我们需要谈谈“不良”韧性。
We need to talk about 'bad' resilience.
机构信息
Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
Department of Economics, University of Zambia, Lusaka, Zambia.
出版信息
BMJ Glob Health. 2024 Feb 6;9(2):e014041. doi: 10.1136/bmjgh-2023-014041.
Abstract
In this analysis, we argue against seeing health system resilience as an inherently positive concept. The rise in the popularity of health system resilience has led to its increasingly normative framing. We question this widely accepted perspective by examining the underlying assumptions associated with this normative framing of 'good' resilience. Our focus is on the risks of accepting the assumption, which can lead us to ignore the social nature of health systems and overlook the consequences of change if resilience is seen as a positive, achievable objective. Finally, we suggest that seeing resilience as a normative concept can be detrimental to health system policy and research, and encourage a critical rethinking of these assumptions so that we can maintain resilience's usefulness for health systems.
摘要
在本分析中，我们反对将卫生系统弹性视为固有积极的概念。卫生系统弹性的普及度不断提高，使其日益规范化。我们通过审视这种“良好”弹性规范化框架所隐含的假设，对这一广泛接受的观点提出质疑。我们关注的是接受这一假设所带来的风险，这可能导致我们忽视卫生系统的社会性质，并忽略如果将弹性视为积极且可实现的目标时所带来的变化的后果。最后，我们认为将弹性视为规范性概念可能对卫生系统政策和研究有害，并鼓励对这些假设进行批判性反思，以便我们能够保持弹性对卫生系统的有用性。
相似文献
1
We need to talk about 'bad' resilience.我们需要谈谈“不良”韧性。
BMJ Glob Health. 2024 Feb 6;9(2):e014041. doi: 10.1136/bmjgh-2023-014041.
2
The resilient subject: exploring subjectivity, identity and the body in narratives of resilience.有适应力的主体：探索韧性叙事中的主体性、身份认同和身体。
Health (London). 2012 Sep;16(5):548-63. doi: 10.1177/1363459312438564. Epub 2012 Apr 30.
3
Resilience's role in clinical belongingness and presenteeism of new nurses: A moderated mediation model.韧性在新护士临床归属感和出勤主义中的作用：一个有调节的中介模型。
Nurs Health Sci. 2024 Mar;26(1):e13078. doi: 10.1111/nhs.13078.
4
Resilience and risk competence in schools: theory/knowledge and international application in project rebound.学校中的复原力与风险应对能力：项目反弹中的理论/知识及国际应用
J Drug Educ. 2010;40(4):331-59. doi: 10.2190/DE.40.4.b.
5
Master resilience training and its relationship to individual well-being and stress buffering among army national guard soldiers.陆军国民警卫队士兵的复原力训练大师及其与个人幸福感和压力缓冲的关系。
J Behav Health Serv Res. 2013 Apr;40(2):140-55. doi: 10.1007/s11414-013-9320-8.
6
The utility of resilience as a conceptual framework for understanding and measuring LGBTQ health.复原力作为理解和衡量 LGBTQ 健康的概念框架的效用。
Int J Equity Health. 2016 Apr 6;15:60. doi: 10.1186/s12939-016-0349-1.
7
Embracing resilience in multiple sclerosis: a new perspective from COVID-19 pandemic.拥抱多发性硬化症的韧性：COVID-19 大流行带来的新视角。
Psychol Health Med. 2022 Feb;27(2):352-360. doi: 10.1080/13548506.2021.1916964. Epub 2021 Apr 25.
8
The contribution of a complex systems-based approach to progressive social resilience.基于复杂系统方法对渐进式社会韧性的贡献。
Health (London). 2024 Sep;28(5):754-774. doi: 10.1177/13634593231195784. Epub 2023 Aug 30.
9
Annual Research Review: What is resilience within the social ecology of human development?年度研究综述：人类发展的社会生态中，什么是适应力？
J Child Psychol Psychiatry. 2013 Apr;54(4):348-66. doi: 10.1111/jcpp.12025. Epub 2012 Dec 7.
10
Positive appraisal style: The mental immune system?积极评价风格：心理免疫系统？
Behav Brain Sci. 2015;38:e112. doi: 10.1017/S0140525X14001629.
引用本文的文献
1
Ideas matter: An analysis of the effects of framing on health system strengthening in Zimbabwe.观念很重要：对框架构建对津巴布韦卫生系统强化影响的分析。
Health Res Policy Syst. 2025 Sep 2;23(1):111. doi: 10.1186/s12961-025-01327-7.
2
Self-Reported Resilience During the COVID-19 Pandemic.新冠疫情期间的自我报告复原力
JAMA Netw Open. 2025 Jul 1;8(7):e2520360. doi: 10.1001/jamanetworkopen.2025.20360.
3
Normative convergence between global health security and universal health coverage: a qualitative analysis of international health negotiations in the wake of COVID-19.全球卫生安全与全民健康覆盖之间的规范趋同：对新冠疫情后国际卫生谈判的定性分析
Global Health. 2025 Feb 24;21(1):5. doi: 10.1186/s12992-025-01099-3.
4
Exploring the inherent resilience of health districts in a context of chronic armed conflict: a case study in Eastern Democratic Republic of the Congo.探索长期武装冲突背景下卫生区的内在恢复力：以刚果民主共和国东部为例
Health Res Policy Syst. 2024 Dec 24;22(1):175. doi: 10.1186/s12961-024-01252-1.
5
Resilience: Now What? Comment on "Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic".恢复力：接下来怎么办？评《重新评估我们对新冠疫情期间卫生系统恢复力的认识：大流行头两年的经验教训》
Int J Health Policy Manag. 2024;13:8563. doi: 10.34172/ijhpm.8563. Epub 2024 Aug 6.
6
Factors of Power and Equity: Enhancing Our Health System Resilience Research Frameworks Comment on "Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic".权力与公平因素：加强我们的卫生系统韧性研究框架 对《重新评估我们在新冠疫情期间对卫生系统韧性的认识：大流行头两年的经验教训》的评论
Int J Health Policy Manag. 2024;13:8606. doi: 10.34172/ijhpm.8606. Epub 2024 Aug 12.
7
Learning Health Systems Are Resilient Health Systems Comment on "Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic".学习型卫生系统是有韧性的卫生系统 评《重新评估我们在新冠疫情期间对卫生系统韧性的认识：大流行头两年的经验教训》
Int J Health Policy Manag. 2024;13:8676. doi: 10.34172/ijhpm.8676. Epub 2024 Sep 7.
本文引用的文献
1
Rethinking international financing for health to better respond to future pandemics.重新思考应对未来大流行病的国际卫生筹资。
BMJ Glob Health. 2023 Nov 24;8(11):e012988. doi: 10.1136/bmjgh-2023-012988.
2
Strengths, Weaknesses, Opportunities, and Threats Analysis of the Use of Digital Health Technologies in Primary Health Care in the Sub-Saharan African Region: Qualitative Study.撒哈拉以南非洲地区基层医疗中数字健康技术使用的优势、劣势、机遇和威胁分析：定性研究。
J Med Internet Res. 2023 Sep 7;25:e45224. doi: 10.2196/45224.
3
Health system resilience: a critical review and reconceptualisation.卫生系统弹性：批判性回顾与再概念化。
Lancet Glob Health. 2023 Sep;11(9):e1454-e1458. doi: 10.1016/S2214-109X(23)00279-6.
4
Medical Dominance in Global Health Institutions as an Obstacle to Equity and Effectiveness Comment on "Power Dynamics Among Health Professionals in Nigeria: A Case Study of the Global Fund Policy Process".全球卫生机构中的医学主导地位对公平与效力的阻碍 评“尼日利亚卫生专业人员之间的权力动态：以全球基金政策过程为例”
Int J Health Policy Manag. 2023;12:7734. doi: 10.34172/ijhpm.2022.7734. Epub 2023 Jan 4.
5
Health System Resilience as the Basis for Explanation Versus Evaluation Comment on "The COVID-19 System Shock Framework: Capturing Health System Innovation During the COVID-19 Pandemic".健康系统弹性作为解释而非评估的基础 述评“COVID-19 系统冲击框架：捕捉 COVID-19 大流行期间的卫生系统创新”。
Int J Health Policy Manag. 2023;12:7481. doi: 10.34172/ijhpm.2023.7481. Epub 2023 Feb 26.
6
Making 'resilience' useful again: recognising health system resilience as an effective boundary object.让“恢复力”再次发挥作用：将卫生系统恢复力视为一种有效的边界对象。
BMJ Glob Health. 2023 May;8(5). doi: 10.1136/bmjgh-2023-012064.
7
How resilience affected public health research during COVID-19 and why we should abandon it.韧性如何影响 COVID-19 期间的公共卫生研究，以及我们为何应该摒弃韧性。
Glob Public Health. 2023 Jan;18(1):2212750. doi: 10.1080/17441692.2023.2212750.
8
Community health workers and Covid-19: Cross-country evidence on their roles, experiences, challenges and adaptive strategies.社区卫生工作者与新冠疫情：关于其作用、经历、挑战及适应策略的跨国证据
PLOS Glob Public Health. 2023 Jan 4;3(1):e0001447. doi: 10.1371/journal.pgph.0001447. eCollection 2023.
9
A health systems resilience research agenda: moving from concept to practice.卫生系统弹性研究议程：从概念到实践。
BMJ Glob Health. 2021 Aug;6(8). doi: 10.1136/bmjgh-2021-006779.
10
Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries.应对 COVID-19 大流行的卫生系统韧性：28 个国家的经验教训。
Nat Med. 2021 Jun;27(6):964-980. doi: 10.1038/s41591-021-01381-y. Epub 2021 May 17.
Zotero 插件