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Understanding and preventing situations of abuse in health care: Navigation work in a Swedish palliative care setting
Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0002-1514-677x
Linköping University, Department of Thematic Studies, The Department of Gender Studies. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0001-7715-0478
Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.ORCID iD: 0000-0002-2902-7077
2019 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 222, p. 52-58Article in journal (Refereed) Epub ahead of print
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. Vol. 222, p. 52-58
Keywords [en]
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: urn:nbn:se:liu:diva-153753DOI: 10.1016/j.socscimed.2018.12.035OAI: oai:DiVA.org:liu-153753DiVA, id: diva2:1276646
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-11

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Brüggemann, JelmerPersson, AlmaWijma, Barbro

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Brüggemann, JelmerPersson, AlmaWijma, Barbro
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Technology and Social ChangeFaculty of Arts and SciencesDivision of Children's and Women's healthFaculty of Medicine and Health SciencesThe Department of Gender StudiesDepartment of Gynaecology and Obstetrics in Linköping
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Social Science and Medicine
Health Care Service and Management, Health Policy and Services and Health Economy

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2324252627282926 of 70
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