Use of qualitative methods to optimize collaborative practices by highlighting differences in perceptions between professionals: an example of patient education.

Interprofessional working must be approached within health promotion interventions using systematic methods to identify areas of suboptimal collaboration. We designed a qualitative study with a purposive sample of seven French therapeutic patient education programs. Semi-structured individual interviews were conducted with 14 healthcare providers and seven clinician leaders (coordinators) involved in patient education. We used the same interview guide and thematic grid regardless of the professional's profile to compare their perceptions on elements affecting outcome, participation and sustainability of programs. Healthcare providers and coordinators addressed non-convergent issues at both ends of a continuum from a micro-level nested in the program delivery to a macro-level corresponding to the structured implementation and sustainability of the program. Meso-level issues featured convergent perspectives. Our methodology could be used at the level of health services in a health system to provide a complete recovery of stakeholders' perspectives (without "blind spots" from one stakeholder or another). In our study, we focused on patient education in the French health system and pointed out possible considerations to optimize the functioning of programs. Such considerations include specific training plan development, encouraging reflection on the content and use of initial assessment, leading sessions in pairs to save on work time, and communication on the ins and outs of organizational imperatives that require healthcare providers' contributions.

A realist synthesis of interprofessional collaborative practices in early intervention for children with speech, language and communication needs.

BACKGROUND: Interprofessional collaborative practices (IPCP) are considered to be a crucial factor in the optimal support of young children (3-6 years) with speech, language and communication needs (SLCN) in inclusive early childhood education and care (ECEC). AIMS: To investigate IPCP in interventions using a collaborative approach for young children with SLCN in ECEC, by identifying mechanisms within IPCP and how these mechanisms relate to specific context factors and professional and child-related outcomes. METHODS: A realist review of 22 empirical intervention studies, published between 1994 and 2019, was conducted to synthesise context-mechanism-outcome (CMO) configurations, combining context factors, IPCP mechanisms and outcomes at staff and child level. MAIN CONTRIBUTION: Reciprocal IPCP mechanisms were reported together with interprofessional intervention practices, whereas one-directional IPCP mechanisms were restricted to gains in professional development. Our review further suggests that collective ownership of intervention goals, combined with personal cooperation and communication skills of staff, is vital for inclusive practices and functional communication of children with SLCN. CONCLUSION: Our review has revealed indications for effective IPCP mechanisms, context factors at staff level, and positive outcomes for the professional development of staff working with children with SLCN. In addition, our findings support a link between IPCP and child-related outcomes regarding speech, language and communication development. Future studies should increase our insight into how practitioners, children and families profit from daily collaborative practices. WHAT THIS PAPER ADDS: What is already known on this subject Interventions using a collaborative approach for young children (3-6 years) with SLCN in ECEC are considered to be part of the optimal support of these children. What this paper adds to existing knowledge Conducting a realist review of 22 empirical studies on collaborative intervention offered the possibility to identify specific context factors, IPCP mechanisms and professional and child-related outcomes and to synthesise CMO configuations. Findings suggest multiple routes from effective delivery of SLCN services to improvement of speech, language and communication development, supporting the suggested beneficial function of collaboration between multiple professions. Collective ownership of intervention goals, combined with personal cooperation and communication skills of staff, seems to be vital for inclusive practices and functional communication of children with SLCN. Reciprocal IPCP mechanisms were reported together with interprofessional intervention practices, whereas one-directional IPCP mechanisms were restricted to gains in professional development. What are the potential or actual clinical implications of this work? High-quality collaborative intervention for children with SLCN in requires awareness of and critical reflection on IPCP mechanisms in order to improve outcomes for both professionals and children. Both, institutional structural support and individual communicative and cooperative skills are required to increase interprofessional collaboration with the aim to meet the needs of every individual child with SLCN.

PET-Saúde: contribuições para implementação da EIP e o desenvolvimento de competências colaborativas / PET-Saúde: contributions to the implementation of IPE and the development of collaborative competencies

Resumo: Introdução: Cada vez mais no cenário global vem sendo observado o avanço das iniciativas de educação interprofissional (EIP) com o intuito de gerar inovações e solucionar problemas nos cenários de saúde. Ainda que tímidas, no Brasil, tem-se notado a implantação dos seus preceitos em busca de práticas mais colaborativas, especialmente alinhadas às diretrizes e aos preceitos do Sistema Único de Saúde (SUS). Objetivo: Este estudo teve como objetivo analisar a implementação da EIP e o desenvolvimento de competências colaborativas na formação dos estudantes e na prática dos preceptores e docentes que participaram do PET-Saúde/Interprofissionalidade da Universidade Federal de Viçosa (UFV). Método: Trata-se de uma pesquisa qualitativa que utilizou como técnica de coleta de dados a análise documental. Foram analisados quatro documentos: o edital que dispõe sobre o programa, o documento de inscrição e os relatórios, parcial e final. Resultado: Destacaram-se três aspectos nos documentos avaliados: "cumprimento dos objetivos", "desafios para efetivação da EIP" e "desenvolvimento de competências colaborativas", e, assim, notou-se que, de modo geral, houve o cumprimento dos objetivos do programa, apesar dos desafios impostos pelo modelo hegemônico de formação uniprofissional e pela pandemia da Covid-19. Além disso, foi observado o desenvolvimento de competências fundamentais para uma prática integral em saúde, como: comunicação interprofissional, trabalho em equipe, resolução de conflitos, escuta ativa e qualificada, liderança colaborativa, clareza de papéis, entre outras. Conclusão: Apesar dos percalços, houve a aplicação da EIP e o desenvolvimento de competências colaborativas, as quais favorecem a prática interprofissional e o efetivo trabalho em equipe nos cenários de saúde.

Abstract: Introduction: Interprofessional Education (IPE) initiatives are being increasingly seen on the global stage with the aim of generating innovations and solving problems in healthcare settings. Although timid, Brazil has witnessed the implementation of its precepts in search of more collaborative practices, especially aligned with the guidelines and precepts of the Unified Health System (SUS). Objective: To analyse the implementation of IPE and the development of collaborative competencies in the training of students and in the practice of preceptors and teachers who participated in the PET-Sáude/Interprofessional programme of the Universidade Federal de Viçosa (UFV). Methods: This is qualitative research that used document analysis as a data collection technique. Four documents were analysed: the public notice for the programme, the registration document and the partial and final reports. Results: Three aspects were highlighted in the documents evaluated: "fulfillment of the objectives", "challenges for the implementation of IPE" and "development of collaborative competencies". Accordingly, it was noted that, in general, the programme objectives were met, despite the challenges imposed by the hegemonic model of uniprofessional training and the Covid-19 pandemic. In addition, the development of fundamental competencies for comprehensive healthcare practices was observed, such as, for example: interprofessional communication, teamwork, conflict resolution, active and qualified listening, collaborative leadership, clarity of roles. Conclusion: Despite the setbacks, IPE was applied and collaborative competencies were developed, which favour interprofessional practice and effective teamwork in healthcare setttings.

PET-Saúde Interprofissionalidade e a disponibilidade dos estudantes para a aprendizagem interprofissional / PET-Health Interprofessionality and the readiness of students for interprofessional learning

Resumo A interprofissionalidade foi tema central do nono edital do Programa de Educação pelo Trabalho para a Saúde. O objetivo deste estudo foi descrever a disponibilidade dos estudantes que participaram do programa para a aprendizagem interprofissional. A pesquisa, de abordagem quantitativa e de perspectiva descritivo-exploratória, coletou dados através da readiness for interprofessional learning scale, adaptada para o português do Brasil. Os resultados indicam que há disponibilidade para o trabalho em equipe e a colaboração. Também foram encontrados percentuais significativos relacionados à identidade profissional, o que indica disponibilidade para a aprendizagem interprofissional, embora aspectos relacionados à competição tenham aparecido através de percentuais menores de concordância em relação à aprendizagem compartilhada e interdependência das práticas profissionais. Para a atenção centrada no usuário também foram encontrados resultados que indicam boa disponibilidade entre os participantes; porém, aspectos relacionados à colaboração do usuário na produção dos serviços de saúde ainda expressam a tendência de uma lógica centrada nos profissionais. Conclui-se que há disponibilidade positiva para a educação interprofissional, que precisa ser cada vez mais estimulada nas políticas e estratégias de reformas curriculares.

Abstract Interprofessionality was the central theme of the ninth call for proposals of the Education by Working for Health Program. The objective of this study was to describe the readiness of students who participated in the program for interprofessional learning. The research, of a quantitative approach and descriptive-exploratory perspective, collected data by applying the readiness for interprofessional learning scale (RIPLS), adapted for Brazilian Portuguese. The results indicate an important readiness for teamwork and collaboration. Relevant percentages were also found regarding professional identity, indicating good readiness for interprofessional learning, although aspects related to competition appeared in lower percentages of agreement regarding shared learning and interdependence of professional practices. For user-centered care, results were also found indicating good readiness among participants; however, aspects related to the collaboration of the user in the production of health services still express the tendency of a professional-centered logic. In conclusion, there is a positive readiness for interprofessional education, which needs to be increasingly stimulated in policies and strategies of curricular reforms.

ColaborAtiva: A Platform Based on Gamified Collaborative Practices to Prevent Pressure Injuries for Wheelchair Users.

Pressure injuries are wounds caused by reduced blood circulation for regular and repetitive periods when pressing the human body against a hard surface. It is a pathology that needs daily preventive care and health promotion to avoid incidences. Thus, this article aims to validate a platform based on the gamified collaborative practices model to prevent pressure injuries. The methodological contribution is Design Science, and the software was evaluated by 16 wheelchair users who aimed at usability (SUS), user experience (UEQ), and ability to promote the system (NPS). In addition to creating a collaborative network using the interactions that occurred during the platform's use. Wheelchair users rated 73.28 for SUS; on the UEQ benchmark scales, they classified: excellent (efficiency, dependability, stimulation, and novelty), good (attractiveness), and above-average (perspicuity) and in NPS obtained 62.5%. Moreover, they provided feedback to improve and legitimize that gamification positively interfered in the execution of collaborative practices. In the end, it is possible to suppose that the prototype contributes to the prevention of pressure injuries. In addition, it is possible to adapt it to apply to other pathologies that require continuous health care such as diabetes, mental illness, heart disease, addictions, multiple sclerosis, cancer, among others, maximizing its purpose.

Exploration of patient and caregiver cancer education using electronic health records.

The objective of this short report was to describe types of education provided to older, hospitalized patients with cancer and their caregivers using electronic health record data. A total of 437 patients, representing 512 inpatient stays (admissions), met the inclusion criteria. The sample were predominately male (58%) and White (95%). The average patient age at first admission was 74 years (SD 6.21 years) and the average length of admission was 5 days (SD 3.41 days). Out of all admissions, 89% included at least one documented education session with a provider. Three important results emerged from this study 1) education on medications is commonly conveyed to cancer patients (77%), 2) nurses are primarily responsible for providing education (65%), and 3) caregivers are infrequently involved (41%) in patient education. Additional educational topics tailored to the long-term needs of older adults with cancer are warranted. These topics should be delivered by an array of interprofessional care providers with demonstrated competency. Lastly, patient education should ensure inclusion of caregivers as part of the interprofessional cancer care team to promote successful management of cancer-related concerns.

Perceptions of person-centred care in two large university hospitals: A cross-sectional survey among healthcare professionals.

BACKGROUND: Patient-centred care (PCC) including collaborative practices is the core component of modern health care. Despite this, it has proven difficult to implement. AIMS: To examine (1) healthcare professionals' (HCPs') perception of whether they perceive a PCC culture, their attitudes towards involving patients in decisions and their experiences of barriers for PCC; and (2) variables that may contribute to explain differences in perceived person-centred culture. METHODS: A questionnaire survey of HCPs from 27 different departments from two university hospitals in Denmark. HCPs were eligible if they held a profession as physician, Registered Nurse, nurse assistant, physiotherapist, occupational therapist, dietician, midwife or psychologist and excluded if they reported not being involved in patient treatment and care. The questionnaire consisted of four items from the Context Assessment Index (CAI). The remaining items were purpose-designed. RESULTS: In total 1140 (24% response rate) HCPs completed the questionnaire and were included in the analyses. Most of the HCPs perceived a culture of PCC (e.g. 91% agreed or agreed to a high degree that patients were provided with opportunities to participate in decisions). Most HCPs also held positive attitudes towards involving patients in decisions. Time and prioritisation from the management were perceived as barriers for PCC, and many HCPs also believed that involving patients in decisions could be difficult for the patients. The HCPs who were least involved in treatment and care, and working in the acute setting or in surgery, were least likely to perceive a PCC culture. HCPs with the longest or shortest educations, and HCPs working primarily with outpatients or with planned inpatients, were most likely to perceive a person-centred culture. CONCLUSION: The HCPs generally perceived a culture of PCC and held positive attitudes towards involving patients in decisions. To further promote PCC, time and prioritisation must be invested at an organisational level.

Primary care providers' perceptions and experiences of family-centered care for older adults: a qualitative study of community-based diabetes management in China.

BACKGROUND: Family-centered care, as a contemporary model of health service delivery, involves a mutually beneficial partnership between healthcare providers, patients and their families. Although evidence on the positive effects of family-centered care on older adults and their families is accumulating, less is known about the providers' beliefs, attitudes and practices related to family-centeredness, especially regarding community-based primary healthcare services for the rapidly-ageing Chinese population. METHODS: This study investigated Chinese primary care providers' perceptions and experiences of family-centered care for older adults, using community-based diabetes management services as an example. Ten focus-group interviews involving 48 community health professionals were conducted. Major themes were identified using thematic analysis. RESULTS: The interviews revealed that the providers acknowledged the importance of the family in older patients' diabetes management, while their current scope of practice with the patients' families was limited and informal. The barriers to implementing family-centered care were attributed to structural and environmental obstacles associated with the patients' families and the community healthcare context and culture. To engage patients' families more effectively, the providers suggested that family-centered values endorsed by their healthcare organizations and reinforced by policies, a trained interdisciplinary team of health professionals and community social workers, and also that the utilization of technology would be beneficial. CONCLUSIONS: Our study extends the evidence of family-centered care for older adults in Chinese community-based healthcare settings, contributing to the design of a tailored healthcare delivery model embodying ageing in place.

Práticas colaborativas interprofissionais em cuidados de saúde primários: um protocolo de scoping review / Interprofessional collaborative practices in primary health care: a scoping review protocol / Prácticas colaborativas en el proceso de trabajo interprofesional en atención primaria: protocolo de revisión exploratoria: un protocolo scoping review

Resumo Enquadramento: As práticas colaborativas têm sido recomendadas como ferramentas do processo de trabalho para qualificar o cuidado na atenção primária à saúde (APS). Objetivo: Mapear o conhecimento existente sobre as práticas colaborativas no processo de trabalho interprofissional. Método de revisão: Protocolo de scoping review fundamentado pelo Joanna Briggs Institute. Pretende responder à seguinte questão fundamentada pela estratégia População-Conceito-Contexto (PCC): Quais são as estratégias adotadas pelas equipas de saúde para desenvolver práticas colaborativas de trabalho interprofissional em unidades de APS? As pesquisas incluirão estudos publicados ou não, com métodos quantitativos ou qualitativos, revisão da literatura e literatura cinzenta. A seleção dos estudos será realizada por 2 revisores independentes e às cegas, por meio do Rayyan Qatar Computing Research Institute (QCRI). Apresentação e interpretação dos resultados: A descrição dos achados ocorrerá de forma narrativa e dividida em categorias que possam emergir das análises. Poderão ser utilizadas imagens ou gráficos. Conclusão: Fornecerá contribuição para o fortalecimento do processo de trabalho colaborativo em equipa, em busca da integralidade do cuidado.

Abstract Background: Collaborative practices have been recommended as working tools to improve Primary Health Care (PHC). Objective: To map interprofessional collaborative practices used in PHC based on available data. Review method: Scoping review protocol as recommended by the Joanna Briggs Institute. This review aims to answer the following questions based on the Population-Concept-Context (PCC) strategy: What strategies do the health teams use to develop interprofessional collaborative practices in PHC units? Searches will include both published and unpublished studies using quantitative or qualitative methods, literature reviews, and grey literature. Two independent "blinded" reviewers will select the studies using the Rayyan software (Qatar Computing Research Institute, QCRI). Presentation and interpretation of results: The results will be described in a narrative format and divided into categories that may emerge from the analyzes. Images or graphics may be used. Conclusion: This study will contribute to strengthening the collaborative teamwork process in search of comprehensive care.

Resumen Marco contextual: Las prácticas colaborativas han sido recomendadas como herramientas del proceso de trabajo para cualificar los cuidados en la atención primaria de salud (APS). Objetivo: Mapear el conocimiento existente sobre las prácticas de colaboración en el proceso de trabajo interprofesional. Método de revisión: Protocolo de revisión exploratoria (scoping review) basado en el Instituto Joanna Briggs. Pretende responder a la siguiente pregunta fundamentada en la estrategia Población-Concepto-Contexto (PCC): ¿Cuáles son las estrategias adoptadas por los equipos de salud para desarrollar prácticas colaborativas de trabajo interprofesional en las unidades de APS? La investigación incluirá estudios publicados o no, con métodos cuantitativos o cualitativos, revisión de la literatura y literatura gris. La selección de los estudios la realizarán dos revisores independientes a ciegas mediante el Rayyan Qatar Computing Research Institute (QCRI). Presentación e interpretación de los resultados: La descripción de los hallazgos se hará de forma narrativa y podrá dividirse en categorías que puedan surgir del análisis; se podrán utilizar imágenes o gráficos. Conclusión: Aportará una contribución al fortalecimiento del proceso de trabajo colaborativo en equipo, en busca de la integralidad de la atención.

A transactional approach to patient safety: understanding safe care as a collaborative accomplishment.

Within the last two decades, it has been commonly agreed that patient safety and error management in healthcare organizations can best be attained by adopting a systems approach via re-engineering efforts and the introduction of industrial safety technologies and methodologies. This strategy has not delivered the expected result. Based on John Dewey's pragmatism, we propose another vocabulary for understanding, inquiring into and learning from safety situations in healthcare. Drawing especially on Dewey's understanding of transaction as the inseparability between human and environment, we develop an analytical approach to patient safety understood as a transactional accomplishment thoroughly dependent on the quality of situated and shared habits and collaborative practices in healthcare. We further illustrate methodologically how a transactional attitude can be situationally practised through video-reflexive ethnography, a method that allows for inquiry into mundane safety practices by letting interprofessional teams see, reflect upon and possibly modify their shared practices and safety habits.

Centering the Voice of the Client: On Becoming a Collaborative Practitioner with Low-Income Individuals and Families.

Despite current interest in collaborative practices, few investigations document the ways practitioners can facilitate collaboration during in-session interactions. This investigation explores verbatim psychotherapy transcripts to describe and illustrate therapist's communications that facilitate or hinder centering client's voice in work with socioeconomically disadvantaged populations. Four exemplar cases were selected from a large intervention trial aimed at improving shared decision making (SDM) skills of psychotherapists working with low-income clients. The exemplar cases were selected because they showed therapist's different degrees of success in facilitating SDM. Therapist's verbalizations were grouped into five distinct communicative practices that centered or de-centered the voice of clients. Communication practices were examined through the lens of collaborative approaches in family therapy. The analysis suggests that cross-fertilization between SDM and family-oriented collaborative and critical approaches shows promise to illuminate and enhance the challenging road from clinician-led to client-led interactions. This paper also stresses the importance of incorporating relational intersectionality with individuals and families who may not feel entitled to express their expectations or raise questions when interacting with authority figures.

A pesar del interés actual en las prácticas colaborativas, pocas investigaciones documentan las maneras en las que los profesionales pueden facilitar la colaboración durante las interacciones dentro de las sesiones. Esta investigación analiza transcripciones textuales de la psicoterapia para describir e ilustrar las comunicaciones de los terapeutas que facilitan u obstaculizan la centralización de la voz del paciente en el trabajo con poblaciones desfavorecidas socioeconómicamente. Se eligieron cuatro casos ejemplares de un ensayo grande de intervención orientado a mejorar las habilidades para la toma de decisiones compartidas de psicoterapeutas que trabajan con pacientes de bajos recursos. Los casos ejemplares se eligieron porque demostraban los diferentes grados de éxito de los terapeutas a la hora de facilitar la toma de decisiones compartidas. Las verbalizaciones del terapeuta se agruparon en cinco prácticas comunicativas diferentes que centralizaban o descentralizaban la voz de los pacientes. Se examinaron las prácticas de comunicación desde la perspectiva de los enfoques colaborativos en la terapia familiar. El análisis sugiere que la fertilización entre el esquema de decisiones compartidas y los enfoques teóricos críticos y colaborativos orientados a la familia promete iluminar y mejorar el difícil camino desde las interacciones dirigidas por el clínico a las dirigidas por los clientes. Este artículo también acentúa la importancia de incorporar la interseccionalidad relacional con personas y familias que posiblemente no se sientan con derecho a expresar sus expectativas o a hacer preguntas cuando interactúan con figuras de autoridad.

Interprofessional education in healthcare and health workforce (HRH) planning in Brazil: experiences and good practices.

We report a review of interprofessional education (IPE) for health in Brazil with the objective of identifying experiences and good practices related to the different contexts of changing education and health systems. Our approach is an integrative bibliographic review using surveys and analysis of documents related to IPE in the Virtual Health Library scientific data base. The Brazilian scenario on IPE is still rudimentary, lacking clarity in its definition and scientific progress. Records of successful experiences of IPE and collaborative practices show some growth, with a tendency toward great adherence of professionals, students and teachers in the training model reshuffle. Collaborative practices are strategically used as innovative pedagogical approaches to foster the establishment of integrated teaching-service-community curricula, which coexist with traditional ones. IPE initiatives and collaborative practices have existed in Brazil since the mid-twentieth century. However, the dynamics of training models have not been accompanied by the same pace of change in health services, even under pressure to expand the primary health care (PHC) network and international influence for changes in educational models. The main challenge in this context is to make changes in the three components of training programmes: theoretical orientation, pedagogical approach and scenarios of practices, responding to population health needs and improving people's quality of life.

Efficiency Analysis of Integrated Public Hospital Networks in Outpatient Internal Medicine.

Healthcare systems are evolving towards a complex network of interconnected services due to the increasing costs and the increasing expectations for high service levels. It is evidenced in the literature the importance of implementing management techniques and sophisticated methods to improve the efficiency of healthcare systems, especially in emerging economies. This paper proposes an integrated collaboration model between two public hospitals to reach the reduction of weighted average lead time in outpatient internal medicine department. A strategic framework based on value stream mapping and collaborative practices has been developed in real case study settled in Colombia.

A escrita de narrativas e o desenvolvimento de práticas colaborativas para o trabalho em equipe / La escritura de narrativas y el desarrollo de prácticas colaborativas para el trabajo en equipo / The writing of narratives and the development of collaborative practices for teamwork

O objetivo deste artigo é analisar o potencial da narrativa como mais uma estratégia para o desenvolvimento do trabalho em equipe, por meio da prática colaborativa. Consiste em estudo qualitativo, com análise de entrevistas semiestruturadas, aplicadas a 18 estudantes da Universidade Federal de São Paulo, Campus Baixada Santista, de Educação Física, Fisioterapia, Nutrição, Psicologia, Serviço Social e Terapia Ocupacional(e). Resultados revelam que a escrita de narrativas sensibiliza para o cuidado em equipe multiprofissional de saúde, por meio de acordos e do respeito às particularidades profissionais e pessoais de cada um.

El objetivo de este artículo es analizar la narrativa como una estrategia más para el desarrollo del trabajo en equipo a través de la práctica colaborativa. El presente texto consiste en un estudio cualitativo con análisis de entrevistas aplicadas a 18 estudiantes de la Universidad Federal de São Paulo, Campus Baixada Santista, de los cursos de Educación Física, Fisioterapia, Nutrición, Psicología, Trabajo Social y Terapia Ocupacional. Los resultados revelan que la escritura de narrativas sensibiliza a los estudiantes para el cuidado en equipo multidisciplinario de salud, por medio de acuerdos y del respeto de las características profesionales y personales de cada uno.

This paper aims to analyze the potential of the narrative as a supplementary strategy for the development of teamwork through collaborative practice. It is a qualitative study, analyzing semi-structured interviews applied to 18 students of the Federal University of São Paulo, Campus Baixada Santista, pertaining to the Physical Education, Physiotherapy, Nutrition, Psychology, Social Work and Occupational Therapy programs. Results reveal that writing narratives sensitizes for care in multi-professional health teams, through agreements and respect for professional and personal characteristics of each one.

Establishing good collaborative research practices in the responsible conduct of research in nursing science.

BACKGROUND: Team science is advocated to speed the pace of scientific discovery, yet the goals of collaborative practice in nursing science and the responsibilities of nurse stakeholders are sparse and inconclusive. The purpose of this study was to examine nurse scientists' views on collaborative research as part of a larger study on standards of scientific conduct. METHODS: Web-based descriptive survey of nurse scientists randomly selected from 50 doctoral graduate programs in the United States. RESULTS: Nearly forty percent of nurse respondents were not able to identify good collaborative practices for the discipline; more than three quarters did not know of any published guidelines available to them. Successful research collaborations were challenged by different expectations of authorship and data ownership, lack of timeliness and communication, poorly defined roles and responsibilities, language barriers, and when they involve junior and senior faculty working together on a project. CONCLUSION: Individual and organizational standards, practices, and policies for collaborative research needs clarification within the discipline.

Quem é o cliente: criando o cenário para a terapia colaborativa com crianças e suas famílias / Who is the client: setting the stage for collaborative therapy with children and their families

Este artigo discute o processo de criação de um cenário para o trabalho colaborativo com crianças e suas famílias e aborda a seguinte questão: Quem é o cliente? Trata-se de uma apresentação teórica dos princípios básicos da clínica colaborativa seguida de um exemplo com comentários e reflexões que visam ilustrar como estas ideias são colocadas em prática.(AU)

This article talks about the process of setting the stage in working collaboratively with children and their families and addresses the question: Who is the client? A theoretical presentation of the main principles of collaborative practices is followed by a case vignette with comments and reflections as an example of how these ideas are put into practice. The article addresses the dilemmas practitioners face when working with children and families.(AU)

"Walking alongside:" collaborative practices in mental health and substance use care.

BACKGROUND: Although the importance of collaboration is well established as a principle in research and in theory, what it actually means for practitioners to collaborate in practice, to be partners in a collaborative relationship, has thus far been given less attention. The aim of this study was to identify key characteristics of the ways in which mental health practitioners collaborate with service users and their families in practice. METHODS: This was a qualitative action research study, with a cooperative inquiry approach that used multi-staged focus group discussions with ten mental health care and social work practitioners in community mental health and substance use care. Thematic analysis was applied to identify common characteristics. RESULTS: We identified three major themes related to practitioners' experiences of collaborative practices: (1) walking alongside through negotiated dialogues, (2) maintaining human relationships, and (3) maneuvering relationships and services. CONCLUSIONS: It appears that even with the rich knowledgebase that has developed on the merits of collaborative relationships, it continues to be challenging for practitioners to reorient their practice accordingly. The findings of this study indicate that the practitioners focus on two types of processes as characterizing collaborative practice: one focusing on conversations among practitioners and service users and their families and the other focusing on management and control among health care providers, service sectors, and service users (i.e., inter/intra-system collaboration).

Development of interprofessional collaborative practices within undergraduate programs on healthcare: case study on the family health alliance in Fortaleza (Ceará, Brazil) / O desenvolvimento da prática de colaboração interprofissional na graduação em saúde: estudo do caso da liga de saúde da família em Fortaleza (Ceará, Brasil) / El desarrollo de la práctica de la colaboración inter-profesional en la graduación en salud: estudio del caso de la Liga de Salud de la Familia en Fortaleza (Ceará, Brasil)

The authors present the dynamics of mentoring work within the Family Health Alliance (FHA), an extension program that fosters interprofessional collaboration from a social learning perspective. The objective of this study was to describe and evaluate the program dynamics and their repercussions among the participants. The context, basis, objectives and organization of work situations for students from six different undergraduate programs on health sciences were analyzed by means of an exploratory development study conducted between January and December 2008. In the first phase, the participants were two teams consisting of one mentor and four students. In the second phase, there were three mentors and eight students. Thematic analysis on the students discourse emphasized their enthusiasm about the possibility of interprofessional collaboration as an instrument for change. The professional mentors were found to have developed a better understanding of their role and greater teaching awareness.

Os autores apresentam a dinâmica de trabalho dos mentores no interior da Liga de Saúde da Família, um programa de extensão que estimula a colaboração interprofissional, na perspectiva da aprendizagem social. O objetivo do estudo foi descrever e analisar a dinâmica do programa e suas repercussões entre os participantes. O contexto, os fundamentos, objetivos e a organização de situações de trabalho para estudantes de seis diferentes cursos de graduação em ciências da saúde são analisados por meio de uma pesquisa de desenvolvimento do objeto, exploratória, realizada de janeiro a dezembro de 2008. Na primeira fase participaram duas equipes com um mentor e quatro estudantes. Na segunda fase três mentores e oito estudantes. A análise temática do discurso dos estudantes ressaltou seu entusiasmo com as possibilidades da colaboração interprofissional como um instrumento de mudança. Dos mentores profissionais é possível apreender uma melhor compreensão do seu papel e uma maior sensibilidade pedagógica.

Los autores presentan la dinámica de trabajo de los mentores en el interior de la Liga de Salud de la Familia, un programa de extensión que estimula la colaboración inter-profesional en la perspectiva de aprendizaje social. El estudio describe y analiza la dinámica del programa y sus repercusiones entre los participantes. Contexto, fundamentos, objetivos y la organización de situaciones de trabajo para estudiantes de seis diferentes cursos de graduación en ciencias de salud se analizan por medio de una investigación de desarrollo del objeto realizada de enero a diciembre de 2008. El análisis temático del discurso de los estudiantes resalta su entusiasmo con las posibilidades de colaboración inter-profesional como un instrumento de cambio.