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


Nugus, P and Ranmuthugala, G and Travaglia, J and Greenfield, D and Lamothe, J and Hogden, A and Kolne, K and Braithwaite, J, Advancing interprofessional theory: Deliberative democracy as a participatory research antidote to power differentials in aged care, Journal of Interprofessional Education and Practice, 15 pp. 100-111. ISSN 2405-4526 (2019) [Refereed Article]

Copyright Statement

2018 Elsevier Inc. All rights reserved.

DOI: doi:10.1016/j.xjep.2018.09.005


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.

Item Details

Item Type:Refereed Article
Keywords:interprofessional collaborative practice, interprofessional education, deliberative democracy, participatory research (PR), aged care, collaboration decision-making, conscientization
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Aged health care
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health and support services not elsewhere classified
UTAS Author:Greenfield, D (Professor David Greenfield)
UTAS Author:Hogden, A (Dr Anne Hogden)
ID Code:133939
Year Published:2019
Deposited By:Australian Institute of Health Service Management
Deposited On:2019-07-16
Last Modified:2020-05-05

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