Patients' experiences of and roles in interprofessional collaborative practice in primary care: a constructivist grounded theory study.

Alexandra R Davidson, Mark Morgan, Lauren Ball, Dianne P Reidlinger
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Abstract

Aim: This constructivist grounded theory study aimed to (1) explore patients' experiences of and roles in interprofessional collaborative practice for chronic conditions in primary care and (2) consider the relevance and alignment of an existing theoretical framework on patients' roles and based on the experiences of patient advocates.

Background: High-quality management of chronic conditions requires an interprofessional collaborative practice model of care considering an individual's mental, physical, and social health situation. Patients' experiences of this model in the primary care setting are relatively unknown.

Methods: A constructivist grounded theory approach was taken. Interview data were collected from primary care patients with chronic conditions across Australia in August 2020 - February 2022. Interviews were recorded, transcribed verbatim, and thematically analysed by (1) initial line-by-line coding, (2) focused coding, (3) memo writing, (4) categorisation, and (5) theme and sub-theme development. Themes and sub-themes were mapped against an existing theoretical framework to expand and confirm the results from a previous study with a similar research aim.

Findings: Twenty adults with chronic conditions spanning physical disability, diabetes, heart disease, cancer, autoimmune, and mental health conditions participated. Two themes were developed: (1) Adapting to Change with two sub-themes describing how patients adapt to interprofessional team care and (2) Shifting across the spectrum of roles, with five sub-themes outlining the roles patients enact while receiving care. The findings suggest that patients' roles are highly variable and fluid in interprofessional collaborative practice, and further work is recommended to develop a resource to support greater patient engagement in interprofessional collaborative practice.

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患者在初级医疗跨专业合作实践中的经历和角色:一项建构主义基础理论研究。
目的:这项建构主义基础理论研究旨在:(1)探讨患者在初级医疗慢性病跨专业合作实践中的经验和角色;(2)根据患者倡导者的经验,考虑现有理论框架与患者角色的相关性和一致性:背景:高质量的慢性病管理需要一种跨专业合作实践的护理模式,这种模式要考虑到个人的心理、生理和社会健康状况。患者在初级医疗环境中对这一模式的体验相对未知:方法:采用建构主义基础理论方法。访谈数据收集于 2020 年 8 月至 2022 年 2 月期间,来自澳大利亚各地的初级医疗慢性病患者。对访谈进行记录、逐字转录,并通过以下方法进行主题分析:(1)初步逐行编码;(2)重点编码;(3)撰写备忘录;(4)分类;(5)主题和次主题发展。根据现有的理论框架对主题和次主题进行了映射,以扩展和确认以前一项具有类似研究目的的研究的结果:20 名患有慢性疾病的成年人参加了此次研究,这些慢性疾病包括身体残疾、糖尿病、心脏病、癌症、自身免疫性疾病和精神疾病。研究提出了两个主题:(1) 适应变化,其中两个子主题描述了患者如何适应跨专业团队护理;(2) 角色转换,其中五个子主题概述了患者在接受护理时所扮演的角色。研究结果表明,在跨专业合作实践中,患者的角色是高度可变和多变的,建议进一步开展工作,开发一种资源,支持患者更多地参与跨专业合作实践。
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