人文关怀在临床护理教学中的实践及效果

目的 探讨临床护理带教中的人文关怀教学方法.方法 选取120名实习护生为对象,从带教老师的人文培训、带教老师对护生的关怀及人文关怀教学实践方面进行为期3周的护理人文关怀教学.结果 教学后,护生的人文关怀能力及住院患者对护生的人文关怀护理满意度显著高于教学前(均P＜0.01).结论 人文关怀教学有利于提高护生人文关怀能力...     

基础护理操作训练中提升护生人文关怀能力的研究

目的：探索基础护理操作训练中渗透人文关怀能力要素对提高护生人文关怀能力的效果。方法选择护理本科二年级护生86名,按学生选课分为干预组与对照组,干预组45人,对照组41人,干预前两组护生在一般社会学资料及人文关怀能力基线水平方面无明显差别( P﹥0.05)。对照组护生接受传统的护理技能训练,教师采用讲解、演示-模仿练习-回复示教的模式进行授课。干预组采用引导-行动-反思的模式将人文关怀要素融入护理操作训练中,干预时间为5个月。干预后采用护理专业大学生人文关怀能力量表进行效果评价。结果干预前低年级护生人文关怀能力的水平较低,总均分为(109.90±48.8)分,得分指标为48.8％。干预后干预组护生人文关怀能力较干预前有所提高,而对照组人文关怀能力得分下降,两组间人文关怀能力的变化有明显差别(P<0.05),特别是“灌输信念和希望”“健康教育”“科学解决健康问题”维度。结论采用引导-行动-反思的模式将人文关怀要素融入护理操作训练中能明显提升护生人文关怀能力。     

Cancer patient and staff perceptions of caring and clinical care in free versus forced choice response formats

Two questions were investigated: whether cancer patients (n = 32) and staff (n = 30) have different cognitive representations of the concepts ‘caring’ (Swedish: ‘omvårdnad’) and ‘clinical care’ (Swedish: ‘vård’), and whether results differ between forced vs. free choice response formats. Two Swedish versions of the CARE-Q instrument were used: (i) a CARE-Q sorting (forced format) and (ii) a CARE-Questionnaire (free format). Four groups of patients and 4 groups of staff completed (i) the forced format/caring, (ii) the forced format/clinical care, (iii) the free format/caring and (iv) the free format/clinical care versions, respectively. Participants were asked to rank the importance of 50 CARE-Q behaviours for the specific method/concept combination. Results demonstrated that neither patients nor staff, to any great extent, valued CARE-Q subscales differently when regarded as examples of ‘caring’ vs. ‘clinical care’. Further, the free vs. forced choice format did not influence patient and staff perceptions of the importance of CARE-Q subscales, except that both groups gave higher values to all subscales in the free choice response format. The assumptions that different cognitive representations of the concepts or the response formats had affected previous CARE-Q results were not substantiated.     

Caring, patient autonomy and the stigma of paternalism

Caring, patient autonomy and the stigma of paternalism ¶This paper utilizes data generated during a qualitative study in palliative and maternity care settings to guide discussion of the current discourse, which emphasizes patient autonomy and derides paternalism. Data are presented which illustrate that this ideology is established in nursing practice. Respect for patient autonomy is identified as an essential element of individualized, patient-centred and ethical care but conversely, it is suggested that over-emphasis may confuse and suppress beneficent intervention. The value of ethical theory to provide an objective means to explore ethical dilemmas in practice is not debated, but exploration of the issues raised by the data suggest, that principle-based ethical theory suffers the following constraints: the predetermined balance of ethical principles in favour of respect for autonomy prevents an unbiased perspective and optimum guidance; in contrast to caring relationship, application of ethical theory does not reveal the particulars necessary to guide ethical decisions aimed at promoting good for the individual; current discourse appears to disregard the inherent inequality in the relationship between the helped and helper and practitioners' need to preserve their own moral integrity. Consequently, this paper argues that beneficence derived through caring should not be superseded uncritically and suggests that mutual nurse-patient relationship, which balances respect for patient autonomy and beneficent guidance based on practitioner's clinical expertise, protects the moral integrity of both patient and practitioner. For conciseness, the term patient will be used to indicate recipients of both nursing and midwifery care and while both nurses and midwives are not always specified, any term referring to nurses, denotes both.     

Oncology patients' and oncology nurses' perceptions of nurse caring behaviours

Previous research on patients' and nurses' perceptions of nurse caring behaviours has documented significant differences in the ranking of important behaviours. However, these samples have included a variety of medical-surgical patients and nurses and different types of institutional settings, all of which may have affected the results. The present study sought to determine if patients and nurses from one subspecialty area and one institution would have more concordant perceptions of caring. Forty-four oncology patients and 49 oncology nurses completed the Respondents Perceptions of Caring Behaviour Scale (RPCBS). Results showed that overall mean patient rankings were highly correlated with mean nurse rankings (Spearman's correlations coefficient 0.94, P<0.0001). The Wilcoxon two-sample rank sum test was used to test the difference in rank of the 20 items between the patients and nurses. There was a significant difference in rank in only six of the 20 items. These data suggest that oncology patients and nurses have more concordant perceptions of caring than previously investigated groups. Implications for practice and further research are discussed.     

护理硕士研究生人文关怀能力与课堂氛围现状及其相关性研究

目的：调查护理硕士研究生的人文关怀能力现状,分析人文关怀能力与课堂氛围的相关性,为改善课堂氛围,提升护理硕士研究生的人文关怀能力提供依据。方法：对湖南省两所高校49名护理硕士研究生进行人文关怀能力和课堂氛围的抽样问卷调查,并应用SPSS13.0软件包对所有数据进行统计学处理。结果：护理硕士研究生的人文关怀能力总均分为（3.68±0.29）分,处于中等偏上水平;高校课堂氛围的总均分为（3.42±0.57）分,与人文关怀能力的相关系数为0.913。结论：护理硕士研究生的人文关怀能力处于较高水平,课堂氛围与人文关怀能力呈正相关,高校教师应继续改善课堂氛围,从而进一步提高护理硕士研究生的人文关怀能力。