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Interprofessional communication in a psychiatric outpatient unit – an ethnographic study
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.ORCID iD: 0000-0001-6519-3374
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.ORCID iD: 0000-0002-6381-1922
Mälardalens högskola; Karolinska institutet.
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.ORCID iD: 0000-0002-2610-8998
2023 (English)In: BMC Nursing, E-ISSN 1472-6955, Vol. 22, article id 286Article in journal (Refereed) Published
Abstract [en]

Background

Communication in healthcare has been extensively studied, but most research has focused on miscommunication and the importance of communication for patient safety. Previous research on interprofessional communication has mainly focused on relationships between physicians and nurses in non-psychiatric settings. Since communication is one of the core competencies in psychiatric care, more research on interprofessional communication between other clinicians is needed, and should be explored from a broader perspective. This study aimed to explore and describe interprofessional communication in a psychiatric outpatient unit.

Method

During spring 2022, data consisting of over 100 h of fieldwork were collected from observations, formal semi-structured interviews and informal conversations inspired by the focused ethnography method. Data was collected at an outpatient unit in central Sweden, and various clinicians participated in the study. The data analysis was a back-and-forth process between initial codes and emerging themes, but also cyclical as the data analysis process was ongoing and repeated and took place simultaneously with the data collection.

Results

We found that a workplace’s history, clinicians´ workload, responsibilities and hierarchies influence interprofessional communication. The results showed that the prerequisites for interprofessional communication were created through the unit’s code of conduct, clear and engaging leadership, and trust in the ability of the various clinicians to perform new tasks.

Conclusion

Our results indicate that leadership, an involving working style, and an environment where speaking up is encouraged and valued can foster interprofessional communication and respect for each other´s professional roles is key to achieving this. Interprofessional communication between different clinicians is an important part of psychiatric outpatient work, where efficiency, insufficient staffing and long patient queues are commonplace. Research can help shed light on these parts by highlighting aspects influencing communication.

Place, publisher, year, edition, pages
Springer , 2023. Vol. 22, article id 286
Keywords [en]
Code of conduct; Focused ethnography; Interprofessional communication; Psychiatric outpatient care
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:hig:diva-42959DOI: 10.1186/s12912-023-01446-yISI: 001088254300003PubMedID: 37626326Scopus ID: 2-s2.0-85169145954OAI: oai:DiVA.org:hig-42959DiVA, id: diva2:1793314
Available from: 2023-08-31 Created: 2023-08-31 Last updated: 2025-03-18Bibliographically approved
In thesis
1. Interprofessional Communication Shaping Health-Promoting and Sustainable Working Life in Psychiatric Outpatient Units
Open this publication in new window or tab >>Interprofessional Communication Shaping Health-Promoting and Sustainable Working Life in Psychiatric Outpatient Units
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis research describes and explores how interprofessional communication shapes a health-promoting and sustainable working life in psychiatric outpatient units. Four studies are conducted using qualitative methods, including a concept analysis using a hybrid model, a focused ethnography, focus groups, and a vignette study. These methods analyze the role of inter-professional communication in collaboration, clarifying professional roles, and influencing the work environment in psychiatric outpatient units. The studies identify key elements such as trust, role understanding, and openness as central to strengthening communication, teamwork, and patient safety. The results show that leadership plays an important role in enabling an open communication culture but that hierarchical structures and unclear areas of responsibility can create barriers. Standardized communication tools, such as SBAR, contribute to structured information transfer, but at the same time, the importance of informal communication to build relationships and promote collaboration emerges. The studies highlight the need for a cultural change toward more equal and inclusive communication, which requires organizational changes in which all clinicians have a voice in decision-making. The work environment can be improved by strengthening interprofessional communication, promoting a longterm sustainable workplace, and contributing to better care for patients in psychiatric outpatient units.

Abstract [sv]

Denna avhandling beskriver och utforskar hur interprofessionell kommunikation formar ett hälsofrämjande och hållbart arbetsliv på psykiatriska öppenvårdsmottagningar. Fyra studier genomförs med kvalitativa metoder, inklusive en begreppsanalys baserad på en hybridmodell, en fokuserad etnografi, fokusgrupper och en vinjettstudie. Dessa metoder analyserar den interprofessionella kommunikationens roll i samarbete, tydliggörande av yrkesroller och påverkan på arbetsmiljön för kliniker. Studierna identifierar nyckelfaktorer såsom tillit, rollförståelse och öppenhet som centrala för att stärka kommunikation, teamarbete och i slutändan patientsäkerhet. Resultaten visar att ledarskap spelar en viktig roll för att möjliggöra en öppen kommunikationskultur, men att hierarkiska strukturer och otydliga ansvarsområden kan skapa barriärer. Standardiserade verktyg, såsom SBAR, bidrar till strukturerad informationsöverföring men samtidigt framträder vikten av informell kommunikation för att bygga relationer och främja samverkan. Studierna belyser behovet av en kulturell förändring mot mer jämlik och inkluderande kommunikation vilket kräver organisatoriska förändringar där alla kliniker ges en röst i beslutsfattandet. Genom att stärka den interprofessionella kommunikationen kan arbetsmiljön förbättras, vilket i sin tur främjar en långsiktigt hållbar arbetsplats och bidrar till bättre vård för patienter inom psykiatrisk öppenvård.

Place, publisher, year, edition, pages
Gävle: Gävle University Press, 2025. p. 56
Series
Doctoral thesis ; 60
Keywords
Collaboration, Interprofessional communication, Leadership, Psychiatric outpatient units, Sustainability, Qualitative method, Work environment, Arbetsmiljö, Hållbarhet, Interprofessionell kommunikation, Kvalitativ metod, Ledarskap, Psykiatrisk öppenvård, Samverkan
National Category
Medical and Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-46639 (URN)978-91-89593-62-6 (ISBN)978-91-89593-63-3 (ISBN)
Public defence
2025-06-05, 33:202, Kungsbäcksvägen 47, Gävle, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2025-05-14 Created: 2025-03-18 Last updated: 2025-05-14Bibliographically approved

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Rudberg, IngelaOlsson, AnnakarinSalzmann-Erikson, Martin

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