Body work and body meanings in patient-centered care: Healthcare professionals and patients with disabilities in Italian hospitals

Background: This study integrates PCC research and body work studies to understand how a focus on physical and sensorial aspects in the relationship between health care professionals (HPs) and patients contribute to the implementation of PCC at the micro-level of analysis. This study particularly relies on PCC and body work towards patients with disabilities. Purpose: To understand how HPs’ body work practices contribute to the implementation of PCC, we investigate the meanings HPs ascribe to their and to patients’ bodies. The goal is to grasp how these practices and meanings, rooted in unexplored sensorial perceptions, account for the emergence of a relationship of mutual acknowledgement and involvement between HPs and patients. Methodology: 39 in-depth interviews were carried out with HPs who interact with patients with disabilities in Italian hospitals. Results: HPs engage in different body work practices: adopting a diagnostic gaze, an empathetic gaze and touching, and playing. The Diagnostic gaze concurs to create a feeling of promptness between HPs and patients, but also a stronger distance with respect to other practices. The Empathetic gaze, touching and playing are associated with feelings of shared vulnerability and resilience. These shared perceptions and emotions build a common ground between HPs and the patients and shape a relationship strongly focused on patients’ involvement. Practice implications: Voicing and Feedback sessions, to listen to how HPs interpret their own bodies and patients’ bodies; an organizational culture acknowledging emotions to sponsor among HPs the consideration of the sensorial aspects of their connection with patients with disabilities; the encouragement of the value of bricolage, where the HPs feel autonomous in re-adjusting existing tools, spaces and routines for new purposes; sensitivity training exercises, to understand when the interactions with patients with disabilities might be at risk of being more vertically driven by the HPs.