如果你不被认为是一个人,那么以人为本的护理意味着什么?与以人为本的护理以及黑人、酷儿、女权主义者和后人类方法的接触。

IF 2.6 3区 医学 Q1 NURSING
Nursing Philosophy Pub Date : 2022-07-01 Epub Date: 2022-06-24 DOI:10.1111/nup.12401
Jamie B Smith, Eva-Maria Willis, Jane Hopkins-Walsh
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引用次数: 7

摘要

尽管以人为本的护理(PCC)在护理中的突出地位,但对于PCC的假设和意义并没有普遍的共识。我们对其他人的工作表示同情,他们将PCC重新思考为关系的、嵌入的和暂时的自我,而不是个人人格。我们的观点解决了对PCC中人文主义假设的批评,使用批判的后人文主义作为主流价值观的衍射。我们强调了医疗保健中可能产生的问题现实,导致一些人比其他人更有可能被剥夺医疗保健的权利。我们指出,人文主义传统的殖民主义、同性恋和跨性别恐惧症、种族主义、残疾主义和年龄歧视等后果影响了PCC的发展。我们描述了根深蒂固的条件,从结构上维护不平等和破坏护理实践,PCC再现。我们提倡患者的自我决定,并强调我们支持PCC的基本机制,使患者能够选择;然而,如果没有批判性的自省,这些局限于人类的一部分。最后,我们提出了基于我们的白人-顺异性父权制立场的观点的局限性。我们指出,任何对PCC等模式的重新构想都应该通过倾听、追随和将权力交给具有不同维度的人,以及从不同角度存在的生活经验或专业知识来仔细完成。我们指出黑人、酷儿女权主义和批判性残疾研究,将我们的批评观点与人文主义和PCC联系起来,以扩大所有人和社区的平等。理论和哲学有助于理解医疗保健服务中的限制因素,并为提高医疗质量的系统策略提供信息,从而避免对具有不同维度的人群的长期压迫。*我们故意大写Black,小写white来分散白人的身份,这是一种故意的反种族主义行为(参见Tori W. Douglas的“白色家庭作业”播客系列)。**顺异性父权制(cisheterofantiarchy)描述的是具有社会主导群体交叉身份的人;顺性别指的是与你出生时的性别一致的性别认同,异性恋指的是异性恋,父权制指的是基于男性的权力结构体系,女性经常被排除在外,权力较少。***在多样性维度中,我们指的是存在于白人-异性恋父权制的“占主导地位的少数群体”之外的人们的主观生活经验和物质现实,这意味着社会中历史上和现在拥有更多权力的人群,并通过这种方式在结构上主宰了其他人的生活规范和可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
What does person-centred care mean, if you weren't considered a person anyway: An engagement with person-centred care and Black, queer, feminist, and posthuman approaches.

Despite the prominence of person-centred care (PCC) in nursing, there is no general agreement on the assumptions and the meaning of PCC. We sympathize with the work of others who rethink PCC towards relational, embedded, and temporal selfhood rather than individual personhood. Our perspective addresses criticism of humanist assumptions in PCC using critical posthumanism as a diffraction from dominant values  We highlight the problematic realities that might be produced in healthcare, leading to some people being more likely to be disenfranchised from healthcare than others. We point to the colonial, homo- and transphobic, racist, ableist, and ageist consequences of humanist traditions that have influenced the development of PCC. We describe the deep rooted conditions that structurally uphold inequality and undermine nursing practice that PCC reproduces. We advocate for the self-determination of patients and emphasize that we support the fundamental mechanisms of PCC enabling patients' choice; however, without critical introspection, these are limited to a portion of humans. Last, we present limitations of our perspective based on our white*-cisheteropatriarchy** positionality. We point to the fact that any reimagining of models such as PCC should be carefully done by listening, following, and ceding power to people with diversity dimensions*** and the lived experience or expertise that exists from diverse perspectives. We point towards Black, queer feminism, and critical disabilities studies to contextualize our point of critique with humanism and PCC to amplify equity for all people and communities. Theory and philosophy are useful to understand restrictive factors in healthcare delivery and to inform systematic strategies to improve the quality of care so as not to perpetuate the oppression of groups of people with diversity dimensions. * We purposely capitalize Black and use lower case for white to decentre whiteness and as an intentional act of antiracism (see White Homework a podcast series by Tori W. Douglas). ** Cisheteropatriarchy describes people with intersecting identities of dominant social groups; cisgender is the gender identity that aligns with the gender you were assigned at birth, hetero means heterosexual, and patriarchy refers to structural systems of power based on maleness where women are often excluded and hold less power. *** With diversity dimensions, we refer to subjective lived experience and material realities of people that exist outside the 'dominant minorities' of white-cisheteropatriarchy, meaning groups of people in society who historically and currently hold more power and through this, structurally dominate the norms and possibilities of living for other people.

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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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