Practicing During the COVID-19 Pandemic: Experiences of Canadian Hospital-Based Occupational Therapists.

Background. The COVID-19 pandemic disrupted hospital operations worldwide, including services delivered by occupational therapists (OTs). Purpose. This study aimed to understand the experiences of OTs at one Canadian, tertiary care hospital during the 2021-2022 period of the pandemic. Method. We used a qualitative descriptive approach to describe the experiences of OTs during the pandemic. Findings. While there were similarities in the 10 participating OTs' experiences, salient differences were largely linked to the method of service delivery. Inpatient OTs benefitted from the support of colleagues and developed coping strategies in response to high levels of workplace stress and anxiety and a perceived lack of support from many levels of society. Clinically, they spent more time on discharge planning with fewer resources. OTs providing virtual/hybrid services experienced unique challenges related to adapting their practice to a virtual platform, including challenges assessing patients. They described benefits associated with virtual/hybrid service delivery and brought up concerns around equity of service provision. Conclusion. OTs in this hospital setting faced challenges in providing patient care and supporting their own wellness during the pandemic. Future research could explore the role of leadership in supporting occupational therapy practice during public health emergencies.

The Need to Prioritize Education and Resources to Support Exercise in Type 1 Diabetes: Results of an Australian Survey of Adults With Type 1 Diabetes and Health Providers.

OBJECTIVES: Regular exercise is recommended for people with type 1 diabetes (PWD) to improve their health, but many do not meet recommended exercise targets. Educational resources supporting PWD to exercise exist, but their value is unclear. To determine the need for improved exercise resources in Australia, we surveyed adult PWD and health providers (HPs) about their confidence in managing type 1 diabetes (T1D) around exercise, barriers to exercise, and the adequacy of current resources. METHODS: Australian adult PWD and HPs completed surveys to rate the importance of exercise in T1D management, confidence in managing T1D around exercise, barriers to giving and receiving education, resources used, and what form new resources should take. RESULTS: Responses were received from 128 PWD and 122 HPs. Both groups considered exercise to be important for diabetes management. PWD cited time constraints (57%) and concern about dysglycemia (43%) as barriers to exercise, and many lacked confidence in managing T1D around exercise. HPs were more confident, but experienced barriers to providing advice and PWD did not tend to rely on this advice. Instead, 72% of PWD found continuous glucose monitoring most helpful. Both groups desired better resources to support exercise in T1D, with PWD preferring to obtain information through a structured education program and HPs through eLearning. CONCLUSIONS: Australian HPs and PWD appreciate the importance of exercise in T1D management and express a clear desire for improved educational resources. Our findings provide a basis for developing a comprehensive package of resources for both adult PWD and HPs, to support PWD exercise.

Assessing the applicability and appropriateness of ChatGPT in answering clinical pharmacy questions.

OBJECTIVES: Clinical pharmacists rely on different scientific references to ensure appropriate, safe, and cost-effective drug use. Tools based on artificial intelligence (AI) such as ChatGPT (Generative Pre-trained Transformer) could offer valuable support. The objective of this study was to assess ChatGPT's capacity to correctly respond to clinical pharmacy questions asked by healthcare professionals in our university hospital. MATERIAL AND METHODS: ChatGPT's capacity to respond correctly to the last 100 consecutive questions recorded in our clinical pharmacy database was assessed. Questions were copied from our FileMaker Pro database and pasted into ChatGPT March 14 version online platform. The generated answers were then copied verbatim into an Excel file. Two blinded clinical pharmacists reviewed all the questions and the answers given by the software. In case of disagreements, a third blinded pharmacist intervened to decide. RESULTS: Documentation-related issues (n=36) and drug administration mode (n=30) were preponderantly recorded. Among 69 applicable questions, the rate of correct answers varied from 30 to 57.1% depending on questions type with a global rate of 44.9%. Regarding inappropriate answers (n=38), 20 were incorrect, 18 gave no answers and 8 were incomplete with 8 answers belonging to 2 different categories. No better answers than the pharmacists were observed. CONCLUSIONS: ChatGPT demonstrated a mitigated performance in answering clinical pharmacy questions. It should not replace human expertise as a high rate of inappropriate answers was highlighted. Future studies should focus on the optimization of ChatGPT for specific clinical pharmacy questions and explore the potential benefits and limitations of integrating this technology into clinical practice.

Health Professionals' Experiences Supporting People With Type 1 Diabetes Mellitus Who Deliberately Restrict and/or Omit Insulin for Weight, Shape, and/or Appearance: A Meta-synthesis.

OBJECTIVES: It has been reported that health professionals currently lack the required empathy, understanding, and knowledge about the deliberate restriction and/or omission of insulin to influence weight and/or shape, which may impact the quality of care provided. We sought to synthesize existing qualitative research pertaining to health professionals' experiences supporting individuals within this unique population. METHODS: We conducted a meta-synthesis using a meta-aggregative approach. We searched 5 electronic databases. Eligible articles were qualitative or mixed-methods empirical studies with primary data reporting health professionals' experiences supporting people with type 1 diabetes restricting and/or omitting insulin for weight and/or shape control, written in English, from database inception to March 2022. RESULTS: A final sample of 4 primary studies were included. The analysis indicated that in the absence of standardized screening and diagnostic tools, health professionals found it challenging to decide when behaviour became clinically significant. Health professionals were also challenged by complex perceptions and behaviours relating to their illness management and features of broader health-care systems and organizational factors. CONCLUSIONS: Our findings have widespread multidisciplinary implications for health professionals and the broader health-care systems in which they work. We provide evidence-based clinical recommendations and suggestions for vital future research.

Perceived stigma among Tunisian healthcare workers during the COVID-19 pandemic.

BACKGROUND AND OBJECTIVES: Stigma was a major issue during the COVID-19 pandemic. It posed a serious threat to the lives of healthcare workers (HCWs) who were expected to experience higher levels of stigma and increased psychological distress. This is the first survey to investigate forms and correlates of perceived stigma in Tunisian HCWs during the COVID-19 pandemic. METHODS: A cross-sectional web-based survey was conducted between October 8th and November 10th 2020, among 250 Tunisian HCWs. Data were collected using an online questionnaire using the Google Forms® platform. We used a self-reported instrument measuring COVID-19-related stigma, and the Multidimensional Scale of Perceived Social Support (MSPSS) to measure the perceived adequacy of social support from three sources: family, friends, and significant other. RESULTS: The mean stigma score was 18.6±8. Participants sometimes to often experienced stigma in their relationships with friends (22%), neighbors (27.2%), parents (22,4%), and in social activities (30.8%). This stigma was perceived mainly through avoidance (68.4%), and rarely through verbal (6%) or physical aggression (1.2%). The mean MSPSS total score was 5.26±1.24. In multivariate analysis, depression history (P<0.001), long working experience (P<0.001), having presented ageusia/anosmia (P=0.007) and lower total social support scale (P<0.001) were significantly associated with higher perceived stigma score. CONCLUSION: Our findings showed that HCWs perceived stigma in professional, societal and familial domains. Social support from family, friends and others seemed to protect against perceived stigma. Proper health education targeting the public appears to be an effective method to prevent social harassment of both HCWs and COVID-19 survivors.

Ambulatory Heart Function and Transplant Patients' Perceptions of Drug-Drug Interactions: A Qualitative Study.

Background: Drug-drug interactions (DDIs) can cause adverse drug events, leading to hospitalizations and an increase in the risk of morbidity and mortality. Until now, patients' perceptions of DDIs have represented an understudied area of research. Objectives: To explore patients' perceptions of DDIs and identify factors important to patients' understanding of their medications. Methods: Participants were recruited from 2 ambulatory clinics (heart function and transplant) in Vancouver, British Columbia. Participants engaged in key informant interviews and were asked to provide their demographic information, rate their understanding of their own medications, and define a DDI. Afterward, participants were interviewed to gather their perceptions of DDIs and factors important to their understanding of their medications. Results: A total of 7 patients were recruited. Participants struggled to define a DDI and were unsure if they had ever experienced a DDI. There was a reliance on health care professionals to help manage DDIs. Participants did not identify barriers preventing them from accessing medication information from health care professionals; however, they independently sought medication information found on the internet. Conclusions: Patients in this study had an incomplete understanding of DDIs and had difficulties differentiating DDIs from side effects of medications. As a result of their limited understanding of DDIs, patients relied on health care professionals to inform and manage their DDIs. Although patients did not identify barriers to accessing medication information, their pervasive use of the internet suggests that there are unidentified barriers preventing patients from speaking directly to their health care professionals regarding their medication therapy.

Contexte: Les interactions médicamenteuses (IM) peuvent provoquer des événements indésirables, entraínant des hospitalisations et une augmentation du risque de morbidité et de mortalité. Jusqu'à présent, les perceptions des patients concernant les IM représentaient un domaine de recherche sous-étudié. Objectifs: Explorer les perceptions des patients à l'égard des IM et recenser les facteurs importants pour qu'ils comprennent leurs médicaments. Méthodes: Les participants ont été recrutés dans deux cliniques ambulatoires (de la fonction cardiaque et de transplantation) à Vancouver, en Colombie-Britannique. Ils ont participé à des entretiens à titre d'informateurs clés et ont été invités à fournir leurs informations démographiques, à évaluer leur niveau de compréhension de leurs médicaments et à définir ce qu'on entend par « IM ¼. Par la suite, les participants ont été interrogés pour savoir comment ils percevaient les IM et pour recenser des facteurs importants leur permettant de comprendre leurs médicaments. Résultats: Au total, 7 patients ont été recrutés. Les patients avaient du mal à définir une IM et ne savaient pas s'ils avaient déjà vécu une IM. Ils comptaient ainsi sur les professionnels de la santé pour les aider à les gérer. Les patients n'ont identifié aucun obstacle les empêchant d'accéder aux informations sur les médicaments fournis par les professionnels de la santé; cependant, ils ont, de manière indépendante, cherché des informations sur les médicaments sur Internet. Conclusions: Les patients de cette étude avaient une compréhension limitée des IM et avaient des difficultés à faire la différence entre les IM et les effets secondaires des médicaments. En raison de cette compréhension limitée, les patients comptaient sur les professionnels de la santé pour les informer et gérer leurs IM. Bien que les patients n'aient pas signalé d'obstacles les empêchant d'accéder aux informations sur les médicaments, leur utilisation systématique d'Internet suggère que des obstacles non identifiés les empêchaient de parler directement à leurs professionnels de la santé au sujet de leur traitement médicamenteux.

Factors associated with secondary traumatic stress and burnout in neonatal care staff: A cross-sectional survey study.

INTRODUCTION: High rates of secondary traumatic stress and burnout have been found across nursing populations. However, few studies have focused on neonatal staff. OBJECTIVE: The objectives of this article are to explore the prevalence and severity of secondary traumatic stress (STS) and burnout in neonatal staff, and identify risk factors and protective factors for STS and burnout within this population with the aim of informing future staff support. METHODS: A quantitative, cross-sectional study using a survey design was conducted; 246 neonatal staff reported measures of STS, burnout, self-compassion and satisfaction with ward climate. RESULTS: Neonatal staff reported high rates of moderate-severe STS and burnout. STS and burnout were negatively associated with self-compassion and satisfaction with ward climate, suggesting them to be protective factors against STS and burnout. STS was found to be a risk factor for burnout and vice versa. CONCLUSION: Interventions that increase understanding of STS and burnout, nurture self-compassion, provide support and enhance stress management could help mitigate the impact of STS and burnout amongst neonatal staff.

A pandemia COVID-19 em 3 atos: a visão de uma profissional de saúde / La pandémie COVID-19 en 3 actes: le point de vue d'um professionnel de la santé / The COVID-19 pandemic in 3 acts: a health professional's view:

Pandemias são conhecidas e descritas desde a antiguidade. As marcas físicas e psicológicas deixadas por essas doenças que atravessam fronteiras e continentes são objeto de inúmeros estudos científicos. No entanto, as experiências são individuais. A pandemia COVID-19 trouxe abalos psíquicos intensos para cada pessoa envolvida com ela, seja por ter ficado doente, por ter algum parente doente, ou por ter trabalhado no seu enfrentamento. Inúmeros profissionais de saúde continuam vivendo essa montanha russa de sentimentos e a forma como cada um irá "costurar" essa cadeia de emoções poderá ter reflexos no quotidiano deste momento em diante. Ignorância, ansiedade, angústia, impotência, tristeza, raiva, decepção, medo, empatia, entre outros estados psíquicos, serão abordados ao longo deste texto escrito por uma profissional de saúde da linha de frente contra a COVID-19, mesclando dados científicos e momentos vividos

Les pandémies sont connues et décrites depuis l'Antiquité. Les marques physiques et psychologiques que' elles laissent, font l'objet de plusieurs études scientifiques. Cependant, les expériences sont individuelles, chacun ressent ce qui est vécu différemment. La pandémie COVID-19 a apporté des experiénces à chaque être humain impliqué, soit d'avoir tombé malade ou d'avoir de la famille malade, soit parce qu'il travaillait dans les soins de la maladie. D' innombrables professionels de la santé continuent a vivre cette confusion de sentiments et la façon dont chacun va unir les liens de cette chaîne d'emotions peut avoir des répercussions dans la vie de tous les jours à partir de ce moment de. Plusieurs états psychiques, tel que: l' ignorance, l'anxiété, l'angoisse, l'impuissance, la tristesse, la colère, la déception, la peur, l'empathie, seront abordés tout au long de ce texte rédigé par un professionel de santé impliqué dans le combat contre le COVID-19, à l'aide de données scientifiques et de récits d'expériences

Pandemics have been known and described since ancient times. The physical and psychological marks that these diseases, which cross borders and continents leave, are addressed in several scientific studies. However, the experiences are individual and each one sees and feels them differently. The COVID-19 pandemic professionals continue to experience this roller coaster of feelings and the way each one will assemble this chain of emotions may have repercussions in everyday life from this moment on. Feelings of ignorance, anxiety, impotence, sadness, anger, disappointment, fear, empathy, will be addressed throughout this text written by a frontline health professional against COVID-19, mixing scientific data and reports from personal experiences

"Mental Health Professionals Have Never Mentioned My Diabetes, They Don't Get Into That": A Qualitative Study of Support Needs in Adults With Type 1 and Type 2 Diabetes and Severe Mental Illness.

OBJECTIVES: People with severe mental illness (SMI) have a 2- to 3-fold higher risk of developing type 2 diabetes (DM), an increased risk of subsequent DM complications, higher mortality and poorer health-related quality of life. Although mental health professionals have an important role in supporting people with SMI in diabetes management, their primary focus is often on mental health, not physical conditions. Few studies have investigated patients' experiences of living with coexisting SMI and DM to identify their needs for diabetes support from mental health professionals. METHODS: Semistructured interviews were conducted with 15 adults with SMI and DM. Interviews were transcribed and analyzed using systematic text condensation. RESULTS: Five themes emerged from the data: 1) mental illness overshadows diabetes management, 2) mental state substantially influences diabetes care, 3) daily diabetes routines are challenging to maintain, 4) diabetes is burdensome and 5) dialogue about diabetes with mental health professionals is infrequent. CONCLUSIONS: Self-managing DM is extremely complex for patients who also live with SMI. Diabetes care is strongly influenced by emotional and mental states and the ability to establish daily routines. A need exists to enhance support from mental health professionals to improve DM self-management among people with mental illness. The present findings can inform the development of tailored interventions to support people with mental illness in DM self-management.

Coverage and adherence of antiretroviral therapy among Chinese HIV-positive men who have sex with men with high CD4 counts in the era of 'Treat all'.

OBJECTIVES: HIV-positive men who have sex with men (MSM) with CD4 cell counts> 350 cells/mm3 in China recently became eligible for free antiretroviral therapy (ART) due to updated national guidelines. This study aimed to investigate ART coverage and adherence among a large sample of HIV-positive MSM in China. METHODS: A cross-sectional survey was conducted in Chengdu and Hangzhou, China, from February to November 2016. Participants were 277 MSM who had received a confirmatory HIV diagnosis and had CD4 levels of> 350 cells/mm3 . Trained staff of collaborating non-governmental organizations contacted all HIV-positive MSM listed in their service records and invited them to join the study. The ART initiation, ART adherence and interactions between healthcare professionals and the patients were assessed. RESULTS: ART coverage was 60.3%. Among those who were on ART (n = 167), no participants reported missing any doses in the last four days, but 25.7% reported non-compliance to either ART dosing schedule or dosage instructions. After adjusting for background variables and perceived eligibility for ART, two variables were significant factors of higher ART coverage: (i) receiving a recommendation from healthcare professionals for immediate ART initiation and (ii) perceiving having received an adequate explanation of potential harms of ART. Being prescribed> 3 pills per dose and not having a temporary resident permit were associated with non-compliance. CONCLUSIONS: Significant efforts are needed to increase ART coverage among HIV-positive MSM with high CD4 counts in China. Although prevalence of missing doses was low, non-compliance to dosing schedule/instructions should not be neglected. Interactions between healthcare professionals and MSMs play an important role in facilitating ART initiation.

OBJECTIFS: Les hommes VIH positifs ayant des rapports sexuels avec des hommes (HSH) avec un taux de cellules CD4 >350 cellules/mm3 en Chine sont récemment devenus éligibles à la thérapie antirétrovirale (ART) gratuite à la suite de la mise à jour des directives nationales. Cette étude visait à étudier la couverture et la compliance à l'ART dans un large échantillon de HSH VIH positifs en Chine. MÉTHODES: Etude transversale menée à Chengdu et Hangzhou, en Chine de février à novembre 2016. Les participants étaient 277 HSH qui avaient reçu un diagnostic de confirmation du VIH et avaient un taux de CD4 >350 cellules/mm3 . Le personnel formé d'organisations non gouvernementales collaboratrices a contacté tous les HSH positifs pour le VIH répertoriés dans les dossiers de leurs services et les ont invité à prendre part à l'étude. L'initiation de l'ART, la compliance à l'ART et les interactions entre les professionnels de santé et les patients ont été évaluées. RÉSULTATS: La couverture de l'ART était de 60,3%. Parmi ceux qui étaient sous ART (n = 167), aucun participant n'a déclaré avoir manqué de prises au cours des quatre derniers jours, mais 25,7% ont déclaré un manque de compliance soit vis-à-vis du schéma posologique de l'ART ou aux instructions de dosage. Après ajustement pour les variables de base et l'éligibilité perçue pour l'ART, deux variables étaient des facteurs significatifs d'une couverture ART plus élevée: (1) le fait de recevoir une recommandation des professionnels de la santé pour l'initiation immédiate de l'ART et (2) la perception d'avoir reçu une explication adéquate sur les méfaits potentiels de l'ART. Avoir été prescrit >3 comprimés par dose et ne pas detenir un permis de séjour temporaire était associé à la non-compliance. CONCLUSIONS: Des efforts importants sont nécessaires pour augmenter la couverture de l'ART chez les HSH positifs pour le VIH ayant un taux élevé de CD4 en Chine. Bien que la prévalence des doses manquantes ait été faible, la non-compliance au calendrier/instructions posologiques ne doit pas être négligée. Les interactions entre les professionnels de la santé et les HSH jouent un rôle important dans la facilitation de l'initiation de l'ART.

Narrando histórias, coreografando emoções, no trabalho com o nascimento, a dor e a morte de crianças no hospital / Telling stories and choreographing emotions, at hospital work involving the birth, pain and death of children / Produire des récits, chorégraphier des émotions au travail avec la naissance, la douleur et la mort d'enfants à l'hôpital / Narrando historias, coreografiando emociones, en el trabajo con el nacimiento, el dolor y la muerte de niños en el hospital

Trata-se de uma pesquisa qualitativa baseada em narrativas produzidas por meio de entrevistas e oficinas. O estudo pretende demonstrar como profissionais de saúde de sete especialidades de uma UTI neonatal e pediátrica de um Hospital Público Municipal, no interior do Rio de Janeiro, identificam sinais de sofrimento no trabalho. Esses profissionais lidam com nascimento, dor e morte de crianças, mas não incluem essa experiência como parte integrante de seus cotidianos de trabalho. Aposta-se que o uso de narrativas seja um dispositivo capaz de incluir as dimensões da experiência dos quais tenta-se afastar, bem como produzir conhecimentos sobre a vida e a morte nos processos de trabalho.

This paper describes a qualitative research based on narratives collected by means of interviews and workshops. It aims to reveal in what way health professionals from seven specialties of a neonatal and pediatric ICU of a Municipal Public Hospital in the interior of Rio de Janeiro identify signs of suffering at work. These professionals deal with the birth, pain and death of children, but do not include this experience as an integral part into their daily work. We believe that the use of narratives is a device that allows to incorporate the dimensions of these denied experiences and to produce knowledge about life and death in work processes.

Cette recherche qualitative est basée sur des récits produits à travers d'entretiens et d'ateliers. L'étude a pour but de démontrer de quelle façon des professionnels de la santé de sept spécialités d'une unité de soins intensifs néonatals et pédiatriques d'un hôpital public municipal à l'intérieur de l'état de Rio de Janeiro identifient les signes de souffrance au travail. Ces professionnels sont confrontés à la naissance, la douleur et au décès d'enfants, mais ils n'incluent pas cette expérience dans leur travail quotidien. Nous concluons que la production de récits leur permet d'intégrer les dimensions de l'expérience desquelles ils essaient de se distancer, ainsi que de produire des connaissances sur la vie et la mort au travail.

Se trata de una investigación cualitativa basada en narrativas, producidas mediante encuestas y talleres. El estudio pretende demostrar de qué forma los profesionales de salud de siete especialidades de una UCI neonatal y pediátrica de un hospital público municipal, en el interior de Río de Janeiro, identifican señales de sufrimiento en el trabajo. Estos profesionales se enfrentan con el nacimiento, el dolor y la muerte de niños, pero no incluyen esta experiencia como parte integrante de su vida cotidiana de trabajo. Se apuesta a que el uso de narrativas sea un dispositivo capaz de incluir las dimensiones de la experiencia de las que intenta alejarse, así como producir conocimientos sobre la vida y la muerte en los procesos de trabajo.

Dieser Artikel beschreibt eine qualitative Studie, die auf Erzählungen basiert, die während Interviews und Workshops gesammelt wurden. Die Studie stellt dar, wie Gesundheitspersonal von sieben Fachgebieten einer neonatalen und pädiatrischen Intensivstation eines städtischen Krankenhauses im Inland des Staates von Rio de Janeiro Anzeichen von Leiden bei der Arbeit erkennen. Dieses Personal ist der Geburt, den Schmerzen und dem Tod von Kindern ausgesetzt, berücksichtigt diese Erfahrungen jedoch nicht als wesentlichen Bestandteil seiner täglichen Arbeit. Die Verwendung von Erzählungen ist hier ein Mittel, um die Dimensionen dieser Erfahrungen, die man zu vermeiden versucht, zu verarbeiten (Bruner, 1991) und Wissen über Leben und Tod anhand von Arbeitsprozessen zu produzieren.

Exploring Professionals' Experiences in the Rehabilitation of Older Clients with Dual-Sensory Impairment.

En vue de mieux comprendre et d'améliorer le processus de réadaptation des personnes âgées présentant à la fois une déficience auditive et visuelle, soit une double déficience sensorielle (DDS), cette étude s'est penchée sur les perspectives des professionnels de la santé qui œuvrent chez cette population. Treize professionnels aux parcours variés ont été interviewés en lien avec leur expérience de travail auprès de personnes âgées avec DDS. Les entrevues ont été transcrites et codées, et une analyse de contenu a été effectuée. Les participants des diverses professions ont perçu qu'ils devaient assumer les rôles additionnels suivants : (1) conseiller, (2) guide, (3) formateur ou rééducateur. Ces rôles consistaient à aider les personnes avec DDS et leurs familles présentant une dépression, des problèmes d'acceptation, des consultations répétées et des parcours complexes dans le système de santé. Selon les professionnels interviewés, ces rôles supplémentaires accroissent leur charge de travail et les confrontent à des problématiques pour lesquelles ils n'ont pas reçu de formation. Ils suggèrent l'implantation d'une formation sur les DDS pour les professionnels et les membres de la famille concernés, ainsi qu'une approche de réadaptation en équipe multidisciplinaire.To better understand and improve the rehabilitation process of older adults with sensory losses in both hearing and vision or dual sensory impairment (DSI), this study explored the perspectives of health care professionals who work with this population. Thirteen individuals, with varied professional backgrounds, were interviewed about their experiences in working with older adults with DSI. We transcribed and coded the interviews, then conducted content analysis. Regardless of their professional backgrounds, the participants reported additional roles that they perceived they fulfilled: (a) counsellor, (b) navigator, and (c) trainer and re-trainer. These roles involved helping individuals with DSI, and their family, with depression, acceptance, repeat consultations, and way-finding through the health system. From the professionals' perspective, these additional roles increase workload and place them in situations they were not trained for. They suggest education for all professionals and for family members working with people with DSI; moreover, they suggest a multidisciplinary team rehabilitation approach.

Educator Readiness to Improve Gerontological Curricula in Health and Social Service Education.

This study investigated the state of gerontology content in health and social service education programs in Ontario, and readiness indicators for change among administrators and faculty. We conducted a survey of teaching faculty (n = 100) and deans or directors (n = 56) of 89 education programs, which revealed mixed evidence on readiness for change. Most respondents thought their programs were adequate but needed enhancement. However, they were unaware of published gerontological competencies with which to evaluate their curricula. Beliefs about capacity for change varied, with half the participants indicating that their programs had sufficient faculty expertise in gerontology and geriatrics. Factors influencing readiness for change include lack of gerontological expertise; need for institutional and management support; need for additional teaching resources; and recognizing the need for change. There is an opportunity, by committing resources and time, to capitalize on the faculty and administrators who thought their programs should improve.

[Social representations of illness: Comparison of "expert" knowledge and "naïve" knowledge]. / Représentations sociales de la maladie : comparaison entre savoirs « experts ¼ et savoirs « profanes ¼.

INTRODUCTION: The link between social practices and representations is now well known. But while many studies have focused on the social representation of mental illness, in various populations, few studies have focused on the notion of disease/illness by comparing professionals and non-professionals health workers representations. Indeed, the disease is both a reality described, explained and treated by medicine; for those who are affected by a disease, it is an individual experience with psychological, social and cultural impacts. The social representation is determined by the structure of the social groups in which it develops; therefore, it is a form of knowledge socially shaped and shared by the members of a social group. Several theoretical extensions have been elaborated and particularly, the structural approach and the central core theory. These approaches sustain the arguments of a hierarchical organization of a social representation with a central core surrounded by peripheral zones. The central core is common and shared by the majority of the members of a given group, whereas the peripheral zones provide space for the individualization of the social knowledge. PURPOSE: The main goal of our study is to highlight the social representations of disease in health professionals (HP) and in non-health professionals (NHP). The group of HP has been differentiated into three subgroups: "medical doctors", "nurses" and "pharmacists", while that of NHP in two subgroups: those submitted to a "long period medical treatment" and those "without treatment". Our aim is to show that there are different social and professional Representations of disease. The professional representations are specific social representations related to professional contexts. We formulate the following assumptions (a) that the social representations of HP and NHP will be articulated around a common central core. Nevertheless, we expect to find specific peripheral elements related to professional status, based on different knowledge and a differentiated "practice"; (b) the HP should refer to more descriptive aspects of the disease and monitoring of patients, while (c) NHP should refer more to the experience of illness around emotional aspects. METHOD: Our sample is composed of 270 participants (135 HP and 135 HNP). Representations are measured by a free association task based on the target term: disease. The data have been submitted to prototypical and categorical analyses in agreement with the central core theory. RESULTS AND DISCUSSION: The results confirm that there is a common social representation of disease shared by the two groups, which refers essentially to suffering and pain. The analysis of each group brings to light two different registers: the one of the HP with more descriptive words referring to the nature and the illness's characteristics, and the other ones of the HNP with more words connected to emotions and referring to personal real experience of the illness. As expected, the social representation of the HP is referring to the "professional representations" of the disease, while the one for the HNP is linked to "practices" of an illness. An analysis of intra-group differences shows specificities for each of the questioned subgroups. In the HP, medical doctors focus on the diagnosis and consequences of the disease, pharmacists refer to the treatment of the disease and its management, while nurses focus on the treatment and on the relation while monitoring patients. In the NHP, people submitted to a "long period medical treatment" refer to the emotional aspects and to the consequences of the illness on their live, while those without treatment use more descriptive and formal terms. These results suggest to the PS to expand exchanges related to the disease in order to facilitate communication centered on taking care of the patient, considered in its wholeness and not only as an actual or potential patient. This is an important step in improving the health of the patient.

An Integrative Review of the Literature on Pain Management Barriers: Implications for the Canadian Clinical Context.

Despite decades of pain research, substandard pain management continues to be distressingly prevalent across health-care settings. This integrative literature review analyzes and synthesizes barriers to effective pain management and identifies areas for future investigation in a Canadian context. Three sets of key barriers were identified through thematic analysis of 24 original research studies published in the period 2003-13: patient, professional, and organizational. These barriers rarely occurred in isolation, with many studies reporting examples in all three categories. This suggests that interventions need to reflect the multifactorial nature of pain management. Reframing pain education as a public health initiative could lead to sustainable improvement, as could the strengthening of partnerships between patients and health-care providers. There are tremendous opportunities for the advanced practice nurse to take a lead in pain management. The delivery of high-quality care that encompasses effective pain management strategies must be a priority for nursing. Research approaches, such as pragmatic mixed methods, that offer contextual understanding of how pain is managed are suggested.

Bien que la question de la douleur ait fait l'objet de recherches depuis plusieurs décennies, la douleur est encore très mal gérée dans la plupart des milieux de la santé. Le présent examen par intégration de la littérature analyse et fait la synthèse des obstacles qui empêchent une gestion efficace de la douleur et identifie des domaines qui devront faire l'objet d'études en contexte canadien. Trois types d'obstacles ont été identifiés à l'aide d'une analyse thématique de 24 études originales publiées entre 2003 et 2013: ceux qui relèvent du patient, ceux d'ordre professionnel et ceux de nature organisationnelle. Ces obstacles se manifestent rarement de façon isolée et nombre d'études offrent des exemples des trois types, ce qui suggère que les interventions doivent refléter la nature multifactorielle de la gestion de la douleur. Le recadrage de l'éducation en matière de douleur dans le cadre d'une initiative de santé publique pourrait mener à des améliorations durables, tout comme le renforcement des partenariats entre les patients et les professionnels de la santé. Les occasions qui s'offrent aux infirmières en pratique avancée de jouer un rôle de premier plan en matière de gestion de la douleur sont immenses. La prestation de soins de grande qualité qui s'appuient sur des stratégies de gestion de la douleur efficaces doit être une priorité en soins infirmiers. Les auteures suggèrent l'adoption d'approches de recherche offrant une compréhension contextuelle de la gestion de la douleur, telles les méthodes mixtes pragmatiques.

Cuidados paliativos: o desafio das equipes de saúde / Palliative care: The challenge of health teams / Cuidados paliativos: el reto de los equipos de salud / Soins palliatifs: le défi des équipes de santés

O avanço tecnológico possibilitou tanto a redução da morte quanto o prolongamento da vida. Essa última traz consigo a necessidade de se pensar em como cuidar de pessoas fora de perspectiva de cura, especialmente porque tal cuidado inclui aspectos psicossociais, com implicações tanto para as relações entre os profissionais quanto com o paciente e sua família. Este estudo teve como objetivo buscar na literatura nacional artigos sobre equipes de saúde que oferecem cuidados paliativos. Realizou-se uma revisão de produção em periódicos nacionais com os descritores cuidados paliativos, equipe de saúde e neonatologia. Foram identificados 62 trabalhos, porém somente 11 atenderam ao critério de relacionar pelo menos dois descritores. Nenhum artigo relacionou as três palavras-chaves. O baixo número de publicações evidencia a necessidade de mais pesquisas nessa área, pois proporcionar qualidade de vida desde o diagnóstico da doença até o momento do óbito representa grande estresse para os profissionais de saúde.(AU)

Technological advances in neonatology enabled the reduction of both death and life extension. The latter brings with it the need to think about how to care for people diagnosed with incurable disease, especially since such care includes psychosocial aspects, with implications for the relationships between professionals and with the patient and his family. This study aimed to look at national literature articles on health teams providing palliative care in neonatology. We conducted a literature review in national journals with descriptors palliative care, health team and neonatology. We identified 62 studies, but only 11 met the criteria relate at least two descriptors. No article listed the three keywords. The low number of publications highlights the need for more research in this area, since to provide quality of life since the disease diagnosis to the time of death is great stress for health professionals.(AU)

Los avances tecnológicos en neonatología permitieron tanto la reducción de la muerte como la prolongación de la vida. Este último trae consigo la necesidad de pensar en cómo cuidar a las personas por fuera de una perspectiva de cura, sobre todo porque esa atención incluye aspectos psicosociales, con implicaciones tanto para las relaciones entre los profesionales y con el paciente y su familia. Este estudio tuvo como objetivo examinar artículos de literatura nacionales sobre equipos de salud que se ocupan de cuidados paliativos en neonatología. Se realizó una revisión bibliográfica en revistas nacionales con los descriptores: cuidados paliativos, equipo de salud y neonatología. Se identificaron 62 estudios, pero sólo 11 cumplieron con los criterios de relacionar al menos dos descriptores. Ningún artículo relacionó las tres palabras clave. El bajo número de publicaciones destaca la necesidad de realizar más investigaciones en esta área, pues proporcionar calidad de vida a partir del diagnóstico la enfermedad hasta la fecha de la muerte representa un gran estrés para los profesionales de la salud.(AU)

Les progrès technologiques en néonatologie a permis de réduire à la fois la mort et la prolongation de la vie. Celui-ci apporte avec elle la nécessité de réfléchir à la façon de prendre soin de personnes à l'extérieur d'effectuer une cure, d'autant plus que ces soins comporte des aspects psychosociaux, avec des implications tant pour les relations entre les professionnels et avec le patient et sa famille. Cette étude visait à examiner les articles de la littérature sur les équipes nationales de santé dispensant des soins palliatifs en néonatologie. Nous avons effectué une revue de la littérature dans des revues nationales avec les descripteurs palliatifs équipe soignante et de néonatologie. Nous avons identifié 62 études, mais seulement 11 répondaient aux critères portent sur au moins deux descripteurs. Aucun article énuméré les trois mots-clés. Le faible nombre de publications met en évidence la nécessité de poursuivre les recherches dans ce domaine, depuis fournir une qualité de vie à partir du diagnostic de la maladie à la date du décès est un grand stress pour les professionnels de la santé.(AU)

Cuidados paliativos: o desafio das equipes de saúde / Palliative care: The challenge of health teams / Cuidados paliativos: el reto de los equipos de salud / Soins palliatifs: le défi des équipes de santés

O avanço tecnológico possibilitou tanto a redução da morte quanto o prolongamento da vida. Essa última traz consigo a necessidade de se pensar em como cuidar de pessoas fora de perspectiva de cura, especialmente porque tal cuidado inclui aspectos psicossociais, com implicações tanto para as relações entre os profissionais quanto com o paciente e sua família. Este estudo teve como objetivo buscar na literatura nacional artigos sobre equipes de saúde que oferecem cuidados paliativos. Realizou-se uma revisão de produção em periódicos nacionais com os descritores cuidados paliativos, equipe de saúde e neonatologia. Foram identificados 62 trabalhos, porém somente 11 atenderam ao critério de relacionar pelo menos dois descritores. Nenhum artigo relacionou as três palavras-chaves. O baixo número de publicações evidencia a necessidade de mais pesquisas nessa área, pois proporcionar qualidade de vida desde o diagnóstico da doença até o momento do óbito representa grande estresse para os profissionais de saúde...

Technological advances in neonatology enabled the reduction of both death and life extension. The latter brings with it the need to think about how to care for people diagnosed with incurable disease, especially since such care includes psychosocial aspects, with implications for the relationships between professionals and with the patient and his family. This study aimed to look at national literature articles on health teams providing palliative care in neonatology. We conducted a literature review in national journals with descriptors palliative care, health team and neonatology. We identified 62 studies, but only 11 met the criteria relate at least two descriptors. No article listed the three keywords. The low number of publications highlights the need for more research in this area, since to provide quality of life since the disease diagnosis to the time of death is great stress for health professionals...

Los avances tecnológicos en neonatología permitieron tanto la reducción de la muerte como la prolongación de la vida. Este último trae consigo la necesidad de pensar en cómo cuidar a las personas por fuera de una perspectiva de cura, sobre todo porque esa atención incluye aspectos psicosociales, con implicaciones tanto para las relaciones entre los profesionales y con el paciente y su familia. Este estudio tuvo como objetivo examinar artículos de literatura nacionales sobre equipos de salud que se ocupan de cuidados paliativos en neonatología. Se realizó una revisión bibliográfica en revistas nacionales con los descriptores: cuidados paliativos, equipo de salud y neonatología. Se identificaron 62 estudios, pero sólo 11 cumplieron con los criterios de relacionar al menos dos descriptores. Ningún artículo relacionó las tres palabras clave. El bajo número de publicaciones destaca la necesidad de realizar más investigaciones en esta área, pues proporcionar calidad de vida a partir del diagnóstico la enfermedad hasta la fecha de la muerte representa un gran estrés para los profesionales de la salud...

Les progrès technologiques en néonatologie a permis de réduire à la fois la mort et la prolongation de la vie. Celui-ci apporte avec elle la nécessité de réfléchir à la façon de prendre soin de personnes à l'extérieur d'effectuer une cure, d'autant plus que ces soins comporte des aspects psychosociaux, avec des implications tant pour les relations entre les professionnels et avec le patient et sa famille. Cette étude visait à examiner les articles de la littérature sur les équipes nationales de santé dispensant des soins palliatifs en néonatologie. Nous avons effectué une revue de la littérature dans des revues nationales avec les descripteurs palliatifs équipe soignante et de néonatologie. Nous avons identifié 62 études, mais seulement 11 répondaient aux critères portent sur au moins deux descripteurs. Aucun article énuméré les trois mots-clés. Le faible nombre de publications met en évidence la nécessité de poursuivre les recherches dans ce domaine, depuis fournir une qualité de vie à partir du diagnostic de la maladie à la date du décès est un grand stress pour les professionnels de la santé...

Religiosidade e espiritualidade em oncologia: concepções de profissionais da saúde / Religiosity and spirituality in oncology: Health Professionals' conceptions / Religiosidad y espiritualidad en oncología: Concepciones de profesionales de la salud / Religiosité, spiritualité en oncologie: concepts de professionnels de la santé

A literatura especializada vem identificando influências positivas e negativas de crenças religiosas e espirituais no enfrentamento de enfermidades, tais como o câncer. Sendo assim, a presente investigação teve como objetivo conhecer, analisar e compreender as concepções de profissionais da saúde acerca da associação entre religiosidade, espiritualidade e saúde em Oncologia. Em uma primeira etapa, utilizou-se um questionário eletrônico, respondido por 85 profissionais. Na etapa posterior, sete profissionais participaram de grupos focais online. Os resultados indicaram que aproximadamente metade dos participantes da primeira etapa não praticam atividades religiosas. Porém, 85% revelaram grau elevado de espiritualidade. Temas religiosos/ espirituais são frequentes nos atendimentos. Os integrantes dos grupos relataram não ter recebido formação acadêmica para abordar a temática. Em suma, os participantes evidenciaram concepções positivas sobre a influência da religiosidade/espiritualidade para a saúde, com efeitos negativos em menor proporção. Pesquisas futuras podem subsidiar programas destinados à capacitação dos futuros profissionais da área oncológica.(AU)

Specialized literature has been identifying positive and negative influences of religious and spiritual beliefs in coping with diseases such as cancer. Therefore, this research aimed to identify, analyze and understand the concepts of health professionals in regards to the association amongst religiosity, spirituality and health in Oncology. In an initial stage, an electronic questionnaire was answered by 85 professionals. In the later stage, seven professionals participated in online focus groups. Results indicated that approximately half of the participants of the first stage do not practice religious activities. However, 85% revealed a high degree of spirituality. Religious/spiritual themes are common in clinical setting. Group members reported not having received academic training to address such issues. Nonetheless, participants showed positive views as to the influence of religiosity/spirituality on health, with negative effects to a lesser extent. Further studies may support programs aimed at training future professionals in the field of oncology.(AU)

La literatura especializada viene identificando influencias positivas y negativas de creencias religiosas y espirituales en el enfrentamiento de enfermedades, como el cáncer. La presente investigación objetivó conocer, analizar y comprender las concepciones de profesionales de salud respecto a la asociación entre religiosidad, espiritualidad y salud en Oncología. Primeramente, se utilizó un cuestionário electrónico que fue contestado por 85 profesionales. Posteriormente, siete profesionales participaron de grupos focales online. Los resultados indicaron que aproximadamente la mitad de los participantes de la primera etapa no practican actividades religiosas. Todavía, 85% revelaron alto grado de espiritualidad. Temas religiosos/espirituales son frecuentes en los atendimientos. Los integrantes del los grupos relataron que no recibieron formación academica para abordar la temática. En suma, los participantes evidenciaron concepciones positivas sobre la influencia de la religiosidad/espiritualidad a la salud, con efectos negativos en menor proporción. Futuras investigaciones pueden apoyar programas de capacitación de futuros profesionales en la Oncología.(AU)

Plusieurs études soulèvent des influences positives et négatives des croyances religieuses et spirituelles pour faire face à des maladies comme le cancer. Ainsi, cette recherche vise à comprendre et analyser les idées de professionnels de la santé sur l›association religiosité, spiritualité et santé, en Oncologie. Dans un premier temps, on a utilisé un questionnaire électronique, qui a été répondu par 85 professionnels. Ensuite, sept professionnels ont participé aux groupes de discussion en ligne. À peu prés la moitié de l´échantillon n'a pas des activités religieuses. Toutefois, 85% a montré un haut degré de spiritualité. Thèmes religieux/spirituel sont fréquents dans les consultations. Les membres des groupes ont déclaré ne pas avoir de formation pour traiter des questions semblables. En somme, les professionnels ont une opinion positive sur la religiosité, mais reconnaissent aussi ses effets indésirables. Des recherches sont encore nécessaires pour mieux baser la formation du personnel en Oncologie.(AU)

Religiosidade e espiritualidade em oncologia: concepções de profissionais da saúde / Religiosity and spirituality in oncology: Health Professionals' conceptions / Religiosidad y espiritualidad en oncología: Concepciones de profesionales de la salud / Religiosité, spiritualité en oncologie: concepts de professionnels de la santé

A literatura especializada vem identificando influências positivas e negativas de crenças religiosas e espirituais no enfrentamento de enfermidades, tais como o câncer. Sendo assim, a presente investigação teve como objetivo conhecer, analisar e compreender as concepções de profissionais da saúde acerca da associação entre religiosidade, espiritualidade e saúde em Oncologia. Em uma primeira etapa, utilizou-se um questionário eletrônico, respondido por 85 profissionais. Na etapa posterior, sete profissionais participaram de grupos focais online. Os resultados indicaram que aproximadamente metade dos participantes da primeira etapa não praticam atividades religiosas. Porém, 85% revelaram grau elevado de espiritualidade. Temas religiosos/ espirituais são frequentes nos atendimentos. Os integrantes dos grupos relataram não ter recebido formação acadêmica para abordar a temática. Em suma, os participantes evidenciaram concepções positivas sobre a influência da religiosidade/espiritualidade para a saúde, com efeitos negativos em menor proporção. Pesquisas futuras podem subsidiar programas destinados à capacitação dos futuros profissionais da área oncológica.

Specialized literature has been identifying positive and negative influences of religious and spiritual beliefs in coping with diseases such as cancer. Therefore, this research aimed to identify, analyze and understand the concepts of health professionals in regards to the association amongst religiosity, spirituality and health in Oncology. In an initial stage, an electronic questionnaire was answered by 85 professionals. In the later stage, seven professionals participated in online focus groups. Results indicated that approximately half of the participants of the first stage do not practice religious activities. However, 85% revealed a high degree of spirituality. Religious/spiritual themes are common in clinical setting. Group members reported not having received academic training to address such issues. Nonetheless, participants showed positive views as to the influence of religiosity/spirituality on health, with negative effects to a lesser extent. Further studies may support programs aimed at training future professionals in the field of oncology.

La literatura especializada viene identificando influencias positivas y negativas de creencias religiosas y espirituales en el enfrentamiento de enfermedades, como el cáncer. La presente investigación objetivó conocer, analizar y comprender las concepciones de profesionales de salud respecto a la asociación entre religiosidad, espiritualidad y salud en Oncología. Primeramente, se utilizó un cuestionário electrónico que fue contestado por 85 profesionales. Posteriormente, siete profesionales participaron de grupos focales online. Los resultados indicaron que aproximadamente la mitad de los participantes de la primera etapa no practican actividades religiosas. Todavía, 85% revelaron alto grado de espiritualidad. Temas religiosos/espirituales son frecuentes en los atendimientos. Los integrantes del los grupos relataron que no recibieron formación academica para abordar la temática. En suma, los participantes evidenciaron concepciones positivas sobre la influencia de la religiosidad/espiritualidad a la salud, con efectos negativos en menor proporción. Futuras investigaciones pueden apoyar programas de capacitación de futuros profesionales en la Oncología.

Plusieurs études soulèvent des influences positives et négatives des croyances religieuses et spirituelles pour faire face à des maladies comme le cancer. Ainsi, cette recherche vise à comprendre et analyser les idées de professionnels de la santé sur l›association religiosité, spiritualité et santé, en Oncologie. Dans un premier temps, on a utilisé un questionnaire électronique, qui a été répondu par 85 professionnels. Ensuite, sept professionnels ont participé aux groupes de discussion en ligne. À peu prés la moitié de l´échantillon n'a pas des activités religieuses. Toutefois, 85% a montré un haut degré de spiritualité. Thèmes religieux/spirituel sont fréquents dans les consultations. Les membres des groupes ont déclaré ne pas avoir de formation pour traiter des questions semblables. En somme, les professionnels ont une opinion positive sur la religiosité, mais reconnaissent aussi ses effets indésirables. Des recherches sont encore nécessaires pour mieux baser la formation du personnel en Oncologie.

A avaliação psicológica, psicopatologia e as psicoterapias na formação do profissional de saúde para o SUS: um estudo dos currículos dos cursos de Psicologia / The psichological assessment, psicopathology and psychotherapies in the degree of health professional for the SUS: a study of the psychology curricula

Este artigo é resultado de uma pesquisa que teve como objetivo visibilizar de que forma os currículos de cursos de Psicologia do estado do Rio Grande do Sul estão apresentando indicativos de movimento para formar profissionais da saúde para o SUS. Este trabalho foi desenvolvido a partir da análise dos programas das disciplinas, destacando e discutindo os direcionamentos tomados pelas ementas, conteúdos e bibliografias e adotando como balizadores os princípios e diretrizes presentes nas políticas de saúde do SUS. O trabalho toma como foco em especial o estudo das disciplinas direcionadas para os conteúdos de Avaliação Psicológica, Psicopatologia e Psicoterapia. Para o desenvolvimento dessa discussão analisamos a entrada da Psicologia na área da saúde coletiva e as contribuições desta para a construção da nova política de saúde através da formação acadêmica. Essa discussão é pautada pelas principais ferramentas e conceitos teóricos discutidos na área da saúde coletiva, tais como a ampliação do conceito de saúde, o princípio da integralidade, a política de humanização e a perspectiva do cuidado integral na atenção à saúde. A partir da análise que realizamos, apontamos para a necessidade de problematizar a construção do sujeito psicólogo, que profissional da saúde que os currículos de Psicologia vêm produzindo, e os efeitos que podem vir a operar no cotidiano dos serviços de saúde.(AU)

This paper has stemmed from a research aiming at showing how curricula of Psychology courses in Rio Grande do Sul have shown signs of moving towards education of health professionals for SUS. This work has been developed from the analysis of the program of academic subjects, both highlighting and discussing the directions provided by programs, contents and bibliographies, having the principles and guidelines of SUS health policies as its axis. The paper has a special focus on the study of academic subjects that approach the contents of Psychological Assessment, Psychopathology, and Psychotherapy. To develop this discussion we analyzed the input of Psychology in the collective health area and the contributions of this to the construction of the new health policy through the academic formation. This discussion is pointed by the principal tool and theoretical concepts discussed in the collective health area, such as the broadening of the health concept, the principle of integration, the policy of humanization and the comprehensive care perspective in the health care. From the analysis, we have pointed out the need for problematizing the construction of the psychologist subject, a health professional that has been produced by Psychology courses, as well as the effects that might be felt in the daily routine of health services.(AU)

Este artículo es el resultado de una investigación que tuvo como objetivo visualizar como los currículos de los cursos de Psicología del estado de Rio Grande do Sul están mostrando indicios de movimiento para hacer la formación de los profesionales de la salud para el Sistema Único de Salud. Este trabajo fue desarrollado a partir del análisis de los programa de las disciplinas, poniendo de relieve las orientaciones adoptadas por los menús, los contenidos y la bibliografía y tomando como guía los principios y directrices actuales de las políticas de salud del SUS. El trabajo tiene como enfoque especial el estudio de disciplinas con los contenidos de Evaluación Psicológica, Psicopatología y Psicoterapia. Para el desarrollo de esta discusión se analiza la entrada de la psicología en la salud colectiva y la contribución de esta a la construcción de la nueva política de salud a través de la formación académica. Esta discusión es guiada por los principales instrumentos teóricos y conceptos discutidos en el área de la salud pública, tales como la ampliación del concepto de salud, el principio de la integridad, la política de humanización y la perspectiva de atención integral en el cuidado de la salud. A partir del análisis que realizamos, que apuntan a la necesidad de problematizar la construcción del sujeto psicológico, qual és el profesional de la salud que han estado produciendo, y los efectos que pueden operar en los servicios de salud todos los días.(AU)

Cet article est le résultat d'une recherche qui avait comme objectif viabiliser la façon dont les programmes du cours en psychologie de l'État du Rio Grande do Sul sont montre indicatifs de mouvement pour faire la formation des professionnels de la santé pour le SUS. Ce travail a été elaboré a casse de l'analyse sur les programmes des disciplines, en soulignant et en discutant les directions que prend les menus, les contenus et les bibliographies et en adoptant comme un guide les principes et les actuelles orientations politiques de santé pour le SUS. Ce travail prend comme un foyer particulier l'étude des disciplines qui sont direcione pour les contenus de l'évaluation psychologique, la psychopathologie et la psychothérapie. Pour le développement de cette discussion, nous analysons l'entrée de la psychologie dans le branche de la santé publique et les contributions pour la construction de cette nouvelle politique de la santé par la formation académique. Cette discussion est guidée par les principaux outils et concepts théoriques que sont aborde dans le branche de la santé publique, comme l'élargissement du concept de santé, le principe de l'intégralité, la politique d'humanisation et la perspective d'un attencion integral pour la santé. De l'analyse que nous effectuons, nous soulignons la nécessité de problématiser la construction du sujet psychologue, quelle est les professionnels de la santé qui les programmes en psychologie ont produisent, et les effects que peuvent opérer au quotidien dans les services de la santé.(AU)