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- Lundin, Anette
(författare)
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Rättfärdigade prioriteringar : en kvalitativ analys av hur personal i äldreomsorgen hanterar motstridiga verksamhetslogiker
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation aims at contributing to social scientific knowledge about prevailing prioritizations in eldercarepractice by looking at an economic and a caring logic, and how these logics are overlapping, contradictory or comein conflict with each other. A more concrete aim is to understand how the personnel describe their work with orfor balance between the logics and their justifications prioritizations made in the care of older persons. The researchquestion is: How do personnel and care unit manager at a public nursing home understand and handle the twologics that govern care work for facilitating wellbeing of the residents. The aim and research question led to threesub-aims: 1) to analyze the personnel’s experiences of and meaning making about the care work they carry out, 2)to illuminate and problematize the two logics above, and 3)to analyze how the personnel justify their prioritizationsin prevailing context, and how their accountability have an effect on their professional identities.Empirical material was gathered through 13 individual interviews with care personnel and their care unitmanager at a public nursing home in Sweden. These interviews were complemented by a group interview. Thematerial was analyzed by the use of three methods: phenomenology (Paper I and II), reflexive analysis (Paper III),and a positioning analysis (Paper IV). Paper I found that the personnel understands the residents’ well-being asbeing characterized by feeling of being existentially touched. This essence is constituted by feeling freedom ofchoice, pleasure, and closeness to someone or something. In Paper II, the work for facilitating this kind of wellbeingwas characterized by three ambiguities: (i) freedom of choice for the older persons vs. institutionalconstraints, (ii) the residents' need for activation vs. wanting not to be activated, and (iii) the residents' need forroutine vs. the eldercarers' not being able to know what the residents need. Paper III showed that the care unitmanager created a hybrid of the two logics (economy is care and vice versa) and that the personnel oppose thishybrid. The opposition is shaped as the personnel divides their work in care and “those other things”. Thesefindings showed how interaction between the logics expresses itself in practice and that it is the personnel who hasto handle contradictions between the logics in their everyday care work. The positioning analysis in Paper IV hadthree levels. The first level showed how the carers align with their peers and that they find the organizationalframe, within which they have agency, changed due to increased workload. This change led to an order of priorities.The second level showed that the carers relate to three aspects when making accounts: the care itself, the olderpersons, and the media. The third level showed that the carers share a view of administration, cleaning, servingmeals, and filling up supplies, as not being parts of caring.The dissertation’s theoretical framework focused on theories on logics, accountability, and professionalidentity. The conclusion is that both logics are needed in order to facilitate the well-being of the older persons. Therelationships between the two logics are not always clear and if their contradictions are not illuminated, there is arisk for a care practice that does not facilitate the well-being of their residents. An important theoreticalcontribution is that logics of activities should be understood vertically (form political, through management, anddown to the level of practice) instead of horizontally. The practical implications emphasize the importance ofsupporting the personnel’s professional identity on the one hand, and discussing the logics on the other. Byunderstanding differences between definitions on management-level and practice level, a homogeneity can bereached.
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2. |
- Blomgren Mannerheim, Ann, et al.
(författare)
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Parents’ experiences of caring responsibility for their adult child with schizophrenia
- 2016
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Ingår i: Schizophrenia Research and Treatment. - : Hindawi Limited. - 2090-2085 .- 2090-2093.
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Tidskriftsartikel (refereegranskat)abstract
- As a consequence of the latest psychiatry-related reform in Sweden and its implementation, relatives and family members have taken over from the formal healthcare system significant responsibility for the care of persons with a mental disability and illness. The aim of this study was to systematically describe and analyze the experiences of parents' informal care responsibility. The questions were, what are the experiences around parents' informal care activities and responsibilities and how do parents construct and manage their caring responsibility and with what consequences? Semistructured in-depth interviews were conducted (16 hours of recorded material) with eight parents who were all members of the Interest Association for Schizophrenia (Intresseforeningen for Schizofreni (IFS)) in Sweden. A mixed hermeneutic deductive and inductive method was used for the interpretation of the material. The parents endow their informal caring responsibility with meaning of being a good, responsible, and accountable parent with respect to their social context and social relationships as well as with respect to the psychiatric care representatives. In this tense situation, parents compromise between elements of struggle, cooperation, avoidance, and adaption in their interaction with the world outside, meaning the world beyond the care provision for their child, as well as with the world inside themselves.
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3. |
- Gäddman Johansson, Richard, et al.
(författare)
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Developing Care Professionals : Changing Disability Services in Sweden
- 2018
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Ingår i: Professions & Professionalism. - : OsloMet - Oslo Metropolitan University. - 1893-1049. ; 8:2
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, professionalization projects in disability care services are currently being undertaken in order to differentiate and establish a professional identity for professionals within care work. The aim of this paper was to analyse the experiences of care workers’ meaning of the professionalization process concerning their occupation and their occupational identity in relation to tasks they perform in front-line contacts with persons with intellectual and developmental disabilities at respite care service homes. Semi-structured interviews were conducted with ten care workers. The meaning of the professionalization projects is an ongoing process of a connected mission, meaning that the care work is performed in close contact with care receivers and that it takes place within an informal and free framework, predicated on a logic of possessing a particular kind of “care-feeling.”
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4. |
- Hellström Muhli, Ulla, et al.
(författare)
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Parents’ experiences of caring responsibility for their adult child with schizophrenia
- 2017
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Ingår i: ”Every Child has the Right to …”2nd International Young Carers Conference29 – 31 May 2017. - Malmö.
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Konferensbidrag (refereegranskat)abstract
- As a consequence of the latest psychiatry-related reform in Sweden and its implementation, related parties and family members have taken over from the healthcare system a large responsibility for the care of persons with a mental disability and illness. The aim of this study was to systematically analyze and describe the experiences of parents’ care responsibility. The questions were: what are the experiences around the parents informal care activities and responsibilities, how do parents construct and manage their caring responsibility and with what consequences? Semi-structured in-depth interviews were conducted (16 h data recorded material) with eight parents who were all members of the Interest Group for Schizophrenia [Intresseföreningen för schizophrenic (IFS)] in Sweden. A deductive hermeneutic method was used for the interpretation of the data material. The parents endow their informal caring responsibility with meaning of being a good parent, responsible and accountable within the context of their personal and social relationships as well as to the psychiatric care representatives. In this tense situation parents’ compromise between elements of struggle, cooperation, avoidance and adaption in their interaction with the world outside as well as the world inside.
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5. |
- Hellström Muhli, Ulla, et al.
(författare)
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Patient-Involvement in Consultation for Atrial-Fibrillation : The Cardiologists’ Perspective
- 2019
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald Group Publishing Limited. - 0952-6862 .- 1758-6542. ; 32:4, s. 765-776
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose was to analyse the accounts of Swedish cardiologists concerning patient involvement in consultations for atrial fibrillation (AF). The questions were: (i) how cardiologists handle and provide scope for patient involvement in medical consultations regarding AF treatment and (ii) how cardiologists describe their familiarity with shared decision-making.Design/Methodology/Approach: A descriptive study was designed. Ten (n=10) interviews with cardiologists at four Swedish hospitals were held and a qualitative content analysis was performed on the collected data.Findings: The analysis shows cardiologists´ accounts of (i) persuasive practice, (ii) protective practice, (iii) professional role, and (iv) medical craftsmanship when it comes to patient involvement and shared decision-making.Conclusions: - The term “shared decision-making” implies a concept of not only making one decision but also ensuring that it is finalised with a satisfactory agreement between both parties involved, the patient as well as the cardiologist. - In order for the idea of patient involvement to be fulfilled, the two parties involved must have equal power, which can never actually be guaranteed.Practical implications: Cardiologists should prioritise patient involvement and participation in decision-making regarding AF treatment decisions in consultations when trying to meet the request of patient involvement.Originality/value: Theoretically, we have learned that the patient involvement and shared decision-making requires the ability to see patients as active participants in the medical consultation process.
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6. |
- Hellström Muhli, Ulla, et al.
(författare)
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Patient participation, authority and understanding : A case study of communication patterns in a geriatric consultation
- 2015
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Ingår i: Journal of Applied Linguistics and Professional Practice. - Sheffield (UK) : Equinox Publishing. - 2040-3658 .- 2040-3666. ; 12:3, s. 336-353
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objective is to examine communication patterns in the discourse that emerges between a female geriatric patient and a pharmacist in the context of using an inhaler. This analysis is done in order to understand the communicative components of consultation interaction that support the patient learning and demonstrating understanding of medical information.Methods: This article is a qualitative case study from a project that video recorded forty (N=40) clinical consultations. The actual case was selected as a representative example of the use of material and visual information resources during a clinical consultation between a patient and a pharmacist in a geriatric setting.Results: The patient’s understanding of the clinician’s medical advice did not result simply from repeating the clinician’s demonstration. Rather, the patient’s discussion and manipulation of the inhaler produced a communication pattern that increased the patient’s authority over topics and forms of expression.Conclusion: A combination of verbal, visual and tactile activities oriented to visual and material information resources, produced pattterns of interaction that enhanced the patient’s participation, authority and understanding of medical information.Practice implications: Many consultations can incorporate elder patients’ use of various visual and material information resources to improve their participation in treatment decisions.
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7. |
- Hellström Muhli, Ulla, et al.
(författare)
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Well-being in old age : A question of both continuity and change
- 2017
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Ingår i: Well-being and Quality of Life<em></em>. - Rijeka, Croatia : InTechOpen. - 9789535135135 - 9789535135142 ; , s. 147-162
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Bokkapitel (refereegranskat)abstract
- In this chapter, we are concerned with the well-being of people in old age, living at a residential care home (RCH), and how well-being can be supported in gerontological social work and care at the RCH. Based on empirical data consisting of well-being narratives with elderly residents (average age of 91), a dialogical performance analysis was undertaken about their experiences of well-being at the RCH. The findings of importance are reported through three themes: (1) childhood memories as a source of well-being, (2) family and work as a source of well-being, and (3) opportunities for the well-being of the elderly at the RCH. To be an individual with others is a phenomenon of a personal sense of self and a phenomenon of sociality. Well-being is also found in the individual’s self-renewal.Well-being is about a sense of both individual continuity and change. Well-being is created in social situations with others (including caregivers) in daily interactions and in human contacts at the RCH. This kind of individual self-renewal is about human growth and is a human need regardless of age. Consequently, the human growth in (and despite) old age at RCH should be the main target of gerontological social work and care.
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9. |
- Lundin, Anette, et al.
(författare)
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Witnessing presence : Swedish care professionals' experiences of supporting resident's well-being processes within the frame of residential care homes (RCH)
- 2016
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Ingår i: Journal of Aging Studies. - : Elsevier. - 0890-4065 .- 1879-193X. ; 37, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this article is to analyse the phenomenon of supportive care for older persons' well-being. The phenomenon is seen from the eldercarers' meaning-making through their lifeworld perspective at a residential care home. Based on primary empirical interview material with twelve professionals in the context of Swedish eldercare, a phenomenological analysis was undertaken. The result shows that the phenomenon of supportive care for older persons' well-being creates certain ambiguities in the professionals' meaning-making. In practice, it balances between the older persons' (from hereon called residents) needs and the conditions of the eldercare organization. The ambiguities (the what) is made up by three constituents: (i) freedom of choice for the older persons vs. institutional constraints, (ii) the residents' need for activation vs. wanting not to be activated, and (iii) the residents' need for routine vs. the eldercarers' not being able to know what the residents need. The conclusions drawn are that this ambiguity has consequences for the eldercarers' choice of handling supportive care for older persons' well-being (the how). They have to navigate between the support for authenticity, dwelling and mobility, and their own presence and time. In performing supportive care for older persons' well-being, the eldercarers have to consider aspects concerning the resident's lifeworld, the social setting of the eldercare ward, and the institutional demands of the organization. The practical implications for supporting well-being in the care of older residents are manifested in the importance of 'the little things', and the eldercarer's ability to give receptive attention, which requires presence.
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10. |
- Lundin, Anette, et al.
(författare)
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Witnessing presence : Swedish care professionals’ experiences of supporting older people´s well-being processes within the frame of residential home care (RHC)
- 2016
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Ingår i: Journal of Aging Studies. - : Elsevier BV. - 0890-4065 .- 1879-193X. ; 37, s. 1-9
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In this article, we are concerned with analyzing the phenomenon of supportive social care for older people`s well-being from the carers’ meaning making through their life world perspective at a residential care home (RCH). Based on empirical data consisting of interview material with 12 care professionals in the context of Swedish eldercare, a phenomenological analysis was undertaken. The result shows that the phenomenon of supportive social care for well-being is a question of ambiguity in the professionals’ meaning making and in practice it balances between the residents´ needs and the conditions of the care organization. This phenomenon of ambiguity (the what) is made up by three constituents: (i) freedom of choice for the older people vs. institutional constraints, (ii) the residents’ need for activation vs. wanting not to be activated, and (iii) the residents’ need for routine vs. the carers´ not being able to know what the residents need. The conclusions drawn are that this ambiguity has consequences for the carers’ positions for supportive social care for older people´s well-being (the how) in that they have to navigate between the support for authenticity, dwelling and mobility, and carers’ presence and time. In performing a supportive social care for well-being, the carers have to consider aspects concerning the older person’s lifeworld, the social setting of the eldercare ward, and the institutional demands of the organisation. The practical implications for supporting well-being in the social care of older people is manifested in the importance of ‘the little things’, and the carer’s ability to give receptive attention, which requires the presence.
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