敘事護理學在護理研究、實務與教育的發展與應用：以護病溝通為例

Development and Application of Narrative Nursing in Research, Practice and Education: A Case of Nurse-Patient Communication

10.6647/CN.202103_28(1).0002

林琦華(Chi-Hua Lin)；羅彥傑(Yen-Chieh Lo)

敘事 ； 敘事護理 ； 護病溝通 ； 護病關係 ； narrative ； narrative nursing ； nurse-patient communication ； nurse-patient relationship

彰化護理

28卷1期（2021 / 03 / 01）

2 - 9

繁體中文

護理是一門從臨床實務技術發展為教育制度，再進而帶動學術研究的學科。護理類似醫學，因照護對象是人，自始即具人文本質。人文不僅始終是護理教育的核心，也是護理研究的重要主題。自醫學界開始反省過度醫療化的批判、改為強調以病患為中心並重視醫病溝通以來，護理學界也出現類似呼籲。晚近更有不少西方護理學者提倡將敘事觀點運用於護理研究、實務與教育上，逐步建立「敘事護理學」的新典範。然而，何謂敘事？以護病溝通為例，敘事觀點與傳統觀點有何差異？敘事在護理的研究、實務與教育上能帶來哪些啟發？本文透過文獻檢閱釐清上述問題，並嘗試提出敘事護理學的概念架構。

Nursing is a discipline which has begun as a clinical practice and been developed into an educational system and then promoted to academic research. Like medicine, nursing has displayed the humanistic nature since the beginning because of caring people as its duty. Humanities not only become the core of nursing education but also the main theme of nursing research. As the medical community had started to reflect on the critique of medicalization and emphasize a patient-centered care and doctor-patient communication, the nursing discipline followed the steps as well. Recently, many western scholars in nursing called for the narrative use in nursing research, practice, and education, establishing a new paradigm. However, what is narrative? What is the difference between the narrative perspectives and the traditional ones if taking nurse-patient communication as an example? What can narrative nursing inform us in nursing research, practice, and education? This paper is aimed to clarify these questions and tries to set up a conceptual framework of narrative nursing.

1. 余玉眉, M. Y.,蔣欣欣, H. H.(2017)。臨床護理教育的敘事書寫—護理過程紀錄的本質。護理雜誌，64(1)，32-40。
   連結：
2. 郭芳秀, F. H.,黃惠滿, H. M.,孫凡軻, F. K.,林婉如, W. J.(2019)。加護病房護理人員人際溝通能力與衝突處理風格。護理雜誌，66(2)，67-76。
   連結：
3. Charon, R.(2006).Narrative medicine: Honoring the stories of illness.New York:Oxford University Press.
4. Charon, R.(Ed.),Montello, M. M.(Ed.)(2002).Stories matter: The role of narrative in Medical ethics.New York:Routledge.
5. Fitzpatrick, J. J.(2017).Narrative nursing: Applications in practice, education, and research.Applied Nursing Research,37,67.
6. Fitzpatrick, J. J.(2018).Teaching through storytelling: Narrative nursing.Nursing Education Perspectives,39(2),60.
7. Fitzpatrick, J. J.,Rivera, R. R.,Walsh, L.,Byers, O. M.(2019).Narrative nursing: Inspiring a shared vision among clinical nurse.Nurse Leader,17(2),131-134.
8. Fleischer, S.,Zimmermann, M.,Behrens, J.(2009).Nurse-patient interaction and communication: A systematic literature review.Journal of Public Health,17(5),339-353.
9. Framp, A. C.,MacAllister, M.,Dwyer, T.(2019).Narrative research methods with vulnerable people: Sharing insights.Nurse Researcher,27(4),42-47.
10. Fulton, J. S.(1987).Virginia Henderson: Theorist, prophet, poet.Advances in Nursing Science,10(1),1-9.
11. Hall, J. M.,Powell, J.(2011).Understanding the person through narrative.Nursing Research and Practice,2011,293837.
12. Jones, A.(2003).Nurses talking to patients: Exploring conversation analysis as a means of researching nurse-patient communication.International Journal of Nursing Studies,40(6),609-618.
13. Joyce, M.(2015).Using narrative in nursing research.Nursing Standard,29(38),36-41.
14. Kenyon, G.(Ed.),Bohlmeijer, E.(Ed.),Randall, W.L.(Ed.)(2011).Storying later life: Issues, investigations, and interventions in narrative gerontology.Cambridge, MA:Oxford University Press.
15. Kitson, A.,Marshall, A.,Bassett, K.,Zeitz, K.(2013).What are the core elements of patient-centered care? A narrative review and synthesis of the literature form health policy, medicine and nursing.Journal of Advanced Nursing,69(1),4-15.
16. Maclntyre, J. I. S.(2018).The narrative circle model: An Interpretative framework for nursing education and research.Nursing Forum,53(4),432-436.
17. Riessman, C. K.(1993).Narrative analysis.Newbury Park, CA:Sage.
18. Sandelowski, M.(1991).Telling stories: Narrative approaches in qualitative research.The Journal of Nursing Scholarship,23,161-166.
19. Sandelowski, M.(1994).We are the stories we tell: Narrative knowing in nursing practice.Journal of Holistic Nursing,12(1),23-33.
20. Schleifer, B.,Vannatta, J. B.(2013).The chief concern of medicine: The integration of the medical humanities and narrative knowledge into medical practices.Ann Arbor, MI:The University of Michigan Press.
21. Shattell, M.(2004).Nurse-patient interaction: A review of the literature.Journal of Clinical Nursing,13(6),714-722.
22. 周傳姜, C. C.,吳麗珍, C. C.,林妍君, Y. C.(2007)。護理人文教育。護理雜誌，54(1)，29-34。
23. 郭嘉琪, C. C.,金繼春, C. C.,周汎澔, F. H.(2012)。由後現代主義的中心概念反思護病關係。護理雜誌，59(1)，72-76。