医护临床合作关系及其影响因素调查分析

Analysis of nurse-doctor cooperation and its influencing factors

目的 为了提高医务人员合作意识和工作质量,增加病人和家属的满意度,对医护人员进 行医护临床合作行为感知的调查及影响因素的研究.方法 对哈尔滨医科大学附属第二临床医学院的医生和护理人员共200名,采用自行设计问卷和临床实务合作量表进行调查.结果 医生和护理人员的临床合作行为总分皆处于中上等水平,2组比较差异无统计学意义（P＞0.05）.护理人员在与医生沟通医嘱、明确责任、向医生提供护理建议等方面得分较高;医生在明确自身责任、站在护理角度看问题、主动沟通护理措施等方面得分较高;而医护人员在＂共同讨论医疗护理知识＂的得分皆为最低.所在科室、管理者重视合作的程度、医护配置合理度、合作意愿,是影响护士临床合作行为的因素;职称、所在科室、角色期望、文化程度、合作意愿对医生临床合作行为有影响.结论 医生和护理人员的临床合作需要进一步加强,应该更注重在双方知识与信息的沟通的基础上互相理解支持对方的工作,为患者提供高质量的医疗护理服务.

Objective To raise awareness of nurse-doctor cooperation and quality of work, and to increase patient satisfaction, perception of clinical cooperation behaviors of doctors and nurses and corresponding influencing factors were investigated. Methods A total of 200 doctors and nurses in the second affiliated hospital of Harbin medical university were investigated with self-designed questionnaires and Collaborative Practice Scale （CPS）. Results Total scores of clinical cooperation behaviors of the doctors and the nurses were both at upper-middle levels , with no significant difference between the two groups （P ＞ 0. 05 ）. Nurses got higher scores on communicating with doctors on medical orders, clarifying responsibilities and providing nursing suggestions etc; Doctors got higher scores on clarifying self-responsibilities, looking at problems from nurses＇ perspective, communicating with nurses about nursing measures etc. However, both nurses and doctors got lowest scores on discussing health-care knowledge together. Factors influencing nurses＇ clinical cooperation behaviors included sections, the extent the administrative personnel attached importance to cooperation,rationality of human source configuration and cooperation willingness. Sections, titles, role expectations,education levels and cooperation willingness were the influencing factors of doctors＇ clinical cooperation behaviors. Conclusions Clinical cooperation of doctors and nurses should be further strengthened. In order to provide a high-quality health-care service, more attention should be paid to mutual understanding and supporting based on communication of knowledge and information.