title: The roles of specialisation and evidence-based practice in inter-professional jurisdictions: A qualitative study of stroke services in England, Sweden and Poland.
abstract: This paper investigates how the concepts of clinical specialisation and evidence influence the jurisdictional power of doctors, nurses and therapists involved in stroke care in Sweden, England and Poland. How stroke care has become a distinct specialism across Europe and the role that evidence has played in this development are critically analysed. Five qualitative case studies were undertaken across the three countries, consisting of 119 semi-structured interviews with a range of healthcare workers. The informants were purposively selected and their perspectives of evidence-based practice (EBP) within stroke care were explored. The data were analysed through thematic content analysis. The two key themes that emerged from the data were the health professionals' degrees of EBP and specialisation. The results illustrate how the two concepts of clinical specialisation and evidence are interrelated and work together to influence the different professions' degree of professional jurisdiction. It is concluded that doctors' professional dominance gives them full jurisdiction in stroke care and that nurses' and therapists' degrees of jurisdiction is dependent on their ability to specialise.
authors.affiliation: School of Management and Business, King's College London, 150 Stamford Street, London, SE19NH, UK. Electronic address: juan.baeza@kcl.ac.uk.
authors.forename: Juan I
authors.initials: JI
authors.lastname: Baeza
authors.affiliation: Faculty of Health, Social Care and Education, St George's, University of London & Kingston University, 2nd Floor Grosvenor Wing, St George's Hospital, Cranmer Terrace, SW17 0RE, London, UK. Electronic address: A.Boaz@sgul.kingston.ac.uk.
authors.forename: Annette
authors.initials: A
authors.lastname: Boaz
authors.affiliation: London School of Hygiene and Tropical Medicine, Department of Health Services Research and Policy, 15-17 Tavistock Place, WC1H 9SH, London, UK. Electronic address: Alec.Fraser@lshtm.ac.uk.
authors.forename: Alec
authors.initials: A
authors.lastname: Fraser
mesh_terms: D004739:England; D055317:Evidence-Based Practice / Q000458:organization & administration*; D006282:Health Personnel; D006801:Humans; D007400:Interprofessional Relations; D011044:Poland; D024382:Professional Role; D036301:Qualitative Research; D012930:Social Dominance; D013038:Specialization; D020521:Stroke / Q000628:therapy*; D013548:Sweden
keywords: Abbott; England; Evidence; Jurisdictions; Poland; Specialisation; Stroke care; Sweden