国際生活機能分類(International Classification of Functioning, Disability and Health: ICF)にみた福祉・保健・医療の専門職協働における連携に関する貢献と課題

This paper explores the philosophical underpinnings of three major educational research paradigms: scientific, interpretive, and critical. The aim was to outline and explore the interrelationships between each paradigm’s ontology, epistemology, methodology and methods. This paper reveals and then discusses some of the underlying assumptions of educational research. Consequently, this paper is relevant to every English language teacher who is a reader of research.

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Exploring the Philosophical Underpinnings of Research: Relating Ontology and Epistemology to the Methodology and Methods of the Scientific, Interpretive, and Critical Research Paradigms

Zakljucno, potrebno je i nadalje svakodnevno raditi na prevenciji demencije, osiguravati resurse i osmisljavati strategije borbe protiv demencije, jer ce broj osoba s demencijom i u Hrvatskoj u buducnosti biti veci. No, s obzirom da se u svijetu ulažu znatna sredstva u podrucju istraživanja demencije, za ocekivati je pozitivnih pomaka, kako na podrucju terapije, rane dijagnostike, tako i na podrucju rehabilitacije osoba s demencijom. Stoga - vrijeme je na nasoj strani!

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Dementia: a public health priority

Who am I, and how do I know? I am different in talking to different people; I adapt my mask to the expectations I see mirrored in them. Do they change, too? Doctors, no less than others, need to be reminded that the word person, the implications of which we consider so essential to modern medical practice, is derived from a word meaning a mask, such as players wore. The author of this stimulating book goes beyond this verbal derivation to a closer scrutiny of the essential connections of the many masks each of us wears. Names, appraisals, memberships, history, prestige, subtle and overt changes in character, and the constant mutual modifications incident to social intercourse are discussed. Strangely, the author omits all mention of the most typical and vivid American identity confusion—that of the “American” Indians. Sociology, argues the author persuasively, no less than psychology, can contribute to the

Mirrors and Masks: The Search for Identity.

Stroke recovery : He can but does he?

In this paper, we make explicit the changing configurations of power relations that currently characterize the Brazilian Emergency Care System (SAMU) team in Belo Horizonte, Brazil. The SAMU is a recent innovation in Brazilian healthcare service delivery. A qualitative case study methodology was used to explore SAMU’s current organizational arrangements, specifically the power relations that have developed and that demonstrate internal team struggles over space and defense of particular occupational interests. The argument advanced in this paper is that these professionals are developing their work in conditions of exposure, that is, they are always being observed by someone, and that such observational exposure provides the conditions whereby everyday emergency care practices are enacted such that practice is shaped by, as well as shapes, particular, yet recognizable power relationships. Data were collected through the observation of the SAMU’s work processes and through semi-structured interviews. Research materials were analyzed using discourse analysis. In the emergency care process of work, visibility is actually embedded in the disciplinary context and can thus be analyzed as a technique applied to produce disciplined individuals through the simple mechanisms elaborated by Foucault such as hierarchical surveillance, normalizing judgment, and the examination.

Configurations of power relations in the Brazilian emergency care system: analyzing a context of visible practices.

Nursing, knowledge and power: a case analysis.

Introduction: Following hip fracture surgery, patients often experience multiple transitions through different care settings, with resultant challenges to the quality and continuity of patient care. Family caregivers can play a key role in these transitions, but are often poorly engaged in the process. We aimed to: (1) examine the characteristics of the family caregivers’ experience of communication and information sharing and (2) identify facilitators and barriers of effective information sharing among patients, family caregivers and health care providers. Methods:  Using an ethnographic approach, we followed 11 post-surgical hip fracture patients through subsequent care transitions in rural Ontario; in-depth interviews were conducted with patients, family caregivers ( n  = 8) and health care providers ( n  = 24). Results:  Priority areas for improved information sharing relate to trust and respect, involvement, and information needs and expectations; facilitators and barriers included prior health care experience, trusting relationships and the rural setting. Conclusion:  As with knowledge translation, effective strategies to improve information sharing and care continuity for older patients with chronic illness may be those that involve active facilitation of an on-going partnership that respects the knowledge of all those involved.

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Information sharing with rural family caregivers during care transitions of hip fracture patients

In this paper we use Alvesson and Sandberg's strategy of problematisation to analyse the assumptions embedded in the development and use of the concept of ‘care-giver burden’. We do this in order to develop an explanation as to why decades of research into the experience of providing home-based care to a family member with dementia has had little effect in relieving or reducing the ‘burden’ of that care. Though some part of this is undoubtedly political, our analysis suggests that key assumptions of the research limit both knowledge development and intervention effectiveness. Especially problematic are first, an overriding focus on the isolated care-giver–recipient dyad as the appropriate object of inquiry and target of intervention, and second, an absence of an analysis of the materiality of care and care-giving practices. The heterogeneity of care situations, including interrelations among people, technologies, objects, spaces and other organisational worlds, appear in much of the research primarily as methodological problems, variables to be subdued through a more rigorous application of method. The high volume of research and acknowledged low impact of interventions, however, suggests that rethinking the nature of care practices, and how we come to know about them, is necessary if we are to develop and implement strategies that will contribute to better outcomes for people.

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Problematising care burden research.

In this paper we suggest that it is a mistake to understand the current situation in nursing as primarily a problem of ‘shortage’, a problem which may be solved through supplying ‘more nurses, faster’. This way of thinking is understood as reflecting an invalidation of nurses and nursing and, by fostering false beliefs about nursing, as functioning to exacerbate rather than resolve the current situation. Unlike many mainstream conceptualizations of the current situation in nursing, we begin by understanding the experiences and concerns of nurses as meaningful. Feminist and hermeneutic philosophies, as well as Foucauldian perspectives on discourse, encourage us to take seriously the gender relations of power through which nursing comes to be articulated and to cultivate ways of thinking which can generate more productive analyses of the current situation in nursing. Rather than accepting instrumental understandings of nursing as adequate, we question the everyday beliefs and assumptions, the dominant discourses at work both in the world and in ourselves, which allow the suffering of nurses to be thought irrelevant and their concerns to remain unheard. We theorize both why the suffering of nurses can be considered irrelevant in this way and the difference it would make were we to take the experiences of nurses seriously. This undertaking requires that we reflect on that which constrains – and enables – the ways we are able to write, speak and think about nursing.

Christine Ceci

Papers

Configurations of power relations in the Brazilian emergency care system: analyzing a context of visible practices.

Nursing, knowledge and power: a case analysis.

Information sharing with rural family caregivers during care transitions of hip fracture patients

Problematising care burden research.

A 'quiet' crisis in health care: developing our capacity to hear