Health professionals perceive teamwork with relatives as an obstacle in their daily work ‐ a focus group interview

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The changes in the public healthcare system are often driven by several factors such as economy and technological progress. The increased access to information and the acknowledgement of consumers’ rights is a high priority. Therefore, it could be argued that the public healthcare system of today must fulfil two goals at the same time, their social responsibility and their financial goals 1. The public healthcare system is described as a bureaucracy, which can be understood as a system building on another system, which can lead to a disconnection between different organisational levels. This disconnection is often seen between management and clinic and is often described as a hierarchy, where the abstractions of management seem to disconnect from what is actually happening on the floor 1.
Health professionals are guided by public policies and not so often on the norms of professionals 2. Instead of the healthcare system building upon the enthusiasm of a few, it builds on the tolerance of many. The discrepancy between how the organisation is presented and the actual results may explain why many health professionals feel discontented. The demands of caring for patients within constraints of diminished organisational resources and the fact that a hospital ward can have little freedom to act on their own will often lead to frustration among health professionals 3. Health professionals must often balance between different rationalities. On one hand, they have to be regulated towards the system, where they have to answer to standards, political strategies and economy, and on the other hand, they have to make sure that the interest and personal preferences of the individual are pursued 4. It is almost impossible to regulate a system if focus is only on the individual, but at the same time, the needs of patients and their families will not and cannot be defined by the system 4. It could be argued that the health professionals are advancing to a more democratic society, where patients and their relatives do not accept impositions on their individuality. A study argued that by keeping the system and the individual sphere in conflict, it can result in a higher passivity and dependence on the system, thereby reducing the ability for individual alternative 5.
It has been shown that having adequate time with patients, shorter waiting time and the ability to greater professional autonomy can help provide a higher quality of care 4. Empathy and sympathy appear to be crucial components for the health professionals and their relationship to patients 4. A study on physicians’ empathy showed that stress and well‐being were closely related to the development of empathy 5. A study among hospitalised older adults showed that 47% of older adults required some involvement from relatives, especially the more complex patients 6. The study stated that health professionals must perceive the relatives as being in a partnership and consequently communicate with relatives when they are making major medical decisions 6. A study on family participation in care to ICU patients stated that 33% of family members showed symptoms of anxiety, depression and stress during the admission of a relative and that the symptoms were found up to 3 months after the patients were discharged 7. It was established that 96% of the relatives were very approving to participate in the care of the patient and that a more family‐centred care could optimise a better well‐being for the relatives 7. The interaction between health professionals and relatives has, to our knowledge, not been investigated using a focus group interview with health professionals.
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