A assistência ao parto na maternidade: representações sociais de mulheres assistidas e profissionais de saúde

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Filosofia e Ciências Humanas. Programa de Pós-Graduação em Psicologia.Objetivo: investigar quais as representações sociais (RS) de mulheres assistidas e profissionais de saúde sobre a assistência ao parto na maternidade. Método: estudo de caráter descritivo e comparativo em que se empregou a técnica de observação indireta, por meio de entrevistas com um roteiro semi-estruturado. Participaram do estudo 20 mulheres com experiência recente de parto e 20 profissionais de saúde com formação universitária. Utilizou-se o software ALCESTE (Análise Lexical Contextual de Conjuntos de Segmentos de Texto) e a análise categorial para a análise dos dados. Resultados: entre os profissionais de saúde encontrou-se, de um lado, uma RS que aponta para uma visão medicalizada da assistência, predominante entre os profissionais pertencentes à categoria dos médicos e de outro lado, uma RS predominante entre a categoria das enfermeiras obstetras, que indica uma concepção da assistência identificada com o modelo proposto pelo Movimento pela Humanização do Parto e Nascimento. Entre as mulheres assistidas não foram observadas RS tão claramente definidas. Os resultados indicam que a qualidade da relação estabelecida com os profissionais de saúde é o fator que maior influência exerce sobre a maneira como as mulheres percebem a assistência recebida. Objective: investigate women and health care professionals´ social representations (SR) of hospital labor assistance. Method: a descriptive and comparative study carried through indirect observation technique, by the means of interviews with a semi-structured script. Twenty women with a recent childbirth experience and 20 graduate health care professionals took part in the research. Data was analyzed by the ALCESTE software (Lexical and contextual analysis of a set of text segments) and categorical analysis. Results: among health care professionals, physicians have predominantly presented a medicalized SR of childbirth assistance, whilst obstetrical nurses have predominantly presented a SR of childbirth assistance identified with concept proposed by Social Movement of Labor and Birth Humanization. Among women, the social representation of childbirth assistance was not clearly defined. The results indicates that the quality of relationship established with the health care professionals is the factor that influences the most the way women perceive the childbirth assistance they received

Quality of life in patients with stable coronary artery disease submitted to percutaneous, surgical, and medical therapies : a cohort study

Background: Clinical, surgical, and percutaneous strategies similarly prevent major cardiovascular events in patients with stable coronary artery disease (CAD). The possibility that these strategies have differential effects on healthrelated quality of life (HRQoL) has been debated, particularly in patients treated outside clinical trials. Methods: We assigned 454 patients diagnosed with CAD during an elective diagnostic coronary angiography to coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or optimal medical treatment (OMT), and followed them for an average of 5.2 ± 1.5 years. HRQoL was assessed using a validated Brazilian version of the 12-Item Short-Form Health Survey questionnaire. The association between therapeutic strategies and quality of life scores was tested using variance analysis and adjusted for confounders in a general linear model. Results: There were no differences in the mental component summary scores in the follow-up evaluation by therapeutic strategies: 51.4, 53.7, and 52.3 for OMT, PCI, and CABG, respectively. Physical component summary scores were higher in the PCI group than the CABG and OMT groups (46.4 vs. 42.9 and 43.8, respectively); however, these differences were no longer different after adjustment for confounding variables. Conclusion: In a long-term follow-up of patients with stable CAD, HRQoL did not differ in patients treated by medical, percutaneous, or surgical treatments

Effectiveness of clinical, surgical and percutaneous treatment to prevent cardiovascular events in patients referred for elective coronary angiography: an observational study

Purpose: To ascertain the most appropriate treatment for chronic, stable, coronary artery disease (CAD) in patients submitted to elective coronary angiography. Patients and Methods: A total of 814 patients included in the prospective cohort study were referred for elective coronary angiography and were followed up on average for 6±1.9 years. Main outcomes were all-cause death, cardiovascular death, non-fatal myocardial infarction (MI) and stroke and late revascularization and their combinations as major adverse cardiac and cerebral events (MACCE): MACCE-1 included cardiovascular death, nonfatal MI, and stroke; MACCE-2 was MACCE-1 plus late revascularization. Survival curves and adjusted Cox proportional hazard models were used to explore the association between the type of treatment and outcomes. Results: All-cause death was lower in participants submitted to percutaneous coronary intervention (PCI) (0.41, 0.16–1.03, P=0.057) compared to medical treatment (MT). Coronary-artery bypass grafting (CABG) had an overall trend for poorer outcomes: cardiovascular death 2.53 (0.42–15.10), combined cardiovascular death, nonfatal MI, and stroke 2.15 (0.73–6.31) and these events plus late revascularization (2.17, 0.86–5.49). The corresponding numbers for PCI were 0.27 (0.05–1.43) for cardiovascular death, 0.77 (0.32–1.84) for combined cardiovascular death, nonfatal MI, and stroke and 2.35 (1.16–4.77) with the addition of late revascularization. These trends were not influenced by baseline blood pressure, left ventricular ejection fraction and previous MI. Patients with diabetes mellitus had a significantly higher risk of recurrent revascularization when submitted to PCI than CABG. Conclusion: Patients with confirmed CAD in elective coronary angiography do not have a better prognosis when submitted to CABG comparatively to medical treatment. Patients treated with PCI had a trend for the lower incidence of combined cardiovascular events, at the expense of additional revascularization procedures. Patients without significant CAD had a similar prognosis than CAD patients treated with medical therapy

The challenges in the construction of psychopedagogical materials in health education

Trabalho apresentado em XIII Congreso Internacional Galego-Portugués de Psicopedagoxía, Área 6 Formación de profesores y agentes educativos. Universidad da Coruña, 2 de Setembro de 2015.A cidadania constitui um processo ativo, no qual o indivíduo e a sociedade interagem para o alcance de objetivos e de superação de dificuldades comuns. O contexto escolar, é assim considerado um dos meios mais privilegiados para que a aprendizagem se consolide, dado ser um local integrador, das várias áreas do saber, e de preocupações transversais à sociedade. Como tal, a aposta na educação para a cidadania e a sua inserção no currículo escolar torna-se importante desde os níveis de ensino mais precoces. A elaboração de projetos que permitam concretizar os objetivos que norteiam esta área de conhecimento deve ter em linha de conta não só as necessidades e fragilidades específicas da comunidade escolar, na qual se desenvolverá uma determinada ação, mas também possibilitar a extensão destas ações aos restantes contextos onde o indivíduo se encontra inserido. Uma das áreas de abordagem da educação para a cidadania diz respeito à Educação para a Saúde. [...].ABSTRACT: Citizenship is an active process in which individuals and the society interact in order to achieve common goals and overcome common difficulties. Therefore, school settings are considered one of the privileged means of learning consolidation, as it consists in a context of integration of several areas of knowledge and expertise, as well as one of the major areas of concern to the society. As such, the investment in education for citizenship and the introduction of this discipline in regular school curricula from early school years is of central importance. The development of projects that allow the accomplishment of goals in this area of expertise must take into account not only the specific frailties and needs from the school community in which those actions will take place, but must also make possible to extend these actions to the remaining contexts in which the individuals participate. In the current Citizenship curricula, one of the main themes is Health Education. […]