Doctoral Dissertations

Date of Award

12-2018

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Comparative and Experimental Medicine

Major Professor

Kathleen Conroy Brown

Committee Members

Cristina Barroso, Michael Bleich, Soghra Jarvandi, Elizabeth Strand

Abstract

The prevalence and severity of chronic health conditions are on the rise worldwide. Persons living with chronic and complex conditions face serious sequelae, which may benefit from new approaches to prevention and treatment. This study explored how persons living with chronic conditions in a medically unserved area experienced team-based interprofessional collaborative practice (TBICP). Using a concurrent mixed methods approach, patients’ experiences were captured through a survey and semi-structured interviews. Survey and interview data were analyzed separately through descriptive statistics and open, thematic coding, respectively. Surveys revealed high scores in patient-centered care (PCC) and a prevalence of positive answers to open-ended questions. Thematic analysis of interviews identified the overarching theme: Two minds are better than one, and subthemes included 1) They listened to everything I had to say, 2) Let’s go through the whole process, 3) There was [sic] minds coming together, and 4) I felt more confident that it would work for me. Quantitative and qualitative results were triangulated and integrated. Through inductive analysis, findings were categorized as 1) Patient-Centered Care (PCC) Behaviors, 2) ICP Inquiry, 3) ICP Problem-Solving, and 4) ICP Consensus on a Plan of Care. A grounded theory is proposed in a model of "Team-Based ICP." This study presents evidence that TBICP can build powerful inquiry and problem-solving capacity, while placing the patient at the center of the team, practicing collaboratively, and building consensus on goals and planning. Patients said that the ICP plan of care addressed "all of my concerns," offered "more options," was more likely to be "accurate," and made them "feel better." Patients reported increased confidence that their individualized TBICP plan of care was efficacious.

Orcid ID

http://orcid.org/0000-0003-3673-5570

Available for download on Thursday, December 15, 2022

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