| 1. |
- Adams, Mary, et al.
(författare)
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‘It’s sometimes hard to tell what patients are playing at’ : How healthcare professionals make sense of why patients and families complain about care
- 2018
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Ingår i: Health. - : Sage Publications. - 1363-4593 .- 1461-7196. ; 22:6, s. 603-623
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Tidskriftsartikel (refereegranskat)abstract
- This article draws from sociological and socio-legal studies of dispute between patients and doctors to examine how healthcare professionals made sense of patients’ complaints about healthcare. We analyse 41 discursive interviews with professional healthcare staff working in eight different English National Health Service settings to explore how they made sense of events of complaint and of patients’ (including families’) motives for complaining. We find that for our interviewees, events of patients’ complaining about care were perceived as a breach in fundamental relationships involving patients’ trust or patients’ recognition of their work efforts. We find that interviewees rationalised patients’ motives for complaining in ways that marginalised the content of their concerns. Complaints were most often discussed as coming from patients who were inexpert, distressed or advantage-seeking; accordingly, care professionals hearing their concerns about care positioned themselves as informed decision-makers, empathic listeners or service gate-keepers. We find differences in our interviewees’ rationalisation of patients’ complaining about care to be related to local service contingences rather than to fixed professional differences. We note that it was rare for interviewees to describe complaints raised by patients as grounds for improving the quality of care. Our findings indicate that recent health policy directives promoting a view of complaints as learning opportunities from critical patient/consumers must account for sociological factors that inform both how the agency of patients is envisaged and how professionalism exercised contemporary healthcare work.
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| 2. |
- Annandale, E, et al.
(författare)
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Constructing the "gender-specific body" : a critical discourse analysis of publications in the field of gender-specific medicine
- 2011
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Ingår i: Health. - London : Sage publicationd ltd. ; 15:6, s. 571-587
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Tidskriftsartikel (refereegranskat)abstract
- Gender-specific medicine, a new and increasingly influential ethos within medical research and practice, has received little critical attention to date. The objective of this article is to critically examine the attributes of gender-specific medicine as imparted by its advocates. Through a critical discourse analysis of its two leading academic journals, we identify five interrelated discourses: of male/female difference; of hegemonic biology; of men's disadvantages; of biological and social reductionism; and of the fragmented body. Together these comprise a master discourse of the 'gender-specific body'. The discourse of the 'gender-specific body' is discussed in relation to the current neoliberal political agenda which frames healthcare as a market good and locates health and illness in individual bodies rather than in the wider social arrangements of society. We argue that the 'gender-specific body' threatens not only to turn back the clock to a vision of the biological body as fixed and determinate, but to extend this ever deeper into the social imagination. Lost in the process is any meaningful sense of the human body as a relatively open system which develops in interaction with its social world. We propose that, as it gains momentum, the 'gender-specific body' is likely progressively to circumscribe our thinking about the health of women and men in potentially problematic ways.
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| 3. |
- Antelius, Eleonor
(författare)
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Whose body is it anyway? Verbalization, embodiment, and the creation of narratives
- 2009
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Ingår i: Health. - : SAGE Publications. - 1363-4593 .- 1461-7196. ; 13:3, s. 361-379
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Tidskriftsartikel (refereegranskat)abstract
- This article examines the creation of narratives between people with severe disabilities and the personnel working with them. It shows that although a co-created narrative of what it means to be severely disabled (the story of dependence) seems to prevail, another narrative (the story of autonomy) is also told, where the story of dependence is rejected by the person with disabilities. However, this story of autonomy only becomes clear if we recognize three central claims: (1) there is a connection between where the physical body of the person with disabilities is positioned in space and what he or she is allowed or able to be and do; (2) since the body is a communicative tool, the moving of the body could be interpreted as a narrative, told through the embodiment of space; and (3) the embodied story can challenge existing social structures. The article highlights the inherent struggle for power within narrations and how the creation of alternative narratives can contest existing social structures.
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| 4. |
- Bergman, Karolin, 1979-, et al.
(författare)
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'Writing nutritionistically' : A critical discourse analysis of lay people´s digital correspondence with the Swedish Food Agency
- 2022
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Ingår i: Health. - : Sage Publications. - 1363-4593 .- 1461-7196. ; 26:5, s. 554-570
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Tidskriftsartikel (refereegranskat)abstract
- This article analyzes lay people’s use of nutritionistic discourse in written correspondence with the Swedish Food Agency, an authority responsible for dietary advice. Examining 60 food related written digital messages, we apply a critical discourse analysis to parse the terms and grammar people use when constructing “food” in scientific terms. Findings show that message writers place nutrients at the discursive center and frequently use terms that indicate preciseness, such as numbers and amounts, reinforced by modality (auxiliary verbs) and transitivity (nominalizations). Messages therefore emphasize the what, but not the how, of eating, implying a focus on food as subject to regulation and control. As such, eating is discursively reduced to an act of ingesting nutrients that can be decontextualized and managed in isolation – as entities to increase or avoid separately. These discursive features preclude the conceptualization of food choice and eating as subjective experiences of feelings, taste, and tradition.
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| 5. |
- Bradby, Hannah, 1966-
(författare)
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International medical migration : A critical conceptual review of the global movements of doctors and nurses
- 2014
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Ingår i: Health. - London : Sage Publications. - 1363-4593 .- 1461-7196. ; 18:6, s. 580-596
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Tidskriftsartikel (refereegranskat)abstract
- This paper critically appraises the discourse around international medical migration at the turn of the 21st century. A critical narrative review of a range of English-language sources, including grey literature, books and research reports, traces the development and spread of specific causative models. The attribution of causative relations between the movement of skilled medical workers, the provision of health care and population health outcomes illustrates how the global reach of biomedicine has to be understood in the context of local conditions. The need to understand migration as an aspect of uneven global development, rather than a delimited issue of manpower services management, is illustrated with reference to debates about ‘brain drain’ of Africa’s health-care professionals, task-shifting and the crisis in health-care human resources. The widespread presumed cause of shortages of skilled health-care staff in sub-Saharan Africa was overdetermined by a compelling narrative of rich countries stealing poor countries’ trained health-care professionals. This narrative promotes medical professional interests and ignores historical patterns of underinvestment in health-care systems and structures. Sociological theories of medicalization suggest that the international marketization of medical recruitment is a key site where the uneven global development of capital is at work. A radical reconfiguration of medical staffing along the lines of ‘task-shifting’ in rich and poor countries’ health-care systems alike offers one means of thinking about global equity in access to quality care.
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| 6. |
- Bradby, Hannah, 1966-, et al.
(författare)
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Visibility, resilience, vulnerability in young migrants
- 2019
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Ingår i: Health. - : SAGE Publications. - 1363-4593 .- 1461-7196. ; 23:5, s. 533-550
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Tidskriftsartikel (refereegranskat)abstract
- Young unaccompanied asylum seekers have been portrayed as vulnerable, resilient or both. Those granted residency in Europe are offered support by health and social care systems, but once they leave the care system to make independent lives, what part can these services play? Our review of research with migrants who have been in care in Sweden and the United Kingdom found evidence of unmet need, but little research describing their own views of services. The limited published evidence, supplemented by interviews with care leavers in a UK inner city, suggests that in defining health needs, young people emphasise housing, education, employment and friendship over clinical or preventative services. Some felt well supported while others described feeling vulnerable, anxious, angry or sad. These experiences, if linked with the insensitivity of even one professional, could lower young people’s expectations of healthcare to the extent that they avoided contact with service providers. In supporting young migrants’ resilience to meet everyday challenges, friendly support from peers, carers and professionals was important. They needed determined advocacy at key moments. The different challenges for the Swedish and UK health and welfare systems along with the resilience/vulnerability trajectory are described.
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| 7. |
- Bredström, Anna, 1972-, et al.
(författare)
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Conceptual unclarity about COVID-19 ethnic disparities in Sweden: Implications for public health policy
- 2023
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Ingår i: Health. - : SAGE Publications. - 1363-4593 .- 1461-7196. ; 27:2, s. 186-200
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic has shed light on abundant racial and ethnic health disparities in many countries around the world. In Sweden, statistics on COVID-19 mortality and morbidity from both the first and the second wave of the pandemic show that foreign-born individuals have been disproportionately affected as compared to Swedish-born individuals. However, as demonstrated in this article, key stakeholders including politicians and public authorities, mainstream media, and medical researchers do not draw on the same explanatory framework when conceptualizing the health disparity. Probing the different discourses that were articulated through oral and written accounts during the first wave, the article identifies three different frameworks of how ethnic health disparities in relation to COVID-19 were understood in Sweden: the socioeconomic framework, the cultural framework and the biological framework. In a concluding discussion, we discuss the importance of our findings for health policy and argue for continued interrogation of epidemiological knowledge production from a critical vantage point in order to successfully combat health inequalities.
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| 8. |
- Bülow, Pia, et al.
(författare)
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Patient school as a Way of Creating Meaning in a Contested Illness : The Case of CFS
- 2003
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Ingår i: Health. - : SAGE Publications. - 1363-4593 .- 1461-7196. ; 7:2, s. 227-249
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Tidskriftsartikel (refereegranskat)abstract
- Creating meaning in a situation of contested illness like Chronic Fatigue Syndrome (CFS) is an interactive process. As an example of how meaning is created, a CFS patient school organized by a hospital clinic in Sweden is discussed. This school can be seen as both a school and a medically oriented activity. The presence of different frameworks provides an opportunity to use different perspectives to understand CFS. It makes it possible for the participating men and women to regard the illness both from the outside as a social object, from the inside through personal experiences and to put the diagnosis and suffering in a larger ‘sickness’ perspective. Consequently, a number of different interpretations are brought up and used to create meaning in a situation of illness. The patients/students are thus learning discursively to manage the illness at the same time as they examine different ways to interpret their experiences through this discursive activity.
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| 9. |
- Edenroth-Cato, Fanny, 1983-
(författare)
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Motherhood and highly sensitive children in an online discussion forum
- 2020
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Ingår i: Health. - : SAGE Publications. - 1363-4593 .- 1461-7196. ; 24:4, s. 442-458
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Tidskriftsartikel (refereegranskat)abstract
- Discourse on the highly sensitive child as a mode of individual coming-into-being is transforming notions of good motherhood. Mothering a child is weighted with practical challenges, normative expectations, and moral implications, all of which can be accentuated when parenting a child that appears to differ from the average. How mothers address themselves to a highly sensitive child can reveal much about contemporary currents in family life. Through analysis of the online discussions in a Swedish forum, I examine mothers’ discourse regarding categorization of highly sensitive children, elaboration on the behaviors that constitute this category of protean individuality, and the negotiation of motherhood norms. Three themes are identified: the way in which participants established entitlement to the application of the highly sensitive child label through a process of “enlightenment” based on observing their children and scrutinizing their own childrearing practices; discourse on the “allure” of the highly sensitive child since it depicts the children as super-normal and themselves as mothers called to the custodianship of a “different child”; and finally, how the highly sensitive child label deflects the guilt and frustration linked with handling challenging behaviors, in tension with permitting the sensitive child’s self-determined development. The article suggests that the mothers’ discourse reflects the intensive mothering norms of child-centered parenting that prevail in Western countries such as Sweden. Through the lens of the highly sensitive child, however, motherhood acquires new anticipatory, considerate and susceptible norms, and strategies that constitute a highly sensitive parenting style.
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| 10. |
- Edvardsson, David, et al.
(författare)
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Ward atmospheres of horror and healing: a comparative analysis of narrative
- 2003
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Ingår i: Health. - : SAGE Publications. - 1363-4593 .- 1461-7196. ; 7:4, s. 377-396
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Tidskriftsartikel (refereegranskat)abstract
- Aspects of a social setting profoundly influence personal experience in the setting. The purpose of our study was to further understand the phenomenon of ward atmosphere through a detailed case study. One narrator describes and contrasts two ward experiences, one where she lost her mother through death, and the other where she became a mother through birthing. Using classic storytelling forms, she develops a long narrative juxtaposing the two settings: one healing, the other horrifying. Close examination of narrative structure and aesthetics of the illness narrative shows how the narrator forges a discourse about the moral life - how healing should occur. Experiences in the two settings continue to have significance in her subjectivity. The research suggests aspects of ward atmosphere that warrant further investigation.
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