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|Title: ||Patients' Narratives of Open-heart Surgery: Emplotting the Technological|
|Authors: ||Lapum, Jennifer Lynne|
|Advisor: ||Angus, Janet Elizabeth|
|Department: ||Nursing Science|
|Issue Date: ||24-Sep-2009|
|Abstract: ||The steady increase of technology has become particularly ubiquitous in environments of heart surgery. Patients in these environments come into close contact with technology in its many guises. Often, practitioners may be deterred from engaging with patients because technology and the associated routines of care become the focus. As a result, it is important to understand how patients make sense of the technological situations encountered during treatment and recovery with attention to the constitution of identity and emerging moral issues. A narrative methodology was employed to examine patients’ experiential accounts of the technological in open-heart surgery and recovery. Sixteen patients were interviewed 3-4 days after surgery and 4-6 weeks after discharge, in addition participant journals were employed.
Study results pointed to the technological as the dominant discourse in heart surgery and recovery, strongly organizing health care practices and patients’ recovery. These discursive influences shaped participants’ stories resulting in two temporal shifts of authorial voice. Authorial voice reflects the dominant discourse and structured how stories unfolded. The first temporal shift exhibited how technology acted as the authorial voice, structuring stories of the preoperative and early postoperative period. Although participants were the narrators of their own stories, they were strongly influenced by the dominant discourse of the technological and its
associated dimensions of care. Participants’ stories revealed how patients were at the centre of activity, but passive, universal and undifferentiated. Although technology continued to influence stories of the later postoperative period and recovery at home, there was a shift of authorial voice to participants. Narratives reflected how the technological was incorporated into participants’ daily lives, but their stories included more personal elements rooted in their own particularities.
Study implications involve a critical uptake of technology that emphasizes the balance between technologically- and humanistically-focused practices in heart surgery and recovery. A key implication is the critical need to encompass affective and social dimensions of patients within the technologically-driven practices of heart surgery. Of great significance is how practitioners, particularly nurses, can act as supporting characters in helping with transitions of authorial voice from the technological back to the participant.|
|Appears in Collections:||Doctoral|
Lawrence S Bloomberg Faculty of Nursing - Doctoral theses
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