护患双方认知的差异性对建立和谐护患关系的影响

[目的]了解护患双方对医患关系认知的差异性，为建立和谐护患关系提供实践指导依据。[方法]采取整群随机抽样方法，对浙江省某市城区4家医院的部分护士和病人进行问卷调查。[结果]护患双方除了对医患关系重要性的认知一致外，对医患关系的性质和发展趋势、医患冲突的常见诱因、主要解决方式等方面的认知情况均有统计学意义。[结论]护患双方对医患关系的认知差异是导致护患问有效沟通的障碍，相互理解和彼此尊重是解决认知分歧和建立和谐护患关系的根本要求。     

医疗卫生机构护患关系存在的问题及应对措施

分析医疗卫生机构护患关系方面存在的问题,并提出相应的对策。     

Patient adherence to treatment: three decades of research. A comprehensive review

Low compliance to prescribed medical interventions is an ever present and complex problem, especially for patients with a chronic illness. With increasing numbers of medications shown to do more good than harm when taken as prescibed, low compliance is a major problem in health care. Relevant studies were retrieved through comprehensive searches of different database systems to enable a thorough assessment of the major issues in compliance to prescribed medical interventions. The term compliance is the main term used in this review because the majority of papers reviewed used this term. Three decades have passed since the first workshop on compliance research. It is timely to pause and to reflect on the accumulated knowledge. The enormous amount of quantitative research undertaken is of variable methodological quality, with no gold standard for the measurement of compliance and it is often not clear which type of non-compliance is being studied. Many authors do not even feel the need to define adherence. Often absent in the research on compliance is the patient, although the concordance model points at the importance of the patient's agreement and harmony in the doctor-patient relationship. The backbone of the concordance model is the patient as a decision maker and a cornerstone is professional empathy. Recently, some qualitative research has identified important issues such as the quality of the doctor-patient relationship and patient health beliefs in this context. Because non-compliance remains a major health problem, more high quality studies are needed to assess these aspects and systematic reviews/meta-analyses are required to study the effects of compliance in enhancing the effects of interventions.     

Hindrance for patient participation in nursing care

THE STUDY'S RATIONALE: Patients' influence in health care through participation, freedom of choice and information, is laid down in laws, national and local directives. In nursing care situations, the degree to which a patient participates depends on the nursing staff. Accordingly, hindrances for patient's participation during nursing care is an important question for the nursing profession. AIMS AND OBJECTIVES: The aim was to focus on Swedish Registered Nurses opinion of hindrances for patient participation in nursing care and to uncover the informants' perspectives in depth. METHODOLOGICAL DESIGN AND JUSTIFICATION: The study was limited to inpatient somatic care and has a qualitative approach. Data were collected through seven focus group interviews with 31 Registered Nurses from five hospitals. An analysis of the tape-recorded interview material was made, combining elements of content analysis with aspects of the Grounded Theory approach. ETHICAL ISSUES AND APPROVAL: The ethics of scientific work was followed. The participants gave informed consent. Verbal and written information was given as a guarantee that all information would be treated confidentially outside the focus group. Formal approval by ethical committee was not required according to national and local directives. RESULTS: Hindrance for patient participation in nursing care comprised three themes: Competence, Influence of significant others and Organization and work environment, and their seven underlying subthemes. CONCLUSIONS: The study clarified factors, which individually or combined may be hindrance for patient participation in nursing practice. Professional nurses must be able to find a balance for their patients' participation in nursing care activities through identification and coping with the hindrances. The three themes and seven subthemes here identified, can be used in patient care and its' evaluation, like also quality assurance of care and work organization and in nursing education. For further development replication studies are needed, like additional studies of patients and significant others.     

'Take my hand, help me out': mental health service recipients' experience of the therapeutic relationship

ABSTRACT: The purpose of this study was to describe mental health service recipients' experience of the therapeutic relationship. The research question was ‘what is therapeutic about the therapeutic relationship?’ This study was a secondary analysis of qualitative interviews conducted with persons with mental illness as part of a study of the experience of being understood. This secondary analysis used data from 20 interviews with community‐dwelling adults with mental illness, who were asked to talk about the experience of being understood by a health‐care provider. Data were analysed using an existential phenomenological approach. Individuals experienced therapeutic relationships against a backdrop of challenges, including mental illness, domestic violence, substance abuse, and homelessness. They had therapeutic relationships with nurses (psychiatric/mental health nurses and dialysis nurses), physicians (psychiatrists and general practitioners), psychologists, social workers, and counsellors. Experiences of the therapeutic relationship were expressed in three figural themes, titled using participants' own words: ‘relate to me’, ‘know me as a person’, and ‘get to the solution’. The ways in which these participants described therapeutic relationships challenge some long‐held beliefs, such as the use of touch, self‐disclosure, and blunt feedback. A therapeutic relationship for persons with mental illness requires in‐depth personal knowledge, which is acquired only with time, understanding, and skill. Knowing the whole person, rather than knowing the person only as a service recipient, is key for practising nurses and nurse educators interested in enhancing the therapeutic potential of relationships.     

'They all said you could come and speak to us': patients' expectations and experiences of help on an acute psychiatric inpatient ward

Acute psychiatric inpatient care forms an integral part of mental health services. Few studies have focussed on the patient experience of acute care. Research into patient experience is increasingly important to policy and service development processes. Knowledge of patient experiences facilitates the development of nursing practice. The aim of the study was to gain insight into the experience of being a patient on an acute inpatient psychiatric ward. Thirteen participants were recruited from the acute ward. Unstructured interviews were used to gather narrative data of their experiences. Holistic analysis of the narratives was informed by Gee's socio-linguistic theories that meaning is linked to narrative structure. Reading of the holistic analyses yielded themes of help, safety and power running across the participants' experiences. The patient experience was characterized by dissonance between expectation and experience, the search for a nurse-patient relationship and the development of strategies to cope with being on the acute ward. This paper focuses on the theme of 'Help' where participants describe their expectation that they will receive help through the development of relationships with the nurses, and their experience of the barriers to this. In response, participants developed strategies to support each other.     

Nurse-patient interaction: a review of the literature

Aims. The aims of this paper are to review a theoretical model useful for developing nursing knowledge related to nurse–patient interaction, review the literature on nurse–patient interaction, and discuss areas for further research. Theoretical model. Goffman's theory of face work. Results. Nurse–patient interaction is a central element of clinical nursing practice. This paper shows how Goffman's model can be used as a theoretical framework for understanding nurse–patient communication. Relevance to clinical practice. Issues such as power, the social and cultural context, and interpersonal competence are shown to be important in the quality of nurse–patient interactions and nurses need to take cognizance of these factors in their interactions with patients.     

急诊科护士共情能力培训效果研究

目的 探讨急诊科护士共情能力的培训效果.方法 通过共情理论知识与技能的培训,使用中文版杰弗逊共情量表对21名参加共情能力培训的急诊科护士进行调查.结果 参加共情能力培训后急诊科护士共情能力得分与患者就诊满意度均高于培训前,差异具有统计学意义(P＜0.01或P＜0.05).结论 通过培训,急诊科护士共情能力的增强和技能的...     

Israeli E-patientsʼ Informational Needs

Background

Online medical information has transformed the way patients obtain information.

出院患者回访工作对医患关系管理的启示

通过信件和电话两种方式对某院2006—2007年32 037人次出院患者进行回访,共有25 459例病人反馈了意见,其中满意者25 171例,288例不满意者反馈意见或建议311条,涉及服务态度、服务效率、服务水平、就医环境、服务流程、医患沟通、医疗收费、医德医风共8个方面。分析回访数据,掌握服务现状,揭示了医患关系管理的重点,包括医院软环境建设;改善医院服务态度、提高服务效率;不断构建全程医患沟通渠道。笔者认为：出院患者回访工作对构建和谐医患关系,提升管理水平有积极的促进作用,但仍需科学化;医患关系紧张甚至形成冲突成因复杂,需要行业性、全方位的解决方案。     

护理人员语言与护患关系

随着现代医学的发展,生物医学模式已转变为生物、心理、社会医学模式,相应地,护患模式也发生了改变。新的护患模式要求护士对患者实施全方位的身心护理,而不再是简单的“打针”、“送药”等技能性动作,其中建立良好的护患关系是至关重要的。建立良好的护患关系,必须一切以病人为中心,根据患者的不同情况,以有声语言和体态性语言(仪表、着装、姿态、情绪等)与患者进行沟通,增加病人对护士的信赖感,使消极情绪转变为积极情绪,配合治疗和护理,以达到早日康复的效果。为此,必须明确语言在护患关系中的重要性,护士在护患沟通中应具有的语言素质和运用技巧。     

整体护理对心内科护患关系信任度的影响

通过调查心内科住院患者对护士的信任程度,进行模式病房与普通病房护患信任度的对比分析,探讨整体护理实践对护患间信任度的影响。结果提示建立护患信任的根本在于实施“以病人为中心”的整体护理,护士要充分发挥主观能动性,在构成护患信任的五要素上努力。作者认为模式病房的实践,对护患间信任度有促进作用,并提出全面开展整体护理的必要性。     

护理人员的护患沟通能力调查及分析

目的了解护理人员护患沟通能力的状况,分析其影响因素,以提高护理质量。方法采用自行设计的护患沟通能力调查问卷表对本院96名护理人员进行问卷调查。结果高职称的护理人员沟通能力较强;不同学历护理人员的沟通能力无明显差异。结论为了更好地服务于患者,对护理人员尤为年轻护理人员的沟通能力培养有着重要的意义。     

医护关系在优质护理服务中的调查分析

目的 以优质护理服务深入开展为契机,探讨医护关系在期间的作用,以加强医护协作,从而提高患者满意度。方法 2010－2012年,采用自行设计的《医生对护士能力需求表》及《住院病人满意度调查表》对外科医师31人、住院患者180人次进行调查并当场收回问卷,回收率为100%。结果 通过调查这一活动,医师对于优质护理的了解度上升,对于护士的需求度改变。结论 加强新型医护关系的建设,既提高了医生对护理工作的满意度,密切了医护患关系,更有利于提升医疗、护理质量,提升患者满意度。     

刻板印象的研究进展及其对医患关系研究的启示

文章通过对刻板印象的概念及特点、测量方法和研究内容进行综述,探讨了医患角色认知刻板印象对医患关系的启示,并对医患角色认知刻板印象的研究方向进行展望。     

护理实践中落实患者知情同意权的问题与困惑

本文概述了落实患者知情同意权的意义,分析了护士在落实患者知情同意权过程中存在的问题与困惑,提出了有待进一步探讨的问题。