由後現代主義的中心概念反思護病關係

Reflecting on Nurse-Patient Relationships Using Core Postmodernist Concepts

自有護理以來， 護病關係的詮釋、維護與因應，始終是護理所關注的。隨著歷史的演變、典範的轉移，護病關係也跟著在轉變。現今醫療體系大都強調「以病人為中心」建立護病的「夥伴關係」，其代表的意涵為何？適合於所有護病情境嗎？對護病關係可能帶來什麼樣的衝擊？以及護理應該如何因應護病關係的轉變？本文試圖以後現代主義「解構（deconstruction）」、「去中心（decentralization）」、「多元（multiplicity）」、「互為主體性（inter-subjectivity）」的中心概念，剖析與反思護病關係，並衍生以病人的疾病管理為中心，以尊重與關懷為核心，以解放（emancipation）、啟蒙（enlightenment）、充能（empowerment）為方法的「雙主動」、「雙專家」之護病「夥伴關係」。

The task of defining, maintaining, and mutually adapting the nurse-patient relationship has been ongoing since modern nursing's earliest days. The nurse-patient relationship changes with social changes and paradigm shifts. Most medical centers today strive to incorporate the concept of partnership into the nurse-patient relationship in response to patient-centered medical care. What is the implication of this relationship? Is it suitable for all nurse-patient situations? What are the impacts on nurses and patients? How should nurses adapt to change in nurse-patient relationships? This article analyzes and reflects upon the nurse-patient relationship within a postmodernist framework guided by concepts of ”deconstruction”, ”de-centralization”, ”multiplicity”, and ”inter-subjectivity.” We derive a ”dual-active” and ”dual-expert” partnership between nurses and patients that centers on patient disease management. Core values of this partnership are respect and caring, and strategies include emancipation, enlightenment, and empowerment.