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长期护理背景下作为叙事实践的照护:理论思考

Care as narrative practice in the context of long-term care: Theoretical considerations.

作者信息

Berendonk Charlotte, Blix Bodil Hansen, Randall William L, Baldwin Clive, Caine Vera

机构信息

Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.

Department of Health and Care Sciences, Faculty of Health Sciences, Centre for Care Research, The Arctic University of Norway, Tromsø, Norway.

出版信息

Int J Older People Nurs. 2017 Dec;12(4). doi: 10.1111/opn.12156. Epub 2017 Jun 30.

Abstract

AIMS AND OBJECTIVES

In this article, we introduce care itself as a narrative practice. We emphasise that all interactions between care providers and older adults in long-term care settings are narrative in nature and foreground experience.

BACKGROUND

Every person consists of innumerable stories based on experiences over time. Some experiences can be recalled and told as narratives, while others are inscribed into our bodies; they are embodied. These narratives shape who we are and are becoming, and influence how care providers experience and provide nursing care in long-term care settings.

MAIN CONTRIBUTIONS OF THE THEORETICAL CONSIDERATIONS

We highlight the importance of stories to narrative identities and focus on the embodied act of coconstructing new stories in interaction. We emphasise the idea that care in gerontological nursing would benefit from acknowledging and fostering embodied narratives in a systematic way with older adults.

CONCLUSIONS

To foster, elicit, and coconstruct evolving and forward-looking narratives based on older adults' verbal and embodied narratives is essential for the quality of care in long-term settings. Care providers must be aware that they are co-authors of older adults' continuous storying and restorying of their lives.

IMPLICATIONS FOR PRACTICE

To recognise that both residents and care providers are narrative beings shift the current culture of care away from rationalised and emotionally devoid consequences of care. Understanding the theoretical underpinnings of care itself as narrative practice is a first step in developing care practices that place relationships between residents and care providers at the centre of practice. There is a need for the implementation of strategies to think and work narratively in long-term care settings.

摘要

目的与目标

在本文中,我们将护理本身作为一种叙事实践来介绍。我们强调,长期护理环境中护理提供者与老年人之间的所有互动本质上都是叙事性的,并以体验为重点。

背景

每个人都由基于长期经历的无数故事组成。有些经历可以作为叙事被回忆和讲述,而其他经历则铭刻在我们的身体中;它们是具身化的。这些叙事塑造了我们是谁以及正在成为什么样的人,并影响护理提供者在长期护理环境中体验和提供护理的方式。

理论思考的主要贡献

我们强调故事对叙事身份的重要性,并关注在互动中共同构建新故事的具身行为。我们强调这样一种观点,即老年护理若能以系统的方式承认并培育与老年人的具身叙事,将会从中受益。

结论

基于老年人的言语和具身叙事来培育、引出并共同构建不断演变且具有前瞻性的叙事,对于长期护理环境中的护理质量至关重要。护理提供者必须意识到,他们是老年人持续讲述和重新讲述其生活故事的共同创作者。

对实践的启示

认识到居民和护理提供者都是叙事性的存在,这会使当前的护理文化从理性化且缺乏情感的护理结果中转变过来。理解护理本身作为叙事实践的理论基础,是发展以居民与护理提供者之间的关系为实践核心的护理实践的第一步。在长期护理环境中,需要实施以叙事方式进行思考和工作的策略。

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