Hawkins Colette, Wheatman Amy, Black David, Pala Alexis, Fu Yu, Robinson Tomos, Ling Jonathan, Gorman Sarah, Beardon Sarah, Genn Hazel, Hesselgreaves Hannah
South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.
Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Health Soc Care Deliv Res. 2024 Sep 11:1-21. doi: 10.3310/YGRA9852.
Social welfare legal needs (matters of daily life, such as finances, housing and employment with legal rights, entitlements or protections) are prevalent towards end of life, creating significant difficulties for both patients and carers. Most people do not know where to go, although a range of services provide advice and support for addressing social welfare legal problems. Navigating this complex and fragmented system across health, social care and social welfare legal support is very challenging. Healthcare professionals are often the first contact for social welfare legal needs, although these are often overlooked and their impact on health and well-being unrecognised. Interprofessional learning can increase awareness of social welfare legal needs and build connections between service providers, offering a more holistic and cohesive multiagency response to the complex needs around end of life. The aim of the research was to co-create a robust foundation for cross-agency research investigating the impact of interprofessional learning on social welfare legal needs towards end of life in the North East England region.
Convene a research partnership group across academics, multiagency service providers and members of the public with lived experience. Consider and agree key issues for successful place-based multiagency research in this area. Co-create a complexity-appropriate research proposal with interprofessional learning as an intervention.
A series of research activities was implemented to convene a multiagency partnership group and consider the key issues for successful place-based multiagency research. Data were collected from two online workshops, an optional reflective workbook, and a modified Delphi technique. Initial participants were selectively recruited from our established stakeholder and patient and public involvement groups. Increasing diversity of the partnership continued throughout the project, using contacts provided by group members. Representation of services supporting underserved groups was a priority.
All invited participants were recruited to the partnership, although contribution to research activities was variable. The partnership bridged knowledge gaps between services and united diverse perspectives, expertise and experience. A greater understanding of the barriers and opportunities for place-based multiagency working was generated, such as considering the importance of language in facilitating collaboration and responding to concerns around capacity. A non-hierarchical partnership was meaningful, with both personal and professional insights viewed as equally important. Facilitators to engagement with interprofessional learning were identified including the need for leadership endorsement. A non-traditional, mixed-method approach to interprofessional learning evaluation was favoured, with both qualitative and quantitative measures at three levels: patient and carer, professional learners and organisations. Important outcomes included raising awareness, connectedness and space to reflect.
The partnership group expanded throughout the course of the project. While this extended diversity, variable participation hindered depth of discussion, with participants engaging at different points and with different understanding levels of the project. Supplementary materials provided some mitigation. Capacity and funding constraints limited engagement for some participants.
Convening a multiagency partnership generated insights into the benefits, barriers and facilitators to research co-design and potential measures of success of interprofessional learning.
Learning from this project has informed a complexity-appropriate research proposal to evaluate the impact of interprofessional learning as an intervention across different stakeholders.
This article presents independent research funded by the National Institute for Health and Care Research (NIHR) programme as award number NIHR135276.
临终时社会福利法律需求（如财务、住房和具有法定权利、应享待遇或保护的就业等日常生活事务）普遍存在，给患者和护理人员都带来了重大困难。大多数人不知道该去哪里寻求帮助，尽管有一系列服务可为解决社会福利法律问题提供建议和支持。在卫生、社会护理和社会福利法律支持这一复杂且分散的系统中找到方向极具挑战性。医疗保健专业人员往往是社会福利法律需求的第一接触者，尽管这些需求常常被忽视，其对健康和福祉的影响也未得到认识。跨专业学习可以提高对社会福利法律需求的认识，并在服务提供者之间建立联系，为围绕临终的复杂需求提供更全面、更具凝聚力的多机构应对措施。该研究的目的是共同创建一个坚实的基础，用于开展跨机构研究，以调查跨专业学习对英格兰东北部地区临终时社会福利法律需求的影响。
召集一个由学者、多机构服务提供者和有实际生活经验的公众组成的研究合作小组。思考并商定该领域成功开展基于地点的多机构研究的关键问题。共同创建一个适合复杂性的研究提案，将跨专业学习作为一项干预措施。
开展了一系列研究活动，以召集一个多机构合作小组，并思考基于地点的多机构研究成功的关键问题。数据收集自两个在线研讨会、一本可选的反思工作手册以及一种改良的德尔菲技术。最初的参与者是从我们已有的利益相关者、患者及公众参与小组中选择性招募的。在整个项目过程中，利用小组成员提供的联系方式不断增加合作关系的多样性。优先考虑为服务不足群体提供支持的服务机构的代表性。
所有受邀参与者都加入了合作小组，尽管对研究活动的参与程度各不相同。该合作小组弥合了服务之间的知识差距，汇聚了不同的观点、专业知识和经验。对基于地点的多机构合作的障碍和机遇有了更深入的理解，比如认识到语言在促进合作方面的重要性以及应对能力方面的担忧。一个非等级制的合作关系很有意义，个人见解和专业见解都被视为同等重要。确定了参与跨专业学习的促进因素，包括需要领导层的认可。人们倾向于采用一种非传统的、混合方法的跨专业学习评估方式，在患者和护理人员、专业学习者和组织三个层面采用定性和定量措施。重要成果包括提高了认识、增强了联系以及提供了反思空间。
合作小组在项目过程中不断扩大。虽然这增加了多样性，但参与程度的差异阻碍了讨论的深度，参与者在不同时间点参与，对项目的理解程度也不同。补充材料起到了一定的缓解作用。能力和资金限制使一些参与者的参与受到限制。
召集一个多机构合作小组，使我们深入了解了研究共同设计的益处、障碍和促进因素以及跨专业学习潜在的成功衡量标准。
从该项目中吸取的经验为一个适合复杂性的研究提案提供了信息，以评估跨专业学习作为一项干预措施对不同利益相关者的影响。
本文介绍了由英国国家卫生与保健研究所（NIHR）项目独立资助的研究，资助编号为NIHR135276。
