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Licentiatavhandling Stockholm : Kungliga tekniska högskolan, 2005.

This project examines the medical management of pain and injury in British Olympic sport. By drawing upon the perspectives of health-care providers, it explores key developments such as the professionalisation, formalisation and bureaucratisation of sports medicine and the consequences of such developments on doctors' and physiotherapists' working practices, relationships with each other and on athlete care. A questionnaire about the backgrounds (e.g. the qualifications, experience and methods of recruitment and appointment) was sent to members of the British Olympic Association's Medical Committee and Physiotherapy Forum in November 2007 and in-depth, semi-structured interviews were conducted with 14 doctors and 14 physiotherapists between January and June 2008. Data indicate that attempts to professionalise sports medicine into a medical speciality have created fragmentation and resistance among the various groups involved in athlete care at this level. Whilst clinicians were committed by multi-disciplinary practice overall, data reveal qualitative differences between practitioners who have established themselves within bureaucratic organisations such as the English Institute of Sport (EIS) compared to those who provide largely voluntary medical services via National Governing Bodies of Sport (NGBs). Thus, practitioners in positions of managerial authority were constrained to negotiate the underlying amateur values of numerous sports medicine staff at the same time as striving for a professional ethos. Processes of professionalisation have also impacted upon the inter-professional relations between doctors and physiotherapists and the social organisation of athlete-care. As a consequence of their work setting, clinicians were constrained to adhere to the performance-motivated demands of their athlete and coach clients over longer-term health concerns. Because of their greater orientation towards performance, physiotherapists were able to effectively "compete" with doctors in a number of practice contexts and so claim considerable professional autonomy. This project adds to the existing body of knowledge on the medical practices of sports medicine clinicians in elite level sport and demonstrates the heterogeneity within this area of practice. Furthermore, the thesis highlights the importance of understanding clinicians working practices as a consequence of their particular work setting.

This thesis offers a rethinking of the role for education as critical workplace pedagogy in complex problems of health care. Taking the case of paediatric diabetes, the study explored how health-care professionals learn the work of supporting children, and their parents, to self-manage the condition. By reconceptualising work problems as sociomaterial learning struggles, this research contributes new understandings of informal professional learning in everyday health-care provision. Data were generated through fieldwork in an outpatient clinic. Particular challenges of supporting self-management in this case were the difficulties of balancing policy aspirations for empowerment with biomedical knowledge about risks to immediate and long-term health. Tracing the materialisation of learning as it unfolded in moments of health-care practice showed professionals handling multiple and contradictory flows of information. Particular challenges were posed by insulin-pump technologies, which have specific implications for professional roles and responsibilities, and introduce new risks. A key insight is that professionals were concerned primarily with the highly complicated perpetual discernment of safe parameters within which children and their parents might reasonably be allowed to contribute to self-management. Such discernment does not readily correspond to the notion of empowerment circulating in the policies and guidelines intended to enable professionals to accomplish this work. As a result, this thesis argues that the work of discernment is obscured. Learning strategies evolve, but could be supported and extended by explicit recognition of the important work of learning as it unfolds in everyday practices of supporting self-management in paediatric diabetes. Most importantly, workplace pedagogies could be developed in ways that attune to the profound challenges and uncertainties that are at stake in these practices.

Submitted by Edileide Reis (leyde-landy@hotmail.com) on 2013-05-06T12:53:08Z No. of bitstreams: 1 Souza, Eliane.pdf: 1922990 bytes, checksum: f4e9a4ebc5724ddd3c42d6e5a6441a28 (MD5) / Rejected by Maria Auxiliadora Lopes(silopes@ufba.br), reason: Favor renomear o nome do arquivo. Grata, Auxiliadora on 2013-05-08T19:56:08Z (GMT) / Submitted by Edileide Reis (leyde-landy@hotmail.com) on 2013-05-09T11:53:41Z No. of bitstreams: 1 Norma Fagundes.pdf: 1922990 bytes, checksum: f4e9a4ebc5724ddd3c42d6e5a6441a28 (MD5) / Approved for entry into archive by Maria Auxiliadora Lopes(silopes@ufba.br) on 2013-05-16T18:03:09Z (GMT) No. of bitstreams: 1 Norma Fagundes.pdf: 1922990 bytes, checksum: f4e9a4ebc5724ddd3c42d6e5a6441a28 (MD5) / Made available in DSpace on 2013-05-16T18:03:09Z (GMT). No. of bitstreams: 1 Norma Fagundes.pdf: 1922990 bytes, checksum: f4e9a4ebc5724ddd3c42d6e5a6441a28 (MD5) Previous issue date: 2003 / O presente estudo busca compreender como algumas experiências de trabalho, desenvolvidas entre a UFBA, serviços públicos de saúde e moradores de bairros, nos quais a Universidade atua com projetos de ensino, pesquisa ou extensão, podem se tornar espaços de aprendizagens diferenciadas, para uma formação acadêmica mais plural e heterogênea. Analisa-se, assim, de que forma os processos de interação entre as pessoas, entre os saberes, possibilitados por este tipo de prática, podem contribuir para o desenvolvimento de aprendizagens plurais, extrapolando o limite das puramente instrumentais/técnico/científicas, hegemonicamente demandadas pelos atuais currículos de formação de profissionais de saúde. São analisadas experiências de trabalho com comunidades desenvolvidas pelos cursos de enfermagem, odontologia e medicina, com os seguintes objetivos: I) Identificar e discutir os distintos modos dos sujeitos conceberem o trabalho coletivo entre a universidade e a comunidade. II) Caracterizar as aprendizagens referidas como (re)construídas em experiências de trabalho conjunto entre a universidade e a comunidade. III) Identificar possíveis relações entre as aprendizagens referidas e o espaço onde as práticas ocorrem. IV) Contribuir para a discussão e instituição de novas formas de fazer currículo, para além das formas verticais, centralizadas e pouco participativas que tradicionalmente têm caracterizado esse processo. A proposta epistemológica/metodológica tem como principal substrato a abordagem multirreferencial, que orienta a análise documental e o trabalho de campo, constituído por grupos focais e observação direta. Participaram da pesquisa estudantes e professores dos três cursos envolvidos, lideranças comunitárias e agentes de saúde atuantes no distrito sanitário Barra/ Rio Vermelho em Salvador. O maior ganho proporcionado pelo trabalho cooperativo na opinião de todos os grupos envolvidos foi o processo de construção de vínculos mais sólidos como parte de um novo compromisso ético firmado entre a universidade e a comunidade. Na opinião dos estudantes, as aprendizagens mais significativas foram: melhoria da capacidade de comunicação (falar e escutar); aprender a se relacionar e a acolher o outro; perceber que a população tem seus próprios saberes e que não dependem exclusivamente daqueles disseminados pela universidade ou pelos técnicos de saúde; gerir situações que ocorrem no cotidiano do trabalho; resolver problemas criativamente; atentar para uma prática profissional humanizada; compreender de forma mais ampla os limites e as possibilidades da atuação profissional. A análise evidenciou também a necessidade do desenvolvimento de um maior aporte de práticas fora do espaço confinado da universidade como forma de se buscar caminhos para a superação da concepção dominante da educação como prática unidirecional, autoritária, baseada na idéia de aprendizagem como simples aquisição de informações. Esta forma de conceber a educação constitui-se no principal elemento de crítica dos estudantes aos currículos de seus respectivos cursos e dos representantes da comunidade em relação ao trabalho dito cooperativo. A possibilidade de que as práticas estudadas venham a ser um lócus efetivo de construção compartilhada de conhecimentos, a partir da troca, da interação e do reconhecimento e autorização do saber do outro, foi muito pouco evidenciada. / Salvador

Este estudo objetivou conceber, aplicar e avaliar a eficácia de um programa de capacitação em comunicação interpessoal em cuidados paliativos. O programa foi desenvolvido com base em referencial teórico de comunicação interpessoal em saúde, de processo de morrer e nos princípios e filosofia dos cuidados paliativos. Foi aplicado à 303 profissionais de saúde de distintas disciplinas, em 11 turmas, em 5 diferentes instituições, no período de agosto de 2008 a julho de 2009. Os conhecimentos e habilidades comunicacionais dos sujeitos foram avaliados antes e imediatamente após a capacitação por meio da aplicação de um instrumento de avaliação especialmente desenvolvido para este estudo. Um ano após a intervenção educacional, 32 sujeitos que haviam completado a capacitação foram entrevistados, com o intuito de avaliar se os conhecimentos e habilidades adquiridos/aprimorados eram mantidos com o transcorrer do tempo e aplicados na prática diária destes profissionais. As variáveis qualitativas foram trabalhadas por agrupamentos por semelhança e expressas segundo sua frequência, por número e porcentagem. Para a análise das variáveis quantitativas foram utilizadas médias e medianas para resumir as informações e desvios-padrão, mínimo e máximo, para indicar a variabilidade dos dados. Para realizar a comparação entre as médias dos sujeitos de diferentes turmas foram utilizados os teste não paramétricos de Mann-Whitney e Kruskal-Wallis, assumindo-se nível de significância de 5%. Os discursos dos sujeitos foram analisados de acordo com a metodologia de análise do conteúdo. Os dados evidenciaram a superficialidade do conhecimento teórico e das habilidades comunicacionais empíricas pré-capacitação. Após a intervenção educacional houve aprimoramento de conhecimentos e habilidades comunicacionais em cinco das sete dimensões avaliadas, evidenciado pela alta significância estatística (p-valor < 0,0001) na comparação dos escores pré e pós-capacitação. As estratégias comunicacionais mais valorizadas pelos profissionais na atenção paliativista foram o toque afetivo, a afirmação verbal de solicitude, a escuta ativa e a presença mais frequente. Os conhecimentos e habilidades adquiridos/ aprimorados mantiveram-se no decorrer de um ano, à medida que do discurso dos sujeitos após este período emergiram sete categorias que evidenciaram que o aprendizado maior que a capacitação lhes proporcionou foi a prática comunicacional reflexiva. Esta prática possibilitou aos sujeitos reflexão e auto-avaliação constantes, propiciando mudanças em suas atitudes comunicacionais no âmbito paliativista. Frente ás evidências de sua eficácia recomenda-se a adoção do programa para a capacitação de profissionais de saúde em formação e já atuantes, tanto em âmbito acadêmico quanto das instituições de saúde. / The objective of this study was to design, apply, and evaluate the efficacy of a training program in interpersonal communication in palliative care. The program was developed based on a theoretical framework of interpersonal health communication, on the process of dying and on the principles and philosophy of palliative care. The program participants were 303 health professionals from different disciplines, consisting of 11 classes, from 5 institutions, and it was performed from August 2008 to July 2009. The subjects knowledge and communication skills were evaluated before and immediately after the training program using an evaluation instrument designed exclusively for this study. One year after the educational intervention, interviews were performed with 32 subjects who had completed the program, with the purpose to evaluate if the knowledge and skills they had learned/improved were maintained over time and applied in their daily practice. The qualitative variables were analyzed in groups according to their similarity and expressed according to their frequency, by number and percentage. To analyze the quantitative variables, means and medians were used to summarize the information, and standard deviations, minimum and maximum were used to indicate the variability of the data. To compare the means of subjects from different classes, Mann-Whitney and Kruskal-Wallis nonparametric tests were used, with a level of significance at 5%. The subjects discourses were analyzed according to the content analysis methodology. The data showed that the before participating in the program, subject had superficial theoretical knowledge and only empirical communication strategies. After the educational intervention there was improvement in their knowledge and communication skills in five of the seven evaluated dimensions, shown by the high statistical significance (p-value < 0.0001) when comparing the scores before and after the program. The communication strategies most valued by the professionals in palliative care were the affective touch, verbal encouragement of solicitude, active listening, and more frequent presence. The knowledge and skills that were learned/improved were kept after one year, as the subjects discourse after that interval made reference to seven categories that showed that the greatest improvement that the program gave them was the reflexive communicational practice. This practice made it possible for subjects to always reflect and perform self-evaluations, promoting changes in their communicational attitudes in the palliative care context. Considering the evidence of its efficacy, it is recommended that the program be used to train health professionals, those being prepared as well as those already working, in the academic environment as well as at health institutions.

Este estudo objetivou conceber, aplicar e avaliar a eficácia de um programa de capacitação em comunicação interpessoal em cuidados paliativos. O programa foi desenvolvido com base em referencial teórico de comunicação interpessoal em saúde, de processo de morrer e nos princípios e filosofia dos cuidados paliativos. Foi aplicado à 303 profissionais de saúde de distintas disciplinas, em 11 turmas, em 5 diferentes instituições, no período de agosto de 2008 a julho de 2009. Os conhecimentos e habilidades comunicacionais dos sujeitos foram avaliados antes e imediatamente após a capacitação por meio da aplicação de um instrumento de avaliação especialmente desenvolvido para este estudo. Um ano após a intervenção educacional, 32 sujeitos que haviam completado a capacitação foram entrevistados, com o intuito de avaliar se os conhecimentos e habilidades adquiridos/aprimorados eram mantidos com o transcorrer do tempo e aplicados na prática diária destes profissionais. As variáveis qualitativas foram trabalhadas por agrupamentos por semelhança e expressas segundo sua frequência, por número e porcentagem. Para a análise das variáveis quantitativas foram utilizadas médias e medianas para resumir as informações e desvios-padrão, mínimo e máximo, para indicar a variabilidade dos dados. Para realizar a comparação entre as médias dos sujeitos de diferentes turmas foram utilizados os teste não paramétricos de Mann-Whitney e Kruskal-Wallis, assumindo-se nível de significância de 5%. Os discursos dos sujeitos foram analisados de acordo com a metodologia de análise do conteúdo. Os dados evidenciaram a superficialidade do conhecimento teórico e das habilidades comunicacionais empíricas pré-capacitação. Após a intervenção educacional houve aprimoramento de conhecimentos e habilidades comunicacionais em cinco das sete dimensões avaliadas, evidenciado pela alta significância estatística (p-valor < 0,0001) na comparação dos escores pré e pós-capacitação. As estratégias comunicacionais mais valorizadas pelos profissionais na atenção paliativista foram o toque afetivo, a afirmação verbal de solicitude, a escuta ativa e a presença mais frequente. Os conhecimentos e habilidades adquiridos/ aprimorados mantiveram-se no decorrer de um ano, à medida que do discurso dos sujeitos após este período emergiram sete categorias que evidenciaram que o aprendizado maior que a capacitação lhes proporcionou foi a prática comunicacional reflexiva. Esta prática possibilitou aos sujeitos reflexão e auto-avaliação constantes, propiciando mudanças em suas atitudes comunicacionais no âmbito paliativista. Frente ás evidências de sua eficácia recomenda-se a adoção do programa para a capacitação de profissionais de saúde em formação e já atuantes, tanto em âmbito acadêmico quanto das instituições de saúde. / The objective of this study was to design, apply, and evaluate the efficacy of a training program in interpersonal communication in palliative care. The program was developed based on a theoretical framework of interpersonal health communication, on the process of dying and on the principles and philosophy of palliative care. The program participants were 303 health professionals from different disciplines, consisting of 11 classes, from 5 institutions, and it was performed from August 2008 to July 2009. The subjects knowledge and communication skills were evaluated before and immediately after the training program using an evaluation instrument designed exclusively for this study. One year after the educational intervention, interviews were performed with 32 subjects who had completed the program, with the purpose to evaluate if the knowledge and skills they had learned/improved were maintained over time and applied in their daily practice. The qualitative variables were analyzed in groups according to their similarity and expressed according to their frequency, by number and percentage. To analyze the quantitative variables, means and medians were used to summarize the information, and standard deviations, minimum and maximum were used to indicate the variability of the data. To compare the means of subjects from different classes, Mann-Whitney and Kruskal-Wallis nonparametric tests were used, with a level of significance at 5%. The subjects discourses were analyzed according to the content analysis methodology. The data showed that the before participating in the program, subject had superficial theoretical knowledge and only empirical communication strategies. After the educational intervention there was improvement in their knowledge and communication skills in five of the seven evaluated dimensions, shown by the high statistical significance (p-value < 0.0001) when comparing the scores before and after the program. The communication strategies most valued by the professionals in palliative care were the affective touch, verbal encouragement of solicitude, active listening, and more frequent presence. The knowledge and skills that were learned/improved were kept after one year, as the subjects discourse after that interval made reference to seven categories that showed that the greatest improvement that the program gave them was the reflexive communicational practice. This practice made it possible for subjects to always reflect and perform self-evaluations, promoting changes in their communicational attitudes in the palliative care context. Considering the evidence of its efficacy, it is recommended that the program be used to train health professionals, those being prepared as well as those already working, in the academic environment as well as at health institutions.

Submitted by Mariana Dornelles Vargas (marianadv) on 2015-05-27T13:41:36Z No. of bitstreams: 1 espiritualidade_saude.pdf: 282576 bytes, checksum: 5990e68be9241695da113d4c93700557 (MD5) / Made available in DSpace on 2015-05-27T13:41:36Z (GMT). No. of bitstreams: 1 espiritualidade_saude.pdf: 282576 bytes, checksum: 5990e68be9241695da113d4c93700557 (MD5) Previous issue date: 2010 / Nenhuma / O estudo é uma pesquisa de abordagem qualitativa com o objetivo de conhecer a opinião dos profissionais da saúde sobre a influência da espiritualidade/religiosidade do usuário no processo saúde-doença. Para coleta de dados foi usada a discussão focal com profissionais do Serviço de Saúde Comunitária do Grupo Hospitalar Conceição do município de Porto alegre, RS, no período de setembro de 2009. A amostra tentou abarcar a diversidade de áreas de atuação. Os dois temas de discussão foram a relação entre saúde e espiritualidade e o modo como os profissionais lidam com a religiosidade dos usuários no seu trabalho. Para interpretar os dados foi usada a análise de conteúdo. Duas categorias aparecem nessa análise: influência da espiritualidade/religiosidade sobre a saúde e o respeito pela religiosidade do usuário como imparcialidade. Os achados mostram que os profissionais possuem concepções positivas e negativas sobre a espiritualidade/religiosidade dos usuários na saúde. As negativas mostram que falta um melhor preparo para lidar com essa dimensão no trabalho, embora respeitem as idéias religiosas do usuário, mas unicamente como imparcialidade, não como algo que possa ajudar na terapêutica. / The study is a research of qualitative approach with the objective of knowing the opinion of health professionals about the influence of the user´s spirituality/religiosity in the health sickness process. The collecting of data has been the focus discussion with professionals of communitarian health services of the ?Grupo Hospitalar Conceição? of the city of Porto Alegre (RS) in September of 2009. The sample tries to embrace all the diversity of professionals. The two issues of discussion have been the relation between health and spirituality and how the professionals strive with religiosity of user in his work. The data have been interpreted by the content analysis. Two categories are coming out in this analysis: The influence of spirituality/religiosity in health and the respect of the user religiosity as impartiality. The findings pointed out that the professionals have positive and negative conceptions about spirituality/religiosity of users in health. The negative one show that they miss a better preparing to strive with this dimension in his work, although they respect the religious ideas of user but only as impartiality not as something that could help in therapy.

Die Akademisierung der Gesundheitsberufe erhöht die Bedeutung interprofessioneller Zusammenarbeit. Dabei stehen nicht nur die bedarfsgerechte Patientenversorgung im Fokus, sondern ebenso strukturelle Veränderungen im Bereich der Qualifizierung für die Gesundheitsprofessionen. Dieses Vorgehen stellt die Akteure vor Herausforderungen, da sie die vorherrschenden Strukturen auf der Bildungsebene und im Kontext der Gesundheitsfürsorge zu berücksichtigen haben. Für die Gewährleistung einer qualitativ hochwertigen Erbringung von Gesundheitsleistungen stellt das Vermitteln von spezifischen Kompetenzen im beruflichen Kontext die Weichen. Hier zeigt sich die Besonderheit einer Kompetenzdualität. Einerseits spielt die Fachkompetenz, die die Lehrer aus dem Gesundheitsberuf mitbringen, eine wesentlich Rolle für die Wissensvermittlung und andererseits bedarf es pädagogischen Könnens, um den Lernenden ein wertschätzendes Miteinander zu vermitteln. Durch die Monoprofessionalität der Lehrer ist das interprofessionelle Handeln begrenzt, da nur auf unzureichendes Grundlagenwissen zurückgegriffen werden kann. In der theoretischen Auseinandersetzung sind die Bedürfnisse der Lehrer für diesen Lehrkontext bisher nicht angemessen repräsentiert. In dem Bewusstsein, dass Lehrer durch ihr pädagogisches Handeln die Lernenden beeinflussen, sind deren Vorstellungen über Interprofessionalität bedeutsam. Aufgrund ihrer persönlichen Haltung stehen sie als Vorbild für ein gelingendes Miteinander und öffnen den Blick für interprofessionelle Teamarbeit. So ist den Fragen nachgegangen worden, wie die berufliche Identität, bezogen auf das eigene Berufsbild, die Rollenbilder der anderen Gesundheitsprofessionen und die Meinung zur Interprofessionalität sich entfaltet und welcher Einfluss sich auf die Gestaltung der interprofessionellen Lehre abzeichnet. Ein zentrales Anliegen dieser Forschungsarbeit zeigt sich demnach in der systematischen Herleitung und Offenlegung von Wirkzusammenhängen der beruflichen Identität und dem Lehrerhandeln in der interprofessionellen Lehre. Diese Analyse leistet einen Beitrag zur Erweiterung des empirischen Wissenstandes in der gesundheitsberuflichen Bildung. Anhand leitfadengestützter Interviews sind Dozenten, die im Projekt Operation Team der Robert Bosch Stiftung mitgewirkt haben, als Experten befragt worden. Dabei sind verschiedene Dimensionen wie Handlungswissen, Rollenklarheit, Erfahrungen und die eigene Persönlichkeit betrachtet worden. Im Rahmen der qualitativen Bildungsforschung ist mittels der inhaltlich strukturierenden qualitativen Inhaltsanalyse nach Kuckartz das gesamte Datenmaterial ausgewertet worden. Die Ergebnisse zeigen, dass die Lehrer eine starke Verbindung zu dem Erleben in ihrem Berufsfeld haben und ihre Lehrerrolle als eine Erweiterung ihrer Gesundheitsprofession sehen. Die Identitätsentwicklung der Teilnehmer wird durch ihre beruflichen Erfahrungen, ihr Bildungsniveau und ihre persönlichen Wertvorstellungen geprägt. Barrieren, wie mangelnde Anerkennung, fehlende Kommunikation und begrenzte Karrieremöglichkeiten, die ihnen im Berufsalltag begegnen, sind in den Interviews identifiziert worden. Gleichwohl haben sie von Strategien berichtet, wie kritischen Situationen entgegengewirkt werden kann. Darüber hinaus kommt in der Studie zum Ausdruck, welche Bedeutung die Selbstreflexion in dem Prozess hat und wie dies sich auf die berufliche Identität auswirkt. Die Wahrnehmung der eigenen Rolle stellt einen engen Bezug zum Kompetenzvermögen hinsichtlich der Wissensvermittlung des Berufswissens her und prägt somit die Kompetenzdualität entscheidend mit. Durch den Austausch mit Kollegen anderer Gesundheitsberufe und der gemeinsamen Arbeit an Problemlösungen geben die Experten an, ein besseres Verständnis für ihre eigene Rolle im Team und im Gesundheitssystem zu entwickeln. Dies trägt dazu bei, dass sie ihre Arbeit als sinnvoll und erfüllend empfinden. Zusammenfassend lassen die empirischen Ergebnisse der Untersuchung den Schluss zu, dass interprofessionelle Zusammenarbeit ein wichtiger Ansatz zur Stärkung der beruflichen Identität in den Gesundheitsberufen ist. Die berufliche Identitätsentwicklung ist eng mit der persönlichen Haltung verbunden. Das zeigt sich darin, dass Haltung und berufliches Handeln von der Einstellung und den Werten beeinflusst werden. Somit spielt vor diesem Hintergrund die Haltung eine besondere Rolle. Die positive Haltung aus dem Gesundheitsberuf heraus wirkt sich in entsprechendem Maß auf die interprofessionelle Lehre aus. Die Lehrer sind eher motiviert und engagiert mit einem klaren Fokus auf das Miteinander, wenn sie selbst Erfolg und Zufriedenheit in ihrem Beruf erlebt haben. Aufbauend auf diese Forschungsarbeit bietet sich die Entwicklung eines Qualifizierungskonzeptes für Lehrer in der interprofessionellen Lehre an. In diesem Fall sollen interprofessionelle Themenschwerpunkte und Berufsrollen alludiert werden. Die interprofessionelle Handlungskompetenz erfährt in diesem Zusammenhang eine besondere Aufmerksamkeit. Diskussionswürdig ist auf der Grundlage der erhobenen Daten das Definieren von Rahmenbedingungen, die eine Qualifizierung der Lehrer in der IPL und die Lehrveranstaltungen selbst sicherstellen.:Teil A Einführung in das Forschungsfeld 1 Einleitung 1.1 Relevanz des Themas 1.2 Formulierung des Forschungsvorhabens 1.3 Zielsetzung des Forschungsvorhabens Teil B Theoretischer Rahmen 2 Interprofessionelles Lehren und Lernen 2.1 Der Begriff Interprofessionalität 2.2 Geschichtlicher Exkurs 2.2.1 Entwicklungsstufen von IPE in den angloamerikanischen Ländern 2.2.2 Entwicklungsphasen in Schweden am Beispiel von Linköping 2.2.3 Entwicklung in Deutschland 2.3 Qualifizierung von Lehrern in der interprofessionellen Lehre 2.3.1 Kompetenz 2.3.2 Kompetenzprofil der IPL-Lehrer 2.3.3 Kooperation 2.3.3.1 Was ist Kooperation? 2.3.3.2 Kooperatives Handeln und Interprofessionalität 2.3.3.3 Bedeutung von Zusammenarbeit für das interprofessionelle Lehrerhandeln 3 Identität 3.1 „Patchwork-Identität“ – Identitätsbegriff nach Keupp 3.2 Identitätsbegriff nach Frey und Haußer 3.3 „Balancierende Identität“ – Identitätsbegriff nach Krappmann 3.4 Berufliche Identität 3.4.1 Was ist ein Beruf? 3.4.2 Berufliche Identitätsentwicklung von Lehrern in der IPL 3.4.3 Berufliche Identität & Stereotype im Kontext interprofessioneller Lehre 3.4.4 Berufliche Identität & Subjektive Theorien 3.4.4.1 Subjektive Theorien – eine Begriffsdefinition 3.4.4.2 Subjektive Theorien als Basis für interprofessionelles Lehrerhandeln 3.4.5 Berufliche Identität & Lehrervorstellungen 3.4.6 Lehrervorstellungen – eine Begriffsklärung 3.5 Gegenüberstellung der Begriffe und Zusammenfassung 4 Betrachtungen zum Forschungsfeld 4.1 Berufe im deutschen Gesundheitswesen 4.1.1 Medizin – Arztberuf 4.1.2 MTLA – Medizinisch-technische Laboratoriumsassistenz 4.1.3 Pflege 4.1.4 Ergotherapie 4.1.5 Physiotherapie 4.1.6 Ernährungswissenschaft 4.2 Gesundheitsberufe – Strukturen im Bildungssystem 4.2.1 Duale Berufe nach BBiG 4.2.2 Gesundheitsberufe auf der Grundlage von Berufszulassungsgesetzen 4.3 Rechtliche und institutionelle Rahmenbedingungen 4.4 Regelung der Berufsbildung im Gesundheitswesen 4.4.1 MTLA – Medizinisch-technische Laboratoriumsassistenz 4.4.2 Pflege 4.4.3 Therapeutische Berufe 4.4.3.1 Physiotherapie 4.4.3.2 Ergotherapie 4.5 Akademische Bildung im Gesundheitswesen 4.5.1 Akademisierung 4.5.2 Akademisierung der Gesundheitsberufe 4.5.3 Studium der Medizin 4.5.4 Ernährungswissenschaft 4.5.5 Pflegestudium 4.5.6 Studium der Therapiewissenschaften 4.5.6.1 Studium der Ergotherapie 4.5.6.2 Studium der Physiotherapie 4.6 Lehrerbildung im Gesundheitswesen 4.6.1 Geschichtliche Einordnung 4.6.2 Begründungsrahmen 4.6.3 Lehrerbildung im Kontext der Medizin 4.6.4 Organisation der Lehrerbildung 4.7 Operation Team – Interprofessionelle Lehrkonzepte aus der Förderlinie der Robert Bosch Stiftung 4.7.1 Inter-M-E-P-P – Berlin 4.7.2 GReTL 2.0 – Halle-Wittenberg 4.7.3 Interprofessionelles Ernährungsmanagement – Düsseldorf 4.7.4 Einander schätzen-im Team versorgen – Marburg 4.7.5 FInKo – München 4.7.6 Interprofessionelle Teamkommunikation – Heidelberg Teil C Systematik des Forschungsvorhabens 5 Empirischer Teil 5.1 Systematik des Forschungsprozesses 5.2 Begründung des Untersuchungsdesigns 5.2.1 Forschungsinteresse 5.2.2 Forschungsdesign 5.2.3 Qualitative Gütekriterien 5.3 Datenerhebung 5.3.1 Das Experteninterview als Erhebungsmethode 5.3.2 Design der Erhebungsinstrumente 5.3.2.1 Interviewerhebungsbogen 5.3.2.2 Interviewleitfaden 5.3.3 Sampling 5.4 Forschungsethik 5.5 Vorgehensweise bei der Datenerhebung 5.6 Transkription 5.7 Datenauswertung 5.7.1 Die inhaltlich strukturierende qualitative Inhaltsanalyse nach Kuckartz 5.7.2 Ablaufschema der Inhaltsanalyse nach Kuckartz 5.7.2.1 Kategorienbildung 5.7.2.2 Intercodierungsprozess 6 Analyse des Datenmaterials 6.1 Rekrutierung der Experten 6.2 Vorstellung der Interviewpartner 6.3 Durchführung der Interviews 6.3.1 Interviewdaten 6.3.2 Interviewverlauf 6.4 Auswertung des Datenmaterials 6.4.1 Kategorienentwicklung 6.4.1.1 Ausgangspunkt 6.4.1.2 Phase 1: Textarbeit 6.4.1.3 Phase 2: Thematische Hauptkategorien 6.4.1.4 Phase 3: Erster Codierprozess 6.4.1.5 Phase 4: Zusammenstellung 6.4.1.6 Phase 5: Subkategorien 6.4.1.7 Phase 6: Zweiter Codierprozess 6.4.1.8 Phase 7: Analyse 6.4.1.9 Zwischenfazit 7 Empirische Ergebnisse 7.1 Einführung in die Ergebnisdarstellung 7.2 Themenmatrix I – Kontextgebundenheit 7.2.1 Gesundheitssystem 7.2.1.1 Gesetzliche Vorgaben 7.2.1.2 Sicht auf den Patienten 7.2.1.3 Versorgungsstruktur 7.2.1.4 Organisationale Hierarchie 7.2.2 Bildung im Gesundheitssektor 7.2.2.1 Interprofessionalität als Lerngegenstand 7.2.2.2 Heterogene Ausgangslage 7.2.2.3 Strategiewechsel 7.2.3 Projekt „Operation Team“ 7.2.3.1 Projektplanung 7.2.3.2 Projektaufgaben 7.2.4 Lehrerqualifikation 7.2.4.1 Ideen für IPL-Konzepte 7.2.4.2 Qualifizierungsbedarf 7.2.5 Zusammenfassung: Themenmatrix I 7.3 Themenmatrix II – Erfahrungen im beruflichen Handlungsfeld Gesundheit 7.3.1 Berufsrolle 7.3.1.1 Berufsidentität 7.3.1.2 Berufsverständnis 7.3.1.3 Berufliche Handlungskompetenz 7.3.1.4 Erfahrungen im Berufsalltag 7.3.2 Kooperationskultur 7.3.2.1 Persönliche Kooperationserfahrungen 7.3.2.2 Gelingensbedingungen 7.3.2.3 Barrieren 7.3.3 Haltung 7.3.3.1 Status / Statusdenken 7.3.3.2 Zugehörigkeitsgefühl 7.3.3.3 Anerkennung 7.3.3.4 Fehlende Anerkennung 7.3.3.5 Vorbild 7.3.4 Stereotyp 7.3.4.1 Vorurteile 7.3.4.2 Schubladendenken 7.3.5 Zusammenfassung: Themenmatrix II 7.4 Themenmatrix III – Interprofessionelle Lehrtätigkeit 7.4.1 Phänomene der IPL 7.4.1.1 Herausforderungen der IPL 7.4.1.2 Persönliches Erleben 7.4.1.3 Spannungsfelder 7.4.1.4 Erkenntnisgewinn 7.4.2 Pädagogisches Können 7.4.2.1 Handlungskonzepte 7.4.2.2 Methodenvielfalt 7.4.2.3 Inhaltliche Ausrichtung 7.4.3 Schlüsselkompetenzen 7.4.3.1 Persönlichkeitskompetenz 7.4.3.2 Kennen von Berufsprofilen 7.4.3.3 Sozialkompetenz 7.4.4 Zusammenfassung: Themenmatrix III Teil D Schlussbetrachtung 8 Interpretation 8.1 Diskussion der Ergebnisse im theoretischen Kontext 8.1.1 Berufliche Identitätsentwicklung im Gesundheitsberuf 8.1.1.1 Gesundheitssystem 8.1.1.2 Berufsrolle 8.1.1.3 Kooperationskultur 8.1.1.4 Stereotyp 8.1.1.5 Kernkategorie Haltung 8.1.2 Einfluss der gesundheitsberuflichen Identität auf die IPL 8.1.2.1 Pädagogisches Können 8.1.2.2 Schlüsselkompetenzen 8.2 Kritische Reflexion der Forschungsmethodik 9 Resümee 9.1 Fazit zur Prägung der beruflichen Identität 9.2 Fazit zum Einfluss der Berufsidentität auf die IPL 9.3 Kompetenzdualität 9.4 Erkenntnisgewinn 9.5 Ausblick 9.6 Nebenschauplätze 9.6.1 Bildung im Gesundheitssektor 9.6.2 Gelingensbedingungen interprofessioneller Kooperation 9.6.3 Barrieren interprofessioneller Kooperation 9.6.4 Phänomene der IPL

The author in her diploma theses deals with the problem of elderly suicide rates in the helping professionals' point of view in the district of Karlovy Vary. Her two key focus areas are personal experiences of the helping professionals with this particular topic and their knowledgeableness of it. Furthermore, the author validates whether the helping professionals are supported adequately enough to be able to deal with this phenomenon appropriately. In the theoretical part of the study the author presents basic introduction into the issue of suicide itself - briefly outlines the history of suicide rate and the most common motive, causes and forms of suicidal behavior. Moreover, she sketches the specifics of suicide rate among seniors and ways of working with this particular target group. Last but not least she drafts possible preventive techniques of suicide behavior among seniors. In the empirical part of the study the author explains the research methodology and briefly describes the district of Karlovy Vary. Most importantly the author presents findings concerning experience and knowledgeability of suicide rate among seniors by helping professionals gathered by research consisting of semi-structured interviews. She also thoroughly examines the professionals' point of view on individual elements...