Enns Carol, Gregory David
Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.
J Adv Nurs. 2007 May;58(4):339-47. doi: 10.1111/j.1365-2648.2007.04237.x. Epub 2007 Apr 10.
This paper is a report of a phenomenological study of caring from the perspective of nurses working on surgical wards.
While care and caring are complex foundational nursing concepts which have received considerable and ongoing attention from theorists, researchers and clinicians, there has been little research into caring on surgical units.
A convenience sample of ten nurses working on surgical units in a public teaching hospital in Canada was interviewed using van Manen's phenomenological approach. Data were collected during 2001 using semi-structured interviews.
The major theme of lamentation and loss was identified from the data. Participants revealed a dichotomous tension between what caring should be and what actually occurs. This tension was pervasive and generated lament - an expression of grief and mourning for the loss of caring. The essential structures supporting this theme included lack of time, lack of caring support, tasking, increased acuity, lack of continuity of care, emotional divestment and not caring for each other. Loss and sadness were articulated and participants lamented and grieved about the loss of care in contemporary practice.
The forces and influences described by participants undermined caring in the new practice milieu. If this is a glimpse of the future, then the values of the nursing profession may be under siege. Caring as the central core, the essence or unifying concept of nursing may be subject to marginalization in contemporary practice.
本文是一篇关于从外科病房护士视角进行关怀现象学研究的报告。
尽管关怀是复杂的护理基础概念，受到了理论学家、研究者和临床医生的广泛且持续关注，但对外科病房关怀的研究却很少。
采用范曼的现象学方法，对加拿大一家公立教学医院外科病房的10名护士进行了便利抽样访谈。2001年期间通过半结构化访谈收集数据。
从数据中确定了哀悼与失落这一主要主题。参与者揭示了关怀应有的样子与实际发生的情况之间的二元张力。这种张力普遍存在并引发了哀悼——对关怀缺失的悲伤和悲痛的表达。支撑这一主题的基本结构包括时间不足、缺乏关怀支持、任务分配、病情严重程度增加、护理缺乏连续性、情感剥离以及互不关心。参与者表达了失落和悲伤，对当代实践中关怀的缺失感到哀悼和悲痛。
参与者所描述的各种力量和影响破坏了新实践环境中的关怀。如果这是对未来的一种预示，那么护理专业的价值观可能受到威胁。关怀作为护理的核心、本质或统一概念，在当代实践中可能会被边缘化。
