Study on Processes of Understanding Humans According to Psychiatric Nursing Practice

The learner objectives
1. The lerner who are student nurses will be able to aware of interactions with patients by evaluating their interpersonal relatiotonship  objectively in the psychiatric nursing practice.
2. The learner will be able to clarify processes to understand human beings including self and non-self. Student nurses who participated in the psychiatric nursing practice attempted to understand patients by deepening self-understanding.

The purpose of this presentation
The psychiatric nursing practice of this study aimed to make student nurses aware of interactions with patients by evaluating their interpersonal relationship objectively. Self-understanding was considered a key factor for building interpersonal relationship in psychiatric nursing. Therefore, we designed this study to clarify processes to understand human beings including self and non-self. Student nurses who participated in the psychiatric nursing practice attempted to understand patients by deepening self-understanding.

The target audience of this presentation
The psychiatric nursing practice of this study aimed to make student nurses aware of interactions with patients by evaluating their interpersonal relationship objectively. Therefore,the target audience of this presentation are professors and students who teach or study in psychiatric nursing practice.

Methods
We provided written and verbal instructions on the objectives and methods of this study, encouragement of voluntary participation, and privacy protection; accordingly, 22 nurses consisting of graduates and fourth-year students of our school gave written consent to be enrolled in the study. After the psychiatric nursing practice, we conducted a semi-structured interview to allow the nurses to speak freely, and also used the document recorded during the practice, “nursing reconstruction,” in order to review their “experiences of self-awareness” and “experiences that they deepened understanding of patients through self-awareness.” In the psychiatric nursing practice of this study, we adopt record paper introduced by book "The dicipline and teaching of nursing process : An evaluative study" that was written by Orlando, I. Jean and was published in 1972 as a record sheet of "nursing reconstruction ". Furthermore, as a document to look back toward the nursing reconstruction in conference, we adopt a self-evaluation item introduced in book "Clinical nursing : A helping art" that was written by Wiedenbach, Ernestine and was published in 1964.The Grounded Theory approach developed by Strauss and Corbin was employed for analysis.

The procedure of the analysis based on Grounded Theory approach
1.The reading of data for understanding
Extracting of propaties and a dimensions every piece
2.Labeling data
Comparison of dimensions and proparties between labels
3.Labeling categories
Comparison of dimensions and proparties between categories
4.Grasping relations between categories
Making a category association map based on a paradigm
5.Theoretical sampling 

The comparison is performed through all processes of analysis 

Results and Discussion
We analyzed the results to extract the following five categories related to experiences that nurses linked their self-awareness to understanding of patients: "students' considerations of patients' emotions and thoughts," "students' reactions to patients' emotions and thoughts, "students' self-expressions according to their feelings," "patients’ sympathize and cooperate with students," and “students' recognition of nursing effects." Nurses strove to consider patients’ emotions and thoughts when they became interested in and paid attention to patients. They deepened understanding of patients in proportion to their capacity for imagination. In addition, to make decisions about nursing, student nurses communicated with their patients to confirm whether their considerations were correct, and changed their nursing styles according to individuals’ responses. Even when students did not empathize with their patients, they were encouraged to reconsider themselves. This resulted in student nurses’ self-insight and understanding. Furthermore, students attempted to find the best way to express their feelings consciously after they reconsidered themselves, and explained to their patients that they used not only their knowledge but also feelings and considerations to take care of patients. As the result, patients felt that student nurses respected patients’ emotions and were actively engaged in nursing activities. This made patients sympathize and cooperate with nurses. Accordingly, student nurses could perform nursing care more efficiently. Students were also encouraged to become interested in and pay attention to patients when they felt good responses from patients. The results of the understanding processes shown by student nurses during the psychiatric nursing practice suggest that humans need to understand themselves to deepen understanding of other people as well as they become interested in themselves through a process of understanding of others and deepen self-understanding after they reconsider themselves.