Kliche T, Kröger G
Universitätsklinikum Eppendorf, Institut und Poliklinik für Medizinische Psychologie, Hamburg.
Gesundheitswesen. 2008 Dec;70(12):715-20. doi: 10.1055/s-0028-1102956. Epub 2008 Dec 11.
Empowerment is an important concept in health care, but despite its prevalence it seems to be more of a buzz word. Thus, a conceptual review on empowerment in prevention and health promotion was carried out. 62 German and international theoretical contributions, reviews and studies were incorporated, covering the fields of prevention, care and therapy, rehabilitation, health-care research, nursing and work-related stress. The analysis revealed eight main dimensions of empowerment: (1) shared decision-making, (2) self-efficacy, (3) social support and social capital, (4) skills and competences, (5) health care utilisation, (6) goal setting and attainment, (7) reflexive thought and (8) innovation. Their empirical assessment can be carried out on a micro-, meso-, or macro-level. Three distinct basic conceptual notions emerged from the analysis, each applying its own specific research questions and measurement instruments: clinical, organizational-professional and political understanding of "empowerment". Therefore, these three specific conceptual notions should each be developed and tested separately, in particular in reviews, and empirical studies should embrace all eight subdimensions.
赋权是医疗保健中的一个重要概念,但尽管它很普遍,却似乎更像是一个时髦词汇。因此,开展了一项关于预防和健康促进中赋权的概念性综述。纳入了62篇德国和国际的理论贡献、综述及研究,涵盖预防、护理与治疗、康复、医疗保健研究、护理以及工作相关压力等领域。分析揭示了赋权的八个主要维度:(1)共同决策,(2)自我效能感,(3)社会支持与社会资本,(4)技能与能力,(5)医疗保健利用,(6)目标设定与实现,(7)反思性思维,以及(8)创新。它们的实证评估可以在微观、中观或宏观层面上进行。分析中出现了三种不同的基本概念观念,每种都应用其自身特定的研究问题和测量工具:对“赋权”的临床、组织-专业和政治理解。因此,这三种特定的概念观念应各自分别加以发展和检验,尤其是在综述中,并且实证研究应涵盖所有八个子维度。