The Status And Influencing Factors Of Nurse-physician Cooperation Perceived By Emergency Nurses

Objectives:To investigate the status of nurse-physician cooperation perceived by emergency nurses,analyze the influence of demographic variables,self-efficacy,task load,nurse-physician interactional exchange,practice environmental on nurse-physician cooperation in order to provide implications for nurse managers in implementing targeted interventions to enhance nurse-physician cooperation.Methods:326 emergency nurses from eight 3A-level hospitals were randomly selected from September to November 2020.Data were collected with general information questionnaire,nurse-physician collaboration scale,general self-efficacy scale,task load index,nurse-physician interactional exchange questionnaire,nursing practice environmental questionnaire.SPSS 26.0 was used to conduct statistical analysis,including descriptive analysis,independent t-test,one-way analysis of variance,Pearson correlation analysis and multivariate linear regression analysis.Result:1.Demographic data of emergency nurses326 nurses,aged between 21～54,with an average of(30.74±5.41)years,most of them were female(70.55%).1～33 years of working experience in emergency department;the highest degree was bachelor’s degree(88.04%);Most of the professional titles were nurses(77.61%);clinical nurse was the main position(77.61%);the main way of employment was contract nurses(87.73%).most of them were married(69.02%).2.Nurse-physician cooperation of emergency nursesIn this study,the average score of medical cooperation perceived by emergency nurses was(3.73±0.93),which was above the middle level.The scores of the three dimensions from high to low were as follows:patient information exchange(3.88±0.85),the relationship between nurses and doctors(3.77±0.89),and participation in treatment or nursing(3.61 ±0.98).3.Influence of demographic data on nurse-physician cooperationResults of independent t-test,one-way analysis indicated that there is no statistical significance in gender,age,education,working years,marital status,position and hiring(P>0.05);However,nurse-physician cooperation of these nurses are statistically different in professional.4.Scores of self-efficacy,task load,doctor-nurse interpersonal exchange and practice environment of nurses in emergency departmentThe average score of general self-efficacy of nurses in emergency department was(2.88±0.67).The total average score of task load is(16.59±3.55),which is at a high level.The highest score of the four dimensions is effort(17.07±3.44),and the lowest score is mental demand(15.86±3.73).The total average score of interpersonal exchange between doctors and nurses was(3.96±0.74),which was above the middle level.The highest score of the four dimensions was trust(4.08 ± 0.70),and the lowest score was effective communication(3.89 ± 0.74).The total average score of the practicing environment was(71.08±25.77),which was at the upper-middle level.Three of the nine dimensions with higher scores were quality management(80.21±20.42),manpower(77.51±20.81),and clinical nursing specialty(75.01±20.50).The three dimensions with low scores are social status(66.55±24.01),salary(60.13±27.61)and hospital management participation(47.50±29.69).5.Correlations among the study variablesPearson correlation analysis showed that the total score of medical cooperation and its dimensions were positively correlated with general self-efficacy(r=0.291～0.329,P<0.001),the total score of medical interpersonal exchange and its dimensions(r=0.486～0.692,P<0.001),and the total score of practicing environment and its dimensions(r=0.192～0.414,P<0.001),with statistical significance.The total score of medical and nursing cooperation and the decision-making process of patient information exchange and participation in treatment or nursing in the two dimensions were positively correlated with the total score of task load,mental demand and effort(r=0.113～0.175,P<0.05),and the communication of patient information was positively correlated with time demand(r=0.122,P<0.05).6.Multiple hierarchical regression analysisMultiple hierarchical regression was performed using nurse-physician cooperation score as the dependent variable,independent variable are those significant foctors identified in ANOVA analysis,including position、self-efficacy、effort level、nurse-physician interactional exchange、practice environmental.the results shows that cooperative willingness、effective communication and internal support can fit into the regression equation of nurse-physician cooperation and account for 51.60%of the total variation.Conclusion:1.Nursing cooperation perceived by emergency nurses is above the medium level and there is room for improvement.Communication of patients’information is the basis of medical cooperation,which has the highest score.Co-participation in the treatment or care decision-making process scored lowest,suggesting that managers take measures to promote the level of medical cooperation in this regard.2.The level of medical cooperation perceived by nurses in emergency department is affected by their professional titles.Nurses have the highest evaluation of medical cooperation,and the level of cooperation decreases with the promotion of professional titles.It is suggested that when formulating strategies,nursing managers should take into account the factor of professional title,formulate hierarchically,so that nurses with low professional titles have the ability to participate in decision-making,and nurses with high professional titles have the opportunity to promote the level of medical cooperation and improve the quality of medical services..3.The stronger the self-efficacy of emergency nurses,the better the doctor-nurse interpersonal exchange and the healthier the practice environment,the higher the level of doctor-nurse cooperation.4.Willingness to cooperate,effective communication and internal support are the significant influencing factors of medical cooperation.Managers can make doctors and nurses realize the importance of medical cooperation through relevant courses,enhance their willingness to cooperate,carry out communication skills training,improve communication ability,and strengthen internal support to improve the level of medical cooperation.