COLLABORATIVE PRACTICE TEAMS IN ONCOLOGY: EXAMINING THE ROLE OF PSYCHOLOGICAL SAFETY AND ITS RELATIONSHIP WITH CLINICIAN WELL-BEING AMONG ADVANCED PRACTICE PROVIDERS

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dc.contributor.advisorHausmann, Robert C.
dc.contributor.committeeMemberMcNeil, Sara G.
dc.contributor.committeeMemberHolladay, Courtney
dc.contributor.committeeMemberReynolds, Rae B.
dc.creatorWei, Steven H.
dc.creator.orcid0000-0002-1966-6617
dc.date.accessioned2022-12-29T00:30:47Z
dc.date.available2022-12-29T00:30:47Z
dc.date.createdMay 2022
dc.date.issued2022-01-05
dc.date.updated2022-12-29T00:30:49Z
dc.description.abstractBackground: As health care continues to evolve in the United States, there has been a growing emphasis on providing high-quality, team-based care, especially in the care of cancer patients. Advanced practice providers (APPs), including physician assistants (PAs) and nurse practitioners (NPs), have helped to bridge the gap to meet the demand of patient oncology needs; however, APPs remain at a higher risk of developing clinician distress and burnout. To address a “system in crisis,” particularly during the COVID-19 pandemic, teamwork and effective team functioning may be a necessary solution. Psychological safety (PS) may be a contributing factor that affects team engagement in health care. Studies among PAs in oncology have demonstrated that high burnout rates could be associated with team leadership factors, such as the PA relationship with the collaborating physician (CP), as well as their leadership qualities. Among APPs in oncology care, the question remains whether PS correlates with clinician well-being (WB), including the risk of distress and adverse work-related outcomes. Purpose: This study aimed to examine the professional characteristics and team leadership factors that may contribute to PS among oncology APPs and determine whether PS was related to clinician well-being (WB). Methods: A national web-based, cross-sectional survey of oncology APPs from two leading oncology APP professional societies was completed during a 60-day study period in the setting of the COVID-19 pandemic in early 2021. Descriptive statistics were obtained, followed by a series of bivariate tests to identify which demographic, professional, and team-leadership variables were significantly related to the dependent variables, PS and clinician WB. All explanatory variables that demonstrated a statistically significant relationship with the dependent variables were included in the third phase, multivariate analysis using multiple linear regression models. Lastly, since this study was conducted in the setting of the COVID-19 global pandemic, respondents provided context to their responses through two open-ended questions. Results: The study consisted of 84 oncology APPs who completed the survey, and 28.6% (n = 24) reported WBI scores within the high-risk group of distress. On final multivariate analysis, high PS scores were associated with high leader inclusiveness and leader-member exchange (LMX) scores, and low PS scores were related to those within the high-risk group of distress. Study participants in hematology-oncology specialty were five times more likely to be within the high-risk group of distress compared with those in the medical oncology group. Participants with high PS scores had a reduced likelihood of being in the group with a high risk of distress. Conclusion: Among oncology collaborative practice teams, APPs play a crucial role in providing high-quality patient care, but they remain at increased risk of developing clinician distress. Team-leadership factors affecting APPs may contribute to low PS, which may also be associated with low clinician well-being. Efforts to optimize clinician well-being should also address effective team functioning, team engagement, and leadership development.
dc.description.departmentCurriculum and Instruction, Department of
dc.format.digitalOriginborn digital
dc.format.mimetypeapplication/pdf
dc.identifier.urihttps://hdl.handle.net/10657/13128
dc.language.isoeng
dc.rightsThe author of this work is the copyright owner. UH Libraries and the Texas Digital Library have their permission to store and provide access to this work. Further transmission, reproduction, or presentation of this work is prohibited except with permission of the author(s).
dc.subjectPsychological safety
dc.subjectWell-being
dc.subjectCollaborative practice
dc.subjectTeams
dc.subjectOncology
dc.subjectAdvanced practice providers
dc.subjectLeadership
dc.titleCOLLABORATIVE PRACTICE TEAMS IN ONCOLOGY: EXAMINING THE ROLE OF PSYCHOLOGICAL SAFETY AND ITS RELATIONSHIP WITH CLINICIAN WELL-BEING AMONG ADVANCED PRACTICE PROVIDERS
dc.type.dcmiText
dc.type.genreThesis
thesis.degree.collegeCollege of Education
thesis.degree.departmentCurriculum and Instruction, Department of
thesis.degree.disciplineProfessional Leadership, Education
thesis.degree.grantorUniversity of Houston
thesis.degree.levelDoctoral
thesis.degree.nameDoctor of Education

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