Perspectives of Healthcare Professionals Toward Interprofessional Collaboration in Primary Care Settings in a Middle Eastern Country

Figures & data

Table 1 Sociodemographic and Professional Characteristics of Healthcare Professionals Practicing in Primary Healthcare Centers in Qatar (n=1415)

Characteristics	Frequency (%)	Missing (n, %)
Gender*		10 (0.8)
Female	904 (63.8)
Male	501 (35.4)
Age in years*		9 (0.6)
18–24	7 (0.5)
25–33	627 (44.3)
34–44	544 (38.4)
45–54	182 (12.9)
55–65	43 (3.0)
Older than 65	3 (0.2)
Healthcare professional category*		14 (1)
Nurses	687 (48.6)
Pharmacists	187 (13.2)
Physicians	167 (11.8)
Medical laboratory technologists	140 (9.9)
Radiological technologists	88 (6.2)
Dentists	50 (3.5)
Dental assistant	37 (2.6)
Physiotherapist	12 (0.8)
Dietician	6 (0.4)
Others	27 (1.9)
Years of experience*		16 (1.1)
Less than 1	19 (1.3)
1–5	244 (17.2)
6–10	508 (35.9)
11–15	301 (21.3)
16–20	191 (13.5)
More than 20	136 (9.6)
Country of origin*		17 (1.2)
Egypt	175 (12.4)
India	361 (25.5)
Jordan	103 (7.3)
Palestine	42 (3.0)
Philippines	428 (30.2)
Sudan	92 (6.5)
Qatar	30 (2.1)
Others	167 (11.8)
Country of their first professional degree*		16 (1.1)
Philippines	425 (30.0)
India	368 (26.0)
Egypt	191 (13.5)
Sudan	63 (4.5)
Jordan	109 (7.7)
Qatar	51 (3.6)
Palestine	5 (0.4)
Others	187 (13.2)
Years of practice in PHCC in Qatar*		11 (0.8)
Less than 1	115 (8.1)
1–5	718 (50.7)
6–10	211 (14.9)
11–15	220 (15.5)
16–20	86 (6.1)
More than 20	54 (3.8)
Years since graduation with a professional degree*		19 (1.3)
Less than 1	1 (0.1)
1–5	122 (8.6)
6–10	514 (36.3)
11–15	320 (22.6)
16–20	237 (16.7)
More than 20	202 (14.3)

Note: *Some missing data.

Table 2 Experience About Interprofessional Education and Collaborative Practice Among Healthcare Professionals in All Primary Health Centers in Qatar (N= 1415)

Items	Frequency (%)
How often do you interact with other healthcare professional? (n=1329)
Not at all	6 (0.5%)
Somewhat	137 (10.3%)
Quiet a lot	175 (13.2%)
Regularly	1011 (76%)
How often do you collaborate with other healthcare professional? (n=1323)
Not at all	14 (1.1%)
Somewhat	190 (14.4%)
Quiet a lot	272 (20.56%)
Regularly	847 (64.02%)
Indicate the healthcare professionals you interact with? ^† (n=1323)
Physician	1164 (88%)
Nurse	1121 (85%)
Pharmacist	934 (71%)
Others	379 (29%)
Physiotherapist	99 (7.5%)
Indicate the healthcare professionals you collaborate with? ^†(n=1323)
Physician	1165 (89%)
Nurse	1096 (84%)
Pharmacist	876 (67%)
Others	222 (17%)
Physiotherapist	97 (7.4%)
Have you participated in any interprofessional education activities? (n=1315)
Yes	1062 (81%)
No	253 (19%)
Have you had any experience of collaborative practice? (n=1290)
Yes	771 (60%)
No	519 (40%)

Note: ^†This question was a “multiple options response” type.

Table 3 Readiness for Interprofessional Learning Among Healthcare Professionals in All Primary Health Centers in Qatar

	Strongly Disagree	Disagree	Undecided	Agree	Strongly Agree
Sub-scale 1: Teamwork and collaboration
Learning and working with other healthcare professionals will help me be a more effective member of a healthcare team (n = 1283)	12 (0.94)	6 (0.47)	9 (0.70)	541 (42.17)	715 (55.73)
For small group learning, to be effective, healthcare professionals need to trust and respect each other (n = 1282)	11 (0.86)	3 (0.23)	15 (1.17)	483 (37.68)	770 (60.06)
Team-working skills are essential for all healthcare professionals to learn (n = 1283)	11 (0.86)	4 (0.31)	13 (1.01)	404 (31.49)	851 (66.33)
Interprofessional learning will help me understand my own limitations (n = 1282)	10 (0.78)	3 (0.23)	29 (2.26)	573 (44.70)	667 (52.03)
Patients ultimately benefit if healthcare professionals work together to solve their problems (n = 1280)	10 (0.78)	5 (0.39)	12 (0.94)	460 (35.94)	793 (61.95)
Learning with other healthcare professionals will increase my ability to understand clinical problems (n = 1280)	10 (0.78)	3 (0.23)	17 (1.33)	494 (38.59)	756 (59.06)
Learning with healthcare students from other disciplines before qualification would improve relationships after qualification (n = 1280)	14 (1.09)	13 (1.02)	88 (6.88)	604 (47.19)	561 (43.83)
Communication skills should be learned with other healthcare professionals (n = 1281)	15 (1.17)	15 (1.17)	49 (3.83)	570 (44.50)	632 (49.34)
Interprofessional learning will help me to think positively about other healthcare professionals (n = 1282)	16 (1.25)	2 (0.16)	20 (1.56)	619 (48.28)	625 (48.75)
Interprofessional learning with other healthcare professionals will help me to communicate better with patients and other professionals (n = 1285)	11 (0.86)	8 (0.62)	21 (1.63)	595 (46.30)	650 (50.58)
I would welcome the opportunity to work on small-group projects with other healthcare professionals (n = 1283)	12 (0.94)	4 (0.31)	52 (4.05)	616 (48.01)	599 (46.69)
Interprofessional learning helps to clarify the nature of patient problems (n = 1280)	13 (1.02)	10 (0.78)	28 (2.19)	596 (46.56)	633 (49.45)
Interprofessional learning before qualification would help healthcare professionals become better team workers (n = 1277)	16 (1.25)	9 (0.70)	59 (4.62)	577 (45.18)	616 (48.24)
Sub-scale 2: Sense of professional identity
Clinical problem-solving skills should only be learned with professionals from my own discipline (n = 1278)	103 (8.06)	440 (34.43)	140 (10.95)	453 (35.45)	142 (11.11)
The function of other healthcare professionals is mainly to provide support for doctors (n = 1282)	150 (11.70)	466 (36.35)	139 (10.84)	391 (30.50)	136 (10.61)
There is little overlap between my role and that of other healthcare professionals (n = 1275)	81 (6.35)	377 (29.57)	225 (17.65)	485 (38.04)	107 (8.39)
I would feel uncomfortable if another healthcare professional knew more about a topic than I did (n = 1283)	237 (18.47)	568 (44.27)	104 (8.11)	289 (22.53)	85 (6.63)
I have to acquire much more knowledge and skills than other healthcare professionals (n = 1270)	86 (6.77)	349 (27.48)	235 (18.50)	469 (36.93)	131 (10.31)
Sub-scale 3: Patient centeredness
I like to understand the patient’s side of the problem (n = 1284)	11 (0.86)	7 (0.55)	19 (1.48)	657 (51.17)	590 (45.95)
I like to understand the patient’s side of the problem (n = 1287)	13 (1.01)	7 (0.54)	15 (1.17)	460 (35.74)	792 (61.54)
I try to communicate compassion to my patients (n = 1287)	11 (0.85)	9 (0.70)	27 (2.10)	546 (42.42)	694 (53.92)
Thinking about the patient as a person is important in getting treatment right (n = 1288)	13 (1.01)	8 (0.62)	21 (1.63)	473 (36.72)	773 (60.02)
In my profession, one needs skills in interacting and cooperating with patients (n = 1286)	12 (0.93)	5 (0.39)	30 (2.33)	515 (40.05)	724 (56.30)

Table 4 Statistical Differences in Interprofessional Learning Scores Between Demographic Groups

Subscales	Scale 1- Teamwork and Collaboration	P Value*	Scale 2- Sense of Professional Identity	P Value*	Scale 3- Patient Centeredness	P Value*	Total RIPLS Score	P Value*
Gender	(Mean ± SD)
Female	58.5 ± 8	(<0.001)	15.4 ± 5	(0.64)	22.5 ± 3	(0.07)	96.3 ± 11	(0.05)
Male	58.5 ± 5		14.6 ± 5		22.5 ± 3		96.9 ± 9
Age
18–33	58.8 ± 8	(0.23)	15.7 ± 5	(0.64)	22.3 ± 3	(0.18)	95.1 ±11	(0.02)
34 and more	58.3 ± 6		15.3 ± 5		22.6 ± 3		96.2 ± 9
Profession^ⱡ
Nurses	57.8 ± 8		15.0 ± 5		22.4 ± 3		95.2 ± 11
Pharmacists	58.1 ± 5		15.1 ± 5		22.2 ± 3		95.3 ± 9
Physicians	58.1 ± 6	(0.38)	16.1 ± 5	(0.05)	23.0 ± 3	(0.31)	97.2 ± 10	(0.15)
Lab technicians	57.9 ± 6		15.5 ± 5		22.3 ± 2		95.5 ± 9
Others	59.1 ± 6		15.2 ± 5		22.5 ± 2		97.0 ± 9
Experience
1–5	58.1 ± 8	(0.001)	14.8 ± 5	(0.84)	22.4 ± 3	(0.27)	95.3 ± 11	(0.16)
6 and more	58.1 ± 6		15.2 ± 5		22.5 ± 3		96.1 ± 10
Country of first degree^ⱡ
Philippines	59.4 ± 6		16.1 ± 4		23.5 ± 2		98.2 ± 10
India	57.1 ± 9	(<0.001)	15.0 ± 5	(<0.001)	22.6 ± 3	(0.3)	95. 5 ± 12	(<0.001)
Egypt	58.3 ± 6		14.2 ± 5		22.5 ± 3		95.1 ± 9
Others	57.4 ± 6		15.0 ± 4		22.2 ± 3		94.3 ± 9
Participation in IPE
Yes	58.5 ± 7	(0.80)	15.3 ± 5	(0.58)	23.1 ± 3	(0.83)	96.5 ± 10	(0.85)
No	56.2 ± 7		14.5 ± 4		22.5 ± 3		92.5 ± 10
Experience of IPC
Yes	59.1 ± 7	(0.83)	15.3 ± 5	(0.007)	23.5 ± 3	(0.50)	97.1 ± 10	(0.97)
No	57.1 ± 6		15.3 ± 4		22.1 ± 3		94.0 ± 10

Notes: *P values were calculated using Student’s t-test; ^ⱡP values were calculated using ANOVA test.

Table 5 Themes and Key Issues Identified from the Content Analysis of the Three Open-Ended Questions

Themes	Key Issues Identified	Illustrative Quote
Description of IPC experiences	Workshops, programs, projects, continuous professional development, orientation, Cerner (electronic health record system) development (n= 183).	Quote 100: “I attended professional development program in 2016 which provided me an opportunity to interact with other health professionals to understand their different aspects. This improved teamwork and thus motivating others to work for one goal that is patient safety culture”.
	Daily work and in treatment rooms (n= 113).	Quote 1: “I had experienced the importance of collaborative practice while managing emergency cases. The physicians with nurses, code blue team, EMS, laboratory and pharmacy collaborate to manage an emergency case”.
Impact of IPC on practice	Benefits of IPC (improves the quality of work and performance, enhance knowledge, reaching more achievable goals for patient-centered care, patient safety, reduces errors) (n= 126).	Quote 113: “Firstly common interest of patient care and organizational practice. Secondly update the knowledge. Thirdly, clarify the doubts for patient safety (e.g.: medication, dose, treatment for wounds, new technology etc.) and finally.it will help achieve smooth and effective health care system”.
Facilitators to collaborative practice	Teamwork and communication (n= 77).	Quote 275: “Mutual respect, teamwork culture, environment and practice, perceptions of collaborative relationships”.
	Quality improvement projects, workshops (n= 41).	Quote 27: “Enhancing practice with professions through regular simulation cases and meetings held in center”.
	Respect (n= 29).	Quote 52: “Respecting contribution of other health professions”.
	Leadership and institutional support (n= 33).	Quote 330: “Full support from management”.
Barriers to collaborative practice	Time (n= 21).	Quote 31: “Time commitment because of different shift and busy schedule sometimes healthcare professionals were not able to collaborate well with some given situations”.
	Workload issues (increase in the number of patients, high workload, shortage of staffs and time) (n= 163).	Quote 18: “Lack of supplies and venues”. Quote 80: “Time constrains, volume of work”.
	Communication (language, culture, active listening and conflict of ideas) (n= 91).	Quote 7: “Lack of communication, self-centred.”
	Resources (leadership support, administrative support, financial aid/cost, reimbursement and system) (n= 68).	Quote 449: “Resources needed, leadership and administrative support”.
	Personal factor (beliefs, behavior, respect, interest, knowledge, understanding of roles and responsibilities, trust, tiredness, commitment and satisfaction) (n= 47).	Quote 278: “In my opinion, the barriers that I encounter is limited understanding of healthcare professionals roles and responsibilities. This is important for effective collaborative practice.„
	Resistance (attitude of patients/HCPs, confidentiality) (n= 22).	Quote 449: “Resistance by healthcare professionals for the collaborative practice”.
	Relationship, hierarchy, no cooperation, superiority/ego (n= 15).	Quote: 194: “Resistance, no interest, irresponsible behaviour”. Quote 288: “Miscommunication, unconfident, hierarchy, less experiences and knowledge, high self-esteem, ambiguous roles”.