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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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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

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.

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

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.

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.

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

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.

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.

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

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.

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.

Mental health problems are a grave concern in construction. Although the distinction between high job demands and low job resources, as reflected in the Job Demands-Resources (JD–R) model, has been used to examine the extent to which psychosocial hazards influence mental health for construction practitioners, limited research has reflected on the nature of these psychosocial hazards by exploring experiences of site-based construction practitioners.

This study adopted a phenomenological approach to examine people’ experiences and thoughts of the complex phenomena of psychosocial hazards and mental health in construction. In total, 33 semi-structured interviews were undertaken with site-based construction practitioners in Australia to unveil construction-focused psychosocial hazards and their effects on mental health. The data were analysed via content analysis, employing an interpretation-focused coding strategy to code text and an individual-based sorting strategy to cluster codes.

Eighteen psychosocial hazards were identified based on the JD–R model. Six of these represented a new contribution, describing salient characteristics inherent to the construction context (i.e. safety concerns, exposure to traumatic events, job insecurity, task interdependency, client demand and contract pressure). Of particular importance, a number of interrelationships among psychosocial hazards emerged.

The significance of this qualitative research lies in elucidating psychosocial hazards and their complex interrelatedness in the context of the mental health of construction practitioners, enriching the understanding of this central health and safety issue in the high-risk setting of construction work. The findings contribute to addressing mental health issues in the Australian construction industry by identifying higher order control measures, thereby creating a mentally healthy workplace.