Patient participation as discursive practice-A critical discourse analysis of Danish mental healthcare

Nurs Inq. 2018 Apr;25(2):e12218. doi: 10.1111/nin.12218. Epub 2017 Sep 21.

Abstract

Patient participation is one of the most prevalent focus areas in the Danish healthcare debate. Patient participation is generally presented as a fundamental democratic right, and is stated in an objective language with legal requirements for healthcare professionals to ensure that patients systematically participate in their own courses of care and treatment. In the research literature, it is not clear what is meant by 'patient participation', and several discourses on patient participation exist side by side. This study explores how discourses of patient participation unfold and are at play in the articulations in official legal and political documents and patient records relating to a Danish psychiatric context. The documents and patient records have been analyzed using a Fairclough-inspired critical discourse approach which is concerned with how power is exercised through language. The research findings show that patient participation within Danish psychiatric healthcare is governed within a neoliberal discourse where underlying discourses; discourse of biomedicine, paternalism, management, evidence and ethics of care are embedded, and a discourse that seems to ascribe stigmatizing traits to mentally ill patients.

Keywords: critical discourse analysis; fairclough; mental healthcare; neoliberalism; nurse; patient participation; psychiatry.

MeSH terms

  • Denmark
  • Humans
  • Mental Health Services / standards*
  • Mental Health Services / trends
  • Patient Participation / methods*
  • Patient Participation / psychology
  • Social Control, Formal / methods