Nigerian healthcare workers’ perception of transdisciplinary approach to older adults’ care: A qualitative case study

Abstract

Introduction There is a growing interest in collaborative care for older adults in Nigeria; however, little is known about the application of a transdisciplinary approach to care in a typical Nigerian geriatric unit. Therefore, we described healthcare professionals’ (HCPs’) perception of a transdisciplinary approach to older adults’ care in Southern Nigeria. Methods Using Stakian’s approach to a qualitative case study, we purposively invited 16 HCPs working in the geriatric unit of a teaching hospital in Nigeria to a single, in-depth, semi-structured interview. We analysed data using Stakian’s approach of categorical aggregation and direct interpretation. Results Our participants identified five-key features of a transdisciplinary approach to care: consolidated consultation, consolidated care documentation, care files accessibility, shared care decision and a designated care manager. HCPs stated that transdisciplinary approach to care allowed for a consolidated consultation of patients, with all the HCPs (in the same room or via telehealth/telemedicine) and care decisions should be shared between all stakeholders and documented in an accessible unified electronic care document that is managed by a care manager. Factors ranging from lack of consensus on time for a consolidation consultation to inter-professional conflicts were perceived as possible hindrances to a transdisciplinary approach to older adults’ care. Discussion The features of transdisciplinary care described in this study partly aligned with the WHO’s integrated care for older people (ICOPE). Additional components not captured in ICOPE were found. While the description of transdisciplinary was from the perceptive of our study participant, caution should be applied when interpreting these findings.

Healthcare Teams: Terminology, Confusion, and Ramifications

“…CDTs are defined as teams of professionals who collaborate and have an advanced understanding of other members’ roles but maintain discipline boundaries. 25 This definition matches some of the characteristics associated with IDTs and IPTs, which are frequently described to include members with different professional perspectives who work in a patient-centered, interdependent, and collaborative manner to share knowledge and decision-making, develop shared plans, and achieve common goals. 6 , 7 , 12 , 18 , 20–22 , 28 Importantly, patient-centered care occurs when healthcare professional/s partner with the patient (or their representative) and integrate patient preferences, needs, experiences, and goals into every phase of care.…”

“…17 The latter characteristic aligns with intradisciplinary or intraprofessional teams, which involve professionals interacting within their own discipline. 14 , 25 …”

“…Transdisciplinary teams (TDTs), synonymous with transprofessional or supra-disciplinary teams, 12 , 22 are consistently described as skill-sharing or multi-skilling models where professionals from multiple disciplines blur and transcend traditional professional boundaries by exchanging knowledge and skills, blending perspectives, sharing decision-making, and integrating elements of assessment, treatment, and goal setting. 6 , 7 , 11 , 12 , 17 , 18 , 22 , 25 Blurred professional boundaries means that team roles are re-designed, cross-training is required, and one health professional can take on the traditional role of another health professional by agreement. 12 , 14 , 17 , 20 TDTs describe a streamlined approach to healthcare delivery, rather than replacement of professionals and their expertise.…”

“… 6 , 7 , 11 , 12 , 18 However, agreement within the literature regarding training and leadership in TDTs is not as unified with few authors indicating that training staff across numerous skills is essential for TDTs, 12 , 20 and that a leader should be appointed to oversee team discussion and care. 7 , 25 …”

Care coordination during and beyond the coronavirus: Learning together and faster to strengthen health systems

“…As such an approach is currently in its infant state, a lot can be learned from the perceptions of healthcare professionals as presented in this case study. 9 In their paper on the attitudes and perspectives of physicians regarding the uptake of psychosocial aspects and/or patient preference during multidisciplinary team meetings in oncology, Baes et al. point out how such team meetings can be optimised.…”