http://hdl.handle.net/11422/14 2026-07-31T01:18:28Z http://hdl.handle.net/11422/29868 Title: Redes sociais de pessoas com tuberculose em situação de rua: mapeamento social para atenção à saúde Author(s)/Inventor(s): Sodré, Vitória Regina Domingues Advisor: Souza, Maria Helena do Nascimento Abstract: Introduction: Tuberculosis remains a major public health problem and disproportionately affects highly vulnerable groups, particularly people experiencing homelessness. Objectives: To map the structure of the primary and secondary social networks of people with tuberculosis experiencing homelessness; to identify the types of support provided by social networks for the treatment and control of tuberculosis; and to propose guidelines for Family Health Strategy teams and Street Outreach Clinics that enable the use of a social network approach in the care of people experiencing homelessness with tuberculosis. Method: This qualitative study was conducted through semi-structured interviews with 15 individuals diagnosed with tuberculosis who were receiving care at two primary health care units in Rio de Janeiro, Brazil, between December 2024 and March 2025. Data were analyzed using Bardin’s thematic content analysis technique. Results: The findings showed that the study participants (n = 15; aged 18–59 years) were predominantly male (80%), self-identified as mixed-race or Black (93.3%), and had low educational attainment (66.7% had completed only elementary education). Participants presented small and low-density primary social networks, characterized by a limited number of interpersonal relationships. They reported receiving support from their secondary social networks, composed mainly of health professionals who developed strategies focused on coping, welcoming care, and ensuring access to government social assistance and income-transfer programs. Conclusion: This study highlighted important aspects of how people experiencing homelessness perceive tuberculosis care within the context of their social relationships. Primary social networks were found to be fragile, whereas relationships with secondary networks facilitated the establishment of bonds with health professionals. Among the social support demands identified, material, financial, and emotional support were considered essential for overcoming challenges related to treatment. In situations of extreme vulnerability, tuberculosis treatment is often marked by interruptions and discontinuities, demonstrating the complexity of health care in the absence or fragility of social networks and in the presence of profound socioeconomic difficulties. Therefore, strengthening public policies that address the social networks of vulnerable populations should be prioritized within primary health care. Knowledge of social networks, as well as social support and care needs, constitutes an important tool for Family Health Strategy teams and Street Outreach Clinics, contributing to the successful control and cure of tuberculosis among people experiencing homelessness. Publisher: Universidade Federal do Rio de Janeiro Type: Tese 2026-03-25T00:00:00Z http://hdl.handle.net/11422/29847 Title: Consolidação do centro de testagem e aconselhamento para o vírus da imunodeficiência humana no município de São João de Meriti: contribuições da enfermagem (1997-2005) Author(s)/Inventor(s): Augusto, Patrícia dos Santos Advisor: Almeida Filho, Antonio José de Abstract: This thesis aims to analyze the role of nursing in the process of consolidation of the Counseling and Testing Center (CTA) for HIV/AIDS in the municipality of São João de Meriti, Rio de Janeiro, Brazil, between 1997 and 2005. This is a historical-social study grounded in the perspective of the History of the Present Time, using written, iconographic, and oral documentary sources. The theoretical and methodological framework is based on Pierre Bourdieu’s concepts of field, habitus, and symbolic capital, articulated with Erving Goffman’s theory of stigma, enabling an understanding of the meanings and symbolic effects of nursing practice in the context of the HIV/AIDS epidemic. The findings indicate that the consolidation of the CTA in São João de Meriti took place in a context marked by social inequalities, structural weaknesses in the public health system, and strong stigma associated with HIV/AIDS. In this scenario, nursing played a central role in organizing the service, expanding access to testing, providing counseling, and developing care practices grounded in welcoming, qualified listening, and comprehensive care. Nursing actions contributed to strengthening public health policies at the local level, promoting the decentralization of prevention and diagnostic strategies and fostering stronger bonds between users and health services. It is concluded that, throughout the consolidation process of the CTA/SJM, nursing accumulated symbolic capital and established itself as a strategic agent in the field of HIV/AIDS care, not only in technical and operational terms but also as a political and social actor. This study contributes to the preservation of the institutional memory of the CTA and to the historical recognition of nursing in the response to the HIV/AIDS epidemic, highlighting its relevance in the construction of ethical, humanized, and socially committed care practices aligned with the principles of the Brazilian Unified Health System. Publisher: Universidade Federal do Rio de Janeiro Type: Tese 2026-04-15T00:00:00Z http://hdl.handle.net/11422/29837 Title: Representações sociais das enfermeiras e médicas da atenção primária à saúde acerca da violência de gênero contra as mulheres Author(s)/Inventor(s): Silva, Luana Christina Souza da Advisor: Queiroz, Ana Beatriz Azevedo Abstract: Introduction: The object of the study was the social representations of nurses and physicians regarding gender-based violence against women and its implications for the care of these women in the context of Primary Health Care. Objectives: To identify the contents and meanings that structure and organize the social representations about gender-based violence against women among nurses and physicians working in Primary Health Care; To characterize the strategies used by nurses and physicians in caring for women experiencing situations of gender-based violence; To discuss the implications of these social representations for care in the context of Primary Health Care for women experiencing gender-based violence; To propose strategies based on the social representations of nurses and physicians that contribute to improving care for women experiencing such violence. Methodology: This is a descriptive and exploratory study grounded in the Theory of Social Representations by Serge Moscovici, adopting both structural and processual approaches. A total of 100 professionals participated, including 50 nurses and 50 physicians working in Family Health Clinics in programmatic area 4.0 of the municipality of Rio de Janeiro. Data collection was conducted through a socioeconomic and demographic questionnaire, the Free Word Association Test, and semi-structured interviews. Questionnaire data were analyzed using simple frequency in Excel, while data from the test and interviews were processed through matrix analysis and descending hierarchical classification using the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEq). The research was approved by the Ethics Committee of the Anna Nery School of Nursing, the São Francisco de Assis Health Care Institute, and the Municipal Health Secretariat, under opinion no. 6.142.502. Results: The majority of participants were between 25 and 34 years old, self-identified as white, Catholic, married with children, and held postgraduate degrees. Nurses predominantly worked 40 hours per week, while physicians worked either 20 or 40 hours. In the structural approach, machismo, prejudice, and justice emerged as the central core. Among nurses, an affective and evaluative positive dimension regarding their work emerged, considered rewarding, although also recognized as exhausting and stressful. The understanding of violence against women was associated with family experiences, and care was influenced by personal experiences. Among physicians, a positive evaluation of their work was also identified. Gender-based violence was anchored in intimate partner domestic violence, and the care provided was considered adequate despite difficulties, being guided by strategies built from their experiences. The triangulation of methods allowed the identification of representational fields for each group, highlighting their ways of understanding and acting in relation to the phenomenon. Based on the results, an interactive educational card was developed to support professional practice. Final considerations: It is therefore argued that violence against women is neither linear nor homogeneous and is part of the daily lives of nurses and physicians. Addressing this situation requires integrated strategies, continuous training, strengthening of support networks, public policies, and actions aimed at combating the structural roots of gender inequalities. Publisher: Universidade Federal do Rio de Janeiro Type: Tese 2025-12-15T00:00:00Z http://hdl.handle.net/11422/29834 Title: Efetividade da intervenção breve para o consumo de substâncias psicoativas entre profissionais de enfermagem hospitalar Author(s)/Inventor(s): Falcão, Livia Mendes Advisor: Zeitoune, Regina Célia Gollner Abstract: Introduction: The study focuses on the brief intervention for the consumption of psychoactive substances among hospital nursing professionals, based on evidence that it is necessary to detect early involvement of these professionals with psychoactive substances and intervene in order to minimize the consequences of abusive use, as nursing is considered a vulnerable category for the consumption of these substances. It is necessary to detect early the involvement of these professionals with psychoactive substances and to intervene, in order to minimize the consequences of abusive use, as nursing is considered a category vulnerable to the consumption of these substances. General aim: to evaluate the effectiveness of Brief Intervention for psychoactive substance use among hospital nursing professionals. Method: quasi-experimental. A sample of 264 nursing professionals from a public university hospital. A questionnaire was used to outline the socioeconomic, lifestyle, occupational, and health profile, and the Alcohol, Tobacco, and Other Substances Use Screening Instrument, with follow-up through brief interventions and Readiness Ruler for 6 months when moderate and high-risk consumption was identified. Results: The sample composed mostly of adults over 39 years old, predominantly non-white race and female sex, who lived with a partner, had children, watched streaming at home as their preferred leisure activity, and did not consume psychoactive substances during leisure. They were evenly distributed between nurses and nursing technicians, and most had completed postgraduate studies. The majority were permanent employees, with up to ten years of work at the institution, working daytime shifts, holding a single employment contract, in inpatient care sectors. They reported good health, rarely resorted to self-medication, and frequently reported emotional disorders and arterial hypertension. Alcohol, tobacco, and anxiolytics were the substances most experimented with over their lifetimes, and moderate/high-risk consumption was noted for tobacco, alcohol, sedatives, amphetamines, and marijuana. Even so, the prevalence of participants with moderate/high-risk consumption was considered low compared to the general population. Some characteristics were identified as protective factors, such as having religion; preferring cultural activities for leisure; having dual employment. Conversely, risk factors were understood to include: using psychoactive substances during leisure activities; preferring leisure activities in bars/restaurants; working night shifts; and practicing self-medication. Following the implementation of Brief Intervention, behavioral changes were observed, reflected in a reduction in the frequency of use and the quantity consumed, including cases of cessation of consumption. Conclusion: Based on the results, it is affirmed that the research met its objectives and confirmed its hypotheses, corroborating the effectiveness of the brief intervention. The contribution of this thesis to the scientific field, professional practice, and the health of hospital nursing workers is highlighted, since in addition to outlining the socioeconomic, occupational, and health profile of these participants, the pattern of psychoactive substance use was identified, and the associations between the profiles and this pattern of use were analyzed. As a product of the thesis, educational material on the subject was developed and a reflective essay on the applicability of Dorothea Orem's Theory for brief intervention as a care-education technology. As for the limitations of the study, it is understood that conducting it in a single healthcare unit may affect its results. Publisher: Universidade Federal do Rio de Janeiro Type: Tese 2026-02-09T00:00:00Z