Dissertations / Theses on the topic 'Interprofessional relations'
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Hoppe, Elizabeth Susan. "Optometry's expanding scope of practice legislation, interprofessional relations, and risk." Ann Arbor, Mich. : University of Michigan, 1999. http://books.google.com/books?id=uxQvAAAAMAAJ.
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Redford, Morag. "Interprofessional communication in education : a case study." Thesis, University of Stirling, 2013. http://hdl.handle.net/1893/13177.
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This thesis is concerned with communication in interprofessional practice, an issue which is identified as a ‘difficulty’ but ‘essential’ in the literature. The research is based on a case study focusing on the communication between professionals in a series of planning meetings held to support the transition of a child with additional support needs from playgroup into the nursery class of a primary school in Scotland. The study explores the dynamics and complexities of communication through the theoretical frameworks of ethnography of communication and Dewey’s concept of communication as participative action. This joint analysis illustrates the way in which the group worked together to make something in common and the extent of commonality that was needed for them to work actively together. The findings show the interprofessional group functioning as a speech community with a bounding feature of working with the child. The soft-shell of this community illustrates a flexibility of practice and the ability of the group to expand or contract to meet the needs of the child and family. The way in which the participants worked together to agree the outcomes they were working towards is an illustration of Deweyan communication, making something in common between them. This process included the recognition of the competence and responsibility of individual professions. The study demonstrates that the doctors who were members of the interprofessional group were recognised as holding more power than the other members of the group and were bound by the outcomes and procedures of their own profession. This difference affected the dynamics of communication within the interprofessional team. The findings add to our understanding of the complexities of communication in an interprofessional team and show that communication in a Deweyan sense can strengthen the work of an interprofessional group and develop their support for the child or family they are working with.
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Sinha, Dr Samir K. "The sociology of interprofessional relations: A case study of English care trusts." Thesis, University of Oxford, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.491064.
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The health and social care needs of older people are varied and complex and often require the involvement and expertise of a number of professionais. Practitioners who provide services for older people have skills that have been historically defined by different training and professional pathways and often work for different health and social care agencies. There is significant interest in interprofessional working. However, its development has been shown to be a process that can be easily complicated when structural and professional factors are not considered or understood. As a result, further research on the factors that underpin effective interprofessional working will be central to this approach.
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Phillips, Joy Coursey. "Interprofessional collaboration for low income and immigrant families : a case study /." Digital version accessible at:, 1999. http://wwwlib.umi.com/cr/utexas/main.
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Levesque, Marie-Julie. "Interprofessional Collaboration in the Operating Room: A Nursing Perspective." Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/42751.
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The aim of this thesis was to examine the contribution of nurses to interprofessional collaboration (IPC) in the operating room (OR) guided by the Interprofessional Education Collaborative Patient Care Practice (IECPCP) framework. First, a secondary analysis of interviews with 19 registered nurses was conducted. Twenty emergent themes were identified. The most prevalent of the four dimensions (internalization; shared goals and vision; governance; and formalization) consisted of the internalization dimension relating to human interaction and sense of belonging within the interprofessional team. A scoping review then identified 20 studies evaluating four interventions (briefings, checklists, team training, and debriefings) used to improve IPC in the OR. Despite weak study designs, these interventions showed improvements in communication, teamwork, and safety outcomes. OR nurses contribute mainly through interactional processes and they require organizational support to foster their efforts in IPC. Nurse are involved in all IPC interventions and their contribution is important to support IPC in the OR.
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Gocan, Sophia J. "How Is Interprofessional Collaboration Making a Difference in Tobacco Dependence Treatment?" Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23503.
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Objective: To explore the role of interprofessional collaboration in the delivery of team-based tobacco dependence treatments within primary care.
Methods: A narrative review of the literature was completed to examine FHT team functioning in Ontario, followed by a single, multi-site qualitative exploratory case study.
Results: Interprofessional collaboration contributed to changes in tobacco dependence treatment through the initiation of system-wide change, cultivation of collective action, and supporting enhanced quality of smoking cessation care.
Conclusion: Interprofessional collaboration can enhance the comprehensive delivery of evidence-based treatments for individuals trying to quit smoking. Supportive public policy, education for patients and providers, and evaluation research is needed to advance FHT functioning.
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O'Carroll, Veronica. "Practice mentors' attitudes and perspectives of interprofessional working, and interprofessional practice learning for students : a mixed-methods case study." Thesis, University of St Andrews, 2017. http://hdl.handle.net/10023/10482.
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The demands on health and social care organisations require professions to work more collaboratively. During pre-registration training, health care and social work students learn within practice settings, supported by practice mentors. These settings are rich learning environments to experience interprofessional working (IPW) and for students to learn together through interprofessional practice learning (IPPL). There is, however, evidence that students' experiences of both are varied or limited. The value placed on IPW, and IPPL, is therefore of interest. This thesis will investigate practice mentors' attitudes to IPW and IPPL, and explore their perspectives of the enablers and barriers to these occurring in practice settings. A mixed-methods case study approach was used to measure the attitudes of practice mentors from health and social work, and to identify enablers and barriers to IPW, and IPPL for students. Online surveys and semi-structured face to face interviews were carried out with a range of professions within one Scottish health board and associated local authority. Results showed that attitudes to IPW, and IPPL for students were generally positive. Attitudes were not significantly affected by governing body, gender, area of work, years of experience, or prior experience of IPE. IPW was perceived to be enabled by shared processes and policies, IPPL for staff, effective communication, established teams, and shared processes and policies. Proximity to other professions and shared spaces encouraged informal communication and positive interprofessional relationships. Regular structured IPPL opportunities for students were limited. However, where opportunities did occur, this was linked to areas where practice mentors perceived that there was a strong interprofessional team identity. Although attitudes to IPW, and IPPL for students are positive, further work is needed to identify systems for improving IPW, to strengthen professions' identity as interprofessional teams, and to increase IPPL opportunities for students.
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Kvarnström, Susanne. "Interprofessionella team i vården : en studie om samarbete mellan hälsoprofessioner /." Linköping : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-9837.
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Head, French Janet. "How and in what context do osteopathic medical students learn about interprofessional practice." Diss., Columbia, Mo. : University of Missouri-Columbia, 2007. http://hdl.handle.net/10355/4828.
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Thesis (Ed. D.)--University of Missouri-Columbia, 2007.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on February 13, 2008) Vita. Includes bibliographical references.
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Gran, Bruun Anne-Marie, and Ulrik Anne-Marie Grell. "Udviskede professionsgrænseri : interprofessionelt samarbejde mellem læger og sygeplejersker inden for klinisk anæstes." Thesis, Nordic School of Public Health NHV, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3194.
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Studiet har haft til formål at undersøge, hvorledes to fagprofessioners rolleopfattelse påvirker deres arbejde og indbyrdes relation inden for klinisk anæstesi. Der er valgt et kvalitativt afsæt med et salutogenetisk perspektiv med hovedvægt på at skabe et billede af forventningerne til den gode fagprofessionelle og det gode samarbejde. Samtidig afdækkes forskellige potentielle konfliktfelter. Rolleopfattelsen fremstår som et handlingsideal, der har fælles træk uafhængigt af professionsbaggrund. Der synes at være god overensstemmelsen mellem professionernes forventninger til rolle og mandat. Dette kan danne basis for et godt samarbejde, men samtidig skabe grobund for konflikter. Der afdækkes en anerkendelse af værdien af begge fagprofessioners spidskompetencer i mødet med patienten. Typen af samspil mellem professionerne er afhængig af opgavernes karakter samt deltagernes personlighed og erfaringer. Overføring af opgaver til den anden profession kan opfattes som en provokation mod professionernes integritet. Hierarki og revirbeskyttelse synes at kunne give anledning til en vis rigiditet i arbejdets organisering. Viden og færdigheder udveksles på tværs af professionerne. Dette islæt af empowerment synes at resultere i en unik kollegialitet og binding. Ingen af de fagprofessionelle ønsker at arbejde i en monofaglig kontekst. Men den udtalte overlapning kan give anledning til mellemmenneskelige udfordringer i forhold til både at give hinanden rum samtidig med, at man kræver plads til egne kompetencer og værdier.The study has had the purpose of examining how the self-perception of two professions affects their work and mutual relation in the area of clinical anaesthesia. A qualitative starting point with a salutogenetic perspective has been chosen with emphasis on creating a clear picture of expectations about what is good professionally and what is good teamwork. Concurrently, different potential areas of conflict are uncovered. The perception of roles appears as an ideal about how to act, which has common features independently of professional background. There appears to be good accordance between the different professions and their expectations of roles and mandate. This can create a basis for good co-operation, but at the same be a cause of conflict. Acknowledgement of the value of both professions’ core competences in dealing with patients is uncovered. The type of teamwork between the professions is dependent on the character of the assignment as well as the participants’ personality and experience. Transferral of assignments to the other profession can be seen as provocation against the integrity of both professions. Hierarchy and turf-protection appears to give rise to certain rigidity in the organisation of the work. Knowledge and skills are exchanged across the professions. This strain of empowerment seems to result in a unique collegiate spirit and binding. Neither of the two professions want to work in a mono professional context. But the pronounced overlap can give rise to inter-human challenges in connection to giving each other space while also demanding room for one’s own competencies and values.
ISBN 978-9185721-40-5
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Thomas, Godwin Dogara Ayenajeh. "A virtual-community-centric model for coordination in the South African public sector." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/d1021073.
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Organizations face challenges constantly owing to limited resources. As such, to take advantage of new opportunities and to mitigate possible risks they look for new ways to collaborate, by sharing knowledge and competencies. Coordination among partners is critical in order to achieve success. The segmented South African public sector is no different. Driven by the desire to ensure proper service delivery in this sector, various government bodies and service providers play different roles towards the attainment of common goals. This is easier said than done, given the complexity of the distributed nature of the environment. Heterogeneity, autonomy, and the increasing need to collaborate provoke the need to develop an integrative and dynamic coordination support service system in the SA public sector. Thus, the research looks to theories/concepts and existing coordination practices to ground the process of development. To inform the design of the proposed artefact the research employs an interdisciplinary approach championed by coordination theory to review coordination-related theories and concepts. The effort accounts for coordination constructs that characterize and transform the problem and solution spaces. Thus, requirements are explicit towards identifying coordination breakdowns and their resolution. Furthermore, how coordination in a distributed environment is supported in practice is considered from a socio-technical perspective in an effort to account holistically for coordination support. Examining existing solutions identified shortcomings that, if addressed, can help to improve the solutions for coordination, which are often rigidly and narrowly defined. The research argues that introducing a mediating technological artefact conceived from a virtual community and service lenses can serve as a solution to the problem. By adopting a design-science research paradigm, the research develops a model as a primary artefact to support coordination from a collaboration standpoint. The suggestions from theory and practice and the unique case requirement identified through a novel case analysis framework form the basis of the model design. The proposed model support operation calls for an architecture which employs a design pattern that divides a complex whole into smaller, simpler parts, with the aim of reducing the system complexity. Four fundamental functions of the supporting architecture are introduced and discussed as they would support the operation and activities of the proposed collaboration lifecycle model geared towards streamlining coordination in a distributed environment. As part of the model development knowledge contributions are made in several ways. Firstly, an analytical instrument is presented that can be used by an enterprise architect or business analyst to study the coordination status quo of a collaborative activity in a distributed environment. Secondly, a lifecycle model is presented as meta-process model with activities that are geared towards streamlining the coordination of dynamic collaborative activities or projects. Thirdly, an architecture that will enable the technical virtual community-centric, context-aware environment that hosts the process-based operations is offered. Finally, the validation tool that represents the applied contribution to the research that promises possible adaptation for similar circumstances is presented. The artefacts contribute towards a design theory in IS research for the development and improvement of coordination support services in a distributed environment such as the South African public sector.
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Ellery, Ana Ecilda Lima. "Interprofissionalidade na estratÃgia saÃde da famÃlia: condiÃÃes de possibilidade para a integraÃÃo de saberes e a colaboraÃÃo interprofissional." Universidade Federal do CearÃ, 2012. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=9201.
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FundaÃÃo de Amparo à Pesquisa do Estado do CearÃO princÃpio da interprofissionalidade à critÃrio fundamental que orienta equipes multiprofissionais na EstratÃgia SaÃde da FamÃlia. A aÃÃo profissional, no entanto, parece ser marcada por uma lÃgica caracterizada pela delimitaÃÃo estreita de territÃrios de cada categoria, conformando um quadro de disputa entre as lÃgicas contraditÃrias da profissionalizaÃÃo e da interprofissionalidade. Esta à compreendida como a sÃntese de um processo de integraÃÃo de saberes e de colaboraÃÃo interprofissional, processos estes mediados pelos afetos. Considerando haver obstÃculos diversos para a efetivaÃÃo da interprofissionalidade, a pesquisa objetiva compreender a dinÃmica das relaÃÃes interprofissionais na produÃÃo do cuidado na EstratÃgia SaÃde da FamÃla, explorando a existÃncia de condiÃÃes de possibilidade para a construÃÃo da interprofissionalidade na AtenÃÃo PrimÃria à SaÃde no Brasil. Trata-se de estudo de caso, de natureza qualitativa, inspirado na HermenÃutica. O cenÃrio de estudo à um Centro de SaÃde da FamÃlia, numa capital brasileira. A recolha das informaÃÃes foi procedida no perÃodo de marÃo a agosto de 2011, com realizaÃÃo de entrevistas abertas, observaÃÃo das atividades desenvolvidas pelas equipes e realizaÃÃo de oficinas de produÃÃo de conhecimento, envolvendo 23 profissionais da ESF, NÃcleos de Apoio à SaÃde da Familia e residentes de Medicina e de SaÃde da FamÃlia e Comunidade. Foram identificadas condiÃÃes de possibilidades da interprofissionalidade na ESF, sintetizadas em trÃs dimensÃes: organizacional, coletiva e subjetiva. Incluem-se na dimensÃo organizacional dispositivos e arranjos institucionais, suportes para as atividades interprofissionais, quais sejam: a estruturaÃÃo de uma âRede de SaÃde â Escolaâ, transformando todas as unidades de saÃde de um municÃpio em espaÃos de ensino, pesquisa e assistÃncia; a âEducaÃÃo Permanente Interprofissionalâ que contribua para ultrapassar a lÃgica da profissionalizaÃÃo ainda hegemÃnica na formaÃÃo dos trabalhadores da saÃde; bem como a âAbordagem Centrada na FamÃliaâ, em contraposiÃÃo à tendÃncia de organizar os serviÃos de saÃde com base em interesses corporativos. A segunda dimensÃo enfoca aspectos relacionados à organizaÃÃo dos profissionais como grupo de trabalho, ou seja, a organizaÃÃo do coletivo em comunidade de prÃtica, caracterizada pela pactuaÃÃo de um projeto em comum, engajamento mÃtuo e repertÃrios compartilhados. Mesmo tendo sido os profissionais da saÃde formados hegemonicamente para a lÃgica da profissionalizaÃÃo, envolvendo luta por status e reserva de mercado de trabalho, a participaÃÃo numa equipe da ESF, constituida como comunidade de prÃtica, possibilita a aprendizagem de outros valores, favorecendo a integraÃÃo de saberes e a colaboraÃÃo interprofissional, embora nÃo livre de conflitos. A terceira dimensÃo privilegia aspectos subjetivos, como a identificaÃÃo dos profissionais com o modelo assistencial da ESF, saber lidar com frustraÃÃes e a afetividade. Consideramos ser possÃvel a interprofissionalidade, desde que sejam disponibilizadas condiÃÃes organizacionais e coletivas, mobilizadoras de aspectos subjetivos dos profissionais. A oferta das condiÃÃes de possibilidade, no plano organizacional, à indispensÃvel, mas nÃo suficiente para a integraÃÃo de saberes e a colaboraÃÃo interprofissional. Sem a mobilizaÃÃo dos afetos, dos desejos e dos micropoderes de cada sujeito, nÃo hà interprofissionalidade possÃvel.
The principle of interprofessional learning and practice is a fundamental criterion that guides multidisciplinary teams in the Family Health Strategy (FHS).The professional action however, seems to be marked by a logic characterized by the narrow boundaries of the territories of each category as a scene of contention between the contradictory logics of professionalization and interprofessional practice. This is understood as the synthesis of a process of integration of knowledge and interprofessional collaboration (COLET, 2002). These processes are mediated by affects. Considering that there are several obstacles to the realization of the interprofessional learning and practice, the research aims to understand the dynamics of inter-relationships in the production of care in the familyÂs health strategy, exploiting the existence of conditions of possibility for the construction of interprofessional learning and practice. This is a qualitative case study inspired by hermeneutics. The scenario is a study of the Family Health Center, in a Brazilian capital. The gathering of the information was provided from March to August 20122, with open interviews, observation of activities in the FHS and workshops for knowledge production, involving 23 professionals. Conditions were identified in the possibilities of interprofessional FHS, combined in the following groups: Organizational, collective, and subjective. Included in the organizational dimension are devices and institutional arrangements, cross-media activities for the structuring of a âHealth-Education systemsâ, transforming all health facilities of a municipality into areas of teaching, research, and assistance. The âinterprofessional continuing educationâ helps to overcome the hegemonic logic of professionalism, sill found in the training of healthcare workers and user-centered approach, in contrast to the trend of organizing health service base on corporate interests. The second dimension focuses on aspects related to the organization of professionals working as a group, or the organizations of the collective community practice, characterized by agreeing on a common project, mutual engagement and shared repertoire. Even though health professionals trained to the hegemonic logic of professionalization, involving a struggle to preserve status and labor market participation in the ESF team, the way they are formed as a community of practice, enables the learning of other values, knowledge and practice, favoring the integration of interprofessional collaboration and knowledge, though not free of conflict. The third dimension includes subjective aspects such as the identification of professionals of the ESF health care model, dealing with frustration and affection. We consider that the interprofessional learning and practice is possible, if subjected to the organizational and collective conditions, mobilizing subjective aspects of professionals. The offering conditions of possibility in the organizational level are essential but not sufficient for integration of knowledge and interprofessional collaboration. Without the mobilization of emotions, desires and micro powers of each subject, inter-professional learning and practice is not possible.
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Degiovani, Mariella Vargas. "A residência multiprofissional no Hospital São Paulo (HU – Unifesp): percepção dos residentes sobre o processo de ensino em saúde e atuação em equipe interprofissional." Universidade Federal de São Paulo, 2017. http://repositorio.unifesp.br/11600/45813.
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Previous issue date: 2017Introdução: As residências multiprofissionais em saúde (RMSs) no Brasil surgem como uma das estratégias utilizadas para fomentar o processo de aprendizado em serviço, visando a consolidação das propostas do SUS. Enquanto tal, as RMSs se inseriram em diversos cenários, desde o hospitalar até o nível de atenção básica, quando de sua implementação na Estratégia de Saúde da Família. Contudo, apesar de seu grande alcance, ainda são restritas às iniciativas que buscaram compreender, conhecer e avaliar tais residências e seu impacto na formação dos profissionais de saúde. Objetivos: analisar a percepção dos residentes multiprofissionais em saúde em relação às motivações e vivências no âmbito dos Programas de Residências Multiprofissionais em Saúde desenvolvidas no Hospital São Paulo (HSP)/Universidade Federal de São Paulo (UNIFESP), assim como mapear suas motivações, apreender as concepções dos residentes sobre trabalho em equipe, discutir as dificuldades que os residentes identificam para o trabalho em equipe multiprofissional e mapear as contribuições da Residência Multiprofissional para o trabalho em equipe. Métodos: Trata-se de uma pesquisa qualitativa, de caráter descritivo-exploratório. Os dados foram coletados por meio de entrevistas semiestruturadas. A população analisada foi composta por residentes do primeiro e do segundo ano da Residência Multiprofissional em Saúde do HSP-UNIFESP. As entrevistas foram gravadas e transcritas e os dados analisados por meio da técnica de análise de conteúdo, modalidade temática. Resultados e Discussão: Um total de 17 residentes multiprofissionais foram entrevistados. As categorias temáticas relevantes para este estudo foram: motivação para a inserção da RMS, concepção sobre o trabalho em equipe na RMS, dificuldades do trabalho em equipe multiprofissional e contribuição da residência para a atuação em equipe multiprofissional. As percepções colhidas por meio deste trabalho apontam para uma heterogeneidade entre as experiências dos residentes multiprofissionais. As motivações que levaram à busca pela RMS foram, em sua maioria, pragmáticas e voltadas à obtenção de uma formação complementar após a graduação. Ainda que muitos dos sujeitos tivessem conhecimento prévio do conceito de trabalho em equipe multiprofissional, a experiência foi inédita para todos e foi apontado ganho significativo no que tange à prática da multiprofissionalidade. Os sujeitos apontam, contudo, dificuldades expressivas na condução de tal trabalho, notadamente uma dicotomia entre o projeto pedagógico elaborado e o implantado, evidenciando uma quebra de expectativas no processo de formação. Ainda assim, a experiência foi avaliada pela maioria como significativa enquanto preparo para a futura prática profissional fora do cenário acadêmico supervisionado. Ademais, muitos participantes salientaram o papel da experiência na RMS como catalisador de um processo de autoconhecimento. Conclusão: O estudo representa um aprofundamento sobre as atividades de ensino dentro das RMSs. As categorias analisadas representam pontos essenciais para o aperfeiçoamento do processo de formação dos residentes da área multiprofissional em saúde, além da necessidade de uma aproximação entre o projeto pedagógico elaborado e as práticas de ensino. Ações de integração ensino-serviço específicas poderão melhorar a avaliação da RMS por meio de estratégias de ensino. Dentre tais estratégias, emerge a criação de um grupo interprofissional de reflexão sobre as práticas na RMS, configurando-se o produto desta pesquisa. São necessários outros estudos que possam abordar a perspectiva do professor e do preceptor nas RMSs para ampliar e articular com os achados e as análises produzidas nesse estudo.
Introduction: Multiprofessional residencies in the health field exist in Brazil merging as one of the strategies employed to increase the process of hands-on learning, seeking the consolidation of the propositions of the SUS (Brazilian Public Health System). As such, the multiprofessional residency programs have inserted themselves in many scenarios, from hospital-based to primary care, when they were implemented in the Family Health Strategy. However, despite its broad reach, there are few initiatives seeking to understand, know and evaluate said residencies and their impact in the shaping of health professionals. Objectives: This research sought to analyze the perception of multiprofessional residents regarding conceptions and experiences of interprofessional work within Multiprofessional Residencies in Health in HSP-UNIFESP. Methodology: This project consisted in a qualitative research, of descriptive-exploratory character. The data was collected through semi-structured interviews. The analyzed population were the first and second year residents of the Multiprofessional Health Residency program of the HSP-UNIFESP. Interviews were recorded and transcripted and data was analyzed through the content analysis technique, thematic modality. Results: A total of 17 multiprofessional residents were interviewed. Thematic categories relevant to this study were: motivation for the insertion in the Multiprofessional Health Residency program, conception of teamwork in the Multiprofessional Health Residency program and contribution of the Multiprofessional Health Residency program to working in a multiprofessional team. The perceptions captured by this study point towards a certain heterogeneity among the experiences of residents. The motivations that led to seeking a Multiprofessional Health Residency program were, for the most part, pragmatic and aimed towards the obtention of a complementary formation after completing a degree. Even though many subjects had previous knowledge of the concept of work in a multiprofessional team, the experience was new to all and pointed as a significant gain regarding Multiprofessional practice. Subjects pointed out, however, that there were expressive difficulties in the conduction of said work, notably a dichotomy between the elaborated pedagogical project and the one that was implemented, showing a break of expectations in the formation process. Furthermore, many participants highlighted the part that the Multiprofessional Health Residency program played as a catalyzer in a self-knowledge process. Conclusion: The study represents a deepening on the teaching activities within the Multiprofessional Health Residencies. The analyzed categories represent essential points towards perfecting the formation process of residents in the multiprofessional health field and also the need of an approximation between the formulated pedagogical project and the teaching practices. Specific actions in integration between teaching and practice can improve the evaluation of Multiprofessional Health Residency programs through teaching strategies. Among those strategies is the creation of an interprofessional group meant to rethink practices in the Multiprofessional Health Residency program, as well as other studies that can address the professor and preceptor perspectives in Multiprofessional Health Residency programs in order to complement the information obtained in the study.
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Thibodeau, Stéphane. "Solitude professionnelle d'enseignants du secondaire : relations avec le leadership du directeur d'école /." Thèse, Trois-Rivières : Montréal : Université du Québec à Trois-Rivières ; Université du Québec à Montréal, 2006. http://proxy.uqtr.ca/login.cgi?action=login&u=uqtr&db=theses_UQTR&url=http%3A%2F%2Fwww.uqtr.ca%2Fbiblio%2Fnotice%2Fdocument%2F24941573D.pdf.
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Thèse (D. en éducation)--Université du Québec à Montréal, 2006.En tête du titre: Université du Québec à Trois-Rivières en association avec Université du Québec à Montréal. CaQTU Bibliogr.: f. [151]-183. Également disponible en formats microfiche et PDF. CaQTU
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Birchall, Elizabeth. "Working together? : a survey of professional perceptions in child protection in England." Thesis, University of Stirling, 1993. http://hdl.handle.net/1893/2193.
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This thesis presents findings from a postal survey in 1991, mainly in three diverse areas in the north of England. 339 members responded from six important professions in child protection: social workers, health visitors, teachers, police, general practitioners and paediatricians. The overall response rate was 60%. It explores practitioners' varied exposure to child protection training and experience of cases, their different severity ratings of brief vignettes of abuse, their thoughts and action proposals and choice of contacts in relation to an unfolding vignette, and their perceptions of local procedures and the functioning of their local child protection networks. The work rests on a literature review published in 1991 under the title Coordination and Child Protection: a review of the literature by Christine Hallett and myself. The general findings of the survey are that interprofessional cooperation and coordination are well accepted tenets among workers in the system and that most informed respondents believe the system works fairly well, particularly in the assessment stage. However, many people, particularly among teachers and general practitioners, revealed an extremely limited involvement in or knowledge of the system. A complex network is revealed. Social workers, specialist police and consultant paediatricians clearly emerge as the core but health visitors appear to be a crucial bridge between frontline agencies and the core professions. Many other professions and agencies appear to have peripheral or episodic involvement in cases. Despite the generally favourable view of the system's functioning, many points of tension and conflict are evident. These range from discrepant evaluations of cases through many other factors to competing priorities and resource shortfalls as obstacles to coordination. A number of proposals to ameliorate some of these tensions are put forward.
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Paterlini, Larissa Solange Moreira. "Triagem e diagnóstico de dificuldades de aprendizagem - Aplicação e desfecho de avaliações interdisciplinares de uma série de casos." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17160/tde-23042018-104135/.
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O processo de aprendizagem escolar ocorre em um dinamismo evolutivo a partir do amadurecimento das áreas corticais superiores, o que permite a aquisição da leitura, escrita, interpretação, argumentação, cálculo e raciocínio lógico. Diversos fatores podem interferir negativamente nesse processo levando às dificuldades de aprendizagem. Essas interferências podem ser por fatores intrínsecos primários como as alterações neurobiológicas que ocorrem no Transtorno Específico de Aprendizagem e no Transtorno de Déficit de Atenção e Hiperatividade (TDAH), ou por fatores intrínsecos secundários como os problemas psicoemocionais e doenças crônicas, ou ainda por interferências extrínsecas como os ambientais desfavoráveis. Neste trabalho, foi descrito o processo de triagem interdisciplinar do Ambulatório de Distúrbio de Comportamento e Aprendizagem (ADCA) do Hospital das Clínicas da Faculdade de Medicina Ribeirão Preto da Universidade de São Paulo (HCFMRPUSP), para diagnóstico de dificuldade de aprendizagem em crianças de 6 a 10 anos procedentes de uma única escola do ensino fundamental. Devido à complexidade e interdisciplinaridade do tema abordado contou-se com profissionais da área da saúde (fonoaudiólogo, neuropediatra, neuropsicólogo, psiquiatra infantil e terapeuta ocupacional) e da educação (pedagogo) que participaram da aplicação de testes e discussão dos resultados para definição de diagnóstico. Foi realizada uma triagem baseada em análise estatística do rendimento escolar em 104 crianças, com seleção de 56 alunos (54%). No entanto, apenas 27 alunos (48%) dessa amostra concluíram as avaliações. Após a bateria de testes, todos os alunos selecionados que compareceram à avaliação, obtiveram ao menos um diagnóstico compatível com dificuldade de aprendizagem. Entre as causas mais frequentes das dificuldades de aprendizagem, encontrou-se os sintomas/transtornos de ansiedade, o TDAH e os transtornos específicos de aprendizagem, representados por 15 (55%), 13 (48%) e 6 (22%), respectivamente, dos alunos avaliados. Em alguns casos essas condições foram comórbidas. Conclui-se que a escolha por uma escola atendeu as expectativas de homogeneizar a população em estudo; a análise estatística de rendimento escolar pode ser considerado um método com boa sensibilidade; a baixa adesão às avaliações permite evidenciar o quão difícil é para os pais compreenderem a importância dessa investigação; a abordagem interdisciplinar foi uma avaliação criteriosa e conclusiva sobre os variados diagnósticos encontrados e por fim, os diagnósticos mais encontrados foram os sintomas/transtornos de ansiedade, seguido por TDAH e por Transtornos Específicos de Aprendizagem.The process of school learning occurs in an evolutionary dynamism from the maturation of the upper cortical areas. They allow the acquisition of writing, reading, interpretation, argumentation, calculation and logical reasoning. Thus, many factors can interfer in this process negatively, generating learning disabilities. These interferences can be associated with; (1) primary intrinsic factors like the neurobiological alterations observed in the Attention Deficit Hyperactivity Disorder (ADHD) and Specific Learning Disorders (SLD); (2) secondary intrinsic factor like the psicoemotional problem or cronic diseases; (3) extrinsic interferences such as unfavorable ambient. This work described interdisciplinary evaluations to diagnose learning disabilities in children to 6 from 10 years. All the students are at the same school. It was chosen just one place to homogenize the population sample. The tests were applied in the Behavioral Disorder Learning Ambulatory (BDLA) in the Clinical Hospital of the School of Medicine of Ribeirão Preto - University of São Paulo. Due to the complexity and the interdisciplinary question, different types of health and educational professionals (speech therapist, neuropsychologist, neuropsychologist, child psychiatrist, occupational therapist and educacionalist) participated in this study. It was made a sorting of 104 children based on their school performance, which was selected 56 (54%). However, just 27 students (48%) finished the evaluation. After the tests, all students presented at least one diagnosis associated with learning disabilities. The most important causes found: 15 students (55%) with anxiety symptoms, 13 (48%) with ADHD and 6 (22%) with Specific Learning Disorders. In some situations, this conditions occurred simultaneously. In this way, it was concluded that: the statistical analysis showed a good sensibility; the lower accession in this research showed that the parents didn\'t know about the importance of this investigation; the interdisciplinary approach were carefully and conclusive evaluation of various diagnoses and the most frequence of them were: anxiety symptoms followed by ADHD and Specific Learning Disorders.
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Boakes, Jon C. "Clinical psychologists and multi-disciplinary teams : an investigation into team/professional identification, job satisfaction and burnout in clinical psychologists." Thesis, n.p, 1998. http://ethos.bl.uk/.
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LaFave, Lea R. Ayers. "Nursing Practice as Knowledge Work Within a Clinical Microsystem: A Dissertation." eScholarship@UMMS, 2008. https://escholarship.umassmed.edu/gsn_diss/9.
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Nurses have a key role in keeping patients safe from medical errors because they work at the point of care where most errors occur. Nursing work at the intersection of patients and health care systems requires high levels of cognitive activity to anticipate potential problems and effectively respond to rapidly evolving and potentially harmful situations. The literature describes nursing work at the intersection of patient and health care system as well as barriers to providing safe patient care. However, little is known about the systems knowledge nurses use to negotiate the health care system on their patients’ behalf, or how this systems information is exchanged between nurses.
Using the clinical microsystem as the conceptual framework, this qualitative descriptive investigation identified and described: 1) the components of systems knowledge needed by nurses, 2) how systems information is exchanged between nurses, and 3) systems information exchanged between staff nurses and travel nurses. Data were collected from a stratified maximum variation sample of 18 nurse leaders, staff nurses, and travel nurses working within a high-functioning neonatal intensive care nursery within a large academic medical center in New England. Data collection methods included participant observation, document review, individual interviews, and a focus group session. Data were analyzed through constant comparison for emerging themes and patterns. Findings were compared for commonalities and differences within and across groups.
Three components of systems knowledge emerged: structural, operational, and relational. Systems information exchange occurred through direct and indirect means. Direct means included formal and informal mechanisms. The formal mechanism of orientation was identified by each participant. Informal mechanisms such as peer teaching, problem solving, and modeling behaviors were identified by participants from each of the three nurse groups. Travel nurses’ descriptions of the common themes focused on individual efficacy. Staff nurses focused on fostering smooth unit functioning. Nurse leaders described common themes from a perspective of unit development. Four overarching domains of systems information were exchanged between staff nurses and travel nurses: practice patterns; staffing patterns and roles; tips, tricks, tidbits, and techniques; and environmental elements. Communication emerged as a common theme across nurse groups and domains of systems information exchanged. These findings have implications for nursing orientation and staff development, continuous improvement at the local level, and curriculum development.
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Cope, Julie K. "Exploring the Effect of an Interdisciplinary Teamwork Intervention in Acute Rehabilitation." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/6459.
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Purpose: The purpose of this study was to explore the efficacy of an interdisciplinary intervention on interdisciplinary teamwork and patient functional outcomes in an acute inpatient rehabilitation unit at a mid-sized regional hospital. Design: Pilot mixed-methods pre-post intervention study. Methods: Interdisciplinary teamwork and patient functional outcomes were measured before and after a teamwork intervention. Interdisciplinary teamwork was measured with the Healthcare Team Vitality Instrument (HTVI) and a qualitative staff questionnaire developed by a content expert. Patient functional outcomes were measured by aggregated Functional Independence Measure (FIM®) scores. Findings: Post-intervention FIM® gain scores increased significantly (p = .008). Staff questionnaire revealed improvement in interdisciplinary teamwork, with the major themes of teamwork and appreciation/respect. Post-intervention HTVI showed no significant change (p=.528). Conclusions: Initial results of this intervention are promising; additional research is needed to study the effectiveness of this intervention in a variety of acute rehabilitation settings. Clinical Relevance: Rehabilitation leaders can implement low-cost teamwork interventions to improve interdisciplinary teamwork and patient outcomes.
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Redus, Jason Cole. "An assessment of professional judgement as it relates to indoor mold investigations." Oklahoma City : [s.n.], 2006.
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Matuda, Caroline Guinoza. "Cooperação interprofissional: percepções de profissionais da Estratégia Saúde da Família no município de São Paulo (SP)." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-26102012-102123/.
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Pública, Universidade de São Paulo; 2012. O Núcleo de Apoio à Saúde da Família (NASF) é constituído por uma equipe multiprofissional e atua de forma conjunta com as equipes da Estratégia Saúde da Família (ESF). Ambos configuram-se como um espaço favorável para o estudo da interação entre os profissionais, o grau de cooperação e a produção de cuidado. O objetivo deste trabalho foi identificar elementos facilitadores e barreiras para o trabalho compartilhado, no âmbito da ESF e NASF. Para tanto, foi realizada uma pesquisa qualitativa, que utilizou de entrevistas em profundidade como instrumento de coleta de dados. Participaram do estudo 15 profissionais da ESF/NASF do município de São Paulo. As entrevistas foram transcritas e analisadas segundo a técnica de análise do discurso. Os resultados evidenciaram três categorias: recursos de cooperação; modelo de cooperação interprofissional; e metas, carga horária e rotatividade. A cooperação interprofissional está relacionada aos sentidos e significados que os profissionais dão ao seu papel no trabalho compartilhado, à sua forma de atuação e às diretrizes de trabalho. A utilização dos recursos, a adequação ao modelo de cooperação e a forma como os profissionais lidam com as metas denotam a coexistência de diferentes modelos de produção do cuidado. Observou-se insuficiência de dispositivos organizacionais para apoiar o trabalho compartilhado na ESF. O estudo destaca a necessidade de se ampliar o conhecimento sobre os processos colaborativos na ESF, reconhecendo o seu potencial de contribuição no campo da gestão do trabalho e da reforma dos modelos de atençãoThe Family Health Supporting Center (NASF) consists in multidisciplinary team which has principle to operate together with Family Health Strategy (ESF). Both of them are configured to a favorable space for the study of interaction between professionals, cooperation degrees and care. The aim of this study was to identify enablers and barriers of shared work in ESF/NASF. For this purpose a qualitative study was conducted. In-depth interviews were used for data collection. Fifteen São Paulo NASF/ESF professionals participated. The interviews were analyzed using discourse analysis technique. The results indicate the categories: collaboration resources, interprofessional collaboration model and goals, working hours, turnover. The interprofessional collaboration is related to the meanings that professionals give to their role in shared work, their way of acting and working guidelines. The use of resources, the cooperation model adequacy and how the professionals deal with the goals denote the coexistence of different models of care. There are insufficient organizational devices to support the shared work in the ESF. The study highlights the need to increase knowledge about the collaborative processes in the ESF, recognizing its potential contribution in the field of labor management and reform of health care models
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Reiners, Felix. "Networking in Organisationen /." Mering, Schwab : Hampp, R, 2008. http://deposit.d-nb.de/cgi-bin/dokserv?id=3125253&prov=M&dok_var=1&dok_ext=htm.
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Hällsten, Freddy. "Det dygdiga personalansvaret : om chefers ansvarstagande för personal utifrån etiska perspektiv /." Göteborg : BAS, 2003. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=010659224&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Hanada, Heloisa. "Os psicólogos e a assistência a mulheres em situação de violência." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-02062008-103651/.
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O presente estudo buscou identificar e analisar a inserção do psicólogo na assistência a mulheres em situação de violência, na rede de serviços específicos da região metropolitana de São Paulo. A partir da perspectiva da necessidade de ações multiprofissionais e intersetoriais no enfrentamento e atenção às situações de violência de gênero, estudou-se como a assistência psicológica é organizada em serviços de diversas vocações assistenciais e como suas ações são articuladas com outros profissionais e outros serviços. Para tanto, foram levantados documentos normativos para a assistência (Ministério da Saúde e Secretaria Especial de Políticas para as Mulheres) e foram analisadas informações obtidas em entrevistas com profissionais de 109 serviços paulistas de diversas vocações assistenciais (policial, jurídico, saúde, psicossocial, abrigos, orientações básicas). Os psicólogos estavam presentes e foram solicitados em todos os tipos de serviços, com menor participação nos serviços policiais e jurídicos. Tiveram inserção tanto na capacitação e supervisão dos profissionais em geral, como no atendimento direto à clientela dos serviços. Na assistência, notou-se grande diversidade de práticas - atividades clínicas, educativas, de orientação, mediação jurídica, sendo freqüente o ajustamento destas intervenções aos objetivos e cultura hierárquica de cada categoria de serviço. No geral, os psicólogos eram chamados para atuar no fortalecimento da auto-estima, retomada da vida sexual, reestruturação da vida, elaboração da situação de violência, elaboração e saída da condição de vitimização, promoção de autonomia e busca de transformação dos padrões de relacionamento familiar/ conjugal ou de gênero. Esses objetivos estavam postos para as equipes dos serviços em geral, especialmente o primeiro. Na formulação dos objetivos dos serviços e do formato das atividades propostas percebeu-se influência de concepções e propostas assistenciais do movimento de mulheres. Observou-se que nem sempre havia distinção clara entre o trabalho do psicólogo e de outros profissionais, principalmente com relação ao trabalho do assistente social, resultando em indefinição de funções e ações. Esta indefinição poderia representar dificuldades no diálogo entre profissionais e entre serviços e na articulação de ações multiprofissional, o que comprometeria a atenção integral às mulheres em situação de violência. Por outro lado, essa indefinição pareceu possibilitar inovações na prática assistencial. Observou-se também que a articulação multiprofissional foi buscada, em geral, no interior das equipes dos próprios serviços, mas em alguns os profissionais buscaram a complementariedade de suas ações pela articulação com serviços de outras vocações assistenciais. Levantou-se a necessidade de melhores definições sobre a assistência psicológica voltada para mulheres em situação de violência, em relação ao trabalho especifico do psicólogo na rede especializada e na rede geral de atenção de São Paulo.The aim of the present investigation was to identify and analyse the insertion of psychologists working in the network of services for assisting women experiencing violence in the metropolitan region of Sao Paulo. The organization of psychological assistance in diverse assistance vocations and the integration of psychologists in work teams and in other services were studied from the perspective of women\'s needs, and multi-professional and intersectoral actions in facing the situations and providing care for gender-based violence. For that, normative documents on violence care were researched (Ministry of Health and Department of Special Policy for Women) and data from interviews with professionals working in 109 services with diverse assistance vocations in Sao Paulo (police, justice, health, psychosocial assistance, shelters, basic assistance) were analysed. Psychologists are present and their work is requested in all types of services, but with less participation in police and justice facilities. They work in the training and supervision of other professionals, as well as directly assisting the public. A great diversity of practices was observed in the assistance - clinical, educational, orientation and judicial mediation activities - with frequent adjustment of these interventions to the objectives and hierarchical culture within each category of service. In general, psychologists are called to work in the strengthening of self-esteem, the resuming of sexual life, restructuring life itself, understanding of the situation of violence, working-out of and escape from the victim condition, promotion of autonomy and search for transformation in family/ intimate relationships or gender patterns. These objectives are put to the general teams working in the services, especially the first one. The influence of conceptions and proposals from the women\'s movement is perceived in the formulation of the services\' objectives and in the way the activities are developed. The distinction between the psychologists\' work and the work of other professionals is not always clear, especially regarding social work. This results in imprecise functions and actions, which may represent difficulties in the dialogue between professionals and services, and in the integration of multi-professional actions, potentially compromising integral care to women experiencing violence. On the other hand, this impreciseness opens up space for innovations in assistance practices. Multi-professional integration is, in general, also sought within work teams of each service, but in some of them the professionals search for complementarity in their actions and integration with services with different assistance vocations. There is a need for better definitions on the specific role of psychologists in the assistance of women experiencing violence, considering the specific network and the broader assistance network in Sao Paulo.
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Gehling, Cristina Roveré. "Planejamento familiar e a possibilidade de atuação na realidade através do trabalho em equipe multiprofissional." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/106857.
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INTRODUÇÂO: pesquisas direcionadas para atender às necessidades das comunidades locais, especificamente no caso de comunidades vulneráveis, além de produzirem resultados mais efetivos, devido à possibilidade de identificação e atuação na realidade observada, são também uma forma de qualificar e fortalecer a atenção primária em saúde. Este artigo é uma proposta de atuação embasada em referencial teórico. OBJETIVOS: conhecer as expectativas dos profissionais, bem como seus conhecimentos e disponibilidade para prestarem informações sobre planejamento familiar; conhecer as expectativas e necessidades das usuárias; e desenvolver estratégias para capacitação de profissionais de saúde que atuam em planejamento familiar. MÉTODOS: propõe-se uma pesquisa de avaliação com abordagem qualitativa e utilização da técnica de grupo focal. Sugere-se proceder à análise dos dados através da técnica de análise de conteúdo cujo processo deverá contemplar dois momentos: análise específica de cada grupo e análise cumulativa e comparativa do conjunto dos grupos pesquisados. CONCLUSÃO: através do trabalho em equipe multiprofissional é possível identificar e superar obstáculos que possam dificultar o processo de trabalho, com vistas a se obterem melhorias na qualidade do atendimento, com foco no planejamento familiar, respeitando-se as expectativas e necessidades das usuárias dos serviços de saúde.INTRODUCTION: researches aimed at meeting the needs of local communities, specifically in the case of vulnerable communities, produce highly effective results due to the possibility of identifying and acting on the observed reality; being also a way to qualify and strengthen primary healthcare. This article is an action proposal based on theoretical framework. PURPOSES: to understand the healthcare worker´s expectations, knowledge and readiness to provide information on family planning; to meet the expectations and needs of the users; and to develop strategies for training health professionals working in family planning. METHODS: it is proposed an evaluation research with qualitative approach and the use of the focus group technique. It is suggested to analyze the data using the technique of content analysis including in this process two stages: specific analysis of each group and cumulative and comparative analysis of all the groups surveyed. CONCLUSION: by working with multidisciplinary team, it is possible to identify and overcome obstacles that may hinder the care process that aims at achieving improvements in the quality of healthcare, with a focus on family planning, respecting the expectations and needs of the health services users.
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Qvarfort, Elisabeth. "Standardiserade vårdplaner : nyckeln till framgång? : En forskningsöversikt." Thesis, Sophiahemmet Högskola, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-1629.
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Crecencio, Salete Santos da Hora [UNIFESP]. "Práticas profissionais em um ambulatório oncológico." Universidade Federal de São Paulo (UNIFESP), 2014. http://repositorio.unifesp.br/11600/41919.
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Previous issue date: 2014-08-22Introdução: No campo da saúde o trabalho em equipe pode ser definido como a integração das disciplinas e das profissões que, durante o desenvolvimento de uma tarefa, almejam o mesmo objetivo, para a execução das práticas de saúde, com base na nova concepção biopsicossocial do processo saúde-doença. Considerando o atendimento ambulatorial a pacientes oncológicos, os profissionais que compõem a equipe podem perceber necessidades específicas relacionadas a esse universo, por alterações causadas pela doença. Tais necessidades envolvem as esferas biológica, emocional e sociocultural, o que justifica a necessidade de inter-relação entre as diferentes especialidades. Objetivo: Identificar as concepções dos profissionais que compõem a equipe multiprofissional de um Ambulatório Oncológico de Quimioterapia e Radioterapia sobre a prática profissional. Métodos: O estudo teve como cenário o ambulatório oncológico de quimioterapia e radioterapia de um hospital de ensino, tendo como participantes os profissionais que compõem as equipes multiprofissionais desses ambulatórios, com atuação diretamente ligada à área assistencial. Trata-se de uma pesquisa descritiva, de natureza qualitativa, tendo como abordagem metodológica o estudo de caso. Adotou-se, para coleta de dados, a realização de entrevistas semiestruturadas, e a análise de dados baseou-se na técnica de análise de conteúdo. Todos os procedimentos éticos foram seguidos, havendo aprovação dos Comitês de Ética em Pesquisa. Os relatos direcionaram para o desenvolvimento de quatro eixos temáticos. Resultados: No primeiro eixo intitulado Compreensão do Trabalho em Equipe os relatos sobre a concepção dessa forma de atuação demonstraram um olhar multiprofissional, devido a uma interação limitada no contexto de equipe, distorção na caracterização das diferentes perspectivas de trabalho e valorização do envolvimento entre os profissionais, por favorecer o aprendizado sobre as outras profissões. O segundo eixo Desenvolvimento das Práticas identificou momentos de atuação profissional isolada na perspectiva multidisciplinar, bem como de integração entre os membros da equipe, e a valorização da prática colaborativa que pode favorecer o cuidado e a resolução de questões práticas dentro da organização. No eixo Fatores Dificultadores os participantes relataram dificuldades no cotidiano das equipes que podem desfavorecer uma atuação integrada entre os profissionais, como sobrecarga de trabalho e deficiência na interação profissional por falha no processo de comunicação. No último eixo, intitulado Fatores Facilitadores, os relatos evidenciaram situações que contribuem para uma comunicação entre as diferentes especialidades, como o acesso facilitado aos profissionais por meio do diálogo, as reuniões multiprofissionais, que permitem importantes trocas e discussões, e a perspectiva interprofissional, como direcionadora do trabalho em equipe. Considerações finais: O estudo permitiu identificar o conhecimento dos profissionais que compõem as equipes multiprofissionais sobre a prática profissional e o trabalho em equipe, além de revelar como as práticas interprofissionais são desenvolvidas sob a ótica desses profissionais e a presença de momentos que expressam a integração entre os membros da equipe. Acredita-se que os resultados apresentados possam contribuir para o debate sobre as práticas profissionais na área da saúde, de modo que as instituições, os profissionais de saúde e as equipes criem condições para a realização de um trabalho em equipe integrado.
Introduction: In the health field, teamwork can be defined as the integration of disciplines and professionals which, during the development of a task, aim for the same objective - the execution of health practices, based on the new biopsychosocial conception of the health-disease process. Considering outpatient care provided to oncology patients, the professionals who make up the team can perceive specific needs related to this universe, through changes caused by the disease. These needs involve biological, emotional and sociocultural aspects, which explain the need for an interrelationship among different specialties. Objective: To identify the conceptions of professionals who make up the multiprofessional team of a chemotherapy and radiotherapy oncology outpatient clinic about their professional practice. Methods: The study setting was the chemotherapy and radiotherapy oncology outpatient clinic of a teaching hospital, and participants were the professionals who make up the multiprofessional teams of this clinic, who work directly in the care area. A qualitative descriptive study was conducted, using case study as the methodological approach. Data were collected by means of semi-structured interviews and analyzed using the content analysis technique. All ethical procedures were observed, and the research proposal was approved by a research ethics committee. The participants‘ statements led to the development of four thematic axes. Results: In the first axis, entitled Understanding of Teamwork, the statements about the conception of this form of activity showed a multiprofessional perspective, due to a limited interaction in the team context, a distortion in the characterization of the different perspectives of work and the appreciation of the involvement among professionals, as this favors learning about other professions. The second axis, regarding the Development of Practices, identified moments of isolated professional activity in the multidisciplinary perspective, as well as an integration among team members, and the appreciation of the collaborative practice that can favor care and resolution of practical issues within the organization. In the axis Hindering Factors, the participants reported difficulties in the daily routine of the teams that can hinder an integrated performance among the professionals, such as work overload and a deficient professional interaction due to failures in the communication process. In the last axis, entitled Facilitating Factors, the statements evidenced situations that contribute to a good communication among different specialties, such as facilitated access to professionals through dialogue, multiprofessional meetings, which allow for important exchanges and discussions, and the interprofessional perspective, guiding teamwork. Final considerations: The study allowed to identify the knowledge of professionals who make up multiprofessional teams on professional practice and teamwork, in addition to revealing how interprofessional practices are developed from the perspective of these professionals and the presence of moments that express the integration among team members. The results of this study are expected to contribute to the discussion on professional practices in the health area, so that institutions, health professionals and teams can create conditions for developing integrated teamwork.
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Park, Lauren Sarah. "Differential Well-Being in Response to Incivility and Surface Acting among Nurses as a Function of Race." PDXScholar, 2018. https://pdxscholar.library.pdx.edu/open_access_etds/4480.
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Demand for healthcare services is rising dramatically as the proportion of older adults in the United States increases, and the success of these healthcare organizations depends on cooperation among patients, doctors, and nurses. These interpersonal interactions come with costs associated with managing one's emotions in ways that are in line with completing job tasks effectively, especially as past research has demonstrated that nurses are likely to experience and respond to incivility, and nurses of minority backgrounds even moreso. This study examines the effect of experiencing incivility on engaging in surface acting, or simulating emotions that are not actually felt; how these two factors influence well-being outcomes; and the impact of racial differences in these relationships. A sample of 100 Black and White nurses participated in this research. Results indicate that experiencing incivility increases emotional exhaustion both directly and indirectly through engaging in surface acting in response to incivility. Additionally, findings suggest that Black nurses are more likely than White nurses to experience incivility from other nurses. These results highlight how incivility can contribute to burnout and negative health outcomes and that this effect may be particularly salient among Black nurses.
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Pirolo, Sueli Moreira. "Atuação interprofissional na terapia intensiva: a integralidade do cuidado e o agir comunicativo de Habermas." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-19122008-154253/.
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A atuação interprofissional em saúde tem-se constituído em um elemento importante para produção das ações de saúde, frente à complexidade do processo saúde-doença. Um desafio do trabalho em saúde é o de buscar o comprometimento dos trabalhadores, na perspectiva de produzir cuidado integral. Diante do contexto atual, em que as experiências do cuidado sob o eixo da integralidade para os doentes em situações clínicas críticas ainda são incipientes, esta investigação estabelece como objeto de estudo a atuação interprofissional no atendimento das necessidades de saúde dos doentes em situações clínicas e cirúrgicas críticas. Assim, o presente estudo elege por objetivo geral: produzir análise crítica, segundo Habermas, da atuação interprofissional no contexto da terapia intensiva na perspectiva da integralidade do cuidado em saúde. Para tanto, passamos por momentos de compreender a atuação dos profissionais que compõem a equipe de saúde; de interpretar as possibilidades e dificuldades da interação entre os diferentes profissionais de saúde e, de compreender as potencialidades e fragilidades da articulação interprofissional. Escolhemos as situações de admissão, alta, visita clínica aos doentes internados na terapia intensiva como eventos potenciais para apreensão da prática interprofissional. O presente estudo insere-se na abordagem qualitativa de pesquisa e consiste, ainda, em estudo descritivo elegendo o estudo de caso como modalidade de investigação. A Unidade de Terapia Intensiva do Hospital de Clínicas I de Marília foi escolhida como campo empírico. Os sujeitos da pesquisa são médicos, enfermeiros, fisioterapeutas e nutricionistas que atuaram nos eventos observados. A captação do material empírico consistiu em observação do cenário e entrevistas semi-estruturadas juntos aos trabalhadores de saúde. Para tratamento do material empírico utilizamos a técnica de interpretação de sentidos. A análise permitiu identificar dois eixos temáticos: o cuidado em saúde centrado nas necessidades individuais e a relação com a atuação profissional, atribuindo a atuação profissional o sentido biomédico, fragmentado do cuidado e centrado na tarefa; as possibilidades na transformação do cuidado em saúde na perspectiva da integralidade do cuidado e do agir comunicativo evidenciam que a ação instrumental está relacionada à interação multiprofissional enquanto a ação comunicativa se associa à interprofissionalidade. Finalizamos esse estudo com uma reflexão sobre a prática do enfermeiro, a qual evidencia a importância da articulação de ações de saúde quanto à integridade da pele do doente acamado.The health inter-professional performance has been an important element for the production of health actions, face to the complex health-disease process. A challenge on the health work is to seek the workers commitment, on the perspective to produce an integral care. On the present context, where the care experiences under the integrality axle for the patients in critical clinical situations are still incipient, this investigation sets as the study subject the inter-professional action on the attendance of the patients health care needs in critical clinical or surgical situations. Thus, this study has as general objective: to produce, according to Habermas, critical analysis of the inter-professional performance on the intensive therapy context on the perspective of the health cares integrality. For this, we have gone through moments to comprehend the performance of the professionals that make part of the health team; to interpret the possibilities and difficulties to interact between the different health professionals, and to comprehend the potentialities and weaknesses of the inter-professional articulation. We have chosen the situations of admission, discharge, and clinical visit to the patients on the Intensive Care Unit as potential events for apprehension of the inter-professional practice. This study is inserted on the qualitative research approach and consists of a descriptive study, electing the case study as the investigation modality. The Intensive Care Unit in the Hospital das Clínicas I in Marilia has been chosen as empiric field. The research subjects are physicians, nurses, physiotherapists and nutritionists that have acted as observed events. The empiric material caption has been observation of the scenery and semi-structured interviews to the health professionals. For treatment of the empirical material, we have used the sense interpretations technique. The analysis has allowed us to identify two thematic axles: the health care directed to the individual needs and the relation to the professional performance, giving the biomedical point of view, fragmented on the care and focused on the task; the possibilities on the transformation of the health care under the perspective of the care integrality and the communicative act show that the instrumental action is related to the multi-professional interaction while the communicative action is related to the inter-professionality. We have finished this study by reflecting on the nurse practice, which shows the importance of the articulation of health actions regarding the skin integrality of the patient on bed.
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Eckenschwiller, Maud. "Etude de l’émergence de la collaboration interprofessionnelle au sein du système hospitalier français." Electronic Thesis or Diss., Bourgogne Franche-Comté, 2023. http://www.theses.fr/2023UBFCF009.
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La collaboration interprofessionnelle (CIP) est au cœur des pratiques hospitalières en France. En regard d’un environnement complexe et en permanente évolution, elle apporte de nombreux bénéfices concernant les patients (Ben Maaouia, 2018 ; D'Amour & al., 2005), les professionnels (Brunelle, 2009 ; Lemieux-Charles & McGuire, 2006) et l’organisation (Aumais & al., 2012 ; Nielsen, 2004). Toutefois, les mécanismes de sa mise en œuvre nécessitent d’être davantage identifiés, explorés et compris, cela principalement aux niveaux organisationnel et interactionnel (Dumas & al., 2016 ; Gheorghiu & Moatty, 2005 ; Nobre, 2013 ; Vallejo, 2018). Ce travail de recherche s’appuie sur les recommandations de la littérature pour traiter de la CIP. Il s’agit notamment d’aborder la CIP en tant que processus (Humphrey & Aime, 2014 ; Kosremelli Asmar et Wacheux, 2007), de prendre en compte les interactions (Lemieux & McGuire, 2006 ; Ben Maaouia, 2017) et de traiter prioritairement de ses facteurs organisationnels (Jacob, 2015 ; Nolte & Tremblay, 2005 ; Robidoux, 2007 ; Sicotte & al., 2002) et de ses états émergents (Marks & al., 2001 ; Seeber & al., 2014 ; Waller & al., 2016).A partir de ces constats, notre travail de recherche, articulé en trois études, repose sur la problématique suivante : « Comment favoriser l’émergence de la collaboration interprofessionnelle au sein du système hospitalier français ? ». Pour répondre à cette problématique, nous menons d’une part une recension des écrits qui nous permet d’identifier et de mobiliser deux cadres théoriques complémentaires. Il s’agit premièrement du cadre théorique de la Formation Interdisciplinaire pour la Pratique en Collaboration Centrée sur le Patient de Oandasan, D’Amour & al. (2004) qui traite en particulier des facteurs organisationnels. Deuxièmement, il s’agit du cadre de performance collaborative de Bedwell & al. (2008) qui traite des états émergents. D’autre part, nous conduisons une étude qualitative et abductive, auprès d’agents d’un groupe hospitalier français.Les principaux résultats de notre travail de recherche concernent l’identification des enjeux de la CIP au sein des hôpitaux français, celle des interactions entre les facteurs organisationnels et les principaux états émergents de la CIP (confiance, cohésion, reconnaissance mutuelle, volonté de collaborer et leadership) et la contextualisation de ces différents éléments. L’étude ouvre vers des perspectives managériales inédites reposant sur le développement de modèles mentaux partagés en faveur de l’émergence de la CIP.Les perspectives futures s’orientent quant à elles vers l’application plus avant de notre cadre théorique et de notre proposition de cadre de réflexion managérial à de nouvelles recherches empiriquesInterprofessional collaboration (CIP) is at the heart of hospital practices in France. In view of a complex and constantly changing environment, it brings many benefits for patients (Ben Maaouia, 2018; D'Amour & al., 2005), professionals (Brunelle, 2009; Lemieux-Charles & McGuire, 2006) and the organization (Aumais & al., 2012; Nielsen, 2004). However, the mechanisms of its implementation need to be further identified, explored and understood, mainly at the organizational and interactive levels (Dumas & al., 2016; Gheorghiu & Moatty, 2005; Nobre, 2013; Vallejo, 2018). This research work based on the literature’s recommendations to address IPC. These include addressing IPC as a process (Humphrey & Aime, 2014; Kosremelli Asmar and Wacheux, 2007), considering interactions (Lemieux & McGuire, 2006; Ben Maaouia, 2017) and prioritizing its organizational factors (Jacob, 2015; Nolte & Tremblay, 2005; Robidoux, 2007; Sicotte & al., 2002) and its emerging states (Marks & al., 2001; Seeber & al., 2014; Waller & al., 2016).Based on these findings, our research work, articulated in three studies, is based on the following problem: “How to promote the emergence of interprofessional collaboration within the French hospital system?”.To address this problem, we are conducting a literature review that allows us to identify and mobilize two complementary theoretical frameworks. The first is the theoretical framework of the Interdisciplinary Training for Collaborative Practice in Oandasan, D'Amour & al. (2004), which deals in particular with organizational factors. Second, it is the Bedwell & al. (2008) collaborative performance framework dealing with emerging states. On the other hand, we are conducting a qualitative and abductive study with agents of a French hospital group.The main results of our research work is about the identification of the issues of the CIP within French hospitals, about the interactions between organizational factors and the main emerging states of the CIP (trust, cohesion, mutual recognition, willingness to collaborate and leadership) and the contextualization of these different elements.The study opens up new managerial perspectives based on the development of shared mental models for the emergence of IPC.Future perspectives are directed towards the further application of our theoretical framework and our proposal for a framework for managerial reflection to new empirical research
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Jové, Massó Anna Maria. "Barreres i facilitadors de la comunicació i la col·laboració entre el metge d’atenció primària i el farmacèutic comunitari." Doctoral thesis, Universitat Autònoma de Barcelona, 2014. http://hdl.handle.net/10803/284478.
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Introducció: La coordinació entre els professionals de l’àmbit de l’atenció primària de salut és clau per a l’atenció de qualitat i eficient. Segons l‘OMS, en aquest nivell els farmacèutics han de col·laborar amb els metges.
Els metges d’atenció primària i els farmacèutics de la comunitat són professionals que sovint comparteixen els mateixos pacients amb els mateixos objectius.
Múltiples estudis demostren una millora en els resultats de salut quan col·laboren. I també revelen que la manca de comunicació afecta la seguretat del pacient, i causa problemes evitables de salut. Tanmateix encara no és una pràctica habitual en el nostre entorn. Alguns estudis qualitatius previs assenyalen diversos factors que l’afavoreixen o la dificulten, però no són extrapolables al nostre context per les diferències existents.
Objectius: L’objectiu principal és identificar i analitzar, des de la perspectiva dels mateixos professionals, els factors que afecten la comunicació i la col·laboració entre els metges d’atenció primària i els farmacèutics comunitaris al territori de l‘Estat espanyol. Els objectius secundaris són explorar les diferències entre els col·lectius de professionals, entre Comunitats Autònomes i entre els professionals amb i sense experiència en col·laboració, així com avaluar la percepció d’utilitat de la col·laboració.
Metodologia. S‘ha dut a terme un estudi qualitatiu multicèntric exploratori-descriptiu amb entrevistes semiestructurades individuals a una mostra de metges d’atenció primària i farmacèutics comunitaris amb i sense experiència de col·laboració entre ells de dues Comunitats Autònomes: Catalunya i les Illes Balears.
Resultats: Es van fer un total de 37 entrevistes a 19 farmacèutics i 18 metges.
Els factors que afecten la col·laboració depenen del moment en que aquesta es trobi. Els factors que afecten l'inici de la col·laboració quan encara no n‘hi ha s’han agrupat en quatre factors clau: la percepció d’utilitat, l’interès del director de l‘equip d’atenció primària, l’actitud dels professionals així com les condicions geogràfiques i legislatives. Quan la col·laboració ja s‘ha establert amb èxit, s‘han agrupat en dos factors clau que n‘afecten la continuïtat: l’assoliment dels objectius i els canvis en la direcció del centre d’atenció primària.
Els factors relacionats amb les actituds han estat els més rellevants per tots els professionals. Els que han experimentat la col·laboració aporten més riquesa de dades sobre facilitadors. En canvi, els que no l’han experimentada o els que han intentat establir-la sense èxit, proporcionen més informació sobre les barreres que la dificulten.
No s‘han observat diferències destacables entre els diferents segments estratificats. La diferència observada entre Comunitats Autònomes és deguda als diferents tipus de gestió dels equips d’atenció primària.
Els metges d'atenció primària i els farmacèutics de la comunitat expressen opinions similars respecte la majoria dels components dels factors clau amb algunes diferències en cada col·lectiu, com en el conflicte d’interessos, que és específic per a cadascun.
Tots els participants han opinat que col·laborar produeix efectes positius: per al Sistema Sanitari, els professionals i els pacients. D‘opinions negatives respecte la utilitat de col·laborar, només se n‘ha detectat en professionals sense experiència en col·laboració.
Conclusions: Aquest estudi contribueix a conèixer i comprendre per què no hi ha col·laboració entre metges d’atenció primària i farmacèutics comunitaris en cas que sigui així. Quan col·laboren, permet identificar les àrees de millora i els factors que influeixen en que es perpetuï. També permet desenvolupar diverses estratègies i intervencions per promoure-la.
En estudis futurs seria interessant avaluar les estratègies i intervencions proposades perquè la col·laboració es dugui a terme amb èxit, així com l’impacte de la col·laboració en relació amb la intensitat en què aquesta es produeix.Introduction: Coordination among primary health care professionals plays a key role in providing high-quality and effective primary health care. The WHO strongly recommends that pharmacists and general practitioners collaborate at this level. Both community pharmacists and general practitioners are professionals who often share the same patients and objectives. A number of studies have shown that collaboration between these professionals leads to improved results in community health. Findings also indicate that a lack of communication between them affects the patient's security and causes avoidable health problems. However, collaborating is still not common practice in the Spanish health system. Some previously conducted qualitative studies show that there are several factors which favour or hinder collaboration, but because of existing differences they are not applicable to Spain. Objectives: The main objective of this study is to identify and analyse the primary and secondary factors affecting communication and collaboration between community pharmacists and practitioners in Spain from their perspective. The secondary objectives are to explore the differences between professional collectives, between Autonomous Communities and between professionals with and without experience in collaboration, and to evaluate how useful this collaboration is perceived to be. Methods: This study is based on qualitative exploratory-descriptive and semi-structured multicentre face-to-face interviews conducted with primary health practitioners and community pharmacists – both with and without experience in collaborating – based on two Autonomous Communities: Catalonia and the Balearic Islands. Findings: A total of 37 interviews with 19 pharmacists and 18 practitioners were conducted. The factors affecting collaboration depend on the collaboration phase. Four key factors with an impact on the initiation of collaboration were identified: perceived usefulness, interest of the head of the primary health care team, the professionals' attitude, and geographical as well as legal conditions. Once successfully set up, the continuity of a collaboration appears to depend on two factors: the fulfilment of objectives and changes in the management of the primary health care centre. Attitude-related factors were the most relevant for professionals. Those with a background in collaboration provided more data and information about facilitators. In turn, those without experience provided more information about barriers and difficulties. No significant differences between the stratified segments were observed. The differences between Autonomous Communities are due to divergent management approaches within the primary health care teams. Primary health practitioners and community pharmacists expressed similar opinions regarding the majority of these key factors with some differences specific to each professional collective, e.g. regarding conflicts of interest which are specific to each professional group. All participants of both professions agreed that collaborating has positive effects on the health care system, the patients and the professionals themselves. Negative opinions have only been found in professionals without experience in collaboration. Conclusions: This study is a contribution to exploring and understanding the lack of collaboration between primary health practitioners and community pharmacists. It also helps to identify potential room for improvement and factors affecting the continuity of existing collaborations. Finally, it provides a basis for developing strategies and measures in order to promote collaboration. Future studies should evaluate the proposed measures and strategies for a successful collaboration as well as the impact it creates in relation to the intensity with which it is carried out.
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Medeiros, Angelica Teresa Nascimento de. "Atividades profissionais da enfermagem no contexto hospitalar: influ?ncias nas rela??es de trabalho." Universidade Federal do Rio Grande do Norte, 2010. http://repositorio.ufrn.br:8080/jspui/handle/123456789/14707.
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Previous issue date: 2010-10-04The present study is based on an analysis of professional work relationships in the nursing team from the task/skills of its members as a contribution to understanding the work process in nursing. It is aimed to identify the skills of the nursing team members through the vision of nurses, technicians and nursing assistants, thus it attempts to find strategies to improve the health assistance to patients. It is a descriptive and analytical study with a qualitative approach grounded in theoretical and methodological framework of Symbolic Interactionism. The research was carried out in the participant work place, a Public Hospital of Reference for the SUS, located in the eastern health district of Natal/RN. Nineteen nursing professionals participated in the study, which seven was nurse and twelve nursing technician. As procedure to collect data we used an unstructured interview accompanied by a standard topic guide which was recorded and later transcribed. The content analysis was chosen as the main methodology to analyze the discussion, which gave rise to thematic categories that were considered relevant based on the theoretical framework of this study, and the interactionist theory. This study was in accordance with the ethical principles of the Resolution n?. 196/96, it has obtained an appropriate consent of the UFRN Research Ethics Committee. The results indicate that the professionals seen the nursing as a profession strongly attached to the health care process and as a profession that acquired a scientific status very recently. Regarding to the nursing functions in the work process in nursing, the professionals they identified the manage/administer category as the main activities developed by these professionals, thus the education and complex care in nursing categories. Concerning to the technicians and nursing assistants functions, it was figured out in the professional s opinion that there is not distinction among the attribution of these categories. The interviewed were unanimous in report that these professionals are more involved in direct patient health care through performance of basic duties in nursing care. Finally, with regard to the work relationship among nursing team members, the majority of those interviewed see this relationship as disharmony and quarrelsome and in general, there is not bond between categories that comprise the process of work in nursing. On the basis of our results we consider the importance of knowing the meaning of nursing given by these professionals; also their skills could be useful as basis to identify problems, which source could be detected in the power relationship, deviations of functions, gap between design (knowledge) and performance (doing) work, besides the loss of the global activities view in the process of nursing work
O presente estudo faz uma an?lise das rela??es de trabalho na equipe de enfermagem a partir das atribui??es/compet?ncias de seus membros, como contribui??o para o entendimento do processo de trabalho em enfermagem. Teve como objetivos identificar as compet?ncias dos membros da equipe de enfermagem atrav?s da vis?o de enfermeiros, t?cnicos e auxiliares de enfermagem, al?m de tentar detectar estrat?gias para melhorar a assist?ncia prestada ao paciente. Trata-se de um estudo descritivo e anal?tico com abordagem qualitativa, fundamentado em princ?pios te?rico-metodol?gicos do Interacionismo Simb?lico. Teve como cen?rio o local de trabalho dos participantes, sendo este um Hospital P?blico de Refer?ncia para o SUS, localizado no Distrito Sanit?rio Leste do Munic?pio de Natal/RN. Participaram do estudo 19 profissionais de enfermagem, dos quais, 07 eram enfermeiros e 12 eram t?cnicos de enfermagem. Como procedimento de coleta, utilizou-se uma entrevista n?o-estruturada acompanhada de formul?rio, cuja foi gravada e posteriormente transcrita. Para a an?lise dos resultados, utilizou-se a an?lise de conte?do, a qual fez emergir categorias tem?ticas relevantes, que foram analisadas tendo por base os referenciais te?ricos desse estudo, bem como a teoria interacionista. O estudo obedeceu aos preceitos ?ticos da Resolu??o n?. 196/96, com parecer favor?vel do Comit? de ?tica e Pesquisa da UFRN. Os resultados obtidos indicam que para os profissionais a Enfermagem ? uma profiss?o fortemente atrelada ao processo de cuidar e recentemente vem adquirindo status de ci?ncia. No que se refere ?s fun??es do enfermeiro, no processo de trabalho em enfermagem, tais profissionais relacionaram as categorias gerenciar/administrar como sendo as principais atividades desenvolvidas por eles, al?m da categoria de ensino e da presta??o de assist?ncia em cuidados de enfermagem complexos. Com rela??o ?s fun??es dos auxiliares e t?cnicos de enfermagem, notou-se que na opini?o dos profissionais, n?o existe mais uma distin??o entre as atribui??es dessas categorias. Os entrevistados foram un?nimes em relatar que a esses profissionais est? atribu?do o cuidado direto ao paciente, atrav?s da realiza??o de cuidados de enfermagem mais simples. E, por fim, no que tange ?s rela??es de trabalho entre os membros da equipe de enfermagem, para a maioria dos entrevistados tais rela??es s?o conflituosas, desarm?nicas e, geralmente, n?o existe uni?o entre as categorias que comp?em o processo de trabalho em enfermagem. Diante desses achados, considera-se que a import?ncia de se conhecer o significado de enfermagem atribu?do por estes profissionais, bem como as suas compet?ncias pode servir de base para a identifica??o dos problemas, cuja origem pode se localizar nas rela??es de poder, desvios de fun??es, distanciamento entre concep??o (saber) e execu??o (fazer) do trabalho, al?m da perda da globalidade das atividades realizadas no processo de trabalho em enfermagem
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Ekole, Elizabeth. "Relational Intelligence: A Framework to Enhance Interprofessional Collaborative Care." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2068.
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Many studies have reported that the training for practitioners does not stimulate reflexes that contribute to the tenets of teamwork and collaboration. No studies were found to investigate relational intelligence (RQ) in pharmacist-physician relationships as a catalyst for collaborative and hence cost effective quality care. This study addressed the role and potential opportunity to promote RQ as a critical leadership skill in the collaboration between pharmacists and physicians. Using RQ as the conceptual framework, this phenomenological study explored how pharmacists and physicians in a hospital setting perceive RQ as a leadership skill when working collaboratively. A total of 10 participants (5 pharmacists and 5 physicians) from a 443-bed comprehensive hospital in Michigan were selected using purposive sampling. Pharmacists and physicians included had at least 4 years of hospital experience. Data were collected through semistructured in-depth interviews and analyzed using the hierarchical approach. Results indicated interest among both pharmacists and physicians to use RQ as a leadership skill to work collaboratively. Further findings highlighted the need for face-to-face communication between pharmacists and physicians, better collaboration, accountability, feedback, focus and alignment, promotion of positive relationships, and a leadership position directed by a PhD-prepared practitioner with expertise in RQ. These findings bring awareness to both pharmacists and physicians of barriers to collaboration; these findings also suggest the need for multidisciplinary training that incorporates RQ theory as a foundation for both pharmacists and physicians, which may decrease health care costs while improving communication, trust, mutual understanding, collaboration, and quality care.
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Goulart, Bethania Ferreira. "Aspectos facilitadores e dificultadores do trabalho em equipe em Unidade de Alta Densidade Tecnológica." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/83/83131/tde-24112015-135310/.
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O trabalho em equipe representa estratégia para superação da frágil articulação entre profissionais, sendo potencializado pela prática colaborativa entre agentes e gestão participativa. Entretanto, os arranjos organizacionais não favorecem a interação entre os profissionais e dificultam o trabalho em equipe. A magnitude dos agravos cardiovasculares por serviços regulados e estruturados, pautados num enfoque multiprofissional em saúde, a carência de publicações científicas sobre trabalho em equipe na atenção hospitalar, a potência do trabalho em equipe para responder às demandas reais de saúde justificam investigações a respeito do trabalho em equipe de saúde em Unidade Coronariana, particularizando a compreensão de aspectos que dificultam e facilitam esse trabalho. Assim, esta pesquisa teve como objetivo analisar o trabalho em equipe, desenvolvido em unidade hospitalar de alta densidade tecnológica, segundo a perspectiva da equipe de saúde. É um estudo descritivo, utilizando dados qualitativos e quantitativos, realizado em Unidade Coronariana de um Hospital público, de ensino, de nível terciário, referência para atendimento de alta densidade tecnológica. A população constituiu-se de profissionais da equipe multiprofissional que atuavam na referida unidade há, pelo menos, um ano, sendo excluídos aqueles que se encontravam afastados do trabalho à época da coleta dos dados e os não localizados após três tentativas para agendamento da entrevista. Utilizou-se a Técnica do Incidente Crítico, e os dados primários foram coletados por meio de entrevista semiestruturada. A análise dos dados fundamentou-se em análise de conteúdo. Participaram do estudo 45 profissionais da equipe de saúde, sendo 20 técnicos/auxiliares de enfermagem; 11 médicos; nove enfermeiros; quatro fisioterapeutas e um psicólogo. Das entrevistas, emergiram 49 situações, das quais 38 (77,6%) receberam referências negativas e 11 (22,4%), positivas; 385 comportamentos, sendo 209 (54,2%) positivos e 176 (45,8%) negativos; além de 182 consequências que receberam 131 (71,9%) referências negativas e 51 (28,1%) positivas. As referências positivas indicam aspectos que facilitam o trabalho em equipe e as negativas, aqueles que dificultam. Foram considerados facilitadores do trabalho em equipe colaborar/relacionar-se com os outros profissionais, desenvolver assistência ao paciente conforme a competência profissional, relacionamento entre agentes pautado na prática colaborativa e comunicação. Aspectos como baixa colaboração entre profissionais, gerenciamento inadequado de agentes, despreparo profissional no atendimento à parada cardiorrespiratória/emergência, divergências nas condutas terapêuticas, limitação de recursos materiais e agir de maneira descomprometida com o trabalho dificultam o trabalho em equipe. Conclui-se que, apesar do predomínio de situações e consequências negativas relativas à dinâmica do trabalho em equipe nessa Unidade Coronariana, a ênfase em comportamentos positivos, favoráveis ao trabalho em equipe, evidencia investimento e esforço para superar dificuldades, na perspectiva da potência do trabalho em equipe para atingir a finalidade do trabalho em saúde. A partir dos resultados, acredita-se que aspectos relativos à formação/capacitação profissional e à organização do serviço precisam favorecer o trabalho em equipe, estando a centralidade do processo de trabalho dessa equipe nas relações entre agentesTeamwork is a strategy for overcoming the fragile link between professionals, enhanced by collaborative practices between agents and participatory management. However, the organizational arrangements do not favor the interaction between professionals, hindering teamwork. The magnitude of cardiovascular diseases, worsened by regulated and structured services, guided by a multi-professional approach to health, and the lack of scientific publications on teamwork in hospital care and its potential to meet real health needs justify studying the teamwork of a health team in a Coronary Care Unit, individualizing the understanding of aspects that hinder and facilitate this work. Thus, the aim of this study was to analyze the teamwork developed in hospital of high technological density, from the perspective of the health team. It is a descriptive study using qualitative and quantitative data, held in a teaching, tertiary, reference Coronary Care Unit for a high technological density service. The population consisted of professionals from the multidisciplinary team who worked in that unit for at least one year, excluding those who were out of work at the time of data collection or who were not located after three attempts to schedule the interview. The Critical Incident Technique was used, and primary data were collected through semi- structured interviews. Data analysis was based on content analysis. Study participants were 45 health team professionals, 20 nursing technicians/aides; 11 physicians; 9 nurses; 4 physical therapists and 1 psychologist. The interviews revealed 49 situations, of which 38 (77.6%) were negative references and 11 (22.4%) positive; 385 behaviors, where 209 (54.2%) were positive and 176 (45.8%) negative; in addition to receiving 182 consequences of which 131 (71.9%) were negative and 51 (28.1%) were positive references. Positive references indicate aspects that facilitate teamwork and negative aspects that hinder it. The characteristics among staff such as collaboration/relationship with other professionals, development of patient care according to professional competence, relationship between guided agents in collaborative and communication practice were considered teamwork facilitators. Aspects such as low collaboration among professionals, inadequate agent management, lack of professional preparation to assist heart arrests/emergencies, differences in therapeutic approaches, limitation of material resources and lack of commitment to work hinder teamwork. In conclusion, despite the predominance of negative situations and consequences related to the dynamics of teamwork in this Coronary Care Unit, the emphasis on positive behavior, favorable to teamwork, shows investment and effort to overcome difficulties in view of the teamwork potential to achieve the purpose of health work. Analyzing these results, it is believed that aspects of the professional education/training and service organization must promote teamwork, with the centrality of the working process of this team focused on the relationships among agents
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Ferigollo, Juliana Prestes. "INTERDISCIPLINARIDADE: DA FORMAÇÃO A PRÁTICA PROFISSONAL EM REABILITAÇÃO EM SAÚDE." Universidade Federal de Santa Maria, 2016. http://repositorio.ufsm.br/handle/1/6597.
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The present study aimed to identify in the field of training and in the perception of rehabilitation professionals-physiotherapists, speech therapists and occupational therapists-South region of Brazil, as develops the theme of interdisciplinarity of caution. This is a cross-sectional study of qualitative and quantitative approach in view of the instruments chosen for the collection of data which will be exploratory-descriptive research. The data collection took place from online quizzes created in Google DocsOffline®,, for each of the specific professional areas and also from the analysis of the teaching designs of graduation courses in physiotherapy, speech therapy and occupational therapy, in the South region, available online. For the data analysis we used the descriptive analysis of the studied variables and Chi-square test of Pearson. Also content analysis was used for the open questions. The results found by analyzing the training of physiotherapists, speech therapists and occupational therapists regarding interdisciplinary character experiences during undergraduate studies have shown that this is not a recurring theme for all professionals, showing that their absence in the period of formation interferes with the recognition of other assignments in addition to specialties make it difficult for professionals, during practice, the recognition of the need for other professional and need to make referrals. The analysis of the educational projects of the courses and the perception of the coordinators of the courses of the studied areas identified that such actions, at graduation, happen in elective courses, extension projects or research, not being mandatory in character and therefore not part of the education of all students. The second time, by analyzing the perception of physiotherapists, speech therapists and occupational therapists on the exercise of the interdisciplinarity in their professional practice it has been observed that these professionals recognize the importance of interdisciplinarity in the area, however not all perform interdisciplinary actions in your daily work. This happens due to a lack of professionals in the workplace, but also by the ignorance about the assignments of some professionals. In relation to the importance of interdisciplinary care to Human Communication Disorders found that professionals are aware and recognize that the subject attended both by physical therapy, and speech therapy and occupational therapy require an integral vision and not just look at its pathology. Given this, it is possible to point out the need for initial training that addresses the interdisciplinarity in health care and to prepare professionals to practice based on an interdisciplinary context. Highlights the importance of teachers sensitized and concerned to propose actions of interdisciplinary character to form professionals to develop the practice based on interdisciplinary logic.O presente estudo teve como objetivo identificar no campo da formação e na percepção de profissionais de reabilitação fisioterapeutas, fonoaudiólogos e terapeutas ocupacionais da região sul do Brasil, como se desenvolve o tema da interdisciplinaridade no cuidado em saúde. Trata-se de um estudo transversal de abordagem qualitativa e quantitativa tendo em vista os instrumentos escolhidos para a coleta de dados os quais serão de investigação exploratório-descritiva. A coleta dos dados se deu a partir de questionários online criados no Google DocsOffline®, específicos para cada uma das áreas profissionais e para coordenadores dos cursos de graduação das mesmas áreas, e a partir da análise dos projetos pedagógicos de cursos de graduação em Fisioterapia, Fonoaudiologia e Terapia Ocupacional, da região sul, disponíveis online. Para análise dos dados utilizou-se a análise descritiva das variáveis estudadas e o Teste do Qui-Quadrado de Pearson. Também se utilizou a análise de conteúdo para as questões abertas. Os resultados encontrados ao analisar a formação de fisioterapeutas, fonoaudiólogos e terapeutas ocupacionais quanto às experiências de caráter interdisciplinar durante a graduação mostraram que este não é tema recorrente para todos os profissionais. Observou-se que a ausência do tema no período da formação interfere no reconhecimento das atribuições de outras especialidades além de dificultar para os profissionais, durante a prática, o reconhecimento da necessidade de outro profissional e da necessidade de realizar encaminhamentos. Da análise dos projetos pedagógicos dos cursos e da percepção dos coordenadores dos cursos das áreas estudadas identificou-se que tais ações, na graduação, acontecem em disciplinas eletivas, projetos de extensão ou pesquisa, não sendo de caráter obrigatório e, portanto, não fazendo parte da formação de todos os alunos. No segundo momento, ao analisar a percepção de fisioterapeutas, fonoaudiólogos e terapeutas ocupacionais sobre o exercício da interdisciplinaridade na sua prática profissional observou-se que esses profissionais reconhecem a importância da interdisciplinaridade na área, porém nem todos realizam ações de caráter interdisciplinar no seu cotidiano de trabalho. Isso acontece pela falta de profissionais da área nos locais de trabalho, mas também pelo desconhecimento sobre as atribuições de alguns profissionais. Em relação à importância da interdisciplinaridade no cuidado aos Distúrbios da Comunicação Humana observou-se que os profissionais estão cientes e reconhecem que os sujeitos atendidos tanto pela Fisioterapia, quanto pela Fonoaudiologia e pela Terapia Ocupacional necessitam de uma visão integral e não apenas do olhar sobre sua doença. Diante disso, é possível apontar a necessidade de uma formação inicial que aborde a interdisciplinaridade no cuidado em saúde e que prepare os profissionais para a prática baseada nesse contexto. Evidencia-se a importância de professores sensibilizados e implicados em propor ações de caráter interdisciplinar para que assim se formem profissionais capacitados para desenvolver a prática pautada nessa lógica.
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Molina, Mula Jesús. "Saber, poder y cultura de sí en la construcción de la autonomía del paciente en la toma de decisiones. Relación de la enfermera con el paciente, familia, equipo de salud y sistema sanitario." Doctoral thesis, Universitat de les Illes Balears, 2013. http://hdl.handle.net/10803/112120.
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La literatura científica sitúa la autonomía del paciente en la toma de decisiones en el ámbito clínico, en una encrucijada entre dos posiciones éticas; el paternalismo y la elección informada. Analizar los textos de los registros de las historias clínicas y los discursos de las enfermeras, mediante una metodología cualitativa y desde la perspectiva de la ética foucaultiana, permite conocer los factores que determinan el poder de decisión de los pacientes. Este estudio revela que el paciente no es autónomo en la toma de decisiones sobre sus cuidados debido; a una determinada institucionalización de la atención, que marca los ritmos de las decisiones, a las características de las relaciones interprofesionales y a las dinámicas relacionales que se establecen entre los profesionales, en particular, de la enfermera con el paciente y la familia. Se debe liberar al paciente de las reglas impuestas, promoviendo su propia conducta, su propio estilo de vida.The scientific literature places the patient autonomy in decision-making in the clinical setting, at a crossroads between two ethical positions, paternalism and informed choice. Analyze records of clinical histories and nurses discourses, using a qualitative methodology and from the perspective of foucauldian ethics, allows knowing the factors that determine the power of patient decision. This study reveals that the patient is not autonomous in making decisions about your care because, to a certain institutionalization of care, which marks the rhythms of the decisions, the characteristics of the interprofessional-relationships and relational dynamics that exist between professionals, in particular, of the nurse with the patient and family. It should free the patient from the rules imposed by promoting their own behavior, their own lifestyle.
La literatura científica situa l'autonomia del pacient en la presa de decisions en l'àmbit clínic, en una cruïlla entre dues posicions ètiques, el paternalisme i l'elecció informada. Analitzar els textos dels registres de les històries clíniques i els discursos de les infermeres, mitjançant una metodologia qualitativa i des de la perspectiva de l'ètica foucaultiana, permet conèixer els factors que determinen el poder de decisió dels pacients. Aquest estudi revela que el pacient no és autònom en la presa de decisions sobre les seves cures a causa, a una determinada institucionalització de l'atenció, que marca els ritmes de les decisions, a les característiques de les relacions interprofessionals i les dinàmiques relacionals que s'estableixen entre els professionals, en particular, de la infermera amb el pacient i la família. Cal alliberar el pacient de les regles imposades, promovent la seva pròpia conducta, el seu propi estil de vida.
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Medina, Aline Gomes. "Terapia ocupacional e a educação para a interprofissionalidade em residências multiprofissionais em saúde." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5170/tde-23062016-084223/.
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A formação em serviço realizada pelo programa de Residência Multiprofissional em Saúde (RMS) é uma estratégia educativa que visa a mudança do perfil dos profissionais da saúde para atuação no Sistema Único de Saúde (SUS). Dentre as profissões que compõem as residências, a terapia ocupacional foi eleita como foco deste estudo com o objetivo de conhecer e refletir sobre os desafios e tendências do processo de educação profissional e interprofissional na perspectiva de tutores, preceptores e residentes terapeutas ocupacionais. A metodologia eleita foi a abordagem qualitativa com realização de entrevistas e análise de conteúdo para a elaboração dos resultados e discussão. Foram realizadas 17 entrevistas em três programas de RMS de diferentes municípios do estado de São Paulo com cenários educativos realizados na atenção hospitalar e na atenção básica. Duas categorias empíricas foram identificadas nos resultados: (i) \"Residência multiprofissional de saúde como dispositivo de mudança\" dividida em duas subcategorias: \"Trabalho em equipe\" e \"Trabalho na perspectiva do SUS\" e (ii) \"Singularidades na formação do terapeuta ocupacional em RMS\" agrupada nas subcategorias: \"Particularidades da inserção profissional do terapeuta ocupacional nos cenários educativos\", \"Produção de identidades e a fragmentação da atuação do terapeuta ocupacional nas RMS\" e \"Terapia ocupacional e as práticas colaborativas e interprofissionais no SUS\". A pesquisa permitiu conhecer o potencial de mudanças dos programas de RMS em relação à formação dos residentes e à disseminação de práticas em saúde, colaborativas em equipe e sob a perspectiva do SUS. Os resultados apontaram a singularidade do processo formativo de terapeutas ocupacionais nas RMS que sofrem impactos pela insuficiente contratação de profissionais nos serviços, pelo desconhecimento do papel profissional do terapeuta ocupacional e pela fragmentação da atuação profissional nos cenários de prática; experiências que geram insegurança de residentes e profissionais quanto aos limites da atuação profissional e interprofissional no trabalho em equipe. O foco da terapia ocupacional nas atividades e cotidianos das pessoas no processo do cuidado em saúde e a mediação do cuidado de pessoas com deficiência e transtornos mentais foram identificados como contribuições da terapia ocupacional para as práticas colaborativas e interprofissionais no SUS. Conclui-se que o potencial de mudanças dos programas para a atuação dos residentes como futuros profissionais está diretamente relacionado com as estratégias pedagógicas desenvolvidas nos cenários educativos. A formação de terapeutas ocupacionais nas RMS depende das características dos cenários educativos, no que se refere a sua organização e interação interprofissional pré-existente, à suficiência do número de preceptores, à consolidação de fluxos assistenciais e ao (re)conhecimento da Terapia Ocupacional pelos demais profissionais dos serviços. Por fim, os participantes afirmaram a importância da RMS para a aprendizagem de saberes e práticas - próprios da profissão, comuns aos profissionais de saúde e construídos em equipe de forma colaborativa - com o propósito da qualificação do cuidado em saúdeThe in-service education carried out by the multi-professional residency in health (MPRH) is a strategy that aims at a profile change of health professionals in order to prepare them to work in the Brazilian Unified Health System (SUS). Among the professions included in MPRH, the occupational therapy was selected as the focus of this study in order to explore and reflect on the challenges and tendencies of the professional and inter-professional education process from the perspective of occupational therapy tutors, preceptors, and residents. The selected methodology was the qualitative approach, carried out by means of interviews and content analyses that led to the elaboration of results and discussions. Seventeen interviews were carried out in three MPRH programs of different municipalities in the State of São Paulo, and had their educational scenarios centered in hospital care and basic health care. Two empiric categories were identified in the results: (i) \"MPRH as a means of change,\" divided into two subcategories: \"Team Work\" and \"Work from the perspective of SUS ,\" and (ii) \"Singularities in the education of the occupational therapist in MPRH\", which was grouped in the following subcategories: \"Particularities of the inclusion of occupational therapists into the educational scenarios,\" \"Production of identities and the fragmentation of the occupational therapists\' work in MPRH\" and \"Occupational Therapy and the collaborative and inter-professional practices in SUS.\" The research allowed for the identification of possibilities of changes brought about the MPRH regarding the professional education of residents and the dissemination of collaborative practices among health service professionals from the perspective of SUS. Results pointed out the singularity of the educative process of occupational therapists in the MPRH, which are impacted by the insufficient professional staffing, the unawareness of the occupational therapist\'s professional role and the fragmentation of the professional work in practice settings; experiences which cause insecurity to residents and professionals regarding the limits of the professional and inter-professional team work. The occupational therapy focus on the activities and daily life of people in health care and the mediation of the care given to people with physical and mental disabilities were identified as occupational therapy contributions to collaborative and inter-professional practices in SUS. The conclusion is that the potential for change that programs provide for the activities of residents as future professionals is directly related to the pedagogical strategies developed in the educational settings. The education of occupational therapists in MPRH depends on the characteristics of the practice settings, regarding their organization and the pre-existing inter-professional interaction, a sufficient number of preceptors, the consolidation of assistance flows, and the recognition of occupational therapy by other health professionals. Finally, the participants restated the importance of the MPRH for the learning of knowledge and practices - particular to the profession, common to health professionals, and accrued through collaborative team work - as the purpose of the qualification in health care services
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Farias, Danyelle Nóbrega de. "A interdisciplinaridade na prática profissional na estratégia da saúde da família." Universidade Federal da Paraíba, 2015. http://tede.biblioteca.ufpb.br:8080/handle/tede/7959.
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The complexity of the health problems that are presented to family health teams requires more strongly the need for interdisciplinary actions, aiming at integral care. However, the formation of professionals that make up these teams, the overload work with which they live and the own organization of the work process does not always favor the achievement of these practices. This is the problem in which this study focuses. The objective of this study is to analyze the limits, and possibilities of interdisciplinary actions in professional practice of nurses, doctors and dentists in family health units. This is a cross-sectional study, exploratory, descriptive and inferential, developed from the qualitative and quantitative approaches. The sample consisted of Nurses, Physicians and Surgeon dentists of Family Health Teams in João Pessoa city. The questionnaire was constructed, validated and applied to all professionals by lot of the Family Health Teams. The qualitative part was made from participant observation during two months. The results of the questionnaires were submitted to Cluster Analysis. While the observation, thematic analysis was performed and the data were compared with quantitative results. The three professions had limitations on the interdisciplinary practice. The findings of this study show that the exercise of interdisciplinary professional practice depends on the objective order factors related to the labor process, and subjective factors inherent to the worker himself.
A complexidade dos problemas de saúde que se apresentam às equipes de saúde da família impõe mais fortemente a necessidade de ações interdisciplinares, visando ao cuidado integral. No entanto, a formação dos profissionais que compõem essas equipes, a sobrecarga de trabalho com a qual convivem e a própria organização do processo de trabalho nem sempre favorecem a realização dessas práticas. Esse é o problema sobre o qual o presente estudo se debruça. O objetivo deste estudo é analisar os limites e possibilidades de realização das ações interdisciplinares na prática profissional de enfermeiros, médicos e cirurgiões dentistas nas unidades de saúde da família. Trata-se de um estudo transversal, exploratório, descritivo e inferencial, desenvolvido a partir das abordagens qualitativa e quantitativa. A amostra foi composta por Enfermeiros, Médicos e Cirurgiões dentistas das Equipes de Saúde da Família do município de João Pessoa. O questionário foi construído, validado e aplicado mediante sorteio das Equipes de Saúde da Família. A parte qualitativa foi realizada a partir de Observação Participante, com duração de dois meses. Os resultados dos questionários foram submetidos à Análise de Agrupamento. Enquanto que para observação, foi realizada análise temática e os dados foram confrontados com os resultados quantitativos. As três profissões apresentaram limitações quanto à prática interdisciplinar. Os achados deste estudo evidenciam que o exercício da interdisciplinaridade na prática profissional depende de fatores de ordem objetiva, relacionados ao processo de trabalho, e de fatores subjetivos, inerentes ao próprio trabalhador.
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O'Hara, Sullivan Susan. "Macrocognition in the Health Care Built Environment (m-HCBE): A Focused Ethnographic Study of 'Neighborhoods' in a Pediatric Intensive Care Unit: A Dissertation." eScholarship@UMMS, 2016. https://escholarship.umassmed.edu/gsn_diss/46.
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Objectives: The objectives of this research were to describe the interactions (formal and informal) in which macrocognitive functions occur and their location on a pediatric intensive care unit (PICU); describe challenges and facilitators of macrocognition using three constructs of space syntax (openness, connectivity, and visibility); and analyze the health care built environment (HCBE) using those constructs to explicate influences on macrocognition.
Background: In high reliability, complex industries, macrocognition is an approach to develop new knowledge among interprofessional team members. Although macrocognitive functions have been analyzed in multiple health care settings, the effect of the HCBE on those functions has not been directly studied. The theoretical framework, “Macrocognition in the Health Care Built Environment” (m-HCBE) addresses this relationship.
Methods: A focused ethnographic study was conducted, including observation and focus groups. Architectural drawing files used to create distance matrices and isovist field view analyses were compared to panoramic photographs and ethnographic data.
Results: Neighborhoods comprised of corner configurations with maximized visibility enhanced team interactions as well as observation of patients, offering the greatest opportunity for informal situated macrocognitive interactions (SMIs).
Conclusions: Results from this study support the intricate link between macrocognitive interactions and space syntax constructs within the HCBE. These findings help to advance the m-HCBE theory for improving physical space by designing new spaces or refining existing spaces, or for adapting IPT practices to maximize formal and informal SMI opportunities; this lays the groundwork for future research to improve safety and quality for patient and family care.
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Marques, Tatiane Cristina. "Indicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatório." Universidade Federal de Sergipe, 2015. https://ri.ufs.br/handle/riufs/3572.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorIntroduction.The study of quality of health services constitutes a major change tool and incentive for health care services, such as pharmaceutical services, meet minimum quality standards and promote a renewal of its work culture. In Brazil, however the development and evaluation of the quality of services such as Medication Review is still in its infancy and needs to be implemented aiming to improve the practices of patient care. Aim. Evaluate structure and process indicators in the implementation of Medication Review services of the ambulatory of a university hospital. Methods. The study was structured in three stages from February 2012 to March 2015. The first stage corresponded to a methodological development research, in which structure and process indicators were collected from national and international literature for use in evaluating the Medication Review services.The second stage corresponded to translation to Portuguese and the transcultural adaptation to Brazil of Scale of Attitudes Toward Physician-Pharmacist Collaboration . The third stage corresponded to a longitudinal study evaluating the process of a collaborative practice model of Medication Review service in the ambulatory of a University Hospital of Sergipe. Results. From the literature (stage 1) were surveyed in the study, 28 indicators divided into structure criteria: physical installations, human resources, material resources, documentation and financing. The evaluation of the structural indicators of Medication Review service showed that the ambulatory has met most of the criteria submitted. About the process was able to gather 54 indicators divided into two categories: 21 technical-managerial indicators and 33 technicalassistance indicators. The second stage resulted in a translated and adapted scale for the Portuguese of Brazil used to evaluate the collaborative attitudes of pharmacists and physicians. In the third stage, the analysis of Medication Review service found that 146 patients were treated on average 2.1 ± 1.1 times during the study.The prescriptions of these patients contained3,3±1,9 drugs and24,5% of them had five or more drugs. The study identified 366 drug therapy problems (DTPs) and most frequent was a indication category (67,5%) and it was observed that patients who have had four to five pharmaceutical consultations has 1.14 times more likely to have identified their DTPs (χ2= 33,83; p<0,0001). Moreover, the analysis showed that patients who had between 1-2 pharmaceutical consultations had 1.22 times more likely to have not resolved their DTPs when compared to the group with more than 3 pharmaceutical consultations (χ2= 3,44; p<0,05). This study also reported 173 pharmaceutical interventions, of which 52,6% were intended for physicians, 46,2% for students of medicine and the most of them were accepted (98,7%). Conclusion. The structure and process indicators may be used to evaluate the implementation of Medication Review service. The pharmacist can collaborate with physicians identifying and solving DTPs, as well as assisting in the monitoring and decision making on pharmacotherapy, benefiting the patient.
Introdução. O estudo da qualidade e da implementação de serviços de saúde configura um importante instrumento de mudança e incentivo para que os serviços de atenção à saúde, como os serviços farmacêuticos, cumpram padrões mínimos e promovam uma renovação da sua cultura de trabalho. No Brasil, entretanto o desenvolvimento e a avaliação da qualidade de serviços como a Revisão da Farmacoterapia ainda é incipiente e precisa ser implementada visando aprimorar as práticas de cuidado ao paciente. Objetivo. Avaliar indicadores de estrutura e processo na implementação de um serviço de Revisão da Farmacoterapia no ambulatório de um Hospital Universitário. Metodologia. O estudo foi estruturado em três etapas, de fevereiro de 2012 a março de 2015. A primeira correspondeu a uma pesquisa de desenvolvimento metodológico, na qual indicadores de estrutura e processo foram reunidos da literatura nacional e internacional para serem utilizados na avaliação do Serviço de Revisão da Farmacoterapia. A segunda etapa correspondeu tradução para o português e adaptação transcultural para o Brasil da Scale of Attitudes Toward Physician-Pharmacist Collaboration . A terceira etapa correspondeu a um estudo longitudinal que avaliou o processo de um modelo colaborativo de serviço de Revisão da Farmacoterapia no ambulatório de um Hospital Universitário de Sergipe. Resultados. A partir da literatura (etapa 1) foram levantados, no estudo, 28 indicadores de estrutura divididos nos critérios: instalações físicas, recursos humanos, recursos materiais, documentação e financiamento. A avaliação dos indicadores de estrutura do serviço de Revisão da Farmacoterapia do ambulatório estudado revelou que o mesmo atendeu a maioria dos critérios apresentados. Quanto ao processo foi possível reunir 54 indicadores divididos em duas categorias: 21 indicadores técnico-gerencias e 33 técnico-assistenciais. Da segunda etapa resultou uma escala traduzida e adaptada para o português do Brasil usada para avaliar as atitudes colaborativas de farmacêuticos e médicos. Na terceira etapa, a análise do serviço de Revisão da Farmacoterapia verificou que 146 pacientes foram atendidos em média 2,1±1,1 vezes durante o estudo. As prescrições médicas desses pacientes continham 3,3±1,9 medicamentos e 24,5% das mesmas tinham cinco ou mais medicamentos. No estudo foram identificados 366 problemas relacionados ao uso de medicamentos (PRMs) sendo a maioria de necessidade (67,5%) e foi observado que os pacientes que tiveram 4 a 5 atendimentos farmacêuticos tem 1,14 vezes mais probabilidade de terem seus PRMs identificados (χ2= 33,83; p<0,0001). Ademais, a análise demonstrou que os pacientes que tiveram entre 1 a 2 atendimentos farmacêuticos apresentaram 1,22 vezes mais probabilidade de não terem seus PRMs resolvidos quando comparado ao grupo com mais de 3 atendimentos farmacêuticos (χ2= 3,44; p<0,05). Neste estudo ainda foram notificadas 173 intervenções farmacêuticas, das quais 52,6% foram destinadas aos médicos, 46,2% aos estudantes de Medicina e a maioria delas (98,7%) foi aceita. Conclusão. Os indicadores de estrutura e processo reunidos podem ser utilizados para avaliar a implementação do Serviço de Revisão da Farmacoterapia. O farmacêutico pode colaborar com os médicos identificando e resolvendo PRMs, bem como auxiliando no monitoramento e na tomada de decisão sobre a farmacoterapia, beneficiando o paciente.
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Tresidder, Anna Foucek. "The Institutional Context that Supports Team-Based Care for Older Adults." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1517.
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The aging population in the U.S. is dramatically increasing; it is predicted that not only will individuals live longer but also that they will live with multiple chronic diseases that could require high levels of medical and social resources. While the aging population increases, the number of health care providers choosing to specialize in caring for the elderly is decreasing just as dramatically. Teams are believed to be a possible response to more efficiently use the providers available, take advantage of alternative provider types, and integrate a range of health and social services to meet patient needs more effectively. Interdisciplinary teams are the best practice in the care of older adults, who require both medical and social services. However, maintaining functional collaborative teams has been an ever-present challenge to health and social care organizations. Research has found that institutional support is critical for teams to benefit patients and organizations alike.
This study examined the role of institutional context in supporting interdisciplinary teams (IDT) in the care of older adults through interviews of the management and staff of the Program for All-Inclusive Care of the Elderly (PACE) in six states. PACE organizations must commit to an interdisciplinary model of care consisting of 11 different disciplines from across the professional spectrum. The research question posed for this study was: What elements of institutional context support the use of interdisciplinary teams in the care of older adults? Due to the standardized team structure used, PACE was selected as the model to see how institutions at macro and micro levels support the work done by PACE teams and possibly highlight where support is still lacking. A case study approach drawing upon qualitative methods was used to examine policy-regulative, cultural-cognitive, normative, relational, and procedural elements of institutional context and the extent to which they support collaborative teamwork. Thirty-two interviews were conducted with administrators and team members from seven PACE programs across the country. For these PACE programs, five elements and 14 categories of support were identified by the interviewees. Policy and regulatory elements constrain and systematize behavior. PACE IDT experience these constraints and systems through regulatory body practices, resource allocation, and quality measurement. Cultural-cognitive elements mediate between an IDT's external environmrder to make sense of what is happening. PACE IDTs create meaning through their interactions with their external environments through interdependence, demographic characteristics, and organizational structure. Normative findings constrain behavior and confer the rights and duties of IDT members, which arise from organizational mission and values, leadership, and professient and the response of the IDT in oonal boundaries. Relational elements emphasize relationships among IDT members and team interaction with the organization's environment. Social constructs within the team affect role definition and communication, which support IDT practice. Procedural support standardizes practices to maintain highly functional teams. In order to support IDT practice, PACE organizations highlighted recruitment and retention, time and space, and training and education as the primary ways to support IDTs. These categories illustrate the complexity of supporting teams and actualizing teamwork in practice. These findings suggest that PACE is succeeding in supporting the IDT model and provides lessons for other organizations that wish to do the same.
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Barbier, Jean-Luc. "Contribution a l'etude des relations entre les professions et l'etat. L'exemple du comite interprofessionnel du vin de champagne." Reims, 1986. http://www.theses.fr/1986REIMD002.
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Les professions ont besoin de l'etat et l'etat a besoin des professions. Il s'etablit entre eux des relations denses et intimes, complexes aussi. Tandis que les organisations professionnelles fustigent sans cesse l'intervention etatique, les instances dirigeantes de l'appareil d'etat deplorent regulierement les pressions professionnelles. Pour demeler l'echeveau des liens tisses entre l'etat et les professions, l'exemple du comite interprofessionnel du vin de champagne fournit un fil conducteur utile. L'interprofession champenoise vise d'abord a realiser une certaine integration communautaire. Des la fin du xixe siecle, les vignerons et les negociants se sont reunis pour delimiter ensemble le territoire viticole, fixer les regles de la culture de la vigne et de l'elaboration du vin de champagne, definir l'appellation champagne, proteger leur patrimoine commun. Des syndicats unitaires et rassembleurs se sont crees, differentes instances relationnelles ont fonctionne. Constitue par la loi du 12 avril 1941, le comite interprofessionnel du vin de champagne veille au maintien d'un equilibre regulateur entre les deux groupes professionnels, a la reduction des conflits, a la reproduction d'un sentiment communautaire intense. L'interprofession champenoise vise ensuite a etablir un certain pouvoir. A l'interieur du microcosme professionnel, elle a instaure une sorte d'autogestion : elle s'est fait reconnaitre un monopole dont elle assure le maintien avec rigueur et elle a erode les multiples controles susceptibles de s'imposer a elle. La nature jurididique du comite n'est pas sans consequence : parce qu'il s'agit d'une personne privee, il beneficie d'une grande souplesse de fonctionnement ; parce qu'il est charge d'une mission de service public, il recourt a l'usage de prerogatives de puissance publique. Les caracteristiques mises en evidence par l'etude de l'organisation professionnelle champenoise apporte les materiaux d'une construction theorique exprimant l'emprise exercee par les professions sur l'appareil d'etat. Pour rendre compte de ce phenomene, il convient de recourir, apres l'avoir definie avec soin, a la notion de corporatisme. Toutefois, pour s'epanouir pleinement les corporations recherchent une etroite promiscuite avec l'etat et contribuent en fait a son renforcementThe professions need the state and the state needs the professions. They hence set up dense and intimate relations, intricate ones too. While professional organizations unceasingly criticize the state interference, the latter keeps on regretting professional pressures. To clear up the links between the state and the professions, the comite interprofessionnel du vin de champagne is a helpful case. Champagne interprofession first aims at reaching some kind of a communal integration. As form the end of the xixth century, vine-growers and merchants joined together to demarcate the vine-growing area, to establish strict standards to cultivate the vine and elaborate the wine of champagne, to define the champagne appellation, to protect their common heritage. Unitary and gathering associations and various relational systems came up. Created by the statute of april 12, 1941, the comite interprofessionnel du vin de champagne attends to the maintenance of the regulating balance existing between the two groups, to the minimizing of conflicts, to the representation of an intense communal feeling. The champagne interprofession is also anxious to establish a sort of power. Inside the professional microcosm, it has establish some kind of a self-management : it has been acknowledged as a monopoly which is strictly preserved and which has eroded the various possible controls on its activity. The legal nature of the comite is not without any consequences : for it is private, it has a much flexible functioning, for it has the mission of a public utility service, it may use the privileges of a public authority. The characteristics emphasized by the study of the champagne professional organization supply which the base of a theoretic structure expressing the ascendancy of the professions on the state. To present this phenomenon, it is advisable to resort to the notion of corporatism after having it defined. Anyway, to thrive fully, the corporations have been looking for a close promiscuity with the state, hence contributing to its strengthening
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Barbier, Jean-Luc. "Contribution à l'étude des relations entre les professions et l'Etat l'exemple du Comité interprofessionnel du vin de Champagne." Lille 3 : ANRT, 1987. http://catalogue.bnf.fr/ark:/12148/cb37595710h.
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Ferreira, Silvia Regina. "Residência integrada em saúde : uma modalidade de ensino em serviço." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2007. http://hdl.handle.net/10183/12419.
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A legalização do Sistema Único de Saúde (SUS), o qual preconiza uma visão ampliada de saúde, os setores da saúde e educação apontam para a necessidade de uma reforma na formação profissional. A Residência Integrada em Saúde (RIS) é uma modalidade de educação em serviço que objetiva especializar profissionais das diversas categorias desta área para atuarem em equipe, segundo os princípios do SUS. Esta dissertação tem a finalidade de contribuir para a reflexão sobre a formação de trabalhadores da área da saúde, através de uma pesquisa tipo Estudo de Caso sobre a RIS a partir da área de ênfase em intensivismo do GHC. Trata-se de uma abordagem qualitativa, descritiva, analítica que utiliza etapas da Avaliação de Quarta Geração. Os participantes deste estudo foram o grupo de interesse composto pelos residentes dessa área de ênfase. Para analisar as informações foi utilizada a análise proposta por Minayo. Os resultados desta pesquisa mostraram que a proposta da RIS é especializar profissionais da área da saúde para agirem em equipe interdisciplinar, visando formá-los com base em um perfil adequado a atuar no SUS para além da qualificação técnica curativa. A RIS diferencia-se das outras residências por ter como proposta a integração das diferentes áreas de conhecimento. Essa modalidade de ensino em serviço, em algum grau, tem atingido seus objetivos, porém ela tem apresentado dificuldades relacionadas à falta de conhecimento da proposta, à organização e estrutura dessa formação. As atividades interdisciplinares não estão dadas, assim como a metodologia problematizadora preconizada por esse programa leva a uma contínua reformulação das atividades para atingir os objetivos da formação. Esse caráter dinâmico pode dar um aspecto de desordem ao processo, todavia foi percebido que a proposta está continuamente sendo avaliada, reformulada e tem apresentado mudanças e crescimento em relação à sua criação.With the legalized Brazilian Health System (SUS-Sistema Único de Saúde), which advocates a broader view of health, the health and education sectors indicate the need to remodel professional training. Integrated Health Residency (RIS-Residência Integrada em Saúde) is a modality of on-the-job training aiming at specializing professionals of different categories in this field to work as a team according to the SUS principles. The purpose of this thesis is to contribute to thinking about health care worker training, by performing a Case Study-type research on RIS based on an emphasis on intensive care at GHC. This is a qualitative, descriptive, analytical approach that uses stages of the Fourth Generation Evaluation. The participants in this study were the group of interest constituted by residents in this particular field. The method proposed by Minayo was used to analyse this information. The results of this research showed that the RIS proposal is to specialize health care professionals to work in a crossdisciplinary team, with a view to training them based on a profile appropriate to work at SUS beyond the curative technical qualification. RIS is different from other residencies because it proposes to integrate different fields of knowledge. This modality of on-the-job training has achieved its aims to some degree, but it has presented problems involving lack of knowledge about the proposal, the organization and structure of this training. Crossdisciplinary activities are not given, and the problematizing methodology advocated by this program leads to the continuous reformulation of activities to achieve the training objectives. This dynamic character could give the process a disorganized look, but it was noted that the proposal is continuously evaluated and reformulated, and it has presented changes and growth compared to when it was created.
La legalización del Sistema Único de Salud (SUS), lo cual preconiza una visión ampliada de salud, los sectores de la salud y educación apuntan para la necesidad de una reforma en la formación profesional. La Residencia Integrada en Salud (RIS) es una modalidad de educación en servicio que objetiva especializar profesionales de las diversas categorías de esta área para que actúen en equipo, según los principios del SUS. Esta disertación tiene la finalidad de contribuir para la reflexión sobre la formación de trabajadores del área de la salud, a través de una pesquisa tipo Estudio de Caso sobre la RIS a partir del área de énfasis en intensivismo del GHC. Se trata de un abordaje cualitativo, descriptivo, analítico que utiliza etapas de la Evaluación de Cuarta Generación. Los participantes de este estudio fueron el grupo de interés compuesto por los residentes de esa área de énfasis. Para analizar las informaciones fue utilizado el análisis propuesto por Minayo. Los resultados de esta pesquisa mostraron que la propuesta de la RIS es especializar profesionales del área de la salud para que obren en equipo interdisciplinar, visando formarlos con base en un perfil adecuado a actuar en el SUS para el más allá de la cualificación técnica curativa. La RIS se diferencia de las otras residencias por tener como propuesta la integración de las diferentes áreas de conocimiento. Esa modalidad de enseñanza en servicio, en algún grado, tiene atingido sus objetivos, sin embargo ella tiene presentado dificultades relacionadas a la falta de conocimiento de la propuesta, a la organización y estructura de esa formación. Las actividades interdisciplinares no están dadas, así como la metodología problematizadora preconizada por ese programa lleva a una continua reformulación de las actividades para atingir los objetivos de la formación. Ese carácter dinámico puede dar un aspecto de desorden al proceso, sin embargo fue percibido que la propuesta está continuamente siendo evaluada, reformulada y tiene presentado cambios y crecimiento en relación a su crianza.
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Linden, Hampus, and Hanna Blid. "Uppfattningar av det interprofessionella samarbetet mellan sjuksköterskor och läkare i Skandinavien." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25464.
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Bakgrund: Yrkesrelationen mellan sjuksköterskan och läkaren har funnits sedan en lång tid tillbaka. Trots det nära samarbetet, präglas det av gamla normer och strukturer som försvårar relationen. Sjuksköterskan har fått en mer tydlig roll inom vården i och med att sjuksköterskeutbildningen har utvecklats och numera leder till en examen inom omvårdnad. Makten som förr har tillhört läkaren faller nu mellan två expertisområden, omvårdnad och medicin. Syfte: Syftet var att undersöka sjuksköterskor och läkares uppfattning av deras samarbete på sjukhus och vårdboende i Skandinavien. Metod: En litteraturstudie baserad på 10 vetenskapliga artiklar från Skandinavien. Resultat: Resultatet presenteras utifrån fem kategorier: yrkesrelation, omsättning av personal, gemensamt mål, rond och informationsutbyte samt teamwork. Resultatet visade att professionernas skillnader ledde till svårigheter i kommunikationen. Den rådande hierarki inom vården försvårade enligt såväl läkare som sjuksköterskor kommunikationen ytterligare. Trots att sjuksköterskor uppfattade kommunikationen som otillräcklig, ansåg läkare att den var tillräcklig. I flera studier belystes bristande samarbete vara relaterat till omsättning av läkare. Samarbetet och kommunikationen uppskattades i större utsträckning av sjuksköterskor då läkare hade fast placering på avdelningen. Ronden lyftes fram som en viktig del för samarbetet där bland annat viktig information om patienter kunde utbytas. Konklusion: Det finns en viss diskrepans mellan sjuksköterskors och läkares uppfattning av samarbete. Resultatet visar på uppfattningar som är positiva och negativa. Slutsatser utifrån resultatet är att det behövs utbildning i interprofessionellt samarbete för att förbättra professionernas kommunikation. För att möjliggöra detta behövs även ett professionellt förhållningssätt och ett samarbete där gemensamma mål utformas.Background: The professional relationship between nurses and physicians has existed for a long time. Despite their close interprofessional relation, it is characterized by old norms and structures that complicates the relationship. The nurse has been given a clearer role in health care since the developing of the education which has led to a degree in nursing. The power that previously belonged to the physician now falls between two areas of expertise, nursing and medicine. Aim: The purpose of this study was to describe nurses and physicians’ perception of their interprofessional relationship at hospitals and nursing homes in Scandinavia. Method: A literature review based on ten scientific articles from Scandinavia. Result: The result is presented in five categories: the professional relationship, staff turnover, common goal, round and exchange of information and teamwork. The result showed that differences in the professions led to difficulties in communication. The existing hierarchy in healthcare made the communication more difficult, according to both physicians and nurses. Although nurses perceived the communication as inadequate, physicians perceived as adequate. In several studies, lack of co-operation was highlighted in relation to the turnover of physicians. The co-operation and communication were appreciated by nurses when physicians had a permanent position at the ward. The round was highlighted as an important part of the co-operation, where important information about patients could be exchanged. Conclusion: There was a certain discrepancy between nurses and physicians' perception of cooperation. The result shows there are both positive and negative perceptions. Conclusions made from the result show that education in interprofessional co-operation is needed to improve their communication. To make this possible, a professional approach and cooperation are also needed where common goals are established.
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Forsyth, Rowena Public Health & Community Medicine Faculty of Medicine UNSW. "Tricky technology, troubled tribes: a video ethnographic study of the impact of information technology on health care professionals??? practices and relationships." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/30175.
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Whilst technology use has always been a part of the practice of health care delivery, more recently, information technology has been applied to aspects of clinical work concerned with documentation. This thesis presents an analysis of the ways that two professional groups, one clinical and one ancillary, at a single hospital cooperatively engage in a work practice that has recently been computerised. It investigates the way that a clinical group???s approach to and actual use of the system creates problems for the ancillary group. It understands these problems to arise from the contrasting ways that the groups position their use of documentation technology in their local definitions of professional status. The data on which analysis of these practices is based includes 16 hours of video recordings of the work practices of the two groups as they engage with the technology in their local work settings as well as video recordings of a reflexive viewing session conducted with participants from the ancillary group. Also included in the analysis are observational field notes, interviews and documentary analysis. The analysis aimed to produce a set of themes grounded in the specifics of the data, and drew on TLSTranscription?? software for the management and classification of video data. This thesis seeks to contribute to three research fields: health informatics, sociology of professions and social science research methodology. In terms of health informatics, this thesis argues for the necessity for health care information technology design to understand and incorporate the work practices of all professional groups who will be involved in using the technology system or whose work will be affected by its introduction. In terms of the sociology of professions, this thesis finds doctors and scientists to belong to two distinct occupational communities that each utilise documentation technology to different extents in their displays of professional competence. Thirdly, in terms of social science research methodology, this thesis speculates about the possibility for viewing the engagement of the groups with the research process as indicative of their reactions to future sources of outside perturbance to their work.
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Blomgren, Carolina, Sofie Laszlo, and Elisabeth Olsson. "Att lindra smärta i livets slut : - en litteraturöversikt om sjuksköterskans erfaranheter." Thesis, Jönköping University, HHJ, Avd. för omvårdnad, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-52637.
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Bakgrund: Palliativ vård fokuserar på att främja livskvalitet och lindra lidande för patient och anhörig i samband med livets slut. Patientens lidande kan lindras genom att smärtan minskar. Smärta är ett vanligt symtom i livets slut, och kan lindras både farmakologiskt och icke-farmakologiskt. Sjuksköterskan ansvarar för att lindra smärta. Om sjuksköterskans kunskap brister, brister sjuksköterskan i sitt professionella ansvar och patienten utsätts för onödig smärta. Syfte: Att beskriva sjuksköterskans erfarenheter av att lindra smärta vid palliativ vård i livets slut. Metod: Kvalitativ litteraturstudie baserat på 12 artiklar som analyserats med Fribergs kvalitativa analysmetod. Två teman och sex subteman skapades. Resultat: Resultatet utgörs av två teman: Erfarenheter av olika smärtlindringsmetoder och Samarbetets betydelse för smärtlindringen, med tillhörande subteman. Slutsats: Huvudfynden som framkom var Erfarenheter av att bedöma smärta objektivt och subjektivt, Att våga möta och lindra existentiell smärta och Vikten av samarbete mellan sjuksköterska, läkare och andra professioner. Sjuksköterskan beskrevs som en viktig person för att identifiera patientens smärtlindringsbehov och för att smärtskatta patienten. Sjuksköterskan var länken i teamet runt patienten, men det framkom flera hinder som försvårade detta arbete. Dessa hinder kunde vara bristande kommunikationen i teamet eller att läkaren inte litade på deras bedömning.Background: Palliative care aims to promote quality of life and ease suffering for patients and relatives in care at the end of life. The patient’s suffering can be relieved through pain relief. Pain is a common symptom in palliative care and can be eased with both pharmacological and non-pharmacological interventions. The nurse is responsible for relieving the pain. If the nurse lacks knowledge, the nurse might fail in their professional responsibility and the patient might endure unnecessary pain. Aim: Was to describe nurses’ experiences of pain relief in palliative care at the end of life. Method: Qualitative review article, based on 12 articles analysed with Friberg’s qualitative analysis method. Two themes and six subthemes were identified. Results: The result was presented in two themes: Experiences of different methods for pain relief, and The Meaning of collaboration in pain relief, with associated subthemes. Conclusion: The main findings were: Experiences of assessing pain objectively and subjectively, Dare to meet and relief existential pain and The meaning of collaboration between the nurse and physician. The nurse is important when identifying the patient’s need of pain relief, and to assess the pain. The nurse is the link in the interprofessional team surrounding the patient, but several hindering factors were identified. These factors could be lack of communicaton within the team, or when the physician did not listen to the nurse’s assessment.
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Ben, Maaouia Maroua. "Etude qualitative des dimensions de la collaboration interprofessionnelle et de leur interdépendance : cas des équipes de soin au sein du CHU Mongi-Slim." Thesis, Le Mans, 2017. http://www.theses.fr/2017LEMA2004/document.
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Le travail collectif est un défi considérable pour les organisations de santé, en particulier les hôpitaux publics. La complexité des structures, la pluralité des mains qui agissent et la variabilité des pratiques médicales suggestionnent la pratique collaborative. Dans un tel contexte, il convient de se pencher sur les dimensions de la collaboration interprofessionnelle permettant l’unicité de l’activité médicale. Ce concept prend une importance particulière si l’on considère que la dispensation des services de santé appelle de plus en plus à un haut degré de coordination entre les différents professionnels. Ce travail de recherche analyse la concrétisation de la collaboration interprofessionnelle dans le cas d’un CHU moyennant une méthodologie qualitative. En se basant sur les travaux précurseurs de D’Amour (1997), cette présente thèse identifie les principales dimensions de la collaboration interprofessionnelle ainsi que leur lien d’'interdépendanceAs the delivery of healthcare evolves to become more interconnected, coordinating care between nurses, pharmacists, physicians, social workers and other disciplines has become increasingly important. In its simplest form, inter professional collaboration is the practice of approaching patient care from a team-based perspective. Improved health care collaboration has been cited as a key strategy for health care reform. Collaboration in health care has been shown to improve patient outcomes. In a such area it’s interesting to examine the interprofessional collaborations’ dimensions. This work aims to highlight the construction of interprofessional collaboration using a qualitative research design based on the model of D’Amour (1997)
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Owens, Melissa, Christine A. Dearnley, Caroline M. C. Plews, and Peter Greasley. "Evaluation of a multifaceted pre-registration interprofessional education module." 2010. http://hdl.handle.net/10454/6982.
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"Causal determinants of organizational commitment: the case of Hong Kong hospital nurses." Chinese University of Hong Kong, 1991. http://library.cuhk.edu.hk/record=b5886952.
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by Chan Siu Shan.Thesis (M.Phil.)--Chinese University of Hong Kong, 1991.
Bibliography: leaves [111-119].
Chapter Chapter One --- Introduction --- p.1
Chapter Chapter Two --- Literature Review and Theoretical Discussion --- p.6
Chapter I. --- The Debate --- p.6
Chapter II. --- Management-oriented Perspective of Organizational Research --- p.11
Chapter III. --- The Implicit Model of Actor: Rational or Behavioristic --- p.20
Chapter IV. --- Reapproaching From Work and Occupation --- p.23
Chapter V . --- The Incorporat ion of Occupational Image as A Classification Scheme --- p.27
Chapter VI. --- The Addition of Social Relation Approach --- p.31
Chapter Chapter Three --- "Objectives, Hypotheses and Conceptualization of Variables" --- p.35
Chapter Chapter Four --- Research Design --- p.50
Chapter I. --- General Profile of the Research --- p.50
Chapter A. --- Population --- p.50
Chapter B. --- Sampling Method --- p.50
Chapter C. --- Sample Size --- p.51
Chapter D. --- Method of Data Collection --- p.51
Chapter E. --- Response Rate and Representativeness of the Resaerch Result --- p.52
Chapter F. --- Demographic Profile of Respondents --- p.53
Chapter II. --- Operationalization of Variables --- p.54
Chapter Chapter Five --- Findings --- p.66
Chapter I. --- Regression Analysis I: The Comparison Among the Three Approaches --- p.68
Chapter II. --- Regression Analysis II： Test of Conditional Hypotheses --- p.72
Chapter Chapter Six --- "Summry, Theoretical Interpretation and Practical Implication" --- p.86
Chapter I. --- Assertion of the Occupational Image as a Valid Conditional Variable in the Explanation of Organizational Commitment --- p.86
Chapter II. --- Further Disscussion on the Implication of Organizational Commitment --- p.92
Chapter III. --- Limitation and Suggestion for Further Study --- p.102
Chapter Appendix --- The Chinese Version of Questionnaire
Bibliography
Source of Questionnaire