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Social Capital and Relational Coordination in Outpatient Clinics.

机译:门诊诊所的社会资本和关系协调。

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摘要

Coordination is a vital component in health care provision and teamwork. The need for better coordination is particularly prominent in outpatient setting where patients assume the primary responsibility to follow-up on their own health care, especially when treatment is complex and lengthy in duration. Relational coordination represents a type of informal coordination process reinforced by communication and supportive relationships. This concept has been associated with enhanced interprofessional team performance, including patient care outcomes.;This study aimed to examine the theoretical underpinnings of relational coordination in the outpatient setting using social capital theory. It was hypothesized that social capital, resources embedded within network of relationships, would predict relational coordination. Additionally, social capital was hypothesized to be predicted by team tenure; and relational coordination was hypothesized to be predicted by formal coordination mechanisms.;A non-experimental, cross-sectional survey design was used to examine the relationship between social capital and relational coordination. Participants (N=342) were physicians and nurses recruited from outpatient clinics in two University affiliated hospitals. Study surveys were sent to 501 nurses and 187 physicians with follow-up reminders sent at three, five and seven weeks after the initial distribution of surveys. The overall response rate was 49.71%. Study variables were measured using previously validated instruments with acceptable levels of reliability and validity.;Structural equation modeling (SEM) was used for hypothesis testing. Final analysis revealed good fit of data to the hypothesized model (χ 2=383.38, df=177, p<0.001; CFI=0.966; RMSEA=0.060; SRMR=0.0316). SEM revealed that social capital predicted both factors of relational coordination [communication (β=0.70, p <0.001); supportive relationship (β=0.81, p<0.001)], and team tenure predicted social capital (β=0.13, p<0.05). In addition, the association between team tenure and relational coordination (β=0.09, p<0.05) was found to be partially mediated by social capital.;Findings of this study suggested that characteristics within relational ties are predictive of informal coordination. Administrators may facilitate teamwork through team building initiatives that foster these relational qualities, such as trust and shared language. Future research can further investigate the association between social capital and relational coordination in other health care settings, as well, in larger teams involving health care professionals in addition to physicians and nurses.
机译:协调是提供医疗保健和团队合作的重要组成部分。在门诊患者中,尤其是在治疗复杂且持续时间长的患者中,患者承担着对自己的医疗保健进行随访的主要责任,因此,对更好协调的需求尤为突出。关系协调代表了一种非正式的协调过程,该过程通过沟通和支持关系得到加强。该概念与增强的跨专业团队绩效(包括患者护理结果)相关联。;本研究旨在使用社会资本理论研究门诊环境中关系协调的理论基础。假设社会资本,关系网络中嵌入的资源将预测关系协调。另外,假设社会资本是由团队任期预测的。关系协调的假设是通过正式的协调机制来预测的。;采用非实验性的横断面调查设计来检验社会资本与关系协调之间的关系。参加者(N = 342)是从两家大学附属医院的门诊诊所招募的医生和护士。在最初分发调查后的三,五和七周,向501名护士和187名医生发送了研究调查问卷,并发出了后续提醒。总体回应率为49.71%。研究变量是使用先前经过验证的,具有可接受水平的信度和效度的仪器进行测量的。;结构方程模型(SEM)用于假设检验。最终分析表明,数据与假设的模型非常吻合(χ2 = 383.38,df = 177,p <0.001; CFI = 0.966; RMSEA = 0.060; SRMR = 0.0316)。扫描电镜显示,社会资本预测了关系协调的两个因素[交流(β= 0.70,p <0.001);支持性关系(β= 0.81,p <0.001)],以及团队任期预测的社会资本(β= 0.13,p <0.05)。此外,团队任期与关系协调之间的关联(β= 0.09,p <0.05)被发现部分地由社会资本介导。研究结果表明,关系纽带内的特征是非正式协调的预测。管理员可以通过团队建设计划来促进团队合作,这些计划可以培养这些关系品质,例如信任和共享语言。未来的研究可以进一步调查在其他医疗机构中社会资本与关系协调之间的关联,以及在除了医生和护士之外还包括医疗专业人员的更大团队中。

著录项

  • 作者

    Lee, Charlotte Tsz-Sum.;

  • 作者单位

    University of Toronto (Canada).;

  • 授予单位 University of Toronto (Canada).;
  • 学科 Health Sciences Nursing.;Health Sciences Health Care Management.
  • 学位 Ph.D.
  • 年度 2012
  • 页码 152 p.
  • 总页数 152
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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