School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
Department of Teaching and Learning, Wellington Institute of Technology, Wellington, New Zealand.
Int J Ment Health Nurs. 2018 Feb;27(1):287-295. doi: 10.1111/inm.12319. Epub 2017 Feb 15.
The present study uses stories of mental health support workers talking about their relationship with clients to wonder about how trust might be limited by the professional boundaries of nursing. The writing arose out of an appreciative inquiry study looking at the role of mental health support workers. Participants talked about how they worked with their clients. As researchers, we were struck by the depth of trust that was built between worker and client. We have brought a phenomenological lens to wonder about the nature of trust, as shown in the data. The original research sought to identify what was working well for mental health support workers. The present study brings a phenomenological interpretive approach to four stories from the discovery phase of the study, with our thinking informed by Heidegger and van Manen. Interviews were conducted with 26 mental health support workers and six stakeholders in 2012-2103. For this paper, we drew from those transcripts stories of three mental health support workers and one stakeholder. Through a process of talking together, writing, and rewriting, we wondered about the meaning within these stories, with a strong focus on how trust was enacted. We saw that mental health support workers in this study, by not carrying the boundaries of being 'professional', seemed free to grow a stronger relationship of trust which was therapeutic. We ask: Is it time to rethink how professional boundaries limit the level of trust achieved with clients to the detriment of impactful care?
本研究使用心理健康支持工作者讲述他们与客户关系的故事，探讨信任可能如何受到护理专业界限的限制。该写作源于一项赞赏性探究研究，旨在探讨心理健康支持工作者的角色。参与者谈论了他们如何与客户合作。作为研究人员，我们被工作者和客户之间建立的深厚信任所震撼。我们借鉴了现象学视角，对信任的本质进行了思考，这在数据中有所体现。最初的研究旨在确定心理健康支持工作者哪些方面做得很好。本研究采用现象学解释方法，对研究发现阶段的四个故事进行了分析，我们的思考受到了海德格尔和范马伦的启发。2012 年至 2013 年期间，我们对 26 名心理健康支持工作者和 6 名利益相关者进行了访谈。在本文中，我们从这些访谈记录中选取了 3 名心理健康支持工作者和 1 名利益相关者的故事。通过共同讨论、写作和改写的过程，我们对这些故事的含义进行了思考，重点关注信任是如何体现的。我们发现，在这项研究中，心理健康支持工作者通过不承担“专业”的界限，似乎能够自由地建立更强大的信任关系，这种关系具有治疗作用。我们不禁要问：是否是时候重新思考专业界限如何限制与客户建立信任的程度，以及这种限制对有影响力的护理的影响了？
