Hunter Billie
School of Health Science, University of Wales Swansea, Vivian Tower, Swansea SA2 8PP, UK.
Midwifery. 2004 Sep;20(3):261-72. doi: 10.1016/j.midw.2003.12.004.
to explore how a range of midwives experienced and managed emotion in their work.
a qualitative study using an ethnographic approach. Data were collected in three phases using focus groups, observations and interviews.
South Wales, UK.
Phase One: self-selected convenience sample of 27 student midwives in first and final years of 18-month (postnursing qualification) and 3-year (direct entry) programmes. Phase Two: opportunistic sample of 11 qualified midwives representing a range of clinical locations and clinical grades. Phase Three: purposive sample of 29 midwives working within one NHS Trust, representing a range of clinical locations, length of clinical experience and clinical grades.
community and hospital environments presented midwives with fundamentally different work settings that had diverse values and perspectives. The result was two primary occupational identities and ideologies that were in conflict. Hospital midwifery was dominated by meeting service needs, via a universalistic and medicalised approach to care; the ideology was, by necessity, 'with institution'. Community-based midwifery was more able to support an individualised, natural model of childbirth reflecting a 'with woman' ideology. This ideology was officially supported, both professionally and academically. When midwives were able to work according to the 'with woman' ideal, they experienced their work as emotionally rewarding. Conversely, when this was not possible, they experienced work as emotionally difficult and requiring regulation of emotion, i.e. 'emotion work'.
unlike findings from other studies, that have located emotion work primarily within worker/client relationships, the key source of emotion work for participants was conflicting ideologies of midwifery practice. These conflicts were particularly evident in the accounts of novice midwives (i.e. students and those who had been qualified for less than 1 year) and integrated team midwives. Both groups held a strong commitment to a 'with woman' ideology.
understanding the dilemmas created by conflicting occupational ideologies is important in order to improve the quality of midwives' working lives and hence the care they give to women and families. In the short term, strategies involving education and supervision may be of assistance in enabling midwives to reconcile these conflicting perspectives. However, in the long term more radical solutions may be required to address the underpinning contradictions.
探讨一系列助产士在工作中如何体验和管理情绪。
采用人种志方法的定性研究。数据分三个阶段收集，使用焦点小组、观察和访谈。
英国南威尔士。
第一阶段：18个月（护理资格后）和3年制（直接入学）课程的一年级和最后一年的27名学生助产士的自我选择便利样本。第二阶段：11名合格助产士的机会样本，代表一系列临床地点和临床级别。第三阶段：在一个国民保健服务信托机构工作的29名助产士的目的样本，代表一系列临床地点、临床经验长度和临床级别。
社区和医院环境为助产士提供了具有根本不同价值观和观点的工作环境。结果产生了两种相互冲突的主要职业身份和意识形态。医院助产主要通过普遍主义和医学化的护理方法来满足服务需求；其意识形态必然是“与机构一致”。基于社区的助产更能够支持反映“与女性一致”意识形态的个性化、自然分娩模式。这种意识形态在专业和学术上都得到官方支持。当助产士能够按照“与女性一致”的理想工作时，他们会将工作体验为情感上的回报。相反，当无法做到这一点时，他们会将工作体验为情感上困难且需要调节情绪，即“情绪工作”。
与其他研究的结果不同，其他研究主要将情绪工作定位在工作者/客户关系中，参与者情绪工作的关键来源是助产实践中相互冲突的意识形态。这些冲突在新手助产士（即学生和资格不到1年的人）和综合团队助产士的描述中尤为明显。这两组人都坚定地信奉“与女性一致”的意识形态。
理解相互冲突的职业意识形态所造成的困境对于提高助产士的工作生活质量以及他们给予妇女和家庭的护理质量很重要。短期内，涉及教育和监督的策略可能有助于使助产士调和这些相互冲突的观点。然而，从长远来看，可能需要更激进的解决方案来解决根本矛盾。
