Developing a Tool for Increasing the Awareness about Gendered and Intersectional Processes in the Clinical Assessment of Patients: A Study of Pain Rehabilitation

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Hammarström, AnneUmeå universitet,Socialmedicin,Umeå universitet, Socialmedicin (författare)

Developing a Tool for Increasing the Awareness about Gendered and Intersectional Processes in the Clinical Assessment of Patients : A Study of Pain Rehabilitation

Artikel/kapitelEngelska2016

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2016-04-07
Public Library of Science (PLoS),2016
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:umu-119116
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-119116URI
https://doi.org/10.1371/journal.pone.0152735DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-309193URI

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Språk:engelska
Sammanfattning på:engelska

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OBJECTIVE: There is a need for tools addressing gender inequality in the everyday clinical work in health care. The aim of our paper was to develop a tool for increasing the awareness of gendered and intersectional processes in clinical assessment of patients, based on a study of pain rehabilitation.METHODS: In the overarching project named "Equal care in rehabilitation" we used multiple methods (both quantitative and qualitative) in five sub studies. With a novel approach we used Grounded Theory in order to synthesize the results from our sub studies, in order to develop the gender equality tool. The gender equality tool described and developed in this article is thus based on results from sub studies about the processes of assessment and selection of patients in pain rehabilitation. Inspired by some questions in earlier tools, we posed open ended questions and inductively searched for findings and concepts relating to gendered and social selection processes in pain rehabilitation, in each of our sub studies. Through this process, the actual gender equality tool was developed as 15 questions about the process of assessing and selecting patients to pain rehabilitation. As a more comprehensive way of understanding the tool, we performed a final step of the GT analyses. Here we synthesized the results of the tool into a comprehensive model with two dimensions in relation to several possible discrimination axes.RESULTS: The process of assessing and selecting patients was visualized as a funnel, a top down process governed by gendered attitudes, rules and structures. We found that the clinicians judged inner and outer characteristics and status of patients in a gendered and intersectional way in the process of clinical decision-making which thus can be regarded as (potentially) biased with regard to gender, socio-economic status, ethnicity and age.IMPLICATIONS: The clinical implications of our tool are that the tool can be included in the systematic routine of clinical assessment of patients for both awareness raising and as a base for avoiding gender bias in clinical decision-making. The tool could also be used in team education for health professionals as an instrument for critical reflection on gender bias.CONCLUSIONS: Thus, tools for clinical assessment can be developed from empirical studies in various clinical settings. However, such a micro-level approach must be understood from a broader societal perspective including gender relations on both the macro- and the meso-level.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Public Health, Global Health, Social Medicine and Epidemiology hsv//eng
SAMHÄLLSVETENSKAP Annan samhällsvetenskap Genusstudier hsv//swe
SOCIAL SCIENCES Other Social Sciences Gender Studies hsv//eng
folkhälsa
Public health

Biuppslag (personer, institutioner, konferenser, titlar ...)

Wiklund, MariaUmeå universitet,Socialmedicin,Fysioterapi,Stress and Health in Youth (Umeå SHY),Umeå universitet, Sjukgymnastik(Swepub:umu)maawid81 (författare)
Stålnacke, Britt-MarieUmeå universitet,Rehabiliteringsmedicin,Umeå universitet, Rehabiliteringsmedicin(Swepub:umu)brst0005 (författare)
Lehti, ArjaUmeå universitet,Professionell utveckling,Umeå universitet, Professionell utveckling(Swepub:umu)arle0001 (författare)
Haukenes, IngerDepartment of Public Mental Health, Division of Mental Health, Norwegian Institute of Public Health; Research Unit for General Practice, Uni Research Health, Kalfarveien 31, Bergen, Norway(Swepub:umu)inha0036 (författare)
Fjellman-Wiklund, AnncristineUmeå universitet,Fysioterapi,Umeå universitet, Fysioterapi(Swepub:umu)anfj0005 (författare)
Umeå universitetSocialmedicin (creator_code:org_t)

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Ingår i:PLOS ONE: Public Library of Science (PLoS)11:41932-6203

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Av författaren/redakt...: Hammarström, Ann ...; Wiklund, Maria; Stålnacke, Britt ...; Lehti, Arja; Haukenes, Inger; Fjellman-Wiklund ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Hälsovetenskap; och Folkhälsovetensk ...

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