Department of Global Health Entrepreneurship, Division of Public Health, Tokyo Medical and Dental University, Tokyo, 113-8519, Japan.
Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila, 1000, Metro Manila, Philippines.
Hum Resour Health. 2021 Apr 19;19(1):52. doi: 10.1186/s12960-021-00568-1.
There is limited information on how the barriers to interprofessional collaboration (IPC) across various professionals, organizations, and care facilities influence the health and welfare of older adults. This study aimed to describe the status of IPC practices among health and social workers providing care for older adults in the Philippines; investigate the perceived barriers to its implementation and perceived effects on geriatric care; and identify possible solutions to address the barriers limiting collaborative practice.
A case study approach was utilized employing 12 semi-structured in-depth interviews and 29 focus group discussions with care workers from selected primary health care units, public and private hospitals, and nursing homes that are directly involved in geriatric care delivery in two cities in the Philippines. Overall, 174 health and social workers consented to participate in this study. All interviews were audio-recorded and transcribed verbatim. An inductive thematic analysis using NVivo 12® was used to identify and categorize relevant thematic codes.
Interprofessional geriatric care provided by health and social workers was observed to be currently limited to ad hoc communications typically addressing only administrative concerns. This limitation is imposed by a confluence of barriers such as personal values and beliefs, organizational resource constraints, and a silo system care culture which practitioners say negatively influences care delivery. This in turn results in inability of care providers to access adequate care information, as well as delays and renders inaccessible available care provided to vulnerable older adults. Uncoordinated care of older adults also led to reported inefficient duplication and overlap of interventions.
Geriatric care workers fear such barriers may aggravate the increasing unmet needs of older adults. In order to address these potential negative outcomes, establishing a clear and committed system of governance that includes IPC is perceived as necessary to install a cohesive service delivery mechanism and provide holistic care for older adults. Future studies are needed to measure the effects of identified barriers on the potential of IPC to facilitate an integrated health and social service delivery system for the improvement of quality of life of older adults in the Philippines.
关于跨专业协作（IPC）在不同专业人员、组织和护理机构之间的障碍如何影响老年人的健康和福利，相关信息有限。本研究旨在描述菲律宾为老年人提供护理的卫生和社会工作者之间的 IPC 实践现状；调查实施 IPC 的障碍感知及其对老年护理的影响；并确定解决限制协作实践的障碍的可能解决方案。
采用案例研究方法，对菲律宾两个城市的选定基层医疗单位、公立和私立医院以及养老院中直接参与老年护理服务的护理人员进行了 12 次半结构化深入访谈和 29 次焦点小组讨论。共有 174 名卫生和社会工作者同意参与本研究。所有访谈均进行录音并逐字转录。使用 NVivo 12®进行归纳主题分析，以识别和分类相关主题代码。
观察到卫生和社会工作者提供的跨专业老年护理目前仅限于临时沟通，通常仅解决行政问题。这种限制是由多种障碍造成的，例如个人价值观和信念、组织资源限制以及从业者认为会对护理服务产生负面影响的孤岛系统护理文化。这反过来又导致护理提供者无法获得足够的护理信息，导致护理延迟和无法获得为弱势老年人提供的护理。对老年人的护理不协调导致报告称干预措施效率低下，存在重复和重叠。
老年护理工作者担心这些障碍可能会加剧老年人日益增长的未满足需求。为了解决这些潜在的负面后果，建立一个明确和坚定的 IPC 治理系统被认为是必要的，以建立一个有凝聚力的服务交付机制，并为老年人提供全面的护理。需要进一步的研究来衡量确定的障碍对 IPC 促进一体化的卫生和社会服务提供系统的潜力的影响，以提高菲律宾老年人的生活质量。
