迈向医疗复杂性的价值观导向方法：阐释学评论。
Toward a Values-Informed Approach to Complexity in Health Care: Hermeneutic Review.
机构信息
University of Oxford.
University of Olso.
出版信息
Milbank Q. 2023 Sep;101(3):646-674. doi: 10.1111/1468-0009.12656. Epub 2023 May 23.
Abstract
Policy Points The concept of value complexity (complexity arising from differences in people's worldviews, interests, and values, leading to mistrust, misunderstanding, and conflict among stakeholders) is introduced and explained. Relevant literature from multiple disciplines is reviewed. Key theoretical themes, including power, conflict, language and framing, meaning-making, and collective deliberation, are identified. Simple rules derived from these theoretical themes are proposed.
摘要
政策要点 引入并解释了价值复杂性（由于人们的世界观、利益和价值观的差异而产生的复杂性，导致利益相关者之间产生不信任、误解和冲突）的概念。 回顾了来自多个学科的相关文献。 确定了关键的理论主题，包括权力、冲突、语言和框架、意义构建和集体审议。 从这些理论主题中得出了简单的规则。
相似文献
1
Toward a Values-Informed Approach to Complexity in Health Care: Hermeneutic Review.迈向医疗复杂性的价值观导向方法：阐释学评论。
Milbank Q. 2023 Sep;101(3):646-674. doi: 10.1111/1468-0009.12656. Epub 2023 May 23.
2
Hermeneutic Constructivism: An Ontology for Qualitative Research.阐释建构主义：定性研究的本体论。
Qual Health Res. 2018 Feb;28(3):389-407. doi: 10.1177/1049732317706931. Epub 2017 May 15.
3
Exploring the intersection of hermeneutics and implementation: a scoping review.探索诠释学与实施的交叉点：范围综述。
Syst Rev. 2023 Mar 2;12(1):30. doi: 10.1186/s13643-023-02176-7.
4
A Narrative Approach to Spirituality and Spiritual Care in Health Care.一种健康照护中的灵性和灵性关怀的叙述方法。
J Relig Health. 2020 Jun;59(3):1524-1540. doi: 10.1007/s10943-019-00912-9.
5
Methodological and hermeneutic reduction - a study of Finnish multiple-birth families.方法论与诠释学的简化——芬兰多胞胎家庭研究
Nurse Res. 2015 Jul;22(6):28-34. doi: 10.7748/nr.22.6.28.e1328.
6
[The Two Sources of Meaning: A Critique of the Psychiatric Hermeneutic in Reference to Schleiermacher].《意义的两个来源：关于施莱尔马赫的精神病学诠释学批判》
Fortschr Neurol Psychiatr. 2021 Jan;89(1-02):37-43. doi: 10.1055/a-0942-9514. Epub 2020 Mar 27.
7
Rethinking Integrated Care: A Systematic Hermeneutic Review of the Literature on Integrated Care Strategies and Concepts.反思整合照护：整合照护策略与概念文献的系统诠释学回顾。
Milbank Q. 2020 Jun;98(2):446-492. doi: 10.1111/1468-0009.12459. Epub 2020 May 20.
8
The future of Cochrane Neonatal.考克兰新生儿协作网的未来。
Early Hum Dev. 2020 Nov;150:105191. doi: 10.1016/j.earlhumdev.2020.105191. Epub 2020 Sep 12.
9
Ricoeur's narrative philosophy: A source of inspiration in critical hermeneutic health research.里科尔的叙事哲学：批判解释学健康研究的灵感源泉。
Nurs Philos. 2020 Apr;21(2):e12254. doi: 10.1111/nup.12254. Epub 2019 May 14.
10
Understanding heart failure; explaining telehealth - a hermeneutic systematic review.理解心力衰竭；解读远程医疗——一项诠释学系统评价。
BMC Cardiovasc Disord. 2017 Jun 14;17(1):156. doi: 10.1186/s12872-017-0594-2.
引用本文的文献
1
Navigating value complexity in care pathway development: a qualitative case study.在护理路径开发中应对价值复杂性：一项定性案例研究
BMJ Open. 2025 Aug 13;15(8):e098157. doi: 10.1136/bmjopen-2024-098157.
2
HTA responsiveness to today's challenges to health systems: a responsible innovation in health perspective.卫生技术评估对当今卫生系统挑战的应对能力：从健康领域负责任创新的视角来看
Int J Technol Assess Health Care. 2025 Mar 3;41(1):e16. doi: 10.1017/S0266462325000121.
3
Rural perinatal nursing in Canada: A hermeneutic literature review.加拿大农村围产期护理：一项诠释学文献综述。
Int J Nurs Stud Adv. 2025 Jan 24;8:100300. doi: 10.1016/j.ijnsa.2025.100300. eCollection 2025 Jun.
4
What next for the Australian Atlas of Healthcare Variation series? Focusing the system on appropriate and sustainable health care.《澳大利亚医疗保健差异地图集》系列的下一步计划是什么？将系统聚焦于适当且可持续的医疗保健。
Res Health Serv Reg. 2024 Dec 19;3(1):20. doi: 10.1007/s43999-024-00056-8.
5
Commentary: Without Values, Complexity is Reduced to Mathematics.评论：没有价值观，复杂性就沦为数学问题。
J Eval Clin Pract. 2025 Feb;31(1):e14263. doi: 10.1111/jep.14263.
6
Why a medical student's learning environment matters: the enabling effect of supportive social climates.为何医学生的学习环境至关重要：支持性社会氛围的促进作用。
J R Soc Med. 2024 Oct;117(10):329-332. doi: 10.1177/01410768241274048. Epub 2024 Oct 25.
7
A decade of change towards Value-Based Health Care at a Dutch University Hospital: a complexity-informed process study.荷兰大学附属医院迈向基于价值的医疗保健的十年：一项复杂性知情的过程研究。
Health Res Policy Syst. 2024 Aug 5;22(1):94. doi: 10.1186/s12961-024-01181-z.
本文引用的文献
1
Desperately Seeking Intersectionality in Digital Health Disparity Research: Narrative Review to Inform a Richer Theorization of Multiple Disadvantage.迫切寻求数字健康差异研究中的交叉性：叙事综述以丰富多重劣势的理论化
J Med Internet Res. 2022 Dec 7;24(12):e42358. doi: 10.2196/42358.
2
The Lancet Commission on lessons for the future from the COVID-19 pandemic.《柳叶刀》新冠疫情对未来的启示委员会
Lancet. 2022 Oct 8;400(10359):1224-1280. doi: 10.1016/S0140-6736(22)01585-9. Epub 2022 Sep 14.
3
What were the historical reasons for the resistance to recognizing airborne transmission during the COVID-19 pandemic?在 COVID-19 大流行期间，为什么人们对承认空气传播存在阻力？历史原因是什么？
Indoor Air. 2022 Aug;32(8):e13070. doi: 10.1111/ina.13070.
4
Introduction to the special issue on the importance of .关于……重要性的特刊引言
Eur J Law Econ. 2021;52(2-3):203-208. doi: 10.1007/s10657-021-09717-2. Epub 2021 Dec 3.
5
Epistemic Injustice in Incident Investigations: A Qualitative Study.事件调查中的认知不公正：一项定性研究。
Health Care Anal. 2022 Dec;30(3-4):254-274. doi: 10.1007/s10728-022-00447-3. Epub 2022 May 31.
6
Orthodoxy, and playing the scientific game: a Bourdieusian analysis of infection control science in the COVID-19 pandemic.正统观念与参与科学游戏：布迪厄对新冠疫情中感染控制科学的分析
Wellcome Open Res. 2021 Oct 22;6:126. doi: 10.12688/wellcomeopenres.16855.3. eCollection 2021.
7
Talking it better: conversations and normative complexity in healthcare improvement.谈得更好：医疗保健改进中的对话和规范性复杂性。
Med Humanit. 2022 Mar;48(1):85-93. doi: 10.1136/medhum-2020-012129. Epub 2021 May 25.
8
Putting the social back into sociotechnical: Case studies of co-design in digital health.将社会放回社会技术中：数字健康共同设计的案例研究。
J Am Med Inform Assoc. 2021 Feb 15;28(2):284-293. doi: 10.1093/jamia/ocaa197.
9
It Is Time to Address Airborne Transmission of Coronavirus Disease 2019 (COVID-19).是时候应对2019冠状病毒病（COVID-19）的空气传播问题了。
Clin Infect Dis. 2020 Dec 3;71(9):2311-2313. doi: 10.1093/cid/ciaa939.
10
Towards a translational medical humanities: introducing the cultural crossings of care.迈向转化医学人文学：介绍关怀的文化交汇。
Med Humanit. 2020 Jun;46(2):e2. doi: 10.1136/medhum-2019-011751. Epub 2020 Apr 27.
Zotero 插件