Individual-level determinants of interprofessional team collaboration in healthcare

Analyzing readiness for interprofessional education among health program students using hierarchical clustering

This study employs a clustering approach to assess the readiness for interprofessional education (IPE) among students enrolled in health-related study programs in Albania. Among a sample of 1470 students, complete data were available for 1383 participants, while 87 cases had missing data. Three distinct clusters were identified using hierarchical clustering analysis based on age and readiness domains: Teamwork (TW) and Professional Practice Identity (PPI). The average scores for TW and PPI were 4.4 ± 0.51 and 4.3 ± 0.51, respectively. Cluster A, consisting of 123 students, exhibited lower scores in both domains and a higher proportion of male students, while Clusters B (846 students) and C (414 students) demonstrated greater readiness for IPE and a higher representation of female students. These findings highlight varying perceptions and values associated with IPE across genders and health-related study programs, emphasizing the necessity for tailored and gender-aware IPE-enhancing interventions. Furthermore, our research underscores the importance of introducing IPE early in the healthcare curriculum and utilizing student clustering to tailor interventions, thus laying the foundation for broader research endeavors. Future studies are recommended to delve deeper into these results and assess the effectiveness of tailored interventions based on this approach in fostering readiness for IPE.

Validation and reliability assessment of the Persian Adaptation of the Interprofessional Team Collaboration Scale II (P-AITCS-II) for Iranian healthcare providers

The primary objective of this study was to perform a psychometric evaluation of the Persian adaptation of the Assessment of Interprofessional Team Collaboration Scale (P-AITCS-II). This methodological study aimed to assess the validity and reliability of the AITCS-II for practitioners within the Iranian healthcare context. Data were collected from a sample of 230 Iranian healthcare providers between May and June 2024. Confirmatory factor analysis demonstrated good model fit indices (χ2 = 540.20, df = 224, χ2/df = 2.41, CFI = 0.917, IFI = 0.918, TLI = 0.907, PNFI = 0.768, PCFI = 0.812, and RMSEA = 0.079 [CI90% 0.070-0.087]). These results confirm the validity of the P-AITCS-II model. Additionally, the internal consistency and composite reliability of the three factors were higher than 0.7. Convergent validity was considered acceptable for the P-AITCS-II, as the Average Variance Extracted (AVE) was greater than 0.5. The Persian adaptation of the Assessment of Interprofessional Team Collaboration Scale II (P-AITC-II), consisting of 23 items within three factors-partnership, cooperation, and coordination-demonstrated good validity and reliability. However, further research is needed to confirm its robustness and usefulness for improving interprofessional team collaboration.

Barriers perceived by university faculty in implementing interprofessional education: A scoping review protocol

Interprofessional Education (IPE) enhances collaboration among health professionals and improves patient care. Despite its benefits, university implementation of IPE is limited due to various barriers perceived by faculty members. Identifying these barriers is crucial for developing strategies to integrate IPE into higher education curricula. This scoping review protocol outlines a study to map and synthesize literature on barriers perceived by university faculty in implementing IPE, aiming to inform future interventions and research. Following the Joanna Briggs Institute methodology and adhering to PRISMA-ScR guidelines, a comprehensive search will be conducted across databases including PubMed, Embase, CINAHL, Scopus, Web of Science, and Google Scholar without time restrictions. All types of publications focusing on faculty-perceived barriers to IPE will be included. Data extraction and analysis will involve thematic synthesis and advanced topic modeling using the OCTIS framework to identify key themes and patterns. The review will provide an overview of the types of barriers faced by faculty, their causes, and proposed strategies to overcome them, offering valuable insights for enhancing IPE integration in university settings.•The scoping review will map existing literature on faculty-perceived barriers to implementing Interprofessional Education.•Advanced topic modeling with the OCTIS framework will be utilized to analyze and synthesize findings.•The outcomes aim to inform strategies for effective IPE integration in higher education curricula.

Academic hospitals in the Toronto region collaborate to optimize occupational health and safety

In March 2020, as the COVID-19 cases began to rise in Ontario, Canada, the central role of Occupational Health and Safety (OHS) to ensure the well-being of hospital workforce became highly visible. While Ontario's hospitals concentrated efforts to meet each challenging and uncertain wave stressing the system, it was apparent that there is a lack of consistency in best practices and policy response across the healthcare sector. Additionally, the unprecedented pressure on healthcare workforce as they attempted to meet the pandemic's new surging demands resulted in workforce shortages and increased levels of burnout, making it difficult to engage, support, and retain the staff necessary for delivering highest quality of services. The Toronto Academic Health Science Network (TAHSN), a dynamic consortium of 14 healthcare organizations, established a collaborative to implement an integrated effort and align on structure, processes, and standards that will increase strength and defensibility of TAHSN programs. To foster community building, identify areas of common concern, and co-create practices during and beyond the COVID-19 pandemic, a structured network of 14 OHS directors across the healthcare organizations was established. This article discusses the origin of the TAHSN collaborative, the thriving community vision for partnership, and the case study methodology used to combine capabilities to showcase innovation and excellence in care together.

Shared understanding and task-interdependence in nursing interns' collaborative relations: A social network study of vocational health care internships in the Netherlands

Shared understanding among collaborators is a key element of delivering successful interprofessional care and a main challenge for professional education concerns nurturing such understanding among students. We assessed how nursing students perceived different levels of shared understanding in their collaborations with others in clinical internships. We analyse the collaborative networks of interns to examine whether individual factors (attitudes, perceptions of collaborative cultures, and motivation) or relational factors among collaborators (task-interdependence, cooperation frequency, and interprofessional and hierarchical roles) affect shared understanding among 150 Dutch nursing interns and their collaborators (n = 865). Theoretically, we stress the importance of focusing on collaborative relations in interprofessional care settings. Multilevel models distinguish two levels in explaining the variation in shared understanding, nesting collaborative relationships within individuals. Results indicate merely 37.4% of found variation of shared understanding could be attributed to individual-level factors (variation between interns), while 62.6% of variation is found within interns, showing that shared understanding differs substantially between the collaborations one intern engages in. Multilevel models reveal that task-interdependence strongly predicts shared understanding in inter- and intraprofessional collaborations. We conclude that focusing on collaborative relations is essential to foster shared understanding in vocational internship programmes, and that health care organisations should pay explicit attention to task-interdependence in interns' collaborations.

"I don't see the whole picture of their health": a critical ethnography of constraints to interprofessional collaboration in end-of-life conversations in primary care

CONTEXT

Interprofessional collaboration is recommended in caring for frail older adults in primary care, yet little is known about how interprofessional teams approach end-of-life (EOL) conversations with these patients.

OBJECTIVE

To understand the factors shaping nurses' and allied health clinicians' involvement, or lack of involvement in EOL conversations in the primary care of frail older adults.

METHODS/SETTING

A critical ethnography of a large interprofessional urban Family Health Team in Ontario, Canada. Data production included observations of clinicians in their day-to-day activities excluding direct patient care; one-to-one semi-structured interviews with clinicians; and document review. Analysis involved coding data using an interprofessional collaboration framework as well as an analysis of the normative logics influencing practice.

PARTICIPANTS

Interprofessional clinicians (n = 20) who cared for mildly to severely frail patients (Clinical Frailty Scale) at the Family Health Team.

RESULTS

Findings suggest primary care nurses and allied health clinicians have the knowledge, skills, and inclination to engage frail older adults in EOL conversations. However, the culture of the clinic prioritizes biomedical care, and normalizes nurses and allied health clinicians providing episodic task-based care, which limits the possibility for these clinicians' engagement in EOL conversations. The barriers to nurses' and allied health clinicians' involvement in EOL conversations are rooted in neoliberal-biomedical ideologies that shapes the way primary care is governed and practiced.

CONCLUSIONS

Our findings help to explain why taking an individual-level approach to addressing the challenge of delayed or avoided EOL conversations, is unlikely to result in practice change. Instead, primary care teams can work to critique and redevelop quality indicators and funding models in ways that promote meaningful interprofessional practice that recognize the expertise of nursing and allied health clinicians in providing high quality primary care to frail older patients, including EOL conversations.

Cultural Adaptation and Psychometric Properties of the Trust Me Scale-Italian Version: A Validation Study

BACKGROUND

The Trust Me Scale is a widely used instrument to measure trust in healthcare providers. However, no Italian version of the scale exists yet, limiting its use in Italian-speaking populations. The aim of this study is to translate and validate the Trust Me Scale for use in Italian-speaking populations in nurses and nurse managers.

METHODS

The translation process involved methodological steps of collaborative and iterative translation with cultural adaptation. The validation process included a cross-sectional study enrolling a convenience sample of 683 nurses and 188 nurse managers who completed the Italian version of the Trust Me Scale and measures of intention to leave, satisfaction, and organizational commitment.

RESULTS

Item 5 was removed for poor factor loading, and items 11 and 13 were removed following an a priori strategy focused on deleting items with correlations between residual variables different than expected based on theoretical expectations derived from previous research. The final model fit well to sample statistics with a three-factor structure (harmony, reliability, and concern) and 13 items. A multiple-indicator multiple-cause model showed a measurement invariance between nurses and nurse coordinators. Construct validity was also supported by the evidence that the measured domains of trust align with the theoretical expectations and are related to the intention to leave, job satisfaction, and organizational commitment. Each dimension showed adequate scale reliability.

CONCLUSIONS

The Italian version of the Trust Me Scale is a valid and reliable instrument to measure trust in nurses and nurse managers in Italian-speaking contexts. It can be used for research in nursing and leadership and evaluation of interventions aimed at improving trust in healthcare contexts.

Individual-Level Variables Associated with Self-Efficacy in Nutritional Care for Older People among Italian Nurses: A Multicenter Cross-Sectional Study

Malnutrition in older people is still an unsolved issue. Clinical nurses have a key role in malnutrition prevention. This study aims to describe the individual-level variables associated with self-efficacy in nutrition care for older adults among nurses. A cross-sectional descriptive observational study was performed involving nurses from four northern Italy hospitals. The self-efficacy scale for nursing nutrition care (SE-NNC) and Multiple linear regression (MLR) models were used, enrolling 305 nurses. The mean SE-NNC total score was 53.3 ± 19.7. Considering the three dimensions of the SE-NNC, mean scores were 45.9 ± 21.7 for boosting knowledge, 55.4 ± SD = 20.3 for assessment and evidence utilization, and 57.7 ± 21.1 for care delivery. To be a younger nurse, working in a chronic care setting, and being male were associated with a higher level of self-efficacy, both considering the SE-NNC total score and its dimensions. Working in acute care settings and being an older nurse was associated with lower nursing self-efficacy in nutrition care for older adults.

Relationship between parental mental health and developmental disorders in early childhood

Social intervention with children with disabilities and their families should be understood through the principles of family-centred practice. In Spain, early intervention is understood as interventions aimed at children from 0 to 6 years old and their families. Professionals carry out the reception, assessment and intervention. This study aims to analyse the relationship between mental and physical health, caregivers' levels of anxiety and depression and the child's development during the fostering and assessment phase. The sample is made up of 135 families using child development centres in the Balearic Islands. Four questionnaires were completed: Health-Related Quality of Life SF-12, Anxiety and Depression Scale, Child Behaviour Checklist (CBCL 1½-5) and socio-demographic questionnaire. The results show that parents of children with disabilities have higher levels of mental health impairment than physical health impairment. They also score higher on anxiety than on depression. It is worth noting that professional discipline is a variable to be taken into account in relation to parents' perception of their child's developmental improvement. In addition, the association between the developmental subscales, where the more the child is affected, the more the parents' mental health is affected. The same pattern occurs with caregivers' levels of anxiety and depression. In short, we propose a reflection on the application of family-centred practices during interventions, understanding the lack of professional training as a predictor of the quality of early intervention.

Italian Translation and Validation of the Readiness for Interprofessional Learning Scale (RIPLS) in an Undergraduate Healthcare Student Context

Interprofessional education requires that two or more professionals learn from and with each other to allow effective collaboration and improve health outcomes. Thus far, the interprofessional collaboration of healthcare students might be assessed using the Readiness for Interprofessional Learning Scale (RIPLS), which is currently not available in its Italian version. This study aimed to provide the intercultural adaptation of the RIPLS in Italian (I-RIPLS) and assess its validity and reliability. A two-phase validation study was performed in 2020, using a single-centre approach in students enrolled in the medical degree, physiotherapy, nursing, and dentistry courses at an Italian-speaking university in Albania. The first phase of the study determined the cross-cultural adaptation of the items by involving two translators who followed a forward and backward translation process. In the second phase, a sample of 414 students was enrolled. The preliminary corrected item-total correlations showed that five items did not show significant item-to-total correlations. Even if their deletion was not mandatory for generating a suitable correlation matrix for factor analysis, the advantages of keeping only items contributing to a more stable measurement with a shorter scale represented the rationale for removing items with non-significant item-to-total correlation from the correlation matrix before testing the dimensionality of the I-RIPLS with factor analysis. The answers from the first 50% of responders (n = 207) were used to determine the most plausible dimensionality of the I-RIPLS by employing an exploratory factor analysis (EFA), and the second 50% were used to cross-validate the most plausible dimensionality derived from EFA by employing confirmatory factor analysis (CFA) models. The most plausible dimensionality from EFA, by acknowledging the interpretation of the scree plot, the eigenvalues greater than 1, a parallel analysis, and the previous theoretical dimensions of the tool had two factors with adequate internal consistency. The CFA confirmed the two-factor solutions and the internal consistency for each domain. The I-RIPLS has 14 items with adequate evidence of validity and reliability. Future research should revise the tool for pursuing cross-cultural multigroup measurement invariance.

Adaptation and psychometric evaluation of the Swedish version of the Assessment of Inter professional Team Collaboration Scale (AITCS-S) for use in occupational health services

Interprofessional team collaboration (ITC) in the Swedish Occupational Health Service is an important part of the service given to the customer. The Occupational Health Service (OHS) could be more competitive if they were able to show how successful is their ITC. The Assessment of Interprofessional Team Collaboration Scale (AITCS) is an instrument that measures ITC in teams working with the client as part of the team. The aim of this study was to adapt the Swedish version of the instrument for use in OHS and to evaluate the psychometric properties of the adapted version and the adapted short version. The study included 472 participants from different OHSs, all members of the trade association of occupational health care in Sweden. Face and content validity of the instrument were assessed, and floor and ceiling effects were measured. Internal consistency was measured with Cronbach's alpha and an exploratory factor analysis was conducted on the 42-item adapted instrument and the short, 24-item version. The exploratory factor analysis gave a three-factor solution with an eigenvalue >1 and explaining a total variance of 57.1% and 62.3% for the short version. The study concludes that AITCS-S-(OHS) as well as the short version, is a reliable and valid questionnaire. Further development of the AITCS-S-(OHS) needs to be undertaken and assessed by confirmatory factor analysis.