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1.
Am J Respir Crit Care Med ; 210(3): 311-317, 2024 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-38358858

RESUMO

Rationale: Organizing ICU interprofessional teams is a high priority because of workforce needs, but the role of interprofessional familiarity remains unexplored. Objectives: Determine if mechanically ventilated patients cared for by teams with greater familiarity have improved outcomes, such as lower mortality, shorter duration of mechanical ventilation (MV), and greater spontaneous breathing trial (SBT) implementation. Methods: We used electronic health records data of five ICUs in an academic medical center to map interprofessional teams and their ICU networks, measuring team familiarity as network coreness and mean team value. We used patient-level regression models to link team familiarity with patient outcomes, accounting for patient and unit factors. We also performed a split-sample analysis by using 2018 team familiarity data to predict 2019 outcomes. Measurements and Main Results: Team familiarity was measured as the average number of patients shared by each clinician with all other clinicians in the ICU (i.e., coreness) and the average number of patients shared by any two members of the team (i.e., mean team value). Among 4,485 encounters, unadjusted mortality was 12.9%, average duration of MV was 2.32 days, and SBT implementation was 89%; average team coreness was 467.2 (standard deviation [SD], 96.15), and average mean team value was 87.02 (SD, 42.42). A 1-SD increase in team coreness was significantly associated with a 4.5% greater probability of SBT implementation, 23% shorter MV duration, and 3.8% lower probability of dying; the mean team value was significantly associated with lower mortality. Split-sample results were attenuated but congruent in direction and interpretation. Conclusions: Interprofessional familiarity was associated with improved outcomes; assignment models that prioritize familiarity might be a novel solution.


Assuntos
Unidades de Terapia Intensiva , Equipe de Assistência ao Paciente , Respiração Artificial , Humanos , Respiração Artificial/estatística & dados numéricos , Masculino , Feminino , Pessoa de Meia-Idade , Unidades de Terapia Intensiva/estatística & dados numéricos , Idoso , Mortalidade Hospitalar , Adulto
2.
BMC Med Educ ; 24(1): 649, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862911

RESUMO

BACKGROUND: The healthcare system is highly complex, and adverse events often result from a combination of human factors and system failures, especially in crisis situations. Crisis resource management skills are crucial to optimize team performance and patient outcomes in such situations. Simulation-based training offers a promising approach to developing such skills in a controlled and realistic environment. METHODS: This study employed a mixed-methods (quantitative-qualitative) design and aimed to assess the effectiveness of a simulation-based training workshop in developing crisis resource management skills in pediatric interprofessional teams at a tertiary care hospital. The effectiveness of the intervention was evaluated using Kirkpatrick's Model, focusing on reaction and learning levels, employing the Collaboration and Satisfaction about Care Decisions scale, Clinical Teamwork Scale, and Ottawa Global Rating Scale for pre- and post-intervention assessments. Focused group discussions were conducted with the participants to explore their experiences and perceptions of the training. RESULTS: Thirty-nine participants, including medical students, nurses, and residents, participated in the study. Compared to the participants' pre-workshop performance, significant improvements were observed across all measured teamwork and performance components after the workshop, including improvement in scores in team communication (3.16 ± 1.20 to 7.61 ± 1.0, p < 0.001), decision-making (3.50 ± 1.54 to 7.16 ± 1.42, p < 0.001), leadership skills (2.50 ± 1.04 to 5.44 ± 0.6, p < 0.001), and situation awareness (2.61 ± 1.13 to 5.22 ± 0.80, p < 0.001). No significant variations were observed post-intervention among the different teams. Additionally, participants reported high levels of satisfaction, perceived the training to be highly valuable in improving their crisis resource management skills, and emphasized the importance of role allocation and debriefing. CONCLUSIONS: The study underscores the effectiveness of simulation-based training in developing crisis resource management skills in pediatric interprofessional teams. The findings suggest that such training can impact learning transfer to the workplace and ultimately improve patient outcomes. The insights from our study offer additional valuable considerations for the ongoing refinement of simulation-based training programs. There is a need to develop more comprehensive clinical skills evaluation methods to better assess the transferability of these skills in real-world settings. The potential challenges unveiled in our study, such as physical exhaustion during training, must be considered when refining and designing such interventions.


Assuntos
Equipe de Assistência ao Paciente , Treinamento por Simulação , Humanos , Pediatria/educação , Masculino , Feminino , Competência Clínica , Relações Interprofissionais , Emergências , Atenção à Saúde , Gestão de Recursos da Equipe de Assistência à Saúde
3.
J Pediatr Nurs ; 77: 1-12, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38461775

RESUMO

AIM: A critical review examined how childrens participation rights as represented in the United Nations Convention on the Rights of the Child inform the work of pediatric teams in healthcare settings. METHODS: We systematically searched peer-reviewed literature on the enactment of child participation rights, within the context of pediatric teams. Articles were evaluated using the LEGEND (Let Evidence Guide Every New Decision) tool. Data extraction and analysis highlighted themes and disparities between articles, as well as gaps. A total of 25 studies were selected. RESULTS: We reviewed studies from around the globe, with the majority of papers from the UK. Qualitative and mixed methods approaches were administered. The following observations were made: (1) limited language of children's rights exists in the literature, (2) lack of information regarding the composition of pediatric healthcare teams and how they work with children, (3) children's perspectives on what constitutes good interactions with healthcare providers are replicated, (4) minimal references to theory or philosophical underpinnings that can guide practice. CONCLUSION: Explicit references to children's participation rights are lacking in the literature which may reflect the absence of rights language that could inform pediatric practice. Descriptive understandings of the tenets of pediatric interprofessional team composition and collaboration are necessary if we are to imagine the child as part of the team along with their family. Despite these shortcomings, the literature alludes to children's ability to discern desirable interactions with healthcare providers.


Assuntos
Equipe de Assistência ao Paciente , Humanos , Criança , Equipe de Assistência ao Paciente/organização & administração , Defesa da Criança e do Adolescente/legislação & jurisprudência , Pediatria , Feminino , Participação do Paciente , Masculino
4.
J Interprof Care ; 38(4): 593-601, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38517041

RESUMO

Effective interprofessional team function is integral to high-quality care in the intensive care unit (ICU). However, little is known about how familiarity develops among teams, which may be an important antecedent to effective team function and quality care. To examine team familiarity and how it impacts ICU team function and care, we conducted an ethnographic study in four ICUs (two medical ICUs, one mixed medical-surgical ICU, and one surgical ICU) in two community hospitals and one academic medical center. We conducted 57.5 h of observation, 26 shadowing experiences, and 26 interviews across the four ICUs sequentially. We used thematic analysis to examine familiarity among the team. We found that ICU team members become familiar with their team through interpersonal, relational interactions, which involved communication, time working together, social interactions, trust, and respect. Our findings underscore the relational aspect of effective teams and demonstrate that time working together, social interactions, communication, developing trust, and respect are pathways to familiarity and optimal team function. Leveraging unique and creative ways to enhance the relational aspects of ICU teams could be an area for future research and lead to improved ICU outcomes.


Assuntos
Antropologia Cultural , Comunicação , Unidades de Terapia Intensiva , Relações Interprofissionais , Equipe de Assistência ao Paciente , Confiança , Humanos , Unidades de Terapia Intensiva/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Comportamento Cooperativo , Interação Social , Feminino , Masculino , Respeito , Relações Interpessoais , Entrevistas como Assunto
5.
J Interprof Care ; 38(2): 331-345, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37226329

RESUMO

In the context of the COVID-19 pandemic, many healthcare and social services professionals have had to provide services through virtual care. In the workplace, such professionals often need to be sufficiently resourced to collaborate and address collaborative care barriers in telehealth. We performed a scoping review to identify the competencies required to support interprofessional collaboration among clinicians in telehealth. We followed Arksey and O'Malley's and the Joanna Briggs Institute's methodological guidelines, including quantitative and qualitative peer-reviewed articles published between 2010 and 2021. We expanded our data sources by searching for any organization or experts in the field via Google. The analysis of the resulting thirty-one studies and sixteen documents highlighted that health and social services professionals are generally unaware of the competencies they need to develop or maintain interprofessional collaboration in telehealth. In an era of digital innovations, we believe this gap may jeopardize the quality of the services offered to patients and needs to be addressed. Of the six competency domains in the National Interprofessional Competency Framework, it was observed that interprofessional conflict resolution was the competency that emerged least as an essential competency to be developed, while interprofessional communication and patient/client/family/community-centered care were identified as the two most reported essential competencies.


Assuntos
Relações Interprofissionais , Telemedicina , Humanos , Pandemias , Comunicação , Apoio Social
6.
J Interprof Care ; 38(4): 695-704, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38734870

RESUMO

Bias in advanced heart failure therapy allocation results in inequitable outcomes for minoritized populations. The purpose of this study was to examine how bias is introduced during group decision-making with an interprofessional team using Breathett's Model of Heart Failure Decision-Making. This was a secondary qualitative descriptive analysis from a study focused on bias in advanced heart failure therapy allocation. Team meetings were recorded and transcribed from four heart failure centers. Breathett's Model was applied both deductively and inductively to transcripts (n = 12). Bias was identified during discussions about patient characteristics, clinical fragility, and prior clinical decision-making. Some patients were labeled as "good citizens" or as adherent/non-adherent while others benefited from strong advocacy from interprofessional team members. Social determinants of health also impacted therapy allocation. Interprofessional collaboration with advanced heart failure therapy allocation may be enhanced with the inclusion of patient advocates and limit of clinical decision-making using subjective data.


Assuntos
Insuficiência Cardíaca , Equipe de Assistência ao Paciente , Humanos , Insuficiência Cardíaca/terapia , Equipe de Assistência ao Paciente/organização & administração , Pesquisa Qualitativa , Relações Interprofissionais , Comportamento Cooperativo , Tomada de Decisão Clínica , Masculino , Feminino , Determinantes Sociais da Saúde , Tomada de Decisões , Processos Grupais , Pessoa de Meia-Idade
7.
J Interprof Care ; 38(4): 621-631, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38470835

RESUMO

The objective of this study was to enhance understanding of team functioning in a neurorehabilitation team by identifying the factors that impede and facilitate effective interprofessional team collaboration. We focused on team identification, psychological safety, and team learning, and conducted the research at a neurorehabilitation center treating young patients with severe acquired brain injury in the Netherlands. A mixed-methods approach was employed, integrating quantitative data from questionnaires (N = 40) with qualitative insights from a focus group (n = 6) and in-depth interviews (n = 5) to provide a comprehensive perspective on team dynamics. Findings revealed strong team identification among participants, denoting a shared sense of belonging and commitment. However, limited psychological safety was observed, which negatively affected constructive conflict and team learning. Qualitative analysis further identified deficiencies in shared mental models, especially in shared decision-making and integrated care. These results highlight the crucial role of psychological safety in team learning and the development of shared mental models in neurorehabilitation settings. Although specific to neurorehabilitation, the insights gained may be applicable to enhancing team collaboration in various healthcare environments. The study forms a basis for future research to investigate the impact of improvements in team functioning on patient outcomes in similar settings.


Assuntos
Comportamento Cooperativo , Relações Interprofissionais , Reabilitação Neurológica , Equipe de Assistência ao Paciente , Humanos , Equipe de Assistência ao Paciente/organização & administração , Reabilitação Neurológica/organização & administração , Masculino , Feminino , Países Baixos , Adulto , Grupos Focais , Lesões Encefálicas/reabilitação , Pesquisa Qualitativa , Processos Grupais , Entrevistas como Assunto
8.
J Interprof Care ; : 1-10, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39351693

RESUMO

Social workers frequent interprofessional healthcare teams, but few studies examine the day-to-day experiences of these providers on interprofessional teams. Our study utilized semi-structured interviews with 54 medical social workers practicing on interprofessional healthcare teams. A thematic analysis was used to analyze the day-to-day functions of these social workers. The analysis resulted in three primary themes: 1) Social Workers' Self-Perceptions of their Roles within Interprofessional Teams, 2) Social Workers Shifting Roles on Interprofessional Teams, and 3) Interprofessional Team Dynamics that Impact the Role of a Social Worker. Social workers perceived their primary roles as contributing a unique systems approach to interprofessional healthcare teams while emphasizing patient self-determination. These self-perceptions influenced their shifting roles on interprofessional healthcare teams (e.g. clinician, case manager, bridge builder). In addition to individual self-perceptions, the healthcare system infrastructure influenced social work roles. For example, social workers in outpatient settings more frequently assumed the role of a mental health practitioner compared to those in inpatient settings. Last, there was variation in interprofessional communication and workflow assignment based on the healthcare infrastructure. Future research should examine the education and training efforts of social workers and other allied health professions for interprofessional healthcare teams.

9.
Community Dent Health ; 40(2): 97-102, 2023 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-37067039

RESUMO

BACKGROUND: A home visiting programme was offered to first-time parents in the south of Sweden to reduce health inequalities among young children and support parents. The programme involved a collaboration between child healthcare nurses and midwives, social workers, and dental hygienists/dental nurses. It is unusual for dental professionals to participate in such programmes. OBJECTIVE: To describe the experiences of collaboration between child healthcare nurses and dental professionals and their views on the programme from a dental perspective. BASIC RESEARCH DESIGN: Qualitative semi-structured interview study with content analysis. PARTICIPANTS: Four child healthcare nurses, three dental hygienists, and two dental nurses. RESULTS: Analysis identified five themes: contribution of knowledge, reinforced oral health advice, family-based oral health advice, financial considerations, and future role of the dental care. CONCLUSIONS: Participants stressed the importance of dental professionals' knowledge, the need for child healthcare nurses and dental professional to conduct home visits together to deliver family-based and reinforced dental advice. They suggested a follow-up visit and the participation of the public dental service before a private dental care provider since most children will visit a public dentist later. The programme was perceived as worth the costs, but for the best utility, the resources should primarily be for non-native parents. Further research should focus on the effect of the home visiting programme on the children's oral health.


Assuntos
Saúde Bucal , Pais , Criança , Humanos , Pré-Escolar , Pesquisa Qualitativa , Odontólogos , Suécia
10.
BMC Med Educ ; 23(1): 694, 2023 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-37740200

RESUMO

BACKGROUND: Interprofessional education (IPE) is a core element of many health professional education curricula. To date the focus of much research has been on student perceptions of, and attitudes towards, the learning experience. Little is known about the impact of early IPE experience on how students understand and learn about effective interprofessional teamwork. METHODS: This qualitative study involved first year university students enrolled in health professions degrees and investigated their descriptions of interprofessional teamwork through graphic elicitation and interviews. Participants were enrolled in a large-scale interprofessional unit (subject) in the university. RESULTS: The data were analysed through the lens of a tool that classifies dimensions of interprofessional activity. The findings indicated the majority of students had what was classified as a Stage 1 (or 'nascent') understanding of integration between work practices and a Stage 2 (or 'emerging') understanding of the dimensions of interprofessional teamwork which were commitment, identity, goals, roles and responsibilities, and interdependence. CONCLUSIONS: Based on the findings, the stages for a learning trajectory for interprofessional education are proposed and each stage is mapped to dimensions of interprofessional activity. A number of pedagogical strategies are suggested in order to move students through this two-stage model of learning and ensure their readiness for interprofessional teamwork as health professionals.


Assuntos
Educação Interprofissional , Aprendizagem , Humanos , Estudantes , Currículo , Equipe de Assistência ao Paciente
11.
J Interprof Care ; 37(3): 400-409, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35880772

RESUMO

Health-care systems around the world are striving to be patient-centered, and there is growing evidence that engaging patients and families in their care, as well as in efforts to redesign services, contributes to improved outcomes and experiences for patients and providers. This patient-oriented care movement includes efforts to improve the quality of information and communication between health-care professionals and patients as well as families and caregivers. Whiteboards have emerged as a best practice in hospitals to promote engagement and improve information and communication, yet with limited empirical evidence regarding their value to patients, families, or interprofessional teams. We introduced whiteboards on an acute medical unit at a community hospital and conducted an evaluation using a pre-post design collecting both qualitative and quantitative data. Baseline and post-implementation data were collected via qualitative interviews with patients/family and providers and using the Canadian Patient Experience Survey; focus groups were held with staff and members of the care team. Qualitative results highlighted improvements in communication between the care team and patients as well as family members. Implications for practice include attention to patient/family empowerment and safety, adherence to guidance for good communication, and support for regular training and education in the use of communication tools for members of the interprofessional team.


Assuntos
Família , Relações Interprofissionais , Humanos , Canadá , Pacientes , Cuidadores , Equipe de Assistência ao Paciente , Comunicação
12.
Aust Crit Care ; 36(1): 99-107, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36460589

RESUMO

BACKGROUND: During the COVID-19 pandemic, new intensive care units (ICUs) were created and clinicians were assigned or volunteered to work in these ICUs. These new ICU teams were newly formed and may have had varying practice styles which could affect team dynamics. The purpose of our qualitative descriptive study was to explore clinician perceptions of team dynamics in this newly formed ICU and specifically understand the challenges and potential improvements in this environment to guide future planning and preparedness in ICUs. METHODS: We conducted 14 semistructured one-on-one interviews with six nurses and eight physicians from a newly formed 36- to 50-bed medical ICU designed for COVID-19 patients in a teaching hospital. We purposively sampled and recruited ICU nurses, medical/surgical nurses, fellows, and attending physicians (with pulmonary/critical care and anaesthesia training) to participate. Participants were asked about team dynamics in the ICU, its challenges, and potential solutions. We then used a rapid analytic approach by first deductively categorising interview data into themes, based on our interview guide, to create a unique data summary for each interview. Then, these data were transferred to a matrix to compare data across all interviews and inductively analysed these data to provide deeper insights into team dynamics in ICUs. RESULTS: We identified two themes that impacted team dynamics positively (facilitator) and negatively (barrier): interpersonal factors (individual character traits and interactions among clinicians) and structural factors (unit-level factors affecting workflow, organisation, and administration). Clinicians had several suggestions to improve team dynamics (e.g., scheduling to ensure clinicians familiar with one another worked together, standardisation of care processes across teams, and disciplines). CONCLUSIONS: In a newly formed COVID ICU, interpersonal factors and structural factors impacted the team's ability to work together. Considering team dynamics during ICU reorganisation is crucial and requires thoughtful attention to interpersonal and structural factors.


Assuntos
COVID-19 , Humanos , Pandemias , Unidades de Terapia Intensiva , Cuidados Críticos , Pesquisa Qualitativa
13.
Ann Fam Med ; 20(6): 512-518, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36443085

RESUMO

PURPOSE: Interprofessional primary care has the potential to optimize hospital use for acute care among people with dementia. We compared 1-year emergency department (ED) visits and hospitalizations among people with dementia enrolled in a practice having an interprofessional primary care team with those enrolled in a physician-only group practice. METHODS: A population-based, repeated cohort study design was used to extract yearly cohorts of 95,323 community-dwelling people in Ontario, Canada, newly identified in administrative data with dementia between April 1, 2005 and March 31, 2015. Patient enrollment in an interprofessional practice or a physician-only practice was determined at the time of dementia diagnosis. We used propensity score-based inverse probability weighting to compare study groups on overall and nonurgent ED visits as well as on overall and potentially avoidable hospitalizations in the 1 year following dementia diagnosis. RESULTS: People with dementia enrolled in a practice having an interprofessional primary care team were more likely to have ED visits (relative risk = 1.03; 95% CI, 1.01-1.05) and nonurgent ED visits (relative risk = 1.22; 95% CI, 1.18-1.28) compared with those enrolled in a physician-only primary care practice. There was no evidence of an association between interprofessional primary care and hospitalization outcomes. CONCLUSIONS: Interprofessional primary care was associated with increased ED use but not hospitalizations among people newly identified as having dementia. Although interprofessional primary care may be well suited to manage the growing and complex dementia population, a better understanding of the optimal characteristics of team-based care and the reasons leading to acute care hospital use by people with dementia is needed.


Assuntos
Demência , Atenção Primária à Saúde , Humanos , Estudos de Coortes , Ontário , Pontuação de Propensão , Demência/terapia
14.
Health Expect ; 25(4): 1730-1740, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35702988

RESUMO

INTRODUCTION: Improving health services integration through primary health care (PHC) teams for patients with chronic conditions is essential to address their complex health needs and facilitate better health outcomes. The objective of this study was to explore if and how patients, family members, and caregivers were engaged or wanted to be engaged in developing, implementing and evaluating health policies related to PHC teams. This patient-oriented research was carried out in three provinces across Canada: British Columbia, Alberta and Ontario. METHODS: A total of 29 semi-structured interviews with patients were conducted across the three provinces and data were analysed using thematic analysis. RESULTS: Three key themes were identified: motivation for policy engagement, experiences with policy engagement and barriers to engagement in policy. The majority of participants in the study wanted to be engaged in policy processes and advocate for integrated care through PHC teams. Barriers to patient engagement in policy, such as lack of opportunities for engagement, power imbalances, tokenism, lack of accessibility of engagement opportunities and experiences of racism and discrimination were also identified. CONCLUSION: This study increases the understanding of patient, family member, and caregiver engagement in policy related to PHC team integration and the barriers that currently exist in this engagement process. This information can be used to guide decision-makers on how to improve the delivery of integrated health services through PHC teams and enhance patient, family member, and caregiver engagement in PHC policy. PATIENT OR PUBLIC CONTRIBUTION: We would like to acknowledge the contributions of our patient partners, Brenda Jagroop and Judy Birdsell, who assisted with developing and pilot testing the interview guide. Judy Birdsell also assisted with the preparation of this manuscript. This study also engaged patients, family members, and caregivers to share their experiences with engagement in PHC policy.


Assuntos
Cuidadores , Doença Crônica , Atenção à Saúde , Família , Política de Saúde , Participação do Paciente , Atenção Primária à Saúde , Canadá , Atenção à Saúde/normas , Humanos , Equipe de Assistência ao Paciente , Atenção Primária à Saúde/normas , Pesquisa Qualitativa
15.
J Pediatr Nurs ; 64: 164-173, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34794847

RESUMO

PURPOSE: In this study, we examined the influence of interprofessional American Heart Association (AHA) resuscitation courses on pediatric health care professionals' (N = 218) self- reported collaborative practice behaviors (CPBs) and examined differences in CPBs between nursing, medicine, and respiratory therapy. DESIGN AND METHODS: A mixed methods explanatory design was utilized with a sample of pediatric nurses, nurse practitioners, physicians, and respiratory therapists. Data were collected using the Interprofessional Collaborative Competency Attainment Survey (ICCAS) and two open-ended questions. Data analysis included: exploratory factor analysis, paired t-tests, mixed effects modeling and directed content analysis. Inferences were made across quantitative and qualitative data. RESULTS: Statistically significant improvement in mean CPB scores was demonstrated by all professions (t (208) = -12.76; ρ < 0.001) immediately after the AHA courses. Qualitative responses indicated physicians identified roles and responsibilities (94%, n = 17) as the most important CPB. Communication was identified by nurses (78%, n = 76), nurse practitioners (100%, n = 11) and respiratory therapists (71%, n = 5) as most important. CONCLUSIONS: Participation in an interprofessional AHA course significantly increased mean self-reported CPB scores. Changes in mean CPB scores were sustained over 6 weeks upon return to clinical practice. PRACTICE IMPLICATIONS: Future research focused on CPBs of front-line health care professionals can provide an accurate portrayal of an interprofessional team and can inform how collaborative practice is established in everyday clinical practice.


Assuntos
Relações Interprofissionais , Enfermeiros Pediátricos , Atitude do Pessoal de Saúde , Criança , Comportamento Cooperativo , Humanos , Equipe de Assistência ao Paciente , Autorrelato , Inquéritos e Questionários
16.
J Interprof Care ; 36(4): 520-528, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34372750

RESUMO

The provision of holistic care for athletes often involves interprofessional teams with specialists to support athletic performance and overall wellness. Yet, regarding psychological support, some have advocated for a single professional to attain both a certified mental performance consultant (CMPC) credential and any type of mental health license (e.g., Licensed Psychologist [LP], Licensed Social Worker [LSW], or Licensed Professional Counselor [LPC]) to address the mental performance and mental health needs of athletes. Unfortunately, this approach may hinder interprofessional collaboration and ignore distinctions between CMPCS and other types of mental health professionals. Alternatively, CMPCs and various types of mental health professionals may work together on interprofessional psychological support teams. The purpose of this paper is to clarify the distinct historical and theoretical foundations of mental performance consulting, clinical psychology, social work, and professional counseling in sport contexts to serve as a resource for enhancing interprofessional competence within such teams. The distinct training pathways of CMPCs, LPs, LSWs, and LPCs are outlined with attention to how each can serve a valuable role on an interprofessional support team for athletes. Applications of the World Health Organization's framework for interprofessional education and collaborative practice (IPECP) to psychological support teams in sport contexts is discussed.


Assuntos
Serviços de Saúde Mental , Esportes , Comportamento Cooperativo , Humanos , Relações Interprofissionais , Equipe de Assistência ao Paciente , Esportes/psicologia
17.
Soc Work Health Care ; 61(3): 139-157, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35481456

RESUMO

Parkinson's Disease is a neurological disease affecting over 10 million people worldwide. Interdisciplinary teams provide integrated care to people with Parkinson's Disease, including care for non-motor symptoms such as anxiety and depression, and many of these teams include social workers. This study sought to learn more about (a) clinical social work utilization across the continuum of care of PWP and their family care partners and (b) how patterns in utilization and service provision have shifted during the pandemic. This mixed method study identifies the breadth of roles performed by social workers in the comprehensive care of people with Parkinson's Disease (PWP). Findings underscore the important roles social workers play in providing comprehensive care for PWP and their families and their contributions to interdisciplinary teams providing holistic, integrated care, particularly during COVID-19 and into the future.


Assuntos
COVID-19 , Doença de Parkinson , Ansiedade/epidemiologia , COVID-19/epidemiologia , Humanos , Doença de Parkinson/epidemiologia , Doença de Parkinson/terapia , Serviço Social
18.
Am J Geriatr Psychiatry ; 29(10): 1053-1057, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246517

RESUMO

Although the highest attainable standard of health is a fundamental human right, oral health is often not considered an important component of overall health. Older people experience poorer quality of life due to discomfort and uncleanliness of their mouth and there continue to be barriers within health systems that contribute to this poor oral health. This paper advocates for oral health to be considered part of the basic human right to good health care and discusses how stakeholders can collaborate and work together to begin to meet the needs of this population, proposing solutions and recommendations to bring about change.


Assuntos
Saúde Bucal , Qualidade de Vida , Idoso , Humanos
19.
Health Expect ; 24(4): 1168-1177, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33949060

RESUMO

BACKGROUND: Widespread policy reforms in Canada, the United States and elsewhere over the last two decades strengthened team models of primary care by bringing together family physicians and nurse practitioners with a range of mental health and other interdisciplinary providers. Understanding how patients with depression and anxiety experience newer team-based models of care delivery is essential to explore whether the intended impact of these reforms is achieved, identify gaps that remain and provide direction on strengthening the quality of mental health care. OBJECTIVE: The main study objective was to understand patients' perspectives on the quality of care that they received for anxiety and depression in primary care teams. METHODS: This was a qualitative study, informed by constructivist grounded theory. We conducted focus groups and individual interviews with primary care patients about their experiences with mental health care. Focus groups and individual interviews were recorded and transcribed verbatim. Grounded theory guided an inductive analysis of the data. RESULTS: Forty patients participated in the study: 31 participated in one of four focus groups, and nine completed an individual interview. Participants in our study described their experiences with mental health care across four themes: accessibility, technical care, trusting relationships and meeting diverse needs. CONCLUSION: Greater attention by policymakers is needed to strengthen integrated collaborative practices in primary care so that patients have similar access to mental health services across different primary care practices, and smoother continuity of care across sectors. The research team is comprised of individuals with lived experience of mental health who have participated in all aspects of the research process.


Assuntos
Ansiedade , Depressão , Ansiedade/terapia , Depressão/terapia , Grupos Focais , Humanos , Equipe de Assistência ao Paciente , Atenção Primária à Saúde , Pesquisa Qualitativa , Estados Unidos
20.
BMC Health Serv Res ; 21(1): 963, 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521410

RESUMO

BACKGROUND: Many countries, including Canada, have introduced primary care reforms to improve health system functioning and value. The purpose of this study was to examine the association between receiving care from interprofessional primary care teams and after-hours access to care, patient-reported walk-in clinic visits and emergency department use. METHODS: We conducted a retrospective cohort study linking population-based administrative databases to Ontario's Health Care Experience Survey (HCES) between 2012 and 2018. We adjusted for physician group characteristics as well as individual physician and patient characteristics while assessing the relationship between receiving care from interprofessional teams and the outcomes of interest. RESULTS: As of March 31st, 2015, there were 465 physician groups with HCES respondents of which 177 (38.0%) were interprofessional teams and 288 (62.0%) were non-interprofessional teams in the same blended capitation reimbursement model. In this period, there were 4518 physicians with HCES respondents, of whom 2131 (47.2%) were in interprofessional teams and 2387 (52.8%) were in non-interprofessional teams. There were 10,102 HCES respondents included in this study, of whom 42.4% were in interprofessional teams and 42.3% were in non-interprofessional teams. After adjustment, we found that being in an interprofessional team was associated with an increase in the odds of patients reporting same/next day access to care by 12.0% (OR = 1.12 CI = 1.00 to 1.24 p-value 0.0436) and a decrease in the odds of patients reporting walk-in clinic use by 16% (OR = 0.84 CI = 0.75 to 0.94 p-value 0.0019). After adjustment, there were no significant differences in patient-reported after-hours access to care and emergency department use. CONCLUSIONS: Ontario has invested heavily in interprofessional primary care teams. As compared to patients in non-interprofessional teams, patients in interprofessional teams self-reported more timely access to care and less walk-in clinic use but no significant difference in self-reported access to after-hours care or in emergency department use. For jurisdictions aiming to expand physician voluntary participation in interprofessional teams, our study results inform expectations around access to care and health services utilization.


Assuntos
Utilização de Instalações e Serviços , Atenção Primária à Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Ontário/epidemiologia , Estudos Retrospectivos
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