Patients' narrative accounts of open-heart surgery and recovery: Authorial voice of technology
Patients' narrative accounts of open-heart surgery and recovery: Authorial voice of technology
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DOI：
10.1016/j.socscimed.2009.11.021
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发表时间：
2010-03-01
影响因子：
5.4
通讯作者：
Watt-Watson, Judy
中科院分区：
文献类型：
--
作者：
Lapum, Jennifer;Angus, Jan E.;Watt-Watson, Judy
在这次叙述性调查中，我们研究了患者对心脏直视手术和康复技术的体验描述。从加拿大心脏服务区域中心的术前诊所招募了 16 名个体的方便样本。每个人在从心血管重症监护室转院后以及出院后 4-6 周都参加了两次访谈。参与者还在日记中记录了出院后前 3-4 周的经历。该研究理论基础的焦点是叙事情节，它关注情节构建和塑造故事力量的主动过程。在我们的叙事分析中，我们使用叙事映射来记录事件的时间流程。我们发现，技术在参与者的叙述如何形成和展开方面充当了作者的声音或控制影响力。关键在于技术作为作者的声音与参与者成为背景人物和投降机构的联系方式。对于医疗保健专业人员来说，问题和重要的是确保作者的声音转移回患者身上，以便他们积极参与制定自己的康复过程。这项研究强调了在健康科学研究中使用叙事分析等文学技巧的好处。检查塑造患者故事的叙事结构和力量，可以揭示医疗保健专业人员及其技术驱动的护理实践如何强烈影响故事的内容及其展开方式。通过关注故事的展开方式，我们揭示了可以加强心脏手术实践和患者康复过程的方法。 (C) 2009 Elsevier Ltd. 保留所有权利。
In this narrative inquiry, we examined patients' experiential accounts of technology in open-heart surgery and recovery. A convenience sample of sixteen individuals was recruited from a preoperative clinic at a regional centre for cardiac services in Canada. Each participated in two interviews following transfer from cardiovascular intensive care and 4-6 weeks post discharge from the hospital. Participants also documented their experiences in journals during the first 3-4 weeks following discharge. The focal point of the study's theoretical foundations was narrative emplotment, which directs attention to the active processes of plot construction and shaping forces of stories. In our narrative analysis, we used narrative mapping to document the temporal flow of events. We found that technology acted as the authorial voice, or controlling influence, over how participants' narratives were shaped and unfolded. Key were the ways in which technology as the authorial voice was linked with participants becoming background characters and surrendering agency. Problematic and important to health care professionals is ensuring that authorial voice shifts back to patients so that they become active in shaping their own course of recovery. This study underscores the benefits of using literary techniques such as narrative analysis in health science research. Examining the narrative structures and forces that shape patients' stories sheds light on how health care professionals and their technologically-driven practices of care strongly affect the stories' content and how they unfold. By focusing on how stories unfolded, we revealed ways in which cardiac surgery practices and patients' course of recovery could be enhanced. (C) 2009 Elsevier Ltd. All rights reserved.