UNASSIGNED: To demonstrate and discuss the potential of substantive theories to enhance interpretation of complex challenges in clinical knowing in general practice.
UNASSIGNED: We present a fictional case to demonstrate how interdisciplinary substantive theories, with a relevant and specific match to concrete questions, can situate the clinical interaction at an accountable platform. A female patient with Parkinson\'s disease consults her GP complaining that the disease is restraining her life and threatening her future. The GP has some new ideas from Bandura\'s theory of self-efficacy and introduces the patient to strategies for further action.
UNASSIGNED: The case presents an example of how a relevant substantive theory may offer the GP: 1) a sharper focus for achievement: recognising the issues of fear and identity in chronic, progressive illness, 2) a subsequent position for individualized understanding of adequate strategies: encouraging physical and social activity in a well-known context, and 3) an invitation to consider further possibilities: finding ways to alleviate the burden of fear and progressive decline; engaging in joyful living.
UNASSIGNED: General practice knowledge embraces a diversity of sources with different evidence power. The transparency mediated to clinical practice when supported by relevant substantive theories may contribute to recognition of experience-based knowing as evidence-based practice.
Experience-based knowing is an important capacity for interpretation of complex phenomena in general practice, but support for elaboration and analysis of such strategies is limitedInterdisciplinary substantive theories can enable reflexivity and enhance clinical practiceSubstantive theories may offer sharper focus, individualised understanding and recognition of additional possibilitiesA connection to specific theoretical ideas may augment the transparency of experience-based knowing, thus advancing attitudes for evidence-based practice.
■证明和讨论实质性理论的潜力,以增强对一般实践中临床知识中复杂挑战的解释。
■我们提出了一个虚构的案例来证明跨学科的实质性理论,与具体问题相关和具体的匹配,可以将临床互动置于一个负责任的平台上。一名患有帕金森病的女性患者咨询她的全科医生,抱怨这种疾病限制了她的生命并威胁着她的未来。全科医生从班杜拉的自我效能理论中获得了一些新的观点,并向患者介绍了进一步行动的策略。
■该案例提供了一个相关的实质性理论如何为GP提供示例:1)更专注于成就:认识到长期的恐惧和身份问题,进行性疾病,2)对适当策略的个性化理解的后续立场:在众所周知的背景下鼓励身体和社会活动,和3)邀请考虑进一步的可能性:找到减轻恐惧和逐渐下降的负担的方法;从事快乐的生活。
■一般实践知识包含具有不同证据能力的多种来源。在相关实质性理论的支持下,对临床实践的透明度可能有助于将基于经验的知识视为基于证据的实践。
基于经验的知识是解释一般实践中复杂现象的重要能力,但是对此类策略的阐述和分析的支持是有限的跨学科实质性理论可以使反身性和增强临床实践实质性理论可以提供更清晰的重点,对其他可能性的个性化理解和认识与特定理论思想的联系可能会增强基于经验的知识的透明度,从而推进对循证实践的态度。