Advancing interprofessional theory: deliberative democracy as a participatory research antidote to power differentials in aged care

Peter Nugus, Geetha Ranmuthugala, Joanne Travaglia, David Greenfield, Josianne Lamothe, Anne Hogden, Kendall Kolne, Jeffrey Braithwaite

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Introduction: Interprofessional relations in health care have been examined through the frame of “clinical democracy”. Yet, traditional interpretations of democracy have assumed a zero-sum, competitive interpretation of power, leading to unelaborated invocations for health professionals to “collaborate” more or do “teamwork” better. The aim of this study was to understand the priorities that health professionals from different occupations have for individual patient care, and the opportunities they have to express those priorities, as a foundation for a more expansive democratic theory. Materials and methods: The case setting was a mixed-method, pre-post, participatory research (PR) study examining the dynamics and levels of satisfaction of interprofessional information-sharing and decision-making on an acute aged care unit. Results: Stage 1, pre-intervention, revealed that non-medical health professionals – nursing and, in particular, allied health professionals – lacked opportunities for input into decision-making for patient care. Following deliberative, public feedback of the findings to managers and health professionals, an intervention was negotiated to re-structure the weekly case conference and referral processes. Stage 2, the post-interventional findings showed an increase in perceptions of information-sharing, and participation in case conferences, as well as recognition of power differentials in interprofessional relations. Conclusions: In the public negotiation of increased prominence of particular roles and aligning role clarity with the needs of particular patients, the findings show that the notion of deliberative democracy characterizes the qualitative-cumulative, rather than merely quantitative-redistributive power among health professionals in different occupational roles. As a case of conscientization, deliberation engages practical interprofessional improvement simultaneously as educational empowerment.

LanguageEnglish
Pages100-111
Number of pages12
JournalJournal of Interprofessional Education and Practice
Volume15
DOIs
Publication statusPublished - 1 Jun 2019

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deliberative democracy
health professionals
patient care
international leading power
occupational role
democracy
decision making
interpretation
teamwork
deliberation
empowerment
occupation
nursing
manager
health care
participation

Keywords

  • aged care
  • collaboration
  • conscientization
  • decision-making
  • deliberative democracy
  • Interprofessional collaborative practice
  • interprofessional education
  • participatory research (PR)

Cite this

Nugus, Peter ; Ranmuthugala, Geetha ; Travaglia, Joanne ; Greenfield, David ; Lamothe, Josianne ; Hogden, Anne ; Kolne, Kendall ; Braithwaite, Jeffrey. / Advancing interprofessional theory : deliberative democracy as a participatory research antidote to power differentials in aged care. In: Journal of Interprofessional Education and Practice. 2019 ; Vol. 15. pp. 100-111.
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Advancing interprofessional theory : deliberative democracy as a participatory research antidote to power differentials in aged care. / Nugus, Peter; Ranmuthugala, Geetha; Travaglia, Joanne; Greenfield, David; Lamothe, Josianne; Hogden, Anne; Kolne, Kendall; Braithwaite, Jeffrey.

In: Journal of Interprofessional Education and Practice, Vol. 15, 01.06.2019, p. 100-111.

Research output: Contribution to journalArticleResearchpeer-review

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