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医患关系观察:一项混合方法研究,探讨是否熟悉是护士提供心理社会支持的条件。

Observations of professional-patient relationships: a mixed-methods study exploring whether familiarity is a condition for nurses' provision of psychosocial support.

机构信息

School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK.

出版信息

Palliat Med. 2014 Mar;28(3):256-63. doi: 10.1177/0269216313499960. Epub 2013 Aug 9.

Abstract

BACKGROUND

There is a popular belief that the professional-patient relationship is a prerequisite in the provision of psychosocial support. Studies suggest that professionals must know, or be familiar with, a patient in order to effectively provide psychosocial support.

AIM

To examine the association between familiarity and the provision of psychosocial care by professionals.

DESIGN

A mixed-methods study involving participant observation, interviews and organisational and documentary analysis was conducted over 8 months in an inpatient hospice setting.

PARTICIPANTS

In total, 38 nurses (registered and auxiliary) and 47 patients were included in a maximum variation sampling strategy. Data were analysed using both qualitative and quantitative techniques.

RESULTS

The data disconfirm the belief that familiarity is either a necessary or sufficient condition for the provision of psychosocial support. Nurses familiar with patients did not necessarily respond to patients' psychosocial needs, and nurses with no prior contact with the patient immediately dealt with psychosocial needs.

CONCLUSION

Psychosocial support can be provided on a patient's first contact with a clinician and does not rely on building a professional-patient relationship. This suggests that high-quality psychosocial care can be provided in the short time frame available to palliative care clinicians.

摘要

背景

有一种普遍的观点认为,医患关系是提供心理社会支持的前提。研究表明,专业人员必须了解或熟悉患者,才能有效地提供心理社会支持。

目的

探讨专业人员的熟悉程度与提供心理社会关怀之间的关系。

设计

这是一项混合方法研究,参与者观察、访谈以及组织和文件分析,历时 8 个月,在一家住院临终关怀机构进行。

参与者

共有 38 名护士(注册护士和助理护士)和 47 名患者参与了最大差异抽样策略。使用定性和定量技术对数据进行分析。

结果

数据不支持这样一种观点,即熟悉是提供心理社会支持的必要或充分条件。熟悉患者的护士不一定能回应患者的心理社会需求,而与患者没有先前接触的护士则能立即处理心理社会需求。

结论

心理社会支持可以在患者与临床医生的首次接触时提供,并不依赖于建立医患关系。这表明,姑息治疗临床医生可以在可用的短时间内提供高质量的心理社会关怀。

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