O clima de trabalho em equipe dos Núcleos Ampliados de Saúde da Família e Atenção Básica

Abstract

Introduction: The consolidation of Primary Health Care (PHC) in recent decades represents one of the most relevant advances of the Unified Health System as a public policy and universal health system in Brazil. This advance is largely due to the scope of the Family Health Strategy, its main care model. However, given the increase in demands and limitations, the Support Center for Family Health and Primary Care (NASF-AB) was created to expand the scope of actions in primary care, through teams formed by different professions. The study of the Team Work Climate allows the evaluation of teams to monitor the effectiveness of teamwork, in the production of results in the care of users and population. Objective: To analyze the NASF-AB teamwork climate. Methods: This is a cross-sectional quantitative study of multiple cases (João Pessoa/PB and Campo Grande/MS). The sample consisted of 182 professionals from the NASF-AB in these two capitals. In order to obtain the data, from January to March 2020, a structured questionnaire with questions that characterized the participants and their work process and the Team Climate Scale (ECE) was applied. For storage, processing and analysis, using the Excel program and the R statistical package. Respondents were grouped by teams and their total score was calculated (mean of the individual scores of the ECE). From this, teams were classified into 4 types. Results: The NASF-AB consisted of 10 different professions, with physical therapists being the most prevalent. Young adult professionals, women, specialists, who wanted to work at NASF-AB, graduated about 9 years ago, with an average of 4 years of experience in PHC and with an average of 2 years of relationship with their current teams, predominated. The professionals were satisfied with their own work and with that of their team, with the relationship and communication with other team members, with the unit manager and with how much their work was centered on the users' needs, but dissatisfied with the infrastructure of the units. The services provided were predominantly individual and with curative actions. An analytical model of the characteristics of physiotherapists and their work process at NASF-AB was developed, showing that it is centered on the needs of users. It was seen that teams that support new ideas, are clear about the team's objectives, have adequate task orientation and that develop fewer activities with other professionals from the NASF-AB and the ESF, are those that had the best teamwork climate. Conclusions: In order for there to be a good teamwork climate and for interprofessional collaboration to take place in practice, the involvement of professionals is paramount. Thus, permanent education is fundamental for the transformation of professional practice, in an integrated and collaborative way. Furthermore, the development of dialogic spaces, the implementation of strategies, institutional support, the meeting of teams, the exchange of knowledge, the sharing of practices and the definition of action plans with a functioning counter-referral system must be promoted.