The ‘Narcissistic-We’ model: A conceptual framework for multidisciplinary team working, researching and decision-making with traumatised individuals

The objective is to explore how clinical decisions are made in a cancer multidisciplinary team meeting (MDM). The study design is qualitative based on participant observation, in depth interviews, and questionnaires. The research setting was weekly cancer MDM which provides a forum for clinical debate for practitioners in the field of women's health, working within one Cancer Network in England. The participants were 53 practitioners attending a weekly MDM over a 4-month period. Analysis of nonparticipant observation data and practitioner interview narratives identified key influences on the work of the MDM, and in particular decision-making. The research identified three major influences on the conduct of the MDM. First, MDM discussions are dominated by those with surgical, medical, or diagnostic expertise with limited contributions from those with a nursing, palliative, or psychosocial background. Second, decision-making is shaped by an overriding need to comply with policy initiatives concerning the organization of diagnosis and treatment. The third influence is whether the patient is known or unknown to some degree by members of the MDM. Where there is preexisting knowledge of the patient, the discussion and decision is inclusive of a wider range of disciplines. Team working in these circumstances is an acknowledged source of satisfaction and motivation. Where the patient is not known, discussion concerns only the physical details necessary to make a diagnosis and contributions from the wider team (including those with knowledge of psychosocial care) are rare. Practitioners' sphere of expertise, Department of Health policy, and familiarity of the team with the patient are key factors in shaping decision-making in MDMs.

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Multidisciplinary Team Working: From Theory to Practice: Discussion Paper

PsycEXTRA Dataset ◽

10.1037/e657312010-001 ◽

2006 ◽

Cited By ~ 5

Keyword(s):

Multidisciplinary Team ◽

Discussion Paper ◽

Team Working ◽

Theory To Practice

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Using a multidisciplinary approach to reveal decision-making capacity within acute care for an individual with aphasia

SAGE Open Medical Case Reports ◽

10.1177/2050313x211027098 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110270

Author(s):

Ruth Maxwell ◽

Michelle O’Brien ◽

Deirdre O’Donnell ◽

Lauren Christophers ◽

Thilo Kroll

Keyword(s):

Decision Making ◽

Multidisciplinary Team ◽

Team Approach ◽

Term Care ◽

Multidisciplinary Team Approach ◽

Decision Making Capacity ◽

Health And Social Care ◽

Functional Assessments ◽

Health Nursing ◽

Communication Approach

Formal assessments of cognition that rely on language may conceal the non-linguistic cognitive function of people with aphasia. This may have detrimental consequences for how people with aphasia are supported to reveal communicative and decision-making competence. This case report demonstrates a multidisciplinary team approach to supporting the health and social care decision-making of people with aphasia. The case is a 67-year-old woman with Wernicke’s type aphasia. As the issue of long-term care arose, the speech and language therapist used a supported communication approach with the patient who expressed her wish to go home. A multidisciplinary team functional assessment of capacity was undertaken which involved functional assessments and observations of everyday tasks by allied health, nursing, catering and medical staff. In this way, the patient’s decision-making capacity was revealed and she was discharged home. A collaborative multidisciplinary team approach using supported communication and functional capacity assessments may be essential for scaffolding the decision-making capacity of people with aphasia.

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Medical and Nonmedical Information during Multidisciplinary Team Meetings in Cancer Care

Current Oncology ◽

10.3390/curroncol28010098 ◽

2021 ◽

Vol 28 (1) ◽

pp. 1008-1016

Author(s):

Jessica Wihl ◽

Linn Rosell ◽

Tobias Carlsson ◽

Sara Kinhult ◽

Gert Lindell ◽

...

Keyword(s):

Decision Making ◽

Multidisciplinary Team ◽

Cancer Care ◽

Family Relations ◽

Patient Characteristics ◽

Psychological Status ◽

Treatment Preferences ◽

Case Discussions ◽

Case Presentations ◽

Data Elements

Background: Multidisciplinary team (MDT) meetings provide treatment recommendations based on available information and collective decision-making in teams with complementary professions, disciplines and skills. We aimed to map ancillary medical and nonmedical patient information during case presentations and case discussions in MDT meetings in cancer care. Methods: Through a nonparticipant, observational approach, we mapped verbal information on medical, nonmedical and patient-related characteristics and classified these based on content. Data were collected from 336 case discussions in three MDTs for neuro-oncology, sarcoma and hepato-biliary cancer. Results: Information on physical status was presented in 48.2% of the case discussions, psychological status in 8.9% and comorbidity in 48.5% of the cases. Nonmedical factors, such as family relations, occupation, country of origin and abode were referred to in 3.6–7.7% of the cases, and patient preferences were reported in 4.2%. Conclusions: Provision of information on comorbidities in half of the cases and on patient characteristics and treatment preferences in <10% of case discussions suggest a need to define data elements and develop reporting standards to support robust MDT decision-making.

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17 Interprofessional mentoring: the key towards a better multidisciplinary team working model?

10.1136/leader-2020-fmlm.17 ◽

2020 ◽

Author(s):

Baguiasri Mandane ◽

Shivanee Nakum ◽

Jagraj Thandi ◽

Jekaterina Jasina

Keyword(s):

Multidisciplinary Team ◽

Working Model ◽

Team Working

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Structured decision making as a conceptual framework to identify thresholds for conservation and management

Ecological Applications ◽

10.1890/08-0255.1 ◽

2009 ◽

Vol 19 (5) ◽

pp. 1079-1090 ◽

Cited By ~ 168

Author(s):

Julien Martin ◽

Michael C. Runge ◽

James D. Nichols ◽

Bruce C. Lubow ◽

William L. Kendall

Keyword(s):

Decision Making ◽

Conceptual Framework ◽

Structured Decision Making ◽

Conservation And Management

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Collective decision-making and fission-fusion dynamics: a conceptual framework

Oikos ◽

10.1111/j.1600-0706.2011.19685.x ◽

2011 ◽

Vol 120 (11) ◽

pp. 1608-1617 ◽

Cited By ~ 108

Author(s):

Cédric Sueur ◽

Andrew J. King ◽

Larissa Conradt ◽

Gerald Kerth ◽

David Lusseau ◽

...

Keyword(s):

Decision Making ◽

Conceptual Framework ◽

Collective Decision ◽

Collective Decision Making

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A conceptual framework for wisdom-based decision-making process in audit profession

Library Hi Tech ◽

10.1108/lht-10-2020-0256 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Hoang To Loan Nguyen

Keyword(s):

Decision Making ◽

Grounded Theory ◽

Conceptual Framework ◽

Research Process ◽

Decision Making Process ◽

Ethical Orientation ◽

Content Type ◽

External Auditors ◽

Wise Decision ◽

Knowledge Assimilation

PurposeWisdom is considered as crucial in decision-making in both management and auditing practice. This research aims to investigate the concept of wisdom in auditing, thereby empirically exploring the determinants of wisdom in audit decision-making and explaining inter-relations among these determinants.Design/methodology/approachThis study employs grounded theory methodology that is based on in-depth interviews with twenty-seven practicing auditors who are audit partners, managers, seniors and assistants of auditing firms. Guided by the grounded theory, data collection and data analyses were conducted simultaneously to look into the new insights of the research phenomenon. The coding process was constantly compared until the research's theoretical saturation is reached after four rounds. At the end of the research process, the study conducted a survey to confirm the proposed framework as well as examine the inter-relationships between the defined determinants.FindingsResults suggest developing a conceptual framework to interpret wisdom-based decision-making process in auditing. A wise process of audit decision-making is defined as an integrated exercise of multiple determinants including knowledge assimilation, judgmental ability and ethical orientation. The research also explains and examines the potential interrelationships among these determinants in the audit decision-making process.Practical implicationsWisdom is a valuable tacit ability for all external auditors. The development of wise decision-making abilities of auditors should be considered an integral part of multiple virtues including knowledge and judgmental and ethical aspects.Originality/valueThe contributions of this study are original and significant because it proposes a new approach to explain for the audit decision-making process and enhances better understandings of the concept of wisdom in auditing practices and its roles in audit decision-making.

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PERCEPTIONS OF A MULTIDISCIPLINARY TEAM ON THE PSYCHOLOGICAL REPERCUSSIONS OF SEXUAL VIOLENCE AGAINST CHILDREN AND ADOLESCENTS

Texto & Contexto - Enfermagem ◽

10.1590/1980-265x-tce-2020-0500 ◽

2021 ◽

Vol 30 ◽

Author(s):

Marimeire Morais da Conceição ◽

Breno de Oliveira Ferreira ◽

Edsângela Thalita Passos Barreto ◽

Carmen Lúcia Pereira Dias Nery ◽

Jacilene Santiago do Nascimento Trindade dos Santos ◽

...

Keyword(s):

Sexual Violence ◽

Children And Adolescents ◽

Multidisciplinary Team ◽

Depressive Disorders ◽

Psychological Disorders ◽

Daily Basis ◽

Warning Signs ◽

Health Team ◽

Team Working ◽

Institutional Review

ABSTRACT Objective: to understand the perceptions of a multidisciplinary health team in caring for hospitalized children and adolescents with psychological repercussions of sexual violence, in the light of Symbolic Interactionism Theory. Method: this is a qualitative study, carried out with 30 professionals from the multidisciplinary health team working in a general public hospital in Salvador, Bahia, Brazil. The interviews took place between June and July 2019, using a semi-structured questionnaire and, after being recorded, the reports were transcribed. In analysis, the data were categorized by similar themes following the steps: pre-analysis, material exploration, treatment of results and interpretation. The project was approved by an Institutional Review Board. Results: among the psychological disorders presented by children and adolescents are aggressiveness, mutism, eating disorders, infantilized behavior, hypersexualized behaviors, depressive disorders, anxiety disorders, psychotic episodes, and delusions. Conclusion: the study demonstrates the perceptions resulting from the interaction allowed in caring for the multidisciplinary team to children and adolescents who experienced sexual violence and developed psychological disorders. In this way, it raises warning signs for family members, health professionals, education, protective devices and the whole of society about the need to observe signs of these changes on a daily basis, seeking to investigate their possible relationship with sexual assault.

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