当事者が知覚した精神科看護師の行動と当事者自身の反応：対人円環モデルを枠組みとした質的研究

Psychiatric Nurses' Behavior as Perceived by Clients and Clients' Reactions: A Qualitative Study Using Interpersonal Circumplex Model Framework

要旨

　目的：対人円環モデル（Interpersonal Circumplex model：IPC）の構造を枠組みに，当事者が知覚した精神科看護師の行動と当事者自身の反応を明らかにする．

　方法：当事者への半構造化面接で得た5名の語りを，IPCの8領域に演繹的に分類した後，当事者の知覚と反応に分けてコード化した．

　結果：当事者の知覚は，IPCの8領域ごとに1〜10個のコードが生成され，看護師の優位性−劣位性と拒否性−親和性の濃淡によって特徴づけられた．例えば《避けられる》という看護師の拒否的な行動は，「上から目線」として優位性も当事者に知覚されていた．当事者の反応は1〜9個のコードが生成され，特に優位性−劣位性の知覚に対する当事者の反応では経時的に変化するコードもあった．

　結論：当事者の知覚と反応をIPCの枠組みで明らかにしたことによって，当事者−看護師関係の振り返りへの利用可能性が示された．

　Objective: This study aimed to investigate clients' perceptions and responses to nursing behaviors during psychiatric services using the interpersonal circumplex(IPC) model.

　Methods: Semistructured interviews were conducted with five clients, and the clients' narratives were studied and classified into eight IPC domains(dominant behavior, selfish behavior, cold behavior, self-negating behavior, submissive behavior, accepting behavior, warm behavior, and self-affirming behavior). Narratives were separately coded as perceptions and reactions.

　Results: Clients perceived nurses' behavior across a spectrum of dominant-submissive and coldwarm domains(e.g., cold behavior of being "avoided" by the nurse was also perceived as dominance). Each IPC domain generated perception codes(1-10) and response codes(1-9). Notably, some of the client's responses to perceived dominant-submissive behavior evolved over time.

　Conclusion: This study employing the IPC framework reveals insights into clients' perceptions and reactions to psychiatric nurses' behavior, underscoring the model's utility in evaluating clientnurse relationships.