ABSTRACT
A aprendizagem baseada em projeto orientada pelos fundamentos da educação interprofissional é um modelo que pode contribuir para a formação de relacionamentos interpessoais, criatividade, empatia e colaboração na educação médica, por meio de uma colaboração mútua com profissionais de saúde da rede. Muito se fala da efetividade desse método no campo do ensino e aprendizagem médica, mas há a necessidade de incluir a importância do desenvolvimento de habilidades interprofissionais, com equipes colaborativas, em ações extensionistas, diante das necessidades locais no contexto da atenção primária, pensando na melhoria dos resultados de saúde. O objetivo deste trabalho é apresentar um relato de experiência de aprendizagem baseada em projeto de estudantes de Medicina no contexto da Estratégia Saúde da Família. Participaram deste trabalho estudantes do Módulo Integração Ensino, Serviço e Comunidade da Faculdade de Medicina da Universidade Federal dos Vales do Jequitinhonha e Mucuri que executaram, em colaboração com uma equipe interprofissional o projeto sobre a saúde do homem. Como resultado da análise qualitativa do feedback entre os integrantes, observaram-se mudanças no comportamento dos estudantes, com melhorias na comunicação, empatia e nas relações interpessoais, por meio do trabalho colaborativo com a equipe interprofissional. Esta experiência poderá ser adaptada para implementar o ensino e aprendizagem no projeto pedagógico orientado pela educação interprofissional na atenção primária.
Project-based learning guided by the fundamentals of interprofessional education is a model that can contribute to the formation of interpersonal relationships, creativity, empathy and collaboration within medical education, through mutual collaboration with health professionals in the health network. Much has been said about the effectiveness of this method in medical teaching and learning, but there is a need to include the importance of developing interprofessional skills, with collaborative teams, within extension actions, in view of local needs in the context of primary care, thinking about the improved health outcomes. The objective of this work was to present a report of a project-based learning experience of medical students in Family Health Strategy. Students from the Teaching, Service and Community Integration Module of the Faculty of Medicine of Universidade Federal dos Vales do Jequitinhonha e Mucuri participated in this work, executing in collaboration with an interprofessional team a project about men's health. As a result of the qualitative analysis of the feedback among the members, changes in student behavior were observed with improvements in communication, empathy and interpersonal relationships through collaborative work with the interprofessional team. This experience can be adapted to implement teaching and learning in the pedagogical project guided by interprofessional education in primary care.
El aprendizaje basado en proyectos y guiado por los fundamentos de la educación interprofesional es un modelo que puede contribuir a la formación de relaciones interpersonales, creatividad, empatía y colaboración dentro de la educación médica, a través de la colaboración mutua con los profesionales de la salud en la red de salud. Mucho se habla de la efectividad de este método dentro de la enseñanza y el aprendizaje médico, pero es necesario incluir la importancia del desarrollo de habilidades interprofesionales, con equipos colaborativos, dentro de las acciones de extensión, frente a las necesidades locales en el contexto de la atención primaria, pensando sobre los mejores resultados de salud. El objetivo de este trabajo es presentar un informe de experiencia de aprendizaje basado en proyectos de estudiantes de medicina en la Estrategia de Salud Familiar. Participaron en este trabajo estudiantes del Módulo Integración Enseñanza, Servicio y Comunidad de la Facultad de Medicina de la Universidade Federal dos Vales do Jequitinhonha e Mucuri que ejecutaron en colaboración con un equipo interprofesional el proyecto sobre la salud del hombre. Como resultado del análisis cualitativo de la retroalimentación entre los integrantes, se observaron cambios en el comportamiento de los estudiantes con mejoras en la comunicación, la empatía y las relaciones interpersonales a través del trabajo colaborativo con el equipo interprofesional. Esta experiencia puede adaptarse para implementar la enseñanza y el aprendizaje en el proyecto pedagógico guiado por la educación interprofesional en atención primaria.
Subject(s)
Humans , Patient Care Team , Health Personnel , Education, Medical , Interprofessional EducationABSTRACT
Resumen Antecedentes: La participación de las mujeres en el fútbol se ha incrementado exponencialmente en los últimos años, por lo que integrar antecedentes basados en la evidencia en esta población, permite una mejor compresión y análisis del desempeño deportivo de atletas femeninas. Objetivo: Determinar el nivel de asociación entre los indicadores de composición corporal y el rendimiento en test 30-15 IFT en futbolistas mujeres de primera división. Métodos: Participaron 29 jugadoras profesionales de un equipo de primera división de Chile. Se evaluó el test 30-15, se analizó la velocidad final alcanzada (VIFT) y se estimó el consumo máximo de oxígeno (VO2máx). La composición corporal (CC) fue estimada a través de antropometría y se analizó la talla, masa corporal, índice de masa corporal (IMC), masa adiposa absoluta (MA) y relativa (PMA), masa muscular absoluta (MM) y relativa (PMM) y sumatoria de 6 pliegues (S6P). Para analizar el nivel de asociación, se utilizó el coeficiente de correlación de Pearson (r) con un alfa de 0.05. Resultados: Se encontraron correlaciones negativas débiles entre MA con VIFT (r = -0.384 y p = 0.04) y VO2máx (r = -0.375 y p = 0.45); correlaciones negativas moderadas entre S6P con VIFT (r = -0.476 y p = 0.009) y VO2máx (r=0.454 y p=0.013); correlaciones negativas moderadas entre IMC con VIFT (r = 0.401 y p = 0.031) y VO2máx (r = -0.379 y p = 0.043). No se hallaron correlaciones entre MM y PMM con VIFT o VO2máx. Conclusión: Es posible concluir que el rendimiento en el 30-15IFT presenta asociación con la composición corporal, específicamente con la MA, S6P e IMC en las jugadoras evaluadas.
Abstract Background: The participation of women in football has increased exponentially in recent years, so integrating evidence-based background in this population allows a better understanding and analysis of the sporting performance of female athletes. Objective: Determine the level of association between body composition indicators and performance in the 30-15 IFT test in first division female football players. Methods: 29 professional female players from a first division team in Chile participated. The 30-15 test was evaluated, the final velocity achieved (VIFT) was analyzed, and the maximum oxygen consumption (VO2máx) was estimated. Body composition (CC) was estimated through anthropometry and height, body mass, body mass index (BMI), absolute (AM) and relative (RM) adipose mass, absolute (MM) and relative (RMM) muscle mass, and 6-fold sum (S6P) were analyzed. Pearson's correlation coefficient (r) with an alpha of 0.05 was used to analyze the level of association. Results: Weak negative correlations were found between MA with VIFT (r = -0.384 and p = 0.04) and VO2máx (r = -0.375 and p = 0.45); moderate negative correlations between S6P with VIFT (r = -0.476 and p = 0.009) and VO2máx (r = 0.454 and p = 0.013); moderate negative correlations between BMI with VIFT (r = 0.401 and p = 0.031) and VO2máx (r = -0.379 and p = 0.043). No correlations were found between MM and PMM with VIFT or VO2máx. Conclusion: It is possible to conclude that performance in the 30-15IFT is associated with body composition, specifically with MA, S6P, and BMI in players evaluated.
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Objetivo: avaliar pontuação da National Early Warning Score (NEWS) em relação ao tipo de desfecho e perfil dos pacientes da enfermaria clínica médica de um hospital em Teresina, Piauí, Brasil. Método: estudo quantitativo realizado num hospital público, em Teresina, com 150 prontuários de pacientes internados no setor clínica médica de fevereiro de 2022 a dezembro de 2022, a partir de registros demográficos, clínicos e valores da escala na admissão e desfecho. Resultados: houve associação dos valores da escala com a faixa etária (p=0,029), tempo de internação (p=0,023) e tipo de desfecho (p < 0,001). Alto risco clínico prevaleceu entre pacientes do sexo masculino (13%), na faixa etária de 60 a 94 anos (13%), com permanência de 21 a 57 dias (19,2%) e óbito como desfecho (100%). Conclusão: implementação da referida escala evidenciou ser fundamental para prever agravos clínicos e melhorar qualidade da assistência.
Objective: to evaluate the National Early Warning Score (NEWS) in relation to the type of outcome and profile of patients in the medical clinical ward of a hospital in Teresina, Piauí, Brazil. Method: a quantitative study conducted in a public hospital in Teresina, with 150 medical records of patients admitted to the medical clinic sector from February 2022 to December 2022, based on demographic and clinical records and scale values at admission and outcome. Results: there was an association between the scale values and the age group (p=0.029), length of stay (p=0.023) and type of outcome (p < 0.001). High clinical risk prevailed among male patients (13%), aged between 60 and 94 years (13%), with a stay of 21 to 57 days (19.2%), and death as an outcome (100%). Conclusion: implementation of the aforementioned scale proved to be fundamental for predicting clinical problems and improving care quality.
Objetivo: evaluar el puntaje de la National Early Warning Score (NEWS) con respecto al tipo de desenlace y el perfil de los pacientes de la enfermería clínica médica de un hospital en Teresina, Piauí, Brasil. Método: estudio cuantitativo realizado en un hospital público en Teresina, con 150 historiales médicos de pacientes internados en el sector de clínica médica desde febrero de 2022 hasta diciembre de 2022, a partir de registros demográficos, clínicos y valores de la escala en la admisión y desenlace. Resultados: hubo asociación de los valores de la escala con la edad (p=0,029), tiempo de internación (p=0,023) y tipo de desenlace (p < 0,001). El alto riesgo clínico prevaleció entre los pacientes del sexo masculino (13%), en la franja de edad entre 60 y 94 años (13%), con una estancia de 21 a 57 días (19,2%) y fallecimiento como desenlace (100%). Conclusión: la implementación de dicha escala demostró ser fundamental para prever agravios clínicos y mejorar la calidad de la asistencia.
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Objective: Compare the number of puerperal women submitted to blood transfusion before and after the implementation of a care protocol for postpartum hemorrhage (PPH) with multidisciplinary team training. Methods: Cross-sectional study in a university hospital, analyzing births from 2015 to 2019, compared the use of blood products before and after the adoption of a PPH protocol with multidisciplinary training. Results: Between 2015 and 2019, there were 17,731 births, with 299 (1.7%) postpartum women receiving blood products and 278 postpartum women were considered for this analysis, 128 (0.7%) at Time 1 and 150 (0.8%) at Time 2. After the multiprofessional team training (T2), there was a difference in the complete use of the PPH protocol (use of oxytocin, misoprostol and tranexamic acid) (T1 = 5.1% x T2 = 49.5%, p≤0.0001). An individual categorized analysis revealed that, in the T2 period, there was lower use of blood component units per patient compared to T1 (Mann-Whitney, p=0.006). It should be noted that at T1 and T2, 54% and 24% respectively received two units of blood products. It is important to highlight that after the multidisciplinary team training for the PPH protocol, the goal of zero maternal death due to hemorrhage was reached. Conclusion: The adoption of a specific protocol for PPH, combined with the training of a multidisciplinary team, had an impact on the ability to identify women at high risk of hemorrhage, resulting in a decrease in the use of blood components.
Subject(s)
Blood Transfusion , Patient Care Team , Postpartum Hemorrhage , Humans , Postpartum Hemorrhage/therapy , Female , Cross-Sectional Studies , Adult , Pregnancy , Clinical Protocols , Misoprostol/therapeutic use , Oxytocin/therapeutic useABSTRACT
Infective Endocarditis (IE) is a complex, life-threatening disease. The aim of the present study was to evaluate the impact of the Endocarditis-Team on management of IE. This observational study conducted at a university hospital (2015â22), included adult patients with IE. The study period was divided in two periods: before (pre-Endocarditis-Team; pre-ET) and after the establishment of the Endocarditis-Team (post-Endocarditis-Team; post-ET) on January 2018. Among 505 IE episodes (187 in pre-Endocarditis-Team, 318 in post-ET period), 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography was more commonly used in post-ET period (14 % vs. 28 %; p < 0.001). Overall, thirty-day and one-year mortality were 14 % and 27 %, respectively; no difference was observed between the two periods. In post-ET period, the administration of 4-weeks, rather than 6-weeks, of intravenous antimicrobial treatment was higher than in the post-ET period (15 % vs. 45 %; p < 0.001). Indication for surgery was present in 115 (61 %) patients in pre-ET and in 153 (48 %) in the post-ET period. In post-ET period, among patients with indication, valve surgery was more frequently performed (66 % vs. 78 %; p = 0.038). Such difference was due to a higher acceptance of operative indication by the cardiac surgeon (69 % vs. 94 %; p = 0.013). The observed increase in number of patients benefiting from cardiac surgery in the post-ET period led to a decrease of subsequent embolic events, since among patients with operative indication (n = 268), new embolic events after the establishment of the indication were more common in the pre-ET period compared to post-ET (23 % vs. 12 %; p = 0.033). After the implementation of the multidisciplinary Endocarditis-Team we observed several improvements in the general management of IE patients.
Subject(s)
Endocarditis , Patient Care Team , Humans , Male , Female , Middle Aged , Endocarditis/mortality , Aged , Adult , Positron Emission Tomography Computed Tomography , Anti-Bacterial Agents/therapeutic use , Treatment OutcomeABSTRACT
Background: Bladder cancer (BC) is an aggressive disease that begins in the cells lining the bladder, which grows abnormally due to mutations. One of the aggravating factors during treatment is the nutritional risk, contributing to increased morbidity and mortality. Nutritional screening can be extremely important for these patients since the nutritional condition can deteriorate during treatment and due to the progression of the disease. Objectives: This cross-sectional observational study aimed to compare the results of using the Mini Nutritional Assessment (MNA) nutritional screening tool obtained by urologists and nutritionists at our center. Methods: The target audience were adult patients diagnosed with BC. They were followed up at the urology outpatient clinic and were asked to answer the questions in the short version of MAN during a nutritional screening conducted by a medical team, and later answer the questions contained in the full version of the instrument during a nutritional consultation by nutritionists. The data were analyzed and organized by employing a RedCap database. Statistical analysis of data was performed using the SPSS software package. For comparison between continuous variables, the Mann-Whitney U-test and Student's t-test were utilized. For analyses of the categorical variables, the Wilcoxon Matched Pairs test and the Cohen Kappa test were used. A significance level of 5% (P ≤ 0.05) with a confidence level of 95% was set for all statistical tests. Results: A total of 46 patients were evaluated. The medical team identified 18 (39.1%) with normal nutritional status, while the nutrition team identified 13 (28.3%). In comparison, the use of the full version of the MNA administered by the nutrition team found that 32 (69.6%) patients were at nutritional risk. Individual questions of the short-version MNA were also compared between the two groups and the Wilcoxon Matched Pairs test was performed. The short-version MNA was found to be an excellent screening tool. When applied by a urologist, it yielded a sensitivity of 87.5% (P = 0.87) and a sensitivity of 93.7% (P = 0.76) when used by the nutritionist. A raw match rate was 71.7% achieved by both questionnaires, and the Cohen Kappa test showed that the agreement was moderate, with an agreement rate of 77.9% (k = 0.50). Conclusion: The application of short-version MNA has a high sensitivity. However, the full-version MNA is necessary for nutritional screening to improve the sensitivity of the assessment and to serve as a guide for nutritionists and the multidisciplinary care team.
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This study aims to identify contextual situations (score, game time, the interaction between teammates and opponents, start and restart plays) that increase the odds ratio of maintenance of ball possession and scoring a goal. Twenty professional futsal players were evaluated in seven home official matches. The games were filmed to analyze the offensive actions. In total, 828 attacking plays were analyzed. The absence of defensive pressure from the opponent resulted in a greater odds ratio (OR) for loss of ball possession (OR = 1.7, 95% CI = 1.7 to 2.2), but also increased total effectiveness (OR = 6.5; 95%CI = 2.2 to 19.5). The received fouls did not increase the total effectiveness (OR = 0.2; 95%CI = 0.01 to 4.2; p = 0.40). The court regions close to the opponent's goal area and areas where there was less defensive pressure had a higher frequency of goals (p < 0.05). The results demonstrated that shooting close to opponents' areas and having no defensive pressure were the situations with increased odds of goal-scoring. Maintaining ball possession per se did not increase the OR of goal scoring, however situations when shootings were performed with low defensive pressure could increase chances of goal scoring.
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BACKGROUND: Acute malnutrition in children <5 years of age has a direct relationship with medical complications and mortality. We aimed to describe the etiologic factors in children with moderate and severe non-illness-related acute malnutrition who required hospitalization for treatment of malnutrition in two high-complexity hospital centers in Bogotá, Colombia. METHODS: This is a multicenter case series (December 2016 to December 2020) including patients aged 1-59 months with a weight/height indicator less than -2 SD. Electronic health records were reviewed, and demographic (sex, age, city of origin, and socioeconomic status) and clinical data (gestational age at birth, edema, and nutrition status) were collected. Descriptive analysis of information was performed. An exploratory bivariate analysis by diagnostic categories of moderate and severe acute malnutrition vs days of hospitalization was also performed. RESULTS: Forty-five patients were included, 62.2% of whom were male, with a median age of 14 months (Q1-Q3: 7-24). The main etiologic factors of malnutrition were related to problems with total food intake (33.3%), transition in consistency of feeding (31.1%), and breastfeeding technique (22.2%). Only 13.3% had problems related to food insecurity. There were no statistically significant differences between moderate (median: 7 days; Q1-Q3: 5-12) and severe (median: 8 days; Q1-Q3: 5-16) acute malnutrition when compared by days of hospitalization. CONCLUSIONS: The main etiologic factors of malnutrition in our study population were related to problems in the amount of food provided and transition in consistency of complementary feeding.
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BACKGROUND: Vascular malformations (VaMs) are caused by errors in vascular morphogenesis. Diagnosis and treatment can be complex. Few specialized centers care for these patients, and limited literature exists regarding their characteristics and clinical course. The vascular anomalies clinic (VAC) at the Instituto Nacional de Pediatría (National Institute for Pediatrics) is a multidisciplinary team and has been a reference center for patients with VaMs since 2012. We sought to describe the characteristics of patients cared for at the VAC, types of VaMs, treatments used, and clinical course. METHODS: This was a descriptive, observational, retrospective, and cross-sectional study conducted from 2012 to 2022. RESULTS: We included 435 patients with VaMs; the median age of presentation was 1 month. The most frequent signs and symptoms were increased volume (97.2%), superficial color change (65.5%), and pain (43.3%). The most common VaMs were lymphatic (36.7%) and venolymphatic (18.3%). Sclerotherapy was the most frequent treatment (73.4%), followed by medical treatment with sirolimus (18.5%); response to both was excellent/good in > 85% of cases. CONCLUSION: In this retrospective study of children with VaMs, we found that low-flow malformations were the most common, and sclerotherapy and sirolimus were the most frequently used treatments. The therapeutic response was excellent/good in most cases.
INTRODUCCIÓN: Las malformaciones vasculares (MaV) son secundarias a errores en la morfogénesis vascular. El diagnóstico y tratamiento puede ser complejo. Existen pocos centros especializados en su atención y escasa literatura respecto a características y evolución clínica. La Clínica de Anomalías Vasculares (CAV) del Instituto Nacional de Pediatría es un equipo multidisciplinario y centro de referencia para estos pacientes desde 2012. Buscamos describir las características de los pacientes atendidos en la CAV, tipo de MaV, tratamiento y evolución clínica. MÉTODOS: Estudio descriptivo, observacional, retrospectivo y transversal del periodo 2012 al 2022. RESULTADOS: Se incluyeron 435 pacientes con MaV, con edad mediana de presentación de 1 mes de vida. Los síntomas y signos más reportados fueron aumento de volumen (97.2%), cambio en coloración de la piel (65.5%) y dolor (43.3%). Las MaV más comunes fueron linfáticas (36.7%), siguiéndoles las venolinfáticas (18.3%). La escleroterapia fue el tratamiento más frecuente (73.4%) y el tratamiento médico más utilizado fue sirolimus (18.5%), ambos con excelente/buena respuesta en > 85% de los pacientes. CONCLUSIONES: En este estudio retrospectivo de niños con MaV encontramos que las más frecuentes son de bajo flujo y el tratamiento más usado escleroterapia y sirolimus. La respuesta terapéutica de la mayoría fue excelente/buena.
Subject(s)
Sclerotherapy , Vascular Malformations , Humans , Retrospective Studies , Vascular Malformations/therapy , Vascular Malformations/diagnosis , Infant , Male , Female , Cross-Sectional Studies , Child, Preschool , Child , Infant, Newborn , Sclerotherapy/methods , Sirolimus/administration & dosage , Adolescent , Treatment OutcomeABSTRACT
Multidisciplinary care is essential for the management of patients with psoriatic disease (PsD), considering the great range of cutaneous and musculoskeletal symptoms and the potential for associated comorbidities and extraarticular manifestations. Consequently, combined rheumatology/dermatology clinics represent a gold standard model of care for patients with PsD. Many challenges are associated with the establishment of these clinics in routine clinical practice. In this report, we describe the thoughts and debates within a collaborative care breakout session during the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2023 annual meeting. The breakout discussion focused around 3 main topics: (1) challenges of dermatologist-rheumatologist collaboration; (2) innovative approaches to encourage collaboration; and (3) how to identify patients with psoriasis at high risk of developing PsA.
Subject(s)
Arthritis, Psoriatic , Dermatologists , Psoriasis , Rheumatologists , Rheumatology , Humans , Psoriasis/therapy , Arthritis, Psoriatic/therapy , Arthritis, Psoriatic/diagnosis , Dermatology/methods , Patient Care Team/organization & administrationABSTRACT
Introdução:Esteartigo apresenta uma revisão integrativa da literatura em relação à compreensãodos profissionais sobre humanização na Unidade de Terapia Intensiva. Objetivo: Analisar os estudos científicos que abordem a percepção sobre humanização entre profissionais da saúde atuantes em Unidades de Terapia Intensiva.Metodologia:Revisão integrativa da literatura. Nas bases de dados e biblioteca virtual selecionadas, utilizou-se os descritores em ciências da saúde: percepção, humanização da assistência e unidades de terapia intensiva, combinados com o operador booleano "AND".As etapas de seleção dos artigos,compreenderam: identificação do tema e seleção da pergunta norteadora; estabelecimento dos critérios de inclusão e exclusão; identificação dos estudos selecionados e pré-selecionados; categorização dos estudos selecionados; análise e interpretação dos resultados; apresentação dos achados da revisão com a síntese do conhecimento.Os critérios de inclusão abrangeram:publicações dos últimos 10 anos (2013-2023), que atendessem ao objetivo do estudo, artigos disponíveis na íntegra nas bases de dados selecionadas, nos idiomas inglês, português e espanhol. Foram excluídos estudos duplicados, trabalhos de conclusão de curso, teses, dissertações, editoriais, cartas, resumos de anais, livros, estudo de caso e relatos de experiência. Resultados:Foram incluídos 16 artigos, revelandotrês categorias temáticas: compreensão dos profissionais sobre a humanização, fatores facilitadores e dificultadores para consolidar a humanização e os benefícios da prática humanizada.Considerações finais:Verificou-se a dificuldade em definir um conceito de humanização pelos profissionais da saúde. Foram destacados os elementos facilitadores da prática humanizada, incluindo empatia, respeito, acolhimento e comunicação adequada. Além disso, foi possível observar os obstáculos, como a falta de materiais, dimensionamento inadequado, ambiente inadequado, sobrecarga de trabalho, rotatividade da equipe e estresse. Adicionalmente, foi possível observar a percepção dos profissionais quanto aos benefícios da prática humanizada na Unidade de Terapia Intensiva (AU).
Introduction:This article presents an integrative literature revision of the understanding ofprofessionals about humanization in the Intensive Care Unit. Objective:Analyze scientific studies that address the perception of humanization among health professionals working in Intensive Care Units. Methodology:Literature integrative revision. In thedatabases and virtual library selected, we used the descriptors in health sciences: perception, humanization of assistance and intensive care units, combined with the Boolean operator "AND". The article selection steps included: identification of the topic and selection of the guiding question; establishment of inclusion and exclusion criteria; identification of the selected and pre-selected studies; categorization of the selected studies; analysis and interpretation of the results; presentation of the results of the revision and the synthesis of knowledge. The inclusion criteria were: publications from the last 10 years (2013-2023), which met the study's objective, articles available in full in the selected databases, in English, Portuguese and Spanish. Duplicate studies, term papers, theses, dissertations, editorials, letters, abstracts from proceedings, books, case studies and experience reports were excluded. Results:Sixteen articles were included, disclosing three thematic categories: professionals' understanding of humanization, factors that facilitate and hinder the consolidation of humanization, and the benefits of humanized practice. Final considerations:Health professionals had difficulty defining a concept of humanization. The elements that facilitate humanized practice were highlighted, including empathy, respect, hospitality and proper communication. In addition, there were obstacles including a shortage of materials, inadequate dimensioning, an unsuitable environment, work overload, staff turnover and stress. In addition, it was possible to observe the professionals' perception of the benefits of humanized practice in the Intensive Care Unit (AU).
Introducción:Este artículo presenta una revisión integradora de la literatura en relación a la comprensión de los profesionales sobre humanización en la Unidad de Cuidados Intensivos. Objetivo:Analizar los estúdios científicos que aborden la percepciónsobre humanización entre profesionales de la salud actuantes en Unidades de Cuidados Intensivos. Metodología:Revisión integrativa de la literatura. En las bases de datos y biblioteca virtual seleccionadas, se utilizó los descriptores en ciencias de la salud: percepción, humanizaciónde la asistencia y unidades de cuidados intensivos.Las etapasde selección de los artículos fueron las siguientes: identificación del tema y selección de la pregunta orientadora; establecimiento de los criterios de inclusión y exclusión;identificación de los estúdios seleccionados y preseleccionados; categorización de los estudios seleccionados; análisis e interpretación de los resultados; presentación de los hallazgos de la revisióncon la síntesis delconocimiento. Los criterios de inclusión abarcaron: publicaciones de los últimos diez años (2013-2023),que atendieran al objetivo del estudio, artículos disponibles íntegramente en las bases de datos seleccionadas, en los idiomas inglés, portugués y español. Se excluyeron estudios duplicados, trabajos de fin de grado, tesis, disertaciones, editoriales, cartas, resúmenes de anales, libros, estudio de caso y relatos de experiencia. Resultados:Fueron incluidos 16 artículos, revelando tres categorías temáticas: comprensión de los profesionales sobre la humanización, factores facilitadores y dificultadores para consolidar la humanización y los beneficios de la práctica humanizada. Consideraciones finales:Se verificó la dificultad para definir un concepto de humanización por los profesionales de la salud. Se destacaron los elementos facilitadores de la práctica humanizada, incluyendo empatía, respeto, acogimiento y comunicación adecuada. Además de eso, fue posible observar los obstáculos, como la falta de materiales, dimensionamiento inadecuado, ambiente inadecuado, sobrecarga de trabajo, rotación del equipo y estrés. Adicionalmente, fue posible observar la percepción de los profesionales en cuanto a los beneficios de la práctica humanizada en la Unidad de Cuidados Intensivos (AU).
Subject(s)
Humans , Male , Female , Patient Care Team , Health Personnel , Humanization of Assistance , Intensive Care Units , ComprehensionABSTRACT
Resumo O ambiente organizacional está relacionado com o grau de motivação de seus colaboradores. Essa percepção é essencialmente sentida, não se vê e nem se toca, mas tem uma existência real. Este estudo objetiva identificar as dificuldades e potencialidades relacionadas ao clima organizacional dos servidores de enfermagem de um hospital público do Distrito Federal. Metodologicamente foi realizado um estudo descritivo e exploratório caracterizado por uma abordagem qualitativa. A análise de conteúdo temática conduziu a três dimensões interpretativas: ambiente e condições de trabalho; comunicação, relacionamento interpessoal e fluxos de trabalho; e motivação para a melhoria do ambiente de trabalho. Os resultados apontam para um déficit de recursos humanos, escassez de recursos materiais, insumos, estrutura física precária, além de problemas de relacionamento interpessoal, como a (des)valorização do profissional enfermeiro e da enfermagem. Os desafios postos para os gestores estão para além da dimensão técnica e estrutural, da complexidade tecnológica dos equipamentos sem manutenção, desdobra-se pela dimensão humana, pelos sentimentos e pelas necessidades não atendidas (de valorização) da enfermagem, que precisa ser cuidada, valorizada, ouvida e vista no seu processo de cuidar.
Abstract The organizational climate is related to the degree of motivation of its employees. This perception is essentially felt, it is neither seen nor touched, but it is real. This study aims to identify difficulties and potentialities related to the organizational climate of the nursing staff at a public hospital in the Federal District. Methodologically, a descriptive and exploratory study was carried out characterized by a qualitative approach. The thematic content analysis led to three interpretative dimensions: environment and working conditions; communication, interpersonal relationship and work flows; motivation to improve the work environment. The results indicate a deficit of human resources, scarcity of material resources, supplies, precarious physical structure, in addition to interpersonal relationship problems, such as the (de)valuation of professional nurses and nursing. The challenges posed to managers go beyond the technical and structural dimension, the technological complexity of equipment without maintenance, as it unfolds through the human dimension, feelings and unmet needs (of appreciation) of nursing, which needs to be cared for, valued, heard and seen in their care process.
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Introdução:A inserção das equipes de saúde bucal na Estratégia Saúde da Família, embora tardia, representa um avanço significativo para a ampliação da cobertura e da qualidade dos serviços odontológicos no Brasil. No entanto, aindaexistem muitosdesafiosnas práticas do cirurgião-dentista na Estratégia Saúde da Família. A atuação majoritariamente clínica prejudica a realização deum trabalho humanístico, resolutivo, interdisciplinar e multiprofissional. Objetivo:Relatar a experiência de atuação de uma cirurgiã-dentista residente na Atenção Primária em Saúde no município de Santo Estêvão, Bahia, Brasil, durante o Programa de Residência Multiprofissional em Saúde da Família da Universidade Estadual de Feira de Santana. Metodologia:Trata-se de um estudo qualitativo, do tipo relato de experiência, que visa descrever as atividades desenvolvidas durante o Programa de Residência Multiprofissional em Saúde da Família, da Universidade Estadual de Feira de Santana, no município de Santo Estêvão, Bahia, Brasil, no período de março de 2022 a novembro de 2023. Resultados:As atividades descritas abrangem as diferentes possibilidades de trabalho do cirurgião-dentista na Atenção Primária, envolvendo ações assistenciais através das consultas individuais e levantamento epidemiológico, educação permanente e em saúde com atuação nos grupos operativos e capacitações com os profissionais da rede e as ações de planejamento e gestão, através do desenvolvimento de estratégias para fortalecer a rede de atenção à saúde. Conclusões:É preciso motivar os profissionais de saúde bucal a repensarem suas práticas, tendo como ponto de partida o investimento e o estímulo à educação permanente e continuada. A especialização em saúde da família permite que cirurgiões-dentistas que atuam ou têminteresse em trabalhar no serviço público desenvolvam habilidades e práticas voltadas para uma assistência integral e multiprofissional da saúde, contribuindo para a consolidação do Sistema Único de Saúde (AU).
Introduction:The oral health team inclusion in the Family Health Strategy represents a significant advance in expanding the coverage and quality of dental services in Brazil. However, there arestill many challenges in the dental surgeons practices in the Family Health Strategy. The ppredominantly clinical approach hinders the achievement of ahumanistic, problem-solving, and interdisciplinary and multidisciplinary. Objective:To report the experience of a dental surgeon resident in Primary Health Care in the city of Santo Estêvão, Bahia, Brazil, during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana. Methodology:This is a qualitative study, experience report type, which aims to describe the activities developed during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana, in the city of Santo Estêvão, Bahia, Brazil, from March 2022 to November 2023. Results:The activities described cover the different work possibilities of dental surgeons in Primary Care, involving assistance actions through individual consultations and epidemiological surveys, ongoing health education with work in operative groups and training with network professionals, and planning and management actions through the development of strategies to strengthen the health care network. Conclusion:It is necessary to motivate oral health professionals to rethink their practices, with investment and encouragement for permanent and continuing education as a starting point. Specialization in family health allows dental surgeons who work or are interested in working in the public service to develop skills and practices aimed at comprehensive and multidisciplinary health care, contributing to the consolidation of the Unified Health System (AU).
Introducción: La inclusión de los equipos de salud dental en la Estrategia de Salud Familiar, aunque tardía, representa un avance significativo en la ampliación de la cobertura y la calidad de los servicios dentales en Brasil. Sin embargo, los cirujanos dentistas siguen enfrentándose a muchos retos em la Estrategia de Salud Familiar. El enfoque mayoritariamente clínico obstacualiza la realización de um enfoque humanista, resolutivo, interdisciplinario y multiprofesional.Objetivo:Reportar la experiencia de un cirujano dentista residente en Atención Primaria de Salud en el ayuntamiento de Santo Estêvão, Bahía, Brasil, durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana.Metodología:Se trata de un estudio cualitativo, del tipoinforme de experiencia, que tiene como objetivo describir las actividades desarrolladas durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana, en el ayuntamiento de Santo Estêvão, Bahía, Brasil, de marzo de 2022 a noviembre de 2023. Resultados:Las actividades descritas abarcan las diferentes posibilidades de trabajo del cirujano dentista en la Atención Primaria, implicando actividades asistenciales mediante consultas individuales y encuestas epidemiológicas, educación sanitaria continuada con actuación en los grupos operativos y capacitaciones con los profesionales de la red y actividades de planificación y gestión mediante el desarrollo de estrategias de fortalecimiento de la red de atención sanitaria.Conclusiones:Es necesario motivar a los profesionales de la salud dental a replantear sus prácticas, con la inversión y el fomento de la formación permanente y continua como punto de partida. La especialización en salud familiar permite a los cirujanos dentistas que trabajan o están interesados en trabajar en el servicio público desarrollar competencias y prácticas dirigidas a la atención sanitaria integral y multiprofesional, contribuyendo a la consolidación del Sistema Único de Salud (AU).
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Humans , Female , Dental Care , Dentists , Dental Care Team , Internship and Residency , Primary Health Care , National Health Strategies , Qualitative ResearchABSTRACT
Introdução:A atenção à Saúde Bucal no Brasil foi qualificada a partir da Política Nacional de Saúde Bucal (PNSB), através do Sistema Único de Saúde (SUS), fomentando ações de promoção, prevenção e recuperação da saúde bucal da população. A avaliação da prevalência de cárie dentária em determinada comunidade, para Estudos Epidemiológicos em Saúde Bucal, pode ser realizada por meio do índice CPOD, que fornece a quantidade média de dentes cariados, perdidos e obturados. Objetivo:O presente trabalho objetivouaferir o índice CPOD dos moradores de uma área coberta pela Equipe de Saúde Bucal (ESB) de um município de pequeno porte, caracterizar seu perfil socioeconômico, verificar seu comportamento quanto ao uso de serviços odontológicos e identificar fatores associados ao índice. Metodologia:Foi realizado um estudo de prevalência do tipo exploratório e descritivo com abordagem quantitativaem residentes de um município de pequeno porte com cobertura pela Equipe de Saúde Bucal. Foi utilizado um questionário de caracterização individual abordando identificação socioeconômica e comportamento relacionado à saúde bucal.Resultados:Na análise do CPOD, a média de dentes perdidos (5,44) foi maior que a dos dentes obturados (4,31) e cariados (1,34). Odesfecho CPOD foi associado positivamente com a idade e a necessidade do uso de prótese dentária.Conclusões:Observou-se uma média mais alta de dentes perdidos, seguida por dentes obturados, e uma média menor de dentes cariados. Verificamos que o índice CPOD individual foi mais elevado em pessoas com mais de 34 anos e naqueles que necessitavam de próteses dentárias (AU).
Introduction:Oral Health care in Brazil was qualified basedon the National Oral Health Policy (PNSB), through the Unified Health System (SUS), promoting actions to promote, prevent and recover the oral healthof the population. Assessing the prevalence of tooth decay in a community, for Epidemiological Studies inOral Health, can be conductedusing the DMFT index, which provides the average number of Decayed, Missing and Filled Teeth. Objective:Thisstudy aimed to measure the DMFT index of residents of an area covered by anOral Health Team (ESB) of a small municipality, characterize their socioeconomic profile, verify their behavior regarding the use of dental services,and identify factors associated with this index. Methodology:An exploratory and descriptive prevalence study was conductedwith a quantitative approach in residents of a small municipality covered by the Oral Health Team. An individual characterization questionnaire addressing socioeconomic identification and behavior related to oral health was used. Results:The total samplewas of 283 individuals with an average of 34 years of age. In the DMFT analysis, the average number of missing teeth (5.44) was higher than that of filled (4.31) and decayed ones(1.34). The occurrence of a DMFTindexgreater than 11 was significantly higher in individuals over 34 years of age (p value 0.000) and in subjects who needed dental prosthesis (p value 0.001). Conclusions:A higher average of missing teeth was observed, followed by filled ones, and a lower average of decayed teeth. The DMFT outcome was positively associated with age and the need to use dental prostheses (AU).
Introducción:La atención a la salud bucal en Brasil ha sido calificada por la Política Nacionalde Saúde Bucal (PNSB), a través del Sistema Único de Saúde (SUS), promoviendo acciones de promoción, prevención y recuperación de la salud bucal de la población. Para estudios epidemiológicos de salud bucal, la prevalencia de caries dental en una determinada comunidad puede ser evaluada utilizando el índice DMFT, que proporciona el número medio de dientes cariados, perdidos y obturados. Objetivo:El objetivo de este estudio fue medir el índice DMFT de los residentes de un área cubierta por el Equipo de Salud Bucal (ESB) de un pequeño municipio, caracterizar su perfil socioeconómico, verificar su comportamiento en cuanto al uso de servicios odontológicos e identificar factores asociados al índice. Metodología:Se realizó un estudio exploratorio y descriptivo de prevalencia con abordaje cuantitativo en residentes de un pequeño municipio cubierto por un Equipo de Salud Bucal. Se utilizó un cuestionario de caracterización individual que abordaba la identificación socioeconómica y el comportamiento relacionado conla salud bucodental. Resultados:La muestra total fue de 283 individuos con una edad media de 34 años. En el análisis de la DMFT, la media de dientes ausentes (5,44) fue superior a la de dientes obturados (4,31) y cariados (1,34). La incidencia de un DMFTsuperior a 11 fue significativamente mayor en los individuos de más de 34 años (valor p 0,000) y en los que necesitaban un tratamiento dental. Conclusiones:Hubo un mayor número medio de dientes ausentes, seguido de dientes obturados, y un menor número medio de dientes cariados. El resultado del DMFT se asoció positivamente con la edad y la necesidad de prótesis dentales (AU).
Subject(s)
Humans , Male , Female , Adult , National Health Strategies , DMF Index , Oral Health , Dental Care Team , Health Policy , Brazil/epidemiology , Epidemiologic Studies , Chi-Square Distribution , Logistic Models , Cross-Sectional Studies/methods , Multivariate Analysis , Surveys and QuestionnairesABSTRACT
This study aimed to determine, through the use of a highly sensitive statistical tool, whether real changes in performance were present; and compare the rates of meaningful variations in strength, speed, and power parameters at different time-points during the competitive season in national team rugby players. Thirty-two players were assessed 5 times across the season using the following tests: squat jump and countermovement jump tests; 30-m sprint velocity; and one-repetition maximum (1RM) in the half-squat and bench-press exercises. A repeated-measures analysis of variance was conducted to test for differences between successive time-points. Individual coefficients of variation values were used to set target scores for post-measurements and examine whether changes in performance parameters were greater than the natural test variance, thus providing an indication of whether "true changes" occurred. No significant changes were detected in the vertical jump height, 1RM measures, and sprint velocity and momentum throughout the 11-month period (P > 0.05). True changes occurred much more frequently for strength-power measures than for sprint velocity and momentum. Elite rugby union players did not exhibit significant variations in neuromuscular performance across the competitive period, when a group-based analysis was conducted. However, at the individual level, "true changes" in strength-power-(but not in speed-) related qualities were consistently observed over the competitive season.
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Introduction: Evaluating the body composition and dietary habits of non-professional athletes can help identify areas for improvement to enhance sports performance. The present study aimed to describe the anthropometric and body composition features, as well as the dietary habits, of non-professional rugby players in Argentina. Methods: Fifty-seven rugby players from a Group III Club of the Unión de Rugby de Buenos Aires (URBA) were assessed using extensive anthropometric measurements according to the International Society for the Advancement of Kinanthropometry (ISAK) protocol. Reference data from professional rugby players in Group I clubs were used as a control for body composition comparisons. Dietary intake was evaluated using the 24-h recall method, and nutrient analysis was performed with SARA software. Results: Non-professional rugby players were shorter (Forwards: 175.9 vs. 181.5â cm; Backs: 172.5 vs. 175.7â cm), had higher body fat percentages (Forwards: 16.4 vs. 12.3%; Backs: 11.0 vs. 9.3%), and were less muscular (Forwards: 46.0 vs. 48.8%; Backs: 48.4 vs. 50.2%) compared to professional rugby players. The average dietary intake was 3,363â Kcal, with protein and carbohydrate intakes of 1.4â g kg-1 day-1 and 4.1â g kg-1 day-1, respectively, and 35% of energy intake from fat. Backs reported a higher caloric intake than forwards (3,682 vs. 2,827â Kcal). There was a high prevalence of insufficient intake of calcium (58%), vitamin A (49%), and vitamin C (65%), the latter two corresponding with a low intake of fruits and vegetables (6% of total energy intake). Meal pattern analysis showed that 46% of total energy was ingested at dinner. Conclusions: The body composition of non-professional rugby players from low-income clubs could be improved to enhance rugby performance, as compared to players in more competitive tiers. Economic constraints might contribute to a sub-optimal nutritional profile, potentially affecting body composition and on-field performance negatively. Recommendations to improve dietary intake should be made considering the budget constraints of these players.
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Objective: This study was conducted with the aim of the effect of team members teaching design (TMTD) vs. regular Lectures method on the self-efficacy of the multiple sclerosis patients. Methods: This research is a randomized controlled trial study. In this study, 48 multiple sclerosis persons of members of Jahrom MS Society participated. The persons were selected by simple random sampling and then divided into three groups of: TMTD (n=16), regular lecture method (n=16), and control (n=16), by random allocation method. In the intervention groups, six training sessions were held twice a week; control group did not receive education. Data was collected by the MS self-efficacy questionnaire of Rigby et al. in the before, immediately and one month after the intervention. Results: Patients in three intervention and control groups were similar in terms of demographic variables. The results of the repeated measurement test before, immediately and one month after the intervention showed that the mean of the all dimensions of self-efficacy in two intervention groups had increased significantly (p<0.05). While these changes were not significant in the control group (p ≥ 0.05). Also, there was a significant difference in the mean of the all dimensions of self-efficacy between the intervention groups of TMTD and regular lectures. Conclusion: Based on the findings, TMTD compared to regular lectures method had a more significant effect on improving the self-efficacy of multiple sclerosis patients. Therefore, it is recommended that nursing use this educational approach to increase patients' self-efficacy.
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Multiple Sclerosis , Self Efficacy , Teaching , Humans , Multiple Sclerosis/psychology , Iran , Female , Adult , Male , Middle Aged , Surveys and Questionnaires , Patient Education as Topic/methods , Young AdultABSTRACT
PURPOSE: To demonstrate the technical aspects of the novel Penumbra Indigo Lightning Flash System (Penumbra, Inc.) for mechanical thrombectomy of pulmonary embolism (PE). TECHNIQUE: The novel Penumbra Lightning Flash catheter is a 16 French (F) sheath-compatible device designed for advanced thrombectomy, especially in the pulmonary arteries. This device has large thrombus burden removal capacity; however, technical nuances are necessary to accomplish more with efficacy pulmonary embolism management. Access sites, pulmonary arteries catheterization technique, thrombectomy device navigation and mechanism of action are described thoroughly. CONCLUSION: Penumbra Indigo Lightning Flash system for mechanical thrombectomy as other catheter-directed treatments (CDTs) represents a major advance in contemporary PE management. With favorable safety profile and efficacy, CDTs have become an integral component of the multidisciplinary approach to PE care. CLINICAL IMPACT: The article highlights the Penumbra Indigo Lightning Flash System as a significant advancement in mechanical thrombectomy for pulmonary embolism (PE). By detailing technical aspects and procedural nuances, it supports clinicians for improvement in endovascular PE management. The system's integration into multidisciplinary care represents a major step forward, providing an effective alternative to traditional therapies, particularly for high-risk PE patients. This innovation promises to enhance patient outcomes in contemporary PE management.
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Objetivo: O objetivo deste estudo foi identificar e descrever os cuidados essenciais que os enfermeiros devem ter ao atuar em uma Unidade de Terapia Intensiva (UTI). Métodos: Realizou-se uma revisão bibliográfica da literatura, com uma abordagem qualitativa, descritiva e exploratória. As buscas foram realizadas PubMed, SciELO, LILACS e BIREME. Resultados: Os cuidados de enfermagem desempenham um papel crucial na recuperação e bem-estar dos pacientes em estado crítico na UTI. As intervenções dos enfermeiros devem ser embasadas em conhecimento científico, empatia e habilidades técnicas avançadas. Discute-se a importância da monitorização rigorosa, controle de infecções, prevenção de complicações da imobilidade, abordagem holística ao paciente e comunicação efetiva na UTI. Conclusão: Conclui-se que os enfermeiros devem basear suas intervenções em conhecimento científico, empatia e habilidades técnicas avançadas, destacando-se a importância da monitorização, controle de infecções, prevenção de complicações da imobilidade, abordagem holística ao paciente e comunicação efetiva na UTI.(AU)
Objectives: The objective of this study was to identify and describe the essential care that nurses must take when working in an Intensive Care Unit (ICU). Methods: A bibliographical review of the literature was carried out, with a qualitative, descriptive and exploratory approach. The searches were carried out in PubMed, SciELO, LILACS and BIREME. Results: Nursing care plays a crucial role in the recovery and well-being of critically ill patients in the ICU. Nurses' interventions must be based on scientifi c knowledge, empathy and advanced technical skills. The importance of rigorous monitoring, infection control, prevention of immobility complications, a holistic approach to the patient and effective communication in the ICU are discussed. Conclusion: It is concluded that nurses must base their interventions on scientifi c knowledge, empathy and advanced technical skills, highlighting the importance of monitoring, infection control, prevention of immobility complications, a holistic approach to the patient and effective communication in the ICU.(AU)
Objetivos: El objetivo de este estudio fue identifi car y describir los cuidados esenciales que deben tener las enfermeras cuando trabajan en una Unidad de Cuidados Intensivos (UCI). Métodos: Se realizó una revisión bibliográfi ca de la literatura, con un enfoque cualitativo, descriptivo y exploratorio. Las búsquedas se realizaron en PubMed, SciELO, LILACS y BIREME. Resultados: Los cuidados de enfermería juegan un papel crucial en la recuperación y el bienestar de los pacientes críticos en la UCI. Las intervenciones de las enfermeras deben basarse en el conocimiento científi co, la empatía y las habilidades técnicas avanzadas. Se discute la importancia de un seguimiento riguroso, el control de infecciones, la prevención de complicaciones de la inmovilidad, un enfoque holístico del paciente y una comunicación efi caz en la UCI. Conclusión: Se concluye que los enfermeros deben basar sus intervenciones en el conocimiento científi co, la empatía y las habilidades técnicas avanzadas, resaltando la importancia del seguimiento, control de infecciones, prevención de complicaciones de la inmovilidad, abordaje holístico del paciente y comunicación efectiva en la UCI.(AU)
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Critical Care , Intensive Care Units , Nursing, TeamABSTRACT
A Reforma Psiquiátrica Brasileira possibilitou a reinserção das pessoas com transtornos mentais na sociedade. Isso acarretou a necessidade de implementar outras formas de olhar e acompanhar essa população, instigando a construção do cuidado em liberdade. Assim, objetivou-se identificar as percepções dos profissionais da atenção básica em saúde sobre a responsabilidade no cuidado integral à pessoa com transtorno mental e/ou sofrimento mental. Trata-se de um estudo descritivo, de abordagem qualitativa, realizado com sete profisionais de uma equipe de Saúde da Família, na região metropolitana de Porto Alegre, Sul do Brasil. Os dados foram coletados por meio de entrevistas individuais e analisados conforme análise de conteúdo. Evidenciou-se que existe o movimento de tomada de responsabilidade por parte dos profissionais entrevistados, a partir da construção de cuidado e acompanhamento em saúde mental. Influenciam esse movimento aspectos como: a escuta, a construção do vínculo, o estigma como modificador da percepção e os fluxos/encaminhamentos para outros serviços. A enfermagem demonstrou ter um papel fundamental na tomada de responsabilidade na atenção básica, em que o profissional enfermeiro é visto como referência na realização dos cuidados e capacitação da equipe.
The Brazilian Psychiatric Reform enabled the reintegration of people with mental disorders into society. This led to the need to implement other ways of looking at and supporting this population, encouraging the construction of care in freedom. Thus, the aim was to identify the perceptions of primary health care professionals regarding responsibility for comprehensive care for people with mental disorders and/or mental distress. This is a descriptive study with a qualitative approach, conducted with seven professionals from a Family Health Team in the metropolitan region of Porto Alegre, Southern Brazil. Data were collected through individual interviews and analyzed using content analysis. It was evident that there is a movement towards taking responsibility on the part of the interviewed professionals, through the construction of mental health care and monitoring. Aspects influencing this movement include: listening; building rapport; stigma as a modifier of perception; and referrals to other services. Nursing demonstrated a fundamental role in taking responsibility in primary care, where the nurse professional is seen as a reference in providing care and training the team.