Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Orchard, Carole

Abstract

The movement in the healthcare system towards interprofessional collaborative teamwork values the perspectives of various healthcare professionals. Although this system shift has been essential to quality improvement, there have been indications of issues occurring between professionals that include conflict and impaired team performance. Although the current literature on interprofessional collaboration acknowledges the competencies and demonstrated behaviours that indicate successful and difficult collaborative efforts there is a lack of research investigating the relational variables that occur between healthcare professionals.

The purpose of this research was to test a theoretically derived model of healthcare professionals’ relational variables. These variables related to warmth, competence and agreeableness associated with respect and the shame strategies of attack self, attack other, withdrawal, avoidance and adapt to see if these variables moderated or mediated health professionals’ socialization in the healthcare team. This study used an online questionnaire to capture responses to the survey from 315 healthcare professionals consisting of Registered Nurses, Registered Practical Nurses and Physicians.

The conceptual model was supported by data associated with several proposed hypotheses. In this study, hypotheses for research question 1 confirmed that health professionals who displayed warmth were more likely to receive a high level of respect, while those who displayed high degrees of competence were more likely to receive high levels of agreeableness from team members. When high degrees of warmth were exhibited health professionals were more likely to receive high levels of competence from team members.

Three mediation relationships associated with research question 2 were confirmed indicating the shame responses of attack self and attack other accounted for some of the relationship between low respect and poor socialization through partial mediation. The shame response of withdrawal, accounted for full mediation of the relationship between low respect and poor socialization.

Two global questions asked whether healthcare professionals felt comfortable and included in the team. It was found that Physicians felt more comfortable and included while Registered Nurses and Registered Practical Nurses differed, feeling much less comfortable and less included as part of their teams.

Summary for Lay Audience

It has been well documented that healthcare professionals struggle to get along while at work. Around the world many individuals have researched these struggles in the hope to uncover how to improve working relationships between nurses and doctors. Many areas were studied including professional knowledge, skills, attitudes and values, but few studies have focused on the relational context between these professionals.

What prompted the need for this study was a recognition that how healthcare professionals get along with each other could influence not only nurses and doctors’ wellbeing, but also could have negative and potentially risky outcomes for patient care delivery. Understanding the behaviours that assist or disrupt how nurses and doctors relate to one another therefore is important, to understand and improve effective working relationships.

A total of 315 healthcare professionals consisting of Registered Nurses, Registered Practical Nurses and Physicians participated in this study. This study aimed to know more about the variables that could explain interactions between nurses and doctors leading to their ability to work together within teams. The effects of health providers warmth, competence and agreeableness on how these impacted on the respect they received from others were examined. It is suggested in the literature that when health professionals are exposed to disrespectful experiences in practice settings, these can cause responses in future events that may result in use of behaviours such as attack self, attack other, withdrawal, avoidance and/or adapt. In this study, I wanted to learn if these variables moderated or mediated health professionals’ socialization abilities to work together in their collaborative teams. What was discovered was that when respect was low, it mediated through shame responses impacting work team’s socialization.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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