Interdisciplinary Hospice Team Processes and Multidimensional Pain: A Qualitative Study

Abstract

Hospice teams may address multidimensional pain through the synergistic interaction of team members from various professional disciplines during regularly scheduled team meetings. However, the occurrence of that critical exchange has not been adequately described or documented. The purpose of this qualitative study was to explore two processes in team pain palliation: communication and collaboration. Data were gathered through individual interviews and a 1-year observation of team members from two hospices (physicians, nurses, aides, chaplains, social workers). Utilizing constant comparison, 14 final thematic categories were discovered. Use of biopsychosocial/spiritual terms by all team members meant that the team had the common language needed to communicate about multidimensional pain. Interviews and observation revealed a gap in translating multidisciplinary communication in team meetings into collaborative acts for pain treatment. In addition, structural influences inhibited creativity in pain palliation. There was no mutual understanding of the purpose for team meetings, no recognition of the need to reflect on team process, or common definition of leadership. Social work roles in hospice should include leadership that moves teams toward interdisciplinary care for multidimensional pain.

Interprofessional Collaboration between General Physicians and Emergency Department Teams in Belgium: A Qualitative Study

“…Communication would allow both role negotiation and clarification [ 54 55 ] and foster relationships between individuals [ 56 ]. Efficient flow of information between teams would build trust up and allow ideas and decisions to be rigorously debated [ 57 ].…”

Communication Within Hospice Interdisciplinary Teams

“…33 Another study that assessed the extent to which hospice team members address multidimensional pain within their practice found high levels of interdependence, flexibility, and collective goal setting among members. 8 Interestingly, in this study, participants divorced collaboration from communication, noting that although communication occurred on a regular basis, collaboration occurred more sparingly. In another qualitative study, social workers provided examples of positive and problematic issues regarding interdependence, newly created professional activities, flexibility, ownership of goals, and reflection on process as components for collaboration.…”

“…6,7 In the hospice setting, the IDT is responsible for the biomedical, psychosocial, and spiritual health care of the patient. 8 The registered nurse (RN) usually serves as the case manager and is responsible for team coordination, assessment of patient and caregiver needs, and implementation of the care plan. 6,9 Despite the growing body of research on IDT functioning and its quality implications in health care settings such as mental health, palliative care, and intensive care units, there have been little empirical inquisition into IDT functioning and dynamics within the hospice setting.…”

A Prospective Study of the Clinical Content of Palliative Medicine Interdisciplinary Team Meetings

“…A common language was used to communicate specific aspects of care, for example, pain, but there seemed to be a lack in recognition of the need to reflect on team processes. 3…”