The Pictor technique: a method for exploring the experience of collaborative working.

Collaborative working is a crucial part of contemporary health and social care. Researching the experiences of those involved--as professionals, patients, or carers--is challenging, given the complexity of many cases and the taken-for-granted nature of roles and identities in relation to it. In this article we introduce the Pictor technique for exploring experiences of collaborative working. This is a visual technique in which participants construct a representation of roles and relationships in a particular case using arrow-shaped adhesive notes or cards. The chart so produced helps the participant tell the story of his or her experience and serves as a focus for further exploration with the researcher. We describe the background to Pictor and illustrate its use with professionals, patients, and carers, drawing on recent and current research. We examine how Pictor relates to other visual methods, and conclude by considering how the technique might be developed in the future.

Community palliative care: role perception.

Community nurses play a key part in palliative care for patients and their families, yet there is relatively little research examining how their role is understood by nurses themselves. This paper presents findings from a qualitative study exploring how district nursing teams and community matrons (CMs) understood their own and each other's roles in palliative care. Twenty-four district nurses (DNs), 15 CMs and seven other key stakeholders were interviewed. DNs saw themselves as having a pivotal role, often coordinating other services as well as providing hands-on care. CMs agreed with the importance of the DN role, but had doubts about whether DNs had the capacity or skills to provide genuine case management. Both sets of nurses varied in their views of the CM role in palliative care, from seeing it as negligible to extensive and valuable. Organizational change contributed to the defensiveness of many DNs about their role, and to CMs' experiences of suspicion towards theirs.

"Go Make Your Face Known": Collaborative Working through the Lens of Personal Relationships.

BACKGROUND: Collaborative working between professionals is a key component of integrated care. The academic literature on it largely focuses either on integration between health and social care or on the dynamics of power and identity between doctors and nurses. With the proliferation and extension of nursing roles, there is a need to examine collaborative working amongst different types of nurses. METHOD: This study explored experiences of collaborative working amongst generalist and specialist nurses, in community and acute settings. We carried out semi-structured interviews, incorporating the Pictor technique, with 45 nurses, plus 33 other key stakeholders. Transcripts were analysed using Template Analysis. This article focuses on one major thematic area that emerged from the analysis: the significance of interpersonal relationships amongst nurses, and between them and other professionals, patients and carers. RESULTS: Relationship issues were ubiquitous in participants' accounts of collaborative working. Good personal relationships facilitated collaboration; face-to-face interaction was especially valued. Relationships were recognized as requiring effort, especially in new roles. Organisational changes could disrupt productive personal networks. CONCLUSION: Relationship issues are integral to successful collaborative working. Policy and practice leaders must take this into account in future service developments. Further research into collaborative relationships in different settings is needed.