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精神科住院病房护患冲突情境中的共情过程:一项定性研究。

Empathic processes during nurse-consumer conflict situations in psychiatric inpatient units: A qualitative study.

机构信息

School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia.

出版信息

Int J Ment Health Nurs. 2018 Feb;27(1):92-105. doi: 10.1111/inm.12298. Epub 2016 Dec 26.

Abstract

Empathy is a central component of nurse-consumer relationships. In the present study, we investigated how empathy is developed and maintained when there is conflict between nurses and consumers, and the ways in which empathy can be used to achieve positive outcomes. Through semistructured interviews, mental health nurses (n = 13) and consumers in recovery (n = 7) reflected on a specific conflict situation where they had experienced empathy, as well as how empathy contributed more generally to working with nurses/consumers. Thematic analysis was used to analyse the data, utilizing a framework that conceptualizes empathy experiences as involving antecedents, processes, and outcomes. The central theme identified was 'my role as a nurse - the role of my nurse'. Within this theme, nurses focussed on how their role in managing risk and safety determined empathy experienced towards consumers; consumers saw the importance of nurse empathy both in conflict situations and for their general hospitalization experience. Empathy involved nurses trying to understand the consumer's perspective and feeling for the consumer, and was perceived by consumers to involve nurses 'being there'. Empathic relationships built on trust and rapport could withstand a conflict situation, with empathy a core component in consumer satisfaction regarding conflict resolution and care. Empathy allows the maintenance of therapeutic relationships during conflict, and influences the satisfaction of nurses and consumers, even in problematic situations. Nurse education and mentoring should focus on nurse self-reflection and building empathy skills in managing conflict.

摘要

同理心是护患关系的核心组成部分。在本研究中,我们调查了当护患之间存在冲突时同理心是如何发展和维持的,以及同理心如何被用来实现积极的结果。通过半结构化访谈,心理健康护士(n=13)和康复中的消费者(n=7)反思了他们经历过同理心的特定冲突情况,以及同理心如何更普遍地有助于与护士/消费者合作。我们使用了一种将同理心体验概念化为涉及前因、过程和结果的框架来分析数据。确定的中心主题是“我的护士角色-我的护士的角色”。在这个主题中,护士们关注的是他们在管理风险和安全方面的角色如何决定对消费者的同理心体验;消费者认为护士同理心在冲突情况下以及他们的一般住院体验中都很重要。同理心涉及护士试图理解消费者的观点和感受,并且被消费者认为护士在“陪伴”他们。基于信任和融洽关系的同理心关系可以承受冲突情况,同理心是消费者对冲突解决和护理满意度的核心组成部分。同理心允许在冲突期间维持治疗关系,并影响护士和消费者的满意度,即使在有问题的情况下也是如此。护士教育和指导应该注重护士的自我反思和建立同理心技能,以处理冲突。

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