在职初级卫生保健中的跨专业合作阻力。
Resistance to interprofessional collaboration in in-service training in primary health care.
机构信息
Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Estomatologia, Saúde Coletiva e Odontologia Legal, Ribeirão Preto, SP, Brazil.
Universidade Estadual de Campinas, Faculdade de Ciências Medicas, Departamento de Saúde Coletiva, Campinas, SP, Brazil.
出版信息
Rev Esc Enferm USP. 2022 May 13;56:e20210473. doi: 10.1590/1980-220X-REEUSP-2021-0473en. eCollection 2022.
OBJECTIVE
to analyze the resistance to interprofessional collaboration in the professional practices of residents in primary health care.
METHOD
Social and clinical qualitative research with 32 residents of a Multiprofessional Residency, carried out from 2017 to 2018. Data production included Institutional Analysis of Professional Practices, document analysis; investigator's diary; and observation. Data were analyzed based on Institutional Analysis concepts.
RESULTS
There were contradictions between the reproduction of uniprofessional education with a focus on the specialty and interprofessional collaborative practices. The resistance analysis pointed to two axes: not-knowing as an analyzer of resistance to collaboration; interprofessional interference and knowledge-power relations. Residents' practices were characterized as resistant to interprofessional collaboration.
CONCLUSION
The resistance analysis in the Multiprofessional Residency showed integrative movements of assimilation and disputes with physician-centered power, with damage to the sharing of care and interprofessional communication. The collective analysis questioned health professionals education, revisiting the perspective of comprehensive care guided by the users' needs.
目的
分析基层医疗保健领域住院医师职业实践中的跨专业协作阻力。
方法
这是一项社会和临床定性研究，共有 32 名多专业住院医师参与，研究时间为 2017 年至 2018 年。数据收集包括职业实践的制度分析、文献分析、研究人员的日记和观察。数据根据制度分析的概念进行分析。
结果
以专业为重点的单一专业教育的再生产与跨专业协作实践之间存在矛盾。阻力分析指向两个轴：作为协作阻力分析器的“不知”；以及跨专业干扰和知识-权力关系。住院医师的实践具有跨专业协作的特点。
结论
多专业住院医师的阻力分析显示出整合的同化运动，以及与以医生为中心的权力的争议，这对护理共享和跨专业沟通造成了损害。集体分析对卫生专业人员教育提出了质疑，重新审视了以用户需求为指导的综合护理视角。
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