Fatores associados à avaliação do trabalho em equipe nos núcleos ampliados de saúde da família e atenção básica

Abstract

Introduction. Teamwork is understood as the joining of several people who join efforts to solve a certain problem they have in common. On the other hand, when two or more people work together to perform a task, this dynamic allows for the sharing of knowledge from different professional categories, and then collaboration facilitates the production of efficient care. In this context, the joint work between the teams of “Núcleo Ampliado de Saúde da Família e Atenção Básica (NASF-AB)” (the Expanded Center for Family Health and Primary Care) and “Equipes de Saúde da Família (EqSF)” (the Family Health Teams) make it possible to develop strategies such as permanent education for professionals and for users, identification of health problems and development of expanded therapeutic approaches. With a view to consolidating and supporting the insertion of the Family Health Strategy in the health service network and increasing coverage, resolution, regionalization and territorialization, as well as expanding AB actions, the Ministry of Health created the Support Centers for the family health (NASF), in 2008, under Ordinance GM nº 154 of 01/24/2008. In 2017, the NASF were renamed with the reformulation of the National Primary Care Policy (PNAB) and were renamed Expanded Family Health and Primary Care Centers - NASF-AB. Goal. To analyze the factors associated with the assessment of teamwork among NASF-AB professionals from two capitals in Brazil. Materials and Method. This is a quantitative and cross-sectional study with 182 professionals from NASF-AB, two capitals of Brazil were defined as case units: João Pessoa, capital of Paraíba (PB), and Campo Grande, capital of Mato Grosso do Sul (MS). The collection process was carried out from February to March 2020. To collect the data, a structured questionnaire was applied to a random sample of higher-level workers who make up the NASF-AB teams. To verify the homogeneity of the sample between the municipalities, the chi-square test (χ2) was performed to compare the frequency of each independent and dependent variable in the municipalities of João Pessoa and Campo Grande. To verify the individual association between the dependent and independent variables, the outcomes were adjusted in the Binary Logistic Regression models and inserted in the Multiple Logistic Regression model, when associated. Associations were expressed as Odds Ratio (OR) values and 95% confidence intervals (95%CI). The research was approved by the SMS of the two cities, and by the Ethics Committees in Health Sciences Research of the UFPB opinion no. 3,281,041 and the opinion nº 3,584,953 from the UFMS. Results. There was a predominance of females (n=151; 83%), between 25 and 45 years old (n= 153; 84%), most had more than five years of graduation (n=137; 75.2 %). Workers satisfied with communication between their team partners (OR= 4.83; 95%CI 1.52 – 16.49. They presented more chances to evaluate positively the interprofessional work between NASF-AB and ESF. Workers with more time in the NASF-AB (OR= 5.82; 95%CI 1.39 – 40.77) and who felt fulfilled with their work at NASF-AB (OR= 2.85; 95%CI 1.31 – 6.40). Final considerations. It is possible to present some propositions to qualify care in the context of PHC and teamwork, and it was possible to observe the adoption of collaborative practices to improve the service. However, it is necessary to train and raise the awareness of professionals from the two teams (NASF-AB and ESF) in the two capitals studied, regarding shared work. Two of the six competences for interprofessional collaboration were associated with a positive assessment of teamwork, which suggests that this topic should be addressed in continuing education activities. It should also be noted that NASF-AB professionals, Public Health students and other Health professionals should carry out training activities based on interprofessional collaborative work, with the aim of stimulating debates among workers, so that they adopt habits that provide service satisfaction and collaborative practices.