Vulnerability in health care – reflections on encounters in every day practice

Abstract

Vulnerability is a human condition and as such a constant human experience. However, patients and professional health care providers may be regarded as more vulnerable than people who do not suffer or witness suffering on a regular basis. Acquiring a deeper understanding of vulnerability would thus be of crucial importance for health care providers. This article takes as its point of departure Derek Sellman's and Havi Carel's discussion on vulnerability in this journal. Through different examples from the authors' research focusing on the interaction between health professionals and patients, existential, contextual, and relational dimensions of vulnerability are illuminated and discussed. Two main strategies in the professionals' interactions with patients are described. The strategy that aims at understanding the patients or families from the professional's own personal perspective oftentimes ends in excess attention to the professional's own reactions, thereby impairing the ability to help. The other strategy attempts to understand the patients or families from the patients' or families' own perspective. This latter strategy seems to make vulnerability bearable or even transform it into strength. Being sensitive to the vulnerability of the other may be a key to acting ethically.

Vulnerabilidade, empoderamento e conhecimento: memórias e representações de enfermeiros acerca do cuidado

“…For presenting a well branded representational field, positive or negative attitudes and a body of consolidated knowledge, vulnerability and empowerment present themselves as objects of representation, such as have been explored by other authorsFurthermore, this study reinforced the assumption that fragilities, which touch the human being, particularly the nurse when providing care to other human beings in vulnerable situations, were answered with attitudes, knowledge and practices whose goal was to move the subjects to a more favorable context, in which a greater degree of empowerment could be achieved. (1)(2)(3)(4)(5)(6)(7)(8)9,(11)(12)(13)(14)(15)(16) Data highlight that knowledge maintains interfaces with vulnerability, with empowerment, with social representations of AIDS and of nursing care for patients with HIV. Even when dealing with distinct objects of representation, it is postulated that there was an intertwining of them, of complex configurations, and that it was susceptible to transformations consonant with interpersonal relationships among the social actors involved in daily healthcare and, more broadly, the geopolitical injunctions related to the AIDS phenomenon.…”

“…In consonance with polysemy, complexity and usability of the vulnerability concept by various areas of knowledge, (1) the healthcare field shows itself productive in the problematic and conceptual approach of the subject, since it is in the human essence, especially in its frailties, that the phenomenon of vulnerability settles. In the last years, conceptual prepositions of vulnerability have expressed facets that emphasize the social context of population groups, (2)(3)(4)(5)(6) not considering their quantifiable aspects that could potentially produce the illness.…”

Evidência e análise de vulnerabilidades de pessoas com Diabetes Mellitus: potencialidades para o cuidado

“…Para proceder à análise, foi organizado e estruturado o conteúdo dos dados seguindo as fases sequenciais: a pré-análise, a exploração do material e o tratamento dos resultados 11 . resultado e dIscussão Na base de dados BVS, foram encontrados oito artigos [12][13][14][15][16][17][18][19] , porém somente dois eram pertinentes à temática, no entanto não estavam disponíveis na íntegra. Na base de dados CINAHL, foram encontrados 177 trabalhos, sendo que apenas oito estavam disponíveis na íntegra e contemplavam a temática escolhida.…”

“…Os oito artigos encontrados foram apresentados segundo o título, os autores, periódico, base de dados e delineamento da pesquisa [12][13][14][15][16][17][18][19] , conforme mostra Figura 1. No que se refere ao ano de publicação, não foi localizada produção sobre o tema no período de 2005-2009.…”

“…No que se refere ao ano de publicação, não foi localizada produção sobre o tema no período de 2005-2009. Verifica-se um número de publicações maior no ano de 2010, com três estudos 12,16,18 , uma em 2011 19 , 2012 17 , 2013 13 , seguido por duas em 2015 14,15 . Quanto à área dos estudos publicados, percebe-se a autoria de um artigo procedente da área de economia 12 , um da medicina 15 , outro da educação física 18 e cinco artigos da enfermagem 13,14,16,17,19 .…”