护患沟通的要素分析与讨论

Analysis and Discussion of the Elements of Nurse-Patient Communication

目的本文对临床护患沟通问题进行梳理,将沟通过程分解成六个要素,以期提高护患沟通水平。方法对北京大学口腔医院的三个护理岗位进行相关培训及调查,量表包括"友好氛围、有效倾听、语言艺术、情感同步、保持冷静、服务补救"六个要素。培训后在第1、2、3、6个月不同阶段对106名护理人员进行实施效果的主观评价。结果实施后不同岗位改善效果评分相近,差异均无统计学意义(p>0.05);与第1个月比较护理人员主观评价得分随着实施时间的推移,其中四个条目不同时间点上的评分差异均有统计学意义(p<0.05),有效倾听和保持冷静条目虽未呈现统计学意义但具有重要的临床意义。结论 "沟通六要素"适用于临床各护理岗位,而有效倾听和保持冷静两项内容在临床实践过程中受客观因素的影响较大,是沟通中的难点,需要护理管理者厘清责任重点关注。

Objective To sort out the issues of communication through dividing the communication process into six elements, so as to improve the level of nurse-patient communication. Method The nursing staff of three positions at the Peking University Hospital of Stomatology were trained and investigated with scales. The scale covered six elements, including friendly atmosphere, effective listening, language art, emotional synchronization, calmness, and service remedy. Subjective evaluation of the training effect was performed in 106 nursing staff at 1, 2, 3, 6 months after training, respectively. Results The improvement of scores of different positions was close and the difference was not statistically significant（p〉0.05）. Compared with the first month, the scores of four items in the subjective evaluation of different stages showed significant difference（p〈0.05）. The difference of effective listening and calmness was not statistically significant but still meaningful for clinical practice. Conclusion The ＂six elements of communication＂ is applicable to all clinical nursing positions. Effective listening and calmness are influenced by objective factors in the course of clinical practice, and they are difficult parts in communication requiring clear responsibility seperation and more attention of nursing managers.