ICU{重症监护病房}的护患沟通

论文编号:HL250 论文字数:18430,页数:36

 论文题目：护患沟通情景素材的开发和应用
 摘　要
 研究目的
 1为护士提供一种亲身体验、反复实践护患沟通技能的学习情景。
 2检验本研究开发的护患沟通情景素材是否能够更大限度地激发护士学习护患沟通知识的兴趣，帮助护士建构护患沟通知识体系，促进护士的护患沟通知识向能力的转化，最终达到提高护士护患沟通能力的目的。
 研究方法
 通过文献研究、专家咨询，创设接近真实的护患沟通学习情景；再应用本研究开发的护患沟通情景素材对山西医科大学第一临床医院新招聘的2005年7月毕业的62名应届护士采用随机对照的方法进行为期十周的实验研究。实验组护士每周培训一次，每次两个学时，同时要求实验组护士在临床护理活动中应用本周所学的知识和技巧；对照组护士不参加培训。使用《护患沟通能力测评量表》对两组护士的护患沟通能力进行测评。
 研究结果
 1以《管理培训游戏全案》中关于人际沟通能力的培训游戏为框架，以护理专业大学生护患沟通能力的结构要素、具体内涵及行为表现为指导，以临床护理活动中的护患沟通实例为素材，开发出以游戏形式为主的十讲护患沟通情景素材。
 2应用本研究开发的护患沟通情景素材进行培训的实验研究结果显示，实验组护士的四个一级测量指标，即基本语言沟通能力、基本非语言沟通能力、运用沟通技巧能力、协调沟通网络能力，以及七个二级测量指标，即口头语言表达能力、文字语言表达能力、身体语言沟通能力、倾听能力、共情言语能力、群体协调能力、解决冲突能力，与对照组比较有显著差异，明显优于对照组。但两组护士的副语言沟通能力和借助媒体沟通能力无显著差异。
 研究结论
 本研究开发的护患沟通情景素材可以较好地作为提高护士护患沟通能力的培训材料，特别是应届毕业护士进入临床科室前的培训材料；也可以作为护患沟通课程的一种教学辅助材料，应用于医学院校护理专业学生的课堂教学。
 本研究创新之处
 本研究开发的护患沟通情景素材在国内同类研究中尚属前沿，其具有一定的实用价值和推广价值。
 关键词：护士；护患沟通能力；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
 
 目录
摘　要 5
Abstract 7
1前言 10
1.1提高护士护患沟通能力的必要性 11
1.1.1护理服务的对象决定了护士必须具备良好的护患沟通能力 11
1.1.2医学模式的转变要求护士必须具备良好的护患沟通能力 11
1.1.3护士角色的发展要求护士必须具备良好的护患沟通能力 12
1.2提高护士护患沟通能力的教学方法的研究现状 12
1.2.1在护理专业课教学中渗透护患沟通的内容 12
1.2.2创造实践机会 13
1.2.3录像或录音回馈 13
1.2.4角色扮演 13
1.3研究意义 14
1.4相关概念界定 14
2护患沟通情景素材的开发 15
2.1、理论依据 15
2.1.1建构主义学习理论的基本观点 15
2.1.2建构主义学习理论对开发护患沟通情景素材的启示 16
2.2护患沟通情景素材开发的必要性和可行性分析 16
2.2.1护患沟通情景素材开发的必要性分析 16
2.2.2护患沟通情景素材开发的可行性分析 17
2.3研究目的 18
2.4材料与方法 18
2.4.1材料来源 18
2.4.2方法 20
2.5结果 21
2.5.1护患沟通情景素材的内容 21
3护患沟通情景素材的应用 23
3.1研究目的 23
3.2研究对象与方法 23
3.2.1研究对象 23
3.2.2分组方法 24
3.2.3研究工具 25
3.2.4实验方法 25
3.2.5资料收集 25
3.2.6数据处理方法 25
3.3结果与分析 26
3.3.1两组护士《护患沟通能力测评量表》二级测量指标的得分比较 26
3.3.2两组护士《护患沟通能力测评量表》一级测量指标的得分比较 29
3.4讨论 31
3.4.1护患沟通情景素材能培养和激发护士学习护患沟通知识的兴趣 31
3.4.2护患沟通情景素材能促进护士的沟通知识向能力的转化 31
3.4.3护患沟通情景素材有利于护士的情感教育 32
3.4.4护患沟通情景素材有利于护士应变能力的培养 32
3.4.5护患沟通情景素材有利于护士批判性思维能力的培养 33
3.4.6护患沟通情景素材开发中的启示 33
3.4.7护患沟通情景素材应用中的启示 33
3.4.8本研究的创新之处 33
3.4.9继续开展本研究的设想 34
结论 34
参考文献 35

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