A qualitative study of interprofessional collaborative practice in community based dementia care in Scotland and Japan – the nurse perspective
Japan has experienced an unprecedented growth in its numbers of elderly, and is now has to deal with the increasing problem of dementia care. Furthermore, the number of people diagnosed with dementia is increasing worldwide including in many European countries that are regarded as developed countries in dementia care. Particularly, Scotland with a similar increasing dementia demographic as Japan it is at the forefront in community based dementia care.
People living with dementia require diverse care as their symptoms worsen, therefore, interprofessional collaborative practice (IPCP) becomes essential in dementia care. The nurse is often perceived as the significant profession in dementia care teams because of their involvement at various stages.
In this study, we aim to identify the features of IPCP implemented in community based dementia care in Scotland and Japan.
This was a qualitative study which interviewed key stakeholders in dementia care in Scotland and Japan, including nurses. Participants were recruited through convenience purposive sampling within community based dementia care. Interviews included the following questions “Can you explain about the team you work in and different professions involved in caring for people living with dementia?” “Is there any professions you would like to see involved?” The transcriptions ware analysed using the qualitative data analysis method, “Steps for Coding And Theorization” (SCAT). This study was approved by the Ethics Committee of Nagoya University School of Medicine and Ethics Review Committee of each collaborative research facility.
From the analysis differences between the processes for community based dementia care emerged both countries had a degree of collaborative practice but each had elements that were not ideal. In Scotland, the situation could at times have duplication of resources that could be considered to be a problem, however in some areas the care for patients by each profession became more mature and was carried out with “clear-boundary collaboration”. In Japan, there was no connection among healthcare professions and this was considered to be a problem which could be solved by strengthening their teamwork. The paradigm for collaborative practice in Japan was “vague-boundary collaboration”.
One reason for the differences was that the Scottish are developing an integrated health and social care system based on collaborative practice which encourages pragmatism in care while the Japanese focus on the emotional side. By identifying the differences between the two countries, and analysing patient care needs in dementia care, interprofessional collaboration was considered to be the most appropriate method for care in each country. Included in the research was the sharing of knowledge on the socio-cultural and health care backgrounds of both countries. It is hoped that the comparison of two diverse countries approach to community based dementia care can inform the development of quality dementia care worldwide.