Expressions of power and powerlessness in discharge planning: a case study of an older woman on her way home

Abstract

The aim of this case study was to illuminate and describe the phenomenon of power as it appeared in a discharge planning conference. The patient was an older woman who needed long-term care as a result of stroke and heart failure. Data comprised transcriptions of a video-recorded discharge planning conference and two audio-recorded interviews focusing on the patient's experience of the discharge planning conference. The findings reveal that the content of the discharge planning conference focused on the patient's medical state and routine administrative protocols. Analysis of the participants' activities, strategies and attitudes during the conference indicate that the professional carers dominated the conversation. Analysis further reveals that the patient experienced a feeling of powerlessness and of being treated as an object. The findings are interpreted and discussed based on the concepts of 'institutional frame' and 'client's frame', derived from Agar's theory of institutional discourse.

Understanding help-seeking decisions in people with heart failure: A qualitative systematic review

“…Avoiding the situation Buetow et al (2001), Efraimsson et al (2003), Granger et al (2009), Riegel and Carlson (2002), Schnell et al (2006), Winters (1999), Zambroski (2003). Reducing physical activity Bennett et al (2000), Edmonds et al (2005), Freydberg et al (2010), Riegel and Carlson (2002).…”

Cultural diversity between hospital and community nurses: implications for continuity of care

“…However, deficits in communication and information transfer and lack of coordination when patients are transferred between different health care organizations and providers result in patients not receiving effective care [8, 9]. Such ineffective health care systems complicate hospital discharge [9], threaten patient safety [1], lengthen hospital stays [11], increase the number of re-hospitalizations [12], and contribute to the patient's feelings of powerlessness [13, 14]. …”

How do people with learning disabilities experience and make sense of the ageing process?

“…Some older people experience dependency, for example as a result of physical illness or dementia, but this is not the case for all older people (Bond & Cabrero, 2007). Articles on older people living with chronic physical illness (Efraimsson, Rasmussen, Gilje & Sandman, 2003;Yu, Lee, Kwong, Thompson & Woo, 2007), or in residential care (Lee, Woo & Mackenzie, 2002) do acknowledge powerlessness as part of their experience but their findings are not directly relevant to this study, which is focused on experiences of healthy ageing.…”