Isaksson Rø Karin, Veggeland Frode, Aasland Olaf G
LEFO - Institute for Studies of the Medical Profession, Postboks 1152 Sentrum, 0107, Oslo, Norway.
Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Postboks 1089, Blindern, 0317, Oslo, Norway.
Soc Sci Med. 2016 Aug;162:193-200. doi: 10.1016/j.socscimed.2016.06.037. Epub 2016 Jun 21.
Peer support can entail collegial responsibility for counselling and support as well as reactions to academic or ethical failure. These considerations can be complementary, but also conflicting.
This article focuses on how the peer support programme in Norway addresses these considerations.
Focus group interviews held with Norwegian peer counsellors from August 2011 to June 2012 were analysed by a stepwise deductive-inductive method.
Based on organisational theory, two "ideal types" of counsellors were identified from the data, and these were then used to reanalyse the text. We found that the organisational framework is associated with the peer counsellors' role conception and thereby the relationship between the counsellor and the help-seeking doctor. The relationship between informal frameworks like collegiality, confidence and discretion, and more formalized incentive-driven frameworks, appear to influence the accessibility to peer support, the mandate to provide relevant help and the understanding of what peer support represents.
The study showed the need for a continuous awareness of a balance between the informal and the more formalized elements in the framework for peer support. This is of importance for how the service can contribute to better health among doctors and to secure quality and safety in the treatment of patients. The analysis can also be used to demonstrate the consequences of how the peer support program is designed - such as the degree of formalisation and the balance between "hard" and "soft" ways to regulate the interaction between peer counsellors and doctors - for the ability to achieve the stated objectives of the service.
同伴支持可能涉及同事间在咨询和支持方面的责任，以及对学术或道德失误的反应。这些考量可能相互补充，但也可能相互冲突。
本文重点关注挪威的同伴支持计划如何处理这些考量。
采用逐步演绎-归纳法，对2011年8月至2012年6月期间与挪威同伴咨询师进行的焦点小组访谈进行分析。
基于组织理论，从数据中识别出两种“理想类型”的咨询师，然后用这些类型重新分析文本。我们发现，组织框架与同伴咨询师的角色观念相关，进而与咨询师和寻求帮助的医生之间的关系相关。诸如同事关系、信任和谨慎等非正式框架与更正式的激励驱动框架之间的关系，似乎会影响同伴支持的可及性、提供相关帮助的权限以及对同伴支持含义的理解。
该研究表明，需要持续意识到同伴支持框架中非正式和更正式元素之间的平衡。这对于该服务如何促进医生的健康以及确保患者治疗的质量和安全至关重要。该分析还可用于说明同伴支持计划的设计方式（如形式化程度以及规范同伴咨询师与医生互动的“硬”方式和“软”方式之间的平衡）对实现该服务既定目标的能力的影响。
