Práticas colaborativas, trabalho em equipe e as barreiras para efetivação da interprofissionalidade: um olhar na possível transformação do cuidar

Abstract

Introduction: Primary Health Care, due to its applicability in care, represents a strategic context for the implementation of comprehensiveness, considering its aspects of multi/interprofessional, transdisciplinary, intersectoral action, work dynamics and preferential entry point into Health Care Networks. At this level of care, teams are composed of professionals from different areas of knowledge, who together share and support practices in the territories, aiming to overcome fragmented care. In this nexus, interprofessionality comes as the foundation of joint, collaborative work based on the sharing of objectives and knowledge in favor of comprehensive care, centered on the user, considering the complex and dynamic nature of health, citizens and the community. Objectives: To analyze care practices and interprofessional exercise in Primary Health Care, in a city in the interior of Bahia. As specific objectives, to understand care practices from the perspective of care resolution and comprehensiveness; to identify the barriers and obstacles to the practice of interprofessional practice in Primary Health Care; and to promote the qualification, through technical products, of health workers and students for interprofessional and collaborative care in the daily work processes in health. Methodology: This is a qualitative and exploratory study. It was conducted in the city of Anguera-Bahia, in the Central-East region of this state. The participants were workers from the Family Health teams and the multiprofessional team, with at least six months of experience in the municipal health service. The definition of the sample by saturation resulted in a total of 18 interviewees for the production of data. Semi-structured interviews were used and the interpretation of the data was based on Thematic Content Analysis. The work was approved by the Ethics Committee of the State University of Bahia. In addition to the scientific production, two technical products were produced based on the need identified, based on the data produced: a practical guide on interprofessionality and a course on this topic. Results: The importance of the multidisciplinary team in conjunction with the Family Health teams, through collaborative work, proved to be fundamental in the search for comprehensive care for users, as reported by the interviewees. To this end, professionals from different health backgrounds, each contributing with their skills, can offer an integrated approach to care so that users and communities benefit from being assisted by a multidisciplinary team integrated into Family Health. The recognition of insufficient professional qualification actions, the scarcity of resources and the high demand for care were pointed out by workers as barriers that permeate the daily routine of health services and hinder collaborative professional action, which is a challenge to guarantee comprehensive and effective care, as recommended by the Unified Health System. In addition to the scientific production, a mini-course was held that addressed interprofessionality and collaborative practice, as well as the construction of a practical guide, delivered in printed and digital form, with the fundamental elements of this way of acting in care, in order to promote greater knowledge on the subject and given that the interviewees demonstrated little theoretical knowledge on the subject. Conclusion: Aspects ranging from team qualification to the provision of financial resources in Primary Care can constitute obstacles to the full articulation of the different knowledge centers in the exercise of shared care and collaborative practices. In view of this, the multidisciplinary team, when working together with the minimum team and performing the exercise of interprofessional practice, presents itself as a tool that reduces fragmented and individual views within the team, which ultimately contributes to the implementation of comprehensive care and problem-solving capacity. Thus, it is essential to produce paths to consolidate transformations that contribute to changing the logic of fragmented care, with the implementation of training processes that aim at comprehensive and problem-solving care, as recommended by the Unified Health System.