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      Atenção centrada no paciente na prática interprofissional colaborativa Translated title: Atención centrada en el paciente y práctica interprofesional colaborativa Translated title: Patient centred care in interprofessional collaborative practice

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          Abstract

          Este estudo foi realizado com o objetivo de descrever os elementos-chave da atenção centrada no paciente e sua relação com a prática interprofissional colaborativa na atenção primária à saúde, no contexto do Sistema Único de Saúde, apoiado em revisão de literatura nacional e internacional. Os resultados mostram que, à medida que os profissionais centram atenção no paciente e suas necessidades de saúde, operam simultaneamente um deslocamento de foco para um horizonte mais amplo e além de sua própria atuação profissional. Esse deslocamento é reconhecido como componente de mudança do modelo de atenção à saúde na perspectiva da integralidade, com potencial de impacto na qualidade da atenção.

          Translated abstract

          El objetivo de este estudio es describir los elementos clave de la atención centrada en el paciente y su relación con la práctica interprofesional colaborativa en la Atención Primaria de la Salud. El mismo se apoya en la revisión de literatura nacional e internacional. Los resultados muestran que cuando los profesionales desplazan su actuación hacia la atención centrada en el paciente y hacia las necesidades del paciente, amplían sus horizontes de actuación más allá de los límites de su propia profesión. Este desplazamiento es un componente positivo para el cambio del actual modelo de Atención a la Salud desde la perspectiva de la integralidad y con potencial impacto en la calidad de los servicios.

          Translated abstract

          The aim of this study is to describe key-elements of patient-centred care and its relationship with interprofessional collaborative practice in Primary Health Care, in the context of Unified Health System. Based on national and international review. The outcomes show that as professionals shift their focus towards patient centred care and patient’s needs, their scope of view is broadened beyond the limits of their own professional activities. This shift is an enabler for changes in the current health care model towards comprehensive care and potentially impacting the quality of services.

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          Patient-centredness: a conceptual framework and review of the empirical literature.

          A 'patient-centred' approach is increasingly regarded as crucial for the delivery of high quality care by doctors. However, there is considerable ambiguity concerning the exact meaning of the term and the optimum method of measuring the process and outcomes of patient-centred care. This paper reviews the conceptual and empirical literature in order to develop a model of the various aspects of the doctor-patient relationship encompassed by the concept of 'patient-centredness' and to assess the advantages and disadvantages of alternative methods of measurement. Five conceptual dimensions are identified: biopsychosocial perspective; 'patient-as-person'; sharing power and responsibility; therapeutic alliance; and 'doctor-as-person'. Two main approaches to measurement are evaluated: self-report instruments and external observation methods. A number of recommendations concerning the measurement of patient-centredness are made.
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            Equipe multiprofissional de saúde: conceito e tipologia

            Apresenta-se um conceito e uma tipologia de trabalho em equipe, bem como os critérios de reconhecimento dos tipos de equipe. O conceito e a tipologia foram elaborados com base na literatura sobre o tema e em uma pesquisa empírica sobre trabalho multiprofissional em saúde, fundamentada teoricamente nos estudos do processo de trabalho em saúde e na teoria do agir comunicativo. Segundo essa formulação teórica, o trabalho em equipe consiste numa modalidade de trabalho coletivo que se configura na relação recíproca entre as intervenções técnicas e a interação dos agentes. A tipologia proposta refere-se a duas modalidades de equipe: equipe integração e equipe agrupamento, e os critérios de reconhecimento dos tipos de equipe dizem respeito a comunicação entre os agentes do trabalho; diferenças técnicas e desigual valoração social dos trabalhos especializados; formulação de um projeto assistencial comum; especificidade de cada área profissional; e flexibilidade da divisão do trabalho e autonomia técnica.
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              What are the core elements of patient-centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing.

              To identify the common, core elements of patient-centred care in the health policy, medical and nursing literature. Healthcare reform is being driven by the rhetoric around patient-centred care yet no common definition exists and few integrated reviews undertaken. Narrative review and synthesis. Key seminal texts and papers from patient organizations, policy documents, and medical and nursing studies which looked at patient-centred care in the acute care setting. Search sources included Medline, CINHAL, SCOPUS, and primary policy documents and texts covering the period from 1990-March 2010. A narrative review and synthesis was undertaken including empirical, descriptive, and discursive papers. Initially, generic search terms were used to capture relevant literature; the selection process was narrowed to seminal texts (Stage 1 of the review) and papers from three key areas (in Stage 2). In total, 60 papers were included in the review and synthesis. Seven were from health policy, 22 from medicine, and 31 from nursing literature. Few common definitions were found across the literature. Three core themes, however, were identified: patient participation and involvement, the relationship between the patient and the healthcare professional, and the context where care is delivered. Three core themes describing patient-centred care have emerged from the health policy, medical, and nursing literature. This may indicate a common conceptual source. Different professional groups tend to focus on or emphasize different elements within the themes. This may affect the success of implementing patient-centred care in practice. © 2012 Blackwell Publishing Ltd.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                s_icse
                Interface - Comunicação, Saúde, Educação
                Interface (Botucatu)
                UNESP
                1414-3283
                December 2016
                : 20
                : 59
                : 905-916
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Prefeitura Municipal de Campinas Brazil
                Article
                S1414-32832016000400905
                10.1590/1807-57622015.0511
                eeae3220-1759-4323-be36-86f2192327d2

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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                SciELO Public Health

                Self URI (journal page): http://socialsciences.scielo.org/scielo.php?script=sci_serial&pid=1414-3283&lng=en

                Assistência centrada no paciente,Atenção Primária à Saúde,Relações interprofissionais,Atención centrada en el paciente,Atención Primaria de la Salud,Relaciones interprofesionales,Patient-centred care,Primary Health Care,Interprofessional relations

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