Standing Holly, Patterson Rebecca, Dalkin Sonia, Exley Catherine, Brittain Katie
Department of Nursing, Midwifery and Health, Northumbria University, UK.
Research and Innovation Services, Northumbria University, UK.
Soc Sci Med. 2020 Dec;266:113300. doi: 10.1016/j.socscimed.2020.113300. Epub 2020 Aug 31.
This article critically examines how professional boundaries and hierarchies influence how end-of-life care is managed and negotiated between health and social care professionals. Our findings suggest there is uncertainty and lack of clarity amongst health and social care professionals regarding whose responsibility it is to engage, and document, the wishes of patients who are dying, which can lead to ambiguity in treatment decisions. We go on to explore the potential role of a new electronic system, designed to facilitate information sharing across professional boundaries, in shaping and bridging professional boundaries in the delivery of end-of-life care. We highlight potential negative impacts that may arise when health and social care groups are permitted varying levels of access to the system, and how this may be seen to reflect the value placed on their role in end-of-life care.
本文批判性地审视了专业界限和等级制度如何影响临终护理在卫生保健和社会护理专业人员之间的管理与协商。我们的研究结果表明，卫生保健和社会护理专业人员对于确定谁有责任了解并记录临终患者的意愿存在不确定性且缺乏明确性，这可能导致治疗决策的模糊性。我们接着探讨了一个旨在促进跨专业界限信息共享的新型电子系统在塑造和弥合临终护理服务中的专业界限方面的潜在作用。我们强调了在允许卫生保健和社会护理群体对该系统有不同访问权限时可能产生的潜在负面影响，以及这如何被视为反映了对他们在临终护理中角色的重视程度。
