McCarthy Bernard
McCarthy Psychology Centre, Eltham, Victoria, Australia.
Dementia (London). 2017 Feb;16(2):249-253. doi: 10.1177/1471301216634921. Epub 2016 Jul 26.
Appreciative Inquiry is an approach to organisational change that has been effective and popular around the world for the past two decades. What could it have to offer us as an alternative to traditional 'behaviour management'? Traditionally, in modern dementia care, we take a psychiatric approach to the range of actions that people engage in when stressed or traumatised by the cognitive, social and psychological losses associated with dementia. We call them symptoms of an illness - Behavioural and Psychological Symptoms of Dementia. Then, we medicate them away because if they are symptoms then medical solutions are called for. We may obtain a better outcome from a different direction. Appreciative Inquiry focuses on an organization as a 'solution designed in its own time to meet a challenge or satisfy a need of society'. This approach focuses on what is working well and is effective in organisations rather than seeing the organisation as a problem to be solved. In this way, we may approach the individual person as a solution designed in its own time to meet a challenge or satisfy a need. Using the 4Ds of the Appreciative Inquiry approach, this article examines the process of Discovery, Dream, Design and Destiny, as it is applied to a case example of a care situation that usually ends with disruption and distress. By formulating affirmative topic choices, the staff group and individual carers may resolve issues with what people with dementia do or say in a way that is humane and hopeful.
积极探寻是一种组织变革方法,在过去二十年里在全球范围内都很有效且广受欢迎。作为传统“行为管理”的替代方法,它能为我们提供什么呢?传统上,在现代痴呆症护理中,对于人们在因与痴呆症相关的认知、社会和心理丧失而感到压力或受到创伤时所采取的一系列行为,我们采用的是精神病学方法。我们将这些行为称为疾病症状——痴呆症的行为和心理症状。然后,我们通过药物来消除这些症状,因为如果它们是症状,那就需要医学解决方案。我们或许可以从不同的方向获得更好的结果。积极探寻将组织视为“在其自身时代设计出来以应对挑战或满足社会需求的解决方案”。这种方法关注的是组织中运行良好且有效的方面,而不是将组织视为一个需要解决的问题。通过这种方式,我们可以将个体视为在其自身时代设计出来以应对挑战或满足需求的解决方案。本文运用积极探寻方法的四个阶段,即发现、梦想、设计和命运,来审视一个护理案例的过程,这个案例通常以混乱和痛苦告终。通过制定肯定性的主题选择,工作人员团队和个体护理人员可以以一种人道且充满希望的方式解决痴呆症患者的行为或言语问题。