Brazilian Nursing Journal (Revista Brasileira de Enfermagem - REBEn)

874

Authors: Maria Goretti David Lopes

Editorial.

887-93

Authors: Maria Lúcia Habib Paschoal, Valéria Castilho

The study had the objective to compare the efficiency of the Automated System of Management of Hospital Medical Materials as opposed to the traditional system in relation to the consumption of stock of materials. It involved a comparative analysis with a quantitative approach adopted in the Surgical Center of the University Hospital of the University of São Paulo. The study dealt with 293 items of hospital medical materials during the month-periods of February to May of 2007 and of 2008. The results showed that the use of materials in 2008 decreased by 8.13% as compared to 2007. The volume of materials in stock in 2008 was reduced by 26.22% also in the same period, and the cost of these materials stocked in 2008 showed a 12.46% decrease. Key words: Perioperatory nursing; Opertaing room nursing; Management of hospital medical materials

900-7

Authors: Fernanda Barreto Mielke, Agnes Olchowsky

The objective of this article is to assess the matrix support under the perspective of 14 professionals of a family care unit, in an evaluative and qualitative study based on Fourth Generation Evaluation. The data were collected in observations and interviews, and were analyzed by the Constant Comparative Method, focusing on the inclusion of mental health actions in the Family Health Strategy. Professionals from these studied teams assessed the need for care support as well as technical orientations from teams that specialized in mental health as to carry out mental health actions in the territory, which could be implemented by the matrix support. We assessed that this form of organization is important when building mental health actions in the territory. Key words: Health evaluation; Family health; Mental health; Health services; Qualitative research.

913-20

Authors: Simone Alves Landim, Nildo Alves Batista, Gilberto Tadeu Reis da Silva

This qualitative research in phenomenological design aimed at understanding the meaning of hospital clinical experience in the nurse’s training in a Multiprofessional Family Health Residency. The study was developed in a teaching institution. Data collection was based on interviews and had as study population eight resident nurses. I investigated the residents’ experience according to their speeches, by making the following guiding question: “Talk about your hospital experience, how does it show itself in your training as a resident”? One open categorie emerged from the subject’ description: Causing to approach the hospital experience and the Primary Health Care. Among the meanings attributed to the hospital experience, there is the need and relevance as an integrant part of the curriculum vitae of the Multiprofessional Family Health Residency for the nurses. Key words: Clinical ds: competence; Nursing, education; Internship and residency.

927-32

Authors: Juliana Nogueira Franco, Gabriele Ribeiro, Maria D’Innocenzo, Brícia Pompeo Amaral Barros

The nursing staff, responsible for the last stages of the administration of medications can detect failures and avoid them. The security in the administration of medicines is essential, therefore it is necessary to identify the types of errors and the risk factors in the occurrence of failure. This study sought to identify the causes of errors in administering medication and preventive measures. This is a quantitative, descriptive and exploratory research. Fifty-two professionals participated in this research. The administration of drugs is one of the most important activities of nursing, so the awareness of all the nursing staff that there will be no punishment in the occurrence of error should be made clear. Key words: Nursing; Medication errors; Notice.

940-5

Authors: Simone Coelho Amestoy , Maria Elisabeth CestariII, Maira Buss ThofehrnIII, Viviane Marten Milbrath, Letícia de Lima Trindade, Vânia Marli Schubert Backes

Qualitative study, descriptive and exploratory which aimed to ascertain the role of an institution of higher education and hospital training and continuing education of nurse-leaders. Was developed during the months of February and March 2008, with the participation of eleven nurses from a large hospital in the southern region of Rio Grande do Sul. For data collection was carried out semi-structured interviews and focus groups. Using the Content Analysis for the treatment of data, two categories emerged: the role of higher education institution in the training of nurses, leaders and role of the hospital in continuing education of nurses-leaders. There is the existence of gaps related to the teaching of leadership and development of competence in the hospital context. Key words: Nursing; ds: Leadership; Education; Health services.

950-5

Authors: Lígia Mara Dolce Lemos Lígia Mara Dolce LemosI , Wilany Jesus PereiraI , Joseilze Santos AndradeI , Aglaé da Silva Araújo Andrade

Given the importance of play in the everyday life of hospitalized children, the purpose of the study was to identify the perception of the nursing team in the preparation of children and adolescents for hospital procedures at university hospital in Aracaju. We used exploratory search with a qualitative approach with the nursing staff of the pediatric unit. It is that professionals do not perform the techniques with the plays in their daily activities, but know the importance of this resource. For evidence, it is necessary to insert the toy in the treatment of pediatric nursing care. Beware of play is one of the most efficient means of assisting a child in hospital. Keywords: Play and playthings; ds: Pediatric nursing; Child, hospitalized; Care

964-70

Authors: Inacia Sátiro Xavier de França, Lorita Marlena Freitag Pagliuca, Rosilene Santos Baptista, Eurípedes Gil de França, Alexsandro Silva Coura, Jeová Alves de Souza

A descriptive study which aimed to characterize the conditions of people with disabilities (PD) in the Basic Health Units-UBS. Data were collected in January 2009 in 20 UBSF. It was used digital camera and check list based on the 9050-NBR ABNT. The results showed: Access town - no traffic lights (100%) of lanes for pedestrians (100%), bumpy sidewalks (90%); Access in UBS: non-standard ports (30%) staircases without banisters (20%); floor outside the standard (75%), in disagreement with standard mobile (20%), drinking at odds with standard (55%), making it difficult to people with disabilities to use a filter (30%), has no drinking or filters (15%); telephones installed inadequately (55%); inaccessible restrooms (96%). Access to UBS of PD is permeated by the symbolic violence. Key words: Nursing; Disabled persons; Health services accessibility; Architectural accessibility .

978-82

Authors: Erika Priscila Lisboa Müller, Márcia Regina Cubas, Laudelino Cordeiro Bastos

This paper presents the results of geoprocessing data from a Family Health Unit in Curitiba-PR. A research dealt with both descriptive and operational aspects, using the Geographical Information System (GIS). It gathered available information from the Health Unit, identified which data is relevant for public health assessments, organized it in a database targeted for geoprocessing, and finally generated thematic maps. The paper focuses on cases of high-risk pregnancies and high-risk newborns. The thematic maps show the geographical distribution of the incidence and concentration of such cases, as well as correlations between them. Finally, the paper shows that georeferenced maps of public health issues support a better focused planning and management of health services offered to the local population. Key words: Residence characteristics; Family Health Program; Medical informatics; Health management.

991-7

Authors: Denise Cristina de Oliveira Ferreira, Aparecida Yoshie Yoshitome

This retrospective study seeks to check the prevalence of falls in older people from a long-term care institution for elderly people, in São Paulo, to describe the fallers and the events. We analyzed 121 medical records and 87 fall reports, between August 2006 and August 2007. There were 114 falls suffered by 45 ancians, a prevalence of 37,2%. The majority of fallers are women, average age 83,75 years. We found recurrent falls, various diagnoses and polipharmacy. The majority occurred in own height, in their bedroom, producing mainly hematomas. There is a need of implementation of fall preventive guidelines, due to the importance of this issue and its repercussions to the functional status of the institutionalized elderly. Key words: Ag ords: ed; Homes for the aged; Accidental falls; Geriatric nursing.

1005-9

Authors: Geny Rose Cardoso Costa, Maria Bethânia da Costa Chein, Mônica Elinor Alves Gama, Leidyane Silva Caldas Coelho, Andreia Susana Vieira da Costa, Carlos Figueiredo Cunha, Luciane Maria Oliveira Brito

The purpose of the study was to characterize the coverage of prenatal care in the State of Maranhão. A population-based study, descriptive in 30 municipalities of the State of Maranhão, with 2075 women of childbearing age, with previous pregnancy, from July 2008 to Januray 2009. The results demonstrated that the units of family health accounted for 45.9% of the care of pregnant women and that 46.8% reported carrying out consultations six or more prenatal care during last pregnancy and 64.6% started prenatal in the first three months of pregnancy. The coverage of prenatal care, without regard to adequacy, was 85.6%, however, when considering the coverage of adequate prenatal as established by Brazilian Health Ministry was 43.4%. Although coverage of prenatal above 80%, less than half is considered adequate, showing a gap in primary care quality. Keywords: Prenatal care; Women’s Health; Health service.

1019-27

Authors: Margarete Consorti Bellan, Izilda Ismenia Muglia Araújo, Sebastião Araújo

Objectives of the study: to apply a theoretical qualification program for nurses in cardiopulmonary resuscitation and compare the theoretical knowledge group-A-control with group-B-experimental. This program comprised three stages: Stage-I, evaluation pre-theoretical qualification; Stages-II and III, evaluation of the recent (one week after stage-I) and later (three months after stage-I) qualification. The sample was composed of 21 nurses in Group-A and 38 in Group-B. The mean performance score in Group-A varied in a progressive form: 6.45; 6.66 and 7.10; in Group-B, in an oscillating form: 6.48; 8.36 and 8.0; stages II and III (p<0,001). It was concluded that: Group-B has been superior to Group-A. However, the performance of Group-B stage-II was superior to stage-III, while in the Group-A it was observed a gradual improvement. Key words: Cardiac arrest; Cardiopulmonary resuscitation; Qualification in service.

1035-9

Authors: Silvana Sidney Costa Santos

Objective of this essay was to lead a reflection/critics about the theoretical and philosophical ideas on the concepts of aging/elderly/old age, and gerontogeriatric nursing. Benchmarks of nursing, gerontology and the complexity of Morin as theoretical were used. The gerontology is still a new science in Brazil, emerging, rising, and walking to the need to implement actions aimed at improving the quality of life of those who are older and a guarantee of autonomy and independence of that part of the old already. There is a need to establish terms that approximate to give a common language among health workers/nurses that act, to act in that area or those who are concerned to use appropriate terms in reference to gerontology. Key words:Aging; Aged; Nursing; Philosophy, nursing.

1046-51

Authors: Ana Maria Dyniewicz

This research study identified clinical nurses’ publications. A literature review was carried out in three national periodicals between 2000 and 2007, totalizing 1918 articles. Data demonstrated that clinical nurses’ authorship or co-authorship of 162 articles (8.5%); titling was not identified in 75 publications; doctors published the most along with nurses; areas with the highest number of articles were health and nursing education, adult and elderly health. It was concluded that nurses have easier access to publish in research groups; resuming practice, even after post-graduation, they do not keep up scientific production. This entire professional category must double efforts to broaden their participation in periodicals. Key words: Nursing research; Scientific and technical publications; Authorship.

1056-60

Authors: Leonardo Tadeu de Andrade, Eduardo Gomes de Araújo, Karla da Rocha Pimenta Andrade, Débora Mendonça Soares, Tânia Couto Machado Cianca

This study reviews the literature concerning improvement of rehabilitation nurse role, suggesting paths to reach this goal and evoking a still poorly discussed area. Some questions were raised to provoke reflection and discussion. It is evident, based on the literature, that nurses have a total role in rehabilitation, however the boundaries are not clearly defined. Professional nurses must must join rehabilitation practice with permanent education, that will contribute for a more efficient and influence in processes and rehabilitation services. Key words: Rehabilitation; Rehabilitation nursing; Nurse’s role.

1067-70

Authors: Rosana Freitas Azevedo, Regina Lucia Mendonça Lopes

Breast cancer has been the responsible for the largest mortality rate in the world, becoming one of the great concerns in health, regarding woman’s health. Related to the therapeutics, although wide approaches of interventions that make possible better cure perspectives exist, the mastectomy is as treatment base. Article of philosophic reflection, had as study women’s that lived the mastectomy aiming at to reflect the conception of these women’s body starting from the work Phenomenology of the Perception of Merleau-Ponty object and of authors that work with the theme regarding the woman mastectomized. Key words: Breast neoplasms; Mastectomy; Body image.

1077-80

Authors: Stefanie Griebeler Oliveira, Alberto Manuel Quintana, Karla Cristiane Oliveira Bertolino

This reflection proposes a reinsertion on the death theme, in a more present form, in the daily routine of the nurse and its similar, starting with a historic on death, focusing on the transfer of it, that occurred in the bedroom of the moribund, to the hospital bedroom. Soon after, some considerations about the reason to fear death and the need of discussing it, as well as a reflexion on the planning of actions looking as much as to care as to confort the dying patient. With that, it is easy to realize the relevance of the come back of the approach of the subject in the professional daily basis, considering the need to demystify it, to allow that nurses and its similars plan actions of confort to the dying patient. Key words: Death; Taboo; Nursing; Nursing care

695-6

Authors: Jussara Gue Martini

Editorial.

706-11

Authors: Elke Annegret Krezschmar Cordeiro, Emil Kupek, Jussara Gue Martini

Study of the prevalence of smoking among school children, using secondary data from the Survey School “Doing Research - Monitoring of Smoking in School”, conducted by the Centre for Oncologic Research of Santa Catarina. Included variables such as age, the starting in smoking, level of knowledge about the subject, among others. It was found that 41.6% of students smoked sometime in life, no statistical difference between the sexes. Among those who have tried, 38.3% did so between 7 and 11 years. The analysis provided a characterization of the prevalence of risk factors, subsidizing a more effective prevention of nursing and its integration in schools. Key words: Smoking; Prevalence; Risk factors; Nursing.

719-26

Authors: Antônio Marcos Tosoli Gomes, Ivone Evangelista Cabral

The aims of this paper were unveiling the caregiver’s everyday life of caring for children under antiretroviral therapy (ARVT), and analyzing the dimensions of care them. Qualitative research was conducted with a creative-sensitive method including seven family members and data were treated through discourse analysis. These family members’ everyday life in the medication implementation was marked by concealing and silencing. The first one was represented by linguistic regularities, as expressions and acronyms do not appear in their enunciation, and also in the way their lives are organized facing stigma and bias related to the ARVT. The last one occurred in the relationship with children, as when family members were questioned about the medication, they answered in an evasive way. Concealing and silencing related to child HIV/AIDS are themes which need to be approached by nurses in their caring and health education interventions. Key words: HIV; Child; Pediatric nursing; Health education.

735-40

Authors: Mônica Augusta Mombelli , Sônia Silva Marcon , Jaquilene Barreto Costa

The purpose of this research was to characterize the profile of adolescents hospitalized for detoxification in a public hospital in the West of Paraná and correlate the socio-demographic variables with the use of street drugs. It is a retrospective study from the consultations in 81 protocols of admission of addicted adolescents hospitalized from March 2007 to April 2008. The largest admission was of male adolescents (79%).The most frequently used drugs by were crack (87.6%), followed by marijuana (85.2%), from these, 79% of these adolescents use these two drugs concomitantly. Most adolescents (55.6%) reported using drugs for more than three years, and 56.8% had already received some type of treatment before admission. Factors that lead to abusive consumption of drugs, such as easy access, leaving school, the use of drugs in the family and lack of motivation for treatment were identified. Key words: Adolescent; Mental health; Street drugs; Hospitalization.

749-54

Authors: Renato Ohara, Márcia Regina Antonietto da Costa Melo, Ana Maria Laus

It was developed an exploratory study, having as a method the study of case which aimed to characterize the profile of adult patients admitted at the emergency medical service in a general public hospital in São Paulo as subsidy for the nursing personal downsizing. Subjects were the patients admitted during the period of thirty days. Data was obtained through application of a patient classification instrument by Fugulin. This study showed patients in the category of intensive care, semi-intensive, high dependence, intermediate and minimal and occupation rate above official prediction making physical space inappropriate to the patients and professionals, reflex of the lack of control service. Key words: Emergency ds: medical services; Personnel downsizing; Nursing, team.

762-9

Authors: Kênia Lara Silva, Andreza Trevenzoli Rodrigues

Qualitative study with the purpose of analyzing intersectorial actions for health promotion in the context of the Family Health Strategy, identifying experiences, facilitating and restricting factors to the process of building partnerships. Subjects were health managers and informers from social equipment in the territory covered by a local health service in Belo Horizonte/Minas Gerais, Brazil. The results indicate the existence of a wide social network. However, intersectorial health promoting actions are still incipient. Intersectorial actions are faced with the challenge of creating communication spaces that allow the resolution of complex problems. It is concluded that intersectorial actions constitute an innovative strategy which is still under construction, and the paths of which are still being unraveled. Key words: Health promotion; Family Health Program; Intersectorial action.

775-81

Authors: Eliane Matos Eliane Matos, Denise Elvira Pires de Pires, Gastão Wagner de Sousa

This is a qualitative study developed with the interdisciplinary health care teams of two public hospitals in Brazil. One team gave palliative care to cancer patients and the other gave care to the elderly. The study contributes to thinking about work elationships in the health care sector upon analyzing the contribution of these experiences for the constitution of new forms of health care work organization. The results reveal that the interdisciplinary perspective of performance in health care makes better work relationships possible among professionals and between professionals and patients/family, as well as approximates the professionals to the needs of the patient, beyond contributing to better quality care. We conclude that interdisciplinary practice approximates new forms of work organization and, upon favoring these links, reception, and access, contributes to the greater efficiency of the Brazilian National Health Care System. Key words: Labor; Patient care team; Interdisciplanary communication; Job Satisfaction.

786-92

Authors: Samanta Rauber Gallas, Rosane Teresinha Fontana

Qualitative study that aimed at investigating concepts and practices of nursing technicians on biosecurity and its interface with biological hazards, with 20 workers developed a clinical care unit of a hospital in the interior of Rio Grande do Sul. Data were collected through interviews and systematic observation. Thematic analysis was the methodology used for data processing. The negligence of its employees on the use of individual protection equipment and work overload are risk factors for accidents with biological material. Suggested that partnerships between the actors involved in caring for the construction of healthy environments and accountability for negligence on biosecurity. Descriptors: Descriptors: Exposure to biological agents; Occupational health; Nursing, team.

799-805

Authors: Claudinei José Gomes Campos, Egberto Ribeiro Turato

The objective of this paper was to analyze the meaning attributed by renal patients to the hemodialysis treatment received. Using the clinical – qualitative method interviews were conducted, following a semi-structured questionnaire with seven patients from a hemodialysis unit, selected through intentional sampling. The data were examined by thematic content analysis. Survival emerged as the most significant objective of the treatment. The fact that the treatment was mandatory placed the patient in a situation of implicit transference of responsibilities, when making decisions about the adopted therapeutic, to the team of health professionals, generating compliance or conformity regarding his/her own participation in this process. The patients attributed to culture lack of knowledge about the treatment. Key words: Renal dialysis; Chronic renal insufficiency; Qualitative research.

811-6

Authors: Ana Lucia de Lourenzi Bonilha, Joice Moreira Schmalfuss, Jussara Mendes Lipinski, Mariana Bello Porciuncula

The commitment with the promotion and support of breastfeeding justified the training of professionals that give prenatal care in primary health. This is a exploratory, qualitative study, based on the assumptions of participant research. It aimed to identify the thematics about breastfeeding and report the actions and strategies proposed during the meetings. Data was registraded in a field diary and analysis was done according to the categorization of data. Discussion of findings showed the lack of professionals update and lack of standardization in their conducts. The research gave the oportunity to discuss the politics and programms that were implanted by the government management, searching for alternatives inside the context of the users and workers that are involved with prenatal care. Key words: Prenatal care; Breastfeeding; Training; Human resourses formation.

823-9

Authors: Moema da Silva Bor , Hellén Cristina Pereira da Silva

Qualitative study which purpose was to identify the central nucleus of the social representations about the concepts of taking care and treating under the vision of the nursing professionals. Participated in the study45 subject. The data had been analyzed with the aid of Evoc software. The results reveal that the social representations of the professionals concerning the concepts of taking care and treating point to opposing actions and not complementary in the act of taking care. We conclude that this aspect can compromise the definition of the field of nursing practice and its professional identity. The challenge is in linking the treatment effect that care process and the contributions of the nursing cares in the health practices are irreplaceable. Key words: Interpersonal relations; Professional Competence; Nursing care; Love; Knowledge.

837-40

Authors: Larissa Chaves Pedreira, Regina Lúcia Mendonça Lopes

The purpose was to Identify the knowledge production about the stroke in elderly under home care. Bibliographic research whose data were collected though the abstracts from 1997 to 2007, contained in LILACS and SciELO atabases. The following key words were used: home assistance, aged people and cerebrovascular accident. Fifty-two references were found in the LILACS database, nine in the SciELO Brazil, and three in the SciELO Cuba. Most of the researches were carried out in 2000. Regarding the method, qualitative method predominace were observed, and central theme is related to the care giver, as well as to the clinical and epidemiologic aspects of the disease. It was observed that this knowledge is still established in Brazil, and the themes related to the person submitted to home care and violence to the aged are still little explored. Key words: Aged; Home nursing; Cerebrovascular accident; Review literature.

844-7

Authors: Simone Coelho Amestoy, Letícia de Lima TrindadeI , Roberta Waterkemper, Ivonete Teresinha Schülter Heidman, Astrid Egged Boehs, Vânia Marli Schubert Backes

The aim of this study is make a theorical-reflection about the importance of using dialogical leadership in hospital institutions through Freirean referencial. The dialogical leadership pattern differs from the coercive and autocratic methods, for being reasoned on the establishment of an efficient communicational process, able to stimulate autonomy, co-responsibility and appreciation of each member from nurse team. The dialogical leadership, unlike the directive one, is a management instrument, that pursuits to minimize the conflicts and stimulate the formation of healthy interpersonal relationships, which can contribute to the improvement of organizational atmosphere and quality care provided to health services users. Key words: Nursing; Leadership; Health services

853-8

Authors: Emília Campos de Carvalho, Ana Maria Laus, Maria Helena Larcher Caliri, Luci Grupioni Rossi

Although it is desirable that professionals use research results, often they are not prepared for that. This article aims to present the process of development and establishment of innovations, based on Rogers’ model, through strategies to train nurses to use the best evidences for a quality clinical practice. It is a partnership between a educational institution and a hospital care institution. Following identification of problems from nurses’ own practice in a health institution research proposals were developed to search for evidences and to test interventions. Results of this experience evidenced the viability of use of a model presented as a methodological framework what contributed to reach the institutions’ goal. Key words: Nursing research; ds Education, nursing; Hospitals, teaching

506

Authors: Maria Goretti David Lopes Maria Goretti David Lopes

Editorial.

517-22

Authors: Elisângela Maria Soares, Sueli Riul da Silva

A study of socio-epimiological demographic profile of patients in chemotherapy for cancer in the Gynecology and Obstetrical Ward in HE- UFTM, presented in the periodo from 1998 to 2006. Retrospective study whose data collection was obtained from health records It was built a data base using Epi-Info. Data analysis considered simple distribution, mediacy with value between the maximum and the minimum and stand deviation. The sample was constituted of 321 health records; the more incident age group was 46 to 50 years-old; breast cancer was the most noticed cancer (45%); the chemotherapy most used was ciclofosfamida, in 173 treatments; had an increase in breast cancer. It was concluded that had a change in the patient’s profile. Descriptors: Descriptors: Descriptors: Neoplasms/chemotherapy; Women’s health; Nursing.

529-32

Authors: Monalisa de Cássia Fogaça, Werther Brunow de Carvalho, Luiz Antônio Nogueira-Martins

To compare the demand and control over work of physicians and nurses working in pediatric and neonatal critical care units. Crosssectional study with 37 doctors and 20 nurses. We used the Job Content Questionnarie. Physicians from the ICU Neonatal differ in social support received from the supervisor (p= 0.01) compared to the ICU Pediatric. ICU nurses of the Neonatal present job insecurity (p= 0.05). Physicians and nurses from the ICU Pediatric differ in control over the work, psychological demands of work, physical effort and support of the supervisor (p <0.05). Physicians and nurses from the ICU Neonatal show statistical differences in control over the work, physical effort and support of the supervisor (p<0.05). The work environment in the ICU’S presents high demand and low control over the work. Key words: Nursing team; ds: Stress; Intensive care units; Physicians.

541-7

Authors: Maria Helena Menezes Guariente, Márcia Fontão Zago, Zeneide Soubhia, Maria do Carmo Lourenço Haddad

The aim of this study was to analyze the meanings given to investigative research by nurse clinicians enrolled in a research support group. The interpretive anthropology theoretical frame was used along with an ethnographic case study. Data was collected through semi-structured individual and group interviews, document and statement analysis as well as field diary notes. The statements of 36 participants were analyzed interpretively identifying four categories: activity’s value, researching is learning, the movements about the activity, the activity is hard work that demands personal effort. We understand that once research training initiative is supported by the organization and desired by the nurse, it becomes a scientific-pedagogical strategy for academic nursing formation with positive repercussions to care assistance. Key words: Nursing research; Nurse clinicians; Culture.

555-60

Authors: Valéria Lamb Corbellini, Beatriz Regina Lara dos Santos, Beatriz Sebben Ojeda, Luiza Maria Gerhart, Olga Rosária Eidt, Sarah Ceolin Stein, Denise Teixeira de Mello

The objective of the study was to know the linkages and challenges between professional training and practice and the Curriculum Guidelines for Nursing Baccalaureate Degree Programs. It was a qualitative study, with 34 graduates in nursing, who answered an emailed questionnaire. Data analysis was based on Michael Foucault’s discourse analysis. The ethical aspects were observed. Analysis showed three themes in graduates discourses - Unified Health System, generalist professional training and humanization. The study revealed an approximation of concepts and guidelines of the Curriculum Guidelines for Nursing Baccalaureate Degree Programs and of the Unified Health System with the reality of professional practice along with challenges in the training of professional nurses. Key words: Education, nursing ds: ; Curriculum; Teaching.

567-73

Authors: Maria Clara Porto Fernandes, Vânia Marli Schubert Backes

Qualitative study whose research subjects were the members of a Health Family Strategy. and has as purpose to know their perspectives about health education and presents them through the dialogical conception of Paulo Freire. In the circles of culture, four themes emerged: family health team, health education, health education practice in team work and how to improve the stock of existing health education, were encode, decode and critically unveiled its concepts, hallenges,opportunities and expectations of their educational practices. The field research was the development of a Primary Care Unit of Health of Cachoeira do Campo, Minas Gerais. The results showed that health education is recognized by the subjects as a liability, but its practice is facing cultural barriers, and receives little emphasis in the daily work. Key words: Health education; Family Health Program; Nursing

581-6

Authors: Karelline Izaltemberg Vasconcelos Rosenstock, Maria José das Neves

Qualitative study conducted with nurses from the Family Health Strategy in João Pessoa, PB, Brasil. The purpose was to investigate the nurses’ role in the approach to the drug addict, analyzing the strategies of basic nursing care applied to them. The selection for the study followed the criterion for acceptance. The data were collected through a semi-structured interview, giving priority to participant’s talks. One noticed the lack of professional training of the nurses in relation to the drug addiction, by restricting their actions to taking these users to more specialized services in mental health. It must redefine the attention, putting a new paradigm of health as a right and as a social community construction, from a global view of the processes of social interaction. Key-words: Nursing; ds: Substance-related disorders; Family Health Program.

595-602

Authors: Débora Cristina Arruda, Sonia Silva Marcon

The objective of the study was to describe the experience of the family that lives with the sequels of prematurity in the first years of a child’s life. That was qualitative study developed in Maringá, PR, Brazil, with eight families of children born from 1998 to 2008 at a University Hospital. Data was collected through open interviews carried out at the home of the families in the period from January to June 2006. The families of premature babies revealed the anguish and the suffering experienced when they found little by little, the limitations, differences and current sequels of prematurity. They emphasized that this experience can be translated as a long path in search of a better understanding of the whole process. Key words: Family; Infant, low birth weight; ds Pediatric nursing.

608-15

Authors: Antonio Marcos Tosoli Gomes, Denize Cristina de Oliveira

This work has the objective of describe and analyse the social representation of professional autonomy build by public health nurses. The methodology theoretical referencial was the Theory of Social Representation. Interviews were deeply made with 30 nurses of a city in state of Rio de Janeiro. The information was analysed by Alceste software. The results showed the professional autonomy drawing based on professional characteristics (responsibility is balance) and health programming as an important space to autonomy building. It can be concluded that autonomy process is under construction and that the existence of its representation. Key words: Public health in ds: Nursing; Professional practice; Public health; Professional autonomy

623-8

Authors: Márcio Flávio Moura Araújo, Lívia Silva de Almeida, Poliana Carina Viana da Silva, Hérica Cristina Alves de Vasconcelos, Marcos Venícius de Oliveira Lopes, Marta Maria Coelho Damasceno

The purpose of the study was to identify cases of overweight among adolescents in private schools in Fortaleza, Brazil. We investigated 794 students between 12 and 17 years old from 12 private schools, in the months March to June and August-September 2007. The prevalence of overweight and obesity was 20% and 4%, respectively. Among the young people who watch TV while eat, the weight accumulated was higher and the cases of obesity was the double (p = 0, 000). About 28% of people who practiced regular physical activity were overweight (p <0, 001). In the fight against adolescent adiposity, to the nursing is primarily the preventive actions, because attenuate various pathological effects related to the accumulation of body weight. Key wor ey words: Overweight; ds: Obesity; Adolescent health.

637-43

Authors: Valéria Lamb Corbellini, Beatriz Sebben Ojeda, Beatriz Regina Lara dos Santos, Marion Creutzberg

The purpose of this research was to analyze how the undergraduate teaching of nursing in Rio Grande do Sul has constructed its knowledge, since the first course, as of the decade of 1950s. The survey has involved teaching nurses who have lived such period of our history, and the discourse analysis has been utilized for the documental analysis. The information data indicate, among them, the most integrated curriculum that seeks articulating theory/practice without fragmenting the knowledge and the teaching-learning relationship, wherein professors and students are subjects of such procedure. Key words: Education, nursing; Teaching; ds: History of nursing.

652-9

Authors: Manuela Beatriz Velho, Maria Emília de Oliveira, Evanguelia Kotzias Atherino dos Santos

The objective of this bibliographic study is to identify the state of the art of production published in the area of obstetrics nursing involving the birth process, to contribute to future investigations, and to assist in reflection upon this theme. Data was collected through the bibliographic analysis of the LILACS, MEDLINE, Cochrane Library, and SciELO databases. Descriptors used: nurse-midwives, childbirth work, normal childbirth, and Nursing care. Five studies were selected and later catalogued in bibliographic files. The themes selected were: professional regulation, care, assistance given, link established, educational actions, administrative activities, and difficulties. While the studies recognize this professional as a capacitated, legally backed professional who offers humanized assistance and thus reaffirms normal vaginal delivery, – thus proportioning dignity, security, and autonomy to the delivering mother – much still needs to written in order for the same autonomy and ethical-legal respect is acquired for health care professionals and clientele. Key words: Obstetrical nursing; L : abor, obstetric; Natural childbirth; Nursing care.

666-70

Authors: Hilton Giovani Neves, Roselma Lucchese , Denize Bouttelet Munari

The family/people integrally attention is one of health services and professionals challenges, creating spaces for metal health in the primary level health attention. The aim of this study is to reflect about the constitution necessity of new knowledges/dones to the mental health at the primary attention, taking as perspective the competence referential. Essay developed since the historical assumptions ascertains that contextualize the Family Health Strategy and its interfaces with the psychosocial principles and some nurse background implications since the competence development theoretical intentions. We consider that reality transformation, with the health attention improvement asks for knowledges/dones constitution that attends to the psychosocial attention and the Unique Health System rules. Key words: Family Health Program; Mental health; Education, nursing.

675-8

Authors: Miria Conceição Lavinas Santos avinas SantosI , Francisco Stélio de SousaI , Pricilla Cândido Alves, Isabela Melo Bonfim , Ana Fátima Carvalho Fernandes

The authors report their experience as teacher-nurse for years in oncologic hospital with the aim of enabling reflection on the development of nursing therapeutic communication at the hospital preoperative unit for mastectomized women. It was found that the practice of therapeutic communication becomes a favorable practice, because establish the nurse-patient relationship, with patient producing his own care. Understanding the fragility of the patient at this stage, the nurse takes commitment to predefine the nursing care in partnership, in order to meet the patient needs, aiming to, mainly, the autonomy of care. In this way, the authors present a proposal for nursing managed care based on a mutal relationship, human and participatory care. Key words: Communication; Nursing; Preoperative care; Mastectomy.

356

Authors: Jussara Gue Martini Jussara Gue Martini

Eeditorial.

366-70

Authors: Valéria Marli Leonello, Maria Amélia de Campos Oliveira

The objective of this study was to identify the meaning of comprehensiveness as found in the discourse of those involved in primary nursing education. The methodological framework employed was historic and dialectical materialism. Thirty subjects were interviewed: five professors, five students, ten nurses, two managers and eight patients from two healthcare teaching clinics. Discourse was analyzed using the discourse analysis method. Although comprehensiveness takes on different meanings in the discourse of the respondents, they are all associated with comprehensiveness know-how, where healthcare is based on a true commitment and a sense of trust between professionals and patients. In conclusion, promoting the comprehensiveness of healthcare is a fundamental competency that needs to be further developed in primary nursing education. Key words: Health education; Education, nursing; Professional competence; Nursing care; Education, higher.

377-84

Authors: Leandro Barbosa de Pinho, Antonio Miguel Bañon Hernández, Luciane Prado Kantorski

This study aims to know the dynamic and controversial which is the practice in mental health. For that, it’s analyzes the discourse of workers of mental health about the concept of on the concept of the clientele of the service. The corpus of this work is composed for interviews applied to 17 of the 25 professionals of mental health who work in a service substitute of a city of the Brazilian South Region. The theoretical-philosophical referential was the Critical Discourse Análisis. The methodological device was the “axiologic-discursive diagram”. The results demonstrate that the workers assume relations of benevolence because the clientele conceptual undefinition, fruit of the difficulty in establishing what is normal and pathological in mental health. We wait that the study it contributes to problematize the process of consolidation of the Brazilian psychiatric reform. Key words: Language studies; Mental health; Social sciences; Psychiatric nursing.

391-6

Authors: Maria da Conceição Samu Pezzi, Joséte Luzia Leite

Research developed in three Central of Material and Sterilization for investigation of the nurse’s managerial practice, in view of the human resources. It is part of the master dissertation which objectives were identify the meaning of the managerial practice in CME, describe its process, and construct a theoretical model about human resources management. Study of qualitative nature, whose participants were nurses of three public hospitals of the Rio de Janeiro. We utilized as referential the Symbolic Interaction and the Grounded Theory. Based on the collected data and realities of each CME are found five categories, beyond the central phenomenon. Process of nurses´ basic actuation is attached to the experience in the personal knowledge, work process knowledge and science of its realities. Key words: Nursing; Human Resources; Sterilization; Hospital administration

404-9

Authors: Sílvio Éder Dias da Silva, Maria Itayra Padilha, Ivaneide Leal Ataíde Rodrigues, Esleane Vilela Vaconcelos, Lucialba Maria Silva dos Santos, Ralrizônia Fernandes Souza, Vander Monteiro da Conceição

This study aims at identifying social representations of diabetic clients on your body after the amputation, and analyze the relationship of these representations to the care of themselves. The research was a qualitative, exploratory, with the use of the social representations theory and case study method. The scenario was a hospital in the city of Belém, Pará, 20 subjects participated. The data collection techniques were: a free association of words and watch free. After examining three categories emerged: the healthy body - term health of living well, the body work - the perfection and beauty in daily life, The body amputated - the limitation caused by amputation; and the amputated body and its relation to the care of themselves. It is clear concern to recover the lost welfare. Key words: Diabetes Mellitus; Amputation; Nursing.

416-20

Authors: Ivonete Buss Schülter Heidemann, Astrid Eggert Boehs, Antônio Miranda Wosny, Karine Patrícia Stulp

This study aims to present the application of the Method of Paulo Freire in a research with professionals of family health teams, users and community leaders about the use of the notion of health promotion. It describes how to obtain and analyze data in the Culture Circles performed in three phases: thematic research, coding /decoding and unveiling critical. This methodology contributed reflections of health practices of participants, allowing alternatives to transform them. The theoretical limits for their payment, among them the difficulty of deconstruction of the authoritarian conferred by the power of professional knowledge. Key words: Methodology; Community health nursing; Family health

427-34

Authors: Denise Conceição Silva, Neide Aparecida Titonelli Alvim

The purpose of this qualitative research was to characterize the elements that constitute the environment of the Surgical Center and to analyze its implications for dynamic of care and nursing care. Based on the Environmental Theory’s principals. Participated twelve nurses from the Surgical Center of a College Hospital in Rio de Janeiro. Data were gathered through the creativity and sensitivity technique “Map-Speaker”, semi-structered interviews and participant observation, and were analyzed by thematic categories. The results showed that care can happen directly and indirectly in favor of full client recovery, counting the environment that the integrate in purpose to maintain harmonic and balanced. The nurse interventions aim to maintain the environment in favorable conditions so that a higher standard of care can be promoted. Key words: Environment; Nursing care; ds: Operating room nursing.

440-5

Authors: Liliane Yukie Hayakawa, Sonia Silva Marcon, Ieda Harumi Higarashi, Maria Angélica Pagliarini Waidman

With the intention of understanding how the support network of the families of children admitted in a hospital Pediatric Intensive Care Unit (PICU) is established, and its importance in the life of their relatives, a descriptive study with qualitative approach was carried out with 21 parents of children admitted in a PICU of a University Hospital located in the northwest area of Paraná State. It was observed that, the support network to the families was made of a mixed of affectivity, faith and solidarity as the fundamental components to relieve the suffering and out-of-hospital support. The study also showed, that the work with families should be permeated by the special attention to the peculiarities that surround each family context and its relationships, what ratifies the importance of a more comprehensive performance of nursing, better understanding the multiple influences of the different configurations of the family and social support network on the quality and effectiveness of the implemented interventions. Key words: Family; Social support; Life changes events; Pediatric nursing.

452-8

Authors: Doris Marli Petry Paulo da Silva , Eduardo Augusto Tomanik

Purpose: Purpose: To Purpose: investigate the self-reported morbidity rate of riverbank dwellers from Porto Rico, PR, Brazil. Methods: Methods: The Methods: case study compared the self-reported morbidity of two groups of residents. The sample consisted of 63 individuals of the three affordable housing complexes of that municipality. Information was collected through home surveys, during the months of June 2005 and January 2006. Results: Results: Most Results: interviewed subjects had a positive perception of their health. The main health problems recalled were associated with arterial hypertension, nervous system conditions, depression, heart and respiratory problems and assorted infections. Alcohol was mentioned more often by group B and tobacco by group A. Conclusion: Conclusion: Conclusion: Health education, with emphasis on adopting healthy life habits helps in facing adverse health situations and promotes health. Key words: Health services evaluation; Health education; Life style; Ecological studies; Health status.

464-9

Authors: Daniela Ries Winck, Odaléa Maria Brüggemann

The objective of this literature review is to identify how aspects related to legal responsibilities of the obstetrics nurse and the obstetrics nursing assistant have been approached in Brazilian publications. After researching the following databases for the period of 1980 to 2009; BDENF, CINAHL, LILACS, and SciELO, seven articles which dealt with judicial aspects were selected for this study. It was clear that none of these focused upon legal responsibilities for obstetrical nurses. Error prevention was highlighted among the majority of these publications, as well as civil and ethical responsibilities. However, the majority point out administrative sanctions and penal responsibilities. These aspects need to be researched in greater depth and reported upon, for they may contribute to more qualified formal education for nurses concerning the legal implications of their practice. Key words: Nursing; Obstetrical nursing, Liability, legal

477-9

Authors: Aline Bueno, Isabela Lovizutto Iessi, Débora Cristina Damasceno

Superstitions are found everywhere in our lives, and medicine, a profession that is prides itself on an evidence-based approach to treatment, is not exempt. A superstition that pervades the labor and delivery floor is that it is busier during certain phases of the lunar cycle, specifically the full moon. Although some studies have demonstrated an increase in deliveries that are related to the lunar cycle,there has been disagreement about when, in the lunar cycle, the peak volume occurs. Front to the divergence of the existent results in the literature to relate the events of the lunar cycle with deliveries, the aim of this review was to accomplish the literature in the attempt of explaining this popular culture with base in the results presented by different researchers. Key words: Moon; Delivery; Obstetrical nursing.

487-90

Authors: Cláudia Prado, Genival Fernandes de Freitas, Irene Mari Pereira, Vera Lucia Mirai, Maria Madalena Januário Leite

This experience report had as purpose to describe the evaluation process in curriculum clerckship of nursing administration in the Nursing Course of the School of Nursing at the University of São Paulo, in the light of dialectical methodology. In this perspective, knowledge is constructed in three stages: síncrese, analysis and synthesis, in which the pedagogical task of the teacher is mediating the steps of mobilization, construction and synthesis of knowledge through the doubt and criticism. It was concluded that assessment of learning valued interpersonal relations and participation of the subjects involved, through the host and establishment of links in the process, encouraging the development of knowledge from the practice of creating problem situations constructive and meaningful, developing multiple competences. Key Words: Nursing; Teaching; Learning.

174

Authors: Jussara Gue Martini Jussara Gue Martini

Editorial.

183-9

Authors: Mariana Gondim Mariutti, Antonia Regina Ferreira Furegato

This qualitative study aimed to identify risk and protection factors for depression caused by abortion; statements of 13 women were analyzed. Their reports were analyzed and enabled the construction of two thematic categories: risk and protection factors. The risk factors are associated to the precarious socio-economic and affective conditions; drugs; prostitution; lack of family and social support; violence. Socio-economic conditions favorable to raising children; social and family support (especially from partner); profession and work were observed as protection factors. The recognition of these aspects open ways for improving care to women who had abortion. Key words: Mental health; Women; Abortion.

196-202

Authors: Anna Maria de Oliveira Salimena, Ivis Emília de Oliveira Souza

This qualitative study had as its object the daily-life of women after being submitted to a histerectomy. Following this sense the phenomenological approach was chosen as methodological framework , supported by Martin Heidegger´ phenomenology. The deponents were twenty five women submitted to a histerectomy at HU/UFJF in 2006. The interpretative understanding, showed, under Hedegger perspective, that women´s daily-life after being submitted to histerectomy expresses itself in a movement that goes forward and backward for inauthenticity to an indication of properties and improperties. In the daily-life after the surgery is that she understands herself as being-there-with-the-other and revealing herself as “being-of-possibilities” in a self world. It showed that the assistential dynamics must be considered from the perspective of the subjectivity of the woman who will be submited to histerectomy. Key words: Women’s health; Nursing; Histerectomy; Qualitative research.

209-15

Authors: Felismina Rosa Parreira Mendes, Maria de Fátima Mantovani

This research study, with a qualitative approach was carried out aiming to identify nurses’ representation on current professional dynamics, evolutionary landmarks and the future outlook for Portuguese nursing with twenty nurses from Évora, Portugal, in April / May of 2009, through narrative testimony. Qualification obtained along the years as well as the Nurses’ Association were mentioned as the central representative pillars in order to build up professional identity. Autonomy is part of daily caring routine, however hegemonic power issues in the health team still ground nurses’ action and underpin their self and peer professional and social recognition. Future outlook addresses issues such as employment, career uncovering hope for some and uncertainty for others. Key words: Professional practice; Professional autonomy; Nursing

222-9

Authors: Rinaldo de Souza Neves, Helena Eri Shimizu

This study seeks to analyze the execution of the Infirmary Attendance Systematization Nursing stages through an exploratory, qualitative and retrospective approach. The retrospective analysis took place using 25 medic reports containing 25 historical reports, 12 diagnosis reports, 100 prescriptions and 100 nursing evolution reports. The results demonstrated the many difficulties the nurses faced to make Nursing Asssitance Systematization operational. Although all Nursing Asssitance Systematization stages were accomplished – historical, diagnosis, prescription, evolution and nursing – it was verified a larger frequency in filling prescription and historical related forms and a lesser one related with evolution and diagnosis related forms. In short, Nursing Asssitance Systematization procedures still are fragmentized, showing the need to reorganize this attendance methodology attendance, and, above all, to invest in continuous nursing training to improve the customer care services quality. Key words: Nursing assessment; Nursing process; ds Patient care; Rehabilitation nursing

238-42

Authors: Laureana Cartaxo Salgado Pereira Silva, Cecília Nogueira Valença, Raimunda Medeiros Germano

This study aims to describe the perceptions of nursing professionals and identify their feelings against the death of newborns in the intensive care unit (ICU). Qualitative research with phenomenological focus. Respondents were nurses and nursing technicians in a neonatal ICU, answering the following research question: How do you feel against the death of the newborn in the ICU where you work? Emerged the question, about this phenomenon, a variety of feelings such as loss, compassion, sadness, resulting in a sensitive world of experience of each one. The analysis has both theoretical contribution the authors dealing with the phenomenology, as scholars of the subject’s death. From the understanding of the phenomenon studied, say to be the death of the newborn for nurses in an ICU experience a conflict of feelings, sometimes painful, for the complexity of issue. Key words: Nursing; Death; Intensive care; Feelings; Newborn; Qualitative research.

250-6

Authors: Maria Helena Marziale, Amanda dos Santos Zapparoli, Vanda Elisa Felli, Marina Hideko Anabuki

Quasi-experimental study that aimed at evaluating the proposed interactive training, as a strategy for change in the behavior of workers, seeking the appropriate use of gloves in the administration of intravenous drugs. The interactive training was structured in the Model of Health Promotion of Pender, conducted through access to the web site of the Network Prevention of Accidents at Work (REPAT)available from: http://repat.eerp.usp.br/estrategia/index.php and applied in 60 workers nursing from two hospitals in the state of Sao Paulo. On the week before the training 58.3% of the workers were wearing gloves to administrate intravenous drugs and 83.3% of the workers informed the intention of wearing gloves after the training. Conclusion: the use of interactive tool facilitated the implementation of educational strategy in work and showed that training can help in changing behavior. Key words: Nursing; Accidents, occupational; Occupational health; Occupational risks.

264-73

Authors: Cristina Silva Ar Cristina Silva Arruda, Eliza Nogueira, Milena Silva de Oliveira, Eliane Ramos Pereira, Rose Mary Costa Andrade Silva

The psoriasis, chronic disease with uncertain cause, affects 1 to 3% of world population, produces great psychological impact and changes in quality of life, a challenging reality. The objective is to analyze the scientific production of nursing on psoriasis, examining the approaches and contributions to care. It’s a bibliographic study carried on virtual database Medline using the terms psoriasis and nursing. Of the 21 articles selected, in 1997/2008, 19% focus on the pathophysiology and differential diagnosis, 48% treatment, 28% psychological aspects and 42% in nursing care. The rescue of the scientific knowledge increases the challenge of maximizing the scientific production about this subject, bringing significant contributions to advances to a more holistic intervention and higher quality with this clientele. Key words: Psoriasis; Nursing; Nursing care.

279-84

Authors: Alessandra Conceição Leite Funchal Camacho, Maria José Coelho

The objective of this work was to analyze the development of health of the elderly based on references contained in the main databases. Study of systematic review considering the period from 01/09/08 to 30/09/08 in the databases of the Library of Health to check that the information was held to organize the content on the year, publication type and methods / techniques, content and essence of the production of knowledge, database, the authors’ recommendations. The results emphasize the development of research focused on the dissemination and results of health policies and their knowledge by health professionals who care for elderly is a necessary direction and specific training. Key words: Health Public Policy; Aged; Nursing.

290-9

Authors: Keila de Oliveira Lisboa Sanchez, Noeli Marchioro Liston Andrade Ferreira, Giselle Dupas, Danielli Boer Costa

Network and social support are resources that nursing can offer to families. This review identifies which aspects of social support are being investigated for the family of the cancer patient. Fifty one articles were found of which 70% were quantitative research and 26% were published in the last two years. The issues addressed were: Family caregivers as provider of social support; Factors that interfere with social support; Religiosity as social support as well as support coming from educative programs, group activity and technological resources. Of these papers, 49% were written by nurses, with international emphasis on needs assessment, family experiences and support offered, while national articles emphasize definition concepts and identifying family needs focusing on intervention planning. Key words: Family; Social Support; ds: Neoplasms; Nursing.

307-11

Authors: Janete Tamani Tomiyoshi Nakagawa, Janine Schirmer, Márcia Barbieri

This article refers to a review of literature about the HPV virus and the cervical neoplasia, aiming at raising aspects of the virus infection which influences in the natural development of the uterine cervical cancer such as: the type of virus, the duration and the persistence of the infection and also the association with the manifestations of the preceding lesions up to the evolution of the neoplasia. It was possible to notice the strong association of the infection with the evolution of the cervical neoplasia, however, studies to better elucidate certain aspects of the infection of the HPV virus that acts on the uterine cervix are still necessary so that the actions of prevention and fight against the disease will be more efficient. Key words: Uterine cervical : neoplasms; Cervical dysplasia; Papillomaviruses; Epidemiology.

317-21

Authors: Rosa Maria Ruthes, Liliane Bauer Feldman, Isabel Cristina Kowal Olm Cunha

Reflection about a doctorate’s thesis. It was carried through an abstraction of the described theory by specialist authors in thematic, a transposition for the practical of competency management in nursing. The essential competency shows attributes of knowledge, ability and attitude - called CHA, to add value to the organization of health with focus in the customer. It is essential to awake in all the team, the responsibility and real concern with the patient, family and visitors. The professional constitutes oneself as the inspired leader of its group. The management competency of the nurse can give change to the development of the human resources and promote the enchantment in the attendance of the customers, making the difference in the health organizations. Key words: Practice management; Nursing; Professional competency.

328-33

Authors: Wania Regina Veiga Martines, Ana Lúcia Machado

This is a theoretical reflection concerning the link between production of care and subjectivity, and the ideas that support this connection. It was performed a search for studies that had been previously elaborated in the database from University of São Paulo. The discussions upon de findings were based on some ideas of post-modernity and its criticism to the instrumental rationality, that relies on contemporaneous conceptions and actions concerning care. Recovering the subject and their very subjectivity production means to recover a kind of care that mix the edge between objective and subjective and bets on an integrated view of daily human productions and actions. Key words: Delivery of health care; Health; Human activities; Interpersonal relations.