Bakke Marion C A, Fluttert Frans, Juritzen Truls I
Oslo University Hospital, Oslo, Norway.
Molde University College, Molde, Norway.
Nurs Inq. 2025 Jul;32(3):e70032. doi: 10.1111/nin.70032.
In mental health, the safety and risk concept refers to a complex phenomenon with strong connections to risk management strategies, simultaneously influenced by the ideals of patient involvement and empowerment. The aim of this paper is to analyze discourses linked to patient involvement and the management of risk and safety, as articulated in the protocol for the Early Recognition Method (ERM) risk management strategy. As an analytical tool, we have drawn inspiration from the discourse theory of Michel Foucault and utilized Hall's six elements for discourse analysis. Our analysis indicates that the ERM protocol rests its discursive authority upon two main discourses: one, a scientific medical discourse and the other, a discourse strongly linked to empowerment and patient involvement. These two discourses are interrelated in a complex fluctuation of power dynamics in which they sometimes complement each other and, at other times, are in conflict. We claim that by applying a Foucauldian angle on discourse, power, and knowledge, our analysis may facilitate a critical awareness of the power dynamics inherent in risk management discourses and provide valuable insights into how articulations of safety and risk - combined with ideals of participation and empowerment - contribute to reframing practices in mental health care.
在心理健康领域，安全与风险概念指的是一种与风险管理策略紧密相连的复杂现象，同时受到患者参与和赋权理念的影响。本文旨在分析与患者参与以及风险和安全管理相关的话语，这些话语在早期识别方法（ERM）风险管理策略的协议中有所阐述。作为一种分析工具，我们从米歇尔·福柯的话语理论中汲取灵感，并运用霍尔的话语分析六要素。我们的分析表明，ERM协议的话语权威基于两种主要话语：一种是科学医学话语，另一种是与赋权和患者参与紧密相关 的话语。这两种话语在权力动态的复杂波动中相互关联，它们有时相互补充，有时相互冲突。我们认为，通过从福柯的角度审视话语、权力和知识，我们的分析可能有助于批判性地认识风险管理话语中固有的权力动态，并为安全与风险的表述如何与参与和赋权理念相结合从而有助于重塑精神卫生保健实践提供有价值的见解。
