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“嗯,这与医生密切相关”——门诊环境中全科医疗诊所与护士之间的跨专业沟通与协作:德国南部的一项定性研究。

"Well, it's very doctor-related" - interprofessional communication and collaboration between GP practices and nurses in the ambulant setting: a qualitative study in southern Germany.

作者信息

Nordmann Kim, Sauter Stefanie, Redlich Marie-Christin, Möbius-Lerch Patricia, Schaller Michael, Fischer Florian

机构信息

Bavarian Research Center for Digital Health and Social Care, Kempten University of Applied Sciences, Kempten, Germany.

出版信息

BMC Health Serv Res. 2025 May 3;25(1):642. doi: 10.1186/s12913-025-12819-1.

Abstract

BACKGROUND

The demographic transition in Germany is leading to an increase in the number of people needing care or nursing services in their own homes. Interprofessional communication and collaboration among healthcare professions providing outpatient care is paramount to ensure effective and high-quality patient-centred care. However, interprofessional communication and collaboration comes with complex prerequisites and rarely works smoothly. Thus, it is necessary to assess the current status quo. Therefore, the aim is to characterize communication patterns, factors influencing interprofessional communication and collaboration and expectations towards communication and collaboration between home-care nursing services and general practitioner practices in Germany.

METHODS

Semi-structured interviews with healthcare professionals in general practitioners' practices (n=7) and nurses working in home-care nursing services (n=10) were conducted in southern Germany. The interviews were analysed using inductive thematic content analysis.

RESULTS

Current communication occurs via fax, telephone or personal contact for various purposes, including issuing or rectifying prescriptions and exchanging information about change in a patient's condition. Key factors influencing interprofessional communication are organizational (e.g., lack of direct communication), profession-related (e.g., hierarchy) and individual (e.g., capacity to provide care). Interprofessional collaboration is scarce. Healthcare professionals expect uncomplicated, efficient and quick communication and collaboration through set channels.

CONCLUSIONS

Current interaction patterns are deficient and require political, structural and educational changes to establish well-functioning collaboration in the ambulant sector that facilitates patient-centred care. Educational and political reforms should comprise expanding interprofessional education in curricula and the introduction of clear and secure communication channels.

摘要

背景

德国的人口结构转变导致需要居家护理服务的人数增加。提供门诊护理的医疗专业之间的跨专业沟通与协作对于确保以患者为中心的高效、高质量护理至关重要。然而,跨专业沟通与协作存在复杂的前提条件,且很少能顺利开展。因此,有必要评估当前的现状。所以,本研究旨在描述德国居家护理服务机构与全科医生诊所之间的沟通模式、影响跨专业沟通与协作的因素以及对沟通与协作的期望。

方法

在德国南部对全科医生诊所的医疗专业人员(n = 7)和居家护理服务机构的护士(n = 10)进行了半结构化访谈。采用归纳式主题内容分析法对访谈进行分析。

结果

当前的沟通通过传真、电话或个人联系进行,目的多种多样,包括开具或修改处方以及交流患者病情变化的信息。影响跨专业沟通的关键因素包括组织层面(如缺乏直接沟通)、职业相关层面(如等级制度)和个人层面(如护理能力)。跨专业协作很少。医疗专业人员期望通过既定渠道进行简单、高效且快速的沟通与协作。

结论

当前的互动模式存在缺陷,需要进行政治、结构和教育方面的变革,以在门诊部门建立起运转良好的协作关系,促进以患者为中心的护理。教育和政治改革应包括在课程中扩大跨专业教育以及引入清晰、安全的沟通渠道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adf6/12048923/25847572a380/12913_2025_12819_Fig1_HTML.jpg

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