Patterns of Nurse-Physician Relationships

护医关系模式

• 批准号: 6868267
• 负责人: BARBARA DICICCO-BLOOM
• 金额: $ 7.57万
• 依托单位: UNIV OF MED/DENT NJ-R W JOHNSON MED SCH
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-15 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6868267
• 关键词: behavioral /social science research tag; case history; chronic disease /disorder; clinical research; data collection methodology /evaluation; diabetes mellitus; health care model; health care personnel performance; health care policy; health care professional practice; health care service evaluation; health services research tag; human data; hypertension; interpersonal relations; interview; managed care; nurse role; patient /disease registry; patient care management; patient care personnel attitude; primary care physician; questionnaires; social cooperation

DESCRIPTION (provided by the applicant): Primary care practices have access to the majority of the population at risk for chronic illness, so that registered nurses represent an untapped resource to prevent complications and modify the course of chronic disease. Nurses and physicians spend a lot of time together and yet, often do not share vital insights about their patients and their practice. The adaptation of primary care practices to increasingly complex chronic care needs of patients may in part depend on the quality of the relationships among practice members (i.e. nurses and physicians). Primary care practices can be viewed holistically by seeing them as complex adaptive systems in which the interrelationships of nurses and physicians help determine what will be successful for patients and the practice. A major contribution of research on complex adaptive systems has been to develop ideas that help us see the sources and consequences of distinctive interaction patterns among people. Patterns of interactions can help explain why some systems function more effectively and adapt to their environment better than others. The study aims to: 1) describe the presence of social capital (i.e. trust, reciprocity, and cooperation), and 2) describe the presence of movement in conceptual space (i.e. information flow) among nurses and physicians, in primary care practices and determine their association with standards of chronic illness care. The above aims will be addressed using data from a group randomized clinical trial of family practices in New Jersey. Baseline information from the first twenty practices serves as the data for this study. This data will be obtained using a practice-based observational data process called the Multimethod Assessment Process (MAP). MAP has been developed for understanding the unique barriers, opportunities and complexity of diverse primary care practice settings. A comparative case study analysis will identify features of relationships among nurses and physicians in primary care settings that are associated with utilization of standards for chronic illness care.

描述（由申请人提供）：初级保健实践可以覆盖大多数有慢性病风险的人群，因此注册护士是预防并发症和改变慢性病病程的未开发资源。 护士和医生花费大量时间在一起，但往往不会分享关于患者及其实践的重要见解。 初级保健实践适应患者日益复杂的慢性护理需求可能部分取决于实践成员（即护士和医生）之间关系的质量。 初级保健实践可以被整体地看待，将其视为复杂的适应性系统，其中护士和医生的相互关系有助于确定什么对患者和实践将是成功的。 复杂适应系统研究的一个主要贡献是提出了一些想法，帮助我们了解人与人之间独特的互动模式的来源和后果。 交互模式可以帮助解释为什么某些系统比其他系统更有效地运行并更好地适应环境。 该研究旨在：1) 描述社会资本的存在（即信任、互惠和合作），2) 描述初级保健实践中护士和医生之间概念空间（即信息流）中运动的存在，并确定它们与慢性病护理标准的关联。 上述目标将利用来自新泽西州家庭实践的一组随机临床试验的数据来实现。 前 20 次实践的基线信息作为本研究的数据。 该数据将使用基于实践的观察数据过程（称为多方法评估过程（MAP））获得。 MAP 的开发是为了了解不同初级保健实践环境的独特障碍、机会和复杂性。 比较案例研究分析将确定初级保健机构中护士和医生之间关系的特征，这些特征与慢性病护理标准的利用相关。