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影响全科医疗与志愿及社区部门组织合作的因素。

Factors affecting general practice collaboration with voluntary and community sector organisations.

作者信息

Southby Kris, Gamsu Mark

机构信息

Centre for Health Promotion Research, Leeds Beckett University, Leeds, UK.

出版信息

Health Soc Care Community. 2018 May;26(3):e360-e369. doi: 10.1111/hsc.12538. Epub 2018 Jan 12.

Abstract

Collaborative working between general practice (GP) and voluntary and community sector (VCS) organisations is increasingly championed as a means of primary care doing more with less and of addressing patients' "wicked problems". This paper aims to add to the knowledge base around collaborative practice between GPs and VCS organisations by examining the factors that aid or inhibit such collaboration. A case study design was used to examine the lived-experience of GPs and VCS organisations working collaboratively. Four cases, each consisting of a GP and a VCS organisation with whom they work collaboratively, were identified. Interviews (n = 18) and a focus group (n = 1) were conducted with staff within each organisation. Transcribed data were analysed thematically. Whilet there are similarities across cases in their use of, for example, Health Trainers and social prescribing, the form and function of GP-VCS collaborations were unique to their local context. The identified factors affecting GP-VCS collaboration reflect those found in previous service evaluations and the broader literature on partnership working; shared understanding, time and resources, trust, strong leadership, operational systems and governance and the "negotiation" of professional boundaries. While the current political environment may represent an opportunity for collaborations to develop, there are issues yet to be resolved before collaboration-especially more holistic and integrated approaches-becomes systematically embedded into practice.

摘要

全科医疗(GP)与志愿及社区部门(VCS)组织之间的合作日益受到推崇,被视为一种初级保健以更少资源做更多事情并解决患者“棘手问题”的方式。本文旨在通过研究促进或阻碍此类合作的因素,来增加围绕全科医生与VCS组织之间合作实践的知识库。采用案例研究设计来考察全科医生与VCS组织合作的实际经验。确定了四个案例,每个案例都由一名全科医生和一个与之合作的VCS组织组成。对每个组织的工作人员进行了访谈(n = 18)和一次焦点小组讨论(n = 1)。对转录的数据进行了主题分析。虽然各案例在使用例如健康培训师和社会处方等方面存在相似之处,但全科医生与VCS合作的形式和功能因当地情况而异。确定的影响全科医生与VCS合作的因素反映了先前服务评估以及关于伙伴关系工作的更广泛文献中所发现的因素;共同理解、时间和资源、信任、强有力的领导、运营系统和治理以及专业界限的“协商”。虽然当前的政治环境可能为合作发展提供机会,但在合作——尤其是更全面和综合的方法——系统地融入实践之前,仍有一些问题有待解决。

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