Creating the Carative Environment in the Child and Family Care

目的本研究的目的是确定医疗设施中共同创造的健康环境，以提高儿童、家庭和临床工作人员的护理。方法2007 - 2010年开展参与式行动研究。通过行动研究，分析了创造性环境的形成和促进因素。整个研究过程由专门从事行动研究的护士研究员监督。促进护理环境的线索包括：护士关心的问题研讨会、与他人非正式地谈论自己关心的问题、对参与护理的护士态度变化的反馈、给予护理策略的建议。这些线索使护士有机会获得新的知识，分享知识，了解自己的情况，披露自己的感受和想法，并意识到其他人的感受和想法是相同的。(2)创造有利的环境实地查明的有关情况得到了改善，而不是消除。护理人员的痛苦和工作欲望的丧失转变为对自己和护理的信心，这可能会引起对儿童和家庭护理的提前保证。结果表明，该领域的关注只是创造良好环境的起点。本研究中创造创造性环境的过程反映了沃森关怀理论中的一些创造性因素。本研究显示，促进性护理因素是医院改善儿童、家庭及医护人员照护的重要因素。

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.