Heliker D
School of Nursing, University of Texas at Galveston, USA.
Issues Ment Health Nurs. 1999 Nov-Dec;20(6):513-25. doi: 10.1080/016128499248330.
The negative effects of institutionalization in a long-term care facility include depersonalization, decreased self-concept and self-esteem, and decreased psychological well being. To modify these effects, an innovative narrative approach to long-term care in the format of story telling and listening is proposed. Narrative practice, in the format of story telling and listening, leads to an ethics-based care that prioritizes the resident's personal meanings, values staff-patient relationships, and permits the resident to define quality care. The purpose of this article is to demonstrate how the functions of storytelling can be applied in the long-term care setting using the themes that emerge in the life story of a particular resident. These themes, findings of a phenomenological study, were incorporated into the resident's care plan by staff and, consequently, quality of care improved. Recognizing the value of story and incorporating the themes that emerge into a personalized care plan transforms nursing practice.
长期护理机构中机构化的负面影响包括人格丧失、自我概念和自尊下降，以及心理健康状况下降。为了改善这些影响，本文提出了一种创新的叙事方法，采用讲故事和倾听的形式来进行长期护理。以讲故事和倾听为形式的叙事实践会带来一种基于伦理的护理，这种护理将居民的个人意义置于优先地位，重视员工与患者的关系，并允许居民定义优质护理。本文的目的是展示如何利用特定居民生活故事中出现的主题，将讲故事的功能应用于长期护理环境。这些主题是一项现象学研究的结果，工作人员将其纳入了居民的护理计划，从而提高了护理质量。认识到故事的价值并将出现的主题纳入个性化护理计划会改变护理实践。
