Feasibility of Participatory Theater Workshops to Increase Staff Awareness of and Readiness to Respond to Abuse in Health Care: A Qualitative Study of a Pilot Intervention Using Forum Play among Sri Lankan Health Care Providers.

Jennifer J Infanti,Katarina Swahnberg,Anke Zbikowski,Kumudu Wijewardene

doi:10.3390/ijerph17207698

Abstract

Women globally experience mistreatment by health providers during childbirth. Researchers have identified strategies to counteract this type of abuse in health care, but few have been evaluated. We used a theater technique, Forum Play, in a brief training intervention to increase awareness of abuse in health care and promote taking action to reduce or prevent it. The intervention was implemented in four workshops with 50 participating physicians and nurses from three hospitals in Colombo, Sri Lanka. This article reports the views of 23 workshop participants who also took part in four focus group discussions on the acceptability and feasibility of the method. The participants reported that the intervention method stimulated dialogue and critical reflection and increased their awareness of the everyday nature of abuses experienced by patients. Participants appreciated the participatory format of Forum Play, which allowed them to re-enact scenarios they had experienced and rehearse realistic actions to improve patient care in these situations. Structural factors were reported as limitations to the effectiveness of the intervention, including under-developed systems for protecting patient rights and reporting health provider abuses. Nonetheless, the study indicates the acceptability and feasibility of a theater-based training intervention for reducing the mistreatment of patients by health care providers in Sri Lanka.

Highlights

Patients experience neglect, disrespect, verbal and other types of mistreatment, or abuse perpetrated by their health providers in a wide spectrum of health settings and patient–provider relationships around the world [1,2]
In analyzing the focus group discussions (FGDs) data, it became clear that participants appraised the Forum Play (FP) intervention largely as stimulating, empowering, and positive
Our study findings suggest that participatory theater techniques, such as FP, hold potential as an intervention method for preventing and addressing abuse in health care (AHC) in Sri Lanka

Summary

Introduction

Disrespect, verbal and other types of mistreatment, or abuse perpetrated by their health providers in a wide spectrum of health settings and patient–provider relationships around the world [1,2]. We refer to this global phenomenon as abuse in health care (AHC). AHC experienced by women in childbirth, disrespectful behavior and physical violence, has been documented in numerous studies [2,3,4,5,6,7,8,9,10,11,12]. It is sometimes referred to as obstetric violence or disrespect and abuse (D&A) during facility-based childbirth. Public Health 2020, 17, 7698; doi:10.3390/ijerph17207698 www.mdpi.com/journal/ijerph

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Discussion

Conclusion