Health Services Management Centre University of Birmingham Park House, 40 Edgbaston Park Road, Birmingham, B15 2RT, UK.
Nottingham University Business School, University of Nottingham Jubilee Campus, Nottingham, NG8 1BB, UK.
Soc Sci Med. 2023 Sep;333:116145. doi: 10.1016/j.socscimed.2023.116145. Epub 2023 Aug 5.
The changing organisation and governance of healthcare work represents a persistent focus of micro-politics. Whilst there is a developed literature describing the micro-political struggles that occur amongst healthcare occupations, there is little understanding about how, when and why actors become politically aware and active. Framed by research on political activation and the concept of identity work, this paper reports on a narrative interview study with 65 people, specifically doctors, nurses and managers, working in the English healthcare system. The narratives show that healthcare workers become increasingly aware of and engaged in micro-political activities through incremental stages based on their accumulating experiences. These stages are opportunities for identity work as actors make sense of their experiences of micro-politics, their occupational affiliations and their evolving sense of self. This identity work is shaped by actors' changing views about the morality of playing politics, the emotional implications of their engagement, and their deepening political commitments. The study shows that political socialisation and activation can vary between occupations and rather than assuming political affiliations are given or acquired the papers highlights the reflective agency of healthcare actors.
医疗工作的组织和治理不断变化，这一直是微观政治的焦点。虽然有大量文献描述了医疗职业之间发生的微观政治斗争，但对于参与者如何、何时以及为何变得具有政治意识和积极参与，人们的理解甚少。本文以政治激活研究和身份工作概念为框架，报告了对 65 名在英国医疗保健系统工作的医生、护士和管理人员进行的叙事访谈研究。这些叙述表明，医疗工作者通过基于经验积累的渐进阶段，越来越意识到微观政治活动并参与其中。这些阶段是身份工作的机会，因为参与者理解他们的微观政治经历、职业联系以及自我不断发展的感觉。这种身份工作受到参与者对参与政治的道德观念、情感影响以及政治承诺加深的影响。该研究表明，政治社会化和激活在不同职业之间可能有所不同，而不是假设政治关联是给定的或获得的，本文强调了医疗保健参与者的反思性代理。
