Educação interprofissional e trabalho colaborativo em saúde: Compreensões e vivências de docentes e precetores / Interprofessional education and collaborative work in health: Perceptions and experiences of teachers and tutors / Educación interprofesional y trabajo colaborativo en salud: Comprensión y experiencias de profesores y preceptores

Resumo Enquadramento: A formação em saúde tem sido debate em diferentes cenários especialmente pelas mudanças nos modelos de atenção à saúde, sendo a Educação Interprofissional em Saúde uma estratégia afinada para este fim. Objetivo: Analisar as visões sobre educação interprofissional e os desafios na mudança do modelo de formação profissional, conforme percebido por docentes e precetores de cursos de saúde numa universidade pública do sul do Brasil, através da participação no Programa de Educação pelo Trabalho (PET) - Saúde Interprofissionalidade. Metodologia: Pesquisa qualitativa, do tipo descritiva-exploratória, utilizando entrevistas semiestruturadas e análise temática. Resultados: As experiências no programa provocaram novas perceções sobre o trabalho em equipa, colaborativo e uniprofissional destacando a Educação Interprofissional (EIP) como fundamental na formação e trabalho. Conclusão: Integrar a colaboração interprofissional na educação é crucial para mudanças curriculares significativas, como visto no Programa de Educação pelo Trabalho (PET). Isso impulsiona o trabalho colaborativo no Sistema Único de Saúde (SUS) através da Educação Interprofissional (EIP), impactando o perfil profissional na saúde.

Abstract Background: Health training has been debated in different scenarios, especially due to changes in health care models, with Interprofessional Health Education being a strategy tailored for this purpose. Objective: To analyze the perception of health teachers and tutors of a public university in southern Brazil about interprofessional education and the challenges for changing the professional training model, based on their experience in the Education through Work Program (PET) - Interprofessional Healthcare. Methodology: Qualitative, descriptive-exploratory research, using semi-structured interviews and thematic analysis according to Minayo (2016). Results: The experiences in the PET generated new perceptions about teamwork, collaborative work, and uniprofessional work, highlighting Interprofessional Education (IPE) as fundamental in training and work. Conclusion: Inserting interprofessional and collaborative work into teaching is fundamental for changes in curricular guidelines, as evidenced by experiences with the PET. Therefore, promoting collaborative work within the Unified Health System (SUS) through IPE becomes a relevant strategy for changing the professional profile in health work.

Resumen Marco contextual: La formación sanitaria ha sido objeto de debate en diferentes escenarios, especialmente debido a los cambios en los modelos de atención sanitaria. La Educación Sanitaria Interprofesional es una estrategia adecuada para este fin. Objetivo: Analizar las visiones sobre la educación interprofesional y los desafíos en el cambio del modelo de formación profesional, según lo percibido por los profesores y preceptores de cursos sobre salud en una universidad pública en el sur de Brasil, a través de la participación en el Programa de Educación por el Trabajo (PET) - Interprofesionalidad en la Salud. Metodología: Investigación cualitativa, descriptiva-exploratoria, mediante entrevistas semiestructuradas y análisis temático. Resultados: Las experiencias en el programa han llevado a nuevas percepciones de trabajo en equipo, colaborativo y uniprofesional, entre las que destaca la Educación Interprofesional (EIP) como fundamental en la formación y el trabajo. Conclusión: Integrar la colaboración interprofesional en la educación es fundamental para realizar cambios curriculares significativos, como se observa en el Programa de Educación por el Trabajo (PET). Este impulsa el trabajo colaborativo en el Sistema Único de Salud (SUS) a través de la Educación Interprofesional (EIP), lo que repercute en el perfil profesional de la atención sanitaria.

Emotional intelligence, leadership, and work teams: A hybrid literature review.

Emotional intelligence (EI) has been widely researched in different fields of knowledge. This paper reviews the literature on emotional intelligence, leadership, and teams in 104 peer-reviewed articles and reviews provided by the Web of Science and Scopus databases from 1998 to 2022. It is a hybrid or mixed review as it uses both quantitative and qualitative analysis techniques. The aims of this study are a performance analysis of the selected documents (years of publication, country, sectors, techniques used, most cited authors, authors with more publications, journals, journal quartiles, and scope of publication), as well as a co-word analysis using Atlas. ti v8. The results of the quantitative analysis indicate that the majority are empirical works. The qualitative analysis is a co-word analysis providing the following results: (i) classification of authors by major themes-categories (EI, leadership, team), (ii) classification of themes within each major theme: three subcategories in EI, 17 subcategories in leadership, and 19 subcategories in team and, lastly, (iii) classification according to the chronological development of main objectives from the most cited authors' articles we analyzed. Leadership (transformational, emergence, virtual, effective, health, effectiveness) is the major theme we studied. Our in-depth review of the articles has shown that emotionally intelligent leaders improve both behaviors and business results and have an impact on work team performance. It also highlighted a positive relationship between emotional competence and team members' attitudes about work. The new trends focus on the impacts of COVID19, the global crisis due to the Ukraine War, working in VUCA and BANI environments, comparative studies between generations, the application of artificial intelligence and the influence of mindfulness on organizations.

Trabajo colaborativo en el manejo de malformaciones faciales congénitas / Collaborative Work in the management of congenital facial malformations

RESUMEN El sistema de servicios de salud en el Perú es fragmentado y segmentado, en este nuevo siglo se requiere de una actitud coordinada y cooperativa entre los profesionales de la salud. Las malformaciones labio alveolo palatinas, son anomalías congénitas más frecuentes de la región bucomaxilofacial, afecta el crecimiento y desarrollo de estructuras orofaciales de las dos terceras partes de la cara, alterando reflejos orales innatos como la mordida, succión, deglución y la capacidad de la cavidad bucal para permitir acumulación de presión. Un desempeño adecuado en los servicios de salud se logra con una visión y postura compartida entre los integrantes del equipo de trabajo, sumada a una gestión eficaz, para lo cual la práctica colaborativa interprofesional requiere de cambios de paradigma, en el que se demuestre una evidencia sustancial e irrefutable de una cultura de equipo y un entorno interdisciplinario confiable, reconociendo responsabilidad compartida en los resultados.

ABSTRACT The health services system in Peru is fragmented and segmented, in this new century a coordinated and cooperative attitude is required among health professionals. Lip alveolus-palatine malformations are the most frequent congenital anomalies on the bucomaxillofacial region, affecting the growth and development of orofacial structures of two-thirds of the face, altering innate oral reflexes such as biting, sucking, swallowing and the capacity on the cavity buccal to allow pressure build-up. Adequate performance in health service is achieved with a shared vision and posture among the members of the work team, added to effective management, for which interprofessional collaborative practice requires paradigm changes, in which evidence is demonstrated substantial and irrefutable of a team culture and a reliable interdisciplinary environment, recognizing shared responsibility for results.

Effective Behaviors in Work Teams: Spanish Adaptation of the Individual Behavior Analysis Scale.

There are hardly any instruments to measure teamwork behaviors from an individual approach. This applies both in interprofessional teams or not, and in teams involved in health, social care, and other areas. The Individual Behavior Analysis (IBA) scale measures efficacious behavior in work teams. It is one of the few instruments proposed in the literature to measure personal skills necessary for teamwork. Only a previous exploratory analysis of the scale was informed in another study. This article analyzes its internal structure using different confirmatory factor analyses and its internal consistency, with a sample of 815 employees working for Spanish social organizations in the geriatric field, both private and public. The results of the definitive version adapted to Spanish, referred to as Individual Behavior Analysis -25, indicate a good fit of the model to the data and good reliability. Factor analysis confirmed the existence of two factors: Communication skills and Acceptance, with good internal consistency coefficients. This scale is a useful instrument for assessing, based on the reviewed literature, two of the most important individual skills an efficacious team should have.

PET-Saúde Interprofissionalidade CER II: narrativas de um grupo sobre ações cotidianas de trabalho frente às alterações provocadas pela Covid-19 / PET-Health Interprofessionality CER II: group narratives on everyday work activities in front of the changes driven by Covid-19 / PET-Salud Interprofesionalidad CER II: narrativas de un grupo sobre acciones cotidianas de trabajo frente a las alteraciones provocadas por la Covid-19

Este artigo tem por objetivo relatar a experiência de um grupo de estudantes, preceptores e tutoras participantes do Programa Educação pelo Trabalho para a Saúde - PET-Saúde Interprofissionalidade, da Universidade Federal de São Paulo, no contexto de pandemia de Covid-19. Foram construídas narrativas coletivas das estudantes, preceptoras e tutoras. As narrativas explicitam as dificuldades pessoais, o sofrimento decorrente do distanciamento social, as mudanças no trabalho e na universidade e a preocupação em ofertar novas formas de cuidado aos usuários. Pôde-se constatar que as atividades on-line exigem muito mais dos atores envolvidos e os conduzem a uma reflexão sobre o fazer interprofissional. Utilizando a narrativa, contamos o que acontece em um contexto de rupturas, como o grupo se fortaleceu e reinventou estratégias de cuidado. Ao narrar as experiências do grupo, que nos tocam, de forma grupal elas tornam-se coletivas e compartilham um modo de vivenciar o mundo.(AU)

This article recounts the experiences of a group of students, preceptors and tutors participating in the Education through Work for Health Program- PET-Health Interprofessionality at the Federal University of Sao Paulo in the context of the Covid-19 pandemic. We constructed collective narratives based on the students', preceptors' and tutors' accounts. The narratives reveal personal difficulties, distress caused by social distancing, changes at work and the university, and concern with offering new forms of care to service users. The findings demonstrate that online activities demand much more from the actors involved, prompting them to reflect on interprofessional education. Using narratives, we recount what happens in a context of ruptures and how the group became stronger and reinvented care strategies. By narrating touching group experiences as a group, these experiences become collective and share a way of experiencing the world.(AU)

El objetivo de este artículo es relatar la experiencia de un grupo de estudiantes, preceptores y tutoras participantes del PET-Salud Interprofesionalidad, de la Universidad Federal de São Paulo, en el contexto de la pandemia de Covid-19. Se construyeron narrativas colectivas de las estudiantes, preceptoras y tutoras. Las narrativas muestran las dificultades personales, el sufrimiento proveniente del distanciamiento social, los cambios en el trabajo y en la universidad y la preocupación de ofrecer nuevas formas de cuidado a los usuarios. Se puede constatar que las actividades on-line exigen mucho más de los actores envueltos y los conduce a una reflexión sobre el quehacer interprofesional. Utilizando la narrativa, contamos lo que sucede en un contexto de rupturas, cómo el grupo se fortaleció y reinventó estrategias de cuidado. Al narrar las experiencias del grupo, que nos son próximas, de forma grupal, ellas se convierten en colectivas y comparten una forma de experimentar el mundo.(AU)

Relationships Among Leaders' and Followers' Work Engagement and Followers' Subjective Career Success: A Multilevel Approach.

Using a sample of 52 work teams (52 work team leaders and their 348 followers) in China, we investigated the influence mechanism of leaders' work engagement on their followers' work engagement and subjective career success. A multilevel structural equation model (MSEM) was applied to analyze the survey data. The results of this study indicated that leaders' work engagement positively influenced their followers' subjective career success, and this relationship was mediated by the followers' work engagement. Implications of these findings, limitations, and directions for future research are discussed in the final section of the paper.

Validity evidence of the Team Psychological Safety Survey / Evidências de validade da Escala de Segurança Psicológica em Equipe / Evidencias de validez de la Escala de Seguridad Psicológica en Equipo

The objective of this study was to adapt and investigate validity evidence for the Team Psychological Safety Survey for Brazil and to test its feasibility to emerge at the team level. A sample of 8,310 female workers answered the scale. Initial analyses indicated the single-factor solution fitness, with Cronbach's alpha = 0.84. Confirmatory factor analysis model obtained good fitness coefficients, CFI = 0.995, RMSEA = 0.07. Emersion was viable due to group variance identified by and ICC calculations. The hypothesis stated that psychological safety correlates with perceived organizational practices and that differences exist between men and women's practices. Findings support that the good practices positively related to psychological safety, with differences between gender, while a negative relationship with bad practices was partially confirmed. A quadratic trend was identified between organizational status and psychological safety. Results provide validity evidence for the survey for samples of Brazilian women. (AU)

O presente estudo teve como objetivo a adaptação e investigação de evidências de validade da Escala de Segurança Psicológica em Equipe para o Brasil. A amostra foi composta por 8.310 trabalhadoras. Análises iniciais indicaram adequação da solução unifatorial, alfa de Cronbach = 0,84. Análise confirmatória do modelo unifatorial obteve bons índices de adequação, CFI = 0,995, RMSEA = 0,07. ADMd e ICC indicaram que parte da variância é explicada pelo grupo, ICC(1) = 0,195, viabilizando a emersão do construto. Hipotetizou-se que a segurança psicológica teria correlações com a percepção de práticas organizacionais. Os achados sustentam que as boas práticas investigadas possuem relação positiva com o construto, sendo mais forte com as práticas adotadas por homens. A relação negativa com as más práticas foi parcialmente confirmada. Por fim, identificou-se uma tendência quadrática entre status organizacional e segurança psicológica. Os resultados oferecem evidências de validade da escala para amostras de mulheres brasileiras. (AU)

El presente estudio tuvo como objetivo no solo adaptar e investigar las evidencias de validez de la Escala de Seguridad Psicológica en Equipo para la población brasileña, sino también probar su viabilidad para emerger a nivel de equipo. La muestra se compuso por 8.310 trabajadoras que contestaron la escala. Los primeros análisis señalaron la adecuación de la solución de un solo factor, α = 0,84. El modelo unifactorial del análisis factorial confirmatorio obtuvo buenos índices de adecuación, CFI = 0,995, RMSEA = 0.07. ADMd e ICC indicaron que parte de la varianza se explica por el grupo, ICC (1) = 0,195, viabilizando la emersión del constructo. Se planteó la hipótesis de que el constructo tendría correlaciones con la percepción de las prácticas organizacionales. Los hallazgos avalan que las buenas prácticas investigadas disponen de una relación positiva con el constructo, siendo más fuerte con las prácticas adoptadas por los hombres. La relación negativa con las malas prácticas se ha confirmado parcialmente. En conclusión, se identificó una tendencia cuadrática entre el estado organizacional y la seguridad psicológica. Los resultados proporcionan evidencias de validez de la escala para muestras de mujeres brasileñas. (AU)

Conditions for distributed leadership practices among managers in elder- and disability care organizations: A structural equation modeling approach.

Background: Against the backdrop of worldwide increases in life expectancy, there is a growing concern about the future of health and social care services in many countries, including Sweden. This is not least due to expected cutbacks in tax revenues and increasing staff shortages in the welfare sector. Challenges such as these have spurred leadership reforms aimed at mobilizing employee engagement and promoting job attractiveness. For instance, distributed leadership, whereby leader responsibilities are distributed and shared among team members, has gained momentum in recent decades. Nevertheless, there is still limited knowledge as to whether and how organizational conditions impact first-line managers' inclination to distribute influence and control. Objective: This study aims to examine the organizational precursors of two interrelated aspects of distributed leadership among first-line managers in municipal elder- and disability care: collaborative decision-making and the presence (or lack of) a participatory leadership approach. Methods: Utilizing survey data from managers working in the elder- and disability care sectors in the municipality of Gothenburg, Sweden (N = 250), associations between conditions and aspects of distributed leadership were analyzed by means of Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM). Results: Both aspects of distributed leadership were positively and significantly associated with managers' perceptions of having well-functioning collaborations with their employees (ß = 0.277 [0.122-0.432]; ß = 0.492 [0.346-0.637]) as well as with the managers' active participation in development work aimed at, e.g., promoting organizational trust (ß = 0.242 [0.039-0.446]; ß = 0.251 [0.103-0.398]). No significant associations between distributed leadership and support from senior management or positive collaborations with support functions were observed in the controlled analyses. However, managers' perceptions of organizational governance deficits were shown to be significantly and positively associated with having a more participatory leadership approach (ß = 0.261 [0.032-0.491]). Conclusions: In line with the notion of distributed leadership as a "collective activity", which is realized in the interaction between managers and their employees, the findings demonstrate that trusting collaborations with responsible and knowledgeable employees play a key role in its practical implementation. Also, distributed leadership, and the work team relations through which it is enabled, are likely to mutually and positively reinforce each other. Additionally, the analyses revealed that managers' experiences of poor organizational governance appear to promote certain distributed leadership practices. Potentially, this could be because such deficits encourage them to seek support and guidance from their employees, but more research exploring these mechanisms is needed.

How Leaders' Psychological Capital Influence Their Followers' Psychological Capital: Social Exchange or Emotional Contagion.

Using a sample of 32 work teams (32 work team leaders and their 321 followers) in Chinese cultural context, this study investigated the relationships between leaders' and their followers' psychological capital and the multilevel multiple mediation effects of social exchange and emotional contagion. PsyCap questionnaire (PCQ), leader-member exchange scale, and the positive affect scale in the positive and negative affect scale (PANAS) were adopted to measure variables. A total of 430 questionnaires were distributed in 2014 and the response rates were 90.2%. Structural equation model and hierarchical linear model were applied to analyze the survey data. The results revealed that leaders' psychological capital had a positive influence on their followers' psychological capital. Leader-member exchange was the cross-level mediator between leaders' psychological capital and their followers'. The cross-level mediating effect of leaders' positive emotions perceived by followers was not significant. The results of this study extended the social exchange theory and enriched researches on leadership. The implication was discussed in details.

Team performance in the Italian NHS: the role of reflexivity.

Purpose The purpose of this paper is twofold: first, to investigate the goodness of the input-process-output (IPO) model in order to evaluate work team performance within the Italian National Health Care System (NHS); and second, to test the mediating role of reflexivity as an overarching process factor between input and output. Design/methodology/approach The Italian version of the Aston Team Performance Inventory was administered to 351 employees working in teams in the Italian NHS. Mediation analyses with latent variables were performed via structural equation modeling (SEM); the significance of total, direct, and indirect effect was tested via bootstrapping. Findings Underpinned by the IPO framework, the results of SEM supported mediational hypotheses. First, the application of the IPO model in the Italian NHS showed adequate fit indices, showing that the process mediates the relationship between input and output factors. Second, reflexivity mediated the relationship between input and output, influencing some aspects of team performance. Practical implications The results provide useful information for HRM policies improving process dimensions of the IPO model via the mediating role of reflexivity as a key role in team performance. Originality/value This study is one of a limited number of studies that applied the IPO model in the Italian NHS. Moreover, no study has yet examined the role of reflexivity as a mediator between input and output factors in the IPO model.

Influence of Leaders' Psychological Capital on Their Followers: Multilevel Mediation Effect of Organizational Identification.

We investigated the relationships between leaders' and their followers' psychological capital and organizational identification in a Chinese community. Participants included 423 followers on 34 work teams, each with its respective team leader. Hierarchical linear models (HLM) were used in the analyses to delineate the relationships among participants' demographic background (gender, age, marital status, and educational level), human capital, and tenure. The results revealed that leaders' psychological capital positively influenced their followers' psychological capital through the mediation effect of enhancing followers' organizational identification. The implications of these findings, the study's limitations, and directions for future research are discussed.

Modelo para la gestión y análisis de conocimiento para la selección de equipos de trabajo quirúrgico en sistemas de información en salud mediante técnicas de inteligencia organizacional / Knowledge management and analysis model for the selection of surgical work teams in health information systems applying organizational intelligence techniques

El presente trabajo tiene como objetivo proponer un modelo para la gestión y análisis de conocimiento para la selección de equipos de trabajo quirúrgico en sistemas de información en salud, con la aplicación de técnicas de inteligencia organizacional que mejoren la efectividad en la conformación de los equipos. Para el desarrollo de la investigación se utilizaron diversos métodos científicos, entre los que se destacan el análisis documental, y se aplicó el enfoque histórico-cultural teniendo en cuenta los procesos sociotecnológicos de gestión, análisis y selección de equipos de trabajo en el sector de la salud. El desarrollo del modelo a aplicar en el Sistema Nacional de Salud -el cual cuenta con los componentes gestión de la información de los servicios quirúrgicos, gestión del conocimiento, inferencia de redes de interacción profesional, análisis de procesos quirúrgicos y selección de equipos de trabajo- mejora la efectividad en la selección de los equipos de trabajo quirúrgico y tiene un impacto positivo en el aumento de la efectividad de las intervenciones quirúrgicas, con lo que aumenta la calidad de vida de los pacientes.

The present study is aimed at proposing a knowledge management and analysis model for the selection of surgical work teams in health information systems, applying organizational intelligence techniques that improve effectiveness in the formation of teams. The study was based on a variety of scientific methods, among which document analysis stood out, and a historical-cultural approach was applied which took into account the sociotechnical processes of management, analysis and selection of work teams in the health sector. Development of a model to be used by the National Health System, which includes the components information management of surgical services, knowledge management, inference of professional interaction networks, analysis of surgical processes, and selection of work teams, improves efficacy in the selection of surgical work teams and has a positive impact on the increased effectiveness of surgical interventions, thus raising the quality of life of patients.

Modelo para la gestión y análisis de conocimiento para la selección de equipos de trabajo quirúrgico en sistemas de información en salud mediante técnicas de inteligencia organizacional / Knowledge management and analysis model for the selection of surgical work teams in health information systems applying organizational intelligence techniques

El presente trabajo tiene como objetivo proponer un modelo para la gestión y análisis de conocimiento para la selección de equipos de trabajo quirúrgico en sistemas de información en salud, con la aplicación de técnicas de inteligencia organizacional que mejoren la efectividad en la conformación de los equipos. Para el desarrollo de la investigación se utilizaron diversos métodos científicos, entre los que se destacan el análisis documental, y se aplicó el enfoque histórico-cultural teniendo en cuenta los procesos sociotecnológicos de gestión, análisis y selección de equipos de trabajo en el sector de la salud. El desarrollo del modelo a aplicar en el Sistema Nacional de Salud -el cual cuenta con los componentes gestión de la información de los servicios quirúrgicos, gestión del conocimiento, inferencia de redes de interacción profesional, análisis de procesos quirúrgicos y selección de equipos de trabajo- mejora la efectividad en la selección de los equipos de trabajo quirúrgico y tiene un impacto positivo en el aumento de la efectividad de las intervenciones quirúrgicas, con lo que aumenta la calidad de vida de los pacientes(AU)

The present study is aimed at proposing a knowledge management and analysis model for the selection of surgical work teams in health information systems, applying organizational intelligence techniques that improve effectiveness in the formation of teams. The study was based on a variety of scientific methods, among which document analysis stood out, and a historical-cultural approach was applied which took into account the sociotechnical processes of management, analysis and selection of work teams in the health sector. Development of a model to be used by the National Health System, which includes the components information management of surgical services, knowledge management, inference of professional interaction networks, analysis of surgical processes, and selection of work teams, improves efficacy in the selection of surgical work teams and has a positive impact on the increased effectiveness of surgical interventions, thus raising the quality of life of patients(AU)

Desenvolvimento de competências especializadas em cuidados paliativos / Development of expertise in palliative care

Face ao contexto atual, fortemente marcado pelo envelhecimento progressivo da população, com forte aumento das doenças crónicas e degenerativas, os Cuidados Paliativos surgem como uma resposta cada vez mais essencial às necessidades físicas, psicológicas, sociais e espirituais, prolongando a sua ação até ao luto. É através deles que garantimos o máximo bem-estar e qualidade de vida de cada pessoa até ao fim da vida. Neste sentido, pareceu-nos importante realizar um estágio de Natureza Profissional de 350 horas presenciais na Unidade Local de Saúde de Matosinhos ­ Equipa de Suporte em Cuidados Paliativos com o objetivo de desenvolver competências especializadas na área dos cuidados paliativos, nomeadamente nas quatro componentes primordiais: controlo de sintomas; comunicação adequada; trabalho em equipa e apoio à família. A nossa finalidade com a realização deste estágio consiste na obtenção de competências através do treino, da reflexão crítica e analítica para um cuidar humano, integral na construção de um processo de morrer condigno e para uma tomada de decisão consistente e adequada às necessidades efetivas da pessoa em fim de vida e família. A nossa prestação de cuidados de enfermagem especializados assentou em metodologias ativas, dinâmicas e participativas de forma a integrar e aplicar os conhecimentos teóricos adquiridos. Salientamos, que tivemos em atenção um cuidar centrado no doente e família, a obediência dos princípios éticos e deontológicos e a garantia de cuidados com qualidade. Desenvolver competências a nível da comunicação é difícil na medida que envolve muitas especificidades pelo facto de termos que tomar decisões que envolve situações complexas, únicas e individuais. Assim estas competências foram desenvolvidas através de um estilo comunicacional facilitador e centrado na pessoa, numa análise critica e reflexiva e no estabelecimento de uma relação de ajuda. Também o trabalho em equipa foi sempre uma nossa preocupação de forma adquirir e aprofundar estratégias de trabalho em equipa, nomeadamente colaborar eficazmente na prestação de cuidados, bem como participar nas reuniões semanais dando o nosso contributo. A nível do controlo de sintomas desenvolvemos competências na avaliação das necessidades, avaliação e monitorização de sintomas, medidas farmacológicas e não farmacológicas, refletindo sempre nos ganhos para o doente. A nível do acompanhamento familiar enfatizo as conferências familiares como uma ferramenta facilitadora da integração da família no cuidado ao doente. A nossa participação no âmbito da gestão, formação e investigação permitiu não só o desenvolvimento de competências como promoveu mudanças e novas formas de intervenção. Sobressai da realização deste estágio que para conseguir dar uma resposta mais organizada face à necessidade de tratar, cuidar e apoiar ativamente os doentes na fase final de vida, prestando cuidados de excelência, aumentando assim a qualidade de vida do doente e família é necessário competências técnicas, cientificas, relacionais e pensamento crítico e analítico. Consideramos ter desenvolvido competências para prestar cuidados paliativos de excelência.

Towards the current context, heavily marked by the progressive aging of the population, with a strong increase of chronic and degenerative diseases, Palliative Care comes up as an answer more and more essential to the physical necessities, psychological, social and spirituals, prolonging their action to the mourning. It is through them that we guarantee the well-being and life quality of each person till the end of its life. Facing that, it seemed important to us to realize a professional internship of 350 hours in the Health Local Unit of Matosinhos- Support team in Palliative Care with the goal of develop expertises in the field of palliative care, namely in the four essential components: control symptoms; proper communication; team work and family support. Our goal with this internship consist in obtain skills through the practice, critical and analytical thinking for a human care, integral in building a dignified dying process and for taking a consistent and appropriate decision to the actual needs of a person in the end of his life and family. Our provision of specialized nursing care was based on active methodologies, dynamic and participatory in order to integrate and apply the theoretical knowledge acquired. We point out that we had in mind a care focused in the patient and family, the obedience of ethical and deontological principles and ensuring quality care. Develop communication skills is difficult as it involves many specifics because we have to make decisions involving complex, unique and individual situations. So, this skills were developed throughout a communicational style facilitator and centred in the person, in a critical and reflexive analyse and in the establishment of a caring relationship. Also the work team has always been a concern in a way that we could gain and go deep in the work strategies in team, namely collaborate effectively in the caring, as also participate in weekly meetings with our contribute. On the level of the symptoms control we developed skills in the evaluation of necessities, evaluation and monitoring of symptoms, pharmacological measures and non-pharmacological measures, always reflecting in the gains for the patient. On the level of the family support I emphasize the family conferences as a facilitator of integration of family in the care to the patient. Our participation in the organization, formation and research has permitted not only the development of skills as it promoted changes and new ways of intervention. In this internship it is to put on focus that in order to give an answer more organized to the necessity of caring, to care and support actively the patients in the end of their lives, giving cares of excellence, increasing in that way the life quality of the patient and family it is necessary scientific tactics, relational and critical and analytical though. We consider to have developed skills to give palliative cares of excellence.

Saúde mental e trabalho na gestão do SUS: linhas que se atravessam e traços que contornam uma equipe de trabalho / Mental health and work in Health Unic System management: lines that across and strokes that outline a work team

O trabalho tornou-se fundamental na concepção do ser humano no sentido de formação pessoal, moral e social. Este envolvimento também pode gerar uma sobrecarga psíquica o que pode levar muitas equipes de trabalho a reproduzirem comportamentos burocratizados que cristalizam qualquer possibilidade de inserir novas práticas no seu cotidiano. Ao analisar o funcionamento das equipes profissionais percebem-se poucas ações no sentido da promoção da saúde mental tendo como disparador a identificação dos processos de trabalho a fim de pensar em ações que impulsione uma atuação mais potente. Através dos contornos da cartografia, o presente trabalho busca, sob os olhares dos pesquisadores, problematizar as experiências vivenciadas por uma equipe de trabalhadores da área da tecnologia da informação no território da Secretaria Estadual da Saúde do Rio Grande do Sul (RS). Chamando a atenção para os deslocamentos que possam refletir sobre um modelo de gestão e produção de saúde que priorize mais as relações entre todos os envolvidos no processo de trabalho. (AU)

Work has become fundamental in the conception of the human being in the sense of personal, moral and social formation. This involvement can also generate a psychic overload which can lead many work teams to reproduce bureaucratic behaviors that crystallize any possibility of inserting new practices in your daily life. When analyzing the work of the professional teams few actions are (they perceive themselves) seen in the sense of the promotion of mental health, taking as a trigger the identification of the work processes in order to think about actions that promote a more powerful performance.Through the contours of cartography, the present essay seeks, under the eyes of the researchers, to problematize the experiences experienced by a team of workers in the area of information technology in the territory of the State Department of Health of Rio Grande do Sul (RS). Calling theattention to the displacements that may reflect on a health management and production model that prioritizes the relationship among all those involved in the work process. (AU)