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韧性是一种不良事件:对健康服务研究和公共卫生中韧性理论的批判性讨论。

Resilience is an Adverse Event: A Critical Discussion of Resilience Theory in Health Services Research and Public Health.

机构信息

The Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL, USA.

Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA.

出版信息

Community Health Equity Res Policy. 2024 Apr;44(3):339-343. doi: 10.1177/2752535X231159721. Epub 2023 Mar 1.

Abstract

Resilience, the individual trait of being able to persist and cope with, often recurrent, negative experiences, has experienced an explosion in recent years as a topic of study. In this commentary, we critique this surge and problematize the co-occurring development of the "resilience as treatment" paradigm. We show that resilience is an expectation foisted primarily on historically and contemporarily oppressed and excluded populations often in response to systemic and structural forms of discrimination. We argue that this represents a fundamental mismatch of intervention and problem; offering an individual-level solution to a structural toxin. In doing so, we re-contextualize resilience as an adverse event, more analogous to scar tissue than a reliable treatment paradigm. Our essay concludes with offering alternatives to resilience that originate with the holistic trauma and liberation health frameworks. These paradigms are united in that, in contrast to resilience, they emphasize healing from structural violence, rather than adapting to it.

摘要

韧性,即个体能够持续应对、通常是反复出现的负面经历的特质,近年来作为一个研究课题经历了爆发式增长。在这篇评论中,我们对这一热潮提出批评,并对随之而来的“韧性作为治疗方法”范式的发展提出质疑。我们表明,韧性主要是强加给历史上和当代受压迫和被排斥的人群的一种期望,这通常是对系统性和结构性歧视形式的回应。我们认为,这代表了干预和问题之间的根本不匹配;为一种结构性毒素提供了一种个体层面的解决方案。这样做的同时,我们将韧性重新定义为一种不良事件,更类似于疤痕组织,而不是一种可靠的治疗模式。我们的文章最后提出了一些替代韧性的方法,这些方法源于整体创伤和解放健康框架。这些范式的共同点是,与韧性相反,它们强调从结构性暴力中疗愈,而不是适应它。

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