Studying the clinical encounter with the Adaptive Leadership framework.
Studying the clinical encounter with the Adaptive Leadership framework.
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DOI：
10.2147/jhl.s32686
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发表时间：
2012-08
影响因子：
4.4
通讯作者：
Anderson RA
中科院分区：
文献类型：
--
作者：
Bailey DE Jr;Docherty SL;Adams JA;Carthron DL;Corazzini K;Day JR;Neglia E;Thygeson M;Anderson RA
在本文中，我们讨论的概念，领导作为一个个人的能力，而不是一个人的地位在等级制度。这种类型的领导使我们能够重新定义护士和其他一线临床工作人员的护理和组织角色。很少有研究已经做了，以探讨什么样的领导意味着在护理点，特别是在医疗保健从业人员和病人及其家庭照顾者之间的关系。基于复杂性科学理论的适应性领导理论框架为研究护理实践者的领导行为提供了一个有用的透镜。该框架提出，患者面临两大类挑战：技术和适应性。虽然技术挑战是由医生提供的技术解决方案来解决的，但适应性挑战需要患者（或家庭成员）适应新的情况，并进行适应，学习和行为改变的工作。适应性领导是从业者动员和支持患者进行适应性工作的工作。本文的目的是描述这一框架，并展示其在护理研究中的应用。我们证明了框架的效用与五个例子的护理研究问题，范围从个人到系统的水平。该框架有可能指导研究人员提出新的问题，并获得新的见解，以了解从业人员如何在护理点与患者互动，以提高患者解决挑战性问题的能力，并改善自己的医疗保健结果。它是一个潜在的强大框架，用于开发和测试新一代干预措施，通过利用和了解患者在其生活环境中的适应能力来解决复杂问题。
In this paper we discuss the concept of leadership as a personal capability, not contingent on one's position in a hierarchy. This type of leadership allows us to reframe both the care-giving and organizational roles of nurses and other front-line clinical staff. Little research has been done to explore what leadership means at the point of care, particularly in reference to the relationship between health care practitioners and patients and their family caregivers. The Adaptive Leadership framework, based on complexity science theory, provides a useful lens to explore practitioners' leadership behaviors at the point of care. This framework proposes that there are two broad categories of challenges that patients face: technical and adaptive. Whereas technical challenges are addressed with technical solutions that are delivered by practitioners, adaptive challenges require the patient (or family member) to adjust to a new situation and to do the work of adapting, learning, and behavior change. Adaptive leadership is the work that practitioners do to mobilize and support patients to do the adaptive work. The purpose of this paper is to describe this framework and demonstrate its application to nursing research. We demonstrate the framework's utility with five exemplars of nursing research problems that range from the individual to the system levels. The framework has the potential to guide researchers to ask new questions and to gain new insights into how practitioners interact with patients at the point of care to increase the patient's ability to tackle challenging problems and improve their own health care outcomes. It is a potentially powerful framework for developing and testing a new generation of interventions to address complex issues by harnessing and learning about the adaptive capabilities of patients within their life contexts.