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被迫的滋味不好受:儿童关于医疗程序中约束的叙述。

It hurts to get forced: Children's narratives about restraint during medical procedures.

作者信息

Forsner Maria, Cyrén Monika, Gerdin Anna, Rullander Anna-Clara

机构信息

Department of Nursing Umeå University Umeå Sweden.

Gävle Sjukhus Gävle Sweden.

出版信息

Paediatr Neonatal Pain. 2023 Feb 2;5(4):110-118. doi: 10.1002/pne2.12093. eCollection 2023 Dec.

Abstract

According to the UN Convention on the Rights of the Child (UNCRC), children have the right to be involved in decisions about medical procedures affecting them. However, research has shown that healthcare professionals sometimes find this difficult to achieve and those procedures then are performed against the will of the child. The aim was to illuminate restraint from the perspective of children's and young people's experiences of feeling forced during medical procedures. Following the phenomenological hermeneutic method, a secondary qualitative analysis of narrative data from four datasets collected between 2001 and 2020 was performed. Twelve children and young people aged 6-19 years (three male, nine female) from central and northern Sweden narrated their experiences of restraint related to medical procedures in nine narrative interviews and three short written narratives. The analysis revealed that it hurts to get forced, this being illustrated in six themes: , , , , , and From the perspective of children and young people, restraint was interpreted with inspiration from the philosopher Michel Foucault, as being overpowered - not voluntary submission but offering resistance - and according to the theory of caring and uncaring, a relationship in which the healthcare professional is perceived as indifferent to the patient as a person. In conclusion restraint hurts and means powerlessness to the child, leaving deep traces that remain for a long time. The findings call the healthcare profession to take action to support children's self-determination, participation, and integrity in healthcare. How children experience restraint in healthcare merits further investigation from the children's own perspective.

摘要

根据《联合国儿童权利公约》(UNCRC),儿童有权参与影响自身的医疗程序决策。然而,研究表明,医护人员有时发现这很难实现,于是这些程序是违背儿童意愿进行的。目的是从儿童和年轻人在医疗程序中感到被迫的经历角度来阐明约束问题。遵循现象学诠释学方法,对2001年至2020年期间收集的四个数据集的叙事数据进行了二次定性分析。来自瑞典中部和北部的12名6至19岁儿童和年轻人(3名男性,9名女性)在9次叙事访谈和3篇简短书面叙述中讲述了他们与医疗程序相关的约束经历。分析表明,被强迫是痛苦的,这体现在六个主题中: , , , , , 以及 从儿童和年轻人的角度来看,约束从哲学家米歇尔·福柯的灵感中被解释为被压制——不是自愿服从而是进行抵抗——并且根据关怀与不关怀的理论,这是一种医护人员被视为对患者个人冷漠的关系。总之,约束对儿童来说是痛苦的,意味着无力,会留下长期深刻的痕迹。这些发现呼吁医疗行业采取行动,支持儿童在医疗保健中的自决、参与和尊严。儿童在医疗保健中如何体验约束值得从儿童自身角度进行进一步调查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3675/10749400/7724aeff1100/PNE2-5-110-g001.jpg

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