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Abstract

Persons with life-threatening illness are increasingly being cared for and dying at home. Palliative care strives to cater to multiple dimensions of persons, such as physical, psychosocial and spiritual or existential, and meeting these needs of patients and families requires multiple competencies. Palliative care organizations like the WHO and the EAPC, as well as Swedish national guidelines, propose organization and delivery of care in teamwork models, however, teamwork is complex and in healthcare, team members often vary from shift to shift. The overall aim of the project was to explore perspectives of team function in specialist palliative care teams, among health care professionals, patients, and families, in order to gain a deeper knowledge of structures and relationships so as to optimize team functioning. Results of the studies are: (I) health care professionals report that competence, communication, and organization are crucial components of teamwork in specialist palliative homecare, (II) patients and families report that they experience security and continuity of care due to 24/7 availability, flexibility and sensitivity to changing needs and a collective team approach that fostered experiences of continuity of care, and (III) that the 77 participating teams in the Swedish context all have a core of registered nurses, physicians, and social workers, while physiotherapists and occupational therapists were present in most teams. The explored teams have existed for 7-21 years, are foremost of medium size and tend to work in an integrated manner, rather than in parallel. Positive associations were found between team maturity and team effectiveness. Based on our findings, clarification of team goals and professional roles together with the development of psychosocial traits and team processes should be prioritized in clinical settings. Patients and families will most likely experience that their needs are met and feel greater satisfaction with care provided by mature teams.

Biography

Anna Klarare completed her Ph.D. in Medical Science at Karolinska Institute in June 2016. She is a registered nurse with 20 years clinical experience with specialist palliative home care. She has a Master’s in Nursing Education and is presently the senior lecturer in palliative care at Ersta Skondal Bracke University College in Stockholm, Sweden. She has five published papers, three more submitted and is presently pursuing post-doctoral studies. She is highly appreciated as a workshop leader in continuing palliative care education nationally in clinical settings.

E-mail: anna.klarare@esh.se