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重塑人格障碍患者的人性。

Reclaiming the humanity in personality disorder.

作者信息

Wright Karen, Haigh Kevin, McKeown Mick

机构信息

Department of Nursing, University of Central Lancashire, Preston, UK.

出版信息

Int J Ment Health Nurs. 2007 Aug;16(4):236-46. doi: 10.1111/j.1447-0349.2007.00480.x.

Abstract

This paper provides a commentary upon the nursing care of individuals diagnosed with personality disorder and associated education courses. The discussion focuses upon recent policy trends in the UK as a point of departure. This policy discourse is critical of mainstream mental health services in previously operating to exclude such individuals. One of the consequences has been a recent growth in interest in relevant training courses, many of which devote significant attention to staff attitudes regarding this client group. Various previous researchers and commentators have remarked upon the implications for practice of a perceived negative attitude among care staff. We reflect upon our own anecdotal experience of developing and delivering new university-based courses for practitioners working in the field of personality disorder to offer a particular critique of the UK context, in which this policy, training, and practice is framed. Social constructionist theories are drawn on to offer insights into public and practitioner discourse and the possible effects on therapeutic relationships. The available discourse constructs individuals with a diagnosis of personality disorder as essentially different from other people. We argue that staff training and practice development initiatives are likely to be more successful if such discourse is challenged, and attempts are made in therapeutic encounters to recognize shared characteristics and positive attributes as much as perceived difference and negative attributes. We refer to this as a re-engagement with common humanity. Despite the singular national context, the discursive themes explored are not necessarily restricted to the UK.

摘要

本文对被诊断患有人格障碍的个体的护理及相关教育课程进行了评论。讨论以英国近期的政策趋势为出发点。这种政策论述批评了以往主流心理健康服务机构将此类个体排除在外的做法。其中一个后果是,最近对相关培训课程的兴趣有所增加,许多课程都非常关注工作人员对这一客户群体的态度。此前的各种研究人员和评论家都谈到了护理人员中存在的负面态度对实践的影响。我们反思了自己在为从事人格障碍领域工作的从业者开发和提供新的大学课程方面的轶事经历,以对英国的背景进行特别批判,在这种背景下制定了该政策、开展了相关培训并付诸实践。我们借鉴社会建构主义理论,以深入了解公众和从业者的论述以及对治疗关系可能产生的影响。现有的论述将被诊断患有人格障碍的个体建构为本质上与其他人不同。我们认为,如果对这种论述提出质疑,并在治疗过程中努力认识到共同特征和积极属性,以及所察觉到的差异和消极属性,那么工作人员培训和实践发展举措可能会更成功。我们将此称为重新回归共同的人性。尽管是在单一的国家背景下进行探讨,但所讨论的话语主题并不一定局限于英国。

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