Avances en el trabajo de equipos multidisciplinares para la atención al paciente con asma grave no controlada. Una visión post-COVID (Proyecto TEAM 2.0) / Advances in the work of multidisciplinary teams for the care of patients with severe uncontrolled asthma. A post-COVID vision (TEAM 2.0 project)

El asma es una enfermedad respiratoria crónica con un alto impacto sanitario, social y económico, en particular, en el caso del asma grave no controlada (AGNC). Por ello, son especialmente necesarias nuevas estrategias para mejorar su abordaje, con un enfoque personalizado a cada paciente y desde una perspectiva multidisciplinar, además de integrar las nuevas prácticas de telemedicina y telefarmacia impulsadas a raíz de la pandemia de COVID-19. En este contexto se ha desarrollado el proyecto TEAM 2.0 («Trabajo en Equipos de Asma Multidisciplinares»), continuación del proyecto TEAM llevado a cabo en 2019, con el objetivo de actualizar y priorizar buenas prácticas de trabajo multidisciplinar en AGNC en un contexto post pandemia y analizar los avances conseguidos. Un grupo coordinador, constituido por 8 equipos multidisciplinares de farmacéuticos hospitalarios, neumólogos y alergólogos, llevó a cabo una revisión bibliográfica actualizada, puesta en común de buenas prácticas multidisciplinares y análisis de avances. A través de 5 reuniones regionales con otros expertos con experiencia en AGNC, se compartieron las buenas prácticas identificadas y fueron sometidas a debate, evaluación y priorización. En total, 23 buenas prácticas de trabajo multidisciplinar en AGNC, agrupadas en 5 ámbitos de trabajo: 1) organización del trabajo en equipos multidisciplinares, 2) educación al paciente, autoadministración y adherencia, 3) resultados en salud, seguimiento de datos y persistencia, 4) telefarmacia y experiencias implantadas durante la pandemia de COVID-19 y 5) formación e investigación, fueron evaluadas y priorizadas por 57 profesionales del ámbito de la farmacia hospitalaria, la neumología, la alergología y la enfermería. Este trabajo ha permitido actualizar la hoja de ruta de acciones prioritarias, para seguir avanzando en modelos óptimos de atención al paciente con AGNC en un contexto post-COVID-19. (AU)

Asthma is a chronic respiratory disease with a high health, social and economic impact, particularly in the case of Severe Uncontrolled Asthma (SUA). For this reason, new strategies are especially necessary to improve its approach, with a personalized approach to each patient and from a multidisciplinary perspective, in addition to integrating the new telemedicine and telepharmacy practices promoted as a result of the COVID-19 pandemic. In this context, the TEAM 2.0 project (“Work in Multidisciplinary Asthma Teams”) has been developed, following the TEAM project carried out in 2019, with the aim of updating and prioritizing good multidisciplinary work practices in SUA in a post pandemic context and analyze the progress made. A coordinating group, made up of eight multidisciplinary teams of hospital pharmacists, pulmonologists, and allergists, carried out an updated bibliographic review, sharing of good multidisciplinary practices, and analysis of advances. Through five regional meetings with other experts with experience in SUA, the good practices identified were shared and subjected to debate, evaluation and prioritization. In total, 23 good multidisciplinary work practices in SUA, grouped into five work areas: 1) Organization of work in multidisciplinary teams, 2) Patient education, self-management and adherence, 3) Health results, data monitoring and persistence, 4) Telepharmacy and experiences implemented during the COVID-19 pandemic and 5) Training and research, were evaluated and prioritized by 57 professionals from the field of Hospital Pharmacy, Pulmonology, Allergology and Nursing. This work has made it possible to update the roadmap of priority actions to continue advancing in optimal models of care for patients with AGNC in a post-COVID-19 context. (AU)

[Translated article] Advances in the work of multidisciplinary teams for the care of patients with severe uncontrolled asthma. A post-COVID vision (TEAM 2.0 project).

Asthma is a chronic respiratory disease with a high health, social and economic impact, particularly in the case of Severe Uncontrolled Asthma (SUA). For this reason, new strategies are especially necessary to improve its approach, with a personalized approach to each patient and from a multidisciplinary perspective, in addition to integrating the new telemedicine and telepharmacy practices promoted as a result of the COVID-19 pandemic. In this context, the TEAM 2.0 project ("Work in Multidisciplinary Asthma Teams") has been developed, following the TEAM project carried out in 2019, with the aim of updating and prioritizing good multidisciplinary work practices in SUA in a post pandemic context and analyze the progress made. A coordinating group, made up of eight multidisciplinary teams of hospital pharmacists, pulmonologists, and allergists, carried out an updated bibliographic review, sharing of good multidisciplinary practices, and analysis of advances. Through five regional meetings with other experts with experience in SUA, the good practices identified were shared and subjected to debate, evaluation and prioritization. In total, 23 good multidisciplinary work practices in SUA, grouped into five work areas: 1) Organization of work in multidisciplinary teams, 2) Patient education, self-management and adherence, 3) Health results, data monitoring and persistence, 4) Telepharmacy and experiences implemented during the COVID-19 pandemic and 5) Training and research, were evaluated and prioritized by 57 professionals from the field of Hospital Pharmacy, Pulmonology, Allergology and Nursing. This work has made it possible to update the roadmap of priority actions to continue advancing in optimal models of care for patients with AGNC in a post-COVID-19 context.

Advances in the work of multidisciplinary teams for the care of patients with severe uncontrolled asthma. A post-COVID vision (TEAM 2.0 project). / Avances en el trabajo de equipos multidisciplinares para la atención al paciente con asma grave no controlada. Una visión post-COVID (Proyecto TEAM 2.0).

Asthma is a chronic respiratory disease with a high health, social and economic impact, particularly in the case of Severe Uncontrolled Asthma (SUA). For this reason, new strategies are especially necessary to improve its approach, with a personalized approach to each patient and from a multidisciplinary perspective, in addition to integrating the new telemedicine and telepharmacy practices promoted as a result of the COVID-19 pandemic. In this context, the TEAM 2.0 project ("Work in Multidisciplinary Asthma Teams") has been developed, following the TEAM project carried out in 2019, with the aim of updating and prioritizing good multidisciplinary work practices in SUA in a post pandemic context and analyze the progress made. A coordinating group, made up of eight multidisciplinary teams of hospital pharmacists, pulmonologists, and allergists, carried out an updated bibliographic review, sharing of good multidisciplinary practices, and analysis of advances. Through five regional meetings with other experts with experience in SUA, the good practices identified were shared and subjected to debate, evaluation and prioritization. In total, 23 good multidisciplinary work practices in SUA, grouped into five work areas: 1) Organization of work in multidisciplinary teams, 2) Patient education, self-management and adherence, 3) Health results, data monitoring and persistence, 4) Telepharmacy and experiences implemented during the COVID-19 pandemic and 5) Training and research, were evaluated and prioritized by 57 professionals from the field of Hospital Pharmacy, Pulmonology, Allergology and Nursing. This work has made it possible to update the roadmap of priority actions to continue advancing in optimal models of care for patients with AGNC in a post-COVID-19 context.

Valoración y seguimiento de pacientes y familias por parte del equipo de psicólogos de cuidados paliativos / Assessment and control of patients and their families by the pyschological palliative care team

Introducción: Los cuidados paliativos (CP) tienen como finalidad la mejora en la atención a los pacientes con enfermedades avanzadas, resguardando la capacidad de los individuos para hacer frente al proceso de enfermedad terminal. Una de las principales áreas de intervención de los psicólogos se realiza en estas unidades especializadas.Objetivo: Analizar las actividades de valoración, intervención y seguimiento de pacientes y familias por los psicólogos de CP y poner en evidencia el valor añadido de estos profesionales en los equipos de CP.Material y método: Estudio descriptivo retrospectivo de pacientes y familiares atendidos por los psicólogos del equipo de CP durante un periodo de 3 meses, en visitas de valoración y segui- miento en el área hospitalaria del Hospital Virgen Macarena de Sevilla.Resultados: Se incluyeron 310 sujetos en este estudio, de los cuales el 39,68 % eran pacientes y el 60,32 % familiares. La mayoría (89,68 %) pertenecía al grupo oncológico y el 84 % estaban en estadio terminal. Un 69 % de los sujetos evaluados padecía malestar emocional, así como un 32,9 % ansiedad y un 63,9 % depresión. Se encontró asociación entre estos 2 síntomas, de tal forma que los pacientes con sintomatología depresiva tenían mayor riesgo de presentar también ansiedad (OR: 3,48). Conforme se establecía una mayor relación entre los sujetos del estudio y los psicólogos, se observaron mejoras significativas en los síntomas psicológicos evaluados, así como en el malestar emocional, la información percibida y el grado de vinculación con los psicólogos.Conclusión: La intervención por parte de profesionales expertos influye en la evolución de los síntomas psicológicos en CP y en el sufrimiento en las etapas finales de la vida. (AU)

Background: Palliative Care (PC) teams aim to improve care for patients with advanced diseases, safeguarding the ability of individuals to cope with the process of terminal illness. One of the main areas of intervention of psychologists is performed in these specialized units.Objective: A study that aims to analyze the assessment, intervention and follow-up of patients and families by the palliative care psychological team, highlighting the added value of these teams.Material and methods: A retrospective descriptive study of patients and family members treated by CP team’s psychologists during a period of 3 months in assessment and follow-up visits in Virgen Macarena Hospital (Seville).Results: A total of 310 subjects were included in this study (39.68 % patients; 60.32 % family members), a large majority (89.68 %) belonged to the oncological group and 84 % were in the terminal stage; 69 % of the subjects tested suffered from emotional distress, 32.9 % had anxi- ety and 63.9 % had depression. A link was found between these 2 symptoms, so that patients with depressive symptomatology were at higher risk to develop anxiety (OR: 3.48). Significant improvements were observed in the psychological symptoms evaluated, as well as in the emo- tional discomfort, degree of information perceived, and degree of linkage with psychologists as a greater relationship was established with them.Conclusion: Psychological interventions by well trained professionals do influence on psychologi- cal symptoms (depression and anxiety) in palliative care, as well as in emotional discomfort in end-of-life stages. (AU)

Trayectorias de complejidad en el final de la vida: un estudio multicéntrico prospectivo observacional longitudinal / End-of-life complexity trajectories: a prospective, longitudinal observational multicenter study

Antecedentes: La complejidad se ha convertido en un tema central en cuidados paliativos. Se describe la evolución de la complejidad en atención domiciliaria y su relación con la ubicación de la muerte. Métodos: Estudio observacional de una cohorte prospectiva en el ámbito de la atención provista por los equipos de soporte a la atención domiciliaria en Cataluña. Los equipos evaluaron y acordaron el nivel de complejidad tras la primera visita y al exitus. El modelo HexCom incluye seis áreas de necesidades (clínicas, psicológicas, espirituales, sociofamiliares, éticas y relacionadas con la muerte), con tres niveles de complejidad: alto, moderado y bajo. Resultados: n = 648 pacientes: oncológicos 426 (65,7 %). Murieron en casa 364 (56,2 %), aumentando hasta el 86,4 % en los enfermos con demencia y al 81 % en los enfermos con fragilidad (p < 0,001). La puntuación de complejidad aumentó de 42 a 114 (p < 0,001), y este aumento fue más acusado en el grupo neurológico (de 32 a 213, p < 0,001). Se halló una asociación lineal entre complejidad y ubicación de la muerte (p < 0,001). La complejidad clínica y la sociofamiliar se asociaron a la ubicación de la muerte fuera del domicilio (p < 0,000). Conclusiones: La complejidad aumenta a medida que nos acercamos a la muerte, y esto se cumple en los grupos de pacientes oncológicos, con fallo de órgano y en los pacientes neurológicos, pero no en la demencia y la fragilidad/multimorbilidad. La complejidad se asocia con la ubicación de la muerte, principalmente en las áreas clínica y sociofamiliar. (AU)

Background: Complexity has become a central issue in palliative care. The evolution of complexity in home care and its relationship to place of death are described. Methods: An observational, prospective cohort study in the context of the care provided by home care supporting teams in Catalonia. Teams evaluated and agreed upon a complexity level after their first visit and after patient demise. The HexCom model includes six need areas (clinical, psychological, spiritual, family environment, ethical, and related to death) with three levels of complexity: high, moderate, and low. Results: n = 648 patients, of which 426 (65.7 %) were cancer patients. A total of 364 (56,2 %) subjects died at home, this figure reaching up to 86.4 % for patients with dementia, and to 81 % for fragile patients (p < 0.001). The Complexity Score increased from 42 to 114 (p < 0.001), an increase that was most pronounced in the neurological group (from 32 to 213, p < 0.001). A linear relationship was found between complexity and place of death (p < 0.001). Clinical and family environment complexity was associated with places of death outside the place of residence (p < 0.000). Conclusions: Complexity increases as death is approached, a relationship that holds for cancer patients, patients with organ failure, and neurological patients, but not for those with dementia or fragility/multimorbidity. Complexity is associated to place of death, mainly in the clinical and family environment areas. (AU)

Gestión del cuidado de enfermería en la persona mayor hospitalizado / Nursing care management in the elderly hospitalized

La Gestión del Cuidado en Enfermería en las personas mayores es todo un desafío para la profesión en la actualidad. Cifras entregadas por el Instituto Nacional de Estadísticas (INE) proyectan un porcentaje de población mayor de 65 años para el año 2035 de hasta un 19%, lo que implica planificar y coordinar la entrega de cuidados interdisciplinarios seguros, especializados y de calidad a este grupo etareo, considerando los riesgos y necesidades especiales de las personas mayores y de su entorno. Durante la hospitalización, características intrínsecas del envejecimiento, sumado a factores extrínsecos relacionados a la terapia o procedimientos, además de los procesos propios de la organización, podrían elevar la frecuencia de incidentes, lo que podría a su vez, aumentar la estadía hospitalaria y la ocurrencia de complicaciones. La prevención de eventos adversos durante la hospitalización de los pacientes mayores de 65 años se basa en las siguientes cinco estrategias: Identificación del riesgo, trabajo interdisciplinar, estrategias preventivas prácticas, capacitación continua y supervisión. El siguiente manuscrito tiene como objetivo describir las principales estrategias de gestión de riesgo en enfermería para el adulto mayor, que permitan evitar complicaciones y conservar su nivel de funcionalidad durante el proceso de hospitalización en la Unidad de Cuidados del Adulto Mayor (UCAM) de Clínica las Condes.

Nursing Care Management in the elderly is a challenge for the profession today. Figures provided by the National Statistics Institute (INE) project a percentage of the population over 65 years of age up to 19% by 2035, which implies planning and coordinating the delivery of safe, specialized and quality interdisciplinary care to this group, considering the risks and special needs of the elderly and their environment. During hospitalization, intrinsic characteristics of aging coupled with extrinsic factors related to therapy or procedures, in addition to the organization's own processes, could increase the frequency of incidents, which could, in turn, increase hospital stay and the occurrence of complications. The prevention of adverse events during hospitalization of patients over 65 years of age is based on the following five strategies: Risk identification, interdisciplinary work, practical preventive strategies, continuous training and supervision. The following manuscript aims to describe the main nursing risk management strategies for the elderly, which allow avoiding complications and maintaining their level of functionality during the hospitalization process in the Elderly Care Unit of Clínica las Condes.

Trilha interpretativa como estratégia de educação em saúde: potencial para o trabalho multiprofissional e intersetorial / Interpretive trail as a health education strategy: potential for intersectoral and multiprofessional work / Ruta interpretativa como estrategia de educación en salud: potencial para el trabajo multi-profesional e inter-sectorial

Este relato tem por objetivo divulgar a experiência de uma trilha interpretativa, organizada a partir de um circuito com seis estações temáticas, entre as quais os participantes precisavam se deslocar/caminhar, desenvolvida por estudantes, professores e técnicos da Universidade Comunitária da Região de Chapecó, em conjunto com profissionais de um município do oeste catarinense, no Brasil. Foram realizadas duas trilhas em áreas verdes, as quais consideraram a realidade municipal, discutida com profissionais locais, para abordar nas seis estações, planejadas como atividades multiprofissionais e intersetoriais. As trilhas envolveram, aproximadamente, duzentas pessoas, incluindo: famílias agricultoras, alunos da Casa Familiar Rural, grupos de mulheres e lideranças locais. Destacam-se a integração ensino-serviço-comunidade, o desenvolvimento de estratégias educativas dialógicas, proatividade no planejamento, implementação e avaliação das ações, e a sensibilização quanto à importância da educação e da promoção da saúde pelos estudantes, profissionais e população local...

This report had the aim of disseminating an experience of an interpretive trail that was organized starting from a circuit with six themed stations, among which the participants had to travel/walk. It was developed by students, teachers and technicians at the Community University of the Chapecó Region, together with professionals in a municipality in western Santa Catarina, Brazil. Two trails were made in green areas. These took municipal realities into account through discussions with local professionals so as to address the six stations, which were planned as multiprofessional and intersectoral activities. The trails involved approximately two hundred people, including farming families, students at the Rural Family House, women’s groups and local leaders. Teaching-service-community integration, development of dialogical educational strategies, proactive planning, implementation and evaluation of actions and awareness about the importance of education and health promotion for students, professionals and local people were emphasized...

El objetivo de este relato es divulgar la experiencia de una ruta interpretativa organizada a partir de un círculo con seis estaciones temáticas, entre las cuales los participantes precisaban desplazarse/caminar, desarrollada por estudiantes, profesores y técnicos de la Universidad comunitaria de la Región de Chapecó, en conjunto con profesionales de un municipio del oeste del Estado de Santa Catarina, Brasil. Se realizaron dos rutas en áreas verdes, que se consideraron la realidad municipal, discutida con profesionales locales para abordar en las seis estaciones, planificadas como actividades multi-profesionales e inter-sectoriales. las rutas envolvieron aproximadamente a doscientas personas incluyendo a familias agricultoras, alumnos de la Casa Familiar Rural, grupos de mujeres y liderazgos locales. Se destacan la integración enseñanza servicio-comunidad, el desarrollo de estrategias educativas dialógicas, pro-actividad en la planificación implementación y evaluación de las acciones y la sensibilización sobre la importancia de la educación y de la promoción de la salud por parte de los estudiantes, los profesionales y la población local...

Comprehensive care of amyotrophic lateral sclerosis patients: a care model.

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that presents with muscle weakness, causing progressive difficulty in movement, communication, eating and ultimately, breathing, creating a growing dependence on family members and other carers. The ideal way to address the problems associated with the disease, and the decisions that must be taken, is through multidisciplinary teams. The key objectives of these teams are to optimise medical care, facilitate communication between team members, and thus to improve the quality of care. In our centre, we have extensive experience in the care of patients with ALS through an interdisciplinary team whose aim is to ensure proper patient care from the hospital to the home setting. In this article, we describe the components of the team, their roles and our way of working.

Reflexões de uma equipe de residentes multiprofissionais em saúde da família sobre o processo de reativação de um Conselho Local de Saúde / Reflections from a multidisciplinary team of health family residents about a process of a Local Health Council reactivation / Reflexiones de un equipo de residentes multiprofesionales en salud de familia sobre el trayecto de un Consejo Local de Salud

Os conselhos de saúde são espaços de participação da sociedade civil organizada na gestão da política pública do setor, garantidos pela Lei Orgânica da Saúde. Este relato de experiência objetiva refletir sobre a trajetória percorrida por uma equipe de residentes multiprofissionais em saúde da família, para contribuir no resgate da participação popular em um Conselho Local de Saúde, destacando as potencialidades e as fragilidades desse processo. Foram identificadas como potencialidades: a construção de vínculos entre os profissionais e os usuários; o desenvolvimento de ações coletivas; o apoio da gestão local e a formação dos profissionais para que estes incentivem e legitimem a participação popular nos serviços de saúde. Dentre as fragilidades, o pouco envolvimento dos profissionais e usuários nos movimentos sociais, e o descrédito dos mesmos quanto à efetividade da participação popular. Considerando o CLS como um espaço legítimo e necessário e por reconhecer a importância da participação da população para a efetivação das políticas públicas de saúde, é que os residentes retratam no texto as principais conquistas e limitações enfrentadas na reativação do Conselho Local de Saúde.

The local health councils are areas for civil society participation in public policy management, which is guaranteed by the Organic Law of Health. The experience reported on this paper reflects the trajectory made by a multidisciplinary team of residents in family health, to rescue people's participation in a local health council, highlighting the strengths and weaknesses for reactivate this space. During this process, were identified as potential: building links between professionals and users, the development of collective actions, the local management support and professionals training to encourage them for create spaces like that, which legitimize people's participation in health services. Among the weaknesses, the lack involvement of professionals and users in social movements, and the discrediting about the effectiveness of popular participation. Regarding it as a legitimate and necessary space and recognizing the importance of public participation for the public health policies effectiveness, residents described the major achievements and constraints faced in the reactivation of the local health council.

Los consejos de salud son espacios de participación de la sociedad civil organizada en la gestión de la política pública del sector, garantizados por la Ley Orgánica de la Salud. Este artículo tiene como objetivo reflexionar sobre el trayecto recorrido por un equipo multiprofesional de los residentes en la saluf familiar, para el rescate de la participación popular en un Consejo Local de Salud, presentando reflexiones sobre las potencialidades y las debilidades identificadas en este proceso. Como potencialidades se verificó la construcción de vínculos entre los profesionales y los usuarios, el desarrollo de acciones colectivas, el apoyo de la gestión local y la formación de los profesionales para la creación de espacios que legitimen la participación popular en los servicios de salud. De entre las debilidades, la falta de implicación de los profesionales y usuarios en los movimientos sociales, y el descrédito de los mismos con respecto a la efectividad de la participación popular. Se considera, por tanto, importante la participación de la población en consejos locales de salud, tomándolo como un espacio legítimo y necesario y reconocer la importanciade la participación pública para la eficacia de las políticas de salud pública, es que los residentes en el texto describen los principales logros y limitaciones que enfrentan en la reactivación de lo Consejo Local de Salud.

O cuidado à pessoa diabética e as repercussões na família / La atención a la persona con diabetes y las repercusiones en la familia / The care for the diabetic patient and family repercussion

Esse estudo teve como objetivo compreender as repercussões na família da assistência oferecida após implementação de um programa educativo em diabetes. Entrevistamos seis familiares de pacientes diabéticos de um centro universitário de Ribeirão Preto-SP, em 2007. A análise temática dos dados possibilitou identificar três temas: familiares reconhecem que o Centro constitui um diferencial para adesão ao plano alimentar, atividade física e medicamentos; o Centro é reconhecido como espaço educativo para convívio e controle do diabetes; o paciente como elemento que multiplica e expande o conhecimento acerca do diabetes na família. Os resultados apontam que o programa educativo repercutiu favoravelmente na família, ampliando seu repertório de conhecimentos sobre o tratamento. O apoio do núcleo familiar é fundamental na adesão ao tratamento.

This study aimed to understand the repercussions in the family of the care offered after the implementation of a diabetes education program. We interviewed six relatives of diabetes patients from a university center in Ribeirão Preto-SP, Brazil, in 2007. Thematic data analysis made it possible to identify three themes: relatives recognize that the Center constitutes a differential for adherence to the food plan, physical activity and medication; the Center is acknowledged as an educative space to get together and control diabetes; the patient as an element that multiplies and expands the knowledge about diabetes in the family. The results indicate that the education program favorably affected the family, expanding its knowledge repertoire about treatment, and that the family core's support is fundamental in treatment adherence.

La finalidad de este estudio fue comprender las repercusiones en la familia de la atención ofrecida tras la implementación de un programa educativo en diabetes. Entrevistamos a seis familiares de pacientes diabéticos de un centro universitario de Ribeirão Preto-SP, Brasil, en 2007. El análisis temático de los datos posibilitó identificar tres temas: familiares reconocen que el Centro constituye un diferencial para adhesión al plano alimentario, actividad física y medicamentos; el Centro es reconocido como espacio educativo para convivencia y control del diabetes; el paciente como elemento que multiplica y expande el conocimiento acerca del diabetes en la familia. Los resultados apuntan que el programa educativo repercutió favorablemente en la familia, ampliando su repertorio de conocimientos sobre el tratamiento, y que el apoyo del núcleo familiar es fundamental en la adhesión al tratamiento.

A dor da criança e do adolescente com câncer: dimensões de seu cuidar / The pain of a child/adolescent with cancer: care dimensions / El dolor del niño/adolescente con cáncer: dimensiones de su cuidado

Enfocando a dor da criança/adolescente com câncer como um fenômeno complexo, este estudo tem por objetivo descrever as experiências dos profissionais de saúde envolvidos no cuidado dessa clientela nas hospitalizações e analisá-las, buscando fundamentação nas idéias acerca da complexidade de Edgar Morin. Os dados empíricos foram coletados mediante entrevistas, permitindo vislumbrar possibilidades, como a composição de equipes fixas integradas e o envolvimento da família no cuidado. Evidencia-se a necessidade de distinguir os múltiplos enfoques dos profissionais e compor uma unidade de cuidado em que esses enfoques sejam articulados através de um projeto comum, para atender ao cuidado das múltiplas dimensões da dor desses pacientes.

Focusing on the pain of a child/adolescent with cancer as a complex phenomenon, this study aims at describing the experiences of health professionals involved in caring for these patients in hospitalisations and analysing them, looking for a foundation in Edgar Morin's complexity ideas. Empirical data were collected in interviews, allowing for the visualisation of possibilities, such as a formation of fixed and integrated teams and the family's involvement in the care. Evidently, it is necessary to distinguish the professionals' multiple focuses and compose a care unit in which these focuses are articulated by means of a common project, to provide caring for the multiple dimensions of these patients' care.

Al enfocar el dolor del niño/adolescente con cáncer como un fenómeno complejo, este estudio tiene por objetivo describir las experiencias de los profesionales de salud involucrados en el cuidado de esa clientela en los hospitales y analizarlas, para buscar una fundamentación en las ideas sobre la complejidad que apunta Edgar Morin. Los datos empíricos se recogieron en entrevistas y permitieron ver posibilidades, como la composición de equipos fijos integrados y la participación familiar en el cuidado. Es evidente la necesidad de distinguir los múltiples enfoques de los profesionales y componer una unidad de cuidado, en la cual esos enfoques se articulen en un proyecto común, para alcanzar una atención que abarque las diversas dimensiones del dolor en ese tipo de pacientes.