某醫院住院病房之護病關係

The Nurse-Patient Relationships in the Ward of a Hospital

背景及目的：若病患能獲得護理人員妥適照護，則或可減輕其身心之不適；當護理人員見到病患身心不適獲得改善，亦可對自己之付出感到欣慰，此為大家所樂見之護病關係。因此，本研究之目的是想了解住院病患與護理人員之間對護病關係之看法及差距。方法：蒐集文獻歸納護病關係諸題項而製作護病關係問卷，研究對象為某醫院之病房護理師及住院病患，獲有效問卷計護理師109份及病患147份。研究方法包含問卷之信度與效度、敘述統計、Mann-Whitney U檢定及重要性──績效分析法等。結果：病患與護理師對護病關係諸題項之看法頗一致，病患同意度平均數最高之前四項及最低之後五項均與護理師相同，且病患在各題項之同意度均超過3.2分（滿分為4分），此顯示病患對護理師之表現高度肯定。將填答結果作差距分析顯示：護理師自認頗尊重病患、頗保護病患隱私以及常對病患說一些安慰或鼓勵的話；然而，病患對這三個題項之感受卻低於全部題項之平均值。結論及建議：病患同意度較低的三個題項多屬內隱行為，以致病患較難清楚察覺，因此建議醫院對護理師實施溝通與表達訓練，並授權在容許之範圍內盡量滿足病患之需求，且盡可能對病患說一些安慰或鼓勵的話，勿公開談論病患之病情、社經地位及個人特質，印製較詳細之疾病相關衛教知識並由護理師詳加解釋，務必讓病患及照顧者能完全了解，藉此加強病患與護理師之良好關係。

Background and Objective: If inpatients get the help and care of nurses, they may feel comfortable. When inpatients get better, nurses could be satisfied with the outcome of their efforts. This shows a good nurse-patient relationship. Therefore, the objective of this study is to explore the viewpoints about the nurse-patient relationship of inpatients and nurses and the gaps between them. Methods: We collected some relevant literatures to form a questionnaire on the nursepatient relationship. The subjects of this study were inpatients and nurses in the hospital ward. The questionnaire was issued to the subjects and completed by 147 inpatients and 109 nurses. The data were analyzed by statistical software. Statistical methods included reliability and validity, descriptive statistics, Mann-Whitney U test, Importance-Performance Analysis (IPA), etc. Results: The viewpoints of inpatients on the nursing-patient relationship are quite consistent with ward nurses. The highest four and lowest five items, according to average of agreement, of inpatients are the same as nurses. All the items averages of inpatients were higher than 3.2 (out of 4 points), it showed that inpatients highly appreciated the performances of nurses. The gap analysis of responses revealed that nurses consider themselves quite respect inpatients, protect their privacy, and often say to inpatients some comforting or inspiring words; however, the agreements of inpatients for these three items are lower than average of all items. Conclusion and Suggestions: The lowest three items are implicit, so it is hard for inpatients to be aware of. We suggest that nurses should attend the trainings of communication and expression, and met the inpatients’ need, with authorization and within an allowable range, as possible as they could. We also suggest that nurses should say to inpatients some comforting or inspiring words, and do not talk publicly about the condition, socio-economic status, and personal traits of the inpatients. Hospital should give inpatients the leaflets with more detailed knowledge of the disease and health care, explained by nurses to let inpatients and caregivers understand fully. All above suggestions might improve the nursing-patient relationship.