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BMJ Open. 2012; 2(5): e001111.
Published online Sep 26, 2012. doi:  10.1136/bmjopen-2012-001111
PMCID: PMC3467650
Staff's perception of abuse in healthcare: a Swedish qualitative study
Katarina Swahnberg and Barbro Wijma
Division of Gender and Medicine, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
Correspondence to Dr Katarina Swahnberg; katarina.swahnberg/at/liu.se
Received March 13, 2012; Accepted August 20, 2012.
Abstract
Objective
The study aim was to apprehend staff's perception of abuse in healthcare (AHC) after an intervention based on ‘Forum Play’, and make comparisons to preintervention interviews and interviews with male and female patients. AHC can be described as a failing encounter from the patient's perspective.
Design
Qualitative interview follow-up study.
Setting
A Swedish Women's Clinic.
Participants
In a preintervention study 21 staff members were interviewed. Eligible for the follow-up study were 14 informants who had participated in the intervention. Four declined participation leaving ten informants for this study.
Intervention
During January 2008–January 2009, all staff members (N=136) were invited to participate in Forum Play workshops. Seventy-four participants took part in at least 1 of the 17 half-day workshops.
Primary outcome measures
Staffs perception of AHC.
Results
The core category, ‘a summoning stone in the shoe’, was constructed of five categories: ‘Dehumanising the patient’, ‘Unacceptable: you are bound to act!’, ‘Ubiquitous’, ‘Unintentional’ and ‘Relative’. Forum Play had demonstrated possibilities to act even in seemingly ‘impossible’ situations, and that the taboo status of AHC was altered at the clinic. When our results were compared to those in the preintervention study, we found an increased awareness about AHC, more concrete examples of AHC, a stronger empathy for patients, and fewer explanations, justifications and trivialisations of AHC.
Conclusion
In this follow-up study staff's perception of AHC was closer to the patient's perspective. Compared to the preintervention interviews staff showed a greater willingness not only to acknowledge AHC, but also to take on a responsibility to act in order to stop or prevent AHC. Explanations for this stance could be that Forum Play had showed staff that there were possibilities to act, and that the taboo status of AHC had been broken at the clinic.
Keywords: Education & Training (see Medical Education & Training), Ethics (see Medical Ethics), Qualitative Research
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