探索医院医疗服务提供者多学科倡议和复杂护理合作的方法:一项定性研究。

IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Journal of Multidisciplinary Healthcare Pub Date : 2025-04-30 eCollection Date: 2025-01-01 DOI:10.2147/JMDH.S513370
Mikkel Aagaard, Andreas Kjær Stage, Trine Boje Møller, Steen B Pedersen, Charlotte Gjørup Pedersen
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引用次数: 0

摘要

背景:尽管影响协作的因素有充分的证据,但医疗保健提供者的观点仍然有限。这些观点是理解他们如何有效地管理复杂的病人护理的关键。本研究探讨了医院医疗服务提供者对多学科合作的看法,以及他们对糖尿病和多种慢性疾病患者复杂护理管理干预的开放性。方法:访谈研究。研究方法采用解释性描述法,以边界工作为分析框架。采用有目的抽样,数据包括22个半结构化的面对面个人访谈和对丹麦奥胡斯大学医院护士、初级医生和医生的两次焦点小组访谈。结果:出现了三个主题:广泛的支持和多学科合作的需要;诊所间现有合作及其局限性以及引入合作倡议:干预。举报人一致认为,广泛的和与具体干预有关的合作与协调是重要的,可以改善护理协调,增强患者的安全感,明确专业角色,丰富专业知识,简化资源使用。然而,组织结构和专业动态往往阻碍这种努力。与干预相关的一个关键挑战是确定有复杂病例的患者进行转诊。结论:本研究突出了医院医疗服务提供者对加强跨专业合作以有效管理复杂病例的迫切需要的认识。诸如孤立的专业化和繁重的工作量等重大障碍要求采取有针对性的政治和管理行动。在识别复杂病例方面的挑战表明,需要采取一种全面的、以患者为中心的方法,以细致入微地了解患有多种慢性疾病并在不同医院诊所接受治疗的个人所面临的挑战。在未来,这种方法可以简化复杂病例的转诊,需要更多的研究来探索灵活的多学科团队会议的潜力,以加强复杂护理途径中的合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring Hospital Healthcare Providers' Approaches to Multidisciplinary Initiatives and Complex Care Collaboration: A Qualitative Study.

Background: Despite well-documented factors influencing collaboration, healthcare providers' perspectives remain limited. These perspectives are key for understanding how they manage complex patient care effectively. This study explores hospital healthcare providers' views on multidisciplinary collaboration and their openness to an intervention for managing complex care in patients with diabetes and multiple chronic conditions.

Methods: An interview study. The Interpretive Description approach was employed as the research methodology, with Boundary Work as the analytical framework. Purposive sampling was utilised, with data consisting of 22 semi-structured, face-to-face individual and two focus group interviews with nurses, junior physicians, and physicians at Aarhus University Hospital, Denmark.

Results: Three main themes emerged: Wide Support and Need for Multidisciplinary Collaboration; Existing Collaboration Between Clinics - and Their Limitations; and Introducing a Collaborative Initiative: the Intervention. The informants agreed that collaboration and coordination - both broadly and in relation to the specific intervention - are important and could improve care coordination, enhance patients' sense of security, clarify professional roles, enrich expertise, and streamline resource use. However, organisational structures and professional dynamics often hinder such efforts. A key challenge related to the intervention was identifying patients with complex cases for referral.

Conclusion: This study highlights hospital healthcare providers' recognition of the critical need to strengthen collaboration across specialties to manage complex cases effectively. Significant barriers, such as siloed specialisation and heavy workloads, call for targeted political and managerial action. Challenges in identifying complex cases point to the need for methods that adopt a holistic, patient-centred approach to gain a nuanced understanding of the challenges individuals face in living with multiple chronic conditions and receiving care across different hospital clinics. In the future, this approach could streamline the referral of complex cases, with additional research required to explore the potential of flexible multidisciplinary team meetings in enhancing collaboration within complex care pathways.

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来源期刊
Journal of Multidisciplinary Healthcare
Journal of Multidisciplinary Healthcare Nursing-General Nursing
CiteScore
4.60
自引率
3.00%
发文量
287
审稿时长
16 weeks
期刊介绍: The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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