Durham University, Department of Geography and the Centre for Medical Humanities, Lower Mountjoy, DH1 3LE, United Kingdom.
Durham University, Department of Geography and the Centre for Medical Humanities, Lower Mountjoy, DH1 3LE, United Kingdom.
Soc Sci Med. 2018 Feb;198:53-60. doi: 10.1016/j.socscimed.2017.12.022. Epub 2017 Dec 18.
Hope serves as an overarching concept for a range of engagements that demonstrate the benefits of a positive outlook for coping with chronic conditions of ill-health and disability. A dominant engagement through medicine has positioned hope as a desirable attribute and its opposite, hopelessness, as pathological. In this engagement hope is individual, internally located and largely cognitive and able to be learned. Attaining hope reflects a process of coming to terms with the losses associated with long-term conditions and of imagining new meanings and purposes for the future ahead. This process is characterised by a set of linear temporal stages, from loss and denial to acceptance and reappraising the life-course, by an emphasis on the morally desirable exercise of self-care and by a desired outcome that, in the absence of cure, is hope. Through interviews, we aim to unsettle the privileged status given to a positive outlook through examining the expressions, contexts and negotiations of hopelessness of people living with multiple conditions of ill-health and/or disability. These narratives of hopelessness disclose the ways in which realistic imagined possibilities for the future are constrained by external structures of time and function that demand complex negotiations with places, bodies and other people. As a situated and relational narrative, hopelessness draws our attention to the need to rebalance the exclusive attention to individual, internal resources with a renewed attention to contexts and settings. Moreover, hopelessness can be generative for those living with multiple conditions in shaping alternatively framed priorities with respect to their temporal and interpersonal relations.
希望是一个广泛的概念，涵盖了一系列的活动，这些活动展示了积极的态度对应对慢性疾病和残疾的益处。医学领域的主导观点将希望定位为一种理想的属性，而其对立面——绝望，则被视为病态。在这种观点中，希望是个人的、内在的，主要是认知的，并且可以通过学习获得。获得希望反映了一个与长期疾病相关的损失达成妥协，并为未来想象新的意义和目的的过程。这个过程的特点是一系列线性的时间阶段，从失落和否认到接受和重新评估人生轨迹，强调自我保健的道德可取性，以及在没有治愈的情况下，希望是一个理想的结果。通过访谈，我们旨在通过检查那些患有多种疾病或残疾的人的绝望的表达方式、背景和协商，来打破对积极态度的特权地位。这些绝望的叙述揭示了未来的现实想象可能性如何受到时间和功能的外部结构的限制，这些结构要求与地点、身体和其他人进行复杂的协商。作为一种情境化和关系化的叙述，绝望引起了我们对重新平衡个体内部资源的关注，同时也需要重新关注背景和环境。此外，对于那些患有多种疾病的人来说，绝望可以通过塑造关于他们的时间和人际关系的替代框架的优先级来产生影响。
