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跨越业余与专业界限协商精神疾病:朋辈工作咨询中的角色扮演。

Negotiating mental illness across the lay-professional divide: Role play in peer work consultations.

机构信息

The Danish Center for Social Science Research, Copenhagen, Denmark.

Department of Sociology, University of Copenhagen, Copenhagen, Denmark.

出版信息

Sociol Health Illn. 2022 Apr;44(4-5):815-829. doi: 10.1111/1467-9566.13456. Epub 2022 Mar 5.

DOI:10.1111/1467-9566.13456
PMID:35247209
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9311446/
Abstract

Patient involvement is a prominent policy aim in modern health care. Today, mental health services employ peer workers (PWs) who have personal experiences with mental illness. Based on 22 interviews with PWs and 26 audio recordings of real-life consultations, we show how PWs talk about their personal experiences as professional qualifications. Furthermore, we demonstrate how in real-life encounters, PWs and patients convert personal experiences into a professional approach through an interactionist role play that balance PWs role as former patients and current professionals. Our analysis shows that PWs combine the personal pronoun 'I' (stressing that it is personal) with the indefinite pronoun 'one' (referring to generalised patient experiences) when they recount illness experiences. This convey that PWs engage with mental illness as both a personal and professional topic. In addition, the analysis shows that PWs (and patients) use professional clues to manifest PWs' positions as professionals. Overall, the article demonstrates that instead of focussing on authentic patient relationships, as previous research has done, it is beneficial to investigate peer work from a symbolic interactionist approach revealing how PWs and patients skilfully manoeuvre the contradictions embedded in the PWs' dual role as former patients and current professionals.

摘要

患者参与是现代医疗保健的一个突出政策目标。如今,精神卫生服务机构聘请了有精神疾病个人经历的同伴工作人员(PW)。基于对 22 名 PW 和 26 次真实咨询的音频记录的采访,我们展示了 PW 如何将个人经历作为专业资格进行讨论。此外,我们还展示了在现实生活中,PW 和患者如何通过互动角色扮演将个人经历转化为专业方法,这种角色扮演平衡了 PW 作为前患者和当前专业人员的角色。我们的分析表明,PW 在讲述疾病经历时,将人称代词“我”(强调这是个人经历)与不定代词“one”(指的是普遍的患者经历)结合在一起。这表明 PW 将精神疾病作为个人和专业话题来处理。此外,分析表明,PW(和患者)使用专业线索来体现 PW 作为专业人员的立场。总体而言,本文表明,与其像之前的研究那样专注于真实的患者关系,从符号互动主义的角度研究同伴工作更有益,这揭示了 PW 和患者如何巧妙地应对 PW 作为前患者和当前专业人员的双重角色中所嵌入的矛盾。

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Sociol Health Illn. 2022 Apr;44(4-5):815-829. doi: 10.1111/1467-9566.13456. Epub 2022 Mar 5.
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本文引用的文献

1
Unintended consequences of institutionalizing peer support work in mental healthcare.将同伴支持工作制度化在精神卫生保健方面带来的意外后果。
Soc Sci Med. 2020 Oct;262:113249. doi: 10.1016/j.socscimed.2020.113249. Epub 2020 Jul 28.
2
Feeling less alone online: patients' ambivalent engagements with digital media.线上不再孤单:患者对数字媒体的矛盾参与
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'Keeping It Real': women's Enactments of Lay Health Knowledges and Expertise on Facebook.“保持真实”:女性在 Facebook 上展现的非专业健康知识和专长。
Sociol Health Illn. 2019 Nov;41(8):1637-1651. doi: 10.1111/1467-9566.12982. Epub 2019 Aug 7.
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Knowledge and expertise in care practices: the role of the peer worker in mental health teams.护理实践知识和专长:同伴工作者在精神卫生团队中的作用。
Sociol Health Illn. 2019 Sep;41(7):1305-1322. doi: 10.1111/1467-9566.12944. Epub 2019 Apr 23.
5
Agency and clientship in public encounters: co-constructing 'neediness' and 'worthiness' in shelter placement meetings.在公共场合的代理和客户关系:在收容安置会议中共同构建“需要”和“值得”。
Br J Sociol. 2019 Dec;70(5):1640-1660. doi: 10.1111/1468-4446.12633. Epub 2019 Jan 9.
6
Strategic Storytelling: An Exploration of the Professional Practices of Mental Health Peer Providers.策略叙事:精神健康同行照护者专业实践的探索。
Qual Health Res. 2019 Jul;29(9):1266-1276. doi: 10.1177/1049732318821689. Epub 2019 Jan 7.
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Alignments and differentiations: People with illness experiences seeking legitimate positions as health service developers and producers.定位与分化:有疾病经历的人寻求成为健康服务开发者和生产者的合法身份。
Health (London). 2020 May;24(3):223-240. doi: 10.1177/1363459318800154. Epub 2018 Sep 16.
8
'You're there because you are unprofessional': patient and public involvement as liminal knowledge spaces.“你之所以在那里是因为你不专业”:患者及公众参与作为阈限知识空间
Sociol Health Illn. 2018 Mar;40(3):463-477. doi: 10.1111/1467-9566.12655. Epub 2017 Dec 27.
9
Experience as knowledge: Disability, distillation and (reprogenetic) decision-making.经验即知识:残疾、提炼和(再生育)决策。
Soc Sci Med. 2017 Oct;191:186-193. doi: 10.1016/j.socscimed.2017.09.013. Epub 2017 Sep 8.
10
Lived experience practitioners and the medical model: world's colliding?患者体验从业者与医学模式:世界的碰撞?
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