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Gendered communicative construction of patients in consultation settings
Jönköping University, School of Education and Communication, HLK, Lifelong learning/Encell.
Jönköping University, School of Education and Communication, HLK, Lifelong learning/Encell.
Gothenburg Research Institute, School of Business, Economics and Law, University of Gothenburg, Gothenburg, Sweden.
Karolinska Institute/Sofiahemmet University, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
2014 (English)In: Women & health, ISSN 0363-0242, E-ISSN 1541-0331, Vol. 54, no 6, 513-529 p.Article in journal (Refereed) Published
Abstract [en]

This study aimed to explore the communication in consultations between patients and health care staff from a gender perspective. We used 23 tape-recorded consultations between patients with Atrial Fibrillation and 5 nurses and 5 physicians at cardiac outpatient clinics at 6 different hospitals in southern Sweden during autumn 2009 to explore the verbal gendered constructions of patients. Through critical discourse analysis, we revealed that the male patients tended to describe their ailments with performance-oriented statements, whereas the female patients usually used emotional-oriented statements. The staff downplayed the male patients' questions and statements, while they acknowledged concern toward the female patients. Both the patients and the staff made conclusions according to a mutual construction. Male patients were constructed as competent, and female patients as fragile through gender-stereotypical communication. Open-ended statements and questions enabled consultations to be less limited by gender stereotypes.

Place, publisher, year, edition, pages
2014. Vol. 54, no 6, 513-529 p.
Keyword [en]
communication, consultations, critical discourse analysis, gender equity
National Category
URN: urn:nbn:se:hj:diva-24334DOI: 10.1080/03630242.2014.903551ISI: 000340402700003PubMedID: 24964371OAI: diva2:737685
Available from: 2014-08-13 Created: 2014-08-13 Last updated: 2016-09-21Bibliographically approved
In thesis
1. The production and maintenance of inequalities in health care: A communicative perspective
Open this publication in new window or tab >>The production and maintenance of inequalities in health care: A communicative perspective
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The Swedish health care system does not offer care on equal terms for all its end-users. Discrimination toward patients can take the form substandard communication toward women or foreign born patients. Discrimination is also embedded in the organizational context. Health care is under pressure to increase efficiency and quality of care at the same time. There is a risk that demands for equality will be pushed aside. This thesis aims to contribute to our understanding of how discrimination is expressed in interpersonal- and organizational communication within health care, and highlight educational implications for health care practices. This thesis is comprised of three empirical studies and one conceptual study. In the first study, critical discourse analysis (CDA) is used to categorize gender patterns in communication between health care workers and patients, and finds that both patients and health care workers reproduced the gender order. Open questions created a setting less prone to be limited by gender stereotypes. In the second study, CDA is used and complemented with Linell’s dialogic perspective in order to explore whether patients who were native speakers of Swedish were constructed differently than those who were not, in patient-physician consultations. Findings indicated that the non-native speakers actually were model, participative patients according to patient-centered care. Notwithstanding this they were met by argumentation, whereas the more amenable native patients were met by accommodating responses. In the third study, qualitative content analysis is used to analyze how health care workers talked about patients in their absence. The results revealed that communication about patients who were perceived as not acting according to socially accepted gender norms contained negative and disparaging statements. The final study focused on Clinical Microsystems, a New Public Management-based model for multi-professional collaboration and improvement of health care delivery. Drawing on theories of New Public Management, gender, and organizational control, this study argues that the construction of innovative and flexible health care workers risks reproducing the gender order. The thesis concludes that gender and ethnic stereotypes are reproduced in health care communication, and that an efficiency-inspired organizational and institutional discourse may be an impediment to equal care. This calls for focus on learning about communication for prospective and existing health care workers in a multicultural health care context.

Place, publisher, year, edition, pages
Jönköping: School of Education and Communication, Jönköping University, 2014. 179 p.
Doktorsavhandlingar från Högskolan för lärande och kommunikation, ISSN 1652-7933 ; 26
communication, gender, ethnicity, health care, organization, critical discourse analysis, social constructionism, social positions, qualitative content analysis
National Category
urn:nbn:se:hj:diva-24380 (URN)978-91-628-9074-2 (tryckt) (ISBN)978-91-628-9076-6 (digitalt) (ISBN)
Public defence
2014-09-12, Hb116, Högskolan för lärande och kommunikation, Jönköping, 13:15 (Swedish)
Available from: 2014-08-20 Created: 2014-08-20 Last updated: 2014-08-21Bibliographically approved

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