الفهرس 
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Abstract
Collaboration is understood as the way in which physicians and nurses interact with each other in relation to clinical decision making. Collaboration involves direct and open communication, respect for different perspectives, and mutual responsibility for problem solving. Collaborative practice are defined as interactions between nurse and physician that enable the knowledge and skills of both professionals to synergistically influence the patient care being provided. Knowledge sharing is based on individual behavior, and defined as behavior’s set which involve exchanging of information or assistance with others. The most challenging part in encouraging knowledge sharing behavior is that nurses and physicians need trust between each other for ensuring the spontaneously and efficiently knowledge sharing.
Aim of The Study:
This study aims to examine the relationship between nurses-physicians collaboration and knowledge sharing behavior.
Research Question:
What is the relationship between nurses-physicians collaboration and knowledge sharing behavior?
Material &methods:
Research design:
A descriptive correlational research design was used in this study.
Setting of the study:
• This study was conducted at all critical and intensive care units of both Alexandria Main University Hospital (N=13) and New Educational Hospital Alexandria University (N=5).The former include intensive care units namely: unit I, unit II, unit III, triage, emergency intensive care unit, anesthesia unit, urology, medical emergency, ENT, neurology, cardio thorax, hepatology and maxilla -facial intensive care unit.;and the latter include intensive care units namely: coronary unit, open heart unit, first floor, seventh floor and eighth floor icu (Total N=18)
Subjects of the study:
Two groups of subjects was included in this study. (Total N=386)
1- All staff nurses, who are working in the previously mentioned settings and who were available at the time of data collection, with at least one year of experience. (N=280)
2- All Resident physicians who are working in the previously mentioned settings and who were available at the time of data collection, with at least one year of experience. (N=106)
Tools of the study
Two tools were used in this study for data collection
Tool (I): Nurse/ Physician Collaboration Scale (NPCS):
This scale was developed by Ushiro (2009), and adopted by researcher to measures the collaborative behavior between nurse and physician based on self-reported assessment. It is composed of 27 items, divided into three domains namely: sharing of clinical patient information (9-item); joint participation in the cure/care decision making process (12-item); and nurse/physician collaboration (6-items). Responses were measured on a 5-point Likert scale ranging from (1) strongly disagrees to (5) strongly agree. Higher score of the instrument imply greater use of collaboration by the nurse or physicians. The overall score level range from (27 to 135).Higher score (81-135) imply greater use of collaboration by the nurses or physicians; lower score (27-80). Cronbach, s alpha coefficient was (0.953).
Tool (II): Knowledge sharing behavior scale:
It was developed by Bock et al. (2005); and was adapted by the researcher to assess knowledge sharing behavior among coworkers (nurse and physician). It includes seven main dimensions composed of 38 items; namely: perceived behavioral control (6-items); perceived organizational incentives (5-item); perceived reciprocal benefits (3-items); perceived reputation enhancement (6-items); perceived loss of knowledge Power (4-items); Perceived enjoyment in helping others (4-items); perceived organizational climate (10-items). Five point Likert scale was used ranging from (1) strongly disagree to (5) strongly agree. The overall score level range from (38 to 190).The higher score (140 -190), the more knowledge sharing between nurses and physicians; Moderate score (89 -139); and the lower score (38 -88). Cronbach, s alpha coefficient (0.815).
In addition, demographic data sheet was developed by the researcher, and included questions related to working unit, age, educational qualification, years of experience, and marital status.
Methods
An official permission was obtained from the Faculty of Nursing, Alexandria University and the administrators of the identified hospitals to obtain an approval for collecting the necessary data from the selected units. The tools were translated into Arabic, and tested for its content validity and translation by panel of five expert from Faculty Of Nursing, A pilot study for the questionnaires was carried out on (10%) of total sample size; staff nurses (n=28) and physicians (n=11) who were excluded from the study; in order to check and ensure the clarity of the questionnaires, identify obstacles that may be encountered during data collection.
Data collection
Data collection for this study was conducted by the researcher through self-administered questionnaire, which was hand delivered to the study subjects for every nurse and physician took about 15 minutes to fill the tools. The data collection took two and half months from12-4-2018to 27-6-2018.
The following were the core results of the present study:
1- Nurse’s and physician did not show significant differences in collaboration, These results continued when comparing item to item with only exception of nurse-physician collaboration as physicians had significantly higher score than nurses.
2- Nurse’s knowledge share score was significantly higher than physicians and when comparing item to item, the difference was significant in innovativeness, perceived loss of knowledge power, affiliation, fairness and perceived organizational incentives. The highest mean was observed for perceived reputation enhancement dimension while the lowest mean was for perceived loss of knowledge power dimension.
3- The results showed a significant relation for nurses between knowledge share with both age and educational degree but not years of experience or marital status while, for physician the significant relations were with age and years of experience.
4- Nurse’s collaboration score was significantly related to age, educational level and years of experience. In contrast with physicians, who showed no significant relation to any of the measured parameters.
5- Statistically significant relation was found between the nurses’ and physicians’ knowledge sharing and their collaboration mean score
6- Using binary logistic regression analysis to identify the predictors of knowledge share score, the present results found level of education, years of experience and position as a nurse were predictors of knowledge sharing score.
7- Using binary logistic regression analysis to identify the predictors of collaboration score among nurses and physicians, the present results found namely level of education, years of experience were predictors of collaboration.
Recommendation
The recommendations were given to enhance collaboration among nurses and physician through introducing of educational programs, about the importance of cooperation, and transfer of knowledge, and improve knowledge sharing skills among them to improve outcomes related to patient and all over the organization.