Complex and chronic health conditions with multiple diagnoses
and lacking in clinical practice guidelines often require a multidisciplinary
care management scheme. Research has shown that the domain
knowledge for these conditions is multidisciplinary, inconsistent, nonstandardized
and poorly categorized making them heterogeneous and
consequently challenging for collaborative work.
The application of the boundary objects approach has come to the
forefront as a way of closing communication gaps in collaborative work.
There are limited research efforts in the application of boundary objects in
the health care field and almost none in the area of complex chronic
conditions. Research investigation of the application of boundary objects
in heterogeneous domains is also limited.
The primary objective(s) of this thesis is (are) to develop, test and
evaluate a model and a methodology for creating boundary objects in the
heterogeneous domain of complex chronic conditions. The methodology
in this research applies a two-staged approach for enabling interoperability
in the domain. The first stage is the development of a controlled
vocabulary as a boundary object and the second stage of the two-staged
approach is the development of an ontology as a boundary object to
generate syntactic, semantic and pragmatic levels of interoperability in the
dynamic domain. Towards these objectives, the boundary objects
developed in the study satisfy certain unique requirements, namely to,
have pragmatic boundaries, be dynamic in nature and be in standardized
forms. To the best of our knowledge, this research is the first to
investigate the development of boundary objects in the heterogeneous
domain of complex chronic conditions.
The outcome of this research is the development of a model for the
generation of boundary objects to enhance communication among
multidisciplinary clinicians. The model is developed in the heterogeneous
domain of two complex chronic health conditions, namely, multiple
chemical sensitivity and chronic pain. A testing and an evaluation process
conducted in this research demonstrates that a high percentage of
clinicians (>80%) agree on the overall usefulness of the boundary objects
developed in this research. The results from the research are promising in
terms of the potential applications of boundary objects in closing
communication gaps in the multidisciplinary management of complex
conditions.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:NSHD.ca#10222/14155 |
| Date | 19 July 2011 |
| Creators | Sampalli, Tara |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
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