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

SWALLOW, Veronica, NIGHTINGALE, R., WILLIAMS, J., LAMBERT, H., WEBB, N.J., SMITH, T., WIRZ, L., QIZALBASH, L., CROWTHER, L. and ALLEN, D. (2013). Multidisciplinary teams, and parents, negotiating common ground in shared-care of children with long-term conditions: A mixed methods study. BMC Health Services Research, 13 (1), p. 264.

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Background: Limited negotiation around care decisions is believed to undermine collaborative working between parents of children with long-term conditions and professionals, but there is little evidence of how they actually negotiate their respective roles. Using chronic kidney disease as an exemplar this paper reports on a multi-method study of social interaction between multidisciplinary teams and parents as they shared clinical care. Methods. Phases 1 and 2: a telephone survey mapping multidisciplinary teams' parent-educative activities, and qualitative interviews with 112 professionals (Clinical-psychologists, Dietitians, Doctors, Nurses, Play-specialists, Pharmacists, Therapists and Social-workers) exploring their accounts of parent-teaching in the 12 British children's kidney units. Phase 3: six ethnographic case studies in two units involving observations of professional/parent interactions during shared-care, and individual interviews. We used an analytical framework based on concepts drawn from Communities of Practice and Activity Theory. Results: Professionals spoke of the challenge of explaining to each other how they are aware of parents' understanding of clinical knowledge, and described three patterns of parent-educative activity that were common across MDTs: Engaging parents in shared practice; Knowledge exchange and role negotiation, and Promoting common ground. Over time, professionals had developed a shared repertoire of tools to support their negotiations with parents that helped them accomplish common ground during the practice of shared-care. We observed mutual engagement between professionals and parents where a common understanding of the joint enterprise of clinical caring was negotiated. Conclusions: For professionals, making implicit knowledge explicit is important as it can provide them with a language through which to articulate more clearly to each other what is the basis of their intuition-based hunches about parents' support needs, and may help them to negotiate with parents and accelerate parents' learning about shared caring. Our methodology and results are potentially transferrable to shared management of other conditions. © 2013 Swallow et al.; licensee BioMed Central Ltd.

Item Type: Article
Uncontrolled Keywords: Activity theory; Chronic kidney disease; Common ground; Communities of practice; Ethnography; Long-term; Multi-disciplinary teams; Negotiation; Parents; Professionals; Adolescent; Child; Child, Preschool; Female; Health Care Surveys; Humans; Interdisciplinary Communication; Male; Negotiating; Patient Care Team; Professional-Family Relations; Qualitative Research; Renal Insufficiency, Chronic; United Kingdom; Humans; Health Care Surveys; Interdisciplinary Communication; Negotiating; Professional-Family Relations; Qualitative Research; Adolescent; Child; Child, Preschool; Patient Care Team; Female; Male; Renal Insufficiency, Chronic; United Kingdom; 1117 Public Health and Health Services; 0807 Library and Information Studies; Health Policy & Services
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Page Range: p. 264
SWORD Depositor: Symplectic Elements
Depositing User: Symplectic Elements
Date Deposited: 18 May 2020 15:38
Last Modified: 18 Mar 2021 01:45

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