中国全科医学 ›› 2024, Vol. 27 ›› Issue (04): 502-508.DOI: 10.12114/j.issn.1007-9572.2022.0373

• 医学人文 • 上一篇    

慢性病叙事下的中风康复家庭研究——基于河北省T市中医院康复大厅的田野调查

梁天一, 刘鹏*()   

  1. 510006 广东省广州市,广州中医药大学基础医学院
  • 收稿日期:2023-05-12 修回日期:2023-09-12 出版日期:2024-02-05 发布日期:2023-11-09
  • 通讯作者: 刘鹏

  • 作者贡献:梁天一提出问题与研究思路,开展调查并负责文章撰写;刘鹏为负责文章的审校与修订,并对论文最终负责。
  • 基金资助:
    广州中医药大学2020年度人文社科项目(2020SKZD09)

Study on Stroke-rehabilitative Families under Chronic Illness Narratives: a Field Study Based on Rehabilitation Hall of Traditional Chinese Medicine Hospital in T City, Hebei Province

LIANG Tianyi, LIU Peng*()   

  1. School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
  • Received:2023-05-12 Revised:2023-09-12 Published:2024-02-05 Online:2023-11-09
  • Contact: LIU Peng

摘要: 背景 在中风加剧家庭与社会负担的背景下,基于医院田野经验的康复家庭研究尚有欠缺。目的 从病患、家属、家庭和医者四种叙事视角,分析医院康复大厅中存在的社会文化氛围。方法 本文访谈对象均来自2021年4—7月T市中医院康复科,从患者叙事、家属叙事、家庭叙事、医生叙事四个方面,考察康复大厅内的社会文化氛围。结果 中风康复患者在自身与集体的共同进步中感受到"创伤后成长"的正向体验;家属在互相交流中自发建构起俱乐部文化,并在陪伴中起到了"医患桥梁"等作用;作为整体的中风康复家庭承受两方面张力,即家庭经济负担的外部张力和家属患者之间难以互相理解的内部张力;医生能更加理性看待中风康复家庭,通过医生-患者与教师-学生的关系对比,阐明医生在与患者相处时在一定程度上扮演了教师的角色。结论 通过对康复大厅社会文化氛围的分析,指出中风防治面临防治重心难以下沉和部分患者难以就医的困难。医学人文研究尤其是医学人类学的研究方法有助于建构积极的医患关系。

关键词: 中风, 中风康复, 慢性病, 经济负担, 质性研究, 医学人类学, 医学人文

Abstract:

Background

There is a lack of research on rehabilitative families based on hospital field experiences in the context of stroke-exacerbated family and social burdens.

Objective

To analyze the socio-cultural atmospheres present in hospital rehabilitation halls in four narrative dimensions of patients, relatives, families, and medical providers.

Methods

The interviews were conducted with participants from the rehabilitation department of Traditional Chinese Medicine Hospital in T city between April and July 2021 to examine the socio-cultural atmospheres in the rehabilitation hall from four perspectives of patients' narratives, relatives' narratives, families' narratives, and doctors' narratives.

Results

Stroke survivors have enjoyed the positive experience of "post-traumatic growth" in individual and collective joint progress; relatives have spontaneously established a club culture during mutual communications and played the role of "doctor-patient bridge" in accompanying each other; stroke-rehabilitative families as a whole suffered from two tensions, including the external tension due to financial burden on the family, and the internal tension arising from the difficulties in mutual understanding between family members and patients. Doctors were able to be more rational with stroke-rehabilitative families. A comparison between doctor-patient and teacher-student relationships illustrated that doctors would play the role of teacher to some extent when dealing with patients.

Conclusion

As revealed in the analysis of the socio-cultural atmospheres in the rehabilitation hall, the prevention and treatment of stroke are facing two problems, including difficulty in implementing key effort of prevention and treatment in the primary level, and troubles in accessing medical care resources of some patients. Research on medical humanities, especially the research methodology of medical anthropology, is conducive to constructing a positive doctor-patient relationship.

Key words: Stroke, Stroke rehabilitation, Chronic disease, Economic burden, Qualitative research, Medical anthropology, Medical humanities