Association between team functioning and self-efficacy and quality of life for primary care patients in British Columbia, Nova Scotia, and Ontario

Abstract Aim: We aimed to examine the association between team functioning in primary care and patients’ self-efficacy and quality of life. We also examined the moderation effect of multimorbidity and social vulnerability on this association. Background: Team-based care has been adopted as an appropriate model to deliver comprehensive primary care services to meet the complex needs of patients. Little is known about the association between team functioning and patients’ self-efficacy for managing chronic conditions (SEMCD) and quality of life. Methods: We used mixed-random effect modelling to analyse secondary cross-sectional data. Data were collected in primary care practices in three Canadian regions. Dependent variables included patients’ SEMCD and quality of life. The independent variable was team functioning measured using the Team Climate Inventory scale (TCI). We also included two interaction terms: social vulnerability and TCI, and multimorbidity and TCI. Control variables included patient characteristics, patients’ experience with care and practice characteristics. Findings: Eighty-seven practices and 1,929 patients participated in the study. Of these, 67% were female, 5% had two or more social vulnerabilities and 65% had multimorbidity. Regression analyses failed to find an association between team functioning and patients’ self-efficacy or quality of life. There was a strong positive association between team functioning and self-efficacy for people with multimorbidity ( p = .005) compared to those without multimorbidity. There was also a strong positive association between team functioning and quality of life for those with two or more vulnerabilities ( p < .001) but not for those with fewer vulnerabilities. The findings showed people with multimorbidity and increased vulnerabilities could benefit from well-functioning teams. Supporting better team functioning through effective communication (e.g., team meetings) and care coordination; encouraging full participation of all team members in service delivery; and establishing clear team objectives, roles and responsibilities can better meet the needs of complex patients.