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首页> 外文期刊>BMC Health Services Research >NEGOTIATING HEALTH: patients’ and guardians’ perspective on “failed” patient-professional interactions in the context of the Swedish health care system
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NEGOTIATING HEALTH: patients’ and guardians’ perspective on “failed” patient-professional interactions in the context of the Swedish health care system

机译：协商健康：在瑞典医疗体系的背景下，患者和监护人对“失败的”医患互动的看法

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Sweden has a largely tax-funded health care system that aims at providing equal access for everyone. However, the individual’s perception and experience of the health care system remains a relevant topic for researchers. The aim of this study is to learn the patient’s perspective on how patients and professionals negotiate in the social context of the Swedish health care system. Eight essays that had spontaneously been contributed to a medical writing contest were analyzed using narrative methods. Narratives were defined as a sequence of clauses that correspond to an order of events in the narrator’s biography. The analysis comprised a three-step process. First, the essays were read and narratives were extracted. Second, an agency analysis was performed. Third, an analysis of social positioning was employed. The Swedish health care system provides the social context and background for negotiations between patients and professionals. The narrators position the protagonists of the illness narratives as either patients or guardians of underage patients. The protagonists meet health care representatives in negotiation situations. Due to the lack of emotional connection between the negotiating parties, impossible situations arise. False promises are made which ultimately result in the patients’ suffering. Thus, all negotiations failed from the narrators’ perspective. The narrators invited their audience to solve negotiation situations differently. This study discusses some actions that may help navigate negotiation situations: Health care providers should acknowledge the patient’s or guardian’s social position and dilemma, allow emotions, involve all parties in the decision-making process and manage expectations. Writing competitions may provide a tool for experience-based assessment of health care systems.
机译：瑞典拥有一个由税收资助的医疗体系，旨在为所有人提供平等的医疗服务。但是，个人对医疗保健系统的看法和经验仍然是研究人员关注的主题。这项研究的目的是了解患者对患者和专业人员如何在瑞典卫生保健系统的社会环境中进行谈判的观点。使用叙述方法分析了八篇自发地为医学写作比赛撰写的论文。叙述被定义为一系列子句，它们与叙述者传记中的事件顺序相对应。分析包括三个步骤。首先，阅读文章并提取叙述。其次，进行了代理分析。第三，对社会定位进行了分析。瑞典的卫生保健系统为患者和专业人员之间的谈判提供了社会背景和背景。叙述者将疾病叙述的主角定位为患者或未成年患者的监护人。在谈判情况下，主角会见医疗保健代表。由于谈判双方之间缺乏情感联系，出现了不可能的情况。错误的承诺最终会导致患者的痛苦。因此，从叙述者的角度来看，所有谈判都失败了。叙述者邀请听众以不同的方式解决谈判情况。这项研究讨论了一些可能有助于解决谈判问题的行动：医疗保健提供者应承认患者或监护人的社会地位和困境，允许情绪激动，让各方参与决策过程并管理期望。写作比赛可以为基于经验的卫生保健系统评估提供工具。

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