Dissertações em Enfermagem (Mestrado) - PPGENF/ICS
URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/4815
O Mestrado Acadêmico iniciou-se 01/01/2011 pertence ao Programa de Pós-Graduação em Enfermagem (PPGENF) do Instituto de Ciências da Saúde (ICS) da Universidade Federal do Pará (UFPA).
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Item Acesso aberto (Open Access) Conhecimento de enfermeiros da atenção primária à saúde sobre síndromes hipertensivas específicas da gestação(Universidade Federal do Pará, 2020-08-27) SIQUEIRA, Lorena Saavedra; TAVARES, Roseneide dos Santos; http://lattes.cnpq.br/2302813977671086; https://orcid.org/0000-0003-4556-2683The Specific Hypertensive Syndrome of Pregnancy (SHEG) is characterized by clinical manifestations such as hypertension and proteinuria, a symptom that manifests itself after the 20th week of pregnancy, is considered the first cause of maternal death in Brazil. In this context, through the inclusion of preventive and curative procedures and health promotion, prenatal care can be considered a protective factor for the health of pregnant women. The nurse is the health professional most qualified to identify, and perform the first care and referral for high-risk pregnant women to prenatal care if necessary. The nursing care practiced by the nurse is permeated by several knowledge and skills that have a strong influence on care during the puerperal pregnancy cycle. It is essential to know and understand pregnancy and its complications for measures to be taken in a timely manner to protect the health of the mother and fetus. Thus, the objective was to unveil the knowledge of nurses who attend prenatal care in basic health units about Specific Hypertensive Syndromes of Pregnancy in the city of Belém, state of Pará. A field research with a qualitative descriptive approach was carried out in the eight administrative districts of Belém, and the sample consisted of fifteen nurses who attend prenatal care in primary care, the collection was made through an oral and recorded interview, the analysis Data analysis was carried out through Bardin's Content Analysis, and to assist in processing, the IRAMUTEQ software was used as a tool that brings statistical rigor to qualitative research carried out according to Reinert's method, which uses the Descending Hierarchical Classification. In the results, four categories and three subcategories emerged. Category 1 “Main aspects about SHEG” with subcategories 1 and 2, respectively, “Knowledge of prenatal nurses about SHEG and its clinical manifestations”, “Preventive measures to reduce complications triggered by SHEG during prenatal care. primary ", category 2" Prenatal care in primary care of pregnant women with SHEG ", with subcategory 1" Factors associated with referral of pregnant women with SHEG to Obstetric Urgencies and Emergencies ", Category 3" Nurses' assistance to pregnant women diagnosed with SHEG "and Category 4" Nurses' knowledge about nutritional factors during pregnancy and the relationship with SHEG ". Nurses who work in prenatal care have knowledge about SHEG, however they have difficulties in its classification, describing the pathology in a more general way. In addition, some clinical signs such as edema are described as a diagnostic criterion, despite the literature demonstrate the opposite. Another relevant factor concerns the prevention of SHEG, where nurses describe healthy habits as protective factors, which according to the evidence only prevent complications that this pathology causes, besides, within the management, a strong tendency to refer to the pre-natural high-risk and obstetric emergencies, however there is no reference to the return of this woman to her unit of origin to share prenatal care as guided by women's health protocols. We concluded that most of the participants had been without training on prenatal care for a long time, which may be related to the outdated information about changes in protocols and inappropriate conduct. Through investigation, we understand the need for professional improvement of nurses on SHEG, and that the creation and use of care protocols based on the most current scientific evidence being addressed in the clinical practice of nurses are extremely important to guide the decision-making process and ensuring the provision of quality and safe care. In this context, we can say that nurses have knowledge about SHEG, however there are still many gaps regarding the proper classification of the pathology, the clinical management within primary care shows a difference in the procedures adopted despite the existence of national protocols.Item Acesso aberto (Open Access) Covid-19 em parturiente e seus neonatos: estudo de caso controle em uma maternidade de referência na Amazônia brasileira(Universidade Federal do Pará, 2022-10-25) BARROS, Sirley Costa de; PARENTE, Andressa Tavares; http://lattes.cnpq.br/2584253687792237; https://orcid.org/0000-0001-9364-4574; ARAÚJO, Eliete da Cunha; http://lattes.cnpq.br/5906453187927460The Covid-19 pandemic and its rapid global spread had major health repercussions due to its high potential for transmissibility. Pregnant women at any gestational age and women in the puerperal period belong to the risk group. Objective: To know the clinical evolution of Covid-19 in the parturient and her neonates. Methodology: An observational, retrospective, case-control epidemiological study was carried out, comparing 48 parturients with Covid-19 and their respective neonates (case group) and 98 healthy parturients and their respective neonates (control), hospitalized at Santa Casa de Misericórdia do For. The medical records of parturients diagnosed with Covid-19, during the study period, and parturients without Covid-19, both of any age, of all types of delivery, with or without alterations to the physical examination, admitted to the hospital in April were included. from 2020 to June 2021, in a total of 292 participants (parturients and neonates). Data were collected from medical records, from August 2021 to May 2022, and analyzed using the Bioestat 5.3 program. P<0.05 was considered statistically significant. Results: the mean age among parturients in the case group (n=48) and in the control group (n=98) was 27.7 and 28.5 years, respectively. Analytical statistics and Odds Ration (OR) calculations were statistically significant and higher in pregnant women with Covid-19 for the following variables, respectively: cesarean delivery (p < 0.0001/OR= 6.1), preterm labor (p < 0.0001/ OR=20.2), length of stay longer than 48 hours (p<0.0001/OR=3.6), altered body temperature (p=0.0038/OR=7.5) and altered respiratory rate (p<0.0001/OR=9.6) were statistically significant and greater parturients with Covid19 compared to parturients in the control group. The statistically significant repercussions on newborns of mothers with Covid-19 were: lower percentage of breastfeeding (p < 0.0001/OR= 33.7), length of stay longer than 48 hours (p < 0.0015/ OR= 3.9) and referral the neonatal unit (p < 0.0015/OR= 24.3). The death outcome (fetal+neonatal) had 5 (10.4%) occurrences in the case group. Conclusion: the clinical evolution and outcomes are different between parturients positive for Covid-19 and healthy parturients, with important repercussions on newborns.Item Acesso aberto (Open Access) Parto domiciliar planejado no contexto amazônico: escolha e direito das mulheres(Universidade Federal do Pará, 2022-07-01) REIS, Laena Costa dos; RODRIGUES, Diego Pereira; http://lattes.cnpq.br/8470989067617455; https://orcid.org/0000-0001-8383-7663This is a study from the point of view of choice and women's right to planned home birth, considering that this option has been gaining ground in the national and international scenery, as an alternative to the prevailing obstetric model, hegemonically technocratic, showing their right as the choice of form and place of delivery. The study has as general objective: to understand the factors that lead women to choose a planned home birth in the metropolitan region of the state of Pará and as specific objectives: to identify how the process of choosing women for planned home birth occurs; to analyze the information that women obtain to support the choice of planned home birth; unveil how obstetric nursing care provides the guarantee for choosing a planned home birth. Descriptive, exploratory study, in the case study modality, under a qualitative approach, where the study participants were 20 women who had a planned home birth in the Metropolitan region of the State of Pará, with the Naiá Home Birth Obstetric Nursing Team. The data were submitted to content analysis, in which three categories emerged, respectively: 1) Support to women for the choice of planned home birth, characterized by the importance of the female support network in this choice; 2) The empowerment of women as a factor for choosing a planned home birth, with emphasis on information that guarantees mastery of the decision and autonomy in the birth scenario; 3) Obstacles to ensure the choice of planned home birth, demonstrating that the shortage of specialized teams, financial factors, lack of social and family support and difficulty in accessing the SUS are the main obstacles faced in the process of choosing the PDP. Thus, it is possible to understand that the choice of women about the planned home birth in the Metropolitan region of the State of Pará takes place in the search for the valorization and validation of the female strength, a possibility subsidized by the work of the professionals of the EO Team to support and substantiate these women against their rights. Therefore, talking about PDP is talking about public health, a topic in which more research is needed to fill in the gaps on the subject.Item Acesso aberto (Open Access) Percepção dos preceptores da residência em enfermagem obstétrica sobre o processo ensino aprendizagem à luz da teoria de Edgar Morin(Universidade Federal do Pará, 2022-08-19) AMARAL, Elannira Sozinho; CARNEIRO, Márcia Simão; http://lattes.cnpq.br/3702559186954581; https://orcid.org/0000-0001-7732-1310The object of this study is the obstetric nursing residency preceptors’ perception about the teaching-learning process on the light of Edgar Morin's theory. The residency is a lato sensu postgraduate course in which teaching is effective during practical training in healthcare services. The preceptor is the professional working in the healthcare services who is responsible for the practical training of the resident. Guiding question: What is the obstetric nursing residency preceptors’ perception about the teaching-learning process? General objective: To analyze the perception about the teaching-learning process among the obstetric nursing residency preceptors. Methodology: This is a descriptive study with a qualitative approach. The research was set in the Obstetric Nursing Residency Program at the Federal University of Pará (UFPA). The study participants were 16 preceptors. Inclusion criteria: Being a specialist in Obstetric Nursing; having two years' experience in obstetrics; Acting as a preceptor for at least two years. Exclusion criteria: Preceptors absent due to vacation or leave of absence. Data collection took place through a semis-tructured interview in May 2022. The interviews were audio recorded using an electronic device (cell phone) with an average duration of 14 minutes, later it was transcribed their full content, analyzed and interpreted using the methodological technique of content analysis, proposed by Bardin (2016), to assist in the treatment of the results, the IRAMUTEQ software was used. Edgar Morin was used as a theoretical reference. Results: Sociodemographic profile: the mean age was 44 years; 87.5% (14) were female; 37.5% (06) declared themselves single; 50% (08) married and 12.5% (02) in a stable union. All graduates from public universities; 68.8 (11) completed a lato sensu postgraduate course with a workload of 360 hours and 31.2% (05) in the residency modality; 12.5% (02) had a master's degree. Three analyzes generated by IRAMUTEQ were used. For analysis, word cloud techniques and similarity analysis and Descending Hierarchical Classification (DHC) were used. It was found 6 classes separated into 4 categories, entitled TeachingLearning Process; Challenges for the Realization of the Teaching-Learning Process; Teaching Focused on Comprehensive Care; The Importance of Residency for the Teaching-Learning Process Effectiveness. Conclusion: The study revealed the importance of the preceptor for the teaching-learning process in the residency modality. It was evident that teaching is focused on techniques and procedures based on institutional protocols. As challenges, the absence of pedagogical planning stood out; distance between university and hospital institution; lack of preceptors’ pedagogical preparation as well as incentives to exercise preceptorship; the existence of dispute over the teaching scenario and accumulation of tasks that compromise efficient teaching for residents. The need for teaching focused on Morin's complex thinking is highlighted, which articulates teaching, it aims at the multidimensional, transdisciplinary, favors self-criticism and reflection with the goal of changing realities.Item Acesso aberto (Open Access) Os significados entre residentes de enfermagem obstétrica sobre o processo de ensino-aprendizagem no campo de prática assistencial(Universidade Federal do Pará, 2022-08-29) MOURA, Letícia Diogo de Oliveira; PEREIRA, Audrey Vidal; http://lattes.cnpq.br/2510148795147954; https://orcid.org/0000-0002-6570-9016; RODRIGUES, Diego Pereira; http://lattes.cnpq.br/8470989067617455; https://orcid.org/0000-0001-8383-7663The teaching learning process in Obstetric nursing education seeks to include technical recommendations that significantly contribute to the transformation of the obstetric care scenario. Understanding the importance of the teaching-learning process in the qualification of new professionals is part of the transformation of this scenario. Object of study: the meanings amongst residents about the teaching-learning process in the practice scenarios of the Residency Program in Obstetric Nursing. Guiding question: What are the meanings amongst residents about the teaching-learning process carried out in the practice scenario of obstetric nursing? General objective: to analyze the meanings amongst residents about the teaching-learning process in the practice scenarios of the Residency Program in Obstetric Nursing. Specific objectives: to describe the teaching-learning process experience with residents in obstetric nursing; to discuss the possible obstacles in the practice scenario that impact the teaching-learning process. Methodology: a qualitative case study approach. The research was carried out in the obstetric nursing residency program at the Institute of Health Sciences of the Federal University of Pará. The research participants were twenty-two residents of the 1st and 2nd year of the program, which followed the intentional recruitment and application of the following inclusion criteria: being regularly enrolled as residents; have spent at least 1 month at the UBS, hospital and management level. The following exclusion criteria were established: residents on maternity leave or due to illness; residents who dropped out of the program. Data collection was carried out through four focus groups with both classes, being three groups with six residents and one group with 4 residents, obtaining two refusals to participate. The groups had two face-to-face meetings and an average lenght of 120 minutes. A conceptual map on positive and negative aspects of the residence was also used. Audio recording was used, which was transcribed in full with the information. The study was approved by the Research Ethics Committee of the Institute of Health Sciences of the Federal University of Pará, under No. 5.443.574/2022. The data were submitted to content analysis in the thematic modality with organization support of the ATLAS.ti 22.7 software, with the realization of the following codes: Preceptorship; resident R2; residency reception; the residency course in obstetric nursing. The results showed that preceptorship is a facilitating and integrating link in learning, with many professional references focused on training new qualified obstetric nurses. But also, the need of reception, empathy, involvement and integration in the training of preceptorship and with scientific evidence, aligned with theory and practice. Also, the extension of investment in preceptorship as a foundation to grant better formation. However, the second-year resident constitutes an important strategy for the aggregation of preceptorship with the firstyear residents, with their reception and conflict mediation. However, the lack of a sense of belonging and the management organization are important senses that must be worked along with the course and the practice scenario. It is concluded that this study achieved its initial objectives, elucidating the meanings of residents in obstetric nursing about the learning teaching process and provided support for future changes to be thought and carried out in the training of new obstetric professionals.