Ethnography of Hospital Wards ; the Notion of Illness Among Inpatients in Japan

这项研究是目前正在进行的“医院病房人种志”的一部分。我通过采访和观察护理站和咨询室医患关系，研究了两家医院住院病人的疾病观念。这两家医院都是中等规模，一家专门从事胃肠病学，另一家专门从事神经外科。本研究揭示了四个重点。首先，住院病人往往否认他们是“byonin”（病人），尽管他们了解自己的疾病。他们会说他们生病了，但不会说“byonin”，有时甚至在被诊断患有癌症后也会说他们很健康或精力充沛。其次，住院病人在寻找他们疾病的原因时经常会提到他们的生活史。当被问及他们在医院期间的担忧时，他们会谈论他们与家人、同事和社区成员的关系。然而，他们会对某些人（如年迈的父母、兄弟姐妹、亲戚和社区成员）隐瞒自己的住院情况，以免给他们带来麻烦。这种行为表明了住院病人的地位和在日本住院的意义。第三，当我让他们评估自己的住院情况时，住院病人经常提到有价值的经历。他们重视自己的经历，因为他们可以结识来自不同时代、不同职业、不同疾病的人，尤其是因为他们可以了解其他的生活经历和生活哲学。在现代日本，由于城市化和较小的核心家庭，这种经历在医院病房之外并不常见。因此，住院病人会评价他们在病房的宝贵经验。最后，住院病人将治疗的决定权交给主治医生，但在开药、额外检查、出院日期等方面则由主治医生主动决定。

This research is part of "Ethnography of Hospital Wards" which is currently in progress. I examined notions of illness among inpatients at two hospitals through interviews and observations of nursing stations and doctors-inpatients interrelationships in consulting rooms. Both hospitals are mid-sized, with one specializing in gastroenterology and other specializing in neurosurgery. There are four important points illuminated by this research. First, inpatients tend to deny they are "byonin" (ill person) although they understand their disease. They would say they are sick but not "byonin" and would sometimes say they are healthy or energetic even after they are diagnosed with cancer. Seconderly, inpatients often spork of their life history when searching for reasons for their illness. When asked about their concerns while they were in the hospital, they would talk about their relationship with family members, colleagues, and community members. However, they would keep their hospitalization a secret from certain people (e.g. elderly parents, siblings, relatives, and community members) so as not to cause them trouble. This behavior indicates the inpatient's position and the meaning of being hospitalized in Japan. Thirdly, when I asked them to assess their hospitalization, inpatients often referred to valuable experiences. They valued their experiences because they could become acquainted with people who were from different generations and occupations, have different illnesses, and especially because they could get to know other life experiences and life philosophies. In modern Japan, this sort of experience is uncommon out side of hospital ward due to the urbanization and smaller nuclear famillies. Therefore, inpatients would evaluate their precious experiences on the ward. Lastly, inpatients entrust the attending physician with decisions regarding the cure, but took the initiative regarding prescribing medicine, extra tests, the discharge date.