Sikkerhet, følelser og fellesskap

Opplevelse av stagnasjon i arbeidet med sikkerhet i nordsjøen, har fått oljeindustrien til å søke nye veier for å komme videre i sikkerhetsarbeidet. Denne artikkelen beskriver og analyserer to prosjekt der en forsøkte å bedre sikkerheten offshore gjennnom å ta utgangspunkt i 'lagånd' (team spirit). I gruppeprosesser med ansatte reflekterte en over konkrete erfaringer fra arbeidssituajsoner. Gruppeprosessene ble utviklet på bakgrunn av objektsrelasjonsteori (teori om kontaktutvikling) og helsefremmende ideologi

Silence about encounters with dying among healthcare professionals in a society that ‘de-tabooises’ death

Background: Empirical studies on healthcare personnel indicate that professionals’ experiences with dying and death become silenced and unutterable within the healthcare service. Aim: To explore and interpret silence about encounters with death and dying among healthcare professionals in Norway. Method: The method used was theoretical exploration, using a psychosocial approach. Findings: This analysis reveals complex interrelations and two-way dynamics between subject-worlds, sociocultural and societal worlds when it comes to dealing with death and dying at work. A performance culture saturates these worlds, and may be implicated in silencing death within the healthcare institutions of the Norwegian welfare state. Conclusions: This article suggests that silence about death and dying among healthcare professionals is indicative of crucial emerging and unresolved tensions in the neoliberal episteme, accompanied and reinforced by the ineluctable basic conditions of life and intrapsychic defence against threats towards the self. Implications for practice: •Silence about death and dying presents a serious challenge for dying patients and next of kin. Healthcare professionals should be enabled to acknowledge their thoughts and emotions about death in order to be able to support and contain patients and next of kin •Learning activities such as peer support and supervision can help the processing of difficult psychological content and allow for emotional aspects of professionals’ work to be acknowledged and thought about in a way that encourages reflective and sound practice •Clinical managers should address whether performance pressures induce shameful feelings in staff, who may believe that by providing appropriate levels of care they are compromising productivity. Shame in turn, may undermine professionals’ emotional wellbeing and ability to continue to provide attuned and adequate care for dying patients •Creative approaches to facilitate reflection on this difficult topic could be encouraged by introducing death as a cultural trope (for example, by the symbolic use of art, literature, music) into clinical contextspublishedVersio

Et for friskende arbeidsliv? - Helsetjenestens rolle og funksjon i inkludering av mennesker med psykiske helsevansker i ordinært arbeidsliv, sett fra et lederperspektiv

I Norge har det vært økende vektlegging av arbeidsintegrerende tiltak for mennesker med psykiske helsevansker i ordinært arbeidsmarked. I denne artikkelen utforsket vi lederes erfaringer med helsetjenestens rolle i arbeidsinkluderingen. Det ble foretatt 15 semi-strukturerte intervju med ledere fra ulike deler av arbeidslivet. Analyse av materialet viste at lederne hadde liten erfaring med helsetjenesten, og hadde vanskelig for å se for seg helsetjenestens rolle i inkluderingsprosessen. Noen av lederne uttrykket likevel behov for økt kompetanse på psykiske helseplager. Lederne hadde negative forestillinger om helsetjenesten som kan utgjøre en barriere i samarbeidet

Thinking from Experience in Psychosocial Practice: Reclaiming and Teaching ‘Use of Self’

A course based on psychosocial theory and students' experiences in practice has been taught in the UK, Norway and Quebec. It departs from the classical social work concept ‘use of self’ and aims to help novices in health and social work to understand how the social world is internalised and re-produced and the value of thinking from experience. International developments such as, competency-based education, New Public Management and evidence-based practice reduce opportunities for experiential learning. This trend has been exacerbated by a focus on anti-oppressive practice without a corresponding understanding of how oppressive relations are internalized and enacted by defended and conflicted subjects. Attempts to rectify a relational deficit through traditions of reflective practice and critical reflection are important developments, but could be further strengthened by psychosocial and psychodynamic perspectives. The course combines critical, contextual and relational thinking for students in caring profession

Ethics of care in technology-mediated healthcare practices: A scoping review

Background Introducing new technologies into healthcare practices may challenge professionals' traditional care cultures. The aim of this review was to map how the ‘ethics of care’ theoretical framework informs empirical studies of technology-mediated healthcare. Method A scoping review was performed using eight electronic databases: CINAHL with full text, Academic Search Premier, MEDLINE, the Philosopher's Index, SocINDEX with Full Text, SCOPUS, APA PsycInfo and Web of Science. This was followed by citation tracking, and articles were assessed against the inclusion criteria. Results Of the 443 initial articles, 18 met the criteria and were included. We found that nine of the articles used the concept of ‘ethics of care’ (herein used interchangeably with the terms ‘feminist ethics’ or ‘relational ethics’) insubstantially. The remaining nine articles deployed care ethics (or its equivalent) substantially as an integrated theoretical framework and analytical tool. We found that several articles suggested an expansion of ethics of care to encompass technologies as part of contemporary care. Furthermore, ethics of care contributed to the empirical research by recognising both new relationships between patients and healthcare professionals as well as new ethical challenges. Conclusion Ethics of care is sparsely used as a theoretical framework in empirical studies of technology-mediated healthcare practices. The use of ethics of care in technology-mediated care brings new dilemmas, relational tensions and vulnerabilities to the foreground. For ethics of care to be used more explicit in empirical studies, it is important that it is recognised by research community as an adequate, universal ethical theory.publishedVersio

CARING FUTURES: a study protocol for transdisciplinary qualitative research on technology-mediated care practices and theory development for ethics of care

Introduction The world’s population is ageing. As older persons live longer and increase in number, society faces a greater disease burden and, in public welfare, a corresponding resource deficit. New technology is one solution to this deficit but there is scarce knowledge about ethical aspects of such innovations in care practices. In CARING FUTURES, we address this scarcity by interrogating how new technology in care can become ethically sound and, correspondingly, how ethics of care can become more technology aware. Our concern is to protect quality care for the future. Methods and analysis CARING FUTURES advances transdisciplinarity through knowledge exchange around technology-mediated care and ethics of care, involving key stakeholders. We rely on established and innovative methods to generate experience-near and practice-near knowledge. Through this empirical research, we seek to expand understanding of technology-mediated care and to enrich ethics of care theory. Ethics and dissemination Empirical studies have been approved or await approval by national ethics committees. CARING FUTURES is designed to create societal impact through Knowledge Transfer Events targeting stakeholders in health, care and welfare, and Educational Packages for students of care—providing knowledge-exchange forums for future academics and practitioners of care. The project’s societal impact is also ensured in that participating researchers are also practitioners and/or educators of care personnel for the future. Project findings will be disseminated through scientific publications and conference presentations. Through communication in both traditional and digital media platforms, we engage in dialogues between researchers, user groups, policy makers and the wider public.publishedVersio

Spenninger i flerkulturelle arbeidsfellesskap ved sykehjem. En etnografisk studie

Bakgrunn: Pleiepersonellets samhandling i sykehjem er viktig for kvaliteten på omsorgen for mennesker i livets sluttfase og for de ansattes egen velferd. I studien undersøker vi hvordan pleiepersonell i norske sykehjem opplever og forholder seg til det flerkulturelle arbeidsfellesskapet. Metode: Etnografisk feltarbeid og narrative intervjuer med nøkkelinformanter i sykehjem. Dataanalysen tok utgangspunkt i to situasjoner beskrevet i feltnotater som var representative for spenninger i arbeidsfellesskapet. Disse ble videre undersøkt gjennom en psykososial tilnærming med gruppebasert dybdehermeneutisk fortolkning. Resultat: Gjennom analyseprosessen identifiserte vi to nøkkelfunn: 1) Å se pleiere med innvandrerbakgrunn som et problem i en arbeidshverdag preget av travelhet og tidspress, og 2) Strategier for å unngå å bli stigmatisert som et (innvandrer)problem. Funnene viser hvordan diskriminering og rasisme utspiller seg på sykehjem, både gjennom indirekte og direkte ytringer. Konklusjon: I denne studien anvendte vi begrepene «indre rasist» og «mikroaggresjon» for å fortolke nøkkelfunnene og bedre forstå både minoritets- og majoritetsnorske pleieres uttalelser om ansatte med minoritetsbakgrunn så vel som våre egne holdninger som forskere i omgang med data fra feltarbeidet. De reelle uttrykkene for både implisitt og eksplisitt diskriminering og rasisme som belyses i denne studien, angår oss alle som medmennesker og medborgere i et mangfoldig samfunn.publishedVersio

Livshistorier i omsorgsarbeid. Utfordringer og muligheter ved bruk av livshistoriedokumentasjon på sykehjem

Nyere helse- og omsorgspolitiske dokumenter løfter fram livshistorier som en viktig kilde til kunnskap i eldreomsorgen, og et relevant verktøy for profesjonelt omsorgsarbeid på sykehjemmet. Men hvilke utfordringer og muligheter ligger i livshistorier som omsorgsverktøy i praksis? Denne artikkelen er basert på et tverrfaglig samarbeidsprosjekt mellom forskere innenfor praksisfeltet, sykepleierstudenter, samfunnsvitere, helsevitere og humanister. Vår hensikt er å få ny kunnskap om utbredelse av livshistorier som omsorgsverktøy på sykehjem, og hva som karakteriserer slike verktøy. Ved hjelp av en kartleggingsstudie om livshistorier som et verktøy for dokumentasjon og kommunikasjon ved sykehjem i en region på Vestlandet, fant vi stor variasjon i utforming av skjemaene som brukes til å dokumentere pasientenes livshistorie. Gjennom en komparativ nærlesning av skjemaenes stilistiske utforminger og kommunikasjonsformer, drøfter vi implikasjonene av det vi ser som en utfordrende sammenblanding av instrumentelle og relasjonelle hensikter ved bruk av livshistorier i profesjonell omsorg.publishedVersio

Imagining transitions in old age through the visual matrix method: thinking about what is hard to bear

Dominant discourses of ageing are often confined to what is less painful to think about and therefore idealise or denigrate ageing and later life. We present findings from an exploratory psychosocial study, in a Nordic context into three later-life transitions: from working life to retirement, from mental health to dementia, and from life to death. Because, for some, these topics are hard to bear, and therefore defended against and routinely excluded from everyday awareness, we used a method led by imagery and affect - the Visual Matrix - to elicit participants’ free associative personal and collective imagination. Through analysis of data extracts, on the three transitions, we illustrate oscillations between defending against the challenges of ageing and realism in facing the anxieties it can provoke. A recurring theme includes the finality of individual life and the inter-generational continuity, which together link life and death, hope and despair, separation and connectedness

Psychosocial and symbolic dimensions of the breast explored through a Visual Matrix

This article explores knowledge about the breast in the psychosocial interplay of lived experience, addressing a gap in empirical research on this highly gendered cultural trope and embodied organ. We present findings from a study that used a free-associative psychosocial method – the Visual Matrix – in order to stimulate, and capture expressions of, tacit aspects of the breast that have evaded discursive representation, as well as to generate understanding of relations between embodied and enculturated experience. Little research has been conducted on women’s affirmative experience of breasts, possibly because their bio-psycho-sociocultural complexity affords an onto-epistemological and empirical challenge. Our data revealed how an aesthetic of the grotesque in one matrix allowed the mainly female group to use humour as a “creative psychic defence” against culturally normative and idealised aspects of the breast. This was expressed through sensual symbolisations of breasted experience, affectively delivered with exuberance and joy. There was an emphasis on the breast’s potency and its potential for both abundant nurturance and potent “weaponisation”. By establishing this feminine poetic mode, Visual Matrix imagery symbolised life and death as tolerable, inseparable yet ambiguous dimensions of breasts, thereby resisting anxious splitting. The breast’s life-affirming qualities included the sensual, the visceral and the joyful – a materialsemiotic knowing. This was in marked contrast to a second matrix where associations were weighted towards the spectacular breast of an ocular-centric culture that privileges heteromasculine looking. This matrix reflected a more ambivalent and sometimes troubled response among participants. Reasons for the difference between the two matrices are discussed in terms of how they responded to the tension between embodied and enculturated experiences