PDF(Pubmed)
Abstract：
Interdisciplinary communication and collaboration are crucial in the care of people with multiple long-term conditions (MLTCs) yet are often experienced as insufficient. Through the lens of complexity science, this study aims to explain how healthcare professionals (HCPs) adapt to emerging situations in the care of patients with MLTC by examining interdisciplinary communication and collaboration in the outpatient hospital setting. We used the constant comparative method to analyze transcribed data from seven focus groups with twenty-one HCPs to generate a constructivist grounded theory of \'interdisciplinary communication and collaboration in the outpatient setting of the hospital for patients with multiple long-term conditions\'. Our theory elucidates the various pathways of communication and collaboration. Why, when, and how team members choose to collaborate influences if and to what degree tailored care is achieved. There is great variability and unpredictability to this process due to internalized rules, such as beliefs on the appropriateness to deviate from guidelines, and the presence of an interprofessional identity. We identified organizational structures that influence the dynamics of the care team such as the availability of time and financial compensation for collaboration. As we strive for tailored care for patients with MLTC, our theory provides promising avenues for future endeavors.
摘要：
跨学科的沟通和合作对于照顾患有多种长期疾病（MLTC）的人至关重要，但往往被认为是不足的。通过复杂性科学的镜头，本研究旨在通过检查门诊医院环境中的跨学科沟通和合作,解释医疗保健专业人员(HCP)如何适应MLTC患者护理中出现的新情况.我们使用恒定的比较方法分析了来自七个焦点小组的21个HCP的转录数据，以产生建构主义的理论，即“在医院门诊环境中，针对多种长期疾病的患者进行跨学科交流和合作”。我们的理论阐明了沟通和合作的各种途径。为什么,when,以及团队成员如何选择协作影响是否以及在何种程度上实现了量身定制的护理。由于内在化的规则，这个过程有很大的可变性和不可预测性，例如对偏离准则的适当性的信念，以及跨专业身份的存在。我们确定了影响护理团队动态的组织结构，例如合作的时间和经济补偿。当我们努力为MLTC患者提供量身定制的护理时，我们的理论为未来的努力提供了有希望的途径。
