护理是什么?——诠释植根中国文化的护理概念

What is Nursing? A Phenomenological Analysis of the Characteristics of Chinese Nursing

目的 :了解中国护士对护理概念的理解和认识 ,以诠释具有中国特色的护理概念。方法 :采用质性研究与量性研究相结合的方法 ,分为两个研究阶段完成了资料的收集和分析。第一阶段采用随机抽样的方法对全国省、市、区级综合医院和中医院的护士进行了问卷调查 ,要求调查对象详尽地书写个人对护理工作的体验和观点。共回收了 2 5 4份问卷 ,然后采用范甘的“查验解说”分析方法 ,提取出了护士用于描述护理概念的含义、特点、目标、活动和职责的词语和句子共 117项。第二阶段对全国八个地区的护士做了进一步的问卷调查 ,以了解护士对这些词句的认同度 ,共收回 1782份问卷。结果 :护士对这些词句的认同度颇高。我国护士对护理一词的理解 ,已由前专业转化到专业的用词 ,并认为护理是情、理、知、行的组合。护理特点是由“情”反映出来关顾的意识 ,“理”的伦理的意识 ,“知”的知识的意识和“行”的实践的意识。护士认同护理的目标是要面向全人类、社会、个体和临终。护士对护理的活动及护理职责的理解是正面多于负面。结论 :现阶段我国护士对护理概念的理解和认识可以概括为 :了解个人健康状况的动态变化 ,对所出现的健康问题进行辨证 ,准确施护 ,帮助个人掌握健康知识 ,从自身状况出发 ,防治疾病 。

Objective:In China today, nursing reforms are being undertaken to strengthen nursing as a profession and to improve nursing quality. However, these experimental projects were seen as borrowed concepts, instituted with funds and expert consultation from abroad. How far these 'borrowed concepts' are in congruence with indigenous practice has yet to be examined. Nursing definitions used in Chinese nursing textbooks are translated from the Western literature. Systematic study of how nursing is articulated in everyday practice is lacking. This study aimed to fill this knowledge gap regarding the way in which Chinese nurses define nursing as they practice it. Method: A systematic inquiry using a modified version of Van Kaam's controlled explication was designed. In the pre-scientific phase, 254 written accounts of nurses' views on nursing as lived in their everyday practice were collected in eight Chinese cities. In the scientific phase, concept analysis based on Aristotle's notion of four causes was adopted for capturing the richness of the phrases that explicate the multi-dimensionality of Chinese nurses' concepts of nursing. This was followed by a survey study of 1782 nurses to verify the findings. The most commonly held view of how Chinese conceptualize nursing is delineated. Results: Nursing in the Chinese sense is to understand the dynamic health status of a person, to dialectically verify health concerns, and to deliberate interventions with the goal of assisting the person to master the appropriate health knowledge and skills for the attainment of optimal well-being. The survey findings show that nursing has developed into a professional caring practice in China today. The four epistemic concerns, contextual (qing), ethical (li), theoretical (zhi), and practical (xin), are grounded in traditional Chinese medicine philosophy and Eastern ideologies. Conclusion: The study findings provide Chinese nurses with a definition of nursing articulated in their own language. The findings can enhance nurses' engagement in a cross-cultural dialogue for better understanding of nursing as it is practiced in different parts of the world.