Lanceley Anne, Clark Jill Macleod
Dept. of Women's Cancer, the UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, Medical School Building 74 Huntley Street London WC1E 6AU.
Br J Psychother. 2013 May;29(2):182-201. doi: 10.1111/bjp.12023.
Despite evidence that nurses may play a crucial part in the wellbeing and recovery of cancer patients by facilitating their expression of feelings, research is lacking into the emotional content of nurse-patient talk and patients' use of language in emotion disclosure. In this study, 23 participating nurses in a variety of cancer care settings were asked to tape-record their conversations with patients during daily care. A data set of 60 nurse-patient conversations was collected. Individual expression of emotion by patients was identified through interpretive literary analysis within a framework of psychodynamic theory. Overall the picture of emotion disclosure was intense. In particular, patients' use of metaphor and figurative language to express their distress was powerful and pervasive. Participating nurses demonstrated responsive skills but their responses to figurative expression were often problematic. The study provides evidence of unconscious processes in nurses' work and advocates career-long psychoanalytically informed supervision for nurses to better support them in challenging dialogue with cancer patients. Research is needed to evaluate the impact of supervision on communications with cancer patients to ensure patients have access to appropriate emotional supportive and care.
尽管有证据表明护士通过促进癌症患者表达情感，可能在其福祉和康复中发挥关键作用，但对于护患交谈中的情感内容以及患者在情感表露中语言的运用，仍缺乏相关研究。在本研究中，23名参与的护士来自各种癌症护理环境，她们被要求在日常护理期间录制与患者的对话。收集了一个包含60次护患对话的数据集。通过在心理动力学理论框架内的解释性文学分析，识别出患者个体的情感表达。总体而言，情感表露的情况很强烈。特别是，患者使用隐喻和比喻性语言来表达痛苦的情况很突出且普遍。参与的护士展示了回应技巧，但她们对比喻性表达的回应往往存在问题。该研究提供了护士工作中无意识过程的证据，并提倡为护士提供贯穿职业生涯的精神分析学指导监督，以便在与癌症患者进行具有挑战性的对话时更好地支持她们。需要开展研究来评估监督对与癌症患者沟通的影响，以确保患者能够获得适当的情感支持和护理。
