護病關係中的情感轉移－攝護腺癌個案為例

Transference in the Nurse-Patient Relationship: A Case Report on a Prostate Cancer Patient

王敏家(Min-Chia Wan) ； 黃文聰(Wen-Tsung Huang) ； 張書展(Shu-Chan Chang)

《護理雜誌》 62卷4期 (2015/08) Pp. 95-102

https://doi.org/10.6224/JN.62.4.95

摘要

在人際關係中情感轉移是不可避免的，而護病關係中護理人員與個案依據個人過去情感經驗及心理需求產生反應，因此，護理人員情緒及行為反應將影響個案回饋，在與個案會談過程中應以中立不批判的態度，試著感受及暸解個案想法。個案管理模式為癌症個案提供一諮詢平台，促進改善個案生活品質，醫療團隊鼓勵個案管理師以專業、穩重、嚴謹的態度與個案一同討論性、愛與歸屬感等基礎需求議題，然而，若個案未能從自身環境得到情感滿足時，而對護理師產生情感轉移，即使是專業醫護人員往往也難以招架。故本文提及此議題在醫護關係的重要性，以個案案例分享經歷，協助同仁暸解過程及改善醫病互動以提昇醫療護理品質。

關鍵字

攝護腺癌 ； 個案管理 ； 情感轉移 ； 同理心

並列摘要

This article explores the dilemma posed with regard to a prostate cancer patient suffering from transference syndrome. Transference is generally recognized as an unconscious and inevitable part of relationships. Both nurse and patient ＂transfer＂ their past emotional and psychological needs into present situations and react accordingly. Consequently, the emotions and behaviors of nurses influence the reactions of their patients. Nurses must better understand their contributions to the nurse-patient relationship in order to better detect patient thoughts and feelings. Furthermore, nurses must recognize the needs of their patients and maintain a neutral and uncritical attitude. We developed a case management model to provide a consultation corner for cancer patients. Additionally, in an attempt to improve the quality of life of cancer patients, the developed model encouraged medical personnel to discuss sexual, belonging, and love problems with patients and to hold attitudes of professionalism, composure, caring, and solemnity. Belonging and love are basic human needs. However, for patients with prostate cancer, this basic need cannot be satisfied. Even professionally trained medical personnel have difficulty directly addressing this problem. This paper describes the meaning of transference and the importance of this concept in the therapeutic nurse-patient relationship. Finally, developing better insights into the nurse-patient relationship will help nurses use these insights to improve the quality of patient interactions and of care.

並列關鍵字

prostate cancer ； case management ； transference ； empathy

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