什么是人际关系和人际沟通.ppt

1,Chapter6RoleRelationshipPatterns,2,whatkindsofoutlinearethemostimportantinthechapter?,RoleRelationshipPatterns,3,BasicConceptsDefinitionsRelatedTermsPersonalInterpretationsofRoleSocietalInterpretationsRoleEffectsofAlterationinRolePerformanceonOthers,OUTLINE,p.108,RoleRelationshipPatterns,4,ApplicationsProfessionalNurseRoleTypesofProfessionalRolesRoleSocializationRoleStressSelf-awarenessintheProfessionalRole,OUTLINE,p.108,RoleRelationshipPatterns,5,ClientRolePatientsBillofRightsRolePerformanceasaNursingDiagnosisSupportiveInterventionsDevelopingNewSolutionsSummary,OUTLINE,p.108,RoleRelationshipPatterns,6,Whataretheobjectivesoflearningorstudyinginourlesson?,RoleRelationshipPatterns,7,Attheendofthechapter,thestudentwillbeableto1.Defineroleandroleperformance2.Describethefourcomponentsofprofessionalrolesocialization3.Discusstheprofessionalrolesofthenurse4.Discussthecharacteristicsofthesickrole,Objectives,p.108,RoleRelationshipPatterns,8,RoleRelationshipPatterns,ObjectiveOne:Defineroleandroleperformance,9,Whatisrole?,Aroleisdefinedasasetofexpectedbehavioralstandardsestablishedbythesocietyorcommunitytowhichapersonbelongs(Creasia,1991).,Definitions,p.109-110,RoleRelationshipPatterns,10,Whatisrolerelationship?,Rolerelationshipsinfluencecommunicationcontentandprocess.Consideryourownrole”asanursingstudentandhowitinfluencescommunicationcontentandprocess.,Definitions,p.109-110,RoleRelationshipPatterns,11,什么是人际关系和人际沟通？,人际关系人际关系是人们通过交流与相互作用而形成的比较稳定的心理关系，反映着个体或群体满足其社会需要的心理状态，其发展变化取决于双方社会需要的满足程度。人际关系外延很广，包括朋友关系、夫妻关系、师生关系、同学关系、同事关系等。内涵是个体之间的心理上的关系，表现为亲近或疏远、敌对或友好等心理上的距离。,p.310,RoleRelationshipPatterns,12,什么是人际关系和人际沟通？,人际沟通人际沟通是指人际间的信息交流。可以是面对面的，也可以是非面对面的，可以是语言的，也可以是非语言的，旨在传达思想、交换意见、表达感情和需要等。它包括关系沟通与内容沟通，即每个沟通都包含着一定的内容和确定一定的关系。内容是指沟通中所传信息的实质含义，关系是指沟通各方在沟通中所处的地位和联系方式。,p.303p.310,RoleRelationshipPatterns,13,你能举例说明人际关系沟通和内容沟通之间的联系吗？,护士：“昨晚我给xx（患者）的药为什么没吃？,护患关系内容沟通效果,很熟悉成功一般有心理距离但可能成功紧张很难有效，患者家属可能说“我怎么知道？没吃药到底是谁的责任。”,RoleRelationshipPatterns,14,Whatisroleperformance?,Roleperformancereferstoapersonscapacitytofunctioninaccordwithsocialexpectationsofaparticularrole.Perceptionsofbehavioralstandardsforroleperformancedifferfrombasedoncultural,gender,institutional,andfamilyexpectations;Peoplestillexpectdifferentrolebehaviorsfrommenandwomendespitetremendousadvancesinequalopportunity.,Definitions,p.109-110,RoleRelationshipPatterns,15,Roletransitiondescribeschangesinroleexpectationsthatoccurasdevelopmentallifecrisesorwhenunexpectedlifeeventssuchasillnessorinjuryalterrolefunction.Forexample,newmotherexperiencesasignificantroletransitionwiththebirthofherfirstchild,asdoesayoungathletestruckdowninaballgamewithaspinalcordinjury.,Whatisroletransition?,Definitions,p.109-110,RoleRelationshipPatterns,16,Whatisposition?,Positionrepresentsastandardizeddescriptionofaroleandassociatedexpectationsthatmakesitunderstandabletoothersinthecommunityorgroup.Socialpositionrelatestothestatusandidentitythepersonholdsinthecommunity.Theconceptofpositionsometimesplaysaroleinhowhelpingprofessionalsrespondtoclients:theysometimestreatclientsinhighpositionsdifferentlythanthosewithnomoneyorlowsocialstatus.,Definitions,p.109-110,RoleRelationshipPatterns,17,Whereasitisimportantforthenursetorecognizedifferencesinpositionasrelevantfactorsinsupportingclientintegrityandself-esteem,nursesneedtoviewallclientsasveryimportantpersons,treatingthemallwiththesamerespectandgivingthemallqualitycareregardlessofposition.,Definitions,p.109-110,Whatisposition?,RoleRelationshipPatterns,18,RoleRelationshipPatterns,ObjectiveTwo:Describethefourcomponentsofprofessionalrolesocialization,19,Unlikeotherformsofeducation,thenursingstudentmustsimultaneously(同时地)adjusttolearningnewmaterialwhilestartingonthejobtraininginwhichthestakes(风险)arehigh.Cohenidentifiedfourgoalsofprofessionalsocialization(seeBox6-4).,Whichisthefourcomponentsofprofessionalrolesocialization?,ProfessionalNurseRole,p.114-115,RoleRelationshipPatterns,20,Box6-4.StepsintheSocializationProcessLearnthetechnologyoftheprofession:thefacts,skills,andtheory.Internalize(使内在化)theprofessionalcultureFindapersonallyandprofessionallyacceptableversionoftherole.Integratethisprofessionalroleintoalltheotherliferoles.,RoleRelationshipPatterns,21,Box6-4.StepsintheSocializationProcess学会专业技能：专业法规、技术和理论。与专业文化融为一体。找到就个人和职业而言都可接受的角色类型。把职业角色整合到所有其它生活角色中。,RoleRelationshipPatterns,22,ExerciseLookingatMyDevelopmentasaProfessionalNurse,Purpose:Tohelpyoufocusonyourself-developmentasaprofessionalnurse,RoleRelationshipPatterns,23,ExerciseLookingatMyDevelopmentasaProfessionalNurse,Procedure:Writethestoryofhowyouchosetobecomeanurseinaone-totwo-pageessay(maybedoneasahomeworkassignment).Therearenorightorwronganswers;thisissimplyyourstory.Youmayusethefollowingasguidesindevelopingyourstory.,RoleRelationshipPatterns,24,ExerciseLookingatMyDevelopmentasaProfessionalNurse,Procedure:Whatareyourreasonsforchoosingnursingasaprofession?Whatfactorsinfluencedyourdecision;people,circumstances,orsituations?Describeyourvisionofyourselfasanurse.Whatfearsdoyouhaveaboutyourabilitytofunctionasaprofessionalnurse?Howdoyouthinkbeinganursewillaffectyourpersonallife?,RoleRelationshipPatterns,25,Inwhatwaysisyourstorysimilartoordifferentfromthoseofyourclassmates?Asyouwroteyourstory,wereyousurprisedbyanyofthedataorfeelings?,RoleRelationshipPatterns,Discussion:,26,Studentscandiscusssomeoftherealisticdifficultiesencounteredasnursingstudentsbothprofessionallyandpersonallyandwaystohandlethem.Explorethroughdiscussionthefollowing:ThepracticesnursingstudentswillneedtofollowtoachievetheirvisionThetypesofsupportsnursesneedtofostertheirongoingprofessionaldevelopment,RoleRelationshipPatterns,Discussion:,27,RoleRelationshipPatterns,ObjectiveThree:Discusstheprofessionalrolesofthenurse,28,WhicharethereProfessionalNursingRoles,P.116,1.Caregiver:a.Providescompleteorpartialcompensatorycareforclientswhocannotprovidetheseself-carefunctionsforthemselvesb.Implementssupportive/educativeactionstopromoteoptimumhealthReinforcesthenatural,developmental,andhealingprocesseswithinapersontoenhancewell-being,comfort,function,andpersonalgrowth,ProfessionalNurseRole,RoleRelationshipPatterns,29,2.Teacher:a.Provideshealthteachingtoindividualclientsandfamiliesb.Developsandimplementspatienteducationprogramstopromote/maintainhealthfulpracticesandcompliancewithtreatmentrecommendationsc.Guidesindividualsintheirhumanjourneytowardwholenessandwell-beingthroughpsychoeducation,WhichareProfessionalNursingRoles,P.116,RoleRelationshipPatterns,30,3.Clientadvocate:a.Protectsclientsrighttoself-determinationb.Motivatesindividualsandfamiliestobecomeinformedactiveparticipantsintheirhealthcarec.MediatesbetweenclientandothersinthehealthcareenvironmentActsasclientsagentincoordinatingeffectivehealthcareservices,WhichareProfessionalNursingRoles,P.116,RoleRelationshipPatterns,31,4.Manager:a.Coordinatesstaffandproductivityb.DelegatesdifferentiatedtaskstoappropriatepersonnelFacilitatescommunicationwithinandamongdepartmentsServesoncommitteestoimproveandmaintainqualityofcaree.Makesdecisionsanddirectsrelevantchangestoensurequalitycare,WhichareProfessionalNursingRoles,P.116,RoleRelationshipPatterns,32,5.Evaluator:a.Setsqualityassurance/carestandardsReviewsrecordsandmonitorscompliancewithstandardsc.Makesrecommendationsforimprovement,WhichareProfessionalNursingRoles,P.116,RoleRelationshipPatterns,33,6.Researcher:Developsandimplementresearch/grantproposalstobroadenunderstandingofimportantissuesinclinicalpracticeandvalidatenursingtheoriesasabasisforeffectivenursingpractice,WhichareProfessionalNursingRoles,P.116,RoleRelationshipPatterns,34,7.Consultant:Providesspecializedknowledge/advicetoothersonhealthcareissuesb.Evaluatesprograms,curricula,andcomplexclinicaldatac.Servesasexpertwitnessinlegalcases,WhichareProfessionalNursingRoles,P.116,RoleRelationshipPatterns,35,8.CaseManager:a.Administerscareforacaseloadofclientsb.Coordinatescost-effectivecareoptionsMonitorsclientprogresstowardexpectedbehavioraloutcomesCollaborateswithotherprofessionalstoensurequalitycareacrosshealthcaresettings,WhichareProfessionalNursingRoles,P.116,RoleRelationshipPatterns,36,RoleRelationshipPatterns,ObjectiveFour:Discussthecharacteristicsofthesickrole,37,Fromtheclientperspective,lossoforchangesinnormalroles,rolerelationships,androleperformanceareimportantdimensions(尺度/元)oftheemotionalpainclientsexperienceinhealthcaresituations.Howwellpeopleareabletoperformtheirroleswithinthefamilyandsocietyinfluencestheirreputationwithinthecommunityandtheirsenseofself-esteem.Whenillnessorinjuryaffectsroleperformance,italsoimpactsrolerelationshipswithothersandself-esteem.,HowtounderstandClientrole,rolerelationships,performanceandtransition?,p.119,RoleRelationshipPatterns,38,Thenursemaybetheonlypersonwhohastheexpertiseandwillingnesstofacilitatediscussionsoftheimplicationsofrolechangesstemmingfrom(源于)alteredhealthstatusfortheclientinanobjective,compassionatemanner.,p.119,HowtounderstandClientrole,rolerelationships,performanceandtransition?,RoleRelationshipPatterns,39,Talkingaboutthemeaningofrolechangeisjustasimportantastalkingabouthowtochangeadressingorwhataphysicalsymptommeans.Lossofrole,changesinroleexpectationsandperformance,rolerelationshipsandroletransitionscanoccurasaresultofage,illness,lossofjoborsignificantperson,injury,andmentaldisorders,HowtounderstandClientrole,rolerelationships,performanceandtransition?,p.119,RoleRelationshipPatterns,40,Mostpeopledonotassumethesickrolevoluntarily.Illnessortrauma(外伤)canchangeanindividualssocialrolefromoneofindependentself-sufficiencytooneofvulnerability(脆弱性)andvaryingdegreesofdependencyonothers,apersonalrolefromoneofindependencetodependence.Whenclientsenterahealthcaresituation,theyencounteraninterpersonalenvironmentthatencouragesthedevelopmentoffeelingsofanonymity(无名)andhelplessness.,HowtounderstandClientrole,rolerelationships,performanceandtransition?,p.119,RoleRelationshipPatterns,41,Atthehospitaldoor,theclientforsakes(放弃)recognizedsocialrolesinthefamily,worksituation,andcommunity,temporarilyorpermanently.Regardlessofhowcompetentthepersonmaybeinotherliferoles,whenillnessstrikes(打击),questionsaboutroleperformanceinevitablyarise.Oftenclientsmustlearnnewrolebehaviorsthatareunfamiliarandunsettlingtopreviouslyheldself-concepts.,HowtounderstandthetransitionofClientrole,rolerelationships,androleperformance?,RoleRelationshipPatterns,p.119,42,Adjustmenttoachangeinhealthcarestatusrequiresawholenewsetofcopingskillswithoutnecessarilyhavingthesamesocialsupports.Clientsclearlyneedthesupportofthenursetoincorporatetherapidlychangingmeaningoftheenvironmentalandpersonalchangesencounteredinillnessintoanotherwisebasicallyhealthyself-concept.,HowtounderstandthetransitionofClientrole,rolerelationships,androleperformance?,RoleRelationshipPatterns,p.119,43,Differencesinperspectivesplayamajorpartindeterminingwhichillnessesanddisordersarerecognizedaslegitimate(合理的),therolesclientsassumeintheirhealthcare,andwhobecomestheculturallyassignedexpert(在.中当专家)inpromoting,maintaining,andrestoringhealth.Forexample,someculturesbelievethatillnessispunishmentfromGodoranimbalanceofenergythatinterfereswiththebodysfunctioning.Theseculturalunderstandingscanaffectrolerelationshipsinhealthcaresettings.,HowtounderstandthetransitionofClientrole,rolerelationships,androleperformance?,RoleRelationshipPatterns,p.119,44,ClientRole,Clientsareexpectedtoactasparticipating,cooperativeagentsintheirrecoveryprocess.However,anAsianclientmayappearasapassiverecipientofhealthcare,strikinglydependentonfamilyandhealthcaregiverforallguidanceandcare.Withoutaclearunderstandingofthisculturallyacceptableexpressionofthesickrole,thenursemayrespondinappropriately.,p.120,RoleRelationshipPatterns,45,WhatisaPatientsBillofRights?,p.121,1.Thepatienthastherighttoconsiderateandrespectfulcare.,ClientRole,RoleRelationshipPatterns,46,WhatisaPatientsBillofRights?,p.121,2.Thepatienthastherightto,andisencouragedtoobtainfromphysiciansandotherdirectcaregivers,relevant,current,andunderstandableinformationconcerningdiagnosis,treatment,andprognosis.Exceptinemergencieswhenthepatientlacksdecisionmakingcapacityandtheneedfortreatmentisurgent,thepatientisentitledtotheopportunitytodiscussandrequestinformationrelatedtothespecificproceduresandtreatments,risksinvolved,lengthofrecuperation,andmedicallyreasonablealternativesandtheiraccompanyingrisksandbenefits.,ClientRole,RoleRelationshipPatterns,47,WhatisaPatientsBillofRights?,ClientRole,3.Patientshavetherighttoknowtheidentityofphysicians,nurses,andothersinvolvedintheircare,aswellasthestatusofthecaregivers(e.g.,whenthoseinvolvedarestudents,residents,orothertrainees.).,p.121,RoleRelationshipPatterns,48,WhatisaPatientsBillofRights?,ClientRole,4.Thepatienthastherighttomakedecisionsabouttheplanofcarebeforeandduringthecourseoftreatment,torefusearecommendedtreatmentorplanofcaretotheextentpermittedbylawandhospitalpolicy,andtobeinformedofthemedicalconsequencesofthisaction.,p.121,RoleRelationshipPatterns,49,WhatisaPatientsBillofRights?,ClientRole,5.Thepatienthastherighttohaveanadvancedirective(suchaslivingwill,healthcareproxy,ordurablepowerofattorneyoverhealthcare)concerningtreatmentordesignatingasurrogatedecisionmakerwiththeexpectationthatthehealthcareinstitutionwillhonortheintentofthatdirectivetotheextentpermittedbylawandhospitalpolicy.Healthcareinstitutionsmustadvisepatientsoftheirrighttomakeinformedmedicalchoices.,p.121,RoleRelationshipPatterns,50,WhatisaPatientsBillofRights?,ClientRole,6.Thepatienthastherighttoeveryconsiderationofprivacy.Casediscussion,consultation,examination,andtreatmentshouldbeconductedsoastoprotectthepatientsprivacy.7.Thepatienthastherighttoexpectthatallcommunicationsandrecordspertainingtocarewillbetreatedasconfidentialbythehospital,exceptincasessuchassuspectedabuseandpublichealthhazards,whenreportingispermittedorrequiredbylaw.,p.121,RoleRelationshipPatterns,51,WhatisaPatientsBillofRights?,ClientRole,8.Thepatienthastherighttoreviewrecordspertainingtomedicalcareandtohavetheinformationexplainedorinterpretedasnecessary,exceptwhenrestrictedbylaw.9.Thepatienthastherighttoexpectthat,withinitscapacityandpolicies,ahospitalwillmakereasonableresponsetotherequestofapatientforappropriateandmedicallyindicatedcareandservices.Thehospitalmustprovideevaluation,service,andreferralasindicatedbytheurgencyofthecase.,p.121,RoleRelationshipPatterns,52,WhatisaPatientsBillofRights?,ClientRole,10.Thepatienthastherighttoaskandbeinformedoftheexistenceofbusinessrelationshipsamongthehospital,educationalinstitutions,andotherhealthcareprovidersorpayersthatmayinfluencethepatientstreatmentandcare.,p.121,RoleRelationshipPatterns,53,WhatisaPatientsBillofRights?,ClientRole,11.Thepatienthastherighttoconsentdeclinetoparticipateinproposedresearchstudiesorhumanexperimentationaffectingcareandtreatmentorrequiringdirectpatientsinvolvementandtohavethosestudiesfullyexplainedbeforeconsent.,p.121,RoleRelationshipPatterns,54,WhatisaPatientsBillofRights?,ClientRole,12.Thepatienthastherighttoexpectreasonablecontinuityofcarewhenappropriateandtobeinformedbyphysiciansandothercaregiversofavailableandrealisticpatientcareoptionswhenhospitalcareisnolongerappropriate.Thepatienthastherighttobeinformedofhospitalpoliciesandpracticesthatrelatetopatientcare,treatment,andresponsibilitiesandtobeinformedofavailableresourcesforresolvingconflicts.,p.121,RoleRelationshipPatterns,55,licensurelegalconfidentialityidentificationinformedconsentethicalcodeconsiderationinconsiderateimpulseappetitecapriceparameterssequenceassumedisciplineprescribeappropriatemutuallyperformance,Vocabulary,compensationsubstantialfindingcounselingsupervisiondelegationexecutionregimenregisterednurseaccountableresponsiblecompetencystatuteterritorymonitorprioritizecoordinatepersonnelboardmandate,representativeviolationrevisearticulatebenchmarkoncologicalgerontologicalpsychiatrictenetrelevancetortbenchmarkjudgenegligencebreachdocumentfalsifywithholdprivilegedcommunication,compromisemandatecommunicablestatutoryInadditiontoinanywayInformedConsentknowledgeable,56,57,BasicConceptsAmericanNursesAssociationsDefinitionofProfessionalNursingPracticeProfessionalLicensureNursePracticeActsProfessionalStandardsofCareLegalStandardsConfidentialityInformedConsentProtectingClientRights,OUTLINE,58,OUTLINE,EthicalCodeforNursesApplicationsNursingProcessNursingProcessandProfessionalRelationsAssessmentDiagnosisPlanningandOutcomeIdentificationImplementationEvaluationCriticalPathwaysSummary,59,OBJECTIVES,1.Defineprofessionalnursing2.Discusstheimplicationsofnursepracticeactsinthenurse-clientrelationship3.Identifyprofessionalstandardsofcare4.Discusslegalstandards5.Discussimplicationsofthecodeofethicswithinterpretivestatementsforthenurse-clientrelationship6.Describethenursingprocessasaframe-workforprofessionalnursingpracticeandthenurse-clientrelationship7.Discusscriticalpathwaysasamethodofcommunication,60,Ifamansactionsarenotguidedbythoughtfulconsiderations,thentheyareguidedbyinconsiderateimpulse,unbalancedappetite,capriceortheCircumstancesofthemoment.JohnDewey(1933),如果一个人的行为不被深思熟虑的思想所指导,那么他们就受轻帅的冲动，不平衡的欲望,反复无常或片刻的环境所左右。约翰Dewey(1933),61,ProfessionalLicensure,Theregisterednursesprofessionallicenseensuresthateachindividualnursehassuccessfullycompletednursingprogramrequirementsandcandemonstratetheknowledge,skills,andcompetenciestofunctionasahealthproviderofsafe,effectivenursingcare.Allpersonspracticingnursingarerequiredbylawtohaveacurrentlicenseinthestateinwhichtheypracticeandtoupdatetheirlicensureyearly.Thislicenserequiresan