Ravn Iben M, Frederiksen Kirsten, Beedholm Kirsten
VIA University College, Viborg, Denmark.
Aarhus University, Aarhus, Denmark.
Qual Health Res. 2016 Mar;26(4):545-54. doi: 10.1177/1049732315570133. Epub 2015 Feb 6.
This article reports on the results of a Fairclough-inspired critical discourse analysis aiming to clarify how chronically ill patients are presented in contemporary Danish chronic care policies. Drawing on Fairclough's three-dimensional framework for analyzing discourse, and using Dean's concepts of governmentality as an interpretative lens, we analyzed and explained six policies published by the Danish Health and Medicines Authority between 2005 and 2013. The analysis revealed that discourses within the policy vision of chronic care consider chronically ill patients' active role, lifestyle, and health behavior to be the main factors influencing susceptibility to chronic diseases. We argue that this discursive construction naturalizes a division between people who can actively manage responsible self-care and those who cannot. Such discourses may serve the interests of those patients who are already activated, while others remain subjugated to certain roles. For example, they may be labeled as "vulnerable."
本文报道了一项受费尔克劳夫启发的批判性话语分析结果，旨在阐明当代丹麦慢性病护理政策中慢性病患者是如何被呈现的。借鉴费尔克劳夫的话语三维分析框架，并将迪恩的治理概念作为解释视角，我们分析并阐释了丹麦卫生药品管理局在2005年至2013年间发布的六项政策。分析表明，慢性病护理政策愿景中的话语将慢性病患者的积极作用、生活方式和健康行为视为影响慢性病易感性的主要因素。我们认为，这种话语建构使能够积极进行自我负责护理的人和不能做到的人之间的区分自然化。这样的话语可能符合那些已经被动员起来的患者的利益，而其他患者则仍然受制于某些角色。例如，他们可能被贴上“弱势群体”的标签。
