Twinn S F
Department of Nursing Studies, King's College London, England.
J Adv Nurs. 1991 Aug;16(8):966-73. doi: 10.1111/j.1365-2648.1991.tb01802.x.
The interpretation of health visiting practice has formed the focus of a professional debate amongst practitioners and those involved in health visiting education for many years. More recently, changes in nurse education, government legislation and general anxiety about the future of health visiting have added to the intensity of the debate. In re-examining the conceptual origins of health visiting, this paper proposes one possible explanation for this phenomenon in which the author describes four conflicting paradigms of practice. The author argues that it is the tendency of practitioners to adopt one specific paradigm of practice which has contributed to the continuing debate and current professional uncertainty experienced by health visitors. The authors goes on to suggest a conceptual framework for practice developed from an epistemology of practice grounded in reflection in practice and the principles of health visiting. It is argued that this approach to practice allows practitioners to reconsider their practice in terms of the values and beliefs underpinning health visiting rather than identified tasks and client groups. It may also provide practitioners with the opportunity of developing and adapting strategies to meet current health needs rather than the traditions of practice.
多年来，健康访视实践的解读一直是从业者以及参与健康访视教育的人员之间专业辩论的焦点。最近，护士教育的变革、政府立法以及对健康访视未来的普遍担忧加剧了这场辩论的激烈程度。在重新审视健康访视的概念起源时，本文针对这一现象提出了一种可能的解释，作者在其中描述了四种相互冲突的实践范式。作者认为，正是从业者倾向于采用一种特定的实践范式，导致了持续的辩论以及健康访视人员目前所经历的专业不确定性。作者接着提出了一个实践概念框架，该框架源自基于实践反思和健康访视原则的实践认识论。有人认为，这种实践方法使从业者能够根据支撑健康访视的价值观和信念，而非既定任务和客户群体，重新审视他们的实践。它还可能为从业者提供机会，去制定和调整策略以满足当前的健康需求，而非遵循实践传统。
