The conceptual basis for interprofessional collaboration: core concepts and theoretical frameworks

Interprofessional collaboration is a key factor in initiatives designed to increase the effectiveness of health services currently offered to the public. It is important that the concept of collaboration be well understood, because although the increasingly complex health problems faced by health professionals are creating more interdependencies among them, we still have limited knowledge of the complexity of interprofessional relationships. The goal of this literature review was to identify conceptual frameworks that could improve our understanding of this important aspect of health organizations. To this end, we have identified and taken into consideration: (A) the various definitions proposed in the literature and the various concepts associated with collaboration, and (B) the various theoretical frameworks of collaboration. Our results demonstrate that: (1) the concept of collaboration is commonly defined through five underlying concepts: sharing, partnership, power, interdependency and process; (2) the most complete models of collaboration seem to be those based on a strong theoretical background, either in organizational theory or in organizational sociology and on empirical data; (3) there is a significant amount of diversity in the way the various authors conceptualized collaboration and in the factors influencing collaboration; (4) these frameworks do not establish clear links between the elements in the models and the outputs; and (5) the literature does not provide a serious attempt to determine how patients could be integrated into the health care team, despite the fact that patients are recognized as the ultimate justification for providing collaborative care.     

Interdisciplinary collaboration: the heart and soul of health care

In a health care system in which patient complexity, outcome indicators, and informed families are representative of current reality, an interdisciplinary approach to care is crucial to successful navigation of a patient's experience in the ICU. To guide practitioners toward favorable patient progression, a thorough understanding of interdisciplinary collaboration is necessary. This article focuses on definitions of, benefits of, and barriers to interdisciplinary collaboration and provides practical solutions for implementation.     

Religion and spirituality defined according to current use in nursing literature.

The nursing literature published from 1963 to 1989 was screened for definitions to distinguish the concept of religion from that of spirituality. Following concept analysis procedures, definitions were selected from journal articles and textbooks and the key words in the definitions were listed in order of frequency. In definitions of religion, six words appeared most frequently--system, beliefs, organized, person, worship, practices; in definitions of spirituality, nine words appeared most frequently--personal, life, principle, animator, being, God (god), quality, relationship, transcendent. Only the word person(al) appeared on both lists. Using these two lists, the words (defining attributes) that appeared most frequently were formed as consensus definitions. It was concluded that spirituality is currently the broader term and may subsume aspects of religion. If these concepts are not clearly defined, the care related to personal life principles, relationships, and transcendent experiences may be confused with care for personal beliefs and worship practices.     

Conceptualizing collaboration in nursing

Nurses practicing at every level need a clear definition of collaboration before applying the concept in daily practice. Additionally, a conceptual definition of collaboration in nursing assists nurse researchers in finding or developing instruments for measuring collaboration and attributes of collaboration, which will enhance research findings. Collaboration extends beyond communication and includes sharing, teamwork, and respect. Multiple databases including CINAHL, PubMed, and ERIC were searched using the keywords collaboration, nursing, concept analysis, sharing, respect, and teamwork. For this analysis, using Walker and Avant’s method, the conceptual definition of collaboration in nursing is an intraprofessional or interprofessional process by which nurses come together and form a team to solve a patient care or healthcare system problem with members of the team respectfully sharing knowledge and resources. Two instruments consistent with the conceptual definition of collaboration are The Mayo High Performance Teamwork Scale (MHPTS) and Team Strategies and Tools to Enhance Performance and Patient Safety (Team STEPPS) and these instruments are summarized in this study. Finally, case scenarios are given to illustrate exemplars of collaboration in clinical practice.     

Can one eat collaboration? Menus as metaphors of interprofessional collaboration

The turn of the century has seen a sudden upsurge in publications and initiatives around the development of interprofessional collaboration in Japan. In Japanese, the term 'team-treatment' is generally used to mean interprofessional collaboration, but hitherto there have been no generally accepted definitions and conceptualizations of the term, nor are there guidelines as to how it may be implemented in practice. In order to facilitate understanding of the different modes of interprofessional collaboration and issues in practice, we introduced the use of menus as metaphors for interprofessional collaboration in a class of first year students of nursing. There were two 90-minute classes available for exploring this topic. Through the use of a metaphor the students demonstrated they were able to conceptualize interprofessional collaboration, identify the value of nurses working together with other professionals and issues involved in making team-treatment work. The purpose of this paper is to share the experience of using metaphors as a teaching/learning strategy, including reflection on the successes and some limitations of what, for us, was an interesting educational innovation.     

Hispanic acculturation: a concept analysis.

Although acculturation has been widely used as a health research variable among Hispanics, several inconsistencies exist in the definitions of this concept. The work of Walker and Avant is used as a guide to analyze and to clarify the definitions of acculturation in the Hispanic population. Multidisciplinary research studies involving Hispanic populations and the concept of acculturation are reviewed. Defining attributes include interaction between two cultures, change, learning, adaptation, and sociocultural context. Antecedents, consequences, case studies, and empirical referents are discussed. Implications for future practice and research are also identified.     

Quality and Safety Education for Nurses

Quality and Safety Education for Nurses (QSEN) addresses the challenge of preparing nurses with the competencies necessary to continuously improve the quality and safety of the health care systems in which they work. The QSEN faculty members adapted the Institute of Medicine(1) competencies for nursing (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics), proposing definitions that could describe essential features of what it means to be a competent and respected nurse. Using the competency definitions, the authors propose statements of the knowledge, skills, and attitudes (KSAs) for each competency that should be developed during pre-licensure nursing education. Quality and Safety Education for Nurses (QSEN) faculty and advisory board members invite the profession to comment on the competencies and their definitions and on whether the KSAs for pre-licensure education are appropriate goals for students preparing for basic practice as a registered nurse.     

Empathy: a literature review and concept analysis

• ? Empathy appears to be an important concept in the interpersonal repertoire of the nurse. There are a number of definitions and models of empathy available in the literature.
• ? These definitions and models are explored and analysed using Walker & Avant's (1983) approach to concept analysis. A model case of the concept is described and the relevant defining attributes identified. A borderline case and an example of ‘not the case’ are also examined.
• ? This concept analysis may assist practitioners to develop the behavioural skills of empathy and to recognize and coach it in their students and colleagues.

     

Empathy: a therapeutic phenomenon in nursing care

• ? Although numerous definitions have been presented and several attempts have been made to operationalize the concept of empathy, no theoretical framework exists that addresses the concept in depth.
• ? This paper focuses on the concept of empathy as it is presented in the literature by comparing the different theoretical and operational approaches pertaining to the concept.
• ? A theoretical definition of the concept of empathy is developed.
• ? The appropriateness of the different definitions of empathy will be considered in terms of their pragmatic adequacy for nursing.

     

The diversity of case management models

Case management is experiencing rapid growth and evolutionary transition. This article explores the diversity and richness of case management models found in practice. Interdisciplinary communication in case management programs can be facilitated by an awareness of discipline-specific definitions and models. A categorization of models is described as a device to stimulate multidisciplinary case management collaboration.     

Working together for better health

To provide effective and comprehensive care. Nurses, physicians and other health care professionals must collaborate with each other. No group can claim total authority over the other. Each profession exhibits different areas of professional competence that, when combined together, provide a continuum of care that the consumer has come to expect. The definitions of collaboration have not been structured to reflect true practice. Instead, at best, they reflect compromise, and at worst are conditioned and tailored to limit competition.     

Health literacy: a concept/dimensional analysis

Abstract   The terms "health" and "literacy" form a powerful concept that has evolved from the 1970s to one that has garnered the attention of a wide range of disciplines; most notably, education and health care, but also library science, public health, and the mental health arena. There are many definitions of health literacy, but none that encompass the totality by which the concept is constructed. This paper presents an analysis of the concept of health literacy using the technique of concept/dimensional analysis. A clear understanding of the concept is essential as health literacy has implications that are far-reaching and impact both the individual and society.     

The diversity of case management models

Case management is experiencing rapid growth and evolutionary transition. This article explores the diversity and richness of case management models found in practice. Interdisciplinary communication in case management programs can be facilitated by an awareness of discipline-specific definitions and models. A categorization of models is described as a device to stimulate multidisciplinary case management collaboration.     

Definitions of quality of life: a taxonomy

Quality of life is of central concern in evaluative research, improved quality of life is probably the most desirable outcome of all health care policies However, definitions of quality of life are as numerous and inconsistent as the methods of assessing it Stemming from a larger piece of work looking at the definition and measurement of quality of life, this paper highlights the lack of a consensus definition of quality of life by means of a taxonomy of definitions that emerge from the literature The paper describes and gives examples of four main types of definition which make up the taxonomy global (type I), component (type II), focused (type III), and combination definitions (type IV) In addition, an outline of factors influencing the definition of quality of life is given, and an alternative strategy for both defining and measuring the concept (the use of lay definitions) is suggested     

Interprofessionalism and ethics: consensus or clash of cultures?

The ethical arguments which underpin the call for interdisciplinary collaboration are analysed. In particular, the concept of 'teamwork' is considered as well as the organisational, professional, personal and cultural obstacles that constitute the barriers to the effective development of interdisciplinary relationships.     

Concept clarification in professional practice — dignity

Dignity is recognized as being important to maintain, but what is it, and is it the same for each person? The purpose of this study was to explore the meaning of dignity, to clarify the concept in order to benefit clients, and to forward knowledge in nursing. The concept analysis was carried out by examining personal definitions of dignity contributed by students of DipHE Nursing courses, a literature review, and discussion with other professionals. The concept analysis contains a review of definitions, postulates critical attributes, offers case examples, and suggests related cases and antecedents. It is not intended to be conclusive, but to provide a catalyst for further thought and exploration.     

Psychiatric patients' views on the concept of self-determination: findings from a descriptive study

? Using content analysis of unstructured interviews, this study examined the views of 72 long-term psychiatric patients on the concept of self-determination. ? The aim was to shed further light on the meaning of the concept for the purpose of developing a better tool for evaluation. ? One-third of the patients were familiar with the concept, another third had never heard of self-determination. ? The majority (52 patients) presented their views and definitions regardless of whether they had heard of the concept before. ? Content analysis revealed two central aspects in the definitions: an intrapersonal aspect, with self-determination defined in relation to the patients themselves or to their own activities; and an interpersonal aspect, with the focus on the patients' relationship with other persons. ? In spite of its limitations, the study certainly adds to our understanding of the concept of self-determination. ? It demonstrates that psychiatric patients are capable of offering valuable insights into key concepts of nursing, even if they are abstract. ? The results open new avenues for strengthening the self-determination of psychiatric patients.     

Interprofessionalism and ethics: consensus or clash of cultures?

The ethical arguments which underpin the call for interdisciplinary collaboration are analysed. In particular, the concept of 'teamwork' is considered as well as the organisational, professional, personal and cultural obstacles that constitute the barriers to the effective development of interdisciplinary relationships.