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Team climate and attributes of primary healthcare (PHC) are key elements for collaborative practice. Few researchers have explored the relationship between team climate and patients' perceptions of PHC. This study aimed to assess the association between team climate and patients' perceptions of primary healthcare attributes. A quantitative approach was adopted. In Stage 1, Team climate was assessed using Team Climate Inventory in 118 Family Health Strategy (FHS) teams at a PHC setting. In Stage 2, Patients' perceptions of PHC attributes were assessed using the Primary Care Assessment Tool (PCATool) in a sample of 844 patients enrolled in teams studied in Stage 1. Cluster analysis was used to identify team climate groups. The analysis used multilevel linear regression models. Patients assigned to teams with the highest team climate scores had the highest PHC attributes scores. Patients who reported affiliation at the team level had the highest PCATool scores overall. They also scored higher on the attributes of comprehensiveness and coordinated care compared to patients with affiliation to the health unit. In conclusion, patients under the care of FHS teams exhibiting a more favorable team climate had more positive patient perceptions of PHC attributes.

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OBJECTIVE: To synthesise scientific evidence on interprofessional practice in hospital care and the effects on nursing workload. METHODS: Systematic mixed method review, registered in PROSPERO (CRD42021225627) and conducted in the following databases: CINAHL, Medline, Web of Science and Scopus, with no restrictions on the publication period of the studies. Primary studies were recruited on nurses' interprofessional practice (actions and interactions with other professional categories) in hospitals and the effects on one or more dimensions of nursing workload (quantitative, qualitative, physical, cognitive, emotional, time and variation). Scientific articles available in open access, in English, Spanish or Portuguese, were included. The searches were carried out in January 2021. The studies were evaluated by pairs of independent researchers to verify methodological quality, through the Mixed Method Appraisal Tool, and data extraction. To summarise the studies, thematic analysis was adopted. RESULTS: A total of 1774 publications were assessed for eligibility and 17 studies were included. Of these, two were mixed methods, four were qualitative, and 11 were quantitative, published between 2011 and 2020. The main scenarios investigated were Intensive Care Units and/or Inpatient Units. During data analysis, three thematic categories emerged: Interprofessional practice in coping with emotional overload; Time dedicated by nurses to professional communication; and Working conditions and patient care. The third category consisted of three subthemes: Conflict and flexibility in the context of practice; Working conditions and interprofessional practice; and Effects on patient care. CONCLUSIONS: The evidence points to the emotional overload of nurses in the face of uncooperative practices. Interprofessional actions, especially communicative ones, demand nurses' time and impact the care provided. The results contribute to political decisions and health work management.

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ABSTRACT Objective: To understand the perception and experience of health professionals regarding fall prevention practices in hospital inpatient units. Method: This is a qualitative exploratory and descriptive case study based on the Canadian framework of interprofessional competences. Data was collected from two focus groups, with different health professionals in each group, and thematic content analysis was used. Results: Five categories were drawn up which showed intense convergence between the participants of the two focus groups, within the context of fall prevention practices: communication between professionals and patients/carers for fall prevention, interprofessional communication for fall prevention, clarification of roles for fall prevention, health education about risk and fall prevention and continuing education for fall prevention. Conclusion: Teamwork and collaborative practice are important for achieving good results in the prevention of falls in hospital care, but for this to happen, health professionals need to acquire the necessary competences for collaborative action.

RESUMEN Objetivo: Conocer la percepción y experiencia de los profesionales de la salud en relación a las prácticas de prevención de caídas en unidades de internación hospitalaria. Método: Se trata de un estudio de caso cualitativo, exploratorio y descriptivo, basado en el marco canadiense de competencias interprofesionales. Se recogieron datos de dos grupos focales, con diferentes profesionales sanitarios en cada grupo, y se utilizó el análisis de contenido temático. Resultados: Se elaboraron cinco categorías que mostraron una intensa convergencia entre los participantes de los dos grupos focales, en el contexto de las prácticas de prevención de caídas: comunicación entre profesionales y pacientes/cuidadores para la prevención de caídas, comunicación interprofesional para la prevención de caídas, clarificación de roles para la prevención de caídas, educación sanitaria sobre riesgos y prevención de caídas y formación continuada para la prevención de caídas. Conclusión: El trabajo en equipo y la práctica colaborativa son importantes para conseguir buenos resultados en la prevención de caídas en la atención hospitalaria, pero para ello es necesario que los profesionales sanitarios adquieran las competencias necesarias para la acción colaborativa.

RESUMO Objetivo: Compreender a percepção e a experiência vivenciada pelos profissionais de saúde quanto às práticas de prevenção de quedas na unidade de internação hospitalar. Método: Trata-se de um estudo qualitativo do tipo exploratório e descritivo, na modalidade estudo de caso, desenvolvido com base no referencial canadense de competências interprofissionais. Os dados foram coletados através de dois grupos focais, com profissionais de saúde diferentes em cada grupo, utilizando análise de conteúdo temática. Resultados: Foram elaboradas cinco categorias que mostraram intensa convergência entre os participantes dos dois grupos focais, dentro do contexto das práticas para prevenção de quedas: comunicação entre profissionais e pacientes/acompanhantes para a prevenção de quedas, comunicação interprofissional para a prevenção de quedas, clarificação de papéis para a prevenção de quedas, educação em saúde sobre risco e prevenção de quedas e educação permanente para a prevenção de quedas. Conclusão: O trabalho em equipe e a prática colaborativa são importantes para atingir bons resultados na prevenção de quedas na assistência hospitalar, mas para isso os profissionais de saúde precisam se apropriar das competências necessárias para o agir colaborativo.

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A complexidade do cuidado tem ultrapassado os saberes de uma única profissão, superando uma visão unicamente biológica, médico-sanitária e higienista das práticas de assistenciais. Iniciativas que promovam a segurança do paciente e a qualidade na assistência à saúde exigem articulação de uma terapêutica descentralizada. Afirma-se, assim, a necessidade de haver mecanismos de comunicação interdisciplinar que viabilizem um cuidado colaborativo e seguro. A corrida de leito é considerada uma das formas de interlocução interdisciplinar para assegurar o fluxo rápido de informações ligadas à assistência, se configuram, portanto, em um espaço para que os profissionais de diferentes categorias discutam e determinem condutas coletivamente. Apesar da prática interdisciplinar potencializar a integração no trabalho em saúde por articular diversos saberes e fazeres profissionais, no contexto hospitalar há relações próprias de uma organização, com lutas por espaços e defesa de interesses que conduzem a uma reflexão sobre como os agentes sociais se inserem num sistema de posições e relações de poder estabelecidas. Na perspectiva das relações de poder, acredita-se que o trabalho articulado entre as equipes de saúde se apresenta como uma fragilidade para que as condutas de saúde estejam alinhadas. Com o objetivo de analisar a configuração das corridas de leito sob a ótica das relações de poder constituídas nos e pelos saberes de médicos e enfermeiros em um setor aberto e um setor fechado de um hospital, desenvolveu-se uma pesquisa qualitativa na perspectiva pós-estruturalista, com base no referencial teórico-metodológico de Michael Foucault. O cenário do estudo foi o Centro de Terapia Intensiva e o Posto 04 de uma Unidade de Internação de um hospital filantrópico geral, de grande porte, localizado na cidade de Belo Horizonte, Minas Gerais, Brasil. Nos setores, procedeu-se à observação das corridas de leito e a realização de entrevistas com roteiro semiestruturado com 11 médicos, 18 enfermeiros e oito informantes-chaves (por terem apresentado comportamento em destaque durante a observação das corridas de leito nos setores). A partir da análise dos discursos constituídos, identificou-se três categorias empíricas principais: corrida de leito: elementos e circunstâncias; A corrida de leito na percepção e subjetivação dos agentes envolvidos; e Composição de forças interdisciplinares na corrida de leito. Os discursos dos participantes, associados ao que foi possível observar, retrataram a corrida de leito como um reflexo do ambiente relacional. Os resultados demonstraram que a estruturação da corrida de leito hospitalar não favorece a articulação do trabalho entre médicos e enfermeiros, inibe a circulação do poder prejudicando iniciativas interdisciplinares e mantém o médico como agente principal nas decisões clínicas, comprometendo a integralidade do cuidado. As relações de poder imbricadas no processo de corrida de leito interferem negativamente na interdisciplinaridade das práticas de saúde entre médicos e enfermeiros no ambiente hospitalar, acarretando prejuízo assistencial ao paciente. Estudos dessa natureza podem subsidiar reflexões sobre práticas individuais e coletivas na perspectiva de que seja possível estabelecer maior fluidez nas relações entre as equipes de saúde em prol de um cuidado cada vez mais qualificado e seguro.

The complexity of care has exceeded the knowledge of a single profession, overcoming a solely biological, medical-sanitary, and hygienist perspective on care practices. Initiatives promoting patient safety and healthcare quality demand coordination with a decentralized therapy. Therefore, there is a need for interdisciplinary communication mechanisms that enable collaborative and safe care. Bedside rounding is considered one of the forms of interdisciplinary dialogue to ensure the rapid flow of information linked to care. It is thus a space for professionals from different categories to collectively discuss and determine the conduct to be adopted. Although interdisciplinary practice enhances integration in healthcare work by articulating different knowledge and professional practices, in the hospital setting there are certain relationships typical of organizations, including the struggle for space and defense of interests that lead to a reflection on how social agents are inserted in a system of well-established positions and power relations. From the perspective of power relations, it is believed that the coordinated work between health teams presents itself as a weakness in guaranteeing that health behaviors are aligned. Aiming to analyze the configuration of bedside rounding from the power perspective of power relations formed in and by the knowledge of doctors and nurses in open and closed departments of a hospital, this study consists of qualitative research developed from a post-structuralist view based on Michael Foucault's theoretical-methodological framework. The chosen setting was the Intensive Care Unit and Station Four of an Inpatient Unit of a large philanthropic general hospital, located in Belo Horizonte, Minas Gerais, Brazil. Bedside rounding was observed in the departments, and interviews with a semi-structured script were carried out with 11 doctors, 18 nurses, and eight key informants (as they stood out during the bedside rounding observation in the departments). Through discourse analysis, three main empirical categories were identified: bedside rounding: elements and conditions; bedside rounding in the perception and subjectivation of the involved agents; and interdisciplinary collaboration in bedside rounding. The participants' speeches, associated with what was observed, portray the bedside rounding as a reflection of the relational environment. The results demonstrated that the bedside rounding structure doesn't favor coordinating the work between doctors and nurses; it also hinders the circulation of power, damaging interdisciplinary initiatives and keeping doctors as the main agents in clinical decisions, compromising the comprehensiveness of care. The power relations involved in the bedside rounding process negatively interfere with the quality of interdisciplinarity in care practices between doctors and nurses in the hospital setting, affecting patient care. Studies of this nature might support reflections on individual and collective practices, considering that it is possible to establish greater fluidity in relationships between health teams towards increasingly modern and safe care.

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Resumo Introdução: A violência sexual é um grave problema na sociedade brasileira cujas repercussões no âmbito da saúde pública tornam imperativa a abordagem dessa questão no contexto da formação das suas profissões. Igualmente, a integralidade do cuidado destinado às pessoas em situação de violência sexual requer a atuação conjunta de diversas profissões, além da integração em rede e articulação de diferentes equipamentos sociais. Objetivo: Este estudo teve como objetivo reconhecer quais competências - entendidas como o conjunto de conhecimentos, habilidades e atitudes - são necessárias para o desenvolvimento do cuidado integral destinado às pessoas em situação de violência sexual, segundo os melhores padrões de qualidade e segurança para a saúde delas. Método: Realizou-se um estudo qualitativo de caráter exploratório e descritivo que envolveu a aplicação de um formulário prévio sobre os conhecimentos acerca das competências, seguido da dinâmica da construção da figura humana, que consiste na confecção de um boneco no qual os conhecimentos estariam representados pela cabeça, as habilidades pelos membros e as atitudes pelo corpo, na realização de uma oficina com 76 participantes de diferentes profissões. Adicionalmente, aplicou-se um questionário a 32 profissionais com reconhecida expertise na área de violência sexual e com experiência prática no atendimento às pessoas nessa situação. Foi empregada a análise temática categorial. Resultado: Identificaram-se desafios a serem superados nas três dimensões constituintes das competências, com nítida deficiência de conhecimentos para a atuação em rede visando à efetividade e à integralidade do cuidado. Reconheceram-se 15 competências comuns aos profissionais que lidam com a violência, e o produto final foi representado num infográfico de disposição radial com a organização dos conhecimentos, das habilidades e das atitudes identificados como necessários para o desenvolvimento de tais competências. Conclusão: Reconhecer competências comuns e identificar, separadamente, quais conhecimentos, habilidades e atitudes as constituem representa estratégias promotoras da abordagem transversal desses conteúdos na formação das profissões, sobretudo da saúde. A proposição de uma matriz de competências comuns para prática interprofissional no cuidado destinado às pessoas em situação de violência sexual pode orientar a qualificação desse cuidado e alicerçar a interprofissionalidade em cenários cruciais de atuação coletiva para o enfrentamento da flagrante injustiça social que a violência sexual significa.

Abstract Introduction: Sexual violence is a serious problem in Brazilian society whose repercussions on public health make it imperative to address this issue in the context of training in professions. Likewise, comprehensive care for people in situations of sexual violence requires the joint action of different professions, in addition to network integration and articulation of different social facilities. Objective: This study aimed to reflect which competencies - understood as the set of knowledge, skills and attitudes - are permitted for the development of comprehensive care for people in situations of sexual violence, according to the best standards of quality and health safety they. Method: A qualitative study of an exploratory and descriptive nature was carried out, which involved the application of a preliminary form on knowledge about skills, followed by the dynamics of the construction of the human figure, which consists of manufacturing a doll in which the knowledge would be represented by the head, by the skills of the members and by the attitudes of the body, in the creation of an office with 76 participants from different professions. Furthermore, a questionnaire was administered to 32 professionals with experience in the area of sexual violence and with practical experience in caring for people in this situation. Categorical thematic analysis was used. Result: Result: Challenges were identified to be overcome in the three dimensions that constitute competencies, with a clear lack of knowledge for working in a network aiming at the effectiveness and comprehensiveness of care. 15 competencies common to professionals who deal with violence were recognized, and the final product was represented in a radially arranged infographic with the organization of knowledge, skills and attitudes identified as necessary for the development of such competencies. Conclusion: Recognizing common competencies and identifying, separately, which knowledge, skills and attitudes constitute them represent strategies that promote a transversal approach to these contents in the training of professions, especially in health. Proposing a matrix of common competencies for interprofessional practice in care for people in situations of sexual violence can guide the qualification of this care and support interprofessionality in crucial scenarios of collective action to combat the blatant social injustice that sexual violence means.

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OBJETIVO: reflexionar sobre la educación y práctica colaborativa Interprofesional en salud desde su aplicación y desafíos para la enfermería. METODOLOGÍA: reflexión teórica sobre la educación interprofesional y el trabajo en salud, fundamentado en la perspectiva de la enfermería. RESULTADOS: fue desarrollado en tres tópicos: Necesidad de promover la educación y la práctica colaborativa interprofesional en salud; Competencias en educación y práctica colaborativa interprofesional en salud; y, Desafíos para la educación y la práctica colaborativa interprofesional desde la perspectiva de enfermería. Los cambios culturales y la historia de la enfermería dificultan el reconocimiento y la identidad profesional, pudiendo influir en el desarrollo de lógicas de trabajo interprofesional. Una regulación que promueva la educación y la práctica colaborativa interprofesional en enfermería podría traer avances importantes para la profesión. CONCLUSIONES: se reconoce la relevancia de la educación y práctica colaborativa interprofesional en los resultados en salud. Existen factores que influyen en su desarrollo en algunas profesiones como lo es enfermería. El riesgo a perder reconocimiento y posición frente a otras profesiones se puede convertir en un obstáculo para adoptar lógicas de trabajo interprofesional. Es fundamental abordar la educación y el trabajo interprofesional para entender qué es realmente la interprofesionalidad y por qué es importante.

OBJECTIVE: to reflect on the role of interprofessional education and collaborative practice in healthcare, based on its application and challenges for nursing. METHODOLOGY: theoretical reflection on interprofessional education and work in health from the nursing perspective. RESULTS: development occurred in three areas: The need to promote interprofessional education and collaborative practice in health; Competencies in education interprofessional and collaborative practice in health; and, Challenges for interprofessional education and collaborative practice from a nursing perspective. Cultural changes and the history of nursing hinder professional recognition and identity, which may influence the development of interprofessional working relations. A regulation that promotes education and interprofessional collaborative practice in nursing could bring important advances to the profession. CONCLUSIONS: the relevance of interprofessional education and collaborative practice for health outcomes is recognized. There are factors that influence its development in some professions, such as nursing. The perceived lack of recognition and position relative to other professions may become an obstacle to the adoption of interprofessional working relations. It is essential to address interprofessional education and collaborative practice to understand what interprofessionalism really is and why it is important.

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OBJECTIVE: To assess the prevalence of bullying in medical residents and its associated factors. METHODS: In this systematic review and meta-analysis, articles from MEDLINE, EMBASE, Scopus, PsycInfo, Cochrane databases, and Web of Science were searched. Published and unpublished cross-sectional studies were included. Cochrane's Q test and I2 statistics were used to assess the existence of heterogeneity. Subgroup analysis and sensitivity analysis were performed on evidence of heterogeneity. Egger's test and funnel plots were performed to investigate publication bias. RESULTS: A total of 13 cross-sectional studies with a total of 44 566 study participants from different medical residencies were analyzed. The overall prevalence of bullying was 51% (95% CI 36-66). Furthermore, female residents and residents that belong to a minority group had higher odds of experiencing bullying compared to their peers. CONCLUSION: A high prevalence of bullying in medical residents exists around the world. There is a need for education, dissemination, and more effective interventions among the residents and authorities about bullying to build and promote adequate behaviors and diminish bullying prevalence.

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INTRODUCTION: Telehealth is a growing topic, with potential to improve access to primary healthcare. However, there is a lack of knowledge regarding how telehealth could facilitate interprofessional collaboration that is recommended to strengthen the comprehensive approach of primary healthcare. The objective is to identify the characteristics and applications of telehealth services related to the interprofessional collaborative practice of primary healthcare professionals. METHODS AND ANALYSIS: This review will cover studies including as target population those health professionals who work in telehealth services; as concept, telehealth in relation to collaborative interprofessional practice; and as context, primary healthcare. A scoping review will be carried out according to the Joanna Briggs Institute methodology. Databases to be searched include MEDLINE, CINAHL, Embase, Eric, Scopus, LILACS and Web of Science. All identified records will be grouped, duplicates will be removed, titles and abstracts will be selected by two independent reviewers, and the full text of selected articles will be evaluated in detail. A data extraction tool developed by the reviewers will be used for data extraction. The results will be presented in data map format in a logical way, in a diagram or in a tabular format, accompanied by a descriptive summary. ETHICS AND DISSEMINATION: No ethical approval is required for this study. A manuscript based on this scoping review will be submitted to a journal and we hope it will contribute to scientific knowledge on the interprofessional field and key research findings will be sent to key events on interprofessional practice and education. SYSTEMATIC REVIEW REGISTRATION: This scoping review was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/2BV8D).

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Background: Interprofessional Education is considered a necessary approach to develop skills for collaborative work in the training of professionals in order to improve the quality of health care. The curricula are the guiding documents for training and should explain how Interprofessional Education is adopted in undergraduate health courses. Objective: To analyze curricula of undergraduate health courses, from the perspective of Interprofessional Education, in a Brazilian public university. Design: Qualitative study of document analysis. Settings: Undergraduate health courses at a Brazilian public university. Methods: 13 undergraduate health courses were analyzed. Data collection was conducted based on an adapted quality assessment script for Interprofessional Education. From the thematic content analysis, three analytical categories emerged. Results: In the category "Curriculum organization and interprofessionality", the courses do not make free periods available in the curriculum, and each of the courses provide space for elective subjects at different times. In the category "Training guided by social reality and health needs" the courses propose training based on the health needs of patients from the Brazilian public health system. In the category "Learning for interprofessional action", the term "multiprofessional" characterizes learning for teamwork, with a discrete number of interprofessional disciplines. Conclusions: The theoretical bases of IPE and organizational goals are necessary to establish training objectives, specific shared times, and mutual interests that are directed to interprofessionality. Interprofessional Education can be expanded from activities that already exist in the curricula of undergraduate courses.

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Resumo Este estudo tem por objetivo compreender a experiência de residentes sobre a Prática Colaborativa Interprofissional (PCI) em um hospital universitário (HU) do estado de São Paulo. É uma pesquisa qualitativa realizada por meio de entrevistas semiestruturadas com base na Técnica do Incidente Crítico, com 14 residentes de programas de residência uni e multiprofissionais, analisadas pela análise temática de Bardin. O HU mostrou-se potente para efetivação da PCI por proporcionar interações entre profissionais de diferentes áreas e níveis de formação. A qualidade das interações entre trabalhadores, residentes, usuários e família foi determinante para o desenvolvimento da PCI. Foram identificadas barreiras como ausência de estruturação organizacional, sobrecarga dos profissionais, fragilidade na oferta de Educação Permanente relacionada à educação interprofissional e predomínio do modelo biomédico de Atenção à Saúde. As ações colaborativas mediadas pela comunicação informal constituem o dispositivo mais utilizado para os atendimentos compartilhados.(AU)

Abstract The aim of this study was to explore residents' experiences of interprofessional collaborative practice (ICP) in a university hospital (UH) in São Paulo. We conducted a qualitative study with 14 residents undertaking uniprofessional and multiprofessional residency programs. The data were collected using critical incident technique-based semi-structured interviews and analyzed using thematic analysis as proposed by Bardin. The UH was shown to be a potent training setting for ICP, promoting interactions between professionals from a range of areas and with varying levels of qualification. The quality of interactions between workers, residents and patients and their families was a determining factor for the development of ICP. Barriers to ICP included lack of organizational structure, excessive workload, weaknesses in the provision of permanent training in ICP and the predominance of the biomedical model of health care. Collaborative actions mediated by informal communication were the most common mechanism used for providing shared consultations.(AU)

Resumen Este estudio reta comprender la experiencia de los residentes sobre la Práctica Colaborativa Interprofesional (PCI) en un hospital universitario (HU) en el estado de São Paulo. Investigación cualitativa a través de entrevistas semiestructuradas basadas en la Técnica del Incidente Crítico con 14 residentes de programas de residencia uni y multiprofesionales, analizadas por análisis temático de Bardin. El HU demostró ser potente para la implementación de la PCI al propiciar interacciones entre profesionales de diferentes áreas y niveles de formación. La calidad de las interacciones entre trabajadores, residentes, usuarios y familiares fue crucial para el desarrollo de la PCI. Se identificaron barreras como falta de estructura organizacional, sobrecarga de profesionales, debilidad en la provisión de educación permanente interprofesional y predominio del modelo biomédico de atención. Las acciones colaborativas mediadas por comunicación informal son el dispositivo más utilizado para el cuidado compartido.(AU)