健康教育视域下医患沟通问题解释学分析——以乙肝患者预后为例  

Hermeneutic analysis on the problem of doctor-patient communication from the perspective of health education:taking the prognosis of hepatitis B patients as an example

作　　者：郑洪桃 王伟 汪德飞 ZHENG Hongtao;WANG Wei;WANG Defei(Oncology Department of the First People’sHospital of Yongkang,Yongkang 321300,China;The First People’sHospital of Yongkang,Yongkang 321300,China;School of Marxism,Huzhou University,Huzhou 313000,China)

机构地区：[1]永康市第一人民医院肿瘤内科,浙江永康321300 [2]永康市第一人民医院,浙江永康321300 [3]湖州师范学院马克思主义学院,浙江湖州313000

出　　处：《中国医学伦理学》2024年第3期266-271,共6页Chinese Medical Ethics

摘　　要：慢性病预后转归不确定性是医学界的一种顽症。质疑病(顽固性)、器(医护水平)、人(低依从性)等机械归因,认为此类疾病治疗水平突破性进展后,预后低依从性深层原因剖析存在偏颇。在解释学视域下,以乙肝患者为例,厘清健康教育中医患沟通问题的医患认知非同一性等原因。同时,发现医患之理解本体上存在异质性经验的前结构,在其对话逻辑历史中呈现内在的有限性、开放性、生成性和外在微观权力的渗透性。最后,从认识论上明晰医患由异质“意义理想”重构指向同一性效果历史,由视界融合下意义理想导向理解确定性、消除主观性,由具身实践养成引向良好个性化预后行为素养等要义。The uncertainty of prognosis for chronic diseases is a persistent problem in the medical community.Mechanical attribution such as questioning disease(stubbornness),equipment(medical and nursing level),and patients(low compliance),it is believed that there is a bias in analyzing the deep causes of low compliance on prognosis after breakthrough progress in the treatment of this type of diseases.Taking hepatitis B patients from the perspective of hermeneutics as an example,this paper clarified the reasons for the non-identity of doctor-patient cognition on the problem of doctor-patient communication in health education.Meanwhile,it was found that there is a pre-structure of heterogeneous experience in the ontology of understanding between doctors and patients,which presents inherent limitations,openness,generativity,and external micro power penetration in their history of dialogue logic.Finally,epistemologically,this paper clarified the essence such as the history of identity effect was pointed by the reconstruction of heterogeneous“meaning ideals”of doctors and patients,the understanding of certainty and elimination of subjectivity was guided by meaning ideals under the fusion of horizons,as well as good personalized prognostic behavioral literacy was led by cultivations of embodied practice.

关 键 词：哲学解释学 健康教育 视界融合 理解前结构 具身性实践 

分 类 号：R-052[医药卫生]