Pohlmann Martin
Fachhochschule Osnabrück, Studiengang Pflegewissenschaft, Osnabrüick.
Pflege. 2006 Jun;19(3):156-62. doi: 10.1024/1012-5302.19.3.156.
The nurse-patient relationship has received particular attention in the relevant literature. For patients in life threatening and existentially challenging situations, nursing activities often require a close intimacy. A good nurse-patient relationship is a precondition for effective nursing interventions, but by itself also contributes to the healing process. How such a relationship is realized in everyday nursing situations remains, however, unclear Literature predominantly details normative expectations on the nurse-patient relationship that are based on nursing theory or concepts from humanistic psychology. The operationalisation of these concepts into nursing practice is not given. In order to answer the research question "How do nurses experience their relationship with the patient?" qualitative interviews were conducted. Thus, the nurse-patient relationship was explored from the perspective of the nurses and considered in the context of their specific working situations. Nurses related their experiences, emotions and stress resulting from different kinds of nurse-patient relationships. Data were collected, organised and analysed following Giorgi's 1985 phenomenological analysis. Results show an ambivalence by nurses between closeness and distance in their relationship with patients. These relationships also show a polar vascillation between, for example, "sympathy" and "antipathy", or "being able to help" and "helplessness". The development of the relationship is often not very professional and depends on the specific situation and those individual persons participating in it. It is also apparent that those models of the humanistic psychology which have been discussed in nursing contexts cannot serve as such as a basis for the development of the nurse-patient relationship. A particular aspect of developing relationships in nursing are nursing interventions which necessitate bodily contact and physical work with patients. Concepts including these aspects of nursing can serve as valid and concrete starting points in order to find a way unique to nursing to create effective relationships with patients.
护患关系在相关文献中受到了特别关注。对于处于危及生命和存在挑战情境中的患者，护理活动通常需要密切的亲密关系。良好的护患关系是有效护理干预的前提条件，但其本身也有助于康复过程。然而，在日常护理情境中这种关系是如何实现的仍不明确。文献主要详细阐述了基于护理理论或人本主义心理学概念对护患关系的规范性期望。这些概念在护理实践中的实施情况并未给出。为了回答“护士如何体验他们与患者的关系？”这一研究问题，进行了定性访谈。因此，从护士的角度探索了护患关系，并在其特定工作情境的背景下进行了考量。护士们讲述了不同类型护患关系所带来的经历、情感和压力。按照 Giorgi 1985 年的现象学分析方法收集、整理和分析了数据。结果显示，护士在与患者的关系中在亲密与距离之间存在矛盾心理。这些关系还表现出例如“同情”与“反感”，或“能够帮助”与“无助”之间的两极波动。关系的发展往往不太专业，取决于具体情况和参与其中的个人。同样明显的是，在护理背景下讨论过的人本主义心理学模型不能作为护患关系发展的基础。护理中关系发展的一个特殊方面是护理干预，这需要与患者进行身体接触和体力工作。包含护理这些方面的概念可以作为有效且具体的起点，以便找到一种独特的护理方式来与患者建立有效的关系。
