title: Ingroup identity as an obstacle to effective multiprofessional and interprofessional teamwork: findings from an ethnographic study of healthcare assistants in dementia care.
abstract: Rising dementia incidence is likely to increase pressures on healthcare services, making effective well coordinated care imperative. Yet, barriers to this care approach exist which, we argue, might be understood by focussing on identity dynamics at the frontlines of care. In this article, we draw upon findings from an ethnographic study of healthcare assistants (HCAs) from three dementia wards across one National Health Service mental health trust. Data revealed that the HCAs are a close-knit 'in-group' who share low group status and norms and, often highlight their own expertise in order to promote self worth. HCAs' social identity is considered as a barrier to effective teamwork with strong ingroup behaviour suggested as a consequence of their marginalisation. We explore these findings with reference to social identity theory (Tajfel, 1974; Turner, 1978 ) and discuss implications for delivering multiprofessional and interprofessional care.
authors.affiliation: Department of Clinical Psychology and Neuropsychology, Queens Medical Centre, Nottingham NG7 2UH, UK. joanne.lloyd@nuh.nhs.uk
authors.forename: Joanne
authors.initials: J
authors.lastname: V Lloyd
authors.forename: Justine
authors.initials: J
authors.lastname: Schneider
authors.forename: Kezia
authors.initials: K
authors.lastname: Scales
authors.forename: Simon
authors.initials: S
authors.lastname: Bailey
authors.forename: Rob
authors.initials: R
authors.lastname: Jones
mesh_terms: D000488:Allied Health Personnel / Q000458:organization & administration*; D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D017598:Efficiency, Organizational; D017144:Focus Groups; D006801:Humans; D007297:Inpatients; D007400:Interprofessional Relations; D005791:Patient Care / Q000379:methods*; D010348:Patient Care Team; D011287:Prejudice; D011582:Psychological Theory; D020377:Self Efficacy; D012933:Social Identification; D006113:United Kingdom