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From perpetrator to victim in a violent situation in institutional care for elderly persons: exploring a narrative from one involved care provider.
Umeå University, Faculty of Medicine, Omvårdnad.
Umeå University, Faculty of Medicine, Omvårdnad.ORCID iD: 0000-0001-5994-4012
2006 (English)In: Nursing Inquiry, ISSN 1320-7881, Vol. 13, no 3, 194-202 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2006. Vol. 13, no 3, 194-202 p.
Keyword [en]
Aged, Aged; 80 and over, Attitude of Health Personnel, Attitude to Health, Elder Abuse/*psychology, Female, Frail Elderly/*psychology, Freedom, Humans, Institutionalization, Middle Aged, Models; Psychological, Narration, Nurse-Patient Relations, Nurses' Aides/*psychology, Nursing Methodology Research, Patient Rights, Power (Psychology), Psychological Theory, Questionnaires, Restraint; Physical/psychology, Self Concept, Semantics, Sweden
URN: urn:nbn:se:umu:diva-6778DOI: doi:10.1111/j.1440-1800.2006.00321.xPubMedID: 16918787OAI: diva2:146448
Available from: 2007-12-18 Created: 2007-12-18 Last updated: 2016-02-01Bibliographically approved
In thesis
1. Våld i särskilda boenden för äldre: språk och sociala interaktioner
Open this publication in new window or tab >>Våld i särskilda boenden för äldre: språk och sociala interaktioner
2008 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The present thesis aims to study the relationship between the violence that occurs in institutional care for older people and the language employed when this violence and the involved parties are talked and narrated. The thesis has been guided by social constructionism, and violence, victims and perpetrators have been considered as social phenomena constructed in discursive processes.

Narrative interviews were conducted with 57 care providers who had been involved in social interactions in which violence occurred. The thesis comprises four studies. Study I is a qualitative description of the interactions. In study II, narrative analysis and positioning theory were used to explore the involved parties’ positions. Discourse analysis was employed to investigate discursively created identities (Study III), discursive constructions and how problems related to violence are framed (Study IV).

When the care providers described the interactions, they talked about mutual misunderstandings, mutual invasions of personal space and an acceptance of violence in their work. It seemed more reasonable to consider the involved parties as both victims and perpetrators as opposed to one party being exposed and the other perpetrating the violence (I). When the positions of victim and perpetrator were questioned in one care provider’s narrative, they appeared to alter from perpetrator to victim to protector throughout the account by use of available discourses. The way of narrating, taking up or resisting the positions offered by the available discourses made it possible to create a preferred identity (II). These discursively created identities can be viewed as a way of defining an undesirable situation, thereby legitimizing the actions taken. The various identities led to consequences and effects such as loss of autonomy, the use of force, humiliation and exclusion. The construction of identities was connected to various beliefs about older persons (III). Beliefs define what actions are possible and legitimate in a certain context as well as forming the basis for the articulation of problems, thus studying such expressions made it possible to explore beliefs. The articulated problems were viewed as a way to create boundaries, indicating certain possible and relevant solutions. When the care providers talked about the interactions, they presented them as being due to a difficult and unavoidable problem related to the illness, caring for the body, competence and profession as well as social order (IV).

The discursive struggle, competence, power, powerlessness, resistance, identity constructions, justification and quality of care are reflected upon and discussed. The analysis of the care providers’ narratives has made it possible to disclose how discourses concur and compete in order to give meaning to concrete social interactions involving violence. It has also been possible to show how to describe, understand and resist as well as to legitimize and justify the actions performed in relation to such interactions. The narratives opened up possibilities to study practices that are talked about as natural. The things that the care providers narrated about have been regarded as manifestations of discourses. Discourses produce certain versions of the interactions, victims and perpetrators, but it must be borne in mind that these are just a few among many possible versions, which are constantly changing.

Place, publisher, year, edition, pages
Umeå: Omvårdnad, 2008. 75 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1218
omvårdnad, våld, äldre, särskilda boenden, diskursanalys
National Category
urn:nbn:se:umu:diva-1934 (URN)978-91-7264-664-3 (ISBN)
Public defence
2008-12-12, Aulan, Vårdvetarhuset, Institutionen för omvårdnad, Umeå universitet, Umeå, 13:00 (English)
Available from: 2008-11-24 Created: 2008-11-24 Last updated: 2011-04-08Bibliographically approved

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