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急诊室的可信度工作和道德评价。

Credibility work and moral evaluation at the ED.

机构信息

Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Room ES331, 111 Ren'ai Road, Suzhou Dushu Lake Higher Education Town, Jiangsu Province, 215123, China.

出版信息

Soc Sci Med. 2020 Mar;248:112845. doi: 10.1016/j.socscimed.2020.112845. Epub 2020 Feb 7.

Abstract

This paper contributes to the understanding of triage decision making by analyzing the credibility work jointly performed by patients and staff and its contribution to the non-clinical evaluation of clientele. I argue that the assessment of credibility occurs at the intersection between staff-devised typifications and patients' interactional performance, and is mediated by staff's experiential knowledge. In ordinary circumstances, patients can achieve credibility through three interactional strategies: embodying distress, limiting the voice of the lifeworld, and conveying narrative frankness. Patients belonging to groups associate by triage workers with disreputable characteristics, such as dishonesty, have the additional task of establishing themselves as trustworthy interlocutors by mobilizing worth claims. Embodying distress and limiting the voice of the lifeworld are instrumental to asserting legitimacy, whereas narrative frankness is an interactional prerequisite for manufacturing reasonableness.

摘要

本文通过分析患者和医务人员共同进行的可信度工作及其对客户非临床评估的贡献,有助于理解分诊决策。我认为,可信度的评估发生在工作人员设计的类型学和患者的互动表现的交叉点,并且受到工作人员经验知识的调节。在一般情况下,患者可以通过三种互动策略来获得可信度:表现出痛苦、限制生活世界的声音和传达叙事坦率。被分诊工作人员归类为具有不名誉特征的群体的患者,如不诚实,通过调动价值主张,还有额外的任务,即通过自己表现出值得信任的对话者来建立可信度。表现出痛苦和限制生活世界的声音有助于主张合法性,而叙事坦率则是制造合理性的互动前提。

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