Rogers Anne, Gately Claire, Kennedy Anne, Sanders Caroline
National Primary Care Research and Development Centre and National Institute of Health Research School for Primary Care Research, 5th Floor, Williamson Bldg, Oxford Road, Manchester M13 9PL, UK.
Chronic Illn. 2009 Dec;5(4):305-17. doi: 10.1177/1742395309350384. Epub 2009 Nov 19.
Social comparisons influence self-evaluation and social and psychological adjustment to illness but are under-explored in relation to self-skills training group situations.
A longitudinal qualitative study embedded within an RCT of a national programme of lay led self-care support in England (Department of Health, 2001). In-depth interviews were undertaken with a purposeful maximum variation sample of recruits. Data were analysed thematically. Three key themes emerged highlighting (1) the experience of group participation and interaction, (2) the process and (3) function of social comparison.
Data highlight the salience of social comparison as an underlying feature of the group dynamics of self-care skills training. The nature, dimensions and scope of social comparisons extend beyond the cognitive states and dimensions traditionally forming the focus of social-psychological approaches to social comparison to include wider dimensions including entitlement to resources. The results confirm the tendency to make positive comparisons that result in beneficial self-evaluations. However, positive comparisons allow respondents to present themselves as socially and morally worthy, which may act to mask the identification of appropriate need and inequalities.
Social comparisons function both as an accurate representation of internal cognitive states but also constitutes identity work involving competing values and moral requirements. We show that even those who report significant needs will sometimes portray themselves in a way that suggests positive social comparisons, which fit with a rationed and morally prescriptive and acceptable view of entitlement to NHS services. Such insights suggest that social comparisons in initiatives such as the EPP may be beneficial for some but exacerbate rather than alleviate health inequalities in long-term condition management for others.
社会比较会影响自我评估以及对疾病的社会和心理调适，但在自我技能训练小组情境方面的研究尚少。
一项纵向定性研究，嵌套于英国一项由非专业人员主导的全国性自我护理支持项目（卫生部，2001年）的随机对照试验中。对有目的地选取的最大差异样本的招募人员进行了深入访谈。对数据进行了主题分析。出现了三个关键主题，突出了（1）小组参与和互动的体验，（2）社会比较的过程，以及（3）社会比较的功能。
数据凸显了社会比较作为自我护理技能训练小组动态的一个潜在特征的显著性。社会比较的性质、维度和范围超出了传统上构成社会比较社会心理学方法重点的认知状态和维度，涵盖了更广泛的维度，包括对资源的权利。结果证实了进行积极比较从而产生有益自我评估的倾向。然而，积极比较使受访者能够将自己展现为在社会和道德上有价值的人，这可能会掩盖对适当需求和不平等的识别。
社会比较既作为内部认知状态的准确反映，又构成涉及相互竞争的价值观和道德要求的身份建构工作。我们表明，即使是那些报告有重大需求的人，有时也会以一种暗示积极社会比较的方式来描绘自己，这符合对国民保健服务（NHS）服务权利的一种配给制、道德规定性且可接受的观点。这些见解表明，诸如增强权能项目（EPP）等举措中的社会比较可能对一些人有益，但在长期疾病管理中，对另一些人而言，可能会加剧而非缓解健康不平等。
