Milne Alisoun, Larkin Mary
School of Social Policy, Sociology and Social Research, University of Kent, Kent, UK.
Health Soc Care Community. 2015 Jan;23(1):4-13. doi: 10.1111/hsc.12143. Epub 2014 Oct 13.
While discourse about care and caring is well developed in the UK, the nature of knowledge generation about care and the research paradigms that underpin it have been subjected to limited critical reflection and analysis. An overarching synthesis of evidence - intended to promote debate and facilitate new understandings - identifies two largely separate bodies of carer-related research. The first body of work - referred to as Gathering and Evaluating - provides evidence of the extent of care-giving, who provides care to whom and with what impact; it also focuses on evaluating policy and service efficacy. This type of research tends to dominate public perception about caring, influences the type and extent of policy and support for carers and attracts funding from policy and health-related sources. However, it also tends to be conceptually and theoretically narrow, has limited engagement with carers' perspectives and adopts an atomistic purview on the care-giving landscape. The second body of work - Conceptualising and Theorising - explores the conceptual and experiential nature of care and aims to extend thinking and theory about caring. It is concerned with promoting understanding of care as an integral part of human relationships, embedded in the life course, and a product of interdependence and reciprocity. This work conceptualises care as both an activity and a disposition and foregrounds the development of an 'ethic of care', thereby providing a perspective within which to recognise both the challenges care-giving may present and the significance of care as a normative activity. It tends to be funded from social science sources and, while strong in capturing carers' experiences, has limited policy and service-related purchase. Much could be gained for citizens, carers and families, and the generation of knowledge advanced, if the two bodies of research were integrated to a greater degree.
虽然在英国,关于护理和关怀的论述已经相当成熟,但关于护理知识的产生本质以及支撑它的研究范式却受到了有限的批判性反思和分析。一项旨在促进辩论并推动新理解的全面证据综合研究,确定了两个在很大程度上相互独立的与护理者相关的研究领域。第一个研究领域——称为“收集与评估”——提供了关于护理提供程度、谁为谁提供护理以及产生何种影响的证据;它还侧重于评估政策和服务的效果。这类研究往往主导着公众对护理的认知,影响着政策的类型和范围以及对护理者的支持,并吸引来自政策和健康相关来源的资金。然而,它在概念和理论上也往往较为狭隘,与护理者的观点互动有限,并且对护理提供格局采取原子主义的视角。第二个研究领域——“概念化与理论化”——探索护理的概念和体验本质,旨在拓展关于护理的思考和理论。它关注促进将护理理解为人类关系中不可或缺的一部分,嵌入生命历程,是相互依存和互惠的产物。这项工作将护理概念化为一种活动和一种倾向,并突出了“护理伦理”的发展,从而提供了一个视角,在其中既能认识到护理提供可能带来的挑战,又能认识到护理作为一种规范性活动的重要性。它往往由社会科学来源提供资金,虽然在捕捉护理者的经历方面很强,但与政策和服务相关的影响力有限。如果这两个研究领域能在更大程度上整合,那么公民、护理者和家庭将受益匪浅,知识的产生也将取得更大进展。