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Legitimising and rationalising in talk about satisfaction with formal healthcare among bereaved family members

机译:失去亲人的家人对正规医疗的满意度合法化和合理化

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摘要

While there is a fair amount of knowledge regarding substantive features of end of life care that family members desire and appreciate, we lack full understanding of the process whereby family members formulate care evaluations. In this article we draw on an analysis of interview data from 24 bereaved family members to explicate how they interpret their experiences and formulate evaluations of end of life care services. Most participants wove between expressing and legitimising dissatisfaction, and qualifying or diffusing it. This occurred through processes of comparisons against prior care experiences and expectations, personalising (drawing on personal situations and knowledge), collectivising (drawing on conversations with and observations of others) and attempting to understand causes for their negative care experiences and to attribute responsibility. The findings suggest that dissatisfaction might be diffused even where care is experienced negatively, primarily through the acknowledgement of mitigating circumstances. To a lesser extent, some participants attributed responsibility to the 'system' (policy and decision-makers) and individual staff members. The findings are discussed in relation to the theoretical understanding of satisfaction and evaluation processes and how satisfaction data might inform improvements to care quality.
机译:尽管有很多关于家庭成员渴望和欣赏的临终护理实质特征的知识,但我们对家庭成员制定护理评估的过程缺乏充分的了解。在本文中,我们将对来自24个失去亲人的家庭成员的访谈数据进行分析,以阐明他们如何解释自己的经历并制定对生命终止服务的评估。大多数参与者在表达和合法化不满,以及限定或散布不满意之间徘徊。这是通过与以前的护理经历和期望进行比较,个性化(借鉴个人情况和知识),集体化(借鉴与他人的交谈和观察)以及试图了解造成他们负面护理经历的原因并归因于责任的过程而发生的。研究结果表明,即使在护理受到负面影响的情况下,不满情绪也可能会弥漫,这主要是通过对缓解情况的承认。在较小程度上,一些参与者将责任归于“系统”(政策和决策者)和个别工作人员。讨论的结果与对满意度和评估过程的理论理解以及满意度数据如何为改善护理质量提供信息有关。

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