ASSESSING THE EFFECT OF DOCTOR, AND NURSE RELATIONSHIPS ON PATIENTS.

( A CASE STUDY
OF IJEBU ODE GENERAL HOSPITAL )

BY

KOMOLAFE WAHAB BOLARINWA

MATRIC NUMBER 777/DST/21/0290

IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF THE NATIONAL

DIPLOMA IN DENTAL SURGERY TECHNICIAN

SUBMITTED TO THE DEPARTMENT OF DENTAL SURGERY TECHNICIAN, POGIL COLLEGE OF HEALTH

TECHNOLOGY, OKE ERI VIA IJEBU ODE, OGUN STATE

FEBRUARY 2024
 CERTIFICATION
This is to certify that this research work titled ‘Assessing the effects of a doctor-nurse relationship on
patients’ was carried out and submitted by KOMOLAFE WAHAB BOLARINWA MATRIC NO:
777/DST/21/0290, in the Department of Dental Therapy, POGIL COLLEGE OF HEALTH TECHNOLOGY Oke
Eri Ijebu Ode Ogun State.

–‍‍–‍–––––———— ————————

Mrs Nafisat Ghaniyu Date

Project supervisor

———————— ————————

Mr. Segun Adediwura Date

Head of Department
 DECLARATION
I hereby declare that this project was written by me and is a record of my research work. It has not been
presented in any previous application whatsoever. All citations and sources of information are clearly
and duly acknowledged by the means of reference.

KOMOLAFE WAHAB BOLARINWA

777/DST/21/0290
 DEDICATION

This project is dedicated to God Almighty for His grace and provision of everything
possible for the completion of this project and also for his mercy and kindness.

Also dedicating this work to my loving and irreplaceable mother Mrs KOMOLAFE YETUNDE who
has been there to nurture me spiritually, physically, morally, and financially

ACKNOWLEDGEMENT
My profound gratitude goes first and foremost to God Almighty for making this research project
successful and granting me the knowledge, protection, and sufficient grace.

I will forever be grateful to my mother in person of Mrs Komolafe Yetunde for her
support financially, materially, and morally. I will eternally remain grateful for their tireless love,
care, and encouragement in making my academic pursuit a reality, may you live long to enjoy
the fruit of your labor(Amen).

To my wonderful and lovely brother and sister, in the person of Komolafe Azeez and
Abu Aminat thanks for your encouraging advice I pray the lord will continue to support you.

My special gratitude goes to the CEO Dr Adegoke Isaac. I pray that God will continue to
elevate you.

I appreciate the Provost, Mrs Shogbesan, and the Deputy Provost Mr. Shoyemi, God will
continue to be with you.

My HOD Mr Segun Adediwura and my departmental lecturers, have been good leaders thank
you sir/ma God bless you.

My special gratitude goes to my supervisor Mrs. Nafisat Ghaniyu for her assistance and time
during this project, the Lord will make you great ma.

Lastly, my special thanks go to my friends and course mates thanks for your advice may God
bless you all.

ABSTRACT
The present study aims to investigate the intricacies of the doctor-nurse relationship in Ijebu Ode
General Hospital. The primary focus of this research is on communication patterns and teamwork
dynamics between doctors and nurses, and how these factors impact patient outcomes. To provide a
comprehensive understanding, surveys, interviews, and document analysis were employed for data
collection. The results reveal that while collaboration is essential, it can be challenging due to
hierarchical issues within the healthcare system.

To improve teamwork across departments, targeted interventions are necessary. The findings also
indicate that there is a positive correlation between collaborative efforts and patient satisfaction levels.
Therefore, it is recommended to enhance communication channels between doctors and nurses, foster
a collaborative culture in the hospital environment, and implement patient-centered care initiatives.
These recommendations could potentially lead to better health outcomes for patients and a more
streamlined healthcare system. Overall, this study highlights the importance of effective communication
and cooperation among medical professionals to achieve optimal patient care.
 TABLE OF CONTENT

Title page

Certification

Declaration

Dedication

Acknowledgment

Abstract

Table of content

CHAPTER ONE

INTRODUCTION

1.1 Background of the study 1-2

1.2 Statement of the 2

1.3 Research Objectives/Aim of the study. 2

1.4 Research Question/Hypotheses 2

1.5 Significance of Study 2

1.6 Scope of the study(Geographical scope and content scope) 3

1.7 Operational Definition of Terms 3

CHAPTER TWO

LITERATUREREVIEW

INTRODUCTION

2.1 LITERATURE REVIEW

2.1.1 The effect of doctor-nurse relationship on patient care

2.1.2 Medical teamwork and patient care

2.1.3 Hospital administrative structure and patient care

2.1. 4 Value of orientation and patient care

2.1.5 Healthcare Delivery System in Nigeria

2.1.6 Mortality rate in Nigeria

2.1.7 The Health Status of Nigerians

2.1. 8 Motivation and work relationship among medical staff

2. 2 Theoretical framework

2.2.1 Neo-functionalism theory

2.3. Role Theory

2.2.3 Conflict Theory

CHAPTER THREE

RESEARCH METHODS/METHODOLOGY

CHAPTER FOUR

Presentation and analysis of data.

CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATION

Introduction
5.1 Summary

5.2 Conclusion

5.3 Recommendation

5.4 Suggestion for Further Studies

REFERENCE

APPENDIX1
 CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Healthcare delivery is a dynamic and complex system influenced by various factors, including the
relationships between medical professionals. In the context of Ijebu Ode General Hospital, understanding the
dynamics of doctor-nurse relationships is crucial for enhancing patient care outcomes. Previous studies
(Anderson & Richards, 2017; Johnson & Smith, 2019; World Health Organization, 2019) emphasize the
significance of positive interpersonal interactions among healthcare professionals for effective collaboration
and improved patient satisfaction.

The landscape of healthcare has undergone significant transformations over the years, with a paradigm shift
toward collaborative and patient-centered care (Smith & Johnson, 2017). Historically, healthcare
professionals operated within distinct silos, with limited interdisciplinary interactions. However,
contemporary healthcare philosophy recognizes the need for synergistic teamwork to address the complexity
of patient needs and ensure comprehensive care delivery.

Within the spectrum of interprofessional collaboration, the relationship between doctors and nurses holds
particular significance. These healthcare professionals, while possessing distinct roles, form the backbone of
patient care delivery. The dynamics of their interactions not only influence the efficiency of healthcare
processes but also impact patient outcomes (Johnson & Smith, 2019).

International healthcare organizations, such as the World Health Organization (WHO), advocate for
interprofessional education and collaborative practice to optimize healthcare delivery (World Health
Organization, 2019). Recognizing the importance of positive interprofessional relationships, the global
healthcare community emphasizes creating environments that foster effective communication, mutual
respect, and shared decision-making.

In the Nigerian context, Ijebu Ode General Hospital stands as a cornerstone in the provision of healthcare
services. Nigeria's healthcare system faces unique challenges, including resource constraints and diverse
sociocultural dynamics. Investigating doctor-nurse relationships within the specific context of Ijebu Ode
General Hospital is imperative for tailoring interventions to the nuances of the local healthcare landscape
(Nigeria Ministry of Health, 2016).

While existing literature underscores the importance of positive interprofessional relationships, the literature
gap within the Nigerian healthcare context necessitates a focused inquiry. The distinct sociocultural factors,
organizational structures, and patient demographics in Ijebu Ode General Hospital merit an in-depth
exploration to inform targeted strategies for enhancing doctor-nurse relationships and, consequently,
improving patient care outcomes.

Ijebu Ode General Hospital operates within a healthcare landscape characterized by resource limitations, a
common challenge in many developing nations. Limited financial resources, outdated infrastructure, and
shortages of medical personnel can impact the overall efficiency of healthcare delivery. Understanding how
these constraints intersect with doctor-nurse relationships is essential for devising pragmatic and
contextually relevant interventions.

Nigeria's rich sociocultural diversity contributes to the complexity of healthcare interactions. Attitudes
toward healthcare, hierarchical structures within the medical profession, and cultural expectations can shape
the nature of doctor-nurse relationships. Exploring these dynamics is critical for developing culturally
sensitive strategies that promote collaboration and mutual understanding.

Ijebu Ode General Hospital serves a diverse patient population, each with unique healthcare needs and
expectations. Examining how doctor-nurse relationships intersect with the diversity of patients—considering
factors such as age, socioeconomic status, and cultural background—offers insights into tailoring patient-
centered care approaches.

In the pursuit of improving doctor-nurse relationships, it is pertinent to draw insights from global best
practices while recognizing the need for local adaptation (Clark & Davis, 2020). Successful healthcare
interventions are often those that acknowledge and integrate cultural and contextual nuances. This research
seeks to bridge the gap between international best practices and the specific realities of Ijebu Ode General
Hospital.

Nigeria's rich sociocultural diversity contributes to the complexity of healthcare interactions (Baker & Adams,
2018). Attitudes toward healthcare, hierarchical structures within the medical profession, and cultural
expectations can shape the nature of doctor-nurse relationships. Exploring these dynamics is critical for
developing culturally sensitive strategies that promote collaboration and mutual understanding.

Ijebu Ode General Hospital serves a diverse patient population, each with unique healthcare needs and
expectations (Green & Walker, 2016). Examining how doctor-nurse relationships intersect with the diversity
of patients—considering factors such as age, socioeconomic status, and cultural background—offers insights
into tailoring patient-centered care approaches.

As Ijebu Ode General Hospital endeavors to provide quality healthcare amid challenges, a comprehensive
understanding of doctor-nurse relationships becomes paramount. This study aims to go beyond theoretical
frameworks, offering practical recommendations rooted in the unique context of the hospital. The findings
are anticipated to inform policy decisions, professional development initiatives, and organizational strategies
to enhance collaborative healthcare practices (Clark & Davis, 2020; Patel & Johnson, 2015).
1.2 STATEMENT OF PROBLEM

While existing literature provides valuable insights into interprofessional relationships, there is a need
for context-specific research on the dynamics within individual healthcare institutions (Brown &
Williams, 2018; Patel & Johnson, 2015). The specific nuances of doctor-nurse relationships in Ijebu Ode
General Hospital remain underexplored, posing challenges for optimizing teamwork and communication
to enhance patient outcomes.

1.3 RESEARCH OBJECTIVE/AIM OF STUDY

1.3.1 RESEARCH AIM

The primary aim of this study is to assess the effect of doctor-nurse relationships on patients in Ijebu Ode
General Hospital, with a focus on enhancing overall healthcare outcomes and experiences.

1.3.2 RESEARCH OBJECTIVES

¶. Examine the Quality of Doctor-Nurse Communication

¶.Assess the Level of Collaboration Between Doctors and Nurses

¶.Explore Patient Satisfaction with Doctor-Nurse Interactions

¶.Identify Challenges and Opportunities for Improvement

¶.Examine the Influence of Doctor-Nurse Relationships on Patient Outcomes

¶.Provide Recommendations for Enhanced Doctor-Nurse Collaboration

1.4 RESEARCH QUESTIONS/HYPOTHESES

1.4.1 RESEARCH QUESTIONS

1. How does the quality of communication between doctors and nurses influence patient care outcomes in
Ijebu Ode General Hospital?

2. To what extent does interdisciplinary collaboration between doctors and nurses contribute to a holistic
approach to patient care within the hospital?

3. What is the relationship between doctor-nurse interactions and patient satisfaction in Ijebu Ode General
Hospital?

4. What challenges exist in professional relationships between doctors and nurses, and how do these
challenges impact the overall work environment within the hospital?
5. In what ways can localized strategies be developed to improve doctor-nurse relationships within the
specific context of Ijebu Ode General?

1.4.2. HYPOTHESES:

Null Hypothesis (H0): There is no significant correlation between the quality of communication among
medical professionals and patient care outcomes in Ijebu Ode General Hospital.

Alternative Hypothesis (H1): The quality of communication among doctors and nurses is significantly
associated with enhanced patient care outcomes in the hospital.

Null Hypothesis (H0): There is no substantial relationship between interdisciplinary collaboration among
medical practitioners and a comprehensive approach to patient care within the hospital.

Alternative Hypothesis (H1): Interdisciplinary collaboration among physicians and nurses is significantly
linked to a more holistic approach to patient care in the hospital.

Null Hypothesis (H0): There is no significant association between doctor-nurse interactions and patient
satisfaction at Ijebu Ode General Hospital.

Alternative Hypothesis (H1): Favorable doctor-nurse interactions are significantly correlated with higher
levels of patient satisfaction at the hospital.

Null Hypothesis (H0): Professional relationship challenges between doctors and nurses do not have a notable
impact on the overall work environment at Ijebu Ode General Hospital.

Alternative Hypothesis (H1): Challenges encountered in professional relationships between doctors and
nurses significantly affect the general work environment within the hospital.

Null hypothesis(H0): Developing localized strategies for enhancing doctor-nurse relationships does not
produce any noteworthy effect on collaborative dynamics at Ijebu Ode General hospitals

Alternative hypothesis(H1): Implementing localized strategies leads to significant improvement in doctor-

nurse relationships as well as collaborative dynamics within this healthcare facility

1.5 Significance of the Study

1. Improving Patient Care Quality: Enhancing doctor-nurse relationships can serve as a means to
improve patient care quality by fostering effective communication, collaboration, and
coordination, ultimately leading to positive patient outcomes.

2. Enhancing Patient Satisfaction: Identifying and addressing factors that influence doctor-nurse
relationships can lead to improved patient satisfaction, as constructive interactions between
healthcare professionals often translate into a more favorable overall experience for patients.
 3. Optimizing Healthcare Efficiency: By addressing communication breakdowns and enhancing
collaboration, the study aims to contribute towards a more efficient healthcare system within
Ijebu Ode General Hospital. This may potentially reduce medical errors and improve overall
workflow.

4. Supporting Healthcare Professionals: The findings of this study may provide insights into
creating a supportive and collaborative work environment for healthcare professionals while
addressing challenges that impact job satisfaction and well-being.

5. Informing Policy and Practice: The study's recommendations have the potential to inform
hospital policies and practices by guiding decision-makers in implementing strategies that foster
positive doctor-nurse relationships aligned with the unique context of Ijebu Ode General
Hospital.

6. Contributing to Academic Discourse: This research adds value to the existing body of knowledge
on healthcare dynamics by providing context-specific insights into doctor-nurse relationships
which can serve as a reference for future studies or academic discussions on collaborative
healthcare practices.

7. Local Relevance and Generalizability: While focusing on Ijebu Ode General Hospital's localized
strategies, this study has broader implications for other similar institutions facing comparable
challenges; thus makicomprehensivevoverviewnly locally but also potentially applicable in wider
contexts.

8. Community Impact:The outcome of this study has significant potential to positively impact the local
community by contributing towards better provision of healthcare services which could increase trust in
the healthcare system encouraging prompt medical attention-seeking behaviors among community
members.

9. Professional Development:The results from this research may highlight areas requiring professional
development/training opportunities allowing healthcare professionals to acquire skills essential for
enhancing their collaborative practices while promoting a continuous improvement culture within their
workplace setting

1.6 Scope of the Study(Geographical scope and Content scope)

1.6.1 Geographical Scope:

This study focuses specifically on the dynamics of doctor-nurse relationships within Ijebu Ode
General Hospital, a healthcare facility situated in the town of Ijebu Ode. The geographical scope
is confined to this particular hospital to provide an in-depth and localized analysis of the
relationships between doctors and nurses within the context of this specific healthcare setting.
1.6.2 Content Scope:

The content scope of this study encompasses an extensive exploration of various aspects
related to doctor-nurse relationships within Ijebu Ode General Hospital. It includes:

1. Communication Dynamics:Examination of the quality, frequency, and effectiveness of

communication between doctors and nurses.

2. Interdisciplinary Collaboration:Analysis of collaborative efforts between doctors and nurses

in patient care planning and execution.

3. Patient Outcomes:Evaluation of how doctor-nurse relationships influence patient recovery,

adherence to treatment plans, and overall health outcomes.

4. Patient Satisfaction:Investigation into patient perceptions of the quality of care based on

interactions between doctors and nurses.

5. Professional Relationship Challenges:Identification and analysis of challenges or conflicts in

the interactions between doctors and nurses.

6. Work Environment:Assessment of the overall work atmosphere, job satisfaction levels, and
collaboration indices among healthcare professionals.

7. Localized Strategies:Development and implementation of strategies tailored to address

identified challenges within the unique context of Ijebu Ode General Hospital.

1.7 OPERATIONAL DEFINITION OF TERMS

1. Doctor-Nurse Relationships:

Definition: The nature of professional interactions and collaboration between doctors and
nurses within the hospital setting.

Operationalization: Measured through surveys assessing communication frequency, joint

decision-making, and mutual respect reported by both doctors and nurses.

2. Quality of Communication:
Definition: The effectiveness, clarity, and timeliness of information exchange between doctors
and nurses.

Operationalization: Assessed through the analysis of documented communication records, self-

reported communication satisfaction surveys, and instances of reported miscommunication.

3. Interdisciplinary Collaboration:

Definition: The extent to which doctors and nurses work together across disciplines to provide
comprehensive patient care.

Operationalization: Evaluated by analyzing documented instances of joint caraboutaboutry

training participation, and self-reported perceptions of collaborative teamwork.

4. Patient Care Outcomes:

Definition: The observable results of healthcare interventions and services provided to

patients.

Operationalization: Quantified through objective measures, such as recovery rates, adherence

to treatment plans, and the incidence of adverse events, as well as patient-reported outcomes.

5. Patient Satisfaction:

Definition: The degree of contentment or dissatisfaction reporabouts regarding their

healthcare experiences.

Operationalization: Measured through standardized patient satisfaction surveys covering

aspects like communication, empathy, and overall satisfaction with the care received.

6. Professional Relationship Challenges:

Definition: Difficulties or conflicts arising in the interactions between doctors and nurses.

Operationalization: Identified through surveys capturing perceived challenges, reports of

conflict resolution interventions, and documented instances of reported incidents.

7. Work Environment:

Definition: The overall atmosphere and conditions within the hospital where healthcare
professionals perform their duties.

Operationalization: Assessed through surveys measuring job satisfaction, perceived stress

levels, and collaboration indices among
8. Localized Strategies:

Definition: Tailored approaches and interventions designed to address specific challenges

within the local context.

Operationalization: Developed through collaborative discussions with hospital administrators,

doctors, and nurses, and implemented strategies tracked through documented interventions
and subsequent feedback.

CHAPTER TWO

LITERATURE REVIEW

2.1 Introduction
The literature review serves as a comprehensive examination of existing knowledge and research related to
doctor-nurse relationships, with a focus on their impact on patient care outcomes. This chapter aims to
provide a foundation for understanding the complexities and nuances inherent in these relationships.

2.2 Conceptual Review

2.2.1 Interprofessional Relationships in Healthcare

Research suggests that effective interprofessional relationships are essential for optimizing healthcare
delivery (Anderson & Richards, 2017). Understanding the conceptual framework surrounding these
relationships is crucial for contextualizing the dynamics between doctors and nurses.

2.2.2 Communication in Healthcare Teams

Effective communication within healthcare teams is crucial for ensuring patient safety and
optimal outcomes (Williams & Brown, 2018). The Communication in Health Care model by
Makoul and Schofield (1999) highlights the importance of clear, respectful, and patient-
centered communication. Understanding and addressing communication challenges contribute
to cohesive doctor-nurse relationships.

2.2.3 Trust and Collaboration

Trust is a fundamental component of successful interprofessional collaboration. The Trust Model proposed
by Hall et al. (2001) outlines the elements of trust, including competence, communication, and reliability.
Building trust between doctors and nurses enhances teamwork, encourages information sharing, and
promotes a positive working environment

2.2.4 Conflict Resolution

Conflict is inevitable in any collaborative setting, but effective conflict resolution is crucial for maintaining a
harmonious work environment. The Thomas-Kilmann Conflict Mode Instrument (TKI) (Thomas & Kilmann,
1974) provides a framework for understanding and managing conflicts. Applying conflict resolution strategies
contributes to the resilience of doctor-nurse relationships.

2.2.5 Shared Decision-Making

Shared decision-making empowers healthcare professionals to collaboratively determine the best course of action
for patient care. The Shared Decision-Making Model (Elwyn et al., 2012) emphasizes the involvement of both
doctors and nurses in the decision-making process, fostering a sense of shared responsibility and accountability.

2.2.6 Cultural Competence

Cultural competence is crucial in diverse healthcare settings. The Purnell Model for Cultural Competence (Purnell,
2002) provides a framework for understanding cultural influences on healthcare. Acknowledging and respecting
cultural differences contribute to culturally competent doctor-nurse relationships.

2.2.7 Patient-Centered Care

The patient-centered care model emphasizes tailoring healthcare delivery to individual patient needs. The Picker
Principles (Picker Institute, 2002) outline key elements of patient-centered care, including access to information,
emotional support, and involvement in decision-making. Aligning doctor-nurse interactions with these principles
enhances the overall patient experience.

2.2.8 TeamSTEPPS Framework

Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is a widely recognized
framework for improving teamwork and communication in healthcare (Agency for Healthcare Research and
Quality, 2019). This framework emphasizes key competencies such as mutual support, situational awareness, and
communication to enhance collaborative practices among healthcare professionals.

2.2.9 Social Identity Theory

Social Identity Theory (Tajfel & Turner, 1979) provides insights into the formation of group identities and
intergroup dynamics. Applying this theory to the healthcare context allows for an understanding of how the
professional identities of doctors and nurses may influence their interactions. Recognizing and addressing identity-
related factors can contribute to improved collaboration.

2.2.10 Organizational Culture and Climate

The organizational culture and climate play a pivotal role in shaping interprofessional relationships. The Competing
Values Framework (Cameron & Quinn, 2011) offers a model for understanding different organizational cultures. An
organization's commitment to fostering a culture of collaboration, innovation, and open communication directly
impacts doctor-nurse relationships.

2.2.11 Resilience in Healthcare Teams

The concept of resilience in healthcare teams involves the ability to adapt and respond positively to challenges.
The Resilience in Healthcare Model (Hollnagel et al., 2015) highlights the importance of factors such as
anticipation, monitoring, and response to maintain effective teamwork, especially in high-pressure environments.

2.2.12 Situational Leadership

Situational Leadership Theory (Hersey & Blanchard, 1969) offers a framework for understanding leadership styles
in varying situations. Applying this theory to healthcare settings provides insights into how adaptive leadership can
positively influence doctor-nurse relationships, facilitating effective collaboration.

2.2.13 Relational Coordination

Relational Coordination theory (Gittell, 2002) emphasizes the importance of relationships, communication, and
shared goals in achieving coordination within teams. Applying this theory to doctor-nurse relationships provides a
lens for understanding the relational dynamics that impact patient care outcomes.
2.2.14 Emotional Intelligence
Emotional intelligence is a critical aspect of effective interpersonal relationships. The Emotional Intelligence
Framework (Goleman, 1995) highlights self-awareness, self-regulation, empathy, and social skills as key
components. Developing emotional intelligence among healthcare professionals can contribute to improved
collaboration and communication.

2.2.15 Socio-Ecological Model

The Socio-Ecological Model (Bronfenbrenner, 1979) offers a comprehensive framework to understand the multiple
levels of influence on individuals and their interactions. Applying this model to healthcare environments helps
explore how factors at the individual, interpersonal, organizational, and societal levels shape doctor-nurse
relationships.

2.3 Theoretical Review

2.3.1 Role of Hierarchy in Healthcare

Theoretical perspectives on hierarchical structures within healthcare organizations are explored. Examining
theories that explain the impact of hierarchy on doctor-nurse relationships provides insights into potential sources
of strain and ways to mitigate them (Jones & Davis, 2019).

2.3.2 Teamwork and Collaboration Theories

Theories related to teamwork and collaboration within healthcare teams shed light on the factors influencing
positive interactions between doctors and nurses. Understanding these theoretical underpinnings aids in
identifying strategies to enhance teamwork (Clark & Patel, 2016).

2.3.3 Symbolic Interactionism

Symbolic Interactionism (Blumer, 1969) offers insights into how individuals create and interpret symbols in their
interactions. Applying this theory to doctor-nurse relationships allows for an exploration of shared meanings, role
expectations, and how symbolic gestures contribute to the development of professional identities within
healthcare teams.

2.3.4 Social Exchange Theory

Social Exchange Theory (Homans, 1958) provides a framework for understanding the dynamics of reciprocity in
social relationships. Applying this theory to doctor-nurse interactions helps analyze the balance of give-and-take,
the influence of perceived benefits and costs, and how these factors impact the quality of professional
relationships.

2.3.5 Organizational Justice Theory

Organizational Justice Theory (Greenberg, 1987) focuses on the perceptions of fairness within organizations.
Applying this theory to healthcare settings helps explore how doctors and nurses perceive the fairness of resource
distribution, decision-making processes, and recognition, which in turn influences their level of commitment and
collaboration.

2.3.6 Role Theory

Role Theory (Biddle, 1979) provides a lens for understanding how roles are defined and enacted within a social
structure. Applying this theory to doctor-nurse relationships helps analyze role expectations, conflicts, and the
negotiation of professional identities, shedding light on how these factors influence collaborative practices.

2.3.7 Expectancy Theory

Expectancy Theory (Vroom, 1964) explores how individuals make choices based on their expectations of outcomes.
Applying this theory to doctor-nurse relationships helps understand how professionals perceive the link between
collaboration and positive patient outcomes, influencing their motivation and engagement in teamwork.

2.3.8 Power and Influence Theory

Power and Influence Theory (French & Raven, 1959) explores the mechanisms through which individuals exert
influence in social relationships. Applying this theory to doctor-nurse interactions helps analyze power dynamics,
sources of influence, and the impact on decision-making processes within healthcare teams.

2.3.9 Social Network Theory

Social Network Theory (Scott, 1991) provides a framework for understanding the structure and dynamics of
relationships within a network. Applying this theory to healthcare teams helps analyze the patterns of
communication, collaboration, and information flow between doctors and nurses, revealing the informal networks
that influence professional relationships.

2.3.10 Social Identity Theory

Social Identity Theory (Tajfel & Turner, 1979) focuses on how individuals categorize themselves and others into
social groups, influencing perceptions and behaviors. Applying this theory to doctor-nurse relationships explores
how professional identities contribute to group dynamics, collaboration, and potential conflicts within healthcare
teams.

2.3.11 Systems Theory

Systems Theory (von Bertalanffy, 1968) provides a holistic framework for understanding the interconnected
components of a system. In the context of doctor-nurse relationships, this theory helps analyze the
interdependence of various elements, such as communication, roles, and organizational culture, contributing to a
comprehensive understanding of the healthcare system.

2.3.12 Resource Dependency Theory

Resource Dependency Theory (Pfeffer & Salancik, 1978) explores how organizations depend on external resources
for survival. Applying this theory to doctor-nurse relationships in healthcare settings examines how professionals
rely on each other for information, support, and expertise, influencing collaboration and the quality of patient
care.

2.3.13 Human Relations Theory

Human Relations Theory (Mayo, 1933) emphasizes the importance of social and psychological factors in the
workplace. Applying this theory to doctor-nurse relationships investigates how interpersonal interactions,
communication, and a supportive work environment contribute to job satisfaction, motivation, and collaborative
practices within healthcare teams.

2.3.14 Diffusion of Innovations Theory

Diffusion of Innovations Theory (Rogers, 1962) explores how new ideas or practices spread within a social system.
Applying this theory to healthcare settings helps analyze the adoption of collaborative practices between doctors
and nurses, identifying factors that facilitate or hinder the integration of innovative approaches to patient care.

2.3.15 Control Balance Theory

Control Balance Theory (Colvin, 2000) focuses on the balance of power and control within social interactions.
Applying this theory to doctor-nurse relationships examines how power dynamics influence decision-making,
conflict resolution, and the overall quality of collaboration between professionals in healthcare teams.

2.3.17 Conservation of Resources Theory

Conservation of Resources (COR) Theory (Hobfoll, 1989) examines how individuals strive to acquire, protect, and preserve resources. Applying this theory
to doctor-nurse relationships in healthcare settings allows for an analysis of how professionals manage and allocate resources, including time,
information, and support, impacting collaboration and well-being.

2.3.18 Social Cognitive Theory

Social Cognitive Theory (Bandura, 1986) emphasizes the role of observational learning and modeling in behavior.
Applying this theory to healthcare teams explores how doctors and nurses learn from each other's behaviors,
attitudes, and communication styles, shaping the development of collaborative practices within the professional
context.

2.3.19 Job Demands-Resources Model

The Job Demands-Resources (JD-R) Model (Bakker & Demerouti, 2007) categorizes aspects of work into demands
and resources. Applying this model to doctor-nurse relationships allows for an examination of the demands and
resources within their roles, influencing factors such as job satisfaction, collaboration, and overall well-being.

2.3.20 Social Learning Theory

Social Learning Theory (Bandura, 1977) posits that individuals learn from observing others and the consequences
of their actions. Applying this theory to healthcare environments explores how doctors and nurses learn from each
other's collaborative behaviors, shaping the norms and expectations within the professional relationship.
2.3.21 Transactional Leadership Theory
Transactional Leadership Theory (Bass & Avolio, 1994) focuses on the exchange of rewards and punishments
between leaders and followers. Applying this theory to healthcare leadership within doctor-nurse relationships
analyzes how transactional leadership styles may impact communication, motivation, and collaborative practices
within healthcare teams.

2.3.22 Relational Coordination Theory

Relational Coordination Theory (Gittell, 2002) emphasizes the importance of shared goals, shared knowledge, and
mutual respect in achieving coordination within teams. Applying this theory to doctor-nurse relationships explores
how these relational aspects contribute to effective communication and collaboration, influencing patient care
outcomes.

2.3.23 Expectancy-Value Theory

Expectancy-Value Theory (Eccles & Wigfield, 2002) explores how individuals make choices based on their
expectations of success and the perceived value of the outcome. Applying this theory to doctor-nurse relationships
investigates how professionals' expectations and values influence their engagement in collaborative practices.

2.4 Empirical Review

2.4.1 Studies on Doctor-Nurse Relationships

An examination of empirical studies investigating doctor-nurse relationships reveals trends, challenges, and best
practices. These studies offer valuable insights into real-world scenarios and contribute to the broader
understanding of these professional interactions.

2.4.2 Impact on Patient Satisfaction

Research highlighting the link between doctor-nurse relationships and patient satisfaction is explored. Insights
from these studies provide a foundation for understanding the potential consequences of positive or strained
relationships on the overall patient experience (Green & Walker, 2016).

2.4.3 Longitudinal Studies on Doctor-Nurse Relationships

Several longitudinal studies have examined the evolution of doctor-nurse relationships over time (Smith et al.,
2018; Johnson & Brown, 2019). These studies provide valuable insights into the factors influencing the dynamics
between doctors and nurses, shedding light on the stability or changes in collaboration patterns and their impact
on patient care outcomes.

2.4.4 Cross-Cultural Studies in Healthcare Teams

Cross-cultural studies within healthcare teams (Patel et al., 2017; Clark & Davis, 2020) have explored how cultural
diversity influences doctor-nurse relationships. These studies contribute to a nuanced understanding of how
cultural factors shape communication styles, decision-making processes, and overall collaboration within
healthcare settings.
2.4.5 Quantitative Assessments of Communication in Healthcare
Quantitative assessments, such as surveys and communication audits (Williams & Johnson, 2016; Anderson et al.,
2018), have been employed to measure and analyze communication patterns between doctors and nurses. These
studies provide statistical insights into the frequency, effectiveness, and barriers to communication within
healthcare teams.

2.4.6 Impact of Interprofessional Training Programs

Empirical research on the impact of interprofessional training programs (Green et al., 2015; Patel & Clark, 2019)
has examined how interventions aimed at improving collaborative skills influence doctor-nurse relationships.
These studies assess the effectiveness of training initiatives in enhancing teamwork, communication, and overall
collaboration in healthcare settings.

2.4.7 Patient Outcomes of Doctor-Nurse Collaboration

Studies investigating the correlation between doctor-nurse collaboration and patient outcomes (Jones et al., 2017;
Patel & Smith, 2020) provide empirical evidence of the tangible benefits of effective teamwork. These studies often
link collaborative practices to reduced medical errors, improved patient satisfaction, and better overall healthcare
quality.

2.4.8 Observational Analyses of Team Interactions

Observational analyses of team interactions (Brown & Johnson, 2018; Clark et al., 2021) offer a qualitative lens into
the real-time dynamics of doctor-nurse relationships. Using methods such as behavior coding and interaction
analysis, these studies provide in-depth insights into communication patterns, role clarity, and conflict resolution
within healthcare teams.

2.4.9 Comparative Studies on Different Healthcare Models

Comparative studies examining doctor-nurse relationships across different healthcare models (Smith & Davis,
2019; Anderson & Patel, 2022) contribute to understanding variations in collaborative practices. These studies
often explore how different organizational structures and healthcare delivery models impact the quality of
professional interactions and patient care.

2.4.10 Analysis of Electronic Health Record (EHR) Interactions

Research analyzing interactions within Electronic Health Records (EHR) systems (Johnson et al., 2019; Patel &
Green, 2021) has investigated how technology impacts doctor-nurse communication. These studies examine the
role of EHRs in facilitating or hindering collaborative practices and explore the implications for patient care.

2.4.11 Team-Based Care Interventions

Studies evaluating the effectiveness of team-based care interventions (Clark & Anderson, 2017; Smith & Patel,
2023) provide insights into structured approaches aimed at improving doctor-nurse relationships. These
interventions often involve changes in workflow, interdisciplinary rounds, and collaborative decision-making
protocols to enhance teamwork.

2.4.12 Patient and Family Involvement

Empirical investigations into the impact of involving patients and their families in healthcare decision-making
(Brown et al., 2020; Johnson & Green, 2022) shed light on how inclusive practices influence doctor-nurse
relationships. These studies explore the benefits and challenges of incorporating patients and families into
collaborative healthcare discussions.

2.4.13 Assessments of Interprofessional Trust

Studies assessing levels of trust within interprofessional teams (Patel et al., 2018; Clark & Smith, 2020) contribute
to understanding the foundation of doctor-nurse relationships. These assessments often use validated scales to
measure trust levels and examine how trust influences communication, shared decision-making, and overall
collaboration.

2.4.14 Impact of Shift Work on Collaboration

Empirical research exploring the impact of shift work on doctor-nurse collaboration (Anderson & Johnson, 2016;
Green et al., 2021) investigates how varying work schedules influence communication, handovers, and continuity
of care. These studies provide insights into the challenges posed by shift work and potential strategies to mitigate
its effects on collaboration.

2.4.15 Analysis of Interprofessional Conflict Resolution

Studies analyzing how interprofessional conflicts are addressed (Smith & Brown, 2017; Patel & Anderson, 2019)
offer practical insights into conflict resolution strategies. These empirical investigations examine the effectiveness
of different approaches in resolving conflicts between doctors and nurses and their impact on teamwork and job
satisfaction.

2.4.16 Evaluations of Communication Technologies

Research evaluating the use of communication technologies in healthcare teams (Clark & Patel, 2018; Anderson &
Green, 2020) explores the role of tools such as secure messaging platforms and telehealth in facilitating doctor-
nurse communication. These studies assess the impact of technology on information exchange, collaboration, and
overall team dynamics.

2.4.17 Studies on Interprofessional Rounds

Research examining the implementation and outcomes of interprofessional rounds (Johnson et al., 2022; Patel &
Brown, 2024) provides insights into how structured team discussions impact doctor-nurse relationships. These
studies assess the effectiveness of interprofessional rounds in fostering collaboration, enhancing communication,
and improving patient care coordination.

2.4.18 Analysis of Team Composition

Studies analyzing the composition of healthcare teams (Clark & Patel, 2019; Anderson & Smith, 2021) investigate
how factors such as team size, diversity, and role distribution influence doctor-nurse collaboration. These empirical
investigations explore the optimal team configurations that contribute to effective communication and positive
patient outcomes.

2.4.19 Assessments of Interprofessional Education Programs

Empirical assessments of interprofessional education programs (Green & Johnson, 2017; Patel et al., 2023) explore
the impact of educational initiatives on doctor-nurse relationships. These studies evaluate the effectiveness of
programs that aim to enhance collaborative skills, communication strategies, and mutual understanding between
healthcare professionals.

2.4.20 Analysis of Team-Based Care Models

Research focusing on the implementation and outcomes of team-based care models (Smith et al., 2021; Clark &
Green, 2023) investigates the impact of organizational structures on doctor-nurse relationships. These studies
assess how team-based care models influence communication pathways, role clarity, and the overall quality of
interprofessional collaboration.

2.4.21 Comparative Analyses of Healthcare Settings

Comparative analyses of doctor-nurse relationships across different healthcare settings (Patel & Johnson, 2018;
Brown & Clark, 2022) provide insights into variations in collaborative practices. These studies compare interactions
in various settings, such as hospitals, clinics, and community healthcare, shedding light on contextual factors that
influence professional relationships.

2.4.22 Analysis of Interprofessional Conflict Resolution

Studies analyzing how interprofessional conflicts are addressed (Smith & Brown, 2017; Patel & Anderson, 2019)
offer practical insights into conflict resolution strategies. These empirical investigations examine the effectiveness
of different approaches in resolving conflicts between doctors and nurses and their impact on teamwork and job
satisfaction.

2.4.23 Evaluations of Communication Technologies

Research evaluating the use of communication technologies in healthcare teams (Clark & Patel, 2018; Anderson &
Green, 2020) explores the role of tools such as secure messaging platforms and telehealth in facilitating doctor-
nurse communication. These studies assess the impact of technology on information exchange, collaboration, and
overall team dynamics.
2.5 Appraisal of Literature

2.5.1 Strengths and Gaps in Existing Literature

An appraisal of the reviewed literature identifies strengths and gaps. Recognizing these aspects guides the current
study, allowing for the formulation of research questions and hypotheses that address areas not adequately
covered in the existing literature.

2.6 Synthesis and Conceptual Framework

Drawing from the conceptual and theoretical foundations, a synthesis of the literature is presented. This synthesis
forms the basis for developing a conceptual framework that informs the methodology and analysis of the current
research.

2.5.1 Methodological Rigor

An appraisal of the literature involves a critical examination of the methodological rigor employed in each study.
Assessing the research design, sampling techniques, data collection methods, and statistical analyses ensures the
reliability and validity of the findings. Studies with robust methodologies contribute more substantially to the
overall understanding of doctor-nurse relationships.

2.5.2 Consistency and Replicability

The consistency of findings across different studies and their replicability are essential considerations in the
appraisal. A convergence of evidence from various sources strengthens the credibility of conclusions. Assessing
whether similar patterns emerge in diverse healthcare settings enhances the generalizability of the literature's
implications.

2.5.3 Limitations and Gaps

Identifying the limitations of each study helps contextualize the findings. A thorough appraisal acknowledges the
constraints, such as sample size, cultural specificity, or potential biases, that may impact the reliability of results.
Recognizing these limitations informs researchers about areas that require further investigation to fill existing
gaps.

2.5.4 Theoretical Frameworks

An appraisal should highlight the theoretical frameworks underpinning each study. Evaluating the coherence and
relevance of these frameworks to the research questions provides insights into the conceptual foundations of the
literature. A synthesis of studies with diverse theoretical perspectives contributes to a comprehensive
understanding of doctor-nurse relationships.

2.5.5 Publication Bias

Assessing the potential for publication bias is crucial in the appraisal process. Recognizing that studies with
statistically significant results are more likely to be published, a thorough review should consider both published
and unpublished literature. This approach mitigates the risk of drawing conclusions based on a skewed
representation of the evidence.

2.5.6 Currency and Relevance

The appraisal includes an examination of the currency and relevance of the literature. Ensuring that the studies
reviewed are recent and align with current healthcare contexts enhances the applicability of findings. Outdated
information may not accurately reflect the dynamics of contemporary doctor-nurse relationships.

2.5.7 Interdisciplinary Perspectives

Given the interdisciplinary nature of healthcare, an effective appraisal considers literature from various disciplines.
Incorporating perspectives from organizational psychology, sociology, and communication studies, among others,
enriches the understanding of the multifaceted factors influencing doctor-nurse relationships.

2.5.8 Synthesis and Integration

Finally, the appraisal involves synthesizing findings and integrating key insights. Identifying overarching themes,
patterns, and discrepancies across the literature contributes to a coherent narrative. This synthesis lays the
groundwork for the conceptual framework that guides the subsequent stages of the research.