Health 'care' interventions: making health inequalities worse, not better?

Hart, Angie and Freeman, M. (2005) Health 'care' interventions: making health inequalities worse, not better? Journal of Advanced Nursing, 49 (5). pp. 502-512. ISSN 0309-2402

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Abstract

Aim. The aim of this paper is to present a model, the ‘Effect of the Professional Ego’, which provides a psychodynamically informed analytical framework for examining professional practice in arenas where issues of inequalities need to be addressed. Background. There is a great deal of literature on the psychosocial aspects of inequalities in health care provision. However, the impact of intrapsychic and professional cultural elements has not been explored in this context. Moreover, the body of work which does explore these elements in relation to health care workers does not address how they might impact on health inequalities. Discussion. Drawing on empirical work, we discuss ways in which intrapsychic and professional cultural elements feed into the dynamic between clients and health care professionals in a way which can subvert espoused, positive client health outcomes. Based on this discussion, we propose the Effect of the Professional Ego model, which identifies two main aspects of the professional ego – the grandiose self and selfpreservation – and how they influence the professional/client dynamic. Conclusion. Systematic self-reflection on the part of professionals would be a valuable contribution to the development of professional practice. This applies particularly to conceptualizing the links between the actions of service providers and the adverse health of clients

Item Type: Journal article
Uncontrolled Keywords: inequalities in health care, discrimination, psychosocial, health inequalities, professional, ego, inverse care law, nursing
Subjects: L000 Social Sciences > L500 Social Work
B000 Health Professions > B700 Nursing and Midwifery
DOI (a stable link to the resource): 10.1111/j.1365-2648.2005.03357.x
Faculties: Faculty of Health and Social Sciences > School of Nursing and Midwifery
Depositing User: editor snam
Date Deposited: 10 Apr 2007
Last Modified: 21 May 2014 11:01
URI: http://eprints.brighton.ac.uk/id/eprint/349

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