Markon Marie-Pierre, Chiocchio François, Fleury Marie-Josée
a Department of Psychiatry , McGill University, Douglas Mental Health University Institute Research Centre , Montreal , Quebec , Canada.
b Telfer School of Management , University of Ottawa , Ottawa , Ontario , Canada.
J Interprof Care. 2017 Jul;31(4):520-528. doi: 10.1080/13561820.2017.1305951. Epub 2017 Apr 13.
The purpose of mental healthcare system reform was to enhance service efficiency by strengthening primary mental healthcare and increasing service integration in communities. Reinforcing interprofessional teamwork also intended to address the extensive and multidimensional needs of patients with mental disorders by bringing together a broader array of expertise. In this context, mental healthcare professionals (MHCPs) from various health and social care professions are more interdependent in many aspects of their work (tasks, resources, and goals). We wanted to examine the effect of perceived interdependence among MHCPs on their work role performance in the context of mental healthcare. For this purpose, we developed and tested a model coherent with the Input-Mediator-Outcome-Input (IMOI) framework of team effectiveness. Data from questionnaires administered to 315 MHCPs from four local health service networks in Quebec, Canada were analysed through structural equation modelling and mediation analysis. The structural equation model provided a good fit for the data and explained 51% of the variance of work role performance. Perceived collaboration, confidence in the advantages of interprofessional collaboration, involvement in the decision process, knowledge sharing, and satisfaction with the nature of the work partially mediated the effect of perceived interdependence among team members on work role performance. Therefore, perceived interdependence among team members had a positive impact on the work role performance of MHCPs mostly through its effect on favourable team functioning features. This implies, in practice, that increased interdependence of MHCPs would be more likely to truly enhance work role performance if team-based interventions to promote collaborative work and interprofessional teaching and training programs to support work within interprofessional teams were jointly implemented. Participation in the decision process and knowledge sharing should also be fostered, for instance, by adopting knowledge management best practices.
精神卫生保健系统改革的目的是通过加强基层精神卫生保健和提高社区服务整合度来提升服务效率。加强跨专业团队合作还旨在汇聚更广泛的专业知识，以满足精神障碍患者广泛的多维度需求。在这种背景下，来自不同卫生和社会护理专业的精神卫生保健专业人员（MHCPs）在工作的许多方面（任务、资源和目标）相互依存度更高。我们想研究MHCPs之间感知到的相互依存度对他们在精神卫生保健背景下工作角色表现的影响。为此，我们开发并测试了一个与团队有效性的输入-中介-结果-输入（IMOI）框架相一致的模型。通过结构方程建模和中介分析，对来自加拿大魁北克四个地方卫生服务网络的315名MHCPs的问卷调查数据进行了分析。结构方程模型与数据拟合良好，解释了工作角色表现差异的51%。感知到的协作、对跨专业协作优势的信心、参与决策过程、知识共享以及对工作性质的满意度部分中介了团队成员之间感知到的相互依存度对工作角色表现的影响。因此，团队成员之间感知到的相互依存度主要通过其对有利的团队运作特征的影响，对MHCPs的工作角色表现产生积极影响。这在实践中意味着，如果联合实施基于团队的干预措施以促进协作工作以及支持跨专业团队内部工作的跨专业教学和培训项目，那么MHCPs之间相互依存度的提高更有可能真正提升工作角色表现。例如，通过采用知识管理最佳实践，也应促进参与决策过程和知识共享。
