Shaw M C, Halliday P H
Arthritis Society (BC and Yukon Division), Vancouver, Canada.
J Adv Nurs. 1992 May;17(5):537-43. doi: 10.1111/j.1365-2648.1992.tb02829.x.
While chronic illness has a profound impact upon the individual, an immense burden is imposed upon the family. When the competing demands of an illness and the family escalate exponentially, there may be a crisis. Traditionally, crisis theory has been applied to acute care contexts such as emergency, intensive care and mental health nursing. Yet, clinical experience with families and chronic illness supports the notion of periodic crises from the prediagnostic phase to the long-haul of the illness. Moreover, the authors hypothesize that the family's perception of the event determines whether the crisis is perceived as a threat or a challenge. This paper thus addresses the perception of crisis within the framework of chronic illness from a biological and family systems nursing perspective. First, the theory of Humberto Maturana, a Chilean biologist, is explored and applied to clinical observations regarding family, crisis and chronic illness. Second, an evolutionary model for conceptualizing crisis and chronic illness is presented. Third, the role of beliefs in the family perceptions of crisis and chronic illness is discussed.
虽然慢性病对个人有深远影响，但家庭也会承受巨大负担。当疾病需求与家庭需求的竞争呈指数级增长时，可能就会出现危机。传统上，危机理论一直应用于急诊、重症监护和心理健康护理等急性护理环境。然而，与患有慢性病的家庭的临床经验支持这样一种观点，即从疾病的预诊断阶段到疾病的长期过程中会出现周期性危机。此外，作者推测家庭对事件的认知决定了危机被视为威胁还是挑战。因此，本文从生物学和家庭系统护理的角度，探讨慢性病框架内的危机认知。首先，探讨智利生物学家温贝托·马图拉纳的理论，并将其应用于有关家庭、危机和慢性病的临床观察。其次，提出一个将危机和慢性病概念化的进化模型。第三，讨论信念在家庭对危机和慢性病认知中的作用。
