Dissertation/Thesis Abstract

A mixed methods study of nurse-physician work relationships
by Lopez, Karen Dunn, Ph.D., The University of Iowa, 2008, 215; 3421008
Abstract (Summary)

Several decades of research have been conducted on nurse-physician work relationships. However, little is known about influences of physician experience, work relationships in medical surgical settings and the nature of relationships in settings with a history of unfavorable nurse-physician relationships. To address these gaps, a mixed methods study was undertaken. In Phase I, the aim was to determine physician variables that influence physician's perceptions of these relationships. In Phase II, the aim was to further describe the nature of these relationships in order to validate and extend "The Integrated Model of Nurse-Physician Relationships".

In Phase I, a single Likert item was used to measure physician perception of satisfaction with inpatient nurses in a secondary analysis of a multi-center survey. Analysis was undertaken using logistic regression models. Findings indicate that physician experience plays an important role in physician perception of their satisfaction with inpatient nurses (Wald Chi2 10.36, P=.03), with length of time in an institution playing the most significant individual role (β=.11, p=.01).

In Phase II, a qualitative study was undertaken in the site from the Phase I whose physicians were less satisfied with their work relationships. Face-to-face, semi-structured interviews were conducted with inpatient staff nurses and attending physicians on general medicine units. Directed content analysis methods were used. Themes that emerged included: inadequate communication between the professions, role of familiarity and informal social exchange in promoting patient centered communication, importance of communication skills, stronger relationships between nurses and hospitalists, influence of organizational traits, influence of patient characteristics, role of nursing background and tension caused by racial imbalance between the professions.

Results of this study contribute to our understanding of nurse-physician work relationships in three primary areas. First, it provides a description of work relationships in general medical inpatient units, where work between physicians and nurses is asynchronous. Second, it provides a description of unfavorable nurse-physician work relationships. Third, it provides information related to favorable influences of physician experience and hospitalist specialty on nurse-physician work relationships.

Indexing (document details)
Advisor: Craft-Rosenberg, Martha
Commitee:
School: The University of Iowa
School Location: United States -- Iowa
Source: DAI-B 71/09, Dissertation Abstracts International
Source Type: DISSERTATION
Subjects: Nursing
Keywords: Nurse-physician relationships, Work relationships
Publication Number: 3421008
ISBN: 978-1-124-19141-6
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