Creating the Carative Environment in the Child and Family Care

目的-本研究的目的是确定在医疗设施，以提高儿童，家庭和临床工作人员的carative environment的共同创造。分析了行动研究所产生的活动环境的创造及其促进因素。结果（1）促进线索促进护理环境的线索有：护士关心的问题的研讨会、与他人的非正式交谈、对投入的护士的态度变化的反馈、对护理策略的建议。这些线索引发了护士获得新知识、分享知识、了解自己的情况、表达自己的感受和想法以及意识到其他人的感受和想法的机会。(2)创建Carative环境在实地查明的有关情况得到改善，而不是溶解。护理人员的苦恼和工作欲望的丧失，转化为对自己和护理工作的信心，这可能会提前对儿童和家庭的护理工作提出保证。讨论结果表明，对护理领域的关注只是创造护理环境的起点。本研究中的关怀环境创设过程体现了沃森关怀理论中的关怀因素。该研究表明，促进Carative因素是医院加强儿童，家庭和工作人员护理的强大变革力量。

Purpose The purpose of this research was to identify co-creation of carative environment at medical facilities to enhance child, family and clinical staff care.Methods Participatory action research was conducted from 2007 to 2010. The creation of and facilitating factors of carative environment due to action research were analyzed. The entire research process was supervised by nurse researchers specialized in action research.Results (1) Facilitating Clues The clues to facilitate carative environment were : the seminar regarding concerns what nurses had, informal talk with others about concerns what they had, feedback of the attitude change to nurses who were committed in, and giving the advice on nursing strategies. These clues triggered the opportunity for nurses to gain new knowledge, to share the knowledge, to understand their situation, to disclose their feeling and thoughts, and to realize that the others felt and thought in the same way. (2) Creation of the Carative Environment The concerning situations identified in the fields were improved rather than dissolved. Distress and loss of desired to work in nurses turned to the confidence in oneself and nursing care, which might invite the assurance of child and family care in advance.Discussion The result showed the concerns in the field were just the starting point to create the carative environment. The process of creation of carative environment in this study reflects some of the Carative Factors in Watson's Caring Theory. The study showed the facilitating Carative factors were the powerful change agent in the hospital to enhance child, family, and staff care.