Kristy Inouye & Chelsey Gowan

Inflammatory Arthritis Care Teams: Re-examining Notions of Client-Centred Practice

Authors: Kristy Inouye, Chelsey Gowan, Dr. Melinda Suto, & Dr. Laura Nimmon

Introduction. Team approaches are common in inflammatory arthritis (IA) care. Following diagnosis, clients face learning to manage their care in the context of multiple new healthcare relationships. Little is known regarding how different team members providing care to the same newly-diagnosed client negotiate this shared responsibility. This knowledge is required to inform client-centred care, a foundational concept of occupational therapy. Objective. To examine how power is perceived and negotiated amongst IA healthcare teams. Methods. This analysis drew on data from a large-scale three-year ethnographic study that used a sociological power lens to explore how IA client care is negotiated amongst team members. Researchers conducted individual semi-structured interviews with all team members and wrote ethnographic field notes. Data were drawn from two men with IA and their care teams, including healthcare professionals and one family member. Researchers used thematic analysis to identify patterns of relationships in the data to illuminate insights into our research question. Results. Our analysis highlighted opportunities and challenges in team communication, and subsequent impacts on client care. An overarching analytic lens of knowledge as power framed two main themes revealing how teams negotiate power by 1) seeking and sharing information and 2) striving to coordinate unified care. Conclusions. Preliminary findings emphasize the importance of team communication dynamics beyond the dyadic relationship of client and care provider. We suggest that communication and power negotiation can be improved through interprofessional educational initiatives.