liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Alternative names
Publications (10 of 130) Show all publications
Brüggemann, A. J., Forsberg, C., Colnerud, G., Wijma, B. & Thornberg, R. (2019). Bystander passivity in health care and school settings: Moral disengagement, moral distress, and opportunities for moral education. Journal of Moral Education, 48(2), 199-213
Open this publication in new window or tab >>Bystander passivity in health care and school settings: Moral disengagement, moral distress, and opportunities for moral education
Show others...
2019 (English)In: Journal of Moral Education, ISSN 0305-7240, E-ISSN 1465-3877, Vol. 48, no 2, p. 199-213Article in journal (Refereed) Published
Abstract [en]

Bystander passivity has received increased attention in the prevention of interpersonal harm, but it is poorly understood in many settings. In this article we explore bystander passivity in three settings based on existing literature: patient abuse in health care; bullying among schoolchildren; and oppressive treatment of students by teachers. Throughout the article we develop a theoretical approach that connects Obermann's unconcerned and guiltybystanders to theories of moral disengagement and moral distress respectively. Despite differences between the three settings, we show striking similarities between processes of disengagement, indicators of distress, and the constraints for intervention that bystanders identify. In relation to this, we discuss moral educational efforts that aim to strengthen bystanders’ moral agency in health care and school settings. Many efforts emphasize shared problem descriptions and collective responsibilities. As challenging as such efforts may be, there can be much to gain in terms of welfare and justice.

Place, publisher, year, edition, pages
Routledge, 2019
Keywords
bystander passivity, moral disengagement, moral distress, school, health care
National Category
Social Psychology Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-150900 (URN)10.1080/03057240.2018.1471391 (DOI)000463712200004 ()2-s2.0-85049631558 (Scopus ID)
Note

Funding agencies: Swedish Research Council [2011-2478, 2013-7753, 2014-2749]

Available from: 2018-09-04 Created: 2018-09-04 Last updated: 2019-05-14Bibliographically approved
Wijma, B., Persson, A., Ockander, M. & Brüggemann, J. (2019). Kränkningar i vården är vanligt förekommande: Viktigt med aktivt arbete mot att patienter kränks. Läkartidningen, 1-6
Open this publication in new window or tab >>Kränkningar i vården är vanligt förekommande: Viktigt med aktivt arbete mot att patienter kränks
2019 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, p. 1-6Article in journal (Other academic) Published
Abstract [sv]

Trots goda intentioner hos vårdpersonal upplever patienter ofta möten i vården som misslyckade. Det kan vara möten där patienten har fått en helt korrekt medicinsk behandling, men av andra anledningar upplever sig kränkt eller överkörd. Ofta lägger vårdgivare inte ens märke till att det sker. Om patienten i efterhand försöker få upprättelse är det heller inte säkert att ett sådant samtal når sitt syfte. Ämnet kränkningar i vården är tabubelagt och känslomässigt laddat. För att ge legitimitet åt insatser att hjälpa personal att motverka kränkningar behövs därför en god kunskapsbas.

Med denna utgångspunkt startades för 20 år sedan ett nytt forskningsfält om kränkningar i vården vid enheten för genus och medicin, Linköpings universitet. I denna artikel redovisar forskargruppen några av sina resultat och lärdomar.

Place, publisher, year, edition, pages
Stockholm: Läkartidningen Förlag AB, 2019
National Category
Medical Ethics Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-153881 (URN)
Available from: 2019-01-16 Created: 2019-01-16 Last updated: 2019-01-22Bibliographically approved
Brüggemann, J., Persson, A. & Wijma, B. (2019). Understanding and preventing situations of abuse in health care: Navigation work in a Swedish palliative care setting. Social Science and Medicine, 222, 52-58
Open this publication in new window or tab >>Understanding and preventing situations of abuse in health care: Navigation work in a Swedish palliative care setting
2019 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 222, p. 52-58Article in journal (Refereed) Published
Abstract [en]

In their everyday work, health professionals find themselves in situations that they perceive to be abusive to patients. Such situations can trigger feelings of shame and guilt, making efforts to address the problem among colleagues a challenge. This article analyzes how health professionals conceptualize abusive situations, and how they develop collective learning and explore preventive strategies. It is based on an interactive research collaboration with a hospice and palliative care clinic in Sweden during 2016–2017. The empirical material consists of group discussions and participant observations collected during interactive drama workshops for all clinic staff. Based on three types of challenges in the material, identified through thematic analysis, we establish the concept of navigation work to show how health professionals prevent or find ways out of challenging and potentially abusive situations. First, the navigation of care landscapes shows how staff navigate the different territories of the home and the ward, reflecting how spatial settings construct the scope of care and what professionals consider to be potentially abusive situations. Second, the negotiation of collective navigations addresses the professionals' shared efforts to protect patients through the use of physical and relational boundaries, or mediating disrupted relationships. Third, the navigation of tensions in care highlights professionals’ strategies in the confined action space between coercing and neglecting patients who oppose necessary care procedures. Theoretically, the concept of navigation work draws upon work on care in practice, and sheds light on the particular kind of work care professionals do, and reflect on doing, in order to navigate the challenges of potentially abusive situations. By providing a perspective and shared vocabulary, the concept may also elicit ways in which this work can be verbalized, shared, and developed in clinical practice.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Sweden; Abuse in health care; Navigation work; Care practice; Interactive research; Qualitative study; Forum play
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-153753 (URN)10.1016/j.socscimed.2018.12.035 (DOI)000459838900006 ()30599436 (PubMedID)2-s2.0-85059148325 (Scopus ID)
Note

Funding agencies: Swedish Research Council [2014-2749]

Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-03-20Bibliographically approved
Wijma, B., Persson, A., Ockander, M. & Brüggemann, J. (2019). Upprepad utsatthet - bakgrund av övergrepp hos kvinnor och män och risken att uppleva kränkningar i vården. Socialmedicinsk Tidskrift, 96(4), 499-518
Open this publication in new window or tab >>Upprepad utsatthet - bakgrund av övergrepp hos kvinnor och män och risken att uppleva kränkningar i vården
2019 (Swedish)In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 96, no 4, p. 499-518Article in journal (Refereed) Published
Abstract [en]

Forskning visar att var sjätte kvinnlig och var trettonde manlig patient har upplevt kränkningar i vården. En bakgrund av övergrepp ökar risken att som vuxen uppleva sig kränkt i vården. 

Detta samband analyseras i artikeln liksom dess orsaker och konsekvenser för patienter och vårdgivare. På basen av mångårig interventionsforskning diskuteras även hur vården på både strukturell och individuell nivå kan förhindra att patienter kränks och speciellt patienter med en bakgrund av övergrepp. 

Ett stort ansvar vilar på vårdens alla ledningsnivåer, från myndighet till klinik, för att skapa förutsättningar i form av tid, kunskap och verktyg så att vårdgivare kan agera mot att patienter kränks. Artikeln beskriver ett antal sådana verktyg.

Place, publisher, year, edition, pages
Stiftelsen Socialmedicinsk Tidskrift, 2019
Keywords
Vårdmöten; traumatiserade patienter; strukturellt/kulturellt våld; interventionsforskning; prevention
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-161050 (URN)
Available from: 2019-10-10 Created: 2019-10-18
Smirthwaite, G., Lundstrom, M., Wijma, B., Lykke, N. & Swahnberg, K. (2016). Correction: Inequity in waiting for cataract surgery - an analysis of data from the Swedish National Cataract Register (vol 15, 10, 2016). International Journal for Equity in Health, 15(63)
Open this publication in new window or tab >>Correction: Inequity in waiting for cataract surgery - an analysis of data from the Swedish National Cataract Register (vol 15, 10, 2016)
Show others...
2016 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 15, no 63Article in journal (Other academic) Published
Abstract [en]

n/a

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2016
National Category
Clinical Medicine Other Social Sciences
Identifiers
urn:nbn:se:liu:diva-128750 (URN)10.1186/s12939-016-0355-3 (DOI)000374521600001 ()27068258 (PubMedID)
Available from: 2016-06-01 Created: 2016-05-30 Last updated: 2018-11-15
Smirthwaite, G., Lundstrom, M., Wijma, B., Lykke, N. & Swahnberg, K. (2016). Inequity in waiting for cataract surgery - an analysis of data from the Swedish National Cataract Register. International Journal for Equity in Health, 15(10)
Open this publication in new window or tab >>Inequity in waiting for cataract surgery - an analysis of data from the Swedish National Cataract Register
Show others...
2016 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 15, no 10Article in journal (Refereed) Published
Abstract [en]

Background: Swedish Health and Medical Services act states that good care should be given to the entire population on equal terms. Still studies show that access to care in Sweden differ related to for example gender and socioeconomic variables. One of the areas in Swedish health care that has attracted attention for potential inequity in access is Cataract Extraction (CE). Previous studies of access to CE in Sweden show that female patients have in general poorer vision before they are operated and longer waiting times for CE than male patients. The aim of the study was to describe the waiting times in different patient groups with regards to visual acuity, gender, age, native country, educational level, annual income and whether the patient was retired or still working. Methods: The study was designed as a register study of 102 532 patients who have had CE performed in Sweden 2010-2011. Linear regression was used to analyse the association between patient characteristics and waiting times. Mean waiting times for women and men were calculated for all groups. Results: At significance level p < 0.05 longer waiting times corresponded to patients having good visual acuity, being of female gender, high age, retired, born outside the Nordic countries and having low income and education. Calculations of mean waiting times for all groups showed that women had longer waiting times than men. Conclusions: The differences between groups defined, for example, by gender, age, native country, income, education and retirement are statistically significant. We do not consider them as clinically significant, but we consider the consistent pattern that we have found noteworthy in relation to the principle of equity in health care.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2016
Keywords
Health inequalities; Social inequity; Cataract extraction; Intersectionality; Gender; Doing gender
National Category
Clinical Medicine Other Social Sciences
Identifiers
urn:nbn:se:liu:diva-125151 (URN)10.1186/s12939-016-0302-3 (DOI)000368796300002 ()26786522 (PubMedID)
Available from: 2016-02-15 Created: 2016-02-15 Last updated: 2018-11-15
Pelters, B. & Wijma, B. (2016). Neither a sinner nor a saint: Health as a present-day religion in the age of healthism. Social Theory & Health, 14(1), 129-148
Open this publication in new window or tab >>Neither a sinner nor a saint: Health as a present-day religion in the age of healthism
2016 (English)In: Social Theory & Health, ISSN 1477-8211, E-ISSN 1477-822X, Vol. 14, no 1, p. 129-148Article in journal (Refereed) Published
Abstract [en]

In Western societies, religious imagery is often used in conjunction with the topic health in this biomedicalized, healthistic time, but is that enough to qualify the structural characteristics of the presentations and practices of health as a present-day health religion? And what may be gained by adopting such a perspective? This article explores these questions by a hermeneutical rereading, using a comprehensive list of 10 religious features derived from the sociology of religion on texts describing (a) religiously charged health phenomena, (b) the interconnection between health and society and (c) health theories. The results show that health can rightfully be called a religion, with characteristics resembling Webets protestant work ethic, which may accelerate the formation of a new economic and health-related underclass. Viewing health from a religious angle has the potential of introducing new concepts and ideas of religious origin into the sphere of health. We believe that this introduction will facilitate and inspire new ways of thinking about health which add a religious edge to the seeming rationality of health, that is, an emotionalized commitment to health as a dignified authority, which an understanding of health as a moral obligation hardly captures.

Place, publisher, year, edition, pages
PALGRAVE MACMILLAN LTD, 2016
Keywords
representations of health; religion; power; healthism; commitment
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-125309 (URN)10.1057/sth.2015.21 (DOI)000368960800007 ()
Available from: 2016-02-24 Created: 2016-02-19 Last updated: 2018-11-15
Wijma, B., Zbikowski, A. & Brüggemann, J. (2016). Silence, shame and abuse in health care: theoretical development on basis of an intervention project among staff. BMC Medical Education, 16(75)
Open this publication in new window or tab >>Silence, shame and abuse in health care: theoretical development on basis of an intervention project among staff
2016 (English)In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, no 75Article in journal (Refereed) Published
Abstract [en]

As health care exists to alleviate patients suffering it is unacceptable that it inflicts unnecessary suffering on patients. We therefore have developed and evaluated a drama pedagogical model for staff interventions using Forum Play, focusing on staffs experiences of failed encounters where they have perceived that the patient felt abused. In the current paper we present how our preliminary theoretical framework of intervening against abuse in health care developed and was revised during this intervention. During and after the intervention, five important lessons were learned and incorporated in our present theoretical framework. First, a Forum Play intervention may break the silence culture that surrounds abuse in health care. Second, organizing staff training in groups was essential and transformed abuse from being an individual problem inflicting shame into a collective responsibility. Third, initial theoretical concepts "moral resources" and "the vicious violence triangle" proved valuable and became useful pedagogical tools during the intervention. Four, the intervention can be understood as having strengthened staffs moral resources. Five, regret appeared to be an underexplored resource in medical training and clinical work. The occurrence of abuse in health care is a complex phenomenon and the research area is in need of theoretical understanding. We hope this paper can inspire others to further develop theories and interventions in order to counteract abuse in health care.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2016
Keywords
Sweden; Abuse in health care; Forum play; Silence; Shame; Regret; Health care intervention; Professional education; Moral learning
National Category
Clinical Medicine Other Social Sciences
Identifiers
urn:nbn:se:liu:diva-126252 (URN)10.1186/s12909-016-0595-3 (DOI)000371126800004 ()26922381 (PubMedID)
Note

Funding Agencies|Swedish Research Council [2006-2503, 2009-2380, 2011-2478, 2014-2749]

Available from: 2016-03-21 Created: 2016-03-21 Last updated: 2018-11-15
Nieminen, K., Andersson, G., Wijma, B., Ryding, E.-L. & Wijma, K. (2016). Treatment of nulliparous women with severe fear of childbirth via the Internet: a feasibility study. Journal of Psychosomatic Obstetrics and Gynaecology, 37(2), 37-43
Open this publication in new window or tab >>Treatment of nulliparous women with severe fear of childbirth via the Internet: a feasibility study
Show others...
2016 (English)In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 37, no 2, p. 37-43Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of the present study was to test the feasibility of Internet interventions among nulliparous women suffering from severe fear of childbirth (FOC) by means of an Internet-delivered therapist-supported self-help program based on cognitive behavioral therapy (ICBT).

Design: Prospective, longitudinal cohort study.Setting: A feasibility study of an ICBT program for the treatment of severe FOC in pregnant women.Sample: Twenty-eight Swedish-speaking nulliparous women with severe FOC recruited via a project home page from January 2012 to December 2013.

Methods: The main components of the ICBT program for the treatment of severe FOC comprised psycho-education, breathing retraining, cognitive restructuring, imaginary exposure, in vivo exposure and relapse prevention. The study participants were anonymously self-recruited over the Internet, interviewed by telephone and then enrolled. All participants were offered 8 weeks of treatment via the Internet. Participants reported their homework weekly, submitted measurements of their fear and received feedback from a therapist via a secure online contact management system.

Main outcome measures: Level of FOC measured with the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ A) during screening at enrollment and weekly during the treatment (W-DEQ version A), and after the delivery (W-DEQ version B).

Results: A statistically significant (p < 0.0005) decrease of FOC [W-DEQ sum score decreased pre to post-therapy, with a large effect size (Cohen’s d = 0.95)].Conclusions: The results of this feasibility study suggest that ICBT has potential in the treatment of severe FOC during pregnancy in motivated nulliparous women. The results need to be confirmed by randomized controlled studies.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
National Category
Clinical Medicine Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-126491 (URN)10.3109/0167482X.2016.1140143 (DOI)000372410100001 ()26918752 (PubMedID)
Note

Funding agencies: Swedish Research Council for Health, Working Life and Welfare (FORTE); Medical Research Council of Southeast Sweden (FORSS); County Council in Ostergotland (LIO)

Available from: 2016-03-29 Created: 2016-03-29 Last updated: 2018-11-15Bibliographically approved
Brüggemann, J., Swahnberg, K. & Wijma, B. (2015). A first online intervention to increase patients perceived ability to act in situations of abuse in health care: reports of a Swedish pre-post study. BMC Medical Ethics, 16(35)
Open this publication in new window or tab >>A first online intervention to increase patients perceived ability to act in situations of abuse in health care: reports of a Swedish pre-post study
2015 (English)In: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 16, no 35Article in journal (Refereed) Published
Abstract [en]

Background: Efforts to counteract abuse in health care, defined as patient-experienced abuse, have mainly focused on interventions among caregivers. This study is the first to test an online intervention focusing on how patients can counteract such abuse. The intervention aimed at increasing patients intention and perceived ability to act in future situations where they risk experiencing abuse. Methods: Participants were recruited through a nephrology clinic in Sweden. The intervention consisted of an online program that aimed to stimulate patients to think of possible actions in situations in which they risk experiencing abuse. The program comprised stories and exercises in text and comic form. The participants filled out a questionnaire immediately before and after going through the program, as well as during follow-up four to eight weeks later. Results: Forty-eight patients (39 %) participated in the study and spent, on average, 41 min responding to questions and going through the program. Both men and women, of various ages and educational backgrounds, participated. An increase in participants self-reported ability to identify opportunities to act in a given situation was seen immediately afterwards, as well as during follow up. Conclusion: The current study suggests that it is feasible and most likely useful to a variety of patients to work with the provided material that has the aim of counteracting abuse in health care. It would be of interest to further develop ways of using comics and to test similar interventions in other health care settings.

Place, publisher, year, edition, pages
BioMed Central, 2015
Keywords
Abuse in health care; Patient intervention; Online intervention; Patient empowerment; Comics
National Category
Other Social Sciences Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-121147 (URN)10.1186/s12910-015-0027-7 (DOI)000359415300001 ()26003674 (PubMedID)
Note

Funding Agencies|Swedish Research Council [2011-2478]

Available from: 2015-09-08 Created: 2015-09-08 Last updated: 2018-11-15
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-2902-7077

Search in DiVA

Show all publications