Department of Ear, Nose, Throat and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark.
Section for Nursing, Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.
Nurs Inq. 2020 Apr;27(2):e12327. doi: 10.1111/nin.12327. Epub 2019 Dec 20.
Although principles such as 'patient participation' and 'patient involvement' have become ideals in health-care, they have proven to be difficult to apply in practice. In 2014, one Danish region issued an official document that included the vision of 'the patient as partner'. However, little is known about how such a vision affects clinical practice. The purpose of this study was to investigate nurses' views on how partnerships between them and patients are established considering this vision. We conducted semi-structured interviews with eight nurses working in Danish hospitals. Then, we analysed the interviews in a Norman Fairclough-inspired critical discourse analysis. During this three-dimensional analysis, we identified three discourses. We found that a liberalistic discourse wins hegemony based on the nurses' expectations of the patient's role. Nurses construct a picture of the patient's role, expecting the patient to be responsible and to participate. For the partnership to arise as envisioned, the patient is perceived as being dependent on the nurse's professional knowledge. Surprisingly, the nurses' articulations of the patient's role were identical to the vision's elements. Therefore, we suggest that the vision reflects prevailing societal norms for individuals, thereby reflecting society's attitude towards people's responsibility for their own lives.
虽然“患者参与”和“患者投入”等原则已成为医疗保健的理想目标,但事实证明,这些原则难以付诸实践。2014 年,丹麦的一个地区发布了一份官方文件,其中包含“将患者视为合作伙伴”的愿景。然而,对于这种愿景如何影响临床实践,人们知之甚少。本研究旨在调查护士对建立这种合作伙伴关系的看法,考虑到这一愿景。我们对在丹麦医院工作的 8 名护士进行了半结构化访谈。然后,我们在诺曼·费尔克拉夫启发式的批判性话语分析中对访谈进行了分析。在这个三维分析中,我们确定了三个话语。我们发现,基于护士对患者角色的期望,自由主义话语占据了主导地位。护士构建了患者角色的图景,期望患者负责并参与。为了实现预期的合作伙伴关系,患者被视为依赖护士的专业知识。令人惊讶的是,护士对患者角色的表述与愿景的要素完全一致。因此,我们认为,这一愿景反映了社会对个人的普遍期望,从而反映了社会对人们对自己生活负责的态度。