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Interprofessional Communication in Psychiatric Units: Barriers, Prerequisites, and Its Role in Shaping Person-Centered Practices – A Vignette 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. Karolinska institutet.ORCID iD: 0000-0003-0964-1747
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.ORCID iD: 0000-0002-2610-8998
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.ORCID iD: 0000-0002-6381-1922
2025 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 46, no 9, p. 891-901Article in journal (Refereed) Published
Abstract [en]

Interprofessional communication is fundamental in healthcare, particularly where patient needs demand coordination and shared understanding. It fosters role clarity, care coordination, and team cohesion. However, unclear hierarchies, heavy workloads, and interpersonal conflicts can disrupt collaboration, affecting professional relationships and patient outcomes. This study explores experiences of and reflections on prerequisites for and barriers to interprofessional communication in psychiatric outpatient settings. While previous research has described barriers, few studies have examined how communication itself constitutes professional roles, boundaries, and collaborative practices. To address this gap, the study applies the Four Flows framework—membership negotiation, self-structuring, activity coordination, and institutional positioning—as an interpretive lens. Using vignettes and semi-structured interviews with 11 clinicians in psychiatric outpatient units, the study analyzed how communication shapes and is shaped by interprofessional collaboration. Analysis identified four key categories: systemic barriers and organizational challenges; social dynamics and interprofessional relationships; supportive leadership and team culture; and patient focus and involvement. These categories intersect across the Four Flows, illustrating how communication acts as a structuring process rather than a neutral tool. The overarching theme,” From Separate Paths to Shared Care,” highlights how clinicians enact person-centered collaboration through communicative practice in psychiatric outpatient settings.

Place, publisher, year, edition, pages
Taylor & Francis , 2025. Vol. 46, no 9, p. 891-901
National Category
Psychiatry
Research subject
Health-Promoting Work
Identifiers
URN: urn:nbn:se:hig:diva-46689DOI: 10.1080/01612840.2025.2535652ISI: 001564208500001PubMedID: 40906969Scopus ID: 2-s2.0-105015189432OAI: oai:DiVA.org:hig-46689DiVA, id: diva2:1947779
Available from: 2025-03-26 Created: 2025-03-26 Last updated: 2026-03-17Bibliographically 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: 2025-10-02Bibliographically approved

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Rudberg, IngelaThunborg, CharlottaSalzmann-Erikson, MartinOlsson, Annakarin

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