Interprofessional Collaboration and Work Stress in Chinese Healthcare Providers during the COVID-19 Pandemic: A Comparative Study

Background/Rationale

Population health, patient satisfaction, and healthcare costs are the triple aims of modern healthcare, where healthcare professional well-being is fundamental to achieving these three aims. The Covid-19 pandemic has had a huge impact on HCP well-being as HCPs are providing care in new ways while also managing high levels of work/life stress. Interprofessional practice (IPP) has also been identified as a key contributor to the healthcare organizational culture of wellness and health care provider morale. The purpose of this study is examining the impact of interpersonal collaboration (IPC) on their work stress among healthcare providers (HCPs) in China and comparing the differences in associations between IPC and work stress between Chinese physicians and nurses.

Methods/Methodology

With a survey research design, 1,036 HCPs were electronically recruited. The outcome variable, Work Stress, was a total score of 35 questions from the Health and Safety Executive Management Standards Indicator Tool. Interprofessional collaboration was measured using the subscale of Cooperation from the Assessment of Interprofessional Team Collaboration Scale. The reliability alpha of the subscale of Cooperation’s is 0.97. Five multiple linear regression models were developed to examine the association between IPC and work stress among general HCPs, physicians, and nurses.

Results

The frequency of collaborating with other health care professionals to plan, deliver, and evaluate patient care several times per week. The average work stress among all participants scored 51.56 out of 140, while the minimum was five and the maximum was 123. we found IPP generally plays a positive role in reducing HCPs’ work stress. The HCPs who engage in higher levels of IPP report lower levels of work stress (p<0.00). IPP factors associated with job stress differed among physicians and nurses. Having mutually satisfying solutions and a sense of trust were both negatively associated with physician (p=0.00) and nurse (p=0.01) work stress. Different from physicians, we identified that hours of work moderated the influence of mutually satisfying resolution on work stress among nurses. Understanding each other's work boundaries was only negatively associated with nurses' work stress (p=0.01), not physicians.

Conclusions

Interprofessional collaborative teamwork can significantly reduce work stress among Chinese HCPs. Achieving mutually satisfactory solutions, having a clear understanding of boundaries, and a sense of trust are negatively associated HCPs’ work stress, but team reflective revision was positively associated HCPs’ work stress during the COVID-19 pandemic. Team trust was more effective than team reflection in reducing HCPs' work stress. For physicians, team trust appeared essential to reducing their work stress, but the negative impact of the stress of COVID-19 on HCP well-being cannot be ignored. For nurses, it is especially important that IPP team members have a clear understanding of each other's professional boundaries. Developing strategies and training programs that promote IPP skills, such as improving effective communication and enhancing team trust, are encouraged to reduce Chinese HCPs' work stress. Policymakers could increase interprofessional meetings to give HCPs more time and opportunities to communicate and develop collaborative relationships.