M Pool Natalie
College of Nursing, University of Arizona, Tucson, AZ, USA.
SAGE Open Nurs. 2019 Feb 11;5:2377960819826791. doi: 10.1177/2377960819826791. eCollection 2019 Jan-Dec.
The establishment of caring relationships with racial and ethnic minority populations is challenging for many cancer care nurses. Nurses serving American Indian (AI) patients frequently encounter population-specific issues, yet their experiences are largely unknown.
The purpose of this study was to describe the meaning of the AI patient-cancer care nurse relationship from nurses' perspectives. The study included three objectives: (a) to describe the immediate experiences of nurses that have engaged in cancer care relationships with AI patients, (b) to identify the underlying structures of the AI patient-cancer care nurse relationship as described by nurses, and (c) to interpret the meaning of the patient-nurse relationship within the context of AI cancer care experiences.
This was an interpretive phenomenological study using a hermeneutical process for data collection and analysis of multiple, exploratory interviews. Thematic reduction was completed to explicate the fundamental structures of this particular relationship. Reduction of individually situated themes resulted in seven shared meta-themes including from task to connection; unnerving messaging; we are one; the freedom of unconditional acceptance; attuning and opening; atoning for the past, one moment at a time; and humanizing the inhumane.
Nine cancer care nurses participated. Reconstitution of data and reflective writing suggested that the essential meaning of the AI patient-cancer care nurse relationship was expressed in contradictory yet simultaneous patterns for nurses. Nurses sought synchronicity with their AI patients despite their contextual differences and similarities, yet most lacked adequate cultural safety training. Being in relationship provided nurses great purpose within the universal human context of caring.
Results contribute to the development of interventions designed to improve both the AI cancer care experience and the support and training of nurses. The mutually dependent nature of the patient-nurse relationship implies that strengthening and improving support for one entity may in turn positively impact the other.
对许多癌症护理护士而言，与种族和少数民族群体建立关怀关系颇具挑战。为美国印第安（AI）患者提供护理的护士经常遇到特定人群的问题，但其经历在很大程度上尚不为人所知。
本研究旨在从护士的角度描述AI患者与癌症护理护士关系的意义。该研究包含三个目标：（a）描述与AI患者建立癌症护理关系的护士的即时经历，（b）识别护士所描述的AI患者与癌症护理护士关系的潜在结构，以及（c）在AI癌症护理经历的背景下解读护患关系的意义。
这是一项诠释现象学研究，采用诠释学过程进行数据收集和对多次探索性访谈的分析。完成了主题归纳以阐明这种特殊关系的基本结构。对个体情境主题的归纳产生了七个共同的元主题，包括从任务到联系；令人不安的信息；我们是一体的；无条件接纳的自由；协调与开放；一次弥补过去的一个时刻；以及将不人道人性化。
九名癌症护理护士参与了研究。数据重构和反思性写作表明，AI患者与癌症护理护士关系的本质意义在护士的矛盾但同时存在的模式中得以体现。尽管存在背景差异和相似之处，护士仍寻求与AI患者同步，但大多数护士缺乏足够的文化安全培训。建立关系在普遍的人类关怀背景下为护士提供了重大意义。
研究结果有助于开发旨在改善AI癌症护理体验以及护士支持和培训的干预措施。护患关系的相互依存性质意味着加强和改善对一方的支持可能反过来对另一方产生积极影响。
