Abstract

Introduction : Team building has been found to improve the effectiveness and efficiency of workforce in the healthcare system generally. The aim of this study was to assess effect of training on team building on the knowledge and attitude of healthcare workers in two federal tertiary health facilities in Southern Nigeria.
Materials and Methods: This was a quasi-experimental study carried out between November 2013 and February 2014. Multistage sampling technique was used to select a total of 242 subjects from ten categories of professionals of study group (Nnamdi Azikiwe University Teaching Hospital, NAUTH Nnewi) and control group (Federal Medical Centre , FMC Asaba) with 121 subjects in each group. Equal number of ten categories of professionals were matched for age (groups), gender and professional category before recruiting to eliminate /minimize risk of introducing statistical bias. The study consisted of a pre-intervention, intervention and post-intervention phases. Subjects participated in the study using same self-administered questionnaire for study and control groups at pre-intervention and post-intervention (three months interval) phases. The training intervention instituted used a mix of conceptual framework of the Health Belief Model and others.
Results: At pre-intervention phase information on the 15 variables of knowledge and attitude of team building were collected and analysed with results as follows for study and control groups respectively with statistical significance of p = or < 0.01: respondents that heard of team in healthcare 74.4% and 91.0% (p< 0.01); those that heard of inter-professional team composition in healthcare 65.9% and 78.7% ( p> 0.01); those that defined correctly team building 75.6% and 91.0% (p<0.01); those that defined correctly inter-professional team building 73.5% and 81.4% (p> 0.01); those with source(s) of information on it 57.3% (mainly health publication) 65.1% (mainly lectures/ conferences) ; those that defined correctly a team 70.4% and 88.4% (p<0.01); those that had good knowledge competencies to possess to be an effective team member 65.9%
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and 69.6% (p>0.01); those that agreed its events resulted to benefits in their organization 71.8% and 86.7% (p>0.01); those that agreed to participate in it if given an opportunity 70.7% and 75.6% (p>0.01); those that agreed to recommend it to improve inter-professional working relationship 67.15 and 88.4% (p <0.01); those that agreed to recommend it to resolve conflict 53.7% and 70.9% (p<0.01); those that agreed to be an effective team member the attitude competencies to possess should include assertiveness 36.6% and 75.6% (p ,0.01); cooperative attitude 71.9% and 89.3% (p <0.01); courage to disagree 47.6% and 59.3% (p< 0.01).
During the intervention phase , training on team building was successfully conducted in three days for study group. At post-intervention phase for study and control group respectively, same data were collected ,analyzed and the results were as follows. Those that correctly defined team building 6.6% and 52.5% (p<0.01); those that correctly defined inter-professional team building 83.8 and 81.4% (p>0.01); those with different source(s) of information about it 57.3% (mainly health publications) and 71.3% (mainly lectures/conferences (p <0.01); those that correctly defined a team 90.45 and 20.45 (p <0.01); those with good knowledge of knowledge competencies to possess to be an effective team member 95.8% and 70.9% (p <0.01) ; those that agreed its events resulted to benefits in their organization 91.8% and 79.4% (p < 0.01) those that agreed to participate in it if given an opportunity 70.9% and 75.6% (p<0.01); those that agreed to recommend it to improve inter-professional working relationship 97.1% and 88.4% (p, 0.01); those that disagreed its events to be waste of time and money 100% and 88.2% (p<0.01); those that agreed to recommend it to resolve conflict 93.9% and 70.9% (p<0.01); those that agreed to be an effective team member the attitude competencies to possess should include the following assertiveness 79.1% and 75.6% (p>0.01); cooperative attitude 97.5% and 89.3% (p<0.01); and courage to disagree 67.6% and 59.3% (p<0.01). The results showed there was statistical significant difference in 10 out of the 15 variables between the two groups at pre-intervention phase as determined by chi-square test (p<0.01). There was statistical significant difference in 13
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out of the 15 variables between the two groups as determined by chi-square test(p< 0.01) at post-intervention phase. The change in the variables was highest at 92.2 % for respondents that correctly defined team building. There was also statistical significant difference across all variables as determined by chi-square test (p<0.01) between pre-intervention and post-intervention phases of study group with the exception of 1 variable whereas there was statistical significant difference in only 2 variables between pre-intervention and post-intervention phases of control group.Weighted relatively higher scores adjudged as good grade for all 7 knowledge variables were more at post –intervention phase of study than control group,81.5% and 48.5% ,respectively , as against pre-intervention phase of study and control groups scores with good grade of 57.9% and 78.0% respectively. Weighted relatively higher scores adjudged as good grade for all 8 attitude variables were more at post –intervention phase of study than control group,77.8% and 68.7% ,respectively as against pre-intervention phase of study and control groups scores with good grade of 77.3% and 68.7% respectively.
Conclusion and Recommendation . Team building was effective in improving knowledge and attitude of health workers in healthcare in the study tertiary health facility . It is ,therefore, recommended health workers should seek to be trained and re-trained on team building in order to persistently improve their knowledge of and attitude towards team building to ultimately improve health outcomes.