Journal of Interprofessional Care最新文献

The aim of this study was to evaluate the effect of nurse-physician collaboration on the incidence of complications, anxiety and depression, quality of life, and satisfaction with nursing care among cervical cancer patients undergoing three-dimensional intracavitary brachytherapy. In this randomized, single-blinded, placebo-controlled trial, 92 eligible cervical cancer patients were equally divided into two groups upon admission. The control group was given routine nursing, and the intervention group received a nurse-physician collaboration in addition to routine care. Anxiety, depression, and health-related quality of life in both groups were assessed and compared at baseline and discharge. The intervention group had significantly fewer complications and showed marked improvements in mental health and quality of life compared to the control group. Satisfaction with nursing care was substantially greater in the intervention group. These results support the clinical adoption of a nurse-physician collaborative care model in the management of cervical cancer with three-dimensional intracavitary brachytherapy.

Patient-centered, interprofessional occupational therapy is feasible in complex patients in the early phase of rehabilitation, and it contributes to meet needs in the domains of self-care, productivity, and leisure, promoting social role. We planned this single-center single-blind two-arm parallel individual patient randomized controlled trial, to verify the superiority of interprofessional experimental occupational therapy (EOT) compared to standard rehabilitation (SR) in producing higher levels of patients' social participation assessed by the Reintegration to Normal Living Index. EOT is a patient-centered, hospital/home-based rehabilitation intervention based on the Canadian Model of Occupational Performance and Engagement. This appropriately powered study will provide evidence regarding the effectiveness of EOT on the recovery of social participation in the critical transition of complex patients from hospital to the home setting.

This study evaluates whether the implementation of an in-hospital care pathway (CP) improves interprofessional teamwork across countries and tests whether improved communications ("relational coordination") is the mechanism of action. A hospital-based cluster randomized controlled trial in Ireland, Belgium, Italy, and Portugal was performed. Fifty-six interprofessional teams caring for patients admitted with an exacerbation of chronic obstructive pulmonary disease or for patients with a proximal femur fracture were included and randomly assigned to an intervention group (31 teams and 567 team members), where a CP was implemented, and a control group (25 teams and 417 team members) representing usual care. Multilevel regression and mediation analysis were applied. First, although no significant effect was found on our primary outcome relational coordination, our CP significantly improved several team inputs, team processes (team climate for innovation) and team output (the level of organized care, level of competence) indicators. Second, our team process indicator of team climate for innovation partially mediated the association between CP implementation and team output indicator of better level of organized care. In conclusion, a CP sets in motion various mechanisms that improve some but not all aspects of interprofessional teamwork. Relational coordination does not appear to be the mechanism by which team outputs are enhanced.

The purpose of this quasi-experimental study was to explore the influence of an interprofessional simulation experience on student perceptions of interprofessional collaboration, as well as to explore the influence of the participant and observer roles on these beliefs. A two-session simulation experience was developed to engage professional students in the collaborative care of a patient admitted to a home health agency. To provide the simulation experience in a time efficient manner within the curriculum, students participated in two interprofessional teams of nursing and physical therapy students. Each team actively participated in the collaborative care of the patient in one session. In the alternate session, the interprofessional team observed the care of the patient, documented behaviors ideal for interprofessional teamwork, and provided feedback regarding the interprofessional collaboration and communication observed during debriefing. Observers in this study consistently improved their self-perceived comfort in working with others irrespective of the order in which they participated in the simulation scenario. The use of observers in simulation may provide opportunities for programs to integrate large scale simulation experiences in a time efficient manner to further engage students in active learning as a component of interprofessional education.

Our group developed an interprofessional education (IPE) program for home-based end-of-life (EOL) care among health and welfare professionals, with the purpose of understanding professional roles in EOL care and promoting mutual respect among team members. This study aimed to verify the understanding and awareness of the elements of IPE. Seven districts in a city in Japan were cluster-randomized into an education group or a control group. A questionnaire survey using original items to evaluate two purposes of the IPE program was conducted before the IPE workshop and seven months later. In total, 291 professionals participated in the study: 64 homecare nurses, 129 care managers, and 98 head care workers. Care managers and care workers in the education group significantly understood their own and other professional roles in EOL care (p= .01, p < .0001, respectively) and gained confidence in collaboration among health and welfare professionals (p = .02, p < .0001, respectively). Care workers in the education group felt respect for team members (p = .02). For homecare nurses, no significant effects were observed. The IPE was more effective for welfare professionals who had difficulty cooperating in end-of-life care.

The modified Attitudes Toward Health Care Teams Scale (mATHCTS) is a self-administered questionnaire with 14 items to assess participants' perceptions of the impact of interprofessional collaboration. Its validity and reliability have been widely evaluated. The effect of interprofessional education (IPE) has been evaluated using changes in mATHCTS factor scores. However, several aspects of the scale require clarification: the difficulty of correctly answering each item; how well each item discriminates between respondents' abilities; and whether the mATHCTS is better at identifying those with higher/lower abilities. We investigated the mATHCTS's item characteristics such as difficulty, discrimination, and measurement accuracy using item-response theory (IRT) analysis. Health and welfare university students were administered a questionnaire prior to starting IPE in 2021. The results for 180 participants were analyzed based on IRT. The test-response (TRF) and test-information (TIF) functions, discrimination, and difficulty were estimated. All items' discrimination and difficulty were adequate. The TRF, which shows the relationship between scores and ability, increased monotonically. The TIF, which shows the relationship between ability and measurement accuracy, decreased as the total score increased. The mATHCTS effectively assessed participants' attitudes toward health care teams as a one-dimensional ability. The mATHCTS performed well in identifying participants with relatively low scores.

Effective interprofessional collaboration (IPC) in primary care is essential for providing high-quality care for patients with chronic illness. However, the traditional role-based leadership approach in which physicians are the sole leaders, may hinder IPC. To improve IPC, leadership roles may need to shift dynamically based on expertise and experience, allowing for fluid transitions between leaders and followers within teams. Until now, most studies exploring this phenomenon focus on secondary care settings where teamwork is often physician-led, protocol-driven, and time-limited. Our understanding of followership in primary care remains limited. Therefore, we present a protocol for a scoping review to map the research on leadership and followership within IPC in primary care settings for patients with chronic illness and relevant training interventions within this context. An electronic search will be conducted across PubMed, Embase, and Web of Science to identify studies published in English. Three independent reviewers will assess publications for eligibility. Data will be extracted on definitions, conceptualizations, and training programs of leadership and followership. Through descriptive and thematic analysis, the review will map the landscape of leadership and followership, and provide insights into related competencies necessary for effective IPC in primary care for patients with chronic illness.

This study examined the effect of simulation on readiness for collaborative practice and learning using a randomized-controlled trial design that used the same education protocol with interprofessional and uniprofessional groups. The sample consisted of 43 students from four different majors. The students were assessed with the Readiness for Interprofessional Learning Scale, and a care plan measurement instrument. The interprofessional group showed a small increase (0.1 ± 0.43; p = .02) in readiness for teamwork and collaboration; the uniprofessional group showed a smaller increase for teamwork and collaboration (0.04 ± 0.31; p = .04) and for patient-centred care (0.0 ± 0.35; p = .01). The enriching work of interprofessional learning was evident within the care plan activity, suggesting that interprofessional simulation is an effective learning method for interprofessional education.

Expanding workforce training opportunities for opioid use disorder (OUD) treatment is a priority. We report on the impact of a 6-month-long team training program using the Extension for Community Healthcare Outcomes (ECHO) model to scale an interprofessional education (IPE) intervention to primary care teams who offered medications for OUD treatment as part of their care plan. Thirteen healthcare teams participated in the program's first cohort. We studied 52 participants' pre-post responses to seven scales that examined individual efficacy, team efficacy, high performance teamwork behaviors, adaptive teamwork behaviors, ability to treat patients in two case examples, and stigma and harm reduction. Significant improvements occurred on six scales. Large effect sizes were observed for individual efficacy (d = 0.78), team efficacy (d = 1.25), and team's ability to treat patients (d = 0.77, d = 0.83). Moderate effect sizes were observed for high performance teamwork behaviors (d = 0.69) and adaptive teamwork behaviors (d = 0.57). Only stigma and harm reduction did not show a change. The training program delivered an IPE-ECHO intervention that was effective at increasing the teams' perceptions of their efficacy, functioning, and ability to treat patients. Future researchers should use objective measures to verify the team's perceptions of their increased ability to work together.