Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFSCAR |
Texto Completo: | https://repositorio.ufscar.br/handle/ufscar/15902 |
Resumo: | Introduction: Clinical reasoning is recognized as a complex phenomenon, intrinsic to practice, studied in Occupational Therapy since the 1980s. One of the factors underpinning clinical reasoning is the framework employed in professional practice. The Dynamic Occupational Therapy Method is a Brazilian framework that has been constructed since the 1970s. Objective: To explore the clinical reasoning of Brazilian expert occupational therapists employing the Dynamic Occupational Therapy Method as the main framework in their professional practice. Methodology: The Constructivist Grounded Theory approach was used to guide this qualitative study. The participants were 10 expert occupational therapists employing the Dynamic Occupational Therapy Method as the main framework in their professional practice. The data were collected through: participant characterization form, individual interviews, group interview, and field journal. The constant comparative analysis method was used for data analysis. The data were collected and analyzed simultaneously. Results: As the Dynamic Occupational Therapy Method was being constructed, specific ways of thinking about practice and acting in practice were also being proposed. Expert occupational therapists who employ the Dynamic Occupational Therapy Method as the main framework in their practice have a clinical reasoning largely supported by this framework. They employ, throughout the practice, three types of reasoning: ethical-aesthetic, associative, and dynamic, structuring their practice dynamically around the three processes proposed in the Dynamic Occupational Therapy Method: 1) construction of the situational diagnostic; 2) establishment and management of the triadic relationship; and 3) dialogical assessment of the therapeutic process/associative paths, processes along which specific characteristics of thinking are also employed. Engaging in post-undergraduate formation and in reflective strategies – such as training after completing their undergraduate in Occupational Therapy, supervision, peer-discussion about their practice, theoretical studies based on their professional practice, and writing about their practices – were factors that contributed to the reasoning expansion of the participants, that became less focused on biomedical aspects and more focused on the health and on the expansion of the everyday life of their clients, based on what is important, singular, and situational for each target-person. Discussion: This research advances: 1) by proposing a grounded theory about how a Brazilian framework underpins the clinical reasoning of occupational therapists; 2) by describe three types of reasoning – ethical-aesthetic, associative and dynamic; 3) by detailing how the clinical reasoning of the participants is dynamically constructed based on the processes of the Dynamic Occupational Therapy Method; 4) by showing that several factors - especially the training in the Dynamic Occupational Therapy Method and the supervision - contribute to the expansion and improvement of the occupational therapists’ clinical reasoning. Conclusions: It was possible to identify that the Dynamic Occupational Therapy Method is a framework that supports a situated, singular, ethical-aesthetic, associative, and dynamic reasoning, which allows occupational therapists to consider, in the construction of their clinical reasoning, several important aspects for a client-centred care, based on the needs and on the desires of the target-person. |
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Araujo, Angélica da SilvaMarcolino, Taís Quevedohttp://lattes.cnpq.br/7197838515800679http://lattes.cnpq.br/1045852104533065134f867c-a5c6-4b9f-a5f9-c2750a1a7b952022-04-25T13:50:58Z2022-04-25T13:50:58Z2022-02-25ARAUJO, Angélica da Silva. Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica. 2022. Tese (Doutorado em Terapia Ocupacional) – Universidade Federal de São Carlos, São Carlos, 2022. Disponível em: https://repositorio.ufscar.br/handle/ufscar/15902.https://repositorio.ufscar.br/handle/ufscar/15902Introduction: Clinical reasoning is recognized as a complex phenomenon, intrinsic to practice, studied in Occupational Therapy since the 1980s. One of the factors underpinning clinical reasoning is the framework employed in professional practice. The Dynamic Occupational Therapy Method is a Brazilian framework that has been constructed since the 1970s. Objective: To explore the clinical reasoning of Brazilian expert occupational therapists employing the Dynamic Occupational Therapy Method as the main framework in their professional practice. Methodology: The Constructivist Grounded Theory approach was used to guide this qualitative study. The participants were 10 expert occupational therapists employing the Dynamic Occupational Therapy Method as the main framework in their professional practice. The data were collected through: participant characterization form, individual interviews, group interview, and field journal. The constant comparative analysis method was used for data analysis. The data were collected and analyzed simultaneously. Results: As the Dynamic Occupational Therapy Method was being constructed, specific ways of thinking about practice and acting in practice were also being proposed. Expert occupational therapists who employ the Dynamic Occupational Therapy Method as the main framework in their practice have a clinical reasoning largely supported by this framework. They employ, throughout the practice, three types of reasoning: ethical-aesthetic, associative, and dynamic, structuring their practice dynamically around the three processes proposed in the Dynamic Occupational Therapy Method: 1) construction of the situational diagnostic; 2) establishment and management of the triadic relationship; and 3) dialogical assessment of the therapeutic process/associative paths, processes along which specific characteristics of thinking are also employed. Engaging in post-undergraduate formation and in reflective strategies – such as training after completing their undergraduate in Occupational Therapy, supervision, peer-discussion about their practice, theoretical studies based on their professional practice, and writing about their practices – were factors that contributed to the reasoning expansion of the participants, that became less focused on biomedical aspects and more focused on the health and on the expansion of the everyday life of their clients, based on what is important, singular, and situational for each target-person. Discussion: This research advances: 1) by proposing a grounded theory about how a Brazilian framework underpins the clinical reasoning of occupational therapists; 2) by describe three types of reasoning – ethical-aesthetic, associative and dynamic; 3) by detailing how the clinical reasoning of the participants is dynamically constructed based on the processes of the Dynamic Occupational Therapy Method; 4) by showing that several factors - especially the training in the Dynamic Occupational Therapy Method and the supervision - contribute to the expansion and improvement of the occupational therapists’ clinical reasoning. Conclusions: It was possible to identify that the Dynamic Occupational Therapy Method is a framework that supports a situated, singular, ethical-aesthetic, associative, and dynamic reasoning, which allows occupational therapists to consider, in the construction of their clinical reasoning, several important aspects for a client-centred care, based on the needs and on the desires of the target-person.Introdução: O raciocínio clínico é um fenômeno complexo e intrínseco à prática, investigado na Terapia Ocupacional desde a década de 1980. Um dos elementos que sustenta o raciocínio clínico é o referencial teórico-metodológico utilizado na prática. O Método Terapia Ocupacional Dinâmica é um referencial teórico-metodológico que vem sendo construído no Brasil desde a década de 1970. Objetivo: Construir uma compreensão teórica sobre o raciocínio clínico de terapeutas ocupacionais experts brasileiras que utilizam o Método Terapia Ocupacional Dinâmica como principal referencial teórico-metodológico na prática profissional. Metodologia: Como metodologia de pesquisa qualitativa, foi utilizada a vertente construtivista da Teoria Fundamentada em Dados. As participantes foram 10 terapeutas ocupacionais experts. Os dados foram coletados por meio de: ficha de caracterização das participantes, entrevistas individuais, entrevista em grupo e diário de campo. O método Análise Comparativa Constante foi utilizado para análise dos dados. Coleta e análise de dados foram conduzidas simultaneamente. Resultados: Conforme o Método Terapia Ocupacional Dinâmica foi sendo construído, modos específicos de pensar a prática e de agir também foram sendo propostos. As terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica têm um raciocínio clínico amplamente sustentado neste referencial. Elas empregam, ao longo de toda a prática, três tipos de raciocínio: ético-estético, associativo e dinâmico, construindo uma prática que percorre dinamicamente os processos propostos no Método Terapia Ocupacional Dinâmica: 1) construção do diagnóstico situacional; 2) estabelecimento e manejo da relação triádica; e 3) avaliação dialógica do processo terapêutico/trilhas associativas, ao longo dos quais modos específicos de pensamento também são empregados. Envolver-se em estratégias formativas e reflexivas – formações após a graduação, supervisão, discussão de casos com pares, estudos dirigidos a partir de situações da prática e registros escritos dos atendimentos – foram fatores que contribuíram para que o raciocínio dessas profissionais experts deixasse de ser focado em aspectos biomédicos e passasse a ser focado na saúde e na ampliação do cotidiano e da vida das pessoas atendidas, a partir do que é significativo, singular e situacional para cada sujeito-alvo. Discussão: Esta pesquisa avança na literatura sobre o tema: 1) ao propor uma compreensão teórica sobre como um referencial teórico-metodológico brasileiro sustenta o raciocínio clínico de terapeutas ocupacionais; 2) ao descrever três tipos de raciocínio ainda não descritos na literatura – ético-estético, associativo e dinâmico; 3) ao detalhar como o raciocínio clínico das participantes é construído dinamicamente com base nos processos do Método Terapia Ocupacional Dinâmica; 4) ao mostrar que diversos fatores – em especial a formação no Método Terapia Ocupacional Dinâmica e a supervisão – contribuem para a ampliação e aprimoramento do raciocínio clínico de terapeutas ocupacionais. Considerações finais: Foi possível identificar que o Método Terapia Ocupacional Dinâmica é um referencial teórico-metodológico que sustenta um pensar-agir situado, singular, ético-estético, associativo, dinâmico e aberto, que permite que terapeutas ocupacionais considerem, na construção do raciocínio clínico, diversos aspectos necessários para um cuidado centrado nas necessidades e nos desejos da pessoa atendida.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)CAPES: Código de Financiamento 001porUniversidade Federal de São CarlosCâmpus São CarlosPrograma de Pós-Graduação em Terapia Ocupacional - PPGTOUFSCarAttribution-NonCommercial-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nc-nd/3.0/br/info:eu-repo/semantics/openAccessRaciocínio clínicoTerapia ocupacionalPrática profissionalTomada de decisão clínicaTeoria fundamentadaClinical reasoningOccupational therapyProfessional practiceClinical decision-makingGrounded theoryCIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALConstruções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional DinâmicaTheoretical constructions on the clinical reasoning of expert occupational therapists employing the Dynamic Occupational Therapy Methodinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis60060070d8ed23-ccdd-47c2-8001-602fa7cabe7breponame:Repositório Institucional da UFSCARinstname:Universidade Federal de São Carlos (UFSCAR)instacron:UFSCARORIGINALTese Angélica da Silva Araujo.pdfTese Angélica da Silva Araujo.pdfTese de doutorado - Angélica da Silva Araujoapplication/pdf4617899https://repositorio.ufscar.br/bitstream/ufscar/15902/1/Tese%20Ange%cc%81lica%20da%20Silva%20Araujo.pdfe98e7a005ed1f47df757565cf77962fbMD51Carta Comprovante Versao Final Tese - Orientador PPGTO.pdfCarta Comprovante Versao Final Tese - Orientador PPGTO.pdfCarta comprovante da versão final de teses e dissertaçõesapplication/pdf73543https://repositorio.ufscar.br/bitstream/ufscar/15902/2/Carta%20Comprovante%20Versao%20Final%20Tese%20-%20Orientador%20PPGTO.pdfbbeb00c689593f3fcdd6be7c9827c78fMD52CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8811https://repositorio.ufscar.br/bitstream/ufscar/15902/3/license_rdfe39d27027a6cc9cb039ad269a5db8e34MD53TEXTTese Angélica da Silva Araujo.pdf.txtTese Angélica da Silva Araujo.pdf.txtExtracted texttext/plain344449https://repositorio.ufscar.br/bitstream/ufscar/15902/4/Tese%20Ange%cc%81lica%20da%20Silva%20Araujo.pdf.txtef7c93c21d7f3620d5a33e3f49da1357MD54Carta Comprovante Versao Final Tese - Orientador PPGTO.pdf.txtCarta Comprovante Versao Final Tese - Orientador PPGTO.pdf.txtExtracted texttext/plain1488https://repositorio.ufscar.br/bitstream/ufscar/15902/6/Carta%20Comprovante%20Versao%20Final%20Tese%20-%20Orientador%20PPGTO.pdf.txt3ae82dff755c286b3ec61da119c9698aMD56THUMBNAILTese Angélica da Silva Araujo.pdf.jpgTese Angélica da Silva Araujo.pdf.jpgIM Thumbnailimage/jpeg5006https://repositorio.ufscar.br/bitstream/ufscar/15902/5/Tese%20Ange%cc%81lica%20da%20Silva%20Araujo.pdf.jpg491d613dd5b20a3207570d7479fbe1eeMD55Carta Comprovante Versao Final Tese - Orientador PPGTO.pdf.jpgCarta Comprovante Versao Final Tese - Orientador PPGTO.pdf.jpgIM Thumbnailimage/jpeg5864https://repositorio.ufscar.br/bitstream/ufscar/15902/7/Carta%20Comprovante%20Versao%20Final%20Tese%20-%20Orientador%20PPGTO.pdf.jpg3197ac135d917d44fd5e267d40f18d41MD57ufscar/159022023-09-18 18:32:18.673oai:repositorio.ufscar.br:ufscar/15902Repositório InstitucionalPUBhttps://repositorio.ufscar.br/oai/requestopendoar:43222023-09-18T18:32:18Repositório Institucional da UFSCAR - Universidade Federal de São Carlos (UFSCAR)false |
dc.title.por.fl_str_mv |
Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica |
dc.title.alternative.eng.fl_str_mv |
Theoretical constructions on the clinical reasoning of expert occupational therapists employing the Dynamic Occupational Therapy Method |
title |
Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica |
spellingShingle |
Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica Araujo, Angélica da Silva Raciocínio clínico Terapia ocupacional Prática profissional Tomada de decisão clínica Teoria fundamentada Clinical reasoning Occupational therapy Professional practice Clinical decision-making Grounded theory CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
title_short |
Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica |
title_full |
Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica |
title_fullStr |
Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica |
title_full_unstemmed |
Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica |
title_sort |
Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica |
author |
Araujo, Angélica da Silva |
author_facet |
Araujo, Angélica da Silva |
author_role |
author |
dc.contributor.authorlattes.por.fl_str_mv |
http://lattes.cnpq.br/1045852104533065 |
dc.contributor.author.fl_str_mv |
Araujo, Angélica da Silva |
dc.contributor.advisor1.fl_str_mv |
Marcolino, Taís Quevedo |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/7197838515800679 |
dc.contributor.authorID.fl_str_mv |
134f867c-a5c6-4b9f-a5f9-c2750a1a7b95 |
contributor_str_mv |
Marcolino, Taís Quevedo |
dc.subject.por.fl_str_mv |
Raciocínio clínico Terapia ocupacional Prática profissional Tomada de decisão clínica Teoria fundamentada |
topic |
Raciocínio clínico Terapia ocupacional Prática profissional Tomada de decisão clínica Teoria fundamentada Clinical reasoning Occupational therapy Professional practice Clinical decision-making Grounded theory CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
dc.subject.eng.fl_str_mv |
Clinical reasoning Occupational therapy Professional practice Clinical decision-making Grounded theory |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
description |
Introduction: Clinical reasoning is recognized as a complex phenomenon, intrinsic to practice, studied in Occupational Therapy since the 1980s. One of the factors underpinning clinical reasoning is the framework employed in professional practice. The Dynamic Occupational Therapy Method is a Brazilian framework that has been constructed since the 1970s. Objective: To explore the clinical reasoning of Brazilian expert occupational therapists employing the Dynamic Occupational Therapy Method as the main framework in their professional practice. Methodology: The Constructivist Grounded Theory approach was used to guide this qualitative study. The participants were 10 expert occupational therapists employing the Dynamic Occupational Therapy Method as the main framework in their professional practice. The data were collected through: participant characterization form, individual interviews, group interview, and field journal. The constant comparative analysis method was used for data analysis. The data were collected and analyzed simultaneously. Results: As the Dynamic Occupational Therapy Method was being constructed, specific ways of thinking about practice and acting in practice were also being proposed. Expert occupational therapists who employ the Dynamic Occupational Therapy Method as the main framework in their practice have a clinical reasoning largely supported by this framework. They employ, throughout the practice, three types of reasoning: ethical-aesthetic, associative, and dynamic, structuring their practice dynamically around the three processes proposed in the Dynamic Occupational Therapy Method: 1) construction of the situational diagnostic; 2) establishment and management of the triadic relationship; and 3) dialogical assessment of the therapeutic process/associative paths, processes along which specific characteristics of thinking are also employed. Engaging in post-undergraduate formation and in reflective strategies – such as training after completing their undergraduate in Occupational Therapy, supervision, peer-discussion about their practice, theoretical studies based on their professional practice, and writing about their practices – were factors that contributed to the reasoning expansion of the participants, that became less focused on biomedical aspects and more focused on the health and on the expansion of the everyday life of their clients, based on what is important, singular, and situational for each target-person. Discussion: This research advances: 1) by proposing a grounded theory about how a Brazilian framework underpins the clinical reasoning of occupational therapists; 2) by describe three types of reasoning – ethical-aesthetic, associative and dynamic; 3) by detailing how the clinical reasoning of the participants is dynamically constructed based on the processes of the Dynamic Occupational Therapy Method; 4) by showing that several factors - especially the training in the Dynamic Occupational Therapy Method and the supervision - contribute to the expansion and improvement of the occupational therapists’ clinical reasoning. Conclusions: It was possible to identify that the Dynamic Occupational Therapy Method is a framework that supports a situated, singular, ethical-aesthetic, associative, and dynamic reasoning, which allows occupational therapists to consider, in the construction of their clinical reasoning, several important aspects for a client-centred care, based on the needs and on the desires of the target-person. |
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2022 |
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2022-04-25T13:50:58Z |
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2022-04-25T13:50:58Z |
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2022-02-25 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/doctoralThesis |
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ARAUJO, Angélica da Silva. Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica. 2022. Tese (Doutorado em Terapia Ocupacional) – Universidade Federal de São Carlos, São Carlos, 2022. Disponível em: https://repositorio.ufscar.br/handle/ufscar/15902. |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufscar.br/handle/ufscar/15902 |
identifier_str_mv |
ARAUJO, Angélica da Silva. Construções teóricas sobre o raciocínio clínico de terapeutas ocupacionais experts que utilizam o Método Terapia Ocupacional Dinâmica. 2022. Tese (Doutorado em Terapia Ocupacional) – Universidade Federal de São Carlos, São Carlos, 2022. Disponível em: https://repositorio.ufscar.br/handle/ufscar/15902. |
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https://repositorio.ufscar.br/handle/ufscar/15902 |
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Universidade Federal de São Carlos Câmpus São Carlos |
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Programa de Pós-Graduação em Terapia Ocupacional - PPGTO |
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UFSCar |
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Universidade Federal de São Carlos Câmpus São Carlos |
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