Práticas interprofissionais colaborativas de nutricionistas em ambiente clínico hospitalar: uma revisão de escopo
Data
2023-09-25
Autores
Dias, Vanessa Araujo 
Orientadores
Batista, Nildo Alves
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A partir de lacunas identificadas na literatura, buscou-se responder a seguinte questão: O que se sabe sobre a prática interprofissional envolvendo nutricionistas no contexto clínico hospitalar na literatura nacional e internacional? Objetivo: Mapear e analisar as práticas interprofissionais colaborativas envolvendo nutricionistas no contexto clínico hospitalar presentes na literatura nacional e internacional. Métodos: O estudo é uma revisão de Escopo conforme recomendações da Joanna Briggs Institute (JBI). Os estudos foram incluídos se preenchessem os critérios para População, Conceito e Contexto estabelecidos para a revisão. Ou seja, se fornecessem informação sobre nutricionistas ou equipes multiprofissionais, envolvendo nutricionistas. Abordassem explicitamente as bases conceituais da prática interprofissional, incluindo a matriz canadense de competências colaborativas ou permitissem aproximação aos conceitos dada à confusão de terminologia já relatada na literatura com a utilização dos termos multiprofissionalidade, interprofissionalidade e interdisciplinaridade. E tivessem sido realizados no ambiente hospitalar. Quatro bases de dados eletrônicos foram pesquisadas. Estratégia de busca foi desenvolvida para uma delas e depois adaptada por uma bibliotecária. Resultados e discussão: As buscas resultaram em 1081 registros que foram transportados para a ferramenta Rayyan®. 353 duplicatas foram sinalizadas automaticamente pelo programa, confirmadas e excluídas manualmente por um dos pesquisadores. Durante a triagem, os títulos e resumos de 728 estudos foram analisados de maneira cega e pareada. Após isso, 45 estudos foram submetidos à etapa de leitura em texto completo. Entre as publicações selecionadas, 42 delas foram lidas de maneira independente em texto completo, uma vez que três foram retiradas, porque não estavam disponíveis on-line e não houve retorno dos autores para disponibilizá-las integralmente. Realizou-se, também, busca pelas citações em revisões com temas semelhantes entre aquelas que foram excluídas durante a triagem, restando apenas uma publicação para inclusão na revisão. Portanto, ao final do processo, 15 estudos foram incluídos que foram publicados e/ou disponibilizados entre 2007 e 2022, sendo 2014 o ano com o maior número de publicações. Quanto à distribuição geográfica, houve preponderância dos estudos realizados na América do Norte e Europa, com três estudos brasileiros e um da Indonésia. 66% das publicações utilizaram abordagens qualitativas, sendo entrevista e grupo focal os procedimentos principais de coleta de dados. Considerando as publicações que informaram número de participantes, no total obteve-se n = 2347. Os maiores percentuais de profissões, excluindo os nutricionistas, foram, respectivamente, enfermagem (93%) e medicina (87%). Entre os estudos incluídos, 10 forneceram informações específicas sobre nutricionistas nos contextos estudados. Conclusões: Em geral, os resultados revelaram que o efetivo trabalho em equipe e a prática interprofissional nos cenários estudados estão distantes das bases conceituais que os definem. Apesar do reconhecimento e da valorização do trabalho em equipe interprofissional, a materialização das competências colaborativas foi ainda introdutória. Nesse sentido, mais manifestações do que precisa acontecer foram encontradas nos discursos do que em eventos reais. Quanto aos nutricionistas, em específico, observou-se de maneira recorrente questões sobre a clareza do papel desses profissionais. Igualmente, constatou-se subordinação ao ato médico e pouca representatividade nas equipes.
Introduction: From gaps identified in the literature, we sought to answer the following question: What is known about clinical hospital dietitians’ interprofissional practice in national and international literature? Objective: Map and analyse the interprofessional collaborative practices involving dietitians in hospital clinical settings present in national and international literature. Methods: A Scoping Review that followed Joanna Briggs Institute (JBI) recommendations. Studies were included if they met Population, Concept and Context criteria. If they provided information about dietitians or multiprofessional teams. Explicitly adressed interprofessional practice conceptual bases, including canadian competency framework, or allowed concept approximation given the confusion in terminology already reported in the literature with the use of the terms multiprofessionality; interprofessionalty and interdisciplinarity. Also, if they were carried out in the hospital environment. Four eletronic databases were used. Search strategy was developed for one of them and later adapted by a librarian Results and discussion: 1081 records were identified and transferred to Rayyan® tool. 353 duplicates were automatically flagged by the tool, confirmed and manually deleted by one of the researchers. 728 studies were blindly and pairwise analyzed. After that, 45 studies were selected for full-text reading stage. 42 of them were read independently in full text, since three studies were removed because they were unavailable online end there was no response from authors. A citation search was also carried out in reviews with similar themes excluded during screening. Only one of those publications was left to be included into the review. At the end process, 15 studies were included. They were published and/or made available between 2007 and 2022. 2014 was the year with the highest number of publications. Most studies were carried out in North America and Europe, with three brazilians studies and one indonesian. 66% of the publications used qualitative approaches, with interviews and focus groups being the maind data collection precedures. Considering publications that resported number of participantes, a total of n= 2347 was obtainded. The highest percentages os professions, excluding dietitians, were nursing (93%) and medicine (87%), respectively. 10 studies provided specific information about dietitians. Conclusions: In general, results revealed that effective teamwork and interprofessional practice in the contexts studied. are far from the conceptual bases that define them. Despite interprofessional teamwork recognition and appreciation, collaborative skills materialization was still introductory. In this sense, more idealized manifestations of what need to happen were found in speeches than in real events. With regard to dietitians, in particular, questions about dietitans’ role were observed frequently. Likewise, there was subordination to the medical act and little representation in teams.
Introduction: From gaps identified in the literature, we sought to answer the following question: What is known about clinical hospital dietitians’ interprofissional practice in national and international literature? Objective: Map and analyse the interprofessional collaborative practices involving dietitians in hospital clinical settings present in national and international literature. Methods: A Scoping Review that followed Joanna Briggs Institute (JBI) recommendations. Studies were included if they met Population, Concept and Context criteria. If they provided information about dietitians or multiprofessional teams. Explicitly adressed interprofessional practice conceptual bases, including canadian competency framework, or allowed concept approximation given the confusion in terminology already reported in the literature with the use of the terms multiprofessionality; interprofessionalty and interdisciplinarity. Also, if they were carried out in the hospital environment. Four eletronic databases were used. Search strategy was developed for one of them and later adapted by a librarian Results and discussion: 1081 records were identified and transferred to Rayyan® tool. 353 duplicates were automatically flagged by the tool, confirmed and manually deleted by one of the researchers. 728 studies were blindly and pairwise analyzed. After that, 45 studies were selected for full-text reading stage. 42 of them were read independently in full text, since three studies were removed because they were unavailable online end there was no response from authors. A citation search was also carried out in reviews with similar themes excluded during screening. Only one of those publications was left to be included into the review. At the end process, 15 studies were included. They were published and/or made available between 2007 and 2022. 2014 was the year with the highest number of publications. Most studies were carried out in North America and Europe, with three brazilians studies and one indonesian. 66% of the publications used qualitative approaches, with interviews and focus groups being the maind data collection precedures. Considering publications that resported number of participantes, a total of n= 2347 was obtainded. The highest percentages os professions, excluding dietitians, were nursing (93%) and medicine (87%), respectively. 10 studies provided specific information about dietitians. Conclusions: In general, results revealed that effective teamwork and interprofessional practice in the contexts studied. are far from the conceptual bases that define them. Despite interprofessional teamwork recognition and appreciation, collaborative skills materialization was still introductory. In this sense, more idealized manifestations of what need to happen were found in speeches than in real events. With regard to dietitians, in particular, questions about dietitans’ role were observed frequently. Likewise, there was subordination to the medical act and little representation in teams.