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1、什么是人际关系和人际沟通第1页，本讲稿共65页what kinds of outline are the most important in the chapter?RoleRelationshipPatterns2第2页，本讲稿共65页BasicConceptsDefinitionsRelatedTermsPersonalInterpretationsofRoleSocietalInterpretationsRoleEffectsofAlterationinRolePerformanceonOthersOUTLINEOUTLINEp.108RoleRelationshipPatterns3第
2、3页，本讲稿共65页ApplicationsProfessionalNurseRoleTypesofProfessionalRolesRoleSocializationRoleStressSelf-awarenessintheProfessionalRoleOUTLINEOUTLINEp.108RoleRelationshipPatterns4第4页，本讲稿共65页ClientRolePatientsBillofRightsRolePerformanceasaNursingDiagnosisSupportiveInterventionsDevelopingNewSolutionsSummary
3、OUTLINEOUTLINEp.108RoleRelationshipPatterns5第5页，本讲稿共65页What are the objectives of learning or studying in our lesson?RoleRelationshipPatterns6第6页，本讲稿共65页At the end of the chapter,the student will be able to 1.Defineroleandroleperformance2.Describethefourcomponentsofprofessionalrolesocialization3.Dis
4、cusstheprofessionalrolesofthenurse4.Discussthecharacteristicsofthesickrole ObjectivesObjectivesp.108RoleRelationshipPatterns7第7页，本讲稿共65页RoleRelationshipPatternsObjectiveOne:Defineroleandroleperformance8第8页，本讲稿共65页Whatisrole?Aroleisdefinedasasetofexpectedbehavioralstandardsestablishedbythesocietyorco
5、mmunitytowhichapersonbelongs(Creasia,1991).Definitionsp.109-110RoleRelationshipPatterns9第9页，本讲稿共65页Whatisrolerelationship?Rolerelationshipsinfluencecommunicationcontentandprocess.Consideryourownrole”asanursingstudentandhowitinfluencescommunicationcontentandprocess.Definitionsp.109-110RoleRelationshi
6、pPatterns10第10页，本讲稿共65页 什么是人际关系和人际沟通？什么是人际关系和人际沟通？人际关系人际关系人际关系是人们通过交流与相互作用而形成人际关系是人们通过交流与相互作用而形成的的比较稳定的心理关系比较稳定的心理关系，反映着个体或群体，反映着个体或群体满足其社会满足其社会需要的心理状态需要的心理状态，其发展变化取决于双方社会需要的，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、
7、是个体之间的心理上的关系，表现为亲近或疏远、敌对或友好等敌对或友好等心理上的距离心理上的距离。p.310 p.310 RoleRelationshipPatterns11第11页，本讲稿共65页 什么是人际关系和人际沟通？什么是人际关系和人际沟通？人际沟通人际沟通人际沟通是指人际间的人际沟通是指人际间的信息交流信息交流。可以是。可以是面对面的，也可以是非面对面的，可以是语言的，也可面对面的，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、表达感情和以是非语言的，旨在传达思想、交换意见、表达感情和需要等。需要等。它它包括关系沟通与内容沟通包括关系沟通与内容沟通，即每个
8、沟通都包含着一，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。的地位和联系方式。p.303 p.310RoleRelationshipPatterns12第12页，本讲稿共65页你能举例说明人际关系沟通和内容沟通之间的联系吗？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：护士：“昨晚我给昨晚我给xx xx（患者）的药为什么没吃？（患者）的药为什么没吃？护患关系护患关系 内容沟通效果内容沟通效果很熟悉很熟悉 成功成功一般一
9、般 有心理距离但可能成功有心理距离但可能成功紧张紧张 很难有效，很难有效，患者家属可能说患者家属可能说“我怎么知道？我怎么知道？没吃药到底是谁的责任。没吃药到底是谁的责任。”RoleRelationshipPatterns13第13页，本讲稿共65页Whatisroleperformance?Roleperformancereferstoapersonscapacitytofunctioninaccordwithsocialexpectationsofaparticularrole.Perceptionsofbehavioralstandardsforroleperformancediffer
10、frombasedoncultural,gender,institutional,andfamilyexpectations;Peoplestillexpectdifferentrolebehaviorsfrommenandwomendespitetremendousadvancesinequalopportunity.Definitionsp.109-110RoleRelationshipPatterns14第14页，本讲稿共65页Roletransitiondescribeschangesinroleexpectationsthatoccurasdevelopmentallifecrise
11、sorwhenunexpectedlifeeventssuchasillnessorinjuryalterrolefunction.Forexample,newmotherexperiencesasignificantroletransitionwiththebirthofherfirstchild,asdoesayoungathletestruckdowninaballgamewithaspinalcordinjury.Whatisroletransition?Definitionsp.109-110RoleRelationshipPatterns15第15页，本讲稿共65页Whatispo
12、sition?Positionrepresentsastandardizeddescriptionofaroleandassociatedexpectationsthatmakesitunderstandabletoothersinthecommunityorgroup.Socialpositionrelatestothestatusandidentitythepersonholdsinthecommunity.Theconceptofpositionsometimesplaysaroleinhowhelpingprofessionalsrespondtoclients:they someti
13、mes treat clients in high positions differently than those with no money or low social status.Definitionsp.109-110RoleRelationshipPatterns16第16页，本讲稿共65页Whereasitisimportantforthenursetorecognizedifferencesinpositionasrelevantfactorsinsupportingclientintegrityandself-esteem,nursesneedtoviewallclients
14、asveryimportantpersons,treatingthemallwiththesamerespectandgivingthemallqualitycareregardlessofposition.Definitionsp.109-110Whatisposition?RoleRelationshipPatterns17第17页，本讲稿共65页RoleRelationshipPatternsObjectiveTwo:Describethefourcomponentsofprofessionalrolesocialization18第18页，本讲稿共65页Unlikeotherforms
15、ofeducation,thenursingstudentmustsimultaneously(同时地)adjusttolearningnewmaterialwhilestartingonthejobtraininginwhichthestakes(风险)arehigh.Cohenidentifiedfourgoalsofprofessionalsocialization(seeBox6-4).Whichisthefourcomponentsofprofessionalrolesocialization?ProfessionalNurseRolep.114-115RoleRelationshi
16、pPatterns19第19页，本讲稿共65页Box6-4.StepsintheSocializationProcessLearnthetechnologyoftheprofession:thefacts,skills,andtheory.Internalize(使内在化)theprofessionalcultureFindapersonallyandprofessionallyacceptableversionoftherole.Integratethisprofessionalroleintoalltheotherliferoles.RoleRelationshipPatterns20第2
17、0页，本讲稿共65页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。RoleRelationshipPatterns21第21页，本讲稿共65页ExerciseLookingatMyDevelopmentasaProfessionalNursePurpose:Tohelpyoufocusonyourself-developmentasaprofessionalnurseRoleRelationshipPatterns22第22页，本讲稿共
18、65页ExerciseLookingatMyDevelopmentasaProfessionalNurseProcedure:Writethestoryofhowyouchosetobecomeanurseinaone-totwo-pageessay(maybedoneasahomeworkassignment).Therearenorightorwronganswers;thisissimplyyourstory.Youmayusethefollowingasguidesindevelopingyourstory.RoleRelationshipPatterns23第23页，本讲稿共65页E
19、xerciseLookingatMyDevelopmentasaProfessionalNurseProcedure:1.Whatareyourreasonsforchoosingnursingasaprofession?2.Whatfactorsinfluencedyourdecision;people,circumstances,orsituations?3.Describeyourvisionofyourselfasanurse.4.Whatfearsdoyouhaveaboutyourabilitytofunctionasaprofessionalnurse?5.Howdoyouthi
20、nkbeinganursewillaffectyourpersonallife?RoleRelationshipPatterns24第24页，本讲稿共65页1.Inwhatwaysisyourstorysimilartoordifferentfromthoseofyourclassmates?2.Asyouwroteyourstory,wereyousurprisedbyanyofthedataorfeelings?RoleRelationshipPatternsDiscussion:25第25页，本讲稿共65页Studentscandiscusssomeoftherealisticdiffi
21、cultiesencounteredasnursingstudentsbothprofessionallyandpersonallyandwaystohandlethem.Explorethroughdiscussionthefollowing:1.Thepracticesnursingstudentswillneedtofollowtoachievetheirvision2.ThetypesofsupportsnursesneedtofostertheirongoingprofessionaldevelopmentRoleRelationshipPatternsDiscussion:26第2
22、6页，本讲稿共65页RoleRelationshipPatternsObjectiveThree:Discusstheprofessionalrolesofthenurse27第27页，本讲稿共65页WhicharethereProfessionalNursingRolesP.1161.Caregiver:a.Providescompleteorpartialcompensatorycareforclientswhocannotprovidetheseself-carefunctionsforthemselvesb.Implementssupportive/educativeactionsto
23、promoteoptimumhealthc.Reinforcesthenatural,developmental,andhealingprocesseswithinapersontoenhancewell-being,comfort,function,andpersonalgrowth ProfessionalNurseRoleRoleRelationshipPatterns28第28页，本讲稿共65页2.Teacher:a.Provideshealthteachingtoindividualclientsandfamiliesb.Developsandimplementspatientedu
24、cationprogramstopromote/maintainhealthfulpracticesandcompliancewithtreatmentrecommendationsc.Guidesindividualsintheirhumanjourneytowardwholenessandwell-beingthroughpsychoeducationWhichareProfessionalNursingRolesP.116RoleRelationshipPatterns29第29页，本讲稿共65页3.Clientadvocate:a.Protectsclientsrighttoself-
25、determinationb.Motivatesindividualsandfamiliestobecomeinformedactiveparticipantsintheirhealthcarec.Mediatesbetweenclientandothersinthehealthcareenvironmentd.ActsasclientsagentincoordinatingeffectivehealthcareservicesWhichareProfessionalNursingRolesP.116RoleRelationshipPatterns30第30页，本讲稿共65页4.Manager
26、:a.Coordinatesstaffandproductivityb.Delegatesdifferentiatedtaskstoappropriatepersonnelc.Facilitatescommunicationwithinandamongdepartmentsd.Servesoncommitteestoimproveandmaintainqualityofcaree.MakesdecisionsanddirectsrelevantchangestoensurequalitycareWhichareProfessionalNursingRolesP.116RoleRelations
27、hipPatterns31第31页，本讲稿共65页5.Evaluator:a.Setsqualityassurance/carestandardsb.Reviewsrecordsandmonitorscompliancewithstandardsc.MakesrecommendationsforimprovementWhichareProfessionalNursingRolesP.116RoleRelationshipPatterns32第32页，本讲稿共65页6.Researcher:Developsandimplementresearch/grantproposalstobroadenu
28、nderstandingofimportantissuesinclinicalpracticeandvalidatenursingtheoriesasabasisforeffectivenursingpracticeWhichareProfessionalNursingRolesP.116RoleRelationshipPatterns33第33页，本讲稿共65页7.Consultant:a.Providesspecializedknowledge/advicetoothersonhealthcareissuesb.Evaluatesprograms,curricula,andcomplexc
29、linicaldatac.ServesasexpertwitnessinlegalcasesWhichareProfessionalNursingRolesP.116RoleRelationshipPatterns34第34页，本讲稿共65页8.CaseManager:a.Administerscareforacaseloadofclientsb.Coordinatescost-effectivecareoptionsc.Monitorsclientprogresstowardexpectedbehavioraloutcomesd.Collaborateswithotherprofession
30、alstoensurequalitycareacrosshealthcaresettingsWhichareProfessionalNursingRolesP.116RoleRelationshipPatterns35第35页，本讲稿共65页RoleRelationshipPatternsObjectiveFour:Discussthecharacteristicsofthesickrole36第36页，本讲稿共65页Fromtheclientperspective,lossoforchangesinnormalroles,rolerelationships,androleperformanc
31、eareimportantdimensions(尺度/元)oftheemotionalpainclientsexperienceinhealthcaresituations.How well people are able to perform their How well people are able to perform their rolesroles within the family and within the family and societysocietyinfluencestheirreputationwithinthecommunityandtheirsenseofse
32、lf-esteem.Whenillnessorinjuryaffectsroleperformance,italsoimpactsrolerelationshipswithothersandself-esteem.HowtounderstandClientrole,rolerelationships,performanceandtransition?p.119RoleRelationshipPatterns37第37页，本讲稿共65页Thenursemaybetheonlypersonwho has the who has the experexpert tise and willingnes
33、s to facilitate discussions of the ise and willingness to facilitate discussions of the implications of role changesimplications of role changesstemmingfrom(源于)alteredhealthstatusfortheclientin an objective,in an objective,comcomp passionate manner.assionate manner.p.119HowtounderstandClientrole,rol
34、erelationships,performanceandtransition?RoleRelationshipPatterns38第38页，本讲稿共65页Talkingaboutthemeaningofrolechangeisjustasimportantastalkingabouthowtochangeadressingorwhataphysicalsymptommeans.Lossofrole,changesinroleexpectationsandperformance,rolerelationshipsandroletransitionscanoccurasaresultofage,
35、illness,lossofjoborsignificantperson,injury,andmentaldisordersHowtounderstandClientrole,rolerelationships,performanceandtransition?p.119RoleRelationshipPatterns39第39页，本讲稿共65页Mostpeopledonotassumethesickrolevoluntarily.Illnessortrauma(外伤)canchangeanindividualssocialrolefromoneofindependentself-suffic
36、iencytooneofvulnerability(脆弱性)andvaryingdegreesofdependencyonothers,apersonalrolefromoneofindependencetodependence.Whenclientsenterahealthcaresituation,theyencounteraninterpersonalenvironmentthatencouragesthedevelopmentoffeelingsofanonymity(无名)andhelplessness.HowtounderstandClientrole,rolerelationsh
37、ips,performanceandtransition?p.119RoleRelationshipPatterns40第40页，本讲稿共65页Atthehospitaldoor,theclientforsakes(放弃)recognizedsocialrolesinthefamily,worksituation,andcommunity,temporarilyorpermanently.Regardlessofhowcompetentthepersonmaybeinotherliferoles,whenillnessstrikes(打击),questionsaboutroleperforma
38、nceinevitablyarise.Oftenclientsmustlearnnewrolebehaviorsthatareunfamiliarandunsettlingtopreviouslyheldself-concepts.HowtounderstandthetransitionofClientrole,rolerelationships,androleperformance?RoleRelationshipPatternsp.11941第41页，本讲稿共65页Adjustmenttoachangeinhealthcarestatusrequiresawholenewsetofcopi
39、ngskillswithoutnecessarilyhavingthesamesocialsupports.Clientsclearlyneedthesupportofthenursetoincorporatetherapidlychangingmeaningoftheenvironmentalandpersonalchangesencountered in illnessintoanotherwisebasicallyhealthyself-concept.HowtounderstandthetransitionofClientrole,rolerelationships,androlepe
40、rformance?RoleRelationshipPatternsp.11942第42页，本讲稿共65页Differencesinperspectivesplayamajorpartin determining which illnesses and disorders are recognized as legitimate(合理的),therolesclients assume in their health care,and who becomes the culturally assignedexpert(在.中当专家)inpromoting,maintaining,andresto
41、ringhealth.Forexample,someculturesbelievethatillnessispunishmentfromGodoranimbalanceofenergythatinterfereswiththebodysfunctioning.Theseculturalunderstandingscanaffectrolerelationshipsinhealthcaresettings.HowtounderstandthetransitionofClientrole,rolerelationships,androleperformance?RoleRelationshipPa
42、tternsp.11943第43页，本讲稿共65页ClientRole Clientsareexpectedtoactasparticipating,cooperativeagentsintheirrecoveryprocess.However,anAsianclientmayappearasapassiverecipientofhealthcare,strikinglydependentonfamilyandhealthcaregiverforallguidanceandcare.Withoutaclearunderstandingofthisculturallyacceptableexpr
43、essionofthesickrole,thenursemayrespondinappropriately.p.120RoleRelationshipPatterns44第44页，本讲稿共65页WhatisaPatientsBillofRights?p.1211.Thepatienthastherighttoconsiderateandrespectfulcare.ClientRoleClientRole RoleRelationshipPatterns45第45页，本讲稿共65页WhatisaPatientsBillofRights?p.1212.Thepatienthastherightt
44、o,andisencouragedtoobtainfromphysiciansandotherdirectcaregivers,relevant,current,andunderstandableinformationconcerningdiagnosis,treatment,andprognosis.Exceptinemergencieswhenthepatientlacksdecisionmakingcapacityandtheneedfortreatmentisurgent,thepatientisentitledtotheopportunitytodiscussandrequestin
45、formationrelatedtothespecificproceduresandtreatments,risksinvolved,lengthofrecuperation,andmedicallyreasonablealternativesandtheiraccompanyingrisksandbenefits.ClientRoleClientRole RoleRelationshipPatterns46第46页，本讲稿共65页WhatisaPatientsBillofRights?ClientRoleClientRole 3.Patients have the right to know
46、 the identity ofphysicians,nurses,and others involved in their care,aswell as the status of the caregivers(e.g.,when thoseinvolvedarestudents,residents,orothertrainees.).p.121RoleRelationshipPatterns47第47页，本讲稿共65页WhatisaPatientsBillofRights?ClientRoleClientRole 4.Thepatienthastherighttomakedecisions
47、abouttheplanofcarebeforeandduringthecourseoftreatment,torefusearecommendedtreatmentorplanofcaretotheextentpermittedbylawandhospitalpolicy,andtobeinformedofthemedicalconsequencesofthisaction.p.121RoleRelationshipPatterns48第48页，本讲稿共65页WhatisaPatientsBillofRights?ClientRoleClientRole 5.Thepatienthasthe
48、righttohaveanadvancedirective(suchaslivingwill,healthcareproxy,ordurablepowerofattorneyover health care)concerning treatment or designating asurrogate decision maker with the expectation that thehealthcareinstitutionwillhonortheintentofthatdirectivetothe extent permitted by law and hospital policy.H
49、ealth careinstitutionsmustadvisepatientsoftheirrighttomakeinformedmedicalchoices.p.121RoleRelationshipPatterns49第49页，本讲稿共65页WhatisaPatientsBillofRights?ClientRoleClientRole 6.Thepatienthastherighttoeveryconsiderationofprivacy.Casediscussion,consultation,examination,and treatment should beconductedso
50、astoprotectthepatientsprivacy.7.Thepatienthastherighttoexpectthatallcommunicationsandrecordspertainingtocarewillbetreatedasconfidentialbythehospital,exceptincasessuchassuspectedabuseandpublichealthhazards,whenreportingispermittedorrequiredbylaw.p.121RoleRelationshipPatterns50第50页，本讲稿共65页WhatisaPatie