- Stavanger, Rogaland Fylke, Norway
Ellen Ramvi
University of Stavanger, Faculty of Health Sciences, Department Member
Denne boken er utgitt Open Access og er omfattet av andsverklovens bestemmelser og Creative Commons-lisens CC BY-NC 4.0. Publikasjonen kan aksesseres pa:... more
Denne boken er utgitt Open Access og er omfattet av andsverklovens bestemmelser og Creative Commons-lisens CC BY-NC 4.0. Publikasjonen kan aksesseres pa: https://s3-eu-west-1.amazonaws.com/spartacus.no/production/attachments/Alt%20som%20lever%20m%C3%A5%20d%C3%B8_Open%20Access.pdf
BackgroundIntroducing 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... more
BackgroundIntroducing 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.MethodA 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.ResultsOf 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.ConclusionEthics 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.
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BACKGROUND Physician-patient relationships are important for patients’ health outcomes. The rapid introduction of new technologies has brought complex dimensions into this relationship. OBJECTIVE The main objective of this scoping review... more
BACKGROUND Physician-patient relationships are important for patients’ health outcomes. The rapid introduction of new technologies has brought complex dimensions into this relationship. OBJECTIVE The main objective of this scoping review is to explore empirical research on the use of digital health technologies and how these affect the physician-patient relationship. METHODS PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used for this scoping review, and 50 studies were included. The data were summarized through a narrative synthesis of the findings. RESULTS We found that physicians perceived digital health software as time-consuming and intrusive. Their lack of trust and concern with the technology resulted in increased inefficiency and workload and in reduced quality of health care delivery. Physicians accepted technology when it resulted in benefits. Patients felt that digital health technology shifted the power balance in their favor....
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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... more
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 sammenblandi...
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Vi vet at foreldres rusmiddelbruk danner mønster for barnas rusmiddelvaner, men av ennå større betydning er foreldres evne til å formidle holdninger om rusmiddelvaner. Vi vet også at hjemmet er en betydelig arena for ungdoms drikking.... more
Vi vet at foreldres rusmiddelbruk danner mønster for barnas rusmiddelvaner, men av ennå større betydning er foreldres evne til å formidle holdninger om rusmiddelvaner. Vi vet også at hjemmet er en betydelig arena for ungdoms drikking. Denne rapporten beskriver resultatene fra et prosjekt der hensikten var å gjøre en første utprøving av en metode for rusmiddelforebyggende arbeid rettet mot barn og unge, der foreldre er sentrale aktører. Metoden ble prøvd ut i en 9 klasse, der ungdom reflekte11e over voksnes rusmiddelvaner, og den ble prøvd ut av foreldre til elever i 6 klasse der foreldrene bevisstgjorde sitt eget forhold til rusmidler. Metoden vil utvikles videre i et prosjekt finansiert av Extra-midler fra Helse og Rehabilitering. Det endelige målet er å utvikle et verktøy som skolen, FAU, frivillige organisasjoner etc., selv kan bruke i sitt rusmiddelforebyggende arbeid
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Vi vet at foreldres rusmiddelbruk danner mønster for barnas rusmiddelvaner, men av ennå større betydning er foreldres evne til å formidle holdninger om rusmiddelvaner. Vi vet også at hjemmet er en betydelig arena for ungdoms drikking.... more
Vi vet at foreldres rusmiddelbruk danner mønster for barnas rusmiddelvaner, men av ennå større betydning er foreldres evne til å formidle holdninger om rusmiddelvaner. Vi vet også at hjemmet er en betydelig arena for ungdoms drikking. Denne rapporten beskriver resultatene fra et prosjekt der hensikten var å gjøre en første utprøving av en metode for rusmiddelforebyggende arbeid rettet mot barn og unge, der foreldre er sentrale aktører. Metoden ble prøvd ut i en 9 klasse, der ungdom reflekte11e over voksnes rusmiddelvaner, og den ble prøvd ut av foreldre til elever i 6 klasse der foreldrene bevisstgjorde sitt eget forhold til rusmidler. Metoden vil utvikles videre i et prosjekt finansiert av Extra-midler fra Helse og Rehabilitering. Det endelige målet er å utvikle et verktøy som skolen, FAU, frivillige organisasjoner etc., selv kan bruke i sitt rusmiddelforebyggende arbeid
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Bakgrunn: Pleiepersonellets samhandling i sykehjemer viktig for kvaliteten på omsorgen formennesker i livets sluttfase og for de ansattes egen velferd. I studien undersøker vi hvordan pleiepersonell i norske sykehjemopplever og... more
Bakgrunn: Pleiepersonellets samhandling i sykehjemer viktig for kvaliteten på omsorgen formennesker i livets sluttfase
og for de ansattes egen velferd. I studien undersøker vi hvordan pleiepersonell i norske sykehjemopplever og forholder
seg til det flerkulturelle arbeidsfellesskapet.
Metode: Etnografisk feltarbeid og narrative intervjuermed 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
problemi 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.
og for de ansattes egen velferd. I studien undersøker vi hvordan pleiepersonell i norske sykehjemopplever og forholder
seg til det flerkulturelle arbeidsfellesskapet.
Metode: Etnografisk feltarbeid og narrative intervjuermed 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
problemi 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.
I denne artikkelen har vi tatt utgangspunkt i en studie der vi har undersøkt helsesykepleieres opplevelse av å ha samtaler med skolebarn i alderen seks til tolv år, og hvilke emosjonelle erfaringer slike barnesamtaler har gitt... more
I denne artikkelen har vi tatt utgangspunkt i en studie der vi har undersøkt helsesykepleieres opplevelse av å ha samtaler med skolebarn i alderen seks til tolv år, og hvilke emosjonelle erfaringer slike barnesamtaler har gitt helsesykepleierne. Artikkelen anvender et psykodynamisk perspektiv i fortolkningen av helsesykepleiernes erfaringer.The purpose of this study was to explore and describe school nurses’ emotional experience of having conversations with children in primary school. Six school nurses were enrolled for interviews. The results from the analysis of these interviews were interpreted from a psychodynamic perspective. We identified that school nurses had high ideals for the relationship they wished to achieve with the child ren. The experience of often being unable to live up to these high expectations for the relation and communication with the children were felt as a th reat to the school nurses’ (professional)identity. In our interpretation, this may lead to risky fo...
Rapporten viser resultatene av evaluering av gjennomføringen av handlingsplanen mot HIV/AIDS-epidemien 1996–2000. Evalueringen er utført på oppdrag fra Sosial- og helsedepartementet på grunnlag av departementets mandag for evalueringen.... more
Rapporten viser resultatene av evaluering av gjennomføringen av handlingsplanen mot HIV/AIDS-epidemien 1996–2000. Evalueringen er utført på oppdrag fra Sosial- og helsedepartementet på grunnlag av departementets mandag for evalueringen. Evalueringen vurderer den epidemiologiske kunnskapsstatus for HIV/AIDS her i landet og går igjennom smittesituasjonen for ulike grupper i befolkningen. Rapporten tar opp den HIV/AIDS-forebyggende innsatsen i handlingsplanperioden og vurderer sterke og svake sider ved denne innsatsen. Rapporten gir til slutt forslag til prinsipper for framtidig planlegging av forebygging mot HIV/AIDS med forslag til organisering og finansiering.Sosial- og helsedepartemente
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I denne rapporten presenteres resultatene fra utviklingen og utprøvingen av en metode for å formulere og implementere rusmiddelpolitikk i arbeidslivet. Utviklingen og utprøvingen av metoden har foregått i en tett dialog med åtte bedrifter... more
I denne rapporten presenteres resultatene fra utviklingen og utprøvingen av en metode for å formulere og implementere rusmiddelpolitikk i arbeidslivet. Utviklingen og utprøvingen av metoden har foregått i en tett dialog med åtte bedrifter innen bransjene avis, olje-industri og teknologibedrifter. Metodikken er presentert og gjort tilgjengelig via en egen hjemmeside på Internett: www.rf.no/igor. På denne siden finnes både generell informasjon om temaet arbeidsliv og rus, linker til andre aktuelle hjemmesider og alle de it-verktøy som er utviklet ved bruk av metodikken i bedriftene. I rapporten presenteres spesielt erfaringene fra utprøvingen av alle faser av metodikken i en bedrift. Til slutt presenteres de videre utviklingsmuligheter vi ser for evaluering og formidling av metodikken, bruk av metodikken på andre arenaer og behovene for videre forsknings- og utviklingsarbeid innen temaet arbeidsliv og rus
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Denne rapporten gir en beskrivelse av det flerkulturelle miljøet ved et hotell i Norge. Beskrivelsen er basert på data samlet inn gjennom feltarbeid og intervju. Resultater av denne studien ble fremlagt muntlig i 2 workshoper der både... more
Denne rapporten gir en beskrivelse av det flerkulturelle miljøet ved et hotell i Norge. Beskrivelsen er basert på data samlet inn gjennom feltarbeid og intervju. Resultater av denne studien ble fremlagt muntlig i 2 workshoper der både ansatte og ledere ved hotellet deltok. På bakgrunn av denne fremstillingen, og diskusjonen i workshopen, ble det utarbeidet en strategi for mangfold i bedriften. Denne strategien presenteres i slutten av rapporten
Hovedintensjonen med prosjektet har vært å utvikle og prøve ut nye måter å jobbe rusmiddelforebyggende på, med foreldre som hovedaktører. Målgruppen for prosjektet har vært foreldre flest, ikke primært personer som er definert å være i en... more
Hovedintensjonen med prosjektet har vært å utvikle og prøve ut nye måter å jobbe rusmiddelforebyggende på, med foreldre som hovedaktører. Målgruppen for prosjektet har vært foreldre flest, ikke primært personer som er definert å være i en risikogruppe i forhold til bruk av rusmidler. Resultatet av utviklingsprosessen er blitt et konkret samtaleprogram for foreldre til barn i 11-12 årsalderen. Programmet, som går over 3 kvelder, er basert på en metodikk der refleksjon og bevisstgjøring settes i fokus - med utgangspunkt i deltakernes egne erfaringer med bruk av rusmidler (i hovedsak alkohol). Det foreligger en kort redegjørelse for programmets innhold og metodikk i kap. 2 i denne rapporten. I arbeidet med prosjektet har vi dratt store veksler på flere års arbeid med kartlegging og vurdering av rusmiddelbruk i tilknytning til arbeidslivet - og en spesiell metodikk for kartlegging og kritisk vurdering av arbeidsrelatert rusmiddelbruk (Nesvåg og Tungland 1999, Nesvåg et.al. 2000). Hovedm...
This article focuses on what both psychoanalysis and anthropology have in common: the emphasis on the researcher's own experience. An ethnographic fieldwork will be used to illustrate how a psychoanalytical approach unfolds the... more
This article focuses on what both psychoanalysis and anthropology have in common: the emphasis on the researcher's own experience. An ethnographic fieldwork will be used to illustrate how a psychoanalytical approach unfolds the material when studying conditions for learning from experience among teachers in two Norwegian junior high schools, and also the strong methodological implications of this approach. The researcher's struggle to remain open is elaborated. Here "openness" is regarded as something more than a principle for research practice. It is a way to relate both to oneself and the other, to emotions as well as actions, to the inner as well as the external world.
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Aim: To explore and develop understanding of nursing home staff's emotional experiences of being in a close relationship with a resident in long-term care who later died. Design: Ethnographic fieldwork. Methods: As part of fieldwork,... more
Aim: To explore and develop understanding of nursing home staff's emotional experiences of being in a close relationship with a resident in long-term care who later died. Design: Ethnographic fieldwork. Methods: As part of fieldwork, narrative interviews were conducted with nursing home staff ( n = 6) in two nursing homes in Norway and analyzed using interpretative phenomenological analysis. Findings: Through data analysis, we identified three superordinate themes: (1) wanting to be something good for the resident and their families, (2) striving to make sense of the resident's death, and (3) struggling to balance being personal and professional. Implications for holistic nursing and conclusion: Nursing home staff experience tensions between ideals of distanced professionalism and the emotional experience of proximity, evidenced by personal commitment and mutual recognition in relationships with “special residents” in long-term care. To support holistic practice, awareness i...
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This article engages with recent shifts in public healthcare policy in Norway through a psychosocial analysis of contemporary cancer care, which evokes the hope of cure and reparation in the psychosocial imaginary. With increasing... more
This article engages with recent shifts in public healthcare policy in Norway through a psychosocial analysis of contemporary cancer care, which evokes the hope of cure and reparation in the psychosocial imaginary. With increasing incidence and prevalence, cancer is a persistent challenge for public health services. Policy makers therefore emphasise that resources must be prioritised while ensuring good-quality care for vulnerable citizens. In 2015, Norway implemented integrated patient pathways as national guidelines to standardise clinical assessment and medical treatment for patients with a suspected cancer diagnosis. In a text analysis of ‘the integrated breast cancer pathway’ as a framework for practice, we found the concept and practice of care absent. There were sparse descriptions of the relational responsibilities of health professionals, beyond informing and communicating. From a psychosocial care understanding, we problematise how the emphasis on information delivery pres...
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IntroductionThe 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... more
IntroductionThe 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 analysisCARING 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 disse...
Aim: To explore and develop understanding of nursing home staff's emotional experiences of being in a close relationship with a resident in long-term care who later died. Design: Ethnographic fieldwork. Methods: As part of fieldwork,... more
Aim: To explore and develop understanding of nursing home staff's emotional experiences of being in a close relationship with a resident in long-term care who later died. Design: Ethnographic fieldwork. Methods: As part of fieldwork, narrative interviews were conducted with nursing home staff (n = 6) in two nursing homes in Norway and analyzed using interpretative phenomenological analysis. Findings: Through data analysis, we identified three superordinate themes: (1) wanting to be something good for the resident and their families, (2) striving to make sense of the resident's death, and (3) struggling to balance being personal and professional. Implications for holistic nursing and conclusion: Nursing home staff experience tensions between ideals of distanced professionalism and the emotional experience of proximity, evidenced by personal commitment and mutual recognition in relationships with "special residents" in long-term care. To support holistic practice, awareness is needed of the emotional impact of relationships on health professionals. Suppressing feelings puts staff at risk of moral distress, compassion fatigue, and burnout, as well as higher turnover and absenteeism. Managers should facilitate discussions on professionals' ideals of relationship-based practice, including processing of, and reflection on, emotional experiences in long-term care. Rituals to mark a resident's death can provide further emotional containment. Authors' Note: This PhD project is part of Work Package 4 in Multicultural workforce in nursing homes: Contemporary challenges, opportunities, and potentials for the future in the Norwegian municipal care sector, MULTICARE, financed by the Research Council of Norway (grant no. 256617). The authors would like to thank the nursing home staff who participated in this study and shared their experiences and time. They also would like to thank Emeritus
Aim To investigate how migrant nursing home staff relate to religion in their care for patients who are approaching death. Method and Theory Individual in-depth interviews were conducted with 16 migrant health care workers from five... more
Aim To investigate how migrant nursing home staff relate to religion in their care for patients who are approaching death. Method and Theory Individual in-depth interviews were conducted with 16 migrant health care workers from five nursing homes in Norway. The overall analytic approach was hermeneutical. The parts and the whole were interpreted in light of each other to gain a “thick description” of the data material in order to show the ways in which experiential meaning-making draws on cultural webs of sign ificance. Findings Religion held various meanings for the migrant health care workers interviewed. Religious and cultural competence and knowledge of migrant nursing home staff was neither asked for by the management nor discussed in the staff group. The way our participants related to religion at work was therefore based on individual preferences and internalized practices. Conclusion and Implication for Practice Organized reflection groups among staff are needed in order to ...
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For the experience of end-of-life care to be 'good' many ethical challenges in various relationships have to be resolved. In this article, we focus on challenges in the nurse-next of kin relationship. Little is known about... more
For the experience of end-of-life care to be 'good' many ethical challenges in various relationships have to be resolved. In this article, we focus on challenges in the nurse-next of kin relationship. Little is known about difficulties in this relationship, when the next of kin are seen as separate from the patient. Research problem: From the perspective of nurses: What are the ethical challenges in relation to next of kin in end-of-life care? A critical qualitative approach was used, based on four focus group interviews. A total of 22 registered nurses enrolled on an Oncology nursing specialisation programme with experience from end-of-life care from various practice areas participated. Ethical considerations: The study was approved by the Norwegian Social Science Data Service, Bergen, Norway, project number 41109, and signed informed consent obtained from the participants before the focus groups began. Two descriptive themes emerged from the inductive analysis: 'A feel...
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Aim: To investigate how migrant nursing home staff relate to religion in their care for patients who are approaching death. Method and Theory: Individual in-depth interviews were conducted with 16 migrant health care workers from five... more
Aim: To investigate how migrant nursing home staff relate to religion in their care for patients who are approaching death. Method and Theory: Individual in-depth interviews were conducted with 16 migrant health care workers from five nursing homes in Norway. The overall analytic approach was hermeneutical. The parts and the whole were interpreted in light of each other to gain a “thick description” of the data material in order to show the ways in which experiential meaning-making draws on cultural webs of significance. Findings: Religion held various meanings for the migrant health care workers interviewed. Religious and cultural competence and knowledge of migrant nursing home staff was neither asked for by the management nor discussed in the staff group. The way our participants
related to religion at work was therefore based on individual preferences and internalized practices. Conclusion and Implication for Practice: Organized reflection groups among staff are needed in order to integrate and develop religious literacy in the multicultural nursing home setting. Such reflection groups can help the individual staff member to perform holistic nursing, that is, to be attentive of the interconnectedness of biological, social, psychosocial, and spiritual aspects in a human being.
related to religion at work was therefore based on individual preferences and internalized practices. Conclusion and Implication for Practice: Organized reflection groups among staff are needed in order to integrate and develop religious literacy in the multicultural nursing home setting. Such reflection groups can help the individual staff member to perform holistic nursing, that is, to be attentive of the interconnectedness of biological, social, psychosocial, and spiritual aspects in a human being.
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This article engages with recent shifts in public healthcare policy in Norway through a psychosocial analysis of contemporary cancer care, which evokes the hope of cure and reparation in the psychosocial imaginary. With increasing... more
This article engages with recent shifts in public healthcare policy in Norway through a psychosocial analysis of contemporary cancer care, which evokes the hope of cure and reparation in the psychosocial imaginary. With increasing incidence and prevalence, cancer is a persistent challenge
for public health services. Policy makers therefore emphasise that resources must be prioritised while ensuring good-quality care for vulnerable citizens. In 2015, Norway implemented integrated patient pathways as national guidelines to standardise clinical assessment and medical treatment for patients with a suspected cancer diagnosis. In a text analysis of ‘the integrated breast cancer pathway’ as a framework for practice, we found the concept and practice of care absent. There were sparse descriptions of the relational responsibilities of health professionals, beyond informing and communicating. From a psychosocial care understanding, we problematise how the emphasis on information delivery presupposes a universally autonomous, competent, resilient and rational patient, rather than a particular human being with complex thoughts, feelings, needs and vulnerabilities in the face of a life-threatening illness. We refer to wider issues effected by neoliberal governance, which may profoundly impact on the relationship between professionals and patients. We raise the concern that integrated cancer care is a case of borderline welfare, characterised by a fear of feelings associated with mutual vulnerabilities and dependencies. We identify values and ethical pressures at stake in an emerging careless policy in Norwegian welfare, in light of the government’s stated ambition to become an international role model for good patient trajectories.
for public health services. Policy makers therefore emphasise that resources must be prioritised while ensuring good-quality care for vulnerable citizens. In 2015, Norway implemented integrated patient pathways as national guidelines to standardise clinical assessment and medical treatment for patients with a suspected cancer diagnosis. In a text analysis of ‘the integrated breast cancer pathway’ as a framework for practice, we found the concept and practice of care absent. There were sparse descriptions of the relational responsibilities of health professionals, beyond informing and communicating. From a psychosocial care understanding, we problematise how the emphasis on information delivery presupposes a universally autonomous, competent, resilient and rational patient, rather than a particular human being with complex thoughts, feelings, needs and vulnerabilities in the face of a life-threatening illness. We refer to wider issues effected by neoliberal governance, which may profoundly impact on the relationship between professionals and patients. We raise the concern that integrated cancer care is a case of borderline welfare, characterised by a fear of feelings associated with mutual vulnerabilities and dependencies. We identify values and ethical pressures at stake in an emerging careless policy in Norwegian welfare, in light of the government’s stated ambition to become an international role model for good patient trajectories.
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Spørsmålet vi forfølger i dette kapitlet, er: Hvordan kan vi skape rom for å uttrykke tanker og følelser rundt døden, og hva kjennetegner det som vanligvis blir liggende «under over averflaten»? Vi baserer oss på et forskningsprosjekt... more
Spørsmålet vi forfølger i dette kapitlet, er: Hvordan kan vi skape rom for å uttrykke tanker og følelser rundt døden, og hva kjennetegner det som vanligvis blir liggende «under over averflaten»? Vi baserer oss på et forskningsprosjekt hvor vi har prøvd ut visuell matrise, en ny eksperimentell metode for datainnsamling i en gruppe. I dette prosjektet brukte vi metoden for å utforske forestillinger rundt overganger i alderdommen, som overgangen fra liv til død. Vi ville finne ut av hva en visuell matrise kunne avlede når det gjelder aspekter ved aldring som kan være krevende å snakke om fordi de er vanskelige å se for seg og å tåle, for både informanter og forskere.
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This paper investigates nursing home staff’s experiences of the “final journey,” when a resident’s dead body is taken to the cold room. The account is based on data from ethnographic fieldwork in two nursing homes in Norway. Accompanying... more
This paper investigates nursing home staff’s experiences of the “final journey,” when a resident’s dead body is taken to the cold room. The account is based on data from ethnographic fieldwork in two nursing homes in Norway. Accompanying the dead body, staff found themselves “betwixt and between” – an anxious and ambiguous state, bordering on
the uncanny. Liminality became a useful theoretical device in the data interpretation. The last offices – a rite of passage governing liminal states – provided a containing structure for this final journey but were not sufficient to banish the uncanny from the staff’s experience.
the uncanny. Liminality became a useful theoretical device in the data interpretation. The last offices – a rite of passage governing liminal states – provided a containing structure for this final journey but were not sufficient to banish the uncanny from the staff’s experience.
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Spørsmålet vi vil forfølge i dette kapitlet, er: Hvordan kan vi skape rom for å uttrykke tanker og følelser rundt døden, og hva kjennetegner det som vanligvis blir liggende «under overflaten»? Vi baserer oss på et forskningsprosjekt hvor... more
Spørsmålet vi vil forfølge i dette kapitlet, er: Hvordan kan vi skape rom for å uttrykke tanker og følelser rundt døden, og hva kjennetegner det som vanligvis blir liggende «under overflaten»? Vi baserer oss på et forskningsprosjekt hvor vi har prøvd ut visuell matrise, en ny eksperimentell metode for datainnsamling i en gruppe (Liveng m.fl., 2017; Ramvi m.fl., 2019). I dette prosjektet brukte vi metoden for å utforske forestillinger rundt overganger i alderdommen. Vi ville finne ut av hva en visuell matrise kunne avlede når det gjelder aspekter ved aldring som kan være krevende å snakke om fordi de er vanskelige å se for seg og å tåle, for både informanter og forskere. Det ble gjennomført tre matriser med tre ulike temaer i dette prosjektet: den første på overgangen fra liv til død, den andre på overgangen fra arbeidslivsdeltakelse til pensjonisttilværelse, og den tredje på overgangen fra normal mental funksjon til demens. I dette kapitlet vil vi rette oppmerksomheten mot den første matrisen, som dreide seg om forestillinger knyttet til overgangen mellom liv og død. Avslutningsvis vil vi komme inn på døden som en utfordring for helsepersonell og gi et frempek knyttet til visuell matrises potensial som intervensjon for helsepersonell som konfronteres med liv-og-død-situasjoner i sitt daglige arbeid med pasienter og brukere. (antologikapittel)
Research Interests: Cultural Studies, Psychoanalysis, Research Methodology, Death, Death Studies, and 11 moreQualitative methodology, Psychosocial Research, Wilfred Bion, Melanie Klein, Psychosocial Studies, Visual Research Methods, Imaginary, Free Association, Life-Course Transitions, Visual Matrix, and Depth-Hermeneutics
This article explores knowledge about the breast in lived experience, addressing a gap in empirical research on a highly gendered cultural trope and embodied organ. We present findings from a study that used a free-associative... more
This article explores knowledge about the breast in lived experience, addressing a gap in empirical research on a 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 expressions of tacit aspects of the breast, aiming to generate an understanding of relations between embodied and enculturated experiences. 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 idealized aspects of the breast. This was expressed through symbolizations, affectively delivered in an exuberant mode, emphasizing the breast's potency and its potential for nurturance and "weaponization". Through this feminine poetic, life and death became inseparable yet ambiguous dimensions of breasts. The breast's life-affirming qualities included the sensual, the visceral, and the joyful-a material-semiotic knowing. This was in contrast to a second matrix, which expressed a more ambivalent and troubled response, and in which associations were weighted towards the spectacular breast of an ocular-centric culture that privileges hetero-masculine looking. We discuss differences between the two matrices in terms of psychosocial tensions between embodied and enculturated experiences.
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The visual matrix method is designed to elicit imagistic and associative contributions established collectively amongst participants in a group setting. In this article, a hard-to-reach area of experience – death and dying – illustrates... more
The visual matrix method is designed to elicit imagistic and associative contributions established collectively amongst participants in a group setting. In this article, a hard-to-reach area of experience – death and dying – illustrates the production of shared cultural images beyond individual experience. Our dual purpose was to assess the suitability of the method for this challenging topic, and to understand the ways in which death figured in the imagination of the participants. Three theorists, Wilfred Bion, Alfred Lorenzer and Gilles Deleuze, enable us to theorise psychosocial processes of symbolisation beyond cognition. Keywords containment death psychosocial methodology reverie This is a preview of subscription content, log in to check access.
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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... more
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 contexts