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Expressions of power and powerlessness in discharge planning: a case study of an older woman on her way home
Umeå University, Faculty of Medicine, Nursing.
Umeå University, Faculty of Medicine, Nursing.
Umeå University, Faculty of Medicine, Nursing.
2003 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, Vol. 12, no 5, 717-716 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this case study was to illuminate and describe the phenomenon of power as it appeared in a discharge planning conference. The patient was an older woman who needed long-term care as a result of stroke and heart failure. Data comprised transcriptions of a video-recorded discharge planning conference and two audio-recorded interviews focusing on the patient's experience of the discharge planning conference. The findings reveal that the content of the discharge planning conference focused on the patient's medical state and routine administrative protocols. Analysis of the participants' activities, strategies and attitudes during the conference indicate that the professional carers dominated the conversation. Analysis further reveals that the patient experienced a feeling of powerlessness and of being treated as an object. The findings are interpreted and discussed based on the concepts of 'institutional frame' and 'client's frame', derived from Agar's theory of institutional discourse.

Place, publisher, year, edition, pages
2003. Vol. 12, no 5, 717-716 p.
Keyword [en]
discharge planning, older women, power, powerlessness
URN: urn:nbn:se:umu:diva-4677DOI: 10.1046/j.1365-2702.2003.00718.xPubMedID: 12919217OAI: diva2:143882
Available from: 2005-09-19 Created: 2005-09-19Bibliographically approved
In thesis
1. Vårdplaneringsmötet.: En studie av det institutionella samtalet mellan äldre kvinnor, närstående och vårdare
Open this publication in new window or tab >>Vårdplaneringsmötet.: En studie av det institutionella samtalet mellan äldre kvinnor, närstående och vårdare
2005 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis is to describe how elderly women’s encounters with an institutionalised world of health care manifest itself in a discharge planning conference (DPC). The thesis is based on eight video recorded DPCs and follow-up interviews with the women who took part in the conferences.

The result of study I, a case study, showed that the woman’s experience of taking part in the DPC was characterised as a feeling of powerlessness. The women’s possibility to have influence on the care planning was small (Study II). Study III revealed that the participants adopted or were assigned to different roles during the DPC. As these roles collided dilemmatic situations occurred. Simultaneously the women and family members struggled to manage the institutional frame that surrounded the meeting by trying to find room within it or by challenging it. Study IV revealed that the women found themselves to be in a vulnerable situation. Their body had failed them, their future was insecure and they felt unprepared as they took part in the DPC. They felt as if they were being affiliated with the other participants in a joint project, as if they were standing outside the event or as if they were in focus for the conversation which. The last was a double edged experience: getting confirmative attention but also being exposed as dependent. Four themes characterise the care that was jointly constructed by all participants during the DPC. These themes are “Care as spirit of community and confirmation”, ”Care as alienation”, ”The incomprehensible care” and “The inflexible and betraitful care”.The result gives rise to questions about the relevance of DPCs in their present shape. Further research and developmental projects requested to achieve dicharge planning conferences that are corresponding better to official caring ideals and the patients needs.

Place, publisher, year, edition, pages
Umeå: Omvårdnad, 2005. 89 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 967
Nursing, Discharge planning, Omvårdnad
National Category
Research subject
Caring Sciences
urn:nbn:se:umu:diva-590 (URN)91-7305-883-1 (ISBN)
Public defence
2005-09-30, Aulan, Vårdvetarhuset, Institutionen för omvårdnad, 901 87Umeå, 13:00 (English)
Available from: 2005-09-19 Created: 2005-09-19 Last updated: 2009-11-11Bibliographically approved

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