Practice and Dilemmas of Junior Doctors in the Construction of Therapeutic Landscapes in Pediatric Hematology: From the Perspective of Emotional Labor

Abstract

Therapeutic landscapes are dynamic systems co-constructed by physical environments, social landscapes, and symbolic landscapes, which play a critical role in patient recovery and professional experiences of medical staff within medical spaces. As a special medical field with high emotional load and high social attention, the construction of therapeutic landscapes in the Department of Pediatric Hematology relies not only on the professional guidance and decision-making coordination of senior physicians such as chief physicians and attending physicians, but also on the frontline participation and daily practice of junior doctors including interns and residents. Based on the therapeutic landscape theory of health geography and emotional labor theory of sociology, this study takes the Department of Pediatric Hematology as the research setting, adopts methods of participant observation, in-depth interviews, and grounded theory coding, and systematically analyzes the specific participation modes of junior doctors (interns and residents) in activating physical spaces, maintaining social relationships, and practicing symbolic interactions. It further reveals the dilemmas they face under factors including emotional labor pressure, institutional constraints, hierarchical power restrictions, and uncertain professional identity, and then proposes optimization paths from four dimensions: spatial support, institutional guarantee, emotional empowerment, and capacity building. The study finds that junior doctors are the daily producers and stable maintainers of therapeutic landscapes in the Department of Pediatric Hematology. Their deep-acting emotional labor helps create a warm and trusting therapeutic atmosphere, while surface acting and defensive tendencies weaken therapeutic effects. The participation dilemmas of junior doctors are essentially the combined result of structural pressure, identity tension, and unequal spatial power. Strengthening the participation of junior doctors in constructing therapeutic landscapes has important practical significance for improving doctor-patient relationships, enhancing the warmth of medical services, and promoting the physical and mental health of medical staff.