Hammarström Lars, Andreassen Devik Siri
Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway.
Int J Qual Stud Health Well-being. 2025 Dec;20(1):2514520. doi: 10.1080/17482631.2025.2514520. Epub 2025 Jun 5.
This study examines the nurse-patient relationship in forensic psychiatric care (FPC) from a philosophical perspective, with a focus on ethical complexities. Using Løgstrup's ethical philosophy, the work explores how trust, moral responsibility, and relational tensions shape caregiving.
A theoretical analysis was conducted based on five empirical qualitative studies of nurses' lived experiences in forensic inpatient care. These studies, rooted in phenomenology and hermeneutics, were re-analysed using reflective lifeworld research (RLR), a phenomenological approach grounded in the lifeworld theory of Husserl and Merleau-Ponty, that emphasizes openness and reflection to capture the meaning of lived experiences. The analysis was interpreted through Løgstrup's ethical framework.
Five key themes emerged: Having Trust or Feeling Distrust, Being Compassionate or Being Indifferent, Having Courage or Being Afraid, Being Genuine or Pretending, and Being a Ballerina or Being a Bulldozer. These themes highlight the "space in-between", where nurses navigate ethical tensions, institutional constraints, and patient interactions.
Forensic psychiatric nursing requires balancing institutional control and compassionate care. Ethical encounters emerge through both self-reflection and relational engagement. Structured reflection and dialogue help nurses navigate ethical challenges, foster professional growth, and enhance patient-centred care.
本研究从哲学角度审视法医精神病护理（FPC）中的护患关系，重点关注伦理复杂性。运用勒斯特鲁普的伦理哲学，该研究探讨信任、道德责任和关系紧张如何影响护理工作。
基于五项关于法医住院护理中护士生活经历的实证定性研究进行理论分析。这些扎根于现象学和诠释学的研究，采用反思性生活世界研究（RLR）重新进行分析，RLR是一种基于胡塞尔和梅洛 - 庞蒂生活世界理论的现象学方法，强调开放性和反思性以捕捉生活经历的意义。分析通过勒斯特鲁普的伦理框架进行解读。
出现了五个关键主题：信任或不信任、同情或冷漠、勇敢或恐惧、真诚或伪装、成为芭蕾舞女或推土机。这些主题突出了“中间地带”，护士们在其中应对伦理紧张关系、机构限制和患者互动。
法医精神病护理需要平衡机构控制和关怀护理。通过自我反思和关系参与产生伦理相遇。结构化的反思和对话有助于护士应对伦理挑战、促进专业成长并加强以患者为中心的护理。
