| Objective:(1)Understand the current situation of emergency department medical cooperation,and analyze the influencing factors of emergency department medical and nursing cooperation.(2)To explore the impact of medical and nursing cooperation on burnout and willingness to leave the emergency department.Methods:This study is a cross-sectional survey adopting the convenience sampling method.The emergency department nurses who worked in the emergency department of Wuxi secondary hospitals and above from December 2021 to October 2022 were selected as the research subjects.Collection:(1)General information:age,gender,education level,number of middle and night shifts,etc.;(2)Medical cooperation:including medical cooperation attitude and status.Attitudes toward Physician-Nurse Collaboration(JSAPNC)was used to assess nurses’ attitudes toward their perceived collaboration with care,including four dimensions:common education and teamwork,control of nursing and treatment,autonomy of nurses,and dominance of doctors;Collaboration with Medical Staff Scale(CMSS)was used to assess nurses’ feelings about medical cooperation,including two dimensions:taking into account nurses’ feelings and valuing nurses’contributions;(3)Anxiety level:Self-Rating Anxiety Scale(SAS)was used to assess patients’ anxiety,including four dimensions:anxiety,autonomic dysfunction,motor tension,mixed symptoms of anxiety and autonomic function;(4)Social support:The Social Support Rating Scale(SSRS)was used to assess the support employees felt by leaders,colleagues and family members for their work,including two dimensions:emotional support and instrumental support;(5)Burnout:The Burnout Survey(MBI-GS)was used to assess the burnout of emergency department nurses,including three dimensions:emotional exhaustion,work attitude,and sense of achievement:(6)Willingness to leave:The Intention of Quitting Scale(IQS)was used to evaluate nurses’ willingness to leave,including three dimensions:the possibility of quitting their current job,the motivation to find other jobs,and the possibility of obtaining external jobs.SPSS 26.0 statistical software was used to process and analyze data.Descriptive statistical analysis was used to explore the general data,anxiety,social support,medical cooperation,burnout,and willingness to leave the emergency department in Wuxi to explore the general data,anxiety,social support,medical cooperation,burnout,and willingness to leave the nursing data,which conformed to the normal distribution,and expressed the mean ± standard deviation,and the t-test or ANOVA were used for comparison between groups.The counting data were expressed in frequency and percentage(%),and the chi-square and Fisher’s exact tests were used to compare groups.Multiple linear regression analysis was used to explore the influencing factors of medical cooperation and the relationship between medical cooperation and burnout and willingness to leave.P<0.05 indicates that the difference is statistically significant.Results:A total of 414 questionnaires were collected,11 questionnaires were eliminated,5 questionnaires were answered regularly,4 questionnaires were contradictory between positive and negative questions,and 394 questionnaires were effectively recovered,with an effective recovery rate of 95.17%.(1)General situation:Among the 394 emergency department nurses,53 were male(13.5%)and 341 were female(86.5%);The age is between 21～48 years old,and the average age is(30.80±7.99)years;There were 226 cases(57.4%)with spouses;There were 187 cases(47.5%)have children.287 cases(72.8%)had a bachelor’s degree or above;There were 229 cases(82.8%)with at least 5 years working experience;241 nurses(61.2%)in tertiary hospitals;There were 177(44.9%)workers in the rescue room,98(24.9%)in the intensive care unit,and 119(30.2%)in the observation room.268 cases(68%)with a monthly income of ≥ 5,000 yuan;There were 122 cases(30.9%)above intermediate and senior level.(2)Medical cooperation:including medical cooperation attitude and status.The total score of medical cooperation attitude was(43.51±7.85),the minimum value was 18 points.and the maximum value was 60 points,including the score of co-education and teamwork(20.68±3.90),the control dimension of nursing and treatment(9.75±2.08).the score of nurse’s work autonomy dimension(8.89±1.84),and the score of doctor’s dominance dimension(4.30±1.45).The total score of medical and nursing cooperation was(19.60±5.70),with a minimum value of 9 points and a maximum value of 36 points.including the score of nurses’ feelings dimension(15.46±4.68)and the dimension score of paying attention to nurses’ contribution(4.14±1.42).(3)Influencing factors of medical and nursing cooperation:The results of multiple linear regression analysis showed that the independent influencing factors of the total score of emergency department nurses’ medical cooperation attitude were anxiety,social support.and monthly income(P<0.05).Regression analysis in each dimension showed that the main influencing factors of the co-education and teamwork dimensions were anxiety and papers published in the past 5 years.The main influencing factor in the control dimensions of care and treatment was social support;The main influencing factors of the dimension of nurses’ work autonomy are anxiety,monthly income,and social support.The influencing factor for the overall score of nurse-care cooperation in the emergency department was anxiety(P<0.05).The regression analysis of each dimension showed that anxiety was the main influencing factor of the nurses’ sensory dimension.The main influencing factor that values the dimension of nurses’ contributions is anxiety.(4)Current status of burnout in the emergency department:the total burnout score is(96.95±22.74)points,the minimum value is 40 points,and the maximum value is 184 points.Among them,the emotional exhaustion dimension score(4.67±1.431)score,the work attitude dimension score(4.49±1.494)score,and the fulfillment dimension score(5.23±1.429)score.(5)Current status of willingness to leave the emergency department:the total score of willingness to leave was(2.84±0.42),the minimum value was 1.67 points,and the maximum value was 3.83 points.Among them,the probability dimension score of quitting the current job was(3.03±0.611),the motivation dimension of seeking other jobs was(2.36±0.714),and the probability of obtaining external work was(3.13±0.532).(6)The effect of medical cooperation on burnout and willingness to leave:The results of multiple linear regression analysis showed that the independent influencing factors of the total score of burnout were medical cooperation status,medical cooperation attitude,anxiety,number of shifts per month,and department(P<0.05).The regression analysis results in various dimensions showed that the main influencing factors of emotional failure were medical cooperation status,medical cooperation attitude,anxiety,children,number of monthly shifts,and departments.The main influencing factors of work attitude are medical cooperation status,medical cooperation attitude,anxiety,and department;The main influencing factors of the sense of achievement are the status of medical and nursing cooperation,social support,professional title,and attitude towards medical and nursing cooperation.The independent influencing factors of the total score of willingness to leave were attitude towards cooperation between care and care,anxiety,and age(P<0.05),The regression analysis results in various dimensions showed that the main influencing factors of the possibility of quitting the current job were medical cooperation attitude,medical cooperation status,and anxiety.The main influencing factors of motivation to seek other jobs are years of employment,attitude towards medical cooperation,and monthly income;The main factors influencing the possibility of obtaining outside employment are the attitude toward medical cooperation and the status of medical cooperation.Conclusions:1.The attitude of nurses and nursing cooperation in the Wuxi Emergency Department is at a high level,among which the scores of common education and teamwork are the highest,and the doctor’s dominance dimension scores are the lowest.Anxiety and emotional support are independent influencing factors of the total score.It is recommended that hospital managers regularly hold psychological stress reduction activities for nursing staff to help them vent negative emotions and stress,regularly investigate and track the mental health of nursing staff,understand their situation and service needs,and provide necessary help;At the same time,hospital managers can release relevant videos about nursing work through the hospital’s self-media to provide emotional comfort for nurses and improve their social support,thereby reducing the negative emotions generated by work.2.The medical cooperation status of nurses in Wuxi Emergency Department is at an upper-middle level,and anxiety is its independent influencing factor.It is recommended to strengthen the degree of attention paid by nursing staff in the future,reduce the negative emotions of nurses,and improve the status of medical and nursing cooperation.3.Wuxi emergency department nurses have a high willingness to leave and burnout,which needs to be solved urgently.The status of medical cooperation,medical cooperation attitude,anxiety,etc.,are independent influencing factors.It is recommended that managers adjust nurses’ salaries appropriately within the scope of the policy,keep abreast of nurses’ stress and problems,and give them adequate help and support.4.Medical cooperation is an independent influencing factor of burnout of nurses in the Wuxi Emergency Department.It is recommended that in the future,the department should pay more attention to the cooperation status and quality of cooperation between doctors and nurses,strengthen teamwork,and hospital managers should strengthen the construction of emergency departments to ensure an excellent working atmosphere and provide a harmonious working environment for medical staff,in order to reduce the burnout of emergency department nurses.5.Medical cooperation is an independent influencing factor of the willingness of nurses in the Wuxi emergency department to leave,which is negatively correlated with it.It is recommended that in the future,doctors and nurses should be strengthened to carry out relevant course training and team building and regularly carry out joint ward rounds and difficult case discussions so that both medical and nursing parties can understand each other’s treatment plans and nursing measures,to improve the level of medical and nursing cooperation,in order to reduce the willingness of emergency department nurses to leave.5.Medical cooperation is an independent influencing factor of the willingness of nurses in the Wuxi emergency department to leave,which is negatively correlated with it.It is recommended that in the future,doctors and nurses should be strengthened to carry out relevant course training and team building and regularly carry out joint ward rounds and difficult case discussions so that both medical and nursing parties can understand each other’s treatment plans and nursing measures,to improve the level of medical and nursing cooperation,in order to reduce the willingness of emergency department nurses to leave. |
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