Nordby Halvor
Department of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Holist Nurs Pract. 2017 May/Jun;31(3):158-166. doi: 10.1097/HNP.0000000000000204.
To ensure patient communication in nursing, certain conditions must be met that enable successful exchange of beliefs, thoughts, and other mental states. The conditions that have received most attention in the nursing literature are derived from general communication theories, psychology, and ethical frameworks of interpretation. This article focuses on a condition more directly related to an influential coherence model of concept possession from recent philosophy of mind and language. The basic ideas in this model are (i) that the primary source of understanding of illness experiences is communicative acts that express concepts of illness, and (ii) that the key to understanding patients' concepts of illness is to understand how they depend on patients' lifeworlds. The article argues that (i) and (ii) are especially relevant in caring practice since it has been extensively documented that patients' perspectives on disease and illness are shaped by their subjective horizons. According to coherentism, nurses need to focus holistically on patients' horizons in order to understand the meaning of patients' expressions of meaning. Furthermore, the coherence model implies that fundamental aims of understanding can be achieved only if nurses recognize the interdependence of patients' beliefs and experiences of ill health. The article uses case studies to elucidate how the holistic implications of coherentism can be used as conceptual tools in nursing.
为确保护理工作中的医患沟通，必须满足某些条件，以实现信念、思想及其他心理状态的成功交流。护理文献中最受关注的条件源自一般沟通理论、心理学以及解释的伦理框架。本文聚焦于一个与近期心灵哲学和语言哲学中颇具影响力的概念拥有连贯模型更直接相关的条件。该模型的基本观点是：（i）对疾病体验理解的主要来源是表达疾病概念的沟通行为；（ii）理解患者疾病概念的关键在于理解这些概念如何依赖于患者的生活世界。本文认为，（i）和（ii）在护理实践中尤为相关，因为已有大量文献记载，患者对疾病的看法受其主观视野的影响。根据连贯主义，护士需要全面关注患者的视野，以便理解患者意义表达的含义。此外，连贯模型意味着，只有护士认识到患者关于健康不佳的信念与体验之间的相互依存关系，才能实现理解的基本目标。本文通过案例研究来说明连贯主义的整体含义如何作为护理中的概念工具加以运用。
