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The interplay between security and gender in forensic psychiatric care: an ethnographic study among nursing staff
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
Röda korsets högskola, Stockholm.
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0001-5670-6908
(English)In: Journal of Forensic Nursing, ISSN 1556-3693Article in journal (Refereed) Submitted
Abstract [en]

The fact that violence affects nursing staff’s ability to care for patients in Forensic Psychiatric Care (FPC) has been well documented. What has not been adequately addressed is how the interaction between security and gender affects the care given the patients. The aim was to illuminate, from a gender perspective, patterns of nursing staff´s views on security and its consequences for care in FPC. This study adopts an ethnographic approach and the data consists of field notes from participatory observations and interviews with nursing staff at two different FPC clinics in Sweden. Data was processed with thematic analysis. The results showed that when protecting society is given higher priority than care, it should not be separated from nursing staff´s values about gender.  For the female nursing staff this means that the care was linked to a mothering role, whereas male nursing staff duties were not linked to a fathering role. The latter’s focus on security created obstacles for the nurse-patient relationship, which were not experienced to the same extent by female staff. Making gender invisible in FPC creates unequal conditions for nursing staff’s tasks, which can lead to difficulties in achieving improved health for patients.

Keywords [en]
ethnography, forensic psychiatric care, gender, nursing staff, thematic analysis, security
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-46708OAI: oai:DiVA.org:mdh-46708DiVA, id: diva2:1385467
Available from: 2020-01-14 Created: 2020-01-14 Last updated: 2020-01-14Bibliographically 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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