Hausbesuch oder Visite – wie erleben Hausärzte und Pflegekräfte den Heimbesuch im Pflegeheim?
Eine qualitative Analyse
Home visit or ward round - GPs’ and nurses’ experience on interprofessional collaboration with a focus on GP’s visits to nursing homes.
A qualitative analysis
by Nina Fleischmann
Date of Examination:2017-06-08
Date of issue:2017-08-21
Advisor:Prof. Dr. Wolfgang Himmel
Referee:Prof. Dr. Wolfgang Himmel
Referee:Prof. Dr. Roland Nau
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EnglishBackground: The increasing number of residents in nursing homes and their complex health status will challenge medical care and the interaction between nurses and general practition-ers (GPs). The nursing home visit is a key element in medical care, but underrepresented in research. Aim: This study explores GPs’ and nurses’ perspectives on interprofessional collaboration with a focus on GP’s visits to nursing homes in order to understand the experiences of both professions. We aim to understand the nursing home visit to gain insights to communicative and interactive structure of the interprofessional collaboration. Methods: Open guideline interviews covering the visit process, interprofessional allocation of tasks and collaboration were conducted with 30 GPs and 18 nurses in three study centers and analyzed with grounded theory methodology. Results: Nurses experience "being-involved" as core category. Their strategies to ensure "being-involved" were e.g. to decide and prepare prior to the visit. Therefore, nurses per-ceived a higher quality of care and a feeling of security, but also conflicting demands for commitment. Nurses influenced residents´ choice of GP to ensure "being-involved". In the GPs’ interviews, the core category was “productive performance”. GPs used different strategies to perform a productive home visit: preparing strategies, on-site strategies and in-vesting strategies. As a result of striving for “productive performance“, GPs feel satisfaction, but sometimes also annoyance or disrespect for the nurses. When conflicts arise, GPs avoid contacting nurses or give up care altogether. Discussion: The findings provide a deeper understanding of the relationship and interaction between nurses and GPs and supplement earlier research focusing on structural aspects. Both the nurses’ need for “being involved” as well as the GPs focus on a “productive perfor-mance” should be considered when aiming to improve nursing home care. Effects on the health and well-being of resident should be subject of future research.
Keywords: Grounded Theory; General Practitioners; Interdisciplinary communication; Nursing Home; Physician-nurse relations; Qualitative Research