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基层医疗中跨专业协作的综述概述:障碍与促进因素

An Overview of Reviews on Interprofessional Collaboration in Primary Care: Barriers and Facilitators.

作者信息

Rawlinson Cloe, Carron Tania, Cohidon Christine, Arditi Chantal, Hong Quan Nha, Pluye Pierre, Peytremann-Bridevaux Isabelle, Gilles Ingrid

机构信息

Center for Primary Care and Public Health (Unisanté), Route de Corniche 10, 1010 Lausanne, Switzerland.

Department of Family Medicine, McGill University, 5858, Chemin de la Côte-des-Neiges, Montreal, Quebec, Canada.

出版信息

Int J Integr Care. 2021 Jun 22;21(2):32. doi: 10.5334/ijic.5589.

Abstract

INTRODUCTION

Interprofessional collaboration (IPC) is becoming more widespread in primary care due to the increasing complex needs of patients. However, its implementation can be challenging. We aimed to identify barriers and facilitators of IPC in primary care settings.

METHODS

An overview of reviews was carried out. Nine databases were searched, and two independent reviewers took part in review selection, data extraction and quality assessment. A thematic synthesis was carried out to highlight the main barriers and facilitators, according to the type of IPC and their level of intervention (system, organizational, inter-individual and individual).

RESULTS

Twenty-nine reviews were included, classified according to six types of IPC: IPC in primary care (large scope) (n = 11), primary care physician (PCP)-nurse in primary care (n = 2), PCP-specialty care provider (n = 3), PCP-pharmacist (n = 2), PCP-mental health care provider (n = 6), and intersectoral collaboration (n = 5). Most barriers and facilitators were reported at the organizational and inter-individual levels. Main barriers referred to lack of time and training, lack of clear roles, fears relating to professional identity and poor communication. Principal facilitators included tools to improve communication, co-location and recognition of other professionals' skills and contribution.

CONCLUSIONS

The range of barriers and facilitators highlighted in this overview goes beyond specific local contexts and can prove useful for the development of tools or guidelines for successful implementation of IPC in primary care.

摘要

引言

由于患者需求日益复杂,跨专业协作(IPC)在初级保健中越来越普遍。然而,其实施可能具有挑战性。我们旨在确定初级保健环境中IPC的障碍和促进因素。

方法

进行了综述概述。检索了九个数据库,两名独立评审员参与了综述选择、数据提取和质量评估。根据IPC的类型及其干预水平(系统、组织、个体间和个体)进行了主题综合,以突出主要障碍和促进因素。

结果

纳入了29篇综述,根据六种IPC类型进行分类:初级保健中的IPC(范围广泛)(n = 11)、初级保健中的初级保健医生(PCP)-护士(n = 2)、PCP-专科护理提供者(n = 3)、PCP-药剂师(n = 2)、PCP-精神卫生保健提供者(n = 6)和跨部门协作(n = 5)。大多数障碍和促进因素在组织和个体间层面被报告。主要障碍包括时间和培训不足、角色不明确、对职业身份的担忧以及沟通不畅。主要促进因素包括改善沟通的工具、同地办公以及对其他专业人员技能和贡献的认可。

结论

本综述中强调的障碍和促进因素范围超越了特定的局部背景,对于开发在初级保健中成功实施IPC的工具或指南可能是有用的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fb8/8231480/44b7889e6b87/ijic-21-2-5589-g1.jpg

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