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Article

Jeppe Oute and Bagga Bjerge

The purpose of this paper is twofold: to explore how gatekeepers’ ways of regulating the researchers’ access to knowledge in/about care services reflect the systemic and…

Abstract

Purpose

The purpose of this paper is twofold: to explore how gatekeepers’ ways of regulating the researchers’ access to knowledge in/about care services reflect the systemic and interpersonal values that inform Danish welfare systems’ daily workings at the street level; and also explore how the authors’ methodological experiences mirror the value-informed regulatory strategies that professionals and users themselves experience in their daily encounters in the same local practices that the authors have studied.

Design/methodology/approach

The paper takes its empirical point of departure in a multisited ethnographic field study of the management of citizens with complex problems in Danish welfare systems.

Findings

By means of Michael Lipsky’s outline of access regulation, the authors will analyze the following regulatory strategies that are identified during the fieldwork: “Gatekeepers’ sympathy and creaming,” “Queuing and delay,” and ‘Withdrawal of consent and “no resources.” The paper suggests that trust, shared goals and sympathy seem to be key to the process of getting access.

Originality/value

Despite principles of neutrality, equal rights and access to services in welfare systems, the authors’ experiences thus tend to support other research within bureaucratic and care organizations, which has found that interpersonal relations, sympathy, dislikes, norms and values, etc., can heavily influence timely access to services, tailored information and support.

Details

Journal of Organizational Ethnography, vol. 8 no. 3
Type: Research Article
ISSN: 2046-6749

Keywords

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Article

Stinne Glasdam and Jeppe Oute

The purpose of this paper is to explore how, and under what conditions, professionals involve relatives in clinical practice.

Abstract

Purpose

The purpose of this paper is to explore how, and under what conditions, professionals involve relatives in clinical practice.

Design/methodology/approach

Two cases were constructed from two studies in Denmark, theoretically inspired by Bourdieu’s concepts of doxa and position and analyzed with focus on the involvement of relatives from the perspective of professionals.

Findings

Support to relatives in practice is rarely included in the way that treatment and care are organized in healthcare. Professionals’ views of the involvement of relatives were characterized by the values of neoliberal ideology and medical-professional rationality, in which relatives are not regarded as a subject of care and support in clinical practice. The involvement of relatives aimed to ensure patients’ participation in randomized clinical trial and to help professionals to care for patients when the professionals were not absolutely needed. Professionals were relatively higher positioned in the clinic than relatives were, which allowed professionals to in – and exclude relatives. Neoliberal ideology and medical-professional rationality go hand in hand when it comes to patient treatment, care and the involvement of relatives; it is all about efficiency, treatment optimization and increased social control of the diagnosed patient. These neoliberal, organizational values consolidate doxa of the medical field and the positions that govern the meeting with patients’ relatives – if it takes place at all.

Originality/value

The results put into perspective how the combination of neoliberalism and medical logic work as an organizing principle in contemporary healthcare systems, and challenge a normative, humanistic view on involving patients’ relatives in the medical clinic.

Details

Journal of Organizational Ethnography, vol. 8 no. 2
Type: Research Article
ISSN: 2046-6749

Keywords

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Article

Jeppe Oute Hansen and Bagga Bjerge

The role of employment in dual recovery from mental illness and substance use is scarcely addressed in previous studies and a deeper understanding of this issue is needed…

Abstract

Purpose

The role of employment in dual recovery from mental illness and substance use is scarcely addressed in previous studies and a deeper understanding of this issue is needed. The purpose of this paper is to cast further light on the conditions that either facilitate or block the road to employment for dually diagnosed people (DDP) and how these conditions could either promote or hinder recovery.

Design/methodology/approach

Drawing on the principles laid out by health researchers Sandelowski and Barroso (2007), the study is designed as a qualitative meta-synthesis comprising a systematic literature search, a critical assessment of the identified studies and an integrative synthesis of the articles’ findings.

Findings

The synthesis outlines that the findings from the seven identified studies show a recovery process in which unemployed, DDP are becoming employed people – or where there is an attempt to restore their status as working persons – and how this process is driven or hindered by personal, interpersonal and systemic facilitators or barriers.

Research limitations/implications

The synthesis adds nuances to the understanding of employment in dual recovery processes and suggests that unconnected means of, and goals for, intervention among these individuals and systems might reduce the chances of DDP obtaining and maintaining a job.

Originality/value

The paper calls for more advanced research and policy on the multiple – and often contradictory – aspects of gaining and maintaining employment as part of dually diagnosed persons’ recovery.

Details

Advances in Dual Diagnosis, vol. 10 no. 3
Type: Research Article
ISSN: 1757-0972

Keywords

Abstract

Details

Journal of Organizational Ethnography, vol. 8 no. 3
Type: Research Article
ISSN: 2046-6749

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