title: Staff members' negotiation of power in client engagement: analysis of practice within an Australian aged care service.
abstract: With increasing focus on client control and active client roles in aged care service provision, client engagement is highlighted as fundamental to contemporary care practice. Client engagement itself, however, is complex and is impacted by a range of issues including the relationships and power dynamics inherent in the care context. These dynamics do not simply reflect the roles that are available to or taken up by clients; just as important are the roles and positions that staff of aged care services are offered, and take up, in client engagement. This paper presents the findings of a study that explored client engagement practice within a large Australian service provider. Analysis of interview and focus group discussions addressed the ways in which staff were positioned - by both themselves and by clients - in terms of the roles that they hold within engagement practice and the power relations inherent within these. Analysis of power from the dominant policy perspective of choice and control, and the alternative perspective of an ethic of care suggests that power relations within the care context are dynamic, complex and involve on-going negotiation and regulation by clients and staff members in aged care. The use of these two contrasting perspectives reveals a more dynamic and complex understanding of power in care practice than dominant uni-dimensional approaches to critique suggest.
authors.affiliation: The University of Queensland, The University of Queensland/Blue Care Research and Practice Development Centre, 56 Sylvan Rd, Toowong, Qld 4066, Australia. Electronic address: a.petriwskyj@uq.edu.au.
authors.forename: Andrea
authors.initials: A
authors.lastname: Petriwskyj
authors.affiliation: The University of Queensland, The University of Queensland/Blue Care Research and Practice Development Centre, 56 Sylvan Rd, Toowong, Qld 4066, Australia. Electronic address: alexandra.gibson@uqconnect.edu.au.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gibson
authors.affiliation: Blue Care, 56 Sylvan Rd, Toowong, Qld 4066, Australia. Electronic address: g.webby@bluecare.org.au.
authors.forename: Glenys
authors.initials: G
authors.lastname: Webby
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001315:Australia; D005260:Female; D017144:Focus Groups / Q000379:methods; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D017008:Negotiating / Q000379:methods*; D009740:Nursing Staff / Q000941:ethics / Q000523:psychology*; D010358:Patient Participation / Q000523:psychology*; D011209:Power, Psychological; D011214:Practice, Psychological; D059039:Standard of Care / Q000941:ethics* / Q000458:organization & administration*; D055815:Young Adult
keywords: Care services; Engagement; Ethic of care; Participation; Power