Hechinger Mareike, Mayer Hanna, Fringer André
Department of Nursing Science, University of Vienna, Alser Straße 23/12, 1080, Vienna, Austria.
School of Health Professions, Institute of Nursing, Zurich University of Applied Sciences ZHAW, Technikumstrasse 81, 8400, Winterthur, Switzerland.
Med Health Care Philos. 2019 Dec;22(4):599-611. doi: 10.1007/s11019-019-09897-4.
The nurse-patient relationship is of great significance for both nurses and patients. The purpose of this article is to gain an understanding of how the individual is constituted through a focus on the execution of the patient's and nurse's role in the joint relationship. The article represents a social-constructionist consideration using Kenneth Gergen's concept of multi-being. Gergen's notions of the self as a multi-being focuses on the individual's relational character through former relationships and social interactions. Gergen's concept is applied onto nurses and patients as individuals to gain an understanding of the broader institutional and social context of each role and their interactions within the nurse-patient relationship. The article focuses on the nurse-patient relationship in general with regard to specific challenges in the home care setting. Various demands and experiences from a myriad of past relationships merge as potential actions for nurses and patients during the forming of a relationship. Nurses as multi-beings see themselves confronted with guidelines and legal conditions, their own as well as the patients' expectations and the actual possible forming of a relationship in the light of daily nursing care. Patients as multi-beings experience an extended social environment that comprises the nurse-patient relationship while simultaneously having to cope with illness and increasing care dependency within their own homes. Discrepancies can be observed in the relationship with regard to the inherent human qualities, the demands of forming a relationship, and the actual relationship arising due to framework conditions.
护患关系对护士和患者都具有重要意义。本文旨在通过关注患者和护士在这种联合关系中角色的履行情况，来理解个体是如何构成的。本文运用肯尼斯·格根的多重自我概念，呈现了一种社会建构主义的思考。格根的自我多重性概念通过个体过去的关系和社会互动，聚焦于个体的关系特性。将格根的概念应用于护士和患者个体，以理解每个角色更广泛的制度和社会背景，以及他们在护患关系中的互动。本文总体上关注护患关系以及家庭护理环境中的特定挑战。在关系形成过程中，来自无数过去关系的各种需求和经历融合为护士和患者的潜在行动。作为多重自我的护士发现自己面临着指导方针和法律条件、自身及患者的期望，以及根据日常护理实际可能形成的关系。作为多重自我的患者体验到一个扩展的社会环境，其中包括护患关系，同时还必须在自己家中应对疾病和日益增加的护理依赖。在关系中，可以观察到在内在人性品质、关系形成的需求以及因框架条件而产生的实际关系方面存在差异。
