D.Cur. / A qualitative approach was followed to conduct a case study. Data was collected through participative observation, document analysis and interviewing of team members representing seven different disciplines. The practice model of Dickoff, James and Wiedenbach (1986:415-435) was utilized as theoretical framework to explore and describe the role players involved in team functioning within the context of primary health care. Team objectives and processes relevant to team functioning as well as the dynamics of team work were described and compared to a guide for team functioning, the elements which were derived from a literature study. The credibility of the research was enhanced through long term involvement in the activities of the study case as participative observer, through triangulation of methods to collect and verify data and through peer evaluation and auditing. It was determined that within the context of a home care service at primary health care level, it was mainly the nurse, being the team member with whom the patient and family have continued personal contact, who acts as team leader and initiates involvement of members from other disciplines. The decisions regarding whom to involve and how and when to involve them, are based on the knowledge and skills of the nurse in relation to the situation he/she has to manage, the acceptability of the team approach and compliance by the patient and family, the attitude, commitment and perception of other team members as well as the availability of facilities and infrastructure to enable team functioning. The organizational and philosophical framework within which service is delivered have a direct impact on team functioning. Community involvement and its acceptance of responsibility for health, enhances quality team functioning, but is dependant on effective empowerment strategies, a sound trust relationship and a reliable support system. Clear and agreed upon goals and objectives for team functioning are essential for effective team work. Innovative and creative strategies are necessary to enable team members representing different disciplines, who function in the context of primary health care, to have sufficient contact with each other to discuss objectives, give feedback and communicate effectively. Processes for and dynamics in team functioning are complex in nature and need to be identified, evaluated and, if necessary, adapted on a regular basis to promote effective team functioning. The objectives of the research, namely to explore and describe team functioning at primary health care level and to formulate guidelines for effective team functioning, were realized. A structure for working from the basis of a core team was proposed, as well as interdisciplinary training of team members, commencing at undergraduate level and continuing throughout professional life. The researcher recommends that the guidelines formulated with regard to the role players, context, objectives, processes and dynamics of team functioning at primary health care level be implemented. Aspects related to team functioning to be further researched have been identified, namely: assessing the quality of team functioning at primary health care level; the effect of interdisciplinary training on team functioning; the relationship between team functioning and the health status of communities; cost-efficiency of team functioning; utilizing latest technological developments for communication between and support for team members at primary health care level; the relationship between community empowerment, community involvement and interdisciplinary team functioning and the design of a model for team functioning at primary health care level. The research report is written in Afrikaans, but the conclusions reached in each of the nine chapters have also been translated into English to enhance the accessibility of research findings.

Indiana University-Purdue University Indianapolis (IUPUI) / The PeerSpirit Circle is a non-hierarchical, intentional, and relationship-centered practice of collaboration. There is a lack of scientific knowledge about the phenomenon of the PeerSpirit Circle in nursing or its potential impact on nursing practice, education, research, and the evolution of the profession and health care. The health care milieu is often entrenched in ways of being that do not support sustained change. For vitality to prosper and creativity to abound, paradigmatic shifts and new models of practice that emphasize collaboration are being called for. The purpose and aims of this phenomenological research study are to explore and give voice to the experiences of nurses who have participated in the PeerSpirit Circle model of practice with other nurses. The study includes interviews from five registered nurses from Canada and the United States conducted from 2009–2010 and interpreted from a Gadamerian philosophical hermeneutic perspective. The research findings reveal three themes: (1) experiencing the Circle container” where participants begin to understand the value of intentional preparation of the interpersonal space for safe human interaction and stronger collaboration—there are experiences of gathering, protecting, appreciating ritual, and sharing stories; (2) Experiencing space where protected space seems to be the essential element to inspire the presencing of participants with self and other, which in turn engenders genuine dialogue, a sense of sacred space, and freedom to be authentic; and (3) Experiencing our humanity, an unfolding theme, where participants experience reconnection with and understanding of their deeper humanity, stronger congruence with their core values, deeper experiences of caring and courage, personal and professional growth, and a profound appreciation for belonging to a lineage of nurses. The findings inspire a deeper understanding of barriers to congruence between values and action in nursing and nurses’ need to acknowledge, honor, support, and protect each other’s vulnerability. The implications for nursing practice, education, and research show that the PeerSpirit Circle model is a beneficial for use in all settings.