Journal of Interprofessional Care最新文献

Interprofessional collaboration (IPC) is a means of delivering high-quality person-centered care. When implemented successfully, IPC creates an integrated and cohesive system that improves care and service provision. However, factors influencing the quality of IPC, such as relationship development at work, are still not fully understood. In this constructivist grounded theory study, we explored practitioners' experiences of interprofessional relationships in an acute stroke care environment in an NHS Trust in the North of England. Following ethical approval, with the support of a senior leader in the setting, 13 participants in a range of practice roles were recruited through purposeful selection, and then, theoretical sampling. Data were collected through observations and interviews and systematically analyzed concurrently through constant comparative analysis. In a propositional grounded theory, we identified a core social process of experiencing growth through interprofessional relationships with four interrelated categories: Developing a sense of belonging; Rewards and recognition; Inclusive working and learning; and Interprofessional compassion. This knowledge may provide leaders of interprofessional healthcare teams with an additional focus for staff development and retention strategies, at a time when retaining and developing the healthcare workforce is a key global priority.

We aimed to explore how specialist nurses and psychiatrists perceive and conceptualize their own responsibility and autonomy in relation to interprofessional colleagues when caring for inpatients with deliberate self-harm. Eight psychiatrists and 10 nurses were interviewed. The interviews underwent thematic analysis by an interdisciplinary group of experts in ethics, law, mental health nursing, and psychiatry. Three themes were found. The first theme focused on role-specific tasks and perceived responsibility. Psychiatrists more often emphasized the legal perspective and specialist nurses the ethical perspective. The second theme was to adapt to other professionals' opinions. When someone else had made a decision, autonomy was perceived to decrease, whereas responsibility increased. The third theme was renunciation of autonomy for achieving cooperation. It was considered important to strive for consensus in the team. Both nurses and psychiatrists believed they had a high degree of autonomy and responsibility when their roles were well-defined. The respondents considered clear roles, good communication, shared expectations, and mutual respect to be prerequisites for interprofessional collaboration in hospital care of patients with deliberate self-harm.

Delivery of health and social care in the UK has shifted toward an integrated care approach in which health and social care professionals work together across preexisting healthcare boundaries in interprofessional teams, referred in UK policy as multi-disciplinary teams (MDTs). If integrated working is to be successful, it is essential that all professionals have the necessary skills to work together effectively. We examined the educational requirements relating to MDT working for different health and social care professions as mandated by regulatory or professional bodies in England to determine current standards and how these may vary across professions. Twenty-six documents were searched using keywords related to MDT working for nine professions; Dietetics, Medicine, Midwifery, Nursing, Pharmacy, Physiotherapy, Occupational Therapy, Speech and Language Therapy and Social Work. Extracts were subjected to content analysis, and categories mapped across professions. Four categories were identified: Interprofessional learning, MDT working, improving patient care, and healthcare policy. Despite areas of consistency (all professions required learning from other professionals) there were some marked differences. A more consistent approach to training our health and social care workforce would better facilitate integrated care delivery.

Interprofessional collaboration (IPC) is crucial for the safe provision of maternity care. However, IPC is poorly understood in the maternity care context, and the role of the childbearing woman within this collaboration remains unclear. The Labouring Together study used a mixed method, multi-site case study design to explore IPC and decision-making with women from the perspectives of maternity health care professionals (HCP). Case studies included a range of maternity models of care in metropolitan and regional settings in Australia. Cross-sectional surveys were used to investigate organizational context and HCPs' attitudes toward collaboration. Experiences and perceptions of collaboration and decision-making were explored using in-depth semi-structured interviews. A conceptual framework "Experience of collaboration: Working together to get the best outcomes" was formed from the interview findings, with major themes of "Organisation of care: working together for the organisation" and "Partnering in care: working together with women." Individual-level behaviors were employed by HCP to transcend interprofessional tensions relating to IPC. Entrenched organizational and policy-level barriers to effective IPC were identified; and whilst participants agreed that women should have autonomy with decision-making, most identified barriers at multiple levels to achieving this ideal.

This study aims to explore the perceptions of junior nurses and junior doctors toward their interpersonal interactions with healthcare professionals in an acute regional hospital setting. A qualitative descriptive method was used. Data were collected by individual semi-structured interviews which were audio-recorded. Participants included junior nurses (n = 6) and junior doctors (n = 4), registered within 3 months to 2 years, and employed at a large regional health service in Victoria, Australia. Data were analyzed using content analysis. Four main themes were identified. First, junior nurses and junior doctors value working as part of an interprofessional healthcare team. Feeling respected by interprofessional team members leads to improved job satisfaction. Second, preparatory education for nurses and doctors' lacks focus on interprofessional communication, including role play simulations. Third, the healthcare system in which junior nurses and junior doctors are employed is strained with heavy workloads, hindering their capacity to engage in effective interprofessional communication. Finally, positive interprofessional interactions inform collaborative approaches, which leads to provision of quality care and improvement in patient outcomes. In contrast, safe and timely patient care can be compromised by poor interprofessional communication. Junior nurses and doctors value opportunities for interprofessional collaboration. However, their capacity to engage with other healthcare professionals may be impeded by hierarchy, lack of confidence, workload demands and inadequate training. Nurses and doctors require specific training in preparatory training programs related to interprofessional communication skills.

We aimed to assess perceptions about interprofessional collaboration (IPC) of healthcare professionals working in an acute medical unit (AMU) in an internal medicine department in the United Arab Emirates. The AMU provides care during the initial 24 to 72 hours of admission and emphasizes interprofessional collaboration. Using the Assessment of Interprofessional Team Collaboration Scale II, the study measured partnership, cooperation, and coordination among team members. Between November 5, 2022, and January 5, 2023, 81 participants completed the survey, including physicians (n = 45; 55.5%), nurses (n = 18; 22.2%), and clinical and non-clinical allied health professionals (n = 18; 22.2%). On a Likert-type scale of one to five, most respondents perceived partnership, cooperation, and team coordination as good collaboration on the AMU, with mean scores of 4.29, 4.16, and 4.15, respectively. There was no significant difference between physicians' (4.18) and nurses' (4.45) perspectives of IPC on the AMU (p = .10), but physicians were less likely to notice collaborative practice changes compared to other professionals. Introducing IPC early in medical education might enhance future collaborative practice. This study sheds light on IPC in non-Western contexts and provides insights into how collaboration is perceived and practiced in diverse healthcare settings.

Interprofessional Training Wards (IPTWs) have become a future-oriented, effective form of interprofessional (IP) education. This paper focuses on the quantitative pre-post analysis of a mixed-methods evaluation study to assess the impact of 3-to-4-week placements on the first IPTW in Switzerland on students, facilitators, and patients. Outcomes for students and facilitators were measured using the University of the West of England Interprofessional Questionnaire (UWE-IP) for communication and teamwork skills as well as attitudes to collaborative learning and working, and the Fragebogen zur Arbeit im Team (FAT) to address team-development. Moreover, patient satisfaction was assessed, using a self-developed questionnaire. 63 students, 31 facilitators and 91 patients placed on the IPTW between 2018 and 2022 were included into the study, along with 71 healthcare professionals and 50 patients of the control-wards. UWE-IP and FAT were analyzed using Wilcoxon signed-rank test for pre-post-IPTW comparison and Kruskal-Wallis independent sample test for differences between post-IPTW and post-control. Mann-Whitney U-test was applied to determine differences in patient satisfaction between IPTW and control-ward. Statistically significant positive effects were seen pre-post IPTW for students and facilitators for two subscales of UWE-IP (Communication & Teamwork, and IP Relationship), as well as for FAT, with effect size up to r = 0.681. Control-ward staff scored significantly lower than post-IPTW participants on two UWE-IP subscales (IP Learning, and IP Relationship) and on FAT. Patient satisfaction exhibited non-significant difference across IPTWs and controls. In conclusion, IPTW-placement benefited students' and facilitators' interprofessional teamwork skills, while keeping patient satisfaction high.

Healthcare clinical microsystems are small, goal-oriented groups of healthcare professionals that work together on a regular basis to provide care to discrete patient populations. They often include team-based frameworks such as bedside interprofessional rounds, geographic colocation of healthcare team members, interprofessional staff leadership, and unit-level data sharing. In inpatient settings, microsystems improve interprofessional communication and collaboration. In this qualitative study, we examined physician experiences of clinical microsystems and the mechanisms underpinning interprofessional communication in this environment. We interviewed 51 resident and hospitalist physicians. Thematic analysis of physician experiences revealed three key themes: (a) Clinical microsystem effect on workflow, (b) Open forum and work relationships, and (c) Face-to-face vs technology-based communication. Physicians described strong interprofessional relationships based on frequent face-to-face communication. Familiarity with healthcare team members, often resulting from being co-located to the same units, created a comfortable work environment, advanced patient care, and accelerated workflow. Physicians preferred in-person communication with interprofessional colleagues over technology-based communicationand described how in-person interactions enriched subsequent technology-led interactions. As the use of technology-based communication grows in inpatient settings, decreasing face-to-face interactions and facilitating dispersed care, understanding and implementing optimal conditions for effective interprofessional communication is essential.

We aimed to perform cross-cultural adaptation of the Interprofessional Collaboration Scale (IPC-BR) and to evaluate evidence of its validity for the Brazilian hospital context. The research consisted of six steps: translation of the instrument into the new language, synthesis of the translated versions, back-translation, synthesis of the versions in the original language, evaluation of the syntheses by an expert committee, and pilot testing or pretesting and validation of the internal structure of the items of the instrument. The pilot testing involved 4 translators, 14 judges, and 30 healthcare professionals; the validation of the internal structure involved 686 professionals including nurses, physicians and physiotherapists. Translation and cross-cultural adaptation revealed no significant changes or discrepancies in meaning from the original model. Exploratory, confirmatory, and parallel factor analyses confirmed that the Brazilian scale is unidimensional. We found unidimensional characteristics and satisfactory factor loadings, with good levels of reliability, which makes the instrument provide consistent and reliable internal evidence for measuring the construct. Thus, the possibility of using it to assess interprofessional collaboration among different target groups in the Brazilian scenario was confirmed.