title: What contributes to abuse in health care? A grounded theory of female patients' stories.
abstract: BACKGROUND
  In Sweden, 20% of female patients have reported lifetime experiences of abuse in any health care setting. Corresponding prevalence among male patients is estimated to be 8%. Many patients report that they currently suffer from these experiences. Few empirical studies have been conducted to understand what contributes to the occurrence of abuse in health care.
  
  
  OBJECTIVE
  To understand what factors contribute to female patients' experiences of abuse in health care.
  
  
  METHODS
  Constructivist grounded theory approach.
  
  
  METHODS
  Women's clinic at a county hospital in the south of Sweden.
  
  
  METHODS
  Twelve female patients who all had reported experiences of abuse in health care in an earlier questionnaire study.
  
  
  METHODS
  In-depth interviews.
  
  
  RESULTS
  The analysis resulted in the core category, the patient loses power struggles, building on four categories: the patient's vulnerability, the patient's competence, staff's use of domination techniques, and structural limitations. Participants described how their sensitivity and dependency could make them vulnerable to staff's domination techniques. The participants' claim for power and the protection of their autonomy, through their competence as patients, could catalyze power struggles.
  
  
  CONCLUSIONS
  Central to the participants' stories was that their experiences of abuse in health care were preceded by lost power struggles, mainly through staff's use of domination techniques. For staff it could be important to become aware of the existence and consequences of such domination techniques. The results indicate a need for a clinical climate in which patients are allowed to use their competence.
authors.affiliation: Linköping University, Faculty of Health Sciences, Gender and Medicine, SE-581 83, Linköping, Sweden. jelmer.bruggemann@liu.se
authors.forename: A Jelmer
authors.initials: AJ
authors.lastname: Brüggemann
authors.forename: Katarina
authors.initials: K
authors.lastname: Swahnberg
mesh_terms: D005260:Female; D006801:Humans; D011369:Professional-Patient Relations; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013548:Sweden; D014932:Women's Health Services