Clarke Amanda, Hanson Elizabeth Jane, Ross Helen
Department of Community, Ageing, Rehabilitation, Education and Research, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK.
J Clin Nurs. 2003 Sep;12(5):697-706. doi: 10.1046/j.1365-2702.2003.00784.x.
Recent policy statements have stressed the need for fundamental changes to the NHS, especially to the hospital care of older people. Person-centred care underpins such changes. If practitioners are to deliver person-centred care, then they need to learn more about the patient as an individual. One way that this might be achieved is through biographical approaches. This paper describes the findings of a developmental study undertaken over a 6-month period to investigate the introduction of a biographical approach to care on a unit in a NHS hospital. It concentrates on the views of the practitioners who used the approach. The study aimed to explore whether a biographical approach - in the form of storytelling - might be used to encourage person-centred practice. Using a practice development approach, the study explored the views of older people, their family carers and practitioners regarding their participation in life story work. Initial data were collected by focus groups with staff from a nursing home who regularly used life stories as a basis for care planning. Further data were collected through focus groups, semistructured interviews and observation - undertaken before and after the introduction of life story work - with older people, family carers and practitioners. Findings revealed that life stories helped practitioners to see patients as people, to understand individuals more fully and to form closer relationships with their families. Support workers also said how much they enjoyed using the approach to inform their care. Further longitudinal research is required to investigate biographical approaches more fully and to work more closely with practitioners to explore how biographical approaches can be undertaken as part of standard practice and be integrated into the culture and management of care.
近期的政策声明强调了对国民医疗服务体系（NHS）进行根本性变革的必要性，尤其是针对老年人的医院护理。以患者为中心的护理是此类变革的基础。如果从业者要提供以患者为中心的护理，那么他们需要更多地了解患者个体。实现这一点的一种方法可能是通过传记式方法。本文描述了一项为期6个月的发展性研究的结果，该研究旨在调查在一家NHS医院的一个科室引入传记式护理方法的情况。它主要关注使用该方法的从业者的观点。该研究旨在探讨传记式方法——以讲故事的形式——是否可用于鼓励以患者为中心的实践。采用实践发展方法，该研究探讨了老年人、他们的家庭护理人员以及从业者对参与生活故事工作的看法。初始数据通过与一家养老院的工作人员进行焦点小组收集，这些工作人员经常将生活故事作为护理计划的基础。通过焦点小组、半结构化访谈和观察——在引入生活故事工作之前和之后进行——收集了与老年人、家庭护理人员和从业者的进一步数据。研究结果表明，生活故事有助于从业者将患者视为人，更全面地了解个体，并与他们的家人建立更密切的关系。支持人员也表示他们非常喜欢使用这种方法来指导他们的护理工作。需要进一步的纵向研究来更全面地调查传记式方法，并与从业者更密切合作，以探索传记式方法如何作为标准实践的一部分来开展，并融入护理文化和管理之中。
