Darbo tikslas: Nustatyti specialistų komandos formavimo reikalingumą gydytojų ir slaugytojų, dirbančių LSMUL VšĮ Kauno klinikų filialo onkologijos ligoninėje, požiūriu. Uždaviniai: 1. Ištirti onkologijos ligoninėje dirbančių gydytojų ir slaugytojų požiūrį į multidisciplinines specialistų komandas; 2. Nustatyti gydytojų ir slaugytojų požiūrį į tai, kokių specialistų pagalbos reikėtų onkologine liga sergantiesiems; 3. Palyginti gydytojų ir slaugytojų nuomones apie specialistų komandos reikalingumą. Tyrimo metodika: Tyrimas atliktas 2012 m. liepos – rugpjūčio mėnesiais, naudojant anoniminę anketinę apklausą. Apklausos metu anketos buvo išdalintos keturiuose onkologijos ligoninės skyriuose (konservatyviosios onkologijos, paliatyviosios onkologijos, chirurgijos, anesteziologijos ir intensyvios terapijos) dirbantiems gydytojams ir slaugytojams. Iš viso išdalintos 127 anketos, iš kurių grįžo 114 (atsako dažnis 89,8 proc.). Statistinė duomenų analizė atlikta SPSS 17.0 ir MS Excel programomis. Statistinis duomenų reikšmingumas tikrintas pagal statistinį reikšmingumą (p < 0,05), chi kvadrato (χ2) kriterijų, laisvės laipsnių skaičių ir z kriterijų. Rezultatai: Atlikus tyrimo duomenų analizę nustatyta, kad tyrimo dalyviai žino apie komandinio darbo svarbą ir privalumus gydymo įstaigoje. 48,2 proc. teigė, kad ligoninėje vyrauja individualus ir komandinis darbas. 48,6 proc. apklaustųjų nurodė, kad konfliktai daugiausiai kyla dėl bendravimo problemų ir hierarchinių santykių, o sprendimai... [toliau žr. visą tekstą] / The aim of the study: To assess the need of multidisciplinary team formation from a perspective of doctors and nurses working in oncological hospital of Lithuanian University of Health Sciences Kaunas Clinics. Objectives: 1) To find out the attitude of doctors and nurses towards the need of multidisciplinary team; 2) To set the view on what kind of specialists are required for oncological patients according to doctors and nurses; 3) To compare opinions among doctors and nurses about the necessity of the multidisciplinary team. Research methodology: The research was carried out during July and August 2012 using an anonymous questionnaire method. Questionnaires were distributed among doctors and nurses working in four units of the oncological hospital. They were the following therapy units: conservative oncology, palliative oncology, surgery, anaesthetic and intensive therapy units. In total were distributed 127 questionnaires from which 114 questionnaires were returned (with a response rate of 89.8%). Statistical analysis of the data was done using SPSS 17.0 and MS Excel software. Statistical significance of the data was verified using statistical significance p value (p<0,05), chi-squared test, degrees of freedom and z value. Results: It was found that respondents are aware of significance and advantages of teamwork. 48.2% of the respondents stated that the most prevalent kind of work at the hospital was individual work and teamwork. 48.6% of the questioned noted that... [to full text]

Darbo tikslas: įvertinti slaugytojų ir šeimos gydytojų požiūrį į komandinį darbą ir jo skirtumus privačiose ir viešosiose asmens sveikatos priežiūros įstaigose. Tyrimo metodika: Tyrimo metu apklausta 342 Kauno PASP įstaigų šeimos gydytojai ir slaugytojai (atsako dažnis 76,0 proc.). Statistinė duomenų analizė atlikta naudojantis SPSS statistiniu paketu (20.0 versija). Hipotezės apie požymių priklausomybes buvo tikrinamos naudojant chi kvadrato (χ²) ir z kriterijus. Skirtumas laikytas reikšmingu, kai p < 0,05. Rezultatai: Dauguma apklaustųjų (77,7 proc.) pritaria komandiniam darbui. Dažniausiai respondentams komanda – tai bendras tikslas, pasitikėjimas vieni kitais, tiksliai atliekantys darbą nariai. Dauguma apklaustųjų nurodė, jog jų komandos veiklą inicijuoja organizacijos vadovas, o labiausiai reikalingu pirminės sveikatos priežiūros specialistų komandos nariu 96,4 proc. tyrimo dalyvių pasirinko šeimos gydytoją. Daugiau nei pusė apklaustųjų pažymėjo, jog didesnė atsakomybė gula gydytojų pečius. Dauguma respondentų žinojo efektyvaus komandinio darbo principus bei padedančius vystytis komandiniam darbui veiksnius, tačiau kaip trukdantį veiksnį nurodė, konkurenciją tarp kolegų. Respondentų nuomonė apie komandinį darbą skyrėsi priklausomai nuo socialinių demografinių veiksnių, pareigų, darbovietės, kurioje dirba rūšies. Nustatyta, jog šeimos gydytojams labiau nei slaugytojoms komandoje svarbūs maksimaliai geri rezultatai. Didesnė dalis šeimos gydytojų negu slaugytojų tik iš... [toliau žr. visą tekstą] / Aim of the study – to assess nurses and family physicians approach to teamwork and the differences between private and public health care institutions. Methods: The study involved 342 family physicians and nurses (response rate 76.0 percent) working in Kaunas city primary health care institution. Statistical data analysis has been done by SPSS 20.0 statistical package. Hypotheses about dependency of features were checked by calculation of χ2 criteria, z criteria. The difference was considered significant when p<0.05. Results: The majority of respondents (77.7 percent) agreed that teamwork is better than the individual. In most cases, respondents identified the team as a general purpose, trust of each other and as a team members precisely conducting the work. The majority of respondents indicated that their team activity is initiated by the head of the organization. 96.4 percent of research participants chose the family doctor as the most needed primary care team member. More than half of the respondents noted that the family doctors have the greater responsibility. The majority of respondents knew the principles of effective teamwork and factors of developing teamwork, but as an interfering factor indicated the competition between colleagues. Respondent’s opinion about teamwork differed depending on the socio-demographic factors, duties and working place. A statistically significantly greater proportion of family doctors than nurses said that maximum good results are... [to full text]

Darbo tikslas: Įvertinti komandinio darbo aspektus slaugytojų praktikoje. Tyrimo metodika: Tyrimas atliktas 2014 m. balandžio mėnesį. Tyrimui buvo naudotas vienmomentinis anoniminės apklausos metodas. Apklausos metu iš viso buvo išdalintos visiems chirurginiuos ir terapiniuos skyriuose tuo metu dirbančioms slaugytojoms. Išdalinta 200 anketų iš sugrįžo - 143, atsako dažnis – 71,5 %. Statistinė duomenų analizė atlikta naudojant statistinį duomenų analizės paketą SPSS 19.0 for Windows. Rezultatai: Du trečdaliai slaugytojų nurodo, jog jų skyriuje dažniausiai praktikuojamas tiek komandinis, tiek individualus darbas, mažiau nei kas ketvirta teigia, jog prioritetas teikiamas komandiniam darbui, o kas dešimta mano, jog daugiau dėmesio skiriama individualiam darbui. Didžioji dauguma tyrimo dalyvių (81,0 %.) nurodė, jog didesnį pasitenkinimą darbu jaučia dirbdamos komandoje, nei individualiai, o 19,0 %. labiau patenkintos darbu dirbdamos vienos. daugiau nei pusė slaugytojų teigia, jog yra gerai susipažinusios (53,9 %), su komandinio darbo pagrindais. Vertinant slaugytojų nuomones apie vyraujantį darbo pobūdį jų skyriuje ir savo žinių apie komandinį darbą vertinimą pagal socialines demografines charakteristikas ir skyriaus, kuriame tyrimo dalyvės dirba profilį, statistiškai reikšmingų skirtumų nenustatyta. Tik 14,0 % slaugytojų dirbančių komandoje teigia, jog yra labai patenkintos savo profesija. Taip pat buvo vertintas slaugytojų pasitenkinimas darbu skalėje nuo 1 balo (labai... [toliau žr. visą tekstą] / Aim of the study: To evaluate aspects of a teamwork within practice of nurses. Methods: The study was accomplished in April 2014. Method of an anonimic survey was used in this study. Questionaires had been provided to all the nurses currently working in surgical and therapeutic departments. 143 questionaires had been returned from the total of 200; the response rate - 71.5 %. Package SPSS 19.0 for Windows had been used in order to analyse data statistically. Results: Two-thirds of the nurses indicate that both, teamwork and individual, works are practised in their Department. Less than every fourth claims that priority is given to a team work, and every tenth presumes that more attention is paid to an individual work. The vast majority of survey participants (81.0 %) indicated that greater satisfaction is felt if working in a team and 19.0 % are more satisfied if working alone. More than half of nurses (53.9 %) claims being familiar with basics in a teamwork. No statistically significant differences had been observed while assessing nurses’ opinion on the dominating approach of work in their Department and own knowledge on a evaluation of a teamwork according to social demographic characteristics and a profile of a department where participants of this study work in. Only 14.0 % of nurses working in a team claim that they are satisfied with their profession. Moreover, a rate of satisfaction of nurses within the scale of 1 (highly unsatisfied) to 10 (highly satisfied) was... [to full text]

Cognitive Work analysis (CWA) as an analytical approach for examining complex socio-technical systems has shown success in modeling the work of single operators. The CWA approach allows room for social and team interactions, but a more explicit analysis of team aspects can reveal more information for systems design. CWA techniques and models do not yet provide sufficient guidance on identifying shared constraints, team strategies, or social competencies of team players. In this thesis, I explore whether a team approach to CWA can yield more information than a typical CWA. Team CWA techniques and models emerge and extend from theories and models of teamwork, past attempts to model teams with CWA, and the results of two sets of observational studies. The potential benefits of using Team CWA models in domains with strong team collaboration are demonstrated through the results of a two-week observation at the Labour and Delivery Department of The Ottawa Hospital and a fifteen-week observation at the IBM Ottawa Software Group.

Coordination is a vital component in health care provision and teamwork. The need for better coordination is particularly prominent in outpatient setting where patients assume the primary responsibility to follow-up on their own health care, especially when treatment is complex and lengthy in duration. Relational coordination represents a type of informal coordination process reinforced by communication and supportive relationships. This concept has been associated with enhanced interprofessional team performance, including patient care outcomes. This study aimed to examine the theoretical underpinnings of relational coordination in the outpatient setting using social capital theory. It was hypothesized that social capital, resources embedded within network of relationships, would predict relational coordination. Additionally, social capital was hypothesized to be predicted by team tenure; and relational coordination was hypothesized to be predicted by formal coordination mechanisms. A non-experimental, cross-sectional survey design was used to examine the relationship between social capital and relational coordination. Participants (N=342) were physicians and nurses recruited from outpatient clinics in two University affiliated hospitals. Study surveys were sent to 501 nurses and 187 physicians with follow-up reminders sent at three, five and seven weeks after the initial distribution of surveys. The overall response rate was 49.71%. Study variables were measured using previously validated instruments with acceptable levels of reliability and validity. Structural equation modeling (SEM) was used for hypothesis testing. Final analysis revealed good fit of data to the hypothesized model (Chi-square=383.38, df=177, p<0.001; CFI=0.966; RMSEA=0.060; SRMR=0.0316). SEM revealed that social capital predicted both factors of relational coordination [communication (β=0.70, p<0.001); supportive relationship (β=0.81, p<0.001)], and team tenure predicted social capital (β=0.13, p<0.05). In addition, the association between team tenure and relational coordination (β=0.09, p<0.05) was found to be partially mediated by social capital. Findings of this study suggested that characteristics within relational ties are predictive of informal coordination. Administrators may facilitate teamwork through team building initiatives that foster these relational qualities, such as trust and shared language. Future research can further investigate the association between social capital and relational coordination in other health care settings, as well, in larger teams involving health care professionals in addition to physicians and nurses.

This thesis addresses the relationship between citizens and the welfare state with a focus on the collaboration between service users and professionals in Swedish health and social care services. The overall aim of the thesis was to explore how professionals and service users experience collaboration in health and social care. Descriptive and interpretative study designs were employed in the four studies that comprise this thesis. A total of 87 persons participated in the four studies, including 22 service users and 65 front-line professionals. The research methods included focused group interviews, individual interviews and interactive participant reflection dialogues. The first study describes the discursive patterns in the front-line professionals’ constructions of ‘we the team’ which positions the service user as both a member and a non-member of the interprofessional team. The second study surfaces the difficulties of interprofessional teamwork as perceived by professionals. The third and the fourth studies explore how service users and professionals construct and perceive the concept of service user participation. The findings show that collaboration in terms of service user participation cannot only be understood as contract relationships between consumers and service providers. Service users and professionals perceive that there are several other ways to act as a citizen and for people to exercise human agency in relation to the welfare state. This thesis shows that the various conceptions of service user participation in interprofessional practice encompass dimensions that include themes of togetherness, understanding and interaction within the clinical microsystem. The findings of the four studies are discussed and used to create models that aim to conceptualise collaboration. These models can contribute to learning and improvement processes which facilitate the development of innovative service user-centered clinical microsystems in health and social care.

This research endeavors to understand people's experience of working in a highly engaged team, and specifically to understand the aspects of the work environment that contribute to their engagement. As participants' own perspectives and views are central to gaining a rich insight, a qualitative approach is taken. Twenty-five participants from a large government agency who had worked in highly engaged teams took part in five focus group discussions. The discussions were analysed following thematic analysis techniques, and a thematic network of three interrelated layers was developed to explain the findings. This thematic network focuses more on people's experiences of working in an engaging environment and the feelings associated with these experiences, whereas the literature focuses more on describing engagement and the aspects of the environment which contributes to engagement. At the base of the engagement model, developed from this research, are the seven aspects of the workplace that contribute to people's engagement: leadership; challenging and or varied work; access to knowledge; latitude and responsibility; social atmosphere; safety, trust and support; and respect. Above this are the feelings people connect with working in this environment: feeling at ease and relaxed, having a sense of achievement and satisfaction, and being valued or validated. The top layer of the model is the overall sense of what working in an engaging environment is about: feeling good in one's self. Three further observations are made. Firstly, the team is an important aspect in people's engagement, and a duality exists where the person and the team simultaneously influence each other. Secondly, engagement is an active process; it changes over time, has a lifecycle over people's careers, actively transfers between people and exists within a reinforcing loop. Lastly, engagement within this organisation, refers to a connection to the work or workplace: people were interested, participated, enjoyed and were connected to their work, but maintained a separation. There was no sense of merging one's identity with the work as noted within some of the literature on engagement.

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Kath. University, Diss.--Eichstätt-Ingolstadt, 2007.

Universiẗat-Gesamthochsch., Diss.--Kassel, 1997.