Rudberg Ingela, Olsson Annakarin, Thunborg Charlotta, Salzmann-Erikson Martin
Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, SE-801 76, Sweden.
Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
BMC Nurs. 2023 Aug 25;22(1):286. doi: 10.1186/s12912-023-01446-y.
Communication in healthcare has been extensively studied, but most research has focused on miscommunication and the importance of communication for patient safety. Previous research on interprofessional communication has mainly focused on relationships between physicians and nurses in non-psychiatric settings. Since communication is one of the core competencies in psychiatric care, more research on interprofessional communication between other clinicians is needed, and should be explored from a broader perspective. This study aimed to explore and describe interprofessional communication in a psychiatric outpatient unit.
During spring 2022, data consisting of over 100 h of fieldwork were collected from observations, formal semi-structured interviews and informal conversations inspired by the focused ethnography method. Data was collected at an outpatient unit in central Sweden, and various clinicians participated in the study. The data analysis was a back-and-forth process between initial codes and emerging themes, but also cyclical as the data analysis process was ongoing and repeated and took place simultaneously with the data collection.
We found that a workplace's history, clinicians´ workload, responsibilities and hierarchies influence interprofessional communication. The results showed that the prerequisites for interprofessional communication were created through the unit's code of conduct, clear and engaging leadership, and trust in the ability of the various clinicians to perform new tasks.
Our results indicate that leadership, an involving working style, and an environment where speaking up is encouraged and valued can foster interprofessional communication and respect for each other´s professional roles is key to achieving this. Interprofessional communication between different clinicians is an important part of psychiatric outpatient work, where efficiency, insufficient staffing and long patient queues are commonplace. Research can help shed light on these parts by highlighting aspects influencing communication.
医疗保健中的沟通已得到广泛研究，但大多数研究都集中在沟通不畅以及沟通对患者安全的重要性上。以往关于跨专业沟通的研究主要集中在非精神科环境中医师与护士之间的关系。由于沟通是精神科护理的核心能力之一，因此需要对其他临床医生之间的跨专业沟通进行更多研究，并且应该从更广泛的角度进行探索。本研究旨在探索和描述精神科门诊单元中的跨专业沟通。
在2022年春季，通过观察、正式的半结构化访谈以及受聚焦民族志方法启发的非正式对话收集了超过100小时的实地调查数据。数据收集于瑞典中部的一个门诊单元，不同的临床医生参与了该研究。数据分析是一个在初始编码和新出现的主题之间反复进行的过程，而且随着数据分析过程的持续、重复以及与数据收集同时进行，它也是循环的。
我们发现工作场所的历史、临床医生的工作量、职责和层级会影响跨专业沟通。结果表明，跨专业沟通的先决条件是通过该单元的行为准则、清晰且有吸引力的领导以及对不同临床医生执行新任务能力的信任来创造的。
我们的结果表明，领导、积极参与的工作方式以及鼓励和重视表达意见的环境可以促进跨专业沟通，而尊重彼此的专业角色是实现这一点的关键。不同临床医生之间的跨专业沟通是精神科门诊工作的重要组成部分，在这种工作中效率低下、人员配备不足和患者长队等候的情况很常见。研究可以通过突出影响沟通的方面来帮助阐明这些部分。
