{"title":"健康:对临床医生观点的批判和基于想象的越界模型","authors":"Alexandra Pârvan","doi":"10.1111/jep.70247","DOIUrl":null,"url":null,"abstract":"<div>\n \n <p>In its first part, the article offers a critique of current definitions of health advanced in medical scholarship. It identifies and discusses their major problematic themes (e.g., wholeness, balance, adaptation, activity), and how these are also relevant for the dominant, professional understanding of <i>mental</i> health. Patient reports are used throughout to illustrate both the argument against the normative type of health that is proposed and operated with in clinical contexts, and, in the second part of the article, the model put forth as a solution. The latter is called ‘transgressiveʼ because it is based on transgressing normative boundaries that are culturally and professionally set in place to establish discrete and value-charged identities for medically relevant realities—such as ‘diseaseʼ, ‘bodyʼ, ‘personʼ, ‘healthʼ—and that are not facilitating either clinical or patient work conducive to lived, personal health. New concepts are introduced (‘autobiologyʼ, ‘health-diversityʼ, ‘poietic injusticeʼ) to argue for: health as a personal creation, a position of diversity about health processes or states, and the importance of training the imagination in the clinical professions. The transgressive model of health is intended as a conceptual tool for practical, clinical application by healthcare practitioners.</p>\n </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 6","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Health: A Critique of Clinicians' Views and a Transgressive Model Based on Imagination\",\"authors\":\"Alexandra Pârvan\",\"doi\":\"10.1111/jep.70247\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <p>In its first part, the article offers a critique of current definitions of health advanced in medical scholarship. It identifies and discusses their major problematic themes (e.g., wholeness, balance, adaptation, activity), and how these are also relevant for the dominant, professional understanding of <i>mental</i> health. Patient reports are used throughout to illustrate both the argument against the normative type of health that is proposed and operated with in clinical contexts, and, in the second part of the article, the model put forth as a solution. The latter is called ‘transgressiveʼ because it is based on transgressing normative boundaries that are culturally and professionally set in place to establish discrete and value-charged identities for medically relevant realities—such as ‘diseaseʼ, ‘bodyʼ, ‘personʼ, ‘healthʼ—and that are not facilitating either clinical or patient work conducive to lived, personal health. New concepts are introduced (‘autobiologyʼ, ‘health-diversityʼ, ‘poietic injusticeʼ) to argue for: health as a personal creation, a position of diversity about health processes or states, and the importance of training the imagination in the clinical professions. The transgressive model of health is intended as a conceptual tool for practical, clinical application by healthcare practitioners.</p>\\n </div>\",\"PeriodicalId\":15997,\"journal\":{\"name\":\"Journal of evaluation in clinical practice\",\"volume\":\"31 6\",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of evaluation in clinical practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jep.70247\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of evaluation in clinical practice","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jep.70247","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Health: A Critique of Clinicians' Views and a Transgressive Model Based on Imagination
In its first part, the article offers a critique of current definitions of health advanced in medical scholarship. It identifies and discusses their major problematic themes (e.g., wholeness, balance, adaptation, activity), and how these are also relevant for the dominant, professional understanding of mental health. Patient reports are used throughout to illustrate both the argument against the normative type of health that is proposed and operated with in clinical contexts, and, in the second part of the article, the model put forth as a solution. The latter is called ‘transgressiveʼ because it is based on transgressing normative boundaries that are culturally and professionally set in place to establish discrete and value-charged identities for medically relevant realities—such as ‘diseaseʼ, ‘bodyʼ, ‘personʼ, ‘healthʼ—and that are not facilitating either clinical or patient work conducive to lived, personal health. New concepts are introduced (‘autobiologyʼ, ‘health-diversityʼ, ‘poietic injusticeʼ) to argue for: health as a personal creation, a position of diversity about health processes or states, and the importance of training the imagination in the clinical professions. The transgressive model of health is intended as a conceptual tool for practical, clinical application by healthcare practitioners.
期刊介绍:
The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.