人性化照護的感通

Correspondence in Humanistic Care

10.6224/JN.000068

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

感通 ； 護理倫理 ； 主題分析 ； 人性化照護 ； 互為主體性 ； correspondence ； nursing ethics ； thematic analysis ； humanistic care ； intersubjectivity

護理雜誌

64卷5期（2017 / 10 / 01）

50 - 58

繁體中文

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。

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.

1. 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。
   連結：
2. 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。
   連結：
3. 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。
   連結：
4. 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。
   連結：
5. 蔣欣欣(2015)。團體對話中的自我反思—精神衛生護理人員的經驗。護理雜誌，62(4)，73-81。
   連結：
6. 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。
   連結：
7. 蔣欣欣(2015)。自由談的督導團體運作—精神衛生護理人員的經驗。護理雜誌，62(3)，41-48。
   連結：
8. 蔣欣欣、廖珍娟、劉盈君(2016)。為人與成己之間—面對他者的照護倫理態度。護理雜誌，61(2)，44-53。
   連結：
9. Allmark, P.(2017).Aristotle for nursing.Nursing Philosophy,18(3),e12141.
10. Annas, G. J.(Ed.),Grodin, M. A.(Ed.)(1992).The Nazi doctors and the nuremberg code: Human rights in human experimentation.New York, NY:Oxford University Press.
11. Benjamin, J.(1988).The bonds of love: Psychoanalysis, feminism, and the problem of domination.New York, NY:Pantheon Books.
12. Buber, M.,Friedman, M. S.,Udoff, A.(1988).The knowledge of man.Amherst, MA:Humanity Books.
13. D'Antonio, P.,Beeber, L.,Sills, G.,Naegle, M.(2014).The future in the past: Hildegard Peplau and interpersonal relations in nursing.Nursing Inquiry,21(4),311-317.
14. Ferrell, B. R.(Ed.),Coyle, N.(Ed.)(2001).Textbook of palliative nursing.New York, NY:Oxford University Press.
15. Freshwater, D.,Cahill, J.,Esterhuizen, P.,Muncey, T.,Smith, H.(2017).Rhetoric versus reality: The role of research in deconstructing concepts of caring.Nursing Philosophy,e12176.
16. Koehn, D.(2012).Rethinking feminist ethics: Care, trust and empathy.New York, NY:Routledge.
17. Macklin, R.(1977).Moral progress.Ethics,87(4),370-382.
18. Morgan, W. J.,Guilherme, A.(2014).Buber and moral education buber and education: Dialogue as conflict resolution.Oxford, UK:Routledge.
19. Newham, R. A.(2017).The emotion of compassion and the likelihood of its expression in nursing practice.Nursing Philosophy,18(3),e12163.
20. Noddings, N.(2003).Caring: A feminine approach to ethics & moral education.Berkeley, CA:University of California Press.
21. Nouwen, H. J. M.、張小鳴譯(1998)。負傷的治療者：當代牧養事工的省思。香港沙田=Sha Tin, Hong Kong:基道=Logos Ministries。
22. Öhlén, J.,Reimer-Kirkham, S.,Astle, B.,Håkanson, C.,Lee, J.,Eriksson, M.,Sawatzky, R.(2017).Person-centred care dialectics-Inquired in the context of palliative care.Nursing Philosophy,e12177.
23. Paterson, J. G.,Zderad, L. T.(1988).Humanistic nursing.New York, NY:John Wiley and Sons.
24. Stankovic, B.(2017).Situated technology in reproductive health care: Do we need a new theory of the subject to promote person-centred care?.Nursing Philosophy,18(1),e12159.
25. Taylor, C. R.(Ed.),Dell'Oro, R.(Ed.)(2006).Health and human flourishing.Washington, DC:Georgetown University Press.
26. Throop, C. J.(2012).On the varieties of empathic experience: Tactility, mental opacity, and pain in Yap.Medical Anthropology Quarterly,26(3),408-430.
27. van Manen, M.(1997).Researching lived experience: Human science for an action sensitive pedagogy.London, Canada:Althouse Press.
28. Watson, J.(2003).Love and caring. Ethics of face and hand -An invitation to return to the heart and soul of nursing and our deep humanity.Nursing Administration Quarterly,27(3),197-202.
29. 西田幾太郎、鄭發育譯、余德慧譯(1984)。善的純粹經驗。台北市=Taipei City, Taiwan, ROC:臺灣商務印書館=The Commercial Press。
30. 唐君毅(1991)。人生之體驗續編。台北市=Taipei City, Taiwan, ROC:台灣學生書局=Student Book。
31. 唐君毅(1986)。生命存在與心靈境界。台北市=Taipei City, Taiwan, ROC:台灣學生書局=Student Book。
32. 高淑清(2008)。質性研究的18 堂課： 首航初探之旅。高雄市=Kaohsiung City, Taiwan, ROC:麗文文化=Li Wen。
33. 國立編譯館、孔穎達(2001)。周易正義。台北市=Taipei City, Taiwan, ROC:新文豐=Shin Wen Feng。
34. 郭佩宜(2014)。共做的「同理心」：重反／返所羅門群島Langalanga礁湖區的田野工作。同理心、情感與互為主體—人類學與心理學的對話，台北市=Taipei City, Taiwan, ROC:
35. 歐美、劉盈君、黃靖淇、招雁翔、李作英、蔣欣欣(2013)。護理人員在護持與承擔中的轉化—以臨終照護反思團體為例。護理雜誌，60(3)，31-39。
36. 蔣欣欣(2006)。護理照顧的倫理實踐。台北市=Taipei City, Taiwan, ROC:心理=Psychological。

1. 郭莉娟,李彥錚,王琬詳(2022)。透過專業讀書會轉化護理師對疼痛的理解。護理雜誌，69(3)，50-57。
2. 蔣欣欣,廖珍娟(2021)。小組對話的師生共學：精神衛生護理學實習為例。中華心理衛生學刊，34(1)，3-24。
3. 蔣欣欣,劉盈君(2020)。面對死亡－護理人員團體的現象學觀點。中華團體心理治療，26(1)，12-26。