ICU{重癥監護病房}的護患溝通

論文編號:HL250 論文字數:18430,頁數:36

 論文題目：護患溝通情景素材的開發和應用
 摘　要
 研究目的
 1為護士提供一種親身體驗、反復實踐護患溝通技能的學習情景。
 2檢驗本研究開發的護患溝通情景素材是否能夠更大限度地激發護士學習護患溝通知識的興趣，幫助護士建構護患溝通知識體系，促進護士的護患溝通知識向能力的轉化，最終達到提高護士護患溝通能力的目的。
 研究方法
 通過文獻研究、專家咨詢，創設接近真實的護患溝通學習情景；再應用本研究開發的護患溝通情景素材對山西醫科大學第一臨床醫院新招聘的2005年7月畢業的62名應屆護士采用隨機對照的方法進行為期十周的實驗研究。實驗組護士每周培訓一次，每次兩個學時，同時要求實驗組護士在臨床護理活動中應用本周所學的知識和技巧；對照組護士不參加培訓。使用《護患溝通能力測評量表》對兩組護士的護患溝通能力進行測評。
 研究結果
 1以《管理培訓游戲全案》中關于人際溝通能力的培訓游戲為框架，以護理專業大學生護患溝通能力的結構要素、具體內涵及行為表現為指導，以臨床護理活動中的護患溝通實例為素材，開發出以游戲形式為主的十講護患溝通情景素材。
 2應用本研究開發的護患溝通情景素材進行培訓的實驗研究結果顯示，實驗組護士的四個一級測量指標，即基本語言溝通能力、基本非語言溝通能力、運用溝通技巧能力、協調溝通網絡能力，以及七個二級測量指標，即口頭語言表達能力、文字語言表達能力、身體語言溝通能力、傾聽能力、共情言語能力、群體協調能力、解決沖突能力，與對照組比較有顯著差異，明顯優于對照組。但兩組護士的副語言溝通能力和借助媒體溝通能力無顯著差異。
 研究結論
 本研究開發的護患溝通情景素材可以較好地作為提高護士護患溝通能力的培訓材料，特別是應屆畢業護士進入臨床科室前的培訓材料；也可以作為護患溝通課程的一種教學輔助材料，應用于醫學院校護理專業學生的課堂教學。
 本研究創新之處
 本研究開發的護患溝通情景素材在國內同類研究中尚屬前沿，其具有一定的實用價值和推廣價值。
 關鍵詞：護士；護患溝通能力；情景素材
 Topic: Development and application of nurse-patient communication situational materials
 Disciplines (professional):
 Applicant:
 Instructor:
 Abstract
 Objective
 1.Provide the learning scene of making them experience personally and practice again and again for nurses.
 2.Testing the nurse-patient communication situational materials developed by this research can or not stimulate the interest of learning the nurse-patient communication knowledge, help nurses construct the knowledge system of nurse-patient communication, promote the conversion of communication knowledge to communication ability and increase the nurse-patient communication ability of nurses.
 Methods
 Set near to true nurse-patient communication learning scene by the document-based study and expert consultation.Then by use of the developed nurse-patient communication situational materials to make ten weeks experimental research by means of random and comparison on 62 nurses graduated in July 2005 who were employed by the First Clinical Hospital of Shanxi Medical University.The nurses of experimental group were trained one time every week,and every time two hour.The nurses of experimental group were required to apply the learned knowledge this week in clinical nursing activities.The nurses of control group were not trained. The nurse-patient communication ability of the nurses of experimental group and control group is tested and assessed by use of measurement table of nurse-patient communication ability.
 Result
 1.With the training game about interpersonal communication in the training game whole case of management as frame,with the structural elements,concrete connotation and behavior performance of nurse-patient communication ability of undergraduate of nursing profession as instruction,with the nurse-patient communication examples in clinical nursing activities as materials,developed ten lectures of nurse-patient communication situational materials with the game as main form.
 2.By use of the developed nurse-patient communication situational materials experimental research,the experimental result of which shows that the four first grade measurement indexes and seven second grade measurement indexes of nurses of experimental group are significantly different from and apparently superior to those of control group.The four first grade measurement indexes is respectively the basic language communication ability,basic non-language communication ability,applying communication skills ability,and coordination communication network ability.The seven second grade measurement indexes is respectively the oral language expressing ability,writing language expressing ability,body language communication ability,listening ability,sharing feeling verbal ability,group coordination ability, and solution conflicts ability.However,they show no clear differences in the vice-language communication ability and communication ability via medium.
 Conclusion
 The nurse-patient communication situational materials developed by this research may better operate as the training materials for increasing the nurse-patient communication ability of nurses,especially for nurses just graduated.The situational materials may also use in teaching of the nurse-patient communication course in medical university.
 The side of new
 The nurse-patient communication situational materials developed by this research foreruns other home homogeneous study,it has certain practical and expansive value.
 Key words：nurses,nurse-patient communication ability,situational materials
 
 目錄
摘　要 5
Abstract 7
1前言 10
1.1提高護士護患溝通能力的必要性 11
1.1.1護理服務的對象決定了護士必須具備良好的護患溝通能力 11
1.1.2醫學模式的轉變要求護士必須具備良好的護患溝通能力 11
1.1.3護士角色的發展要求護士必須具備良好的護患溝通能力 12
1.2提高護士護患溝通能力的教學方法的研究現狀 12
1.2.1在護理專業課教學中滲透護患溝通的內容 12
1.2.2創造實踐機會 13
1.2.3錄像或錄音回饋 13
1.2.4角色扮演 13
1.3研究意義 14
1.4相關概念界定 14
2護患溝通情景素材的開發 15
2.1、理論依據 15
2.1.1建構主義學習理論的基本觀點 15
2.1.2建構主義學習理論對開發護患溝通情景素材的啟示 16
2.2護患溝通情景素材開發的必要性和可行性分析 16
2.2.1護患溝通情景素材開發的必要性分析 16
2.2.2護患溝通情景素材開發的可行性分析 17
2.3研究目的 18
2.4材料與方法 18
2.4.1材料來源 18
2.4.2方法 20
2.5結果 21
2.5.1護患溝通情景素材的內容 21
3護患溝通情景素材的應用 23
3.1研究目的 23
3.2研究對象與方法 23
3.2.1研究對象 23
3.2.2分組方法 24
3.2.3研究工具 25
3.2.4實驗方法 25
3.2.5資料收集 25
3.2.6數據處理方法 25
3.3結果與分析 26
3.3.1兩組護士《護患溝通能力測評量表》二級測量指標的得分比較 26
3.3.2兩組護士《護患溝通能力測評量表》一級測量指標的得分比較 29
3.4討論 31
3.4.1護患溝通情景素材能培養和激發護士學習護患溝通知識的興趣 31
3.4.2護患溝通情景素材能促進護士的溝通知識向能力的轉化 31
3.4.3護患溝通情景素材有利于護士的情感教育 32
3.4.4護患溝通情景素材有利于護士應變能力的培養 32
3.4.5護患溝通情景素材有利于護士批判性思維能力的培養 33
3.4.6護患溝通情景素材開發中的啟示 33
3.4.7護患溝通情景素材應用中的啟示 33
3.4.8本研究的創新之處 33
3.4.9繼續開展本研究的設想 34
結論 34
參考文獻 35