Vossen Emma, Schaafsma Frederieke G, van der Gulden Joost W J, de Kock Cornelis A, Schaap Rosanne, Anema Johannes R, van Genabeek Joost A G M
Afdeling Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, Nederland.
HAN University of Applied Sciences, Nijmegen, Nederland.
TSG. 2022;100(4):138-145. doi: 10.1007/s12508-022-00374-7. Epub 2022 Nov 30.
To this date, there is little to no interprofessional collaboration between professionals in general and occupational health care in the Netherlands. Where earlier initiatives for improvement focused on general practitioners (GPs) and occupational physicians (OPs), we examine the role that professionals working under task delegation of GPs and OPs can play in addressing problems on multiple life domains as well as in interprofessional collaboration. We conducted three focus group interviews with 7 assistant practitioners (APs) in general practice, 11 practice nurses (PNs) in general practice and 8 APs in occupational health practice. All PNs and APs in our study are confronted with multi-domain problems and see a role for themselves in addressing these problems. Moreover, in case of multi-domain problems, they acknowledge the relevance of interprofessional collaboration to provide good care. At this moment, however, there is practically no collaboration at the level of PNs and APs. Challenges are found in the formal task delegation and role identity of the APs in occupational health practice, unfamiliarity and prejudices among especially general practice PNs and APs regarding occupational health care, and practical barriers as privacy laws and reachability. Interprofessional collaboration among PNs and APs in general and occupational health care is possible, provided that a solution is found for fundamental and practical challenges. Potential solutions are to shift the focus from sharing medical information to communicating about the needs of working patients to function healthily on multiple life domains, to address interprofessional collaboration in educations, to adapt consultation protocols to include work and to organize joint meetings between professionals in general and occupational health practice. Finally, addressing structural barriers such as privacy laws and financing requires political action.
截至目前,荷兰普通专业人员与职业卫生保健专业人员之间几乎没有跨专业合作。早期的改进举措主要集中在全科医生(GPs)和职业医生(OPs)身上,而我们研究的是在全科医生和职业医生任务委托下工作的专业人员在解决多个生活领域问题以及跨专业合作中所能发挥的作用。我们对7名全科医疗助理医师(APs)、11名全科医疗执业护士(PNs)和8名职业卫生助理医师进行了三次焦点小组访谈。我们研究中的所有执业护士和助理医师都面临多领域问题,并且认为自己在解决这些问题中能发挥作用。此外,在遇到多领域问题时,他们认可跨专业合作对于提供优质护理的重要性。然而,目前在执业护士和助理医师层面几乎没有合作。在职业卫生实践中,助理医师的正式任务委托和角色认同存在挑战,尤其是全科医疗的执业护士和助理医师对职业卫生保健存在不熟悉和偏见,以及隐私法和可达性等实际障碍。只要能找到解决基本和实际挑战的办法,全科医疗和职业卫生保健中的执业护士和助理医师之间的跨专业合作是可行的。潜在的解决办法包括将重点从共享医疗信息转向就在职患者在多个生活领域健康工作的需求进行沟通,在教育中开展跨专业合作,调整咨询协议以纳入工作内容,并组织全科医疗和职业卫生实践专业人员之间的联席会议。最后,解决隐私法和资金等结构性障碍需要政治行动。