医生与家庭对话中的基于公平的叙述,关于护理目标
Andrew Childress1, Woods Nash2
1Humanities Expression and Arts Lab, Office of the Senior Dean, Baylor College of Medicine.
概括
临床医生必须在治疗目标对话中超越个人主义. 采用以公平为基础的叙事增强了以患者为中心的沟通和共享决策,改善了健康公平.
科学领域:
- 卫生沟通健康沟通
- 医学伦理 医学伦理
- 健康 公平 卫生 公平
背景情况:
- 临床医生经常使用阻碍共同决策的沟通策略.
- 患者经常被视为不属于他们的文化,社会和家庭背景.
- 这种方法加剧了健康不平等和权力不平衡.
研究的目的:
- 引入一种新的方法来实现护理对话的目标.
- 为了解决临床医生的个人主义和以患者为中心的公平性之间的紧张关系.
- 加强沟通,促进共享决策.
主要方法:
- 关于健康沟通和健康公平的文献综述.
- 分析语言,特别是隐喻,以加强权力动态.
- 开发一个基于股权的叙事框架.
主要成果:
- 语言和隐喻可以维持有利于临床医生的系统权力失衡.
- 个人主义的主导叙述往往忽视了对患者的系统性影响.
- 基于股权的叙述承认并解决了这些系统影响.
结论:
- 为制定更有意义的目标提供了指导.
- 拟议的方法可以加强沟通和共享决策.
- 这个框架适用于所有护理讨论的目标,而不仅仅是在ICU.
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