Centre for Addiction and Mental Health and Department of Psychiatry, Toronto, Ontario, Canada.
Qual Health Res. 2009 Nov;19(11):1536-47. doi: 10.1177/1049732309349809. Epub 2009 Sep 24.
In this grounded theory analysis I sought to understand dignity violation in health care and to explore the context in which such violations take place. I found that dignity violation in health care occurs through processes of rudeness, indifference, condescension, dismissal, disregard, dependence, intrusion, objectification, restriction, labeling, contempt, discrimination, revulsion, deprivation, assault, and abjection. The conditions that promote these processes reside in the positions of the actors involved; in the asymmetrical relationships between the actors; in the health care setting itself, which is characterized by multiple tensions-including those between needs and resources, crisis and routine, experience and expertise, and rhetoric and reality; and in the embeddedness of health care in a broader social order of inequality. These findings suggest several interventions that might mitigate dignity violation in health care.
在这项扎根理论分析中,我试图理解医疗保健中的尊严侵犯,并探讨发生这种侵犯的背景。我发现,医疗保健中的尊严侵犯是通过粗鲁、冷漠、屈尊、解雇、忽视、依赖、侵犯、物化、限制、贴标签、轻视、歧视、反感、剥夺、攻击和屈辱等过程发生的。促进这些过程的条件存在于参与者的立场中;在参与者之间的不对称关系中;在以多种紧张关系为特征的医疗保健环境中,包括需求和资源、危机和常规、经验和专业知识以及修辞和现实之间的紧张关系;以及医疗保健在更广泛的不平等社会秩序中的嵌入性。这些发现提出了一些干预措施,可能会减轻医疗保健中的尊严侵犯。