Herulf Scholander Lisa, Vikström Sofia, Boström Anne-Marie, Josephsson Staffan
Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
R&D Unit, Stockholms Sjukhem Foundation, Stockholm, Sweden.
Int J Qual Stud Health Well-being. 2024 Dec;19(1):2367851. doi: 10.1080/17482631.2024.2367851. Epub 2024 Jun 13.
Drawing on data from ethnographic fieldwork and interprofessional focus group discussions, this study enquires into staff's everyday life on a geriatric ward to explore and understand conditions for engaging in narrative relations in in-patient geriatric care. Avoiding individualistic understandings of narrative practices, we applied a narrative-in-action methodology built on a relational understanding of narrativity, where individual narratives are not separated from social and cultural features. This helped us explore how individual interpretations of the conditions for everyday practices come together with broader social or cultural understandings to gain situated insights about how these are continuously related and reformed by one another in everyday situations of geriatric care. The findings offer insights into the opportunities to engage in narrative relations based on how healthcare staff on a geriatric ward interpret conditions for their practices, and how they act based on such interpretations. While some interpretations were associated with attitudes and activities encouraging narrative relations, others simultaneously thwarted narrative relations by enacting task-orientation, division, or a focus on measurable biomedical or function-related outcomes. Moreover, the findings suggest and discuss consequences of the tensions created as interpretations are enacted in everyday healthcare situations, thus questioning assumptions about conditions as something static and linear.
本研究借鉴人种志田野调查数据和跨专业焦点小组讨论结果,探究老年病房工作人员的日常生活,以探索和理解老年住院护理中建立叙事关系的条件。为避免对叙事实践的个人主义理解,我们采用了一种基于对叙事性的关系理解的行动叙事方法,其中个人叙事与社会和文化特征并非分离。这有助于我们探究日常实践条件的个人解读如何与更广泛的社会或文化理解相结合,从而获得关于这些在老年护理日常情境中如何相互持续关联和重塑的情境性见解。研究结果基于老年病房医护人员对其实践条件的解读以及他们基于这些解读的行为方式,揭示了建立叙事关系的机会。虽然一些解读与鼓励叙事关系的态度和活动相关联,但其他解读同时通过实行任务导向、分工或专注于可衡量的生物医学或功能相关结果来阻碍叙事关系。此外,研究结果表明并讨论了在日常医疗情境中实施解读时所产生的紧张关系的后果,从而质疑了将条件视为静态和线性事物的假设。