Department of Community Health Nursing, Japanese Red Cross College of Nursing, Tokyo, Japan.
Health Administration in Nursing, Chiba University, Chiba, Japan.
Geriatr Gerontol Int. 2017 Nov;17(11):1943-1950. doi: 10.1111/ggi.12998. Epub 2017 Feb 21.
To define the team types consisting of doctors, home-visiting nurses and care managers for end-of-life care by measuring the collaboration relationship, and to identify the factors related to the team types.
A questionnaire survey of 43 teams including doctors, home-visiting nurses and care managers was carried out. The team types were classified based on mutual evaluations of the collaborative relationships among the professionals. To clarify the factors between team types with the patient characteristics, team characteristics and collaboration competency, univariate analysis was carried out with the Fisher's exact test or one-way analysis and multiple comparison analysis.
Three team types were classified: the team where the collaborative relationships among all healthcare professionals were good; the team where the collaborative relationships between the doctors and care managers were poor; and the team where the collaborative relationships among all of the professionals were poor. There was a statistically significant association between the team types and the following variables: patient's dementia level, communication tool, professionals' experience of working with other team members, home-visiting nurses' experience of caring for dying patients, care managers' background qualifications, doctor's face-to-face cooperation with other members and home-visiting nurses' collaborative practice.
It is suggested that a collaborative relationship would be fostered by more experience of working together, using communication tools and enhancing each professional's collaboration competency. Geriatr Gerontol Int 2017; 17: 1943-1950.
通过测量协作关系来确定由医生、家访护士和护理经理组成的临终关怀团队类型，并确定与团队类型相关的因素。
对包括医生、家访护士和护理经理在内的 43 个团队进行了问卷调查。根据专业人员之间协作关系的相互评估对团队类型进行分类。为了明确团队类型与患者特征、团队特征和协作能力之间的关系，采用Fisher 确切检验或单向分析和多重比较分析进行单变量分析。
将团队分为三种类型：所有医护人员之间协作关系良好的团队；医生和护理经理之间协作关系较差的团队；以及所有专业人员之间协作关系较差的团队。团队类型与以下变量之间存在统计学关联：患者的痴呆程度、沟通工具、专业人员与其他团队成员一起工作的经验、家访护士照顾临终患者的经验、护理经理的背景资格、医生与其他成员的面对面合作以及家访护士的协作实践。
建议通过更多的合作经验、使用沟通工具和提高每个专业人员的协作能力来促进协作关系。老年医学杂志 2017；17：1943-1950。
