DSpace Coleção:http://bdtd.uftm.edu.br/handle/tede/102026-07-03T20:10:20Z2026-07-03T20:10:20ZConhecimento e atitudes de profissionais de enfermagem frente aos cuidados paliativos e à terminalidadehttp://bdtd.uftm.edu.br/handle/123456789/20812026-06-30T02:03:20Z2025-10-10T00:00:00ZTítulo: Conhecimento e atitudes de profissionais de enfermagem frente aos cuidados paliativos e à terminalidade
Abstract: Introduction: Palliative care aims to alleviate the suffering of patients and families facing life-threatening illnesses. Nursing professionals are the team capable of determining the greatest impact on the quality of this care. Since palliative care is not always included in professional nursing training, access to continuing education is essential to improve knowledge and attitudes toward patients and their families/caregivers. The objectives of this study were to assess nursing professionals' knowledge of palliative care and attitudes toward end-of-life patients and their families/caregivers before and after an In-Service Education Program. Materials and methods: A quasi-experimental, before-and-after intervention study was conducted, analytically and quantitatively, according to the TREND checklist standardization. All nursing professionals from the internal medicine and neurology units at HC-UFTM were invited to participate in a two-stage in-service education program, consisting of two theoretical classes spaced six weeks apart and a conversation circle with case discussions, between June and October 2024. Knowledge assessment questionnaires (Palliative Care Quiz for Nurses) and attitudes (Frommelt Attitude Toward and Care of the Dying Scale Form B) were administered before the first class and ten weeks later, in addition to a sociodemographic questionnaire. Results: Sixty- one professionals participated, most of them nursing technicians, women, with a mean age of 41, White, married or in a stable relationship, with higher education and more than 10 years of professional experience. Most had not received palliative care education during their training, had not participated in events on the topic, considered their knowledge in the area insufficient, and had personal experience with terminal illness. Participants initially scored insufficient on the PCQN (9.0 points), rising to
10.6 in the post-test. From the outset, they demonstrated adequate attitudes according to the FATCOD-B (112.2), improving further to 115.2 in the post-test. The improvement in knowledge and attitudes was statistically significant (p 0.000 and p 0.003, respectively) and had a small effect size. Higher knowledge was demonstrated by women, individuals of Christian faith, nursing technicians, professionals with higher education and postgraduate degrees, those who considered themselves unprepared in palliative care but who had taken specific palliative care courses in their training, and those who had participated in courses or events on the topic. More positive attitudes were observed among professionals who had not taken courses addressing palliative care in their training. Conclusions:
Nursing professionals presented insufficient knowledge in PC and adequate attitudes towards terminality, which increased significantly after the in-service education program, reaching sufficient knowledge and even more positive attitudes.
Tipo: Tese2025-10-10T00:00:00ZValidação da escala de autoeficácia para a autogestão na saúde em uma amostra de idosos brasileiroshttp://bdtd.uftm.edu.br/handle/123456789/20552025-11-13T02:03:01Z2023-04-12T00:00:00ZTítulo: Validação da escala de autoeficácia para a autogestão na saúde em uma amostra de idosos brasileiros
Abstract: The concept of self-efficacy (SE) was introduced in 1977 and refers to the individual's
convictions in relation to their cognitive, motivational and behavioral skills necessary to
perform a specific task at a given time and context. With population aging, there is a need to
identify the factors that correlate with the health conditions of older adults, including SE. The
Self-Efficacy Scale for Self-Direction in Health (SSSH) is an instrument developed in Portugal,
in Portuguese, consisting of 16 items divided into four dimensions, with five response options
that assess the belief of older adults to self-manage their health. This study aimed to crossculturally
adapt the SSSH for use in Brazil and evaluate its psychometric properties in a sample
of Brazilian older adults. This study, approved by the Research Ethics Committee of the Federal
University of Triângulo Mineiro, approved number 5.243.997, is methodological, conducted in
two stages: cross-cultural adaptation of the EAAS and validation of the internal structure of the
adapted version. The cross-cultural adaptation followed national and international
recommendations, namely: translation, evaluation by a committee of judges, back-translation,
semantic evaluation and pre-test. Psychometric properties were assessed through validity and
reliability. Face and content validities and construct validities were evaluated: dimensional,
convergent and by known groups. Reliability was analyzed using internal consistency and testretest.
In the cross-cultural adaptation stage of the SSSH into Brazilian Portuguese, the adapted
version showed semantic, idiomatic, conceptual and cultural equivalence, face and content
validity. The evaluation phase of the psychometric properties of the adapted version involved
the participation of 201 community-dwelling older adults, registered in the Family Health
Strategy-Abadia 1 in the city of Uberaba-MG. Regarding dimensionality, the model showed
adequate adjustment to the proposed dimensional structure in all parameters χ2 (161.507;
p≤0.001), Root Mean Square Error of Approximation (0.057; p≤0.05), Goodness of Fit Index
(0.912) , Tucker-Lewis Index (0.945), Comparative Fit Index (0.955). The convergent construct
validity was evidenced through the correlations between the total SSSH scores and the variables
instrumental activities of daily living, self-esteem, positive affectivity, negative affectivity,
satisfaction with life and age. Construct validity by known groups was confirmed by comparing
the means of the SSSH dimensions with the variables gender, age and marital status. The testretest
reproducibility confirmed the temporal stability of the instrument and the internal
consistency was adequate (α= 0.83), indicating the reliability of the SSSH. It was concluded
that the cross-cultural adaptation process of the version was successfully completed and that
the psychometric analysis of the adapted version of the SSSH gathered good evidence of
validity and reliability, and can be used with the Brazilian older adults population.; El concepto de autoeficacia (AE) se introdujo en 1977 y se refiere a las convicciones del
individuo en relación con sus habilidades cognitivas, motivacionales y conductuales necesarias
para realizar una tarea específica en un momento y contexto determinados. Con el
envejecimiento de la población, surge la necesidad de identificar los factores que se
correlacionan con las condiciones de salud de los ancianos, incluida la AE. La Escala de
Autoeficacia para la Autodirección en Salud (EAAS) es un instrumento desarrollado en
Portugal, en portugués, que consta de 16 ítems divididos en cuatro dimensiones, con cinco
opciones de respuesta que evalúan la creencia de los ancianos para autogestionar su salud. Este
estudio tuvo como objetivo adaptar transculturalmente la Escala de Autoeficacia para la
Autodirección en Salud (EAAS) para uso en Brasil y evaluar sus propiedades psicométricas en
una muestra de ancianos brasileños. Este estudio, aprobado por el Comité de Ética en
Investigación de la Universidad Federal del Triângulo Mineiro, aprobado por dictamen número
5.243.997, es metodológico, realizado en dos etapas: adaptación transcultural de la EAAS y
validación de la estructura interna de la versión adaptada.. La adaptación transcultural siguió
las recomendaciones nacionales e internacionales, a saber: traducción, evaluación por un comité
de jueces, retrotraducción, evaluación semántica y pre-test. Las propiedades psicométricas se
evaluaron a través de la validez y la confiabilidad. Se evaluaron validez de cara, de contenido
y de constructo: dimensional, convergente y por grupos conocidos. La confiabilidad se analizó
mediante consistencia interna y test-retest. En la etapa de adaptación transcultural de la EAAS
para el portugués brasileño, la versión adaptada mostró equivalencia semántica, idiomática,
conceptual y cultural, validez aparente y de contenido. La fase de evaluación de las propiedades
psicométricas de la versión adaptada contó con la participación de 201 ancianos residentes en
la comunidad, registrados en la Estrategia Salud de la Familia-Abadia 1 en el municipio de
Uberaba-MG. En cuanto a la dimensionalidad, el modelo mostró un adecuado ajuste a la
estructura dimensional propuesta en todos los parámetros χ2 (161.507; p≤0.001), Root Mean
Square Error of Aproximation (0.057; p≤0.05), Goodness of Fit Index (0.912), Tucker-Lewis
Índice (0,945), Índice de ajuste comparativo (0,955). La validez de constructo convergente se
evidenció a través de las correlaciones entre los puntajes totales de la EAAS y las variables
actividades instrumentales de la vida diaria, autoestima, afectividad positiva, afectividad
negativa, satisfacción con la vida y edad. La validez de constructo por grupos conocidos se
confirmó comparando las medias de las dimensiones de la EAAS con las variables sexo, edad
y estado civil. La reproducibilidad test-retest confirmó la estabilidad temporal del instrumento
y la consistencia interna fue adecuada (α= 0,83), indicando la confiabilidad de la EAAS. Se
concluyó que el proceso de adaptación transcultural de la versión se completó con éxito y que
el análisis psicométrico de la versión adaptada de la EAAS reunió buenas evidencias de validez
y confiabilidad, y puede ser utilizado con la población anciana brasileña.
Tipo: Tese2023-04-12T00:00:00ZSintomas psicoemocionais e qualidade de vida de pacientes com câncer em quimioterapia: estudo longitudinalhttp://bdtd.uftm.edu.br/handle/123456789/20542025-11-11T02:03:06Z2025-05-28T00:00:00ZTítulo: Sintomas psicoemocionais e qualidade de vida de pacientes com câncer em quimioterapia: estudo longitudinal
Abstract: Introduction: Cancer diagnosis and treatment have a negative impact on patients' physical, psychological, and social aspects, and may reduce their health-related quality of life and cause psychoemotional symptoms such as depression, anxiety, and stress. Objective: To evaluate the presence of psychoemotional symptoms and health-related quality of life in cancer patients during chemotherapy treatment. Method: This is a prospective, quantitative, descriptive, and longitudinal study developed in a chemotherapy center of a public hospital. Data were collected in two moments: the first occurred in the first session of the first, second, or third cycle of chemotherapy, and the second moment was 21 days after the first. Patients aged 18 years or older, of both sexes, diagnosed with cancer in initial treatment were included. The instruments used were: Sociodemographic and Clinical-Therapeutic Questionnaire; Depression, Anxiety, and Stress Scale; and Quality of Life Questionnaire-Core30. For data analysis, the normality test was used, followed by the paired t-test, the t-test for independent groups, and the Pearson test. In case of violation of the normality test, the nonparametric Wilcoxon test was performed. The level of statistical significance was set at 5%. Data were analyzed using the Statistical Package for the Social Sciences version 21.0. The study was approved by the Research Ethics Committee. Results: Thirty-five patients participated, with a mean age of 61.97 years. Most were white, married, Catholic, retired women with low income and low education. The most frequent cancers were: colorectal, breast, and lung, without metastasis. Stress presented the highest means (4.4 and 3.25), with a decrease between collection times, unlike anxiety (means: 2.62 and 2.85) and depression (means: 1.65 and 2.71), which increased. In the evaluation of the Quality of Life Questionnaire-Core30 instrument, the global health scale obtained an adequate score (means: 68.09 and 70.94) and the cognitive (means: 84.76 and 87.14) and social (means: 79.99 and 82.85) functions had the best means. In the symptom scale, insomnia (mean: 41.90) and pain (mean: 34.76) were prevalent in the first collection, while loss of appetite (mean: 50.47) and fatigue (mean: 42.53) were prevalent in the second collection. The variables loss of appetite and diarrhea were statistically significant in the comparison of means. Depression was the variable that showed the highest correlation with quality of life at both collection times. Age and sex showed the highest number of associations with quality of life. Conclusion: During chemotherapy treatment, patients showed reduced stress but
reported increased anxiety and depression, the latter correlated with physical function, fatigue, nausea and vomiting, and insomnia. Quality of life was considered satisfactory, with elderly patients having higher means for emotional function (T1), nausea (T1), pain (T1), and diarrhea (T1) when compared with adult patients; while women had higher means for loss of appetite (T1), diarrhea (T1 and T2), cognitive function (T2), nausea and vomiting (T2) compared with men.
Tipo: Dissertação2025-05-28T00:00:00ZAssistência a crianças com transtorno do espectro autista: vivências de enfermeiros/enfermeiras na atenção primáriahttp://bdtd.uftm.edu.br/handle/123456789/19822025-07-23T02:02:41Z2024-05-29T00:00:00ZTítulo: Assistência a crianças com transtorno do espectro autista: vivências de enfermeiros/enfermeiras na atenção primária
Abstract: Autism Spectrum Disorder (ASD) is a neurodegenerative disorder whose etiology has not been elucidated and is a neurodevelopmental condition that affects a person's communication, behavior and social interaction. Public policies aimed at the population with ASD in Brazil are recent, which results in a lack of up-to-date data on its prevalence. Children with ASD are at greater risk of developing anxiety, depression, isolation, bullying and even self-harm. Their families also face mental health problems. Given the complexity of these people's needs, it is essential that nurses are trained to offer humanized care. However, despite the importance of the issue and the high number of diagnoses in the country, there is a gap in the training of health professionals from the time they graduate. Although Primary Health Care (PHC) has multi-professional teams, neurodivergent groups, such as people with ASD, still receive little attention. In view of this, the aim of this study was to analyse nurses' experiences of caring for children with Autism Spectrum Disorder in Primary Health Care, in the light of humanization in health. This is a descriptive study, with a qualitative approach, carried out in a municipality in the Triângulo Mineiro, with 16 nurses. Data was collected through semi-structured interviews based on a validated script. The interviews were audio-recorded and transcribed in full. The questions aimed to identify Critical Incidents, using this technique to obtain primary data. The analysis was carried out using the content analysis approach. The project was developed in accordance with the principles of Resolution 510/2016, which regulates research with human beings. The interviews resulted in 19 situations that were revealed as CI, where 15 were negative (78.9%) and 4 positive (21.1%), which involved 149 behaviors, 78 were negative (52.4%) and 71 positive (47.6%) and 39 consequences, 25 were negative (64.1%) and 14 positive (35.9%). Given the predominance of negative situations experienced or observed, it can be concluded that professionals are not properly prepared to offer qualified, resolutive, equitable and humanized care to children with ASD and their families, in accordance with the principles of the National Humanization Policy (NHP). Most of the reports indicated difficulties that prevent the care provided by nurses to these children from being conducted from the perspective of humanization. The results showed that nurses face major challenges when caring for children with ASD, especially in activities such as anthropometry and immunization. The lack of an appropriate approach and training aggravates the difficulties in reception, generating a negative perception in children about their visits to health units. Communication with non-verbal children or those with social limitations is another critical point. Despite these difficulties, the professionals strive to offer humanized care. The study highlights the importance of training PHC professionals to provide more efficient and humanized care to these children, and recommends that management promote training and offer support to both professionals and families.
Tipo: Dissertação2024-05-29T00:00:00Z