護(hù)理人際關(guān)系綜述

護(hù)理人際關(guān)系綜述2010481110王一冰摘要：人與人之間從認(rèn)識到熟悉并發(fā)展成為親密的人際關(guān)系，時間有快有慢，過程有長有短，有時是漸進(jìn)、有時可能是速成的?，F(xiàn)代化護(hù)理服務(wù)以護(hù)理對象的健康為中心，次過程中，護(hù)士是唯一能為服務(wù)對象提供全程、整體、晝夜服務(wù)的人員。他們需要隨時為服務(wù)對象的安全及健康承擔(dān)各種責(zé)任，并需要與醫(yī)療機(jī)構(gòu)中的各種人員配合協(xié)調(diào)，建立良好的溝通網(wǎng)絡(luò)及人際關(guān)系，已達(dá)到為服務(wù)對象提供高質(zhì)量將抗服務(wù)的目的。關(guān)鍵詞：人際關(guān)系護(hù)患醫(yī)患和諧現(xiàn)狀常見問題引言：護(hù)理人際關(guān)系是護(hù)士在工作過程中所形成的多種網(wǎng)絡(luò)人際關(guān)系的總和。科學(xué)而恰當(dāng)?shù)靥幚砗萌穗H關(guān)系，既有利于解決服務(wù)對象的谷中問題，促進(jìn)護(hù)理學(xué)科的整體發(fā)展，還有利于護(hù)士個人的身心健康及事業(yè)發(fā)展。研究歷史：萊文格及斯諾克在1972年提出，人際關(guān)系從完全的無關(guān)系到關(guān)系親密要經(jīng)過一系列的發(fā)展過程。并以人際關(guān)系狀態(tài)圖直接地描述了人際關(guān)系發(fā)展?fàn)顟B(tài)的一般規(guī)律O1976年美國學(xué)者薩斯和荷倫德提出了三種醫(yī)患關(guān)系的模式，即薩斯-荷倫德模式。這種醫(yī)患關(guān)系的模式同樣也適用于呼喚關(guān)系。當(dāng)前狀況：一、護(hù)理中的人際關(guān)系。1、建立良好人際關(guān)系的意乂。1.1、有利于提高護(hù)理質(zhì)量級效率良好的護(hù)理關(guān)系是做好各項護(hù)理工作的重要保證級基礎(chǔ)，他有利于促進(jìn)護(hù)士與服務(wù)對象、家屬、醫(yī)生、其他護(hù)士、其他醫(yī)務(wù)人員之間的相互協(xié)調(diào)與信任，使護(hù)士能發(fā)揮在醫(yī)療服務(wù)體系中人際樞紐的作用，協(xié)調(diào)好各種人際關(guān)系，相互配合，共同為解決服務(wù)對象的護(hù)理問題發(fā)揮作用，是所在健康服務(wù)組織的各項活動得以順利進(jìn)行，提高護(hù)理質(zhì)量級效率。⑴⑵1.2、有利于營造良好的健康服務(wù)氛圍，促進(jìn)服務(wù)對象的健康及醫(yī)護(hù)人員的身心健康在各種健康服務(wù)機(jī)構(gòu)中，護(hù)士與服務(wù)對象及其他人之間所形成的相互理解、相互信任、相互關(guān)懷的人際關(guān)系，會使這些場所形成良好的社會心理氛圍。這種氛圍能使醫(yī)護(hù)工作人員合理的心理需求得到滿足。1.3、有利于陶冶護(hù)士情操人際交彳主不僅滿足了人的精神或物質(zhì)需要，同時也是人格互動與影響的過程。它包含人與人之間認(rèn)識上的相互溝通、情感上的相互交流、性格上的相互影響，行為上的相互作用等人格互動過程。在護(hù)理服務(wù)過程中，護(hù)士建立各種人際關(guān)系的過程，實質(zhì)上也是一種人格凈化、陶冶情操的過程。1.4、有利于貫徹以人為本的護(hù)理理念人本主義主張每個人都有自己的獨特性及完整性，強調(diào)人的主觀能動性，選擇權(quán)及自主權(quán)，關(guān)心人的存在、價值、本質(zhì)、理想、自由、個性、尊嚴(yán)、創(chuàng)造性級生活質(zhì)量。人本主義的護(hù)理理念是滿足服務(wù)對象作為一個人的整體需要，護(hù)理活動更注重人的整體性及自主性。⑶1.5、有利于促進(jìn)護(hù)理學(xué)科的發(fā)展護(hù)理作為一門專業(yè)，具有其獨特性及自足性，其從業(yè)人員不僅僅只是機(jī)械地執(zhí)行醫(yī)囑，而應(yīng)該在服務(wù)對象的護(hù)理中用自己獨特的專業(yè)知識級技能，選擇對服務(wù)對象最有利的護(hù)理措施。通過與服務(wù)對象建立良好的護(hù)患關(guān)系，可以幫助護(hù)士更好地明確其需要，并用獨特的護(hù)理手段促進(jìn)服務(wù)對象的健康。2、護(hù)理人際關(guān)系的特征2.1、專業(yè)性這是由護(hù)士的專業(yè)職能決定的。在護(hù)理關(guān)系中，不論是與服務(wù)對象的關(guān)系，還是與醫(yī)生、其他護(hù)士或醫(yī)務(wù)人員的關(guān)系，都屬于專業(yè)關(guān)系。2.2、時限性這是由護(hù)理專業(yè)任務(wù)的特定時間跨度性質(zhì)所決定的。專業(yè)任務(wù)存在，保持關(guān)系；專業(yè)任務(wù)完成，關(guān)系即宣告結(jié)束。時限性在護(hù)理關(guān)系上表現(xiàn)的最為突出。服務(wù)對象入院，關(guān)系開始建立，服務(wù)對象康復(fù)出院，關(guān)系宣告終止。2.3、多面性這是由護(hù)士的角色及功能所決定，護(hù)士在健康服務(wù)群體中具有多方面的角色功能。2.4、復(fù)雜性這是由護(hù)理服務(wù)對象的特殊性與流動性所決定的。護(hù)理的服務(wù)對象是具有生命有感情的人，他們在進(jìn)入護(hù)理人際關(guān)系是帶有自己的社會文化背景及生活經(jīng)歷，有自己的特殊的生理、社會文化、精神心理需求，加上服務(wù)對象的經(jīng)常流動性，會增加護(hù)理人際關(guān)系的復(fù)雜性及處理難度。2.5、協(xié)作性這是由健康服務(wù)工作的整體性級系統(tǒng)性所決定的。健康服務(wù)是許多不同專業(yè)人員及后勤保障人員等所組成的服務(wù)群體，只有共同努力，相互協(xié)調(diào)配合才能完成任務(wù)。2.6、公共性這是由護(hù)理工作的社會性所決定的。護(hù)理對象涉及社會的所有成員。護(hù)士是代表醫(yī)療機(jī)構(gòu)，甚至代表國家的社會保障體系來為公眾服務(wù)。[10]二、護(hù)患關(guān)系1、護(hù)患關(guān)系的特征1.1、護(hù)患關(guān)系是以治療為目的的專業(yè)性、幫助性關(guān)系護(hù)患關(guān)系十一解決服務(wù)對象在患病間所遇到的生理、社會心理、精神等方面的問題，滿足服務(wù)對象需要為主要目的的一種專業(yè)性的人際關(guān)系。這種關(guān)系中所有活動是以專業(yè)活動為中心，以保證服務(wù)對象的健康為目的。[4][5]1.2、護(hù)患關(guān)系是一種工作關(guān)系與其他的人際關(guān)系不同，護(hù)患關(guān)系是狐貍工作的需要，護(hù)士與服務(wù)對象之間的人際交彳主是一種職業(yè)行為。由于是一種工作關(guān)系，護(hù)患關(guān)系雙方應(yīng)避免過度的感情卷入。應(yīng)為：①護(hù)患關(guān)系中雙方過多的感情卷入，會導(dǎo)致服務(wù)對象護(hù)士感情上的高度互動，一旦產(chǎn)生情緒變化，不僅會影響護(hù)士的正常工作情緒，也會使服務(wù)對象的情緒產(chǎn)生不良變化而影響健康。②護(hù)患之間的過度的感情卷入，必然導(dǎo)致出現(xiàn)其他的非工作關(guān)系，如友誼、愛情功利等關(guān)系。③過度的感情卷入，灰化肥護(hù)士大量的時間及精力去滿足與護(hù)理無關(guān)的服務(wù)對象，這會影響忽視的工作效率吧，甚至個人生活。1.3、護(hù)患關(guān)系是一種以服務(wù)對象為中性的關(guān)系一切護(hù)理活動及護(hù)患交彳主都必須以解決服務(wù)對象的護(hù)理問題為目的，乙服務(wù)對象的健康為宗旨。[9]1.4、護(hù)患關(guān)系是一種多方位的人際關(guān)系護(hù)患關(guān)系不完全局限于護(hù)士與服務(wù)對象之間，它涉及醫(yī)療護(hù)理過程中多方位的人際關(guān)系。1.5、護(hù)患關(guān)系是一種互動關(guān)系護(hù)患關(guān)系要達(dá)到雙方對健康知識產(chǎn)生共識，就必須有雙方的互動。1.6、護(hù)患關(guān)系是一種治療關(guān)系研究表明，良好的護(hù)患關(guān)系能有效地減輕會消除服務(wù)對象來自與疾病、診療護(hù)理、環(huán)境及人際關(guān)系多方面的壓力，有利于促進(jìn)服務(wù)對象的健康。［⑴1.7、護(hù)患關(guān)系是一種短暫性的人際關(guān)系護(hù)患關(guān)系是服務(wù)對象在接受護(hù)理服務(wù)過程中存在的一種人際關(guān)系，一旦護(hù)理服務(wù)結(jié)束，一般這種人際關(guān)系就會結(jié)束。⑹2、護(hù)患關(guān)系的基本模式2.1、主動-被動型這是一種最常見的單向性的，乙生物醫(yī)學(xué)模式及疾病的護(hù)理為主導(dǎo)思想的護(hù)患關(guān)系模式。這種模式適用于對昏迷、休克、全麻、有嚴(yán)重創(chuàng)傷及精神病的服務(wù)對象進(jìn)行護(hù)理時的護(hù)患關(guān)系。2.2、指導(dǎo)-合作型這是一種微乳單項，乙生物醫(yī)學(xué)-社會心理及疾病的護(hù)理為指導(dǎo)思想的護(hù)患關(guān)系。這種模式主要運用于對急性病服務(wù)對象護(hù)理時的護(hù)患關(guān)系。［7］2.3、共同參與型這是一種雙向性的，以生物醫(yī)學(xué)-社會心理模式級健康為中心的護(hù)患關(guān)系模式。這種模式主要適用與對慢性病服務(wù)對象的護(hù)理。3、護(hù)患關(guān)系常見問題及解決技術(shù)不到位引發(fā)矛盾現(xiàn)在的患者對醫(yī)護(hù)人員技術(shù)水平和服務(wù)質(zhì)量的要求越來越高。要是護(hù)士在護(hù)理過程中沒有一套過硬的護(hù)理技術(shù)，那就很難令患者及其家屬滿意。最常見的就是打針了，一針扎下去，患者最知道分量。所以說，護(hù)士要練基本功，還得從技術(shù)水平做起。護(hù)理專家們的建議是，護(hù)士不僅要多學(xué)、多練、多請教，平時還要學(xué)習(xí)各學(xué)科的知識，做個'全科護(hù)士”。服務(wù)不到位引發(fā)矛盾雖然現(xiàn)在的醫(yī)院越來越看重服務(wù)，但仍有個別護(hù)士因為各種各樣的原因冷落了患者。例如剛?cè)朐簳r，患者及其家屬情緒都非常焦慮，迫切地想知道有關(guān)住院治療的一系列相關(guān)問題，而有些護(hù)士對患者的首問負(fù)責(zé)制不到位，或用床號”代替患者姓名，或談吐不注意忌語，如對患者的詢問敷衍了事，隨之矛盾也就來了。所以，護(hù)士在接待患者時就得做好“引路人”，針對其心理特點，聽聽患者的想法及要求，一切為患者著想，急患者所急，想患者所想，及時將相關(guān)問題解釋交代清楚，患者才能更好地配合治療。溝通不到位引發(fā)矛盾有些護(hù)士做得并沒錯，但患者要是不知情，就不太能理會護(hù)士的做法，這時候就覺得溝通的重要。曾有位護(hù)士看到一位大媽打點滴的時間很長，于是一言不發(fā)就上去調(diào)整點滴，可大媽不懂她的意思，見她將藥水動來動去的就不高興了，鬧得最后竟然投訴那位護(hù)士。所以，在護(hù)患之間或與患者家屬的交流中護(hù)士要特別注意自己的語言表達(dá)，另外溝通時最好能將專業(yè)術(shù)語通俗化、口語化，深入淺出，通俗易懂。因隱私問題引發(fā)矛盾在查看病歷、注射時，護(hù)士會接觸到一些病人的隱私，可要是護(hù)士管不牢自己的嘴，那就可能引發(fā)矛盾。所以，醫(yī)院規(guī)定護(hù)理人員不議論患者的私生活，不擅自公開患者健康狀況資料，床頭卡上不注明疾病診斷，在給患者擦浴、更衣、肌肉注射、導(dǎo)尿、使用便器或醫(yī)師查房做體檢時，采用屏風(fēng)遮擋。⑻4、促進(jìn)護(hù)患關(guān)系的方法①創(chuàng)造良好的護(hù)患關(guān)系氣氛及環(huán)境；②與服務(wù)對象建立充分的信任關(guān)系；③良好的人際溝通技巧;④為服務(wù)對象樹立角色榜樣，理解服務(wù)對象角色所承受的社會心理負(fù)擔(dān)，減少服務(wù)對象的角色沖突，促進(jìn)服務(wù)對象的絕數(shù)額轉(zhuǎn)換；⑤健康的工作情緒，良好的工作熱情。[12]三、醫(yī)護(hù)關(guān)系1、醫(yī)護(hù)關(guān)系的模式1.1、主導(dǎo)-從屬模式由于歷史及專業(yè)發(fā)展進(jìn)程的變化，特別是受生物醫(yī)學(xué)模式及浪漫主義哲學(xué)思潮對護(hù)理的影響，長期以來醫(yī)護(hù)關(guān)系的模式乙醫(yī)生為主導(dǎo)，護(hù)士從屬為主。這種模式中，護(hù)士的工作只是醫(yī)生工作的附屬或助手，任何專業(yè)決定都必須聽命于醫(yī)生，護(hù)士并不宜接對服務(wù)對象負(fù)責(zé)，只是機(jī)械的執(zhí)行醫(yī)囑，僅對醫(yī)生負(fù)責(zé)。1.2、獨立-協(xié)作模式隨著現(xiàn)代健康學(xué)科的不斷發(fā)展，醫(yī)學(xué)級護(hù)理模式的轉(zhuǎn)變，人們逐漸對健康與疾病的認(rèn)識發(fā)生了根本的變化，經(jīng)過護(hù)士多年的努力級護(hù)理專業(yè)從服務(wù)、教育、科研專業(yè)組織等方面的不斷完善與發(fā)展，護(hù)理已經(jīng)成為一個獨立的專業(yè)，并在預(yù)防保健過程中與醫(yī)生互相合作，共同發(fā)揮著重要的作用。①、醫(yī)療與護(hù)理專業(yè)相對獨立，不可相互替代。②、醫(yī)療與護(hù)理專業(yè)互相協(xié)作互補，共同發(fā)揮作用。2、醫(yī)護(hù)關(guān)系常見問題及原因2.1、角色壓力在實際的健康服務(wù)組織中，醫(yī)護(hù)比例失調(diào)，有些醫(yī)院甚至倒置，造成人員負(fù)擔(dān)過重而影響醫(yī)護(hù)關(guān)系。2.2、缺乏理解健康服務(wù)群體中，不同專業(yè)的教學(xué)一般都是相對獨立進(jìn)行的，專業(yè)之間相互了解不足，就會影響醫(yī)護(hù)合作關(guān)系。2.3、利益斗爭醫(yī)生級護(hù)士是醫(yī)院的主力，特別是在一線工作的醫(yī)護(hù)人員更是如此。由于一線人員之間的利益分配不均或利益分配之爭，會產(chǎn)生醫(yī)護(hù)沖突。2.4、自主權(quán)之爭醫(yī)務(wù)人員按照分工，在自己的職責(zé)范圍內(nèi)限購一定的專業(yè)自主權(quán)，但是在某些情況下，醫(yī)務(wù)人員可能會感覺自主權(quán)受到侵犯，因而產(chǎn)生矛盾或沖突。3、促進(jìn)醫(yī)護(hù)溝通的方法及策略3.1、相互信任，真誠合作醫(yī)生及護(hù)士是良好合作的同事關(guān)系，其目的是促進(jìn)服務(wù)對象的健康。因此，醫(yī)護(hù)之間應(yīng)彼此理解對方的專業(yè)特點，主動配合對方的工作。3.2、主動宣傳護(hù)理專業(yè)的特點護(hù)士在日常的醫(yī)護(hù)配合中，應(yīng)隨時主動宣傳護(hù)理專業(yè)的特點及發(fā)展趨勢，對醫(yī)院的新護(hù)理規(guī)定及要求及時介紹，以增加醫(yī)生對護(hù)理專業(yè)的了理解及支持。3.3、尊重醫(yī)生的專業(yè)自主權(quán)級專業(yè)特征醫(yī)生與護(hù)士的關(guān)系是平等的專業(yè)合作關(guān)系。3.4、堅持原則，適當(dāng)解釋當(dāng)出現(xiàn)危機(jī)服務(wù)對象安全、健康甚至生命的爭議時，護(hù)士就應(yīng)堅持原則，挺身而出，為服務(wù)對象的利益著想，充當(dāng)服務(wù)對象的代言人，然后耐心細(xì)致的做好解釋工作。結(jié)論：護(hù)士在各種健康服務(wù)機(jī)構(gòu)中處于眾多關(guān)鍵的樞紐地位。對服務(wù)對象而言，護(hù)士與服務(wù)對象接觸的時間最長，最熟悉服務(wù)對象的感覺與需要，是服務(wù)對象護(hù)理的主導(dǎo)者；對醫(yī)生來說，護(hù)士與醫(yī)生需要共同協(xié)作，完成服務(wù)對象的診治護(hù)理任務(wù)；對護(hù)理系統(tǒng)內(nèi)部來說，護(hù)士相互協(xié)作，有利于提高護(hù)理效率，最大限度的保證服務(wù)對象的健康。[13]相關(guān)文獻(xiàn)：[1]李小妹《護(hù)理學(xué)導(dǎo)論》人民衛(wèi)生出版社2006⑵李樹貞《現(xiàn)代護(hù)理學(xué)》人民軍醫(yī)出版社2000羅潤來黃麗娜成洪波劉春民姚煒彪《護(hù)理管理中處理好人際關(guān)系的探討》《護(hù)士進(jìn)修雜志》2004孫香愛《談護(hù)士長在護(hù)患關(guān)系中作用》《護(hù)士進(jìn)修雜志》2002陳田林陳勇飛鐘雙喜《從護(hù)患關(guān)系的不協(xié)調(diào)因素分析其實質(zhì)與對策》《護(hù)理學(xué)雜志：綜合版》2007穆燕紅張靜等《影響醫(yī)護(hù)關(guān)系心理因素的分析及對策》《護(hù)理管理雜志》2003王惠賢《健康教育是建立新型護(hù)患關(guān)系的重要環(huán)節(jié)》《實用護(hù)理雜志》2001年3期宋愛東《護(hù)患溝通是和諧護(hù)患關(guān)系的基礎(chǔ)》《中國民康醫(yī)學(xué)》2008年4期ScholarandHollenderTexas1976,AmericanLevinspecificationsandsnooker1972PengLeiOnCommunicationskillsandthenurse-patientrelationship2011PerryPetersonPotterPhysician-patientrelationship1999BarbaraCherrySusanRJacobNurse-patientrelationshipcommunicationskills2001Active-passivemodeisthetraditionalmodelofphysician-patientrelationshipinmodernmedicalpracticeisstillwidespread,isnotcharacterizedbytwo-wayinteractionbetweendoctorsandpatients,butdoctorsplayaroleinpatientswithone-way.Doctorsinthemedicalprocessfullyactive,decision-makinganddecision-makingpowerallthedoctorsside.Medicalauthoritycannotbedoubted,passivepatientstoreceivetreatment.Elementsandfeaturesofthismodelis:"whatapatient",theadvantageistoplayanactiveroleofdoctors,butcompletelyruledoutinpatientswithprimarypossibilities.Activeapassivemodeismainlyappliedinthecontemporarytreatmentofacuteemergencysituation,suchaspatientswithseriousinjuriesorlossofconsciousnessandisdifficulttoexpressthesubjectiveconsciousness.Guidance-amodeofcooperationisthedoctor-patientrelationshipinmodernmedicalpracticebasedmodel,whichischaracterizedbyadoctorinmedicalactivitiestokeepactive,thepatienthassomeinitiative,butthepatient'sphysicianwilltaketheinitiativetoimplementthepremisemandatoryfordoctorstreatmentmeasurescanonlyfollowandcooperation,althoughdoctorsstillhavetoplaytheauthorityoftheinstructor.Elementsandfeaturesofthismodelis:"tellpatientswhattodo,"theadvantageofbothdoctorsandpatientscanplaytheinitiative,enthusiasm,willhelptoestablishaharmoniousdoctor-patientrelationship,improvediagnosisandtreatmentofmedicalerrorsandcorrect,butbetweendoctorsandpatientsrightsisstillunequal.Guidance-apartnershipmodelforclear-headed,abletoexpresstheconditionofpatientswithmedicalpractitioners.Mutualparticipationmodelislookingforwardtothedevelopmentofmodernmedicalnewmodelofphysician-patientrelationship,whichischaracterizedbydoctorsinpatientswithsimilarequalrightsandstatus,thetwosidescomplementeachother,toparticipateinmedicaldecisionsandimplementation.Highlightsandfeaturesofthismodelis"tohelppatientsself-treatment",theadvantageofthemodelwillhelpimproveunderstandingbetweendoctorsandpatients,toeliminatepatientbarrierstoestablishagooddoctor-patientrelationship.Mutualparticipationmodelforchronicdisease,andmedicalsciencehasacertainlevelofknowledgeofpatients.First,themeaningofinterpersonalrelationshipsRelationships(interpersonalrelationship)isthatpeopleinjointactivitiestomeeteachother'sneedsandtoseektoestablishtherelationshipbetweenthepsychological.Wecansaythattheoriginofhumanrelationshipsissynchronizedwiththeoccurrenceofanextremelyancientsocialphenomenon.Relationshipswiththecharacteristicsofthefollowingaspects:individuality.Performanceofthespecificnatureofinterpersonalrelationshipsofindividualsintheinteractiveprocess.Ininterpersonalrelationships,the"teacher"and"students","boss"and"subordinate"andotherfactorsrelegatedtosecondarystatusroles,andtheotherisnotyourfavorite,orwhoarewillingtocloseamajorproblem.Thisistherelationshipoftheindividualcharacteristicsoftheperformance.direct,canbeemotional.Interpersonalrelationshipsinpeopleandevenfacetofacedirectlytheprocessofinteractionformed,itreflectstheneedsofotherstomeettheirpsychologicalstate,everyonecantrulyfeelitspresence.Ingeneral,thereisnodirectcontactisnocontactandrelationships,andestablisharelationshipaslongas,certainlyforthepeopledirectlyexperience.affective.Thebasisofrelationshipsbetweenpeople'semotionalactivities.Emotionalfactorsarethemaincomponentofinterpersonalrelationships.Interpersonalemotionaltendenciescanbesummarizedintotwocategories:oneisclosetoeachotherorattractpeople'sfeelings,thatevenanemotion.Secondly,toenablepeopletomutuallyexclusiveandopposingemotions,thattheseparationofemotion.Second,theinterpersonalbasisofthesocialpsychologyHumanbeingsaresocialanimals,withagregariousandsocialtendencies.Peoplemostofthetimespentwithothers.ReadLarsonetal(1982)onpeople'stimeusewerestudied.Theyletayoungadultsampleandasamplewastestedineveryweektocarryapager.Everydayfromearlymorningtolateatnight,researchersaretestingseveralrandomcalls,thecallofthesubjectswererequiredtocompleteashortquestionnaire,indicatingthattheyaredoing,isaloneortogetherwithotherpeople.Theresultsshowthatpeopleinnearly3/4ofthenon-sleeptimetogetherwithothers,onlytodohouseholdchores,bathing,listeningtomusicorstudyingathomewhenalone.Incontrast,whenpeopleatschoolorwork,themorelikelyandotherstogether.Andtogetherwithothers,individualscouldbemorehappy,alertandexcited.Whydopeopleneedsoaccompanieditwithothers?Psychologistshavemadeavarietyofinterpretations.andtheneedtoproAtkinson(Atkinson)andothersthataffectpeople'ssocialinteraction,therearetwomotives:oneisthepro-anddemand(theneedofaffiliation),isseekinganumberofpositiverelationshipsandmaintainthedesirethatpeoplehaveaccompaniedbyatendencytoneedandothers;theotheristheintimateneeds(theneedofintimacy),isthatpeopleseekingawarm,intimaterelations.Affinityforhumanneeds,theAmericanpsychologistSchacht(Schachter)hasawell-knownexperiment.Hedesignedawindow,butnotair-conditionedroom,whichinadditiontoatable,achair,abed,atoilet,alampoutsidethenootherthings,threemealsadayasmallholethroughthedoorattheendofthedeliveryinto.Whocanstayinthisroomonedaytogetasubstantialrewardforthepurposeofmeasuringwhatpeoplethinkinsuchascenariocanbeisolatedspendafewdays.Fivecollegestudentsservedassubjects,theresultisoneofthemspent20minutesjustcannotstandtogiveuptheexperiment,twopeoplefortwodays,thelongestsubjectsspentonlyeightdays.Thisexploratorystudyshowsthatpeoplearelonelyendurancethereisadifference,butwhocanhardlyliveinendlesslonelyenvironment.Psychologistsandsocialneedsofthefactorsaffectingthepro-conductedin-depthstudyandfoundthatwithfear,anxietyandothercloselyrelated.1andneedtofearandproInthe1950s,Schacht(Schachter)conductedaseriesofclassicexperiments,tryingtounderstandtheneedtoenhancepeople'saffinityfactors.Heproposedthe"fearofpeoplefacingastrongeraffinitywithbehavioraltendencies,"thehypothesis.Toverifythis,hisfemalestudentsweretestedfortherelevantexperiments.Weretestedbygivingdifferentguidancelanguagetomanipulatetheleveloffearlevel.Theresearcherstoldthewomenweretestedonhowtheywanttoparticipateinashockexperimentaffectthephysiologicalresponses.Inthe"highfear"group,thesubjectsweretoldverypainfulshockbutwillnotcausepermanentinjury;"lowfear"ofthesubjectsweretoldonlyalittlepain,shock,orhempupfeelingabititchy.Infacttheyarenotsubjectedtoelectricshocks,theexperimenterjustwanttobelievethattheywillsoonbetestedbysuchashock.AfterSchachtweretoldthattheexperimentalequipmentusedhasnotyetassembled,askedthemfor10minutes.Andweretoldthattheycanseparatethemselves,butalsotogetherwithothersubjectsandsoon.AdaptedfromFriedman,eds:"SocialPsychology",HeilongjiangPeople'sPublishingHouse,1984,p.62.TheresultsshowninFigure8-1,inthecaseofhigh-fear,peoplechoosetowaitalongwithothers,andinthecaseoflowfearaloneismorewillingtowait.Schachtwithsocialcomparisontheory(Socialcomparisontheory)toexplainthisphenomenon,socialcomparisonemphasizesocialcomparisonisthatpeoplegetthroughandaroundtheworldontheirownknowledge.Therefore,itistogetclosewithothers,theirfeelingswithotherpeopleinsimilarsituationsmore.Miller(Miller,1984)furtherbelievesthatpeoplenotonlythroughsocialcomparisontojudgetheirownabilityandself-concept,andthroughittogetemotionalabouttheirchoiceofinformationandevenfriends.(2)anxietyandneedsandproUnlikefear,anxiety,isanotherperson'semotionalstate.Fearistherebecauseoftheactualoranticipatedthreatstothethreatscenariowillcometoarouseemotionsarisingfromanxietygeneratedbythenon-realityisnotpossibletodeterminethecauses.Wealreadyknowthatfearisstronger,thehigheraffinityandneeds.Sowhetheranxietyandfear,aswilltendtoenhancetheaffinityofpeople?Facedwithembarrassingorself-awarenessbutnotwiththephysicalpainofthescenewillcausepeopleanxietyreaction.Accordingly,ShanuoFu(Sarnoff)andZimbardo(Zimbardo)designedanexperimenttostudytheanxiety,fear,andtherelationshipbetweenpro-andtendencies.Beginningoftheexperiment,theexperimenteraskedthesubjectstospecialrequirementsinordertomanipulatethesubject'sanxietyreaction.Highanxietygroupweretestedintheexperimentweretoldtheyneedtowearabib,pacifiersucking;low-anxietygroup,subjectsweretoldthattheyneedintheexperimentsoundedthewhistle.Highandlowanxietygroupofexperimentalresultswithhighandlowfeargroupresultsjusttheopposite:highanxietysubjectsthanlowanxietysubjectsweremorewillingtowaitforasinglepersonbeginningoftheexperiment.Thisshowsthatthefearwillincreasethepro-anddemand,butitwillreduceanxiety,pro-anddemand.Inotherwords,whenapersontogetherwithotherpeoplenotonlycannotgivehimcomfort,butwillmakehimlookembarrassed,hewouldpreferaseparateexperienceembarrassment.Friedman(Friedman)wastestedbymeasuringthedegreeofsexualexcitementinordertotriggertheiranxiety,erpersonalrewardsWiththegrowthofoursocietyneedtobecomemorecomplexanddiverse.Wewillhavefuntogetherwiththosewhocanhelp,ortoacceptastrongrelationshipbetweentheformationofourpeople.Theserelationshipscanbringusbenefits.Socialexchangetheory(socialexchangetheory)thatgetpeoplethroughtheexchangeofsocialpsychologicalandmaterialrewards,sopeoplewilltrytoseekandrewardthantopaytomaintainrelationships.Peoplegetthebenefitsfromtherelationshipformationandmaintenanceofinterpersonalrelationshipsisanimportantreason,Weiss(R.Weiss,1974)todeterminetherelationshipcanprovideanimportantrewardofsixindividuals:Attachment(attachment):referstotheintimaterelationshipsavailabletotheindividual'ssenseofsecurityandcomfort,theattachmentpointtoparents,child,spouseoradultisforclosefriends.Socialintegration(socialintegration):Throughaffinityinteractionwithothersandwithothershavethesameviewsandattitudes,resultingingroupsasenseofbelonging.Usuallyfromfriends,colleagues,teammates,comradesandotherrelationsaccess.Determinethevalue(reassuranceofworth):togetpeopletosupportthemselveswhentheyhavetheabilitytoproducevaluablesense.Reliableallysense(asenseofreliablealliance):Byestablishingagoodrelationshipwithothers,letusformwhenneededsomeonetohelpourunderstanding.Forguidance(theobtainingofguidance):interactionwithotherssothatwecangettherefromthevaluableguidanceofothers,suchasfromdoctors,friendsandteachers,etc..Theopportunitytotakecareofothers(theopportunityofnurturance):responsibleforthehealthofotherswhenwearetheretotakecareofsomeoneistousasenseofneedandself-important.getridoflonelinessPeopleinteractwithothers,thethirdreasonistogetridofloneliness.Loneliness(loneliness)meansthatwhenpeoplelacksomeimportantfeaturesofsocialrelations,whenthesubjectiveexperienceofdiscomfort.Thisdefectmaybequantitative,wemaynothavefriendsorfriendslessthanweexpected;itmaybequality,andwemayfeelsuperficialrelationshipsorfailtomeetthedesiredextent.Notethat,lonelinessandisolation(aloneness)isdifferentwithothers,lonelinessisanobjectivestateofisolation,lonelinesscanbepleasantorunpleasant,suchasreligiousleadersandgreatmenareoftenlonely,buttheyareexploredinsolitudespiritualenlightenmentandsecularprogress,soeventhoughtheyarenotlonelyalone,theycansaythereisnonecessarylinkbetween.Weiss(1973)accordingtothespecificindividuallackingsocialcontent,willbedividedintoemotionallonelinessloneliness(emotionalloneliness)andsocialloneliness(socialloneliness):theformeristhelackofintimateattachmenttotheobjectcausedbytheloneliness,thelattermeansthatwhenanindividuallacksasenseofsocialintegrationorlackoffriendsorcolleaguesfromtheothergroupsprovidedasenseofbelonginggeneratedbyloneliness.Singleindividualmayexperienceacertaintypeofloneliness,suchasthenewlywedsmovedtooff-sitemaynotexperienceemotionalloneliness,becausetheyhaveeachother;butintegratedintolocallifewilltakesometime,sotheymakenewfriends,Priortotheformationofasenseofbelongingtothenewcommunity,theymayexperiencesocialloneliness.Awomanlostherhusbandtoexperiencestrongemotionsmaybelonely,butshestillhasalotofsocialties,suchasrelatives,friends,andsoon.Inmanycases,lonelinessisaresultoflifechangessothatweleaveafriendorintimatepartnercaused.Canoftenleadtolonelinesssituationsincludemovingtoanewurbanliving,leaveschool,startanewjob,cannotmeetafriendorlovedone,endingasignificantrelationship.Althoughsomecasesverydifficulttogetridofloneliness,butfromthecontextmostpeopleeventuallyrecoverduetoloneliness,tore-establishsatisfactorysociallife.However,somepeoplelongtormentedbyloneliness,lifefreefromtheimpactofchanges,thisisknownaschronicloneliness(chronicloneliness),thesepeople'sphysicalandmentalhealthwillbeaffected.Seriouspersonalproblemsassociatedwitharangeofloneliness,depression,alcoholordrugabuse,physicalillness,pooracademicperformance,theelderly,includingnursinghomeplacementandthelikelihoodofdeath.Itcanbesaid,frombirthtodeath,fewpeopleescapethelonelinessoftheproblems,whichisareflectionofpeople'ssocialneeds.Theonlywaytogetridoflonelinessistobuildrelationshipsinordertomeethuman"join"thebasicpsychologicalneeds.Third,theestablishmentanddevelopmentofinterpersonalrelationships(A)thestateofhumanrelationshipsEverydaylifeweoftensay:soandsotoldsoandsothendonotsay,intimacy;andsoandsowithsoandsoisamongstrangers.Thisisourdescriptionofthestateofhumanrelationships.Levincellandsnooker(G.Levinger&G.Snoek,1972)proposedinterdependencemodel(modelofinterdependence)todescribetherelationshipofinterdependencewiththeincreaseinthecharacteristicsoftherelationshipchanges.Theygraphicallyontheinterpersonallevelofinteractionbetweenvariousstateanditsincreasingtiestodoavisualdescription(Figure8-2).Circlegraphthatthetwosidesinvolvedininterpersonalrelationships.Theyputtogetherthepsychologicalandemotionalintegrationofthefieldrangeofindicatorstodescriberelationships.Goodrelationshipsneedtogothroughacloseintegrationfromthesurfaceexposedtothedevelopmentprocess.Theyarenotawareofeachotherinthepresenceofeachother,therelationshipiszeroexposure(zerocontact)state.Atthispointbothsidesarecompletelyindependent,nottomentionanypersonalsenseofemotionalconnection.Onlyonepartybegantonoticeeachother,orbothjointattention,peoplebegantointeractionbetweeneachotheraregivenaninitialimpression,butthisstatehasnoemotionalinvolvement.Becausebothsideshavenodirectverbalcommunicationwitheachothercanonlybeconsideredamerebystander,intheknow(awareness)state.Contactwiththesurface(surfacecontact)istherealbeginningofhumanrelationships,fromthetwosidesbegantotalkdirectlytothemoment,ithadadirectcontactwitheachother.Ofcourse,thiscontactissuperficial,notcommonbetweenthepsychologicalfield.Withthedeepeningandexpansionofbilateralexchanges,bothsidesofpsychologicalareashavegraduallybeenfound.Foundthatthenumberofareasofcommonpsychologicalandemotionallevelofintegrationiscompatible.Themorecommonofthepsychologicalfieldbetweenthetwosidesagreetoacceptandthehigherthedegreeoftrust,thehigherthedegreeofemotionalintegration.Psychologistsinaccordancewiththedegreeofemotionalintegration,therelationshipsinvolvedaredividedintomild,moderateinvolvementanddepthofinvolvementinthree.Stageischaracterizedbymildinvolvement:frombothsidesfoundcommonpsychologicalsmallerareas,thetwosidesofthepsychologicalworldonlyasmallpartoftheoverlap,itisonlyinthiscontext,istheintegrationofbothemotion.Stageischaracterizedbymoderatelyinvolved:bothhavebeenfoundtopaytolivelargeareasofcommonmental,psychologicalworldofthetwosideshadagreateroverlap,eachother'semotionalrangeiscorrespondinglygreaterintegration.Deepinvolvementinthecaseofthetwosideshavefoundcommonpsychologicalfieldisgreaterthanthedifferencesofthepsychologicalfield,thementalworldofahighdegreeofoverlapwitheachother,theemotionalrangeofintegrationcoversmostofthecontentoflife.However,inreallife,onlyafewpeoplecanachievethestatusofspeciesrelationships,butonlywithafewpeoplereachthisstate.Somepeopleneverachievethiswithanydepth,andsomepeoplealifetimerelationshipwithothers,onlyarelativelysuperficiallevel.Notethatyoucanseefromthefigure,bothrelationshipstheworlddoesnotexistentirelypsychologicalcircumstancesofacoincidence.Nomatterhowclosetherelationshipbetweenpeople,howemotionalharmony,nomatterhowsubjectiveexperienceofpeoplebetweenthewhollyowned,twoofthepsychologicalworldcannotachieveacompletecoincidence,everyoneretainstheirmostprivateaspects.Betweenpeoplethereisonlyconsistentwiththeextenttowhichtheproblemdoesnotexistentirelyconsistentwiththesituation.(B)thedevelopmentofinterpersonalrelationshipsandself-exposure1thedevelopmentofinterpersonalrelationshipsSelf-disclosure(self-disclosure)referstotheindividualtotellabouttheirpersonalinformationtoothers,sharewithotherstheirowninnerfeelingsandinformation.Psychologistsbelieveitisthatpeopledevelopcloserelationshipswithothers,animportantway.AndAltmanandTaylor(I.Altman&DATaylor,1973)toself-exposureasameasureofthedegreeofinterpersonaldepthreference.Fromthisview,goodinterpersonalrelationshipsandthedevelopmentofexchangesbetweentheprogressiveapproachfromtheperspectiveofthegeneralneedtogothroughorientation,emotionalexploration,andemotionalstabilityoftheexchangeinteractioninfourphases.orientationphase.Orientationphaseincludedcontactsinthenote,andpreliminarychoiceofcommunicationandotheraspectsofmentalactivity.Boundless,theassociationmayoccurbetweenpeopleisunlimited,Milgram(Milgram)hasputforwardthe"theoryofsixdegreesinterval"(sixdegreesofseparation),alsoknownasthe"smallworldphenomenon"(smallworldphenomenon)thatinthissociety,betweenanytwopeopletoestablishalink,uptosixpeoplethrough.Regardlessofwhetherthetwopeopleknow,livinginanyremoteplaceonearth,theintervalbetweenthemareonlysixdegrees.Therefore,wealmostcannotcontactanypersonwhoonlytookplacethroughtheintermediarysimpleassociation.Butinreallife,wedonotmeetwithanypersonwhohasestablishedagoodrelationship,butthedepthofinteractionobjectsandinteractionishighlyselective.Undernormalcircumstances,onlywhentheotherfeaturescancauseussomeemotionalresonance,thatwouldarouseourspecialattention.Selectthecontactsintheinteractionprocessitselfreflectsthetendencyofsomeparticularneeds,interests,personalitycharacteristicsandotherpsychologicalcharacteristics.Notethatthischoiceisspontaneous,irrational.Whenwethinkaboutwhocanserveasarationalobjectcontactsandmaintaingoodinterpersonalrelationships,itisalreadypartofthedecisionprocess.Onlythosevalues,sowehaveaconsensuswiththepeople,itcouldbecometheobjectoffurthercontacts.Weselectedtheinitialcommunicationisaninteractionobject,tryingtoestablishalinkwiththeobjectofpracticalaction,Ihopeothershavethemostbasicunderstanding,inordertomakethemselvesawareoftheneedforfurtherinteractionwitheachother.Atthesametime,wealsohopetoleaveagoodfirstimpressiontheother,mayformrelationshipsforthelayingasoundpsychologicalfoundation.Interpersonalorientationphase,thetimespanvaries.PeopleencounterandBriefEncounter,directedphasewillbecompletedwhenthefirstmeeting.Fortheremaybemanyopportunitiesforcontactwitheachotherandtheyhaveastrongtendencytoself-defenseforpeoplewhotaketimetocommunicatethisstagetocomplete.emotionalexplorationstage.Thepurposeofthisphaseistoexploreareasofmutualfeelings,carriedouttheroleofsexualcontact,ratherthanmerelyformalinteractionpatternsingeneral.Withthediscoveryofareasofmutualemotional,communicationbetweenthetwowillbecomeincreasinglywidespread,thedepthandbreadthofself-exposureisalsoincreasing.Butatthisstage,peoplestillthesubjectareasintoeachother'sprivacy,orprivacyofsensitiveareas,self-exposuredoesnotinvolvethedeeperaspectsoftheirown.Althoughatthisstageontherelationshippeoplehavebeguntohaveacertaindegreeofemotionalinvolvement,butthemodalitiesofinteractionwiththeorientationphaseisstillsimilartoeachotheralsohaveattentiontocompliancewithexchangenorms,thereisnostrongattractiontoeachother,eveniftherelationshipbreaksdownitdoesnotmatter.emotionalcommunicationphase.Relationshipsdevelopedtothisstage,thenatureoftherelationshipbegantosubstantialchange.Eachother'ssenseofsecurityandtrusthasbeenestablished,thecontentofcommunicationandinteractionhavebeenwidelyinvolvedinmanyaspectsofself-andmoderateemotionalinvolvement.Iftherelationshipisbrokenatthisstage,itwillbringsconsiderablepsychologicalpressure.Atthisstage,thepressurehasbeenaformalcommunicationpatternstendtodisappear,thebehaviorofbothexchangesisbeyondthescopeofofficialcontacts,showingthespontaneousfusionofrelationships.Atthispoint,itwillprovideatrueevaluationofeachotherfeedback,advice,sincereappreciationforeachotherandcriticism.stableexchangestage.Withtheincreaseinthenumberofcontactsfrombothsides,itiscommoninthepsychologicalfieldwillfurtherincrease,andwithdeepemotionalinvolvement,self-exposureandmoreprofoundandwidespread.Atthispoint,ithasbeentoalloweachotheraccesstotheirhighdegreeofprivacyinthepersonalrealm.Butinreallife,fewpeopleachievethislevelofemotionalfriendship.Manypeoplejusttostayinthethirdstageofthesamelevel.(2)self-exposureandself-stratificationAltmanandTaylor,andwithsocialpenetrationtheory(socialpenetrationtheory)toexplaintherelationshipbetweenself-exposureonthedevelopment.Theybelievethattheformationofintimaterelationshipsisa"penetration"ofapersonoverthesurface,thisperson'sinnerselftobetterunderstandtheprocess.Socialpenetrationdepthandbreadthintwodimensionsoccur(Figure8-3).Astherelationshipdevelops,peoplewillbeexposedtomorepersonalinformation;self-exposureofthecontentwillbecomewider,peoplewilltalkaboutbroadertopics,withvariousactivities.RelationsofthesephasesinFigure8-3thatforapersontoenteranotherperson'spersonality

andlifeexperiences"wedge."Forstrangers,anarrowwedgeissuperficial;forclosefriends,thetopicofexposure,thewedgeisthedepth(moreintimate)wide.Andself-exposurelevelcorrespondingtothetheoryofself.Rubinandother(Z.Rubin&S.Shenker,1978)theselfisdividedintofourlevels.Thefirstlayeristhemostsuperficiallevelofself-involvedinterests,hobbies,etc.,suchasdiet,preferences,dailyfun,recreationalactivitychoices.Thesecondistheviewofthingsandattitudes,suchastheevaluationofapoliticalevent,ateacher'sviewandsoon.Thethirdlevelistheself-conceptandself-staterelationships.Suchastheirrelationshipwiththeirparents,theirmaritalrelationship,parent-childrelationship,theirfeelingsofinferiorityandsoon.Thefourthlayeristhedeepestlevelofself,arepartofaperson'sprivacy,nottootherswillnoteasilyexposed.Ifsomeoftheirowncannotbeacceptedbythegeneralconceptofexperience,thoughts,behavior,hasproducedtheideaoftheftortheirfirstsexualexperience.Understandwhatothersareexposingthemselvestoourlevel,youcanunderstandotherpeoplefortheirtrustandacceptanceof,understandingoftheirstateoftherelati