جستجوی مقالات مرتبط با کلیدواژه « همکاری بین حرفه ای » در نشریات گروه « پزشکی »

Concerning the determining role of health care professions in patient care and safety and the effects of interaction and collaboration between related professions on improving the quality and quantity of care and improving service to patients, this study was conducted to determine the correlation between moral sensitivity and interprofessional collaboration in 2023.

This is a descriptive study with a cross-sectional-correlation design. The sampling was done by simple random method and included 150 nurses working in teaching hospitals affiliated with Tehran Islamic Azad University of Medical Sciences. Inclusion criteria were the ability to speak Persian, mental health, absence of stressful issues in the last six months, and willingness to participate in the study. Exclusion criteria were lack of satisfaction to continue cooperation and failure to complete the questionnaire. Data were collected using nurses' moral sensitivity questionnaire (Lützén et al. 1994) and the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (Jefferson 2001). Face and content validity methods were used to validate the instruments, and Cronbach's alpha was used for reliability. Data analysis was done using descriptive and inferential statistics such as Pearson correlation tests.

The results showed that 82.67% of nurses had high moral sensitivity, and 81.33% had a lot of interprofessional collaboration. There was also no significant statistical relationship between nurses' moral sensitivity score and interprofessional collaboration (p=0.125).

Considering the positive and undeniable effects of moral sensitivity and interprofessional collaboration in nursing care, developing professional training in this field can affect the quality of nursing care, increase patient satisfaction, and reduce medical errors.

Improving the quality of providing health services on the one hand requires the participation and inter-professional cooperation of the care and medical team, and on the other hand, empathy of the care and medical team is considered essential to the provision of quality care. But participation in care and medical team always faces challenges which it has become a serious challenge in the Covid-19 pandemic.
Goal: In this regard, the aim of this study was evaluation of effectiveness educational based on inter-professional approach on rate of empathy and inter-professional collaboration among nurses and physicians in emergency department during the Covid-19 pandemic.

The cross-sectional research was applied research and research method was quasi experimental with pretest-posttest design and control group. The statistical population of the study consisted of nurses and physicians of Bahman hospital's emergency department with at least 5 years of work experience. That 40 of them were selected by available method and randomly assigned to experimental and control groups (20 in each group). Then, two separate two-day workshops with the same conditions were held for the experimental and control groups, so that the experimental group was given inter-professional training and the control group was given single-professional training. The tool used was readiness for inter-professional learning scale (Parsell & Bligh, 1999) and scale of physician empathy-health professionals (Jefferson et al, 1987). Data were analyzed by ANCOVA in SPSS, Version 26. 

The Findings showed that as compared to the nurses and physicians who did not receive this program, nurses and physicians that received this program by using the inter-professional education had a significant impact leading to an increase in the empathy and inter-professional collaboration of the nurses and physicians in emergency department (FEmpathy =20. 846, FInter-professional collaboration =27.184; P<0.0001). The effect of using the inter-professional education on empathy and inter-professional collaboration was 36 and 43 percent.

Therefore, the results showed that inter-professional education lead to significant increase in empathy and inter-professional collaboration among nurses and physicians in emergency department during the Covid-19 pandemic.

According to the obtained results, improving the quality of providing health services in emergency department during the Covid-19 pandemic depends on increasing their level of empathy and inter-professional collaboration among nurses and physicians that can be achieved through inter-professional education.

Ventilator-Associated pneumonia (VAP) is one of the prevalent nosocomial infections and the most severe Acquired infection in intensive care units (ICUs) [1]. VAP usually occurs forty-eight hours after the starting of mechanical ventilation. This infection has several complications, including hospital long stay, high medical costs, high antibiotic use, and high mortality rates [2,3]. The prevalence of VAP in developing countries is more than that in developed countries [2]. Despite recent advances in diagnostic and therapeutic methods, VAP has remained a common infection and a major cause of mortality in the ICUs [2,3]. VAP affects approximately 27% of critically ill patients in ICU wards [2,3]. Prevention of VAP is a significant challenge for workers in intensive care units and should be considered as a priority. There are some strategies to prevent VAP, such as appropriate sedation and early weaning, semi-seating position, oral hygiene, applying noninvasive positive pressure ventilation (NPPV), tracheal secretion management, nurses hand hygiene, selective decontamination of the digestive tract, appropriate antibiotic therapy, and subglottic secretion suctioning [2,4,5]. Another under attention approach to preventing VAP is to ensure adequate pressure of endotracheal cuff. Tracheal cuff pressure should be maintained in the accurate range (20–30 cm H2O), and under inflation and over inflation can be associated with the risk of aspiration and tracheal injury [6,7]. Micro aspiration of subglottic secretions due to cuff under Inflation is one of the most critical risk factors for the VAP [4], Therefore, ensuring adequate pressure of cuff to prevent micro aspiration is a low-cost, easy, and practical approach in VAP prevention. However, the importance of this technique in guidelines and studies is under attention. Various methods are used to assess the accuracy of tracheal cuff pressure, including manual (Minimal leak and Finger Palpation) and automatic (Direct Manometer and Continuous Monitoring) methods. Two common methods for checking the accuracy of cuff pressure are the manual method (Minimal leak) and the use of direct manometer [6]. Studies showed that continuous monitoring of cuff pressure could also be more efficient in VAP prevention [1,4]. Given the importance of this issue, the design and implementation of the guillotines to assess and ensure adequate cuff pressure along with other measures is necessary and can help to prevent VAP.

Intensive care units encounter with the complex and different therapeutic and care needs of patients. The effective responsiveness to these needs depends on the knowledge and skills of different health professions, so inter-professional collaboration and teamwork is essential to providing safe and comprehensive care in these areas. Inter-professional collaboration is a process in which different health professions, along with the patient and their families work together in the interaction based on partnership, mutual trust and understanding, information sharing, common goals setting and joint decision making to achieve the best and most effective outcome for the patient. Unfortunately, most current performance in the intensive care units is parallel, independent and without the participation and joint decisions of different professions, and this is one of the reasons for the increase the medical errors and negative patients’ outcome. Numerous factors, including systemic, organizational, and interpersonal interactions, are influential on inter-professional collaboration in the mentioned wards, and understanding them will provide an opportunity to promote inter-professional collaborations in these areas. Strategies such as inter-professional rounds, the development of inter-professional common goals setting sheets, the preparation of guidelines, as well as the tools for measuring team performance and monitoring them can be effective in promoting inter-professional collaboration in intensive care units. It is time to adopt approaches and strategies to improve teamwork and inter-professional collaboration in intensive care units and improve patients’ outcome.

Developing Interprofessional education and collaboration is important in systems of medical sciences to deliver better health care. The present study aimed to assess the validation of the Interprofessional Collaborator Assessment Rubric (ICAR) (validity, reliability and confirmatory factor analysis). Also, the interprofessional collaboration of the healthcare team members in emergency departments was evaluated by ICAR.

This descriptive and cross-sectional study conducted in two phases. In the first phase, the face and content validity of ICAR was assessed. The Rubric includes 17 items in six domains including communication skills, collaboration, role and responsibility, teamwork, collaborative patient-centered approach, and conflict management). Also, a confirmatory factor analysis of Rubric was assessed. The reliability of the Rubric was evaluated by internal consistency and reproducibility (test-retest approach). The CFA assessed using Maximum Likelihood by EQS. In the second phase, the interprofessional collaboration of Emergency care team members (including 70 residents, interns, and nurses) were assessed by direct observations. Also, an inter-professional collaboration of healthcare team members was analyzed using descriptive tests (mean and standard deviation) and one-way analysis of variance was used to compare between groups.

The face and content validity of ICAR approved by consensus of 18 faculty members in medical education, nursing education and clinical specialties (CVI>0.70 and CVR>0.49). The reliability of Rubric approved by Cronbach's alpha =0.89 and ICC=0.80. The construct of Rubric confirmed in six domains through GFI=0.9, AGFI=0.9, CFI=0.976, RMSEA=0.06, χ2/df=1.88, χ2=195.78, df=104, P<0.001. The mean score of participants (including interns, emergency medical assistants, and nursing personnel) in the emergency department was 63.35 (17.53). There was a significant difference between the performance of three groups (nurses, interns and assistants) (p-value=0.03).

The results of the present study showed that the scores of inter-professional cooperation of participants in the present study were lower than expected. It is recommended to plan and implement interprofessional training courses to improve inter-professional collaboration between healthcare providers in the study environment. Regarding, the confirmation of ICAR validation, it can be used to assess the interprofessional collaboration of participants.

Considering the developments of the third millennium in the field of health, creating the ability of inter-professional collaboration and teamwork among students is one of the most important tasks of educational organizations. The aim of this study was to investigate the effectiveness of the educational workshop based on inter-professional approach to changing the attitudes of health science students toward inter-professional learning and collaboration.

Quesi-experimental study was done in 2018 at Baqiyatallah University of Medical Sciences. Sixty-five students from medical and nursing participated in this study. Primary sampling was done by available method, then the samples were randomly assigned to two groups of control and experimental. The intervention was developed as an interactive workshop based on interprofessional approach with educational content of communication and inter-professional collaboration. Data were gathered using readiness and attitude to inter-professional learning scale (RIPLS) with Reliability 0.8 , and was analyzed with SPSS 22 software.

There was no significant difference between the two groups regarding the attitude toward inter-professional learning and collaboration before intervention (p> 0.05); after intervention, the Students’ attitude was in the experimental group with a mean of 80.8 and standard deviation 8.59 and control group with a mean of 59.72 and standard deviation 8.29, so significant difference was observed between the two groups (P < 0.001).

results indicate the availability of an appropriate motivation and perspective for integrating inter-professional education in health sciences in the health science. Educational organizations, for empowerment labor for responding to present and future generation health needs, should design and implement inter-professional education in the field of health from now.

Professional collaboration play an important role in workplace’ health in healthcare organizations. Improving this collaboration may effect on nursing job satisfaction. This study aimed to determine the correlation between nurse/manager professional collaborative behaviors ans nurses’ job satisfaction.
This descriptive, correlational, and cross-sectional study was conducted in 2016. The subjects were 106 nurses, head nurses, and supervisors worked in two hospitals affiliated to Shiraz University of Medical Sciences The convenince sampling was used. Data were collected using Stichler Collaborative Behavior Scale and Index of work satisfaction. Data were analyzed by SPSS software version 22 using Independent t-test, Pearson correlation, Kruskal wallis test, and ANOVA.
The mean score of nurses’s collaborative behavior and job satisfaction were 45.72 ± 1.07, and 158.68 ± 2.09, respectively. A significant association was found between nurse/manager professional collaborative behaviors and nurses’ job satisfaction (r=0.45, P The results of this study indicated that the mean score of collaborative behavior and job satisfaction was at the midpoint of expected score and there were association between these two variables. Therefore, it is recommended to promote the collaborative behaviors by holding workshops and training courses.

Inappropriate collaboration between nurse-physician effects on patient outcomes, job satisfaction of nurses, and hospital costs. This study aimed to determine nurses and physicians attitude toward nurse-physician collaboration in intensive care units of Ardabil.
This descriptive correlational study was performed on 126 nurses and 61 physicians working in intensive care units of educational and therapeutic centers of Ardabil University of Medical Sciences. Data were collected using the Jefferson scale of attitudes toward the nurse-physician collaboration. Descriptive statistics (mean, standard deviation and frequency) and inferential statistics (T-test and one-way ANOVA) were used to analyze the data.
The mean scores of the nurse-physician collaboration from nurses and physicians viewpoints were 47.83±3.9 and 47.85±4.25, respectively. There was no significant difference between attitudes of nurses and physicians toward collaboration (p=0.97). Comparing the scores of nurses-physicians in the four areas showed asignificant difference in “care vs. treatment” (p=0.025) and “nurses autonomy” (p=0.008) areas.
The results showed that nurses and physicians had a positive attitude toward nurse-physician collaboration. However, in some areas of collaboration, there are still differences in the attitudes of nurses and physicians. Given the importance of nurse-physician collaboration, especially in intensive care units, planning is needed to improve their attitude toward collaboration.

Collaboration is a basic strategy in relationships, which minimizes medical errors on patients. Therefore, it is measured in terms of engaging both physicians and nurses in decision-making, influencing patients, and minimizing the disease burden. This study aimed to analyze the perception of inter-professional relationship from the viewpoint of nurses working in Intensive Care Units (ICUs).
This descriptive, cross-sectional study was conducted on 109 nurses working in ICUs at Shiraz University of Medical Sciences selected through convenience sampling. The data were collected using Stichler’s Collaborative Behavior Scale. Then, the data were entered into the SPSS statistical software (v. 22) and were analyzed using Tukey’s test, independent t-test, Pearson’s correlation, and one-way ANOVA.
The nurses had dominantly a moderate viewpoint toward physician-nurse inter-professional behaviors (mean: 46.07±1.22). Besides, few nurses evaluated such behaviors as desirable or undesirable. Moreover, a significant relationship was observed between the nurses’ inter-professional behaviors and their workplace (F=7.34, P The results revealed moderate intra-professional behaviors from the nurses’ viewpoints. Therefore, it is essential to design a comprehensive plan to promote inter-professional behaviors. In this context, holding workshops and training courses for nursing and medical professors as well as students is recommended to identify professional values.

Extensive changes in the health field have compelled many organizations of health sciences education to seek for the most effective educational approaches. Meanwhile, interprofessional education as a novel and efficient approach has recieved attention internationally. We conducted this study for introducing interprofessional education with a focus on its backgrounds and formation in health sciences. This integrative review study was performed during years 2012-2013 using an integrated search in PubMed, CINHAL, Ovid, and Science Direct databases. Moreover, google search engine was also used for searching in various information sources such as validated journals and conference proceedings and reports of educational organizations and assemblies, using main key words such as interprofessional education and interprofessional learning, limiting the results from 1995 to 2013 and mainly in English. We obtained more than 2000 titles including original articles, reports, web pages, letters to editor, and books. Having titles and abstracts assessed, 120 documents that were more appropriate and directly related to the study question were selected and analyzed through qualitative content analysis. Then the text contents were retrieved and final results were categorized and managed by MAXQDA software. Two themes were obtained indicating the formation of interprofessional education in the health system. The challenges theme containing 4 categories: dynamic changes in all aspects of human society, poor quality of care services, staffing crisis, and failures of uniproffessional education. The second theme named constructive strategies containing 4 categories: improvement of interprofessional interactions, promotion of interprofessional collaborations, patient centered team care, and changing in professional socialization process of health sciences students. Interprofessional education with focus on interprofessional interactions and promotion in professional socialization process of health sciences students provides necessary competency and ability for developing interprofessional collaborations and comprehensive patient-centered team care among graduates for addressing challenges in health systems.

In order to achieve teamwork-based and integrated care، one of the issues in health care is the implementation of ethics and values in teamwork. The aim of this study is to develop the interprofessional collaborative ethics framework. This cross sectional study was conducted in two phases. In phase one، core competencies of the interprofessional collaborative ethics were determined by literature review. In phase two، Delphi rounds of experts were undertaken to validate the competencies and calculate content validity indexes through Content Validity Ratio (CVR) and Content Validity Index (CVI). The interviews and Delphi rounds identified 12 competencies categorized in three core themes including patient-centered values، interprofessional collaborative ethics، and team-based values. In phase two، based on the mean scores of importance، utility، and clarity، patient center value (4. 9)، interprofessional ethics competencies (4. 6)، and team-based values (4. 5) were determined as essential themes. In conclusion، the validation of the inter-professional ethics framework was found to be acceptable in the Iranian context. Therefore، the framework for teaching and evaluating inter-professional ethical competencies is an applicable tool in the Iranian context.

Collaboration between nurses and physicians is essential for providing primary care and it is key factor for facilitating empowerment and rehabilitation of patients. This study by determining viewpoints of nurses and physicians toward professional collaboration tries to determine the existing conditions and to fasilate collaboration between nurses and physicians. This cross-sectional study assessed the viewpoints of 134 nurses and 66 physicians regarding interproffeshional collaboration in teaching hospitals of Tabriz-Iran. The data were collected by Jefferson questionnaire. Its reliability was 0. 86 by using test- retest and its validity was received by content validity. Data was analyzed by SPSS-PC (v. 13) software and using of pearson، One-way ANOVA and independent T test. The results showed that the physicians’ attitudes toward profesional collaboration was not so good in physician’s dominance and nurses’ autonomy subscales. There were significant differences between the nurses'' and physicians’ viewpoints in the subscales of: physician’s dominance (p<0. 001)، nurses’ autonomy (p<0. 001)، teamwork (p=0. 003) and caring as opposed to curing (p<0. 001). Assessing relationship between demographic variables of nurses and physicians and their viewpoint toward interprofessional collaboration showed direct relation between physicians’ viewpoint and their experience (p=0. 008،r-0. 42) but، this relationship was reversed in nurses and their viewpoint had been worse with increasing experience (p=0. 03،r- -0. 38). Nurses and physicians’ viewpoint toward interprofessional collaboration in I. C. U and C. C. U wards were better than general wards. Regarding the undesirable attitude of physicians in the physicians’ dominance and nurses’ autonomy subscales، providing training programs for nursing and medical students about professional roles with emphasis on professional communication skills during their educational courses is recommended.