Abstract
Introduction: Our study examined how person-centred care is produced in physiotherapist-led rehabilitation practice—not as a practice of individual therapists according to predefined and standardized procedures—but as contextually, socially, and governmentally situated.
Study design: This secondary analysis drew data from three qualitative studies: conducted in Denmark1 and New Zealand2. We used post-structural- and Science and Technology Studies (STS)-inspired approaches to apply (a) the concept of ‘practisings’ and (b) the concept of ‘care’ to investigate how person-centredness was produced through interacting and co-constituent forces, and how ‘care’ emerged through these relations.
Results: Our analytic framing made visible a striving for care-through-government. For this presentation, we examine constructions of practice and patient potentials, and their intersections with discourses of person-centred practice, physiotherapist ‘identity’ framings, and the institutional logics that govern healthcare. Effects of these forces on possibilities for action produced situated enactments of ‘person-centred care’—within affordances and constraints.
Discussion: Studies examining health professional practices in relation to ‘care’ or person-centredness, particularly those that apply a critical lens, will often articulate conclusions that critique professionals for an apparent lack of adherence to agreed standards and best practices. However, when their subjectivity within governmental practices is folded into an analysis, it creates a different picture of possible action. While power relations are present, they are dynamic and complex. Because of this, we need to examine the subject positions and resulting actions that are made possible at the intersection of health professions, institutions, and governmental systems. If we continually identify both the productive and the exclusionary effects of these constructs, we can see and discuss what is going on and consider mechanisms and directions of change.
Keywords: person-centred care; physiotherapy; poststructuralism; science and technology studies
Study design: This secondary analysis drew data from three qualitative studies: conducted in Denmark1 and New Zealand2. We used post-structural- and Science and Technology Studies (STS)-inspired approaches to apply (a) the concept of ‘practisings’ and (b) the concept of ‘care’ to investigate how person-centredness was produced through interacting and co-constituent forces, and how ‘care’ emerged through these relations.
Results: Our analytic framing made visible a striving for care-through-government. For this presentation, we examine constructions of practice and patient potentials, and their intersections with discourses of person-centred practice, physiotherapist ‘identity’ framings, and the institutional logics that govern healthcare. Effects of these forces on possibilities for action produced situated enactments of ‘person-centred care’—within affordances and constraints.
Discussion: Studies examining health professional practices in relation to ‘care’ or person-centredness, particularly those that apply a critical lens, will often articulate conclusions that critique professionals for an apparent lack of adherence to agreed standards and best practices. However, when their subjectivity within governmental practices is folded into an analysis, it creates a different picture of possible action. While power relations are present, they are dynamic and complex. Because of this, we need to examine the subject positions and resulting actions that are made possible at the intersection of health professions, institutions, and governmental systems. If we continually identify both the productive and the exclusionary effects of these constructs, we can see and discuss what is going on and consider mechanisms and directions of change.
Keywords: person-centred care; physiotherapy; poststructuralism; science and technology studies
| Original language | English |
|---|---|
| Publication date | 14 Feb 2024 |
| Publication status | Published - 14 Feb 2024 |
| Event | 8th international In Sickness & In Health Conference : Diagnosis • destruction • voice • assemblage - Auckland, New Zealand Duration: 13 Feb 2024 → 15 Feb 2024 Conference number: 8 |
Conference
| Conference | 8th international In Sickness & In Health Conference |
|---|---|
| Number | 8 |
| Country/Territory | New Zealand |
| City | Auckland |
| Period | 13/02/2024 → 15/02/2024 |
| Other | The themes for ISIH 2024 are diagnosis • destruction • voice • assemblage.<br/><br/>Firstly, these reflect the four main research interests of our keynote speakers. But they also represent four powerful motifs of contemporary healthcare.<br/><br/>They speak to the ways we consume healthcare and the people who use it. They shape the way healthcare technologies develop, and they drive the motives of governments, health professionals, service users, their families, and communities. And they shape the spaces taken up by healthcare in society and the networks of power at play.<br/><br/>All of these things are of interest to the In Sickness and In Health community.<br/><br/>So if your work engages with critical health questions in any of the following areas, you will find many like-minded practitioners, scholars, and students at the ISIH 2024 conference:<br/><br/>• Technologies and the body<br/>• Dominance and class, race, gender, sexuality, or other structured categories of difference<br/>• Points of resistance<br/>• Critical aspects of health professional practice<br/>• Postcolonial futures<br/>• Ethics in health care in the 21st century<br/>• Post-human conceptions of health and disease<br/>• The Global South and inequities of healthcare access<br/>• Planetary and environmental justice, health, and equity<br/>• Indigenous epistemologies<br/>• The governance of health priorities<br/>• Social justice<br/>• The arts, humanities, and health<br/>• Digital disruption and post-professional futures for healthcare<br/>• Citizenship and migration<br/>• The aesthetics of care<br/>• Discourses of healthcare<br/>• Democratisation of health care, research, and systems<br/>• Intensification of governmentality and its processes<br/>• Neoliberalism, neo-conservatism, and social injustice<br/>• Spaces and places of health production<br/>• Ideologies of risk |
