Mentally Pinioned: Men's Perceptions of Being Abused in Health Care
Swahnberg, Katarina, Wijma, Barbro, Hearn, Jeff, Thapar-Bjorkert, Suruchi, Bertero, Carina, International Journal of Men's Health
The aim of this article is to deepen the understanding of male patients' experiences of abuse in health care (AHC). Thirteen patients who had experienced AHC were interviewed using a Grounded Theory methodology. Three categories, "Crises of Confidence," "Ignored" and "Frustration," intersected to form the core category "Mentally Pinioned." This last category referred to patients not being able to act in accordance with their own conviction and interests. This study shows that men's experience of AHC go far beyond what earlier research had suggested, which generally limited it to disagreements and misunderstandings in health care or hospital errors. In this study, AHC was shown to have a profound impact at a deep personal level, leaving the men concerned "mentally pinioned."
Keywords: men, health care, abuse, grounded theory, patient safety
Men's experiences of abuse or victimization in the health care system remain largely under-researched and under-analyzed in the mainstream literature on violence. Several reasons can be suggested for this. First, the normative and gendered constructions of violence and victimhood have not provided an opportunity for exploring men's experiences of vulnerability (Krantz, 2002). This is tied to dominant cultural constructions of masculinity and femininity which, on the one hand, view violence against women as self-evident, but often at the same time fail to recognise men as victims in similar situations (Kimmel, 1994). Such constructions are also linked to debates that position men chiefly or solely as perpetrators of violence, thus ignoring important associations between masculinity, violence and vulnerability (Kaufman, 1993). Second, dominant cultural injunctions against men to avoid clear demonstrations of many emotions (pace anger), weakness, or having problems mean that men's narratives of violence often remain subsumed by other issues (Taylor, 2005). Third, where the literature has acknowledged gender-specific types of violence (including violence against men), it has generally done so without reference to health outcomes. In relation to the last point, it needs to be mentioned that when violence against men is acknowledged, an emphasis is often placed on women's aggression against men. We suggest that this understanding undermines the significance of violence against men by other men as well.
Research has shown that, like many women, many men experience violence in organisational contexts, for example, in various kinds of workplace (Hearn & Parkin, 2001). The main focus of most of research done in organizations has been on the experiences of professionals, workers, employees, managers and others members. Much less interest has been directed to the experiences of users, consumers, patients, clients and other recipients of services in terms of violence and abuse.
The concept of abuse in health care (AHC) in institutional settings has not been well researched, although iatrogenic illness and disease are often discussed. There are several research topics that may be related to AHC. For instance, Annandale & Hunt (1998), who studied cases that did not lead to a formal complaint, noted that patients recalled events of disagreement to a great extent and often with a fair degree of detail, and that many disagreements lacked closure. Such unsettled disagreements may lead to problems not only for the patients and their families but also for the physicians involved.
Misunderstandings between patients and physicians have been studied by (Britten, Stevenson, Barry, Barber, & Bradley, 2000). All misunderstandings in their study were associated with the fact that the patients had not actively participated in the consultation. They had not voiced their expectations and preferences, nor had they been afforded the opportunity to respond to the physician's decisions and actions. Hospital error is a related topic, but it does not usually focus on the patient's emotional response to error (McFadden, Stock, & Gowen, 2006). …