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慢性阻塞性肺疾病(COPD)的影像学与想象:乌拉圭人描绘他们的肺部。

Imaging and imagining chronic obstructive pulmonary disease (COPD): Uruguayans draw their lungs.

作者信息

Wainwright Megan

机构信息

a Division of Social and Behavioural Sciences, School of Public Health and Family Medicine , University of Cape Town , Cape Town , South Africa.

出版信息

Disabil Rehabil. 2018 Dec;40(26):3094-3103. doi: 10.1080/09638288.2017.1376357. Epub 2017 Sep 11.

Abstract

PURPOSE

This anthropological study investigated what people imagined chronic obstructive pulmonary disease to look like in their lungs, what may be influencing these images and how this imagery shapes embodiment.

METHOD

Employing graphic elicitation, in one of multiple ethnographic interviews, participants were asked to draw their lungs: "If we could look inside your chest now, what would we see?" Lung drawings and accompanying narratives and fieldnotes from 14 participants were analyzed for themes and patterns.

RESULTS

The theme of "imaging/imagining" emerged and three distinct patterns within this theme were identified: the microscope perspective, the X-ray perspective and the reduced pulmonary capacity perspective. These patterns demonstrate how embodiment can be shaped by an integration and reinterpretation of the medical images that form part of everyday clinic visits and pulmonary rehabilitation.

CONCLUSIONS

Medical technology and images impact patients' embodiment. Understanding this is important for rehabilitation practitioners who work in a challenging space created by potentially conflicting medical narratives: on the one hand, chronic obstructive pulmonary disease is incurable permanent damage, and on the other, improvement is possible through rehabilitation. Drawing could be integrated into pulmonary rehabilitation and may help identify perceptions of the body that could hinder the rehabilitation process. Implications for rehabilitation Drawings, when combined with interviews, can lead to a deeper and more complex understanding of patients' perspectives and embodiment. Rehabilitation practitioners should be concerned with how patients embody the medical technology and imagery they are exposed to as part of the educational component of pulmonary rehabilitation and healthcare generally. Asking patients to visualize their illness through drawing may help pulmonary rehabilitation practitioners identify perceptions of the body which could hinder the patient's ability to reap the full benefit of their treatment.

摘要

目的

本人类学研究调查了人们想象中的慢性阻塞性肺疾病在其肺部的样子、可能影响这些想象的因素以及这种意象如何塑造身体认知。

方法

在多次人种志访谈中的一次采用图像诱导法,要求参与者画出他们的肺部:“如果现在能看看你的胸部里面,我们会看到什么?”对14名参与者的肺部绘图以及相关叙述和田野笔记进行主题和模式分析。

结果

出现了“成像/想象”主题,并在此主题内确定了三种不同模式:显微镜视角、X光视角和肺容量降低视角。这些模式展示了身体认知是如何通过对构成日常门诊和肺康复一部分的医学图像进行整合和重新诠释而形成的。

结论

医疗技术和图像会影响患者的身体认知。理解这一点对于在由潜在冲突的医学叙述所营造的具有挑战性的环境中工作的康复从业者很重要:一方面,慢性阻塞性肺疾病是无法治愈的永久性损伤,另一方面,通过康复有可能改善。绘图可纳入肺康复,可能有助于识别可能阻碍康复进程的身体认知。对康复的启示绘图与访谈相结合,可更深入、更全面地理解患者的观点和身体认知。康复从业者应关注患者如何将他们接触到的医疗技术和意象内化为身体认知,这是肺康复及一般医疗保健教育组成部分的一部分。要求患者通过绘图来想象自己的病情,可能有助于肺康复从业者识别那些可能阻碍患者充分受益于治疗的身体认知。

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