The influence of discourse on collaboration among nurses, physicians, and consumers

The aim of this study was to determine whether ongoing discussion among nurses, physicians, and consumers influenced their collaborative beliefs and behavior. A stratified experimental sample of 72 professionals and consumers met in small, multidisciplinary groups on a monthly basis for 2 years to discuss health care relationships. Prior to the onset of these groups, and after their conclusion, the experimental sample, a randomly selected control group of 72 persons, and a matched control group of 72 persons all completed the Management of Differences Exercise, the Multidimensional Health Locus of Control Scales, and the Health Role Expectations Index. Contrary to predictions, the experimental group (M = -6.85) declined more than controls (M = -4.63, p less than .05) in their beliefs regarding the value of shared versus physician-dominated responsibility for health care and increased more (M = 1.58 versus M = -.53, p less than .007) in their beliefs that powerful individuals such as physicians influence the consumer's health status. Results indicate that ongoing discourse may have enhanced traditional, status quo beliefs regarding the authority and power of the physician rather than fostering collaborative values.