護患非語言溝通中觸摸的編碼及標(biāo)準(zhǔn)化流程構(gòu)建的研究
發(fā)布時間：2018-07-15 22:24
【摘要】：研究目的本研究旨在通過調(diào)查術(shù)前老年患者能量情緒狀態(tài)、編碼護理人員和患者的觸摸體驗以及構(gòu)建觸摸技能干預(yù)標(biāo)準(zhǔn)化流程,以明確不同科室術(shù)前老年患者的特征性的能量情緒狀態(tài),幫助患者提高將負性能量轉(zhuǎn)化為正性能量情緒的能力,改善老年患者術(shù)前的負性能量情緒狀態(tài),促進疾病康復(fù),指導(dǎo)護理人員找到最佳時機進行科學(xué)的觸摸技能干預(yù),探索觸摸與護患溝通的相關(guān)性,建立伙伴式合作型建設(shè)性護患關(guān)系。研究方法1.本研究采用量性研究方法即問卷調(diào)查法對第三軍醫(yī)大學(xué)第三附屬醫(yī)院120名老年患者進行手術(shù)前能量情緒狀態(tài)的調(diào)查;2.本研究運用質(zhì)性研究方法即觀察法、深度訪談及焦點小組訪談相結(jié)合,對第三軍醫(yī)大學(xué)3所附屬醫(yī)院的18名護士深度訪談及21名患者及家屬焦點小組訪談,形成觸摸體驗的主題編碼;3.本研究采用量性研究與質(zhì)性研究相結(jié)合的方法,以人際交往理論和奧蘭多的護理程序理論為理論基礎(chǔ),使用Delphi專家函詢法構(gòu)建基于老年患者情緒狀態(tài)的能量等級模型、針對不同能量能級情緒狀態(tài)老年患者的觸摸干預(yù)對策以及護患溝通中觸摸技能對術(shù)前老年患者情緒調(diào)控的標(biāo)準(zhǔn)化干預(yù)流程。研究結(jié)果1.本研究通過對眼科、骨科及腦外科的老年患者的手術(shù)前的能量等級水平、正性負性情緒水平以及焦慮水平進行基線資料的現(xiàn)狀調(diào)查,結(jié)果顯示:手術(shù)前一天中午,眼科視覺剝奪老年患者的能量情緒狀態(tài)以悲傷為主要特征,骨科意外跌倒老年患者以痛苦為主要能量情緒狀態(tài)的特征,腦外科腦出血清醒期老年患者則以壓抑為主要特征。2.本研究根據(jù)對術(shù)前老年患者的能量情緒狀態(tài)和護患溝通中護理人員應(yīng)用觸摸這一非語言溝通技能的現(xiàn)狀,提煉出護患溝通中護理人員與患者觸摸體驗的9大主題,如表1所示:3.基于術(shù)前老年患者的能量情緒現(xiàn)狀和護患溝通中觸摸體驗的9大主題,進一步形成了基于老年患者情緒狀態(tài)的能量等級模型,橫坐標(biāo)為老年患者術(shù)前情緒類型,從左至右依次為消極的情緒類型(悲傷、痛苦、憂郁)、中性的情緒類型(無精打采、被喚醒、中立)、積極的情緒類型(愉快、放松、興奮);縱坐標(biāo)為能量等級,從下至上使患者的能量等級逐級提高;在此基礎(chǔ)上形成針對不同能量能級情緒狀態(tài)老年患者的觸摸干預(yù)對策,使其從消極的情緒狀態(tài)轉(zhuǎn)化為中性甚至是積極的情緒狀態(tài)。4.本研究得出護患溝通中護理人員運用觸摸這一非語言技能調(diào)控術(shù)前老年患者負性能量情緒狀態(tài)的核心標(biāo)準(zhǔn)化流程——“RPNAS”溝通模式:R——建立關(guān)系(Relationship):與患者或家屬互相介紹,構(gòu)建和諧的溝通氛圍;P——介紹病程(Process):向患者或家屬介紹整個病程(現(xiàn)有診斷、病情發(fā)展、疾病預(yù)后、治療計劃);N——詢問意愿(Needs):詢問患者與家屬的需求與意愿;A——調(diào)整需求(Adjustment):進行雙方需求調(diào)整,努力達成一致;S——構(gòu)建安全感(Security):治療方案調(diào)整后再次詢問患者及家屬的其他需求及意愿,構(gòu)建雙方的安全感。5.通過Delphi專家函詢,修訂了在護患溝通中針對不同疾病類型不同情緒狀態(tài)的術(shù)前老年患者觸摸干預(yù)的標(biāo)準(zhǔn)化流程。在臨床護理工作中,通過運用觸摸干預(yù)的標(biāo)準(zhǔn)化流程,可有效調(diào)控術(shù)前老年患者能量情緒狀態(tài),使其負性能量情緒轉(zhuǎn)化為積極能量情緒狀態(tài),提高患者依從性,促進疾病康復(fù),建立良好的護患關(guān)系。結(jié)論本研究通過現(xiàn)狀調(diào)查術(shù)前老年患者的能量情緒狀態(tài)以及質(zhì)性研究,明確了基于老年患者情緒狀態(tài)的能量等級模型,應(yīng)用人際交往理論和奧蘭多護理程序理論為理論基礎(chǔ),構(gòu)建了針對不同能量能級情緒狀態(tài)老年患者的觸摸干預(yù)對策以及護患溝通過程中觸摸干預(yù)的標(biāo)準(zhǔn)化流程——“RPNAS”溝通模式,制訂了針對不同疾病類型、不同情緒類型患者的觸摸干預(yù)核心技能的標(biāo)準(zhǔn)化流程,研究發(fā)現(xiàn)中性的觸摸特別是被喚醒的觸摸是護患雙方關(guān)系“破冰”的臨界點,倡導(dǎo)在臨床實踐中護理人員科學(xué)運用觸摸這一非語言溝通技能,有效調(diào)控術(shù)前老年患者的能量情緒狀態(tài),為促進患者疾病康復(fù),建立和諧的護患關(guān)系提供了參考依據(jù),值得進一步推廣。
[Abstract]:The purpose of this study is to investigate the energy and emotional state of the elderly patients before the operation, to encode the touch experience of the nurses and patients and to construct the standardized process of the touch skill intervention to identify the characteristic energy and emotional state of the elderly patients in different sections of the Department and to help the patients to improve their negative energy into positive energy emotion. The ability to improve the negative energy and emotional state of the elderly patients, promote the rehabilitation of the disease, guide the nursing staff to find the best time to carry out the scientific touch skill intervention, explore the relevance of the communication between the touch and the nurse and the patient, and establish a cooperative and constructive relationship between the patient and the patient. 1. research methods are the quantitative research method, that is, the questionnaire survey The method was used to investigate the energy and emotional state of 120 elderly patients at the Third Affiliated Hospital of Third Military Medical University. The 2. studies used qualitative research methods, such as observation method, deep interview and focus group interview, to interview 18 nurses in 3 affiliated hospitals of Third Military Medical University, and interview 21 patients and family focus group. In the 3. study, a combination of quantitative research and qualitative research is used in the 3. study. Based on the theory of interpersonal communication and the theory of Orlando's nursing procedure, an energy grade model based on the emotional state of the elderly patients is constructed by using the Delphi expert inquiry method. The approach of touch intervention and the standardized intervention process of touch skills on emotional regulation of pre operative elderly patients during the patient communication. Results 1. this study was conducted through the survey of baseline data on the level of energy level, positive negative emotion level and anxiety level before operation in the ophthalmology, Department of orthopedics and Department of cerebral surgery, The results showed that the energy and emotional state of the elderly patients with visual deprivation in the Department of orthopedics were characterized by sadness as the main characteristic of sadness as the main characteristic of the elderly patients in the Department of orthopedics before the operation. The elderly patients in the sober period of cerebral hemorrhage in the Department of cerebral surgery were characterized by depression as the main characteristic.2. based on the ability of the elderly patients before the operation. The status of emotional state and nurse patient communication in the use of touch this non-verbal communication skills, to extract the 9 major themes of the touch experience of nurses and patients, as shown in Table 1: 3. based on the status of the energy and emotion of the elderly patients before the operation and the 9 themes of touch experience in the nurse patient communication, it is further formed on the basis of the old age. The energy level model of the emotional state of the elderly patients, the horizontal coordinate is the emotional type of the elderly patients before the operation, from left to right in turn as negative emotional types (sad, painful, melancholy), neutral emotional types (lethargy, awakened, neutral), positive emotional types (cheerful, relaxed, excited); the ordinate is the energy level, from the bottom to the patient. The level of energy level is improved step by step; on this basis, a touch intervention strategy for elderly patients with different energy levels is formed, which transforms from negative emotional state to neutral or even positive emotional state.4.. This study suggests that nursing staff use touch this nonverbal skill to regulate the negativity of the elderly patients. The core standardization process of energy state of emotion - "RPNAS" communication mode: R - establishing relationship (Relationship): introducing each other with the patient or family, building a harmonious communication atmosphere; P - introduction of the course of disease (Process): introducing the patient or family to the whole course of the disease (now with diagnosis, disease development, disease prognosis, treatment plan); N - inquiring Needs: inquiring the needs and wishes of the patients and their families; A - adjustment requirements (Adjustment): to adjust the needs of both parties and strive to reach agreement; S - build a sense of security (Security): after the adjustment of the treatment plan, the other needs and wishes of the patients and their families are requestioned, and the security.5. of both parties is constructed by the Delphi expert to inquire and amend In the nurse patient communication, the standardized process of touch intervention for the elderly patients with different emotional states and different types of emotional state. In the clinical nursing work, through the use of the standardized process of touch intervention, the energy and emotion state of the elderly patients can be effectively regulated, and the negative performance emotion can be transformed into positive energy state, and the patients can improve the suffering. In this study, the energy level model based on the emotional state of the elderly patients was defined, and the theory of interpersonal communication and Orlando nursing procedure theory were used as the theoretical basis. The touch intervention strategy of the elderly patients with different energy level emotional state and the standardized process of touch intervention during the patient communication process, the "RPNAS" communication model, developed a standardized flow for the core skills of touch intervention for patients with different types of disease and different emotional types, and the study found that neutral touch was especially awakened. The touch is the critical point of the "ice breaking" of the relationship between the two sides. In the clinical practice, it is advocated that the nursing staff should use the non-verbal communication skills to touch the non language communication skills scientifically and effectively regulate the state of the energy and emotion of the elderly patients, and provide reference for the rehabilitation of the patients and the establishment of a harmonious relationship between the patients and the patients.
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R47
本文編號：2125569
[Abstract]:The purpose of this study is to investigate the energy and emotional state of the elderly patients before the operation, to encode the touch experience of the nurses and patients and to construct the standardized process of the touch skill intervention to identify the characteristic energy and emotional state of the elderly patients in different sections of the Department and to help the patients to improve their negative energy into positive energy emotion. The ability to improve the negative energy and emotional state of the elderly patients, promote the rehabilitation of the disease, guide the nursing staff to find the best time to carry out the scientific touch skill intervention, explore the relevance of the communication between the touch and the nurse and the patient, and establish a cooperative and constructive relationship between the patient and the patient. 1. research methods are the quantitative research method, that is, the questionnaire survey The method was used to investigate the energy and emotional state of 120 elderly patients at the Third Affiliated Hospital of Third Military Medical University. The 2. studies used qualitative research methods, such as observation method, deep interview and focus group interview, to interview 18 nurses in 3 affiliated hospitals of Third Military Medical University, and interview 21 patients and family focus group. In the 3. study, a combination of quantitative research and qualitative research is used in the 3. study. Based on the theory of interpersonal communication and the theory of Orlando's nursing procedure, an energy grade model based on the emotional state of the elderly patients is constructed by using the Delphi expert inquiry method. The approach of touch intervention and the standardized intervention process of touch skills on emotional regulation of pre operative elderly patients during the patient communication. Results 1. this study was conducted through the survey of baseline data on the level of energy level, positive negative emotion level and anxiety level before operation in the ophthalmology, Department of orthopedics and Department of cerebral surgery, The results showed that the energy and emotional state of the elderly patients with visual deprivation in the Department of orthopedics were characterized by sadness as the main characteristic of sadness as the main characteristic of the elderly patients in the Department of orthopedics before the operation. The elderly patients in the sober period of cerebral hemorrhage in the Department of cerebral surgery were characterized by depression as the main characteristic.2. based on the ability of the elderly patients before the operation. The status of emotional state and nurse patient communication in the use of touch this non-verbal communication skills, to extract the 9 major themes of the touch experience of nurses and patients, as shown in Table 1: 3. based on the status of the energy and emotion of the elderly patients before the operation and the 9 themes of touch experience in the nurse patient communication, it is further formed on the basis of the old age. The energy level model of the emotional state of the elderly patients, the horizontal coordinate is the emotional type of the elderly patients before the operation, from left to right in turn as negative emotional types (sad, painful, melancholy), neutral emotional types (lethargy, awakened, neutral), positive emotional types (cheerful, relaxed, excited); the ordinate is the energy level, from the bottom to the patient. The level of energy level is improved step by step; on this basis, a touch intervention strategy for elderly patients with different energy levels is formed, which transforms from negative emotional state to neutral or even positive emotional state.4.. This study suggests that nursing staff use touch this nonverbal skill to regulate the negativity of the elderly patients. The core standardization process of energy state of emotion - "RPNAS" communication mode: R - establishing relationship (Relationship): introducing each other with the patient or family, building a harmonious communication atmosphere; P - introduction of the course of disease (Process): introducing the patient or family to the whole course of the disease (now with diagnosis, disease development, disease prognosis, treatment plan); N - inquiring Needs: inquiring the needs and wishes of the patients and their families; A - adjustment requirements (Adjustment): to adjust the needs of both parties and strive to reach agreement; S - build a sense of security (Security): after the adjustment of the treatment plan, the other needs and wishes of the patients and their families are requestioned, and the security.5. of both parties is constructed by the Delphi expert to inquire and amend In the nurse patient communication, the standardized process of touch intervention for the elderly patients with different emotional states and different types of emotional state. In the clinical nursing work, through the use of the standardized process of touch intervention, the energy and emotion state of the elderly patients can be effectively regulated, and the negative performance emotion can be transformed into positive energy state, and the patients can improve the suffering. In this study, the energy level model based on the emotional state of the elderly patients was defined, and the theory of interpersonal communication and Orlando nursing procedure theory were used as the theoretical basis. The touch intervention strategy of the elderly patients with different energy level emotional state and the standardized process of touch intervention during the patient communication process, the "RPNAS" communication model, developed a standardized flow for the core skills of touch intervention for patients with different types of disease and different emotional types, and the study found that neutral touch was especially awakened. The touch is the critical point of the "ice breaking" of the relationship between the two sides. In the clinical practice, it is advocated that the nursing staff should use the non-verbal communication skills to touch the non language communication skills scientifically and effectively regulate the state of the energy and emotion of the elderly patients, and provide reference for the rehabilitation of the patients and the establishment of a harmonious relationship between the patients and the patients.
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R47
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