Department of General Practice, University Medical Center Goettingen, Humboldtallee 38, 37073, Göttingen, Germany.
Department of General Practice and Primary Care, University Medical Center Hamburg- Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
BMC Prim Care. 2024 Mar 4;25(1):79. doi: 10.1186/s12875-024-02313-8.
About one million people in need of home care in Germany are assisted by 15,400 home care services. Home healthcare is mostly a complex endeavour because interprofessional collaboration is often challenging. This might negatively impact patient safety. The project interprof HOME aims to develop an interprofessional person-centred care concept for people receiving home care in a multistep approach. In one of the work packages we explored how people receiving home care, relatives, nurses, general practitioners, and therapists (physiotherapists, occupational therapists, and speech therapists) perceive collaboration in this setting.
Semi-structured interviews were conducted with 20 people receiving home care and with 21 relatives. Additionally, we worked with nine monoprofessional focus groups involving nurses of home care services (n = 17), general practitioners (n = 14), and therapists (n = 21). The data were analysed by content analysis.
Three main categories evolved: "perception of interprofessional collaboration", "means of communication", and "barriers and facilitators". People receiving home care and relatives often perceive little to no interprofessional collaboration and take over a significant part of the organisational coordination and information exchange. Interprofessional collaboration in steady care situations does exist at times and mostly occurs in coordination tasks. Contact and information exchange are rare, however, interprofessional personal encounters are sporadic, and fixed agreements and permanent contact persons are not standard. These trends increase with the complexity of the healthcare situation. Joint collaborations are often perceived as highly beneficial. Means of communications such as telephone, fax, or e-mail are used differently and are often considered tedious and time-consuming. No interprofessional formal written or electronic documentation system exists. Personal acquaintance and mutual trust are perceived as being beneficial, while a lack of mutual availability, limited time, and inadequate compensation hinder interprofessional collaboration.
Interprofessional collaboration in home care occurs irregularly, and coordination often remains with people receiving home care or relatives. While this individual care set-up may work sufficiently well in low complex care situations, it becomes vulnerable to disruptions with increasing complexity. Close interactions, joint collaboration, and fixed means of communication might improve healthcare at home. The findings were integrated into the development of the person-centred interprofessional care concept interprof HOME.
This study is registered on the International Clinical Trails registry platform ClinicalTrials.gov as NCT05149937 on 03/11/2021.
在德国，大约有 100 万人需要家庭护理，由 15400 家家庭护理服务机构提供帮助。家庭医疗保健大多是一项复杂的工作，因为跨专业合作常常具有挑战性。这可能会对患者安全产生负面影响。interprof HOME 项目旨在采用多步骤方法，为接受家庭护理的人员制定跨专业以患者为中心的护理概念。在其中一个工作包中，我们探讨了接受家庭护理的人员、亲属、护士、全科医生和治疗师（物理治疗师、职业治疗师和言语治疗师）如何在这种环境下感知协作。
我们对 20 名接受家庭护理的人员和 21 名亲属进行了半结构化访谈。此外，我们还与 9 个单专业焦点小组合作，其中包括家庭护理服务的护士（n=17）、全科医生（n=14）和治疗师（n=21）。通过内容分析对数据进行了分析。
出现了三个主要类别：“对跨专业合作的看法”、“沟通方式”和“障碍和促进因素”。接受家庭护理的人员和亲属通常认为几乎没有跨专业合作，并承担了组织协调和信息交流的很大一部分工作。在稳定的护理情况下，跨专业合作确实存在，并且主要发生在协调任务中。然而，联系和信息交流很少，但是，偶尔会有跨专业的个人接触，并且没有标准的固定协议和固定联系人。这些趋势随着医疗情况的复杂性而增加。联合协作通常被认为非常有益。电话、传真或电子邮件等沟通方式的使用方式不同，并且常常被认为繁琐且耗时。没有跨专业的正式书面或电子文件系统。个人熟悉和相互信任被认为是有益的，而相互可用性不足、时间有限和补偿不足则会阻碍跨专业合作。
家庭护理中的跨专业合作不规律，协调通常仍由接受家庭护理的人员或亲属负责。虽然这种个体化护理模式在低复杂护理情况下可能运作良好，但随着复杂性的增加，它容易受到干扰。密切互动、联合协作和固定的沟通方式可能会改善家庭医疗保健。研究结果已纳入以人为中心的跨专业护理概念 interprof HOME 的开发中。
该研究在国际临床试验注册平台 ClinicalTrials.gov 上注册，注册号为 NCT05149937，于 2021 年 3 月 11 日注册。
