OsloMet- Oslo Metropolitan University, Oslo, Norway.
Centre for Development of Institutional and Home Care Services in Oslo, Oslo, Norway.
BMC Prim Care. 2024 Aug 24;25(1):314. doi: 10.1186/s12875-024-02554-7.
Home-based healthcare services are facing challenges and pressures of increasing needs due to an ageing population, rising workload for an overburdened workforce, and limited financial resources. The trust model is an approach to address the challenges, by organizing the home-based healthcare services into smaller, autonomous interdisciplinary teams. The aim is to involve users and next of kin in decision-making and trusting frontline workers' professional judgement, thus making the services more flexible and individually tailored. This study explores frontline workers' practices and experiences of working within interdisciplinary teams according to the trust model's goals.
Observations, individual-, and focus groups interviews were conducted within home-based healthcare service in a Norwegian municipality. The participants were leaders and frontline workers at different levels of the home-based healthcare services, including registered nurses, auxiliary nurses, occupational therapists, physiotherapists, and other unskilled healthcare personnel. Data was analysed thematically.
The results are presented in terms of themes: 'We all want the best for service users', 'Belonging to an interdisciplinary team' and 'Maintaining belonging to those with similar work tasks and responsibilities'. The results show a diversity among the participants' experiences of working within interdisciplinary teams. It demonstrates a dilemma between creating belonging to and forming identities within the interdisciplinary team, and at the same time, the importance of maintaining belonging and identity with those in the same profession or with the same tasks and responsibilities.
This study suggests that the frontline workers need for dual belonging seems to be underestimated within the trust model, and by acknowledging this, organisations and policymakers can create environments that support both. Which in turn can enhance the possibility to deliver flexible and individually tailored services for service users.
由于人口老龄化、劳动力负担过重以及有限的财政资源，家庭医疗保健服务面临着需求不断增加的挑战和压力。信任模式是一种应对这些挑战的方法，它将家庭医疗保健服务组织成更小、更自主的跨学科团队。其目的是让用户和家属参与决策，并信任一线工作人员的专业判断，从而使服务更加灵活和个性化。本研究根据信任模式的目标，探讨了一线工作人员在跨学科团队中工作的实践和经验。
在挪威一个市的家庭医疗保健服务中进行了观察、个人和焦点小组访谈。参与者包括家庭医疗保健服务的不同层次的领导和一线工作人员，包括注册护士、助理护士、职业治疗师、物理治疗师和其他非熟练医疗人员。数据采用主题分析方法进行分析。
结果以主题呈现：“我们都希望为服务用户提供最好的服务”、“属于跨学科团队”和“保持与具有相似工作任务和责任的人员的归属”。结果显示了参与者在跨学科团队中工作的经验多样性。它展示了在跨学科团队中建立归属感和形成身份之间的困境，同时，与同一专业或具有相同任务和责任的人员保持归属感和身份认同感的重要性。
本研究表明，信任模式低估了一线工作人员的双重归属感需求，认识到这一点，组织和政策制定者可以创造支持这两者的环境。这反过来又可以提高为服务用户提供灵活和个性化服务的可能性。
