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Illuminating the gendered nature of health-promoting activities among nursing staff in forensic psychiatric care
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0001-5670-6908
The Swedish Red Cross University College, Flemingsberg Stockholm, Sweden.
2019 (English)In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, article id e12332Article in journal (Refereed) Epub ahead of print
Abstract [en]

When people in Sweden are sentenced and handed over to forensic psychiatric care (FPC), the authorities have overall responsibility for their health recovery. How nursing staff construct gender through their relations in this context affects their understanding of health promotion activities. The aim of this study was to illuminate, using a gender perspective, the understanding of nursing staff with respect to health promotion activities for patients. Four focus group interviews were conducted with nursing staff in two FPC clinics in Sweden. The study has a qualitative inductive design with an ethnographic approach. This study sheds new light on FPC in which its dual goals of protecting society and providing care are viewed from a gender perspective. When relationships within the nursing staff group and the nurse–patient relationship are justified by the goal of protecting society, gender becomes invisible. This might cause patients' individual conditions and needs for certain types of activities to go unnoticed. One of the implications of ignoring gender relations in nursing staff health promotion activities is that it risks contributing to gender stereotypes which impact on the nurse–patient relationship and the quality of care.

Place, publisher, year, edition, pages
Blackwell Publishing Ltd , 2019. article id e12332
Keywords [en]
focus group interviews, forensic psychiatric care, gender, health-promoting activities, nursing staff, adult, article, female, health promotion, human, interview, male, mental health care, nurse patient relationship, stereotypy, Sweden
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-46707DOI: 10.1111/nin.12332ISI: 503365000001PubMedID: 31854012Scopus ID: 2-s2.0-85077026178OAI: oai:DiVA.org:mdh-46707DiVA, id: diva2:1385455
Available from: 2020-01-14 Created: 2020-01-14 Last updated: 2020-03-16Bibliographically approved
In thesis
1. Vårdarnas patientnära arbete inom rättspsykiatrisk vård: det komplexa samspelet mellan samhällsskydd och vårdande utifrån genusperspektiv
Open this publication in new window or tab >>Vårdarnas patientnära arbete inom rättspsykiatrisk vård: det komplexa samspelet mellan samhällsskydd och vårdande utifrån genusperspektiv
2020 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background Forensic psychiatric care (FPC) is characterized by the complex interaction between mental illness and the crime the patient has committed. For patient care, this means that male nursing staff are often assigned a superior position within FPC, while female nursing staff are presented as especially suited for providing the care itself. The overall aim was, from a gender perspective, to map patterns of patient care within FPC. Method: The dissertation is based on four qualitative studies. One is a literature study, while the other three adopt an ethnographic approach. The data in Study I consists of peer-reviewed articles that were theoretically analyzed. The Data in Study II consists of interviews that were analyzed by discourse psychology. The data in Study III consists of four focus groups. A thematic analysis was performed on the data. In Study IV, the data consists of observations, field notes and interviews, which were analyzed by thematic analysis. Results: Study I show that health in FPC can be perceived as a complex interplay between protecting society, constructions of masculinity and the physical body. Study II illustrates that nursing staff’s talk about patient care should not be separated from structures framing FPC. Study III illuminates that when nursing staff ignore gender in FPC, this may render invisible patients’ unique health needs linked to their life situation. Study IV reveals a pattern in how protecting society is constructed as superior to providing care. This result can be linked to a gender order that results in unequal conditions for nursing staff’s patient care. Conclusion: The results show how the dual goals are intertwined with nursing staff’s gender values, which affect the nurse-patient relationship and health-promoting activities. By constructing protection of society as having higher priority than care, a gender order is maintained that justifies categorization of patients. Failure to pay attention to the interaction between the dual goals and gender may lead to nursing staff overlooking patients’ individual situations and health needs.

Place, publisher, year, edition, pages
Västerås: Mälardalen University, 2020
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 309
Keywords
Ethnography, forensic psychiatric care, gender, health, health-promoting activities, patient care, nurse-patient relationship
National Category
Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-46709 (URN)978-91-7485-458-9 (ISBN)
Public defence
2020-03-06, Gamma, Mälardalens högskola, Västerås, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2020-01-15 Created: 2020-01-14 Last updated: 2020-01-28Bibliographically approved

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Kumpula, EsaGustafsson, Lena-Karin

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