Multidisciplinary teams, and parents, negotiating common ground in shared-care of children with long-term conditions: a mixed methods study.

摘要: Limited negotiation around care decisions is believed to undermine collaborative working between parents of children with long-term conditions and professionals, but there little evidence how they actually negotiate their respective roles. Using chronic kidney disease as an exemplar this paper reports on a multi-method study social interaction multidisciplinary teams shared clinical care. Phases 1 2: telephone survey mapping teams’ parent-educative activities, qualitative interviews 112 professionals (Clinical-psychologists, Dietitians, Doctors, Nurses, Play-specialists, Pharmacists, Therapists Social-workers) exploring accounts parent-teaching in the 12 British children’s units. Phase 3: six ethnographic case studies two units involving observations professional/parent interactions during shared-care, individual interviews. We used analytical framework based concepts drawn from Communities Practice Activity Theory. Professionals spoke challenge explaining each other are aware parents’ understanding knowledge, described three patterns activity that were common across MDTs: Engaging practice; Knowledge exchange role negotiation, Promoting ground. Over time, had developed repertoire tools support negotiations helped them accomplish ground practice shared-care. observed mutual engagement where joint enterprise caring was negotiated. For making implicit knowledge explicit important it can provide language through which articulate more clearly what basis intuition-based hunches about needs, may help accelerate learning caring. Our methodology results potentially transferrable management conditions.