Friday, 13 January 2006 - 2:22 PM

Social Workers Perceptions of Hospice Interdisciplinary Collaboration

Debra Parker Oliver, PhD, University of Missouri-Columbia, Laura Bronstein, PhD, Binghamton University, and Lori Kurzejeski, MSW, Missouri River Hospice.

For the better part of a century, input from numerous disciplines working together has provided a broader perspective on patient care (Baldwin, 2000). Interdisciplinary teams require the interaction or collaboration among various disciplines who are organized to solve a common set of problems (Hall & Weaver, 2001). Although social work participation on interdisciplinary teams is longstanding, little research has been done to examine its effectiveness. The conceptual framework for this project relies on a model (Bronstein, 2003) developed from four theoretical perspectives: a multidisciplinary theory of collaboration, services integration, role theory, and ecological systems theory. The model identifies five components of successful collaboration: 1) interdependence; 2) newly created professional activities; 3) flexibility; 4) collective ownership of goals; and 5) reflection on process. This framework led to the development of the Index for Interdisciplinary Collaboration (IIC) (Bronstein, 2002). The purpose of this study was to assess the perceptions of hospice social workers regarding their interdisciplinary teams. The research questions included: 1) How do hospice social workers view their interdisciplinary team collaboration?; 2) Does the type of social work degree, hospice census, or type of practice (group or solo), correlate with social workers' perceptions of collaboration?; and, 3) Is there a relationship between social workers' perception of interdisciplinary collaboration and quality of care? This study uses the IIC (Bronstein, 2002) to explore relationships between selected variables and teamwork in the hospice setting and has been found to have strong overall reliability (.92). The sample included 77 social workers from 51 different hospices, representing 77% of the licensed hospices in one state and a 52.7% response rate. Bivariate correlations for instrument and subscale means, demographics and quality of care variables were analyzed to assess possible relationships and explain variances in IIC scores. Using each demographic variable as a factor and the total and subset scores of the IIC as dependent variables, a series of one-way Analysis of Variances (ANOVAs) were done to explore significant differences in the means between groups based on the demographic variables. Finally, multiple regression equations were explored to see if any of demographic variables or the quality of care variable were predictive of IIC total or subscale scores. Five regression models using the total IIC score and each subscale score as independent variables and the demographic variables and deficiency as dependent variables were explored. The data showed that hospice social workers report a high level of interdisciplinary collaboration with colleagues. Education, hospice census, the presence of other social workers and quality of care were not related to overall levels of collaboration. Individual items measuring collaboration did prove to be linked with census, presence of other social workers on the team and quality of care. Practice implications include the importance of training social workers to be effective team members and leaders of interdisciplinary teams. Further research is required to investigate other possible related variables and their impact on successful interdisciplinary collaboration and service delivery as well as the perceptions of other members of interdisciplinary teams.

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