Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia.
St Vincent's Private Hospital, Sydney, New South Wales, Australia.
Int J Ment Health Nurs. 2018 Apr;27(2):783-793. doi: 10.1111/inm.12365. Epub 2017 Jun 23.
This present study is a report of an interview study exploring personal views on participating in group clinical supervision among mental health nursing staff members who do not participate in supervision. There is a paucity of empirical research on resistance to supervision, which has traditionally been theorized as a supervisee's maladaptive coping with anxiety in the supervision process. The aim of the present study was to examine resistance to group clinical supervision by interviewing nurses who did not participate in supervision. In 2015, we conducted semistructured interviews with 24 Danish mental health nursing staff members who had been observed not to participate in supervision in two periods of 3 months. Interviews were audio-recorded and subjected to discourse analysis. We constructed two discursive positions taken by the informants: (i) 'forced non-participation', where an informant was in favour of supervision, but presented practical reasons for not participating; and (ii) 'deliberate rejection', where an informant intentionally chose to not to participate in supervision. Furthermore, we described two typical themes drawn upon by informants in their positioning: 'difficulties related to participating in supervision' and 'limited need for and benefits from supervision'. The findings indicated that group clinical supervision extended a space for group discussion that generated or accentuated anxiety because of already-existing conflicts and a fundamental lack of trust between group members. Many informants perceived group clinical supervision as an unacceptable intrusion, which could indicate a need for developing more acceptable types of post-registration clinical education and reflective practice for this group.
本研究是一项访谈研究报告，旨在探讨未参与监督的精神科护理人员对参与小组临床监督的个人看法。关于抵制监督的实证研究很少，传统上认为抵制监督是被监督者在监督过程中对焦虑的适应不良应对。本研究旨在通过访谈未参加监督的护士来检验对小组临床监督的抵制。2015 年，我们对 24 名丹麦精神科护理人员进行了半结构式访谈，这些护理人员在两个 3 个月的时间段内被观察到未参加监督。访谈进行了录音，并进行了话语分析。我们构建了受访者采取的两种话语立场：（i）“被迫不参与”，其中一名受访者赞成监督，但提出了不参与的实际原因；（ii）“故意拒绝”，其中一名受访者故意选择不参加监督。此外，我们还描述了受访者在其定位中使用的两个典型主题：“与参与监督相关的困难”和“对监督的需求有限和受益有限”。研究结果表明，小组临床监督为小组讨论提供了一个空间，由于已经存在的冲突和小组成员之间基本缺乏信任，这会产生或加剧焦虑。许多受访者将小组临床监督视为一种不可接受的侵犯，这可能表明需要为这一群体开发更可接受的注册后临床教育和反思实践类型。
