Hierarchies and cliques in the social networks of health care professionals: implications for the design of dissemination strategies
Hierarchies and cliques in the social networks of health care professionals: implications for the design of dissemination strategies
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DOI：
10.1016/s0277-9536(98)00361-x
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发表时间：
1999-03-01
影响因子：
5.4
通讯作者：
Newton, JN
中科院分区：
文献类型：
--
作者：
West, E;Barron, DN;Newton, JN
对于如何为了临床和成本效益最好地影响临床医生的行为的兴趣，重新引起了卫生保健专业人员的社会网络的关注。自从科尔曼等人的开创性工作以来。书名/作者：Reach of[Coleman，J.S.，Katz，E.，Menzel，H.医学创新：扩散研究。Bobbs-Merrill，Indianapolis.]，在临床医生在临床实践中采用(或未能采用)新创新的过程中，网络一直被视为重要的。然而，人们实际上对现代医疗环境中临床医生的社交网络知之甚少。本文描述了英国医院中两类卫生保健专业人员--临床医学主任和护理主任--的职业社会网络。我们关注网络密度、中心性和集中化，因为这些特征与信息获取、社会影响力和社会控制过程联系在一起。结果表明，护理主任比临床医学主任在他们的网络中更核心，他们的网络更有层级。临床医学主任往往被嵌入到更紧密的网络中，我们称之为小圈子。护理主任网络比临床医学主任更适合收集和传播信息，但后者可能是改变或抵制临床行为变化的更有力的工具，这一假设源于许多社会学理论。我们的结论是，职业社会化和结构位置是社会网络的重要决定因素，在设计告知和影响临床医生的策略时，这些因素可以被有效地考虑。(C)1999爱思唯尔科学有限公司。保留所有权利。
Interest in how best to influence the behaviour of clinicians in the interests of both clinical and cost effectiveness has rekindled concern with the social networks of health care professionals. Ever since the seminal work of Coleman et al. [Coleman, J.S., Katz, E., Menzel, H., 1966. Medical Innovation: A Diffusion Study. Bobbs-Merrill, Indianapolis.], networks have been seen as important in the process by which clinicians adopt (or fail to adopt) new innovations in clinical practice. Yet very little is actually known about the social networks of clinicians in modern health care settings. This paper describes the professional social networks of two groups of health care professionals, clinical directors of medicine and directors of nursing, in hospitals in England. We focus on network density, centrality and centralisation because these characteristics have been linked to access to information, social influence and social control processes. The results show that directors of nursing an more central to their networks than clinical directors of medicine and that their networks are more hierarchical. Clinical directors of medicine tend to be embedded in much more densely connected networks which we describe as cliques. The hypotheses that the networks of directors of nursing are better adapted to gathering and disseminating information than clinical directors of medicine, but that the latter could be more potent instruments for changing, or resisting changes, in clinical behaviour, follow from a number of sociological theories. We conclude that professional socialisation and structural location are important determinants of social networks and that these factors could usefully be considered in the design of strategies to inform and influence clinicians. (C) 1999 Elsevier Science Ltd. All rights reserved.