| Summary: | 碩士 === 國立成功大學 === 護理學系碩博士班 === 93 === The aim of this study is to understand the essence of the phenomenon of labeling “difficult patients/families” thoroughly by analyzing the experience of clinical nurses and doctors. Six clinical nurses with experiences of using negative words/phrases to describe or categorize the patients/families that have unacceptable verbal words or behaviors to make them feel uncomfortable are chosen as the research subjects, in which these clinical nurses are from one of the medical centers in the southern part of Taiwan. In addition, by gathering information from different kinds of sources so that the truth behind the phenomenon can be revealed, three resident doctors are also interviewed. The investigator used phenomenology study method in which in-depth interviews and participant observations were conducted under the consent of each research subject. These interviews were conducted during the period of September 2004 to November 2004. These interview data were analyzed using the approach developed by Giorgi (1985), in which these interview data can be divided into 17 categories. In particular, categories such as “uncooperative; hard to communicate”, “dominating; like to order”, “demanding; frequently and consistently pressing red lights; needs must be satisfied immediately”, and “abnormal; unpredictable” can be considered as the behaviors of the patients/families that will make the clinical nurses label those patients/families as “difficult”. As for the categories such as “unwilling to consider patient’s pain complaint is true”, “unable to deal with the need of pain relief”, “communication barrier between nurses and patients/families”, “a lack of social support” and “afraid of wrong doing” can be considered as the reasons/causes why clinical nurses label difficult patients/families. As for the categories such as “boring”, “anger”, “incapable”, “complex emotion”, “sympathy”, “unfriendly; unkind”, “unserious; negligent; rush to finish something” and “make self-examination; reflection” can be considered as the response by the clinical nurses when they face “difficult patients/families” It is believed that the results of this study can increase the knowledge about the phenomenon of labeling difficult patients/ families by the clinical nurses and also help understand the reason/cause behind it. In summary, the contributions of this paper are three folds. 1). Provide the materials for clinical nurses to perform self-examination and also be an example of incapable of solving problems using nursing processes. 2). Provide a negative example to be used in nursing training/education 3). Benefit the nurse administration so that they can take appropriate actions to improve the nurse-patient relation and the quality of nursing care.
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