The Education for Practice Institute, Charles Sturt University, 16 Masons Drive, North Parramatta 2151, Sydney, NSW 2151, Australia.
Complement Ther Med. 2010 Feb;18(1):8-12. doi: 10.1016/j.ctim.2009.12.003. Epub 2010 Jan 18.
The increasing use of complementary and alternative medicine (CAM) in developed countries has been attributed more to contemporary cultural trends than to inherent problems in mainstream medicine. The aim of this study was to examine the impact of post-modern values on relationships between practitioners and clients in integrative medicine (IM) clinics in Australia.
This research used hermeneutic phenomenology to uncover experiences of practitioner-client relationships in IM and the meanings clients and practitioners attached to these relationships. Data were collected using cumulative case studies, focus groups and key informant interviews. Data analysis consisted of reading and re-reading texts derived from interview transcripts and field notes and constantly comparing texts to identify meanings and patterns. Themes extracted from the data set were continually refined, discarded and elaborated until meta-themes emerged.
Australian IM clinics where general medical practitioners and CAM practitioners were co-located.
Post-modern values were evident in practitioner-client relationships in Australian IM clinics and were manifested in two ways. (1) Clients did not bring an expectation that they would receive prescriptive treatment regimens. They regarded consultations as opportunities for obtaining information or advice, or for monitoring their health. (2) Practitioners valued clients' knowledge and judgments and respected clients' right to choose and direct their health care.
In the IM clinics in this research, the traditional role of the practitioner as sole possessor of expertise had changed. Practitioners had become one among a number of resources that informed clients used when designing personal health care plans or negotiating health care with practitioners.
在发达国家,补充和替代医学(CAM)的使用不断增加,其原因更多的是当代文化趋势,而不是主流医学本身存在问题。本研究旨在考察后现代价值观对澳大利亚综合医学(IM)诊所中从业者与客户关系的影响。
本研究采用解释学现象学来揭示 IM 中从业者与客户关系的体验,以及客户和从业者对这些关系的理解。使用累积案例研究、焦点小组和关键知情人访谈收集数据。数据分析包括阅读和重新阅读访谈记录和现场笔记中得出的文本,并不断比较文本以识别意义和模式。从数据集提取的主题不断得到改进、摒弃和阐述,直到出现元主题。
澳大利亚的 IM 诊所,那里有全科医生和 CAM 从业者共同执业。
后现代价值观在澳大利亚 IM 诊所的从业者与客户关系中显而易见,表现在两个方面。(1)客户不期望接受规定的治疗方案。他们将咨询视为获取信息或建议,或监测其健康的机会。(2)从业者重视客户的知识和判断,并尊重客户选择和指导自己医疗保健的权利。
在本研究中的 IM 诊所中,从业者作为唯一拥有专业知识的传统角色已经发生了变化。从业者已成为客户在设计个人保健计划或与从业者协商保健时使用的众多资源之一。