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跨专业合作与卫生政策:魁北克混合方法法律研究的结果。

Interprofessional collaboration and health policy: results from a Quebec mixed method legal research.

机构信息

Anesthesiology, University of Montreal, Montreal, Quebec, Canada.

Health-Hub - Politics, Organizations and Law, University of Montreal, CRCHUM, Montreal, Quebec, Canada.

出版信息

J Interprof Care. 2022 Jan-Feb;36(1):44-51. doi: 10.1080/13561820.2021.1891030. Epub 2021 May 6.

Abstract

Interprofessional collaboration (IPC) is central to effective care. This practice is structured by an array of laws, regulations and policies but the literature on their impact on IPC is scarce. This study aims to illustrate the gap between the texts and clinicians' knowledge of the legal framework using an anonymous web-based survey. The survey, sent to nurses and physicians in Quebec, Canada, focused on the IPC legal framework, legal knowledge sources and IPC perceptions or beliefs. The primary outcome was to determine the gap between the law and understanding of the law. The secondary outcome was to identify legal knowledge sources for clinicians in Quebec. A total of 267 participants filled in the survey. For knowledge acquisition, 40% of physicians turned to insurers whereas 43% of nurses turned to their regulatory body. Only 30% of physicians correctly identified what activity is reserved for physicians while 39% of nurses correctly identified their reserved activity. Regarding legal perceptions, 28% of physicians and 39% of nurses thought IPC could increase their liability. These participants have a higher tendency to name liability-related issues as barriers to IPC. These results show an important discrepancy between clinicians' knowledge about law and policies, and the actual texts themselves. This gap can lead to misinterpretations of the law by clinicians, ineffective policy changes by policymakers and can perpetuate ineffective implementation of IPC.

摘要

跨专业协作(IPC)是有效护理的核心。这种实践受到一系列法律、法规和政策的约束,但关于它们对 IPC 影响的文献却很少。本研究旨在使用匿名网络调查来阐明法律文本与临床医生对法律框架的理解之间的差距。该调查针对加拿大魁北克省的护士和医生,重点关注 IPC 法律框架、法律知识来源以及 IPC 感知或信念。主要结果是确定法律与对法律的理解之间的差距。次要结果是确定魁北克省临床医生的法律知识来源。共有 267 名参与者填写了调查。在获取知识方面,40%的医生向保险公司寻求帮助,而 43%的护士则向监管机构寻求帮助。只有 30%的医生正确识别出哪些活动是为医生保留的,而 39%的护士正确识别出他们保留的活动。关于法律认知,28%的医生和 39%的护士认为 IPC 会增加他们的责任。这些参与者更倾向于将与责任相关的问题视为 IPC 的障碍。这些结果表明,临床医生对法律和政策的了解与实际文本之间存在重要差异。这种差距可能导致临床医生对法律的误解、政策制定者对政策的无效修改,并使 IPC 的实施长期无效。

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