Adamson B, Kenny D
Aust J Adv Nurs. 1993 Jun-Aug;10(4):10-9.
Current literature on the sociology of healthy views medical dominance as a structural feature of the health division of labour and a body of literature has developed exploring the structural components that contribute to the subordination of the allied health professions. In this paper, Friedson's four factor definition of medical dominance was employed to provide a framework for assessing the degree to which structural medical dominance of the nursing profession impinges on nurses' perceptions of dominance and how structural and perceived medical dominance affects nurses' workplace satisfaction. A 69 item questionnaire covering aspects of doctor/nurse, doctor/patient, nurse/patient and nurse/hospital administration relationships was developed. One hundred and thirty nurses completed the questionnaire in which they ranked their own level of professional satisfaction and their perceptions of level of doctors' professional satisfaction. Results indicated that nurses were dissatisfied with many aspects of their work environment, i.e. pay and working conditions and experienced very high levels of dissatisfaction with their professional status. Nurses perceived doctors as being highly satisfied and as having more control over a range of procedures intrinsic to the delivery of health care, and the medical profession to be a more powerful and higher status profession that was held in greater regard by the public and other allied health professionals than nursing. The implications of the perceived discrepancy in nurses' and doctors, workplace satisfaction are discussed in terms of the structural barriers created by medical dominance. Implications of the findings for nurse education and nurse practitioners are also discussed, together with suggestions for further research.
当前关于健康社会学的文献将医学主导视为卫生劳动分工的一个结构特征，并且已经形成了一批文献，探讨了导致辅助医疗专业从属地位的结构组成部分。在本文中，采用了弗里德森对医学主导的四因素定义，以提供一个框架，用于评估护理专业的结构性医学主导对护士主导观念的影响程度，以及结构性和感知到的医学主导如何影响护士的工作场所满意度。编制了一份涵盖医生/护士、医生/患者、护士/患者和护士/医院管理关系等方面的69项问卷。130名护士完成了问卷，在问卷中她们对自己的职业满意度水平以及对医生职业满意度水平的看法进行了排序。结果表明，护士对其工作环境的许多方面不满意，即薪酬和工作条件，并且对其职业地位非常不满。护士认为医生非常满意，并且对一系列医疗保健提供过程中固有的程序有更多控制权，而且医学专业是一个更有权力、地位更高的职业，公众和其他辅助医疗专业人员对其的尊重程度高于护理专业。从医学主导造成的结构障碍方面讨论了护士和医生在工作场所满意度方面感知到的差异的影响。还讨论了研究结果对护士教育和执业护士的影响，以及进一步研究的建议。
