Nordby Halvor
Faculty of medicine, Department of health and society, The University of Oslo, Oslo, Norway.
Nurs Philos. 2016 Apr;17(2):103-18. doi: 10.1111/nup.12111. Epub 2016 Feb 2.
It is fundamental assumption in nursing theory that it is important for nurses to understand how patients experience states of ill health. This assumption is often related to aims of empathic understanding, but normative principles of social interpretation can have an important action-guiding role whenever nurses seek to understand patients' subjective horizons on the basis of active or passive expressions of meaning. The aim of this article is to present a philosophical theory of concept possession and to argue that it can shed light on how nurses should seek to understand patients' subjective perspectives on the meaning of illness. The two basic ideas in the theory are that patients' beliefs and thoughts about their experiences involve concepts and that concepts can be communicated on the basis of shared implicit conceptions of what they mean. These conditions of understanding have a striking application: nurse-patient communication is limited by many contextual factors, but it is often possible for nurses to detect shared implicit conceptions of the meaning of concepts of disease and illness. Furthermore, by acting as sympathetic linguistic experts and creating an atmosphere for dialogue, nurses can make patients feel comfortable about deferring to medical explanations of meaning that can constitute a communicative platform. The last part of the article uses a number of cases studies to show how these implications can be implemented as conceptual tools for securing meaningful communication about illness experiences in patient dialogue.
护理理论中的一个基本假设是，护士理解患者如何体验健康不佳状态非常重要。这一假设通常与共情理解的目标相关，但每当护士试图基于意义的主动或被动表达来理解患者的主观视野时，社会解释的规范原则就可以发挥重要的行动指导作用。本文的目的是提出一种关于概念掌握的哲学理论，并论证它能够阐明护士应如何去理解患者对疾病意义的主观观点。该理论的两个基本观点是，患者对自身经历的信念和想法涉及概念，并且概念可以基于对其含义的共享隐性概念来进行交流。这些理解条件有一个显著的应用：护患沟通受到许多情境因素的限制，但护士通常能够察觉到对疾病概念含义的共享隐性概念。此外，通过充当富有同情心的语言专家并营造对话氛围，护士可以让患者放心地接受对意义的医学解释，而这些解释可以构成一个交流平台。文章的最后一部分使用了一些案例研究，展示了这些启示如何作为概念工具来确保在患者对话中就疾病经历进行有意义的沟通。
