法医精神病学中家庭功能的话语建构:批判性人种学视角。

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health Pub Date : 2024-07-01 Epub Date: 2023-06-30 DOI:10.1177/13634593231185263
Jean-Laurent Domingue, Jean-Daniel Jacob
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引用次数: 0

摘要

尽管以家庭为中心的方法在提高治疗依从性、改善就诊率、降低再入院率和减少复发率方面很有效,但在法医精神病学领域实施这种方法仍然存在巨大障碍。我们将这些障碍归咎于我们对家庭功能及其在法医精神病学系统中作用的理解存在根本性的差距。尽管一些家庭要求被纳入其中并被视为合作伙伴,但他们却感到自己被排斥在外、靠边站,这就造成了困扰、不理解和不参与。我们通过对审查委员会的批判性人种学研究以及福柯关于精神病学权力的著作,从话语层面来探讨这种紧张关系,这为我们提供了一个独特的机会,来了解家庭的角色在加拿大法医精神病学系统中是如何构建和维持的。为此,我们从人种学观察和题为 "处置理由 "的文献中获取了数据。通过数据分析,我们发现了家庭功能的两种话语建构:(1)家庭是信息的储存者;(2)家庭是监督者。这些结果对于法医精神病学的医护专业人员和管理者有一定的启示,他们越来越多地坚持以家庭为中心的护理模式,却没有质疑这种护理或这种家庭参与的含义。
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Discursive constructions of family functions in forensic psychiatry: A critical ethnographic perspective.

Significant barriers remain regarding the implementation of family-centred approaches in the domain of forensic psychiatry despite their effectiveness at increasing adherence to treatment, improving attendance to medical appointments, decreasing readmission rates and reducing episodes of relapse. We attribute these barriers to a fundamental gap in our understanding of the family function and its role within the forensic psychiatric system. Despite requesting to be included and considered as partners, some families feel excluded and sidelined, which causes distress, incomprehension and disengagement. We approached this tension at the discursive level through a critical ethnography of the Review Board and the work of Foucault on psychiatric power, which provided us with a unique opportunity to understand how the role of families are constructed and sustained in the Canadian forensic psychiatric system. To do so, we mobilized data stemming from ethnographic observations and documentary artifacts entitled 'reasons for disposition'. Data analysis allowed us to identify two discursive constructions of familial functions: (1) families as repositories of information and (2) families as supervisory agents. These results have implications for health care professionals and administrators in forensic psychiatry who are increasingly adhering to family-centred care models without questioning what such care or what such family engagement entails.

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来源期刊
Health
Health Multiple-
CiteScore
4.90
自引率
0.00%
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0
期刊介绍: Health: is published four times per year and attempts in each number to offer a mix of articles that inform or that provoke debate. The readership of the journal is wide and drawn from different disciplines and from workers both inside and outside the health care professions. Widely abstracted, Health: ensures authors an extensive and informed readership for their work. It also seeks to offer authors as short a delay as possible between submission and publication. Most articles are reviewed within 4-6 weeks of submission and those accepted are published within a year of that decision.
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