The relationship between stress and teamwork during interprofessional collaboration: an integrative literature review

Abstract

The challenges in healthcare such as the inadequate training of graduates, the complex and expensive healthcare systems, health inequity, and working in professional silos, demand a more effective and holistic approach to patientcare. Interprofessional care entails an approach to providing full health services to patients by different health professionals working collaboratively in order to provide quality care within and across certain settings. Interprofessional collaborative practice is the implementation of interprofessional care in health practice through the combined effort of different health professions to improve patientcare through teamwork. Interprofessional collaboration and teamwork involves health professionals (and students) who work closely with one another to provide quality patientcare and to learn with and from different professions. Healthcare staff are widely regarded as a group that is at high risk of work stress. In addition, working in teams, especially in a healthcare environment which involves the health of a patient, can add to this stress. The experience of stress, whether positive or negative, can influence team dynamics, successful collaboration and ultimately, patientcare. In addition, in an educational set-up, stress may influence student learning, especially when Interprofessional Education is new and students still lack confidence. Interprofessional teamwork has been widely researched, but it is not clear if there is a relationship between interprofessional collaboration, teamwork and stress. The purpose of this research was to find evidence of a relationship between interprofessional collaboration, teamwork and stress through an integrative literature review. The concept of stress is used in an attempt to understand whether it influences team dynamics during interprofessional activities, and thus consequently affects effective interprofessional teamwork. The integrative literature review method was used to collect, analyse and synthesise published research on interprofessional collaboration, teamwork and stress, in order to find a link between these three concepts. Initially 4 887 articles were found on the North-West University library databases using the keywords Interprofessional AND Team* AND Stress. After date limitations had been applied and duplicates removed (n=630), the remaining articles (n=4257) were imported into the Evidence for Policy and Practice Information reviewer software programme (EPPI-Reviewer). The titles of the remaining articles were read and articles with unrelated titles were removed (n=3908), resulting in 349 articles remaining. The abstracts of these articles were then scrutinised for relevance, resulting in another 316 articles being excluded. A further 21 articles were removed based on language, accessibility, embargoes, lack of content or irrelevant context. Six articles identified from the reference lists of the included articles were added to the database. A total of 18 articles were then appraised and retained for analysis. The results showed that interprofessional collaboration and teamwork are clearly linked, yet published research on how stress is linked to both these concepts in an interprofessional healthcare context, are limited. Factors that can contribute to stress and consequently influence effective interprofessional collaboration and teamwork, were identified. Further research on the stress experienced by health professionals and students working in interprofessional teams, is recommended.