Background. Many older stroke survivors live with multiple (> 2) chronic conditions (MCC), resulting in the need for care by multiple health and social service providers from multiple organizations and sectors. Managing the physical, social and psychological needs related to stroke in addition to other chronic conditions is a complex process that is best served by an interprofessional team of health care providers working collaboratively toward common goals. Interprofessional education (IPE) has been promoted by numerous organizations as a method to enhance collaborative practice. However, many home care providers have not received formal IPE or training to support collaborative practice. Providing IPE in the home care setting is challenging because providers rarely work in a common location, often work in isolation, and spend much of their time driving to provide care to clients in their homes. Moreover, the effectiveness of IPE on collaborative practice for stroke rehabilitation in the home care setting is undetermined. New approaches to IPE for practicing health care providers working in the home care setting are needed. The purpose of this study was to examine the feasibility and acceptability of implementing a new theory-based, IPE intervention, and to explore its effects on collaborative practice in home care for older adult stroke survivors with MCC. Method. This feasibility study involved the use of both a qualitative descriptive and a quantitative (one-group repeated measures) design. The IPE intervention was developed and evaluated within the context of a larger pragmatic randomized controlled trial (RCT), which evaluated the effectiveness of the Aging Community and Health Research Unit Community Partnership Program (ACHRU-CPP). Informed by the W(e) Learn Framework for Interprofessional Education, the National Interprofessional Competency framework, and the literature, the IPE intervention consisted of four key components: (a) an initial three-hour standardized IPE training session; (b) standardized training for care coordinators; (c) collaborative practice reflective huddles; and (d) outreach visits. The primary outcome was the feasibility of the IPE intervention (enrollment rate, attrition rate, implementation barriers/facilitators). Secondary outcomes included the acceptability of the IPE intervention, the feasibility of the study methods (recruitment/retention rates and procedures, eligibility criteria, data collection and analysis methods), and potential effectiveness of the intervention based on three-month changes in collaborative practice, as measured by the Collaborative Practice Assessment Tool (CPAT) and the 19-Item Team Climate Inventory (TCI). Feasibility and acceptability outcomes were based on descriptive statistics for enrollment and attrition rate and qualitative descriptive analysis of focus group content, field notes, and evaluation of training. The potential effectiveness of the IPE intervention was explored using paired t-tests and Cohen’s d, with the results expressed using descriptive statistics and effect estimates (95% confidence intervals). Results. A total of 37 home care providers from two provider agencies and one Community Care Access Centre (CCAC) in Ontario, Canada participated in the study. Participants included registered nurses, physiotherapists, occupational therapists, personal support workers, care coordinators as well as nursing, rehabilitation and personal support worker supervisors. Participants viewed the intervention as feasible and acceptable. It was effective in improving three domains of collaborative practice as measured by the CPAT (communication/information exchange; community linkage and coordination of care; decision-making and conflict management) and one domain of collaborative practice, as measured by the TCI (task orientation) at six months post initial training. Participants perceived many benefits to the intervention, including improved communication and collaboration within their teams, enhanced role understanding, increased learning with and from each other, and increased appreciation and valuing of the expertise of all team members. Facilitators to implementing the intervention included: funding from the larger trial, support from key stakeholders including agency leadership, provision of key resources (e.g., Team Charter, sample agenda), and continuity of the care coordinators. Barriers included unanticipated delays in recruitment of older adult stroke survivor participants into the larger trial, and higher than expected attrition rates. The study methods were feasible and effective in reaching the target population. We established that the intervention could be delivered as planned. Conclusion. The results of this study provide preliminary evidence for the feasibility, acceptability and preliminary effects of the IPE intervention on collaborative practice for an interprofessional stroke-specific team in home care caring for older adult stroke survivors with MCC. The results also provide knowledge of the facilitators and barriers to successfully implementing and sustaining the intervention into home care practice. Further research is warranted to test this intervention in other chronic populations and settings. / Thesis / Doctor of Philosophy (PhD) / This feasibility study used qualitative and quantitative methods to evaluate the implementation of a new theory-based, Interprofessional Education (IPE) intervention and explored its effects on collaborative practice in home care for older stroke survivors with multiple chronic conditions. The IPE intervention was developed and evaluated within the context of a larger pragmatic randomized controlled trial (RCT), which evaluated the effectiveness of the Aging Community and Health Research Unit Community Partnership Program. The six-month IPE intervention consisted of four key components: (a) an initial three-hour standardized IPE training session; (b) standardized training for care coordinators; (c) collaborative practice reflective huddles; and (d) outreach visits. Participants included 37 home care providers including registered nurses, physiotherapists, occupational therapists, personal support workers, care coordinators, and nursing, rehabilitation and personal support worker supervisors from two service provider agencies and one Community Care Access Centre (CCAC) in Ontario, Canada. The intervention was effective in improving collaborative practice (e.g., communication within teams, role understanding, team decision-making and conflict management). Facilitators to implementing the intervention included: funding from the larger trial, leadership support, provision of key resources, and continuity of the care coordinators. Barriers included unanticipated delays in recruitment of older adult stroke survivor participants into the larger trial, and higher than expected attrition rates. This study offers preliminary evidence that the intervention is feasible to deliver, acceptable to providers, and may improve collaboration within an interprofessional stroke-specific team. Further research is necessary to test this intervention in other chronic populations and settings.

The need to incorporate interprofessional education (IPE) as part of any healthcare profession curricula is growing in an approach to prepare a collaborative practice-ready workforce. Pharmacy students should be equipped with the necessary competencies and skills needed for them to practise interprofessionally, commensurate with the expanding and evolving role of the pharmacist. Thus, the Qatar University College of Pharmacy has decided to incorporate IPE initiatives formally into the pharmacy curriculum in collaboration with other healthcare institutions in Qatar to meet the accreditation standards set by the Canadian Council for Accreditation of Pharmacy Programs (CCAPP) and fulfil the recommendations set in the World Health Organization (WHO) framework. To implement effective IPE strategies, it is important to consider the prior attitudes and expectations of various stakeholders in the process -- particularly students, faculty, and practising pharmacists. The overall aim of this PhD research is to explore the pharmacy perspectives of IPE and collaborative practice from a Middle Eastern context. The research started with a comprehensive systematic review of the literature focusing on the perspectives of pharmacy students, pharmacy faculty, and practising pharmacists on IPE and collaborative practice. Five themes have been identified from the systematic review: inconsistency in reporting IPE research, professional image of the pharmacist, lack of longitudinal follow-up, lack of IPE research on faculty, and lack of mixed method studies. This was followed by three sequential explanatory mixed method designs, to explore the perception of faculty, students, and practising pharmacists, individually. This was undertaken to gain an in depth understanding of the strengths and challenges of each group that can affect the implementation and perspectives toward IPE and collaborative practice. Two data collection methods were used: quantitative surveys and qualitative focus groups. Quantitative data were imported into SPSS® version 22 and analysed using both descriptive and inferential statistics. Qualitative data from the focus groups were analysed using thematic analysis. For the quantitative surveys, the overall response rate was 117 out of 334 (35%) for pharmacy faculty in the Middle East, 102/132 (77%) for pharmacy students in Qatar and 178/285 (63%) for practising pharmacists in Qatar. This was followed by seven focus groups with a total of 51 participants. Findings, from both the survey and focus groups, support that students, faculty and practising pharmacists are ready to engage in IPE and collaborative practice. The findings further identified positive attitudes that reinforce the need to incorporate IPE into healthcare curricula. They perceive anticipated benefits to them as professionals and to the patients. However, a large number of challenges have been highlighted, including the existence of a hierarchical culture, pharmacists’ role and image, a weak sense of professional identity among pharmacists, their marginalised contribution, resistance from the healthcare teams to the evolving role of the pharmacists, and the heterogeneous background of healthcare professionals. Promisingly, the education and healthcare system in Qatar is undergoing significant changes with some positive influences noted within education and practice settings. This is the first study investigating pharmacy perspectives of IPE in Qatar, the Middle East, and worldwide. The findings from this research generated a body of knowledge regarding the pharmacy perspectives of IPE and provided a better understanding of what shapes this perspective from a Middle Eastern context. The research presents a new model based on collective input, efforts, and readiness in five key stages: academic institution, faculty, student, practice, and environment. The model moves beyond focusing on the individual stages separately and expands to consider the complexity of linking and aligning the stages together. Coordinated efforts, between the stages, focused on a more comprehensive and holistic implementation, is essential for successful implementation of IPE and collaborative practice.

Depuis l'avènement des technologies portables et du réseau Internet, de nombreux artistes conçoivent leurs œuvres au delà d'un espace et d'un temps donnés et inventent des formes permanentes et immatérielles disséminées sur les réseaux. Dans le cadre de cette recherche, il s'agit de produire à la fois une série de travaux sonores utilisant le réseau, des modes de participation collaboratifs et également de proposer une pensée sur les concepts révélés par ces nouvelles pratiques et ces formes d'écritures artistiques comme celle du noise, de la poésie sonore et des musiques expérimentales. La recherche est concentrée sur les éléments nécessaires pour constituer un laboratoire connecté de production sonore partagée, dans lequel toutes les questions (et d'autres à venir et à définir ensemble) sont posées à travers notre pratique artistique, des formes d'installations “dé-géolocalisées” ou “non géolocalisées” et enfin des performances musicales en simultané sur Internet. Il est intéressant de pouvoir à la fois envisager une production avec une communauté d'artistes et de penseurs ayant une pratique et des connaissances dans le domaine mais aussi de savoir comment ces artistes, théoriciens formulent leurs pensées et créent de nouveaux concepts. Ainsi, le travail de recherche peut croiser un projet de création, une pratique, un savoir- faire et en dégager une méthodologie théorique qui donne accès à des clefs, à la compréhension de ces nouvelles formes d'écritures / Since the advent of portable technologies and the Internet, many artists conceive their works beyond a given space and time and invent permanent and immaterial forms scattered over the networks. Within the framework of this research, the aim is to produce a series of sound works using the network and collaborative modes of participation, as well as to stimulate discussion of the concepts revealed by these new practices and forms of artistic language: noise, sound poetry and experimental music. This research will focus on the key elements of a connected laboratory of shared sound production: questions will be raised through the lens of the author’s own artistic practice using geodelocalised forms of installation and simultaneous musical performances on the Internet. I will also consider the work and thinking of a community of artists within this field and seek to understand how these artists and theorists formulate their thoughts and create new concepts. Finally, this thesis addresses these creative projects, practices and expertise and articulates a theoretical methodology which draws together current forms of artistic language relating to cutting edge music and poetry and networked practices

Made available in DSpace on 2018-06-18T13:12:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2016 / As Diretrizes Curriculares Nacionais do curso de Fisioterapia referem-se às competências e habilidades gerais e específicas a serem desenvolvidas durante a graduação. Preveem que a formação deve contemplar as necessidades sociais da saúde, com ênfase no Sistema Único de Saúde estimulando o pensamento crítico e produtivo, com base nos problemas da população assistida e valorizando o conhecimento que é cotidianamente produzido nas unidades de saúde e articulando-o com o que é produzido na universidade. Em 2010 a Organização Mundial da Saúde reconhece que o trabalho em equipe e a prática colaborativa podem fortalecer os sistemas de saúde e promover melhor resolutividade e qualidade dos serviços em saúde. O presente estudo teve por objetivo identificar a percepção de fisioterapeutas sobre sua formação profissional para o trabalho em equipe e a prática colaborativa através de uma pesquisa exploratória com abordagem quali-quantitativa. O instrumento, hospedado no GoogleForms, foi respondido por 67 fisioterapeutas atuantes em serviços públicos e privados de atenção e recuperação à saúde, contendo dados de identificação, características sobre a formação profissional, 27 assertivas em Escala “tipo Likert” e questões abertas sobre a prática profissional, competências para o trabalho em equipe e sugestões para implementar/aprimorar o trabalho em equipe no ambiente de prática. Todos os participantes possuem tempo de experiência profissional superior a um ano e assinaram o Termo de Consentimento Livre e Esclarecido. De posse dos dados coletados foi realizada a análise estatística exploratória em busca de indicadores para demonstrar a percepção dos fisioterapeutas em relação às competências desenvolvidas durante sua formação em preparação para o trabalho em equipe e a prática colaborativa. Os resultados indicaram que ainda há dificuldades enfrentadas nos cenários de prática quanto ao trabalho em equipe e prática colaborativa, principalmente no que diz respeito à atenção centrada no paciente, observando-se que ainda vigora o modelo biomédico centrado na doença e na figura do médico. No que diz respeito ao desenvolvimento de competências e habilidades para o trabalho em equipe parece que, mesmo estando presentes em momentos da formação profissional, isso não garante a efetividade do trabalho e das práticas colaborativas nos cenários de prática. / The “Diretrizes Curriculares Nacionais” for Physical Therapy Graduation Course is a curriculum guideline that lists general and specific skills and abilities to be developed by students during graduation. The document is substantiated on the perspective of social and healthcare needs, comprised by the Brazilian Public Health System “Sistema Único de Saúde” (SUS) and aims to encourage critical thinking and productive reasoning based on the main public health issues, valuing practical knowledge regularly produced in health facilities that ought to be linked with the information produced at the University. In 2010 the World Health Organization recognizes that teamwork and collaborative practice can encourage better resolution, improve quality and strengthen health services. The present study aimed to identify physical therapists’ perception about their training for teamwork and collaborative practice through an exploratory research with qualitative and quantitative approaches. An assessment questionnaire, hosted on GoogleForms, was answered by 67 physical therapists’ active in public and private health care services and includes identification data, information on vocational training, 27 assertions in Likert type scale, open-ended questions regarding professional practice skills for teamwork and suggestions to implement and enhance teamwork in the clinical environment. All participants of this study have more than one year of professional practice and signed the consent form. Using the collected data, an exploratory statistical analysis was carried out searching for indicators to demonstrate the physical therapists’ perception concerning the skills developed during their training regarding teamwork and collaborative practice. The outcomes of the research indicated that there are still some difficulties perceived in clinical scenarios regarding teamwork and collaborative practice, especially underlining the patient as the main focus of attention, instead of the still prevailing biomedical model focused on the disease and the doctor. Regarding the development of skills and abilities for teamwork, it seems that even being present during training, this does not guarantee the effectiveness collaborative work practices in clinical scenarios.

Made available in DSpace on 2018-06-18T13:27:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2017 / Introdução: As deformidades craniofaciais apresentam-se como uma situação complexa com consequências psicológicas, fisiológicas e sociais que exigem a intervenção de uma equipe com variados profissionais, como médicos, cirurgiões dentistas, nutricionistas, psicólogos e assistentes sociais, na perspectiva de uma equipe de Prática Colaborativa. Neste contexto, não tem como não mencionar a Formação Interprofissional para esta prática. Esta modalidade de Currículo Inovador, seja em graduação, pós-graduação, formação continuada ou em formação permanente tem sido um desafio atualmente. Segundo a OMS, a educação interprofissional ocorre quando estudantes de duas ou mais profissões aprendem sobre os outros, com os outros e entre si para possibilitar a colaboração eficaz e melhorar os resultados na saúde. Objetivo geral: Investigar o processo de formação e educação permanente para o trabalho em equipe de docentes e discentes que atuam na atenção a pacientes com deformidades craniofaciais com vistas à prática colaborativa e à integralidade do cuidado. Objetivos específicos: Apreender as concepções de trabalho em equipe e prática colaborativa de profissionais que atuam em deformidades craniofaciais, levantar as dificuldades vivenciadas pelos profissionais no seu processo de educação permanente como uma equipe de saúde, e avaliar a incorporação da Educação Interprofissional (EIP) à educação permanente das equipes. Método: O estudo foi quali-quantitativo, de natureza descritiva e exploratória, observando-se os preceitos éticos. A pesquisa se deu em duas etapas: a primeira foi a aplicação do Instrumento Atitudinal do tipo Likert respondido por 36 profissionais, sendo este construído com 3 dimensões fundamentadas nos objetivos do estudo. A segunda etapa foi a realização de entrevistas semi-estruturadas feitas com 15 profissionais (número que se deu pela saturação das informações). Os dados do Likert foram analisados estatisticamente e o conteúdo das entrevistas por meio de análise de conteúdo, modalidade temática e os dados posteriormente triangulados. Resultados: Os respondentes, em sua maioria, concordam com a eficácia do Trabalho em Equipe Colaborativo e entendem que esta prática deve ser melhorada, com a necessidade de intersecção de áreas de atuação profissional no cotidiano de suas atividades e com a importância do planejamento conjunto de ações, entendendo que este ponto deve ser intensificado. Diante das dificuldades vivenciadas na Educação Permanente da Equipe, observa-se um predomínio do enfoque multiprofissional de atuação, a predominância de um modelo de educação permanente multiprofissional, a necessidade de práticas com horários protegidos, formação e atuação interprofissional com metodologias inovadoras, existência de variáveis como falta de tempo, poucos recursos, individualismo, falta de motivação pessoal que atrapalham a EP da equipe. Em relação à Educação Interprofissional, os profissionais confundem EIP com formação fragmentada multiprofissional, reconhecem a EIP como uma estratégia de formação que possibilita que os mesmos adquiram um perfil holístico de atuação e saiam mais preparados para atuar em equipes com perfil colaborativo, percebem que a EIP melhora as relações profissionais, aumenta a resolutividade, diminui custos, diminui estresse, humaniza a relação profissional/paciente. Conclusões: Esperamos que este estudo subsidie propostas de intervenção, de forma dialogada, que permitam a constante evolução do atendimento a pacientes com deformidades craniofaciais, em relação à comunidade e instituições congêneres. / Introduction: Craniofacial deformities present a complex situation with psychological, physiological and social consequences that require the intervention of a team with a variety of professionals, such as physicians, dental surgeons, nutritionists, psychologists, social workers, from the perspective of a team of one Collaborative Practice. In this context, it is impossible not to mention the Interprofessional Training for this practice. This modality of Innovative Curriculum, whether in undergraduate, postgraduate, continuing education or in permanent formation has been a challenge today. According to WHO, inter-professional education occurs when students from two or more professions learn about each other, with each other and with each other to enable effective collaboration and improve health outcomes. General objective: To investigate the process of formation and permanent education for the teamwork of teachers and students who work in the care of patients with craniofacial deformities with a view to collaborative practice and integral care. Specific objectives: To understand the conceptions of team work and collaborative practice of professionals who work on craniofacial deformities, to raise the difficulties experienced by professionals in their process of permanent education as a health team, and value the incorporation of Interprofessional Education (EIP) to the permanent education of the teams. Method: The study was qualitative and quantitative, of descriptive and exploratory nature, observing the ethical precepts. The research was carried out in two stages: first was the application of the Likert type Attitudinal Instrument where 36 professionals answered, being this one constructed with 3 dimensions based on the objectives of the study. The second step was semi-structured interviews with 15 professionals (a number that occurred due to saturation of information). Likert data were analyzed statistically and content of the interviews by content analysis, thematic modality and the later triangulated data. Results: Respondents, for the most part, agree with the effectiveness of Collaborative Teamwork and understand that this practice should be improved, with the need to intersect areas of professional activity in the daily life of its activities and with the importance of joint planning of actions, understanding that this point should be intensified. Faced with the difficulties experienced in the Permanent Education of the Team, a predominance of the multiprofessional approach of action is observed, the predominance of a multiprofessional permanent education model; The need for practices with protected schedules, training and interprofessional work and with innovative methodologies, existence of variables such as lack of time, few resources, individualism, lack of personal motivation that disrupt the EP of the team. In relation to Interprofessional Education, professionals confuse IPE with fragmented multiprofessional training, recognize the IPE as a training strategy that allows them to acquire a holistic profile of performance and leave more prepared to act in teams with a collaborative profile, perceive that IPE improves professional relationships, increases resolution, decreases costs, reduces stress, humanizes the professional / patient relationship. Conclusions: We hope that this study will subsidize intervention proposals, in a dialogical way, that allow the constant evolution of care for patients with craniofacial deformities, relationship with the community and similar institutions.

京都大学 / 0048 / 新制・論文博士 / 博士(人間・環境学) / 乙第12952号 / 論人博第43号 / 新制||人||178(附属図書館) / 27||論人博||43(吉田南総合図書館) / 32251 / (主査)教授 杉万 俊夫, 教授 ﾍﾞｯｶｰ ｶｰﾙ, 教授 吉田 純, 准教授 永田 素彦 / 学位規則第4条第2項該当 / Doctor of Human and Environmental Studies / Kyoto University / DFAM

Birth doulas offer continuous physical, emotional, and informational support before, during, and after birth. There is strong evidence of the maternal health benefits associated with continuous labour support. Nurses are the most common intrapartum care provider and navigate the overlapping labour support role with doulas. While there is evidence of mutual respect, conflicts can occur with negative consequences. This study aimed to explore collaborative practice between nurses and doulas from the perspective of intrapartum nurses in Ontario, Canada. Thorne's qualitative interpretive description (ID) methodology was used. Nurses experienced in working with doulas were recruited via email invitations and postings on a nursing online forum. Semi-structured 1:1 interviews were conducted with six nurses. Experience ranged from 4 to 35 years across nine hospitals. Interviews were recorded and transcribed verbatim. Data analysis was informed by the ID approach. Findings comprised two main themes, each with four sub-themes. First, participants described influences on nurses' readiness to collaborate with doulas. These influences include the culture clash between medicalized and natural birth, support from management and hospital policies and previous professional experiences. These led to the nurses' approach, "it's about the patient". Second, participants' responses reflected a continuum of nurse-doula collaboration, beginning with being open-minded, a necessity for getting on the patient's team, building trust and working together towards shared goals. These findings provide a framework for interventions to facilitate collaborative practice, including in-service training and enactment of appropriate institutional policies. Improved collaboration enhances both nurses' and doulas' practice while promoting better childbirth outcomes.

Introdução: O estudo propõe analisar o trabalho do enfermeiro na atenção básica de saúde, no contexto das relações entre trabalhadores da equipe de saúde da família e do núcleo de apoio à saúde da família (NASF), para conhecer como se dá a participação do enfermeiro na promoção de ações interprofissionais. Objetivos: Identificar as ações interprofissionais nas quais o enfermeiro participa e analisar as concepções dos profissionais de saúde das unidades básicas de saúde (UBS) sobre a participação do enfermeiro nas ações interprofissionais e sobre o trabalho em equipe. Método: Estudo de caso com abordagem qualitativa realizado em uma UBS da região sul do município de São Paulo. Coleta de dados através de observação direta do trabalho das equipes e entrevista com base na técnica de incidente crítico, com 15 profissionais de uma Equipe de Saúde da Família, Saúde Bucal e NASF. Na análise utilizou-se análise temática e triangulação. Resultados: Foram identificados oito tipos de ações interprofissionais nas quais o enfermeiro participa: consulta compartilhada, consulta de enfermagem que se desdobra em consulta compartilhada, atendimento compartilhado, espaço de troca e oportunidades de articulação, discussão de dúvidas, coordenação do cuidado, encaminhamentos pela enfermeira para outros profissionais e encaminhamentos de outros profissionais para a enfermeira. Os resultados mostraram o predomínio de consultas compartilhadas com médico e profissionais do NASF e que o conjunto das ações interprofissionais são orientadas por duas lógicas distintas: lógica das necessidades de saúde do usuário e lógica de agilizar o atendimento, ou a combinação de ambas. Independentemente da orientação da ação, foram identificadas duas abordagens também distintas: biomédica ou atenção integral à saúde. Conclusão: As ações interprofissionais observadas evidenciam características de trabalho em equipe integrado e prática colaborativa, destacando-se a atuação da enfermeira como agente de distribuição e convergência de informações e sua participação na ação interprofissional, em especial relacionada à prática clínica. Nas ações interprofissionais orientadas pela lógica das necessidades de saúde, houve o predomínio da abordagem pautada na busca da integralidade e nas ações interprofissionais voltadas à lógica de agilizar o atendimento, predominou a abordagem biomédica, com foco na doença e aspectos a ela relacionados. As ações desenvolvidas em conjunto entre enfermeira e profissionais do NASF, evidenciam a atuação deste como recurso de matriciamento e de apoio técnico-pedagógico, pois tanto representa a extensão da abordagem das necessidades de saúde de usuários, como educação permanente dos envolvidos / Introduction: In this study we propose to analyze the work of the basic healthcare nurse in the context of the relationship between workers of the family healthcare team and the support nucleus of the family healthcare (NASF -- núcleo de apoio à saúde da família) to acknowledge how the participation of the nurse in the promotion of interprofessional actions occurs. Objective: Identify the interprofessional actions where the nurse takes part and analyze the ideas of the healthcare professionals of the healthcare basic units (UBS -- unidades básicas de saúde) on nurse participation in interprofessional actions and in teamwork. Method: Case study with a qualitative approach conducted in a UBS of the southern area of the municipality of São Paulo. Data collection through direct observation of the work of the teams, and interviews based on the critical incidents technique, with 15 professionals of a Family Health Team, Buccal Health, and NASF. For the analysis, thematic analysis and triangulation were applied. Results: Eight types of interprofessional actions where the nurse takes part were identified: Shared visits, nurse visits that turns into a shared visit, shared care, a space for exchanges and articulation opportunities, discussion of issues, care coordination, referrals by the nurse to other professionals, and referrals of the other professionals to the nurse. The results have shown the predominance of shared visits with physicians and NASF professionals, and that the whole of interprofessional actions are guided by two different reasoning: Reasoning of the health needs of the user, and reasoning of speeding up the care, or a combination of both. Regardless of the action guidance, two approaches, also different, were identified: Biomedical or integral healthcare. Conclusion: The interprofessional actions observed point to integrated teamwork and collaborative practice characteristics, with the nurse action standing out as an agent of information delivery and convergence, and their participation in the interprofessional action, mainly in relation with the clinical practice. The interprofessional actions guided by the reasoning of health needs have shown the predominance of the approach ruled by the search of integrality, and in the interprofessional actions, directed by the reasoning of speeding up care, biomedical approach has prevailed, with focus on disease and their related aspects. The actions developed together by nurses and NASF professionals, point to its action as a matrix and technical and pedagogical support resource, for they represent the extension of the approach of health needs of the user as well as the permanent education of the involved

Introdução: O estudo propõe analisar o trabalho do enfermeiro na atenção básica de saúde, no contexto das relações entre trabalhadores da equipe de saúde da família e do núcleo de apoio à saúde da família (NASF), para conhecer como se dá a participação do enfermeiro na promoção de ações interprofissionais. Objetivos: Identificar as ações interprofissionais nas quais o enfermeiro participa e analisar as concepções dos profissionais de saúde das unidades básicas de saúde (UBS) sobre a participação do enfermeiro nas ações interprofissionais e sobre o trabalho em equipe. Método: Estudo de caso com abordagem qualitativa realizado em uma UBS da região sul do município de São Paulo. Coleta de dados através de observação direta do trabalho das equipes e entrevista com base na técnica de incidente crítico, com 15 profissionais de uma Equipe de Saúde da Família, Saúde Bucal e NASF. Na análise utilizou-se análise temática e triangulação. Resultados: Foram identificados oito tipos de ações interprofissionais nas quais o enfermeiro participa: consulta compartilhada, consulta de enfermagem que se desdobra em consulta compartilhada, atendimento compartilhado, espaço de troca e oportunidades de articulação, discussão de dúvidas, coordenação do cuidado, encaminhamentos pela enfermeira para outros profissionais e encaminhamentos de outros profissionais para a enfermeira. Os resultados mostraram o predomínio de consultas compartilhadas com médico e profissionais do NASF e que o conjunto das ações interprofissionais são orientadas por duas lógicas distintas: lógica das necessidades de saúde do usuário e lógica de agilizar o atendimento, ou a combinação de ambas. Independentemente da orientação da ação, foram identificadas duas abordagens também distintas: biomédica ou atenção integral à saúde. Conclusão: As ações interprofissionais observadas evidenciam características de trabalho em equipe integrado e prática colaborativa, destacando-se a atuação da enfermeira como agente de distribuição e convergência de informações e sua participação na ação interprofissional, em especial relacionada à prática clínica. Nas ações interprofissionais orientadas pela lógica das necessidades de saúde, houve o predomínio da abordagem pautada na busca da integralidade e nas ações interprofissionais voltadas à lógica de agilizar o atendimento, predominou a abordagem biomédica, com foco na doença e aspectos a ela relacionados. As ações desenvolvidas em conjunto entre enfermeira e profissionais do NASF, evidenciam a atuação deste como recurso de matriciamento e de apoio técnico-pedagógico, pois tanto representa a extensão da abordagem das necessidades de saúde de usuários, como educação permanente dos envolvidos / Introduction: In this study we propose to analyze the work of the basic healthcare nurse in the context of the relationship between workers of the family healthcare team and the support nucleus of the family healthcare (NASF -- núcleo de apoio à saúde da família) to acknowledge how the participation of the nurse in the promotion of interprofessional actions occurs. Objective: Identify the interprofessional actions where the nurse takes part and analyze the ideas of the healthcare professionals of the healthcare basic units (UBS -- unidades básicas de saúde) on nurse participation in interprofessional actions and in teamwork. Method: Case study with a qualitative approach conducted in a UBS of the southern area of the municipality of São Paulo. Data collection through direct observation of the work of the teams, and interviews based on the critical incidents technique, with 15 professionals of a Family Health Team, Buccal Health, and NASF. For the analysis, thematic analysis and triangulation were applied. Results: Eight types of interprofessional actions where the nurse takes part were identified: Shared visits, nurse visits that turns into a shared visit, shared care, a space for exchanges and articulation opportunities, discussion of issues, care coordination, referrals by the nurse to other professionals, and referrals of the other professionals to the nurse. The results have shown the predominance of shared visits with physicians and NASF professionals, and that the whole of interprofessional actions are guided by two different reasoning: Reasoning of the health needs of the user, and reasoning of speeding up the care, or a combination of both. Regardless of the action guidance, two approaches, also different, were identified: Biomedical or integral healthcare. Conclusion: The interprofessional actions observed point to integrated teamwork and collaborative practice characteristics, with the nurse action standing out as an agent of information delivery and convergence, and their participation in the interprofessional action, mainly in relation with the clinical practice. The interprofessional actions guided by the reasoning of health needs have shown the predominance of the approach ruled by the search of integrality, and in the interprofessional actions, directed by the reasoning of speeding up care, biomedical approach has prevailed, with focus on disease and their related aspects. The actions developed together by nurses and NASF professionals, point to its action as a matrix and technical and pedagogical support resource, for they represent the extension of the approach of health needs of the user as well as the permanent education of the involved

Orientador: Renato Eugênio da Silva Diniz / Resumo: As analogias são recursos que auxiliam o ensino de conceitos científicos, pois facilitam a transferência de significados de um conceito conhecido para um conceito desconhecido. No entanto, diversos obstáculos para a aprendizagem surgem quando são pronunciadas espontaneamente pelos professores. Assim, o planejamento para o seu uso é essencial, sendo estimulado quando os professores refletem sobre a sua prática em contextos formativos colaborativos. A temática da pesquisa envolveu a formação continuada de professores como práticos-reflexivos e a formação colaborativa. Buscou-se compreender e discutir os desafios e as possibilidades de inserção das analogias no planejamento de ensino de professores de Ciências e Biologia, quando eles refletem e planejam usá-las em um contexto de formação continuada. A abordagem da pesquisa foi qualitativa e as participantes três professoras das disciplinas supracitadas. A coleta de dados foi dividida em cinco etapas: 1) desenvolvimento de um curso sobre o uso de analogias; 2) planejamento de uma aula com o uso desse recurso; 3) implementação da aula; 4) entrevista semiestruturada e 5) discussão em grupo. Todas as etapas foram gravadas em áudio. As fases 1 e 5 foram realizadas com todas as participantes reunidas, e as fases 2, 3 e 4 realizadas individualmente com cada professora e a presença do pesquisador. O referencial analítico adotado foi a análise textual discursiva. Para a 1ª etapa foram geradas oito categorias acerca dos significados que a... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Analogies are resources that assist the teaching of scientific concepts, since they facilitate the transfer of meanings from a known concept to an unknown concept. However, several obstacles to learning arise when analogies are pronounced spontaneously by teachers. Therefore, the planning for its use is essential, and it is encouraged when teachers reflect on their practice in collaborative formative contexts. The theme of the research involved the continued teacher training as practical-reflective agents and the collaborative training. We sought to understand and discuss the challenges and possibilities of the insertion of analogies in the didactic planning of Science and Biology teachers, when they reflect and plan to use them in a continuing teacher training context. The research approach was qualitative, and the participants were three female teachers of the abovementioned subjects. Data gathering was divided into five stages: 1) development of a training course on the use of analogies; 2) planning of a class using this resource; 3) application of the planned class; 4) semi-structured interview and 5) group discussion. All stages were recorded in audio. Stages 1 and 5 were executed with all participants gathered, and phases 2, 3 and 4 were executed with each participant individually with the presence of the researcher. The adopted analytical framework was the discursive textual analysis. For the 1st stage, eight categories were generated on the meanings that the participa... (Complete abstract click electronic access below) / Doutor