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Title
Advancing interprofessional theory: Deliberative democracy as a participatory research antidote to power differentials in aged care
Author(s)
Nugus, Peter
Travaglia, Joanne
Greenfield, David
Lamothe, Josianne
Hogden, Anne
Kolne, Kendall
Braithwaite, Jeffrey
Publication Date
2019-06
Socio-Economic Objective (SEO) 2008
Abstract
<i>Introduction:</i> Interprofessional relations in health care have been examined through the frame of "clinical democracy". Yet, traditional interpretations of democracy have assumed a zero-sum, competitive interpretation of power, leading to unelaborated invocations for health professionals to "collaborate" more or do "teamwork" better. The aim of this study was to understand the priorities that health professionals from different occupations have for individual patient care, and the opportunities they have to express those priorities, as a foundation for a more expansive democratic theory.
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<i>Materials and methods:</i> The case setting was a mixed-method, pre-post, participatory research (PR) study examining the dynamics and levels of satisfaction of interprofessional information-sharing and decision-making on an acute aged care unit.
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<i>Results:</i> Stage 1, pre-intervention, revealed that non-medical health professionals – nursing and, in particular, allied health professionals – lacked opportunities for input into decision-making for patient care. Following deliberative, public feedback of the findings to managers and health professionals, an intervention was negotiated to re-structure the weekly case conference and referral processes. Stage 2, the post-interventional findings showed an increase in perceptions of information-sharing, and participation in case conferences, as well as recognition of power differentials in interprofessional relations.
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<i>Conclusions:</i> In the public negotiation of increased prominence of particular roles and aligning role clarity with the needs of particular patients, the findings show that the notion of deliberative democracy characterizes the qualitative-cumulative, rather than merely quantitative-redistributive power among health professionals in different occupational roles. As a case of conscientization, deliberation engages practical interprofessional improvement simultaneously as educational empowerment.
<br/>
<i>Materials and methods:</i> The case setting was a mixed-method, pre-post, participatory research (PR) study examining the dynamics and levels of satisfaction of interprofessional information-sharing and decision-making on an acute aged care unit.
<br/>
<i>Results:</i> Stage 1, pre-intervention, revealed that non-medical health professionals – nursing and, in particular, allied health professionals – lacked opportunities for input into decision-making for patient care. Following deliberative, public feedback of the findings to managers and health professionals, an intervention was negotiated to re-structure the weekly case conference and referral processes. Stage 2, the post-interventional findings showed an increase in perceptions of information-sharing, and participation in case conferences, as well as recognition of power differentials in interprofessional relations.
<br/>
<i>Conclusions:</i> In the public negotiation of increased prominence of particular roles and aligning role clarity with the needs of particular patients, the findings show that the notion of deliberative democracy characterizes the qualitative-cumulative, rather than merely quantitative-redistributive power among health professionals in different occupational roles. As a case of conscientization, deliberation engages practical interprofessional improvement simultaneously as educational empowerment.
Publication Type
Journal Article
Source of Publication
Journal of Interprofessional Education & Practice, v.15, p. 100-111
Publisher
Elsevier Inc
Place of Publication
United States of America
ISSN
2405-4526
Fields of Research (FoR) 2020
Socio-Economic Objective (SEO) 2020
Peer Reviewed
Yes
HERDC Category Description
Peer Reviewed
Yes
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