Suppr超能文献

从单一声音到多样性:重新定义患者参与中的“代表性”。

From a Single Voice to Diversity: Reframing 'Representation' in Patient Engagement.

机构信息

School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia.

ACT Disability, Aged and Carer Advocacy Service, Canberra, ACT, Australia.

出版信息

Qual Health Res. 2024 Sep;34(11):1007-1018. doi: 10.1177/10497323231221674. Epub 2024 Jan 16.

Abstract

There has been a growing emphasis on consumer representation in the development of health policy, services, research, and education. Existing literature has critiqued how discourses of representativeness can disempower consumers working in health systems. The context of the current study is consumer engagement in the development of COVID-19 triage policy and practice in a local health service. Consumer engagement has often been an afterthought in the COVID response, with few examples of consumers in agenda-setting or decision-making roles. In the Australian Capital Territory, 26 consumer, carer, and community groups worked together with academics and clinicians to develop these principles. Interviews were conducted with stakeholders (including consumers, clinicians, and other health professionals) to evaluate the development of triage principles. A discursive psychological approach to analysis was used to explore participants' understandings about and constructions of consumers being representative (or not) and how this may reproduce power imbalances against consumers. The results explore two distinct ways in which participants talked about consumer representativeness: the first drawing on rhetoric about consumers as lay members of the public (as distinct from being professionally engaged in the health sector), and the second in terms of consumer representatives being diverse and having intersectional identities and experiences. Expectations about consumers to be representative of the general population may reproduce traditional power imbalances and silence lived experience expertise. These power imbalances may be challenged by a shift in the way representativeness is conceptualised to requiring health services to seek out diverse and intersectionally marginalised consumers.

摘要

在卫生政策、服务、研究和教育的制定中,越来越强调消费者的代表性。现有文献批评了代表性话语如何使在卫生系统中工作的消费者失去权力。本研究的背景是消费者参与当地卫生服务部门制定 COVID-19 分诊政策和实践。在 COVID-19 应对措施中,消费者参与通常是事后考虑的,很少有消费者在议程设置或决策角色中的例子。在澳大利亚首都领地,26 名消费者、照顾者和社区团体与学者和临床医生一起制定了这些原则。对利益相关者(包括消费者、临床医生和其他卫生专业人员)进行了访谈,以评估分诊原则的制定情况。采用话语心理学方法对参与者对消费者代表性(或不代表性)的理解和构建进行了分析,并探讨了这可能如何再现对消费者的权力失衡。结果探讨了参与者谈论消费者代表性的两种截然不同的方式:第一种方式是基于消费者作为公众的外行成员(与在卫生部门专业参与不同)的修辞,第二种方式是消费者代表的多样性以及具有交叉身份和经验。期望消费者能够代表普通大众,这可能会再现传统的权力失衡和对生活经验专业知识的沉默。通过将代表性概念化为要求卫生服务机构寻找多样化和交叉边缘化的消费者,可以挑战这种权力失衡。

相似文献

1
From a Single Voice to Diversity: Reframing 'Representation' in Patient Engagement.
Qual Health Res. 2024 Sep;34(11):1007-1018. doi: 10.1177/10497323231221674. Epub 2024 Jan 16.
2
Rhetoric of representation: the disempowerment and empowerment of consumer leaders.
Health Promot Int. 2019 Feb 1;34(1):166-174. doi: 10.1093/heapro/dax070.
5
"Not an afterthought": Power imbalances in systemic partnerships between health service providers and consumers in a hospital setting.
Health Policy. 2018 Aug;122(8):922-928. doi: 10.1016/j.healthpol.2018.06.007. Epub 2018 Jun 28.
7
How do consumer leaders co-create value in mental health organisations?
Aust Health Rev. 2017 Oct;41(5):505-510. doi: 10.1071/AH16105.
8
'Not in the room, but the doctors were': an Australian story-completion study about consumer representation.
Health Promot Int. 2020 Aug 1;35(4):752-761. doi: 10.1093/heapro/daz070.
9
User and carer involvement in the training and education of health professionals: a review of the literature.
Int J Nurs Stud. 2007 Mar;44(3):511-9. doi: 10.1016/j.ijnurstu.2006.05.013. Epub 2006 Jul 13.

本文引用的文献

1
A Hierarchy of Power: The Place of Patient and Public Involvement in Healthcare Service Development.
Front Sociol. 2019 May 8;4:38. doi: 10.3389/fsoc.2019.00038. eCollection 2019.
3
Public Preferences for Allocating Ventilators in an Intensive Care Unit: A Discrete Choice Experiment.
Patient. 2021 May;14(3):319-330. doi: 10.1007/s40271-021-00498-z. Epub 2021 Mar 4.
6
Health systems of oppression: applying intersectionality in health systems to expose hidden inequities.
Health Policy Plan. 2020 Nov 20;35(9):1228-1230. doi: 10.1093/heapol/czaa111.
7
Community engagement for COVID-19 prevention and control: a rapid evidence synthesis.
BMJ Glob Health. 2020 Oct;5(10). doi: 10.1136/bmjgh-2020-003188.
8
"An Active, Productive Life": Narratives of, and Through, Participation in Public and Patient Involvement in Health Research.
Qual Health Res. 2020 Dec;30(14):2265-2277. doi: 10.1177/1049732320961053. Epub 2020 Oct 3.
9
Improving Service User Involvement in Mental Health Nursing Education: Suggestions from Those with Lived Experience.
Issues Ment Health Nurs. 2021 Feb;42(2):119-127. doi: 10.1080/01612840.2020.1780529. Epub 2020 Jul 27.
10
Consumer engagement in health services in Queensland, Australia: A qualitative study about perspectives of engaged consumers.
Health Soc Care Community. 2020 Nov;28(6):2290-2298. doi: 10.1111/hsc.13050. Epub 2020 Jun 8.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验