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转变护患关系——精神卫生保健中护士自我表露的质性研究

Transforming nurse-patient relationships-A qualitative study of nurse self-disclosure in mental health care.

机构信息

Centre for Medical Ethics, University of Oslo, Oslo, Norway.

Department of Health and Social Care, Molde University College, Molde, Norway.

出版信息

J Clin Nurs. 2018 Mar;27(5-6):e798-e807. doi: 10.1111/jocn.14191. Epub 2018 Jan 8.

Abstract

AIMS AND OBJECTIVES

To describe what and why nurses self-disclose to patients in mental health care.

BACKGROUND

Self-disclosure is common, but controversial and difficult to delineate. Extant research suggests that self-disclosure might have several potentially beneficial effects on therapeutic alliance and treatment outcome for patients in mental health care, but results are often mixed and limited by definitional inconsistencies.

DESIGN

Multi-site study with purposive sampling and source triangulation.

METHOD

Qualitative descriptive study including data from 16 nurses taking part in participant observation, individual interviews and focus group interviews.

RESULTS

Separate analyses resulted in four themes addressing the research question of what nurses self-disclose, and one main theme and four subthemes addressing why nurses self-disclose. The content of self-disclosure was captured in the four themes: Immediate family, Interests and activities, Life experiences and Identity. In addition, results showed that disclosures were common among the nurses. Self-disclosure's potential to transform the nurse-patient relationship, making it more open, honest, close, reciprocal and equal, was the overarching reason why nurses shared personal information. The nurses also chose to self-disclose to share existential and everyday sentiments, to give real-life advice, because it felt natural and responsive to patients' question to do so.

CONCLUSION

Nurse self-disclosure is common and cover a variety of personal information. Nurses have several reasons for choosing to self-disclose, most of which are connected to improving the nurse-patient relationship.

RELEVANCE TO CLINICAL PRACTICE

Self-disclosure controversy can make it difficult for nurses to know whether they should share personal information or not. Insights into the diversity of and reasons for nurse self-disclosure can help with deliberations on self-disclosure.

摘要

目的和目标

描述精神卫生保健护士向患者自我披露的内容和原因。

背景

自我披露很常见,但具有争议性,且难以界定。现有研究表明,自我披露可能对精神卫生保健患者的治疗联盟和治疗结果产生一些潜在的有益影响,但结果往往不一致,且受到定义不一致的限制。

设计

多地点研究,采用目的性抽样和来源三角测量。

方法

包括 16 名参与观察、个体访谈和焦点小组访谈的护士的定性描述性研究。

结果

单独分析产生了四个主题,分别涉及护士自我披露的内容,以及一个主要主题和四个子主题,分别涉及护士自我披露的原因。自我披露的内容包括四个主题:直系亲属、兴趣和活动、生活经历和身份。此外,结果表明,护士之间的自我披露很常见。自我披露有可能改变护患关系,使其更加开放、诚实、亲密、互惠和平等,这是护士分享个人信息的首要原因。护士也选择自我披露,分享存在主义和日常情感,提供实际生活建议,因为这感觉自然,对患者的问题做出回应。

结论

护士自我披露很常见,涵盖各种个人信息。护士选择自我披露有几个原因,其中大部分与改善护患关系有关。

临床意义

自我披露的争议可能使护士难以确定是否应该分享个人信息。对护士自我披露的多样性和原因的了解有助于对自我披露进行审议。

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