From the state to the family: reconfiguring the responsibility for long-term nursing care at home.
From the state to the family: reconfiguring the responsibility for long-term nursing care at home.
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DOI：
10.1046/j.1440-1800.2002.00124.x
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发表时间：
2002-03-01
期刊：
影响因子：
2.3
通讯作者：
Bjornsdottir, Kristin
中科院分区：
文献类型：
--
作者：
Bjornsdottir, Kristin
本文探讨了医疗保健服务提供地点从医疗机构向家庭转移所产生的影响，这种转移已经发生，或者预计在未来几年内发生。有人认为，为居家的老年人以及患有长期疾病的居家人员提供所需的护理和帮助的责任已经从公共服务转移到了家庭。对护理人员的研究表明，在很多情况下，他们承受着巨大的负担、经济困难和健康问题。他们的社交生活局限于家中，与朋友和邻居的接触大幅减少。这种情况需要护士来解决，在很多情况下，护士充当着家庭与官方医疗保健系统之间的桥梁。利用福柯对权力的探究，特别是他的治理术理念，构建了冰岛医疗保健中家庭护理的谱系。主要研究结果是，尽管这种情况比许多其他国家发生得稍晚，但国家正在从其先前界定的对国民健康和福祉的责任中退缩。同时，强调了公民维护健康的责任。基于这些研究结果，有人认为冰岛的护士可以对与这些家庭中所提供服务的组织相关的政策制定产生深远影响。文中还就如何做到这一点提出了建议，这可能会引起其他国家护士的兴趣。
This paper discusses the implications of the shift in the location of the provision of healthcare services from healthcare institutions to the home, which has occurred or is projected to occur in coming years. It is argued that the responsibility for the provision of care and assistance needed by the elderly living at home and people with long-term conditions living at home has shifted from public services to the family. Studies of care-givers have shown that in many situations they experience tremendous burdens, financial difficulties and health problems. Their social lives have been confined to the home, and contacts with friends and neighbors have been significantly reduced. This situation needs to be addressed by nurses, who in many cases serve as the bridge between the home and the official healthcare system. Using Foucault's exploration of power, particularly his idea of governmentality, a genealogy of care-giving in the home in Iceland's health-care has been constructed. The main findings were that, although this is occurring somewhat later than in many other countries, the state is withdrawing from its previously defined responsibility for the health and well-being of the nation. At the same time the citizen's responsibility for maintaining health is emphasized. Based on these findings, the argument is made that nurses in Iceland can have a profound influence on policy-making in relation to the organization of services provided in those homes. Suggestions are made as to how this can be done, which may be of interest to nurses in other countries.