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成功开展整合照护跨专业合作的条件——丹麦初级医疗服务的经验教训。

Conditions for successful interprofessional collaboration in integrated care - Lessons from a primary care setting in Denmark.

机构信息

Department of Public Health, Aarhus University, Bartholins Allé, 8000, Aarhus C, Denmark.

VIVE-The Danish Center for Social Science Research, Olof Palmes Allé 22, 8200 Aarhus N.

出版信息

Health Policy. 2021 Apr;125(4):474-481. doi: 10.1016/j.healthpol.2021.01.007. Epub 2021 Feb 3.

DOI:10.1016/j.healthpol.2021.01.007
PMID:33573776
Abstract

INTRODUCTION

Increasing demand for interprofessional collaboration in health care settings has led to a greater focus on how conditions influence the success of interprofessional collaboration, but little is known about the magnitude of the interactions between different conditions. This paper aims to examine the relationships of intervention conditions and context conditions at the professional and organisational level and examine how they influence the staff's perceived success of the interprofessional collaboration.

METHODS

The study was conducted as a multilevel cross-sectional survey in March of 2019 in the second largest municipality in Denmark, Aarhus. The study population was all frontline-staff members and managers in nursing homes, home care units and health care units. The final sample consisted of 498 staff members and 27 managers. Confirmatory path analysis was used to analyse the data.

RESULTS

The results indicate that context conditions greatly influence intervention conditions at the professional and organisational level and that the professional and organisational levels moderately co-variate. Professional level context conditions have the biggest influence on staff's perceived success, partly because its influence is confounded by intervention conditions.

CONCLUSION

Practice and research in health care settings should re-focus their attention from a broad understanding of context as unchangeable and inconsequential, to understanding context as an important condition type for interprofessional collaboration that needs to be further understood and researched.

摘要

简介

医疗环境中对跨专业合作的需求不断增加,这使得人们更加关注各种条件如何影响跨专业合作的成功,但对于不同条件之间相互作用的程度却知之甚少。本文旨在研究专业和组织层面的干预条件和背景条件之间的关系,并探讨它们如何影响员工对跨专业合作的感知效果。

方法

本研究于 2019 年 3 月在丹麦第二大城市奥胡斯进行了一项多水平横断面调查。研究对象为养老院、家庭护理单位和医疗单位的一线工作人员和管理人员。最终样本包括 498 名工作人员和 27 名管理人员。采用验证性路径分析对数据进行分析。

结果

结果表明,背景条件对专业和组织层面的干预条件有很大影响,并且专业和组织层面中度共变。专业层面的背景条件对员工的感知效果影响最大,部分原因是其影响与干预条件相互混淆。

结论

医疗环境中的实践和研究应重新将注意力集中在从广泛理解不可改变和不重要的背景条件,转变为理解背景条件作为跨专业合作的重要条件类型,需要进一步理解和研究。

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