Department of Health Sciences, 59568Lund University Faculty of Medicine, Lund, Sweden.
Policy Polit Nurs Pract. 2022 May;23(2):130-141. doi: 10.1177/15271544221088250. Epub 2022 Mar 21.
The concept of 'patient involvement' is highlighted in healthcare. However, hindrances can prevent its implementation. This article explored how 'patient involvement' is understood and on what ideas this understanding is based through a critical textual analysis of the European document on patient involvement in health systems using a Fairclough-inspired critical discourse analysis. The findings showed that the document arose from a social discourse based on a mix of a neoliberal ideology, with a marketisation of care focusing on a cost-effective and evidence-based logic of care, a humanistic ideology of patient involvement. It had the form of a normative, consensus-based standard, supported by European organisations. The document incorporated a visionary, well-intentioned abstract guide to promote patient involvement across European care contexts, however without addressing hindrances nor differences across the contexts in which it ought to be implemented. It raises questions about its usability, inviting further research into empirical applications.
“患者参与”的概念在医疗保健中得到了强调。然而，一些障碍可能会妨碍其实施。本文通过对欧洲患者参与卫生系统文件的批判性文本分析，利用受福柯启发的批判性话语分析，探讨了“患者参与”是如何被理解的，以及这种理解是基于哪些观念的。研究结果表明，该文件源于一种社会话语，其基础是混合了新自由主义意识形态、以成本效益和循证护理逻辑为重点的护理市场化、以及以患者参与为人文主义意识形态。它采取了规范性、基于共识的标准形式，得到了欧洲组织的支持。该文件包含了一份有远见、立意良好的抽象指南，旨在促进整个欧洲护理环境中的患者参与，但没有解决实施过程中的障碍或不同背景下的差异。这引发了对其可用性的质疑，需要进一步研究其实证应用。
