McLain B R
Family Primary Care Clinical Specialty Program, University of California School of Nursing, San Francisco.
Nurse Pract. 1988 May;13(5):31-5, 38.
This study critically analyzes the underlying values, beliefs and behaviors of 18 family nurse practitioners and physicians who identified themselves as being in a joint practice relationship. Participants in the study were interviewed separately and in pairs around issues related to their reasons for joint practice, their interactional patterns, and how these patterns could be different. Transcribed interviews and data summaries for each practice were returned to the participants for review, discussion and validation. Results of the study suggested that the language, values and behaviors of the nurses continued to support, to varying degrees, the authoritarian and dominant position of the physician. In addition, nurses tended to demonstrate distorted communication and non-meaningful interactions. The possibility for nurses to create conditions in the practice relationship oriented toward mutual understanding and effective collaboration was clearly apparent in a few of these practices. Steps essential in achieving these conditions include the following: 1) self reflection; 2) clarification of goals; 3) examination of interactional patterns; 4) analysis of the level of commitment to mutual understanding; 5) willingness to risk calling issues into question; 6) conscious commitment to maintaining this level of communication over time; and 7) facilitating the physician partner's commitment to these goals.
本研究批判性地分析了18位家庭护士从业者和医生的潜在价值观、信念及行为，这些人认为他们处于联合执业关系中。研究参与者围绕联合执业的原因、互动模式以及这些模式可能存在的差异等问题分别接受了单独访谈和成对访谈。每个执业团队的访谈记录和数据总结都返还给参与者以供审核、讨论和验证。研究结果表明，护士的语言、价值观和行为在不同程度上继续支持医生的权威和主导地位。此外，护士往往表现出沟通扭曲和无意义的互动。在其中一些执业团队中，护士在执业关系中创造有利于相互理解和有效协作的条件的可能性明显存在。实现这些条件必不可少的步骤如下：1）自我反思；2）明确目标；3）审视互动模式；4）分析对相互理解的投入程度；5）愿意冒险质疑问题；6）有意识地长期维持这种沟通水平；7）促使医生伙伴致力于实现这些目标。
