When the helper humiliates the patient: a qualitative study about unintended intimidations.
OBJECTIVE
To explore experiences of intimidating patients/clients from the perspective of the professional.


METHODS
This was a qualitative study based on memory work, a procedure whereby memories are converted into written stories. The setting was a workshop about oppression and empowerment in a rehabilitation conference. Participants were 48 health and social professionals in six groups. Thirty-seven of the participants provided their written stories. The main outcome measures were descriptions of intimidation episodes according to the level of passivity/activity in the professional responsible for the act.


RESULTS
The participants were able to recall episodes where they later realized that they had been involved in events perceived as intimidations by the patient/client. The memory stories described events that were not isolated events, but represented issues that might occur now and then. The first type of intimidation included events where the professional intimidated the patient/client by neglecting various basic needs, such as bodily functions, information, regard, time, and patience. The second type included events where the professional patronized and overruled the patient/client by pursuing the professional's agenda, ridiculing, or only partially acknowledging, the person. Remembering and presenting these events created ideas for alternative modes of action for the professionals.


CONCLUSIONS
Systems for health and social care suffer from lack of resources, time, and proximity -- issues that facilitate the occurrence of intimidation of patients/clients. Yet, the professional remains responsible for his or her moral conduct. High moral awareness and systems with a better balance between reason and emotion are needed to stop vulnerable people being subjected to disempowering practices.
Malterud
Kirsti
K
Research Unit for General Practice, Unifob Health, Bergen, Norway. kirsti.malterud@isf.uib.no
Thesen
Janecke
J
D001291:Attitude of Health Personnel; D003068:Coercion; D006282:Health Personnel / Q000523:psychology*; D006806:Human Rights; D006801:Humans; D008318:Malpractice; D009014:Morals; D028701:Patient Rights; D010361:Patients / Q000523:psychology*; D011369:Professional-Patient Relations; D012752:Shame