Jaqueline Alcântara Marcelino da Silva

Atividades educativas de trabalhadores na atenção primária: concepções de educação permanente e de educação continuada em saúde presentes no cotidiano de Unidades Básicas de Saúde em São Paulo

The objective of this study was to analyze the educ ational activity practices among healthcare workers in primary healthcare units (PHUs) accordin g to the concepts of “educacao permanente em saude” (EPS) 1 and continuing education (CE), healthcare and nurs ing work processes, teamwork and comprehensiveness. This was a cross-sectional s tudy conducted in 10 PHUs in the municipality of Sao Paulo, through structured interviews with 11 0 key informants who represented all professional categories and teams at the PHUs. The interviews covered educational activities developed in 2005. The information was classified a ccording to operational categories for each study variable, based on the theoretical framework. The workers reported 396 educational activities that demonstrated the complementary nature of the c oncepts of EPS and CE. In accordance with the perspectives of the Brazilian Unified Health System (SUS) and the transformation of healthcare practices, there is a need to expand the debate rel ating to EPS as public policy.Esta pesquisa tem o objetivo de analisar a pratica de atividades educativas de trabalhadores da saude em Unidade Basica de Saude (UBS) segundo as concepcoes de educacao permanente em saude (EPS) e de educacao continuada (EC), processo de trabalho em saude e enfermagem, trabalho em equipe e integralidade. Estudo do tipo transversal, realizado em dez UBS do Municipio de Sao Paulo, por meio de entrevista dirigida com 110 informantes-chave, representantes de todas as categorias profissionais e equipes das UBS, sobre as atividades educativas desenvolvidas em 2005. As informacoes foram classificadas segundo categorias operacionais para cada variavel de estudo, com base no referencial teorico. Os trabalhadores relataram 396 atividades educativas, que revelam a complementaridade das concepcoes de EPS e EC. De acordo com a perspectiva do Sistema Unico de Saude (SUS) e da transformacao das praticas de saude, coloca-se a necessidade de ampliacao do debate em torno da EPS como politica publica.

Trabalho em equipe na perspectiva da gerência de serviços de saúde: instrumentos para a construção da prática interprofissional

Estuda-se a contribuicao da acao gerencial para a promocao da pratica interprofissional. Trata-se de pesquisa qualitativa, realizada em 21 servicos publicos de saude de uma regiao de Sao Paulo, por meio de entrevista semiestruturada com 21 gerentes (diretores) e utiliza-se a tecnica de analise tematica. Como resultado, para promover o trabalho em equipe, os gerentes lancam mao dos instrumentos: comunicacao, construcao do compromisso das equipes e dos trabalhadores com o projeto institucional, estimulo a autonomia das equipes, definicao de responsabilidades e accountability, promocao de mudanca da cultura institucional e supervisao externa. Conclui-se que a comunicacao e demais ferramentas quando aplicadas a promocao do trabalho em equipe estao orientadas ao trabalho, isto e, a atencao eficaz e eficiente as necessidades de saude dos usuarios.

[Interprofessional education: training for healthcare professionals for teamwork focusing on users].

The theoretical constructs of interprofessional education (IPE) are analyzed based on two reviews of the literature, taking the context of training for healthcare professionals in Brazil into consideration. Three types of training are identified: uniprofessional, multiprofessional and interprofessional, with predominance of the first type. The first occurs among students of the same profession, in isolation; the second occurs among students of two or more professions, in parallel without interaction; and the third involves shared learning, with interaction between students and/or professionals from different fields. The distinction between interprofessionalism and interdisciplinarity is highlighted: these refer to integration, respectively, of professional practices and disciplines or fields of knowledge. Through the analysis presented, it is concluded that in the Brazilian context, IPE (the basis for collaborative teamwork) is still limited to some recent initiatives, which deserve to be investigated.

Educação no trabalho na atenção primária à saúde: interfaces entre a educação permanente em saúde e o agir comunicativo

Abstract Health work and work education are a double dimen -sion – instrumental action and intersubjectivity. Objective: To analyze the conceptions of education that support educational activities of health care workers in Primary Health Care. Method: This qualita-tive study was conducted in two primary health care units (PHCU) in Sao Paulo, through semi-structured interviews with 36 key informants representing each professional category, including managers and health care workers. Data were analyzed based on thematic content analysis and on the theoretical framework: the healthcare work process, theory of communicative action, continuing education (CE), permanent educa-tion in health (PEH) and integrality (comprehensive approach), which allowed the construction of the em-pirical categories: instrumental/traditional education and communicative/emancipatory education. Results: The results show the prevailing notion of work educa-tion as a collective construction of knowledge from the reality of work, relevant to the PEH that is intended to be introduced in order to change the practices and the biomedical health care model. However, some inter-viewed subjects expressed an instrumental conception of education that emphasizes technical actions and knowledge updating, which is closer to CE. Conclusion: Results show the coexistence of the two conceptions of workers’ education: instrumental and communicative, with the predominance of the second one, which shows the reach of the PEH policy among the health workers of PHCU and the need for deepening the discussion to consolidate educational practice in daily work.Keywords: Permanent education in health. Continu-ing education. Work. Healthcare human resources. Primary Health Care.

Educação permanente de profissionais de saúde em instituições públicas hospitalares

The objectives of this descriptive exploratory study were to identify, characterize and analyze educational activities developed with health professionals based on integrality, teamwork and permanent education. Data collection was carried out in three hospitals of the city of Sao Paulo, by means of key-informant interviews, representing all the professional categories. Interviews were recorded and transcribed, information was systematized into operational categories and storage in data bank. The results showed that educational activities aiming actions to recover health with the assistance of professionals of specific areas, revealed a distance from the integrality conception and team work. It was concluded that actions aiming education of health professionals emphasizes the individual clinical model, with fragmented actions of professional categories. So, we suggest reconsidering the integrated strategies of knowledge to promote integrality of hospital attention.RESUMO Estudo exploratório-descrito cujos objetivos foram identificar, caracterizar e analisar as atividades educativas desenvolvidas com profissionais de saúde, à luz das concepções de integralidade, trabalho em equipe e educação permanente. A coleta de dados ocorreu em três hospitais do Município de São Paulo, através de entrevista dirigida a informantes-chave, representantes de todas as categorias profissionais. As entrevistas foram gravadas e transcritas, as informações sistematizadas em categorias operacionais e armazenadas em banco de dados. Os resultados mostram que predominaram atividades educativas voltadas às ações de recuperação da saúde, com participação de profissionais de áreas específicas, revelando um distanciamento da concepção de integralidade e de trabalho em equipe. Concluiuse que as ações de educação dos profissionais de saúde reiteram o modelo clínico de assistência individual, com fragmentação das ações. Recomenda-se que elas sejam repensadas como estratégia integradora de saberes, capazes de promover a integralidade na atenção hospitalar.The objectives of this descriptive exploratory study were to identify, characterize and analyze educational activities developed with health professionals based on integrality, teamwork and permanent education. Data collection was carried out in three hospitals of the city of Sao Paulo, by means of key-informant interviews, representing all the professional categories. Interviews were recorded and transcribed, information was systematized into operational categories and storage in data bank. The results showed that educational activities aiming actions to recover health with the assistance of professionals of specific areas, revealed a distance from the integrality conception and team work. It was concluded that actions aiming education of health professionals emphasizes the individual clinical model, with fragmented actions of professional categories. So, we suggest reconsidering the integrated strategies of knowledge to promote integrality of hospital attention.

Análise do processo de avaliação da aprendizagem de ações educativas de profissionais de enfermagem

The objective of this study was to analyze the learning evaluation process of nursing staff training programs, regarding its effectiveness and instrument validity. This is an empirical study whose findings support theoretical formulations for the construction of an evaluation methodology. The analysis consisted of learning evaluations related to six training programs, totaling 993 evaluations. The results of these six training programs showed the need to propose an evaluation methodology, defining criteria, instruments and indicators for this purpose. Furthermore, it is important to improve the diagnosis process on training needs and teaching strategies.The objective of this study was to analyze the learning evaluation process of nursing staff training programs, regarding its effectiveness and instrument validity. This is an empirical study whose findings support theoretical formulations for the construction of an evaluation methodology. The analysis consisted of learning evaluations related to six training programs, totaling 993 evaluations. The results of these six training programs showed the need to propose an evaluation methodology, defining criteria, instruments and indicators for this purpose. Furthermore, it is important to improve the diagnosis process on training needs and teaching strategies.

Educação interprofissional e prática colaborativa na Atenção Primária à Saúde

Objetivo Compreender as percepcoes de docentes, trabalhadores e estudantes sobre a articulacao da educacao interprofissional com as praticas na Atencao Primaria a Saude. Metodo Qualitativo compreensivo e interpretativo, cuja coleta de dados foi realizada de 2012 a 2013, por meio de 18 entrevistas semiestruturadas com docentes e quatro sessoes de grupos focais homogeneos com estudantes, docentes e trabalhadores da Atencao Primaria. Resultados A triangulacao dos resultados possibilitou a construcao de duas categorias: pratica colaborativa centrada no usuario e barreiras para educacao interprofissional. A primeira indicou a necessidade de mudanca do modelo de atencao e de formacao dos profissionais de saude, e a segunda apontou dificuldades percebidas pelos diferentes atores sociais no que se refere a implementacao da educacao interprofissional. Conclusao A educacao interprofissional e incipiente no Brasil e sinaliza possibilidades de mudanca em direcao a pratica colaborativa, mas requer maiores investimentos na articulacao ensino-servico.Objective To understand the perceptions of professors, health care providers and students about the articulation of interprofessional education with health practices in Primary Health Care. Method To understand and interpret qualitative data collection, carried out between 2012 and 2013, through semi-structured interviews with 18 professors and four sessions of homogeneous focus groups with students, professors and health care providers of Primary Health Care. Results A triangulation of the results led to the construction of two categories: user-centered collaborative practice and barriers to interprofessional education. The first perspective indicates the need to change the model of care and training of health professionals, while the second reveals difficulties perceived by stakeholders regarding the implementation of interprofessional education. Conclusion The interprofessional education is incipient in the Brazil and the results of this analysis point out to possibilities of change toward collaborative practice, but require higher investments primarily in developing teaching-health services relationship.

Evaluation of effectiveness of training of nursing professionals: a correlational study

Aiming to evaluate the professional training programs, this study wants to evaluate the effectiveness of training about contact precautionary steps, run to nursing professional. This is a correlational design research. The material of analysis is composed by the pre- and post-training learning evaluations (n=248), performed in the University Hospital of the Sao Paulo University, which were submitted to a descriptive and inferential statistical analysis. This study was approved by the Ethics in Research Committee of the institution. The main results showed that, if compared the pre- and post-training periods, there was a significant rise on the post moment, of the average grade, in 10 out of 14 questions from the evaluation chart. Despite the fact the training was considered effective, it was observed there is a necessity to improve the diagnosing method of educational actions, as well as the evolution of a deeper evaluation methodology that embraces the observation of the results of training in assisting care

Teamwork in nursing: restricted to nursing professionals or an interprofessional collaboration?

OBJETIVO Compreender as concepcoes dos profissionais de enfermagem sobre trabalho em equipe e seus elementos constituintes. METODO Pesquisa qualitativa, realizada em hospital oncologico, por meio de entrevista semiestruturada com 21 profissionais de enfermagem. RESULTADOS Duas concepcoes emergiram dos relatos, trabalho em equipe circunscrito a enfermagem e trabalho em equipe com colaboracao interprofissional, com destaque para dimensao interativa: comunicacao, confianca e vinculo, respeito mutuo e reconhecimento do trabalho do outro, colaboracao e conflito. Esta ultima subcategoria foi apontada como obstaculo para o trabalho em equipe. CONCLUSAO A enfermagem concebe majoritariamente o trabalho em equipe como acao interprofissional, e isto decorre da qualidade da interacao entre os profissionais das diferentes areas e o reconhecimento e manejo de conflitos.

Permanent education of health professionals in public hospital organizations

The objectives of this descriptive exploratory study were to identify, characterize and analyze educational activities developed with health professionals based on integrality, teamwork and permanent education. Data collection was carried out in three hospitals of the city of Sao Paulo, by means of key-informant interviews, representing all the professional categories. Interviews were recorded and transcribed, information was systematized into operational categories and storage in data bank. The results showed that educational activities aiming actions to recover health with the assistance of professionals of specific areas, revealed a distance from the integrality conception and team work. It was concluded that actions aiming education of health professionals emphasizes the individual clinical model, with fragmented actions of professional categories. So, we suggest reconsidering the integrated strategies of knowledge to promote integrality of hospital attention.RESUMO Estudo exploratório-descrito cujos objetivos foram identificar, caracterizar e analisar as atividades educativas desenvolvidas com profissionais de saúde, à luz das concepções de integralidade, trabalho em equipe e educação permanente. A coleta de dados ocorreu em três hospitais do Município de São Paulo, através de entrevista dirigida a informantes-chave, representantes de todas as categorias profissionais. As entrevistas foram gravadas e transcritas, as informações sistematizadas em categorias operacionais e armazenadas em banco de dados. Os resultados mostram que predominaram atividades educativas voltadas às ações de recuperação da saúde, com participação de profissionais de áreas específicas, revelando um distanciamento da concepção de integralidade e de trabalho em equipe. Concluiuse que as ações de educação dos profissionais de saúde reiteram o modelo clínico de assistência individual, com fragmentação das ações. Recomenda-se que elas sejam repensadas como estratégia integradora de saberes, capazes de promover a integralidade na atenção hospitalar.The objectives of this descriptive exploratory study were to identify, characterize and analyze educational activities developed with health professionals based on integrality, teamwork and permanent education. Data collection was carried out in three hospitals of the city of Sao Paulo, by means of key-informant interviews, representing all the professional categories. Interviews were recorded and transcribed, information was systematized into operational categories and storage in data bank. The results showed that educational activities aiming actions to recover health with the assistance of professionals of specific areas, revealed a distance from the integrality conception and team work. It was concluded that actions aiming education of health professionals emphasizes the individual clinical model, with fragmented actions of professional categories. So, we suggest reconsidering the integrated strategies of knowledge to promote integrality of hospital attention.