Legitimising and rationalising in talk about satisfaction with formal healthcare among bereaved family members
Legitimising and rationalising in talk about satisfaction with formal healthcare among bereaved family members
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DOI：
10.1111/j.1467-9566.2011.01457.x
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发表时间：
2012-09-01
影响因子：
2.9
通讯作者：
Williams, Allison
中科院分区：
文献类型：
--
作者：
Funk, Laura M.;Stajduhar, Kelli I.;Williams, Allison
虽然有相当数量的知识，关于家庭成员的愿望和赞赏的临终关怀的实质性特点，我们缺乏充分的了解家庭成员制定护理评估的过程。在这篇文章中，我们利用24个丧亲家庭成员的访谈数据分析，以解释他们如何解释他们的经验，并制定生命结束护理服务的评价。大多数参与者在表达和合理化不满之间徘徊，并对其进行定性或扩散。这是通过与先前的护理经验和期望进行比较，个性化（利用个人情况和知识），集体化（利用与他人的对话和观察），并试图了解他们负面护理经验的原因并归因于责任。调查结果表明，不满可能会扩散，即使是护理经历了负面的，主要是通过承认减轻情节。一些与会者在较小程度上将责任归咎于系统（政策和决策者）和工作人员个人。研究结果进行了讨论，满意度和评价过程的理论理解，以及如何满意度数据可能会告知改善护理质量。
While there is a fair amount of knowledge regarding substantive features of end of life care that family members desire and appreciate, we lack full understanding of the process whereby family members formulate care evaluations. In this article we draw on an analysis of interview data from 24 bereaved family members to explicate how they interpret their experiences and formulate evaluations of end of life care services. Most participants wove between expressing and legitimising dissatisfaction, and qualifying or diffusing it. This occurred through processes of comparisons against prior care experiences and expectations, personalising (drawing on personal situations and knowledge), collectivising (drawing on conversations with and observations of others) and attempting to understand causes for their negative care experiences and to attribute responsibility. The findings suggest that dissatisfaction might be diffused even where care is experienced negatively, primarily through the acknowledgement of mitigating circumstances. To a lesser extent, some participants attributed responsibility to the system (policy and decision-makers) and individual staff members. The findings are discussed in relation to the theoretical understanding of satisfaction and evaluation processes and how satisfaction data might inform improvements to care quality.