Salmon P
Department of Clinical Psychology, University of Liverpool, England.
J Adv Nurs. 1993 Jan;18(1):14-9. doi: 10.1046/j.1365-2648.1993.18010014.x.
Two different strategies are possible for improving nurses' interactions with elderly patients. One is to arrange special periods, such as reality orientation, in which a high level of appropriate interaction is encouraged. The other is to improve nurses' attitudes to patients and treatment, or select nurses with better attitudes, on the grounds that poor attitudes might underly poor behaviour. This study was designed to find out whether nurses' interactions with elderly patients varied in relation to their attitudes, or differed between periods of routine care or of special activities based on reality orientation organized by the nurses. Systematic observations were made of the behaviour of 27 nurses working on two psychogeriatric wards, before all nurses completed questionnaires measuring attitudes to nursing care and to elderly people. A higher proportion of interactions were 'positive' (i.e. involved nurses' informing, questioning or making general conversation) during activity periods than at other times. No attitudinal measure predicted the proportion of interactions which were positive, although this was greater in qualified nurses. The results are consistent with the view that formal reality orientation periods can improve the quality of nurses' interactions with elderly patients, but are inconsistent with the view that targeting nurses' attitudes would be effective.
改善护士与老年患者互动有两种不同策略。一种是安排特殊时段，如现实导向训练，在此期间鼓励高水平的恰当互动。另一种是改善护士对患者及治疗的态度，或挑选态度更好的护士，因为态度不佳可能是行为不良的潜在原因。本研究旨在探究护士与老年患者的互动是否因其态度而异，或者在常规护理时段与护士组织的基于现实导向的特殊活动时段之间是否存在差异。在所有护士完成测量对护理及老年人态度的问卷之前，对在两个老年精神科病房工作的27名护士的行为进行了系统观察。与其他时段相比，活动时段“积极”互动（即护士进行告知、提问或进行一般性交谈）的比例更高。没有任何态度测量指标能预测积极互动的比例，尽管在有资质的护士中这一比例更高。研究结果与以下观点一致，即正式的现实导向训练时段可以提高护士与老年患者互动的质量，但与针对护士态度会有效的观点不一致。
