Copyright © 2014 Athina E. Patelarou et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. International Journal of Advanced Nursing Studies, 3 (2) (2014) 113-121 International Journal of Advanced Nursing Studies Journal home page: www.sciencepubco.com/index.php/IJANS doi: 10.14419/ijans.v3i2.3278 Research Paper Do we really collaborate effectively in the operating theatre? A cross- sectional study in two hospitals in Greece Athina E. Patelarou 1 *, Aggelos Laliotis 2 , Dimitra Sifaki Pistola 3 , Sofia Marinaki 4 , Zacharenia Androulaki 5 , Chrysoula Tsiou 6 , Hero Brokalaki 7 1 RN, MPH, Department of Anaesthesiology, University Hospital of Heraklion, Crete, Greece 2 MD, Department of Surgery, St Thomas' Hospital Guy’s & St Thomas’ NHS Foundation Trust 3 Statistician, MPH, Department of Social Medicine, University of Crete, Crete, Greece 4 RN, Independent researcher, Crete, Greece 5 RN, PhD, Department of Nursing, Technological Institute of Nursing, School of Health Science, Crete, Greece 6 RN, PhD, Department of Nursing, Technological Institute of Athnes, School of Health Science, Crete, Greece 7 RN, PhD, Department of Nursing, University of Athens, Athens, Greece *Corresponding author E-mail: athina.patelarou@gmail.com Abstract The aim of this study was to translate the Disagreement and Aggression in the Operating Theatre Scale (DAOTS) into Greek and investi- gate the frequency of perceived conflicts, the sources of disagreement and the suggested methods of coping with them within and among professional groups in operating theatres in Greece. The results of this study support the reliability and validity of the DAOTS. The ma- jority of the respondents had witnessed episodes of aggressive behaviour and/or disagreement during the last six months. Physicians more frequently revealed an aggressive behaviour towards a colleague, while nurses were found to be witnesses of a conflict between different professional teams. Daily/weekly disagreements among respondents about availability of equipment, theatre time, changes in the list order and availability of surgical staff were reported. Additionally, hospital type and years of professional experience are consid- ered to affect the prevalence of exposure to a disagreement. Keywords: Aggression, Disagreement, Nurse, Operating Theatre, Teamwork. 1. Introduction Communication among the team members is essential as it pro- motes work coordination and makes adaption to change possible (Brannick 1997). The operating theatre has been described as the most typical example of an interdisciplinary team working in healthcare, as well as being a particularly demanding work envi- ronment (Gillespie 2003, Timmons 2005). Admittedly, effective multidisciplinary communication is essential for cohesive team- work perioperatively. Any disruption of the effective interaction and collaboration may have devastating consequences on service delivery and patient safety (Schaefer et al. 1995). Under this per- spective, concerns have been raised in the literature regarding the effects of disagreement and aggression among different health care professional groups (Lingard et al. 2004, Moss 2004). There is significant amount of evidence that factors most frequently identified as contributing to aggression and disagreement incidents are high workload, the ineffective management style and the inter- professional conflict between health care workers (Beardwood et al. 1999, Weinberg 2000). Moreover, the fact that patient safety and quality of care rely on an effective teamwork has been emphasized extensively in the litera- ture (Kohn et al. 1999). Particularly, a number of studies have investigated the role of teamwork issues in the prevention of ad- verse events in the operating room. The consequences of subopti- mal teamwork may be devastating for patients, caregivers and institutions. Retained sponges, wrong-site operations, mismatched organ transplants or blood transfusions can be the result of a breakdown in communication and collaboration among the operat- ing team members (Gawande et al. 2003). Research findings highlight that there are numerous accounts of conflict among professional groups in healthcare settings, as well as in European and non-European settings (Lambert et al. 2004, Almost 2006), resulting in the breakdown of successful inter- professional relations (Hudson 2002). In detail, in the operating theatre, Lingard and colleagues (2004) observed a 30% communi- cation failure during surgical procedures, accounting for a 36% rate of observable consequences, such as delay, tension among team members or procedural error (Lingard et al. 2004). These results are also supported by another observational study focusing on the effects of disruption on the surgical process (e.g. communi- cation failure, equipment problems) (Wiegmann et al. 2007). The study found that increased disruption was significantly associated with high percentage of surgical errors, whereas teamwork and communication problems were the strongest predictors of surgical errors (Wiegmann et al. 2007). In Australia, about 50% of adverse events in hospitals are the result of communication problems among healthcare professionals, especially between nurses and doctors (AIHW 2007). Communication failures represent the gap among the particular communication practices used across profes- sional disciplines and the specific collaborative expectations and improvements of the work reality (Bleakley et al. 2006). Most sociological studies on professional boundaries in healthcare have focused on the boundary between nursing and medicine