Hotta Soichiro, Ashida Kaoru, Tanaka Makoto
Department of Adult Health Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
School of Nursing, Faculty of Medicine, Tokyo Medical University, Tokyo, Japan.
Jpn J Nurs Sci. 2024 Oct;21(4):e12622. doi: 10.1111/jjns.12622. Epub 2024 Sep 4.
To develop a scale to assess difficulties that nurses experience when collaborating with physicians in responding to clinical deterioration during night shifts and identify factors associated with scoring using the developed scale.
A web-based questionnaire with a draft scale, the Nighttime Collaboration Difficulties between Nurses and Physicians for Nurses (NCDNP-N), was distributed to nurses working night shifts in acute-care hospitals across Japan. Data were collected between July and October 2023. Of 435 responses, 405 were examined for the NCDNP-N's psychometric validation, including structural validity, criterion-related validity, and reliability assessments. Multiple linear regression analysis was performed for 385 responses excluded by listwise methods to identify factors associated with NCDNP-N scores.
The NCDNP-N has 10 items and three domains: Domain 1, dissatisfaction with physicians' actions; Domain 2, burden of working with night-shift physicians; and Domain 3, barriers to reporting during night shifts. Estimated reliability coefficients exceeded the recommended values. Multiple regression analyses demonstrated that more years of experience in the current ward and frequency of calling the covering physician at night were markedly associated with higher scores, whereas more nursing experience was associated with lower scores.
We developed the NCDNP-N and confirmed its validity and reliability. The study results suggest that the responsibilities and competence of nurses working night shifts and communication with the night-covering physician are associated with difficulties in nighttime collaboration. The NCDNP-N may help identify challenges in clinical settings as well as can be utilized in the evaluation study for improving nighttime collaboration.
开发一个量表，以评估护士在夜班期间与医生协作应对临床病情恶化时所经历的困难，并确定使用所开发量表进行评分的相关因素。
向日本各地急症医院的夜班护士发放了一份基于网络的问卷，其中包含一个量表草案，即护士夜间医护协作困难量表（NCDNP-N）。数据收集于2023年7月至10月期间。在435份回复中，对405份进行了NCDNP-N的心理测量学验证，包括结构效度、效标关联效度和信度评估。对通过列删除法排除的385份回复进行了多元线性回归分析，以确定与NCDNP-N得分相关的因素。
NCDNP-N有10个条目和三个维度：维度1，对医生行为的不满；维度2，与夜班医生合作的负担；维度3，夜班期间报告的障碍。估计的信度系数超过了推荐值。多元回归分析表明，在当前病房的工作年限越长以及夜间呼叫替班医生的频率越高，得分越高；而护理经验越丰富得分越低。
我们开发了NCDNP-N并证实了其效度和信度。研究结果表明，夜班护士的职责和能力以及与夜间替班医生的沟通与夜间协作困难有关。NCDNP-N可能有助于识别临床环境中的挑战，也可用于改善夜间协作的评估研究。
