Fagerström L
Faculty of Social and Caring Sciences, Abo Akademi University, Vasa, Finland.
J Adv Nurs. 1998 Nov;28(5):978-87. doi: 10.1046/j.1365-2648.1998.00822.x.
The aim of the study was to arrive at a deeper understanding of the patient's experience of caring needs, that is, of problems, needs and desires, by investigating and explaining how these will be expressed and shaped in the caring relation and to illuminate its implications for caring. The target population consisted of 38 patients in a medical ward and 37 patients in a surgical ward in a central hospital in Western Finland. The patients were interviewed in the wards and asked about perceived caring needs. By means of a hermeneutical process of interpretation a pattern emerged which was interpreted as pictures of themselves and of the nurses. These types of patients fell into three groups: the satisfied, the complaining and satisfied, and the complaining and dissatisfied patients. The types of nurses were divided into the competent and friendly, the competent and contact-creating and the competent and courageous. The patients' caring needs can be interpreted and understood from the standpoint of their experience of suffering, but also in relation to their experience of pleasure and comfort. The most conspicuous caring needs were experiencing confidence in the competence of the nurses, comfort, guidance, dialogue and closeness, which the patients expressed as problems, needs and desires. The patients' caring needs can contain new possibilities of growth and development. The nurse can relieve patients' suffering by promoting their experience of comfort. If the nurses' view of the limits of reality are extended to comprise the existential/ spiritual dimension of human beings as well, new possibilities will emerge of interpreting and understanding patients' caring needs as a message of suffering.
本研究的目的是通过调查和解释患者的护理需求（即问题、需求和愿望）如何在护理关系中得以表达和形成，并阐明其对护理的影响，从而更深入地理解患者的护理体验。目标人群包括芬兰西部一家中心医院内科病房的38名患者和外科病房的37名患者。在病房对患者进行访谈，询问他们感知到的护理需求。通过一个诠释学的解释过程，出现了一种模式，被解读为患者自身和护士的形象。这些类型的患者分为三组：满意的患者、抱怨但满意的患者以及抱怨且不满意的患者。护士类型分为有能力且友好的、有能力且善于建立联系的以及有能力且勇敢的。患者的护理需求既可以从他们的痛苦经历角度进行解读和理解，也可以与他们的愉悦和舒适体验相关联来理解。最突出的护理需求是对护士能力的信心、舒适感、指导、对话和亲密感，患者将这些表达为问题、需求和愿望。患者的护理需求可能蕴含新的成长和发展可能性。护士可以通过提升患者的舒适体验来减轻他们的痛苦。如果护士对现实界限的看法扩展到包括人类的存在/精神层面，那么将出现新的可能性，即把患者的护理需求解读和理解为痛苦的讯息。
