Development and validation of work-related collaboration among Doctors and Nurses Scale (WCDNS) in Chinese general and specialist public hospitals

Abstract

The professional roles of nurses and doctors is invariably entwined and inseparable. Inter-professional collaboration in an environment with ambiguous job boundaries and non-unanimous work goals is challenging and further exacerbated in a rapidly developing economy when traditional lines of authority and decision-making is rapidly changing. Existing instruments that measure doctor-nurse collaboration were mostly designed for western healthcare institutions only. A 26-item paired design questionnaire on a 4-point rating scale - the Work-Related Collaboration among Doctors and Nurses Scale (WCDNS) is developed, back-translated and validated to evaluate doctor-nurse collaboration that is culturally and psychometrically oriented to a Chinese healthcare environment. The WCDNS was validated in Guangzhou 8th People’s Hospital (comprising a general district and specialist infectious disease hospital) where 398 doctors and nurses participated in the cross-sectional study. Principal component analysis was applied for data reduction and factor extraction of the questionnaire. Three factors, namely work-related autonomy, work-related skills and work-related relationships were identified. Overall, younger employees and nurses tend to be more collaborative than doctors. The general district hospital staff had more positive work-place collaboration scores as compared to the specialist hospital. Doctor-nurse collaboration was negatively associated with working hours, employee depression and number of patients under care. The WCDNS has satisfactory consistency (overall Cronbach alpha=0.83), test-retest reliability, and construct validity. It is a highly potential tool in evaluating doctor-nurse collaboration in public hospitals in China. Future research is to be done to establish whether effective collaboration reduces workplace stress and depression symptoms to improve workplace productivity and efficiency.