Bordbar Shima, Radinmanesh Maryam, Bahmaei Jamshid, Rad Hamidreza Farhadi, Yusefi Ali Reza
Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran.
BMC Health Serv Res. 2025 Aug 12;25(1):1063. doi: 10.1186/s12913-025-13242-2.
Interprofessional collaboration and participation of physicians and nurses in clinical decisions can be an important indicator in increasing the quality of safe care in hospitals. This study was conducted to investigate the level of nurses' participation in physicians' clinical decisions and the factors affecting it from the perspectives of nurses working in teaching hospitals affiliated with Shiraz University of Medical Sciences in southern Iran.
This descriptive-analytical cross-sectional study was conducted on 385 nurses from January to April 2024. The data collection tool was standard questionnaires. Data were analyzed using t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression using SPSS23 software at a significance level of 0.05.
The mean scores of nurses' participation in physicians' clinical decisions and the factors affecting this participation were 41.12 ± 6.57 out of 75 and 84.32 ± 8.16 out of 150, respectively, which indicated the moderate status of these two. Between the amount of nurses' participation in physicians' clinical decisions and factors affecting this participation, including individual factors (P < 0.001, r = 0.825), social factors (P < 0.001, r = 0.784), organizational factors (P < 0.001, r = 0.766), and clinical factors (P < 0.001, r = 0.759), a statistically significant correlation was observed. Furthermore, individual (β = 0.721; CI = 0.400-1.042), social (β = 0.691; CI = 0.395-0.987), organizational (β = 0.664; CI = 0.374-0.954), and clinical (β = 0.639; CI = 0.381-0.897) factors were found to be significantly associated with nurses' participation in doctors' clinical decisions (P < 0.001). In addition, age (β = 0.213; CI = 0.025-0.401) and work experience (β = 0.194; CI = 0.047-0.341) also showed significant associations with the outcome (P < 0.05).
Based on the results, the improvement of individual, social, organizational, and clinical factors may be associated with increasing nurses' participation in physicians' clinical decisions. It is recommended that nurses' participation in clinical decisions be emphasized by holding ongoing training courses such as collaborative management, conflict management, and evidence-based decision-making for physicians. Hospital managers should also train and improve communication skills between physicians and nurses by holding periodic courses and seminars in hospitals. The findings of this study can be a basis for planning to improve the status of nurses' participation in physicians' clinical decisions in hospitals.
跨专业协作以及医生和护士参与临床决策可能是提高医院安全护理质量的一项重要指标。本研究旨在从伊朗南部设拉子医科大学附属教学医院护士的角度，调查护士参与医生临床决策的程度及其影响因素。
本描述性分析横断面研究于2024年1月至4月对385名护士进行。数据收集工具为标准问卷。使用SPSS23软件进行t检验、方差分析、Pearson相关系数分析和多元线性回归分析，显著性水平为0.05。
护士参与医生临床决策的平均得分及影响该参与度的因素得分分别为75分制中的41.12±6.57分和150分制中的84.32±8.16分，这表明两者均处于中等水平。在护士参与医生临床决策的程度与影响该参与度的因素之间，包括个人因素（P<0.001，r=0.825）、社会因素（P<0.001，r=0.784）、组织因素（P<0.001，r=0.766）和临床因素（P<0.001，r=0.759），观察到具有统计学意义的相关性。此外，发现个人（β=0.721；CI=0.400-1.042）、社会（β=0.691；CI=0.395-0.987）、组织（β=0.664；CI=0.374-0.954）和临床（β=0.639；CI=0.381-0.897）因素与护士参与医生临床决策显著相关（P<0.001）。此外，年龄（β=0.213；CI=0.025-0.401）和工作经验（β=0.194；CI=0.047-0.341）也与结果显示出显著关联（P<0.05）。
基于研究结果，个人、社会、组织和临床因素的改善可能与提高护士参与医生临床决策的程度相关。建议通过为医生举办协作管理、冲突管理和循证决策等持续培训课程，强调护士参与临床决策。医院管理者还应通过在医院定期举办课程和研讨会来培训和提高医生与护士之间的沟通技巧。本研究结果可为规划改善医院护士参与医生临床决策的状况提供依据。
