Nurses' Thinking Process in Understanding Patients' Unconscious Denial

Abstract

In the field of nursing, the importance of "putting oneself in the patient's place" has been emphasized. However, there is no evidence regarding such a thinking process in nurse. On the other hand, in the field of psychology, there is a term that means "putting oneself in the other's place", "perspective-taking", "the thinking process in which nurses put themselves in the patients' perspective. This study aims to examine how patients' unconscious denial causes their nurses to misunderstand their perspective and how it affects nursing care. Using a case story of a nurse and patient scheduled to undergo colostomy, we conducted semi-structured interviews with 141 nurses working at general hospitals. The results of our study suggest that patients' remarks arising from unconscious denial are likely to mislead nurses to take inappropriately optimistic perspective of their patients. Further, even if new information is provided to the nurses, they tend to stick to their initial assumptions about their patients without modifying them. This tendency is also a likely cause of the nurses adopting inappropriate perspective. With regard to the association between the patients' perspective and nursing care, the results suggest that having inappropriately optimistic perspective incurs the risk of providing inappropriate nursing care.