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概述经验专长在医疗保健服务共同生产中的专业工作中的作用。

Outlining the role of experiential expertise in professional work in health care service co-production.

机构信息

R&D and Innovation Services, Tampere University of Applied Sciences, Tampere, Finland.

Work Research Centre (WRC), Tampere University, Tampere, Finland.

出版信息

Int J Qual Stud Health Well-being. 2021 Dec;16(1):1954744. doi: 10.1080/17482631.2021.1954744.

Abstract

Patient and public involvement is widely thought to be important in the improvement of health care delivery and in health equity. The article examines the role of experiential knowledge in service co-production in order to develop opiate substitution treatment services (OST) for high-risk opioid users. Drawing on social representations theory and the concept of social identity, we explore how experts' by experience and registered nurses' understandings of OST contain discourses about the social representations, identity, and citizenship of the participants and the effects these may have on developing or hindering inclusive and bottom-up forms of patient and public involvement. The meeting sessions that potentially offer room for creativity and problem-solving fail to provide any new propositions for fixing the system. The health care professionals primarily identify themselves as regulators who protect the correctness of their actions and show little interest in considering experiential knowledge on opioid addiction. The participation of patients has been one of the prominent reforms implemented in health care. The goal of client-centered thinking is often emphasised; however, the implementation is not simple due to the strongly institutionalised knowledge and related working patterns and practices in health care.

摘要

患者和公众的参与被广泛认为对于改善医疗服务和医疗公平至关重要。本文考察了经验知识在服务共同生产中的作用,以便为高风险阿片类药物使用者开发阿片类药物替代治疗服务(OST)。本文借鉴社会表征理论和社会认同概念,探讨了专家和注册护士对 OST 的理解如何包含参与者的社会表征、身份和公民身份的论述,以及这些论述对发展包容性和自下而上的患者和公众参与形式可能产生的影响。那些有可能提供创造力和解决问题空间的会议未能提出任何新的建议来修复这个系统。医疗保健专业人员主要将自己视为监管者,他们保护自己行为的正确性,对考虑阿片类药物成瘾方面的经验知识几乎不感兴趣。患者的参与是医疗保健领域实施的一项重要改革。以客户为中心的思维通常被强调;然而,由于医疗保健中强烈制度化的知识以及相关的工作模式和实践,实施并不简单。

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