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Article
Publication date: 6 January 2020

Christian Beech and Fiona Verity

The purpose of this paper is to explore interprofessional and multidisciplinary working between health and social care practitioners providing services to older people…

Abstract

Purpose

The purpose of this paper is to explore interprofessional and multidisciplinary working between health and social care practitioners providing services to older people through the prism of how risk is assessed and managed. It proposes that whilst interprofessional and multidisciplinary working is a broad and commonly researched topic, there is a relative paucity of evidence specifically regarding how health and social care practitioners work together across structural, cultural and ideological divides. The study aims to expand the domain of integrated health and social care by including perceptions, understanding and use of the concept of risk by professionals from different disciplines.

Design/methodology/approach

This paper is based upon an exploratory study using an interpretivist phenomenological perspective, including 23 semi-structured individual interviews with health and social care practitioners and 2 non-participant observations of multidisciplinary team meetings.

Findings

The paper provides empirical insights around the complex dynamics of interprofessional and multidisciplinary working between health and social care practitioners, in particular the saliency of the interconnectedness of individual practitioner Personalities with the Process of interprofessional and multidisciplinary working under the auspices of relevant Policy drivers.

Research limitations/implications

The research was conducted in Wales and, due to the increasingly divergent policy context within the UK, the research results may lack generalisability from a wider UK or international perspective. Therefore, researchers are encouraged to test the propositions of this research further.

Practical implications

The paper includes implications for both interprofessional and multidisciplinary policy and practice with older people. With new models of integrated care being sought, the findings of this study may offer a timely and valuable contribution, particularly from the inclusion of a social care perspective and in better understanding the interconnectedness of practitioner personalities with process and policy.

Originality/value

This paper fulfils an identified need to study the complex dynamics and interconnectedness between health and social care practitioners who work together to provide services to older people.

Details

Journal of Integrated Care, vol. 28 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

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Article
Publication date: 3 July 2021

Emily Samuels and Nicola Moran

Physical health inequalities and mortality rates are higher amongst individuals with severe mental illness (SMI), including among forensic populations, than the general…

Abstract

Purpose

Physical health inequalities and mortality rates are higher amongst individuals with severe mental illness (SMI), including among forensic populations, than the general population. This paper aims to explore the experiences of individuals accessing primary health care following discharge from secure services, and the practitioners who support them.

Design/methodology/approach

Face-to-face qualitative interviews were conducted with service users (n = 4) and mental health practitioners (n = 4) within a forensic community mental health team in one NHS Trust in England in 2019. Data were analysed using the Interpretative Phenomenological Analysis.

Findings

Four super-ordinate themes emerged: perceived importance of physical health, agency, responsibility and relationships. Service users mostly saw themselves as passive recipients of health care and prioritised their mental health over their physical health. Close working relationships meant that mental health practitioners were often the first contact for service users with any health issue and thus felt a sense of responsibility for their physical health care. Service users who did access primary care reported that consistency of professional, feeling understood and listened to without judgement or stigma were important.

Practical implications

Interventions for service users that include practicalities and strategies to facilitate independence in physical health care, and collaborative working between primary care and forensic mental health services, are encouraged.

Originality/value

This study highlights some of the unique challenges in forensics around improving physical health outcomes for individuals with SMI.

Details

The Journal of Forensic Practice, vol. 23 no. 2
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 5 June 2017

Sally Robinson and Carol Robinson

The purpose of this paper is to outline the development of a resource designed to support practitioners, who are not sexual health specialists, but who work with young…

Abstract

Purpose

The purpose of this paper is to outline the development of a resource designed to support practitioners, who are not sexual health specialists, but who work with young people who may be at risk of teenage pregnancy or parenthood. Its aim was to enable practitioners to carry out an assessment using a screening tool, and to use educational interventions designed to reduce risk-taking behaviour or refer to a sexual health specialist. A research project to examine the perceptions of practitioners who had used the resource is reported.

Design/methodology/approach

The resource was based on a local needs assessment and developed by a multi-agency working group. The research utilised an online questionnaire and telephone interviews with practitioners.

Findings

Practitioners reported using the screening tool with young people with an average age of 13.1 years. They thought the educational interventions provided knowledge and helped with communication, self-awareness, reflection, confidence, attitudes and values clarification.

Research limitations/implications

The project was based in one county in England. A sample of 17 per cent of the practitioners responded to the questionnaire, and they might be biased towards those who had engaged most, or most positively, with the resource. Three practitioners undertook interviews. The views and behaviours of young people are yet to be evaluated.

Originality/value

Within a climate of limited resources, the findings suggest that the project is providing an acceptable proportionate universalist, early sexual health intervention for young people.

Details

Health Education, vol. 117 no. 4
Type: Research Article
ISSN: 0965-4283

Keywords

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Book part
Publication date: 21 October 2008

Adina Nack

Medical encounters are interactional/interpersonal processes taking place within contexts shaped by macro-level social structures. In the case of sexually transmitted…

Abstract

Medical encounters are interactional/interpersonal processes taking place within contexts shaped by macro-level social structures. In the case of sexually transmitted diseases (STDs), medical encounters occur at a stigmatized crossroads of social control and gendered norms of sexual behavior. When women are diagnosed and treated for chronic STDs, practitioner demeanor has an important impact on how patients will view not only their health status but also their moral status. This chapter draws on in depth interviews with 40 women diagnosed with genital infections of herpes and/or human papillomavirus (HPV – the cause of genital warts) to explore three models of patient–practitioner interaction. The analysis focuses on the relationship between gender, construction of illness, and practitioner interaction style. In a broader context, the health risks posed by particular interaction styles to female STD patients shed light on larger public health implications of combining morality with medicine for the broader range of patients with stigmatizing diagnoses.

Details

Care for Major Health Problems and Population Health Concerns: Impacts on Patients, Providers and Policy
Type: Book
ISBN: 978-1-84855-160-2

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Article
Publication date: 11 September 2017

Emma Kaminskiy, Simon Senner and Johannes Hamann

Shared decision making (SDM) prioritises joint deliberation between practitioner and service user, and a respect for service-users’ experiential knowledge, values and…

Abstract

Purpose

Shared decision making (SDM) prioritises joint deliberation between practitioner and service user, and a respect for service-users’ experiential knowledge, values and preferences. The purpose of this paper is to review the existing literature pertaining to key stakeholders’ attitudes towards SDM in mental health. It examines whether perceived barriers and facilitators differ by group (e.g. service user, psychiatrist, nurse and social worker) and includes views of what facilitates and hinders the process for service users and practitioners.

Design/methodology/approach

This review adopts the principles of a qualitative research synthesis. A key word search of research published between 1990 and 2016 was undertaken. Qualitative, quantitative and mixed methods studies were included.

Findings

In total, 43 papers were included and several themes identified for service user and practitioner perspectives. Both practitioners and service users see SDM as an ethical imperative, and both groups highlight the need to be flexible in implementing SDM, suggesting it is context dependent. A range of challenges and barriers are presented by both practitioners and service users reflecting complex contextual and cultural features within which interactions in mental health take place. There were qualitative differences in what service users and practitioners describe as preventing or enabling SDM. The differences highlighted point towards different challenges and priorities in SDM for service users and practitioners.

Originality/value

The presentation of nuanced views and attitudes that practitioners and service users hold represent an important and under reported area and offer insight into the reasons for the gap between idealised policy and actual practice of SDM in mental health settings.

Details

Mental Health Review Journal, vol. 22 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

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Article
Publication date: 1 June 1995

Patrick Asubonteng, Karl J. McCleary and George Munchus

Chronicles the role of nurse practitioners from their earlybeginnings to the present. Not only examines this group′s history butalso explores their present role in health

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Abstract

Chronicles the role of nurse practitioners from their early beginnings to the present. Not only examines this group′s history but also explores their present role in health care delivery. Discusses interprofessional relationships along with consumer perceptions of their function. Concludes with an analysis of the issues facing nurse practitioners and future implications for their viability.

Details

Health Manpower Management, vol. 21 no. 3
Type: Research Article
ISSN: 0955-2065

Keywords

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Article
Publication date: 1 August 1999

Erica Wimbush

Training in research and evaluation skills is a frequently expressed need among health promotion practitioners. Research conducted in Scotland among health promotion…

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950

Abstract

Training in research and evaluation skills is a frequently expressed need among health promotion practitioners. Research conducted in Scotland among health promotion specialists and their managers showed that training in research on its own would be an insufficient response. In this paper, it is argued that there is a need to develop a broader strategy which seeks to strengthen research capacity within health promotion practice settings, rather than simply offering training to improve practitioners’ research skills. This will help to improve the quality of research conducted in practice settings and contribute to building an evidence base for health promotion. A broader professional development strategy for health promotion research in Scotland is proposed which utilizes a range of learning routes and delivery mechanisms. This will be backed up by the establishment of a broad strategic research partnership which brings together practitioners, researchers and policy‐makers so as to develop a better understanding of what evaluation evidence is needed and who is contributing what.

Details

Health Education, vol. 99 no. 4
Type: Research Article
ISSN: 0965-4283

Keywords

Content available
Article
Publication date: 18 July 2019

Debra E. Orr, Gloria Bravo Gutiérrez and Don Fette

In the USA, there has recently been an unprecedented convergence of complementary/alternative medicine (CAM) with mainstream biomedical care. This confluence may lead to a…

Abstract

Purpose

In the USA, there has recently been an unprecedented convergence of complementary/alternative medicine (CAM) with mainstream biomedical care. This confluence may lead to a deeply rooted philosophical conflict. This qualitative study works to identify factors that health-care leaders can use, which will build a pathway to greater integrative practice between medical doctors and CAM practitioners – from parallel existence to partnership – by examining the tensions between biomedical medicine and naturopathic medicine. The purpose of this study is to offer short-term suggestions for partnership and long-term recommendations for better understanding.

Design/methodology/approach

An original qualitative study using semi-structured with CAM practitioners and biomedical practitioners.

Findings

Areas of conflict that are preventing synergy are identified and a pathway for health-care leaders to follow to create greater integration and partnerships is suggested.

Research limitations/implications

This is a qualitative and exploratory study that has significant limitations on generalizability.

Practical implications

This study suggest steps that both types of health-care practitioners can take to increase their success at working together on an individual level, a group level, an organizational level and on an industry-wide basis, as well as provide a specific pathway to create greater integrative practice for health-care leaders.

Social implications

The results indicate that stronger partnerships between different types of medical practitioners increase patient choice, patient satisfaction and outcomes.

Originality/value

Increasing interested in CAM modalities is driving more contact between CAM practitioners and biomedical practitioners. This contact is best established in partnership between practitioners rather than in parallel. This original research outlines the sources of conflict and provides recommendations for encouraging greater synergy.

Details

Leadership in Health Services, vol. 32 no. 4
Type: Research Article
ISSN: 1751-1879

Keywords

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Article
Publication date: 30 October 2018

Tara Officer, Jackie Cumming and Karen McBride-Henry

The purpose of this paper is to lay out how advanced practitioner development occurs in New Zealand primary health care settings. The paper specifically focuses on…

Abstract

Purpose

The purpose of this paper is to lay out how advanced practitioner development occurs in New Zealand primary health care settings. The paper specifically focuses on mechanisms occurring across policy creation and in practice leading to successful role development.

Design/methodology/approach

The authors applied a realist approach involving interviews, document review and field log observations to create refined theories explaining how successful development occurs.

Findings

Three final mechanisms were found to influence successful advanced practitioner role development: engagement in planning and integrating roles; establishing opportunities as part of a well-defined career pathway; and championing role uptake and work to full scopes of practice.

Research limitations/implications

This research focuses on one snapshot in time only; it illustrates the importance of actively managing health workforce change. Future investigations should involve the continued and systematic evaluation of advanced practitioner development.

Practical implications

The successful development of advanced practitioner roles in a complex system necessitates recognising how to trigger mechanisms occurring at times well beyond their introduction.

Social implications

Potential candidates for new roles should expect roadblocks in their development journey. Successfully situating these roles into practice through having a sustainable and stable workforce supply provides patients with access to a wider range of services.

Originality/value

This is the first time a realist evaluation has been undertaken, in New Zealand, of similar programmes operating across multiple sites. The paper brings insights into the process of developing new health programmes within an already established system.

Details

Journal of Health Organization and Management, vol. 33 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

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Article
Publication date: 1 July 2014

Susan A. Nancarrow, Rachael Wade, Anna Moran, Julia Coyle, Jennifer Young and Dianne Boxall

– The purpose of this paper is to analyse existing clinical supervision frameworks to develop a supervision meta-model.

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Abstract

Purpose

The purpose of this paper is to analyse existing clinical supervision frameworks to develop a supervision meta-model.

Design/methodology/approach

This research involved a thematic analysis of existing supervision frameworks used to support allied health practitioners working in rural or remote settings in Australia to identify key domains of supervision which could form the basis of supervision framework in this context. A three-tiered sampling approach of the selection of supervision frameworks ensured the direct relevance of the final domains identified to Australian rural allied health practitioners, allied health practitioners generally and to the wider area of health supervision. Thematic analysis was undertaken by Framework analysis methodology using Mindmapping software. The results were organised into a new conceptual model which places the practitioner at the centre of supervision.

Findings

The review included 17 supervision frameworks, encompassing 13 domains of supervision: definitions; purpose and function; supervision models; contexts; content; Modes of engagement; Supervisor attributes; supervisory relationships; supervisor responsibilities; supervisee responsibilities; structures/process for supervision and support; facilitators and barriers; outcomes. The authors developed a reflective, supervision and support framework “Connecting Practice” that is practitioner centred, recognises the tacit and explicit knowledge that staff bring to the relationship, and enables them to identify their own goals and support networks within the context in which they work.

Research limitations/implications

This is a thematic analysis of the literature which was argely based on an analysis of grey literature.

Practical implications

The resulting core domains of supervision provide an evidence-based foundation for the development of clinical supervision models which can be adapted to a range of contexts.

Social implications

An outcome of this paper is a framework called Connecting Practice which organises the domains of supervision in a temporal way, separating those domains that can be modified to improve the supervision framework, from those which are less easily modifiable. This approach is important to help embed the implementation of supervision and support into organisational practice. This paper adds to the existing growing body of work around supervision by helping understand the domains or components that make up the supervisory experience.

Originality/value

Connecting Practice replaces traditional, more hierarchical models of supervision to put the practitioner at the centre of a personalised supervision and support network.

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