University of Kentucky College of Nursing, Lexington, USA.
J Adv Nurs. 2012 Jan;68(1):230-45. doi: 10.1111/j.1365-2648.2011.05763.x. Epub 2011 Jul 20.
This paper is a report of an analysis of the concept of connectedness.
Previous attempts to conceptualize patient-provider relationships were limited in explaining how such relationships are fostered and maintained, and how they influence patient outcomes. Connectedness is a concept that may provide insights into the advantages of patient-provider relationships; however, the usefulness of this concept in health care is limited by its conceptual ambiguity. Although connectedness is widely used to describe other social relationships, little consistency exists among its definitions and measures.
Sources identified through CINAHL, OVID, PubMed and PsychINFO databases and references lists of selected articles between 1983 and 2010.
A hybrid concept analysis approach was used, involving a combination of traditional concept analysis strategies that included: describing historical conceptualizations, identifying attributes, critiquing existing definitions, examining boundaries and identifying antecedents and consequences.
Using five distinct historical perspectives, seven attributes of connectedness were identified: intimacy, sense of belonging, caring, empathy, respect, trust and reciprocity. A broad definition of connectedness, which can be used in the context of patient-provider relationships, was developed. A preliminary theoretical framework of connectedness was derived from the identified antecedents, attributes and consequences.
Research efforts to advance the concept of connectedness in patient-provider relationships have been hampered by a lack of conceptual clarity. This concept analysis offers a clearer understanding of connectedness, provides recommendations for future research and suggests practice implications.
本文旨在分析关联的概念。
以往对医患关系概念化的尝试在解释这些关系是如何培养和维持的,以及它们如何影响患者的结果方面存在局限性。关联是一个可以深入了解医患关系优势的概念;然而,由于其概念上的模糊性,该概念在医疗保健中的应用受到限制。尽管关联被广泛用于描述其他社会关系,但它的定义和测量方法之间几乎没有一致性。
通过 CINAHL、OVID、PubMed 和 PsychINFO 数据库以及 1983 年至 2010 年选定文章的参考文献列表确定了来源。
采用混合概念分析方法,结合传统概念分析策略,包括:描述历史概念化、确定属性、批判现有定义、检查边界以及确定前因和后果。
使用五个不同的历史视角,确定了七个关联属性:亲密、归属感、关怀、同理心、尊重、信任和互惠。制定了一个可以在医患关系背景下使用的广泛的关联定义。从确定的前因、属性和后果中得出了关联的初步理论框架。
由于概念上的不清晰,在医患关系中推进关联概念的研究工作受到了阻碍。本次概念分析提供了对关联的更清晰理解,为未来的研究提供了建议,并提出了实践意义。