Collaborative Decision Making in Nursing Practice

本研究的目的是确定这种基于医疗消费主义的离职计划的效果，以便护士在与患者合作时改善他们的决策。研究对象为某教学医院1993年的65名护士和130名住院病人，以及北中大学护理学院1994年的274名大四学生，分为实验组和对照组。以上学习计划由学习小组的一名成员执行。先前的调查显示实验组和对照组之间没有显著差异。后测结果显示，实验组护士和护生在医疗消费态度方面得分较高，且与对照组有显著差异；年轻实验组护士在医疗消费态度方面知识习得程度较高。实验组与对照组之间无显著差异。学习计划对护士和护生的协同决策有促进作用。对照组护生表现出的行为改变被认为是他们对改变了护士传统角色的病房的必要适应。对患者无效的一个抑制因素被认为与医疗信息开放系统有关。本研究不仅促成了批判性反思性研究作为一种定性研究方法的发展，而且促成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.