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The many ways of one: An analysis of multiple roles and enactment dimensions for community health workers.

机译:一种方法的多种方式:对社区卫生工作者的多种角色和制定维度的分析。

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This dissertation focused on Community Health Workers' (CHWs) discursive enactment in one-on-one client meetings. It investigated the presence of multiple roles within client meetings as well as discursive dimensions that are managed regardless of role. The study considered 12 CHW-client meetings as well as follow-up interviews, including those with four individual CHWs and two CHW supervisors. The role presence aspect of the study applied Rosenthal's (1998) model with actual interaction discourse. The role enactment dimensions of the dissertation were selected because they appeared in previous discourse literature and were thematically relevant to the CHW field. The role presence findings revealed that Rosenthal's (1998) roles were indeed present, largely as originally outlined. Role enactment dimension results related to the direct-indirect tension, the controlling-facilitating tension, and the personal-professional tension, respectively. CHWs were found to be generally indirect when working with newer clients in order to establish a relationship foundation for the successful completion of subsequent tasks. CHWs were found to generally value a facilitating or empowering style but their actual discourse tended to reflect a controlling style. CHWs had philosophical differences reflecting actual discursive differences regarding the use of personal discourse. While the findings are not generalizable, they do offer insights for follow-up studies as well as CHW program design and training conversations.
机译:本文着重于一对一客户会议中社区卫生工作者(CHW)的话语制定。它调查了客户会议中多个角色的存在以及不分角色而进行管理的话语维度。这项研究考虑了12次CHW客户会议以及后续访谈,包括那些有4位CHW和2位CHW主管的会议。该研究的角色存在方面将Rosenthal(1998)模型与实际互动话语结合起来。选择论文的角色制定维度是因为它们出现在先前的讨论文献中,并且在主题上与CHW领域相关。角色存在的发现表明,Rosenthal(1998)的角色确实存在,很大程度上与最初概述的一样。角色制定维度的结果分别与直接-间接张力,控制-促进张力和个人-专业张力有关。人们发现与新客户合作时,CHW通常是间接的,以便为成功完成后续任务建立关系基础。人们发现CHW通常看重一种促进或赋权的风格,但他们的实际话语往往反映出一种控制风格。 CHW的哲学差异反映了关于个人话语使用的实际话语差异。尽管调查结果无法推广,但确实为后续研究以及CHW计划设计和培训对话提供了见解。

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