看護婦の認知する共感の構造と過程

Percieved Structure and Process of Empathy by Japanese Nurses

要旨

　「共感」は，対象者を理解する上で鍵となる因子であり，援助的意味をもつといわれている．本研究では，看護婦の認知する看護婦－患者関係における共感のプロセスと，その構成要素を，参加観察法及び面接法によって帰納的に導き出した．対象者は，東京都内の某私立大学病院の1内科病棟の看護婦19名である．分析の結果，共感は，まず「共感者（看護婦）」と「被共感者（患者）」がいて，この2者が出合い，その初期の段階で「相性」といわれる感覚が生じる．そしてお互いの私的自己をopenにする「相互open」さらに「同情」がおこり，お互いの気持ちや反応を「確認し合う相互作用」をおこない，それを経て，気持ちが伝わり通じたという「共感」を感じている．一旦共感が体験されると，看護婦は，患者との相互関係が継続し，時がたつにつれて深まっていくと感じている．文献によると，援助者は，共感的関わりにおいては，あたかも対象者であるかのように感じながらも，決してその人と情緒的に同一化すべきでないと強調している．しかしこの研究では，看護婦は，共感する際患者との一体感を強く感じているという結果がえられた．これは，日本人の文化的心理特性によるものであろう．

Abstract

　The concept of empathy is the key factor for understanding the object and contains the meanings of helping. This study aimed to inductively delineate the structure and process of empathy in the patient-nurse relationship through the perception of nurses by using the methods of the participant observation and interview. The subjects of this study were 19 nurses in a medical unit of a private university hospital in Tokyo. The result of the study showed that 1) in the very first moment when a patient and a nurse met, the nurse perceived attraction (aishou) toward the patient, 2) then the both began to disclosure private-self to the other (mutual openness), 3) which led the nurse to sympathize with the patient, 4) and to mutually confirm the feelings and responses to the other, 5) and finally reached the feelings of empathy which was perceived by the nurses that mutual feeling were transmitted and understood. If the empathy was once experienced, the nurses felt that the mutual relationship tended to continue and deepen as the time passed. It has been emphasized in the literature that the helper in the empathetical relationship may feel as if he or she were the client but should not emotionally identify with the person. However, the result of this study indicates that the nurses experience the relationship as the strong feelings of identification with patients. It may occur due to he Japanese cultural context.