Embracing or relinquishing sources of power in interprofessional communication: implications for patient-centered speaking up.

Health professionals working in an interprofessional work environment are entrusted to speak up on behalf of patients. However, that environment is comprised of dynamic intra- and interprofessional hierarchies, characterized by power differentials that affect speaking up behaviors. Drawing on the so...

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Publicado en:Journal of Interprofessional Care Vol. 40; no. 5; pp. 738 - 746
Autores principales: Farrell, Susan E., Bochatay, Naike, Kim, Sara
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Sep/Oct2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep/Oct2026
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      pub: Taylor & Francis Ltd
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        10.1080/13561820.2021.1975665
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        atl: Embracing or relinquishing sources of power in interprofessional communication: implications for patient-centered speaking up.
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        au:
          Farrell, Susan E.
          Bochatay, Naike
          Kim, Sara
        affil: Harvard Medical School, Director, Continuing and Professional Development, Center for Interprofessional Studies and Innovation, MGH Institute of Health Professions, Boston, MA, USA
      sug:
        subj:
          Interprofessional Relations
          Communication
          Patient Centered Care
          Power
          Patient Safety
          Health Personnel Psychosocial Factors
          Attitude of Health Personnel Evaluation
          Human
          Male
          Female
          Funding Source
          Secondary Analysis
          Intraprofessional Relations
          Focus Groups
          Interviews
          Nurses Psychosocial Factors
          Health Information
          Patient Advocacy
          Clinical Competence
          Work Environment
          Teamwork
          Internship and Residency
          Organizational Policies
          Wit and Humor
          Fear
          Anxiety
          Confidence
          Organizational Culture
          Psychological Safety
          Leadership
          Motivation
          Descriptive Statistics
          Male
          Female
      ab: Health professionals working in an interprofessional work environment are entrusted to speak up on behalf of patients. However, that environment is comprised of dynamic intra- and interprofessional hierarchies, characterized by power differentials that affect speaking up behaviors. Drawing on the social bases of power and on power/interaction theory, we analyzed focus group and interview transcripts of 62 health professionals' accounts of speaking up. We focused on their primary sources of power, and described factors associated with health professionals' embracing power to speak up for patient safety, as well as those associated with relinquishing power and remaining silent. Nurses primarily employed direct patient information as a source of power to advocate for patients. Senior nurses and attending physicians exercised their legitimate power through titles or expertise, and when embracing that power, often influenced the healthcare team's speaking up behaviors and the team environment. Physician trainees perceived to have limited sources of power. Participants reported using hospital policies, relationships, and humor for engaging in speaking up behavior. Relinquishing power and remaining silent were associated with fear, anxiety, and lack of confidence. Given the complex, hierarchical environment in healthcare, leaders' inclusive behaviors for setting a culture for speaking up, including modeling speaking up, are critical.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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