Introdução. O trabalho em equipe interdisciplinar é considerado um importante pressuposto para reorganização do processo de trabalho nas práticas de promoção da saúde e prevenção de doenças, visando a uma abordagem mais integral e resolutiva. Objetivo. Discutir aspectos das relações disciplinares entre profissionais de saúde, incluindo barreiras e facilitadores à prática da interdisciplinaridade, tomando como referência o caso de um centro universitário voltado ao ensino e pesquisa em promoção da saúde e prevenção de doenças na prática clínica. Método. Pesquisa qualitativa, realizada no Centro de Promoção da Saúde do Serviço de Clínica Geral do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (CPS-HCFMUSP), com emprego de observação participante e entrevistas semiestruturadas com profissionais de saúde, iniciada após prévia aprovação do Comitê de Ética em Pesquisa e consentimento esclarecido dos entrevistados. Os dados foram submetidos à análise qualitativa, através da análise de conteúdo, modalidade temática. Resultados. Encontram-se práticas realizadas por profissionais com mesmos objetivos, porém com pequena interação entre si, sem método e linguagem comuns, trabalhando sem integração, mas com conhecimento unificado e com diferentes níveis de hierarquia horizontal. No conjunto, esta situação pode representar um momento de transição da pluridisciplinaridade para a interdisciplinaridade. Conclusão. A interdisciplinaridade no caso avaliado não é uma realidade posta, mas um processo ainda em evolução. Fatores sócio-culturais, institucionais e subjetivos podem agir tanto como facilitadores quanto como obstáculos à interdisciplinaridade. / Introduction. Interdisciplinary teams are considered an important premise for the rearrangement of the work process in practices of health promotion and disease prevention, aiming at an integral and resolutive approach. Objective. Discuss the disciplinary relationships among health professionals, including barriers and facilitators to the practice of interdisciplinarity, in the context of a university center for education and research in health promotion and disease prevention in clinical practice. Method. Qualitative research, conducted at the Centro de Promoção da Saúde do Serviço de Clínica Geral do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo -CPS-HCFMUSP, using participant observation and semi-structured interviews with health professionals, started up after approval by the HCFMUSP - Research Ethics Committee and the informed consent of interviewees. The data was subjected to qualitative content analysis, on the basis of thematic modality. Results. It was observed practices performed by professionals with little interaction, no common language and method and lack of integration, but with similar goals, unified knowledge and different levels of horizontal hierarchy. Overall, this may represent a moment of transition from multidisciplinary to interdisciplinary work. Conclusion. Interdisciplinarity is not a fact, but a process still in evolution. Socio-cultural, institutional and individual factors can act both as facilitators or as barriers to its implementation.

Introdução. O trabalho em equipe interdisciplinar é considerado um importante pressuposto para reorganização do processo de trabalho nas práticas de promoção da saúde e prevenção de doenças, visando a uma abordagem mais integral e resolutiva. Objetivo. Discutir aspectos das relações disciplinares entre profissionais de saúde, incluindo barreiras e facilitadores à prática da interdisciplinaridade, tomando como referência o caso de um centro universitário voltado ao ensino e pesquisa em promoção da saúde e prevenção de doenças na prática clínica. Método. Pesquisa qualitativa, realizada no Centro de Promoção da Saúde do Serviço de Clínica Geral do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (CPS-HCFMUSP), com emprego de observação participante e entrevistas semiestruturadas com profissionais de saúde, iniciada após prévia aprovação do Comitê de Ética em Pesquisa e consentimento esclarecido dos entrevistados. Os dados foram submetidos à análise qualitativa, através da análise de conteúdo, modalidade temática. Resultados. Encontram-se práticas realizadas por profissionais com mesmos objetivos, porém com pequena interação entre si, sem método e linguagem comuns, trabalhando sem integração, mas com conhecimento unificado e com diferentes níveis de hierarquia horizontal. No conjunto, esta situação pode representar um momento de transição da pluridisciplinaridade para a interdisciplinaridade. Conclusão. A interdisciplinaridade no caso avaliado não é uma realidade posta, mas um processo ainda em evolução. Fatores sócio-culturais, institucionais e subjetivos podem agir tanto como facilitadores quanto como obstáculos à interdisciplinaridade. / Introduction. Interdisciplinary teams are considered an important premise for the rearrangement of the work process in practices of health promotion and disease prevention, aiming at an integral and resolutive approach. Objective. Discuss the disciplinary relationships among health professionals, including barriers and facilitators to the practice of interdisciplinarity, in the context of a university center for education and research in health promotion and disease prevention in clinical practice. Method. Qualitative research, conducted at the Centro de Promoção da Saúde do Serviço de Clínica Geral do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo -CPS-HCFMUSP, using participant observation and semi-structured interviews with health professionals, started up after approval by the HCFMUSP - Research Ethics Committee and the informed consent of interviewees. The data was subjected to qualitative content analysis, on the basis of thematic modality. Results. It was observed practices performed by professionals with little interaction, no common language and method and lack of integration, but with similar goals, unified knowledge and different levels of horizontal hierarchy. Overall, this may represent a moment of transition from multidisciplinary to interdisciplinary work. Conclusion. Interdisciplinarity is not a fact, but a process still in evolution. Socio-cultural, institutional and individual factors can act both as facilitators or as barriers to its implementation.

The prevailing approach to managing persons with criminal histories involves community supervision professionals like probation and parole officers partnering with other mental health providers to address clients’ needs. The relationships between individual professionals are seldom researched, though, and the current study aims to address this deficit in the empirical literature. This study utilized interviews about professionals’ perceptions of their work experiences, analyzed open-endedly to identify major themes. Mental health providers’ themes included appreciation and process of collaboration, individual characteristics and roles, characteristics of collaboration, elements of interprofessional relationships, and involvement of the courts. Community supervision professionals discussed issues pertaining to appreciation and process of collaboration, individual characteristics and roles, when conflict occurs, and the lack of basic knowledge about other professionals. Second, these partnerships were examined in light of interprofessional healthcare competencies. Themes identified here resembled healthcare values and ethics competencies and roles and responsibilities competencies; healthcare competencies regarding interprofessional communication and teamwork showed partial congruence with the current themes. Overall, interprofessional collaboration is valued. This research highlights the strengths of this type of interprofessional collaboration and offers suggestions for improving the efficacy of collaboration.

The current prevailing approach to managing offenders in the community involves community supervision professionals such as probation and parole officers partnering with other community professionals, such as psychologists, social workers, and other mental health providers to address offenders’ needs. Each type of professional draws from a unique field with goals, values, and theoretical orientations, which do not necessarily overlap. These relationships are rarely studied, and previous examinations are limited. The current study aims to address this deficit in the empirical literature. Drawing on data obtained from qualitative interviews, four aims were examined. First, using thematic analysis, interview data are analyzed open-endedly to identify major themes. Second, these partnerships are examined against the interprofessional competencies in the healthcare system. Third, the perceived impact of partnerships on offenders’ success in the community is discussed. Finally, differences in themes within community supervision professionals and mental health providers were quantitatively examined by comparing groups using a variety of demographic variables. Major themes identified by mental health providers include the appreciation for and challenges to collaboration, individual characteristics and roles, characteristics of collaboration, elements of interprofessional relationship, and the involvement of the courts. Community supervision professionals discussed issues pertaining to collaboration and services coordination, professional roles, when conflict occurs, and their lack of basic knowledge about other professionals. Themes identified in the initial thematic analysis resembled healthcare values and ethics competencies and roles and responsibilities competences; healthcare competencies regarding interprofessional communication and teamwork showed partial congruence with the current data’s themes. Perceived impact on offender outcomes was most evident in how collaboration helps each professional complement the others’ work. Few significant quantitative patterns within groups were evident. Overall, treatment providers and supervision professionals value interprofessional collaboration. Their priorities differ, which provides better opportunities to address clients’ needs but also creates the potential for conflict. Benefits to re-entry outcomes are the result of treatment providers addressing the needs of clients and supervision professionals addressing the motivation of clients. This research highlights the strengths of this type of interprofessional collaboration, and offers suggestions for improving the efficacy of collaborations.

Before the assumptions of SUS (THE Brazilian Unified Health System), the hospital must apply integrality as an organizing axis to the health practice as well as stimulate values among professionals that support its greater concept, requiring a closer relationship between team workers and interprofessional colaboration. This academic work contains a cientific article, as a result of field research for the master’s degree program and also a technical product regarding the subject. The study, from which the article had been born, has as its main aim to investigate the availability and readiness towards Interprofessional Education and colaborative practice in Intesive Therapy. It has been a transversal research, with both quantitative and qualitative approaches and it took place at the ICU (Intensive Care Unit) of a public hospital for emergencies. Forty-three professionals amongst doctors, nurses, psychologists, nutritionists and physiotherapists had taken part in the research, those from the muiltiprofessinal team at the intensive care unit for adults. During data collection, LIKERT questionnaires have been adopted, The Readiness for Interprofessional Learning Scale (RIPLS), also two theme open-ended questions have been analyzed. The RIPLS, validated by PEDUZZI & NORMAN 2012 is composed by 26 assertive disposed in three dimensions: Team work and Collaboration; Professional identity and Patient care, respectively. In order to perform quantitative data analysis, there has been used descriptive statistics and co-relations. The qualitative data has been submitted to theme analysis. On the subjects profile within the research, it has bee made clear that most were female, average age 36,7 year-old and 12 years graduated. The responses to RIPLS have shown readiness from the team towards Interprofessional work and collaborative practice in two dimensions: Team work and Collaboration and Patient care. However, a worrying situation has been shown regarding Professional identity. There have also been disagreements between qualitative and quantitative data on the following dimension: Team work and Collaboration. The study apprehended the relevance of Interprofessional education in the intensive care practice, aiming at better professional conditions to deal with health care, once it potentiates the development of the referred skills, better Interprofessional communication, leading to attention to the subject through the integrality perspective. Although the same team ignores the importance of such education during the formation of the team work itself, showing some attachment to Professional Identity. From these results were developed three technical products: 1) Reflective feedback through a meeting the coordinators of professional categories and managers of the sectors education and development of people, human resource and study center; 2) Technical Report 3) Scientific publications. The products were designed to promote reflection on the results of research carried out, contribute to the development of educational and enhancement to collaborative and interprofessional practice. The results presentation has qualified the up mentioned research, enabling self-criticism and also providing with and efficient dialogic and healthy atmosphere. Besides, it has allowed reaching the purpose of the professional Master’s degree, showing an opportunity to self-criticism that transforms the educational praxis. / Diante das premissas do Sistema Único de Saúde, o hospital deve instituir a integralidade como um eixo organizador das práticas de saúde e estimular nos profissionais valores que sustentem seu conceito ampliado, que requer um estreito relacionamento entre os membros da equipe e a colaboração interprofissional. Este trabalho acadêmico de conclusão de curso consta de um artigo científico, oriundo de uma pesquisa desenvolvida no campo de trabalho da mestranda, e de três produtos técnicos voltados para o tema. O estudo que gerou o artigo científico teve como objetivo conhecer a disponibilidade e prontidão dos profissionais de saúde para a educação Interprofissional e para prática colaborativa em terapia intensiva. Trata-se de uma pesquisa de caráter transversal, com abordagens quantitativa e qualitativa, realizada na Unidade de Terapia Intensiva de um Hospital Público de Urgência e Emergência. Participaram da pesquisa 43 profissionais, dentre estes, médicos, enfermeiros, fisioterapeutas, psicólogos e nutricionistas integrantes das equipes multiprofissionais da unidade de terapia intensiva adulto. No processo de produção de dados, utilizaram-se o questionário, tipo Likert, The Readiness for Interprofessional Learning Scale (RIPLS), e a análise temática de duas perguntas abertas. O RIPLS, validado por Peduzzi e Norman (2012), composto por 26 assertivas dispostas em três dimensões: Trabalho em Equipe e Colaboração, Identidade profissional e Cuidado Centrado no Paciente. Para a análise dos dados quantitativos utilizaram-se estatística descritiva e correlações. Os dados qualitativos foram submetidos à análise temática. No perfil dos sujeitos da pesquisa evidenciouse que a maioria era do sexo feminino, idade média de 36,7 anos e tempo médio de formados de 12 anos. As respostas ao RIPLS mostraram uma prontidão da equipe ao trabalho interprofissional e prática colaborativa em duas dimensões: trabalho em equipe e colaboração e atenção centrada no paciente; e uma situação preocupante para a dimensão identidade profissional. Observaram-se também discordâncias no diálogo entre os dados quanti e qualitativos na dimensão Trabalham em Equipe e Colaboração, e concordância para identidade profissional. O estudo apreendeu a relevância da educação interprofissional na prática da unidade de terapia intensiva, visando a um melhor preparo dos profissionais para o cuidado em saúde, uma vez que potencializa o desenvolvimento de competências referentes a práticas colaborativas, à comunicação interprofissional e ao cuidado com o sujeito na perspectiva da integralidade. Porém, a mesma equipe desconhece a importância dessa educação na formação do grupo para o trabalho em equipe, apresentando aprisionamento à identidade profissional. A partir destes resultados foram desenvolvidos três produtos técnicos: 1) Feedback Reflexivo através de uma reunião os coordenadores das categorias profissionais e gestores dos setores educação e desenvolvimentos de pessoas, recursos humanos e centro de estudos; 2) Relatório Técnico e 3) Publicações Científicas. Os produtos tiveram o intuito de promover uma reflexão sobre os resultados da pesquisa realizada, contribuíssem com o desenvolvimento de ações educativas e de aprimoramento para prática colaborativa e interprofissional. O momento para apresentação dos resultados foi uma iniciativa que qualificou a pesquisa realizada, possibilitando a autocrítica e favorecendo para um ambiente de diálogo eficiente e saudável. Além disso, permitiu atingir os propósitos do Mestrado Profissional, demonstrando uma oportunidade de avaliação crítica e transformadora nos espaços de prática educativa.

Bakgrund: Palliativ vård fokuserar på att främja livskvalitet och lindra lidande för patient och anhörig i samband med livets slut. Patientens lidande kan lindras genom att smärtan minskar. Smärta är ett vanligt symtom i livets slut, och kan lindras både farmakologiskt och icke-farmakologiskt. Sjuksköterskan ansvarar för att lindra smärta. Om sjuksköterskans kunskap brister, brister sjuksköterskan i sitt professionella ansvar och patienten utsätts för onödig smärta. Syfte: Att beskriva sjuksköterskans erfarenheter av att lindra smärta vid palliativ vård i livets slut. Metod: Kvalitativ litteraturstudie baserat på 12 artiklar som analyserats med Fribergs kvalitativa analysmetod. Två teman och sex subteman skapades. Resultat:  Resultatet utgörs av två teman: Erfarenheter av olika smärtlindringsmetoder och Samarbetets betydelse för smärtlindringen, med tillhörande subteman. Slutsats: Huvudfynden som framkom var Erfarenheter av att bedöma smärta objektivt och subjektivt, Att våga möta och lindra existentiell smärta och Vikten av samarbete mellan sjuksköterska, läkare och andra professioner. Sjuksköterskan beskrevs som en viktig person för att identifiera patientens smärtlindringsbehov och för att smärtskatta patienten. Sjuksköterskan var länken i teamet runt patienten, men det framkom flera hinder som försvårade detta arbete. Dessa hinder kunde vara bristande kommunikationen i teamet eller att läkaren inte litade på deras bedömning. / Background: Palliative care aims to promote quality of life and ease suffering for patients and relatives in care at the end of life. The patient’s suffering can be relieved through pain relief. Pain is a common symptom in palliative care and can be eased with both pharmacological and non-pharmacological interventions. The nurse is responsible for relieving the pain. If the nurse lacks knowledge, the nurse might fail in their professional responsibility and the patient might endure unnecessary pain. Aim: Was to describe nurses’ experiences of pain relief in palliative care at the end of life. Method: Qualitative review article, based on 12 articles analysed with Friberg’s qualitative analysis method. Two themes and six subthemes were identified. Results: The result was presented in two themes: Experiences of different methods for pain relief, and The Meaning of collaboration in pain relief, with associated subthemes. Conclusion: The main findings were: Experiences of assessing pain objectively and subjectively, Dare to meet and relief existential pain and The meaning of collaboration between the nurse and physician. The nurse is important when identifying the patient’s need of pain relief, and to assess the pain. The nurse is the link in the interprofessional team surrounding the patient, but several hindering factors were identified. These factors could be lack of communicaton within the team, or when the physician did not listen to the nurse’s assessment.