Erik Eriksson

When they talk about motherhood: a qualitative study of three groups’ perceptions in a Swedish child health service context

BackgroundIn light of the growing emphasis on individualization in healthcare, it is vital to take the diversity of inhabitants and users into consideration. Thus, identifying shared perceptions among group members may be important in improving healthcare that is relevant to the particular group, but also perceptions of the staff with whom interactions take place. This study investigates how motherhood is perceived among three groups: Somali-born mothers; Swedish-born mothers; and nurses at Swedish child health centers. Inequities in terms of access and satisfaction have previously been identified at the health centers.MethodsParticipants in all three groups were asked to finalize two statements about motherhood; one statement about perfect motherhood, another about everyday motherhood. The responses were analyzed using qualitative coding and categorization to identify differences and similarities among the three groups.ResultsThe responses to both statements by the three groups included divergences as well as convergences. Overall, biological aspects of motherhood were absent, and respondents focused almost exclusively on social matters. Working life was embedded in motherhood, but only for the Somali-born mothers. The three groups put emphasis on different aspects of motherhood: Somali-born mothers on the community; the Swedish-born mothers on the child; and the nurses on the mother herself. The nurses – and to some extent the Swedish-born mothers – expected the mother to ask for help with the children when needed. However, the Somali-born mothers responded that the mother should be independent, not asking for such help. Nurses, more than both groups of mothers, largely described everyday motherhood in positively charged words or phrases.ConclusionThe findings of this paper suggest that convergences and divergences in perceptions of motherhood among three groups may be important in equitable access and utilization of healthcare. Individualized healthcare requires nuance and should avoid normative or stereotypical encounters by recognizing social context and needs that are relevant to specific groups of the population.

Representative co-production: Broadening the scope of the public service logic

ABSTRACT Although the public service logic (PSL) has been an important equipoise to the predominant goods-manufacturing logic, there is potential to broaden its scope. An explicit integration of social context may contribute to an enhanced conceptual understanding of the PSL, at the same time addressing a major challenge in healthcare: disparities among population groups. A ‘representative co-production’ approach is suggested. In such an approach, group representatives’ knowledge and skills are used in evaluating, designing, and delivering services with the purpose of supporting other group members’ value co-creation. A case is provided, demonstrating representative co-production in access to preventive health services.

“Brave Men” and “Emotional Women”: A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain

Background Despite the large body of research on sex differences in pain, there is a lack of knowledge about the influence of gender in the patient-provider encounter. The purpose of this study was to review literature on gendered norms about men and women with pain and gender bias in the treatment of pain. The second aim was to analyze the results guided by the theoretical concepts of hegemonic masculinity and andronormativity. Methods A literature search of databases was conducted. A total of 77 articles met the inclusion criteria. The included articles were analyzed qualitatively, with an integrative approach. Results The included studies demonstrated a variety of gendered norms about mens and womens experience and expression of pain, their identity, lifestyle, and coping style. Gender bias in pain treatment was identified, as part of the patient-provider encounter and the professionals treatment decisions. It was discussed how gendered norms are consolidated by hegemonic masculinity and andronormativity. Conclusions Awareness about gendered norms is important, both in research and clinical practice, in order to counteract gender bias in health care and to support health-care professionals in providing more equitable care that is more capable to meet the need of all patients, men and women.

From one-sized to over-individualized? Service logic’s value creation

Purpose There is a current trend in healthcare management away from produced and standardized one-size-fits-all processes toward co-created and individualized services. The purpose of this paper is to increase understanding of the value concept in healthcare organization and management by recognizing different levels of value (private, group and public) and the interconnectedness among these levels. Design/methodology/approach The paper uses social constructionism as a lens to problematize the individualization of service logics value concept. Theories from consumer culture theory/transformative service research and public management add group and public levels of value to the private level. Findings An intersubjective (rather than subjective) approach to value creation entails the construction and sharing of value perceptions among groups of people. Such an approach also implies that group members may face similar barriers in their value creation efforts. Practical implications Healthcare management should be aware of the inherent individualism of service logic and, consequently, the need to balance private value with group and public levels of value. Social implications Identifying and addressing disadvantaged groups and the reasons for their disadvantaged positions is important in order to enhance the individuals value creation prerequisites as well as to address public and societal values, such as equal/equitable health(care). Originality/value It is important to complement service logics value creation with group and public levels in order to understand the complexity and interconnectedness of value and the creation thereof.