Shi Yueping, Gu Pinhua, Wang Qiufeng, Zhang Xuelian
Department of Cardiology, Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine (Preparatory Stage), Shanghai, China.
JMIR Form Res. 2023 Feb 6;7:e41729. doi: 10.2196/41729.
The nurse-physician relationship is important for the stability of collaboration. The COVID-19 pandemic has put unprecedented pressure on the health care system and has placed greater demands on nurse-physician collaboration. Nurses and physicians often struggle to share mutual responsibility and communicate effectively.
This study aimed to evaluate the relationship between nurses and physicians during the COVID-19 pandemic and construct a new model combining the attitude and behaviors of the 2 groups to assess various factors' impacts on job satisfaction and confrontational behavior.
We conducted this quantitative cross-sectional study to assess the relationship between nurses and physicians based on the attitudes and behaviors toward nurse-physician collaboration. We first investigated the satisfaction of nurses and physicians with their relationship and how they thought the COVID-19 pandemic had affected that relationship. We used an adapted and modified Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration questionnaire that consisted of 17 items under 5 dimensions. Structural equation modeling was used to assess the relationships between domains. Ordinal logistic regression was used to evaluate the relationship between different domains of the questionnaire and the satisfaction of the current nurse-physician relationship.
We included a total of 176 nurses and 124 physicians in this study. Compared to 7.2% (9/124) of physicians, 22.7% (40/176) of nurses were dissatisfied with the current nurse-physician relationship. Most physicians (101/124, 81.5%) and nurses (131/176, 74.5%) agreed that the nurse-physician relationship had become better because of the COVID-19 pandemic and that the public had greater respect for them. However, significantly fewer nurses (59/176, 33.5% vs 79/124, 63.7%; P<.001) thought that physicians and nurses were treated with the same respect. Nurses scored significantly higher scores in caring versus curing (mean 16.27, SD 2.88 vs mean 17.43, SD 2.50; P<.001) and physician's authority (mean 8.72, SD 3.21 vs mean 7.24, SD 3.32; P<.001) subscales compared with physicians. The shared education and collaboration subscale had a significantly positive relationship with the nurse's autonomy subscale (standardized coefficient=0.98; P<.001). Logistic regression showed that 4 subscales (shared education and collaboration: P<.001; caring versus curing: P<.001; nurse's autonomy: P<.001; and confrontation: P=.01) were significantly associated with the level of satisfaction of the current nurse-physician relationship.
This study showed that nurses were more dissatisfied with the current nurse-physician relationship than physicians in Shanghai. Policy makers and managers in the medical and educational system should emphasize an interprofessional collaboration between nurses and physicians. Positive attitudes toward shared collaboration and responsibility may help to improve the relationship between the 2 parties.
护士与医生的关系对于合作的稳定性至关重要。新冠疫情给医疗系统带来了前所未有的压力，对护士与医生的合作也提出了更高要求。护士和医生常常难以分担共同责任并进行有效沟通。
本研究旨在评估新冠疫情期间护士与医生之间的关系，并构建一个结合两组态度和行为的新模式，以评估各种因素对工作满意度和对抗行为的影响。
我们开展了这项定量横断面研究，基于对护士与医生合作的态度和行为来评估两者之间的关系。我们首先调查了护士和医生对他们之间关系的满意度，以及他们认为新冠疫情如何影响了这种关系。我们使用了一份经过改编和修改的《杰斐逊医生 - 护士合作态度量表》问卷，该问卷由5个维度下的17个项目组成。采用结构方程模型来评估各领域之间的关系。使用有序逻辑回归来评估问卷不同领域与当前护士 - 医生关系满意度之间的关系。
本研究共纳入176名护士和124名医生。与7.2%（9/124）的医生相比，22.7%（40/176）的护士对当前护士 - 医生关系不满意。大多数医生（101/124，81.5%）和护士（131/176，74.5%）一致认为，由于新冠疫情，护士与医生的关系变得更好了，公众对他们也更加尊重。然而，认为医生和护士受到同等尊重的护士明显更少（59/176，33.5% 对79/124，63.7%；P <.001）。在关怀与治疗（平均16.27，标准差2.88 对平均17.43，标准差2.50；P <.001）和医生权威（平均8.72，标准差3.21 对平均7.24，标准差3.32；P <.001）子量表上，护士的得分显著高于医生。共享教育与合作子量表与护士的自主性子量表有显著正相关关系（标准化系数 = 0.98；P <.001）。逻辑回归显示，4个子量表（共享教育与合作：P <.001；关怀与治疗：P <.001；护士的自主性：P <.001；以及对抗：P = 0.01）与当前护士 - 医生关系的满意度水平显著相关。
本研究表明，上海的护士对当前护士 - 医生关系的不满程度高于医生。医疗和教育系统的政策制定者和管理者应强调护士与医生之间的跨专业合作。对共享合作和责任持积极态度可能有助于改善双方关系。
