Liderança colaborativa no contexto do trabalho em equipe na atenção primária à saúde: revisão integrativa

Abstract

Teamwork based on collaborative practice is a powerful strategy for tackling the challenges involved in the development of work and caring for growing and complex health demands. Collaborative leadership is essential for involving the different players in discussions and in carrying out activities, so as to respect points of view, value suggestions and proposals, and promote autonomy for team members. With autonomy, team members' sense of belonging reaches a different level, leading to greater engagement among professionals. The aim of this study was to analyse the available scientific evidence on collaborative leadership in teamwork contexts and its contributions to primary health care, highlighting how collaborative leadership occurs in the work context and its possible contributions to health outcomes. This is an integrative review that took up the research question: "How have professionals developed collaborative leadership in the context of teamwork in Primary Health Care?". It included original articles available in full online, in Portuguese, English or Spanish, published between 2017 and 2022. For the searches, the following electronic bibliographic databases were consulted: MEDLINE-PUBMED, ERIC, SCOPUS, WEB OF SCIENCE and Lilacs. The search terms (leadership; collaborative; health; professional; teamwork; interprofessional; interdisciplinary; education; training) were applied in Portuguese, English and Spanish, in different combinations with the booleans "AND" and/or "OR". All the articles identified were saved, exported and hosted on Rayyan®. The eligibility criteria were applied by two independent double-blind evaluators. In total, 3,601 articles were identified. The ckecklist and PRISMA flowchart were followed. After the initial screening of abstracts and titles, 47 articles were selected and read in full. Of these, 27 were eliminated. The 23 articles that met all the eligibility criteria were included in the integrative review. The data was extracted, organised in a summary table and categorised. Four categories emerged from the analyses: Conceptions and Perspectives of Leadership; Characteristics of Leadership Models; Challenges and Possibilities of Collaborative Leadership in Healthcare Organisations; and the Potential of Interprofessional Education for Developing Collaborative Leadership Competence. The results indicate the importance of developing shared leadership competences among healthcare leaders and teams. Shared leadership has the potential to improve the commitment and motivation of professionals; contribute to decision-making and effective communication; and promote the continuous training of leaders to favour mutual recognition. Based on the publications, a framework was organised with competences related to collaborative leadership in health contexts. The need to improve leadership studies is clear, especially considering the perspective of interprofessional collaboration as an alternative to authoritarian and hierarchical management models. Collaborative competences involve a combination of knowledge, skills, attitudes, values and judgements that must be developed or improved in the different contexts of training and working in healthcare, in pursuit of quality care.