The Education for Practice Institute, Charles Sturt University, Sydney, Australia.
Physiother Theory Pract. 2012 Aug;28(6):466-73. doi: 10.3109/09593985.2012.676942.
In physiotherapy, as with many other health-care practices, therapeutic interventions, based on scientific knowledge, may be at odds with patient experiences. Patients may understand what they need to do to improve their health condition, but feel that these requirements may be emotionally, socially, or culturally incompatible with their lifestyles, social behavior, or personal choices. To work in the best interest of their patients, physiotherapists need to engage with the tensions that exist between scientific reason and social reality to offer a meaningful and relevant service for their patients. The challenge for physiotherapists is to arrive at decisions and interventions together with their patients that enhance, for example, mobility, social function, and well-being. To achieve this, physiotherapists need to rethink their professional role and translate their technical knowledge and goals into the patient's 'lifeworld', and patients--for their part--need to engage with physiotherapy professional knowledge. Often, the most commonly used strategy for facilitating this reciprocal engagement is open dialogue between patients and therapists. Habermas, a prominent contemporary philosopher and critical theorist, has developed a communicative theory that may support physiotherapists in their efforts to arrive at more sustainable and shared decisions with their patients. In this paper, I examine what constitutes physiotherapists' practice knowledge and how Habermas's theory of knowledge, interest, and communication strengthens shared decision-making and can be used as a vehicle toward emancipatory practice. Drawing on data generated in an action research project, I examine how Habermas's ideas can be applied in emancipatory physiotherapy practice. The paper concludes that emancipatory practice is meaningful because it creates opportunities for reflection, evaluation, and choice for future physiotherapy practice.
在物理治疗中，与许多其他医疗保健实践一样，基于科学知识的治疗干预措施可能与患者的体验不一致。患者可能了解改善健康状况所需做的事情，但感到这些要求在情感、社会或文化上与他们的生活方式、社交行为或个人选择不符。为了从患者的最佳利益出发，物理治疗师需要处理科学理性和社会现实之间存在的紧张关系，为患者提供有意义和相关的服务。物理治疗师面临的挑战是与患者一起做出决策和干预措施，例如增强活动能力、社会功能和幸福感。为了实现这一目标，物理治疗师需要重新思考他们的专业角色，并将他们的技术知识和目标转化为患者的“生活世界”，而患者则需要参与物理治疗专业知识。通常，促进这种相互参与的最常用策略是患者和治疗师之间的开放对话。哈贝马斯是一位杰出的当代哲学家和批判理论家，他提出了一种交际理论，可以帮助物理治疗师与患者一起做出更可持续和共同的决策。在本文中，我探讨了构成物理治疗师实践知识的要素，以及哈贝马斯的知识、利益和沟通理论如何增强共同决策，并可作为解放实践的手段。本文利用行动研究项目中生成的数据，考察了哈贝马斯的思想如何应用于解放性的物理治疗实践。本文的结论是，解放性实践是有意义的，因为它为未来的物理治疗实践创造了反思、评估和选择的机会。
