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复杂适应现象学:医疗保健研究的概念框架。

Complex adaptive phenomenology: A conceptual framework for healthcare research.

机构信息

Monash University, Clayton, Victoria, Australia.

出版信息

J Eval Clin Pract. 2023 Aug;29(5):756-764. doi: 10.1111/jep.13811. Epub 2023 Feb 5.

Abstract

RATIONALE

Healthcare research exploring the lived experiences of health care professionals from different disciplines, such as nursing, medicine, and allied health, has repeatedly highlighted many methodological challenges, especially in understanding the individual human experience within complex systems. In response, complexity theory and phenomenological approaches emerged and evolved in ways that potentially offered researchers frameworks to inform an understanding of the individual human experience. However, while these two theoretical approaches inform a method of inquiry, there is a gap in understanding the phenomenon of 'being' and how this is embodied within complex systems such as the healthcare system.

THE AIMS AND OBJECTIVES

The aim of this paper is to present an integrated theoretical framework, namely complex adaptive phenomenology (CAP). CAP aims to address this inquiry gap by offering a structured conceptual framework wherein complexity theory and phenomenology are complementary but multi-dimensional. The key objective of CAP was to synthesize and integrate two methods of inquiry that examine the relational aspects of 'being', that is the gestalt of perception, action, and context, The authors argue that CAP is well-suited to complex research contexts such as healthcare. The framework focuses on the reciprocal, co-constructive relationships extant between perception, meaning, context, and action that shape experiences of 'being' within complex systems. Complexity theory's connectionist orientation explains the relationships that are formative of the experience of being, while phenomenology explores the manifestations of these formative relationships by attending to the notion of 'being' itself.

CONCLUSION

The authors propose that an integrated framework, of phenomenology and complexity theory, can provide a platform for deeper understandings of the experiences of health professionals and contribute to healthcare scholarship.

摘要

背景

医疗保健研究反复强调了许多方法学上的挑战,尤其是在理解护理、医学和联合健康等不同学科的医疗保健专业人员的实际经历方面。为了解决这些问题,复杂性理论和现象学方法应运而生,并以潜在的方式为研究人员提供了理解个体人类体验的框架。然而,尽管这两种理论方法为探究提供了框架,但对于“存在”的现象以及如何在医疗保健系统等复杂系统中体现这一现象,我们的理解还存在差距。

目的和目标

本文旨在提出一个综合理论框架,即复杂适应现象学(CAP)。CAP 的目的是通过提供一个结构概念框架来解决这一探究差距,该框架中复杂性理论和现象学是互补的,但具有多维性。CAP 的主要目标是综合和整合两种探究方法,以研究“存在”的关系方面,即感知、行动和背景的整体。作者认为,CAP 非常适合医疗保健等复杂的研究环境。该框架侧重于感知、意义、背景和行动之间的相互、共同构建的关系,这些关系塑造了复杂系统中“存在”的体验。复杂性理论的连接主义取向解释了构成存在体验的关系,而现象学则通过关注“存在”本身来探究这些构成关系的表现。

结论

作者提出,现象学和复杂性理论的综合框架可以为深入理解医疗保健专业人员的体验提供一个平台,并为医疗保健学术研究做出贡献。

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