Exploring the readiness of senior doctors and nurses to assess and address patients' social needs in the hospital setting.

Australia Grounded Theory Healthcare Workers In-depth Interviews Social Determinants of Health Social Needs

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
24 Feb 2022
Historique:
received: 13 10 2021
accepted: 14 02 2022
entrez: 24 2 2022
pubmed: 25 2 2022
medline: 26 2 2022
Statut: epublish

Résumé

Adverse social circumstances are a key factor in health outcomes. Hospitals are an opportune setting for assessing and addressing the unmet social needs of patients, however, the readiness of healthcare workers in hospitals to undertake such tasks requires further exploration in the Australian context. This study aimed to generate a theory of doctors' and nurses' readiness to assess and address patients' social needs in a hospital setting. A constructivist grounded theory methodology was applied, with purposive and theoretical sampling used to gather diverse perspectives of readiness during semi-structured interviews with twenty senior doctors and nurses from a variety of clinical specialties working in hospitals serving communities experiencing inequitable social and health outcomes. Line-by-line coding, memo writing, and diagramming were used in analysis to construct an interpretive theory of readiness. Application of constant comparison analytic processes were used to test the robustness of the theory. The readiness of doctors and nurses varies across individuals and departments, and is founded upon a state of being comfortable and confident to assess social need as determined by a range of personal attributes (e.g. knowledge of social need; skills to assess social need); a state of being willing and prepared to assess and address social need facilitated by supportive environments (e.g. departmental culture); and enabling characteristics of the clinical encounter (e.g. time, rapport). We found that the readiness of doctors and nurses is dynamic and impacted by a complex interplay of personal attributes along with contextual and situational factors. These findings indicate that any efforts to strengthen the readiness of doctors and nurses to assess and address social needs must target personal capabilities in addition to characteristics of the working environment.

Sections du résumé

BACKGROUND BACKGROUND
Adverse social circumstances are a key factor in health outcomes. Hospitals are an opportune setting for assessing and addressing the unmet social needs of patients, however, the readiness of healthcare workers in hospitals to undertake such tasks requires further exploration in the Australian context. This study aimed to generate a theory of doctors' and nurses' readiness to assess and address patients' social needs in a hospital setting.
METHODS METHODS
A constructivist grounded theory methodology was applied, with purposive and theoretical sampling used to gather diverse perspectives of readiness during semi-structured interviews with twenty senior doctors and nurses from a variety of clinical specialties working in hospitals serving communities experiencing inequitable social and health outcomes. Line-by-line coding, memo writing, and diagramming were used in analysis to construct an interpretive theory of readiness. Application of constant comparison analytic processes were used to test the robustness of the theory.
RESULTS RESULTS
The readiness of doctors and nurses varies across individuals and departments, and is founded upon a state of being comfortable and confident to assess social need as determined by a range of personal attributes (e.g. knowledge of social need; skills to assess social need); a state of being willing and prepared to assess and address social need facilitated by supportive environments (e.g. departmental culture); and enabling characteristics of the clinical encounter (e.g. time, rapport).
CONCLUSIONS CONCLUSIONS
We found that the readiness of doctors and nurses is dynamic and impacted by a complex interplay of personal attributes along with contextual and situational factors. These findings indicate that any efforts to strengthen the readiness of doctors and nurses to assess and address social needs must target personal capabilities in addition to characteristics of the working environment.

Identifiants

pubmed: 35197049
doi: 10.1186/s12913-022-07642-x
pii: 10.1186/s12913-022-07642-x
pmc: PMC8867718
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

246

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© 2022. The Author(s).

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Auteurs

Katherine J Lake (KJ)

School of Public Health, The University of Adelaide, Adelaide, South, 5005, Australia.

Mark A Boyd (MA)

Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, 5005, Australia. mark.boyd@adelaide.edu.au.
Northern Adelaide Local Health Network, Adelaide, South Australia, 5000, Australia. mark.boyd@adelaide.edu.au.

Lisa Smithers (L)

School of Public Health, The University of Adelaide, Adelaide, South, 5005, Australia.
School of Health and Society, The University of Wollongong, Wollongong, New South Wales, 2522, Australia.

Natasha J Howard (NJ)

Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, 5005, Australia.
Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South, 5000, Australia.

Anna P Dawson (AP)

Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, 5005, Australia.
Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South, 5000, Australia.

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Classifications MeSH