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探索住院医师在调动社会资本方面的障碍及其应对策略:一项定性自我社会网络研究

Exploring Junior Residents' Barriers in Mobilizing Social Capital and Their Coping: A Qualitative Ego Social Network Study.

作者信息

Galema Gerbrich, Wietasch Götz J K G, Jaarsma Debbie A D C, Brouwer Jasperina

机构信息

University of Groningen, University Medical Center Groningen (UMCG), and part of Lifelong Learning, Education and Assessment Research Network (LEARN), She is an anesthesiologist at the department of anesthesiology, NL.

University of Groningen, UMCG, Department of Anesthesiology, He is also part of LEARN, NL.

出版信息

Perspect Med Educ. 2025 Jul 30;14(1):447-461. doi: 10.5334/pme.1629. eCollection 2025.

Abstract

BACKGROUND

Residents rely on social support from team members to navigate patient care, while also facing challenges integrating into the healthcare team. Although prior research has explored help-seeking behavior, little attention has been given to how residents overcome barriers to mobilizing social resources. This study explores how, in daily clinical practice, do residents perceive and respond to barriers in accessing and making use of social capital during challenging situations?

METHODS

We used a mixed-methods social network approach. Twenty-nine junior residents from various specialties participated in qualitative interviews, supplemented by ego (personal) networks to encourage respondents' reflection on social relationship dynamics.

RESULTS

Qualitative ego network analysis revealed that residents encounter significant physical and psychological barriers, such as uncertainty and the perceived costs of seeking support, which limit access to crucial information and expertise. Quantitative ego network analysis showed that residents predominantly turned to supervisors, nurses, and peers in challenging situations. However, interviews highlighted the complexity of supervisory relationships, shaped by concerns about career impact. To navigate these barriers emotional support was sought from friends, parents, and close colleagues, while expertise was sought from supervisors, senior residents, and nurses.

CONCLUSION

Residents face significant barriers in mobilizing social capital, particularly with supervisors. To cope, they draw on different parts of their network for emotional support and expertise. Our results suggest that existing help-seeking models, such as Borgatti and Cross's, require refinement: power dynamics contribute to the perceived 'costs' of help-seeking, and uncertainty about others' supportive potential reflects the influence of role ambiguity and relational comfort.

摘要

背景

住院医师在处理患者护理工作时依赖团队成员的社会支持,同时在融入医疗团队方面也面临挑战。尽管先前的研究探讨了求助行为,但对于住院医师如何克服调动社会资源的障碍却很少关注。本研究探讨在日常临床实践中,住院医师在面临挑战的情况下如何感知和应对获取及利用社会资本的障碍?

方法

我们采用了混合方法的社会网络方法。来自不同专业的29名初级住院医师参与了定性访谈,并辅以自我(个人)网络,以促使受访者反思社会关系动态。

结果

定性自我网络分析显示,住院医师遇到重大的身体和心理障碍,如不确定性和寻求支持的感知成本,这限制了他们获取关键信息和专业知识。定量自我网络分析表明,住院医师在面临挑战的情况下主要向主管、护士和同行求助。然而,访谈突出了监督关系的复杂性,这种关系受到对职业影响的担忧的影响。为了克服这些障碍,他们从朋友、父母和亲密同事那里寻求情感支持,从主管、高级住院医师和护士那里寻求专业知识。

结论

住院医师在调动社会资本方面面临重大障碍,尤其是与主管的关系。为了应对,他们从自己社交网络的不同部分获取情感支持和专业知识。我们的结果表明,现有的求助模型,如博尔加蒂和克罗斯的模型,需要改进:权力动态导致了求助的感知“成本”,对他人支持潜力的不确定性反映了角色模糊和关系舒适度的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/421e/12315688/da2a068ce0b1/pme-14-1-1629-g3.jpg

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