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Investigating complex interventions - Changing perspective and methods along the way
Rikke Dalsted PhD-fellow, MA Sociology, Reg Nurse
16th Nordic Congress of general practiceCopenhagen 13-16 May 2009
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Investigating cooperation PhD-project “Cooperation in cancer
treatment. A research and discussion about patient trajectories”
Aim: Investigate how cooperation is happening between patient and healthcare professionals, and how the existing cooperation can be a point of departure in further development of coherent patient trajectories
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Central concepts
Cooperation: A collective process where ways of working together are seen as social and historical created (Brown & Duguid 1991)
Patient trajectory: The total organization of actions that happens in trajectory of the patients illness and the influence the action have on the involved people (Strauss et al. 1997)
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Methods - until now
12 individual interviews with patients 2 focus group with the patients’ GPs 1 focus group with clinic staff 1 focus group with hospital doctors 2 focus groups with nurses at hospital 1 focus group with home care nurses
Fall 2007- fall 2008
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Preliminary results
Significant part of informal relations Not described or seen as significant Patients active part
Lack of coherence in patient trajectories Shifting treatment from organization or ward Communication profession to profession Lack of inter-organizational thinking
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Conclusion
Level of research developed – preliminary results unknown
Research design readjusted and need for additional methods
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Methods – Next step
Observational study Informal relations Work practice of all health care professionals Interconnection of work Patient trajectories – further investigation
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Discussion
Is it possible to know the “active” component? Cancer treatment as complex intervention Reciprocal impact of multiple factors Patient trajectory – total organization of actions
Is it possible to create a “on fits all” model for investigating complex interventions? The need for flexibility
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Rikke DalstedPhD-fellow, MA Sociology, Reg, NurseThe Research Unit for General Practice, [email protected]
16th Nordic Congress of general practiceCopenhagen 13-16 May 2009