Hamilton B, Manias E, Maude P, Marjoribanks T, Cook K
School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia.
J Psychiatr Ment Health Nurs. 2004 Dec;11(6):683-9. doi: 10.1111/j.1365-2850.2004.00785.x.
This case study explores what informs and organizes the assessment of patients, as undertaken by a nurse, a social worker and a psychiatrist in public, metropolitan, acute mental health service settings. The research data are the transcripts of in-depth interviews with three experienced practitioners, one from each of the three disciplines. The analysis draws on Foucauldian concepts: discourse as constructed through practices of discipline and the gaze. We explored examples of taken-for-granted assessment practices and their interplay with discourse. The findings suggest that participating practitioners use language in assessment in ways that support the powerful discourses of the professional disciplines. The competing discourse of management, associated with industry and economics, is evident in hospital admission processes, dictating the times and places of assessment. Professional and management discourses both effectively marginalize the perspective of another player in assessment, the patient.
本案例研究探讨了在公共大都市急性心理健康服务环境中，护士、社会工作者和精神科医生对患者进行评估时的依据和组织方式。研究数据是对三位经验丰富的从业者（每个学科各一位）进行深度访谈的文字记录。该分析借鉴了福柯的概念：通过学科实践和凝视构建的话语。我们探讨了被视为理所当然的评估实践示例及其与话语的相互作用。研究结果表明，参与研究的从业者在评估中使用语言的方式支持了各专业学科的强势话语。与行业和经济学相关的管理竞争话语在医院入院流程中很明显，它决定了评估的时间和地点。专业话语和管理话语都有效地将评估中的另一个参与者即患者的观点边缘化了。
