Using Foucault to (re)think localisation in chronic disease care: Insights for nursing practice

Abstract

Ageing populations and rising rates of chronic disease globally have shifted key elements of disease management to ideas of integrated care and self‐management. The associated policies and programmes often focus on intervention and support beyond the sites of the hospital and clinic. These shifts have significantly impacted the delivery and practice of nursing for both nurses and the clients with whom they work. This article argues that Foucault's comments on space, place and heterotopia (1986) are useful in exploring these changes from a philosophical perspective, to draw out the complexity of these programmes and add texture to discussions on the ways these shifts to localisation and the dominant discourses of self‐management and responsibility have reconfigured nursing practices. The theoretical discussion is augmented with illustrations from an Australian integrated health care programme.

Body work and body meanings in patient-centered care

“…This study contributes also to a stronger integration of the literature on gazing, touching, and playing as individual body practices (Hansen & Kamp, 2018;Twigg, 2006) into health care management literature. With respect to the seminal work by Foucault about gazing and others following this tradition (Foucault, 1963;Turnbull & Reich, 2023), our study identifies different typologies of gazing by unveiling how they variously produce meanings about both HPs and patients and how they generate a different attention to patients' participation in their care. Different ways of gazing shape meanings about the bodies as sources of information about what an individual can or cannot do, and they can also acknowledge the fragility of the bodies and a shared sense of continuous evolution between HPs and patients.…”

“…Now, we will analyze several studies on those body practices in health care sectors that are vital to grasping the HP-patient relationship, together with their potential and their gaps, for a better understanding of PCC implementation in this setting. The body practices are gazing (Foucault, 1963;Juhila et al, 2022;Källestedt et al, 2023;Nagington et al, 2021;Suijker, 2023;Turnbull & Reich, 2023), touching (Christensen et al, 2023;Cocksedge et al, 2013;Gleeson & Higgins, 2009;Kelly et al, 2018), and playing (Finlay et al, 2008;Hardy, 2020;Scholl & Ragan, 2003).…”

“…However, extant research has not yet analyzed the meanings generated in the HPs-patients interaction through body work and how these meanings may have implications for patients' participation. In addition, extant research has focused more on cognitive processes (e.g., information gathering, knowledge construction) that gazing at the patients elicits when delivering PCC (Turnbull & Reich, 2023). In the current research, we aim to understand how meanings about both HPs' and patients' bodies are constructed through different typologies of gazing and the emotional and sensorial experiences that are involved in the process of centering care around the patient when the bodies are considered.…”