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在急性医学与市政酒精治疗之间:关于酒精问题患者的跨部门合作。

Between acute medicine and municipal alcohol treatment: Cross-sectoral collaborations regarding patients with alcohol problems.

作者信息

Sivertsen Ditte Maria, Becker Ulrik, Andersen Ove, Kirk Jeanette Wassar

机构信息

Copenhagen University Hospital, Denmark; Capital Region of Denmark Psychiatry, Denmark.

National Institute of Public Health, University of Southern Denmark, Denmark.

出版信息

Nordisk Alkohol Nark. 2024 Aug;41(4):403-425. doi: 10.1177/14550725241252256. Epub 2024 May 24.

Abstract

The aim was to examine cross-sectoral collaborations of a Danish emergency department (ED) and two municipal treatment centres in the uptake area regarding patients with alcohol problems. The study was a qualitative exploratory study. We conducted individual interviews with ED nurses and secretaries ( = 21) and group interviews ( = 2) in municipal alcohol treatment centres with three and four participants, respectively. Interviews were analysed, first with qualitative content analysis, then by applying the analytical concept "boundary object". Three themes emerged: (1) Responsibilities in practice; (2) Professional contrasts; and (3) The social nurse in a unique position. Themes illuminated a low degree of collaboration characterising the intersectoral work. Blurred responsibilities, challenged communication and acute versus long-term focus were some of the factors not supporting cross-sector collaborations. However, the function of the social nurse was highly appreciated in both sectors and plays a central role. Nonetheless, implicit limitations of this function entail that not all patients with alcohol problems are referred and handled within an ED setting. Overall, we found a lack of collaborative work between healthcare professionals in ED and municipalities for patients with alcohol problems. However, the "social nurse" function was greatly valued in both sectors due to a mediating role, since healthcare professionals in both sectors experienced lack of organisational structures supporting collaborative network, perceived temporal barriers, limited knowledge exchange and differences in approaches to patients.

摘要

本研究旨在探讨丹麦一家急诊科与两个市政治疗中心在酒精问题患者接收区域的跨部门合作情况。该研究为定性探索性研究。我们分别对急诊科护士和秘书(共21人)进行了个人访谈,并在市政酒精治疗中心进行了小组访谈(共2组),每组分别有3名和4名参与者。访谈首先采用定性内容分析法进行分析,然后应用“边界对象”这一分析概念。出现了三个主题:(1)实践中的职责;(2)专业差异;(3)社会护士处于独特地位。这些主题揭示了部门间工作合作程度较低的情况。职责模糊、沟通受阻以及短期与长期关注点不同等因素都不利于跨部门合作。然而,社会护士的作用在两个部门都得到了高度认可,并发挥着核心作用。尽管如此,该功能存在一些潜在局限性,这意味着并非所有酒精问题患者都能在急诊科得到转诊和处理。总体而言,我们发现急诊科医护人员与市政部门在酒精问题患者的合作方面存在不足。然而,由于社会护士的调解作用,该功能在两个部门都备受重视,因为两个部门的医护人员都认为缺乏支持协作网络的组织结构、存在时间障碍、知识交流有限以及对患者的处理方式存在差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2533/11412477/ef300cb3261e/10.1177_14550725241252256-fig1.jpg

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