Abstract
The growing prevalence of chronic conditions in Australia and globally indicates the need for better management of these conditions which are the predominate focus of primary care. Interprofessional collaborative practice is a model of care aimed at providing high-quality care to patients, families, and carers through multiple health professionals working together and is one model to manage chronic conditions. Despite the growing body of evidence to support interprofessional collaboration in primary care to support chronic condition management and the roles of health professionals, the experience and role of the patient is lacking in the literature. This thesis aimed to explore the experiences and role of patients in interprofessional collaborative practice for chronic conditions in primary care.Constructivist grounded theory methodology by Charmaz was used to guide each phase of this thesis. An integrative systematic literature review was conducted first to establish what is currently known about patient experiences with this model of care globally. Gaps in the literature were then used to design the three-phase qualitative inquiry into three key stakeholder perspectives: Phase 1:patient advocates, Phase 2: patients with chronic conditions, and Phase 3: primary healthcare professionals. Seventeen patient advocates across three focus groups, 20 individual interviews with patients, and 43 primary healthcare professionals were involved in the three-phase qualitative inquiry. Focus groups and interviews were analysed according to constructivist grounded theory. Results from Phase 1 with patient advocates were developed into a theoretical model which outlined three key patient roles: 1) Relinquishing Control to the Team, 2) Joining the Team, and 3)Disengaging from the Team. These roles were further developed using Phase 2 results from individual patient interviews, into five key patient roles, 1) Complying and getting by leads to relinquishing control to the Team, 2) Being guided by the Team, 3) Accessing resources allows joining the Team, 4) Directing the Team, and 5) Resisting leads to disengaging from the Team. Phase 3 results confirmed the five patient roles and highlighted how primary healthcare professionals supported these roles and encouraged patients to move towards the preferred(engaged) roles, where appropriate. Additionally, healthcare professionals provided strategies of how they encouraged patients to be more engaged in IPCP care.
The thesis has provided insights into patients and how their role as a member of the interprofessional collaborative practice team can be realised. The viewpoints of patients have directly informed the development of a theoretical framework for conceptualising a spectrum of patient roles that are adopted according to wider life context, disease stage, and individual characteristics. The results of this research can be used for the creation of a resource to assist in the identification of a patient’s current and ideal role in interprofessional collaborative practice and should be the focus of future research. Overall, patient roles vary and are heavily influenced by other patient factors and should be carefully considered when engaging patients within an inter professional collaborative practice team.
| Date of Award | 29 Nov 2023 |
|---|---|
| Original language | English |
| Supervisor | Dianne Reidlinger (Supervisor), Mark Morgan (Supervisor) & Lauren E. Ball (Supervisor) |