Yngre og eldre brukere av hjemmetjenesten - ulike behov eller forskjellsbehandling. Flerfaglig praksis i et interaksjonsteoretisk perspektiv

Published version.Bakgrunn for dette prosjektet er den store veksten i yngre brukere av kommunale pleie- og omsorgstjenester og at eldre brukere, selv om de er flest, får en stadig mindre andel av ressursene. Ulikheter i tjenestetilbudet til yngre og eldre brukere er allerede godt kartlagt. Et sentralt spørsmål i denne undersøkelsen er synet på hva som er nødvendig og hva som er verdig omsorg, og om det er grunnlag for å snakke om ulike praksiser – eller omsorgsregimer til ulike typer brukere. For å få svar på slike spørsmål må vi vite noe om innholdet i tjenestene, og hvilke begrunnelser, vurderinger, faglige standarder og organisasjonsmessige forhold som ligger til grunn for tildeling og utforming av tjenestene

Struggles of being and becoming: A dialogical narrative analysis of the life stories of Sami elderly

The Sami are an indigenous people living in Norway, Sweden, Finland, and Russia. Historically, national states have made strong efforts to assimilate the Sami people into the majority populations, and the Sami have experienced stigmatization and discrimination. However, after World War II, there has been a revitalization process among the Sami that was pioneered by the Sami Movement and gradually adopted in broader spheres of Norwegian society. The lifespans of the current cohort of elderly Sami unfold throughout a historical period in which contrasting public narratives about the Sami have dominated. The purpose of this study was to explore the relationship between elderly Sami's individual life stories and contrasting public narratives about the Sami. Nineteen elderly Sami individuals in Norway were interviewed. This article is a dialogical narrative analysis of the life stories of four elderly Sami. The article illuminates how individual life stories are framed and shaped by public narratives and how identifying is an ongoing process also in late life. A dialogical relationship between individual life stories and public narratives implies that individual stories have the capacity to shape and revise dominant public narratives. To do so, the number of stories that are allowed to act must be increased. A commitment in dialogic narrative research on minority elderly is to make available individual stories from the margins of the public narratives to reduce narrative silences and to prevent the reproduction of established “truths”

Home care patients in four Nordic capitals – predictors of nursing home admission during one-year followup

The aim was to predict nursing home admission (NHA) for home care patients after a 12-month follow-up study. This Nordic study is derived from the aged in home care (AdHOC) project conducted in 2001–2003 with patients at 11 sites in Europe. The participants in the cohort study were randomly selected individuals, aged 65 years or older, receiving homecare in Oslo, Stockholm, Copenhagen, and Reykjavik. The Resident Assessment Instrument for Home Care (version 2.0) was used. Epidemiological and medical characteristics of patients and service utilization were recorded for 1508 home care patients (participation rate 74%). In this sample 75% were female. The mean age was 82.1 (6.9) years for men and 84.0 (6.6) for women. The most consistent predictor of NHA was receiving skilled nursing procedures at baseline (help with medication and injections, administration or help with oxygen, intravenous, catheter and stoma care, wounds and skin care) (adjusted odds ratio = 3.7, 95% confidence interval: 1.7–7.8; P < 0.001). In this Nordic material, stronger emphasizing on higher qualified nurses in a home care setting could prevent or delay NHA

Body, participation and self transformations during and after in-patient stroke rehabilitation

This study explores stroke survivors' experience of being part of an institutional rehabilitation context and what it means for the immediate experience of discharge home. The aim is to develop a deeper understanding of how the dynamic phenomenon body, participation in everyday life and sense of self interrelates and changes through stroke survivors' movement in and between the two contexts and what this phenomenon means for stroke survivors' process of change and well-being in the early rehabilitation trajectory. Repeated, retrospective, in-depth interviews were conducted with nine persons living with moderate impairment after stroke and their closest relatives. Phenomenological and critical psychological concepts are used for analysing the data. Stroke survivors' experience indicates that their time as in-patients is important for their safety in the early juncture. Being part of an institutional rehabilitation context mobilizes stroke survivors' to optimize focus, energy and hope of physical recovery. At the same time it appears to postpone feelings of uncertainty and grief as well as reflection on their situation. However, immediately after homecoming a critical passage in the stroke survivors' rehabilitation trajectory appears because the perception of body, participation in everyday life and the sense of self undergo profound changes. This study stresses the importance of broadening the scope of professional initiative and paying attention to the post-rehabilitation context of everyday life during the in-patient stay

Mellom profesjonell og folkelig kunnskap. En kvalitativ studie av helsepersonell sin kunnskap om og håndtering av "læsing" i en norsk-samisk kommune

Formålet med artikkelen er å beskrive helsepersonell sin forståelse av tradisjonell helbredelse og hvordan de håndterer dette fenomenet. Artikkelen er basert på to fokusgruppeintervju og semistrukturerte intervju med 13 helsepersonell i en norsk-samisk kommune.In northern Norway spiritual healing traditions are still practiced, especially among people related to Sami background and culture. Studies indicate that the general public believes that health care professionals are sceptical when it comes to the traditional spiritual healing practice known as "reading" or læsing in Norwegian. The purpose of this article is to describe healthcare providers' understanding of traditional healing, and how health care professionals handle it. A qualitative study based on semi structured interviews and two focus group interviws with 13 primary health care professionals, two physicians, seven nurses and four welfare workers, was conducted in a rural Sami area in North-Norway. The study shows that health care professionals have great knowledge of and respect for reading. The knowledge is based on the health care professional's relationship with the community. Health care professionals distinguish between how they relate to reading as private persons and as health care professionals. The analysis provides an understanding of how traditional knowledge and professional biomedical knowledge plays together in health care providers' work in primary health care. It can provide input into the development of a culturally sensitive public health care service.NF

“There are more things in heaven and earth!” How knowledge about traditional healing affects clinical practice: interviews with conventional health personnel

People with Sami and Norwegian background are frequent users of traditional folk medicine (TM). Traditional healing, such as religious prayers of healing (reading) and the laying on of hands, are examples of commonly used modalities. The global aim of this study is to examine whether health personnel’s knowledge, attitudes and experiences of traditional healing affect their clinical practice. Semi-structured individual interviews (n=32) and focus group interviews (n=2) were conducted among health personnel in two communities in Northern Norway. The text data was transcribed verbatim and analysed based on the criteria for content analysis. Six themes were identified. The participants had acquired their knowledge of traditional healing through their childhood, adolescence and experience as health personnel in the communities. They all expressed that they were positive to the patients’ use of traditional healing. They justified their attitudes, stating that “there are more things in heaven and earth” and they had faith in the placebo effects of traditional healing. The health personnel respected their patients’ faith and many facilitated the use of traditional healing. In some cases, they also applied traditional healing tools if the patients asked them to do so. The health personnel were positive and open-minded towards traditional healing. They considered reading as a tool that could help the patients to handle illness in a good way. Health personnel were willing to perform traditional healing and include traditional tools in their professional toolkit, even though these tools were not documented as evidence-based treatment. In this way they could offer their patients integrated health services which were tailored to the patients’ treatment philosophy

Å skape et hjem – kvinners plass i den tidlige institusjonsbyggingen. Nord-Norge før 1940

Scandinavian welfare research has paid more and more attention to the role played by women in building institutions for children, the sick and the elderly. The new institutions were generally called ”homes” and it was precisely this linkage between women and homes that may have led to clear perceptions of what the new ”homes” were like. Concepts like motherliness, homeliness and intimacy are presented as important characteristics, despite (or because of ) the lack of empirical evidence. Historical research has shown that the home was highly idealised around the turn of the last century, but this idealisation was prescriptive and did not necessarily reflect real homes. The aim of this article is to argue that an institution, or any social system, cannot be perceived in isolation from the particular parties that created them – or from the place where they were created. Only then is it possible to say something about which or whose concept of a home was (attempted) realised. A phenomenological perspective on the home will often take as its starting point people’s need for identity, intimacy, security and meaningfulness. From a sociological point of view, the aspects that phenomenology pinpoints as important are created through time-consuming work and relevant categories can be connected with how the work is organised. ”A home” can be a lot of things, so the analysis must draw on both material, structural and symbolic aspects

Kvinnene, byen og helsepolitikken – Narvik før 1940

I 1902 ble byen Narvik en realitet, og som så mange andre byer var veksten stor på den tiden. Byene i Norge økte ikke bare i areal og folketall, men også i sine velferdsproblemer. Hvordan Narvik fikk løst noen av oppgavene knyttet til helse og sykdom og hvem som gjorde hva innenfor kommunens grenser, er tema her