Collaborative Decision Making in Nursing Practice

本研究的目的是调查急诊医院病人和护士对护理协作的态度和认知。本研究的理论基础是护士和患者的态度和认知可能会影响护理决策的协作，并可能影响患者的护理结果。采用的方法是1988年至1991年在挪威、日本、芬兰和美国重复的问卷调查。每个国家都采用了相同的研究程序。在每个国家都进行了一组护士调查和两组患者调查，第一组在入院时进行，第二组在出院时进行。最初用英语编制的调查问卷被翻译成挪威、日本和芬兰各自的母语。调查发现，尽管这些国家的患者和护士在态度上倾向于消费主义观点，但这些态度在国家之间和患者与护士之间的适应方面存在显著差异。护理实践中病人和护士群体对协作决策态度的解释出现了两种不同的模型。然而，对于这两组人来说，年龄和更普遍的消费主义态度与他们对护理合作的态度有关。由于当代的重点是重视卫生保健中的自我决定主义和消费主义，下一次调查应该检查消费主义态度与病人和护士的行为之间的关系，这些行为存在并影响患者的结果。然而，由于不同的医疗保健谈判模式和护患关系可能已经融入每个国家的护理实践，在国际背景下调查这一问题也将是重要的。

The purpose of this study is to investigate patients' and nurses' attitudes and perceptions regarding collaboration in nursing care in acute care hospitals. This study is based on the theory that nurses' and patients' attitudes and perceptions may affect collaboration in nursing care decision making and may influence patient-care outcomes.The method used was a questionnaire-survey which was replicated in Norway, Japan, Finland, and the U.S., between 1988 and 1991. The same research procedures were used in each country. One set of nurse surveys and two sets of patient surveys, the first given at the admission and the second at the time of discharge, were carried out in each country. The survey questionnaires originally developed in English were translated into the respective native languages in Norway, Japan, and Finland.Findings from the survey indicate that while the patients and the nurses in these countries tend to lean toward the consumerist perspective in their attitudes, there were significant differences in the acculturation of these attitudes among the countries and between the patients and nurses. Two different models for the explanation of attitudes regarding collaborative decision making in nursing practice emerged for the patients and the nurses as groups. For both groups, however, age and the more general consumerist attitude have a bearing on their attitude regarding collaboration in nursing.Since the contemporary thrust is on valuing self-determinism and consumerism in health care, the next investigation should examine the relationships between consumerism attitudes and patients' and nurses' behaviors which exist and affect patient outcomes. However, since different patterns of health care negotiation and nurse-patient relationships may have been integrated into nursing practice in each country, it will also be important to investigate this issue in an international context.