https://repositorio.ufba.br/handle/ri/9276 2026-04-17T11:00:09Z https://repositorio.ufba.br/handle/ri/44012 Título: Práticas assistenciais e experiências de gestantes em Centro de Parto Normal Peri Hospitalar (CPNp): análise de conformidade com diretrizes nacionais e internacionais Autor(es): Ribeiro, Thais de Sena Primeiro Orientador: Couto, Telmara Menezes Abstract: Childbirth care practices in Brazil are diverse and often marked by interventions that influence and shape the experiences of pregnant women. However, in Peri-Hospital Birth Centers (CPNp), childbirth tends to respect both the physiological process and women’s autonomy. Therefore, this study aimed to analyze whether women's experiences and the care practices provided during labor and birth in a CPNp are in compliance with national and international guidelines. A mixed-methods approach was adopted, specifically a convergent parallel design, using secondary data extracted from the database of the study "Being Born in Birth Centers in Brazil", at the local level. Data collection took place in a CPNp located in the city of Salvador, Bahia, from May to September 2023. For qualitative analysis, Thematic Content Analysis as proposed by Bardin was employed. Quantitative data were analyzed using a framework of variables that presented care practices across the different stages of labor, based on recommended guidelines, along with descriptive statistics. The results revealed a high degree of alignment, indicating that both the women's reported experiences and the care practices at the CPNp were consistent with established guidelines. Of the 173 women who participated in the study, 94 shared their experiences; 87.9% of them were Black, aged between 20 and 34 years, and had no comorbidities. From the qualitative data, the following category emerged: Women's experiences during labor in a Peri-Hospital Birth Center in relation to the care received. All participants were admitted during the active phase of labor; 93.6% did not undergo amniotomy, 92.5% did not receive oxytocin, 99.4% did not undergo episiotomy, and skin-toskin contact was performed in 95.4% of newborns. It is concluded that the care practices in the Peri-Hospital Birth Center (CPNp) occurred with a frequency exceeding 80%, in accordance with the recommended guidelines, aligning with the women's reports, who perceived the care as attentive and described their experiences as positive. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação 2025-08-25T00:00:00Z https://repositorio.ufba.br/handle/ri/43372 Título: Percepção de pessoas idosas sobre alimentação saudável e envelhecimento Autor(es): Costa, Jessica Santos Primeiro Orientador: Menezes, Tânia Maria de Oliva Abstract: The perception of aging among older adults is considered a good indicator of healthy aging. The aging process is complex and associated with many changes. In this context, nutrition is one of the fundamental factors for healthy aging. The objectives of this research were: General: to understand older adults' understanding of healthy eating and aging. Specific: to identify the factors related to nutrition that influence aging; to determine what dietary changes occur with aging; to identify how food is prepared during aging; and to reveal the importance of nutrition in aging. This is an exploratory, descriptive study with a qualitative approach, conducted with older adults attending a day center at a Geriatric and Gerontological Center in Salvador, Bahia. Participants were older adults aged 60 or older, lucid, globally oriented (time, space, and situation), and capable of verbal communication. The data collection was conducted using a sociodemographic questionnaire and semi-structured interviews between July and August 2024. The data were analyzed using Bardin's Content Analysis technique. This research complied with all ethical requirements, in accordance with the requirements set forth in Resolution No. 466/12. The analysis of the data enabled the understanding of the following categories: 1. Older adults' perceptions of healthy eating and aging; 2. Healthy eating and socioeconomic conditions; 3. Food preparation; 4. Changes in diet with aging; 5. Importance of healthy eating for aging. The study found that older adults perceive healthy eating as an important factor in aging. Maintaining a healthy diet establishes a relationship of prevention and health promotion for older adults. Factors such as socioeconomic conditions directly impact participants' food choices and aging processes. Given the context of rapid population aging and the need for greater training of health professionals and services, the study will contribute to a better understanding of the dietary patterns of elderly people by nutritionists, as well as by health professionals who work with this population segment. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação 2025-06-17T00:00:00Z https://repositorio.ufba.br/handle/ri/43316 Título: Avaliação da Rede de Atenção às Urgências e Emergências na Assistência ao Infarto Agudo do Miocárdio à Liz da Teoria Donabediana Autor(es): Pereira Filho, Edilson da Silva Primeiro Orientador: Teixeira, Giselle Alves da Silva Abstract: This dissertation aimed to evaluate the effectiveness of the Emergency Care Network in the assistance provided to acute myocardial infarction, based on Donabedian’s theory structured in the dimensions of structure, process, and outcomes. It is an evaluative study, with a qualitative and descriptive approach, conducted through the analysis of secondary data extracted from the Department of Informatics of the Unified Health System, the National Registry of Health Establishments, and the State Health Plan of Bahia. The timeframe covered the period from 2013 to 2023, enabling the analysis of a decade of network evolution through indicators of coverage, access, care processes, and outcomes related to acute myocardial infarction. The object of study is part of the cardiovascular line of care, defined as a priority by the National Policy for Emergency Care due to the high mortality of ischemic heart diseases and the timedependent condition of acute myocardial infarction. The choice of this condition as a tracer event was based on its epidemiological relevance and the possibility of measuring objective indicators of the network’s response. The theoretical model adopted was Donabedian’s structure–process–outcome triad, which allows the articulation of available material and organizational conditions, the way services are delivered, and the effects generated on the population’s health, composing a comprehensive evaluation of the network’s effectiveness. The results revealed both advances and weaknesses. In the dimension of structure, the presence of bases of the Mobile Emergency Care Service, Emergency Care Units, and referral hospitals was identified, although unevenly distributed, which highlighted important care gaps. Shortages of intensive care unit beds and coronary care units, along with the concentration of hemodynamic services in Salvador, compromised territorial equity. Regarding care processes, the gradual incorporation of clinical protocols, the implementation of risk classification, and the regulatory role of the mobile emergency service contributed to improving the network’s response. However, failures persisted in the integration between care points, heterogeneous response times, limited availability of pre- and in-hospital thrombolysis, the absence of primary angioplasty in the territory, and reduced articulation with primary health care. These factors compromise the comprehensiveness of care and the full achievement of effectiveness. In terms of outcomes, a paradox was observed: the Northeast Regional Health District presented lower hospital morbidity rates for acute myocardial infarction and, simultaneously, mortality rates also lower than the state average. These findings, although they may indicate resolvability in certain cases, raise the hypothesis of underreporting and flaws in the recording of health information systems, pointing to the need to improve data quality. The critical analysis demonstrated that, although the objectives were achieved by mapping the network, measuring indicators, and discussing its effectiveness structural and organizational limitations persist, revealing a mismatch between the normative design of the policy and its implementation in the territories. In the Northeast Regional Health District of Bahia has achieved significant advances but has not yet reached full effectiveness. More than the existence of isolated services or indicators, effectiveness translates into the ability to provide timely, integrated, and resolutive responses to the population’s needs. The evaluation carried out reaffirms the importance of evaluative research as a scientific and political tool, essential to strengthening the Unified Health System as a public, universal, and equitable system. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação 2025-08-28T00:00:00Z https://repositorio.ufba.br/handle/ri/43153 Título: Sentido de ser enfermeira no Serviço de Atendimento Móvel de Urgência Autor(es): Lírio, Layse Kelle Silva Primeiro Orientador: Santa Rosa, Darci de Oliveira Abstract: Understanding the meaning of being a Mobile Pre-hospital Care Nurse. This is a qualitative study with a comprehensive approach based on Victor Frankl's theoretical analysis. It was conducted through a phenomenological interview with 11 nurses working in Decentralized Bases of the Mobile Emergency Care Service in the Northeast Microregion, Bahia. The phenomenological interview was used for data collection, with prior authorization from the research subject, respecting the ethical issues involving field research using an approach question: What does it mean to you to be a SAMU nurse? And two guiding questions: What does it mean to you to be a nurse working in the mobile emergency care service? And, How do you experience situations that generate suffering in mobile pre-hospital emergency care? The steps of the Triadic Configuration (humanistic, existential, personalistic) were followed as the analysis method. Four thematic categories emerged: Being a nurse in SAMU is experiencing the decision-making process and suffering in care relationships; Being a nurse in SAMU is experiencing the noogenic tension that emerges during professional action; Being a nurse in SAMU is realizing the fulfillment of Franklinian values; Being a nurse in SAMU makes it possible to fulfill life purposes and find meaning in life. The synthesis of the categories made it possible to understand the meaning of being a nurse who works in SAMU in line with feelings of sadness, fear and anguish that cause suffering among these professionals during the practice of care, due to the difficulties encountered during care in an adverse scenario that enhances emotional imbalance. However, the responsibility of acting based on ethics and morals transcends the technical conduct of the care provided by the study participants and gives rise to a feeling of gratitude permeated by experiences and knowledge of professional practice. The study revealed only one facet of the phenomenon identified by a specific group in a defined time and space, which does not allow for a broader understanding of the meaning of being a nurse in the practice of care. We thus learn that the sense experienced by nurses permeated by suffering can contribute to a new approach to care actions motivated by respect for life and humanization in the pre-hospital care setting. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação 0001-02-02T00:00:00Z