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卫生专业人员分担责任和加强跨专业协作的意愿:一项横断面调查。

Health professionals' willingness to share responsibility and strengthen interprofessional collaboration: a cross-sectional survey.

作者信息

Brandt Sophie Karoline, Essig Stefan, Balthasar Andreas

机构信息

Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.

Center for Primary and Community Care, Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.

出版信息

BMC Med Educ. 2025 Jan 21;25(1):102. doi: 10.1186/s12909-024-06351-9.

Abstract

BACKGROUND

Doctors' unwillingness to share responsibility acts as a major barrier to interprofessional collaboration (IPC). Educating both doctors and allied health professionals in taking on or relinquishing responsibility could enhance IPC. Yet there is no evidence that these educational efforts increase IPC willingness. This study aims to (1) compare the willingness to take on or relinquish responsibility for decision-making in patient care and their willingness to strengthen IPC between members of five main health professions, and (2) investigate associations between the willingness to take on or relinquish responsibility and the willingness to strengthen IPC.

METHODS

We conducted a cross-sectional survey targeting pharmacists, doctors, medical practice assistants, nurses, and physiotherapists in Switzerland. Group differences were assessed, and associations were examined using multivariable logistic regression analyses.

RESULTS

Overall, 3670 health professionals participated. Members of all allied health professions were highly willing to take on more responsibility for decision-making for patient care (ranging from 74.3% to 86.5%). Medical practice assistants (52.3%) and nurses (46.8%) were highly willing to relinquish responsibility, less so pharmacists (34.2%) and physiotherapists (37.8%); doctors were torn between high (49.2%) and neither high nor low willingness (38%). Members of all professions were highly willing to strengthen IPC (ranging from 76.4 to 91.2%). We found a strong, statistically significant relationship between willingness to take on more responsibility and willingness to strengthen IPC (OR = 5.30, p < .001). The relationship between willingness to relinquish responsibility and willingness to strengthen IPC was smaller (OR = 3.30, p < .001).

CONCLUSION

Increasing the health professionals' willingness to take on responsibility is crucial to strengthen IPC. Increasing the willingness to relinquish responsibility would likely be less effective. Actions required include educational and political efforts to transfer responsibility to allied health professionals and to enable health professionals to decide when it is appropriate to take on or relinquish responsibility. Given the willingness of many health professionals to strengthen IPC, substantial potential in practice is evident.

摘要

背景

医生不愿分担责任是跨专业协作(IPC)的主要障碍。对医生和专职医疗人员进行承担或放弃责任方面的教育,可能会加强跨专业协作。然而,尚无证据表明这些教育努力能提高跨专业协作的意愿。本研究旨在:(1)比较五个主要卫生专业人员在患者护理决策中承担或放弃责任的意愿,以及他们加强跨专业协作的意愿;(2)调查承担或放弃责任的意愿与加强跨专业协作意愿之间的关联。

方法

我们对瑞士的药剂师、医生、医疗助理、护士和物理治疗师进行了一项横断面调查。评估了组间差异,并使用多变量逻辑回归分析来检验关联。

结果

总体而言,3670名卫生专业人员参与了调查。所有专职医疗人员都非常愿意在患者护理决策中承担更多责任(范围从74.3%到86.5%)。医疗助理(52.3%)和护士(46.8%)非常愿意放弃责任,药剂师(34.2%)和物理治疗师(37.8%)意愿稍低;医生在高意愿(49.2%)和非高非低意愿(38%)之间犹豫不决。所有专业的人员都非常愿意加强跨专业协作(范围从76.4%到91.2%)。我们发现承担更多责任的意愿与加强跨专业协作的意愿之间存在强烈的、具有统计学意义的关系(OR = 5.30,p <.001)。放弃责任的意愿与加强跨专业协作的意愿之间的关系较小(OR = 3.30,p <.001)。

结论

提高卫生专业人员承担责任的意愿对于加强跨专业协作至关重要。提高放弃责任的意愿可能效果较差。所需行动包括教育和政策方面的努力,将责任转移给专职医疗人员,并使卫生专业人员能够决定何时承担或放弃责任。鉴于许多卫生专业人员有加强跨专业协作的意愿,实践中存在巨大潜力。

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