Nursing in the health care system of the postmodern world: crossroads, paradoxes and complexity

Entering the postmodern world in which society is confronting crossroads, paradoxes, and complexity, the health care system is encountering a transformation more comprehensive and revolutionary than has ever been seen before. Analysis of the state of nursing vis a vis these transformations indicates that the current paradigm does not ensure the existence of the profession in the postmodern health care system. That is because of increased difficulties in consolidating the economic and quality issues into the core of nursing, and in understanding the complexity inherent in health related situations.     

Reflective inquiry in nursing practice or 'revealing images'

Reflective inquiry in nursing practice or 'revealing images' Nurses live and work in complex practice worlds; worlds of shrinking resources and expanding needs. Reflection through journaling offers unique opportunities to gain insight into practice. What might we learn from one's journal? A reflective journal can be a source of interplay between the self as written and the self as other. Likewise, the journal may act to situate ourselves in practice, while at the same time enabling us to illuminate how and in what ways our understandings have become distorted. The extent to which one's journal is educative depends upon the manner in which one chooses to use it as a transformative tool, a tool that might well be described as a process of healing and enlightenment. In order to illustrate the reflexive nature of journaling, this paper is presented as a play reading, where a conversation about practice stories between the different aspects of the nurse's self is depicted. In adopting a play reading, an alternative pedagogical tool is used to illustrate different methodologies exemplifying the emergence of how and in what ways we develop and reconstruct our understanding in nursing.     

后现代主义教育理念对临床护生带教管理的启示

归纳了后现代主义教育理念的特征、理论思想以及对护理学理论、护理研究、护理实践的影响,探讨了后现代主义教育理念对护生带教管理的启示。     

后现代主义下的中西医比较

现代主义把自然科学作为人类全部知识的中心和有意义的文化,后现代主义则通过对科学的客观性、经验实证、价值中立、理性以及语言的优越性等进行解构,让人们看到了科学理论与观察、行为、价值观、伦理观、利益、权力等非理性因素的一种全新的关系,从而揭示真正接近真理的科学理论应该是一种社会建构,唤醒人们对不可通约的科学文化的差异性的理解,中医学理论形成过程中的主客体合一和社会互动,正是后现代主义所追求的“反魅”的科学观。     

后现代主义视野中的行为主义及其评析

行为主义是最典型地坚持了实证主义原则的心理学流派，它为心理学设定了突出客观性的学科性质、研究对象和研究方法等。而后现代主义对此大胆质疑，否定了行为主义提倡的心理学的自然学科性质，主张心理学的研究对象不以可观察的对象为限，质疑行为主义推崇的客观实证法的唯一性，并促使整个心理学产生了意义深远的转变。但后现代主义自由中伴随的虚无主义这一不足，决定了行为主义及整个心理学发展的新走向将是现代主义与后现代主义的融合。     

Aging: a body of resistance

The present paper explores the language of aging used, often unthinkingly, by nurses and policy makers. Terms so often used when describing aging, such as "frailty" and "dependence", are used in a way that implies a common knowledge, a point of convergence. It will be argued, using data gathered from research, that these terms often are a point of departure and that they may not signify a common understanding at all. From a postmodern perspective, it will be argued that it is at this point that common knowledge comes up against corporeal or embodied knowledge. In conclusion, the author will argue for a clinical encounter in which intersubjective meanings can be elucidated.     

"Knowing one's self" anorexic: implications for therapeutic practice

OBJECTIVE: Recent postmodernist studies of anorexia nervosa (AN) challenge current clinical understandings and therapies by illuminating not what AN is but how what it is known to be by clinicians helps construct the disorder and therapy for it. This study points to the equal if not greater importance of how patients know AN. METHODS: Using a deconstructive approach, the discourses of a group of women diagnosed with severe AN were analyzed to reveal radically different versions of "knowing one's self" anorexic. RESULTS: These versions of "self" have strategically different implications for, and meanings of, any therapeutic endeavour. DISCUSSION: Postmodernist approaches point to the need for social reconstruction of lay and community understandings of AN. They also have implications at the level of individual therapy, and could be deployed with patients to establish individual but authentic bases for therapy.     

Re-thinking representations, re-writing nursing texts: possibilities through feminist and Foucauldian thought

FOCUS: Critical approaches are increasingly being used to inform theory and research within the discipline of nursing. In this paper we discuss the work of feminist writers, particularly those located within the postmodern, and Michel Foucault. Their work, although having significant points of difference, can be viewed as complementary and our engagement with these ideas has led us to re-think nursing knowledge. RATIONALE: Using ideas from Foucault and postmodern feminism foregrounds critical questions such as whose knowledge is visible in nursing literature, whose is suppressed, and the power relationships reflected in representations of knowledge. Our exploration of representations of knowledge has led us to review fundamental nursing texts that we consider to be important political and ideological artefacts in the enculturation of student nurses. The dominant position of medical knowledge in the texts reviewed continues to position this 'voice' as primary in nursing literature. DISCUSSION: Drawing on our current research on endometriosis to illustrate the potential inherent in rewriting such texts, we argue for a repositioning of knowledge related to the illness experience. Privileging the voices of people who are the focus of our clinical care reflects the reality of nurses' work; the embodied experience of the person is made visible rather than marginalized in the illness discourse.     

The good, the bad and the relative, part two: Goodness and the criterion problem in qualitative research

This (part two) paper finds 'the problem of the criterion' at the heart of disputes about what constitutes goodness in qualitative research, an ancient philosophic conundrum as to how best represent reality. Ways around the problem are considered, including conceiving criteria as open-ended 'lists', and 'enabling conditions'. Discussion principally concerns the impact of postmodernist thinking on the topic, and how qualitative researchers might usefully juxtapose the rationality of a modern world (in which notions such as reliability and validity are prized) with a mounting postmodern sensibility that acknowledges irrationality, fragmentation, and uncertainty. Part one of the paper traced efforts to define 'goodness' in qualitative research within various fields, including nursing. Disputes were found to centre on how the traditional concepts of reliability and validity related to qualitative research. In reviewing various sets of criteria of goodness, these concepts were consequently conceived as being championed, translated, exiled, redeemed, and surpassed.