Empowerment i gynstolen. Teori, empiri och möjligheter

Abstract

Various mechanisms associated with the pelvic examination (PE) situation brings a woman patient into a subordinate position in relation to the examiner. The patient is dependent on help as she exposes her genitals and easily feels humiliated. The interaction in the pelvic chair is mainly by body language, which means that what happens in the PE situation potentially has a great effect. The PE is therefore a suitable model for implementing changes in the power balance between the examiner and the patient. Empowerment has been a focus of interest recently. But this far few studies have applied it to the concept on the doctor-patient relationship. In this paper we apply some of the basic theories of empowerment on the PE situation. Empirical experience is derived from our work with Gynaecologic Teaching Associates. They are healthy women who act as instructors in the pelvic examination technique from the patient position for medical students. In this instruction situation, a model is used where the power balance is inverted. The woman patient is in control of what happens and the examiner works under her supervision to perform the examination in a way, which is beneficial for her. When young women come for their first PE, and when women who fear the PE situation approach the feared situation, the same inverted power model can be applied with good therapeutic effect. Based on empowerment theories and empirical experience, a strategy is drafted through which women in general could be empowered in the pelvic examination chair. It is an urgent research project to build, carry through and evaluate the effects of such a change of the power positions in the PE situation.