Frey Isabel, De Boer Marike E, Dronkert Leonie, Pols A Jeannette, Visser Marieke C, Hertogh Cees M P M, Depla Marja F I A
Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Universiteit van Amsterdam, Amsterdam, The Netherlands.
Qual Health Res. 2020 Jun;30(7):1114-1124. doi: 10.1177/1049732320911370.
This is an ethnographic study of decision-making concerning tube feeding in the acute phase after a severe stroke. It is based on 6 months of ethnographic research in three stroke units in the Netherlands, where the decision-making on life-sustaining treatment was studied in 16 cases of severe stroke patients. Data were collected through participant observation and interviews. For this article, the analysis was narrowed down to the decision whether or not the patient should receive tube feeding. The data on tube feeding were assembled and coded according to different modes of dealing with this decision in clinical practice, which we refer to as "repertoires." We discerned three different repertoires: choice, necessity, and comfort. Each repertoire structures clinical practice differently: It implies distinctive ethical imperatives, central concerns, sources of information, and temporalities. We hope our findings can improve decision-making by uncovering its underlying logics in clinical practice.
这是一项关于严重中风急性期管饲决策的人种志研究。它基于在荷兰三个中风单元进行的为期6个月的人种志研究，在那里对16例严重中风患者维持生命治疗的决策进行了研究。数据通过参与观察和访谈收集。对于本文，分析缩小到患者是否应接受管饲的决策。根据临床实践中处理该决策的不同模式，将管饲数据进行整理和编码，我们将其称为“全部技能”。我们识别出三种不同的全部技能：选择、必要性和舒适度。每种全部技能对临床实践的构建方式不同：它意味着独特的伦理要求、核心关注点、信息来源和时间性。我们希望我们的研究结果能够通过揭示临床实践中决策的潜在逻辑来改善决策。
