“You just can’t cope with having a sermon thrown at you when you’re feeling awful”: How to avoid a reproduction of middle-class moral judgments when inviting marginalized citizens to a dialogue on communication with their GPs

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Abstract

The purpose of this paper is to explore how two different versions of participatory theatre give
marginalized citizens living in disadvantaged areas a very different basis for sharing experiences of being judged in the communication with their GPs.
The data was produced as part of a dialogic evaluation of two health communication interventions, initiated by the Region Zealand. The purpose of both interventions was to invite citizens to participate in a dialogue on their experiences with their GPs, initiated through two versions of participatory theatre. The interventions took place as evening events and were held in a range of disadvantaged areas during 2017, 2018 (the first version:12 events) and 2019 (the second version: 4 events). We used a range of qualitative approaches such as participant observations, focus interviews and individual interviews in order to shed light on a) how the two versions of participatory theatre was developed and b) how the invitation to have a dialogue was experienced by the citizens.

The analyses were conducted abductively moving between the data production, the field of inequality in access to health care services and theories on social inequality and its moral implications.
Theoretically, we employ Bernstein´s concept of framing, Skeggs´ points about class as a relation between moral judges and judged and perspectives on healthism, risk and responsibilization.
The analysis finds that the first version of participatory theatre frames the judge-judged relation as the problem, enabling the participating citizens to share experiences of being judged as morally inferior, while the framing of the second version of participatory theatre implies the judge-judged relation, whereby the participants feel that they are being judged. As a consequence, the participants dis-identify with the patient in the second version and express resentmenttowards health institutions.
We conclude by suggesting that framing is a central perspective when researchers as well as health professionals wish to initiate dialogue with marginalized citizens and that the class perspective presented here is fruitful in exploring experiences of social inequality in access to health care.
Original languageEnglish
JournalSCANDINAVIAN JOURNAL OF SOCIAL MEDICINE
ISSN0300-8037
Publication statusAccepted/In press - 2020

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