Assing Hvidt Elisabeth, Søndergaard Jens, Hansen Dorte Gilså, Gulbrandsen Pål, Ammentorp Jette, Timmermann Connie, Hvidt Niels Christian
University of Southern Denmark.
Akershus University Hospital.
Commun Med. 2017;14(2):108-120. doi: 10.1558/cam.32147.
Although it is broadly recognized that health problems often involve existential and spiritual dimensions, recent research shows that these aspects of illness are rarely attended to by health professionals. Studies explain this in terms of barriers to communication, but health professionals' firsthand experiences and interpretations have so far been largely unexplored. Drawing on the theoretical traditions of phenomenology and hermeneutics, the present study presents Danish general practitioners' (GPs') experiences and interpretations of why the existential and spiritual dimensions are marginalized in patient care. We conducted seven focus groups, constituting a total sample of 31 GPs. Based on the analytic strategy of Interpretative Phenomenological Analysis (IPA), our analysis revealed that the GPs experienced and interpreted individual barriers as created and fostered within dominant biomedical and secular cultures that are characterized as 'solution focused' and 'faith frightened'. Many GPs further understand themselves as barriers, because they are enculturated into these dominating cultures. We discuss these findings through theoretical concepts such as 'secondary socialization', 'system colonization' and 'secularization', and suggest interventions that might challenge current practice culture.
尽管人们普遍认识到健康问题往往涉及生存和精神层面，但最近的研究表明，健康专业人员很少关注疾病的这些方面。研究从沟通障碍的角度对此进行了解释，但健康专业人员的第一手经验和解读迄今为止在很大程度上尚未得到探索。本研究借鉴现象学和诠释学的理论传统，呈现了丹麦全科医生（GPs）对于生存和精神层面在患者护理中被边缘化原因的经验和解读。我们进行了7个焦点小组讨论，共有31名全科医生参与。基于诠释现象学分析（IPA）的分析策略，我们的分析表明，全科医生体验并解读个体障碍是在以“专注解决方案”和“恐惧信仰”为特征的占主导地位的生物医学和世俗文化中产生和形成的。许多全科医生还将自己视为障碍，因为他们深受这些主导文化的影响。我们通过“二次社会化”“系统殖民化”和“世俗化”等理论概念来讨论这些发现，并提出可能挑战当前实践文化的干预措施。
