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Article

Elisabeth Dahlborg, Ellinor Tengelin, Elin Aasen, Jeanne Strunck, Åse Boman, Aase Marie Ottesen, Berit Misund Dahl, Lindis Kathrine Helberget and Inger Lassen

The paper aims to compare and discuss the findings of discursive constructions of patients in legal texts from the three Scandinavian countries. Since traditional welfare…

Abstract

Purpose

The paper aims to compare and discuss the findings of discursive constructions of patients in legal texts from the three Scandinavian countries. Since traditional welfare state systems in Scandinavia are being challenged by new governance systems, new questions are being raised about patient positions and agency, carrying with them potential ethical dilemmas for healthcare professionals.

Design/methodology/approach

The methodology of the paper is inspired by critical discourse analysis. Comprehensively analysing the findings of previous discourse studies on how “the patient” is constructed in central policy texts, this study compares the position of the patient in Norway, Sweden and Denmark.

Findings

The paper reveals ideological struggles across the Scandinavian countries, operating at a political level, a legislative level and a healthcare level. It is shown that national governance systems still exert hegemonic power by strongly influencing patients' degree of choice and autonomy. The discursive struggle between welfare state governance and other governance systems in Scandinavia indicates a shift towards a commercial healthcare market although a traditional welfare model is advocated by professionals and researchers.

Research limitations/implications

Because of the specific conditions of Scandinavian healthcare policy, the findings lack generalisability. The research approach should therefore be explored further in additional contexts.

Practical implications

The findings of this study can inform policymakers, professionals and patients of the ideological values underlying seemingly objective shifts in national policy.

Originality/value

A comparative critical discourse analysis can expose patterns in the Scandinavian approaches to patient rights.

Details

International Journal of Health Governance, vol. 26 no. 1
Type: Research Article
ISSN: 2059-4631

Keywords

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Article

Ellinor Tengelin, Christina Cliffordson, Elisabeth Dahlborg and Ina Berndtsson

Healthcare professionals’ conscious or unconscious norms, values and attitudes have been identified as partial explanations of healthcare inequity. Norm criticism is an…

Abstract

Purpose

Healthcare professionals’ conscious or unconscious norms, values and attitudes have been identified as partial explanations of healthcare inequity. Norm criticism is an approach that questions what is generally accepted as “normal” in society, and it enables professionals to identify norms that might cause prejudice, discrimination and marginalisation. In order to assess norm-critical awareness, a measurement scale is needed. The purpose of this paper is to develop a scale for measuring norm-critical awareness.

Design/methodology/approach

The scale-development process comprised a qualitative item-generating phase and a statistical reduction phase. The item pool was generated from key literature on norm criticism and was revised according to an expert panel, pilot studies and one “think aloud” session. To investigate the dimensionality and to reduce the number of items of the scale, confirmatory factor analysis was performed.

Findings

The item-generation phase resulted in a 46-item scale comprising five theoretically derived dimensions revolving around function, consequences, identity, resistance and learning related to norms. The item-reduction phase resulted in an instrument consisting of five dimensions and 20 items. The analyses indicated that a summary score on the scale could be used to reflect the broad dimension of norm-critical awareness.

Originality/value

The Norm-critical awareness scale comprises five theoretically derived dimensions and can be used as a summary score to indicate the level of norm-critical awareness in educational contexts. This knowledge is valuable for identifying areas in greater need of attention.

Details

Equality, Diversity and Inclusion: An International Journal, vol. 38 no. 6
Type: Research Article
ISSN: 2040-7149

Keywords

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Article

Ellinor Tengelin, Rebecka Arman, Ewa Wikström and Lotta Dellve

The purpose of this paper is to explore managers' boundary setting in order to better understand their handling of time commitment to work activities, stress, and recovery…

Abstract

Purpose

The purpose of this paper is to explore managers' boundary setting in order to better understand their handling of time commitment to work activities, stress, and recovery during everyday work and at home.

Design/methodology/approach

The paper has qualitatively‐driven, mixed method design including observational data, individual interviews, and focus group discussions. Data were analyzed according to Charmaz' view on constructivist grounded theory.

Findings

A first step in boundary setting was to recognize areas with conflicting expectations and inexhaustible needs. Second, strategies were formed through negotiating the handling of managerial time commitment, resulting in boundary‐setting, but also boundary‐dissolving, approaches. The continuous process of individual recognition and negotiation could work as a form of proactive coping, provided that it was acknowledged and questioned.

Research limitations/implications

These findings suggest that recognition of perceived boundary challenges can affect stress and coping. It would therefore be interesting to more accurately assess stress, coping, and health status among managers by means of other methodologies (e.g. physiological assessments).

Practical implications

In regulating managers' work assignments, work‐related stress and recovery, it seems important to: acknowledge boundary work as an ever‐present dilemma requiring continuous negotiation; and encourage individuals and organizations to recognize conflicting perspectives inherent in the leadership assignment, in order to decrease harmful negotiations between them. Such awareness would benefit more sustainable management of healthcare practice.

Originality/value

This paper highlights how managers can handle ever‐present boundary dilemmas in the healthcare sector by regulating their time commitments in various ways.

Details

Journal of Health Organization and Management, vol. 25 no. 5
Type: Research Article
ISSN: 1477-7266

Keywords

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