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      Patterns of knowing: Review, critique, and update :

      Advances in Nursing Science
      Ovid Technologies (Wolters Kluwer Health)

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          In a Different Voice: Women's Conceptions of Self and of Morality

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            Negotiating commitment and involvement in the nurse-patient relationship.

            The relationship that is established between the nurse and the patient is the result of interplay or covert negotiations until a mutually satisfying relationship is reached. Depending on the duration of the contact between the nurse and the patient, the needs of the patient, the commitment of the nurse and the patient's willingness to trust the nurse, one of four types of mutual relationship will emerge: a clinical relationship, a therapeutic relationship, a connected relationship or an over-involved relationship. If the nurse is unwilling or unable to be committed to the patient, a unilateral relationship will develop, with the patient continuing to use manipulative or coercive behaviours, attempting to increase the nursing involvement in the relationship. If the patient is unwilling to trust the nurse and accept his or her illness situation, she or he will manifest 'difficult' behaviours, be withdrawn or elope. The changing nature of the relationship, and the conditions and consequences of each type of relationship are discussed.
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              Beyond empathy: expanding expressions of caring.

              In this paper, a model describing nurses' responses to patients who are suffering is presented. The nurse's level of engagement with the patient is affected by whether the caregiver is focused on him-/herself or on the sufferer (i.e. embodied with the patient) and whether the caregiver is responding reflexively or with a learned response. Four types of communication patterns are identified: engaged responses (first-level) are used in a connected relationship; when the nurse responses reflexively and is focused on him-/herself, the response is reflected; when the caregiver is patient-focused, a learned response is labelled a professional response; and a self-focused, learned response is labelled detached. Examples of each type of response are provided.
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                Author and article information

                Journal
                Advances in Nursing Science
                Advances in Nursing Science
                Ovid Technologies (Wolters Kluwer Health)
                0161-9268
                1995
                June 1995
                : 17
                : 4
                : 73-86
                Article
                10.1097/00012272-199506000-00007
                7625782
                16cb8769-64c7-4c97-b614-4f56153d916f
                © 1995
                History

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