Cuidado ás pessoas com agravos endocrinos e metabólicos / Care for people with endocrine and metabolic problems

O objetivo desse trabalho é descrever a sistematização da Assistência de Enfermagem a pessoas com agravos endócrinos e metabólicos pautado na teoria de Calista Roy. Metodologia: Trata-se de um relato de experiência através da aplicação da Sistematização da Assistência de Enfermagem (SAE), voltado para pessoas com agravos endócrinos e metabólicos no contexto hospitalar. Resultados e discussão: Foi aplicado a teoria da adaptação nas seis fases da Teoria de Calista Roy e foi elaborado diagnósticos de enfermagem para os quatro modos de adaptação: fisiológico, interdependência, autoconceito e função de papel. Considerações finais: Ao aplicar a SAE no indivíduo com agravos endócrinos e metabólicos a enfermeira deve realizá-lo em todas as suas etapas, e utilizar os protocolos para oferecer um cuidado holístico e integral, visando a promoção da saúde, prevenção de risco potencial e adaptação diante das necessidades em saúde.(AU)

The aim of this study is to describe the systematization of nursing care for people with endocrine and metabolic disorders, based on Calista Roy's theory. Methodology: This is an experience report on the application of the Systematization of Nursing Care (SNC) to people with endocrine and metabolic disorders in a hospital setting. Results and discussion: The theory of adaptation was applied in the six phases of Calista Roy's theory and nursing diagnoses were drawn up for the four modes of adaptation: physiological, interdependence, self-concept and role function. Final considerations: When applying the SNC to individuals with endocrine and metabolic disorders, the nurse must carry it out in all its stages, and use the protocols to offer holistic and comprehensive care, aimed at promoting health, preventing potential risks and adapting to health needs.(AU)

El objetivo de este estudio es describir la sistematización de los cuidados de enfermería a personas con trastornos endocrinos y metabólicos, basándose en la teoría de Calista Roy. Metodología: Se trata de un informe de experiencia sobre la aplicación de la Sistematización de los Cuidados de Enfermería (SNC) a personas con trastornos endocrinos y metabólicos en un entorno hospitalario. Resultados y discusión: Se aplicó la teoría de la adaptación en las seis fases de la teoría de Calista Roy y se elaboraron diagnósticos de enfermería para los cuatro modos de adaptación: fisiológica, interdependencia, autoconcepto y función de rol. Consideraciones finales: Al aplicar el SNC a individuos con trastornos endocrinos y metabólicos, la enfermera debe llevarlo a cabo en todas sus fases, y utilizar los protocolos para ofrecer cuidados holísticos e integrales, dirigidos a promover la salud, prevenir riesgos potenciales y adaptarse a las necesidades de salud.(AU)

Multidisciplinary team for patients with neurocutaneous syndromes: The little discussed importance of dentistry.

Neurocutaneous syndromes comprise a heterogeneous group of congenital or hereditary conditions that are known to be associated with the risk of different disorders and complications. Two of the most common neurocutaneous syndromes are Neurofibromatosis type 1 (NF1) and Tuberous Sclerosis Complex (TSC). Although there appears to be a general consensus on the importance of a multidisciplinary approach in managing these cases, there is still very little emphasis in discussions addressed in the literature on the role of dentistry in accordance with the perspective of comprehensive care. Evidence-based propositions, together with a broad discussion of new insights in this regard, should have the ability to strongly impact related future perspectives, aiming for greater advances and better outcomes for these patients. In this review article, the authors discuss updated general aspects of NF1 and TSC, and the potential additional roles of dentistry, in addition to addressing suggestions for actions in dentistry at related levels of care, as well as priorities for future research.

School health-care team members' reflections of their promotion of sexual and reproductive health and rights (SRHR): Important but neglected.

OBJECTIVE: Young people are prioritized regarding the promotion and safeguarding of sexual and reproductive health and rights - SRHR. In Sweden, the school is seen as an important arena with members of the school health-care or SHC team as vital actors in this work. This study explored SRHR-related work in SHC teams in Sweden. METHODS: Within an explorative qualitative design, structured interviews were conducted with 33 nurses, counsellors, SHC unit managers and headmasters. Reflexive thematic analysis was applied, and two main themes found. RESULTS: SHC team members see SRHR as an urgent topic, but address it only 'when necessary', not systematically - and they experience a shortage of guidance and cooperation regarding SRHR-related work. Even in a country with agreement on the importance of SRHR for all and on providing holistic comprehensive sex education in schools, young people are left to chance - i.e., to the SRHR competence in the professionals they meet. CONCLUSION: SHC team members in Sweden see SRHR as an urgent topic but do not address it systematically. Moreover, they experience a shortage of guidance for their work. To avoid any professional stress of conscience and for equitable school health care regarding SRHR to be realized, research-informed policy needs to underline systematic, comparable and proactive practice.

Head and neck cancer patient journey's health literacy: a multidisciplinary team perspective. VOICE study.

PURPOSE: Health literacy is a current Public Health priority in Portugal. The participation of well-informed patients in their care and shared decision making are essential, especially in chronic aggressive and debilitating pathologies such as recurrent or metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC). AIMS: This study aimed to characterize R/M HNSCC patients' and caregivers' information needs identified by healthcare professionals (HCPs). METHODS: Two online Focus Groups, one with only medical doctors and the other with other HCPs involved in the treatment of R/M HNSCC patients, were conducted, using a modified Metaplan, Lean or adapted PDCA methodology. The discussions were audio recorded in full and content analysis was performed using ATLAS.ti qualitative data analysis software. RESULTS: Topics addressed were diagnosis, treatment, quality of life, and global evaluation. In general, all experts agreed that only essential information should be cautiously given, according to patients' and caregivers' wishes. It was consensual that patients are given the necessary information to adhere to treatment. Two main barriers were identified: one barrier was associated with verbal communication due to the lack of health literacy of these patients, and the other barrier regarded healthcare access. It was also considered important to remind patients of the daily and social activities that they could and should maintain, as well as providing sufficient social resources and problem-solving training to caregivers. CONCLUSIONS: This qualitative study highlights the complexity of R/M HNSCC patients' care. Immediate availability of psychologists and psychiatrists should be implemented in all centers that treat HNSCC patients. The differences found between the physicians' Focus Group and other HCPs' Focus Group in some of the addressed topics emphasize the importance of a multidisciplinary and holistic approach, in a biomedical model integrated with a biopsychosocial model.

A systematic review critically appraising quantitative survey measures assessing power dynamics among multidisciplinary teams in acute care settings.

By valuing the knowledge of each discipline holistic patient-centered care can be achieved as decisions arise from expertise rather than established hierarchies. While healthcare has historically operated as a hierarchical power structure (i.e., some voices have more influence), these dynamics are rarely discussed. This review addresses this issue by appraising extant quantitative measures that assess multidisciplinary team (MDT) power dynamics. By identifying psychometrically sound measures, change agents can uncover the collective thought processes informing power structures in practice and develop strategies to mitigate power disparities. Several databases were searched. English language articles were included if they reported on quantitative measures assessing power dynamics among MDTs in acute/hospital settings. Results were synthesized using a narrative approach. In total, 6,202 search records were obtained of which 62 met the eligibility criteria. The review reveals some promising measures to assess power dynamics (e.g., Interprofessional Collaboration Scale). However, the findings also confirm several gaps in the current evidence base: 1) need for further psychometric and pragmatic testing of measures; 2) inclusion of more representative MDT samples; 3) further evaluation of unmatured power dimensions. Addressing these gaps will support the development of future interventions aimed at mitigating power imbalances and ultimately improve collaborative working within MDTs.

Impact of the Multidisciplinary Cancer Team on the Diagnostic and Therapeutic Care Pathway of Early Breast Cancer Patients and Perception of Team Members: The Experience of a Cancer Centre in Italy.

Literature on the role of multidisciplinary team (MDT) in cancer is still controversial. We aimed to investigate MDT impact on a panel of indicators in breast cancer care in a single-center retrospective study performed in a Cancer Reference Center in Italy. We analysed the diagnostic and therapeutic care pathway (DTCP) of 266 early breast cancer patients managed by our MDT during 2019-2020. Process indicators reflecting the change of the diagnostic and therapeutic care pathways occurred after the MDT discussion were computed. Further, the performance of some quality care indicators in breast cancer care since the establishment of the MDT activity and the breast cancer MDT members' perceptions were also investigated. According to our study, the MDT approach improves breast cancer management by increasing the completion of staging and by encouraging neo-adjuvant treatment and an appropriate and faster surgery. In MDT members' perspective it also improves decision-making and training and creates a positive work environment. Globally, our study encourages MDT rollout in breast cancer care. However, to enhance the reliability and comparability of the results of studies investigating MDT effectiveness in clinical practice, shared guidelines on its operationalisation are strongly desirable.

Sistematização do preparo a alta à pessoa adulta com agravos clínicos e cirúrgicos / Systematization of discharge preparation for adults with clinical and surgical problems

Objetivo: O objetivo desse trabalho é descrever a sistematização do preparo a alta à pessoa adulta com agravos clínicos e cirúrgicos. Metodologia: Trata-se de um relato de experiência através da aplicação da Sistematização da Assistência de Enfermagem (SAE), voltado para pessoas com alta no contexto hospitalar. Resultados e discussão: Foi aplicado a teoria da adaptação nas seis fases da Teoria de Calista Roy e foi elaborado diagnósticos de enfermagem para os quatro modos de adaptação: fisiológico, interdependência, autoconceito e função de papel. Considerações finais: Ao aplicar a SAE no indivíduo com alta hospitalar a equipe multidisciplinar deve realizá-lo em todas as suas etapas, e utilizar os protocolos para oferecer um cuidado holístico e integral, visando a promoção da saúde, prevenção de risco potencial e adaptação diante das necessidades em saúde.(AU)

Objective: The aim of this study is to describe the systematization of discharge preparation for adults with clinical and surgical conditions. Methodology: This is an experience report on the application of the Systematization of Nursing Care (SNC) to people being discharged from hospital. Results and discussion: The theory of adaptation was applied in the six phases of Calista Roy's theory and nursing diagnoses were drawn up for the four modes of adaptation: physiological, interdependence, self-concept and role function. Final considerations: When applying the SNC to individuals discharged from hospital, the multidisciplinary team must carry it out in all its stages, and use the protocols to offer holistic and comprehensive care, with a view to promoting health, preventing potential risks and adapting to health needs.(AU)

Objetivo: El objetivo de este estudio es describir la sistematización de la preparación al alta de adultos con patologías clínicas y quirúrgicas. Metodología: Se trata de un informe de experiencia sobre la aplicación de la Sistematización de los Cuidados de Enfermería (SNC) a personas en proceso de alta hospitalaria. Resultados y discusión: Se aplicó la teoría de la adaptación en las seis fases de la teoría de Calista Roy y se elaboraron diagnósticos de enfermería para los cuatro modos de adaptación: fisiológica, interdependencia, autoconcepto y función de rol. Consideraciones finales: Al aplicar el SNC a las personas con alta hospitalaria, el equipo multidisciplinar debe llevarlo a cabo en todas sus fases, y utilizar los protocolos para ofrecer una atención holística e integral, dirigida a la promoción de la salud, la prevención de riesgos potenciales y la adaptación a las necesidades de salud.(AU)

[Management of radiation-induced intestinal injury:from multi-disciplinary team team to holistic integrative management].

Radiation-induced intestinal injury is a radiation injury of the colon and rectum after radiotherapy for pelvic malignant tumors. This condition affects multiple organs in the pelvis, making treatment challenging. In clinical practice, the most effective protocol is often determined through discussion by a multi-disciplinary team (MDT). However, due to the severity and complexity of radiation enteritis, many patients still experience poor diagnosis and treatment outcomes. Holistic integrative management (HIM) is a rapidly developing concept that has greatly enhanced clinical medicine in recent years. It improves the level of diagnosis, treatment, prevention, and rehabilitation from multiple dimensions of prevention, screening, diagnosis, treatment, and rehabilitation. In the context of radiation-induced intestinal injury, HIM also calls for the implementation of an individualized management system that focuses on the patient as a whole within the healthcare team. From the perspective of HIM, this article introduces some of the latest progress of radiation-induced intestinal injury in recent years.

Using an Adapted Tumor Board Evaluation Tool for Quality Assessment of a Thoracic Multidisciplinary Cancer Conference: A Pilot Study.

PURPOSE: Multidisciplinary cancer conferences (MCCs) are crucial for the management of complex oncology patients. Tools to evaluate MCC performance are needed. The aim of this pilot study was to assess the applicability of an existing validated performance assessment tool to evaluate the quality of thoracic MCCs (T-MCCs). METHODS: Data were collected from weekly T-MCCs over a 5-week period using the MCC Performance Assessment Tool and a self-assessment survey. Audio recordings were used to supplement observation notes. Case presentation, discussion duration, decision making contribution, recommendations, and consensus were captured. Quality of information and contribution were rated on a 1-5 scale. The data were analyzed using descriptive statistics to calculate means and composite scores representing overall MCC performance. RESULTS: A total of 44 cases were observed at the T-MCC with the mean presentation and discussion time of 6 minutes and 22 seconds. Quality of case history, radiologic and pathological information, and reason for case discussion were rated above average (>3), whereas inclusion of comorbidities and patient views were rated below average. Surgical oncologists had a higher discussion contribution compared with medical and radiation oncologists (3.6 v 2.9 and 2.4, respectively). The overall mean composite score was 55.9 (deemed average) with no cases categorized as poor or excellent. Radiologists and pathologists had mean preparation times of 81.7 and 144.0 minutes, respectively. CONCLUSION: This study demonstrated the applicability of a previously validated tool to assess the quality of a T-MCC at an academic comprehensive cancer center. The tool was found to be useful in identifying elements of the T-MCC process that needed improvement.

Protecting Personhood: A Classic Grounded Theory.

The importance of perceiving and considering patients as healthcare partners has been increasingly promoted. Healthcare systems around the world are now highly interested in patient engagement, participation, collaboration, and partnership. Healthcare professionals are advised that patients, as autonomous beings, should be active in and responsible for a portion of their own care. The study presented here focused on patients' perceptions of interprofessional collaboration. It was conducted using the classic grounded theory methodology. The theory of protecting personhood emerged as the core concept of hospitalized patients, cared for by interprofessional healthcare teams. This theory encapsulates the process hospitalized patients go through to find balance in their sense of self, oscillating between personhood and patienthood in the unfamiliar hospital environment. The process consists of four stages: the stage of introspection, during which hospitalized patients become aware of their self as a person and as a patient; the stage of preservation, when patients find a balance between the sense of personhood and patienthood; the stage of rupture, wherein patients experience an imbalance between their sense of personhood and patienthood; and the stage of reconciliation, in which personhood is restored. The theory of protecting personhood offers insights into a better understanding of hospitalized patients' experiences and strategies, revealing the importance of relationships, and the driving force of empowerment. This study is about patients' perspectives of interprofessional healthcare teams. A grounded theory process allowed the emergence of patients' concerns and expectations, leading to a substantive theory grounded in the patients' data.

Multidisciplinary Teamwork Perceptions When Mobilizing Ventilated Neurosurgery Patients.

ABSTRACT: BACKGROUND: Multidisciplinary teamwork is essential in delivering holistic care to critically ill populations, including ventilated neurosurgery patients. Although it is considered a safe and feasible aspect of patient care, mobilization is often missed in this population because of negative healthcare provider perceptions regarding barriers and patient safety. Nurse-led teamwork has been suggested to overcome these barriers and to achieve earlier mobilization for patients, as well as positive provider perceptions, which may affect the culture and frequency of mobilization on neurointensive care units. Quantitative studies analyzing multidisciplinary teamwork perceptions to mobilize ventilated neurosurgery patients with or without a nurse-led protocol have not been previously conducted. Analyzing such perceptions may provide insight to team-related barriers related to missed mobility. This pilot quasi-experimental study aimed to determine whether the use of a nurse-led mobility protocol affects teamwork perceptions when mobilizing ventilated neurosurgery patients. METHODS: A sample of multidisciplinary teams, composed of nurses, patient care technicians, and respiratory therapists, mobilized ventilated neurosurgery patients according to either standard of care (for the control group) or a nurse-led mobility protocol (for the interventional group). Teamwork perceptions were measured via the reliable and valid Nursing Teamwork Survey tool. RESULTS: Linear mixed model analyses revealed that multidisciplinary teams in the nurse-led mobility protocol group had significantly higher levels of overall perceived teamwork than those in the control group, t3 = -3.296, P = .038. Such differences were also noted for teamwork variables of team leadership and mutual trust. CONCLUSION: Nurse-led mobility protocols should be considered to increase teamwork when performing multidisciplinary teamwork-based mobility for ventilated neurosurgery patients. Future studies should continue to evaluate teamwork perceptions after nurse-led mobility.

Cultural diversity in health care teams: A systematic integrative review and research agenda.

BACKGROUND: Although team-based work is deemed key to improving the quality of national health care systems, adverse events related to teamwork account for up to one third of all incidents. Health care teams are typically multiprofessional and diverse in many aspects, but cultural diversity is one of the most challenging. PURPOSES: The objective of this review is to systematically analyze the literature to better understand the impact of cultural diversity in health care teams on team processes as well as team and patient outcomes. This study also explores the conditions that enable or hinder team functioning. METHODOLOGY: Through a systematic integrative literature review, this study builds on the input-process-output-context framework. Multiple searches of the main databases led to identifying 43 relevant articles. FINDINGS: The results suggest that, when not proactively managed, cultural diversity may have a negative effect on team communication and integration, increasing team conflict and thereby negatively influencing team performance, team climate, and patient safety, both directly and indirectly. Yet, when managed properly and in the presence of engaged and culturally sensitive leadership, cultural training, and open and transparent procedures, cultural diversity in health care teams can be an asset to health care organizations. Analyzing and aggregating these findings into an integrative framework, our study identifies several themes and a research agenda for future studies on culturally diverse health care teams. PRACTICE IMPLICATIONS: Our findings suggest that culturally diverse health care teams experience a number of challenges, pointing to the need for action or structures that enable these teams to perform better, such as emphasizing learning and allowing team members time to get to know each other outside work.

Psychosocial Care for Pediatric Cancer. Module 05: Strengthening Psychosocial Competencies and the Care Provided by the Multidisciplinary Team

Advances in the treatment of pediatric cancer have made it possible to expand initiatives beyond cure and cover aspects such as early detection, continuity of treatment and reduction in toxicity. All this has paved the way for a more comprehensive vision of patient care, which means better chances of healing and a fuller life - objectives of the World Initiative against Childhood Cancer. Within this comprehensive care, psychosocial care includes the social, psychological, spiritual and functional dimensions of the disease process of patients. This series includes guidelines and standards based on evidence that guarantee the quality of said care. The standards are the result of discussion and review by different professionals from Latin America and the Caribbean. Module 5 focuses on strengthening psychosocial skills and caring for the multidisciplinary team. The competencies that professionals must have to provide comprehensive care are collected, as well as the necessary conditions to optimize interdisciplinary work and for the care and self-care of the teams.

Broadening Heart Failure Care Beyond Cardiology: Challenges and Successes Within the Landscape of Multidisciplinary Heart Failure Care.

PURPOSE OF REVIEW: Heart failure (HF) is a growing public health concern that impairs the quality of life and is associated with significant mortality. As the prevalence of heart failure increases, multidisciplinary care is essential to provide comprehensive care to individuals. RECENT FINDINGS: The challenges of implementing an effective multidisciplinary care team can be daunting. Effective multidisciplinary care begins at the initial diagnosis of heart failure. The transition of care from the inpatient to the outpatient setting is critically important. The use of home visits, case management, and multidisciplinary clinics has been shown to decrease mortality and heart failure hospitalizations, and major society guidelines endorse multidisciplinary care for heart failure patients. Expanding heart failure care beyond cardiology entails incorporating primary care, advanced practice providers, and other disciplines. Patient education and self-management are fundamental to multidisciplinary care, as is a holistic approach to effectively address comorbid conditions. Ongoing challenges include navigating social disparities within heart failure care and limiting the economic burden of the disease.

Embedding Dental Hygienists into Medical Care Teams: Implementation and evaluation of a medical-dental integration approach in Colorado.

This case report describes the implementation approach and evaluation of a medical-dental integration (MDI) project in Colorado that embedded dental hygienists (DHs) into 10 medical practice settings. Through the MDI Learning Collaborative, DHs were integrated into primary care medical care practices to provide full-scope dental hygiene care to patients. Dental hygienists were trained to collect quality-improvement metrics on all encounters, including untreated tooth decay, and referred patients with restorative needs to partnering dentists. Cross-sectional, aggregated clinic-level oral health metrics were submitted monthly from 2019-2022. Descriptive statistics were used to describe the population receiving MDI care and interviews were conducted with MDI staff to describe their perspectives on this approach to comprehensive care. A logistic regression model, adjusted for time and practice, compared untreated dental caries in established vs new MDI patient-visits. From 2019-2021, integrated DHs completed 13,458 visits to low-income patients, Medicaid (70%, n=9,421), uninsured (24%, n=3,230), SCHIP (3%, n=404), private (3%, n=404), of various ages: 0-5 (29%, n=3,838), 6-18 (17%, n=2,266), 18-64 (51%, n=6,825), >65 (4%, n=529). A total of 912 visits were provided to pregnant patients. Services included caries risk assessment (n=9,329), fluoride varnish (n=6,722), dental sealants (n=1,391), silver diamine fluoride (n=382), x-rays (n=5,465) and scaling/root-planing (n=2,882). Improvement was found in untreated decay of established vs. new patient-visits in four of the practices. Dental hygienists integrated into medical teams provided full-scope dental hygiene care to patients and expanded access to dental services. Medical-dental integration (MDI) care was variably associated with reduction in untreated decay. Integrating dental hygienists into primary care medical practices has potential to improve oral health-related outcomes, however access to restorative dental care remains a challenge.

Designing systems for the care we need: A transformation journey in Southwestern Ontario.

Primary care is considered the foundation of any health system. In Ontario, Canada Bills 41 and 74 introduced in 2016 and 2019, respectively, aimed to move towards a primary care-focused and sustainable integrated care approach designed around the needs of local populations. These bills collectively set the stage for integrated care and population health management in Ontario, with Ontario Health Teams (OHTs) introduced as a model of integrated care delivery systems. OHTs aim to streamline patient connectivity through the healthcare system and improve outcomes aligned with the Quadruple Aim. When Ontario released a call for health system partners to apply to become an OHT, providers, administrators, and patient/caregiver partners from the Middlesex-London area were quick to respond. We highlight the critical elements and journey of the Middlesex-London Ontario Health Team since its start.

Five actions for five people: emergency cesarean section protocol.

OBJECTIVE: The scope of this work is to evaluate an operative protocol for emergency C-section to improve teamwork and reduce surgical setup time. METHODS: Sixty-six health care operators working together in the delivery ward (gynecologists, midwives, anesthesiologists) simulated an emergency scenario applying a "five actions for each operator" protocol. For each simulation, the decision to delivery interval was considered and the perception of each operator as a team worker was analyzed with specific tests. RESULTS: The "five actions for five people" protocol significantly reduces the decision to delivery interval (p < 0.001) for emergency C-section. At the same time, a simple and codified scheme improves communication among team members, avoids overlapping roles. Indeed, all the operators become more aware of being helpful to the team (p < 0.001). CONCLUSION: The use of a standardized, simple, and immediately usable protocol improves the performance of the delivery room team in terms of the urgency and quality of the operator's participation in the event. Procedures of this type should be favored within emergency obstetric settings. TRIAL REGISTRATION NUMBER: CEAVNO 19-01-23. Local ethical Committee (COMITATO ETICO REGIONALE PER LA SPERIMENTAZIONE CLINICA - Sezione autonoma Area Vasta Nord Ovest -CEAVNO) approved this study as simulation training study. All the operators participated voluntary during their working time.

Perceptions of the primary health care team about the implementation of integrated care of patients with type 2 diabetes and hypertension in Slovenia: qualitative study.

BACKGROUND: Integrated care involves good coordination, networking, and communication within health care services and externally between providers and patients or informal caregivers. It affects the quality of services, is more cost-effective, and contributes to greater satisfaction among individuals and providers of integrated care. In our study, we examined the implementation and understanding of integrated care from the perspective of providers - the health care team - and gained insights into the current situation. METHODS: Eight focus groups were conducted with health care teams, involving a total of 48 health care professionals, including family physicians, registered nurses, practice nurses, community nurses, and registered nurses working in a health education center. Prior to conducting the focus groups, a thematic guide was developed based on the literature and contextual knowledge with the main themes of the integrated care package. The analysis was conducted using the NVivo program. RESULTS: We identified 12 main themes with 49 subthemes. Health care professionals highlighted good accessibility and the method of diagnostic screening integrated with preventive examinations as positive aspects of the current system of integrated care in Slovenia. They mentioned the good cooperation within the team, with the involvement of registered nurses and community nurses being a particular advantage. Complaints were made about the high workload and the lack of workforce. They feel that patients do not take the disease seriously enough and that patients as teachers could be useful. CONCLUSION: Primary care teams described the importance of implementing integrated care for diabetes and hypertension patients at four levels: Patient, community, care providers, and state. Primary care teams also recognized the importance of including more professionals from different health care settings on their team.

Percepção de residentes de curso multiprofissional em saúde em relação à importância de cuidados odontológicos no hospital / Percepción de residentes de un curso multidisciplinario de salud sobre la importancia de la atención odontológica en el hospitalResumen / Perception of residents of a multiprofessionalresidency program in hospital care regarding the importance of oral careAbstract

O estudo objetivou conhecer a percepção de residentes multiprofissionais de um hospital público sobre a importância dos cuidados odontológicos no cenário hospitalar. Foi realizado um estudo do tipo transversal, observacional, descritivo com amostra por conveniência, composta por 63 residentes do Programa de Residência Multiprofissional Integral de Saúde Hospitalar (RIMUSH) do Hospital Universitário Lauro Wanderley. O instrumento de coleta de dados foi um questionário adaptado contendo sete perguntas. Para análise, os residentes foram divididos em dois grupos, o grupo 1 (G1) possui cirurgião-dentista (CD) na equipe multiprofissional e o grupo 2 (G2) não possui CD na equipe. A maioria dos residentes respondeu que avaliação odontológica nos pacientes hospitalizados é muito importante, que condições sistêmicas, medicações e condição de saúde bucal impactam na recuperação. Porém, os residentes do G1 compreenderam melhor as atribuições do CD na equipe, assim como quando indicar um pedido de consulta odontológica comparados aos do G2. Conclui-se que os residentes das demais áreas da saúde percebem a importância da Odontologia Hospitalar e que a presença do CD nas equipes de residência contribui para a capacitação desses profissionais, para a troca de saberes interprofissionais e para a promoção de assistência integral (AU).

El estudio tuvo como objetivo conocer la percepción de los residentes multidisciplinarios de un hospital público sobre la importancia de la atención odontológica en el ámbito hospitalario. Se realizó un estudio transversal, observacional, descriptivo, con una muestra de conveniencia, conformada por 63 residentes del Programa de Residencia Multiprofesional Integral en Salud Hospitalaria (RIMUSH) del Hospital Universitario Lauro Wanderley. El instrumento de recolección de datos fue un cuestionario adaptado que contenía siete preguntas. Para el análisis, los residentes fueron divididos en dos grupos, el grupo 1 (G1) tiene un cirujano dentista (CD) en el equipo multidisciplinario y el grupo 2 (G2) no tiene un dentista en el equipo. La mayoría de los residentes respondieron que la evaluación dental en pacientes hospitalizados es muy importante, que las condiciones sistémicas, los medicamentos y la condición de salud oral impactan en la recuperación. Sin embargo, los residentes de G1 entendieron mejor las funciones del CD en el equipo, así como cuándo indicar una solicitud de cita dental en comparación con G2. Los residentes de otras áreas de salud se dan cuenta de la importancia de la Odontología Hospitalaria y la presencia de CD en los equipos de residencia contribuye a la formación de estos profesionales, al intercambio de conocimientos interprofesionales y a la promoción de la atención integral (AU).

This study aimed to investigate the perception of multiprofessional residents of a public hospital about the importance of oral care in the hospital setting. A cross-sectional, observational study of descriptive design was conducted with a convenience sample, including 63 residents of the Multiprofessional Integrated Residency Program in Hospital Care (RIMUSH) at the University Hospital Lauro Wanderley. The instrument used for data collection was an adapted questionnaire containing seven questions. For the analysis, residents were divided into two groups: group 1 (G1) included a dental surgeon (DS) in the multiprofessional team, and group 2 (G2) did not include a DS in the team. Most residents answered that dental evaluation of hospitalized patients was very important, and that systemic conditions, medications and oral health had a significant impact on recovery. However, G1 residents had better understanding of the duties of the DS in the team and of timely referral of hospitalized patients for a dental consultation, compared to G2. Residents of other Health Care courses realize the importance of Hospital Dentistry and understand that the presence of DSs in residency teams is acontributing factor to the qualification of these professionals, exchange of interprofessional knowledge and promotion of comprehensive care (AU).