Department of Sociology, European University at St. Peterburg, St. Petersburg, Russia.
Sociol Health Illn. 2022 Jul;44(7):1059-1076. doi: 10.1111/1467-9566.13478. Epub 2022 May 6.
Sociological scholars of healthcare professions are becoming increasingly aware of the organisational dimension of professionalism, including how professionals as institutional actors are exposed to and influence organisational transformation. By tracing the ground-level professional efforts of Russian doulas-a caring profession that has been plunged into a reforming health system-in this article I explore how meaning-making activities and professionals' emotional labour build into and advance institutional changes in post-socialist maternity care. Drawing on qualitative research materials, I define three ways through which doulas' institutional efforts engage with emotions in clinical settings: (1) redefining emotional labour as a compound of maternity care; (2) grounding emotional labour in the context of reforming institutions; (3) using emotional labour to bridge discrepancies within organisational arrangements in healthcare. My research findings provide new insights into how marketisation influences professional care, as well as about caring professionalism in post-socialist maternity care. Attention to doulas' professional efforts allows for the affective transformation and inequality in the context of healthcare reforms to be analytically grasped. In particular, I trace how doulas' institutional agency embodied in emotional labour constructs the neo-liberal patient's identity.
医疗保健职业的社会学者越来越意识到专业性的组织层面，包括专业人员作为机构参与者如何接触和影响组织变革。本文通过追踪俄罗斯导乐的基层专业努力，探讨了在转型期的医疗保健中，意义建构活动和专业人员的情感劳动如何融入并推动机构变革。我运用定性研究材料，定义了导乐在临床环境中与情感互动的三种方式：（1）将情感劳动重新定义为孕产护理的一个组成部分；（2）将情感劳动根植于机构改革的背景下；（3）利用情感劳动来弥合医疗保健中组织安排内的差距。我的研究结果为市场对专业护理的影响以及后社会主义孕产护理中的关怀专业性提供了新的见解。关注导乐的专业努力可以分析性地理解医疗改革背景下的情感转变和不平等。特别是，我追溯了导乐的机构代理如何体现在情感劳动中，构建了新自由主义患者的身份。
