Bloorview Research Institute, Toronto, Ontario, Canada.
The University of Queensland, Brisbane, Queensland, Australia.
Qual Health Res. 2019 Nov;29(13):1890-1903. doi: 10.1177/1049732319838235. Epub 2019 Apr 8.
Clinicians' positive demeanor and "strengths based" focus can include working to create a cheerful atmosphere in health care environments, cheering for improvements in assessment outcomes, and cheering up clients in situations of decline. Drawing from philosopher Karen Barad's theories of inclusions and exclusions, we investigated what comes to matter (and what is excluded from mattering) when there is cheerfulness, cheering, and so forth (cheer*) in the day-to-day practices of a neuromuscular clinic. We worked collaboratively with clinicians, young people with Duchenne muscular dystrophy, and their families to co-examine the clinic in three iterative exploratory method spaces: (a) group "dialogues" with clinicians; (b) consultative interviews with children, families, and clinicians; and (c) transdisciplinary research team analysis sessions. Cheer* made some things matter in the clinic ("normal" physical function, "positive" emotions, test scores, compliance); and excluded others (grief and loss, "non-normative" bodies and lives, alternative practices, embodied knowledge). We discuss implications across health care settings.
临床医生积极的态度和“基于优势”的关注点可以包括努力在医疗环境中营造愉快的氛围，为评估结果的改善而欢呼，在患者病情恶化时为他们加油打气。本研究借鉴哲学家凯伦·巴拉德（Karen Barad）关于包容和排斥的理论，探究在神经肌肉诊所的日常实践中，当出现愉快、欢呼等情况时，哪些因素变得重要（以及哪些因素被排除在重要因素之外）。我们与临床医生、患有杜氏肌营养不良症的年轻人及其家人合作，在三个迭代探索性方法空间中共同检查诊所：（a）与临床医生进行小组“对话”；（b）对儿童、家庭和临床医生进行咨询访谈；（c）跨学科研究团队分析会议。欢呼使诊所有的事情变得重要（“正常”的身体功能、“积极”的情绪、测试分数、依从性），同时也排除了其他因素（悲伤和失落、“非典型”的身体和生活、替代实践、体现知识）。我们讨论了在整个医疗保健环境中的影响。
