Constructing the health care system in Greece: responsibility and powerlessness.
OBJECTIVE
Based on health care professionals' (HPs) and patients' interviews about work demands and quality of care in hospitals, the study explores the way that patients and HPs constructed their identities to describe and construct the health care system in Greece.


METHODS
This is a qualitative study using a focus group (FG) design.


METHODS
Seven FGs discussions were conducted: three FGs discussions were conducted for the assessment of job stressors (1 for doctors, 1 for nurses and 1 for residents) and four FGs discussions for the assessment of quality of care (1 for doctors, 1 for nurses, 1 for residents and 1 for patients). The sample consisted of health care professionals working in a teaching hospital in the region of Thessaloniki, Greece, and patients who had at least one experience of any kind in the same hospital. Transcripts of the FGs discussions underwent discourse analysis.


RESULTS
The results showed that both HPs and patients construct the health care system based on bipolar constructions of responsibility and powerlessness. In particular, participants use these constructions to allocate the responsibility to different levels of the health care system hierarchy or to the system per se constructing, at the same time, themselves as the 'viewers' of this system.


CONCLUSIONS
The study allowed a deeper understanding of issues related to quality of care in hospitals providing context-specific information. Identity in health care organizations was inextricably linked to power and responsibility. The need to deconstruct this responsibility/powerlessness ideology is discussed.
Aristotle University of Thessaloniki, Greece.
Vassiliki
V
Lentza
Anthony J
AJ
Montgomery
Katerina
K
Georganta
Efharis
E
Panagopoulou
D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003695:Delivery of Health Care; D017144:Focus Groups; D006115:Greece; D006784:Hospitals, Teaching; D006801:Humans; D008505:Medical Staff, Hospital; D009741:Nursing Staff, Hospital; D015279:Organizational Culture; D011209:Power, Psychological; D036301:Qualitative Research; D011787:Quality of Health Care; D012941:Social Responsibility