Exploring dental professionals' experiences of interprofessional collaboration with home care services.

Older persons with multimorbidity being cared for at home often have complex needs which cannot be met by one single caregiver. Interprofessional collaboration is therefore considered necessary if care is to be organised according to the needs of the older person. To achieve coherent health care, municipalities and county councils need to develop their collaboration. The aim of this study was to illustrate how various professionals belonging to homemaker services, home care services in municipality and hospital-based home care services experience collaboration in caring for older persons with multimorbidity. A hermeneutic approach was used. Eleven informants participated in the study and were individually interviewed. The findings show that collaboration between players comprises various types of experiences which influence not only the staff who are involved in collaboration but also the outcome of the collaboration itself. The informants' experience of collaboration was defined by distrust and trust and by insecurity and security. To focus on patients' needs and to develop the collaboration further, it was important for informants to take the relations into account and have a reflective and questioning approach. This attitude resulted in a feeling of trust and security, and a flexible and critical approach without boundary drawings between basic and specialised care. Complex situations cannot be solved with simple models. Instead, a flexible approach appears necessary with focus shifting from structures to interpersonal relations and interactions. Therefore, the different professionals have to work as a transprofessional team where close interactions, flexibility and improvisation are keys to success. The transprofessional team approach is suggested to have the potential to take the competence of all staff into account when high-quality home health care to older persons with multimorbidity is to be provided by multiple caregivers.

In this hermeneutic phenomenological study, we examined the experience of interprofessional collaboration from the perspective of nursing and medical students. Seventeen medical and nursing students from two different universities participated in the study. We used guiding questions in face-to-face, conversational interviews to explore students’ experience and expectations of interprofessional collaboration within learning situations. Three themes emerged from the data: the great divide, learning means content, and breaking the ice. The findings suggest that the experience of interprofessional collaboration within learning events is influenced by the natural clustering of shared interests among students. Furthermore, the carry-forward of impressions about physician–nurse relationships prior to the educational programs and during clinical placements dominate the formation of new relationships and acquisition of new knowledge about roles, which might have implications for future practice.

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)

Interprofessional collaboration among health professionals is increasingly recognized as best practice in assessing and supporting autistic children, however limited research has explored whether this collaboration is being practiced. This study explored parents’ experiences of interprofessional collaboration between health professionals involved with the assessment and support of their autistic children. Seventeen parents of autistic children participated in semi-structured interviews exploring their unique experiences of health professional collaboration. Six themes were developed inductively using reflexive thematic analysis. Parents suggested that health professionals are taking a siloed and staggered approach to the assessment of autistic children. When providing support to autistic children, parents reported health professionals had variable understanding of others’ roles, with minimal direct communication across practices, often limited by time and funding. The parents identified the importance of collaboration between the health professionals and school teachers, but identified several barriers to the implementation of supports in the school setting recommended by the health professionals. Overall, parents perceived themselves as their child’s case manager, facilitating professionals’ collaboration. This study’s findings suggest the need for a review of systems and processes to better support interprofessional collaboration between health professionals, along with schools, in the assessment and support of autistic children.

This study aimed to test associations between a municipal social development indicator and indicators of public dental services; examine differences in the achievement of public dental services goals between fluoridated and nonfluoridated municipalities; and, quantify contribution of a municipal social development indicator in estimated mean differences in the public dental services indicators between fluoridated and nonfluoridated municipalities. A secondary analysis of data from 293 municipal dental health services records from Southern Brazil between 2010 and 2015 was conducted. Multivariable log-binomial regression models were fitted to test the associations between municipal Human Development Index (HDI) and multiple public dental services indicators (proportion of public dental health service coverage, the proportion of tooth extraction among all clinical procedures, and monthly participation in supervised tooth brushing). Cut-off points for outcomes were based on state goals for public dental services. Blinder-Oaxaca decomposition analyses were performed to quantify the relative contribution of HDI in the differences in outcomes according to the municipal water fluoridation status. Municipalities within the lowest tertile of HDI had 66% lower prevalence of having insufficient public dental health service coverage (less than state goals)than those in the highest tertile of HDI (PR: 0.44; 95% CI: 0.24, 0.50). Municipalities with lowest HDI had nearly 30% higher prevalence of failing the state goals regarding the proportion of extraction and supervised tooth brushing (PR: 1.30; 95% CI: 1.20, 1.40 and PR: 1.34; 95% CI: 1.23, 1.45, respectively). Mean public dental health service coverage was higher in nonfluoridated municipalities than fluoridated municipalities, and municipal HDI explained 36% of the total estimated mean difference. This study found associations between municipal social development and public dental services indicators in Southern Brazil. However, higher HDI was associated with lower public dental health service coverage, lower proportion of extraction and higher coverage of supervised tooth brushing [Correction added on 2 April 2019, after first online publication: In the preceding sentence, the text "but with a higher proportion of extraction and supervised tooth brushing" was changed to "lower proportion of extraction and higher coverage of supervised tooth brushing"]. Municipal HDI contributed significantly towards the gap in public dental coverage between fluoridated and nonfluoridated municipalities, favoring nonfluoridated municipalities. These findings have important policy implications for reducing oral health inequalities as it highlights the interplay between key oral health policies and their distribution according to municipal social development.

IntroductionThe temporary trauma teams in trauma alerts consist of a diverse group of unique professionals requiring interprofessional collaboration and coordination to achieve efficient, high-quality care. The uncertain situation and complex care environment impose high demands on team dynamics such as individual attitudes and team behaviours. Within interprofessional teams, interaction and coordination reflect the collective success of collaboration and the achievement of goals. Interactions with radiographers have increased in trauma teams given computed tomography's prominent role in providing crucial knowledge for decision-making in trauma care. This study aimed to explore radiographers' experiences of interprofessional collaboration during trauma alerts. MethodThe study was designed with focus group methodology, including 17 radiographers participating in five focus groups, analysed with an inductive focus group analysis. ResultsAn overarching theme, “On the edge of decision-making”, emerged along with three sub-themes: “Feeling included requires acknowledgement”, “Exclusion precludes shared knowledge”, and “Experience and mutual awareness facilitate team interaction”. ConclusionsInterprofessional collaboration from the radiographer's perspective within trauma teams requires a sense of inclusion and the ability to interact with the team. Exclusion from vital decision-making obstructs radiographers' comprehension of situations and thereby the interdependence in interprofessional collaboration. Implications for practiceCommon platforms are needed for knowledge sharing and team practices, including radiographers’ areas of responsibility and relational coordination to foster interprofessional relationships. Through these means interdependence through awareness and shared knowledge can be facilitated on trauma teams.

To understand advanced nurse and midwife practitioners' experience of interprofessional collaboration in implementing evidence-based practice into routine care. A qualitative interpretative phenomenological analysis. A purposeful sample of 10 Registered Advanced Nurse and Midwife Practitioners from a range of practice settings in the Republic of Ireland participated in semi-structured interviews over a 10-month timeframe. Interviews were transcribed verbatim and data were analysed using a multi-stage approach in line with guidance for interpretative phenomenological analysis. Six superordinate themes emerged: Understanding of advanced practice; 'Treated as an equal and as a "nurse"'; Nursing management support; 'A voice to implement anything new'; Confidence and Emotional intelligence. These factors impacted interprofessional relationships and the extent to which advanced practitioners could implement evidence-based practice. There is scope to improve advanced practitioners' ability to collaborate with the interprofessional team in implementing evidence-based practice into routine care. The study findings demonstrate that enhancing understanding of the advanced practice role; increasing organizational support for advanced practitioners and augmenting specific practitioner skills and attributes will increase their ability to collaborate effectively and implement evidence-based practice. Supporting advanced practitioners in this important aspect of their role will positively influence health outcomes for patients. As numbers of both nurse and midwife practitioners increase globally, this study provides timely evidence from a range of practice settings to guide the design of education programmes and policies governing advanced practice. Study recommendations have broad applicability to all healthcare professionals who are engaged in implementing evidence-based practice into routine care. Consolidated criteria for reporting qualitative research (COREQ). No patient or public contribution.

Interprofessional collaboration among health professionals is widely recognised as best practice in the assessment and support of autistic children and their families. Nevertheless, limited empirical research has considered the extent to which health professionals actually collaborate in practice. This study aimed to explore how health professionals from diverse disciplines experience interprofessional collaboration when supporting autistic children and their families in Australia. An exploratory qualitative study was undertaken using semistructured interviews with 15 health professionals from various disciplines including occupational therapy, paediatric medicine, physiotherapy, psychology, social work and speech therapy, who work with autistic children in Australia. Interview data were analysed using inductive reflexive thematic analysis. Five distinct yet interrelated themes were developed from the data that summarised the health professionals’ experiences of interprofessional collaboration in supporting autistic children and their families. These were as follows: interprofessional collaboration is recognised as best practice, differences in attitudes and understandings create conflict, professional networks are a foundation for interprofessional collaboration, concerns about leadership roles and responsibilities and interprofessional collaboration is influenced by broader social systems. Findings have practical implications for individual health professionals and the policy makers and organisations who oversee the delivery of support services to autistic children and their families. Systems should be reorganised and interprofessional education programs expanded to better enable health professionals and those from other sectors to collaborate effectively when supporting autistic children and their families. These findings also highlight a need for further research of the conflict caused by different approaches to autism support.

ObjectiveTo explore dental professionals’ perceptions of their role in the practice of oral health promotion.Material and methodIn-depth interviews were conducted with three dentists, one specialist dentist and seven dental hygienists. All were employed in the public dental service in Kalmar County, Sweden and had at least 2 years’ work experience. The interview questions addressed the experience and views of dental professionals with reference to their role in the practice of health promotion. The interview data were subjected to qualitative content analysis.ResultsAnalysis revealed two themes which capture the essence of the dental professionals’ perception of their role in the practice of oral health promotion. One theme, having person-focused approach, comprised four categories: ‘considering the patient’s life situation’, ‘establishing a trusting relationship with patients’, ‘strengthening patients’ commitment to oral health’ and ‘health education’. The other theme, perceiving social responsibility for oral health, comprised three categories: ‘dissemination of oral health knowledge’, ‘interprofessional collaboration’ and ‘equality in oral health care’.ConclusionDental professionals perceived promotion of oral health to be an important aspect of their professional role. They aspired to patient participation in the decision-making process and educational activities, as well as practising and evaluating skills development. Although the dental professionals perceived that they undertook health promotion activities, they did not clearly distinguish between oral health promotion and disease prevention. There was intra- and inter-professional agreement among the dentists and dental hygienists with respect to expected outcomes for health promotion activities.

Beyond the construction aspects of a residence, a home is a context in which individuals engage in meaningful activities of daily living or occupations. How a constructed space is designed can enhance or hinder occupational performance, improve or aggravate a physical condition and promote or disregard sustainable construction. Performance outcomes for people, populations and communities are improved through collaborative team efforts. Interprofessional collaborative experiences allow practitioners to learn from one another and lead the way for effective and accessible environments which promote health, well-being and quality of life.

ObjectivesThe WHO World Health Assembly established in 2007 a Resolution (WHA60.17) on oral health, which called upon countries to ensure that public health actions for disease prevention and health promotion are established. The objective of the present survey undertaken 10 years later (2017‐2018) was to measure the application of such programmes for key population age groups in low‐, middle‐ and high‐income countries.MethodsOral health focal points of ministries of health worldwide (n = 101) answered a structured questionnaire on existing national oral health systems and the actual public health activities. The response rate was 58.4%. The questionnaire was used to collect information about structural factors, country workforce, financial models, provision of preventive services and promotion for oral health, school health programmes, administration of fluoride, national oral health targets and oral health surveillance. The countries were classified by national income for analysis of data.ResultsCoverage of population groups by primary oral health care and emergency care varied by national income. The gap between countries in delivery of preventive care was strong since low‐income countries less often reported preventive activities than middle‐income countries and particularly when compared to high‐income countries. School oral health programmes were less frequent in low‐income than other countries. Moreover, population methods of fluoridation and use of fluoridated toothpaste were unusual in low‐income countries. Health education, mass communication and community events were often essential elements in health promotion. In disease prevention, many countries considered the link between oral health and general health conditions and intervention towards shared risk factors of NCDs. The health concern for the consumption of tobacco, unhealthy diet and sugars was particularly emphasized by high‐income countries but less highlighted by low‐income countries. Finally, while national oral health targets for children and surveillance systems were frequently reported by countries, similar systems for adolescents, adults and older people were rare.ConclusionsThe inequities between countries in oral disease prevention and health promotion were substantial. Limited financial resources for preventive care and health promotion; inadequate workforce for oral health, and insufficient coverage in primary health care were observed in low‐resource countries. The results of the survey demonstrate the need for building effective oral health systems oriented towards oral disease prevention and health promotion.

Oral health

This article is based on a qualitative research project examining collaboration among practitioners in Norwegian substance use services. Even if the need for interprofessional collaboration is thoroughly described in white papers, research, and the governmental Escalation Plan for substance use services in Norway, little knowledge exists about how professionals experience collaboration. Therefore, our research question was: “How do practitioners experience interprofessional collaboration within substance use services?” The project consisted of semi-structured interviews with five professionals. Interpretative phenomenological analysis (IPA) was used to analyze the data, and four findings were identified: (1) energy and discomfort, (2) problematic organizational structures, (3) closeness and distance in relation to service users, and (4) the experienced collaborator. The discussion is based on Norwegian guidelines as well as systemic and social constructionist theory. This research gives insights into not only the current status of collaborative practice in substance use services but also facilitators and barriers for collaborative practice that may be universal or contextual.»/><meta name=

IntroductionAutistic children commonly receive simultaneous services from various health‐care and other professionals, including occupational therapy, throughout their journey of diagnosis and consequent therapeutic support. Current best practice guidelines for supporting autistic youth emphasise the importance of interprofessional collaboration. Despite this, collaboration among health‐care professionals does not always occur, and little is understood about clinicians' experiences of collaborative care. The aim of this study was to explore Australian paediatric occupational therapists' experiences of interprofessional collaboration and their perception of factors influencing collaboration when supporting autistic children.MethodsThis study employed an exploratory qualitative descriptive design. Semi‐structured interviews were conducted with 13 Australian paediatric occupational therapists involved in service provision to autistic children. Questions explored clinicians' experiences and perceptions of interprofessional collaboration. Reflexive thematic analysis was used to inductively analyse data.Consumer and Community ConsultationThis study was conceptualised and conducted by a team of researchers with a range of personal and professional experiences with the autistic community. The research design was strongly informed by the Autism CRC'S research guidelines.FindingsThree themes were generated highlighting factors that influence collaboration between occupational therapists and other professionals. The first emphasised that ‘clinicians' capacity to collaborate’ at both organisational and individual levels was understood to be greatly influenced by funding structures. The second emphasised that ‘relationships are key to collaboration’ with these often established through shared workplaces or clients. The third, ‘shared perceptions make collaboration easier’ described how shared perceptions of collaboration, the occupational therapy role, and autism‐related frames of reference were perceived to influence interprofessional collaboration.ConclusionFindings indicate that, while occupational therapists perceive interprofessional collaboration as valuable in the support of autistic children, there are barriers to effective collaboration, particularly in the context of a marketised service delivery model.PLAIN LANGUAGE SUMMARYThis study looked at how Australian occupational therapists work with other professionals to support autistic children. Even though it is recommended that professionals work together to support autistic children and their families, this does not always happen. In this study, researchers interviewed 13 occupational therapists and asked what it is like working with other professionals, what is helpful, and what makes working together difficult. From these interviews, it was found that many things affect how well occupational therapists can work with other health professionals and teachers to support autistic children. Factors like funding and workplace rules affect how professionals work together. Having someone take on the role of leader and having good relationships between professionals made it easier to work together. It was also helpful when occupational therapists and other professionals shared similar ideas on how to support autistic children. The study could be improved if it had gathered more information about the occupational therapists' education and what they have learnt about working with other professionals. Overall, the therapists in this study believed that working together to support autistic children and their families was important, but that there are many challenges to making this happen. More research on this topic would be helpful.

Oral diseases pose a significant global public health challenge, affecting 3.5 billion people and surpassing the prevalence of major noncommunicable diseases. There is a growing burden of oral diseases, including dental caries, periodontal diseases, and dentine hypersensitivity (DH) from several countries in Southeast Asia including Malaysia, the Philippines, Vietnam, Thailand, Indonesia, and Taiwan. The impact of oral diseases on quality of life and their association with systemic health emphasize the need for preventive strategies and early interventions. The objectives of the Oral Health Steering Committee were to gain insights and a comprehensive picture of the oral disease burden in the Southeast Asian region including Malaysia, the Philippines, Vietnam, Thailand, Indonesia, and Taiwan, to highlight the importance of early prevention of oral health diseases, as well as the importance of identifying early symptoms of oral discomfort associated with oral diseases and to examine the correlation between oral diseases and systemic health. The committee included nine experts from the region with significant expertise in dental health. A steering committee of nine dental experts from seven Southeast Asian countries reviewed evidence on the burden of oral diseases, the prevention of oral discomfort in early diagnosis and its impact on systemic health. The association between oral health and systemic health was discussed by the group. The committee highlighted that there is a need for comprehensive public health strategies, including population-level preventive measures, professional evaluations, and awareness programs to improve oral health outcomes and reduce treatment costs. The role in interprofessional collaboration between dental professionals and medical professionals in achieving early identification of oral diseases and increases referrals to dental professionals at early stages of diseases was highlighted. These insights stress the importance of early diagnosis, prevention and targeted interventions to mitigate the impact of oral health issues and improve overall public health outcomes in the region.