Aston University, UK.
University of Nottingham, UK.
Soc Sci Med. 2023 Sep;333:116111. doi: 10.1016/j.socscimed.2023.116111. Epub 2023 Jul 26.
It is well known that the demands of working in healthcare can take a psychological toll on staff. Schwartz Centre Rounds are an intervention aimed at supporting staff wellbeing through providing a forum to talk about the emotional, social and ethical complexities of such work, employing facilitated storytelling and group discussion to try and achieve this. However, while prior research, through extensive interviews and surveys, has found Schwartz Rounds to be effective in fostering compassion and wellbeing amongst participants, the talk that occurs within Schwartz Rounds themselves has not been explored. One mechanism that has been considered in how Schwartz Rounds function is the creation of a 'counter-cultural', conversational space, suggesting the nature of the interactions themselves may be important in achieving their beneficial effects. Using conversation analytic (CA) methods, we examine Schwartz Rounds in the UK to address, at a detailed micro-level, how sequences of talk work to accomplish the key aims of this setting. Five separate one-hour Schwartz Rounds were recorded across three UK hospital Trusts, between January 2019 and February 2020. Our analysis addresses how panellists tell their stories in a way that emphasises the uniqueness of their experience but also provides a generalisable emotional 'upshot' and 'stance' for the audience to later respond to. We then focus in on how audience members are able to respond to these stories affiliatively, offering endorsements, generalisations and second stories. Drawing on prior CA literature examining support groups and psychotherapy, we consider how the format of Schwarz Rounds creates important opportunities for interpersonal affiliation in this context. Considering these interactional features alongside other research findings on Schwartz Rounds, we discuss how opportunities for interactional affiliation may be central to their success, with implications for how these interactions can be best facilitated.
众所周知，医疗工作的需求会对员工的心理造成影响。施瓦茨中心轮是一种干预措施，旨在通过提供一个讨论工作中的情感、社会和伦理复杂性的论坛来支持员工的幸福感，通过促进讲故事和小组讨论来实现这一目标。然而，尽管先前的研究通过广泛的访谈和调查发现施瓦茨轮在培养参与者的同情心和幸福感方面是有效的，但施瓦茨轮本身的讨论内容尚未得到探讨。在施瓦茨轮如何发挥作用的机制中，有一种被认为是创造了一种“反文化”的对话空间，这表明互动本身的性质可能对实现其有益效果很重要。我们使用会话分析（CA）方法，在英国研究施瓦茨轮，在详细的微观层面上探讨对话序列如何完成这一设置的关键目标。在 2019 年 1 月至 2020 年 2 月期间，我们在三个英国医院信托机构中记录了五个单独的一小时施瓦茨轮。我们的分析解决了小组成员如何以一种强调其独特经历的方式讲述他们的故事，但也为观众提供了一个可普遍化的情感“结果”和“立场”，以便他们稍后做出回应。然后，我们专注于观众如何能够以亲和的方式回应这些故事，提供认可、概括和第二个故事。借鉴之前关于支持小组和心理治疗的 CA 文献，我们考虑了施瓦茨轮的格式如何在这种情况下为人际联系创造了重要机会。考虑到这些互动特征以及其他关于施瓦茨轮的研究结果，我们讨论了互动联系的机会如何成为其成功的核心，以及如何最好地促进这些互动。
