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Team interactions in specialized palliative care teams: a qualitative study
Karolinska institutet & Sophiahemmet Högskola.ORCID iD: 0000-0001-7935-3260
Karolinska institutet & Sophiahemmet Högskola.ORCID iD: 0000-0002-0197-9121
Karolinska institutet & Lunds universitet.
Karolinska institutet & Sophiahemmet Högskola.
2013 (English)In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 16, no 9, p. 1062-1069Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Teamwork is a standard of care in palliative care and that is emphasized by leading organizations. When interdisciplinary teams communicate their varied assessments, outcomes may be more than additive due to the synthesis of information. Interprofessionality does not guarantee multidimensionality in health care interventions, however, and that interprofessional teams promote collaboration may be questioned.

AIM: The aim was to explore team interaction among team members in specialized palliative care teams.

DESIGN: Semistructured interviews were conducted with health professionals working in specialized palliative home care teams. The interviews were analyzed by content analysis. Setting/participants: Participants were recruited from specialized palliative care units in Sweden. The 15 interviewees included 4 men and 11 women. Physcians, nurses, paramedical staff, and social workers were included.

RESULTS: Organizational issues like resources and leadership have a great impact on delivery of care. Competence was mirrored in education, collaboration, approach, and support within the team; while communication was described as key to being a team, resolving conflict, and executing palliative care.

CONCLUSION: Communication and communication patterns within the team create the feeling of being a team. Team climate and team performance are significantly impacted by knowledge and trust of competence in colleagues, with other professions, and by the available leadership. Proportions of different health professionals in the team have an impact on the focus and delivery of care. Interprofessional education giving clarity on one's own professional role and knowledge of other professions would most likely benefit patients and family caregivers.

Place, publisher, year, edition, pages
2013. Vol. 16, no 9, p. 1062-1069
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:esh:diva-5747DOI: 10.1089/jpm.2012.0622PubMedID: 24041291OAI: oai:DiVA.org:esh-5747DiVA, id: diva2:1070104
Available from: 2017-01-31 Created: 2017-01-31 Last updated: 2021-11-12Bibliographically approved
In thesis
1. Specialized palliative home care teams: Complementary perspectives of team functions and influences on patients and families
Open this publication in new window or tab >>Specialized palliative home care teams: Complementary perspectives of team functions and influences on patients and families
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Persons with life-threatening illness are increasingly being cared for and dying at home. Palliative care strives to cater to multiple dimensions such as physical, psychosocial and spiritual or existential, and meeting these needs in patients and families requires multiple competencies. Palliative care organizations propose organization and delivery of care in teamwork models; however, teamwork is complex and can be approached from various perspectives. Previous research has identified gaps in palliative care regarding which components of teamwork are most effective. The overall aim of this thesis was to explore perspectives of team function in specialized palliative care teams, among health care professionals, families and patients. Study I entailed translation and cultural adaptation of a research questionnaire. Study II entailed qualitative interviews with health care professionals (n=15) working in specialized palliative home care and Study III interviews with patients (n=6) and family members (n=7). In Study IV, an exploratory design was used. Initially team leaders (n=77) in palliative care reported team function. Next, health care professionals (n=61) reported team development in the group development questionnaire, patients (n=43) reported symptoms in the Edmonton Symptom Assessment System and family members (n=45) reported satisfaction with care in the translated and culturally adapted FAMCARE-2 questionnaire. Results of the studies are: (I) a translated culturally adapted and initially tested Swedish language version of the FAMCARE-2 scale, (II) health care professionals report that competence, communication and organization are crucial components of teamwork in specialized palliative homecare, (III) patients and families report that they experience security and continuity of care due to 24/7 care, sensitivity to changing needs and demonstrating caring, and (IV) specialized palliative home care teams have a core of registered nurses, physicians and social workers. Positive associations were found between team maturity and team effectiveness.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2016. p. 86
Keywords
Palliative home care, Teamwork, Patient, Family, Health care professional
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-5745 (URN)9789175496535 (ISBN)
Public defence
2016-06-21, Erforssalen, Sophiahemmet högskola, Valhallavägen 91, 09:30
Opponent
Supervisors
Available from: 2016-06-17 Created: 2017-02-21 Last updated: 2021-11-29Bibliographically approved

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Klarare, AnnaLundh Hagelin, Carina

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