Doutorado em Enfermagem (FEN)

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    Gestão autônoma da medicação para promoção do cuidado seguro em atenção psicossocial
    (Universidade Federal de Goiás, 2023-06-06) Pinho, Eurides Santos; Silva, Nathália dos Santos; http://lattes.cnpq.br/9837208542154956; Bezerra, Ana Lúcia Queiroz Bezerra; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Caixeta, Camila Cardoso; Sousa, Girliani Silva de; Cardozo, Elizabeth Esperidião; Nunes, Fernanda Costa
    INTRODUCTION: Autonomous Medication Management (GAM) enables the co-management of drug treatment by users of mental health services and influences quality and safe care. In Psychosocial Care, the prescription of psychotropic drugs is a care action that focuses on the biological, on the biochemical alterations of psychiatric illnesses without considering the biopsychosocial context of the users. The consumption of psychotropic drugs sometimes disregards the user's participation in conducting the treatment itself. There is evidence of improvements in the context of psychosocial care through investment in the co-management of drug therapy with user involvement in decision-making processes. OBJECTIVE: To analyze, from the perspective of mental health team professionals, the practices of Autonomous Medication Management to promote user involvement in safe care, in psychosocial care. METHOD: This is an intervention-research with a qualitative approach, conducted in four Psychosocial Care Centers in a municipality in the central west region of Brazil, which had the participation of 56 professionals from the teams and health. Data were collected in two stages, the first between May and June 2021 through a questionnaire and semi-structured interview, and the second in August 2022 from the offer of a training process on the autonomous management of medication associated with the perspective of promoting user involvement in safe care. The emerging data were organized using the ATLAS.ti.6.0 software and submitted to content analysis, thematic modality. RESULTS: The GAM is an educational process that encompasses users and professionals. The results of this research were summarized in three categories: Perceptions of professionals about the co-management of drug therapy; Harmless medication in the context of mental health care; Autonomous Medication Management: perspectives for safe care. It was evidenced that the professionals' perception of the demand to involve the user in the decision of drug therapy transits between views based on the hegemony of the biomedical model, which reinforces adherence to the use of psychotropic drugs, between the challenges and existing actions for user involvement and the reformist ideals based on the model of psychosocial care. As actions and challenges to promote co-management, the indiscriminate and inappropriate use of psychotropic drugs and access to information about medications were perceived as intervening in harmless medication and safe care. Autonomous Medication Management was pointed out by professionals with the potential to provide safe care, given the possibilities of carrying out psychoeducational approaches on psychotropic drugs, valuing the participation of family members/caregivers and overcoming obstacles to the involvement of users in medication co-management. FINAL CONSIDERATIONS: The GAM is based on the psychosocial care model, encourages the development of actions that promote co-management through the user's involvement in their treatment and, consequently, provides reflection on their autonomy and protagonism in the face of drug therapy to achieve safe care , in the context of psychosocial care and, more broadly, in mental health.
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    Cobertura vacinal em crianças assentadas, quilombolas e ribeirinhas do estado de Goiás, nascidas entre 2010 e 2017
    (Universidade Federal de Goiás, 2021-08-05) Lima, Juliana de Oliveira Roque e; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Caetano, Karlla Antonieta Amorim; http://lattes.cnpq.br/0112036159794570; Caetano, Karlla Antonieta Amorim; Pagotto, Valéria; Minamisava, Ruth; Pessoni, Grécia Carolina; Junqueira, Ana Luiza Neto
    Vaccination is considered one of the most cost-effective and most effective measures in healthcare services. On the other hand, some population groups that live in geographic and cultural isolation have been showing low rates of vaccination. In Brazil, there are no data evaluating adherence to vaccines recommended by the National Program for the Immunization of Unified Health System, better known by the acronym SUS considering children from rural and traditional communities. Therefore, this study aimed to evaluate vaccination coverage according to the national calendar of vaccination of children for the first year of life, and their distributions in space and trends in time in children living in rural settlements, communities of quilombolas, and riverside dwellers in the state of Goiás, born from 2010 to 2017. This is an epidemiological, retrospective cohort study, carried out in 40 municipalities of Goiás, followed by an ecological study. The sample consisted of 616 children born between 2010 and 2017, residents of a settled, quilombolas or riverside dwellers community in Goiás. To calculate the vaccination coverage, the percentage of children with a complete general vaccination schedule or by the vaccine was considered, with a 95% confidence interval. In the time-series, trend analysis was estimated for communities according to mesoregions of Goiás, and for this purpose, the Prais-Winsten linear regression was used, with robust variance. Trends were classified as increasing, decreasing, or stationary, according to the p-value and regression coefficient. The spatial distribution of vaccination coverage, according to the mesoregions of Goiás, was carried out along the time-series. In total, 616 children had their vaccine data evaluated, most were male (53.7%) and belonging to the quilombolas community (54.7%). The overall vaccination coverage for the recommended vaccines during the first year of life at 12 months and at 18 months was 52.4% (CI95%: 48.5% - 56.3%) and 57.8% (CI95%: 53.9% - 61.6%), respectively. For children born in 2017, just the yellow fever vaccine and measles/mumps/rubella vaccine had vaccination coverage > 90%. According to the birth cohort from 2010 to 2017, in Goiás, of the ten vaccines evaluated, six showed an increasing trend in vaccination coverage (POLIO, 10-valent pneumococcal, human rotavirus, meningococcal, yellow fever, and measles/mumps/rubella). Considering the spatial and temporal distribution, according to the mesoregions where the communities are located, a decreasing trend for vaccination coverage was only observed in the Center Goiano mesoregion for the hepatitis B vaccine. In the North Goiano mesoregion, increasing temporal trends were observed for most vaccine coverage, the exception was for BCG and measles/mumps/rubella vaccines. Despite this, the North Goiano mesoregion was the only one in which no vaccine achieved 90% coverage in the period of birth cohort 2016/2017. The results present an unequal scenario in the access to vaccination services for rural populations and traditional Brazilians and point to the need for urgent strategies to achieve and ensure equity in health for a group with distinct traditions and characteristics of the urban population of Brazil.
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    Violência contra o docente na prática pedagógica em saúde: uma abordagem intercultural
    (Universidade Federal de Goiás, 2021-09-17) Alves, Angela Gilda; Rodriguéz Martín, Dolores Dolores; http://lattes.cnpq.br/6242953215193998; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Guix Comelles, Eva Maria; Pereira, Edna Regina Silva; Santos, José Luis Guedes dos; Martins, Cleusa Alves
    Introduction. Operationalizing the concept of violence, especially against higher education teachers, is difficult. In addition to the various concepts, the violence is presented in expressions of hatred, anger, revenge, acts contrary to social norms of coexistence, prejudice against those that are different, and mistreatment directed toward the teachers, which can lead to consequences and cause harm even in the pedagogical sphere. Intercultural differences enable different spaces, which represent hermeneutical, epistemological and methodological resources. All of this contributes to a dialogic process with other contexts and thoughts that range from the acquisition of information to the emergence of new theories capable of rethinking and transforming learning. Objective. To analyze violence against teachers in the Health pedagogical practice through an intercultural approach. Methodology. This was a multimethod study developed at a University in the Central Region of Brazil, in which the phenomenon of violence was analyzed from different angles, supported by literature reviews (integrative and scoping), the Delphi method, and a qualitative study with the analysis partially using the Constructivist Grounded Theory (CGT). The target population consisted of all teachers at the Faculty of Nursing of the Federal University of Goiás. Data collection took place through recorded and transcribed interviews and, with the use of the NVivo software, analysis categories were created. The analysis used a step of the Grounded Theory. Results. The theoretical contributions of the study were presented, including the concepts of violence and its relationship with the teaching practice in health education. The discussion of knowledge in Higher Education in Health considering Vygotskian theory evidenced convergent terminologies. Violence against teachers can be defined as a set of actions and situations provoked by students in an insidious or chronic way in the workplace and/or through digital media, mediated by the perception of violence, the teacher's coping mechanism and the organizational management of violence. Indicators of violence against the teacher were defined as any threat, attempt, or actual aggressive act, as well as ignoring or disrespecting the teacher through speech, engaging in sexual harassment, homophobia, receiving coercion from the student's family, as well as using information and communication technologies to perform such acts. The factors that lead teachers to suffer violence in Higher Education in Brazil are characterized by the institutional culture, gender, the perception of violence by the teacher and the triggers that lead students to practice violence. Conclusion. Violence by students against teachers deserves pedagogically important reflections. Social origin converted into inequalities triggers positions of domination and, consequently, creates a fertile ground for violence. Teachers will be able to develop actions that blossom into the construction of skills and attitudes for coping with violence, recognize it and intervening in order to prevent aggressive behavior from spreading, causing mutual illness and weakening interpersonal relationships.
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    Adaptação transcultural e validação do instrumento Patient Engagement in Patient Safety within Canadian Healthcare Organizations para uso no Brasil
    (Universidade Federal de Goiás, 2022-05-25) Sousa, Maiana Regina Gomes de; Pomey, Marie-Pascale; Silva, Ana Elisa Bauer de Camargo; http://lattes.cnpq.br/8388407861788466; Silva, Ana Elisa Bauer de Camargo; Bezerra, Ana Lúcia Queiroz; Sousa, Fernanda Raphael Escobar Gimenes de; Vila, Vanessa da Silva Carvalho; Freitas, Juliana Santana de
    INTRODUCTION: for more than two decades, patient safety has been highlighted as a global health challenge, requiring changes and implementation of initiatives to minimize risks, prevent care failures and prevent harm to patients. Patient engagement in patient safety has been one of the strategies used in the main international recommendations to improve the quality and safety of care, making relevant the existence of instruments to evaluate this practice. OBJECTIVE: to produce the Brazilian version of the instrument Patient Engagement in Patient Safety within Canadian Healthcare Organizations. METHOD: methodological study involving cross-cultural adaptation and validation of the instrument Patient Engagement in Patient Safety within Canadian Healthcare Organizations for use in Brazil, developed in two phases. The first phase, held between January 2020 and June 2021, consisted of the cross-cultural adaptation of the instrument for the Portuguese Brazilian and followed six steps: preparation, translation, back translation, pretest with nine health organizations, review, and documentation. The second phase, held between August and November 2021, was to validate of the content of the instrument using the Delphi technique, through the evaluation of a committee of experts in two sequential rounds. The semantic, conceptual, and normative equivalence of the items of the instrument were analyzed using the Coefficient of Agreement between evaluators, being considered satisfactory values greater than or equal to 90.0%. To analyze the content validity was used the Content Validity Index (CVI) and Inter-Rater Agreement (IRA), being considered approved values greater than 0.8, for both CVI and IRA. The analyses were performed using the Software R version 4.1.2. RESULTS: in cross-cultural adaptation, 97.9% of the items of the instrument were considered equivalent by 100% of the evaluators. For the items that presented agreement less than 90%, the best solutions were discussed, until a consensus was reached. The modifications made were approved by the authors of the original instrument. In content validation, most items had CVI approved in all three aspects, with 99.3% for coverage, 95.8% for clarity and 96.1% for relevance. About the IRA, 99.0% of the items presented satisfactory values for coverage, clarity, and relevance. Items with unsatisfactory values were changed and evaluated again by the expert committee and after approval by all the instrument was concluded, available for use in Brazil with the title “Engajamento do Pacientes na Segurança do Paciente em Organizações de Saúde”. CONCLUSION: the instrument is a reliable and valid tool to investigate patient engagement strategies in patient safety implemented in Brazilian health organizations, at different levels of governance.
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    A efetividade de escovas descartáveis e submetidas à desinfecção para a higiene bucal em pacientes ventilados mecanicamente: ensaio clínico
    (Universidade Federal de Goiás, 2019-04-30) Gonçalves, Fernanda Alves Ferreira; Torres, Ieda Maria Sapateiro; http://lattes.cnpq.br/0836649494981715; Campos, Cerise de Castro; http://lattes.cnpq.br/9109822142576433; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Souza, Adenícia Custódia Silva e; Roriz, Virgílio Moreira; Melo, Dulcelene de Sousa; Tipple, Anaclara Ferreira Veiga
    INTRODUCTION: Invasive ventilatory and intubated patients are dependent on the nursing team. The mechanical removal of the biofilm with toothbrush is the first option, but after single use it can be contaminated by microorganisms from the oral cavity, as well as from the external environment. The use of the brush should be associated with chemical control of chlorhexidine digluconate, which is semi-critical and requires high level disinfection or be discarded. Peracetic acid is a high-level disinfectant, but has not been tested for use on toothbrushes. AIM: To compare the effectiveness of the use of disposable toothbrushes and disinfection with peracetic acid used for oral hygiene (OH) of patients under mechanical ventilation. MATERIALS AND METHODS: Randomized-controlled clinical trial performed at an intensive care unit of a public hospital in Goiânia / GO. Data were collected from 31 patients, intubated and under mechanical ventilation, between June 2017 and August 2018. The patients were divided into Control Group (OH with disinfected brushes) and Intervention Group (HB with brushes discarded). A dental evaluation was performed on day 1. Saliva collection was performed on day 1, day 3 and day 5 for counting of colony forming units (CFU). HB was performed twice a day, for up to five days, with 0.12% CHX gel and disinfected or discarded brushes. RESULTS: At admission, patients presented poor oral hygiene, periodontal disease, periodontitis and gingivitis. Most of the participants were male, with a mean age of 59.0 ± 14.4 years and mean of 19 teeth. Throughout the days of HB there was a decreasing tendency of buccal and lingual biofilms, however, there was no significant reduction of UFC, with no difference between the groups that used disposable brushes and disinfected brushes. In relation to the bacteria isolated on the fifth day, there was homogeneity in both groups, with predominance of Pseudomonas aeruginosa, Enterococcus faecium, Klebsiella pneumoniae and Staphylococcus haemolyticus. CONCLUSIONS: There was no difference in tooth and tongue brushing, performed with single use brushes, discarded or disinfected at each use. The important thing is to brush properly, following established protocols.