“We have two different agendas”: the views of general practitioners, social workers and hospital staff on interprofessional coordination for patients with chronic widespread pain

ABSTRACT

Patients with chronic widespread pain (CWP) are often unfit for work and go through lengthy treatment. In Denmark, this includes contacts with the job center in their municipality, their general practitioner (GP) and one or more hospital units. Little is known about how coordination around patients with CWP functions and is perceived by professionals. Therefore, our aim is to explore how GPs, social workers from municipality job centers and hospital staff experience interprofessional coordination for patients with CWP. Interviews with 7 GPs, 12 social workers, and 10 hospital staff were analyzed using interpretative phenomenological analysis. The participants experienced challenges with coordination, primarily in the relations between social workers and GPs. There was an over-reliance on written communication in situations where the actors had divergent agendas, opposing professional roles and conflicting approaches to time. GPs tended to lengthen the time spans for treating patients, while social workers tried to shorten them so that patients could get back to work. Applying the theory of relational coordination (RC), the findings correspond to a low level of RC, indicating a need for shared accountability, and strengthened interpersonal communication between professionals.

Abbreviations: CWP: Chronic widespread pain; GPs: General practitioners; RC: Relational coordination; IPA: Interpretative phenomenological analysis.

KEYWORDS:

• Interviews
• interprofessional research
• co-ordination
• communication
• health and social care

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

The study is funded by the Intersectoral Fund for Health Service Research in the Capital Region of Denmark; The Health Foundation (grant number 17-B-0035); The Danish Rheumatism Association (grant number R150-A4431); and The Research Council for the Practice Sector in the Capital Region of Denmark.

Notes on contributors

Rikke Schultz

Rikke Schultz is a clinical psychologist, PhD, affiliated to the Research Unit for General Practice, University of Copenhagen. Her clinical practice and her research focus mainly on patients with chronic widespread pain or functional disorders, and the experiences of treatment and the inter-professional coordination and collaboration between general practice, hospitals and municipalities concerning this group of patients.

Marius Brostrøm Kousgaard

Marius Brostrøm Kousgaard is a senior researcher at the Research Unit for General Practice at the University of Copenhagen. He holds a master degree in political science and a PhD in management technology. His research is concerned with analyzing the mechanisms and consequences of organizational change processes in health care, particularly in relation to the implementation of complex interventions in primary care.

Annette Sofie Davidsen

Annette Sofie Davidsen, MD, PhD, DMSc, is an associate professor at the Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark. Her main research area is the treatment of common mental disorders in general practice, the gap between general practice and psychiatry and collaborative care between the sectors. The research is mainly qualitative, using both phenomenological and linguistic methods. Moreover, she is interested in theoretical and conceptual aspects in relation to mental disorder and in qualitative method development.