Boundary work in task-shifting practices – a qualitative study of reablement teams

Figures & data

Table 1. Participants’ occupational experience

PTs	Experience	HTs	Experience
1	<5 years as a PT, 6 months in reablement	1	5-10 years as health care assistant, 5 years in reablement
2	>10 years as a PT, 2 years in reablement	2	5-10 years as health care assistant, 2 years in reablement
3	>10 years as a PT, 2 years in reablement	3	>10 years as health care assistant, 1 year in reablement
4	<5 years as a PT, 1 year in reablement	4	>10 years as health care assistant, 2 years in reablement
5	>10 years as a PT, 2 year in reablement	5	>10 years as health care assistant, 2 years in reablement
6	5-10 years as a PT, 3 years in reablement	6	5-10 years as health care assistant, 2 years in reablement
7	>10 years as a PT, one year in reablement	7	<5 years as health care assistant, one year in reablement

Table 2. Examples of the analysis process – from raw data to main themes.

Meaningful quote	“I cannot imagine that we [the PTs] should not participate [in the reablement teams]. It may sound egocentric, but I think our competence regarding body functions and how we observe and assess such functions is crucial to the [team’s] success. Almost every one of the care recipients has some physical or functional problems, for example, impaired walking or reduced balance (…). We [the PTs] are specialists in such impairments, and, thus, we are perhaps the experts in the system. (…) In my opinion, the PTs are a substantial gear in the machinery”	“Generally, two of us attend the first visit. We do it like that because it is important to obtain a wide overview. My favorite way of doing it is to visit the care recipient together with an HT. The first encounter with the recipient is important for the HT; the things that I am saying, what I am emphasizing. In addition, I see how the HT relates to the recipient. Thus, on the first visit, I get quite a holistic view. So, working together is the ideal situation”
Code	“The physiotherapists are the experts”	“We work together to obtain a wide and holistic view”
Code group	Hierarchical team organization	Flat team organization
Subtheme	Hierarchical division of roles	Working together for a holistic approach
Theme	The engine and the assistant -boundary making	The symbiotic team -boundary blurring

Table 3. Analytical development of the themes

Code groups	Subthemes	Themes
Hierarchical team organization	Hierarchical division of roles	The engine and the assistant-boundary making
Asymmetric responsibilities	Claiming the rights of tasks and responsibility
Unequal recognition	‘Reablement physiotherapy’ vs traditional physiotherapy
What is physiotherapy?	Task shifting as a potential conflict
Conflicts and tension
Flat team organization	Working together for a holistic approach	The symbiotic team-boundary blurring
	Continuous and mutual learning
Professional learning	Autonomous and empowered team members