Journal of Interprofessional Care最新文献

There are increasing concerns about the well-being of healthcare students and providers. We describe our university's innovative approach to mitigating poor well-being across multiple healthcare disciplines during an Interprofessional Education (IPE) Day. As part of IPE Day, university health faculty developed a competition where teams of students from health colleges and programs created a strategic vision for mental health and wellness in the workplace. Twelve teams participated (7-9 students/team; N = 95). To help with strategic vision, participants created Mind Maps and Rich Pictures using Appreciative Inquiry as a framework. Appreciative Inquiry is an evidence-based approach that emphasizes strengths rather than weaknesses to facilitate positive change at a systems level. Evaluations included "Shark Tank" judging and audience voting to determine the competition's winner. Findings demonstrated that themes developed across teams converged more than they diverged, showing consensus on the broad key factors, including communication, collaboration, and community. Our study highlighted the success of bringing students from multiple disciplines together to collaborate on creating solutions to improve workplace well-being, benefiting all healthcare professions.

Models of leadership which emphasize collaboration, common goals, and fluidity rather than position are essential to interprofessional practice. Shared leadership in team-based practice helps to improve patient safety and outcomes and to enhance professionals' wellbeing. Developing future health professionals who incorporate these concepts into their work with colleagues and patients is a crucial component of interprofessional education. Assessing students' acquisition of these concepts is paramount and can be important not only in assessing student learning but also in program evaluation and improvement. The framework of our two-year longitudinal interprofessional education curriculum incorporated the seven pillars of servant leadership as a new lens for interprofessional practice. At the end of the curriculum, students from three academic health science colleges completed reflections as a summative assessment. This paper reports the results of a qualitative analysis of these students' reflections using the seven pillars as coding categories to determine the curriculum's effectiveness. All seven pillars of servant leadership were represented in the student reflections demonstrating the acquisition of shared leadership competencies. Importantly, the three pillars most frequently occurring across all reflective statements were compassionate collaborator, skilled communicator, and puts people first. Foresight was the leadership pillar that appeared the least in student reflections. Evaluation of student written reflections as a summative assessment is useful in determining students' acquisition of leadership skills and can be used as part of a continuous improvement process as well as for identifying weaker areas in the curriculum.

Interprofessional collaboration in rehabilitation is essential but challenging. Although factors supporting interprofessional collaboration are well known, how professionals make collaboration work within complex practices is underexamined. In response, we explored interprofessional collaboration and communication in a complex, dynamic rehabilitation setting, along with how healthcare professionals experience such collaboration and their actions to make it work across organizational boundaries. To those ends, we conducted semi-structured individual interviews with 14 healthcare practitioners from a hospital and the primary healthcare rehabilitation services in Western Norway. The interview transcripts were analyzed through thematic analysis, and we applied the theoretical perspective of relational expertise in interpreting the findings. We developed two main themes with sub-themes: that professionals enable and orchestrate collaborative work by (1) using different communication approaches flexibly and adjusting the collaboration to each patient's needs and to the collaborative situation, and (2) acknowledging the significance of interpersonal relations by cultivating mutual trust and understanding. Those new insights contribute to interprofessional practice by urging practice and policymakers to acknowledge practitioners' need for flexibility and to develop relational expertise as well professional expertise, especially in dynamic rehabilitation settings. Practitioners, educators and policymakers should support the cultivation of collaborative skills and structures.

Interprofessional collaboration between physicians and nurses is a critical aspect of healthcare. The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (JSATPNC) is the most widely used instrument for assessing attitudes toward such collaboration. However, this scale has not been validated in Spain. This study aimed to translate and adapt the JSATPNC to the Spanish context and evaluate its psychometric properties. Following its translation and adaptation, the scale was administered to a sample of 205 primary care physicians and nurses. Construct validity was assessed using confirmatory factor analysis (CFA) and Rasch analysis. The CFA based on the original four-dimensional model demonstrated good fit indices (RMSEA = 0.053, RMSR = 0.037, CFI = 0.974, NNFI = 0.947) and suggested the possibility of a unidimensional model (MIREAL = 0.211). Rasch analysis indicated good fit, except for items 1 and 5. Internal consistency reliability was acceptable (Omega = 0.801 [95% CI: 0.734-0.823]). The Spanish version of the JSATPNC (JSATPNC-e) exhibits adequate psychometric properties in terms of construct validity and internal consistency reliability. This study provides the Spanish-speaking population with an adaptation of the most widely used instrument for evaluating interprofessional collaboration between nurses and physicians.

Domestic violence is an underreported public health problem and a serious violation of human rights that affects women throughout all life. We proposed a strategy focused on including a domestic violence approach in antenatal and postnatal care through a quality improvement project. The project was based on Continuous Quality Improvement approach and guided by the Plan-Do-Study-Act interactive cycle, adopting an innovative interprofessional perspective. The evidence-based intervention is part of a larger project that has been conducted within an antenatal and postnatal care service at a university hospital in Campinas, São Paulo, Brazil. We designed a strategy based on parallel small cycles: 1) identification of a strategy for screening domestic violence; 2) selection of a risk assessment scale; 3) development of a system for recording information and referrals; 4) meetings with multidisciplinary teams and brief training sessions; and 5) development of informative and educational materials for users and health professionals, including posters in clinic waiting rooms and support materials for multidisciplinary teams. This strategy is being developed by a multidisciplinary team, supported by intersectoral work with the social assistance network of the community, and facilitated by researchers of the hospital. The inclusion of this topic in healthcare settings is an opportunity to identify women in situations of vulnerability and thus facilitate their access to domestic violence resources from a holistic care and health promotion perspective.

The reorientation of teamwork processes through interprofessional collaboration enables the promotion of comprehensive health care and the continuity of care in contexts of social vulnerability in rural areas. Therefore, the aim of this study is to understand interprofessional collaborative practices in vulnerable municipalities located in rural areas of Northeastern Brazil, based on the perspectives of Family Health Strategy workers in Primary Health Care. This is a qualitative multiple-case study conducted in three vulnerable municipalities in Northeastern Brazil. A total of 23 health professionals from Family Health Strategy teams participated in the study. Interviews were transcribed and analyzed using dialectical hermeneutics. The findings indicate that: the characteristics of the areas influence the delivery of health actions and services; the presence of multiprofessional teams in primary health care does not necessarily ensure the implementation of interprofessionality; and the lack of shared actions among professionals is a common challenge in the municipalities studied. It is therefore necessary to understand interprofessional collaboration in rural settings as strategies to enhance care in Primary Health Care through a comprehensive health approach.

We investigated the relationship between interprofessional teamwork assessed using the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) and intention to leave among healthcare staff in a Japanese municipal hospital. A cross-sectional survey was conducted using the T-TPQ and an intention to leave scale. Participants included nurses, allied health professionals (rehabilitation therapists, radiologic technologists, clinical engineers, and pharmacists), and physicians. In assessing the relationship between teamwork and the intention to leave, logistic regression modeling was used to adjust for confounding factors identified through a directed acyclic graph. Among 296 respondents (response rate, 63.4%), 47 (15.9%) reported a high level of intention to leave. Multivariate analysis using the first quartile as the reference showed that higher T-TPQ scores (i.e. higher perception of teamwork) were associated with lower odds of intention to leave. The adjusted odds ratios of the T-TPQ for intention to leave were 0.67 (95% confidence interval [CI] 0.27 to 1.66) for the second quartile, 0.31 (95%CI 0.10 to 0.91) for the third quartile, and 0.44 (95%CI 0.13 to 1.45) for the fourth quartile. Higher teamwork perception, as measured by T-TPQ, was associated with a lower intention to leave, highlighting the potential importance of teamwork in retention strategies.

Integrating mental health and wellbeing services in schools has the potential to improve students' socio-emotional wellbeing, engagement in learning and education outcomes. This scoping review aimed to establish and synthesize the current evidence base in relation to the junction of education and mental health and wellbeing practice. A systematic search and screening of peer-reviewed and gray research literature was conducted and resulted in the identification of 56 relevant sources. Extracted data was analyzed using descriptive and qualitative synthesis via content analysis. The largely exploratory and qualitative studies examined a range of influences on interdisciplinary collaborations. Enablers and barriers were interconnected and related to interprofessional relationships, the role of teachers and administrators in collaborations, territorialism, or the perceived practice divide between education and mental health, resourcing issues and the need for role clarity, appropriate training and structures and processes which support joint working. Insights gained may inform practice, policy, and research at the evolving intersection of education and mental health and wellbeing practice.

An interprofessional care model is crucial to advancing the quality of integrated, patient-centered care, particularly in critical situations. The purpose of this study was to develop an interprofessional care model for newborns and their families experiencing neonatal death and dying. This is an explanatory sequential mixed-methods design with three phases. Data were collected in two public neonatal units in Brazil. In Phase I, quantitative data were collected from 66 healthcare professionals using two instruments: demographic characterization and the Profile of Attitudes Toward Death - Brazilian version. In Phase II, qualitative data were collected and analyzed using Grounded Theory with 13 professionals. Phase III evaluated the proposed model. The model emphasizes sensitive and holistic care, tailored to the needs of newborns and families experiencing neonatal death and dying. It emphasizes adequate training for the healthcare team, along with a strong support network, solid teamwork, a supportive environment, clear and positive interprofessional and professional-family communication, time reserved for parents with the newborn, and a time to say goodbye. The model was evaluated as suitable for guiding interprofessional teams in the context of neonatal death and dying, with a Content Validity Index (CCI) above 80% in all categories. Although communication and family support are pillars of palliative care, the model proposed in this study stands out for its systematic approach to integrating team support, recognizing that the attitude and well-being of professionals are crucial to the provision of sensitive and holistic interprofessional care. Future research should apply, test, and adjust the model in real neonatal settings.

Effective interprofessional communication among healthcare teams is integral for the function of health systems. We sought to rigorously evaluate the effectiveness of clinical improvisation training in improving interprofessional communication skills among practicing providers, and to identify factors contributing to training success. We used a quasi-experimental wait-list design (intervention group n = 62; control group n = 66) to evaluate the effects of a clinical improvisational training program on interprofessional communication skills using validated baseline surveys and follow-up surveys several months later. Both groups included physicians and advanced practice nurses from various departments in a single academic medical institution. Statistical analysis was focused on examining changes in communication skills between groups and on contributors to communication change in the intervention group. Within-person changes indicated that communication skills significantly modestly improved from baseline to follow-up for the intervention group but not for the control group. Among the intervention group, we observed a significant interaction between excitement about the training and uncertainty tolerance in predicting improvement in communication skills. Clinical improvisation is likely to be effective in improving interprofessional communication skills among practicing healthcare workers. Increasing excitement about the clinical improvisation training programs and reducing uncertainty about it could bolster the success of these programs.