Wener Pamela, Woodgate Roberta L
Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, R125-771 McDermot Ave., Winnipeg, MB, R3E 0T6, Canada.
College of Nursing, University of Manitoba, 465 Helen Glass Centre, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada.
BMC Fam Pract. 2016 Mar 10;17:30. doi: 10.1186/s12875-016-0427-x.
Most individuals with mental health concerns seek care from their primary care provider, who may lack comfort, knowledge, and time to provide care. Interprofessional collaboration between providers improves access to primary mental health services and increases primary care providers' comfort offering these services. Building and sustaining interprofessional relationships is foundational to collaborative practice in primary care settings. However, little is known about the relationship building process within these collaborative relationships. The purpose of this grounded theory study was to gain a theoretical understanding of the interprofessional collaborative relationship-building process to guide health care providers and leaders as they integrate mental health services into primary care settings.
Forty primary and mental health care providers completed a demographic questionnaire and participated in either an individual or group interview. Interviews were audio-recorded and transcribed verbatim. Transcripts were reviewed several times and then individually coded. Codes were reviewed and similar codes were collapsed to form categories using using constant comparison. All codes and categories were discussed amongst the researchers and the final categories and core category was agreed upon using constant comparison and consensus.
A four-stage developmental interprofessional collaborative relationship-building model explained the emergent core category of Collaboration in the Context of Co-location. The four stages included 1) Looking for Help, 2) Initiating Co-location, 3) Fitting-in, and 4) Growing Reciprocity. A patient-focus and communication strategies were essential processes throughout the interprofessional collaborative relationship-building process.
Building interprofessional collaborative relationships amongst health care providers are essential to delivering mental health services in primary care settings. This developmental model describes the process of how these relationships are co-created and supported by the health care region. Furthermore, the model emphasizes that all providers must develop and sustain a patient-focus and communication strategies that are flexible. Applying this model, health care providers can guide the creation and sustainability of primary care interprofessional collaborative relationships. Moreover, this model may guide health care leaders and policy makers as they initiate interprofessional collaborative practice in other health care settings.
大多数有心理健康问题的人会向其初级保健提供者寻求护理，而这些提供者可能缺乏提供护理的舒适度、知识和时间。提供者之间的跨专业协作可改善初级心理健康服务的可及性，并提高初级保健提供者提供这些服务的舒适度。建立和维持跨专业关系是初级保健环境中协作实践的基础。然而，对于这些协作关系中的关系建立过程知之甚少。这项扎根理论研究的目的是从理论上理解跨专业协作关系的建立过程，以指导医疗保健提供者和领导者将心理健康服务整合到初级保健环境中。
40名初级保健和心理健康保健提供者完成了一份人口统计学调查问卷，并参加了个人或小组访谈。访谈进行了录音并逐字转录。转录本被多次审查，然后进行单独编码。对编码进行审查，并使用持续比较法将相似的编码合并形成类别。所有编码和类别在研究人员之间进行了讨论，并通过持续比较和达成共识确定了最终类别和核心类别。
一个四阶段的跨专业协作关系发展模型解释了在同地办公背景下出现的核心类别“协作”。这四个阶段包括：1）寻求帮助；2）启动同地办公；3）融入；4）增强互惠。以患者为中心和沟通策略是跨专业协作关系建立过程中的关键环节。
在医疗保健提供者之间建立跨专业协作关系对于在初级保健环境中提供心理健康服务至关重要。这个发展模型描述了这些关系如何由医疗保健区域共同创建和支持的过程。此外，该模型强调所有提供者必须发展并维持以患者为中心且灵活的沟通策略。应用此模型，医疗保健提供者可以指导初级保健跨专业协作关系的创建和可持续性。此外，该模型可以指导医疗保健领导者和政策制定者在其他医疗保健环境中开展跨专业协作实践。
