Nurses' Experience of Attending to Patients' Narratives : Participant Observation in a Psychiatric Ward

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  • 精神科病棟における患者の語りを聴く看護師の体験 : 病棟における参加観察から
  • セイシンカ ビョウトウ ニ オケル カンジャ ノ カタリ オ キク カンゴシ ノ タイケン : ビョウトウ ニ オケル サンカ カンサツ カラ

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Abstract

Objective: Through fieldwork conducted in a psychiatric ward, this study aimed to clarify aspects of the interactions between a nurse and a patient from the nurses' experience, and examine the therapeutic meanings and difficulties in the nurse-patient relationship, within the context of inpatient psychiatric treatment. Methods: Practical research using participant observation. Participant observation was conducted once a week for a period of 22 months in a single ward (subacute phase psychiatry), a total of 84 times, recording and analyzing interactions with six patients. Results and Discussion: Compared to other occupational categories in the medical setting, nurses interacted with patients in less distinct parameters of time, place, and content, and the patients' narratives included not only words but body contact as well. It was found that intersubjective contact clearly plays an important role in nurses' efforts to understand the chaotic narratives of patients fragmented by delusional thinking or auditory hallucination. The experience, however, aggravated feelings of anxiety in the nurses, leading at times to the routinization of interaction as a defense.

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