The Experience of Applying a Narrative Research Approach with Older People

應用敘事研究法於老年人的經驗

徐明儀(Ming-Yi Hsu) ； Brendan McCormack

《The Journal of Nursing Research》 18卷4期 (2010/12) Pp. 249-257

https://doi.org/10.1097/JNR.0b013e3181fc669e

摘要

背景　證據顯示老一輩的世代對健康照護的期待與參與較新世代的人低。當探索人們的個人經驗時，敘事研究法突破問卷的限制，給予人們表達自己意見的選擇。更進一步提供他們機會，讓他們表達對於選擇治療或檢查的決定過程的考量。這些訊息可以幫助健康照護提供者發展適合他們的健康照護服務。
目的　應用敘事研究方法於復健中心的老年人，以引領健康照護服務的發展。
方法　本研究應用敘事研究方法，收案對象為年齡65歲以上，住在復健中心至少一個星期，認知及身體狀況為可以溝通及簽屬同意書的病人，於通知病人出院日期時，經病人同意下應用敘事訪談技巧進行一對一訪談，共28位病人接受訪談。研究結果以文獻探討及比較分析法分析。
結果　研究結果發現，研究者本身對老年人的尊重與接受度，是成功應用敘事研究於老年人的研究中非常重要的要素。敘事訪談技巧可以幫助研究者在收集資料過程中維持研究者對老年人的尊重與接受度。研究結果亦發現，當老年人被通知其出院日期時，較樂意接受敘事訪談。
結論／實務應用　敘事方法不但可提供醫療服務利用者一個可將他們的經驗發展成他們所需的服務的一個環境；敘事方法和敘事訪談技巧更可進一步促進及培養醫護人員人本為中心的照護。

關鍵字

敘事研究 ； 研究設計 ； 老年人 ； 人本護理

並列摘要

Background: Evidence suggests that older people hold lower expectations of healthcare, which restricts their involvement. Narrative research provides an option to explore personal experiences beyond the boundaries of a questionnaire, providing insights into decisions involving treatment, screening, and various health practices that can help guide the development and provision of effective healthcare services.
Purpose: The purposes of this article were to develop and to implement a narrative research approach in a rehabilitation unit for older people to inform service development.
Methods: This study applied a narrative research approach. Participants in this study were at least 65 years of age and were patients in the target rehabilitation center. They were cognitively and physically able to communicate and give informed consent to participate. Patients were interviewed toward the end of their stay at the rehabilitation center. A total of 28 patients were invited for the interview. Narrative interviewing skills were developed and used in data collection. Literature review and comparative method were used to analyze data.
Results: Findings revealed researcher characteristics, including respect, understanding, and acceptance, as key attributes of success in conducting narrative work with the older people. Narrative interview skills were essential to sustain such characteristics when collecting participant stories. It was found that participants who had been already assigned a discharge date were more likely to participate in the narrative interview.
Conclusions/Implications for Practice: Narrative approaches aim to provide an environment in which service users can experience the development of services through their service utilization experience. The narrative research approach and the narrative interview skills may help practitioners facilitate and cultivate person-centered nursing practice.

並列關鍵字

narrative ； research design ； older people ； person-centered nursing

參考文獻

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