研究生: |
朱書儀 Chu, Shu-Yi |
---|---|
論文名稱: |
樂作醫者—醫師生涯召喚經驗之敘事研究 Joy in Healing—A Narrative Research on the Career Calling Experience of Physicians |
指導教授: |
王玉珍
Wang, Yu-Chen |
口試委員: |
王玉珍
Wang, Yu-Chen 金樹人 Jin, Shuh-Ren 廖士程 Liao, Shih-Cheng |
口試日期: | 2024/04/30 |
學位類別: |
碩士 Master |
系所名稱: |
教育心理與輔導學系碩士在職專班 Department of Educational Psychology and Counseling_Continuing Education Master's Program of Educational Psychology and Counseling |
論文出版年: | 2024 |
畢業學年度: | 112 |
語文別: | 中文 |
論文頁數: | 179 |
中文關鍵詞: | 生涯召喚 、醫師 、敘事研究 |
英文關鍵詞: | career calling, physicians, narrative research |
研究方法: | 敘事分析 |
DOI URL: | http://doi.org/10.6345/NTNU202400846 |
論文種類: | 學術論文 |
相關次數: | 點閱:142 下載:3 |
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本研究旨在探討醫師的生涯召喚經驗,包含開展歷程、召喚內涵以及帶來的影響。研究以立意取樣,邀請三位執業年資大於三年,並主觀確認有生涯召喚經驗並持續實踐召喚的醫師,作為本研究的研究參與者,其年齡介於30—50歲之間,分別是兩位女性一位男性。研究者設計訪談大綱,以半結構式訪談進行資料搜集,並透過敘事研究中「整體—內容」、「類別—內容」方法進行資料處理與分析。
本研究結果如下:(ㄧ)醫師生涯召喚的浮現與確立為動態發展過程,生涯召喚來自於外部親社會動機和內部個人價值展現,從投身於醫療工作與病患互動的過程中逐漸確立,涉及深刻的自我探索。另外隨著個人生涯發展和成長,醫師生涯召喚會經歷質變,從最初收獲回饋的成就感到對助人的奉獻與更高層次的自我實現。(二)醫師生涯召喚的四項共同內涵:興趣與優勢的發揮、利他助人的展現、建立支持關係與連結、生涯的平衡和諧。擁有生涯召喚醫師的個人特質與優勢有三,分別是:彈性適應、高韌性和高挫折忍受力、自我身分清晰。(三)醫師生涯召喚帶來的正面影響:其一為抵抗高壓環境,幫助度過困境並在其中保持高度職業承諾和職業滿意;其二為在工作中展現幫助病患的責任心和惻隱之心,從中收獲成就感與喜悅,個人價值得以實現,進而成為持續工作的動力;其三為促進個人內在成長,包括增加韌性和提升自我覺察能力。醫師生涯召喚的潛在負面後果包含:生涯召喚有其雙面性,過度投入工作導致犧牲生活品質、工作與家庭失衡、支持關係的削弱以及壓力超過負荷。
This study aims to explore the career calling experiences of physicians, including the development process, the essence of the calling, and its impacts. Purposive sampling was used to invite three physicians with more than three years of practice, who subjectively confirmed their experience of a career calling and continuously practiced it, as participants for this study. Their ages ranged from 30 to 50, including two women and one man. The researcher designed an interview outline and conducted data collection through semi-structured interviews, with data processed and analyzed using the "holistic-content" and "categorical-content" approach of narrative research. The findings are as follows:
The development process of physicians' career calling: The emergence and establishment of a career calling is a dynamic development process, stemming from external pro-social motivations and the display of internal personal values, gradually established through engagement in medical work and patient interaction, involving profound self-exploration. Furthermore, as individuals' careers develop and grow, physicians' career callings undergo qualitative changes, from the initial sense of achievement from reaping results to a dedication to helping others and higher levels of self-actualization.
The essence of physicians' career calling: There are four common essences of physicians' career calling: (i) fulfill potential; (ii) altruism; (iii) establishing supportive relationships; (iv) maintaining balance and harmony. Three personal traits and strengths of physicians with a career calling are: (i) adaptability to situations (ii) high resilience and tolerance; (iii) clear self-identity.
The impacts of physicians' career calling: Positive impacts include: (i) resisting high-pressure environments, helping to overcome difficulties while maintaining a high level of professional commitment and job satisfaction; (ii) demonstrating a sense of responsibility and compassion in helping patients at work, thereby gaining a sense of achievement and joy, allowing personal values to be realized, which in turn becomes a motivation to continue working; (iii) promoting personal inner growth, including increasing resilience and enhancing self-awareness. Negative impacts: The career calling has its dual nature; excessive work involvement leads to sacrifices in the quality of life, work-family imbalance, weakening of supportive relationships, and stress overload.
Creswell, J. W., & Poth, C. N.(2018):《質性研究的五種取徑》(李政賢譯)。五南出版社。(原著出版年:2017)
Merriam, S. B.(2011):《質性研究設計與施作指南》(顏寧譯)。五南出版社。(原著出版年:2009)
王玉珍、吳清麟(2017):〈成人生涯召喚量表之編製及其信效度分析〉。《教育心理學報》,49,1–21。https://doi.org/10.6251/BEP.20160905
王玉珍(2018):〈優勢中心生涯諮商與生涯召喚之諮商效果與影響經驗探究〉。《中華輔導與諮商學報》,52,19–50。https://doi.org/10.3966/172851862018080052002
何明宗(2008):〈臺灣地區未來醫師人力供需研究—灰色預測模式之應用〉。《醫務管理期刊》,9,255–270。https://doi.org/10.6174/JHM2008.9(4).255
吳盈瑩(2023):〈國小主任之生涯召喚的感知及實踐經驗〉。《學校行政》,146,160–188。
金樹人(2011):《生涯諮商與輔導(重修版)》。東華書局。
林俊彥(2015):〈基礎醫學教育的新思維〉。《長庚醫訊》,36(3),10–13。
林啓禎(2019):〈臺灣醫師的人才培育回顧與展望〉。《醫療品質雜誌》,13(4),4–8。https://doi.org/10.3966/199457952019071304001
林秀娟(2013):〈重視女醫師之生涯職涯發展〉。《醫療品質雜誌》,7(2),81–84。
邱美櫻(2016)。《教師生涯召喚、生涯調適力與生涯滿意度之研究》(未出版碩士論文),國立臺灣師範大學。
陳端容(2004):〈大型醫院主管職的生涯路徑與醫師職場結構〉。《臺灣社會學刊》,33,109–155。
陳端容、范國棟(2007):〈醫師生涯路徑選擇相關因素的事件史分析—醫師職場階層化的效應〉。《臺灣社會學刊》,38,105–133。https://doi.org/10.6786/TJS.200706_(38).0003
陳再晉、陳冠文、蕭允強、鐘珮純(2021):〈從住院醫師適用勞基法談醫師合理工時〉。《臺灣醫界》,64(2),34–41。https://doi.org/10.6145/jme.200709_11(3).0005
陸洛、李惠美、謝天渝(2005):〈牙醫師職業壓力與身心健康及職業倦怠之關係:以高雄市牙醫師為例〉。《應用心理研究》,27,59–80。
郭耿南(2009)。《醫師培育現況與展望》。國家衛生研究院。
鈕文英(2019)。《質性研究方法與論文寫作(二版)》。雙葉書廊。
楊銘欽、黎伊帆、魏璽倫(2007): 〈教學醫院主治醫師與住院醫師之工作時數與相關因素之研究〉。《醫學教育》,11(3),222–233。
楊義明(2016):〈培育21世紀醫師的六年新制臨床醫學課程—以美國臨床醫學教育百年經驗,著眼與規劃臺灣醫學系六年新制臨床醫學課程〉。《醫療品質雜誌》,10(1),82–93。
劉曉芬、陳清梅(2020):〈矢志為師—師資生靈性取向生涯召喚之探究〉。《師資培育與教師專業發展期刊》,13(1),1–26。https://doi.org/10.3966/207136492020041301001
鄭守夏(計畫主持人)(2012):《醫療服務與管理之問題與分析》。公共政策與法律研究中心101年度研究計畫案期末報告,國立臺灣大學。https://www.cppl.ntu.edu.tw/research/2012research/10102Final.pdf
謝博生(2000)。《醫學人文教育》。金名圖書。
戴正德(2017)。《新時代的醫學人文》。五南圖書。
龔蕾、田秀蘭、金樹人(2023):〈疫情期間成人生涯召喚、生涯混沌知覺、未來工作自我與生涯調適力之關聯性〉。《教育心理學報》,54,759–784。https://doi.org/10.6251/BEP.202306_54(4).0001
Bacchus, D. N. A. (2008). Coping with work-related stress: A study of the use of coping resources among professional black women. Journal of Ethnic and Cultural Diversity in Social Work: Innovation in Theory, Research & Practice, 17(1), 60–81. https://doi.org/10.1080/15313200801906443
Bandura, A., & National Inst of Mental Health. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.
Bloch, D. P., & Richmond, L. J. (1998). Soul work: Finding the work you love, loving the work you have. Davies Black.
Bott, E. M., Duffy, R. D., Borges, N. J., Braun, T. L., Jordan, K. P., & Marino, J. F. (2017). Called to medicine: Physicians’ experiences of career calling. The Career Development Quarterly, 65, 113–130. https://doi.org/10.1002/cdq.12086
Borges, N. j., Manuel, R., & Duffy, R. D. (2013). Specialty interests and career calling to medicine among first-year medical students. Perspectives on Medical Education, 2(1), 14–17. https://doi.org/10.1007/s40037-012-0037-9
Bunderson, J. S., & Thompson, J. A. (2009). The call of the wild: Zookeepers, callings, and the double-edged sword of deeply meaningful work. Administrative Science Quarterly, 54(1), 32–57. https://doi.org/10.2189/asqu.2009.54.1.32
Cardador, M. T., & Caza, B. B. (2012). Relational and identity perspectives on healthy versus unhealthy pursuit of callings. Journal of Career Assessment, 20(3), 338–353. https://doi.org/10.1177/1069072711436162
Chang, B. P., Carter, E., Ng, N., Flynn, C., & Tan, T. (2018). Association of clinician burnout. and perceived clinician-patient communication. American Journal of Emergency Medicine, 36(1), 156–158. https://doi.org/10.1016/j.ajem.2017.07.031
Clinton, M. E., Conway, N., & Sturges, J. (2017). “It’s tough hanging-up a call”: The relationships between calling and work hours, psychological detachment, sleep quality, and morning vigor. Journal of Occupational Health Psychology, 22(1), 28–39. https://doi.org/10.1037/ocp0000025
Creed, P. A., Rogers, M. E., Praskova, A., & Searle, J. (2014). Career calling as a personal resource moderator between environmental demands and burnout in Australian junior doctors. Journal of Career Development, 41(6), 547–561. https://doi.org/10.1177/0894845313520493
Colford, J. M., & McPhee, S. J. (1989). The ravelled sleeve of care. Managing the stresses of residency training. JAMA: the Journal of the American Medical Association, 261(6), 889–893. https://doi.org/10.1001/jama.1989.03420060105041
Colozzi, E. A., & Colozzi, L. C. (2000). Career counseling of college students: An empirical guide to strategies that work. American Psychological Association.
Cooke, M., Irby, D. M., & O ́brien, B. C. (2010). Educating physicians, a call for reform of. medical school and residency. Jossey-Bass
Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. Harper Collins.
Curlin, F. A., Dugdale, L. S., Lantos, J. D., & Chin, M. H. (2007). Do religious physicians disproportionately care for the underserved. The Annals of Family Medicine, 5, 353–360. https://doi.org/10.1370/afm.677
Dalla Rosa, A., Vianello, M., Galliani, E. M., & Duffy, R. D. (2020). Moderators of career calling and job‐search behaviors among unemployed individuals. The Career Development Quarterly, 68(4), 318–331. https://doi.org/10.1002/cdq.12239
Davidson, J. C., & Caddell, D. P. (1994). Religion and the meaning of work. Journal for the. Scientific Study of Religion, 33, 135–147. https://doi.org/10.2307/1386600
Dik, B. J., Sargent, A. M., & Steger, F. M. (2008). Career development strivings: Assessing. goals and motivation in career decision-making and planning. Journal of Career Development, 35(1), 23–41. https://doi.org/10.1177/0894845308317934
Dik, B. J., & Duffy, R. D. (2009). Calling and vocation at work: Definitions and prospects for. research and practice. The Counseling Psychologist, 37, 424–450. https://doi.org/10.1177/0011000008316430
Dobrow, S. R. (2004). Extreme subjective career success: A new integrated view of having a calling. Academy of Management Proceedings, 2004(1), B1–B6. https://doi.org/10.5465/AMBPP.2004.13863838
Dobrow, S. R., & Tosti-Kharas, J. (2011). Calling: The development of a scale measure. Personnel Psychology, 64(4), 1001–1049. https://doi.org/10.1111/j.1744-6570.2011.01234.x
Dobrow, S. R., & Tosti-Kharas, J. (2012). Listen to your heart? Calling and receptivity to career advice. Journal of Career Assessment, 20(3), 264–280. https://doi.org/10.1177/1069072711434412
Duffy, R. D., Allan, B. A., Autin, K. L., & Bott, E. M. (2013). Calling and life satisfaction: It's not about having it, it's about living it. Journal of Counseling Psychology, 60(1), 42–52. https://doi.org/10.1037/a0030635
Duffy, R. D., Allan, B. A., & Bott, E. M. (2011). Calling and life satisfaction among undergraduate students: Investigating mediators and moderators. Journal of Happiness Studies, 13, 469–479. https://doi.org/10.1007/s10902-011-9274-6
Duffy, R. D., Bott, E. M., Allan, B. A., Torrey, C. L., & Dik, B. J. (2012). Perceiving a calling, living a calling, and job satisfaction: Testing a moderated, multiple mediator model. Journal of Counseling Psychology, 59(1), 50–59. https://doi.org/10.1037/a0026129
Duffy, R. D., Dik, B. J., Douglass, R. P., England, J. W., & Velez, B. L. (2018). Work as a calling: A theoretical model. Journal of Counseling Psychology, 65(4), 423–439. https://doi.org/10.1037/cou0000276
Duffy, R. D., Dik, B. J., & Steger, M. F. (2011). Calling and work-related outcomes: Career commitment as a mediator. Journal of Vocational Behavior, 78, 210–218. https://doi.org/10.1016/j.jvb.2010.11.002
Duffy, R. D., Foley, P. F., Raque-Bodgan, T. L., Reid-Marks, L., Dik, B. J., Castano, M. C., & Adams, C. M. (2012). Counseling psychologists who view their careers as a calling: A qualitative study. Journal of Career Assessment, 20(3), 293–308. https://doi.org/10.1177/1069072711436145
Duffy, R. D., Manuel, R. S., Borges, N. J., & Bott, E. M. (2011). Calling, vocational development, and well-being: A longitudinal study of medical students. Journal of Vocational Behavior, 79(2), 361–366. https://doi.org/10.1016/j.jvb.2011.03.023
Duffy, R. D., & Sedlacek, W. E. (2007). The presence of and search for a calling: Connections to career development. Journal of Vocational Behavior, 70(3), 590–601. https://doi.org/10.1016/j.jvb.2007.03.007
Duffy, R. D., & Sedlacek, W. E. (2010). The salience of a career calling among college students: Exploring group differences and links to religiousness, life meaning, and life satisfaction. The Carrer Development Quarterly, 59(1), 27–41. https://doi.org/10.1002/j.2161-0045.2010.tb00128.x
Dyrbye, L. N., West, C. P., Satele, D., Boone, S., Tan, L., Sloan, J., & Shanafelt, T. D. (2014). Burnout among US medical students, residents, and early career physicians relative to the general US population. Academic Medicine, 89(3), 443–451. https://doi.org/10.1097/ACM.0000000000000134
Elangovan, A. R., McLean, M., & Pinder, C. C. (2010). Callings and organizational behavior. Journal of Vocational Behavior, 76(3), 428–440. https://doi.org/10.1016/j.jvb.2009.10.009
French, J. R., & Domene, J. F. (2010). Sense of "calling": An organizing principle for the lives and values of young women in university. Canadian Journal of Counselling and Psychotherapy, 44(1), 1–14.
Hagmaier, T., & Abele, A. E. (2012). The multidimensionality of calling: Conceptualization, measurement and a bicultural perspective. Journal of Vocational Behavior, 81, 39–51. https://doi.org/10.1016/j.jvb.2012.04.001
Hall, D. T., & Chandler, D. E. (2005). Psychological success: When the career is a calling. Journal of Organizational Behavior, 26(2), 155–176. https://doi.org/10.1002/job.301
Hall, O. (1948). The stages of a medical career. American Journal of Sociology, 53, 327–336. https://doi.org/10.1086/220199
Hirschi, A. (2011). Callings in career: A typological approach to essential and optional components. Journal of Vocational Behavior, 79, 60–73. https://doi.org/10.1016/j.jvb.2010.11.002
Hirschi, A., & Herrmann, A. (2013). Calling and career preparation: Investigating developmental patterns and temporal precedence. Journal of Vocational Behavior, 83(1), 51–60. https://doi.org/10.1016/j.jvb.2013.02.008
Hunter, I., Dik, B. J., & Banning, J. H. (2010). College students’ perceptions of calling in work and life: A qualitative analysis. Journal of Vocational Behavior, 76, 178–186. https://doi.org/10.1016/j.jvb.2009.10.008
Jager, A. J., Tutty, M. A., & Kao, A. C. (2017). Association between physician burnout and identification with medicine as a calling. Mayo Clinic proceedings, 92(3), 415–422. https://doi.org/10.1016/j.mayocp.2016.11.012
Jonassen, D. H., & Hernandez-Serrano, J. (2002). Case-based reasoning and instructional. design: Using stories to support problem solving. Educational Technology Research and Development, 50(2), 65–77. https://doi.org/10.1007/BF02504994
Johansson, E. E., & Hamberg, K. (2007). From calling to a scheduled vocation: Swedish male and female students’ reflections on being a doctor. Medical Teacher, 29, e1–e8. https://doi.org/10.1080/01421590601044992
Kao, A. C., & Jager, A. J. (2018). Medical students’ views of medicine as a calling and. selection of a primary care-related residency. Annals of Family Medicine, 16(1), 59–61. https://doi.org/10.1370/afm.2149
Lang, A. (2019). Analysis of burnout and career calling in undergraduate pre-medical students. Journal of Interdisciplinary Undergraduate Research, 11, 7–21.
Lazar, A., Littman-Ovadia, H., & Ovadia, T. (2018). Medicine as a calling among male and female medical students in Israel: Does it make a difference? International Journal for Educational and Vocational Guidance, 18(3), 279–295. https://doi.org/10.1007/s10775-018-9361-x
LeCompte, M. D., Preissle, J., & Tesch, R. (1993). Ethnography and qualitative design in educational research. Academic Press.
Lemke, D. L. (2020). Perceptions of career agency and career calling in mid-career: A qualitative investigation. Journal of Career Assessment, 29(2), 1–24. https://doi.org/10.1177/1069072720956982
Levey, R. E. (2001). Sources of stress for residents and recommendations for programs to assist them. Academic Medicine, 76(2), 142–150. https://doi.org/10.1097/00001888-200102000-00010
Lieblich, A., Tuval-Mashiach, R., & Zilber, T. (1998). Narrative research: Reading, analysis, and interpretation. SAGE Publications.
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. SAGE Publications.
Linn, L. S., Yager, J., Cope, D., & Leake, B. (1985). Health status, job satisfaction, job stress, and life satisfaction among academic and clinical faculty. JAMA: the Journal of the American Medical Association, 254(19), 2775–2782. https://doi.org/10.1001/jama.254.19.2775
Littman-Ovadia, H., Lazar, A., & Ovadia, T. (2015). Gender differences in the perception of presence of, and search for, calling during medical school. Problems of Education in the 21st Century, 67(1), 52–60. https://doi.org/10.33225/pec/15.67.52
Maslach, C., Schaufeli W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of. Psychology, 52, 397–422. https://doi.org/10.1146/annurev.psych.52.1.397
Maslach, C., & Schoufeli, W. B. (1982). Burnout: The cost of caring. Prentice-Hall.
Novak, M. (1996). Business as a calling: work and the examined life. The Free Press.
Pauls, M., & Hutchinson, R. C. (2002). Bioethics for clinicians: 28. Protestant bioethics. Canadian Medical Association Journal, 166, 339–343.
Praskova, A., Hood, M., & Creed, P. A. (2014). Testing a calling model of psychological. career success in Australian young adults: A longitudinal study. Journal of Vocational Behavior, 85(1), 123–135. https://doi.org/10.1016/j.jvb.2014.04.004
Praskova, A., Creed, P. A., & Hood, M. (2015). The development and initial validation of a career calling scale for emerging adults. Journal of Career Assessment, 23(1), 91–106. https://doi.org/10.1177/1069072714523089
Praskova, A., Creed, P. A., & Hood, M. (2015). Self-regulatory processes mediating between career calling and perceived employability and life satisfaction in emerging adults. Journal of Career Development, 42(2), 86–101. https://doi.org/10.1177/0894845314541517
Riessman, C. K. (1993). Narrative analysis. SAGE Publications.
Rotenstein, L. S., Torre, M., Ramos, M. A., Rosales, R. C., Guille, C., Sen, S., & Mata, D. A. (2018). Prevalence of burnout among physicians: A systematic review. JAMA: the Journal of the American Medical Association, 320(11), 1131–1150.
Smythe, W. E., & Murray, M. J. (2000). Owning the story: Ethical considerations in narrative. research. ETHICS & BEHAVIOR, 10(4), 311–336. https://doi.org/10.1207/S15327019EB1004_1
Stewart, M. T., & Serwint, J. R. (2019). Burning without burning out: A call to protect the calling of medicine. Current Problems in Pediatric and Adolescent Health Care, 49(11), 1–5. https://doi.org/10.1016/j.cppeds.2019.100655
Super, D. E. (1990). A life-span, life-space approach to career development. In D. Brown & L. Brooks, Career choice and development: Applying contemporary theories to practice (2nd ed., pp. 197–261). Jossey-Bass.
Thomas, N. K. (2004). Resident burnout. JAMA: the Journal of the American Medical Association, 292(23), 2880–2889. https://doi.org/10.1001/ jama.292.23.2880
Treadgold, R. (1999). Transcendent vocations: Their relationship to stress, depression, and clarity of self-concept. Journal of Humanistic Psychology, 39(1), 81–105. https://doi.org/10.1177/0022167899391010
Weiss, J. W., Skelley, M. F., Haughey, J. C., & Hall, D. T. (2004). Calling, new careers and. spirituality: A reflective perspective for organizational leaders and professionals. Research in Ethical Issues in Organizations, 5, 175–201. https://doi.org/10.1016/S1529-2096(03)05009-0
Wrzesniewski, A., McCauley, C., Rozin, P., & Schwartz, B. (1997). Jobs, careers, and callings: People's relations to their work. Journal of Research in Personality, 31(1), 21–33. https://doi.org/10.1006/jrpe.1997.2162
Yoon, J. D., Brendan, M. D., & Curlin, F. A. (2017). The association between a sense of calling and physician well-being: A national study of primary care physicians and psychiatrists. Academic Psychiatry, 41, 167–173. https://doi.org/10.1007/s40596-016-0487-1
Yoon, J. D., Shin, J. H., Nian, A. L., & Curlin, F. A. (2015). Religion, sense of calling, and the practice of medicine: Findings from a national survey of primary care physicians and psychiatrists. Southern Medical Journal, 108, 189–195. https://doi.org/10.14423/SMJ.0000000000000250.
Zhang, S., Wang, J., Xie, F., Yin, D., Shi, Y., Zhang, M., Yin, H., Li, F., Yang, L., Cao, D., & Sun, T. (2020). A cross-sectional study of job burnout, psychological attachment, and the career calling of Chinese doctors. BMC Health Services Research, 20, Article 193. https://doi.org/10.1186/s12913-020-4996-y