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Disciplinary power and the process of training informal carers on stroke units
Authors:Euan Sadler  Rebecca Hawkins  David J Clarke  Mary Godfrey  Josie Dickerson  Christopher McKevitt
Institution:1. Health Service and Population Research Department, King's Improvement Science and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK;2. Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK;3. Bradford Institute of Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, UK;4. School of Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK;5. National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas’ NHS Foundation Trust and King's College London, London, UK;6. National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London, King's College Hospital NHS Foundation Trust, London, UK
Abstract:This article examines the process of training informal carers on stroke units using the lens of power. Care is usually assumed as a kinship obligation but the state has long had an interest in framing the carer and caring work. Training carers in healthcare settings raises questions about the power of the state and healthcare professionals as its agents to shape expectations and practices related to the caring role. Drawing on Foucault's notion of disciplinary power, we show how disciplinary forms of power exercised in interactions between healthcare professionals and carers shape the engagement and resistance of carers in the process of training. Interview and observational field note extracts are drawn from a multi‐sited study of a training programme on stroke units targeting family carers of people with stroke to consider the consequences of subjecting caring to this intervention. We found that the process of training informal carers on stroke units was not simply a matter of transferring skills from professional to lay person, but entailed disciplinary forms of power intended to shape the conduct of the carer. We interrogate the extent to which a specific kind of carer is produced through such an approach, and the wider implications for the participation of carers in training in healthcare settings and the empowerment of carers.
Keywords:informal carers  stroke  training  empowerment  United Kingdom  Foucault  disciplinary power
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