van der Byl Williams Millie, Zeilig Hannah
London College of Fashion, University of the Arts London, London, UK
Dementia Research Centre, University College London, London, UK.
Med Humanit. 2023 Mar;49(1):38-47. doi: 10.1136/medhum-2022-012387. Epub 2022 Jul 11.
Agency has become an essential component of discussions concerning selfhood, well-being, and care in dementia studies but the concept itself is rarely clearly defined and the use of this term can be confusing and conflicting. This paper outlines some of the key ways in which agency has been conceptualised in relation to dementia, highlighting the complexities surrounding this concept and focusing on agency in a way that is tied to our ideas about citizenship, legal and human rights. Seven key dimensions of agency are examined: embodiment, emotions, sense of agency, intentional conscious action, the social context of agency, decision-making and moral responsibility. Using a critical realist approach, this paper brings together the diverse ways in which agency has been understood into an interdisciplinary, laminated understanding of agency. This model is then used in an applied example demonstrating that this model can be used to identify the ways in which an arts intervention can support the agency of people living with dementia. This paper proposes that agency is layered, multidimensional and exists on a continuum.
在痴呆症研究中，能动性已成为有关自我认同、幸福感和照护讨论的重要组成部分，但该概念本身很少得到明确界定，其使用可能会令人困惑且相互矛盾。本文概述了在痴呆症相关研究中能动性被概念化的一些关键方式，强调了围绕这一概念的复杂性，并以一种与我们关于公民身份、法律和人权的观念相关联的方式聚焦于能动性。文章审视了能动性的七个关键维度：身体性、情感、能动感、有意识的意向行动、能动性的社会背景、决策和道德责任。本文采用批判实在论方法，将对能动性的多种理解方式整合为一种跨学科的、分层的能动性理解。然后将该模型应用于一个实例，表明此模型可用于识别艺术干预支持痴呆症患者能动性的方式。本文提出能动性是分层的、多维度的且存在于一个连续统中。
