O trabalho interprofissional nas equipes do núcleo ampliado de saúde da família e atenção básica em duas capitais brasileiras

Detalhes bibliográficos
Autor(a) principal: Bravin, Pâmela Karine
Data de Publicação: 2021
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da UFMS
Texto Completo: https://repositorio.ufms.br/handle/123456789/4063
Resumo: Interprofessional work aims to overcome the hierarchy of collective work through democratic relationships and the sharing of objectives, identities and responsibilities. Primary Health Care (PHC) in brazilian unified health system, through the integrated arrangement between the teams of the Family Health Strategy (ESF) and those of the The Expanded Family Health and Basic Healthcare Centers (NASF-AB), is in an ideal scenario for consolidating interprofessional work. The NASF-AB, under the logic of matrix support, holds its space as a tool for transforming the curative and fragmented vision of care, through specialized assistance and technical-pedagogical support to ESF teams. This study aimed to analyze and compare the orientation for the interprofessional work of workers from the NASF-AB in two Brazilian capitals, João Pessoa (PB) and Campo Grande (MS). To this end, a cross-sectional study was carried out, with a structured questionnaire applied to a total of 182 professionals from the NASF-AB, which were 120 from João Pessoa and 62 from Campo Grande. The questionnaire was structured in three dimensions, the first referring to the general characterization of the interviewees, the second aimed at characterizing some aspects of the work process and related to interprofessional work and the third dimension was the Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC). The results were divided into two scientific articles. The first article entitled “Characterization of the Expanded Family Health and Basic Healthcare Centers: a comparative study of two Brazilian capitals” corresponds to data obtained from the first two dimensions of the questionnaire. The results in this article showed that in the general sample, females were predominant (83%) and the mean age was 37.1±9.03 years. Professional training time was longer in Campo Grande (66.1% for more than 11 years) when compared to João Pessoa (65% for less than 11 years). About two-thirds of the overall sample (67%) had completed at least one lato sensu postgraduate course. Physiotherapists (25.3%), Psychologists (16.5%) and Nutritionists (16.5%) were most frequently observed in the general sample. However, in Campo Grande, Physical Education Professionals (14.5%) are more numerous than Nutritionists (12.9%) and Pediatricians (8.1%) and Gynecologists and obstetricians (9.7%) are observed, professions not found in João Pessoa. Professional Social Workers are present only in teams from João Pessoa and correspond to 13.3% of the categories in the municipality. The employment relationship in João Pessoa is mostly through temporary contracts (98.3%) while in Campo Grande most professionals follow the statutory regime (85.5%). In the general sample, the accumulated experience in the NASF-AB of the majority is up to five years (63.7%) and the relationship with the current team is less than two years (57.1%). As for the characteristics of the work process, most professionals in Campo Grande (42.6%) spend more time in their weekly schedule (51-75%) with collective care than in João Pessoa (31.5%, 26-50 % of weekly schedule). The same occurs with individual consultations, in which in Campo Grande 59% of professionals dedicate 26-50% of their weekly schedules, while in João Pessoa most of them (46.8%) claim to spend less time (0-25% ) of the workload.As for the development of activities with other professionals, there was a similar distribution of the percentage of 26-50% of the weekly working time dedicated both to the development of activities with professionals from their NASF-AB team (41.9%), and to those developed with the ESF teams (47.2%). In both capitals, most professionals (76.9%) satisfactorily assessed the team's interprofessional work and collaborative elements. In the second article entitled “Interprofessional work in the Expanded Centers for Family Health and Basic Health Care” there is an analysis of the data obtained from JeffSATIC. The average score of NASF-AB professionals at JeffSATIC was 118.63 (±10.12), with a median of 120 and a range from 77 to 140 points. In Campo Grande it was possible to observe that the professionals had a higher average (120.84±8.56) than that observed in João Pessoa (117.48±10.69). When related, the individual variables and the JeffSATIC scores did not imply statistical differences, but the highest medians were observed among female professionals, the youngest, those with less experience, longer with the team and in the category of Occupational Therapists. By comparing the data obtained through questionnaires applied to NASF-AB professionals in two Brazilian capitals, it was possible to identify common characteristics and specificities that fostered the production of knowledge about the organizational arrangement of the PHC with the inclusion of these teams. The high scores of professionals from the NASF-AB, close to the maximum expected at JeffSATIC, demonstrate that they appropriate interprofessional collaborative attitudes as guidelines for the work process in PHC. In this way, it reinforces the potential of NASF-AB teams in mobilizing changes in the traditional care paradigm and favoring the effectiveness of interprofessional work in PHC. The results of this research contribute to the recognition of the experience of these professionals, local managers and public policy makers, in defining strategies for permanent health education and training that lead to more collaborative skills in the exercise of work among teams in the PHC.
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spelling 2021-10-20T13:22:07Z2021-10-20T13:22:07Z2021https://repositorio.ufms.br/handle/123456789/4063Interprofessional work aims to overcome the hierarchy of collective work through democratic relationships and the sharing of objectives, identities and responsibilities. Primary Health Care (PHC) in brazilian unified health system, through the integrated arrangement between the teams of the Family Health Strategy (ESF) and those of the The Expanded Family Health and Basic Healthcare Centers (NASF-AB), is in an ideal scenario for consolidating interprofessional work. The NASF-AB, under the logic of matrix support, holds its space as a tool for transforming the curative and fragmented vision of care, through specialized assistance and technical-pedagogical support to ESF teams. This study aimed to analyze and compare the orientation for the interprofessional work of workers from the NASF-AB in two Brazilian capitals, João Pessoa (PB) and Campo Grande (MS). To this end, a cross-sectional study was carried out, with a structured questionnaire applied to a total of 182 professionals from the NASF-AB, which were 120 from João Pessoa and 62 from Campo Grande. The questionnaire was structured in three dimensions, the first referring to the general characterization of the interviewees, the second aimed at characterizing some aspects of the work process and related to interprofessional work and the third dimension was the Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC). The results were divided into two scientific articles. The first article entitled “Characterization of the Expanded Family Health and Basic Healthcare Centers: a comparative study of two Brazilian capitals” corresponds to data obtained from the first two dimensions of the questionnaire. The results in this article showed that in the general sample, females were predominant (83%) and the mean age was 37.1±9.03 years. Professional training time was longer in Campo Grande (66.1% for more than 11 years) when compared to João Pessoa (65% for less than 11 years). About two-thirds of the overall sample (67%) had completed at least one lato sensu postgraduate course. Physiotherapists (25.3%), Psychologists (16.5%) and Nutritionists (16.5%) were most frequently observed in the general sample. However, in Campo Grande, Physical Education Professionals (14.5%) are more numerous than Nutritionists (12.9%) and Pediatricians (8.1%) and Gynecologists and obstetricians (9.7%) are observed, professions not found in João Pessoa. Professional Social Workers are present only in teams from João Pessoa and correspond to 13.3% of the categories in the municipality. The employment relationship in João Pessoa is mostly through temporary contracts (98.3%) while in Campo Grande most professionals follow the statutory regime (85.5%). In the general sample, the accumulated experience in the NASF-AB of the majority is up to five years (63.7%) and the relationship with the current team is less than two years (57.1%). As for the characteristics of the work process, most professionals in Campo Grande (42.6%) spend more time in their weekly schedule (51-75%) with collective care than in João Pessoa (31.5%, 26-50 % of weekly schedule). The same occurs with individual consultations, in which in Campo Grande 59% of professionals dedicate 26-50% of their weekly schedules, while in João Pessoa most of them (46.8%) claim to spend less time (0-25% ) of the workload.As for the development of activities with other professionals, there was a similar distribution of the percentage of 26-50% of the weekly working time dedicated both to the development of activities with professionals from their NASF-AB team (41.9%), and to those developed with the ESF teams (47.2%). In both capitals, most professionals (76.9%) satisfactorily assessed the team's interprofessional work and collaborative elements. In the second article entitled “Interprofessional work in the Expanded Centers for Family Health and Basic Health Care” there is an analysis of the data obtained from JeffSATIC. The average score of NASF-AB professionals at JeffSATIC was 118.63 (±10.12), with a median of 120 and a range from 77 to 140 points. In Campo Grande it was possible to observe that the professionals had a higher average (120.84±8.56) than that observed in João Pessoa (117.48±10.69). When related, the individual variables and the JeffSATIC scores did not imply statistical differences, but the highest medians were observed among female professionals, the youngest, those with less experience, longer with the team and in the category of Occupational Therapists. By comparing the data obtained through questionnaires applied to NASF-AB professionals in two Brazilian capitals, it was possible to identify common characteristics and specificities that fostered the production of knowledge about the organizational arrangement of the PHC with the inclusion of these teams. The high scores of professionals from the NASF-AB, close to the maximum expected at JeffSATIC, demonstrate that they appropriate interprofessional collaborative attitudes as guidelines for the work process in PHC. In this way, it reinforces the potential of NASF-AB teams in mobilizing changes in the traditional care paradigm and favoring the effectiveness of interprofessional work in PHC. The results of this research contribute to the recognition of the experience of these professionals, local managers and public policy makers, in defining strategies for permanent health education and training that lead to more collaborative skills in the exercise of work among teams in the PHC.O trabalho interprofissional visa superar a hierarquização do trabalho coletivo, através de relações democráticas e do compartilhamento de objetivos, identidades e responsabilidades. A Atenção Primária à Saúde (APS) a partir do arranjo integrado entre as equipes da Estratégia Saúde da Família (ESF) e as do Núcleo Ampliado de Saúde da Família e Atenção Básica (NASF-AB), se encontra em um cenário ideal de consolidação do trabalho interprofissional no Sistema Único de Saúde (SUS). O NASF-AB, sob a lógica do apoio matricial, detém seu espaço como ferramenta de transformação da visão curativista e fragmentada do cuidado, através do trabalho em equipe baseado na retaguarda assistencial especializada e suporte técnico-pedagógico às equipes da ESF. Este estudo teve por objetivo principal analisar e comparar a orientação para o trabalho interprofissional de trabalhadores dos NASF-AB em duas capitais brasileiras, João Pessoa (PB) e Campo Grande (MS). Para tal, foi realizado um estudo de corte transversal, com aplicação de questionário estruturado a um total de 182 profissionais dos NASF-AB, no qual 120 eram de João Pessoa e 62 de Campo Grande. O questionário se estruturou em três dimensões, a primeira referente à caracterização geral dos entrevistados, a segunda destinou-se a caracterizar alguns aspectos do processo de trabalho e relacionados a interprofissionalidade e a terceira dimensão foi a Escala Jefferson de Atitudes Relacionadas à Colaboração Interprofissional (EJARCI). Os resultados foram divididos em dois artigos científicos. O primeiro artigo intitulado “Caracterização dos Núcleos Ampliados de Saúde da Família e Atenção Básica: um estudo comparativo de duas capitais brasileiras” corresponde aos dados obtidos a partir das duas primeiras dimensões do questionário. Os resultados neste artigo apontaram que na amostra geral o sexo feminino foi predominante (83%) e a idade média era de 37,1±9,03 anos. O tempo de formação profissional foi maior em Campo Grande (66,1% há mais de 11 anos) quando comparado a João Pessoa (65% há menos de 11 anos). Cerca de dois terços da amostra geral (67%) haviam concluído pelo menos uma pós-graduação lato sensu. Foram observadas com maior frequência na amostra geral os Fisioterapeutas (25,3%), os Psicólogos (16,5%) e os Nutricionistas (16,5%). Entretanto, em Campo Grande os Profissionais de Educação Física (14,5%) são em maior quantidade que os Nutricionistas (12,9%) e são observados Médicos Pediatras (8,1%) e Ginecologistas e obstetras (9,7%), profissões não encontradas em João Pessoa. Os profissionais Assistentes Sociais estão presentes apenas nas equipes de João Pessoa e correspondem a 13,3% das categorias no município. O vínculo trabalhista em João Pessoa se dá em sua maioria por contratos temporários (98,3%) enquanto em Campo Grande a maior parte dos profissionais segue o regime estatutário (85,5%). Na amostra geral a experiência acumulada no NASF-AB da maioria é de até cinco anos (63,7%) e o vínculo com a atual equipe se apresenta inferior a dois anos (57,1%). Quanto as características do processo de trabalho, a maior parte dos profissionais em Campo Grande (42,6%) dedicam mais tempo da agenda semanal (51-75%) com atendimentos coletivos que em João Pessoa (31,5%, 26-50% da agenda semanal). O mesmo ocorre com os atendimentos individuais, nos quais em Campo Grande 59% dos profissionais dedicam de 26-50% de suas agendas semanais enquanto, em João Pessoa a maioria deles (46,8%) afirmam dedicar menor tempo (0-25%) da carga horária. Quanto ao desenvolvimento de atividades com outros profissionais, verificou-se uma distribuição similar do percentual de 26-50% do tempo de trabalho semanal dedicado tanto ao desenvolvimento de atividades com profissionais de sua equipe NASF-AB (41,9%), quanto para as desenvolvidas com as equipes da ESF (47,2%). Em ambas as capitais a maioria dos profissionais (76,9%) avaliaram satisfatoriamente o trabalho interprofissional da equipe e as competências colaborativas. No segundo artigo intitulado “O trabalho interprofissional nos Núcleos Ampliados de Saúde da Família e Atenção Básica” consta a análise dos dados obtidos a partir da EJARCI. O escore médio dos profissionais do NASF-AB na EJARCI foi de 118,63 (±10,12), com mediana de 120 e variação de 77 a 140 pontos. Em Campo Grande foi possível observar que os profissionais apresentaram uma média superior (120,84±8,56) ao observado em João Pessoa (117,48±10,69). Quando relacionados, as variáveis individuais e os escores da EJARCI não implicaram em diferenças estatísticas, mas as maiores medianas foram observadas entre os profissionais do sexo feminino, os mais jovens, os com menos experiência, com maior tempo de vínculo com a equipe e na categoria dos Terapeutas Ocupacionais. Ao comparar os dados obtidos por meio de questionários aplicados aos profissionais do NASF-AB de duas capitais brasileiras, foi possível identificar características comuns e especificidades que fomentaram a produção do conhecimento sobre o arranjo organizacional da APS com a inserção dessas equipes. Os elevados escores dos profissionais do NASF-AB, próximos ao máximo esperado na EJARCI, demonstram que estes se apropriam das atitudes colaborativas interprofissionais como norteadoras do processo de trabalho na APS. Dessa forma, reforça o potencial das equipes NASF-AB em mobilizar mudanças do paradigma assistencial tradicional e favorecer a efetivação do trabalho interprofissional na APS. Os resultados desta pesquisa contribuem para o reconhecimento da experiência desses profissionais, aos gestores locais e formuladores de políticas públicas, na definição de estratégias de educação permanente em saúde e capacitação que direcionem a competências mais colaborativas no exercício do trabalho entre as equipes na APS.Fundação Universidade Federal de Mato Grosso do SulUFMSBrasilAtenção Primária à SaúdeEquipe de Assistência ao PacienteRelações InterprofissionaisSaúde da FamíliaFamily HealthInterprofessional RelationsPatient Care TeamPrimary Health CareO trabalho interprofissional nas equipes do núcleo ampliado de saúde da família e atenção básica em duas capitais brasileirasinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisBatiston, Adriane PiresBravin, Pâmela Karineinfo:eu-repo/semantics/openAccessporreponame:Repositório Institucional da UFMSinstname:Universidade Federal de Mato Grosso do Sul (UFMS)instacron:UFMSTHUMBNAILDISSERTACAO_PAMELA KARINE BRAVIN.pdf.jpgDISSERTACAO_PAMELA KARINE BRAVIN.pdf.jpgGenerated Thumbnailimage/jpeg1177https://repositorio.ufms.br/bitstream/123456789/4063/3/DISSERTACAO_PAMELA%20KARINE%20BRAVIN.pdf.jpg464ff4e1f902b1d94abb7d675ceb5c8aMD53TEXTDISSERTACAO_PAMELA KARINE BRAVIN.pdf.txtDISSERTACAO_PAMELA KARINE BRAVIN.pdf.txtExtracted texttext/plain91739https://repositorio.ufms.br/bitstream/123456789/4063/2/DISSERTACAO_PAMELA%20KARINE%20BRAVIN.pdf.txt1eb3999443c3683245c601ba0f793518MD52ORIGINALDISSERTACAO_PAMELA KARINE BRAVIN.pdfDISSERTACAO_PAMELA KARINE BRAVIN.pdfapplication/pdf1753855https://repositorio.ufms.br/bitstream/123456789/4063/1/DISSERTACAO_PAMELA%20KARINE%20BRAVIN.pdf0e2fa244e6844d490861c5187d67f8c7MD51123456789/40632023-02-10 07:22:53.137oai:repositorio.ufms.br:123456789/4063Repositório InstitucionalPUBhttps://repositorio.ufms.br/oai/requestri.prograd@ufms.bropendoar:21242023-02-10T11:22:53Repositório Institucional da UFMS - Universidade Federal de Mato Grosso do Sul (UFMS)false
dc.title.pt_BR.fl_str_mv O trabalho interprofissional nas equipes do núcleo ampliado de saúde da família e atenção básica em duas capitais brasileiras
title O trabalho interprofissional nas equipes do núcleo ampliado de saúde da família e atenção básica em duas capitais brasileiras
spellingShingle O trabalho interprofissional nas equipes do núcleo ampliado de saúde da família e atenção básica em duas capitais brasileiras
Bravin, Pâmela Karine
Atenção Primária à Saúde
Equipe de Assistência ao Paciente
Relações Interprofissionais
Saúde da Família
Family Health
Interprofessional Relations
Patient Care Team
Primary Health Care
title_short O trabalho interprofissional nas equipes do núcleo ampliado de saúde da família e atenção básica em duas capitais brasileiras
title_full O trabalho interprofissional nas equipes do núcleo ampliado de saúde da família e atenção básica em duas capitais brasileiras
title_fullStr O trabalho interprofissional nas equipes do núcleo ampliado de saúde da família e atenção básica em duas capitais brasileiras
title_full_unstemmed O trabalho interprofissional nas equipes do núcleo ampliado de saúde da família e atenção básica em duas capitais brasileiras
title_sort O trabalho interprofissional nas equipes do núcleo ampliado de saúde da família e atenção básica em duas capitais brasileiras
author Bravin, Pâmela Karine
author_facet Bravin, Pâmela Karine
author_role author
dc.contributor.advisor1.fl_str_mv Batiston, Adriane Pires
dc.contributor.author.fl_str_mv Bravin, Pâmela Karine
contributor_str_mv Batiston, Adriane Pires
dc.subject.por.fl_str_mv Atenção Primária à Saúde
Equipe de Assistência ao Paciente
Relações Interprofissionais
Saúde da Família
Family Health
Interprofessional Relations
Patient Care Team
Primary Health Care
topic Atenção Primária à Saúde
Equipe de Assistência ao Paciente
Relações Interprofissionais
Saúde da Família
Family Health
Interprofessional Relations
Patient Care Team
Primary Health Care
description Interprofessional work aims to overcome the hierarchy of collective work through democratic relationships and the sharing of objectives, identities and responsibilities. Primary Health Care (PHC) in brazilian unified health system, through the integrated arrangement between the teams of the Family Health Strategy (ESF) and those of the The Expanded Family Health and Basic Healthcare Centers (NASF-AB), is in an ideal scenario for consolidating interprofessional work. The NASF-AB, under the logic of matrix support, holds its space as a tool for transforming the curative and fragmented vision of care, through specialized assistance and technical-pedagogical support to ESF teams. This study aimed to analyze and compare the orientation for the interprofessional work of workers from the NASF-AB in two Brazilian capitals, João Pessoa (PB) and Campo Grande (MS). To this end, a cross-sectional study was carried out, with a structured questionnaire applied to a total of 182 professionals from the NASF-AB, which were 120 from João Pessoa and 62 from Campo Grande. The questionnaire was structured in three dimensions, the first referring to the general characterization of the interviewees, the second aimed at characterizing some aspects of the work process and related to interprofessional work and the third dimension was the Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC). The results were divided into two scientific articles. The first article entitled “Characterization of the Expanded Family Health and Basic Healthcare Centers: a comparative study of two Brazilian capitals” corresponds to data obtained from the first two dimensions of the questionnaire. The results in this article showed that in the general sample, females were predominant (83%) and the mean age was 37.1±9.03 years. Professional training time was longer in Campo Grande (66.1% for more than 11 years) when compared to João Pessoa (65% for less than 11 years). About two-thirds of the overall sample (67%) had completed at least one lato sensu postgraduate course. Physiotherapists (25.3%), Psychologists (16.5%) and Nutritionists (16.5%) were most frequently observed in the general sample. However, in Campo Grande, Physical Education Professionals (14.5%) are more numerous than Nutritionists (12.9%) and Pediatricians (8.1%) and Gynecologists and obstetricians (9.7%) are observed, professions not found in João Pessoa. Professional Social Workers are present only in teams from João Pessoa and correspond to 13.3% of the categories in the municipality. The employment relationship in João Pessoa is mostly through temporary contracts (98.3%) while in Campo Grande most professionals follow the statutory regime (85.5%). In the general sample, the accumulated experience in the NASF-AB of the majority is up to five years (63.7%) and the relationship with the current team is less than two years (57.1%). As for the characteristics of the work process, most professionals in Campo Grande (42.6%) spend more time in their weekly schedule (51-75%) with collective care than in João Pessoa (31.5%, 26-50 % of weekly schedule). The same occurs with individual consultations, in which in Campo Grande 59% of professionals dedicate 26-50% of their weekly schedules, while in João Pessoa most of them (46.8%) claim to spend less time (0-25% ) of the workload.As for the development of activities with other professionals, there was a similar distribution of the percentage of 26-50% of the weekly working time dedicated both to the development of activities with professionals from their NASF-AB team (41.9%), and to those developed with the ESF teams (47.2%). In both capitals, most professionals (76.9%) satisfactorily assessed the team's interprofessional work and collaborative elements. In the second article entitled “Interprofessional work in the Expanded Centers for Family Health and Basic Health Care” there is an analysis of the data obtained from JeffSATIC. The average score of NASF-AB professionals at JeffSATIC was 118.63 (±10.12), with a median of 120 and a range from 77 to 140 points. In Campo Grande it was possible to observe that the professionals had a higher average (120.84±8.56) than that observed in João Pessoa (117.48±10.69). When related, the individual variables and the JeffSATIC scores did not imply statistical differences, but the highest medians were observed among female professionals, the youngest, those with less experience, longer with the team and in the category of Occupational Therapists. By comparing the data obtained through questionnaires applied to NASF-AB professionals in two Brazilian capitals, it was possible to identify common characteristics and specificities that fostered the production of knowledge about the organizational arrangement of the PHC with the inclusion of these teams. The high scores of professionals from the NASF-AB, close to the maximum expected at JeffSATIC, demonstrate that they appropriate interprofessional collaborative attitudes as guidelines for the work process in PHC. In this way, it reinforces the potential of NASF-AB teams in mobilizing changes in the traditional care paradigm and favoring the effectiveness of interprofessional work in PHC. The results of this research contribute to the recognition of the experience of these professionals, local managers and public policy makers, in defining strategies for permanent health education and training that lead to more collaborative skills in the exercise of work among teams in the PHC.
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