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促进残疾包容的健康科学培训:与情感互动的必要性。

Health sciences training for disability inclusion: the need to engage with emotion.

作者信息

Watermeyer Brian

机构信息

Division of Disability and Rehabilitation Studies, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa

出版信息

Med Humanit. 2025 Feb 24;51(1):123-128. doi: 10.1136/medhum-2024-013044.

Abstract

Material aspects of disability inequality, such as access to quality services, housing and employment, are an urgent, worldwide concern. Less recognised though, are psychological layers of prejudice and discrimination, which play a significant role in cementing marginality. Against this backdrop, health practitioners can fill influential roles in shaping the self-identity and citizenship entitlement of people with disabilities. Yet, these professionals are, like the balance of society, socialised in environments where ableism is intrinsic, invisible and unquestioned. Disability prejudice has both an emotional and unconscious basis, and overcoming its effects is argued to require a personal engagement with feelings relating to bodily frailty, universal dependency, mortality and other prickly aspects of the human condition with which it is associated. These aspects are all at play in the clinical encounter between a health professional and a patient with disability, but the layered and consequential nature of such interactions for the flourishing and empowerment of people with disabilities, as well as the disability movement as a whole, is poorly understood. Evidence suggests that mere tuition in social justice has limited effects on behaviour in relation to issues of inequality and exclusion. In this paper I reflect on how socialisation in an ableist world can shape how disability is positioned in the clinical encounter, potentially leading to interactions which embed inequality. Drawing on my own experience as disability studies scholar and disabled person, I then describe a teaching method for facilitating shifts in the personal relationships which health sciences students have to disability, in the context of broader attempts to create clinical spaces and relationships in which empathy and self-compassion are encouraged.

摘要

残疾不平等的物质层面,如获得优质服务、住房和就业的机会,是一个紧迫的全球性问题。然而,较少被认识到的是偏见和歧视的心理层面,它们在巩固边缘化方面发挥着重要作用。在此背景下,医疗从业者在塑造残疾人的自我认同和公民权利方面可以发挥重要作用。然而,这些专业人员与社会的其他部分一样,是在一个能力主义内在、无形且未受质疑的环境中社会化的。残疾偏见既有情感基础,也是无意识的,有人认为,要克服其影响,需要个人直面与身体脆弱、普遍依赖、死亡以及与之相关的人类状况的其他棘手方面相关的感受。这些方面在医疗专业人员与残疾患者的临床接触中都有体现,但这种互动对于残疾人的茁壮成长和赋权以及整个残疾运动的多层次和深远性质却鲜为人知。有证据表明,仅仅接受社会正义方面的培训,对于与不平等和排斥问题相关的行为影响有限。在本文中,我反思了在一个能力主义的世界中社会化如何塑造临床接触中对残疾的定位,这可能导致强化不平等的互动。基于我作为残疾研究学者和残疾人的自身经历,我随后描述了一种教学方法,旨在促进健康科学专业学生与残疾人士之间个人关系的转变,这是在更广泛地尝试创造鼓励同理心和自我同情的临床空间及关系的背景下进行的。

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