Navigating Voice, Vocabulary and Silence: Developing Critical Consciousness in a Photovoice Project with (Un)Paid Care Workers in Long-Term Care

Duijs, Saskia Elise; Abma, Tineke; Schrijver, Janine; Bourik, Zohra; Abena-Jaspers, Yvonne; Jhingoeri, Usha; Plak, Olivia; Senoussi, Naziha

doi:10.3390/ijerph19095570

Cited by 5 publications

(15 citation statements)

References 62 publications

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“…Yet, their experience contrasted with female self-employed care workers. While self-employment allows men to foreground an entrepreneurial identity, which allows for profit-making, often at the expense of their health, women tended to make financial sacrifices as a self-employed to foreground their caring identities and to protect their health (Duijs et al, 2022).…”

Section: And When I Am Older [Now 31] From 45 or 40 And I Have A Fami...mentioning

confidence: 99%

“…PHR is characterized by moral dilemmas and power imbalances. A methodological reflection of our participatory research process is described elsewhere (Duijs et al, 2022).…”

Section: Aimmentioning

confidence: 99%

“…data saturation did not occur in relation to their experiences). hermeneutic dialogue between different types of knowledge, including academic theories (such as intersectionality) and experiential knowledge (Duijs et al, 2022;Gadamer, 1960).…”

Section: Designmentioning

confidence: 99%

“…We understand intersectionality as a normative, methodological and theoretical approach to health research . Intersectionality guided our research question, recruitment, data generation and analysis (Duijs et al, 2022;Hunting, 2014;Stuij et al, 2020).…”

Section: Designmentioning

confidence: 99%

“…The community researchers were could not always join the interviews, due to time constraints or changing work schedules, and later on, due to the COVID-19 pandemic that severely impact their work and lives. In line with our PHR approach, the topic-list for this study was developed with and by the community researchers who identified themes and topics that were relevant to them during a 6-month photovoice project that was conducted prior to this qualitative study (Duijs et al, 2022;. Topics included balancing paid and unpaid care work, financial concerns, age-related health issues, such as menopause, and health strategies of care workers while working in LTC.…”

Section: Data-collectionmentioning

confidence: 99%

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The Caring Class

Duijs¹

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SHORT SUMMARY The health of paid care workers in long-term care is under pressure, but not for all care workers alike (chapter 1 and 2). Therefore, this thesis addresses health inequities among paid care workers. This thesis presents several participatory studies which were conducted by the author, together with paid care workers and a professional photographer. These studies unravel the health strategies of women (chapter 3) and men (chapter 4) working in long-term care and the health issues of self-employed care workers (chapter 5) before and during (chapter 6) the COVID-19 pandemic. All studies were done from a critical gender, diversity-sensitive and intersectional perspective. They present insights for care workers, occupational health professionals, HRM professionals and policy makers in long-term care. This thesis is also relevant for Participatory Health Researchers (PHR) who aim to make their research more critical and diversity-sensitive, as it explores the relevance of intersectionality for PHR (chapter 7 and 8). A series of portraits ‘What You Don’t See’, made by photographer Janine Schrijver in co-creation with care workers and the author, is part of the research presented in this thesis (chapter 9). These portraits address urgent health issues that often remain invisible, including racism and poverty, which squeezes paid care workers out of the organizations into self-employment. Concerns about the health of paid care workers are a persistent societal issue in the Netherlands. They have become increasingly pressing as more and more paid care workers find themselves in precarious positions, no longer able to sustain their own health or support themselves financially. Therefore, this thesis explores the economic, societal and political forces that contribute to the precarization of paid care workers in the Netherlands (chapter 10). Protecting, maintaining and repairing the health of paid care workers is not just an issue of care workers or employers. It is a societal issue and shaped by political choices

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Section: And When I Am Older [Now 31] From 45 or 40 And I Have A Fami...mentioning

confidence: 99%

“…PHR is characterized by moral dilemmas and power imbalances. A methodological reflection of our participatory research process is described elsewhere (Duijs et al, 2022).…”

Section: Aimmentioning

confidence: 99%

Section: Designmentioning

confidence: 99%

Section: Designmentioning

confidence: 99%

Section: Data-collectionmentioning

confidence: 99%

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The Caring Class

Duijs¹

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Negotiating masculinities at the expense of health: A qualitative study on men working in long‐term care in the Netherlands, from an intersectional perspective

Wees

Duijs

Mazurel

et al. 2023

Gender Work & Organization

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While some areas of care work show increased recruitment of men, the care‐gap remains, especially in low paid occupations. Questions arise how masculinities play a part in this, and if caring masculinities obscure gender inequities while at the same time perpetuating them. This qualitative study focusses the negotiation of hegemonic and caring masculinities of men working in residential long‐term care in the Netherlands, and its consequences for health. Semi‐structured interviews (N = 16) were analyzed thematically, drawing upon gender and intersectionality theory to understand inequities between respondents. Findings describe how men move through long‐term care. On entry, men negotiated hegemonic and caring masculinities to gain access, with black men having to work harder. Once inside, men experienced status‐loss and performed hegemonic masculinity, materializing in financial and sexual rewards, especially for white heterosexual men. In time, this performance of hegemonic masculinity backlashed with respect to their own health; herein racialized and homosexual men were hit harder. Consequently, all the men in this study aspired to move out or up from low‐paid care work, with white heterosexual men doing so more successfully. Our study illustrates the importance of an intersectional perspective on caring masculinities at work, showing how caring masculinities perpetuate male privilege for some men more than for others, creating health and labor market inequities among men. In terms of health, this study shows that gender, racism and sexual discrimination need be on the occupational health agenda.

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Squeezed out: Experienced precariousness of self‐employed care workers in residential long‐term care, from an intersectional perspective

Duijs

Abma

Plak

et al. 2022

Journal of Advanced Nursing

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Aim: To understand self-employed long-term-care workers' experiences of precariousness, and to unravel how their experiences are shaped at the intersection of gender, class, race, migration and age.Background: In the Netherlands, increasing numbers of nurses and nursing aides in long-term care (LTC) opt for self-employment. Societal organizations and policy makers express concerns about this development, as self-employment is seen as a risk factor for poor health. Self-employment is not necessarily precarious work but can contribute to the precariousness of specific groups. Knowledge about inequities among self-employed nurses and nursing aides in long-term care is lacking. Design:A participatory, qualitative interview study. The research team consisted of four academic researchers and five (un)paid care workers.Methods: Semi-structured interviews with 23 self-employed nurses and nursing aides in LTC (2019-2020). Data were analysed from an intersectional perspective.Results: First, we describe that feeling precarious as a hired employee-due to increasing workloads, health risks, poverty and discrimination-shapes care workers' choice for self-employment. Second, we describe inequities between self-employed care workers who could (financially) afford to turn to self-employment as a health strategy and those who felt squeezed out of the organizations due to poverty or discrimination.They more often dealt with precarious work in the context of precarious lives, negatively impacting their health. Third, we describe how negotiating an entrepreneurial identity with a caring identity required material sacrifices and thus contributed to selfemployed care workers' financial precariousness, particularly as women. Conclusion:Our findings indicate that working in LTC is becoming increasingly precarious for all care workers, both for hired and self-employed, with younger, lowerpaid and racialized women with unpaid caring responsibilities seemingly most at risk for precariousness.

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Navigating Voice, Vocabulary and Silence: Developing Critical Consciousness in a Photovoice Project with (Un)Paid Care Workers in Long-Term Care

Cited by 5 publications

References 62 publications

The Caring Class

The Caring Class

Negotiating masculinities at the expense of health: A qualitative study on men working in long‐term care in the Netherlands, from an intersectional perspective

Squeezed out: Experienced precariousness of self‐employed care workers in residential long‐term care, from an intersectional perspective

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