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Editorial Preface: Well-Being and Dignity. 社论前言:福祉与尊严。
IF 2.6 3区 医学 Q1 NURSING Pub Date : 2025-04-01 DOI: 10.1111/nup.70026
Stefanos Mantzoukas
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引用次数: 0
Art of Caring Model for Emergency Care Patients and Professionals. 急诊病人及专业人员的护理模式艺术。
IF 2.6 3区 医学 Q1 NURSING Pub Date : 2025-04-01 DOI: 10.1111/nup.70024
Carina Elmqvist, Michaela Ivarsdotter, Anna Bratt

The Art of Caring model is developed from a general structure of the flow in the encounter between the injured patients and the different professionals within emergency care, in turn founded on four phenomenological essences, which encompass the experiences of patients, next of kin, and various professionals during the encounter at the scene of an accident and at the emergency department. The Art of Caring model represents a philosophical and theoretical rethinking of an ethical approach. It draws upon the works of the Danish philosopher Løgstrup, the French philosopher Levinas as well as selected aspects of Merleau Ponty. The Art of Caring model is illustrated by coppersmith and artist Michaela Ivarsdotter, further developed and reflected upon with Anna Bratt, a psychologist working according to the compassion-focused tradition. The model is made to disclose and visualise the Art of Caring and facilitate reflections on achieving a win-win situation for both patients and different professionals within emergency care. Healthcare involves a variety of professions, and for the benefit of the patient, we must recognise the significance of professionals taking on the advocacy role from a caring science perspective, which includes the unique and shared experiences of the lifeworld. This is a challenge within the context of demanding efficiency and time pressure in emergency care. To address this, a concrete action plan for ethical reflections is needed to find a balance between giving and receiving, essential for healthcare professionals to avoid compassion fatigue. In the context of ethical competence and the challenges faced by different healthcare professionals within emergency care, the Art of Caring model could be used for ethical reflections, as an approach to achieve a balance between patient advocacy, ethical considerations, and effective emergency care delivery. Achieving this goal will lead to better patient outcomes and a more supportive work environment for the entire emergency care team.

护理的艺术模式是从急诊护理中受伤病人和不同专业人员之间相遇的一般结构发展而来的,反过来又建立在四个现象学本质上,这些本质包括病人、近亲和各种专业人员在事故现场和急诊室相遇时的经历。关怀的艺术模式代表了对伦理方法的哲学和理论反思。它借鉴了丹麦哲学家洛格斯特鲁普、法国哲学家列维纳斯的作品,以及梅洛·庞蒂的一些方面。“关怀的艺术”模型由铜匠和艺术家Michaela Ivarsdotter绘制,并与心理学家Anna Bratt进一步发展和反思,Anna Bratt根据以同情为中心的传统工作。该模型旨在揭示和可视化护理的艺术,并促进在急诊护理中实现患者和不同专业人员双赢的思考。医疗保健涉及各种专业,为了患者的利益,我们必须认识到专业人员从关怀科学的角度承担倡导作用的重要性,其中包括生活世界中独特和共享的经验。在紧急护理要求效率高、时间紧迫的背景下,这是一项挑战。为了解决这个问题,需要一个具体的道德反思行动计划,在给予和接受之间找到平衡,这对医疗保健专业人员避免同情疲劳至关重要。在伦理能力和急诊护理中不同医护人员面临的挑战的背景下,护理的艺术模型可以用于伦理反思,作为实现患者倡导、伦理考虑和有效急诊护理之间平衡的方法。实现这一目标将带来更好的患者治疗效果,并为整个急诊护理团队提供更支持性的工作环境。
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引用次数: 0
On Alan Armstrong's 'Towards a Strong Virtue Ethics for Nursing Practice'. 论艾伦·阿姆斯特朗的“护理实践的强大美德伦理”。
IF 2.6 3区 医学 Q1 NURSING Pub Date : 2025-04-01 DOI: 10.1111/nup.70027
Roger Newham

Armstrong's (2006) 'Towards a strong virtue ethics for nursing practice' is focused on how the practice of nursing necessitates morally good character traits as virtues including the intellectual virtue phronesis. Because of this, he claims, nursing ethics should also be grounded in virtue ethics. Illness creates a unique phenomenon that involves a special therapeutic as helping relationship necessitating good interpersonal skills and patient-centred care that, for the role of a nurse and nursing ethics, requires a focus on persons and relationships, character and emotions. Obligation, act centred normative theories are, according to Armstrong, incomplete and inadequate for nursing practice. They are incomplete and inadequate as moral theories because they ignore, or at least do not give appropriate moral importance to, other factors of life such as character, moral education, emotions and relationships. Armstrong grounds his virtue ethics in a 'moralised' eudaimonia. This leads to problems of getting from good for to good. It is suggested a non eudaimonistic, virtue ethics by Swanton might be just what Armstrong is after but as an account of ethics not morality.

阿姆斯特朗的(2006)“护理实践的强大道德伦理”侧重于护理实践如何需要道德上良好的性格特征作为美德,包括知识美德。正因为如此,他声称,护理伦理也应该建立在美德伦理的基础上。疾病创造了一种独特的现象,涉及一种特殊的治疗作为帮助关系,需要良好的人际交往技巧和以病人为中心的护理,对于护士的角色和护理伦理来说,需要关注人和关系、性格和情感。义务,行为为中心的规范理论是,根据阿姆斯特朗,不完整和不充分的护理实践。它们作为道德理论是不完整和不充分的,因为它们忽略了生活中的其他因素,如性格、道德教育、情感和关系,或者至少没有给予适当的道德重要性。阿姆斯特朗将他的美德伦理学建立在一种“道德化”的幸福主义之上。这就导致了从善到善的问题。斯旺顿提出了一种非唯美主义的美德伦理学,这可能正是阿姆斯特朗所追求的,但这是一种对伦理的解释,而不是道德。
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引用次数: 0
The Loss of the Nurse as an Individual: Nursing, Well-Being and Existentialism. 护士作为个体的丧失:护理、幸福和存在主义。
IF 2.6 3区 医学 Q1 NURSING Pub Date : 2025-04-01 DOI: 10.1111/nup.70013
Marci Kay Livingston, Stacy Manning

Research into how existentially aware nurses and nursing interventions have highlighted the benefits to patients and patient outcomes. Less is known about how existentially based training affects nurses themselves. This project sought to understand if and how a training programme developed to improve nurses' knowledge of existential theory would affect their well-being. Overall, despite challenges to recruitment, follow-up and data collection, three key themes were developed from the data: (1) Things Are Difficult, (2) We Need More… and (3) Well-Being Is Personal. Existentialist philosophy can be an effective way of providing nurses with the tools to develop and express their own definition of well-being. It can also be useful to healthcare systems and administrators seeking to find ways of reducing burnout and turnover among nursing staff.

研究如何存在意识护士和护理干预已经强调了对病人和病人的结果的好处。关于以生存为基础的培训如何影响护士本身,人们知之甚少。该项目旨在了解为提高护士的存在主义理论知识而制定的培训计划是否以及如何影响他们的福祉。总体而言,尽管在招聘、跟进和数据收集方面存在挑战,但从数据中发展出三个关键主题:(1)事情很困难,(2)我们需要更多……和(3)幸福是个人的。存在主义哲学可以有效地为护士提供工具来发展和表达他们自己对幸福的定义。它也可以是有用的医疗保健系统和管理者寻求减少护理人员的倦怠和流失率的方法。
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引用次数: 0
Nursing and Pluralism: The Work of Michel Serres. 护理与多元化:米歇尔·塞雷斯的作品。
IF 2.6 3区 医学 Q1 NURSING Pub Date : 2025-04-01 DOI: 10.1111/nup.70017
Graham McCaffrey

Nursing theory should reflect the pluralism inherent in nursing practice. Nurses routinely enact different kinds of knowledge in combination to achieve good nursing care. Nursing theoretical and philosophical literature includes many attempts to engage with epistemological pluralism. In this paper, concepts from the work of Michel Serres are introduced as a contribution to the resources available to think pluralistically about nursing. Serres' work is valuable because he is a pluralist thinker, who uses different conceptual tools to explore the complexity of human life, including topology, isomorphism, and the excluded third. Serres' terms are discussed with examples of application to nursing. An extendeddd example of addictions nursing is used to pull together different concepts applied to a complex and multilayered area of practice.

护理理论应反映护理实践的多元性。护士通常将不同种类的知识结合起来,以达到良好的护理效果。护理理论和哲学文献包括许多尝试与认识论的多元化。在本文中,从米歇尔Serres的工作概念被介绍作为一个贡献的资源,可用的思考关于护理的多元化。Serres的作品是有价值的,因为他是一个多元化的思想家,他用不同的概念工具来探索人类生活的复杂性,包括拓扑,同构,和被排除的第三。本文讨论了Serres术语在护理中的应用实例。成瘾护理的一个扩展的例子是用来把不同的概念应用到一个复杂的和多层次的实践领域。
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引用次数: 0
Trust as a Solution to Human Vulnerability: Ethical Considerations on Trust in Care Robots. 信任作为人类脆弱性的解决方案:对护理机器人信任的伦理考虑。
IF 2.6 3区 医学 Q1 NURSING Pub Date : 2025-04-01 DOI: 10.1111/nup.70020
Mario Kropf

In the care sector, professionals face numerous challenges, such as a lack of resources, overloaded wards, physical and psychological strain, stressful constellations with patients and cooperation with medical professionals. Care robots are therefore increasingly being used to provide relief or to test new forms of interaction. However, this also raises the question of trust in these technical companions and the potential vulnerability to which these people then expose themselves. This article deals with an ethical analysis of the two concepts of trust and vulnerability in the context of care robotics. The first step is to examine what can be understood by vulnerability, focusing specifically on Misztal's three proposed types (relationships, future anticipation, past experiences). This strategy is often used as a starting point by authors and also seems relevant for the connection to the concept of trust. In a second step, these three types of human vulnerability are examined on the basis of a technical concept of trust. It is shown that (1) relationships and thus also interdependence can create additional options, (2) the anticipation problem with regard to the actions of others also makes responsibility transferable and (3) an explication of freedom is also associated with potential traumatic experiences. The final step brings together the previous considerations and makes it clear once again that trust in a care robot need not only be associated with vulnerability, but that vulnerability can also potentially be reduced, transferred and overcome.

在护理领域,专业人员面临着诸多挑战,如资源匮乏、病房超负荷、身心疲惫、与病人之间的紧张关系以及与医疗专业人员之间的合作。因此,护理机器人被越来越多地用于缓解压力或测试新的互动形式。然而,这也提出了对这些技术伙伴的信任问题,以及这些人可能面临的脆弱性问题。本文将对护理机器人中的信任和脆弱性这两个概念进行伦理分析。第一步是研究什么可以被理解为脆弱性,特别侧重于米兹塔尔提出的三种类型(关系、对未来的预期、过去的经历)。这一策略经常被作者用作出发点,而且似乎也与信任概念相关。第二步,以信任的技术概念为基础,对这三种人类脆弱性进行研究。结果表明:(1) 关系以及相互依存可以产生额外的选择;(2) 对他人行为的预期问题也使得责任可以转移;(3) 对自由的阐释也与潜在的创伤经历有关。最后一步综合了前面的考虑,再次明确了对护理机器人的信任不一定只与脆弱性相关,脆弱性也有可能被减少、转移和克服。
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引用次数: 0
What Can Free Nursing Schools Do for Anarchism? A Reflection on "What Can Anarchism Do for Nursing" by Martin and Laurin (2023). 免费护理学校能为无政府主义做些什么?反思“无政府主义可以为护理做什么”马丁和劳林(2023)。
IF 2.6 3区 医学 Q1 NURSING Pub Date : 2025-04-01 DOI: 10.1111/nup.70025
Simon Malfait

This is a response on the interesting read "What can anarchism do for nursing" by Martin and Laurin (2023), published in a previous issue of this journal. My foremost point is congratulating the authors on emphasizing the urgent need for a deviant voice or movement within nursing. It is a needed and necessary plea. Without such a voice or movement, which deviates from the current discourse(s) in healthcare, the future of our healthcare systems are looking grim and perhaps even more authoritarian than their current state. Rather than providing a comment to their work, I deemed it useful to make two additions and one suggestion to their essay. I would like to elaborate on (1) why alternative education is crucial in installing this type of thinking and action in nursing and (2) why, next to the concept of mutual aid, the concept of individual deviant action by nurses can be crucial in installing a new paradigm in nursing. I argue that both alternative education and individual action cannot be fostered by the traditional nursing education and common career paths and propose the reinvention of the concept of free (nursing) schools. Such free school could empower nurses, throughout their career, to acquire a general culture in which critical reflection and political awareness are cornerstones to identify the balances of power which affects them. This could enhance the solidarity between nurses and unity in the nursing profession. At the end of this reflection, I outline the principles of these free nursing schools.

这是对Martin和Laurin(2023)发表在本刊上一期的有趣文章“无政府主义能对护理做些什么”的回应。我最重要的一点是祝贺作者强调护理中迫切需要一个异常的声音或运动。这是一个必要和必要的请求。如果没有这样的声音或运动,偏离当前的医疗保健话语,我们的医疗保健系统的未来看起来很严峻,甚至可能比现在的状态更加专制。我并没有对他们的作品进行评论,而是认为在他们的文章中添加两个补充和一个建议是有用的。我想详细说明(1)为什么另类教育对于在护理中建立这种思维和行动至关重要;(2)为什么除了互助概念之外,护士个人越轨行为的概念对于在护理中建立新的范式至关重要。我认为,传统的护理教育和共同的职业道路无法培养替代教育和个人行动,并建议重新发明免费(护理)学校的概念。这种免费学校可以使护士在其整个职业生涯中获得一种普遍的文化,在这种文化中,批判性反思和政治意识是确定影响他们的权力平衡的基石。这可以增强护士之间的团结和护理专业的统一。在反思的最后,我概述了这些免费护理学校的原则。
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引用次数: 0
The Lesson of Sleeping Beauty: Person-Centred Care for the Unconscious, Unresponsive ICU Patient in the Face of Levinas' Radical Alterity. 睡美人的教训:面对列维纳斯激进的改变,对无意识、无反应的ICU病人以人为本的护理。
IF 2.6 3区 医学 Q1 NURSING Pub Date : 2025-04-01 DOI: 10.1111/nup.70022
Theresa Clement, Peter Anna Zeillinger, Hanna Mayer, Brendan McCormack

The development of person-centred practice is inextricably linked with the debate about being a person and personhood. This debate takes on a particular relevance when certain prerequisites, which are often used as defining characteristics of persons, can no longer be autonomously fulfilled. This is the case, for example, with intensive care patients who are often (temporarily) impaired in their responsiveness and consciousness due to their critical state of health. Due to sedation, severity of illness and loss of voice, delivery of person-centred care in the intensive care setting is described as challenging. Despite far reaching implications on the therapeutic, ethical, and legal handling of patients in the intensive care setting, a definition of personhood at the stage of briefly diminished (by anesthetic measures), limited, or absent consciousness and ability to communicate has so far been discussed only superficially. To meet this challenge and to develop an understanding of person-centred practice suitable for the context of intensive care, Emmanuel Levinas' relational ethics and his understanding of radical alterity is discussed. We uncover the implications of Levinas Ethics of Radical Alterity on the care of the unconscious and unresponsive patient in the intensive care unit and further on the person-centred approach to practice. The perspectives proposed in this paper provide an opportunity for the ontological embedding of a person-centred care approach, which makes it possible to meet and care for these patients in a person-centred manner.

以人为本的实践的发展与作为一个人和人格的辩论是密不可分的。当经常被用来界定人的特征的某些先决条件不再能够自主地得到满足时,这一辩论就具有特殊的意义。例如,重症监护病人的情况就是如此,由于他们的健康状况危急,他们的反应能力和意识往往(暂时)受损。由于镇静、病情严重和失声,在重症监护环境中提供以人为本的护理被认为是具有挑战性的。尽管对重症监护患者的治疗、伦理和法律处理有着深远的影响,但在短暂减少(通过麻醉措施)、有限或缺乏意识和沟通能力的阶段,人格的定义迄今为止只是肤浅的讨论。为了应对这一挑战,并发展对适合重症监护背景的以人为本的实践的理解,本文讨论了伊曼纽尔·列维纳斯的关系伦理学和他对激进另类的理解。我们揭示了列维纳斯伦理对重症监护室无意识和无反应病人的护理的影响,并进一步以人为中心的实践方法。本文提出的观点为以人为中心的护理方法的本体论嵌入提供了机会,这使得以人为中心的方式满足和照顾这些患者成为可能。
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引用次数: 0
The Folk Concept of Nursing in Australia: A Decolonising Conceptual Analysis. 澳大利亚的民间护理观念:非殖民化的概念分析。
IF 2.6 3区 医学 Q1 NURSING Pub Date : 2025-01-01 DOI: 10.1111/nup.70012
Jacinta Mackay, Jordan Lee-Tory, Kylie Smith, Luke Molloy, Kathleen Clapham

This article presents a conceptual analysis of the contemporary understanding of NURSING in Australia and proposes strategies for decolonisation. Through historical reflection and the lens of cultural safety and critical race theory, it examines some conditions which make up this concept, including "Florence Nightingale-influenced practices," "intellectual practitioners," and "whiteness in nursing." This analysis aims to identify conditions which we take to be necessary for the folk concept of NURSING to be satisfied and which result in negative outcomes. The article explores why these conditions are plausibly included in this concept and possible objections to their inclusion. These conditions, and subsequently the concept of NURSING, are then critiqued. In this conceptual analysis of NURSING in Australia, we explore three conditions. By critically examining these conditions through the lens of cultural safety and employing decolonising methodologies, the article sheds light on the complex interplay of historical legacies, contemporary practices and potential negative outcomes within the nursing profession. The conclusions drawn propose a shift toward decolonisation, advocating for a cultural safety framework to address historical injustices and highlights possible ways in which one might amend the concept of nursing to be more inclusive of Aboriginal and Torres Strait Islander people. The need for this change is emphasised by the acknowledgement of historical conditions that perpetuated racism and hindered equitable healthcare. Ultimately, the article advocates for a comprehensive decolonisation of the concept of NURSING in Australia, urging the nursing profession to implement cultural safety for the overall well-being of Aboriginal and Torres Strait Islander people. The authors of this article would like to acknowledge the people of the Dharawal and Dharug language group, who are the custodians of the unceded land we have worked on throughout this project. We would also like to acknowledge Aboriginal and Torres Strait Island people nationwide and warn them that some traumatic aspects of Aboriginal and Torres Strait Islander history are mentioned throughout this article. Always was, always will be, Aboriginal land. Two authors on this article identify as Aboriginal, while three do not. Two authors are registered nurses, one is an anthropologist, one is a philosopher and one is a historian.

这篇文章提出了护理在澳大利亚当代理解的概念分析,并提出了非殖民化的策略。通过历史反思、文化安全和批判种族理论的视角,它考察了构成这一概念的一些条件,包括“弗洛伦斯·南丁格尔影响的实践”、“知识分子实践者”和“护理中的白人”。这一分析的目的是确定条件,我们认为是必要的护理的民间概念得到满足,并导致消极的结果。本文探讨了为什么这些条件似乎包含在这个概念中,以及可能存在的反对意见。这些条件,以及随后的护理概念,随后被批评。在这个概念分析护理在澳大利亚,我们探讨三个条件。通过从文化安全的角度和采用非殖民化方法对这些情况进行批判性检查,本文揭示了护理专业中历史遗产、当代实践和潜在负面结果之间复杂的相互作用。得出的结论提出了向非殖民化的转变,倡导建立一个文化安全框架来解决历史上的不公正,并强调了可能的方法,可以修改护理的概念,使其更包容土著和托雷斯海峡岛民。承认历史条件使种族主义永久化,阻碍了公平的医疗保健,强调了这种改变的必要性。最后,文章主张澳大利亚护理概念的全面非殖民化,敦促护理专业为土著人和托雷斯海峡岛民的整体福祉实施文化安全。这篇文章的作者想要感谢Dharawal和Dharug语言群体的人们,他们是我们在整个项目中工作的未割让土地的保管人。我们也要感谢全国各地的土著和托雷斯海峡岛民,并警告他们,这篇文章中提到了土著和托雷斯海峡岛民历史上的一些创伤。一直是,也将永远是,原住民的土地。这篇文章的两位作者认为自己是土著人,另外三位不是。两位作者是注册护士,一位是人类学家,一位是哲学家,一位是历史学家。
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引用次数: 0
Correction to "Transgressive Acts: Michel Foucault's Lessons on Resistance for Nurses". 纠正“越界行为:米歇尔·福柯关于护士抵抗的教训”。
IF 2.6 3区 医学 Q1 NURSING Pub Date : 2025-01-01 DOI: 10.1111/nup.70011
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引用次数: 0
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