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“我们有两个不同的议程”:全科医生、社会工作者和医院工作人员对慢性广泛性疼痛患者跨专业协调的看法。

"We have two different agendas": the views of general practitioners, social workers and hospital staff on interprofessional coordination for patients with chronic widespread pain.

机构信息

The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

J Interprof Care. 2021 Mar-Apr;35(2):284-292. doi: 10.1080/13561820.2020.1749576. Epub 2020 Apr 16.

Abstract

Patients with chronic widespread pain (CWP) are often unfit for work and go through lengthy treatment. In Denmark, this includes contacts with the job center in their municipality, their general practitioner (GP) and one or more hospital units. Little is known about how coordination around patients with CWP functions and is perceived by professionals. Therefore, our aim is to explore how GPs, social workers from municipality job centers and hospital staff experience interprofessional coordination for patients with CWP. Interviews with 7 GPs, 12 social workers, and 10 hospital staff were analyzed using interpretative phenomenological analysis. The participants experienced challenges with coordination, primarily in the relations between social workers and GPs. There was an over-reliance on written communication in situations where the actors had divergent agendas, opposing professional roles and conflicting approaches to time. GPs tended to lengthen the time spans for treating patients, while social workers tried to shorten them so that patients could get back to work. Applying the theory of relational coordination (RC), the findings correspond to a low level of RC, indicating a need for shared accountability, and strengthened interpersonal communication between professionals.: CWP: Chronic widespread pain; GPs: General practitioners; RC: Relational coordination; IPA: Interpretative phenomenological analysis.

摘要

患有慢性广泛性疼痛 (CWP) 的患者通常无法工作,并经历漫长的治疗过程。在丹麦,这包括与所在市的就业中心、全科医生 (GP) 和一个或多个医院部门的接触。对于围绕 CWP 患者的协调工作如何运作以及专业人员如何看待这一问题,我们知之甚少。因此,我们的目的是探讨全科医生、市就业中心的社会工作者和医院工作人员如何为 CWP 患者进行跨专业协调。对 7 名全科医生、12 名社会工作者和 10 名医院工作人员进行了访谈,并使用解释现象学分析对其进行了分析。参与者在协调方面遇到了挑战,主要是在社会工作者和全科医生之间的关系中。在参与者的目标和专业角色存在分歧、方法冲突的情况下,过度依赖书面沟通。全科医生往往会延长治疗患者的时间跨度,而社会工作者则试图缩短时间,以便患者能够重返工作岗位。应用关系协调 (RC) 理论,研究结果与 RC 的低水平相对应,表明需要共同承担责任,并加强专业人员之间的人际沟通。

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