Dewing Jan
Milton Keynes PCT and General NHS Trust, Associate Fellow Practice Development Royal College of Nursing, London, UK.
J Clin Nurs. 2004 Mar;13(3a):39-44. doi: 10.1111/j.1365-2702.2004.00925.x.
There is an increasing need to develop a multi-dimensional discussion and critique around the concept of 'person-centred' in the context of the delivery of nursing care for older people. As the context of nursing being considered here, it is primarily nurses who should be leading with this discourse, although drawing on a broad range of ideas from outside of nursing. The person-centred movement, commonly believed to originate in the care of those with dementia in the UK, is growing, especially in the UK and Australia, with signs of it moving across parts of Western Europe and North America. Person-centredness has a big emotional appeal to many nurses working with older people, perhaps because it 'has the right feel' for them and nurses believe it 'feels right' for older people. It has grabbed the attention of many practising nurses in the UK in a way that humanistic nursing theory and the various associated nursing models from previous decades, seemed to have missed. This paper contributes to the discussion by suggesting that there are conceptual frameworks that nurses can draw on to help them understand and enhance their practice. However, it is suggested that these frameworks are either in their infancy or incomplete and they still need to convince nurses of their utility for day to day practice. It is also pointed out that the underpinning concept of 'personhood' has not yet been fully clarified by nursing.
在为老年人提供护理服务的背景下,围绕“以患者为中心”这一概念展开多维度的讨论和批判的需求日益增加。鉴于此处所考虑的护理背景,虽然要借鉴护理领域之外的广泛观点,但主要应由护士引领这一讨论。以患者为中心的运动通常被认为起源于英国对痴呆症患者的护理,并且正在不断发展,尤其是在英国和澳大利亚,并有迹象扩展到西欧和北美的部分地区。以患者为中心对许多照顾老年人的护士具有很大的情感吸引力,这可能是因为它对他们来说“感觉正确”,而且护士们认为它对老年人来说“感觉也正确”。它以一种人文护理理论以及前几十年的各种相关护理模式似乎未曾做到的方式,吸引了英国许多执业护士的关注。本文通过提出护士可以借鉴一些概念框架来帮助他们理解和改进实践,为这一讨论做出了贡献。然而,有人指出这些框架要么尚处于起步阶段,要么并不完善,它们仍需让护士相信其在日常实践中的效用。还指出护理领域尚未充分阐明“人格”这一基础概念。