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Positionings in healthcare: diabetes training for Arabic-speaking immigrants

Nanna Ahlmark (National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark)
Susan Reynolds Whyte (Department of Anthropology, University of Copenhagen, Copenhagen, Denmark)
Tine Curtis (Social and Health Department, Local Government Denmark, Copenhagen, Denmark)
Tine Tjørnhøj-Thomsen (National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark)

Health Education

ISSN: 0965-4283

Article publication date: 28 January 2014

518

Abstract

Purpose

The purpose of this study is to explore how healthcare professionals in Denmark perceived and enacted their role as diabetes trainers for Arabic-speaking immigrants in three new local authority settings. The paper used positioning theory, which is a dynamic alternative to the more static concept of role in that it seeks to capture the variable, situationally specific, multiple and shifting character of social interaction, as the analytical tool to examine how people situationally produce and explain behaviour of themselves and others.

Design/methodology/approach

The paper generated data through observation of diabetes training and of introductory interviews with training participants in three local authority healthcare centres over a total of five months. The authors conducted 12 individual interviews and two group interviews with healthcare professionals.

Findings

Healthcare professionals shifted between three positionings – caregiver, educator and expert. The caregiver was dominant in professionals’ ideals but less in their practice. Healthcare professionals other-positioned participants correspondingly as: vulnerable, difficult students and chronically ill. The two first other-positionings drew on dominant images of an ethnic other as different and problematic.

Practical implications

Becoming more reflexive and explicit about one's positionings offer the potential for a more conscious, confident, flexible and open-ended teaching practice. Such reflexivity may also reduce the perception that teaching challenges are rooted in participants’ ethnic background.

Originality/value

The paper provides a new understanding of healthcare practice by showing professionals’ multiple and reciprocal positionings and the potential and risks in this regard. The paper demonstrates the need for healthcare workers to reflect on their positionings not only in relation to immigrants, but to all patients.

Keywords

Acknowledgements

We thank the management and the team of diabetes educators at the three healthcare centres in this study for their cooperation. We thank the Danish Health Insurance Foundation, and the Danish Diabetes Association for their financial contributions to this project.

Citation

Ahlmark, N., Reynolds Whyte, S., Curtis, T. and Tjørnhøj-Thomsen, T. (2014), "Positionings in healthcare: diabetes training for Arabic-speaking immigrants", Health Education, Vol. 114 No. 2, pp. 133-151. https://doi.org/10.1108/HE-04-2013-0015

Publisher

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Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited

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