Murray J A, Haynes M P
University of Virginia Health Science Center, Comprehensive Epilepsy Unit, Charlottesville, USA.
J Neurosci Nurs. 1996 Aug;28(4):252-8. doi: 10.1097/01376517-199608000-00007.
Boone and Hartman identified the phenomenon of benevolent overreaction to describe the enmeshment seen in parents and their chronically ill children. The cylce of the benevolent overreaction begins with the child's diagnosis with a chronic illness and the subsequent natural protective behaviors of the parents. However, overprotection may become pathologic if these protective behaviors persist and delay or prevent the child's achieving developmental goals. This ego boundary deficit is one of the most frequently seen phenomena in families with chronically ill children. On the Comprehensive Epilepsy Unit this phenomenon was repeatedly observed. The purpose of this investigation was to ascertain the frequency of benevolent overreaction seen on the unit, and to identify the nursing interventions used to address this issue. A chart review was used to identify the frequency of the phenomenon during the past year, the discipline first identifying the phenomenon and nursing interventions applied to the phenomenon. Nursing staff interviews were then conducted, using unit census records of the past year, to identify staff recall of the phenomenon. Nursing staff frequently identified the components of benevolent overreaction in the inpatient population, however, consistent intervention for the phenomenon was less frequently seen. Autonomy, empowerment and self-advocacy for families are goals of the Comprehensive Epilepsy Unit. Consistent application of the nursing process to this phenomenon is vital to providing quality patient care.
布恩和哈特曼确定了善意过度反应现象，用以描述父母与他们身患慢性病的子女之间的情感纠结。善意过度反应的循环始于孩子被诊断出患有慢性病以及父母随后的自然保护行为。然而，如果这些保护行为持续存在并延迟或阻碍孩子实现发展目标，过度保护可能会变得病态。这种自我边界缺失是慢性病患儿家庭中最常见的现象之一。在综合癫痫病房，这种现象屡见不鲜。本调查的目的是确定该病房中善意过度反应的发生频率，并确定用于解决这一问题的护理干预措施。通过查阅病历以确定过去一年中该现象的发生频率、首先发现该现象的科室以及针对该现象所采取的护理干预措施。随后，利用过去一年的病房普查记录对护理人员进行访谈，以了解工作人员对该现象的记忆情况。护理人员经常能识别出住院患者中善意过度反应的构成要素，然而，针对该现象的一致干预措施却较少见。家庭的自主性、赋权和自我主张是综合癫痫病房的目标。将护理程序持续应用于这一现象对于提供优质的患者护理至关重要。
