Mme Amélia Didier soutient sa thèse en Sciences infirmières, sous la direction de Prof. Maya Zumstein-Shaha le lundi 2 décembre prochain à l'auditoire Auguste Tissot, CHUV à 17 heures.
Abstract
In today’s fast-moving healthcare system, the role of patients is evolving. Patients are recognized as valuable healthcare partners and are expected to be active members in the interprofessional healthcare team. Before considering this shift in the patients’ role, it is necessary to gain an insight into patients’ understanding of interprofessional collaboration (IPC) and their perceived role in IPC. Aim: This thesis explores a) the perspectives of adult and pediatric patients on interprofessional collaboration, b) patients’ role in the process of IPC, and identifies c) the main concerns of adult and pediatric patients within a multidisciplinary healthcare team.
Methods: A qualitative approach was employed by combining qualitative data analysis and a grounded theory approach. Data collection included interviews in three adult and surgical units and in one pediatric unit of a Swiss University hospital. Data collection and analysis were conducted simultaneously, including fieldnotes, coding, constant comparison and theoretical sampling. A systematic review has been conducted to gain a comprehensive view of patients’ perspectives on IPC.
Results: Pediatric patients do observe the interactional and hierarchical aspects of IPC between
nurses and physicians. Pediatric patients need every healthcare professional to be responsive to their needs. They know that some professionals (physicians) have time issues. The nurses were considered complementary to physicians. The pediatric patients did not regard their own role as essential in the interprofessional collaborative process.
The adult patients were more prone to interpretation and assumptions when the healthcare
professionals’ interactions were invisible to them. Adult patients tended to form opinions on the
effectiveness of care coordination, the atmosphere/environment in the care unit and the
patient–professional interactions. The findings of the systematic review shows the importance of
interprofessional interactions and of the interactions between patients and healthcare
professionals underpinned by respect.
The grounded theory approach revealed that interprofessional collaboration and its processes were not patients’ main concern. Patients were more concerned with the way in which the
multidisciplinary team responded to their need for optimal, good care. Optimal care is closely
linked to patients’ need for safe and caring encounters imbued with respect, dignity and humanity, in a complex care environment. These concepts could be summarized in the core concept of Aufgehobenheit, a German term that encompasses the concepts of safety, dignity, humanity and respect. The concepts of patienthood and personhood are closely related to Aufgehobenheit. The “call” of patients for Aufgehobenheit and the “response” of the healthcare professionals can be compared to the primary relationship between a child and a mother or any other significant person. The way the first contact between patients and healthcare professionals unfolds will define the future stance, attitude and behaviors of the patients.
Conclusion: This study highlighted that patients’ needs for humanity influence their understanding of IPC and their perceived role during interprofessional encounters.