毕业论文护士的言行与护患之间的有效沟通研究

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1、湖北省高等教育自学考试毕业论文护士的言行与护患之间的有效沟通主考学校: 武汉大学 专 业: 护理学 指导教师： 考生姓名： 准考证号： 工作单位： 仙桃职业学院 2013年 9月10日 目 录摘 要:1关键词1引 言21、护士的言行分两种311语言行为312非语言行为：32、在临床工作中常常会遇到以下不良的语言方式43、应该发扬及推广的良好的语言形式：54、不良的非语言行为65、阻碍有效沟通的几种表现形式：66、怎样做到护患有效沟通：7致 谢8参考文献9护士的言行与护患之间的有效沟通摘 要:在与患者及家属的交谈中了解，有的护士深受患者及家属的喜爱，而有的却使病人很反感，从患者的言语中了解主要原

2、因，总结改善护士言行的方法，促进有效沟通，提高护理质量，方法阅读大量相关资料，联系护理实践，吸取先进经验，结果护患有效沟通与护士的语言、行为及态度有关，结论护士应将过硬的专业知识；富有责任感的行为；伴有爱心、同情心、耐心的语言相结合才能取得患者的喜爱和信任。 关键词:护士言行；护患关系；有效沟通 Abstract: In conversation with patients and their families learn about, and some nurses by patients and their families love, while others are disgusted

3、 with the patient while filling, the words of understanding from the patients main reason to sum up the words and deeds of the methods to improve the nurse to promote effective communication, improve quality of care, methods to read a lot of relevant information, contact nursing practice, to learn a

4、dvanced experience, the result of effective communication with patients and nurses Nurse language, behavior and attitudes, conclusions should be excellent professional knowledge of nurses; strong sense of responsibility act; with caring, compassion, patience can be achieved combining the language of

5、 love and trust of patients. Key words: Nurse words and deeds; nurse-patient relationship; effective communication 朗读显示对应的拉丁字符的拼音引 言 当今社会，人们的生活水平不断提高，生活质量也随着提高，不仅仅局限吃饱穿暖的层次上，心理也需要得到满足，对于患者来说，身体上的疾病已经引起心里的不适，护理人员的首要任务就是通过关心、帮助，用爱心来满足其心理需要，弥补身体不适的缺陷，做到有效沟通提高护理质量 。在交往过程中，语言沟通扮演着主角，善于运用语言性沟通技巧也越来越重要，护士的

6、言行起着重要的作用，它可以对病人的疾病进行辅助治疗，同时也可以加快疾病的恶化，护士应该用真诚的态度，关心，帮助病人，选择恰当的语言来鼓励、安慰病人，让其树立战胜病魔的信心，积极配合医务人员，促进身体康复，当然，不恰当的语言会对病人造成负面影响，使其丧失对护理人员的信心，放弃治疗，拒绝合作，加重病情，有的甚至发生医疗纠纷。1、护士的言行分两种11语言行为护士口头和书面语言的基本要求，语言的规范性、情感性、保密性；符合礼仪要求的日常护理用语；护理操作中的解释用语。1.1.1规范性：护士的言行要严谨、高尚，说话要清晰、温和、简洁通俗易懂、不要含糊其词，以免病人误解。 1.1.2情感性：夹杂着情感的语

7、言才是真实的、动人的，要有同情心、爱心，要用真诚的心去关心、爱护 、帮助病人，让其感受到护理人员的亲切、温暖。 1.1.3保密性：要尊重和保护病人的隐私，不得嘲笑生理缺陷、性病、精神病患者，要一视同仁，让病人对医务人员产生信赖的心理，根据病人的具体情况，选择恰当的沟通方式（对内向的病人要选择委婉，含蓄的表达方式，对外向积极客观的病人可以直言，并予以鼓励），促进沟通，了解病情，有助于医生的诊断治疗，加快疾病的康复。 12非语言行为：倾听、面部表情、专业皮肤接触、沉默、人际距离等。【1】121倾听：在倾听患者的诉说时，要专心致志、集中精力、交谈时要注意眼神的交流，对倾听到的信息，要及时的通过一些举

8、动反馈给病人，如点头、微笑，也可以在适当的时候说一下自己的见解，鼓励病人继续诉说，同时要把病人往积极向上的思路上引导。 122面部表情：职业性微笑不光是要求服务员，护士也应当具备，没有哪个正常人喜欢一个苦瓜脸，更何况是病人，真诚、亲切的微笑是最具感染性的，病人可以通过护士的微笑感觉到被关注、关心、理解，它是一种精神上的慰藉，有时胜过良药。 123专业行皮肤接触：皮肤接触可以缓解病人的紧张心理，它与心理状态有着密切的关系，在接触时，病人会感到很放松，像家人般关心、呵护，抚摸、怀抱、爱抚对婴儿、儿童、成人的身心健康起着重要作用。皮肤接触还能治疗和预防婴儿的一些疾病。这就它的意义和作用。 124沉默

9、：在看到病人痛苦的表情时，却又无能为力时，静静的看着，默默的守着，也可以表达对病人的同情、理解和尊重。他们也能感受到有人想帮助自己，也会感到欣慰。125人际距离：即人与人之间在空间上所要保持的远近。不同的距离会有不同的感觉，分为亲密区00.46m、熟人区0.461.2m、社交区1.23.6m、 演讲区3.6m。【2】（1）亲密区，是与和自己有亲密关系的人所要保持的距离，如家人，好朋友等。（2）熟人区，如老师，同学等。（3）社交区.如公司的客户等。（4）演讲区，如演讲者与听众，老师讲课时与听课的学生的距离。如果两个陌生人保持在亲密区的范围内，会感到压抑，尤其是异性，也许会理解成对自己的不尊重，如

10、果有亲密关系的两个人保持在社交区甚至演讲区的距离，会感到对方在疏远自己，关系也会随着疏远。 2、在临床工作中常常会遇到以下不良的语言方式（1）下令式：在执行一些操作时，用很僵硬的话，就像上级命令下属一样，如“你今天必须把这药吃了，别说那么多”，“这种治疗你必须做，你不想做就不做了？”不允许病人有任何反对情绪。（2）模糊式：病人经常问护士自己的病情，因为病人太多，护士不可能把每个病人的病情都清楚的了解，掌握，回答时总是吞吞吐吐的过答非所问，如“这个我也不清楚，你去问医生”，这样的话会让病人怀疑治疗的目的或效果，内向的病人还会认为这样的操作是不是在隐藏着其他动机等，会让病人对医务人员的能力产生怀疑

11、，加重病人的心里负担。（3）批评式：在病人不按护士表达的意思去配合时，有的护士便会说“你怎么能这样呢！”，“你为什么不好好配合我”等，会让病人产生逆反心理，如果下次那位护士给他做治疗是，他甚至拒绝治疗。 （4）嘲讽式：护士不得歧视学历低（文盲）、地位低、农民工等，以免伤害病人自尊心。（5）不保守秘密式：在与有特殊疾病（性病、精神病）的病人或家属交谈时，应当避开人多的地方或声音放低一些，注意保护病人隐私，以免影响病人的情绪，对病人有负面影响，信心的家属会把责任推给护理人员，引起不必要的纠纷。（6）麻木式：由于护士在医院接触的病人多了，很多让人心疼的场面都见识过，对一些病人的病情也不是很关心，总是

12、一副不在乎，不负责任的态度，表情冷漠，爱理不理，做操作时也省去很多做思想工作的程序，让病人一头雾水，病人也会更加紧张，不利于治疗。（7）不耐烦式：在病人多次询问自己病情时，一些护士会很不耐烦，甚至大声吼病人，这是有损护士形象的行为，同时让病人很不高兴，有的甚至会加重病情。3、应该发扬及推广的良好的语言形式：（1）主动问候式：要用亲切的问候语做开场白，主动问候病人，向病人介绍不熟悉的环境或其有疑惑的问题。（2）热情解说式：在病人及家属询问时，护士应满腔热情的，详细的解释说明，满足其学习的欲望和对疾病治疗的知情权。（3）耐心劝慰式：对心理负担大的（绝症）病人，要密切观察其一举一动，对异常行为应及时

13、的进行分析，劝导，安慰病人，找出其症结所在，向病人介绍医学的发展动向，鼓励其树立战胜病魔的信心，使其情绪稳定，积极配合治疗。（4）准确陈述式：在向病人陈述其诊断、检查、治疗、护理、预后时，应用准确的语言，不能夸大其词，也不能模棱两可，要做出合理的说明动员病人，使病人主动接受治疗。（5）巧妙说服式：在病人发脾气、拒绝治疗、不吃饭等，故意加重病情的行为时，护士应运用巧妙的、具有很强说服力的语言阻止病人的这些不良行为。 4、不良的非语言行为动作粗鲁：在操作时，动作太大，会使病人对治疗产生恐惧心理，甚至认为护士不尊重自己，产生逆反心理。面无表情：在给病人做操作前的解释说明时，面无表情，像是在背书一样，

14、做完护理就离开，不做任何其他解释，会使病人反感，内向的病人以为护士看不起自己，钻牛角尖，甚至会发生医疗纠纷。交谈时不专心：在与病人交谈时，姿势不雅，左右瞻望，表现出不耐烦，也会使患者产生不被尊重的心理有效沟通能使医护人员准确及时的了解病人病情的发展，能合理有效的采取治疗措施，采用准确的治疗方法，促进疾病的康复，也能及时让病人了解对自己的诊断、治疗及相关护理措施。积极配合，增强治疗效果，提高护理质量，有效沟通70%态度+30%行为，态度决定事情的成败，也左右着行为，所以也要意识到态度的重要性。 5、阻碍有效沟通的几种表现形式：（1）护患交流较少。病人一入院，首先就是和护士打交道，他们对自己的责任

15、医生、护士的业务水平，能力，自己的一些诊断、检查、治疗、预后都一无所知，迫切希望通过和护士交流来解除心中疑虑，这时候护士应针对他们的心里特点，合理有顺序的解释说明，让病人在最短时间内熟悉所处的环境，这样才能放下心里的包袱接受治疗。（2）不能准确掌握语言的表达方式。不能利用通俗易懂的语言与患者进行沟通，在沟通时，过多的使用专业术语或用词不恰当，使病人一头雾水或误解，影响相互之间的理解，信任。不利于有效沟通。（3）做事不稳重，动作不熟练。在给病人做治疗时，动作生疏，或不能流利的回答病人提出的各种各样的问题，含糊其词，会引起患者及家属的不信任，反感，产生不满，甚至投诉。（4）语言不当，解释不到位。在

16、与病人或家属接触时，应注意自己的语言表达方式，不要让病人误解，产生不良情绪，甚至发生医疗纠纷。6、怎样做到护患有效沟通：（一）加强护士自身的道德修养、业务水平、操作技能，增进患者的信赖感。1)首先从仪表抓起，要根据对心理学和美学的分析，来指导护士的穿着打扮，改善护士仪表。2)要经常组织一些能增强操作技能的活动，如技能比武等，加强护士积极性主动。3)要通过多方面的考核来加强护理人员对护理知识的了解掌握。（二）要从心理学的角度，了解患者及家属的心理特点，提高服务质量，要学会通过其言行，来洞悉其心理活动，关心、帮助病人，为病人做实事，解决病人实际面临的问题。（三）为病人提供温馨舒适的就医环境，使患者

17、能够放心的没有任何顾虑的接受治疗，向病人进行健康教育，积极宣传医疗动向，让患者及家属及时准确的了解就医形式的发展动向，让其产生心理上的满足。 南丁格尔曾说过“护理是一门最精细的艺术”，艺术需要想象力，需要情感和创造力，所以，护士在与病人交往中的言、行、举止、姿态、眼神、表情、微笑乃至片刻的沉默，都必须注意技巧问题，护理人员应细心观察、用心体会患者每个眼神、动作，每句话所要表达的含义，巧妙的运用沟通技巧和患者进行有效沟通，达到高质量、高效率的医疗服务的目标。 致 谢三年前，这个校园是我的梦想。三年后，微笑回首来路，一幕幕，宛在昨天。人生就是如此吧，每个段落结束的时候，我们总会感慨时光飞逝。感谢我

18、的指导老师周涛老师，他严谨细致、一丝不苟的作风一直是我工作、学习中的榜样；他们循循善诱的教导和不拘一格的思路给予我无尽的启迪。 感谢周老师和曾帮助过我的老师和同学等对我的教育和帮助。他们细心指导我的学习与研究，在此，我要向诸位老师深深地鞠上一躬。 在论文即将完成之际，我的心情无法平静，从开始进入课题到论文的顺利完成，有多少可敬的师姐、同学、朋友给了我无言的帮助，在这里请接受我诚挚的谢意！参考文献【1】冯敏 陈敏 护理学 北京：人民卫生出版社，2009.11 .6-7【2】陈敏 护理学 北京：人民卫生出版社，2009.11 . 7a您好，为你提供优秀的毕业论文参考资料，请您删除以下内容，O(_)

19、O谢谢！AnationalsurveywasrecentlylaunchedtoevaluatetheeyehealthofChinesechildrenandteenagers.OnJune6,ChinasannualNationalDayforEyeCare,theChinaYouthDevelopmentServiceCenterandZhejiangMedicine,aleadinglistedChinesepharmaceuticalcompany,jointlyannouncedthekickoffofthesurvey.Inaboutonemonth,aquestionnaire

20、compiledbytopeyecaremedicalexpertsinChinawillbedistributedthroughmultipleonlinepartners,includingH,aswellasthroughofflinesurveyeventsheldinuniversities,middleschoolsandprimaryschoolsacrossthecountry.Areportwillbereleasedbasedonthesurveystatisticsandanalysis,andmostimportantly,guidelinesforparentsand

21、youthonhowtocarefortheeyesandpreventmyopiaagrowingprobleminChinasdigitizedsociety,willalsobeattachedonthereport.Myopiaisnotonlyadiseasethatmakespeopleseethingsblurrily,butalsoleadstoseverecomplications,suchasglaucoma(increasedpressurewithintheeyeball),andcancauseblindness,saidZhouYuehua,anestablishe

22、deyecarespecialistwithBeijingTongrenHospital.Itisveryimportantforparentsandchildrentoknowabouttheriskandcarefortheireyes.Thereareabout450millionmyopiapatientsinChina.AmongChinesemyopiapatients,30millionareseverepatients,accordingtoZhouTheprevalenceofmyopiaamonghighschoolandcollegestudentsismorethan7

23、0percent,andthesituationiscontinuouslyworsening,headded.SunZhu,directorwiththeChinaYouthDevelopmentServiceCenter,saidlonghoursofstudy,lackofexercise,especiallyoutdooractivities,andattachmenttoelectronicscreenaresomeofthetopreasonsbehindthewidespreadmyopiaproblems,andtheincreaseofyoungerpatients,alth

24、oughChinahasmadegreatprogressinimprovingthehardwarefacilitiesandlightingconditionsinschools.Hesaidhehopesthesurveywillalertpeopleonthethreateningsituation,andalsohelpmedicalexpertstobetterguidelineparentsandchildrensbehaviorstocareforeyes,basedonthetimelyandfactualstatisticsthesurveycollected.Aserie

25、soffollow-upeventswillalsobeheldinsixcities,includingJinaninShandongprovince,andChangshainHunanprovince,toeducatepeopleonhowtocareforeyesafterthesurveystarted. More and more Chinese are jogging to get and stay fit. Most joggers will run alone, but some will jog with friends or even coaches. The Beij

26、ing Olympic Forest Park is one of the most popular spots. It is packed with runners in the afternoon, usually after work, and at weekends. Jogging after a whole days work can be a way to unwind. It is true for He Wenjun, whose workplace is right near the forest park. She discovered her athletic apti

27、tude at the age of seven, when she began playing tennis. Then she turned to jogging, and she has persevered with it for 10 years. I come to jog almost every day after work, whenever I have time. I think jogging is good for my health. And for me, a girl, it helps me to achieve to eternal goal, to kee

28、p slim, He said. He says she prefers jogging alone, so she can focus better. She loves jogging, even during Beijings smoggy days. If the smog is severe, Ill hold off jogging for a while. But if I really want to get away from work, Ill wear a mask, or just ignore the smog and go on jogging, she said.

29、 For those who are not so athletic, jogging also has its attractions. Wu Houbin started roughly two years ago, when he was severely obese. Within two months, his weight dropped from 82 kilograms to 64 kilograms. The success helped him recover health, and he has made friends. Jogging does not require

30、 speed, but stamina. If you want to stick to the game, you need to take it as a mission, a habit, and then eventually a hobby, Wu said. But persevering with jogging is not always easy. Jogging is beneficial for heart-lung function, and the skeletal system, but doctors say improper technique damages

31、the joints, especially the knees and ankles. Excessive jogging wears down the body, and harms ones health. Poor technique harms the muscles and skeleton, and can cause secondary injures. And, jogging in a bad environment can cause circulation problems, said Lu Zhiyong, attending doctor, Sports Hospi

32、tal, General Admin. of Sports.Dr. Lu has some tips for joggers, and those who are thinking of taking it up.He says people should first evaluate their physical condition, to decide the amount and type of exercise, and jogging in the open air is better running on a treadmill. Conrad Macao will run spe

33、cial programs for the entire month of October this year to support the Hong Kong Cancer Funds Pink Revolution, an annual campaign that seeks to raise awareness and funds for breast cancer research, the hotel recently announced. A major sponsor of the campaign for three years in a row, Conrad Macao h

34、as pledged to donate a portion of its proceeds to the fund, including those collected from selling its popular bear and rubber duck merchandise, in limited pink editions. Pink is the theme for floral arrangements and decorations in the hotel in October. In addition, on Fridays that month, members of

35、 the management and staff will add something pink to their uniforms, regular e-mails and handwritten guest cards. Breast cancer is the most prevalent type of cancer among women in Hong Kong and is also of significant concern in Macao and around the world, regardless of age, general manager Bede Barr

36、y said in a statement. The hotel has enlisted the support of a number of international and local celebrities to help drive the cause, including South Korean actor Jung Suk Won. This year, a lucky guest who stays at the hotel during the campaign and also donates money for the cause will win a necklac

37、e specially designed by Arte Madrid, a Spanish jewelry brand. Women should strive to balance quality of work and life, and have children at a young age. As a doctor I see much suffering because of this imbalance. Xiao Ying, 36, works for a large law firm. Her job means lots of travel, a heavy caselo

38、ad and a large number of meetings, so her schedule is hectic. She has been pregnant twice, but had abortions on both occasions because she felt her busy, high-pressure career wasnt conducive to raising a child. She planned to have children once she had achieved career success so she could provide a

39、stable environment for her baby. After 10 years, Xiao felt the time was right, and she tried to conceive for about six months, but was unable to become pregnant. I conducted comprehensive physical checkups. The results suggested that Xiaos ovarian function has declined and a bilateral oviduct blocka

40、ge has occurred, meaning that in vitro fertilization is her only option. So, after reducing her workload, Xiao underwent IVF treatment. Luckily, she got pregnant after just one treatment cycle, but later experienced vaginal bleeding, and rushed to the hospital. I told her to rest and carry on with t

41、he treatment (to prevent a miscarriage). As Zubin Zarthoshtimanesh, a yoga guru, demonstrated postures at a high school stadium in Dujiangyan city, Sichuan province, some 200 students sat on colorful mats watching him closely. It was part of the first India-China international yoga festival in the p

42、rovincial capital, Chengdu, in Southwest China, where more than 1,000 fans from home and abroad gathered for lessons from 20 leading practitioners of the ancient Indian regimen, from June 17-21. Yoga is to India what perhaps tai chi is to China. Many countries other than India and China, also held t

43、he first World Yoga Day on June 21, after the United Nations last year agreed to Indian Prime Minister Narendra Modis suggestion that a special day be marked in the year for the global practice of the stress-busting regimen, which is already a multibillion dollar industry in the United States. Modi

44、said in the speech: Yoga is an invaluable gift of Indias ancient tradition. . It is not about exercise but to discover the sense of oneness with yourself, the world and nature.Zarthoshtimanesh, who runs his own yoga center, Iyengar Yogabhyasa, in the Indian financial capital of Mumbai, says: Chinese

45、 students are very respectful. For me, all students are the same no matter what their race is and where they come from. The most important thing is to remove mental walls. Zarthoshtimanesh learned yoga from the late Yogacharya Iyengar and traveled with the master to different countries. Consulate Ge

46、neral of India in southern Chinas Guangzhou city organized the Chengdu festival. A terrifying wooden bridge in China has just been replaced by a glass one. This, the worlds longest glass-bottomed walkway, is located in Shiniuzhai Geopark in Hunan, and spans 300m (984f) and is 180m (590f) above groun

47、d. The floor is made of double-layered glass that is 24mm (0.94in), and is reportedly 25 times stronger than regular window glass. The bridge had previously been made of wood, linking the two peaks of Stone Buddha Mountain, but 11 engineers working 12 hours a day converted it to glass. Previously, y

48、ou were considered brave if you steeled yourself to cross the wooden walkway; now, with its glass bottom, the bridge is already being referred to as “hero bridge.” The popular chains longtime executive chef embraces mapo tofu and other exotic elements for the burger-driven menu, Liu Zhihua reports.A

49、t the age of 37, Shanghai native Lin Zhengu has become a star as a Western cuisine chef in the Chinese metropolis, a city that has a wealth of Western restaurants. The executive chef of Blue Frog Bar and Grill, a popular burger-based restaurant and bar chain on the Chinese mainland, Lin is the soul

50、of the restaurant franchises team of more than 550 chefs. Many of the franchises most popular dishes are his brainchild. Lin says his secret of success is innovation rooted in experience: He spends months every year traveling and eating worldwide, seeking new ingredients and inspirations that could

51、improve the offerings of Blue Frog restaurants. The restaurant chain regularly launches a new seasonal menu, usually featuring eight new dishes with fresh ingredients. The best-selling seasonal dishes later replace the least popular items on the regular menu, which is usually updated in late fall an

52、d boasts a selection of about 40 dishes. Food should have no boundaries, Lin says. As long as the food tastes good and is healthy, it doesnt really matter where it originates or how it is cooked. Lin likes to give the American-style restaurants menu some culinary touches from other countries, such a

53、s China and Mexico, and customers love such innovation, he says. He started his career as an apprentice in a Chinese kitchen in 1993. By chance he learned from a French chef in 1994, and soon became enamored with the world of Western food. During the next couple of years, he received strict training

54、 in Western culinary art from French, Chinese and German chefs. That was rare for a Chinese chef in the 1990s, he saysand so was being a Chinese chef who spoke fluent English. When an American entrepreneur invited him to join in his startup Blue Frog in 2000, Lin didnt hesitate to resign from a five

55、-star hotel to work in the new restaurant with just five chefs, eager to explore the excitement of a life that had yet to unfold. Since that Shanghai launch, Blue Frog has opened 24 branches in seven cities across China, including Beijing, Tianjin, Chongqing and Nanjing in Jiangsu province. The new

56、menu for this fall, which was launched in early September, showcases how flavors of East and West meet to create a variety of delicious burgers and other entrees in the cozy, soft-lit restaurants. I liked the mapo burger best. Just imagine the flavorful combination of the hot, mildly numb-spicy mapo tofu sauce and grilled 100-percent Australian beef patty, along with a slice of cheddar cheese and a side of french fries. The savory sauce helped highlight the pattys juicy, tender texture and its delicious beef flavor. Matching that Sichuan flavor with cheese created a new taste experience.12