Healing Humor: The Use of Humor in the Nurse-Patient Relationship

Objective: To identify the importance of using humor in patient/nurse relationship, its factors, its conditions and the barriers that might limit its use. Methods: We systematically searched PubMed, Science Direct and Google Scholar, for relevant articles published in English between 2010 and 2019. We included the studies that investigated humor between nurses and their patient’s relationship. Results: From the initial 287 articles found, 15 were included for final revision. Data allowed retrieving information on humor definition;its applicability as a nursing intervention;humor as a tool to improve nurse-patient communication and relationship;influencing factors;humor benefits in health care context and the limits that come against its use. Conclusion: Humor is considered a powerful communication tool, it promotes well-being, relieves anxiety and stress, helps deal with stressful situations but it should be used cautiously in order to prevent undesired consequences.

Balancing the Inpatient-Nurse Relationship in Anorexia Care

Background: Nurses play a central role in the treatment of inpatients with anorexia, where bonding is a key factor. The inpatient-nurse relationship is based on a confident alliance characterized by important factors such as trust, confidentiality, responsiveness, genuineness, and consistency. Aim and Research Question: The aim of this study was to describe patients’ in-depth experiences of their relationship with nurses when hospitalized for anorexia. The research question was: How do women hospitalized due to anorexia nervosa experience the nurse-patient relationship? Method: A hermeneutic approach with in-depth interviews was employed. Five women with previous experience of inpatient care for anorexia were interviewed. Findings: The findings summarized how the women experienced the relationship with professional nurses in a ward characterized by a high degree of structure. The main theme Balancing feelings of emotional contradictions in the patient-nurse relationship was described by two sub-themes;Opening up for a care relationship in a rigid and structured ward atmosphere and Fluctuating in a paradox of conflicting feelings. Discussion: From the patients’ perspective, balancing the patient-nurse relationship when an inpatient involves conflicting emotional challenges. Structured interventions are perceived as effective by the patients, although they may be ambivalent about them. Therefore, a good relationship depends on the establishment of emotional and stable interaction with the nurses. Implications for Nursing Practice: Patients need interventions based on safe and competent quality care. A hermeneutic approach may improve the nurses’ ability to meet these patients in their lifeworld and establish a confident relationship. Special education related to anorexia care should be a priority in nursing.

Changes in Japanese Nurses’ Awareness of Patient Interactions Following a Japanese Tea Ceremony

This study provided foundational data for use in nursing interventional methods for improving nurse-patient relationships. This was a descriptive study on the effectiveness of a Japanese tea ceremony (in Japanese: chado) intervention for improving nurse-patient relationships. I conducted a Japanese tea ceremony and examined changes in nurses’ awareness regarding interactions with patients after this intervention. The tea ceremonies were conducted with the cooperation of an Urasenke tea ceremony lecturer. A quiet environment with chairs and tables was provided for all participants while they provided written answers to a descriptive survey, which was administered before and after the intervention;they required approximately 20 min to complete the survey. The mean length of each nurse’s description was 800 characters. The tea ceremony was effective in bringing about definite changes in nurses’ awareness concerning interactions with patients. This study is useful in that it suggests how nurses can maintain good interpersonal relationships with patients.

基于CNKI-CiteSpace护患关系研究热点与趋势的可视化分析

目的:探究近年来护患关系相关的热点研究问题。方法:以中国知网数据库(CNKI)中检索出的1137篇相关文献作为基础,运用CiteSpace软件对检索到的文献进行关键词聚类分析,并运用关键词突现功能探讨不同时期护患关系的研究趋势。结果:结合聚类图和关键词频次表,排在频次表前列的依次是护理、护理人员、护士、心理护理等。结论:护患关系的研究热点是护理管理和护患双方。护理质量与安全、护患双方和护患沟通是不同时期护患关系领域研究的关注焦点。

云南省护生-护患关系类型、影响因素及实习成效现状调查

目的:调查云南省住院患者感知的护生-护患关系类型并研究其影响因素及实习成效。方法:采用方便抽样对云南省381例住院患者进行问卷调查。结果:本组患者感知机械型37例、权威型94例、促进型250例,影响因素为护生个人及专业特质、患者特质及合作氛围;患者在护生个人及专业成长、护生自信及自尊增强、患者健康促进及自护增强实习成效评分均有统计学意义(P<0.05),其中权威型和促进型评分均高于机械型(P<0.05)。结论:住院患者认为护生-护患关系大多为促进型,且护生个人及专业特质、患者特质对护生-护患关系有影响作用,同时会影响护生个人及专业成长、护生自信及自尊增强、患者健康促进及自护增强,而患者认为权威型与促进型关系得到的实习成效同样显著。

微信公众平台在IVF-ET健康教育中的应用研究

目的探讨微信公众平台在体外受精-胚胎移植(IVF-ET)健康教育中的应用效果。方法将600例首次于本院行IVF-ET助孕患者随机分为对照组和试验组,每组300例。其中对照组给予常规护理宣教,试验组除了常规宣教外,通过微信公众平台进行宣教和答疑。通过问卷调查来比较2组患者对疾病认知度及治疗依从性的改变;比较2组护患关系信任度及宣教方式的满意度。结果与对照组比较,试验组患者对疾病认知度明显提高,依从性也有显著提高(P<0.05);护患关系信任度和宣教方式的满意度也有明显提高(P<0.05)。结论通过微信公众平台对患者进行疾病宣教可提高患者的疾病认知度和治疗依从性,有利于提高护患关系信任度和对宣教方式满意度。

基于医患“权力”关系的护理单元空间分析--以番禺中心医院C3住院大楼为例

该文基于福柯"权力关系"的微观研究理论,将希利尔的空间句法作为一种基本的研究方法,以番禺中心医院C3住院大楼护理单元作为对象,来研究和解析医护和病患之间的关系,以及这些关系同建筑空间之间的关联。试图从社会学的角度为医院建筑研究提供一种新的可能性。

儿科护士实施人文关怀体验的质性研究

目的了解儿科护士实施人文关怀的真实体验,为促进对护士的关怀和提高护理质量提供参考。方法采用目的抽样法选取15名儿科护士进行半结构式访谈,运用Colaizzi 7步分析法提炼主题。结果儿科护士实施人文关怀过程中的体验归纳为3个主题及11个亚主题,即正性体验(积极实施人文关怀、护患关系改善、职业认同感和价值感增强),负性体验(无奈与挫败、儿科护理人文关怀实践难度高),儿科护理人文关怀实践过程中的阻碍因素(专业技能及人文知识缺乏、工作负荷重、缺乏团队支持、缺乏评价标准、患儿家属信任与尊重的缺失、职场暴力)。结论儿科护士在工作中实施人文关怀较为积极,但也存在诸多障碍。需要加大对儿科护士人文关怀能力及专业知识的培训力度,加强团队合作,制定儿科护理人文关怀评价标准,同时注重对护士的关怀。

医患沟通在临床护理中的重要性探讨

合理的医患沟通是建立良好护患关系、保证护理服务质量的前提和基础。本研究介绍医患沟通基本概念,分析医患沟通在临床护理工作中的重要性,研究临床护理中医患沟通的有效策略,以期为临床开展医疗服务提供参考。

2014年-2018年医疗损害责任纠纷判例赔偿情况分析

目的:分析医疗损害责任纠纷判例赔偿情况,促进医患和谐。方法:采用回顾性研究方法,使用Epidata 3.1和SPSS 19.0软件对2014年1月1日—2018年12月31日中国裁判文书网可查的1797例医疗损害责任纠纷判例进行分析。结果:1797例医疗损害责任纠纷判例中判决1193例。基层法院审理结案判例最多,为1771例(98.6%);华东区判例最多,为801例(44.5%);判例发生数随时间推移呈增长趋势;三级医院判例最多,为1013例(56.4%)。每例医疗损害责任纠纷赔偿金额最多的为三级医院(中位数122110.01元)、儿科(中位数120287.75元)、重复鉴定(中位数111347.47元)、医方完全责任(中位数143476.96元)和一级事故(中位数189762.39元)判例。结论:应遵循注重医疗过错原则、考虑损害参与度原则、保护医患双方合法权益原则、适时调整原则,实行以"一元化"赔偿制度为主、多种条件赔偿为辅的赔偿制度。

Listen and talk to the older patients:a critical emancipatory reflection on the practice of communication issues

Objective: Reflection is a process of deliberating thinking and examining one's practice in the past and thereby encouraging nurses to make improvements in future care delivery. This work outlines a piece of reflection involving the practice of communication between nurses and the elderly, to emancipate the authors from their constraints, help to find values as practitioners, and gain a greater understanding of the nurse-patient relationship.Methods: Using Smyth's four-stage model as a guide, as well as empirical and theoretical knowledge on nurse-patient relationships, this paper presents a deep reflection on the relationship that the authors developed with elderly patients and their families, encountered during the practice as a nurse. By applying the four main stages consisting of describe, inform, confront, and reconstruct, this model enabled the authors to frame, describe the practice issue, and explore the meaning behind it, which helps to facilitate a structured reflection.Results: Critical emancipatory reflection, in association with the Espoused theory and Theory-in-use, as well as reflexivity, critical social theory, and hegemony, was applied to uncover the various power relationships and constraining forces in the authors' practice involved in communicating with the elderly, such as the underlying false consciousness, hegemony, hidden assumptions, influential values, and dominant power structure, which are subtle and persuasive. By applying this process of critical reflection, transformative practice could be achieved.Conclusions: The process of critical reflection facilitated the development of the abilities required to develop and maintain the nursepatient relationship. It helps to enhance the care of old patients and their families, which illuminates the future nursing practice.

Features of Suffering Perceived by Japanese Patients in a Stable Condition: A Text Analysis

Objectives: We performed a text analysis of telephone consultation content regarding features of suffering (thoughts that patients cannot express to nurses) perceived by Japanese patients in a stable condition. Methods: Semi-structured interviews were conducted by 8 telephone counselors who listened to patients’ suffering. Interview content was recorded verbatim, text was organized, and a text and association analysis was conducted (cluster analysis, bubble plot analysis, and a co-occurrence network analysis). Results: Seventy-two conversations were obtained and analyzed. It was confirmed that suffering as perceived by stable, Japanese patients had consistent concerns such as “lack of inference,” “privacy issues,” and “nurses’ not intervening on patients’ behalf.” Additionally, expectations of patients when patients are suffering are extremely diverse and were not characterized by specific tendencies. Conclusions: Emotions have a complicated influence in the context of Japanese patients’ suffering. It is necessary to consider the cultural background of expression in Japan to treat patients’ suffering.

论叙事医学对高职护生共情能力的培养

文章主要对叙事医学与共情的概念及内涵进行梳理,研究叙事医学对护生共情能力培养的作用和影响,分析其必要性与可行性,从医学史与中文叙事的视角出发,具体阐释叙事医学对高职院校护生共情能力培养的两条路径:一是精细阅读医学史,为培养护生共情能力奠定良好契机;二是反思性中文叙事,为构建护患共同体搭起共情桥梁。

精神科护理管理中实施人性化管理理念对护患关系的影响

精神病患者的病情有一定的特殊性,需要较长的康复时间。此外,受新技术不断发展的影响显著增加了业务量,使得护理人员十分缺乏。新时代,患者心理需求多样,护患矛盾不断。强化护理人员的法律观念,提高他们的自我保护意识,规范他们的行为,提高护理质量,建立和谐的护患关系,使医院有了新的思考和研究。本文旨在探讨在精神病护理管理中实施人文管理理念对护患关系的影响。

病区护士长对患者实施人文关怀体验的质性研究

目的 了解病区护士长对患者实施人文关怀的体验,为制定关怀改进策略提供参考。方法 采用现象学研究方法,对7所医院的17名护士长进行半结构深入访谈,采用Colaizzi 7步分析法分析资料。结果 提炼出5个主题:重要性感知、关怀措施丰富、多层面获益、存在阻碍因素、期望关怀与支持。结论 病区护士长对患者实施人文关怀的体验中有收获、有困难,医院管理层应针对现况完善管理机制,促进病区护士长更全面、更深入地开展患者人文关怀。

护患关系量表的汉化及信效度检验

目的:对基于老年病人视角编制的护患关系量表(Interpersonal Geriatric Care Relationship Tool,InteGer)进行汉化,并检验其信效度。方法:对英文版InteGer进行翻译、回译,通过跨文化调试及预试验形成中文版InteGer。选取武汉市某三级甲等医院436例老年病人进行问卷调查,检验量表的信效度。结果:中文版InteGer包括人性化、注意性、兴趣、可及性4个维度,共29个条目。量表总体Cronbach’sα系数为0.942,各维度的Cronbach’sα系数为0.822~0.958;量表总体重测信度为0.935,各维度重测信度为0.857~0.941;量表总体折半信度为0.862,各维度折半信度为0.779~0.969。量表条目水平的内容效度(I-CVI)为0.830~1.000,量表水平的内容效度(S-CVI)为0.967。以护患关系信任度量表为标准,效标关联效度系数为-0.712(P<0.001)。探索性因子分析提取了4个公因子,累计方差贡献率为71.321%。结论:中文版InteGer具有较好的信效度,可用于评估我国老年病人与护士的关系。

Peplau人际关系理论的护理在口腔正畸患者中的应用

目的 探讨基于Peplau人际关系理论的护理干预对口腔正畸患者治疗依从性、身心应激反应及护患关系的影响。方法 选取2019年12月—2021年12月医院行正畸治疗的100例患者为研究对象,按照组间基本特征具有可比性的原则分为观察组和对照组,每组50例。对照组给予常规护理,观察组行基于Peplau人际关系理论的护理干预。比较两组治疗依从性、身心应激状况评分及护患关系满意程度。结果观察组正畸治疗依从性高于对照组,差异有统计学意义(P<0.05)。基于Peplau人际关系理论的护理干预前,两组焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、视觉模拟评分(VAS)比较差异无统计学意义(P>0.05);干预后,观察组SAS、SDS、VAS评分低于对照组,组间比较差异有统计学意义(P<0.05)。观察组满意程度高于对照组,组间比较差异有统计学意义(P<0.05)。结论 基于Peplau人际关系理论的护理干预可以提高口腔正畸治疗依从性,降低身心应激程度,改善护患关系。

老年人模拟体验教学对实习护生共情能力的影响

目的 探讨老年人模拟体验教学对老年病科实习护生共情能力的影响。方法 选取2021年6月—2022年1月在重庆医科大学附属第二医院老年病科3个病区实习的108名护生作为研究对象,采用随机数字表法将其分为对照组(n=54)和试验组(n=54)。对照组采用常规带教方法,试验组在常规带教基础上加入老年人模拟体验教学法。两组护生均实习5周,比较两组护生模拟体验教学前、教学后、出科后3个月的共情能力得分,并由试验组护生评价模拟体验教学效果。结果 教学后、出科后3个月,试验组共情总分、观点采择、情感护理、换位思考评分高于对照组,差异有统计学意义(P<0.05)。试验组有100%(54/54)的实习护生认为体检式教学有利于培养同理心和服务意识。结论 在常规带教的基础上,对实习护生进行老年人模拟体验教学可提高其共情能力,并能保持较长一段时间,可增强护生责任感和同理心,具有较好的教学效果。

共情式心理护理对乳腺癌放化疗患者心理弹性水平与生命质量及护患关系的影响效果分析

目的:分析共情式心理护理对乳腺癌放化疗患者心理弹性水平与生命质量及护患关系的影响效果。方法:选取本院肿瘤科2019年1月至2022年12月收治的72例乳腺癌放化疗患者,采用随机数字表法平均分为两组各36例,其中对照组实施传统心理护理,观察组实施共情式心理护理。分别在护理前、护理3个月时利用心理弹性量表、乳腺癌患者生命质量测定量表(中文版)对心理弹性评分、生命质量评分进行测定,护理3个月时统计护理服务总满意率,并对比以上观察指标数值差异。结果:观察组护理3个月时的心理弹性评分与生命质量评分、护理服务总满意率均高于对照组(P<0.05)。结论:共情式心理护理可显著提升乳腺癌放化疗患者心理弹性水平、改善生命质量以及护患关系,值得临床应用。

精细化护理对改善慢性阻塞性肺疾病并呼吸衰竭患者的效果分析

目的:探究精细化护理对慢性阻塞性肺疾病合并呼吸衰竭患者的预后及和谐医患关系建立的作用。方法:选取2021年1-12月绵阳市中心医院收治的98例慢性阻塞性肺疾病并呼吸衰竭患者为研究对象,根据护理方式的不同,分为对照组与观察组。对照组实施常规护理,观察组实施精细化护理。比较两组患肺部啰音、憋喘消失时间,用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积占用力肺活量比值(FEV_(1)/FVC)水平,并发症发生情况及护理满意度。结果:观察组肺部啰音、憋喘消失时间均短于对照组,差异有统计学意义(P<0.05);观察组FVC、FEV_(1)、FEV_(1)/FVC水平均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05);观察组护理满意度高于对照组,差异有统计学意义(P<0.05)。结论:慢性阻塞性肺疾病并呼吸衰竭患者护理过程中使用精细化护理进行干预,利于改善患者预后,可提高护理满意度,对建立和谐医患关系具有积极影响。