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Interprofessional collaboration in diabetes care: perceptions of family physicians practicing in or not in a primary health care team

机译：在糖尿病护理中辩论协作：对初级医疗团队练习或不在初级保健团队中的家庭医生的看法

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In Canada, most patients with type 2 diabetes mellitus (T2DM) are cared for in the primary care setting in the practices of family physicians. This care is delivered through a variety of practice models ranging from a single practitioner to interprofessional team models of care. This study examined the extent to which family physicians collaborate with other health professionals in the care of patients with T2DM, comparing those who are part of an interprofessional health care team called a Primary Care Network (PCN) to those who are not part of a PCN. Family physicians in Alberta, Canada were surveyed to ascertain: which health professionals they refer to or have collaborative arrangements with when caring for T2DM patients; satisfaction and confidence with other professionals’ involvement in diabetes care; and perceived effects of having other professionals involved in diabetes care. Chi-squared and Fishers Exact tests were used to test for differences between PCN and non-PCN physicians. 170 (34%) family physicians responded to the survey, of whom 127 were PCN physicians and 41 were non-PCN physicians (2 not recorded). A significantly greater proportion of PCN physicians vs non-PCN physicians referred patients to pharmacists (23.6% vs 2.6%) or had collaborative working arrangements with diabetes educators (55.3% vs 18.4%), dietitians (54.5% vs 21.1%), or pharmacists (43.1% vs 21.1%), respectively. Regardless of PCN status, family physicians expressed greater satisfaction and confidence in specialists than in other family physicians or health professionals in medication management of patients with T2DM. Physicians who were affiliated with a PCN perceived that interprofessional collaboration enabled them to delegate diabetes education and monitoring and/or adjustment of medications to other health professionals and resulted in improved patient care. This study sheds new insight on the influence that being part of a primary care team has on physicians’ practice. Specifically, supporting physicians’ access to other health professionals in the primary care setting is perceived to facilitate interprofessional collaboration in the care of patients with T2DM and improve patient care.
机译：在加拿大，大多数患有2型糖尿病的患者Mellitus（T2DM）在家庭医生的实践中被关心初级保健环境。通过各种练习模型来提供这项小心，从单一从业者到侦听团队的护理模型。本研究审查了家庭医生在关注T2DM患者中与其他卫生专业人员合作的程度，比较了那些被称为初级保健网络（PCN）的专业医疗保健团队（PCN）的那些不属于PCN的人。调查加拿大艾伯塔省的家庭医师被调查以确定：他们在关注T2DM患者时参考或有合作安排的卫生专业人员;对其他专业人士参与糖尿病护理的满意和信心;让其他参与糖尿病护理的其他专业人员的感知效果。 Chi-Squared和Fishers精确测试用于测试PCN和非PCN医生之间的差异。 170（34％）家庭医生对调查作出反应，其中127名是PCN医生，41人是非PCN医生（2号未记录）。 PCN医生的比例明显更大，非PCN医生将患者转诊给药剂师（23.6％VS 2.6％）或与糖尿病教育者（55.3％与18.4％），营养师（54.5％vs 21.1％）或药剂师进行合作工作安排（43.1％vs 21.1％）。无论PCN状态如何，家庭医生都表达了对专家的更大满意度和信心，而不是在T2DM患者的药物管理中的其他家庭医生或卫生专业人员中表达了更大的满足感和信心。与PCN相关的医生认为，辅导协作使他们能够将糖尿病教育和监测和/或调整药物调整到其他卫生专业人士，并导致改善患者护理。这项研究阐述了对初级保健团队的一部分对医生的实践的影响的新见解。具体而言，支持医生在初级保健环境中获得其他健康专业人员的访问，以促进在治疗T2DM患者的患者中促进思想协作，并改善患者护理。

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