實證護理之哲學思辯

The Philosophical Foundations of Evidence-Based Nursing

王一奇(Linton Wang) ； 馬維芬(Wei-Fen Ma)

《護理雜誌》 60卷5期 (2013/10) Pp. 5-10

https://doi.org/10.6224/JN.60.5.5

摘要

實證護理作為實證實踐的一個分支，重視整合服務對象的需求、問題解決的資料證據、以及護理專業行動之應用。無論是實證實踐與實證護理，皆以「證據」的判斷、與運用證據於「實踐」為核心基礎，使得證據的判準、以及準確運用證據於臨床護理實務，成為實證護理哲學思辯中重要的理論性關鍵。本文中將從知識論立場來探討證據的判斷，並結合理性決策思慮的觀點來探討實踐行動對證據的運用。最後，在實證實踐理論架構下，本文將藉由實證護理的操作步驟，來說明其哲學思辨的特殊性以凸顯護理核心的價值。

關鍵字

實證實踐 ； 實證護理 ； 哲學思辯 ； 證據 ； 理性決策思慮

並列摘要

As a branch of evidence-based practice, evidence-based nursing emphasizes the integration of patient needs, the evidence for practical problem solving, and the application of nursing expertise. The criteria of evidence and the application of evidence in practice are the central theoretical foundations of evidence-based practice and evidence-based nursing. Therefore, the main philosophical considerations of evidence-based nursing shall focus on the criteria by which evidence supports propositions and how evidence should be applied in practice. In this paper, we explain the criteria of evidence from an epistemological perspective and explain the application of evidence in practice from the perspective of rational decision-making. Finally, we use these philosophical considerations to propose practical guidelines for evidence-based nursing and explain the philosophical significance of nursing practice.

並列關鍵字

evidence-based practice ； evidence-based nursing ； philosophical foundation ； evidence ； deliberation of rational decision-making

參考文獻

Conee, E., & Feldman, R. (2004). Evidentialism: Essays in epistemology. Oxford, NY: Oxford University Press. doi:10.10 93/0199253722.001.0001

DeRose, K. (2010). The conditionals of deliberation. Mind, 119(473), 1－42. doi:10.1093/mind/fzp149

Fawcett, J. (1984). The mataparadigm of nursing: Present status and future refinements. Image: The Journal of Nursing Scholarship, 16(3), 77 －87 . doi:10.1111/j.1547-5069 .198 4. tb01393.x

Flemming, K. (1998). Asking answerable questions. Evidence- Based Nursing, 1(2), 36－37. doi:10.1136/ebn.1.2.36

Gibbard, A., & Harper, W. L. (1980). Counterfactuals and two kinds of expected utility. In W. L. Harper, R. Stalnaker, & G. Pearce (Eds.), Ifs: Conditionals, belief, decision, chance, and time (pp. 153－190). Houten, Netherlands: Springer. doi:10.1007/978-94-009-9117-0_8