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探索英国卫生和社会保健领域中关于患者和公众参与以及志愿者参与的脱节话语。

Exploring disconnected discourses about Patient and Public Involvement and Volunteer Involvement in English health and social care.

机构信息

Institute for Volunteering Research, University of East Anglia, Norwich, UK.

School of Health Sciences, University of East Anglia, Norwich, UK.

出版信息

Health Expect. 2021 Feb;24(1):8-18. doi: 10.1111/hex.13162. Epub 2020 Dec 1.

Abstract

BACKGROUND

Patient and public involvement (PPI) in health and social care policy, service decision-making and research are presented as good practice in England. Yet the explicit rationale for PPI and how it is positioned within the literature, policy and practice remain confused, in particular, in relation to Volunteer Involvement (VI). In health and social care, PPI and VI are managed and valued as conceptually distinct, yet the discourses in their policy and practice documents treat them as closely related in fundamental ways.

OBJECTIVE

Compare and critically evaluate discourses framing PPI and VI within English health and social care.

DESIGN

A critical discourse approach was used to explore the accounts of PPI and VI in policy. These accounts were then compared and contrasted with personal accounts of volunteering in health and social care settings.

RESULTS

Twenty documents from key national health and social care bodies were discursively examined in terms of their framing PPI and VI. A narrative disconnect between the two was repeatedly confirmed. This finding contrasted with an analysis of personal accounts of VI which displayed VI as a form of PPI.

CONCLUSION

There is a disconnect between language, narratives and practice in PPI and in VI which may have direct consequences for policy and practice. Recognising and managing it can offer innovative ways of enabling volunteers to be involved across health and social care settings, ensuring the experiential value added by volunteers' service contributions, to be recognised so that their democratic participation may be seen to shape services.

摘要

背景

患者和公众参与(PPI)在英国的卫生和社会保健政策、服务决策和研究中被视为良好实践。然而,PPI 的明确基本原理及其在文献、政策和实践中的定位仍然存在混淆,特别是在志愿参与(VI)方面。在卫生和社会保健领域,PPI 和 VI 被视为管理和重视概念上截然不同的,但它们的政策和实践文件中的论述在根本上以密切相关的方式对待它们。

目的

比较和批判性评估英语卫生和社会保健领域中 PPI 和 VI 的论述框架。

设计

采用批判话语分析方法探讨了政策中 PPI 和 VI 的论述。然后,将这些论述与卫生和社会保健环境中志愿服务的个人论述进行了比较和对比。

结果

从主要的国家卫生和社会保健机构中选取了 20 份文件,从论述角度对 PPI 和 VI 进行了分析。反复证实了两者之间存在叙述上的脱节。这一发现与对 VI 的个人论述的分析形成了对比,后者将 VI 视为 PPI 的一种形式。

结论

在 PPI 和 VI 中,语言、叙述和实践之间存在脱节,这可能对政策和实践产生直接影响。认识和管理这种脱节可以为志愿者在整个卫生和社会保健环境中参与提供创新方式,确保志愿者服务贡献所带来的经验价值得到认可,从而使他们的民主参与能够被视为塑造服务。

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