Koeniger-Donohue Rebecca
Graduate Program in Primary Health Care Nursing, School for Health Studies, Simmons College, Boston, MA 02115, USA.
J Clin Nurs. 2007 Jun;16(6):1050-60. doi: 10.1111/j.1365-2702.2007.01871.x.
The aim of this study was to explore nurse practitioner (NP) client encounters from the nurse's perspective using a resource exchange paradigm.
In health care interactions there is a need to examine what is reinforcing from the nurse's perspective.
An exploratory descriptive design was used to address the following research questions: Prior to a clinic visit with midlife female clients what are NPs expectations of resources provided? What resources are actually provided during the visit with the NP and the client? To what extent is there congruence between the NP's expectations and the resources actually provided during a clinic visit?
The participants included two expert NPs and eight midlife female clients. Data for the study were derived from an initial larger study which examined resource exchange from the client angle and consisted of audio-taped pre- and postencounter interviews with the NPs, audiotapes of the entire clinic visit and field notes recorded by the researcher of the client visits. Content analysis was conducted using ETHNOGRPAH software.
NPs anticipated that a broad range of resources would be provided. The most prominent resources provided across visits were information, services, time and affirmation (that included affirmation itself, reassurance, reinforcement of positive health behaviours, support and feedback). In the more established relationships nurse self-disclosure was evident.
Resource exchange theoretical formulations can be applied to NP-client interactions to understand and explain the specific nature of resources NPs expect to provide and actually provide.
The nature of resources NPs provide, relationship development, types of exchange relationships in clinical practice were identified and posit a beginning typology for NPs to apply in their own clinical practice.
本研究旨在从护士的角度，运用资源交换范式探讨执业护士与患者的接触情况。
在医疗互动中，有必要从护士的角度审视哪些因素具有强化作用。
采用探索性描述性设计来解决以下研究问题：在对中年女性患者进行门诊就诊之前，执业护士对所提供资源的期望是什么？在与执业护士和患者的就诊过程中实际提供了哪些资源？在门诊就诊期间，执业护士的期望与实际提供的资源之间的一致程度如何？
参与者包括两名专家级执业护士和八名中年女性患者。本研究的数据源自一项最初规模更大的研究，该研究从患者角度考察资源交换，包括对执业护士进行就诊前和就诊后的录音访谈、整个门诊就诊的录音以及研究人员对患者就诊的现场记录。使用ETHNOGRPAH软件进行内容分析。
执业护士预计会提供广泛的资源。各次就诊中提供的最突出资源是信息、服务、时间和肯定（包括肯定本身、安慰、对积极健康行为的强化、支持和反馈）。在关系更稳固的情况下，护士的自我表露很明显。
资源交换理论公式可应用于执业护士与患者的互动中，以理解和解释执业护士期望提供和实际提供的资源的具体性质。
确定了执业护士提供的资源的性质、关系发展、临床实践中交换关系的类型，并为执业护士在自己的临床实践中应用提出了初步的类型学。
