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从护士角度看临床环境中专业间关系对患者决策能力的影响。

Impact of Interprofessional Relationships from Nurses' Perspective on the Decision-Making Capacity of Patients in a Clinical Setting.

机构信息

Nursing and Physiotherapy Department, University of Balearic Islands, 07122 Palma de Mallorca, Spain.

Emergency Care Service 061, 07014 Palma de Mallorca, Spain.

出版信息

Int J Environ Res Public Health. 2017 Dec 29;15(1):49. doi: 10.3390/ijerph15010049.

Abstract

Interprofessional relationships may impact the decision making of patients in a clinical setting. The objective of this study was to analyse the decision-making capabilities of patients from nurses' perspectives of interprofessional relationships using Foucauldian ethics. This qualitative study was based on poststructuralist Foucault references with in-depth interviews of nurses working in internal medicine and specialties in a general hospital. The patients constantly appeared in the definition of teamwork, but also as a passive element used by every professional to communicate with others. Nurses continue modelling a type of patient passivity, or what Foucault called passive subjectivity in relation to oneself, because the patient is guided and directed to take charge of a truth provided by professionals. Nurses must break the rigid design of sections or professional skills, and adopt a model of teamwork that meets the needs of the patient and increases their decision-making power. The quality of care will increase to the extent that professionals establish a relationship of equality with the patient, allowing the patient to make real decisions about their care. An egalitarian model of teamwork is beneficial to the patient, abandoning the idea of a team where the patient and family are constantly excluded from decisions about their care.

摘要

跨专业关系可能会影响临床环境中患者的决策。本研究的目的是从护士对跨专业关系的视角,运用福柯伦理来分析患者的决策能力。这项定性研究基于后结构主义福柯的参考资料,对综合医院内科和专业部门的护士进行了深入访谈。患者在团队合作的定义中不断出现,但也被每个专业人员用作与他人沟通的被动因素。护士继续塑造一种患者的被动性,或者用福柯的话说,与自己有关的被动主体性,因为患者被引导和指导,负责专业人员提供的真相。护士必须打破科室或专业技能的僵化设计,采用符合患者需求并提高其决策能力的团队合作模式。护理质量将提高到专业人员与患者建立平等关系的程度,使患者能够对自己的护理做出真正的决策。团队合作的平等模式对患者有益,摒弃了团队的理念,在这种理念中,患者及其家属经常被排除在对其护理的决策之外。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adff/5800148/422d878940cb/ijerph-15-00049-g001.jpg

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