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通过认同实现自主:对2型糖尿病患者认同过程的定性研究

Autonomy through identification: a qualitative study of the process of identification used by people with type 2 diabetes.

作者信息

Moser Albine, van der Bruggen Harry, Spreeuwenberg Cor, Widdershoven Guy

机构信息

Department of Health Ethics and Philosophy, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands.

出版信息

J Clin Nurs. 2008 Apr;17(7B):209-16. doi: 10.1111/j.1365-2702.2007.01983.x. Epub 2007 Dec 20.

Abstract

AIMS AND OBJECTIVES

The aim of this study is to clarify the process of identification with diabetes as a dimension of autonomy as described by people with type 2 diabetes.

BACKGROUND

People with type 2 diabetes view autonomy as competency in shaping one's life. This concept of autonomy has seven dimensions, which emerged as categories in prior research. Dynamic processes shape these dimensions of autonomy. One of the dimensions of autonomy is identification.

METHOD

This study has a qualitative descriptive and exploratory design and an inductive approach as described in grounded theory. Data were collected by means of in-depth interviews. The sample consisted of 15 people with type 2 diabetes mellitus in a nurse-led, shared-care setting in the Netherlands.

RESULTS

The phases of identification are comprehending, struggling, evaluating and mastering. Each phase has its own characteristics. Identifying with the diabetes is a non-linear, cyclical and continuous process because people with diabetes have to deal with changing conditions.

CONCLUSION

The dynamics of identification is directed to a process of identifying with diabetes and its care requirement. Recognizing identification as an element of autonomy enables nurses to adopt a more patient-oriented view of autonomy.

RELEVANCE TO CLINICAL PRACTICE

Nursing that fosters the process of identification promotes autonomy. This implies that a person with diabetes should be able to identify with the nurse's interventions. Hence it is vital that nurses build supportive partnerships when providing care for such a patient.

摘要

目的与目标

本研究旨在阐明2型糖尿病患者所描述的将认同糖尿病作为自主性一个维度的过程。

背景

2型糖尿病患者将自主性视为塑造自身生活的能力。这种自主性概念有七个维度,这些维度在先前研究中作为类别出现。动态过程塑造了这些自主性维度。认同是自主性维度之一。

方法

本研究采用定性描述性和探索性设计以及扎根理论中描述的归纳法。通过深度访谈收集数据。样本包括荷兰一家由护士主导的共享护理机构中的15名2型糖尿病患者。

结果

认同的阶段包括理解、挣扎、评估和掌握。每个阶段都有其自身特点。认同糖尿病是一个非线性、循环且持续的过程,因为糖尿病患者必须应对不断变化的情况。

结论

认同的动态过程指向认同糖尿病及其护理需求的过程。将认同视为自主性的一个要素使护士能够采取更以患者为导向的自主性观点。

与临床实践的相关性

促进认同过程的护理可促进自主性。这意味着糖尿病患者应该能够认同护士的干预措施。因此,护士在为这类患者提供护理时建立支持性伙伴关系至关重要。

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