Deconstructing the Self-Other Binary in Care Networks by Unravelling Professional’ Perspectives through an Intersectional Lens

Health Care Analysis, vol. 34, pp. 408–428

Abstract

In many western countries informal care is conceived as the answer to the increasing care demand. Little is known how formal and informal caregivers collaborate in the context of an diverse ageing population. The aim of this study was to gain insight in how professionals' perspectives regarding the collaboration with informal carers with a migration background are framed and shaped by intersecting aspects of diversity. We used an intersectionality informed qualitative design with informal conversations (N = 12) and semi-structured interviews (N = 17) with healthcare professionals working with clients with Acquired Brain Injury. Two critical friends were involved in the analysis which was substantiated by a participatory analysis with a community of practice. We identified four interrelated themes: (a) 'The difficult Other' in which professionals reflected on carers with a migration background causing 'difficulties'; (b) 'The dependent Other' refers to professionals' realization that 'difficulties' are intensified by the context in which care takes place; (c) in 'The uncomfortable self' professionals describe how feelings of insecurities evoked by the Other are associated with an inability to act 'professionally', and; (d) 'The reflexive self' shows how some professionals reflect on their own identities and identify their blind spots in collaboration within a care network. These themes demonstrate the tensions, biases and power imbalances between carers and professionals, which may explain some of the existing health disparities perpetuated through care networks.

Authors 4

1. Rieke Hengelaar corresponding

   Amsterdam UMC Location Vrije Universiteit Amsterdam · Amsterdam Public Health · Amsterdam University of Applied Sciences

   Affiliation as printed

   Department Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam University of Applied Science, Amsterdam UMC, location VUmc, Tafelbergweg 51, PO box 2557, 1000 CN, Amsterdam, The Netherlands. a.h.hengelaar@hva.nl

   Department of Occupational Therapy, Amsterdam University of Applied Science, Amsterdam, The Netherlands. a.h.hengelaar@hva.nl

   Department Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam University of Applied Science, Amsterdam UMC, location VUmc, Tafelbergweg 51, PO box 2557, 1000 CN, Amsterdam, The Netherlands

   Department of Occupational Therapy, Amsterdam University of Applied Science, Amsterdam, The Netherlands

2. Margo van Hartingsveldt

   Amsterdam University of Applied Sciences

   Affiliation as printed

   Department of Occupational Therapy, Amsterdam University of Applied Science, Amsterdam, The Netherlands

3. Tineke Abma Aachen Department Public Health and Primary Care

   Leiden University · Leiden University Medical Center · Leyden Academy on Vitality and Ageing

   Affiliation as printed

   Department Public Health and Primary Care, Leiden University Medical Centre, Leiden University and Leyden Academy on Vitality and Ageing, Leiden, The Netherlands

4. Petra Verdonk

   Amsterdam UMC Location Vrije Universiteit Amsterdam · Amsterdam Public Health · Amsterdam University of Applied Sciences

   Affiliation as printed

   Department Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam University of Applied Science, Amsterdam UMC, location VUmc, Tafelbergweg 51, PO box 2557, 1000 CN, Amsterdam, The Netherlands