Valaitis Ruta K, O'Mara Linda, Wong Sabrina T, MacDonald Marjorie, Murray Nancy, Martin-Misener Ruth, Meagher-Stewart Donna
1Associate Professor and Dorothy C. Hall Chair in Primary Health Care Nursing,School of Nursing, Faculty of Health Sciences,McMaster University,Hamilton ON,Canada.
2Associate Professor,School of Nursing,McMaster University,Hamilton,ON,Canada.
Prim Health Care Res Dev. 2018 Jul;19(4):378-391. doi: 10.1017/S1463423617000895. Epub 2018 Apr 12.
AimThe aim of this paper is to examine Canadian key informants' perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration.
Primary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context.
This interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor - effective communication - interacted with all of them. Results support and extend our understanding of what influences successful primary care and public health collaboration at these levels and are important considerations in building and sustaining primary care and public health collaborations.
目的
本文旨在研究加拿大关键信息提供者对影响基层医疗与公共卫生成功协作的个人内部（个体内）及人际（个体间）因素的看法。
通过加强基层医疗与公共卫生之间的协作，可强化初级卫生保健系统。尽管有文献探讨了可影响成功的组织间协作的人际因素，但其中很少有专门探讨基层医疗与公共卫生协作的。此外，未发现考虑个人内部层面因素的论文。本文旨在探讨加拿大背景下的这些空白。
这项解释性描述性研究涉及关键信息提供者（服务提供者、管理人员、主任和政策制定者），他们参与了一小时的电话访谈，以探讨他们对影响基层医疗与公共卫生成功协作的因素的看法。使用NVivo 9对访谈记录进行分析。
共有74名参与者[来自不列颠哥伦比亚省（n = 20）、安大略省（n = 19）、新斯科舍省（n = 21）以及其他省份或国家组织的代表（n = 14）]参与。发现了五个影响公共卫生与基层医疗协作的人际因素，包括：（1）信任和包容的关系；（2）共同的价值观、信念和态度；（3）角色明确；（4）有效的沟通；（5）决策过程。在个人内部层面发现了两个影响因素：（1）个人素质、技能和知识；（2）个人价值观、信念和态度。在所涉及的三个核心省份之间发现了一些差异。在所有人际和个人内部影响因素之间确定了几个复杂的相互作用：一个关键因素——有效的沟通——与所有因素相互作用。研究结果支持并扩展了我们对这些层面上影响基层医疗与公共卫生成功协作的因素的理解，是建立和维持基层医疗与公共卫生协作的重要考虑因素。
