Collaborative Decision Making in Nursing Practice

本研究的目的是确定这样一个学习计划的效果，已经设计，使基于医疗消费主义，护士提高他们的决策与患者合作。研究对象为北里大学护理系1994级274名学生和某教学医院1993级65名护士和130名住院病人，分为实验组和对照组。实验前调查显示实验组与对照组无显著性差异，实验后调查显示实验组护士和护生对医疗消费主义的态度得分较高，与对照组比较差异有显著性：实验组年轻护士对医疗消费主义的知识掌握程度较高。实验组与对照组无显著性差异，学习计画对护理人员与护生合作决策有促进作用。对照组护生的行为改变主要是由于对病房传统护士角色的改变进行了必要的适应。对病人无效的一个抑制因素被推测涉及医疗信息公开系统。本研究不仅促进了批判性反思研究作为一种质的研究方法的发展，而且也促进了对学习计划内容的谨慎选择。

The present study was made to determine the effect of such a learing program as has been devised so that based upon medical consumerism, nurses improve their decision making in collaboration with patients. The subjects were 65 nurses and 130 inpatients of a teaching hospital for 1993 as well as 274-th year students of School of Nursing, Kitasato University for 1994, and were classified into the experimental group and the control group. The above learning program was executed by a member of the study team.The prior survey revealed no significant difference between the experimental and control groups.The post survey revealed the nurses-and nursing students-experimental groups showed high scores for attitude toward medical consumerism and significant differences, compared with the control group : younger nurses-experimental group showed high degree of knowledge acquirement. No significant difference was noted between the patient experimental and control groups.The learning program had an accelerating effect on nurses and nursing students for collaborative decision making. The behavioral change showed by nursing students of the control group was considered as ascribable to their necessary adaptation for a ward changed with traditional roles of nurses. An inhibitory factor in the ineffectiveness on patients was presumed to involve the medical information opening system. The present study led to not only the development of critical reflective research as a qualitative study approach, but also careful selection of the contents of learning prpgram.