Nurse-physician relationships in ambulatory oncology settings.
Nurse-physician relationships in ambulatory oncology settings.
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DOI：
10.1111/j.1547-5069.2012.01458.x
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发表时间：
2012-09
期刊：
影响因子：
--
通讯作者：
Manojlovich M
中科院分区：
文献类型：
--
作者：
Friese CR;Manojlovich M
本研究旨在探讨护士对门诊肿瘤科护医关系的看法，并探讨护医关系对病患安全的影响。这项横断面描述性研究分析了2010年从门诊肿瘤科护士中收集的调查数据。抽样框架是在美国东南部的一个州的护士执照数据库。护士完成了护理工作指数（PES-NWI）的实践环境量表，报告了其环境中的护理质量，并评论了促进或抑制高质量护理服务的因素。数据分析使用了三个研究变量：从PES-NWI中获得的数值，护士报告的护理质量的规模，以及关于其工作场所中促进或阻碍高质量护理的功能的开放文本评论。在对开放文本评论进行分类后，使用方差分析来评估按评论类别划分的PES-NWI分量表的差异。计算卡方检验统计量，以检查评论类别的整体实践环境和护理质量的差异。护士报告说，他们与医生的关系一般是有利的。定性研究结果表明，两个主题，影响护士如何表征他们与医生的工作关系：1）医生的行为和2）结构性因素。PES-NWI评分和护理质量的评分显着较高的护士谁写的医生有利。在门诊环境中良好的护士-医生关系可能反映积极的工作场所，促进高质量的护理。与住院部的研究结果一致，护士与医生的关系对门诊肿瘤护理的质量很重要。系统地测量和关注这些关系中报告的缺陷可能会促进更高质量的护理。
The purpose of this study was to explore nurses’ perceptions of nurse-physician relationships in ambulatory oncology settings, which are linked to patient safety. This cross-sectional, descriptive study analyzed survey data collected in 2010 from oncology nurses employed in ambulatory settings. The sampling frame was the nurse licensure database in one state in the Southeastern United States. Nurses completed the Practice Environment Scale of the Nursing Work Index (PES-NWI), reported on the quality of care in their setting, and commented on factors that promoted or inhibited high-quality care delivery. Data analysis used three study variables: empirically-derived values from the PES-NWI, a scale of nurse-reported quality of care in their setting, and open-text comments about features in their workplace that promoted or hindered high-quality care. After categorizing open-text comments, ANOVA was used to evaluate differences in PES-NWI subscales by comment category. Chi-square test statistics were calculated to examine differences in overall practice environment and quality of care by comment category. Nurses reported their relationships with physicians as generally favorable. Qualitative findings suggest two themes that influence how nurses characterize their working relationships with physicians: 1) physician behaviors and 2) structural factors. Both PES-NWI scores and quality of care were rated significantly higher by nurses who wrote favorably about physicians. Favorable nurse-physician relationships in ambulatory settings may reflect positive workplaces and promote high-quality care. Consistent with findings from inpatient units, nurse-physician relationships are important to the quality of ambulatory oncology care. Systematic measurement and attention to reported deficits in these relationships may promote higher quality care.
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