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挪威公共卫生护理中充满伦理意味的遭遇的意义及其对职业身份的可能影响:一项现象学诠释学研究

The meaning of ethically charged encounters and their possible influence on professional identity in Norwegian public health nursing: a phenomenological hermeneutic study.

作者信息

Dahl Berit Misund, Clancy Anne, Andrews Therese

机构信息

Nordic School of Public Health, Gothenburg, Sweden; Department of Health Sciences, Aalesund University College, Ålesund, Norway.

出版信息

Scand J Caring Sci. 2014 Sep;28(3):600-8. doi: 10.1111/scs.12089. Epub 2013 Oct 14.

Abstract

BACKGROUND

In today's health care, new health reforms focus on market values and demands of efficiency influence health workers' professional practice. Norwegian public health nurses work mainly with healthy populations, but the children, families and young people they meet can be in vulnerable and even dependent situations. Strategies in coping with ethically challenging encounters can be important for the identity of the profession.

AIM

The aim of the study was to illuminate public health nurses' experiences of being in ethically charged encounters and to reflect upon how these experiences can influence their professional identity.

METHOD

A purposive sample of 23 Norwegian public health nurses with experience ranging from 0.5 to 25 years narrated about their work-related experiences. The interviews were interpreted with a phenomenological hermeneutic method inspired by the philosophy of Paul Ricoeur.

FINDINGS

Four themes were identified: feeling responsible, being committed, feeling confident and feeling inadequate. These experiences were related to both work and private life and involved an emotional commitment to the well-being of children, young people and families.

CONCLUSION

On the basis of the findings, it can be estimated that PHNs are committed to their work, and defending children's rights is a strong driving force. Responsibility for service users is a deciding factor that can overshadow institutional demands. It seems as if value conflicts mobilised courage which is essential in maintaining moral strength. This is in turn important for a strong professional identity and can have positive implications for the quality of public health nursing work.

摘要

背景

在当今的医疗保健领域,新的医疗改革聚焦于市场价值,效率需求影响着医护人员的专业实践。挪威公共卫生护士主要服务于健康人群,但他们接触到的儿童、家庭和年轻人可能处于脆弱甚至依赖的状况。应对具有伦理挑战性的情况的策略对于该职业的身份认同可能很重要。

目的

本研究的目的是阐明公共卫生护士在充满伦理挑战的情况下的经历,并思考这些经历如何影响他们的职业身份。

方法

从23名工作经验在0.5年至25年之间的挪威公共卫生护士中进行有目的抽样,让他们讲述与工作相关的经历。访谈采用受保罗·利科哲学启发的现象学诠释学方法进行解读。

结果

确定了四个主题:感到有责任、全身心投入、感到自信和感到不足。这些经历与工作和私人生活都有关,并且涉及对儿童、年轻人和家庭福祉的情感投入。

结论

根据研究结果,可以估计公共卫生护士致力于他们的工作,捍卫儿童权利是一股强大的驱动力。对服务对象的责任是一个决定性因素,可能会使机构要求黯然失色。似乎价值冲突激发了勇气,而勇气对于保持道德力量至关重要。这反过来对于强大的职业身份很重要,并且可能对公共卫生护理工作的质量产生积极影响。

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