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首页> 外文期刊>Journal of advanced nursing >Trust and managerialism: exploring discourses of care.
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Trust and managerialism: exploring discourses of care.

机译：信任和管理主义：探索护理方式。

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AIM: This paper reports a study that explored the relationship between trust and managerialism through an analysis of professional discourse. BACKGROUND: Managerialism is a distinct set of discourses and practices related to managerial effectiveness, flexibility and consumer responsiveness that have come to characterize debates over the provision of health and welfare services across the developed world. At the same time, trust has attracted increasing academic and political interest. Managerial discourses are critical of healthcare professions and the way they operate. Professional opinions are challenged as representing the interests of professions rather than service users; as a consequence trust is contested. However, where practitioners are both professionals and managers, the boundaries between these discourses become blurred. Moreover, paradoxical development occurs where increasing autonomy for practitioners is accompanied by a strengthening of managerial controls over their activity. METHOD: Discourse analysis was used to explore the text from two genres, academic literature and interviews (n = 17), in the context of community residential services for people with learning disabilities. The study was conducted in 2001. FINDINGS: Two broad themes were identified, each with a number of sub-themes. The first focuses on the relationship between managerialism and trust located around the management of expectations. The second, 'the politics of care', explores the way professional and managerial discourse articulate to produce complementary and contradictory positions. CONCLUSION: The colonization of professional activity by managerial discourse has produced a context where professional activity is defined by a series of managerial imperatives; trust, which was once the product of intimate social activity is now shaped through techniques based on distrust such as audits and quality monitoring. Nevertheless, the persistence of tensions between trust and managerialism suggest an ongoing struggle for professional autonomy in the face of increasing managerial controls.
机译：目的：本文报道了一项通过对专业话语的分析探讨信任与管理主义之间关系的研究。背景：管理主义是与管理有效性，灵活性和消费者响应能力有关的一系列独特的论述和实践，这些已成为表征整个发达国家对提供卫生和福利服务的辩论的特征。同时，信任引起了越来越多的学术和政治兴趣。管理论述对医疗保健行业及其运作方式至关重要。专业意见受到挑战，因为代表专业利益而非服务使用者利益;结果，信任受到质疑。但是，如果从业人员既是专业人士又是管理人员，那么这些话语之间的界限就会变得模糊。而且，自相矛盾的发展发生在从业者自主权增加的同时，伴随着对他们活动的管理控制的加强。方法：在为学习障碍者提供社区住宿服务的背景下，通过语篇分析从两种体裁中探索文本，即学术文献和访谈（n = 17）。该研究于2001年进行。结果：确定了两个广泛的主题，每个主题都有许多子主题。第一个重点是围绕期望管理的管理主义与信任之间的关系。第二个是“护理政治”，探讨了专业和管理话语表达出互补和矛盾立场的方式。结论：通过管理话语对专业活动的殖民化已经产生了一种环境，在这种情况下，专业活动是由一系列管理要务来定义的。曾经是亲密社会活动产物的信任现在通过基于不信任的技术（例如审计和质量监控）来塑造。尽管如此，信任与管理主义之间的紧张关系仍然存在，这表明面对日益增加的管理控制，人们正在为职业自治而进行着持续的斗争。

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