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- ItemAcesso aberto (Open Access)Apontamentos e desafios na redução da mortalidade materno infantil no PET-Saúde GraduaSUS(Universidade Federal de São Paulo, 2021-02-19) Fernandes, Amanda Oliveira [UNIFESP]; Uchôa-Figueiredo, Lúcia da Rocha [UNIFESP]; http://lattes.cnpq.br/3179063226554474; Universidade Federal de São Paulo (UNIFESP)Esta pesquisa problematiza o PET-Saúde/GraduaSUS enquanto uma estratégia formativa que coloca estudantes de diferentes cursos trabalhando colaborativamente em serviços diversos, fazendo uma aproximação do estudante com o campo de trabalho. O objetivo dessa pesquisa foi analisar como os diferentes atores envolvidos: alunos, tutores, preceptores e gestores, de três municípios e em duas IES envolvidas, atuaram no enfrentamento de um problema relevante na Baixada Santista que é a elevada taxa de Mortalidade Materno Infantil. Foi realizado um estudo qualitativo de caráter exploratório e descritivo, a partir da leitura de relatórios e diários de campo produzidos e publicizados pelos participantes do projeto. Os relatos apontam que as experiências proporcionadas pelo PET-Saúde/GraduaSUS, na rede de serviços dos municípios possibilitaram a socialização de muitos saberes, colaborando para que os estudantes tivessem mais confiança e se sentissem aptos para estar vivenciando em campo um trabalho interprofissional, participando de reuniões de equipe e de matriciamento com mais segurança e se sentindo aptos para esta prática. As atividades práticas realizadas nos três municípios repercutiram em novos aprendizados e foram essenciais para estimular o raciocínio clínico, provocar discussões entre os estudantes, tutores, preceptores e gestores, incentivar as trocas em sala de aula, ações estas que foram fundamentais no processo formativo e ações para o combate à Mortalidade Materno Infantil.
- ItemSomente MetadadadosAvaliação de experiências interprofissionais na graduação em Saúde: construção e validação de um instrumento(Universidade Federal de São Paulo (UNIFESP), 2018-08-31) Regis, Cristiano Gil [UNIFESP]; Batista, Nildo Alves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Interprofessional education (IPE) is currently recognized as the main strategy for training health workers ready for teamwork. Evaluating IPE is a matter of debate due to the diversity of methods used. There is a predominance of quantitative instruments, especially Likert-type attitudinal scale. Brazil follows the worldwide movement of implementation of IPE initiatives in different levels of the learning continuum. This research aims to construct and validate an instrument to evaluate students' attitudes regarding IPE initiatives during pre-qualification education suitable to the Brazilian reality. We performed a study with multiple strategies of production and data analysis, involving qualitative and quantitative approaches implemented sequentially. Based on Pasquali's model for the elaboration of psychological tests, we performed: (1) a systematized review of IPE measurement instruments in pre-qualification education to analyze its characteristics, (2) content analysis to identify the dimensions that the instruments aim to evaluate and elaboration of a conceptual model, (3) construction of a pilot instrument (4) application of the pilot instrument to a sample of the population and (5) identification of evidence of validity based on test content, internal structure and relation to other variables. The review showed that Likert-type scales are the most used around the world and have from 16 to 31 items grouped in factors or subscales. However, there is little congruence in the grouping. The content analysis resulted in four categories that represent the dimensions that the instruments intend to evaluate: the potential of IPE in teamwork training, the impact of collaborative interprofessional practice on health care, teamwork and the knowledge, image and interaction among team members. Although being developed for undergraduate students, the instruments demand that they answer them as they were health workers. The review based the elaboration of a conceptual model that includes student engagement in IPE, its development and the engagement in teamwork. According to the conceptual model, a set of 31 items was elaborated grouped in four dimensions: (1) IPE as a training strategy for teamwork; (2) characteristics in interprofessional learning; (3) interaction among professions and (4) development of collaborative competencies. The theoretical analysis of items with seven expert judges and eight judges representing the target population resulted in the reformulation of 21 items and the exclusion of three. The pilot instrument was composed of a 28-item Likert-type scale and a questionnaire identifying age, sex, prequalification course and term. It was applied to a sample of 433 students from three IPE initiatives. Using the Mplus 7 software, exploratory factorial analyzes were performed using the Exploratory Structural Equation Modeling (ESEM) method, using the polychor correlations matrix as the information source, the Weighted least squares means and varianceadjusted (WLSMV) method for estimation and oblique rotation GEOMIN to estimate the correlations between the extracted factors. Adjustment indices appropriate to the model (0.95; 0.05 and 0.06) were given by Comparative fit index (CFI), Root mean square error of approximation (RMSEA) and its standardized version (SRMR), respectively. Two factors were extracted: (1) educational process for the development of collaborative competencies and (2) relevance of IPE and interaction among professions, 13 items each, with significant correlation (0.65) and satisfactory internal consistency by Cronbach's alpha (0.87 and 0.77) and Omega (0.91 and 0.82). There were significant differences (p <0.05) in the means of the factors depending on the students features, calculated by Student t test and ANOVA test and their non-parametric equivalents, the Mann-Whitney test and Kruskal-Wallis test. The instrument presents evidence of validity based on content, internal structure and relationship with other variables, and can be used to evaluate Brazilian IPE initiatives.
- ItemAcesso aberto (Open Access)Cuidando do cuidador: um espaço potencializador de educação permanente com equipes de estratégia de saúde da família(Universidade Federal de São Paulo, 2015-10-30) Alcântara, Débora Barbosa e [UNIFESP]; Liberman, Flávia [UNIFESP]; http://lattes.cnpq.br/8790313628912498; http://lattes.cnpq.br/8401729911075273; Universidade Federal de São Paulo (UNIFESP)With the elaboration of SUS, afther the Health Reform, new paradigms have become a part of the routine of health professionals in Brazil. the medical logic focused and the hospital-centric system, lose space out to the longitudinal follow-up, prevention and health promotion to people, regarding the health concept. The new reality makes the profile of the new working professionals adapt to new paradigms that are devoted to life production. Spaces, named by the Ministry of Health, such as Permanent Education ("Educação Permanente"), were created to facilitate this passage. The current study decided to discuss how this tool has been used, to propose a mechanism that in fact enhances the spaces of the Continuing Education in Primary Health Care ("Educação Permanente na Atenção Básica em Saúde"). It has been presented the possibility of eight meetings in the workshop format, intended to improve and facilitate the group processo of two teams of Family Health Strategy, so that they meet their potentials and difficulties regarding the learning needs, uniquely presented, and thus enabling their qualifications to act in this "new" SUS. The chosen method to experiencie this collective process and research was the mapping within the research-intervention, allowing that I could move between the intervention and the observation by lurking around. The meetings have provided delicate changes on the health work of these teams and the perceptions that these have on theis collective. To set these meetings through narratives, photograph and video records, brought an aesthetic perspective to the events, unraveling in the processes, the relevance of the reserach as being a space that has created a power to listen, recognize and investigate situations brought by workers and as an opportunity to "caring for the carers", in the daily work.
- ItemSomente MetadadadosFormação e atuação interprofissional no Centro Pró-Sorriso da Universidade de Alfenas - Unifenas: Trabalho em equipe e educação interprofissional na atenção às deformidades craniofaciais: uma análise(Universidade Federal de São Paulo, 2017) Ferreira, Gustavo [UNIFESP]; Batista, Nildo Alves [UNIFESP]; http://lattes.cnpq.br/9347541615414055; Universidade Federal de São Paulo (UNIFESP)Introduction: Craniofacial deformities present a complex situation with psychological, physiological and social consequences that require the intervention of a team with a variety of professionals, such as physicians, dental surgeons, nutritionists, psychologists, social workers, from the perspective of a team of one Collaborative Practice. In this context, it is impossible not to mention the Interprofessional Training for this practice. This modality of Innovative Curriculum, whether in undergraduate, postgraduate, continuing education or in permanent formation has been a challenge today. According to WHO, inter-professional education occurs when students from two or more professions learn about each other, with each other and with each other to enable effective collaboration and improve health outcomes. General objective: To investigate the process of formation and permanent education for the teamwork of teachers and students who work in the care of patients with craniofacial deformities with a view to collaborative practice and integral care. Specific objectives: To understand the conceptions of team work and collaborative practice of professionals who work on craniofacial deformities, to raise the difficulties experienced by professionals in their process of permanent education as a health team, and value the incorporation of Interprofessional Education (EIP) to the permanent education of the teams. Method: The study was qualitative and quantitative, of descriptive and exploratory nature, observing the ethical precepts. The research was carried out in two stages: first was the application of the Likert type Attitudinal Instrument where 36 professionals answered, being this one constructed with 3 dimensions based on the objectives of the study. The second step was semi-structured interviews with 15 professionals (a number that occurred due to saturation of information). Likert data were analyzed statistically and content of the interviews by content analysis, thematic modality and the later triangulated data. Results: Respondents, for the most part, agree with the effectiveness of Collaborative Teamwork and understand that this practice should be improved, with the need to intersect areas of professional activity in the daily life of its activities and with the importance of joint planning of actions, understanding that this point should be intensified. Faced with the difficulties experienced in the Permanent Education of the Team, a predominance of the multiprofessional approach of action is observed, the predominance of a multiprofessional permanent education model; The need for practices with protected schedules, training and interprofessional work and with innovative methodologies, existence of variables such as lack of time, few resources, individualism, lack of personal motivation that disrupt the EP of the team. In relation to Interprofessional Education, professionals confuse IPE with fragmented multiprofessional training, recognize the IPE as a training strategy that allows them to acquire a holistic profile of performance and leave more prepared to act in teams with a collaborative profile, perceive that IPE improves professional relationships, increases resolution, decreases costs, reduces stress, humanizes the professional / patient relationship. Conclusions: We hope that this study will subsidize intervention proposals, in a dialogical way, that allow the constant evolution of care for patients with craniofacial deformities, relationship with the community and similar institutions.
- ItemAcesso aberto (Open Access)A formação interprofissional em saúde e processo de produção de narrativas: construindo caminhos de aprendizagem(Universidade Federal de São Paulo (UNIFESP), 2014-06-11) Oliveira, Claudia Maria de [UNIFESP]; Uchôa-Figueiredo, Lúcia da Rocha [UNIFESP]; Batista, Sylvia Helena Souza da Silva [UNIFESP]; http://lattes.cnpq.br/7402359906381953; http://lattes.cnpq.br/3179063226554474; http://lattes.cnpq.br/6642124563233926; Universidade Federal de São Paulo (UNIFESP)The main research objective is describe and analyze the path taken by the students of Federal University of São Paulo - Campus Baixada Santista to produce narratives of life history in Health graduation courses. As specific goals are: identify studied population; investigate complicating and facilitator aspects found by students to produce their narratives; analyze students narrative production effects. This study was developed according to a quantitative-qualitative approach, by an application of a multiple choice questionnaire and semi-structured interviews. 146 students from the Health Work Thematic Area, on the Second Year Graduation Courses in Physical Education, Social Work, Physiotherapy, Occupational Therapy and Nutrition, in 2013 were invited to fill out a questionnaire, in order to characterize them as readers and writers. From these students, a sample of 18 was selected for monitoring their narrative process production during six months, by semi-structured interviews applications. These interviews were carried out in 3 phases, recorded in accordance with interviewees consent, and then transcribed. The categorization and analysis of data process was based on content analysis techniques. The results pointed that the main difficulties encountered in students narrative production process are in maintain narrated facts fidelity; pieces of information chronological organization; pieces of information choice to write in pairs using this textual genre. Pair narratives writing was also nominated as facilitator aspect. In addition, lack of writing rules and teacher supervision in classroom are considered facilitator aspects as well. Other results indicated that narratives production in pairs process by students from different Graduation Courses facilitates listening, raises awareness of teamwork, promotes agreements and professional and personal respect. It was observed that as impacts caused by textual genre production experience, on students life-styles, this activity contributed to improve students sensitive listening; College students recognize the importance of patient's life context as a complementary element to disease diagnosis; the conscience to offer more humanized service and a therapeutic relationship was aroused. Furthermore, the activity enabled breaking paradigms and prejudices; overcoming differences between pairs Areas and helped students to understand themselves better from history of others.
- ItemAcesso aberto (Open Access)Formação profissional em saúde na perspectiva do trabalho em equipe e da integralidade no cuidado: percepção de estudantes.(Universidade Federal de São Paulo (UNIFESP), 2014-10-30) Souza, Alexandra de [UNIFESP]; Rossit, Rosana Aparecida Salvador [UNIFESP]; http://lattes.cnpq.br/3333865775403342; Universidade Federal de São Paulo (UNIFESP)As políticas indutoras de Educação e Saúde têm impulsionado as universidades brasileiras a refletir e agir, no sentido de liderar a proposição, implementação e avaliação de ações educacionais e pedagógicas inovadoras, desafiadoras em prol de uma formação de profissionais da saúde aptos para atender as demandas e as necessidades da população com habilidades e competências que priorizem o trabalho em equipe, a humanização dos serviços de saúde, a interdisciplinaridade, a integralidade no cuidado e a melhoria da qualidade dos serviços ofertados à comunidade. Entende-se por competência, o resultado de um conjunto de conhecimentos, habilidades e atitudes, que conferem ao profissional de saúde condições para desenvolver seu trabalho na perspectiva do trabalho em equipe para conferir maior resolutividade nos serviços de saúde. Nesta perspectiva, o presente estudo teve como objetivo analisar a formação de profissionais da saúde na perspectiva da integralidade no cuidado e construir uma matriz que subsidie o planejamento e avaliação de competências. Primeiramente, foi realizada a análise documental dos projetos pedagógicos dos 11 cursos de formação em saúde da UNIFESP, dos princípios do Sistema Único de Saúde e das Diretrizes Curriculares Nacionais dos cursos da saúde. Em seguida, o questionário de Medida da Disponibilidade para Aprendizagem Interprofissional (PEDUZZI e NORMAN, 2012), em escala Likert, foi aplicado com a ampliação de outros dois fatores. A aplicação foi realizada de modo presencial em cada curso de graduação em saúde da UNIFESP: educação física, enfermagem, fisioterapia, fonoaudiologia, medicina, biomedicina, farmácia, nutrição, psicologia, serviço social e terapia ocupacional. Dentre 218 estudantes convidados a responder o questionário, 187 estudantes concluintes dos referidos cursos completaram o instrumento, que teve como ênfase avaliar o preparo para o trabalho em equipe e a integralidade no cuidado na percepção dos estudantes. Os dados receberam tratamento estatístico: análise exploratória dos dados com média, mediana, desvio padrão, frequência absoluta e relativa, Análise Fatorial, Alpha de Cronbach e o Teste do Sinal. Os resultados indicam que os currículos atendem aos princípios estabelecidos pelas DCNs e na percepção dos estudantes concluintes, o desenvolvimento de inúmeras competências foram facilidades durante o processo de formação. Analisando cada fator separadamente por curso, observou-se comportamentos muito similares entre os mesmos. Das 36 assertivas, a maioria encontra-se em zona de conforto, oito assertivas mostram-se em zona de alerta. Os cursos de farmácia, psicologia, serviço social e terapia ocupacional sinalizam zona de perigo apenas para a assertiva A20 que se refere à função do profissional par a atenção centrada no paciente. O produto resultante deste estudo foi a construção de uma matriz que tem por finalidade auxiliar no planejamento e avaliação de competências para a formação profissional nos cursos da área da saúde. Esse produto será socializado com os coordenadores dos cursos da UNIFESP no sentido de subsidiar o aprimoramento da formação em saúde.
- ItemSomente MetadadadosPercepção de fisioterapeutas sobre a formação profissional para o trabalho em equipe e a prática colaborativa(Universidade Federal de São Paulo, 2016) Alves, Dulcimar Batista; Rossit, Rosana Aparecida Salvador; http://lattes.cnpq.br/3333865775403342; http://lattes.cnpq.br/3967882054018234The “Diretrizes Curriculares Nacionais” for Physical Therapy Graduation Course is a curriculum guideline that lists general and specific skills and abilities to be developed by students during graduation. The document is substantiated on the perspective of social and healthcare needs, comprised by the Brazilian Public Health System “Sistema Único de Saúde” (SUS) and aims to encourage critical thinking and productive reasoning based on the main public health issues, valuing practical knowledge regularly produced in health facilities that ought to be linked with the information produced at the University. In 2010 the World Health Organization recognizes that teamwork and collaborative practice can encourage better resolution, improve quality and strengthen health services. The present study aimed to identify physical therapists’ perception about their training for teamwork and collaborative practice through an exploratory research with qualitative and quantitative approaches. An assessment questionnaire, hosted on GoogleForms, was answered by 67 physical therapists’ active in public and private health care services and includes identification data, information on vocational training, 27 assertions in Likert type scale, open-ended questions regarding professional practice skills for teamwork and suggestions to implement and enhance teamwork in the clinical environment. All participants of this study have more than one year of professional practice and signed the consent form. Using the collected data, an exploratory statistical analysis was carried out searching for indicators to demonstrate the physical therapists’ perception concerning the skills developed during their training regarding teamwork and collaborative practice. The outcomes of the research indicated that there are still some difficulties perceived in clinical scenarios regarding teamwork and collaborative practice, especially underlining the patient as the main focus of attention, instead of the still prevailing biomedical model focused on the disease and the doctor. Regarding the development of skills and abilities for teamwork, it seems that even being present during training, this does not guarantee the effectiveness collaborative work practices in clinical scenarios.
- ItemEmbargoA prática interprofissional colaborativa no trabalho em equipe no cenário profissional de Terapeutas Ocupacionais que trabalham na área da infância(Universidade Federal de São Paulo, 2023-01-11) Campanha, Ana Julia [UNIFESP]; Uchôa-Figueiredo, Lúcia da Rocha [UNIFESP]; http://lattes.cnpq.br/3179063226554474; http://lattes.cnpq.br/5812398004565376; Universidade Federal de São Paulo (UNIFESP)A Prática Interprofissional colaborativa (PIC) em saúde é uma estratégia de trabalho para melhorar os resultados das práticas em saúde em todo o mundo, colaborando positivamente para percepção e eficiência das relações de trabalho em equipe e aos cuidados em saúde, revelando-se como uma proposta de alta importância por reverter o modelo de atenção à saúde hegemônico, aumentando a resolutividade do trabalho em equipe, respeitando a integralidade do indivíduo. Este estudo é um recorte de uma pesquisa de Iniciação Cientifica realizado em 2021, para este Trabalho de Conclusão de Curso (TCC) o foco serão os profissionais que trabalham com o público infantil. Desta forma o objetivo desta pesquisa foi compreender a Prática Interprofissional Colaborativa no cotidiano do trabalho das equipes de saúde em diferentes serviços na área da infância. Estudo quali-quantitativo de campo exploratório descritivo. Como método optou-se por utilizar a Escala de Avaliação da Colaboração Interprofissional em Equipe (AITCS II-BR), instrumento diagnóstico elaborado para medir a colaboração interprofissional e perguntas abertas. Participaram deste estudo 13 profissionais Terapeutas Ocupacionais que trabalham em serviços da área da saúde, especificamente na infância, sendo alguns profissionais egressos da UNIFESP campus Baixada Santista e outros profissionais formados em outras instituições de ensino superior. Os resultados do instrumento AITCS II-BR foram analisados usando o mapa comportamental de cores, para tal as médias de cada uma das assertivas foram calculadas. Para a entrevista semiestruturada utilizou-se a análise de conteúdo de Bardin. Os resultados apontam sobre a importância de uma formação acadêmica voltada para a Educação Interprofissional em Saúde, que as práticas compartilhadas colaboram para o aprendizado do trabalho em equipe e da Prática Interprofissional colaborativa, e que o processo vivenciado durante a graduação com a clínica ampliada reflete diretamente no cuidado integral e centrado na pessoa, família e comunidade. Considerações Finais: Há muitos paradigmas e desafios a serem enfrentados, porém, já é perceptível as mudanças que essa prática faz no dia a dia de quem se propõe a usar ou a trabalhar em equipe interprofissional. Ficando evidente que a sociedade se beneficia de profissionais dispostos a dialogar, comunicar e entrar em um consenso sobre cada caso, sem deixar de lado o olhar centrado nas pessoas, família e comunidade.
- ItemAcesso aberto (Open Access)Processo educacional interprofissional participativo de prevenção de broncoaspiração: perspectiva da andragogia(Universidade Federal de São Paulo (UNIFESP), 2018-08-30) Motoyama, Caio Sussumu de Macedo [UNIFESP]; Tanaka, Luiza Hiromi [UNIFESP]; Santana, Carmen Lúcia Albuquerque de [UNIFESP]; http://lattes.cnpq.br/6606709740942303; http://lattes.cnpq.br/9047748805998095; http://lattes.cnpq.br/8114846502789870; Universidade Federal de São Paulo (UNIFESP)Introduction: Interprofessionality presents itself as a condition of integrality in health care, as a result of the effort and confluence of various knowledge of the concrete and singular space of the health service, with work organized in a cooperative way, contemplating activities and routines that reflect learning with and on the different members of the health team. Knowing possibilities of constructive and dialogued interaction implies knowing the totality of the work process. Objective: To understand and analyze the educational process in a participatory interprofessional format, in an andragogical perspective, through the implementation of an educational action to prevent bronchoaspiration in an intensive care unit of a university hospital in São Paulo. Method: Research of qualitative approach in which the methodological strategy of action research was used. An educational action was implemented through interprofessional focus groups, composed of nurses, physiotherapists, speech therapists, physicians, nutritionists and nursing technicians, for the collective construction of a protocol for the prevention of bronchoaspiration, based on the theory of andragogy. Subsequently, an interprofessional training was carried out on the protocol with the collaborators of the ICU multiprofessional team. At the evaluation stage, a comparative study was carried out between the pre- and post-educational activities in which the data collection of the care involving the prevention of bronchoaspiration was carried out by means of a questionnaire, systematic observation of the bedside and analysis of medical records. And the techniques of individual interviews and focus group with the multiprofessional team and with the collaborators who participated in the training. Results: The meetings through focus groups and interviews showed that the interaction provided by the educational action brought greater understanding of the interprofessional educational process and strengthened the awareness of the importance of establishing learning relationships in the work team, motivating the team in the search for strategies to intensify this educational interprofessional exchange, through the proposal of organization deliberated by the group to carry out periodic multiprofessional visits. The objective data after the educational action showed significant statistical differences, such as the increase in the performance of nurses and nursing technicians in the questionnaires, as well as a significant evolution in the performance of bronchoaspiration prevention actions in the systematic observation in the field, such as standardization of the fate given to the residual gastric volume, and in the medical record, on the measurement of cuff pressure and oral hygiene. The good performance of these nursing professionals can be attributed to the fact that the training was carried out from the andragogical perspective and from the interprofessional perspective. Final considerations: Adult learning has a greater potential for success, from the organization of actions using formats that favor dialogue, through teaching-learning techniques that observe andragógical principles. The construction of educational actions in the interprofessional format may be an even more promising path when these andragogical concepts are observed.