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- ItemSomente MetadadadosMãos que cuidam: narrativas sobre a terapia Reiki no Sistema Único de Saúde(Universidade Federal de São Paulo (UNIFESP), 2019-01-31) Amarello, Mariana Monteiro [UNIFESP]; Souza, Karen Mendes Jorge De [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: health care has been increasingly associated with the use of integrative and complementary practices. Among them, Reiki stands out as an energy therapy capable of stimulating the natural mechanisms of health recovery. Method: as a methodological reference, the stages of oral history were developed: interview, transcription of recorded material, texturing, transcription and conference of narratives. The purpose of this study was to analyze narratives about Reiki therapy in the Unified Health System for use and publication. The study was conducted in the city of São Paulo, in three public health services, from March to June 2018. Twenty-three collaborators participated, being 11 therapists and 12 users of the Unified Health System. The language material was inserted in the software Atlas.ti and analyzed according to the thematic content analysis technique. Results: It has been identified that Reiki, for therapists and users, can be understood as a universal and cosmic energy, offering benefits to body, mind and spirit. Moreover, it is related to the divine and to spirituality. Among the users, the main motivations for seeking Reiki therapy were: the need for emotional balance, referral of health professionals and interest in natural therapies. For practitioners, the practice was motivated mainly by the desire for voluntary work for the benefit of the community. The study's collaborators highlighted the results of the therapy: healing of health problems, tranquility, self-knowledge, self-control, resilience, self-confidence and joy of living. Challenges for the expansion of Reiki therapy in the Unified Health System were: the lack of support from the medical team, the incipient number of professionals, the training for the practice and the lack of regulation for these therapists. Conclusion: it is infered that the meanings and experiences with Reiki therapy for users and therapists are plural, but resemble the understanding of this practice as a producer of health, well-being and quality of life, through the integrality of care centered on man.
- ItemSomente MetadadadosMarcadores sorológicos e genéticos da hanseníase em uma comunidade indígena no estado do Acre(Universidade Federal de São Paulo (UNIFESP), 2019-06-27) Teles, Stefanie Ferreira [UNIFESP]; Gamba, Monica Antar [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Leprosy, although presenting a decrease in the number of new cases since the introduction of polychemotherapy (MDT), remains endemic in countries such as India, Brazil, Indonesia, among others, persisting as a public health problem. In the indigenous population of Brazil the coefficient of detection of leprosy is in a situation of high endemicity. Purpose: To analyze the anti-PGL-I and anti-LID-I antibody titers by the anti-PGL-I ELISA and the NDO-LID lateral flow rapid test and compare with HLA alleles identified in the study population. Method: A cross-sectional, clinical study carried out in two indigenous villages, Barão and Ipiranga, in the municipality of Mâncio Lima, Acre. 10 ml blood was collected by venipuncture of the brachial vein, packed in a tube with ethylenediaminetetraacetic acid (EDTA) for the determination of anti-PGL-I IgM antibodies by the ELISA method, the NDO-LID lateral flow test and typing of the HLA class alleles I (A *, B * and C * loci) and II (loci DRB1 * and DQB1 *) by LabType ™ (One-Lambda-USA) technique. The frequency of the alleles was obtained by direct counting. Bivariate analyzes were performed using Pearson's Chi-square test and Fisher's exact test. The adjustment was performed using the binary logistic regression technique and the threshold for statistical significance was set at the alpha level of 5% (p <0.05). The results were presented in Odds Ratio with 95% confidence interval (95% CI). The degree of agreement between the techniques was evaluated by the Cohen Kappa Index. Results: The study evaluated a sample of 285 individuals, most of whom lived in the Barão village (54%), Puyanawa ethnic group (79%), male (51%), less than nine years old schooling (44%), with a family income of less than a minimum salarie wage (56%), young adults (48%), residing in houses with a wooden structure and masonry (52%) with more than 4 rooms (85%) and more than 4 residents per household 58%). Seropositivity was identified by the NDO-LID rapid test in 70 individuals (24.56%) and the PGL-I ELISA test in 30 individuals (10.53%). The concordance between NDO-LID and ELISA-PGL-I results showed a Kappa (Cohen) index of 0.39 indicating a regular and significant agreement. There was a positive association with a chance of seropositivity to antibodies to PGL-I of almost 4 times more for residents in the Ipiranga village than in the Barão. The most common HLA alleles were A * 02: 01 (59.6%), B * 40: 02 (32.1%), C * 04: 01 (26.8%), DRB1 * 16: 02 (45.4%), DQA1 * 05:05 (48.8%) and DQB1 * 03: 01 (68.9%), respectively. In the Barão village, a significant association was found between the NDO-LID1 positive test with the HLA-A * 02 and HLA-B * 53 alleles. In the Ipiranga village there was a significant association of the HLA-B * 15 allele with negative result for the NDO-LID1 test. In the typing of the HLA alleles of the population of the two villages, the HLA-B * 40 allele and HLA-C * 03 were associated with a positive serological response to aPGL-I. Conclusion: Extensive potential for subclinical infection as well as continuous contact with M.leprae. Residing in the Ipiranga village showed the likelihood of presence of aPGL-I seropositivity indicating a nearly 4-fold higher chance of having positive anti-PGL-I ELISA (OR: 3.7). On the genetic analysis, a strong link was found with the Terena lineage and the influence of the HLA class I and II molecules on seroconversion to the NDO-LID1 leprosy and PGL-1 ELISA leprosy tests.
- ItemAcesso aberto (Open Access)O uso da simulação realística no ensino de transporte intra-hospitalar para graduandos de Enfermagem(Universidade Federal de São Paulo (UNIFESP), 2019-06-27) Santana, Ellen Reis [UNIFESP]; Gois, Aecio Flavio Teixeira De [UNIFESP]; Campanharo, Cássia Regina Vancini [UNIFESP]; http://lattes.cnpq.br/1796718487677796; http://lattes.cnpq.br/3890649956345535; http://lattes.cnpq.br/3305878572161442; Universidade Federal de São Paulo (UNIFESP)Aim: To build and validate a scenario to simulate the intra-hospital transportation of critical patients and to analyze the simulation as a teaching strategy for students of the undergraduate nursing course. Methods: A methodological study to build and validate a simulation scenario to teach intra-hospital transportation and, an analytical cross-sectional study with a quantitative approach to assess the execution of the validated scenario. In the first phase of the study, the scenario was built based on the literature about the theme, and after, it was validated by five specialists using the Delphi technique the level of agreement of 80%. In the second phase, applications of the validated scenario were conducted as the assessment of the simulation design, students’ experiences with the debriefing, students’ satisfaction and, the self-confidence related to learning with the simulation. Results: A scenario containing 26 topics was developed to be assessed regarding the pertinence, clarity, objectivity, feasibility, actual content, vocabulary and a field for observations. Between the specialists, the majority was female (80%), with a mean age of 43 years; 80% had a Doctoral degree, all had health-related training, participated in an instructor’s course, with a mean experience of 9.6 years in teaching clinical simulations. Two assessments were needed from specialists to reach an 80% agreement, and the topics that needed adjustments were related to the case description, and duration of the simulated activity. To apply the scenario, the sample was composed by 74 students; mean age of 23.5 (20 – 36) years (n = 74); predominance of females (89.2%), 33.8% had professional experience, the majority as an intern (73.1%) in many sectors. The design simulation analysis demonstrated that all students (100%) totally or partially agreed that the simulation was adequate for their specific level of knowledge and ability, the constructive feedback and simulation allowed to analyze their behavior and the conducted actions, and 95.9% totally or partially agreed that the scenario was similar to a real-life situation. When analyzing the debriefing experience, most students agreed (86.5%) that this moment helped to organize their thoughts and their questions were answered (89.2%). Additionally, 94.6% of participants reported the debriefing as a learning opportunity, and the professors adequately clarified issues. Regarding the students’ learning satisfaction and self-confidence, 90.5% of students totally agreed that the used teaching method was useful and effective, 89% of students totally agreed that the professor used useful resources to teach the simulation and the majority of students demonstrated self-confidence in the content presented in this simulation; 97.3% of students totally or partially agreed with this affirmation. Conclusion: In this study, the construction and validation of a scenario to teach intra-hospital transportation were successfully conducted, which should be used in many services to demonstrate the real impact in the training of nursing students and in professional enhancement. The scenario design was considered adequate to teach intra-hospital transportation of critical patients, most students were able to identify the importance of the experience with the debriefing in the learning consolidation and they were satisfied and self-confident after the simulation.