Interprofessional Teamwork and Competence in Palliative Care

Health and social care professionals’ competence is strongly linked to the quality of care the patient receives. Meeting patients and their family members’ individual needs, as well as maintaining quality of life despite an incurable illness, requires teamwork and interprofessional competence among different health and social care professionals. Interprofessional teamwork and required interprofessional competencies have not been described in the context of specialised palliative care. This two-phase study’s purpose was to describe interprofessional teamwork and required interprofessional competencies in specialised palliative care. Additionally, the interprofessional competence of health and social care professionals working in specialised palliative care was assessed. In the first (theoretical) phase, an integrative literature review (n = 14) was conducted to describe interprofessional teamwork and required interprofessional competencies for health and social care professionals working in specialised palliative care. To gain a more comprehensive understanding, the data were complemented with semi-structured interviews with patients (n = 20), family members (n = 19) and health and social care professionals (n = 50) from specialised palliative care units. The data were analysed using content analysis. In the second (evaluation) phase, health and social care professionals (n = 153) working in specialised palliative hospital care assessed their interprofessional competence using two self-assessment instruments: the Interprofessional Education Collaborative (IPEC)® competency self-assessment instrument and the Interprofessional Competence in Palliative care (ICOPA). The data were analysed using descriptive statistical methods and nonparametric statistical tests. The study’s theoretical phase demonstrated that interprofessional teamwork and the competencies required for it in specialised palliative care include elements from generic interprofessional frameworks, but palliative care’s context influences both teamwork and the competencies required within it. Ethical perspectives, such as respectful interaction, were emphasised in the collaboration between patients, family members and professionals. However, patients and their families did not recognise the care as being delivered through an interprofessional approach. The patient’s declining condition affected both the interprofessional care provided and the number of professionals involved on the interprofessional team. In the evaluation phase, health and social care professionals working in specialised palliative hospital care assessed themselves as capable of providing interprofessional care well. They assessed their competencies as the highest in values and ethics, interprofessional patient care and palliative care-specific interprofessional competence. Competence was found to be associated with the professionals’ education level, participation in interprofessional education and work experience in their profession (palliative care and in their current unit). Furthermore, an association was found between competence and the professionals’ perceptions of teamwork frequency and functionality. Palliative care’s context influences interprofessional teamwork among health and social care professionals, as well as competence requirements for these professionals. They are expected to have competence in their own profession, in palliative care and in interprofessional teamwork. Assessing interprofessional competence is important to ensure care quality for patients receiving palliative care and their family members, as well as to support development of professionals’ interprofessional competence and teamwork in palliative care. In the future, interventions should be developed to strengthen health and social care professionals’ interprofessional competence. In addition, an objective instrument is needed to assess interprofessional competence that could be used alongside subjective self-assessment instruments.