Presence Foundation, Grebbeberglaan 15, 3527 VX, Utrecht, The Netherlands.
Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa.
Med Health Care Philos. 2021 Jun;24(2):189-204. doi: 10.1007/s11019-021-10010-x. Epub 2021 Mar 31.
The Covid-19 pandemic is a tragedy for those who have been hard hit worldwide. At the same time, it is also a test of concepts and practices of what good care is and requires, and how quality of care can be accounted for. In this paper, we present our Care-Ethical Model of Quality Enquiry (CEMQUE) and apply it to the case of residential care for older people in the Netherlands during the Covid-19 pandemic. Instead of thinking about care in healthcare and social welfare as a set of separate care acts, we think about care as a complex practice of relational caring, crossed by other practices. Instead of thinking about professional caregivers as functionaries obeying external rules, we think about them as practically wise professionals. Instead of thinking about developing external quality criteria and systems, we think about cultivating (self-)reflective quality awareness. Instead of abstracting from societal forces that make care possible but also limit it, we acknowledge them and find ways to deal with them. Based on these critical insights, the CEMQUE model can be helpful to describe, interrogate, evaluate, and improve existing care practices. It has four entries: (i) the care receiver considered from their humanness, (ii) the caregiver considered from their solicitude, (iii) the care facility considered from its habitability and (iv) the societal, institutional and scholarly context considered from the perspective of the good life, justice and decency. The crux is enabling all these different entries with all their different aspects to be taken into account. In Corona times this turns out to be more crucial than ever.
Covid-19 大流行是全球范围内遭受重创的人们的一场悲剧。与此同时，它也是对良好护理的概念和实践以及如何衡量护理质量的一次考验。在本文中，我们提出了我们的关怀伦理质量探究模型（CEMQUE），并将其应用于荷兰在新冠疫情期间老年人居住护理的案例。我们不是将医疗保健和社会福利中的护理视为一系列独立的护理行为，而是将其视为一种复杂的关系关怀实践，受到其他实践的影响。我们不是将专业护理人员视为遵守外部规则的官员，而是将其视为具有实践智慧的专业人员。我们不是思考制定外部质量标准和系统，而是思考培养（自我）反思性的质量意识。我们不是从使护理成为可能但也限制护理的社会力量中抽象出来，而是承认这些力量，并寻找应对它们的方法。基于这些批判性的见解，CEMQUE 模型可以帮助描述、探究、评估和改进现有的护理实践。它有四个入口：（i）从人性化的角度考虑护理接受者，（ii）从关怀的角度考虑护理提供者，（iii）从宜居性的角度考虑护理设施，（iv）从美好生活、正义和体面的角度考虑社会、机构和学术背景。关键是要使所有这些不同的条目及其所有不同方面都能被考虑在内。在 Corona 时代，这比以往任何时候都更加关键。
