Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 23 , ISSUE 4 ( April, 2019 ) > List of Articles


Nurse–Physician Collaboration and the Professional Autonomy of Intensive Care Units Nurses

Delshad Aghamohammadi, Behrouz Dadkhah, Masoumeh Aghamohammadi

Keywords : Autonomy, Collaboration, Critical care unit, Nurse, Physician

Citation Information : Aghamohammadi D, Dadkhah B, Aghamohammadi M. Nurse–Physician Collaboration and the Professional Autonomy of Intensive Care Units Nurses. Indian J Crit Care Med 2019; 23 (4):178-181.

DOI: 10.5005/jp-journals-10071-23149

License: CC BY-NC 4.0

Published Online: 01-03-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Background and aims: Poor collaboration between the physicians and the nurses may interfere with nursing performance in patient care. This study aimed to determine the nurse–physician collaboration and professional autonomy of intensive care nurses. Subjects and methods: This descriptive correlational study was performed on 126 nurses working in the intensive care units (ICUs) of Ardabil, Iran. The data were collected using the Jefferson scale of attitudes toward physician–nurse collaboration’ (JSAPNC) and the Dempster Practice Behavior Scale (DPBS). The results were analyzed using descriptive statistics (mean, standard deviation, and frequency) and inferential statistics (t-test, ANOVA, and Pearson). Results: The mean score of the nurse–physician collaboration was found to be 47.83 ± 3.9, which indicates good collaboration between physicians and nurses in the ICUs. The results showed that 73% of the nurses reported a moderate autonomy and 27% of them considered their autonomy to be high. There was no significant relationship between the nurse–physician collaboration and the professional autonomy of the nurses (p >0.05). Conclusion: The nurses who participated in this study had a positive attitude toward collaboration with the physicians and a moderate level of professional autonomy. Interventions may be required to further enhance the level of nurse–physician collaboration and the professional autonomy of nurses.

PDF Share
  1. Mahdizadeh M, Heydari A, et al. Review of the Clinical Interdisciplinary Collaboration among Nurses and Physicians. Open J Nurs. 2015;5(07):654–663.
  2. Georgiou E, Papathanassoglou E, et al. Nurse-physician collaboration and associations with perceived autonomy in Cypriot critical care nurses. Nurs Crit Care. 2017;22(1):29–39.
  3. Jasemi M, Rahmani A, et al. Nurses and Physicians’ Viewpoint toward Interprofessional Collaboration. Iran J Nurs. 2013;26(81):1–10.
  4. Hamlan NM. The Relationship Between Inter-Professional Collaboration, Job Satisfaction, and Patient Safety Climate for Nurses in a Tertiary-Level Acute Care Hospital. Western Ontario: The University of Western Ontario; 2015.
  5. Sharifiyana M, Zohari S, et al. Evaluation of Participation in Clinical Decision Making by Nurses in Selected Hospitals of Shahid Beheshti Universityof Medical Sciences. J Urmia Nurs Midwifery Fac. 2016;13(11):928–934.
  6. Hendel T, Fish M, et al. Nurse/physician conflict management mode choices: Implications for improved collaborative practice. Nurs Adm Q. 2007;31(3):244–253.
  7. Wheelan SA, Burchill CN, et al. The link between teamwork and patients’ outcomes in intensive care units. Am J Crit Care. 2003;12(6):527–534.
  8. Baggs JG, Schmitt MH, et al Association between nurse-physician collaboration and patient outcomes in three intensive care units. Crit Care Med. 1999;27(9):1991–1998.
  9. Manojlovich M, Antonakos CL, et al. Intensive care units, communication between nurses and physicians, and patients’ outcomes. Am J Crit Care. 2009;18(1):21–30.
  10. Karanikola MN, Albarran JW, et al. Moral distress, autonomy and nurse-physician collaboration among intensive care unit nurses in Italy. J Nurs Manag 2014;22(4):472–484.
  11. Mahmoodian F, Seyed Jafari S, et al. Nurses’ Experiences about the challenges of Nurse-Physician Professional Relationships, in 1390. Sadra Medical Sciences J. 2014;2(1):31–42.
  12. Valizadeh L, Zamanzadeh V, et al. Challenges of autonomy in nursing: an integrative review. Quarterly J Nurs Manag. 2013;2(1):9–17.
  13. Motamed-Jahromi M, Jalali T, et al. Evaluation of professional autonomy and the association with individual factors among nurses in the Southeast of Iran. J Nurs Midwifery Sciences. 2015;2(4):37–42.
  14. Dorgham SR, Al-Mahmoud S. Leadership styles and clinical decision making autonomy among critical care nurses: A comparative study. IOSR J Nurs Health Sci. 2013;1(4):71–83.
  15. Papathanassoglou ED, Tseroni M, et al. Practice and clinical decisionmaking autonomy among Hellenic critical care nurses. J Nurs Manag. 2005;13(2):154–164.
  16. Karra V, Papathanassoglou ED, et al. Exploration and classification of intensive care nurses’ clinical decisions: a Greek perspective. Nurs Crit Care. 2014;19(2):87–97.
  17. Amini K, Negarandeh R, et al. Nurses’ autonomy level in teaching hospitals and its relationship with the underlying factors. Int J Nurs Pract. 2015;21(1):52–59.
  18. Mehrabi M, Madanipour A, et al. The Sociological study of Nurse-Physician Professional relationship in Iran. Iran J Nurs Midwifery Res. 2016;21(6):583–588.
  19. Le Roux L. Nurses’ and physicians’ attitudes toward physician-nurse collaboration in private hospital critical care units. A Thesis for the degree of Master of Science in Nursing. Johannesburg: Faculty of Health Sciences, University of the Witwatersrand; 2013.
  20. Adebayo AM, Ilesanmi OS. Collaboration between Doctors and Nurses in a Tertiary Health Facility in South West Nigeria: Implication for Effective Healthcare Delivery. IJCS. 2016;9(1):165.
  21. Liseckiene I, Miseviciene I, et al. Readiness for Interprofessional Collaboration: Attitudes of Lithuanian Community Nurses and Family Physicians. Konuralp Med J. 2016;8(2):72–79.
  22. Zakerimoghadam M, Ghiyasvandian S, et al. Nurse–physician collaboration: The attitudes of baccalaureate nursing students at Tehran University of Medical Sciences. Iran Red Crescent Med J. 2015;17(4):e23247.
  23. Amsalu E, Boru B, et al. Attitudes of nurses and physicians towards nursephysician collaboration in northwest Ethiopia: a hospital based cross-sectional study. BMC Nurs. 2014;13(1):37.
  24. Wang Y, Liu YF, et al. Attitudes toward physician-nurse collaboration in pediatric workers and undergraduate medical/nursing students. Behav Neurol. 2015;2015:846498.
  25. Cotter PT. Clinical autonomy and nurse/physician collaboration in emergency nurses. Ireland: DN Thesis, University College Cork; 2013.
  26. Kramer M, Schmalenberg C. The practice of clinical autonomy in hospitals: 20 000 nurses tell their story. Crit Care Nurse. 2008;28(6):58–71.
  27. Bahadori A, Fitzpatrick JJ. Level of autonomy of primary care nurse practitioners. J Am Assoc Nurse Pract. 2009;21(9):513–519.
  28. Maylone MM, Ranieri L, et al. Collaboration and autonomy: Perceptions among nurse practitioners. J Am Assoc Nurse Pract. 2011;23(1):51–57.
  29. Negarandeh R, Oskouie F, et al. Patient advocacy: barriers and facilitators. BMC Nurs. 2006;5(1):3.
  30. Farsi Z, Dehghan-Nayeri N, et al. Nursing profession in Iran: an overview of opportunities and challenges. Jpn J Nurs Sci. 2010;7(1):9–18.
  31. Gagnon L, Bakker D, et al. Nurse autonomy in cancer care. Cancer Nurs. 2010;33(3):E21–28.
  32. Stewart J, Stansfield K, et al. Clinical nurses’ understanding of autonomy: Accomplishing patient goals through interdependent practice. J Nurs Adm. 2004;34(10):443–450.
  33. Papathanassoglou ED, Karanikola MN, et al. Professional autonomy, collaboration with physicians, and moral distress among European intensive care nurses. Am J Crit Care. 2012;21(2):e41–52.
  34. McAndrew M. The Scope of Autonomy: Kant and the Morality of Freedom by Katerini Deligiorgi (review). J Hist Philos. 2013;51(4):682–683.
  35. Mobasher Amini A, Lakeh B. Ventilator–associated pneumonia in intensive care units and physician-nurse relationship role. J Holistic Nurs Midwifery. 2016;26(1):56–63.
  36. Rose L. Interprofessional collaboration in the ICU: how to define? Nurs Crit Car. 2011;6(1):5–10.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.