfermagem de um hospital público de Goiânia-Goiás
    (Universidade Federal de Goiás, 2011-03-31) Lima, Maisa Carolina de Castro; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225
    Absenteeism is the practice of an employee not being present at work for a period, when the work day has been assigned to him/her. That fact may cause negative effects to health service. There must be shortage of personnel, other workers must be overworked and there will consequently reduce the quality of medical care. We consider as absenteeism both planned and unplanned absences, including unauthorized absence, dental and medical licenses, statement of attendance and work accidents. All of them, considered unexpected absenteeism due to preventable cause, were addressed in this study. Ojective: to investigate the occurrence of unexpected absenteeism due to preventable cause in what concerns nursing staff at public hospitals in Goiânia-GO, from 2005 to 2009. This is a cross-sectional quantitative documentary study. We researched on 549 nursing workers, 86,15% of them have presented at least one episode of absenteeism due to preventable cause. From those, nursing technicians were the great majority. That is also the category with the highest percentage of unexpected absenteeism due to preventable causes (70.19%), while nurses were a small number in that list. We found unexpected absenteeism due to preventable cause was more frequent among workers aged 30 - 39 and 40-49 years old and worked up to seven years at that job. In what concerns workplace, it was more common among workers of Emergency and Surgical Clinic, locations that require large volumes of customer service, diversity and turnover of patients and the high degree of dependence on them. Medical licenses were 82,06% of the reasons for absenteeism due to preventable causes. Among the causes of absenteeism due to illness, there are the diseases of muscular system and connective tissue, followed by mental and behavioral disorder; conditions which influence physical/mental health and the contact in health services and respiratory diseases. Absenteeism rates had increased over the years, and remained, most of the time, above the level recommended by COFEN, demonstrating that the unexpected absenteeism due to preventable causes in the study institution was high. It is noteworthy that rate drop in 2009, which may be the deployment of APH. Through this study we could observe the unexpected absenteeism among workers due to avoidable causes depends on factors intrinsic to the individual: his/her health condition, personal elationships, including family members, his/her contact with the social apparatus, such as the transportation system, among others, but it is largely influenced by the conditions of the workplace: the physical environment itself, the activities performed and the way they have to be performed, relationships with colleagues and supervisors. All of them susceptible to intervention, so as to reduce absenteeism.
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    Acessibilidade às pessoas com deficiência física nas unidades de saúde da atenção primária no estado de Goiás
    (Universidade Federal de Goiás, 2016-03-31) Mamed, Samira Nascimento; Rosso, Claci Fátima Weirich; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4709392U3; Rosso, Claci Fátima Weirich; Dalla Déa, Vanessa Helena Santana; Bezerra, Ana Lúcia Queiroz
    Introduction: Accessibility for disabled people at primary healthcare units has a fundamental role in the use of health services, as well as the organization of health services targeted at this population, since there is an impressive number of disabled people in the state of Goiás and in Brazil in general. Objective: To analyze accessibility of disabled people to primary healthcare services in the state of Goiás. Method: A descriptive cross-sectional study was conducted with secondary data from an external evaluation of the National Program for Improvement of Access and Primary Healthcare Quality (PMAQ-AB, as per its acronym in Portuguese). The study was developed in all 246 cities of Goiás. The sample was made up of 1,216 healthcare units and 677 healthcare professionals in the cycle 1 of PMAQ-AB; and 975 healthcare units and 1,180 healthcare professionals in the cycle 2 of PMAQ-AB. Data were collected between June and August 2012 in the cycle 1 and from January to March 2014 in the cycle 2. The variables were analyzed descriptively and presented by means of absolute numbers, frequencies and means. Results: Only 30% to 40% of the studied healthcare units had sidewalks, floors and ramps accessible to disabled people. Between 20% and 35% of the healthcare units had adapted doors and hallways, except for units in cities with up to 50,000 inhabitants in cycle 2, which accounted for almost 50% of the units with these elements. Regarding adapted restrooms, less than 20% of the healthcare units in cycle 1 had them, whereas between 20% and 55% of the units in cycle 2 presented this feature. As for the organization of healthcare services toward disabled people, almost 95% of the teams defined the coverage area, however only half of them had records on the number of cases of disabled people. Conclusion: Primary healthcare units and services in the state of Goiás are not structured in terms of accessibility to disabled people, which makes the delivery of care to this population poor. In this sense, there is a clear need for investments on the part of health managers and professionals for continuing education and financial resources to adapt these units and qualify healthcare teams to provide universal, comprehensive and humanized health care to disabled people.
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    Acessibilidade e ambiência na atenção básica à saúde do estado de Goiás
    (Universidade Federal de Goiás, 2014-04-29) Ribeiro, Juliana Pires; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Rosso, Claci Fátima Weirich; Souza, Marta Rovery; Souza, Márcia Maria de; Silveira, Nusa de Almeida; Bezerra, Ana Lúcia Queiroz
    Introduction: Basic Health Units accessibility and ambience holds two fundamental importance links for the team work process development. The accessibility is intrinsically linked to meet the health services users’ needs and to ensure the solvability of assistance. Ambience is a concept that refers not only to physical space, but also to the social, made up of interpersonal and professional relationships in order to provide a solving, equitable and warm attention. Objective: To analyze the accessibility to health services and ambience of basic health care units in primary care in Goiás state. Methodology: A cross-sectional descriptive study performed in health care facilities in Primary Care in Goiás state in 2012. The study sample was done in 1216 basic health care units in Goiás state. Data were collected between July and September 2012 through a structured, tandardized and previously validated instrument. They were submitted to Ministry of Health database through the use of tablets and via internet to be analysed. After that these data were stored and grouped into modules I, II and III. Statistical analysis was performed using Statistical Package for the Social Sciences - SPSS software, version 19.0. The study respected ethical and legal aspects recommended by the Resolution 466/2012. Results: Two scientific articles were done. The first one "Accessibility to health care services in primary care in Goiás state" studied factors related to accessibility in health care facilities. The second article "Ambience of basic health care units in primary care in Goiás state " is about environment which provides better service and satisfaction to users and workers. Conclusion: Regarding accessibility and ambience in basic health units in primary care in Goiás state, we can conclude that the inaccessibility is contrary to the principle of integrality, hindering assistance and disrespecting those who need health services. It was also showed that there is a direct relationship between welcoming / humanized service and ambience. The lack of a suitable place for accommodation and care for users affects the development of actions in health care system. To change this reality, it will be necessary to invest in management in order to consolidate the Primary Health Care in a resolutely, equitable and welcoming way.
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    Acidente com material biológico em uma instituição de ensino odontológico: perfil, notificação e sub-notificação
    (Universidade Federal de Goiás, 2008-09-03) SASAMOTO, Sandra Aragão de Almeida; LELES, Claudio Rodrigues; http://lattes.cnpq.br/6740286066154410; TIPPLE, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920
    Cross-sectional study of accidents with biological material developed at the Dental School, Federal University of Goiás (FO / UFG), Goiânia. The study aimed to: 1) to identify the occurrence of accidents involving biological material among academics and professionals, 2) to evaluate the occurrence of sub-reports and their causes, 3) to characterize the profile of accidents, 4) to identify protective measures adopted by professional and academic casualties. The study was approved by the Ethics Committee of the Federal University of Goiás, with protocol 058/2006, and were observed all ethical measures. Data were obtained by evaluation of 71 registration forms for accidents with biological material in the period October 2001 to July 2008, and by applying a questionnaire to all students registered in that period, technicians and teachers, totaling 566 subjects eligible. For this we developed a software: Evaluation and Management Distance System (EMDS), which allowed the circulation of the questionnaire electronically. Data were tabulated and analyzed by SPSS 16.0, and descriptive statistical analysis performed by the measures of frequency and inferential analysis through chi-square and logistic regression. Of the 71 reports, only 41 (57.7%) records had complete data. Of the subjects eligible for the questionnaire (EMDS), 266 (47.0%) participated, being 100.0% of technicians, 85.4% of teachers, 69.4% of academics and 21.0% of former students . The complete vaccination against hepatitis B was reported by 81.9%, and five (1.9%) reported not having been vaccinated. The result of antiHBs was known for 151 (69.3%) who claimed to be responders. Ninety-one (34.2%) claimed to have suffered accidents with biological material, and there was no difference in this occurrence among academics, technicians and teachers (p = 0.496). Only 24 (26.4%) reported formally to the exhibitions department, the rate of underreporting was 73.6%. The reasons cited for not reporting were not considered serious enough to notify (52.2%), considered the low risk (32.4%), did not know they should notify (22.0%). Accidents among students occurred more frequently in the 3rd and 4th years, and most, 71.4%, occurred during the procedure. The exposures were percutaneous in 76.9%, splash on intact skin in 25.3%, and splashes into mucous membranes in 24.2%. The most affected body parts were the fingers of the nondominant hand in 42.8% and 36.3% dominant hand. The biological materials involved in accidents were the saliva (68.1%) and blood (48.3%). Seventy-five subjects (82.4%) reported using all personal protective equipment, and have been neglected gloves (13.2%), face (11.0%), and goggles (7.7%). The accident percutaneous (p = 0.016) with involvement of blood (p = 0.013) presented significant for the notification. The lack of data in records of notifications, the high rates of accidents with biological material, as well as under-reporting signal the need to restructure the notification service, and the importance of disclosure of official protocol of the institution of post-exposure and preventive measures to be adopted by the academic community
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    Acidente com material biológico: risco, perfil e preparo do acadêmico de enfermagem
    (Universidade Federal de Goiás, 2015-05-28) Cardoso, Najara Queiroz; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Galdino Júnior, Hélio; Sousa, Adenícia Custódia Silva e; Prado, Marinésia Aparecida do; Mendonça, Katiane Martins
    For nursing staff the biohazard is a major concern with physical and emotional impact on the health of these workers, with the graduates of this area under the same risk. The objectives of this study were to analyze the epidemiology of accidents with biological material involving nursing students in the scientific literature; describe the frequency and profile of accidents with biological material among nursing students of a higher education institution; identify activities of academic practice considered risk for accidents with biological material in the view of nursing graduates; characterize the preparation of the nursing academic front of an accident with biological material. This study results were presented in the form of two articles, the first being an integrative review of the literature on accidents involving biological material among nursing students, the descriptor available in the Descriptors in Health Sciences of the Virtual Health Library and the Medical Subject Headings in the PUBMED electronic databases Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), no time frame. They found 1849 articles, these 37 met the inclusion criteria. The investigated items showed that the profile of accidents with biological material among undergraduate students follow the same profile of affected by nursing professionals and are associated with the lack of biosecurity measures, post-exposure recommendations and other factors intrinsic to the vocational training process . The second article was a cross-sectional descriptive study by means of an electronic questionnaire with the third nursing students the tenth periods of a public institution of higher education in the state of Goiás. The study was approved under protocol nº414258. The study included 126 undergraduate students with a mean age of 21.6 years. Among the activities of nursing practice the sharps handling was the most cited (64.4%) and 98.4% of the students said to have received prior guidance on the possibility of contact with body fluids during the course of practical activities. However, most did not know how to describe the post-exposure measures. There were four accidents (3.2%), more frequent exposure of the ocular mucosa (75.0%) with the blood longer present as biological material. Two students reported accidents to teachers who have followed all recommended behaviors. It was found that the communication of the accident to the teacher resulted in adherence to recommended post-exposure measures.
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    Acidentes com material biológico entre pessoas sem risco presumido
    (Universidade Federal de Goiás, 2014-08-15) Salgado, Thaís de Arvelos; Tipple, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; Tipple, Anaclara Ferreira Veiga; Oliveira, Adriana Cristina de; Teles, Sheila Araújo; Mendonça, Katiane Martins; Santos, Silvana de Lima Vieira dos
    Most recorded accidents with biological material are related to accidents in Health Care Facilities, which are considered unhealthy environments where the group with the highest exposure is professionals in the healthcare field. However, it should be understood that, any individual who passes through a healthcare facility is exposed to biological risk. The objectives of this study were: to identify the profile of victims of accidents with biological material, occurring in healthcare facilities among those with no presumed risk; to identify the frequency and profile of accidents in this group; to classify pre and post-exposure conduct in accidents with biological material in this group. This retrospective epidemiological study was conducted based on data from two service centers and accident reporting services: Hospital for Tropical Diseases in the State of Goias, Brazil, and the Center of Reference on Worker's Health (CEREST) in the city of Goiania. The two databases were linked. This study analyzed accidents reported by workers who were not trained in healthcare practice that had accidents with biological material inside the healthcare service independent of their professional duties. The study received approval in two Ethics Committee reports, the Hospital for Tropical Diseases, under protocol No. 033 / 2010, and by the IRB of the Hospital das Clinicas, Federal University of Goias, under protocol 414258/2013. There were 8,568 records of accidents with biological material recorded between 1989 and June 2012, 181 of these (2.1%) occurred in health services among those with no presumed risk. The highest frequency of accidents occurred among people between 20 and 29 years, female, and the most frequent occupation was the receptionist's office or lab, followed by administrative assistant. Needlestick accidents were most common (91.7 %) and involved a needle lumen, with higher incidence among females, and blood was the most common biological material. With regard to the circumstances of the accidents, most occurred due to inappropriate disposal of sharps, 20.1% referred to assistance activities such as recapping of needles, injections, or punctures, and material processing support procedures. Less than half of the subjects were vaccinated (49.7 %) against hepatitis B. The source patient was identified in 64 (35.6 %) cases, and of these, 43 (67.2 %) did not undergo serological testing. Post-exposure prophylaxis was recommended in 41 (22.6 %) and immunotherapy in 58 cases (32.0 %), and in 96 (53.0 %) cases completed, 74.0% indicated giving up clinical and laboratory monitoring. There were gaps in the data recorded in the notification forms, which reveals the need for professional training for the correct completion of notifications and active search for cases for follow-up. Data support the fact that healthcare facilities should have a organizational structure focused on resolution, prepared to provide care and / or refer the victim to postexposure prophylactic measures, since the office needs to be responsible for people who have accidents in their area, once the injured person, regardless of the employment relationship becomes a "victim of an accident with biological material" and in need of care, to minimize the risk of disease by taking proper preventive measures after the accident.
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    Acidentes ocupacionais com material biológico : a per- cepção do profissional acidentado.
    (Universidade Federal de Goiás, 2005-03-21) DAMACENO, Ariadna Pires; PEREIRA, Milca Severino; http://lattes.cnpq.br/9304767101674108
    Occupational accidents involving biological materials may bring physical and psychological consequences to the injured professional Many workers commonly give less attention to such events not applying preventive steps as recommended for those procedures which represent risks to their health This paper aims at reporting the workers perception and undertanding on the context involving the accident with biological material including experimented feelings, reactions as well as actions taken The research has been done according to the presumptions of qualitative research and data was analysed in accordance with content analysis technique Data was collected by using questionnaires applied to health-care workers linked with a health care institution and later by an interview with the injured workers from an emergency and urgency reference unit in the city of Goiânia Firstly 382 health-care workers answered a questionnaire in order to identify those who had already suffered an accident 39 of those who had had an accident have participated in the interview concerning aspects related to the accidents The main causes to the accidents mentioned were: unattention non-adoption of preventive steps severity of injured patients hurry due to work overload and appliance structure and material-related deficiencies Among the feelings experimented we could highlight: insecurity fearing infection worries about the family rage and even calmness About half of the workers have reported that the accident had not brought any consequence into their lives The others reported that it had provided them with learning and growth All workers reported awareness of the risks related to the accident however we could note several inadequate conduct in their reports 18 professionals reported all the accidents they had 12 never reported any and 9 reported only those considered most serious Many manifested some difficulty in specifying the protective equipment used on the day of the accident mainly due to the amount of time from the day of the event to the research date The workers perception of such phenomenon is very different from one another regarding the same kind of accident Data shows the need of worker´s health self-valuing as well as programs aimed at improving the occupational safety
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    Ações de saúde mental na atenção primária à saúde: perspectivas para a enfermagem
    (Universidade Federal de Goiás, 2019-03-26) Stival, Ana Paula Cintra; Dallegrave, Daniela; http://lattes.cnpq.br/7963448404748668; Esperidião, Elizabeth; http://lattes.cnpq.br/1143743711641872; Esperidião, Elizabeth; Silva, Nathalia dos Santos; Santos, Patrícia Tavares dos
    Research on the type of intervention with a descriptive-exploratory and qualitative approach, discusses aspects related to the integration process of mental health actions in Primary Health Care (PHC), in view of the need to extend mental health care to the people of community in the territory. With a view to strengthening the Psychosocial Attention Network and mental health care in the field studied, the objective was to identify and analyze the development of mental health actions from the perspective of the supervisors of the family health teams. The following specific objectives were identified: identifying the demands of the field of mental health in the Family Health Strategy (ESF); describe the actions of the mental health field offered by the family health teams; to investigate the factors that influence the development of actions in the field of mental health from the perspective of the supervisors of the Family Health Strategy, in addition to experiencing the implementation of Situational Strategic Planning as a tool for reflection and change in mental health practices in the Family Health Strategy. The research was developed in a medium-sized municipality in the Central West region of Brazil, in which nurses supervising the FHT participated. The data were collected through participant observation at the time of approach and immersion in the field under study, focus groups and by a self-administered questionnaire, aiming at obtaining the professional profile of the participants. Thematic content analysis was followed by qualitative data analysis software. As main results, it was observed that the mental health care in PHC, from a nursing perspective, comprises three dimensions: the reorganization / management of the nursing work process, changes in the professional's posture and effective permanent education plans. In addition, factors that influence the development of actions in the field of mental health by the FHT are described and analyzed. This study indicates the feasibility of instituting permanent education plans for the professionals who are at the forefront of PHC, given the pressing need pointed out by the participants themselves in the discussions undertaken during the research development, as well as highlighting the Situational Strategic Planning as an important strategy for reflection of mental health care actions in the sphere of PHC. Finally, it brings the analysis of these questions into the nursing training dimension.
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    Acolhimento com avaliação e classificação de risco e qualidade dos serviços de urgência e emergência
    (Universidade Federal de Goiás, 2015-03-18) Cabral, Karynne Borges; Oliveira, Lizete Malagoni de Almeida Cavalcante; http://lattes.cnpq.br/2680821388094276; Oliveira, Lizete Malagoni de Almeida Cavalcante; Brasil, Virginia Visconde; Cordeiro, Jacqueline Andréia Bernardes Leão; Siqueira, Karina Machado; Faria, Dálete Delalibera Correa Mota
    INTRODUCTION: The host strategy with risk assessment and classification (AACR) aims to reduce the risk of deaths considered preventable, the extinction of the screening conducted by the doorman or professional not trained and prioritization of care according to clinical criteria and not in order of arrival. Given the concern about the quality of emergency care services offered in public institutions and that nurses play a key role in the effectiveness of the AACR, this study aimed to identify how nurses perceive the AACR classifiers in the context of improving the quality of health services. GOAL: To analyze the perceptions of nurses about the quality of care in urgent and emergency services that has AACR. METHODOLOGY: A descriptive exploratory study with a qualitative approach. The data were collected through semi-structured individual interviews, recorded on digital media, performed with seven nurses working in AACR urgent and emergency units of Goiânia-GO, in May and June, 2014. RESULTS: While acknowledging the difficulties, all participants agreed that the AACR has contributed to improving the quality of emergency care and emergency units, especially because it prevents deaths in queues, prioritizing the care of critically ill patients to the detriment of less severe. The high demand and structural problems such as inadequate human resources, lack of basic materials for patient assessment and inadequate physical space, in addition to the inadequate functioning of public health care facilities were identified as hindering factors of the service. Among the aspects that facilitate the work and contribute to improving the quality of care in the industry, they indicate full staff, acquisition / availability of minimally materials needed for proper evaluation of the patient, presence of a guard / security and the knowledge of the population about this service strategy. Other suggestions included the adequacy of the physical structure and space guarantee that allows privacy for the risk assessment. CONCLUSIONS: The results of the study confirm that the urgent and emergency services share the same difficulties already described for all public primary health care of the population. Although the AACR will contribute to improving the quality of these services, much remains to be done to ensure minimum conditions for the good performance of professionals working in the sector and thus enhance the benefits it can bring to the care of their users.
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    Adesão do paciente portador de diabetes Mellitus tipo 2 ao tratamento Goiânia
    (Universidade Federal de Goiás, 2006-06-30) VIEIRA, ângela Cristina Bueno; SOUSA, Ana Luiza Lima; http://lattes.cnpq.br/6578713509935374
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    Adesão dos enfermeiros às precauções padrão à luz do modelo de crenças em saúde
    (Universidade Federal de Goiás, 2005-03-31) MELO, Dulcelene de Sousa; TIPPLE, Anaclara Ferreira Veiga; http://lattes.cnpq.br/4288704233343920; SOUZA, Adenicia Custodia Silva e; http://lattes.cnpq.br/5966034868102264
    This was a qualitative study done in a big-sized general public hospital in the city of Goiânia Goiás The aims was to analyze nurses´ adherence to standard precautions according to Rosenstock´s health belief model (HBM) (1974) Data were collected using a semi-structured interview guide based on principles of Critical Incidence Technique (CIT) The instrument was validated by judges and was then pre-tested The ethical-legal research principles were observed Among 90 nurses selected to participate in the study 82 agreed to take part in this study Inclusion criteria were nurses who were either in direct contact with patients or in supervisory positions in the hospital cleaning, laundry or sterilization services Data were analyzed in accordance with CIT The analysis categories were constructed using the dimensions of the HBM A total of 139 critical incidents were identified of which 66 were considered positive and 73 negative HBM dimensions were identified within 131 situations: 74 (56,5%) related to perceived susceptibility; 17 (13,0%) to perceived benefits and 40 (30,5%) to perceived barriers The majority of the reported critical incidents related to situations of occupational exposure to biological materials Among the Standard Precautions (SP) use of protective barriers was most frequently utilized Denial of susceptibility was indicated by the lack of use of protective barriers improper management of sharp objects and non-adherence to SP related to patients with multi-resistant pathogens Moderate perceived susceptibility was associated with partial adherence to SP in cases of patients requiring more complex levels of care; in situations following occupational exposure; and when patients needs took priority over personal protection High perceived susceptibility was observed in situations of caring for patients suspected or diagnosed with infections due to pathogens of epidemiological importance and those related to nurses responsibility Perceived seriousness was evident in behaviors and consequences related to critical incidences after occupational exposure in moments when nurses expressed feelings experienced psychosomatic symptoms and were diagnosed with an infection. Perceived benefits emerged above all from positive critical incidente with focus on protective barriers understood as protection strategies which lead to safety while procedures are executed Perceived barriers were: lack of personnel preparation lack of material resources insufficient personnel improper physical structure patient emergencies psychosocial factors lack of personnel policies for cases of exposure to biological material These barriers contribute to lower adherence of SP but they could be addressed by the Health Care Facilities since nurses have demonstrated adequate perception of susceptibility and benefits HBM dimensions were associated with nurses adherence to SP suggesting that plans should be developed to improve the nurses actions and decision-making in day-to-day nursing cars prioritizing the safety of those individuals involved in this process
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    Adesão medicamentosa e hospitalização por eventos cardiovasculares em hipertensos no centro-oeste brasileiro
    (Universidade Federal de Goiás, 2018-05-28) Pacheco, Jade Alves de Souza; Sousa, Ana Luiza Lima; http://lattes.cnpq.br/6578713509935374; Sousa, Ana Luiza Lima; Jardim, Paulo César Brandão Veiga; Cavalcante, Águeda Maria Ruiz Zimmer
    Introduction: Systemic arterial hypertension is indicated as the main risk factor for cardiovascular diseases. The treatment and control are a challenge to the effective management of the hypertensive patient, even front to the vast technical and therapeutic apparatus available. In this context, a adherence is one of the main explanatory variables for the challenge of the clinical monitoring team of the hypertensive. Objective: To evaluate the relationship between hospitalization and adherence to antihypertensive therapy in patients hospitalized for cardiovascular diseases in hospital units in the city of Jataí (GO). Methods: This was a controlled, observational, cross - sectional study developed in Jataí, a small city in the state of Goiás. The study included hypertensive patients hospitalized for cardiovascular causes in hospital units (hospital network) and by hypertensive patients undergoing clinical follow up in primary care (primary care). The data were obtained between September and December of 2017, with the use of a data collection instrument and the Informed Consent Term to the eligible patients. For the evaluation of adhesion, the Morisky Levine Green Test (TMG) was applied. The analysis was performed through the SPSS IBM software version 23.0; Variables were analyzed using the Kolmogorov Smirnof test, for comparing the means with the Student's T-test for independent samples and the Mann Whitney test for comparison of medians, where it was not parametric. The categorical variables were compared with the chi-square test. All tests were true for a significance level of 5% and 95% confidence interval. Results: In the analysis between the groups there was a lower tendency in the group of patients of the hospital network, but without significance; a rate of adherence in the hospital was 38.1% and primary care 51.2%. An intentionality of non-adherence between the groups was similar. Compared with the primary care group, patients in the hospital had higher blood pressure levels. Pressure control, when analyzed between groups, had the lowest frequency (p = 0.038) among the patients in the hospital network. The mean frequency found was 76.8% with the previous diagnosis, with women recording a higher proportion; 63.4% had uncontrolled blood pressure and 74.4% of patients had multimorbidities. The frequency of previous hospitalizations among hospital patients was significantly higher. The hypertensive crisis was the main cause of hospital admission, being more prevalent among women (p = 0.016). Stroke was a third major cause of hospitalization, presenting greater importance among men. Conclusion: the study is not related to the statistically significant progression between treatment and hospitalization for cardiovascular disease. However, patients with sedentarism, previous hospitalization and multimorbity presented more risk about hospitalization for cardiovascular disease.
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    Alterações macroscópicas do cordão umbilical em gestações de alto risco e suas repercussões neonatais
    (Universidade Federal de Goiás, 2014-03-25) Reis, Marilya Rodrigues; Guimarães, Janaina Valadares; Salge, Ana Karina Marques; http://lattes.cnpq.br/7766918925030041; Salge, Ana Karina Ferreira; Castral, Thaíla Corrêa; Vieira, Flaviana
    Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are leading causes of maternal and fetal-neonatal morbidity and mortality. Their effects are believed to be associated with umbilical cord macroscopic changes. This study aimed to examine the association of umbilical cord macroscopic changes and newborn outcomes in high-risk pregnancies. A descriptive cross-sectional study was conducted in a public maternity hospital affiliated to the Brazilian National Health System (SUS) in the city of Goiânia, central-west Brazil, between January and December 2012. Medical information on high- (HDP and GDM) and normal-risk (control) pregnancy women and their newborns was collected in the postpartum period as well as information on the macroscopic characteristics of the umbilical cord of these infants. A total of 265 umbilical cords were examined. Of these, 126 were from the high-risk pregnancy group (64 of children of mothers with HDP and 62 of those of mothers with GDM) and 139 from the control group (73 HDP and 66 GDM controls). The most common umbilical cord macroscopic changes included true knots and non-central cord insertion in newborns of mothers with HDP and cord less than 35 cm long, true knots, and non-central cord insertion in those of mothers with GDM. Maternal age ≥36 years was significantly associated with single umbilical artery (SUA) (p = 0.03) in the control group. No statistically significant association was found between umbilical cord macroscopic changes and clinical characteristics of newborns of high-risk pregnancy women.
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    Alterações neonatais e maternas relacionadas ao óbito infantil em crianças com gastrosquise
    (Universidade Federal de Goiás, 2015-04-17) Coelho, Amanda Santos Fernandes; Guimarães, Janaína Valadares; http://lattes.cnpq.br/0986934969522024; Salge, Ana Karina Marques; http://lattes.cnpq.br/7766918925030041; Salge, Ana Karina Marques; Siqueira, Karina Machado; Castral, Thaíla Correa; Vieira, Flaviana; Prado, Marinésia Aparecida
    Infant mortality is an important indicator of a country’s health. It is observed in several regions of the world a proportion of deaths attributable to congenital malformations. Worldwide, it is estimated that prevalence occurs in 9% of live births. Among the major abnormalities is gastroschisis, that is a congenital malformation in which there is an exteriorization of the viscera through the abdominal wall defect to the right of the umbilical cord, which is implanted in its normal position. The objective of this study was analyze the neonatal and maternal changes related to infant mortality in children with gastroschisis. This is a cross-sectional and retrospective study with a quantitative approach. It used for analysis, secondary data collected from medical records of patients treated at a public hospital in Goiânia-GO, from 2004 to 2014. The study included 123 patients diagnosed with gastroschisis, which met the criteria adopted. In relation to maternal variables, 57.7% of the women were younger than 20 years, 64.2% were first pregnancy, cesarean birth occurred in 65% of cases, there was an average of 4.8 ± 2.5 prenatal consultation. In relation to neonatal variables, 59% of the new born with gastroschisis were male. The gestational age at birth of the 123 pregnancies ranged from 29.4 to 40.4 weeks (average = 36.5 ± 1.8 weeks). The weight of the new born ranged from 890g to 3800g (average = 2351 ± 474,2g), the average of the Apgar index in the first minute was 6.6 ± 1.8. Associated malformations (not intestinal) were found in 10 (8.1%) patients and 17 (13.8%) patients had intestinal abnormalities, and at this last the most common was the intestinal atresia. By observing the eviscerated organs, 70.7% of patients had only exposed intestinal loops and about other herniated organs, the stomach has been externalized in 27.6% of cases. The general mortality rate was 41% of cases. Statistically significant association was observed between the occurrence of death and mothers who performed less monitoring in prenatal care (p = 0.027) and when there was no diagnosis of gastroschisis in prenatal care (p = 0.001). It was also observed statistically significant association between the occurrence of death and the presence of complex gastroschisis (p = 0.032) and herniation of other organs beyond just the intestine (p = 0.018). It is concluded that, in relation to maternal and neonatal profile of gastroschisis, the condition has no gender preference, particularly affecting children of young first-time mothers. Perinatal mortality of gastroschisis in this analysis seems to depend mainly on the reduced prenatal care, the absence of prior diagnosis at birth, the presence of complex gastroschisis and herniation of other organs than just the intestine.
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    A amamentação e o leite materno para o alívio da dor de procedimentos em recém-nascidos pré-termo: revisão sistemática
    (Universidade Federal de Goiás, 2019-07-29) Freitas, Raquel Rodrigues de; Castral, Thaíla Corrêa; http://lattes.cnpq.br/8910125241591217; Castral, Thaíla Corrêa; Bueno, Mariana; Cavalcante, Marcela Maria Faria Peres 
    Introduction: Preterm newborns in the Intensive Care Unit are exposed to different painful procedures. It is recommended that units providing care to the newborn should establish a pain management program, which includes non-pharmacological analgesic interventions. Breastfeeding in full-term newborns is effective in reducing pain responses, but the evidence for preterms is still inconclusive. Objective: To evaluate and synthesize the literature on the evidences of the effectiveness of breastfeeding or breast milk as non-pharmacological interventions for the management of acute procedural pain in preterm newborns. Methods: Systematic review of randomized clinical trials published between 2011 and 2018 in English, Spanish and Portuguese. Search performed according to the acronym PICO, with the research question: Are breastfeeding and breast milk effective in the management of acute pain of procedures in preterm newborns compared to other non-pharmacological methods. Pain was assessed as the predicted value, considering at least one of the following results: scoring of pain assessment scales and evaluation of physiological, behavioral pain indicators or other indicators. The search performed in the electronic databases of MEDLINE, CENTRAL and LILACS, using controlled terms for preterm newborn, pain, breastfeeding, breast milk and randomized clinical trial. Study methodological quality was assessed using the Cochrane Collaboration tool for bias risk assessment from randomized clinical trials. Results: Fifteen studies were included, and two evaluated the use of breastfeeding (128 preterms) and thirteen (1026 preterms) the use of breast milk as an analgesic intervention. The endpoint evaluated in most of the studies (n= 12, 80%) was the PIPP score. The painful procedures examined were heel puncture, ophthalmologic examination for retinopathy of prematurity, aspiration of the airways, removal of adhesive tape from dressing and venipuncture. Conclusion: Breastfeeding has an analgesic effect on heel puncture for late preterm newborns that demonstrate ability to breastfeed. It did not present significant differences in relation to then onnutritive suction and sucrose 24%. Breast milk has a superior effect in relation to water and no treatment, and it shows better results when combined with nonnutritive suction, kangaroo position and enrollement, and is recommended for pain reduction during heel puncture. Studies should be done to investigate other factors that interfere with the efficacy of breastfeeding, such as maternal factors and breastfeeding time, and in addition to investigate different dosages of milk that ensure the best dose / effect to promote analgesia.
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    Análise da acurácia do conjunto de indicadores clínicos do diagnóstico de enfermagem controle ineficaz da saúde em pessoas com hipertensão arterial
    (Universidade Federal de Goiás, 2021-03-04) Silva, Ricardo Costa da; Silva, Viviane Martins da; http://lattes.cnpq.br/9132675598786936; Cavalcante, Agueda Maria Ruiz Zimmer; http://lattes.cnpq.br/2468197020621699; Cavalcante, Agueda Maria Ruiz Zimmer; Jensen, Rodrigo; Santos, Vinicius Batista
    The advanced nursing process early identifies the behavior of clinical practice phenomena, with self-care practices carried out by people with chronic heart diseases being one of the care pillars, especially for Arterial Hypertension (AH). To analyze the accuracy of the set of clinical indicators (CI) of the nursing diagnosis (DE) Ineffective Health Management (IHM) in people with AH undergoing outpatient treatment. In the first stage, a systematic review with meta-analysis was carried out to identify the clinical - population validity of the DE CIS. The PRISMA and STARD protocols were used to retrieve studies from databases MEDLINE via PubMed, Web of Science, SciELO, CINAHL, SCOPUS and EMBASE. For quality analysis, the modified QUADAS-2 protocol was applied. Statistical analysis was performed using software R to calculate sensitivity, specificity and Odds Ratio Diagnostic (ORD) measures with 95% confidence intervals. Heterogeneity was verified by calculating Higgins' I2 and Cochran's Q, using measures of fixed and random effect according to the obtained value. In the second stage, a clinical study of diagnostic accuracy was conducted at the Hypertension League of HC/UFG with a probabilistic sampling of 120 people by telephone consultation between September and November 2020. Cross mapping was used between the items of the Hipertension Self-Care Scale Brazilian version and the CI of the DE IHM for the definition of conceptual and operational definitions, in addition to clinical and sociodemographic instruments developed by the author. The Rasch model was used to analyze the unidimensionality of the clinical construct and the accuracy measures of the model based on the measures of efficiency, sensitivity, specificity and area under the Operator-Receiver Curve (ORC). Stage I: 11 studies were included. The four CI analyses showed ORD statistically higher than the unit value, with emphasizing on “failure to include treatment regimen in daily life” (ORD = 45). Stage II: median of 60 years of age, more frequent female (70%), brown color (55%), married (60%) and retired (36%). The main source of purchase of medicines was the popular pharmacy (66%) and 83% reported some comorbidity, with dyslipidemia being more frequent (38%). The median time of diagnosis of AH was ten years. The CI “failure to include treatment regimen in daily life” was the most frequent in the sample (70%), being more sensitive. The CI “failure to act to reduce risk factors” presented better levels of specificity. There was a frequency of 45 subjects supposedly identified with CIS in the sample (37,5; IC95%: 29,0 – 46,8). The most sensitive CI results from the incongruity of the lifestyle habits necessary for adequate control of AH. The most specific CI is the result of the initial phase of the chronic condition, being present in situations of greater severity of ND. Sociodemographic and clinical variables were similar to other clinical contexts. Nurses can use the summary measures of diagnostic accuracy obtained for early and valid identification of behaviors that predispose to the occurrence of DE IHM.
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    Análise da cultura de segurança em um hospital de ensino da região centro-oeste do Brasil
    (Universidade Federal de Goiás, 2013-08-28) Tobias, Gabriela Camargo; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Freitag, Maria Salete Batista; Silva, Ana Elisa Bauer de Camargo; Najberg, Estela; Minamisava, Ruth
    In the context of health, the safety culture centered on the quality of care and the systematization of work processes contributes to human error prevention avoidable and, therefore, for the patient safety. The study aims to analyze the perception of a teaching hospital nurses about the dimensions of safety culture’s patient. The methodology is descriptive, exploratory, carried out at a teaching hospital in the Central West region of Brazil, with a population of 117 nurses. The data were collected in October to December of 2011 through autoaplicavel instruments,those belongs to the Hospital Survey on Patient Safety Culture, proposed and used by Agency for Health Research and Quality, specific for the detection of safety culture in hospital, translated and validated for the portuguese language. The data were analysed by the Statistical Package for Social Sciences Program, version 18.0. The project was approved, protocol 064/2008. The percentual of participants were 84.8 % of the nurses of the hospital, 89.7 % were female, predominant age range between 45 to 51 years, 51% with 16 to 21 years of profession, 36% with the same time in the institution and 13.7 % worked in the Emergency Room. The weekly workload of 87% was about 20 to 39 hours and 96% had directly contact with the patient. The reply “Not punitive to mistakes” had the lowest rate, 28%. The weaknesses for the institution were: the team considers that their mistakes could be used against them; the team was afraid that the mistakes were recorded in their functional files; insufficient staff; they work more than necessary; occurrence of problems in the exchange of information between the units; the security has to be sacrificed instaed of doing more things; patient safety problem in the unit, procedures and inadequate systems for the mistakes prevention. The strength points were: the supervisor/manager takes the suggestions to improve the patient safety, considers security problems; work actively doing things to improve the servisse quality; support each other; work in a team; treating with respect and having a good relationship with professionals from other units. However, 59% considered safety patient acceptablevin the unit, and 52% said they never reported adverse events. The conclusion was that the research gave the nurses perception and envolved them with the patient security, the same as how to prove that the aplication of a analysed instrument for actions can be used for estimulating the adoption of politics those bring changes and attitudes for the development of institution security culture.
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    Análise da produção científica sobre a utilização de atividades grupais no trabalho do enfermeiro no Brasil
    (Universidade Federal de Goiás, 2004-12-17) GODOY, Maria Tereza Hagen de; MUNARI, Denize Bouttelet; http://lattes.cnpq.br/8409035360598716
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    Análise das alterações anatomopatológicas macroscópicas placentárias das doenças hipertensivas específicas da gestação
    (Universidade Federal de Goiás, 2011-03-25) XAVIER, Raphaela Maioni; GUIMARÃES, Janaína Valadares; http://lattes.cnpq.br/0986934969522024; SALGE, Ana Karina Marques; http://lattes.cnpq.br/7766918925030041
    The etiopathogenesis of gestational hypertension has been widely studied, but it is not very well established in medical literature. Due to the low uteroplacental perfusion, light to moderate hypertension in the third trimester of pregnancy may be an adaptive response of the maternal organism in order to keep adequate blood flow in the fetal compartment. This paper aims to identify the socioeconomic factors of the parturients with gestational hypertension associated with the maternal and fetal conditions, as well as the gross placental pathological changes. The study was conducted in a federal public maternity hospital in Goiânia, in the state of Goiás, between March 2009 and February 2010. Placental and clinical data of 61 parturients with and without diagnosis (control group) of gestational hypertension were collected. 18 placentas of parturients with chronic hypertension (CH) (29.5%), 11 with gestational hypertension (HGE) (18%), 3 with eclampsia (4.9%), 28 of pre-eclampsia (PE) (45.9%), and 1 diagnosed with HELLP Syndrome (1.63%). The main placental changes found were: hematomas, presence of fibrin, fibrosis, infarction, calcifilaxis and areas of detachment. There was statistically significant difference concerning the occurrence of infarction on the maternal side of women with eclampsia (p = 0.047). The deposit of fibrin on the maternal side of the placentas of women with gestational hypertension was significantly larger than that of the women in the control group (p = 0.008). Calcifilaxis was larger on the maternal side of the placentas of women in the control group when compared to the group with gestational hypertension (p = 0.056). A statistically significant result was obtained when analyzing the presence of fibrin in the groups of PE and control (p = 0.024). There was a significantly larger deposit of fibrin on the fetal side of the placentas of women with HGE than of those in the control group (p = 0.048). Hypertensive disorders of pregnancy are studied as a worldwide problem of public health and rank third among the causes of maternal death in the world and first in Brazil. This is the reason why this study was carried out taking into consideration the need of an increasingly humanized obstetric care focused on the main placental changes and their impact on maternal and fetal vitality in the puerperium.