“Sono solo parole”:面临开发和应用术语来记录护理的挑战。

IF 2.6 3区 医学 Q1 NURSING
Cecilia Malabusini
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引用次数: 0

摘要

护士迫切需要记录活动。可用术语的全景是异构的。似乎有必要了解可用工具的前提及其限制和好处,以便做出有意识的选择和塑造未来的发展。分类(如北美护理诊断协会)和“纯术语”(如国际护理实践分类)或护理语言是记录护士活动和产生理论模型或参考系统的可用工具。这些工具首先回应了一个实际问题:将护理事实“翻译”成语言描述。分类法通过归纳设计的详尽定义使现实可描述。因此,我认为他们的哲学基础是naïve语义学。它们的框架是一个封闭的层次结构,也就是说,它是一个提供定义了的概念层次的系统,通过二分规则进行结构化。这就导致了概念之间以及现象之间边界的确定问题,我称之为“关闭概念圈地”的问题。僵化的形而上学结构无法处理护士处理的复杂现象,因此他们似乎无法描述这些现象。我遵循维特根斯坦(Wittgenstein)在《哲学研究》(Philosophical Investigations)中的观点,这对理解这一挑战很有用:术语的定义不是缺乏合适的词汇或一致的决定的问题,而是通过实践训练实现的。纯术语为我们提供了另一种解决问题的方法。它们通常由术语表组成,并搭配规则将它们组合起来以管理意思。它们更像是自然语言,这意味着要更多地适应现象。然后,我认为他们的哲学背景是一种实用主义的语言方法,我讨论了一些后果和反对意见。最后,我发现在记录护理活动时,发展纯粹的术语而不是分类法使我们能够实现关键目标,例如提高健康记录中的护理可见性和可测量性,而不会危及以人为本的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
'Sono solo parole': Facing challenges entailed in developing and applying terminologies to document nursing care.

Nurses' need to document activities is urgent. The panorama of available terminologies is heterogeneous. It seems necessary to understand the premises of available tools and their limits and benefits to make conscious choices and shape future development. Taxonomies (e.g., North American Nursing Diagnosis Association) and 'pure terminologies' (e.g., International Classification for Nursing Practice), or nursing languages, are available tools to document nurses' activities and to produce theoretical models or reference systems. These tools respond first to a practical problem: 'translating' nursing facts into linguistic descriptions. Taxonomies make reality describable through exhaustive definitions designed inductively. Thus, I argue that their philosophical basis is naïve semantics. Their framework is a closed hierarchy, that is, a system that provides defined levels of concepts, structured through dichotomous rules. This causes the problem of determining boundaries between concepts, and thus between phenomena, which I call the problem of 'closing the concept enclosure'. Rigid metaphysical structures are unable to cope with the complexity of phenomena that nurses deal with, so they seem to be unable to describe them. I follow Wittgenstein's argument, from Philosophical Investigations, which is useful to understand this challenge: the definition of terms is not a problem of lack of suitable words or an agreed decision, but is achieved by training in practice. Pure terminologies give us another way to address the question. They are usually composed of a glossary of terms, paired with rules to combine them to manage meaning. They are more like natural language and this implies adapting more to phenomena. Then, I argue that their philosophical background is a pragmatic approach to language, and I discuss some consequences and objections. Finally, I find that the development of pure terminologies rather than taxonomies in documenting nursing activities allows us to achieve key objectives, such as improving nursing visibility and measurability in health records, without jeopardising person-centred care.

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来源期刊
CiteScore
4.80
自引率
9.10%
发文量
39
审稿时长
>12 weeks
期刊介绍: Nursing Philosophy provides a forum for discussion of philosophical issues in nursing. These focus on questions relating to the nature of nursing and to the phenomena of key relevance to it. For example, any understanding of what nursing is presupposes some conception of just what nurses are trying to do when they nurse. But what are the ends of nursing? Are they to promote health, prevent disease, promote well-being, enhance autonomy, relieve suffering, or some combination of these? How are these ends are to be met? What kind of knowledge is needed in order to nurse? Practical, theoretical, aesthetic, moral, political, ''intuitive'' or some other? Papers that explore other aspects of philosophical enquiry and analysis of relevance to nursing (and any other healthcare or social care activity) are also welcome and might include, but not be limited to, critical discussions of the work of nurse theorists who have advanced philosophical claims (e.g., Benner, Benner and Wrubel, Carper, Schrok, Watson, Parse and so on) as well as critical engagement with philosophers (e.g., Heidegger, Husserl, Kuhn, Polanyi, Taylor, MacIntyre and so on) whose work informs health care in general and nursing in particular.
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