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在初级和社区护理中,是什么促进或阻碍了跨专业团队合作?一项文献综述。

What fosters or prevents interprofessional teamworking in primary and community care? A literature review.

作者信息

Xyrichis Andreas, Lowton Karen

机构信息

King's College London, The Florence Nightingale School of Nursing and Midwifery, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.

出版信息

Int J Nurs Stud. 2008 Jan;45(1):140-53. doi: 10.1016/j.ijnurstu.2007.01.015. Epub 2007 Mar 26.

Abstract

BACKGROUND

The increase in prevalence of long-term conditions in Western societies, with the subsequent need for non-acute quality patient healthcare, has brought the issue of collaboration between health professionals to the fore. Within primary care, it has been suggested that multidisciplinary teamworking is essential to develop an integrated approach to promoting and maintaining the health of the population whilst improving service effectiveness. Although it is becoming widely accepted that no single discipline can provide complete care for patients with a long-term condition, in practice, interprofessional working is not always achieved.

OBJECTIVES

This review aimed to explore the factors that inhibit or facilitate interprofessional teamworking in primary and community care settings, in order to inform development of multidisciplinary working at the turn of the century.

DESIGN

A comprehensive search of the literature was undertaken using a variety of approaches to identify appropriate literature for inclusion in the study. The selected articles used both qualitative and quantitative research methods.

FINDINGS

Following a thematic analysis of the literature, two main themes emerged that had an impact on interprofessional teamworking: team structure and team processes. Within these two themes, six categories were identified: team premises; team size and composition; organisational support; team meetings; clear goals and objectives; and audit. The complex nature of interprofessional teamworking in primary care meant that despite teamwork being an efficient and productive way of achieving goals and results, several barriers exist that hinder its potential from becoming fully exploited; implications and recommendations for practice are discussed.

CONCLUSIONS

These findings can inform development of current best practice, although further research needs to be conducted into multidisciplinary teamworking at both the team and organisation level, to ensure that enhancement and maintenance of teamwork leads to an improved quality of healthcare provision.

摘要

背景

西方社会长期疾病患病率上升,随之而来的是对非急性优质患者医疗保健的需求,这使得卫生专业人员之间的协作问题备受关注。在初级保健领域,有人认为多学科团队合作对于制定综合方法以促进和维持人群健康同时提高服务效率至关重要。尽管人们普遍认为没有任何一个学科能够为患有长期疾病的患者提供全面护理,但在实践中,跨专业合作并非总能实现。

目的

本综述旨在探讨在初级和社区护理环境中抑制或促进跨专业团队合作的因素,以便为世纪之交多学科合作的发展提供参考。

设计

采用多种方法对文献进行全面检索,以确定纳入研究的合适文献。所选文章使用了定性和定量研究方法。

结果

在对文献进行主题分析后,出现了两个对跨专业团队合作有影响的主要主题:团队结构和团队流程。在这两个主题中,确定了六个类别:团队场所;团队规模和组成;组织支持;团队会议;明确的目标;以及审计。初级保健中跨专业团队合作的复杂性意味着,尽管团队合作是实现目标和成果的一种高效且富有成效的方式,但仍存在一些障碍阻碍其潜力得到充分发挥;文中讨论了对实践的影响和建议。

结论

这些发现可为当前最佳实践的发展提供参考,不过仍需在团队和组织层面进一步开展关于多学科团队合作的研究,以确保团队合作的加强和维持能带来医疗服务质量的提升。

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