Health Care Relationships in Context: An Analysis of Three Ethnographies
Bibliographic record
Abstract
A qualitative meta-analysis of three ethnographic studies conducted by the original investigators of those studies yielded new understandings of the dynamics of health care relationships in context. Through this analysis, the authors show that moral judgments and decision making in health care are highly relational and contextual. The use of power to compel health care providers and patients to comply with organizational practices is shown as fundamental to organizational functioning, and nurses participate in activities that often perpetuate conditions that contribute to their own moral distress. Furthermore, resistant actions often operate to sustain the practice patterns and ideologies being resisted. The authors call for an understanding of moral distress as relational and for collective strategies to counter practices that thwart ethical practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.034 | 0.073 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.010 | 0.016 |
| Science and technology studies | 0.008 | 0.005 |
| Scholarly communication | 0.005 | 0.007 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".