Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand.
Nurs Inq. 2011 Mar;18(1):2-11. doi: 10.1111/j.1440-1800.2010.00501.x.
Demoralization and remoralization: a review of these constructs in the healthcare literature Development of the constructs of demoralization and remoralization began in the psychiatric literature in the 1970s when a psychiatrist in the USA observed a pattern of characteristics in people referred to him for depression, which he believed, was not depression. These characteristics included hopelessness, helplessness, isolation, low self-esteem and despair. Such characteristics are often termed existential distress. Distinguishing between depression and the existential distress of demoralization is still central in the literature. This is important as successful responses to each condition differ. Research into these constructs has broadened and contributions now come from many different countries and multiple health disciplines, including nursing. This study presents a review and exploration of these constructs in the healthcare literature in an attempt to bring them to the attention of greater numbers of nurses. Facilitating remoralization requires time and sensitivity to people's personal narratives. Difficulty in achieving such a response in the present efficiency climate of many health institutions can lead to moral distress.
对医疗保健文献中这些概念的回顾 去道德化和再道德化概念的发展始于 20 世纪 70 年代的精神病学文献，当时一位美国精神病学家观察到被转介至他处治疗抑郁症的患者所呈现出的一系列特征，他认为这些特征并非抑郁症。这些特征包括绝望、无助、孤立、自卑和绝望。这些特征通常被称为存在性痛苦。在文献中，区分抑郁症和去道德化的存在性痛苦仍然是核心问题。这很重要，因为对每种情况的成功反应是不同的。对这些概念的研究已经扩大，现在来自许多不同国家和多个健康学科的贡献，包括护理。本研究对医疗保健文献中的这些概念进行了回顾和探讨，试图引起更多护士的关注。促进再道德化需要时间和对人们个人叙事的敏感性。在许多卫生机构目前的效率氛围下，很难做出这样的反应，这可能导致道德困境。
