Body work and body meanings in patient-centered care: Health care professionals and patients with disabilities in Italian hospitals.

Abstract

This study integrates patient-centered care (PCC) research and body work studies to understand how a focus on physical and sensorial aspects in the relationship between health care professionals (HPs) and patients contribute to the implementation of PCC. To understand how HPs' body work practices contribute to the implementation of PCC, we investigate the meanings HPs ascribe to their and to patients' bodies. The goal is to grasp how these practices and meanings, rooted in unexplored sensorial perceptions, account for the emergence of a relationship of mutual acknowledgment between HPs and patients. Thirty-nine in-depth interviews were carried out with HPs, who interact with patients with disabilities in Italian hospitals. HPs engage in different body work practices: adopting a diagnostic gaze and an empathetic gaze, touching, and playing. The diagnostic gaze concurs to create a feeling of promptness between HPs and patients, but also a stronger distance with respect to other practices. The empathetic gaze, touching, and playing are associated with feelings of shared vulnerability and resilience. These shared perceptions and emotions build a common ground and shape a relationship focused on patients' involvement. Voicing and feedback sessions can be arranged to listen to how HPs interpret their own and patients' bodies. An organizational culture acknowledging emotions should be promoted to sponsor among HPs the consideration of the sensorial aspects of their connection with patients. The value of bricolage should be observed, where the HPs feel free to readjust tools, spaces, and routines. Sensitivity training exercises should be arranged to understand the interactions with patients with disabilities.