理解缺席却又在场的他人:代表超越生死的阈限植物人状态

IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Edoardo Zulato , Paula Castro , Carolina Silvia Quagliarella , Lorenzo Montali
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引用次数: 0

摘要

临床意义上说,植物人是活着的,但却一直没有意识到,他们处在生与死之间的过渡阶段。反过来,他们的照顾者努力表明本体论和相互作用的困境,这些困境来自于他们与一个缺席但又在场的他人的有限关系,以及他们在时间上的暂停。利用社会表征和阈限理论,本研究探讨了亲属和专业人士如何处理这些困境。在这样做的过程中,研究的重点是关系和时间在表示一个缺席但存在的他者方面的作用。我们分析了2019年2月至2021年9月期间从意大利五家养老院招募的65名亲属(n = 35)和专业人员(n = 30)的半结构化访谈。以话语为导向的主题分析显示了护理人员如何将患者从二元分类和时间性(例如,生/死,人/身体,过去/未来)中解脱出来,将他们表示为存在于本体论悖论中:两者/两者都不是和和/不是。分析还显示了护理人员如何通过参与协作身份识别工作来处理与无声病人互动的困境。一方面,亲属们利用并分享病人过去的记忆,为他们所爱的人构建一个“新的身份”和“现在”。另一方面,专业人士会添加根植于医学特征的“临床身份”,并促进与无声患者的身体交流。这项研究强调了护理人员如何通过调动病人的过去和促进物质社会来表明他们(共同的)现在,日常护理活动,以及处理一个显然毫无意义的情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Making sense of absent-yet-present others: Representing the liminal vegetative state beyond life and death
Clinically alive yet enduringly unaware, individuals in a vegetative state are caught in their transition between life and death. In turn, their carers struggle to signify the ontological and interactional dilemmas emerging from their liminal relations with an absent-yet-present other and their suspension in time. Drawing on social representations and liminality theories, this study investigates how relatives and professionals deal with these dilemmas. In doing so, the study focuses on the role of relations and time in signifying an absent-yet-present other. We analysed 65 semi-structured interviews with relatives (n = 35) and professionals (n = 30) recruited from five Italian nursing homes between February 2019 and September 2021. A discourse-oriented thematic analysis shows how carers de-anchor patients from dichotomous categories and temporalities (e.g., life/death, person/body, past/future), representing them as existing in an ontological paradox: both/neither and and/nor. The analysis also shows how carers deal with the dilemmas of interacting with a voiceless patient by engaging in collaborative identity work. On the one hand, relatives draw on – and share – memories from the patient's past to construct a ‘new identity’ and ‘present’ for their loved ones. On the other, professionals add ‘clinical identities’ rooted in medical characteristics and promote corporeal communication with voiceless patients. The study highlights how carers can signify their (shared) present, everyday caring activities, and deal with an only apparently meaningless situation by mobilising the patients' pasts and promoting a corporeal sociality.
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来源期刊
Social Science & Medicine
Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
9.10
自引率
5.60%
发文量
762
审稿时长
38 days
期刊介绍: Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.
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