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Void and narrative in the clinic of addictions: A theoretical proposal. 成瘾诊所中的虚无与叙事:理论建议。
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-01 Epub Date: 2023-04-12 DOI: 10.1177/13634593231167064
Clément Cimolaï, Vincent Bréjard

We propose a connection between the void and addiction via psychoanalysis and current developments in narration in the context of the psychoanalytic clinic. We maintain that the addicted subject is shaped in particular by a relationship to the void evolving from the disruptive effects of the narrative. Our modern era is marked by a parallel evolution towards an unbearable void, to be filled at all costs. The neo-liberal promise of 'filling' the void with consumer objects in turn feeds the illusion of a so-called freedom, based on alienation to the inseparable duos of growth/jouissance and productivism/consumerism. The void has a multidisciplinary heritage (philosophy, physics, art, psychology) underlining certain aspects of a dialectic of the void that fluctuates between nothing at all and everything as potential. Taking this dialectic into account allows us to construct a concept of the void centred around two types of void: a narrative void and an a-narrative void. We maintain that the toxic in addiction can be interpreted as a narco-narrative that is constructed upon an a-narrative void. The clinical implications and technical proposals are briefly explored as openings to a clinical consideration of the void in the field of addictology.

我们通过精神分析和当前精神分析诊所的叙事发展,提出了空虚与成瘾之间的联系。我们认为,上瘾的主体尤其是由叙事的破坏性影响演变而来的空虚关系所塑造的。现代社会的特点是,人们不惜一切代价填补无法忍受的空虚。新自由主义承诺用消费品来 "填补 "空虚,这反过来又助长了所谓自由的幻觉,而这种自由是建立在与增长/享乐和生产/消费主义这不可分割的二元对立的异化基础之上的。虚无 "具有多学科的遗产(哲学、物理学、艺术、心理学),强调了 "虚无 "辩证法的某些方面。考虑到这一辩证法,我们可以围绕两种类型的虚空构建一个虚空概念:叙事性虚空和非叙事性虚空。我们认为,毒瘾中的毒可以被解释为一种叙事性空洞,而这种叙事性空洞是建立在一种叙事性空洞之上的。我们将简要探讨其临床影响和技术建议,作为成瘾学领域对空洞进行临床思考的开端。
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引用次数: 0
Negotiating with digital self-monitoring: A qualitative study on how patients with multiple sclerosis use and experience digital self-monitoring within a scientific study. 与数字自我监测进行谈判:一项关于多发性硬化症患者如何在科学研究中使用和体验数字自我监测的定性研究。
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-01 Epub Date: 2023-05-17 DOI: 10.1177/13634593231175321
Karine Wendrich, Lotte Krabbenborg

Research shows that patients can have values and use practices that are different from those envisioned by technology developers. Using sociomaterialism as an analytical lens, we show how patients negotiated with digital self-monitoring in the context of a scientific study. Our paper draws on interviews with 26 patients with the chronic neurological disease multiple sclerosis (MS) who were invited to use an activity tracker and a self-monitoring app for a period of 12 months as part of their everyday life. Our study aims to fill a gap: relatively little is known about how digital self-monitoring becomes materialized in the everyday lives of patients with chronic diseases. We show that patients engaged in digital self-monitoring because they are eager to participate in research to contribute knowledge that will benefit the larger community of patients rather than to improve their personal self-management. Although respondents adhered to digital self-monitoring during the study, it is not self-evident that they would do so for private self-monitoring purposes. It became clear that respondents did not necessarily perceive digital self-monitoring as useful for their self-management practices due to their established knowledge and routines. Moreover, respondents referred to the inconvenience of having to perform self-monitoring tasks and the emotional burden of being reminded of the MS because of the digital self-monitoring. We conclude by indicating what could be considered when designing scientific studies, including the suitability of conventional study designs for evaluating technologies used daily by patients and the challenge of integrating patients' experiential knowledge into scientific practices.

研究表明,患者的价值观和使用习惯可能与技术开发者的设想不同。我们以社会物质主义为分析视角,展示了在一项科学研究中,患者是如何与数字自我监控进行协商的。我们的论文借鉴了对 26 名慢性神经疾病多发性硬化症(MS)患者的访谈,这些患者受邀在 12 个月内使用活动追踪器和自我监控应用程序,并将其作为日常生活的一部分。我们的研究旨在填补一个空白:人们对数字自我监控如何在慢性病患者的日常生活中具体化知之甚少。我们的研究表明,患者之所以参与数字自我监测,是因为他们渴望参与研究,以贡献出有益于广大患者的知识,而不是为了改善个人的自我管理。虽然受访者在研究过程中坚持进行数字自我监测,但他们这样做的私人自我监测目的并不明显。显然,受访者并不一定认为数字自我监测对他们的自我管理实践有用,因为他们已经有了自己的知识和习惯。此外,受访者还提到了必须执行自我监测任务所带来的不便,以及因数字自我监测而被提醒多发性硬化症所带来的精神负担。最后,我们指出了在设计科学研究时应考虑的问题,包括传统研究设计是否适合评估患者日常使用的技术,以及将患者的经验知识融入科学实践所面临的挑战。
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引用次数: 0
"The Depressed" and "People with Anxiety" therapists' discursive representations of patients with depression and anxiety in Danish Psychiatry. 丹麦精神病学》中 "抑郁症患者 "和 "焦虑症患者 "治疗师对抑郁症和焦虑症患者的话语表述。
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-01 Epub Date: 2023-05-16 DOI: 10.1177/13634593231173802
Anne Bryde Bryde Christensen, Karoline Dyrloev, Michaela Hoej, Stig Poulsen, Nina Reinholt, Sidse Arnfred

Stigmatization within mental health care has previously been identified, and some diagnoses have been shown to be particularly exposed to negative attitudes and stigma. However, no previous studies have explored practitioners' discursive construction of patients with different diagnoses within a transdiagnostic group context. We performed discourse analysis on 12 interviews with Danish mental health practitioners, who had been conducting either transdiagnostic psychotherapy (The Unified Protocol) or standard group cognitive behavioral therapy (CBT) with patients treated for anxiety disorders or major depressive disorder. The purpose of this study was to identify how patients with anxiety and depression were represented by therapists. We identified a "training discourse," within which patients were evaluated through perceived motivation, responsibility, active participation, and progression. We argue that this training discourse can be related to a broader neoliberal order of discourse valuing efficiency and agency. The analysis indicated that patients with anxiety were sometimes "favorized" over patients with depression, and it is argued that the neoliberal order of discourse and pre-assumptions related to the diagnoses are contributing to this. The interviews indicate that multiple discourses were applied when describing patients, and ambivalence was often detectable. We discuss the findings of the analysis in relation to therapists' general critical attitudes toward the psychiatric system and in relation to broader societal tendencies.

心理健康护理中的污名化现象以前就已被发现,一些诊断尤其容易受到负面态度和污名化的影响。然而,此前还没有研究探讨过从业人员在跨诊断群体背景下对不同诊断患者的话语建构。我们对丹麦心理健康从业者的 12 个访谈进行了话语分析,他们对焦虑症或重度抑郁症患者进行了跨诊断心理治疗(统一协议)或标准团体认知行为治疗(CBT)。本研究的目的是确定焦虑症和抑郁症患者在治疗师心目中的形象。我们发现了一种 "培训话语",在这种话语中,患者通过感知到的动机、责任感、积极参与和进步得到评价。我们认为,这种培训话语与更广泛的新自由主义话语秩序有关,新自由主义话语重视效率和能动性。分析表明,焦虑症患者有时比抑郁症患者更受 "青睐",我们认为,新自由主义的话语秩序以及与诊断相关的预先假定是造成这种情况的原因。访谈表明,在描述病人时使用了多种话语,而且经常可以发现矛盾的情绪。我们将结合治疗师对精神病治疗系统的普遍批判态度以及更广泛的社会趋势来讨论分析结果。
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引用次数: 0
Intercorporeal collaboration: Staging, parsing, and embodied directives in dementia care. 体外协作:痴呆症护理中的分期、解析和体现指令。
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-01 Epub Date: 2023-05-22 DOI: 10.1177/13634593231173809
Lars-Christer Hydén, Anna Ekström, Ali Reza Majlesi

This study shows how concerted bodily movements and particularly intercorporeality play a central role in interaction, particularly in joint activities with people with late-stage dementia. Direct involvement of bodies in care situations makes intercorporeal collaboration the basic form for engaging with people with late-stage dementia. By detailed analysis of a videorecording of a joint activity involving a person with late-stage dementia as an example, we show that the process of concerted bodily movements includes not only an interactive bodywork but also a reconfiguration of the routine activities and actions in situ. Reconfigurations often require, and are the outcome of, particular practices for the systematic modification of the embodied conducts of the participants and their use of artifacts in the surrounding environment. These practices, that we highlight in our study, are (1) staging activities through organization and re-organization of body parts, as well as artifacts (rather than using verbal descriptions of activities); (2) decomposing (parsing) activities into smaller parts possible for the person with dementia to perform (rather than using verbal action descriptions); and (3) providing embodied directions and bodily demonstrations of actions (rather than using verbal directives). As a result, we point to these practices for their reflexive roles in the change of the use of modalities in interaction: from mainly using verbal language to the prominence of visual depiction and bodily demonstration as necessary methods to facilitate the participation of people with latestage dementia in joint activities.

这项研究表明,协同的身体运动,尤其是身体间的协作,在互动中发挥着核心作用,特别是在与晚期痴呆症患者共同开展的活动中。在护理过程中身体的直接参与使得身体间的协作成为与晚期痴呆症患者互动的基本形式。通过详细分析与晚期痴呆症患者共同活动的视频录像,我们发现,身体协调运动的过程不仅包括互动的肢体工作,还包括对现场常规活动和行动的重新配置。重新配置通常需要参与者系统地改变其身体行为和使用周围环境中的人工制品的特定做法,而且这些做法也是重新配置的结果。我们在研究中强调的这些做法是:(1) 通过组织和重新组织身体部位以及人工制品来进行活动(而不是使用活动的口头描述);(2) 将活动分解(解析)为痴呆症患者可能完成的更小部分(而不是使用口头动作描述);(3) 提供身体指令和身体动作示范(而不是使用口头指令)。因此,我们指出这些做法在改变互动方式中的反思作用:从主要使用口头语言到突出视觉描述和身体示范,将其作为促进晚期痴呆症患者参与共同活动的必要方法。
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引用次数: 0
Media portrayals of psychotropic agents in AD/HD treatment: A social constructionist approach. 媒体对AD/HD治疗中精神药物的描述:一种社会建构主义的方法。
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-01 Epub Date: 2023-04-19 DOI: 10.1177/13634593231167060
Josef Qaderi, Jonas Lindblom

In recent decades there has been a significant increase in diagnosing children and adults with Attention-Deficit/Hyperactivity Disorder (AD/HD), and in the use of pharmacological treatment with Ritalin, Concerta and Strattera for AD/HD. This development has given rise to scientific criticism, claiming that the pharmaceuticals prescribed by doctors are, to a large extent, ineffective or harmful. This study discusses media's portrayal of treatment of AD/HD. The aim of the article is to develop a social constructionist perspective, highlighting how scientific critique of pharmaceuticals for AD/HD is handled in the mass media. The authors introduce the concept of "psychopharmacological extensibility," which demonstrates the importance of collective definitional processes in society. Psychopharmacological extensibility reflects the fact that the perception of AD/HD agents as beneficial medicines or harmful drugs is open to interpretation and dependent on social factors related to context, power, rhetoric, and marketization. The empirical data are based on 211 articles from eight of the largest newspapers in Sweden, published between 2002 and 2021. The result shows that Swedish mass media, in numerous ways, neglects or undermines the scientific criticism made, thereby facilitating an increased use of the diagnosis and of psychotropic agents in society.

近几十年来,诊断患有注意力缺陷/多动障碍(AD/HD)的儿童和成人,以及使用利他林、Concerta和Strattera药物治疗AD/HD的情况显著增加。这一发展引起了科学界的批评,声称医生开出的药物在很大程度上无效或有害。本研究讨论了媒体对AD/HD治疗的描述。这篇文章的目的是发展一种社会建构主义的观点,强调大众媒体如何处理对AD/HD药物的科学批评。作者引入了“心理药理学可扩展性”的概念,这表明了集体定义过程在社会中的重要性。心理药理学的可扩展性反映了这样一个事实,即AD/HD制剂作为有益药物或有害药物的认知是开放的,并取决于与背景、权力、修辞和市场化相关的社会因素。实证数据基于瑞典八家最大报纸在2002年至2021年间发表的211篇文章。结果表明,瑞典大众媒体在许多方面忽视或破坏了科学批评,从而促进了诊断和精神药物在社会中的更多使用。
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引用次数: 0
Layers of senses: Experiencing intercorporeality in teletherapy. 感官的层次:在远程治疗中体验体际现实。
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-01 Epub Date: 2023-03-13 DOI: 10.1177/13634593231156811
Ariela Popper-Giveon, Yael Keshet

Teletherapy, namely, therapy that uses technology for communication between patients and therapists, is challenged by the impersonal nature of remote and digital communication. Using Merleau-Ponty's theoretical concept of intercorporeality, which refers to the perceived reciprocity between two people's bodies during communication, this article aims to elaborate on spiritual caregivers' experience of interacting with patients during teletherapy. Semi-structured in-depth interviews were conducted with 15 Israeli spiritual caregivers who use various forms of teletherapy (Zoom, FaceTime, phone calls, WhatsApp messages, etc.). Interviewees emphasized their physical presence with the patient as a main principle in spiritual care. They indicated the involvement of nearly all senses in physical presence therapy, which allows for joint attention and compassionate presence. When making use of various communication technologies in teletherapy, they reported the involvement of fewer senses. The more senses involved in the session and the clearer it is that space and time are shared by both caregiver and patient, the stronger the caregiver's presence with the patient. Interviewees experienced teletherapy as eroding the multisensory joint attention and intercorporeality and, hence, the quality of care. This article points at the advantages of teletherapy for therapists in general and spiritual caregivers in particular but claims, nonetheless, that it challenges the main principles of therapy. Joint attention in therapy is, fundamentally, a multisensory phenomenon that may be understood as intercorporeality. Our use of the notion of intercorporeality sheds light on the reduction of the senses involved in remote interpersonal communication and its impact on care and, more generally, the interpersonal communication experienced during telemedicine. This article's findings may also contribute to the field of cyberpsychology and to therapists engaged in telepsychology.

远程治疗,即利用技术在患者和治疗师之间进行交流的治疗,因远程和数字通信的非个人性质而受到挑战。梅洛-庞蒂(Merleau-Ponty)的理论概念 "身体间性"(interporporeality)指的是两个人的身体在交流过程中的互惠感知,本文旨在阐述心灵关怀者在远程治疗过程中与患者互动的体验。本文对 15 位以色列心灵照护者进行了半结构化深度访谈,他们使用各种形式的远程治疗(Zoom、FaceTime、电话、WhatsApp 消息等)。受访者强调,他们与病人的身体接触是心灵关怀的主要原则。他们表示,在身体在场疗法中,几乎所有的感官都会参与进来,从而实现共同关注和同情。当在远程治疗中使用各种通信技术时,他们表示参与的感官较少。参与治疗的感官越多,护理人员和病人共享的空间和时间越清晰,护理人员与病人的共在感就越强。受访者认为远程治疗会侵蚀多感官共同关注和实体间性,从而影响护理质量。本文指出了远程治疗对一般治疗师,尤其是心灵照护者的优势,但同时也声称远程治疗对治疗的主要原则提出了挑战。从根本上说,治疗中的共同关注是一种多感官现象,可以理解为体间性。我们使用 "实体间性 "这一概念,揭示了远程人际交流中感官的减少及其对护理的影响,更广泛地说,是对远程医疗过程中的人际交流的影响。本文的研究结果还可能对网络心理学领域和从事远程心理学的治疗师有所帮助。
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引用次数: 0
Peer support for accepting distressing reality: Expertise and experience-sharing in psychiatric peer-to-peer group discussions. 接受痛苦现实的同伴支持:精神科同伴小组讨论中的专业知识和经验分享。
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-05-01 Epub Date: 2023-02-27 DOI: 10.1177/13634593231156822
Elina Weiste, Melisa Stevanovic, Lise-Lotte Uusitalo, Hanna Toiviainen

Peer-based interventions are increasingly used for delivering mental health services to help people with an illness re-examine their situation and accept their illness as part of their life story. The role of the peer supporter in these interventions, known as experts-by-experience (EbE), is situated between mutual peer support and semi-professional service delivery, and they face the challenge of balancing an asymmetric, professional relationship with a reciprocal, mutuality-based, equal relationship. This article investigates how EbEs tackle this challenge when responding to clients' stories about their personal, distressing experiences in peer-based groups in psychiatric services. The results show how the EbEs responded to their clients' experience-sharing with two types of turns of talk. In the first response type, the EbEs highlighted reciprocal experience-sharing, nudging the clients toward accepting their illness. This invoked mutual affiliation and more problem-talk from the clients. In the second response type, the EbEs compromised reciprocal experience-sharing and advised clients on how to accept their illness in their everyday lives. This was considered less affiliative in relation to the client's problem description, and the sequence was brought to a close. Both response types involved epistemic asymmetries that needed to be managed in the interaction. Based on our analysis, semi-professional, experience-based expertise involves constant epistemic tensions, as the participants struggle to retain the mutual orientation toward peer-based experience-sharing and affiliation.

以同伴为基础的干预措施越来越多地被用于提供心理健康服务,以帮助患病者重新审视自己的处境,并接受自己的疾病是其生命故事的一部分。在这些干预措施中,被称为 "经验专家"(EbE)的同伴支持者的角色介于同伴互助和半专业服务提供之间,他们面临着平衡不对称的专业关系与互惠、互利、平等关系的挑战。本文研究了在精神科服务的同伴小组中,EbE 在回应客户关于其个人痛苦经历的故事时如何应对这一挑战。研究结果表明,心理咨询师是如何通过两种谈话方式来回应服务对象的经验分享的。在第一种回应类型中,EbEs 强调互惠的经验分享,鼓励客户接受自己的疾病。这引起了客户的相互归属感和更多的问题谈话。在第二种反应类型中,心理咨询师降低了经验分享的互惠性,建议客户如何在日常生活中接受自己的疾病。这被认为与客户的问题描述关联性较小,序列也就结束了。这两种反应类型都涉及到需要在互动中处理的认识不对称问题。根据我们的分析,以经验为基础的半专业性专业知识涉及到持续的认识论紧张关系,因为参与者要努力保持以同伴为基础的经验分享和从属关系的相互取向。
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引用次数: 0
Power, position and social relations: Is the espoused absence of hierarchy in Open Dialogue naïve? 权力、地位和社会关系:开放对话中没有等级之说是否天真?
IF 2.1 4区 医学 Q1 Social Sciences Pub Date : 2024-04-26 DOI: 10.1177/13634593241249101
Rochelle Einboden, Lisa Dawson, Andrea McCloughen, Niels Buus

Open Dialogue practitioners aim to reduce social hierarchies by not privileging any one voice in social network conversations, and thus creating space for a polyphony of voices. This sits in contrast to the traditional privileging of those voices credited with more knowledge or power because of social position or professional expertise. Using qualitative interviews, the aim of this current study was to explore Open Dialogue practitioners' descriptions of challenges in implementing Open Dialogue at a women's health clinic in Australia. Findings revealed how attempts to rhetorically flatten hierarchies among practitioners created challenges and a lack of clarity regarding roles and responsibilities. As the practitioners tried to adjust to new ways of working, they reverted to taking up engrained positions and power aligned with more conventional social and professional roles for leading therapy and decision-making. The findings raise questions about equity-oriented ways of working, such as Open Dialogue, where intentions of creating a flattened hierarchy may allow power structures and their effects to be minimised or ignored, rather than actively acknowledged and addressed. Further research is needed to consider the implications that shifting power relations might have on the roles and responsibilities of practitioners in the move to equity-oriented services.

开放式对话的实践者旨在通过在社交网络对话中不偏袒任何一种声音来减少社会等级,从而为多种声音创造空间。这与传统的因社会地位或专业知识而赋予那些拥有更多知识或权力的声音以特权的做法形成鲜明对比。通过定性访谈,本研究旨在探讨开放式对话实践者对澳大利亚一家妇女健康诊所在实施开放式对话过程中所面临挑战的描述。研究结果表明,试图在言辞上扁平化从业人员之间的等级制度,是如何造成挑战以及角色和责任不明确的。当从业人员试图适应新的工作方式时,他们又回到了与更传统的社会和专业角色相一致的根深蒂固的位置和权力,以领导治疗和决策。研究结果提出了一些关于以公平为导向的工作方式(如开放式对话)的问题,在这种工作方式中,建立扁平化等级制度的意图可能会使权力结构及其影响被最小化或被忽视,而不是被积极承认和解决。需要开展进一步的研究,以考虑权力关系的转变可能对从业人员在转向以公平为导向的服务过程中的角色和责任产生的影响。
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引用次数: 0
Patient-led research and displacements of biomedical knowledge production, distribution, and consumption. 患者主导的研究与生物医学知识的生产、传播和消费的位移。
IF 2.1 4区 医学 Q1 Social Sciences Pub Date : 2024-04-26 DOI: 10.1177/13634593241249096
Dixi Louise Strand, Mari Holen

Patient and Public Involvement in Research (PPIR) has become an increasingly prevalent and integral part of biomedical research. In this paper, we focus on patient-led research, taking as our case the construction of new biomedical knowledge regarding the rare disease ADNP syndrome. Specifically, we seek to understand how concepts of experiential knowledge and lay expertise become integral to rather than separate from scientific expertise. In the case of ADNP, the parent-led research "mimes" biomedical knowledge practices in a way that, on the one hand, enhances the legitimacy of science and scientific expertise, and on the other displaces and transforms science by the fact that other knowledge agents (patients, next-of-kin) enter these practices.

患者和公众参与研究(PPIR)已成为生物医学研究中日益普遍和不可或缺的一部分。在本文中,我们以构建有关罕见疾病 ADNP 综合征的新生物医学知识为案例,重点讨论患者主导的研究。具体而言,我们试图了解经验知识和非专业知识的概念如何成为科学专业知识的组成部分,而不是与之分离。就 ADNP 而言,家长主导的研究 "模拟 "了生物医学知识的实践,一方面增强了科学和科学专业知识的合法性,另一方面,其他知识主体(患者、近亲)也参与了这些实践,从而取代并改变了科学。
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引用次数: 0
'Alright my lovely': The use of terms of endearment as a mitigation device in the care of people living with dementia in the acute hospital environment. 好吧,我亲爱的":在急症医院护理痴呆症患者时使用爱称作为缓解手段。
IF 2.1 4区 医学 Q1 Social Sciences Pub Date : 2024-04-04 DOI: 10.1177/13634593241238856
Lauren Bridgstock, A. Pilnick, Sarah Goldberg, R. Harwood
This paper examines how terms of endearment (ToE) are used as a mitigation device in interactions between staff and people living with dementia (PLWD) in the acute hospital environment. ToE are often discouraged in training for healthcare staff. However, this research demonstrates that they are still commonly used in practice. Using conversation analysis, video and audio data were examined to identify the interactional functions of ToE. Analysis showed that ToE play an important role in mitigating potentially face-threatening actions such as when patients are asked to repeat hard-to-interpret talk, or when patient agency is compromised through instruction sequences or having necessary healthcare tasks undertaken. The success of this mitigation is sensitive to the specific interactional circumstances, as well as the responsiveness of the HCP to the patient's voiced concerns. These findings have implications for healthcare practice, training and wider care of PLWD.
本文探讨了在急症医院环境中,医护人员与痴呆症患者(PLWD)互动时如何使用敬语(ToE)作为缓解手段。在对医护人员的培训中,通常不鼓励使用敬语。然而,本研究表明,在实际工作中,这种方法仍被普遍使用。通过会话分析,研究人员对视频和音频数据进行了检查,以确定 ToE 的互动功能。分析表明,ToE 在缓解潜在的面子威胁行为方面发挥了重要作用,例如当病人被要求重复难以理解的谈话时,或者当病人的自主性因指令序列或执行必要的医疗保健任务而受到损害时。这种缓解措施的成功与否取决于具体的互动环境,以及医护人员对患者所表达的关切的反应能力。这些研究结果对 PLWD 的医疗实践、培训和更广泛的护理工作具有重要意义。
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引用次数: 0
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