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初级保健中的社会资本与文化健康资本:以集体医疗就诊为例。

Social Capital and Cultural Health Capital in Primary Care: The Case of Group Medical Visits.

作者信息

Thompson-Lastad Ariana, Harrison Jessica M, Shim Janet K

机构信息

Department of Family and Community Medicine, Osher Center for Integrative Health, University of California, San Francisco, California, USA.

Osher Center for Integrative Health, University of California, San Francisco, California, USA.

出版信息

Sociol Health Illn. 2025 Jan;47(1):e13868. doi: 10.1111/1467-9566.13868.

DOI:10.1111/1467-9566.13868
PMID:39680019
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11648586/
Abstract

This article focuses on an empirical setting that upends the clinician-patient dyadic norm: group medical visits (GMVs), in which multiple patients gather in the same space for medical care, health education and peer support. Our grounded theory analysis draws on participant observation and interviews (N = 53) with patients and staff of GMVs at four safety-net healthcare organisations in the United States. We delineate (1) how group medical visits provide health-focused social networks that facilitate the mobilisation of social capital, (2) how the organisationally embedded relationships that comprise group visits are made possible through extended time that is part of the GMV field and (3) how clinicians have opportunities rarely found in other settings to learn from patients, using knowledge accrued from GMV networks to advance their own skills, thereby converting social capital into provider cultural health capital. GMVs provide a rich empirical site for understanding the ways in which organisational arrangements can shape opportunities for patients and clinicians to cultivate and mobilise social capital and cultural health capital, and in doing so, materially shift experiences of receiving and providing healthcare.

摘要

本文聚焦于一种颠覆医患二元模式常态的实证情境

集体医疗就诊(GMVs),即多名患者聚集在同一空间接受医疗护理、健康教育和同伴支持。我们基于扎根理论的分析采用了参与观察法,并对美国四个安全网医疗保健机构的集体医疗就诊患者和工作人员进行了访谈(N = 53)。我们阐述了:(1)集体医疗就诊如何提供以健康为重点的社交网络,促进社会资本的调动;(2)构成集体就诊的组织内部关系如何通过作为集体医疗就诊领域一部分的延长时间得以实现;(3)临床医生如何获得在其他环境中很少能找到的向患者学习的机会,利用从集体医疗就诊网络积累的知识提升自身技能,从而将社会资本转化为医疗服务提供者的文化健康资本。集体医疗就诊为理解组织安排如何塑造患者和临床医生培养及调动社会资本和文化健康资本的机会提供了一个丰富的实证场所,并且通过这样做,切实改变接受和提供医疗保健的体验。