Cadogan M P, Franzi C, Osterweil D, Hill T
UCLA School of Nursing, Los Angeles, CA 90095-6919, USA.
J Am Geriatr Soc. 1999 Jan;47(1):71-5. doi: 10.1111/j.1532-5415.1999.tb01903.x.
Effective communication between nurses and physicians is central to the clinical care of nursing home residents. Anecdotal evidence suggests that communication between the groups is unsatisfactory, but no empirical data exist with which to validate assumptions. The purpose of this pilot study was to compare perceptions of potential communication barriers among nurses and physicians in four California nursing homes.
Registered nurses (n = 59), and physicians (n = 47) involved in the direct clinical care of nursing home residents completed a 12-item questionnaire designed to elicit perceptions about potential communication barriers. Five specific categories of barriers were identified. These included nurse competence, time burden of calls, necessity of calls, professional respect, and language comprehension. Responses were compared using t test analysis.
Significant differences in perceived communication barriers were identified. Physicians, but not nurses, perceive nursing competence to be a significant barrier. Nurses perceive physicians to be unpleasant. Both physicians and nurses perceive that physicians do not value nurses' opinions. Neither group perceived language expression, language comprehension, or time burden of phone calls to be barriers to communication.
Issues related to the perceived competency of nurses by physicians is consistent with existing data from other clinical settings. Differences in awareness about scope of practice and regulatory requirements between the groups may offer a partial explanation for the discordant perceptions. Perceptions by nurses (but not physicians) of unpleasantness and/or disrespect during telephone encounters may reflect the broader ongoing differences in professional culture, social status, and gender inequality between the two groups. Further clarification of the causes of barriers to effective communication is essential in order to plan appropriate interventions.
护士与医生之间的有效沟通是疗养院居民临床护理的核心。轶事证据表明，这两个群体之间的沟通并不令人满意，但尚无实证数据来验证这些假设。这项试点研究的目的是比较加利福尼亚州四家疗养院的护士和医生对潜在沟通障碍的看法。
参与疗养院居民直接临床护理的注册护士（n = 59）和医生（n = 47）完成了一份12项问卷，旨在引出对潜在沟通障碍的看法。确定了五个具体的障碍类别。这些包括护士能力、电话的时间负担、打电话的必要性、职业尊重和语言理解。使用t检验分析比较回答。
在感知到的沟通障碍方面发现了显著差异。医生（而非护士）认为护理能力是一个重大障碍。护士认为医生令人不快。医生和护士都认为医生不重视护士的意见。两组均未将语言表达、语言理解或电话的时间负担视为沟通障碍。
医生对护士感知能力的相关问题与其他临床环境中的现有数据一致。两组之间在执业范围和监管要求认识上的差异可能为这种不一致的看法提供了部分解释。护士（而非医生）在电话沟通中对不愉快和/或不尊重的感知可能反映了两组在职业文化、社会地位和性别不平等方面更广泛的持续差异。为了规划适当的干预措施，进一步澄清有效沟通障碍的原因至关重要。
