Older stroke patients' negotiations within the hierarchic medical context.

A stroke can affect a person's whole being and make him or her feel helpless and insecure. In this study, the authors aimed to analyze from a gender perspective how elderly women and men responded to treatment and care after stroke in the acute care setting. They used a strategic selection procedure in this qualitative follow-up interview study, in which 7 women and 5 men aged 75 to 83 participated. Personal interviews were performed, tape-recorded, transcribed verbatim, and analyzed in accordance with grounded theory. In the hierarchic medical context, the participants used four kinds of negotiations. These negotiations were either resistant (striving for autonomy and criticizing the care) or adjustive (following the rules and building alliances) to the hierarchic structure. The authors discuss how the concepts of power from above versus power from below can be applied in the hierarchic medical context.