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Les PDF-Utgave forskning 04 | 10 SYKEPLEIEN FORSKNING > Et vitenskapelig tidsskrift for medlemmer av Norsk Sykepleierforbund Sykepleien forskning 04 |10 Smertebehandling av kreftpasienter 266 forskning 04|10 Foto: Erik M. Sundt forskning 04 | 10 SYKEPLEIEN FORSKNING > Et vitenskapelig tidsskrift for medlemmer av Norsk Sykepleierforbund Sykepleien denne denne forskning Mange kreftpasienter har smerter i ulike faser av sykdommen. 04 |10 Smerter er også ett av de symptomene pasientene frykter mest. utg Artikkelen til Valeberg, Bjordal og Rustøen i denne utgaven av A Sykepleien Forskning bekrefter funn fra tidligere studier om at v en både pasienter og pårørende er redd for å bli avhengig av smerte- stillende medikamenter. Pasientenes barrierer kan bidra til at de ikke får god smertebehandling. Smertebehandling av kreftpasienter 266 REDAKSJONEN REDAKSJONSKOmitÉ: Inger Schou Bård Nylund Per Førsteama- Bachelorstu- Nortvedt nuensis II ved dent i sykepleie Professor Universitetet i ved Høgskolen ved Uni- Oslo og forsker i Oslo. versitetet i ved Ullevål Oslo. universitets- sykehus. Monica Liv Marit Nortvedt Wergeland Kirkevold Professor og Sørbye Professor leder ved Senter Førsteama- ved Univer- for kunnskaps- nuensis ved sitetet basert praksis Diakonhjemmet i Oslo. ved Høgskolen i høgskole i Oslo. Bergen. Lars Liv Merete Tone Mathisen Reinar Rustøen Spesialsyke- Seksjonsleder, Professor pleier PhD ved Nasjonalt kunn- ved Høgsko- thoraxkirurgisk skapssenter for len i Oslo. intensivenhet/ helsetjenesten. Oslo universi- tetssykehus. Rådgiver i NSF. Sykepleien Forskning skal være den foretrukne kanal for å formidle forskning som er relevant for sykepleiere i praksis, for høgskoler og for studenter. Sykepleien Forskning er et bilag til Sykepleien og utøver uavhengig og kritisk forskningsformidling. KOLOFON Sykepleien Forskning Redaktør: Anners Lerdal Statistiker: Guri Feten Bilag til Sykepleien [email protected] [email protected] Tollbugt 22, 5. etg. PB 456 Sentrum, 0104 Oslo Assisterende redaktør: Liv Merete Reinar Design/Layout: Gazette as /Sykepleien Tlf. 22 04 32 00. Faks: 22 04 33 75 [email protected] Grafisk produksjon: Sykepleien www.sykepleien.no Redaksjonssekretær: Susanne Dietrichson Repro og trykk: Stibo Graphic AS [email protected] Ansvarlig redaktør: Utgivelsesplan 2011: Barth Tholens Markedssjef: Ingunn Roald 24/3, 16/6, 29/9, 1/12 [email protected] [email protected] Abonnementspris: Kr. 280,– per år ISSN 1890-2936 254 > LEDER Sykepleier, mer enn koordinator Mens leger, fysioterapeuter, ergo- sykepleier og sosiolog Nina Ols- terapeuter og sosionomer alle vold i sin nylig avlagte doktor- har klart definerte selvstendige grad at «Forskningen tegner ansvarsområder i pasientbehand- et bilde av sykepleiere som lingen, er det typisk at sykepleiere underlagt sterke eksterne omtaler seg selv som koordina- krefter, og som avmektige torer. Det er åpenbart riktig at innenfor systemet. Stort sykepleiere spiller en nøkkelrolle ansvar, lite myndighet som koordinatorer, men hvorfor og manglende kontroll løfter de så sjelden frem sitt eget preger fremstillingen av bidrag utover denne koordinator- sykepleierens arbeidssi- funksjonen? tuasjon.» Uklar kommu- Det kan være flere årsaker, nikasjon av sykepleierens men en er utvilsomt at man funksjon og ansvar i det undervurderer den rollen man tverrfaglige teamet er trolig har når det gjelder å ivareta pasi- en sentral årsak til at sykeplei- entens grunnleggende behov ved ernes avmakt. sykdom. Grunnleggende sykepleie Sykepleiere burde være attrak- kan ofte minne om hverdagslige tive samarbeidspartnere: deres gjøremål. Hvis sykepleiere ikke selvstendige ansvar og funksjon kommuniserer sine vurderinger er rettet mot å gi nødvendig hel- og hensikten med handlingene, vil sehjelp for at pasientene skal få mye av sykepleiernes selvstendige tilfredsstilt sine grunnleggende funksjon bli oppfattet som dag- behov. Sykepleieres arbeid skiller ligdagse gjøremål og deres kunn- seg også fra de andre helsearbei- skap som hverdagskunnskap. dernes arbeid ved at de ofte har For at sykepleiernes funk- døgnkontinuerlig oversikt over sjon skal oppfattes som noe ut pasientens helsehjelp og koordi- over å være koordinatorer i det nerer denne på best mulig måte i tverrfaglige teamet, er det derfor samspillet mellom pasient, pårø- nødvendig å løfte frem hvilke rende og helsetjeneste. Sykeplei- oppgaver man faktisk ivaretar. ernes funksjon i det tverrfaglige På bakgrunn av at det er syke- teamet burde derfor være både pleierne som tilbringer mest tid utøvelse av direkte sykepleie og å i direkte pasientrettet arbeid, koordinere utarbeidelsen av gode mener Patricia Benner at de har og effektive pasientforløp på tvers Redaktør en avgjørende betydning for av faser og tjenestenivåer. Anners Lerdal [email protected] befolkningens helse. Å redusere sykepleiernes ansvar til kun en Dr. philos fra Det medisinske fakultetet ved universitetet i Oslo. Jobber som koordinatorfunksjon er med førsteamanuensis ved Avdeling for Hel- andre ord å nedvurdere sykeplei- sefag, Høgskolen i Buskerud, og forsker ernes bidrag. Samtidig skriver ved Oslo Universitetssykehus -Aker. 255 forskning 04|10 innspill > Cathrine Holst av Cathrine Holst f. 1974 Postdoktor Institutt for sosiologi og sam- funnsgeografi og ARENA – Senter for europaforskning, Universitetet i Oslo En annen vitenskap? > Feministene er selv uenige om den feministiske vitenskapskritikken. I århundrer hadde kvinner har ønsket seg «mer» forsk- Feministiske vitenskapskriti- ingen adgang til universite- ning om kvinner, men også, og kere har for det fjerde ment at tene. At kvinner skulle forske ikke minst, mer forskning om selve måten det forskes og ten- og filosofere, ble betraktet som kjønn; beskrivelser, fortolknin- kes på i akademia er feil. Den ukvinnelig, unaturlig og upas- ger og forklaringer som, der det kanskje «uskyldigste» varian- sende. Den første kvinnen som er relevant, tar kjønn i betrakt- ten av denne kritikken kom- oppnådde doktorgrad ved Det ning. mer til uttrykk som et krav om Kongelige Frederiks Universitet Skytset har for det tredje blitt andre metoder. En del feminis- i Kristiania, var språkforskeren rett mot den akademiske kultu- tiske samfunnsforskere har for Clara Holst, så sent som i 1903. ren. Det er en kultur som, når eksempel hevdet at kvalitative Flere skulle følge. I 2008 var 45 alt kommer til alt, fortsatt ikke metoder, som åpne intervjuer prosent av dem som avla dok- anerkjenner «inntrengerne», og feltarbeid, bedre fanger inn torgrad i Norge kvinner. kvinner og «andre» som avviker hvordan kjønn virker og «gjø- Kvinners inntog i akade- fra den professorale erketype: res» enn statistiske metoder. mia henger sammen med sam- en hvit, dannet mann med privi- funnets økte behov for høyt legert bakgrunn. Denne kultu- Vitenskapelig objektiVitet utdannet arbeidskraft. Men ren kan gi seg ekstreme utslag, Mer radikal er kritikken som utviklingen har også vært villet for eksempel i form av trakas- angriper de etablerte målene og fra feministisk hold. Et sentralt sering. Mer subtilt kan det dreie standardene for vitenskapelig mål for feministers politiske seg om at kvinnelige forskere og virksomhet. Vitenskapsfiloso- virke har vært økt kvinneandel tenkere simpelthen ikke tas helt fen Sandra Harding har foreslått innenfor alle betydningsfulle på alvor. Man regner dem som en ny definisjon av vitenskape- samfunnsinstitusjoner, her- mindre interessante og nyska- lig objektivitet. Kriteriet på en under vitenskapen. pende – relativt uavhengig av teoris objektivitet er ikke at den Feministiske viten- hva som måtte være realitetene stemmer overens med virkelig- skapskritikere har også – eller man bedømmer dem ut heten, eller at forskersamfunnet krevd at forskningen må fra andre, for saken uvedkom- ikke har vært i stand til å til- endre tematisk fokus. Man mende, standarder. bakevise den. Objektivitet opp- 256 > innspill Foto: Universitetet i Oslo Hva som er sant og falskt, avhenger av øynene som ser. nås gjennom å forske ut fra et Feminister i strid liv? Eller å utvikle kvantefysik- feministisk engasjement og med Det er strid blant feminister ken ut fra et feministisk stand- utgangspunkt i kvinners situa- om den feministiske viten- punkt? sjon i et patriarkalsk samfunn; skapskritikken. Særlig omstridt Strategien en del andre femi- gjennom å innta et feministisk er en del av forslagene om en nistiske vitenskapskritikere har standpunkt. God kunnskap pro- «annen» vitenskap. En kritikk valgt om å oppgi selve objektivi- duseres ikke gjennom å tilstrebe som har blitt reist mot Sandra tetsideen for i stedet å betrakte upartiskhet, men gjennom å ta Harding er at kvinner jo ikke alle «sannheter» som «lokale» parti med de undertrykte, fordi uten videre lever i en og samme og relative til kontekst og per- de undertrykte ser verden som situasjon. Det finnes ikke en son, er heller ikke problemfri. den er, bedre og klarere enn de entydig kvinnesituasjon man En slik relativistisk posisjon som undertrykker. kan ta feministisk standpunkt kan for det første vanskelig for- Andre har avvist selve ideen ut ifra. Det kan vel også stilles svares konsekvent: Feministiske om å tilstrebe objektivitet i spørsmål ved Hardings kobling relativister synes å mene at alle forskningen. Hva som er sant mellom det å være undertrykt påstander og teorier kun har og falskt, avhenger av øynene og det å være kunnskapsmessig «lokal» gyldighet. som ser. Det finnes ikke noe vi privilegert. Er det ikke et kjen- Og mener de egentlig fullt ut alle kan bli enige om som objek-
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