Hustoft Merethe, Biringer Eva, Gjesdal Sturla, Aβmus Jörg, Hetlevik Øystein
Centre for Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway.
Department of Global Health and Primary Health Care, University of Bergen, Bergen, Norway.
BMC Health Serv Res. 2018 Sep 17;18(1):719. doi: 10.1186/s12913-018-3536-5.
Rehabilitation services depend on competent professionals who collaborate effectively. Well-functioning interprofessional teams are expected to positively impact continuity of care. Key factors in continuity of care are communication and collaboration among health care professionals in a team and their patients. This study assessed the associations between team functioning and patient-reported benefits and continuity of care in somatic rehabilitation centres.
This prospective cohort study uses survey data from 984 patients and from health care professionals in 15 teams in seven somatic rehabilitation centres in Western Norway. Linear mixed effect models were used to investigate associations between the interprofessional team communication and relationship scores (measured by the Relational Coordination [RC] Survey and patient-reported benefit and personal-, team- and cross-boundary continuity of care. Patient-reported continuity of care was measured using the Norwegian version of the Nijmegen Continuity Questionnaire.
The mean communication score for healthcare teams was 3.9 (standard deviation [SD] = 0.63, 95% confidence interval [CI] = 3.78, 4.00), and the mean relationship score was 4.1 (SD = 0.56, 95% CI = 3.97, 4.18). Communication scores in rehabilitation teams varied from 3.4-4.3 and relationship scores from 3.6-4.5. Patients treated by teams with higher relationship scores experienced better continuity between health care professionals in the team at the rehabilitation centre (b = 0.36, 95% CI = 0.05, 0.68; p = 0.024). There was a positive association between RC communication in the team the patient was treated by and patient-reported activities of daily living benefit score; all other associations between RC scores and rehabilitation benefit scores were not significant.
Team function is associated with better patient-reported continuity of care and higher ADL-benefit scores among patients after rehabilitation. These findings indicate that interprofessional teams' RC scores may predict rehabilitation outcomes, but further studies are needed before RC scores can be used as a quality indicator in somatic rehabilitation.
康复服务依赖于能够有效协作的专业人员。运作良好的跨专业团队有望对护理的连续性产生积极影响。护理连续性的关键因素是团队中的医疗保健专业人员与其患者之间的沟通与协作。本研究评估了躯体康复中心团队功能与患者报告的益处及护理连续性之间的关联。
这项前瞻性队列研究使用了来自挪威西部七个躯体康复中心15个团队的984名患者和医疗保健专业人员的调查数据。线性混合效应模型用于研究跨专业团队沟通与关系得分(通过关系协调[RC]调查测量)与患者报告的益处以及个人、团队和跨边界护理连续性之间的关联。患者报告的护理连续性使用奈梅亨连续性问卷的挪威语版本进行测量。
医疗团队的平均沟通得分为3.9(标准差[SD]=0.63,95%置信区间[CI]=3.78,4.00),平均关系得分为4.1(SD=0.56,95%CI=3.97,4.18)。康复团队的沟通得分在3.4 - 4.3之间,关系得分在3.6 - 4.5之间。由关系得分较高的团队治疗的患者在康复中心团队中的医疗保健专业人员之间经历了更好的连续性(b = 0.36,95%CI = 0.05,0.68;p = 0.024)。患者接受治疗的团队中的RC沟通与患者报告的日常生活活动益处得分之间存在正相关;RC得分与康复益处得分之间的所有其他关联均不显著。
团队功能与康复后患者报告的更好的护理连续性以及更高的日常生活活动益处得分相关。这些发现表明,跨专业团队的RC得分可能预测康复结果,但在RC得分可作为躯体康复的质量指标之前,还需要进一步研究。