Griep E C M, Noordman J, van Dulmen S
NIVEL, Utrecht, The Netherlands.
Radboud University Medical Center, Department of Primary and Community Care, Nijmegen, The Netherlands.
J Psychiatr Ment Health Nurs. 2016 Mar;23(2):77-85. doi: 10.1111/jpm.12279. Epub 2015 Dec 28.
WHAT IS KNOWN ON THE SUBJECT?: A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Patients with mild psychosocial and psychological problems provide signs of worrying or express a clear unpleasant emotion in 94% of consultations with a practice nurse mental health. Nurses' responses to patients' signs of worrying or clear unpleasant emotions were mostly characterized by providing space for patients to talk about these emotions, by using minimal responses. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Practice nurses' mental health have passive listening skills, and to a lesser extent, use active listening techniques. Accurate emotion detection and the ability to pick out emotional signs during consultations must also be considered as an important skill for health providers to improve patient-centred communication.
Patients with physical problems are known to express their emotional concerns in an implicit way only. Whether the same counts for patients presenting mental health problems in primary care is unknown. This study aims to examine how patients with mild psychosocial and psychological complaints express their concerns during consultations with the practice nurse mental health and how practice nurses respond to these expressions.
Fifteen practice nurses mental health working in Dutch general practices participated in the study. Their consultations with 116 patients with mild psychosocial or psychological complaints were video recorded. patients' explicitly expressed emotional concerns and more implicit expressions of underlying emotional problems (cues) as well as nurses' responses to these expressions were rated using the Verona Coding Definition of Emotional Sequences.
Almost all consultations contained at least one cue or concern (94%). Nurses' responses were mostly characterized by providing space for patients to talk about their cue or concern in a non-explicit way (62%), by using minimal responses (42%).
Practice nurses mental health have passive listening skills, and to a lesser extent, use active listening techniques. However, there are no strict rules which way of responding is the best and patients value responses differently.
关于该主题已知的信息有哪些？：执业护士心理健康的一项核心技能是识别和探究患者的不良情绪。患者很少直接且自发地表达他们的不良情绪，而是给出一些间接迹象表明他们有烦心事。本文对现有知识的补充是什么？：患有轻度社会心理和心理问题的患者在与执业护士心理健康进行的94%的咨询中会给出烦心事的迹象或表达出明显的不良情绪。护士对患者烦心事迹象或明显不良情绪的反应大多表现为通过使用极少回应为患者留出谈论这些情绪的空间。对实践的启示是什么？：执业护士心理健康具备被动倾听技能，在较小程度上也使用主动倾听技巧。准确的情绪检测以及在咨询过程中识别情绪迹象的能力也必须被视为医疗服务提供者改善以患者为中心的沟通的一项重要技能。
已知有身体问题的患者仅以隐含的方式表达他们的情绪问题。在初级保健中出现心理健康问题的患者是否也是如此尚不清楚。本研究旨在探究患有轻度社会心理和心理问题的患者在与执业护士心理健康进行咨询时如何表达他们的问题，以及执业护士如何回应这些表达。
在荷兰普通诊所工作的15名执业护士心理健康参与了该研究。对他们与116名患有轻度社会心理或心理问题的患者的咨询进行了视频记录。使用《维罗纳情绪序列编码定义》对患者明确表达的情绪问题以及潜在情绪问题（线索）的更隐含表达以及护士对这些表达的反应进行评分。
几乎所有咨询都至少包含一个线索或问题（94%）。护士的反应大多表现为通过使用极少回应为患者留出以非明确方式谈论他们的线索或问题的空间（62%）。
执业护士心理健康具备被动倾听技能，在较小程度上也使用主动倾听技巧。然而，对于哪种回应方式是最佳方式并没有严格的规定，而且患者对不同回应方式的评价也不同。
