人性化照護的感通

Correspondence in Humanistic Care

背景：人性化護理重視護病間的互為主體性，但缺乏對主體感知的探究。目的：找出以感通說明護病間互為主體的意義與其內涵。方法：採用van Manen主題分析法，根據小組課程對話內容，比較分析完成照護的案例，找出六個臨床護理範例，再繼續比較範例的性質，建構出感通的主題內容。結果：護病關係中的感通，依其源由、倫理、行動性，形成三項主題：（1）共在：不受制於先入為主的「順勢而為」，（2）共做：不設限於無可奈何的「循循善誘」，（3）共榮：不受限於他人眼光的「勇於實踐」。結論／實務應用：當護理人員面對難以照護的人或事時，嘗試著對反面者開朗的「共在」，由成己以成物的「共做」，可達到具體且充實存在的「共榮」，塑造更好的照護行動與自身。顯示具有共在、共做、共榮性的感通，能夠促成照護行動的創造性與豐富性。

Background: Intersubjectivity is a significant element of humanistic care. However, there is a lack of evidence related to the perceptions of nurses in clinical practice settings. Purpose: To explore the evidence of correspondence in clinical intersubjective caring activities. Methods: The van Manen’s thematic analysis approach was used to analyze the data, which was obtained from dialogues in small group learning settings. Six scenarios were identified to define the nature of correspondence in nursing care. Results: In terms of reason, ethical relation, and activity, the following three items of correspondence in humanistic care were identified: coexistence through reconciling relationships with the other, cooperation through bringing out （unfolding） and not through putting in （imposition）, co-transcendence from actions and reflections. Conclusion/Implication for Practice: By adopting openness in correspondence, nurses may promote coexistence through being open-minded to their opposite, promote cooperation with their opposite, and promote co-transcendence through pursuing authentic existence. The findings show that correspondence that is grounded in coexistence, cooperation, and co-transcendence promotes creativity and diversity in caring actions.