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Team type, team maturity and team effectiveness in specialized palliative home care: an exploratory questionnaire study
Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.ORCID iD: 0000-0001-7935-3260
Folkhälsomyndigheten.
Sophiahemmet Högskola; Karolinska institutet.ORCID iD: 000-0003-3204-6583
Lunds universitet.ORCID iD: 0000-0002-2406-6907
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2018 (English)In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567Article in journal (Refereed) Epub ahead of print
Abstract [en]

To meet complex needs in persons and families within specialist palliative care, care team members are expected to work together in performing a comprehensive assessment of patient needs. Team type (how integrated team members work) and team maturity (group development) have been identified as components in team effectiveness and productivity. The aim of the study reported in this paper was to identify team types in specialist palliative care in Sweden, and to explore associations between team type, team maturity and team effectiveness in home care teams. A national web-based survey of team types, based on Thylefors questionnaire, and a survey of healthcare professionals using the Group Development Questionnaire (GDQ-SE3) to assess team developmental phase, effectiveness and productivity were used in an exploratory cross-sectional design. The participants were: Specialist palliative care teams in Sweden registered in the Palliative Care Directory (n = 77), and members of 11 specialist palliative home care teams. Teams comprised physicians, registered nurses, social workers, physiotherapists and/or occupational therapists, full-or part-time. Our national web survey results showed that the 77 investigated teams had existed from 7 to 21 years, were foremost of medium size and functioned as inter- or transprofessional teams. Results from the 61 HCPs, representing 11 teams, indicated that more mature teams tended to work in an integrated manner, rather than in parallel. The effectiveness ratio varied from 52% to 86% in teams. Recommendations arising from our findings include the need for clarification of team goals and professional roles together with prioritizing the development of desirable psychosocial traits and team processes in clinical settings.

Place, publisher, year, edition, pages
2018.
Keywords [en]
Teams, Health care, Leadership, Patient, Home care services, Palliative care, Effectivity
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-5746DOI: 10.1080/13561820.2018.1551861OAI: oai:DiVA.org:esh-5746DiVA, id: diva2:1075844
Note

Publication status in dissertation: Manuscript (preprint)

Available from: 2016-06-16 Created: 2017-02-21 Last updated: 2018-12-20Bibliographically 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
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Available from: 2016-06-17 Created: 2017-02-21 Last updated: 2018-12-20

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