Multiprofessional Health Residency Research Articles

Implementation of the use of active methodologies used by preceptors of the pain outpatient clinic of the University Hospital of the Federal University of Juiz de Fora: Experience report

Introduction: The Multiprofessional Pain Outpatient Clinic (AMD) was created at the University Hospital of the Federal University of Juiz de Fora (HU-UFJF) to offer an integrated and interprofessional approach to the treatment of chronic pain, in line with the Multiprofessional Residency in Adult Health. To face the complex demands of AMD and promote more engaged and meaningful learning, the need arose to use Active Methodologies (AM) in the teaching-learning process of residents. Objective: To report the creation of a preceptorship plan for the implementation of active methodologies in the teaching-learning process of AMD, with the objective of developing critical, communication and teamwork skills in health professionals and promoting more effective and integrated care for patients with chronic pain. Experience Report: The study adopted the format of an experience report and took place at AMD, involving an interprofessional team composed of residents and preceptors. Several active methodologies were used, such as case studies, problem-based learning, interprofessional teaching, experiential learning, among others. The implementation of active methodologies in AMD demonstrated significant potentialities, including improvements in resident performance, development of communication and teamwork skills, favoring interdisciplinary practices, and academia-service integration. A more active and engaged participation of students in the discussions of clinical cases was observed, resulting in a deeper understanding of the clinical concepts presented. Conclusion: Active methodologies represent an effective strategy to promote learning and professional development in AMD, contributing to a more integrated and efficient care for patients with chronic pain. The study highlights the importance of continuous training of health professionals and the search for innovative practices in the context of chronic pain.

Contribuições da fisioterapia para a Atenção Primária à Saúde a partir da residência multiprofissional

Abstract Introduction Multiprofessional residency in health (MHS) is a professional training program focussed on Brazil’s Unified Health System that aims to reorient techno-assistance logics and significantly contributes to the insertion and consolidation of physical therapy into primary health care (PHC). Objective To understand the perceptions of health professionals and managers about the contributions of the MRH to the insertion of physical therapy into PHC. Methods This qualitative study was based on hermeneutics and was conducted in the municipality of Aracati, Ceará, Brazil, with 15 professionals making up a convenience sample. Eligible were PHC professionals with higher education working in urban areas. The data were collected from March to June 2023 through semistructured interviews with the researchers. The data analysis was based on reading the material, organizing it into themes, and interpreting these in depth. Results The first contact with physical therapy occurs in scenarios that range from individual and shared consultations to health programs at school, whose actions are optimized by PHC from the MHS. There are numerous physical therapy care strategies, especially actions focussed on biopsychosocial aspects. The involvement of physical therapists in health promotion is revealed by the inclusion of professionals in health promotion groups. Health education from a multiprofessional perspective enhances care through promotion and prevention. Conclusion The MHS strengthens the need for physical therapy in PHC and enhances primary care.

Perfil clínico e epidemiológico dos atendimentos de urgências odontológicas em uma unidade básica de saúde

ABSTRACT Objectives: This study aimed to establish the causal profile of searches for urgent dental care in a Basic Health Unit, its outcomes and main complications that occurred. Methods: A descriptive, cross-sectional, retrospective study with a quantitative approach was carried out. The sample consisted of patients assisted in the demand of dental urgency. Data were collected through the electronic medical records of all patients treated by residents of the Multiprofessional Residency in Family Health, at the São Francisco Health Unit, located in the city of Cariacica/ES, from March 2021 to March 2022. Results: A total of 212 emergency dental visits were evaluated, of patients of two genders, having females being predominant (57.5%), aged between 1 and 75 years, with toothache as the main complaint (86.8 %). The most frequent diagnoses were dental caries (31.1%), followed by irreversible pulpitis (20.8%) and unsatisfactory restorations (7.5%). Accordingly, the most common emergency treatments performed at the service were: endodontic access (34.0%), tooth extractions (28.8%) and restorations (19.8%). Conclusions: The profile of urgent care surveyed was predominantly female, with an average age of 34 years, with toothache as the main complaint and dental caries as the most common diagnosis. The main interventions performed were endodontic access and tooth extraction.

Stress and residency: a study of a multiprofessional program in collective health

Multiprofessional Health Residency Programs constitute postgraduate education, with training based on the teaching-service process within a complex context of interactions and relationships. The study aimed to analyze the occurrence of stress in residents of a Multiprofessional Collective Health Residency Program at the Health Department of Recife through the application of the “Escala de Estresse no Trabalho” (EET) and a biopsychosocial questionnaire. Out of a total of 23 alternatives, 21 of them depict a higher level of stress among second-year residents, which also corresponds to the period of the COVID-19 pandemic. The stress level was perceived as high in all evaluated dimensions, with a higher occurrence in the "autonomy/control" aspect, revealing a high level of stress among the Multiprofessional Collective Health Residency Program residents. The findings emphasize the importance of taking action and reflecting on the issues and contributing to the generation of support for the development of public policies related to residency programs, particularly in recognizing and valuing the program graduates.

A ELABORAÇÃO DO “AR QUE FALTA”: observações sobre as repercussões psicológicas do adoecer por Fibrose Pulmonar Idiopática (FPI)

The present work is an experience report provided by the Multiprofessional Residency in Health carried out in a Complexo Hospitalar Universitário Federal in the state of Pará, with the objective of descriptively tracing the work of hospital psychology in the Respiratory System Unit in care for people living or going to live with Idiopathic Pulmonary Fibrosis (IPF). The methodology used is exploratory, with a qualitative approach, with the purpose of describing an observation/reflection experienced and performed by the author. When the patient receives the diagnosis of chronic lung disease, which involves significant changes to the dynamics of his life The subject with IPF needs to be understood, listened to and validated as a singularity so that it is possible to provide a multidisciplinary care that can be experienced and understood as humanized.

Analysis of professional training in Multiprofessional Health Residency Programs in Brazil from the perspective of residents.

The aim of this study was to analyze professional training in multiprofessional health residency programs (MHRPs) in primary care from the perspective of residents from 20 programs who had completed residency in the period 2015-2019. We undertook a cross-sectional study analyzing criteria in the dimensions Pedagogical Approach and In-Service Education Settings responded using a 10-point Likert scale. The study sample consisted of 365 graduates from MHRPs in 12 Brazilian states. The highest-scoring criteria in the dimension Pedagogical Approach (Cronbach's α=0.94) were broad concept of care and professional training oriented towards comprehensive care (P50=10). The lowest scoring criteria were those involving preceptorship (P50=7). With regard to the In-Service Education Settings dimension (Cronbach's α=0.90), the main strength was group educational activities (P50=9) and the main weaknesses were adequacy of the physical structure of health facilities (P50=6), participation of residents in local health committees (P50=6), and coordination with medical residency programs (P50=5). The findings show that professional training in MHRPs is aligned with the principles and guidelines underpinning Brazil's public health system, with emphasis on comprehensiveness and prevention. However, efforts are needed to improve preceptor training and address weaknesses in practice settings.

Análise da formação em Programas de Residência Multiprofissional em Saúde no Brasil: perspectiva dos egressos

Abstract The aim of this study was to analyze professional training in multiprofessional health residency programs (MHRPs) in primary care from the perspective of residents from 20 programs who had completed residency in the period 2015-2019. We undertook a cross-sectional study analyzing criteria in the dimensions Pedagogical Approach and In-Service Education Settings responded using a 10-point Likert scale. The study sample consisted of 365 graduates from MHRPs in 12 Brazilian states. The highest-scoring criteria in the dimension Pedagogical Approach (Cronbach’s α=0.94) were broad concept of care and professional training oriented towards comprehensive care (P50=10). The lowest scoring criteria were those involving preceptorship (P50=7). With regard to the In-Service Education Settings dimension (Cronbach’s α=0.90), the main strength was group educational activities (P50=9) and the main weaknesses were adequacy of the physical structure of health facilities (P50=6), participation of residents in local health committees (P50=6), and coordination with medical residency programs (P50=5). The findings show that professional training in MHRPs is aligned with the principles and guidelines underpinning Brazil’s public health system, with emphasis on comprehensiveness and prevention. However, efforts are needed to improve preceptor training and address weaknesses in practice settings.

Assistance in patients with traumatic brain injury in public health of gurupi city – to

The post-hospital discharge treatment of traumatic brain injury is multidisciplinary and requires training to achieve the skills that are usually lost. In this bias, rehabilitation includes four categories of tasks: physical, mental, affective and social. Physical function refers to sensory skills necessary for the performance of daily tasks and tools that are advanced skills and are considered important for the independence of the individual in society (RUIZ, 2018). Therefore, the aim of this research is to analyze the post-hospital discharge care of patients who are victims of TCE in basic health units in the city of Gurupi-TO. This is a qualitative research conducted with the head nurses who attend the Basic Health Units where integrated multiprofessional residence in family and community health (RMISFC) and Residence in Family and Community Medicine of the University of Gurupi - UnirG (Basic Health Units Vila Iris, João Manoel, Pedroso, Vila Nova and Seville). The sample had 5 Units, in each UBS there are 2 head nurses, totaling 10 participants in the research. The analysis allowed us to conclude that there is no protocol to be followed and the commitment necessary to provide the user of the health system with quality care for individuals and families.

Multiprofessional Residency in Health: (trans) formation for SUS in quilombola communities

Resumo A inserção e atuação profissional, no Sistema Único de Saúde (SUS), suscita debates e reflexões a respeito da formação de profissionais. Dessa forma, uma das estratégias para a obtenção de formação para o SUS são as Residências Multiprofissionais em Saúde (RMS). Neste estudo, objetivamos analisar as transformações no cotidiano dos serviços de saúde com a inserção do programa de Residência Multiprofissional em Saúde da Família, com ênfase na saúde da população do campo (RMSFC). Trata-se de um estudo de caso, de natureza qualitativa, tendo como participantes os atores que compõem o quadrilátero da formação, através de entrevistas semiestruturadas. Utilizamos a análise Discurso do Sujeito Coletivo (DSC), com o intuito de fazer o tratamento dos dados. Consideramos que esta pesquisa nos permitiu, ainda, visualizar as práticas e as transformações ocorridas nas Unidades Básicas de Saúde (UBS) após a inserção da RMSFC. Assim, temos informações importantes para refletir acerca de estratégias de formação de profissionais para trabalhar no SUS, especificamente no contexto da Saúde da População do Campo, contemplando comunidades quilombolas.

Admission of alumni from Multiprofessional Residency Programs into the SUS.

ABSTRACTINTRODUCTION:The Multiprofessional Health Residency Programs (PRMS) were set up as a strategy for training workforce for the Brazilian Unified Health System (SUS).OBJECTIVE:To investigate the proportion of alumni from Primary Health Care Multiprofessional Residency Programs admitted into the SUS and associated factors.METHODS:This is a sectional study developed with alumni from Primary Health Care Multiprofessional Residency Programs from all over Brazil, encompassing the period from 2015 to 2019. Participants answered an online questionnaire with general personal information, admission into stricto sensu graduate school, the labor market and, specifically, the SUS. We applied Pearson's chi-square test for bivariate analyses and Poisson's regression for multiple analysis.RESULTS:A total of 365 alumni from Programs from all Brazilian regions participated in the study. Of those, 80.2% reported entry into the labor market and 47.9% reported being employed in the SUS. Admission into the SUS has been associated with the professions that make up the Reference Team for Primary Health Care (PHC) (PR = 1.87; 95% CI 1.54–2.28) and non-admission into stricto sensu graduate programs (PR = 0.77; 95% CI 0.61–0.97). Regarding admission characteristics, the PHC scenario (47.4%) and work focused on health care (84.9%) were prevalent. Almost 40% of alumni who entered the SUS are working with unstable contracts. Besides, being a residency alumnus is often undervalued in recruitment (56.9%). Among those admitted into the SUS, 8.7% reported being selected to work in the Covid-19 pandemic effort.CONCLUSIONS:The results of this study reinforce the need for a policy to encourage the maintenance, creation and valorization of the PRMS. They also warn about the possibility that admission into the SUS for workers is increasingly difficult due to the current underfunding of the health system.

Residência multiprofissional em saúde: As relações profissionais do enfermeiro-preceptor com os demais atores sociais

Objetivo: descrever o relacionamento profissional dos atores sociais da Residência Multiprofissional em Saúde (RMS) com o enfermeiro-preceptor. Metodologia: pesquisa qualitativa, descritiva e exploratória, do tipo estudo de caso único. O cenário foi o Instituto de Atenção à Saúde São Francisco de Assis da Universidade Federal do Rio de Janeiro (HESFA/UFRJ) que possui dois Programas de RMS: Saúde da Mulher (RMS-SM) e Saúde da Família e Comunidade (RMS-SFC). Os dados foram produzidos por meio de entrevista, observação e análise documental. Participaram do estudo 46 profissionais. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem Anna Nery/HESFA/ UFRJ sob o número de Parecer: 776.075 e de CAAE: 34835714.0.0000.5238. Resultados: As atividades que os tutores, docentes, preceptores, coordenadores e residentes (atores sociais) desenvolveram junto ao enfermeiro-preceptor foram distintas visando principalmente à garantia do funcionamento dos programas. Os atores sociais descreveram sua relação profissional na residência junto ao enfermeiro-preceptor, com maior ou menor aproximação, dependendo da função que desempenhavam. Conclusão: Destaca-se a importância da construção de um trabalho coletivo e colaborativo para mudanças efetivas nas práticas dos cenários de saúde, estreitando os vínculos interprofissionais entre todos os protagonistas da RMS.

Interdisciplinarity and interprofessionality in teamwork: perceptions of multiprofessional residents in Hospital Care

Multiprofessional Health Residency Programs were created to further align health training with the needs of the population and, through an emphasis on teamwork, have been contributing to the consolidation of the Brazilian Unified Health System. The present study sought to understand the perceptions of a group of multiprofessional residents in Hospital Care about interdisciplinarity and interprofessionality within the scope of teamwork. This is a qualitative study that had the participation of 29 multiprofessional residents in the ‘Hospital Care’ area of concentration, all female (six psychologists, six social workers, six nurses, six physiotherapists and five nutritionists). Data were collected by means of a semi-structured interview script. The corpus was subjected to thematic content analysis. Most of the participants: (1) reported that their first contact with the notion of interdisciplinarity occurred when they were in college, which led to them assimilating it as a synonym for joint action, and (2) claimed to have no knowledge of the notion of interprofessionality, but valued the horizontalization of relations between health professionals. Additionally, important conditions concerning both interdisciplinarity and interprofessionality were not emphasized by the participants. Further studies on the subject are needed, due to its importance for public health.

Caracterização das residências multiprofissionais em saúde do Brasil

Objetivo: Caracterizar os programas de residências multiprofissionais em saúde do Brasil. Método: Estudo quantitativo, descritivo, transversal. Os dados foram coletados na internet por arquivos cedidos pelo Ministério da Educação e dos editais dos programas de residência, de março a setembro de 2019, através de um instrumento contendo as variáveis: região geográfica, estado brasileiro, financiamento, número de vagas, ano de início do programa, área de concentração, instituição propositora, profissões existentes e cenários de prática. Resultados: Os programas de residência estão concentrados na região sudeste, destacando-se o Estado de São Paulo. São Financiados, em sua maioria, pelo Ministério da Saúde, estando concentrados em instituições públicas. A profissão de enfermagem está inserida em grande parte dos programas. O eixo de concentração na atenção básica/saúde é o mais ofertado. Conclusão: Os programas de residência multiprofissionais em saúde do Brasil são ofertados em todas as regiões do país, a maioria com bolsas do ministério da saúde, em instituições públicas, na área de concentração da atenção básica, sendo a enfermagem a profissão que está inserida em grande parte dos programas. A característica central das residências multiprofissionais em saúde é ser ensino em serviço, o que concretiza a formação interprofissional.

Educational Environment Assessment by Multiprofessional Residency Students: New Horizons Based on Evidence from the DREEM.

The multiprofessional residency in health (MRH) is in its initial stage situated in the long history of the Brazilian and worldwide health system. There are few published analytical data on the teaching environment as perceived by residents. Roff et al. developed a questionnaire to assess the educational environment known as the Dundee Ready Education Environment Measure (DREEM), which is widely used in international literature. To analyse perceptions of the educational environment among residents in various undergraduate health courses at a university hospital in the Midwest Region of Brazil using the DREEM. The DREEM was administered to MRH students in a postgraduate healthcourse consisting of 2 years of in-service training at a university hospital in Brazil in 2017. The results were analysed using the Statistical Package of Social Sciences (SPSS 24.0). Cronbach's alpha reliability coefficient for all the items in this study was 0.76, which indicates good internal consistency. The average (95% CI) total DREEM score was 85.23 (ranging from 79.2 to 91.26), which suggests problems in the educational environment as perceived by health residents and a more negative than positive environment. Several problem areas were identified in all domains of the educational environment that was assessed.

Qualification of multiprofessional residence in health: critical opinions of preceptors

Objetivo: realizar reflexão sobre a percepção de preceptores quanto ao aprimoramento de programas de Residência Multiprofissional em Saúde, em nível hospitalar. Método: estudo qualitativo, realizado por meio de entrevista individual com profissionais da saúde (preceptores) (n=34), junto a residentes multiprofissionais de um hospital universitário do Estado do Paraná, Brasil. As informações foram angariadas por meio de questionário e analisadas. Resultados: os preceptores investigados vislumbram pela melhoria na qualificação do programa e pelo fortalecimento de estratégias, sobre dois prismas. O primeiro refere-se ao capital humano, englobando reforços na consolidação das relações interpessoais e de habilidades de comunicação. O outro considera a gestão do trabalho, com vistas a potencializar de forma mais efetiva a organização do processo de trabalho. Conclusão: sugere-se que gestores de hospitais invistam na capacitação de seus agentes formadores, também no que tange a importância do processo avaliativo institucional, com vistas a angariar e regular a qualidade das residências.

HEALTH PROMOTION CONCEPTIONS AND EXPRESSIONS IN THE TRAINING PROCESS OF THE MULTI-PROFESSIONAL RESIDENCY

ABSTRACT Objective: to analyze the conception and manifestation of health promotion in the training process of the multi-professional residency in health. Method: a qualitative study anchored in the Theory of Social Representations, carried out from the collection of documentary data and from interviews with 13 professionals from the faculty of five multi-professional residency programs in health in Ceará, from March to July 2017. For data analysis, lexical analysis was performed using the ALCESTE software, with emphasis on the significance and correlation of the terms, through the chi-square test. Results: the training process of the multi-professional residency points to the overcoming of the biomedical model, with health promotion being understood as a training strategy and objective, since it is expressed in a transversal manner in the entire training process, by means of activities with emphasis, among others, in territorialization, health planning, teamwork, popular education, participation and social control. Conclusion: there is an alignment between the adopted and expressed conception of health promotion in the training process of the professional residency, representing advances in health practices and training.

Vocational Training and Dental Care in the Unique Health System: Experience Report

Objective: To report the experience lived during the Integrated Multiprofessional Residency in Family Health at the Faculty of Medical Sciences of the University of Pernambuco – FCM/UPE – at the interface with the Residency in Hospital Dentistry with a focus on Oncology at the University of Pernambuco developed at the Oncology Center at the Oswaldo Cruz University Hospital of the University of Pernambuco – CEON/HUOC/UPE. Methods: This is an experience report of dental practice in the context of professional training, in SUS, both in primary, secondary and tertiary care. Results: It is noticeable the need for greater professional qualification of the graduate, their integration in the Services of the institutionalized network and their performance with efficiency in multiprofissional teams, emphasizing the importance of professional training through Residencies, allowing the dental surgeon to improve in the diferente fields of Dentistry activities and, in particular, rescuing the inter-trans-multidisciplinary performance in both primary and hospital care and in the area of oncology. It was noticed that the integrated performance of the dental surgeon in a multidisciplinar team in low and medium complexity with resolvability in oral care is essential for the quality of care in the hospital context. Conclusion: Dental care directly impacts the quality of care and patient’s lives. The training of the dental surgeon throug the Residencies can provide skills and contribute with the other professions to the patient’s quality of life. In addition to its assistance character, the Dentistry Service – CEON/HUOC/UPE assumes an important education function, serving as a teaching research and extension field.

Residência Integrada Multiprofissional em Saúde e a pandemia COVID-19: um relato de experiência

Objetivo: Refletir sobre o processo de formação em serviço proporcionado pela Residência Integrada Multiprofissional em Saúde, e suas contradições, no contexto da pandemia. Relato de experiência: Trata-se de um relato de experiência, vivenciado nos tempos de pandemia da COVID-19, dentro de um hospital universitário, na Residência Integrada Multiprofissional em Saúde, na área de serviço social. Este estudo refere-se a uma pesquisa exploratória, desenhado dentro do método histórico dialético, que enfatiza a dimensão histórica dos processos sociais diante das observações cotidianas. Nesse contexto de pandemia, as adversidades para o trabalho do assistente social, inserido em um processo de trabalho hospitalar, ficaram mais evidentes, como a desprofissionalização, colocações de atribuições e competências que não cabem ao assistente social realizar, sendo necessário um posicionamento dessa categoria profissional. Outro eixo discutido é sobre o processo de formação em saúde do residente, e reflexões sobre a ambiguidade do papel do residente como agente desse processo. Considerações finais: Percebe-se que é fundamental a atuação dos residentes, porém respeitando todos os compromissos firmados nesse processo de ensino-aprendizagem.

Violência intrafamiliar na Infância e Adolescência

Este artigo é produto do trabalho de conclusão da Residência Integrada Multiprofissional em Saúde e em Área profissional da Saúde (RIMS), no Programa da Saúde da Criança em hospital universitário de Porto Alegre/RS. Objetiva-se apresentar a percepção dos Profissionais de Saúde Residentes (PSR) de como a formação em serviço contribui no trabalho profissional, diante da violência intrafamiliar contra as crianças e os adolescentes, no que se refere à concepção, preparação e intervenção. Trata-se de uma pesquisa qualitativa de natureza exploratória, descritiva e empírica por meio de entrevista com 14 residentes, cujas informações foram trabalhadas através de análise de conteúdo na perspectiva de Bardin (2011). Os resultados mostram que a concepção de violência intrafamiliar precisa ser ampliada e elucidada entre os profissionais. Há parca preparação durante a graduação, restringindo a formação e a qualificação profissional à pós-graduação, particularmente a formação em serviço. A intervenção se limita a determinadas áreas profissionais, tendo em vista atribuírem densidades diferentes dos conhecimentos teórico-práticos entre as áreas pelos profissionais. Conclui-se que é imprescindível o trabalho em equipe para garantir a proteção e a integralidade do cuidado na defesa da criança e do adolescente.

Avaliação do nível de estresse e perfil social de estudantes de pós-graduação da área da saúde

O objetivo do estudo foi identificar os níveis de estresse e perfil social dos estudantes de pós-graduação da área da saúde da Universidade Regional do Cariri – URCA em Crato-CE. Trata-se de um estudo quantitativo, descritivo e transversal, realizado com 44 estudantes de pós-graduação, sendo 14 do mestrado acadêmico em Enfermagem e 30 da Residência Multiprofissional em Saúde Coletiva. A coleta de dados foi feita através de um questionário de variáveis sociodemográficas, acadêmicas e de estilo de vida. Para calcular o estresse psicossocial foi utilizado o Job Stress Scale, na formulação de quadrantes do modelo de demanda-controle (MDC), que define as categorias: trabalho de baixa exigência (baixa demanda e alto controle); trabalho passivo (baixa demanda e baixo controle); trabalho ativo (alta demanda e alto controle); e alta exigência (alta demanda e baixo controle). A população do estudo foi composta, predominantemente, por mulheres (77,27%), pela faixa etária de 26 a 30 anos (43,18%), católicos (72,73%), solteiros (70,45%), com renda superior a 4 salários mínimos (45,45%), sem filhos (90,91%), bolsistas (84,09%), com carga horária semanal de 60 horas de dedicação exclusiva (68,18%). A alta demanda esteve presente em 87,3% dos pós-graduandos, o alto controle em 81,4%, evidenciando-se, ainda, um alto apoio social (90,9%). A categoria dos quadrantes que incluiu o maior número de pessoas foi o trabalho ativo (77,27%). De acordo com os resultados, viu-se que predominou o trabalho ativo, com altas demandas psicológicas e alto controle, além do alto apoio social.