A lack of nurse autonomy impacts population health when compared to physician care : an ecological study

Wenpeng You; Lynette Cusack; Frank Donnelly

doi:10.1038/s41598-023-38945-6

A lack of nurse autonomy impacts population health when compared to physician care : an ecological study

Wenpeng You
, Lynette Cusack
, Frank Donnelly

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

This study highlights that the contribution of nursing is secondary to physicians in overall population health (indexed with life expectancy at birth, e (0) ). Scatter plots, bivariate correlation and partial correlation models were performed to analyse the correlations between e (0) and physician healthcare and nursing healthcare respectively. Affluence, urbanization and obesity were incorporated as the potential confounders. The Fisher's r-to-z transformation was conducted for comparing the correlations. Multiple linear regression analyses were implemented for modelling that physicians' contributions to e (0) explain nurses'. Nursing healthcare correlated to e (0) significantly less strongly than physician healthcare in simple regressions. Nursing healthcare was in weak or negligible correlation to e (0) when physician healthcare was controlled individually or together with the three confounders. Physician healthcare remains significantly correlational to e (0) when nursing healthcare alone was controlled or when the three confounders were controlled. Linear regression revealed that nursing healthcare was a significant predictor for e (0) when physician healthcare was "not added" for modelling, but this predicting role became negligible when physician healthcare was "added". Our study findings suggested that nurses still work under the direction of physicians due to lack of autonomy. Without correction, health services will continue to transmit the invisibility of nursing healthcare from one generation of nurses to another.

Original language	English
Article number	12047
Number of pages	9
Journal	Scientific Reports
Volume	13
Issue number	1
DOIs	https://doi.org/10.1038/s41598-023-38945-6
Publication status	Published - Dec 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s).

Open Access - Access Right Statement

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 11 Sustainable Cities and Communities

Access to Document

10.1038/s41598-023-38945-6

Cite this

@article{8989298ad75c437fad458f28f1fa7118,

title = "A lack of nurse autonomy impacts population health when compared to physician care : an ecological study",

abstract = "This study highlights that the contribution of nursing is secondary to physicians in overall population health (indexed with life expectancy at birth, e (0) ). Scatter plots, bivariate correlation and partial correlation models were performed to analyse the correlations between e (0) and physician healthcare and nursing healthcare respectively. Affluence, urbanization and obesity were incorporated as the potential confounders. The Fisher's r-to-z transformation was conducted for comparing the correlations. Multiple linear regression analyses were implemented for modelling that physicians' contributions to e (0) explain nurses'. Nursing healthcare correlated to e (0) significantly less strongly than physician healthcare in simple regressions. Nursing healthcare was in weak or negligible correlation to e (0) when physician healthcare was controlled individually or together with the three confounders. Physician healthcare remains significantly correlational to e (0) when nursing healthcare alone was controlled or when the three confounders were controlled. Linear regression revealed that nursing healthcare was a significant predictor for e (0) when physician healthcare was {"}not added{"} for modelling, but this predicting role became negligible when physician healthcare was {"}added{"}. Our study findings suggested that nurses still work under the direction of physicians due to lack of autonomy. Without correction, health services will continue to transmit the invisibility of nursing healthcare from one generation of nurses to another.",

author = "Wenpeng You and Lynette Cusack and Frank Donnelly",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = dec,

doi = "10.1038/s41598-023-38945-6",

language = "English",

volume = "13",

journal = "Scientific Reports",

issn = "2045-2322",

publisher = "Nature Research",

number = "1",

}

TY - JOUR

T1 - A lack of nurse autonomy impacts population health when compared to physician care : an ecological study

AU - You, Wenpeng

AU - Cusack, Lynette

AU - Donnelly, Frank

PY - 2023/12

Y1 - 2023/12

N2 - This study highlights that the contribution of nursing is secondary to physicians in overall population health (indexed with life expectancy at birth, e (0) ). Scatter plots, bivariate correlation and partial correlation models were performed to analyse the correlations between e (0) and physician healthcare and nursing healthcare respectively. Affluence, urbanization and obesity were incorporated as the potential confounders. The Fisher's r-to-z transformation was conducted for comparing the correlations. Multiple linear regression analyses were implemented for modelling that physicians' contributions to e (0) explain nurses'. Nursing healthcare correlated to e (0) significantly less strongly than physician healthcare in simple regressions. Nursing healthcare was in weak or negligible correlation to e (0) when physician healthcare was controlled individually or together with the three confounders. Physician healthcare remains significantly correlational to e (0) when nursing healthcare alone was controlled or when the three confounders were controlled. Linear regression revealed that nursing healthcare was a significant predictor for e (0) when physician healthcare was "not added" for modelling, but this predicting role became negligible when physician healthcare was "added". Our study findings suggested that nurses still work under the direction of physicians due to lack of autonomy. Without correction, health services will continue to transmit the invisibility of nursing healthcare from one generation of nurses to another.

AB - This study highlights that the contribution of nursing is secondary to physicians in overall population health (indexed with life expectancy at birth, e (0) ). Scatter plots, bivariate correlation and partial correlation models were performed to analyse the correlations between e (0) and physician healthcare and nursing healthcare respectively. Affluence, urbanization and obesity were incorporated as the potential confounders. The Fisher's r-to-z transformation was conducted for comparing the correlations. Multiple linear regression analyses were implemented for modelling that physicians' contributions to e (0) explain nurses'. Nursing healthcare correlated to e (0) significantly less strongly than physician healthcare in simple regressions. Nursing healthcare was in weak or negligible correlation to e (0) when physician healthcare was controlled individually or together with the three confounders. Physician healthcare remains significantly correlational to e (0) when nursing healthcare alone was controlled or when the three confounders were controlled. Linear regression revealed that nursing healthcare was a significant predictor for e (0) when physician healthcare was "not added" for modelling, but this predicting role became negligible when physician healthcare was "added". Our study findings suggested that nurses still work under the direction of physicians due to lack of autonomy. Without correction, health services will continue to transmit the invisibility of nursing healthcare from one generation of nurses to another.

UR - https://hdl.handle.net/1959.7/uws:75761

U2 - 10.1038/s41598-023-38945-6

DO - 10.1038/s41598-023-38945-6

M3 - Article

C2 - 37491376

SN - 2045-2322

VL - 13

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 12047

ER -

A lack of nurse autonomy impacts population health when compared to physician care : an ecological study

Abstract

Bibliographical note

Open Access - Access Right Statement

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this