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福利技术对护理伦理的影响:对医疗保健专业人员和管理人员使用福利技术经验的定性分析。

The impact of welfare technology on care ethics: a qualitative analysis of healthcare professionals and managers' experiences with welfare technologies.

作者信息

Gjerstad Brita, Gjerstad-Sørensen Ragnhild, Teig Inger Lise

机构信息

Department of Social Studies, University of Stavanger, Stavanger, Norway.

NORCE Norwegian Research Centre, Stavanger, Norway.

出版信息

BMC Health Serv Res. 2025 Jan 14;25(1):73. doi: 10.1186/s12913-024-12187-2.

Abstract

BACKGROUND

Providing healthcare for the elderly population is challenging due to a shortage of staff. The challenge is addressed by increased use of technology. The article explores the impact of welfare technology on healthcare personnel's care ethical considerations in Norway's primary healthcare sector. Through a qualitative study of how healthcare professionals, managers, and technology suppliers understand and perceive welfare technology in healthcare, we examine whether instrumental values displace care-ethical values in primary healthcare practices.

METHODS

The study is based on a qualitative analysis of interviews with healthcare workers, healthcare managers and technology suppliers in primary healthcare in Norway. Semi-structured interviews were conducted with managers and quality developers at the municipal administrative level and healthcare managers and staff in healthcare units. Interviews with suppliers/manufacturers of welfare technology (GPS, pill dispensers and robotics) were also conducted. We combined an inductive approach with theoretical exploration as we alternated between the empirical data, a thematic approach, and theories of technology and care ethics.

RESULTS

In the analysis of the empirical material, we identified two overarching themes that were related to our research question: 1) demands and solutions and 2) two sides of autonomy. The informants generally highlighted the benefits of welfare technology, but the informants were also ambiguous about the use of welfare technology. Autonomy was seen as an important value but was attached with ambivalence.

CONCLUSION

Care ethical considerations are significantly present within healthcare professionals' understandings of technology even though managers and technology suppliers were advocating for welfare technology in a more instrumental sense. Despite extensive acclaim for user autonomy, healthcare personnel make decisions about care and technology use independently of the resource situation. They hold onto a professional room of freedom in between the patient's needs, available resources, and suitable technology. They are sceptical about applying technological solutions if they suspect it will lead to potentially adverse consequences, such as loneliness or increased insecurity due to technological illiteracy. By engaging a relational autonomy approach in their care practices, healthcare professionals control technology rather than submit to technology and we see that rather than being displaced by technical-economic reasoning, care ethical reasoning also accommodates technology.

摘要

背景

由于人员短缺,为老年人口提供医疗保健具有挑战性。技术使用的增加解决了这一挑战。本文探讨了福利技术对挪威初级医疗保健部门医护人员护理伦理考量的影响。通过对医疗保健专业人员、管理人员和技术供应商如何理解和看待医疗保健中的福利技术进行定性研究,我们考察了在初级医疗保健实践中工具性价值是否取代了护理伦理价值。

方法

该研究基于对挪威初级医疗保健领域医护人员、医疗保健管理人员和技术供应商访谈的定性分析。与市政行政层面的管理人员和质量开发者以及医疗保健单位的医疗保健管理人员和工作人员进行了半结构化访谈。还对福利技术(全球定位系统、药丸分配器和机器人技术)的供应商/制造商进行了访谈。我们在实证数据、主题方法以及技术与护理伦理理论之间交替,将归纳法与理论探索相结合。

结果

在对实证材料的分析中,我们确定了与我们的研究问题相关的两个总体主题:1)需求与解决方案;2)自主性的两个方面。受访者普遍强调了福利技术的好处,但他们对福利技术的使用也含糊不清。自主性被视为一项重要价值,但也伴随着矛盾情绪。

结论

尽管管理人员和技术供应商在更具工具性的意义上倡导福利技术,但护理伦理考量在医疗保健专业人员对技术的理解中显著存在。尽管对用户自主性广受赞誉,但医护人员会根据患者需求、可用资源和合适技术,独立做出护理和技术使用的决策。他们在患者需求、可用资源和合适技术之间保持着专业的自由空间。如果他们怀疑技术解决方案会导致潜在的不良后果,如因技术文盲导致孤独感或不安全感增加,他们会对应用这些技术持怀疑态度。通过在护理实践中采用关系自主性方法,医护人员控制技术而非屈从于技术,并且我们看到护理伦理推理不仅适应技术,而且并未被技术 - 经济推理所取代。

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本文引用的文献

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