Robert Bruno
Institut de Formation en Soins Infirmiers CHU Amiens.
Rech Soins Infirm. 2007 Mar(88):64-83.
The progress of this research enables to consider the field of health from the angle of voluntary help by the involvement of an association of voluntary ill people in the field of the prevention of cardiovascular diseases. The evolution of the health system with scientific progress, ever-changing political scenes, currents of thought, interests at stake make that since the 50s, health and its standards have been considered from a biomedical angle by legitimizing the dominant position of experts. In this context, what is the place of the laymen in the management of the risk of arisen chronic disease? What are their representations of health? What appropriation do they make of the domestic work of health which tends to make them interiorize new standards and rules of life and modify their health behavior? Some conceptual and theoretical lights and the encounter in the field within an association in an anthropological position through immersion, participating observation at various demonstrations with a preventive aim and conversations led with ill or former ill volunteers put in light certain aspects of the problem. The investment of the volunteers makes sense and tends to come true around the concepts of donation, counter donation, socialization in a new health under the influence of the symbolism of the rites of passage and the testimony to work in the distribution of educational messages. The activity of the volunteer is transformed with a logic which is far from philanthropy. He becomes a mediatory health agent where some genuine work of organization, management, negotiation and training seems to fill the space little invested by experts in health prevention and education.
这项研究的进展使得我们能够从自愿患病者协会参与心血管疾病预防领域的自愿帮助这一角度来审视健康领域。随着科学进步、政治局势不断变化、思想潮流以及利益关系的影响,卫生系统不断演变,自20世纪50年代以来,通过使专家的主导地位合法化,健康及其标准一直从生物医学角度来考量。在这种背景下,外行在慢性病风险管理中处于什么位置?他们对健康有哪些认知?他们如何接受那些旨在使他们内化新的生活标准和规则并改变其健康行为的家庭健康工作?一些概念和理论的启示,以及通过沉浸式参与观察、在各种预防性示范活动中的参与观察以及与患病或曾经患病的志愿者进行的交谈,从人类学角度在一个协会的实地考察中揭示了该问题的某些方面。志愿者的投入是有意义的,并且在捐赠、反捐赠、在过渡仪式象征意义影响下的新健康中的社会化以及在教育信息传播中的工作见证等概念周围趋于实现。志愿者的活动以一种远离慈善的逻辑发生转变。他成为了一名中介性健康推动者,在那里一些真正的组织、管理、谈判和培训工作似乎填补了专家在健康预防和教育方面投入较少的空白。