| 1. |
- Eivergård, Kristina, et al.
(författare)
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Disciplined into Good Conduct : Gender Constructions of Users in a Municipal Psychiatric Context in Sweden
- 2021
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 30:15-16, s. 2258-2269
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To examine how gendered discursive norms and notions of masculinity and femininity were (re)produced in professional conversations about users of long-term municipality psychiatric care. Focus is on the staff's use of language in relation to gender constructions.BACKGROUND: Psychiatric care in Sweden has undergone tremendous changes in recent decades from custodian care in large hospitals to a care mainly located in a municipal context. People who need psychiatric care services often live in supporting houses. In municipal psychiatric care, staff conduct weekly professional meetings to discuss daily matters and the users' needs. Official reports of the Swedish government have shown that staff in municipal care services treat disabled women and men differently. Studies exploring gender in relation to users of long-term psychiatric care in municipalities have problematised the care and how staff, through language, construct users' gender. Therefore, language used by staff is a central tool for ascribing different gender identities of users.DESIGN: The content of speech derived from audio recordings were analysed using Foucauldian discursive analysis. The COREQ checklist was used in this article.RESULTS: The results indicate that by relying on gender discourses, staff create a conditional care related to how the users should demonstrate good conduct. In line with that, an overall discourse was created: Disciplined into good conduct. It was underpinned by three discourses inherent therein: The unreliable drinker and the confession, Threatened dignity, Doing different femininities.CONCLUSION: The community psychiatric context generates a discourse of conduct in which staff, via spoken language (re)produces gendered patterns and power imbalances as a means to manage daily work routines. Such practices of care, in which constant, nearly panoptic, control despite the intention to promote autonomy, urgently require problematising current definitions of good conduct and normality.
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| 2. |
- Eivergård, Kristina
(författare)
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Språkets makt : en studie av vårdpersonals tal om psykiatriska patienter och brukare
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this dissertation was to critically examine, based on three selected psychiatric care environments, how healthcare staff talk about patients and users with a focus on how notions of gender are produced and reproduced during rounds and in reportings.Reportings and rounds are daily activities in almost all healthcare practices. It takes place three to four times a day and is ideally aimed at creating continuity and alignment in the care. In psychiatric contexts, the reportings and rounds constitute important tools in assessing which approach and treatment are most appropriate. Studies on verbal reporting have mainly been carried out in somatic care and have been focused on the reportings’ content, type, cost and time required. Research also suggests that healthcare staff find it difficult to move away from a strictly medical perspective and that reporting and rounds take place in a ritualized way where the staff are socialized into what is valid information to pass on. The reportings can also serve as a way for healthcare staff to support each other in their work. The research also applies in psychiatric care contexts where different power structures also become apparent in the use of language. However, how psychiatric care staff talk about patients and users in reportings and on rounds based from a gender perspective has not been studied to any great extent.The dissertation is based on four sub-studies, all with qualitative research design. The empirical material in all sub-studies consisted of sound recordings from rounds and reports in three different psychiatric care contexts; general psychiatry, forensic psychiatry and municipal psychiatry. In sub-study I and II, content analysis was employed and in sub-study III and IV, discourse analysis was employed. Sub-study I showed how the healthcare staff used everyday words and concepts in both reports as in the rounds. The words and concepts formed the basis for assessing the patient's behaviour and mental condition and decisions about nursing and treatment. Sub-study II showed that the language discourse of the healthcare staff reproduced a gender order in which the female patients were expected to behave according to feminine norms in order to be acceptable as women and, as patients. In sub-study III, the statements studied showed a family oriented caring practice and how power techniques in terms of discursive norms around masculinity contributed to the subordination of men cared for in. The results also revealed how the healthcare staff reproduced a heteronormativity gender order through the language used. In sub-study IV, the statements showed a discourse of care where various techniques of power such as intimacy and confession were used to persuade the users to behave according to feminine or masculine norms. The statements also showed a heteronormative and heterosexual order in which the paradox between the need for support and maintaining one's dignity was clarified.The conclusion of the sub-studies together was that the reports and rounds was a scene for which everyday words and concepts were used to describe and assess patients and users. These everyday words and concepts reproduced power orders in which different disciplining power techniques were displayed. The language also reproduced a heteronormative gender order in which notions of femininity and masculinity participated in the assessments of patients and users´ mental states. Because the patients were not involved in the conversations about themselves, healthcare staff were given the possibility to describe and position the patients and users in ways that they themselves were not aware of. In order to create opportunities to break with stereotypical gender patterns as well as patterns of dominance and subordination in psychiatric nursing and care, students, as well as healthcare staff, should work with awareness and critical reflection on discursive norms and how language constructs the patient and user.
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| 3. |
- Eivergård, Kristina, et al.
(författare)
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Subordinated masculinities : A critical inquiry into the reproduction of gender norms in forensic psychiatric care.
- 2020
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 29:21-22, s. 4227-4238
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To examine how gendered discursive norms and notions of masculinity are (re)produced in professional conversations about men cared for as patients in forensic psychiatric care, with a particular focus on the centrality of language and gender.BACKGROUND: During verbal handovers and ward rounds, care staff converse to share information about patients and make decisions about their mental status. Spoken language is thus a pivotal tool in verbal handovers and ward rounds, one able to reproduce discourses and gender norms.DESIGN: Qualitative. Data collected from audio recordings of verbal handovers and ward rounds in a forensic psychiatric clinic were subjected to discourse analysis. The COREQ checklist was used.RESULTS: While discussing patients, staff subordinated them by reproducing a discourse typical of heteronormative, family-oriented care. The overarching discourse, which we labelled subordinated masculinities, was supported by three other discourses: being unable to take responsibility, being drug-addicted and performing masculinity. Such discourse was identified as a disciplining practice that subordinate's patients as a means to maintain order, rules and gender norms.CONCLUSION: The study reveals a caring practice that position male patients as children or disabled individuals and, in that way, as subordinated other men within a context were staff reproduces a heteronormative family structured care. The process also reveals a practice were downplaying aggressive and deviant behaviour could disempower and reduce patients´ responsibility for personal actions and their possibilities to participate in their care. That finding especially seems to contradict previous findings that patients want to be able to act responsibly and, to that end, want care staff to help them.RELEVANCE TO CLINICAL PRACTICE: Nurses need to deepen their understanding of how language (re)produces discursive norms of gender and masculinity in forensic care and that process's consequences for such care.
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| 4. |
- Eivergård, Kristina, et al.
(författare)
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Subordinated masculinities : a critical inquiry into reproduction of gender norms in handovers and rounds in a forensic psychiatric care
- 2020
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 29:21-22, s. 4227-4238
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To examine how gendered discursive norms and notions of masculinity are (re)produced in professional conversations about men cared for as patients in forensic psychiatric care, with a particular focus on the centrality of language and gender.Background: During verbal handovers and ward rounds, care staff converse to share information about patients and make decisions about their mental status. Spoken language is thus a pivotal tool in verbal handovers and ward rounds, one able to reproduce discourses and gender norms.Design: Qualitative. Data collected from audio recordings of verbal handovers and ward rounds in a forensic psychiatric clinic were subjected to discourse analysis. The COREQ checklist was used.Results: While discussing patients, staff subordinated them by reproducing a discourse typical of heteronormative, family‐oriented care. The overarching discourse, which we labelled subordinated masculinities, was supported by three other discourses: being unable to take responsibility, being drug‐addicted and performing masculinity. Such discourse was identified as a disciplining practice that subordinate's patients as a means to maintain order, rules and gender norms.Conclusion: The study reveals a caring practice that position male patients as children or disabled individuals and, in that way, as subordinated other men within a context were staff reproduces a heteronormative family structured care. The process also reveals a practice were downplaying aggressive and deviant behaviour could disempower and reduce patients' responsibility for personal actions and their possibilities to participate in their care. That finding especially seems to contradict previous findings that patients want to be able to act responsibly and, to that end, want care staff to help them.Relevance to clinical practice: Nurses need to deepen their understanding of how language (re)produces discursive norms of gender and masculinity in forensic care and that process's consequences for such care.
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| 5. |
- Eivergård, Kristina, et al.
(författare)
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The Importance of Being Acceptable - Psychiatric Staffs' Talk about Women Patients in Forensic Care
- 2019
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Ingår i: Issues in Mental Health Nursing. - : Taylor & Francis. - 0161-2840 .- 1096-4673. ; 40:2, s. 124-132
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Tidskriftsartikel (refereegranskat)abstract
- Currently, women comprise about ten percent of those sentenced to psychiatric forensic clinics in Sweden. Those who are sentenced to forensic care because of offending and violent behaviour have already taken a step away from the usually expected female behaviour. On the other hand, there are many women in forensic care who have not committed crimes, but who instead self-harm. Studies have identified a gender bias in diagnosing and care in psychiatric settings, but there are few studies conducted on women in forensic care. The present study therefore examined how the situation of women patients and female norms are expressed in the staff's talk about these women during verbal handovers and ward rounds at a forensic clinic in Sweden. The aim was to explore how psychiatric staff, in a context of verbal handovers and ward rounds, talk about women who have been committed to forensic psychiatric care, and what consequences this might have for the care of the patients. The content of speech was examined using audio recordings and a method of analysis that was inspired by thematic analysis. The analysis identified that the staff talked about the women in a way that indicates that they expected the women to follow the rules and take responsibility for their bodies in order to be regarded as acceptable patients.
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| 6. |
- Eivergård, Kristina, et al.
(författare)
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The Talk About the Psychiatric Patient
- 2016
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Ingår i: Issues in Mental Health Nursing. - : Taylor & Francis. - 0161-2840 .- 1096-4673. ; 37:10, s. 756-764
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Tidskriftsartikel (refereegranskat)abstract
- Essential to psychiatric nursing practice and care, verbal handovers and ward rounds are reporting systems for communication that shapes psychiatric staff's ability to recognize, understand, and construct patients, as well as patients’ ability to construct themselves. Given the centrality of such language in psychiatric practice, the aim of this study was to describe how psychiatric staff talk about patients in psychiatric wards, what their talk encompasses, and what consequences it might pose for patient care. Empirical data were collected from audio recordings of staff discussions of patients during nine verbal handovers and three ward rounds in six different general psychiatric wards in mid and southern Sweden. Findings showed that to describe patients’ mood, characteristics, and behavior, nurses used culturally common words and concepts related to three themes—good patients, bad patients, and to stay or be discharged—and six subthemes—looking well, looking poorly, desirable patients, undesirable patients, continuing work, and being discharged. However, since assessments of and decisions about patients’ conditions and care used everyday language and did not involve patients’ participation, opportunities for patients to participate in their own care were rare.
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