Discrepant attitudes about teamwork among critical care nurses and physicians
Discrepant attitudes about teamwork among critical care nurses and physicians
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DOI：
10.1097/01.ccm.0000056183.89175.76
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发表时间：
2003-03-01
影响因子：
8.8
通讯作者：
Helmreich, RL
中科院分区：
文献类型：
--
作者：
Thomas, EJ;Sexton, JB;Helmreich, RL
Objective.目的：测量并比较重症监护医生和护士对团队合作的态度。横截面调查。设置。8个非外科重症监护病房在两个教学和四个非教学医院在休斯敦，得克萨斯州，大都市地区。在重症监护病房工作的医生和护士。测量和主要结果。，320名受试者（90名医生和230名护士）回答了调查。应答率为58%（医生为40%，护士为71%）。只有33%的护士认为与医生的合作和沟通质量高或非常高。相比之下，73%的医生认为与护士的合作和沟通是高或非常高的。通过因素分析，我们编制了一个七个项目的团队合作量表。多变量方差分析的项目产生了一个综合（F [7，163] = 8.37; p <0.001），表明医生和护士认为他们的团队合作气氛不同。个别项目的分析显示，相对于医生，护士报告说，这是很难说出来，分歧没有得到适当的解决，需要更多的投入到决策，护士的投入是不好接受。重症监护医生和护士对他们彼此经历的团队合作有不同的态度。正如个别项目内容所证明的那样，这种差异包括次优的冲突解决和人际沟通技能。这些发现可能是地位/权力，责任，性别，培训，护理和医生文化差异的结果。
Objective. To measure and compare critical care physicians' and nurses' attitudes about teamwork.Design. Cross-sectional surveys.Setting. Eight nonsurgical intensive care units in two teaching and four nonteaching hospitals in the Houston, TX, metropolitan areaSubjects. Physicians and nurses who worked in the intensive care units.Measurements and Main Results., Three hundred twenty subjects (90 physicians and 230 nurses) responded to the survey. The response rate was 58% (40% for physicians and 71% for nurses). Only 33% of nurses rated the quality of collaboration and communication with the physicians as high or very high. In contrast, 73% of physicians rated collaboration and communication with nurses as high or very high. By using factor analysis, we developed a seven-item teamwork scale. Multivariate analysis of variance of the items yielded an omnibus (F [7, 163] = 8.37; p < .001), indicating that physicians and nurses perceive their teamwork climate differently. Analysis of individual items revealed that relative to physicians, nurses reported that it is difficult to speak up, disagreements are not appropriately resolved, more input into decision making is needed, and nurse input is not well received.Conclusions. Critical care physicians and nurses have discrepant attitudes about the teamwork they experience with each other. As evidenced by individual item content, this discrepancy includes suboptimal conflict resolution and interpersonal communication skills. These findings may be the result of the differences in status/authority, responsibilities, gender, training, and nursing and physician cultures.