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跨专业协作质量、员工福祉与非有益治疗的认知:重症与姑息治疗中护士与医生的比较

Perceptions of Quality of Interprofessional Collaboration, Staff Well-Being and Nonbeneficial Treatment: A Comparison between Nurses and Physicians in Intensive and Palliative Care.

作者信息

Schwarzkopf Daniel, Bloos Frank, Meißner Winfried, Rüddel Hendrik, Thomas-Rüddel Daniel O, Wedding Ulrich

机构信息

Center for Sepsis Control and Care, Jena University Hospital, 07747 Jena, Germany.

Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, 07747 Jena, Germany.

出版信息

Healthcare (Basel). 2024 Mar 7;12(6):602. doi: 10.3390/healthcare12060602.

DOI:10.3390/healthcare12060602
PMID:38540566
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10969805/
Abstract

This study assessed differences in interprofessional collaboration, perception of nonbeneficial care, and staff well-being between critical care and palliative care teams. In six German hospitals, a staff survey was conducted between December 2013 and March 2015 among nurses and physicians in intensive and palliative care units. To allow comparability between unit types, a matching was performed for demographic characteristics of staff. N = 313 critical care and 79 palliative care staff participated, of which 72 each were successfully matched. Critical care nurses perceived the poorest overall quality of collaboration compared with critical care physicians and palliative care physicians and nurses. They also reported less inclusive leadership from attendings and head nurses, and the least collaboration on care decisions with physicians. They were most likely to perceive nonbeneficial care, and they reported the lowest levels of job satisfaction and the highest intention to leave the job. In partial correlations, aspects of high-quality collaboration were associated with less perceived nonbeneficial care and higher staff well-being for both critical care and palliative care staff. Our findings indicate that critical care teams could improve collaboration and enhance well-being, particularly among nurses, by adopting principles of collaborative work culture as established in palliative care.

摘要

本研究评估了重症监护团队和姑息治疗团队在跨专业协作、对无益护理的认知以及工作人员福祉方面的差异。在德国的六家医院,于2013年12月至2015年3月期间对重症监护病房和姑息治疗病房的护士和医生进行了一项工作人员调查。为了使不同类型病房之间具有可比性,对工作人员的人口统计学特征进行了匹配。313名重症监护工作人员和79名姑息治疗工作人员参与了调查,其中各有72人成功匹配。与重症监护医生、姑息治疗医生和护士相比,重症监护护士认为整体协作质量最差。他们还报告说,主治医生和护士长的包容性领导较少,并且在护理决策方面与医生的协作最少。他们最容易察觉到无益护理,并且报告的工作满意度最低,离职意愿最高。在偏相关性分析中,高质量协作的各个方面与重症监护和姑息治疗工作人员较少察觉到的无益护理以及较高的工作人员福祉相关。我们的研究结果表明,重症监护团队可以通过采用姑息治疗中确立的协作工作文化原则来改善协作并提高福祉,尤其是在护士中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5260/10969805/26d1ec0eb6df/healthcare-12-00602-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5260/10969805/d544366bc74e/healthcare-12-00602-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5260/10969805/8b459f36e06e/healthcare-12-00602-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5260/10969805/dc9fbd77b8c9/healthcare-12-00602-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5260/10969805/26d1ec0eb6df/healthcare-12-00602-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5260/10969805/d544366bc74e/healthcare-12-00602-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5260/10969805/8b459f36e06e/healthcare-12-00602-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5260/10969805/dc9fbd77b8c9/healthcare-12-00602-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5260/10969805/26d1ec0eb6df/healthcare-12-00602-g004.jpg

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A qualitative exploration of nurse-physician collaboration in intensive care units.重症监护病房护士-医师合作的定性研究。
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Structure and concept of ICU rounds: the VIS-ITS survey.重症监护病房查房的结构与概念:VIS-ITS调查
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[Overtreatment in intensive care medicine-recognition, designation, and avoidance : Position paper of the Ethics Section of the DIVI and the Ethics section of the DGIIN].[重症医学中的过度治疗——识别、界定与避免:德国重症与急救医学协会伦理委员会及德国重症监护与感染病学会伦理委员会立场文件]
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