護理人際關系綜述

護理人際關系綜述2010481110王一冰摘要：人與人之間從認識到熟悉并發(fā)展成為親密的人際關系，時間有快有慢，過程有長有短，有時是漸進、有時可能是速成的?，F(xiàn)代化護理服務以護理對象的健康為中心，次過程中，護士是唯一能為服務對象提供全程、整體、晝夜服務的人員。他們需要隨時為服務對象的安全及健康承擔各種責任，并需要與醫(yī)療機構(gòu)中的各種人員配合協(xié)調(diào)，建立良好的溝通網(wǎng)絡及人際關系，已達到為服務對象提供高質(zhì)量將抗服務的目的。關鍵詞：人際關系護患醫(yī)患和諧現(xiàn)狀常見問題引言：護理人際關系是護士在工作過程中所形成的多種網(wǎng)絡人際關系的總和?？茖W而恰當?shù)靥幚砗萌穗H關系，既有利于解決服務對象的谷中問題，促進護理學科的整體發(fā)展，還有利于護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，人際關系從完全的無關系到關系親密要經(jīng)過一系列的發(fā)展過程。并以人際關系狀態(tài)圖直接地描述了人際關系發(fā)展狀態(tài)的一般規(guī)律O1976年美國學者薩斯和荷倫德提出了三種醫(yī)患關系的模式，即薩斯-荷倫德模式。這種醫(yī)患關系的模式同樣也適用于呼喚關系。當前狀況：一、護理中的人際關系。1、建立良好人際關系的意乂。1.1、有利于提高護理質(zhì)量級效率良好的護理關系是做好各項護理工作的重要保證級基礎，他有利于促進護士與服務對象、家屬、醫(yī)生、其他護士、其他醫(yī)務人員之間的相互協(xié)調(diào)與信任，使護士能發(fā)揮在醫(yī)療服務體系中人際樞紐的作用，協(xié)調(diào)好各種人際關系，相互配合，共同為解決服務對象的護理問題發(fā)揮作用，是所在健康服務組織的各項活動得以順利進行，提高護理質(zhì)量級效率。⑴⑵1.2、有利于營造良好的健康服務氛圍，促進服務對象的健康及醫(yī)護人員的身心健康在各種健康服務機構(gòu)中，護士與服務對象及其他人之間所形成的相互理解、相互信任、相互關懷的人際關系，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)護工作人員合理的心理需求得到滿足。1.3、有利于陶冶護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。在護理服務過程中，護士建立各種人際關系的過程，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，選擇權及自主權，關心人的存在、價值、本質(zhì)、理想、自由、個性、尊嚴、創(chuàng)造性級生活質(zhì)量。人本主義的護理理念是滿足服務對象作為一個人的整體需要，護理活動更注重人的整體性及自主性。⑶1.5、有利于促進護理學科的發(fā)展護理作為一門專業(yè)，具有其獨特性及自足性，其從業(yè)人員不僅僅只是機械地執(zhí)行醫(yī)囑，而應該在服務對象的護理中用自己獨特的專業(yè)知識級技能，選擇對服務對象最有利的護理措施。通過與服務對象建立良好的護患關系，可以幫助護士更好地明確其需要，并用獨特的護理手段促進服務對象的健康。2、護理人際關系的特征2.1、專業(yè)性這是由護士的專業(yè)職能決定的。在護理關系中，不論是與服務對象的關系，還是與醫(yī)生、其他護士或醫(yī)務人員的關系，都屬于專業(yè)關系。2.2、時限性這是由護理專業(yè)任務的特定時間跨度性質(zhì)所決定的。專業(yè)任務存在，保持關系；專業(yè)任務完成，關系即宣告結(jié)束。時限性在護理關系上表現(xiàn)的最為突出。服務對象入院，關系開始建立，服務對象康復出院，關系宣告終止。2.3、多面性這是由護士的角色及功能所決定，護士在健康服務群體中具有多方面的角色功能。2.4、復雜性這是由護理服務對象的特殊性與流動性所決定的。護理的服務對象是具有生命有感情的人，他們在進入護理人際關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，加上服務對象的經(jīng)常流動性，會增加護理人際關系的復雜性及處理難度。2.5、協(xié)作性這是由健康服務工作的整體性級系統(tǒng)性所決定的。健康服務是許多不同專業(yè)人員及后勤保障人員等所組成的服務群體，只有共同努力，相互協(xié)調(diào)配合才能完成任務。2.6、公共性這是由護理工作的社會性所決定的。護理對象涉及社會的所有成員。護士是代表醫(yī)療機構(gòu)，甚至代表國家的社會保障體系來為公眾服務。[10]二、護患關系1、護患關系的特征1.1、護患關系是以治療為目的的專業(yè)性、幫助性關系護患關系十一解決服務對象在患病間所遇到的生理、社會心理、精神等方面的問題，滿足服務對象需要為主要目的的一種專業(yè)性的人際關系。這種關系中所有活動是以專業(yè)活動為中心，以保證服務對象的健康為目的。[4][5]1.2、護患關系是一種工作關系與其他的人際關系不同，護患關系是狐貍工作的需要，護士與服務對象之間的人際交彳主是一種職業(yè)行為。由于是一種工作關系，護患關系雙方應避免過度的感情卷入。應為：①護患關系中雙方過多的感情卷入，會導致服務對象護士感情上的高度互動，一旦產(chǎn)生情緒變化，不僅會影響護士的正常工作情緒，也會使服務對象的情緒產(chǎn)生不良變化而影響健康。②護患之間的過度的感情卷入，必然導致出現(xiàn)其他的非工作關系，如友誼、愛情功利等關系。③過度的感情卷入，灰化肥護士大量的時間及精力去滿足與護理無關的服務對象，這會影響忽視的工作效率吧，甚至個人生活。1.3、護患關系是一種以服務對象為中性的關系一切護理活動及護患交彳主都必須以解決服務對象的護理問題為目的，乙服務對象的健康為宗旨。[9]1.4、護患關系是一種多方位的人際關系護患關系不完全局限于護士與服務對象之間，它涉及醫(yī)療護理過程中多方位的人際關系。1.5、護患關系是一種互動關系護患關系要達到雙方對健康知識產(chǎn)生共識，就必須有雙方的互動。1.6、護患關系是一種治療關系研究表明，良好的護患關系能有效地減輕會消除服務對象來自與疾病、診療護理、環(huán)境及人際關系多方面的壓力，有利于促進服務對象的健康。［⑴1.7、護患關系是一種短暫性的人際關系護患關系是服務對象在接受護理服務過程中存在的一種人際關系，一旦護理服務結(jié)束，一般這種人際關系就會結(jié)束。⑹2、護患關系的基本模式2.1、主動-被動型這是一種最常見的單向性的，乙生物醫(yī)學模式及疾病的護理為主導思想的護患關系模式。這種模式適用于對昏迷、休克、全麻、有嚴重創(chuàng)傷及精神病的服務對象進行護理時的護患關系。2.2、指導-合作型這是一種微乳單項，乙生物醫(yī)學-社會心理及疾病的護理為指導思想的護患關系。這種模式主要運用于對急性病服務對象護理時的護患關系。［7］2.3、共同參與型這是一種雙向性的，以生物醫(yī)學-社會心理模式級健康為中心的護患關系模式。這種模式主要適用與對慢性病服務對象的護理。3、護患關系常見問題及解決技術不到位引發(fā)矛盾現(xiàn)在的患者對醫(yī)護人員技術水平和服務質(zhì)量的要求越來越高。要是護士在護理過程中沒有一套過硬的護理技術，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，護士要練基本功，還得從技術水平做起。護理專家們的建議是，護士不僅要多學、多練、多請教，平時還要學習各學科的知識，做個'全科護士”。服務不到位引發(fā)矛盾雖然現(xiàn)在的醫(yī)院越來越看重服務，但仍有個別護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，迫切地想知道有關住院治療的一系列相關問題，而有些護士對患者的首問負責制不到位，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)矛盾有些護士做得并沒錯，但患者要是不知情，就不太能理會護士的做法，這時候就覺得溝通的重要。曾有位護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士。所以，在護患之間或與患者家屬的交流中護士要特別注意自己的語言表達，另外溝通時最好能將專業(yè)術語通俗化、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，護士會接觸到一些病人的隱私，可要是護士管不牢自己的嘴，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、導尿、使用便器或醫(yī)師查房做體檢時，采用屏風遮擋。⑻4、促進護患關系的方法①創(chuàng)造良好的護患關系氣氛及環(huán)境；②與服務對象建立充分的信任關系；③良好的人際溝通技巧;④為服務對象樹立角色榜樣，理解服務對象角色所承受的社會心理負擔，減少服務對象的角色沖突，促進服務對象的絕數(shù)額轉(zhuǎn)換；⑤健康的工作情緒，良好的工作熱情。[12]三、醫(yī)護關系1、醫(yī)護關系的模式1.1、主導-從屬模式由于歷史及專業(yè)發(fā)展進程的變化，特別是受生物醫(yī)學模式及浪漫主義哲學思潮對護理的影響，長期以來醫(yī)護關系的模式乙醫(yī)生為主導，護士從屬為主。這種模式中，護士的工作只是醫(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，護士并不宜接對服務對象負責，只是機械的執(zhí)行醫(yī)囑，僅對醫(yī)生負責。1.2、獨立-協(xié)作模式隨著現(xiàn)代健康學科的不斷發(fā)展，醫(yī)學級護理模式的轉(zhuǎn)變，人們逐漸對健康與疾病的認識發(fā)生了根本的變化，經(jīng)過護士多年的努力級護理專業(yè)從服務、教育、科研專業(yè)組織等方面的不斷完善與發(fā)展，護理已經(jīng)成為一個獨立的專業(yè)，并在預防保健過程中與醫(yī)生互相合作，共同發(fā)揮著重要的作用。①、醫(yī)療與護理專業(yè)相對獨立，不可相互替代。②、醫(yī)療與護理專業(yè)互相協(xié)作互補，共同發(fā)揮作用。2、醫(yī)護關系常見問題及原因2.1、角色壓力在實際的健康服務組織中，醫(yī)護比例失調(diào)，有些醫(yī)院甚至倒置，造成人員負擔過重而影響醫(yī)護關系。2.2、缺乏理解健康服務群體中，不同專業(yè)的教學一般都是相對獨立進行的，專業(yè)之間相互了解不足，就會影響醫(yī)護合作關系。2.3、利益斗爭醫(yī)生級護士是醫(yī)院的主力，特別是在一線工作的醫(yī)護人員更是如此。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)護沖突。2.4、自主權之爭醫(yī)務人員按照分工，在自己的職責范圍內(nèi)限購一定的專業(yè)自主權，但是在某些情況下，醫(yī)務人員可能會感覺自主權受到侵犯，因而產(chǎn)生矛盾或沖突。3、促進醫(yī)護溝通的方法及策略3.1、相互信任，真誠合作醫(yī)生及護士是良好合作的同事關系，其目的是促進服務對象的健康。因此，醫(yī)護之間應彼此理解對方的專業(yè)特點，主動配合對方的工作。3.2、主動宣傳護理專業(yè)的特點護士在日常的醫(yī)護配合中，應隨時主動宣傳護理專業(yè)的特點及發(fā)展趨勢，對醫(yī)院的新護理規(guī)定及要求及時介紹，以增加醫(yī)生對護理專業(yè)的了理解及支持。3.3、尊重醫(yī)生的專業(yè)自主權級專業(yè)特征醫(yī)生與護士的關系是平等的專業(yè)合作關系。3.4、堅持原則，適當解釋當出現(xiàn)危機服務對象安全、健康甚至生命的爭議時，護士就應堅持原則，挺身而出，為服務對象的利益著想，充當服務對象的代言人，然后耐心細致的做好解釋工作。結(jié)論：護士在各種健康服務機構(gòu)中處于眾多關鍵的樞紐地位。對服務對象而言，護士與服務對象接觸的時間最長，最熟悉服務對象的感覺與需要，是服務對象護理的主導者；對醫(yī)生來說，護士與醫(yī)生需要共同協(xié)作，完成服務對象的診治護理任務；對護理系統(tǒng)內(nèi)部來說，護士相互協(xié)作，有利于提高護理效率，最大限度的保證服務對象的健康。[13]相關文獻：[1]李小妹《護理學導論》人民衛(wèi)生出版社2006⑵李樹貞《現(xiàn)代護理學》人民軍醫(yī)出版社2000羅潤來黃麗娜成洪波劉春民姚煒彪《護理管理中處理好人際關系的探討》《護士進修雜志》2004孫香愛《談護士長在護患關系中作用》《護士進修雜志》2002陳田林陳勇飛鐘雙喜《從護患關系的不協(xié)調(diào)因素分析其實質(zhì)與對策》《護理學雜志：綜合版》2007穆燕紅張靜等《影響醫(yī)護關系心理因素的分析及對策》《護理管理雜志》2003王惠賢《健康教育是建立新型護患關系的重要環(huán)節(jié)》《實用護理雜志》2001年3期宋愛東《護患溝通是和諧護患關系的基礎》《中國民康醫(yī)學》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