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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Deconstructing the Self-Other Binary in Care Networks by Unravelling Professional' Perspectives through an
Aldiene Henrieke Hengelaar1,2, Margo van Hartingsveldt3, Tineke Abma4
1Department Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam University of Applied Science, Amsterdam UMC, location VUmc, Tafelbergweg 51, PO box 2557, 1000 CN, Amsterdam, The Netherlands. a.h.hengelaar@hva.nl.
Abstract:
In many western countries informal care is conceived as the answer to the increasing care demand. Little is known how formal and informal caregivers collaborate in the context of an diverse ageing population. The aim of this study was to gain insight in how professionals' perspectives regarding the collaboration with informal carers with a migration background are framed and shaped by intersecting aspects of diversity. We used an intersectionality informed qualitative design with informal conversations (N = 12) and semi-structured interviews (N = 17) with healthcare professionals working with clients with Acquired Brain Injury. Two critical friends were involved in the analysis which was substantiated by a participatory analysis with a community of practice. We identified four interrelated themes: (a) 'The difficult Other' in which professionals reflected on carers with a migration background causing 'difficulties'; (b) 'The dependent Other' refers to professionals' realization that 'difficulties' are intensified by the context in which care takes place; (c) in 'The uncomfortable self' professionals describe how feelings of insecurities evoked by the Other are associated with an inability to act 'professionally', and; (d) 'The reflexive self' shows how some professionals reflect on their own identities and identify their blind spots in collaboration within a care network. These themes demonstrate the tensions, biases and power imbalances between carers and professionals, which may explain some of the existing health disparities perpetuated through care networks.
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