Collaboration between doctors and nurses in two public hospitals in China

Abstract

Nurses and doctors have worked together to manage patients for a long time. Within the past decade, collaboration between doctors and nurses to provide improved health care has become commonplace especially, in hospitals. As and nurses differ in their professional goals – clinical care delivery and patient and advocacy – they face challenges in their work-related collaboration. Most instruments to measure doctor-nurse collaboration were developed for western healthcare institutions. As a result they were unlikely to be psychometrically or culturally oriented to a Chinese healthcare environment. The aim of this study was to develop a valid and reliable tool to test doctor-nurse collaboration in a Chinese healthcare setting and to assess collaboration in public hospitals in China. Two hospitals participated in the study, including 398 doctors and nurses. development included content validity through feedback from experts with international medical or nursing backgrounds to inform questionnaire refinement and reliability testing. Factor analysis was used for data reduction and factor structure and to confirm the factor structure of a previously validated instrument. Internal consistency and test-retest reliability were established. Summary descriptive statistics were calculated to compare the prevalence of levels of collaboration. Logistic and linear regression were used to identify factors contributing to work-place collaboration. 398 doctors and nurses participated. A 28-item questionnaire was developed and validated. Three factors (work related autonomy, work related skills and work related relationships) were identified. The high construct validity was determined for each factor and for the overall questionnaire. Overall Cronbach alpha was 0.83, by hospital 0.85 and 0.88 respectively; and by profession (doctors and nurses) 0.81 and 0.84 respectively. a profession nurses vs doctors and by location the general hospital vs the hospital were associated with more positive work-place collaboration scores. variables were included in the regression model explaining 56% of total variance collaboration scores. Doctor-nurse collaboration was negatively associated with working hours and number of patients under care. Finally, a negative relationship between doctor-nurse collaboration and depression was confirmed. In conclusion, the questionnaire “Work-related Collaboration among Doctors and Nurses Scale” had satisfactory validity and reliability. It has the potential to be a useful tool in evaluating doctor-nurse collaboration in public hospitals in China. The evaluation of both the clinical and cost effectiveness of strategies to improve effective inter-professional education and inter-professional work environments for doctors and nurses is needed to confirm these findings and to add to the evidence of the impact of collaboration on work efficiency, conflict management and avoidance, and unnecessary waste. Fostering collaborative relationships has the potential to decrease workplace stress and depression symptoms and perhaps thereby improve productivity and efficiency.