人性化照護的感通

Correspondence in Humanistic Care

蔣欣欣(Hsien-Hsien Chiang) ； 廖珍娟(Jen-Jiuan Liaw)

《護理雜誌》 64卷5期 (2017/10) Pp. 50-58

https://doi.org/10.6224/JN.000068

摘要

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。

關鍵字

感通 ； 護理倫理 ； 主題分析 ； 人性化照護 ； 互為主體性

並列摘要

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.

並列關鍵字

correspondence ； nursing ethics ； thematic analysis ； humanistic care ； intersubjectivity

參考文獻

陳　特（1996）．心性與天道—唐君毅先生的體會與闡釋．鵝湖學誌，17，75–98。[Chen, T. (1996). Mind, human nature and way of heaven-The reinterpretation of Prof. Tang Chun-I. Legein Society, 17, 75–98.]

黃文宏（2013）．論西田幾多郎中期「絕對無」的意義― 以〈睿智的世界〉為線索．臺大文史哲學報，78，117–142。[Huang, W. H. (2013). On the meaning of “absolute nothingness” in middle Nishida's philosophy: Placing focus on his “the intelligible world”. Humanitas Taiwanica, 78, 117–142.] doi:10.6258/bcla.2013.78.04

黃文宏（2011）．論日本現代哲學中的「感性論」傾向—以中村雄二郎的「共通感覺」為例．臺大文史哲學報，75，217–241。[Huang, W. H. (2011). On the aesthetical inclination in contemporary Japanese philosophy: An explication according to Nakamura's theory of common sense. Humanitas Taiwanica, 75, 217–241.] doi:10.6258/bcla.2011.75.07

黃冠閔（2011）．唐君毅的境界感通論：一個場所論的線索．清華學報，41（2），335–373。[Huang, K. M. (2011). Tang Chun-I on affective communion and spiritual realm: A guiding clue for topology. Tsing Hua Journal of Chinese Studies, 41(2), 335–373.] doi:10.6503/THJCS.2011.41(2).04

蔣欣欣（2016）．照護行動的立場—護理倫理課堂之對話．護理雜誌，63（6），69–76。[Chiang, H. H. (2016). The positionality of caring action: Small group dialogue in a course on nursing ethics. The Journal of Nursing, 63(6), 69–76.] doi:10.6224/JN.63.6.69