Wiman Elisabeth, Wikblad Karin
Department of Welfare and Care, Faculty of Health Sciences, Linköping University, Norrköping, Sweden.
J Clin Nurs. 2004 May;13(4):422-9. doi: 10.1111/j.1365-2702.2004.00902.x.
Caring is a core characteristic of nursing. Nurses' caring behaviour has been explored in several studies. When caring for trauma patients, the most important caring behaviour must be the procedures associated with lifesaving. However, it is important not to forget the patient's psychological needs.
The aim of this study was to highlight encounters between injured patients and nurses in the trauma team and to explore whether the theory of caring and uncaring encounters in nursing and health care is applicable in emergency care.
Data were collected by videotaping caring episodes between slightly injured patients and nurses in the trauma team. Five episodes involving 10 nurses were studied. The analysis was carried out in four steps. First the videotapes were studied several times and then transcribed into narratives, which were reduced into courses of events. These were subsequently classified according to aspects of caring and uncaring.
The nurses' verbal and non-verbal communication was poor, and they adopted a wait-and-see policy. A new uncaring aspect, instrumental behaviour, emerged from this poor communication. One of the caring aspects, being dedicated and having courage to be appropriately involved, could not be identified. Most encounters included several aspects of caring and uncaring, but the uncaring aspects predominated. The dominance of uncaring aspects indicates a lack of affective caring behaviour.
The result showed that the theory is partly applicable in emergency care. A new aspect, instrumental behaviour emerged. The nurses' behaviour in the five episodes was labelled as uncaring. Authentic nurse-patient encounters are essential in nursing.
The importance of meeting patients' psychological needs and nurses' affective caring behaviour should be emphasized in trauma care, trauma courses and nursing education. It is necessary to measure the caring behaviour of trauma nurses.
关怀是护理的核心特质。多项研究对护士的关怀行为进行了探讨。在护理创伤患者时，最重要的关怀行为必定是与挽救生命相关的操作。然而，也不能忽视患者的心理需求。
本研究旨在突出创伤团队中受伤患者与护士之间的互动，并探讨护理与医疗保健中关怀与不关怀互动的理论是否适用于急诊护理。
通过拍摄创伤团队中轻伤患者与护士之间的关怀片段来收集数据。对涉及10名护士的5个片段进行了研究。分析分四个步骤进行。首先多次观看录像带，然后转录成叙述内容，再归纳为事件过程。随后根据关怀与不关怀的方面进行分类。
护士的言语和非言语沟通不佳，且采取观望政策。这种糟糕的沟通产生了一个新的不关怀方面，即工具性的行为。未能识别出关怀方面之一，即奉献精神和有勇气适度参与。大多数互动包含多个关怀与不关怀的方面，但不关怀方面占主导。不关怀方面占主导表明缺乏情感关怀行为。
结果表明该理论在急诊护理中部分适用。出现了一个新的方面，即工具性的行为。这5个片段中护士的行为被判定为不关怀。真实的护患互动在护理中至关重要。
在创伤护理、创伤课程和护理教育中，应强调满足患者心理需求以及护士情感关怀行为的重要性。有必要衡量创伤护士的关怀行为。
