Readiness for Interprofessional Collaboration: Attitudes of Lithuanian Community Nurses and Family Physicians

Background: The hierarchical pattern of collaboration between nurses and physicians that prevailed before Lithuanian primary health care reform strengthens the need to investigate the attitudes to autonomy in the nurse's profession. The aim of the survey was to evaluate and compare the attitudes of family physicians and community nurses to mutual collaboration and the autonomy of nurses in daily practice. Methods: The study was conducted by using valid and reliable instrument "Jefferson Scale of Attitudes toward Physician-Nurse Collaboration" in randomly selected PHC centres in Lithuania. In total, 224 questionnaires were distributed to family physicians and 237 to community nurses, with respective response rate of 73% and 76%. The total scores were measured on the instrument scale. The higher total scores reflected more positive attitudes regarding the physiciannurse collaboration. Results: The mean total score (44.3 +/- 0.31) was significantly higher in the group of CNs, which reflects a more positive attitude of CNs towards the physician-nurse collaboration, as compared to that of FPs (42.9 +/- 0.34). Nurses who provide autonomous consultations scored higher vs. those who did not for "shared education and collaboration" (mean score 22.6 vs. 21.8) and "nurse autonomy" (9.2 vs. 8.7), p<0.05. Nurses scored significantly higher vs. physicians such factors as "shared education and collaboration" (22.2 +/- 0.17 vs. 21.3 +/- 0.19) and "caring vs. curing" (9.3 +/- 0.1 vs. 8.8 +/- 0.11). Nurses and physicians scored "nurse's autonomy" (respectively 8.9 +/- 0.1 and 8.8 +/- 0.1) and "physician's authority" low (respectively 3.98 +/- 0.095 and 3.99 +/- 0.097), p=0.9. Conclusions: FPs and CNs positively evaluate the nurse-physician collaboration, though nurses demonstrate a more positive attitude. CNs and FPs attitudes showed that recognition of the autonomy of the CN is more an exception than a rule in Lithuania even though 20 years of PHC reformation process have passed, which contradicts ethical principles of collaboration and team work underlying the PHC concept.