Crowe M, Carlyle D, Farmar R
Centre for Postgraduate Nursing Studies, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
J Psychiatr Ment Health Nurs. 2008 Dec;15(10):800-7. doi: 10.1111/j.1365-2850.2008.01307.x.
There are problems for mental health nurses in using psychiatric diagnoses as outcomes of their nursing assessments and nursing diagnoses present similar issues. However, there is a need in practice to link the assessment to nursing interventions in a meaningful way. This paper proposes that the clinical formulation can be regarded as central to providing this cohesion. The formulation does not merely organize the assessment findings but is also an interpretation or explanation, made in consultation with the client, of what meaning can be attributed to the issues explored in the assessment process. Because this interpretation is dependent on both the client's and the nurse's explanatory frameworks, there are multiple ways of developing the formulation. It is also an evolving and dynamic statement of understanding. A case example is provided in the paper to illustrate how the same case can be interpreted in different ways and the implications this has for the nursing interventions provided.
心理健康护士在将精神科诊断作为护理评估结果时存在问题,护理诊断也存在类似问题。然而,在实践中需要以有意义的方式将评估与护理干预联系起来。本文提出,临床构思可被视为提供这种连贯性的核心。构思不仅整理评估结果,而且是与服务对象协商后对评估过程中所探讨问题可赋予何种意义的一种解释。由于这种解释依赖于服务对象和护士的解释框架,所以有多种形成构思的方式。它也是一种不断发展和动态的理解表述。本文提供了一个案例示例,以说明同一案例如何能以不同方式进行解释以及这对所提供的护理干预有何影响。