La vulnérabilité dans la relation de soin

Zielinski, Agata

doi:10.3917/caph.125.0089

Cited by 28 publications

(4 citation statements)

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“…76,77,92 This seems to be congruent with relational ethics, which considers vulnerability as a virtue. [93][94][95][96] By taking greater account of caregivers' vulnerability, today, the team is mainly focused on active prevention (e.g. recognising the warning signs of anxiety that contribute to triggering the crisis) and is defusing the logic of control which was notably influenced by the historical behavioural culture of the unit.…”

Section: Conclusion: From Self-care To Mutual Respectmentioning

confidence: 99%

Acknowledging caregivers’ vulnerability in the managment of challenging behaviours to reduce control measures in psychiatry

et al. 2022

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Background: The management of challenging behaviours in inpatient with intellectual disability and/or autism spectrum disorders can lead to an escalation of control measures. In these complex situations where patients have an intellectual disability/autism spectrum disorder accompanied by a psychiatric comorbidity, the experiences of caregivers related to the crisis management have rarely been studied. Purpose: This study examined the moral experiences of caregivers related to challenging behaviours’ management and alternatives to control measures. Research design: Using Charles Taylor’s hermeneutic framework, a 2-month focused ethnography with a participatory approach was used. Participants and research context: Sixteen caregivers were interviewed in a Canadian mental health setting for adults with intellectual disability/autism spectrum disorder and psychiatric comorbidity. Ethical considerations: The research was conducted in compliance with the Declaration of Helsinki and local Research Ethics Board approval. Written informed consent was collected systematically from participants. Findings: By accounting for caregivers’ moral experiences, this study sheds light on a neglected dimension of the care relationship: the vulnerability of the caregiver. We highlight the main barriers and facilitators to alternatives to control measures. First, a caregiver’s vulnerability was characterised by the overall impact of challenging behaviours and the moral distress associated with the use of control measures and exclusion mechanisms of intellectual disability/autism spectrum disorder patients. Second, a strong ambiguity between care and control measures and a lack of inclusive approaches were identified as the two main barriers to challenging behaviour management. Third, the involvement, both professional and personal, of caregivers was deemed necessary to implement alternatives to control measures. Discussion: A conflict of values opposes two conceptions of autonomy: a rational autonomy, which is counterproductive to the reduction of control measures, versus a relational autonomy based on shared vulnerability. Conclusion: The recognition of caregiver’s vulnerability is a benchmark to create alternative approaches, which defuse the logic of control and promote an ethics of care within which caregivers’ self-concern can be understood as fostering mutual respect.

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Section: Conclusion: From Self-care To Mutual Respectmentioning

confidence: 99%

Acknowledging caregivers’ vulnerability in the managment of challenging behaviours to reduce control measures in psychiatry

et al. 2022

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“…• envisager la créativité réflexive en formation initiale et continue et ; • induire la reconnaissance sociale pour des métiers dont les acteurs exercent souvent sans filet face aux réalités concrètes et complexes du grand-âge qui affectent « la vulnérabilité du sujet soignant » qu'il convient de ne pas ignorer (P. Pitaud [34], « Regards sur la souffrance des acteurs », pp. 29-64, dans Pitaud, 2018 ; Zielinski [35], 2011).…”

Section: Synthèseunclassified

Bientraitance « | » maltraitance : interroger la limite

Patrizio¹

2022

Éthique & Santé

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“…1.2.1 L'asymétrie : une logique de la comparaison à partir de soi (Zielinski, 2011) Lorsque l'accompagnateur évalue l'activité de l'accompagné ou évalue ses compétences, il produit un exercice de comparaison à partir de lui-même, il évalue alors une absence. Il peut s'agir d'une:…”

Section: L'accompagnement : Une Mise Au Service D'autruiunclassified

L’accompagnement : symétrie dans les asymétries ?

Boucenna

2018

phro

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Cet article présente une analyse de deux entretiens d’accompagnement vécus par une formatrice d’adultes et un directeur d’établissement fondamental et menés par une enseignante universitaire et un conseiller pédagogique. Cette analyse permet d’interroger la nature de « la mise au service de l’accompagné » par l’accompagnateur. Se mettre au service d’autrui implique-t-il systématiquement une relation symétrique comme cela est décrit dans la littérature ? Il apparait que lors de ces deux entretiens l’asymétrie soit bien présente et ne s’inscrit pas une dimension relationnelle mais dans une comparaison à soi.

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La vulnérabilité dans la relation de soin

Cited by 28 publications

References 1 publication

Acknowledging caregivers’ vulnerability in the managment of challenging behaviours to reduce control measures in psychiatry

Acknowledging caregivers’ vulnerability in the managment of challenging behaviours to reduce control measures in psychiatry

Bientraitance « | » maltraitance : interroger la limite

L’accompagnement : symétrie dans les asymétries ?

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