Exploration of the process of interprofessional collaboration among nurses and physicians in Iran

Authors

  • Abbas Heydari Ph.D. of Nursing, Professor, Evidence-Based Care Research Center, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

Keywords:

Grounded theory, Interprofessional relations, Nurses, Physicians, Collaboration

Abstract

Introduction: The development of interprofessional collaboration is of great significance for facilitating the flow of information and provision of collaborated services. In fact, only one single profession cannot respond to all demands. Thus, this study was aimed to investigate clinical nurse-physician collaboration in Iran. 

Methods: This study was performed with nurses and physicians of university hospitals affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, during September 2013-March 2015, using grounded and synthesis theory. The data were obtained using semi-structured interviews and field notes, and MAXQ DA version 10 was employed for data analysis. 

Results: The core variable was defined as “management of strategic goals”, and the main categories included perception of challenging organizational structures, providing a comprehensive supportive net for patients, seeking professional communication, and building solid confidence. Based on views of the participants, they were aiming to apply a stress management strategy, while maintaining their position in the organization, by making passive compromises to protect themselves against the perceived threats.

Conclusion: The participants were trying to overcome barriers through reducing and managing the tension, while maintaining their position in the organization using forced, passive coping strategies to protect themselves against the perceived threats.

 

References

Petri L. Concept analysis of interdisciplinary collaboration. Nurs Forum. 2010; 45(2): 73-82. doi:

1111/j.1744-6198.2010.00167.x. PMID: 20536755.

Martin JS, Ummenhofer W, Manser T, Spirig R. Interprofessional collaboration among nurses and

physicians: making a difference in patient outcome. Swiss Med Wkly. 2010; 140: 13062. doi:

4414/smw.2010.13062. PMID: 20458647.

Mueller CA, Tetzlaff B, Theile G, Fleischmann N, Cavazzini C, Geister C, et al. Interprofessional

collaboration and communication in nursing homes: a qualitative exploration of problems in medical care

for nursing home residents-study protocol. J Adv Nurs. 2015; 71(2): 451-7. doi: 10.1111/jan.12545. PMID:

Nair DM, Fitzpatrick JJ, McNulty R, Click ER, Glembocki MM. Frequency of nurse-physician

collaborative behaviors in an acute care hospital. J Interprof Care. 2012; 26(2): 115-20. doi:

3109/13561820.2011.637647. PMID: 22145999.

Lyndon A, Zlatnik MG, Wachter RM. Effective physician-nurse communication: a patient safety essential

for labor and delivery. Am J Obstet Gynecol. 2011; 205(2): 91-6. doi: 10.1016/j.ajog.2011.04.021. PMID:

, PMCID: PMC3219810.

Ten Have EC, Hagedoorn M, Holman ND, Nap RE, Sanderman R, Tulleken JE. Assessing the quality of

interdisciplinary rounds in the intensive care unit. J Criti Care. 2013; 28(4): 476-82. doi:

1016/j.jcrc.2012.12.007. PMID: 23428713.

Kenaszchuk C, Wilkins K, Reeves S, Zwarenstein M, Russell A. Nurse-physician relations and quality of

nursing care: findings from a national survey of nurses. Can J Nurs Res. 2010; 42(2): 120-36. PMID:

Titzer JL, Swenty CF, Hoehn WG. An interprofessional simulation promoting collaboration and problem

solving among nursing and allied health professional students. Clin Simul Nurs. 2012; 8(8): 325-33. doi:

1016/j.ecns.2011.01.001.

O'Leary KJ, Ritter CD, Wheeler H, Szekendi MK, Brinton TS, Williams MV. Teamwork on inpatient

medical units: assessing attitudes and barriers. Qual Safety Health Care. 2010; 19(2): 117-21. doi:

1136/qshc.2008.028795. PMID: 20351159.

Kaldheim HKA, Slettebø Å. Respecting as a basic teamwork process in the operating theatre-A qualitative

study of theatre nurses who work in interdisciplinary surgical teams of what they see as important factors in

this collaboration. Nord Sygeplejeforskning. 2016; 5(01): 49-64. doi: 10.18261/issn.1892-2686-2016-01- 05.

Fewster Thuente L. Working together toward a common goal. A grounded theory of nurse-physician

collaboration. Loyola University Chicago. 2011.

Berge JM, Loth K, Hanson C, Croll‐Lampert J, Neumark‐Sztainer D. Family life cycle transitions and

the onset of eating disorders: a retrospective grounded theory approach. J Clin Nurs. 2012; 21(9‐10):

-63. doi: 10.1111/j.1365-2702.2011.03762.x. PMID: 21749510, PMCID: PMC3207010.

Urquhart C. Grounded theory for qualitative research: A practical guide. Sage. 2012.

Moore J, Prentice D. Collaboration among nurse practitioners and registered nurses in outpatient oncology

settings in Canada. J Adv Nurs. 2013; 69(7): 1574-83. doi: 10.1111/jan.12017. PMID: 23002812.

Légaré F, Stacey D, Gagnon S, Dunn S, Pluye P, Frosch D, et al. Validating a conceptual model for an inter ‐professional approach to shared decision making: a mixed methods study. J Evalu Clin pract. 2011;

(4): 554-64. doi: 10.1111/j.1365-2753.2010.01515.x. PMID: 20695950, PMCID: PMC3170704.

Bedwell WL, Wildman JL, Diaz Granados D, Salazar M, Kramer WS, Salas E. Collaboration at work: An

integrative multilevel conceptualization. Hum Res Manag Rev. 2012; 22(2): 128-45. doi:

1016/j.hrmr.2011.11.007.

Bender M, Connelly CD, Brown C. Interdisciplinary collaboration: The role of the clinical nurse leader. J

Nurs Manag. 2013; 21(1): 165-74. doi: 10.1111/j.1365-2834.2012.01385.x. PMID: 23339506.

Young HM, Siegel EO, McCormick WC, Fulmer T, Harootyan LK, Dorr DA. Interdisciplinary

collaboration in geriatrics: Advancing health for older adults. Nurs Outlook. 2011; 59(4): 243-50. doi:

1016/j.outlook.2011.05.006. PMID: 21757083.

Organization WH. Interprofessional collaborative practice in primary health care: nursing and midwifery

perspectives. 2013; 13: 24.

Nugus P, Greenfield D, Travaglia J, Westbrook J, Braithwaite J. How and where clinicians exercise power:

Interprofessional relations in health care. Soc Sci Med. 2010; 71(5): 898-909. doi:

1016/j.socscimed.2010.05.029. PMID: 20609507.

Gotlib Conn L, Kenaszchuk C, Dainty K, Zwarenstein M, Reeves S. Nurse-Physician Collaboration in

General Internal Medicine: A Synthesis of Survey and Ethnographic Techniques. Health Interprof Pract.

; 2(2): 2. doi: 10.7772/2159-1253.1057.

Muller-Juge V, Cullati S, Blondon KS, Hudelson P, Maître F, Vu NV, et al. Interprofessional collaboration

between residents and nurses in general internal medicine: a qualitative study on behaviours enhancing

teamwork quality. PloS One. 2014; 9(4): 96160. doi: 10.1371/journal.pone.0096160. PMID: 24769672,

PMCID: PMC4000227.

Muller-Juge V, Cullati S, Blondon KS, Hudelson P, Maître F, Vu NV, et al. Interprofessional collaboration

on an internal medicine ward: role perceptions and expectations among nurses and residents. PloS One.

; 8(2): 57570. doi: 10.1371/journal.pone.0057570. PMID: 23469027, PMCID: PMC3585159.

Al Sayah F, Szafran O, Robertson S, Bell NR, Williams B. Nursing perspectives on factors influencing

interdisciplinary teamwork in the Canadian primary care setting. J Clin Nurs. 2014; 23(19-20): 2968-79.

doi: 10.1111/jocn.12547. PMID: 24476121.

Barnes JJ. Improving Interdisciplinary Communication to Improve Patient Satisfaction. 2014.

Badger F, Plumridge G, Hewison A, Shaw KL, Thomas K, Clifford C. An evaluation of the impact of the

Gold Standards Framework on collaboration in end-of-life care in nursing homes. A qualitative and

quantitative evaluation. Int J Nurs Stud. 2012; 49(5): 586-95. doi: 10.1016/j.ijnurstu.2011.10.021. PMID:

Low LL, Tong SF, Low WY. Selection of Treatment Strategies among Patients with Type 2 Diabetes

Mellitus in Malaysia: A Grounded Theory Approach. PloS One. 2016; 11(1): 0147127. doi:

1371/journal.pone.0147127.

Published

2022-01-18

Issue

Section

Articles