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Establishing Individual Care Plans for Rehabilitation Patients: Traces of Self-Targeting in the Norwegian Universal Welfare State 为康复病人建立个人护理计划:挪威全民福利国家自我定位的痕迹
Pub Date : 2019-06-14 DOI: 10.7577/NJSR.2686
Ivan Harsløf, Mirela Slomic, Ole Kristian Sandnes Håvold
Several countries have introduced devices for coordination of complicated individual cases across care, health and welfare services. This study examined one such device: the individual care plan (ICP), introduced in Norway in 2001 to enhance user involve­ment and coordination across sectors and service providers. Despite strong political imperatives, however, ICPs have remained significantly underused. To understand why, this study investigated the experiences with ICPs among staff in municipal coordinating units, tasked with organising rehabili­ta­tion efforts and case­workers in local labour and welfare services. In focus groups, participants discussed the fictitious vignette of a patient with traumatic brain injury, a person clearly within the ICP target group. They praised ICPs for advancing the rehabilitation process but acknowledged that they were applied too rarely. Through abductive-retroductive recontextualisation, this study identified a practice of de-facto self-targeting: in some municipalities, patients had to request ICPs themselves. We argue that this mechanism may have emerged from ambiguous propensities of rehabilitation, simultaneously emphasising needs and potentials, and ultimately from ambiguities in the Norwegian welfare model balancing universalism and local autonomy.
一些国家已引进了跨护理、卫生和福利服务部门协调复杂个案的装置。本研究考察了一种这样的装置:个人护理计划(ICP),该计划于2001年在挪威推出,旨在加强用户参与和跨部门和服务提供者的协调。然而,尽管有强烈的政治需要,icp仍未得到充分利用。为了理解其中的原因,本研究调查了负责组织康复工作的市政协调单位的工作人员和当地劳工和福利服务部门的个案工作者的icp经验。在焦点小组中,参与者讨论了一个虚构的创伤性脑损伤患者,一个明显属于ICP目标群体的人。他们赞扬ICPs促进了康复进程,但承认它们的应用太少了。通过溯因-回溯再情境化,本研究确定了一种事实上的自我定位做法:在一些城市,患者必须自己请求icp。我们认为,这种机制可能来自于模糊的康复倾向,同时强调需求和潜力,最终来自于挪威福利模式平衡普遍主义和地方自治的模糊性。
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引用次数: 5
Welfare transformations and expectations of sameness. Living on the margins in Denmark. 福利转型和对同一性的期望。生活在丹麦的边缘地带。
Pub Date : 2019-06-14 DOI: 10.7577/NJSR.2858
C. Merrild, R. S. Andersen
In Denmark, as in other welfare societies worldwide, the organisation and ideology of welfare are becoming increasingly influenced by neoliberal ideas. In practice, this means that the original intention behind the provision of social support, which was grounded in the notion of social responsibility, is gradually being pushed aside by notions of responsibilisation, with concepts such as deservingness and work ethic appearing to dominate the discourse. Based on long-term fieldwork and interviews conducted with socially disadvantaged Danes living on social security, this article engages with the current debates regarding responsibility and highlights some of the challenges arising from living a life that diverges from what has been termed Danish ‘in-between middle-classness’. We argue that the divergence between the promise of welfare, the current landscape of political regulation and expectations of individual responsibility leads to new forms of uncertainty, as experienced by those who depend on the services provided by the welfare state. One implication of this is that welfare seems to increasingly be tied to an agenda of sameness, whereby citizenship stems less from a imagination of sameness than from an expectation of sameness.
在丹麦,如同世界上其他福利社会一样,福利的组织和意识形态正日益受到新自由主义思想的影响。在实践中,这意味着以社会责任观念为基础的提供社会支持的初衷正逐渐被责任观念推到一边,诸如应得性和职业道德等概念似乎主导了话语。基于长期的实地调查和对生活在社会保障中的社会弱势丹麦人的采访,本文涉及到当前关于责任的辩论,并强调了与丹麦所谓的“中间中产阶级”不同的生活所带来的一些挑战。我们认为,福利承诺、当前政治监管格局和个人责任期望之间的分歧导致了新形式的不确定性,正如那些依赖福利国家提供的服务的人所经历的那样。这其中的一个含义是,福利似乎越来越多地与千篇一律的议程联系在一起,因此公民身份与其说源于对千篇一律的想象,不如说是源于对千篇一律的期望。
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引用次数: 0
What Works? Family Influences on Occupational Aspirations among Descendants of Middle Eastern Immigrants on the Swedish Labour Market 工作什么?家庭对瑞典劳动力市场上中东移民后裔职业抱负的影响
Pub Date : 2019-01-09 DOI: 10.7577/NJSR.2235
Pınar Aslan, Nader Ahmadi, Stefan Sjöberg, E. Wikström
In this article, we examine family influences on occupational aspirations among employed descendants of Middle Eastern immigrants. Using a qualitative approach, we conducted 21 semi-structured interviews with native-born descendants of Middle Eastern immigrants. We present and analyse their interpretations of their parents’ experiences and living conditions before, during and after migration and demonstrate how these interpretations shaped their own occupational aspirations. We discuss parents’ high expectations of their children in relation to ethnic-community valuations of educational and occupational achievements. These high expectations may increase the chances of social mobility but can also become a negative pressure, especially if parents set high standards but cannot help their children to meet those expectations. In these cases, older siblings who possess valuable knowledge of the educational system and labour market can function as important transferrers of resources.
在这篇文章中,我们研究了家庭对中东移民后裔职业抱负的影响。采用定性方法,我们对中东移民的本土后裔进行了21次半结构化访谈。我们呈现并分析了他们对父母在移民之前、期间和之后的经历和生活条件的解读,并展示了这些解读如何塑造了他们自己的职业抱负。我们讨论了与种族社区对教育和职业成就的评价有关的父母对孩子的高期望。这些高期望可能会增加社会流动性的机会,但也可能成为一种负面压力,特别是如果父母设定了很高的标准,却无法帮助孩子达到这些期望。在这些情况下,拥有教育制度和劳动力市场的宝贵知识的哥哥姐姐可以作为重要的资源转移者。
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引用次数: 2
Young Adults in Nature-Based Services in Norway—In-Group and Between-Group Variations Related to Mental Health Problems 挪威接受自然服务的年轻人:与心理健康问题相关的群体内和群体间差异
Pub Date : 2018-12-13 DOI: 10.7577/NJSR.2301
A. M. Steigen, B. Eriksson, R. Kogstad, H. Toft, Daniel Bergh
Young adults with mental health problems who do not attend school or work constitute a significant welfare challenge in Norway. The welfare services available to these individuals include nature-based services, which are primarily located on farms and integrate the natural and agricultural environment into their daily activities. The aim of this study is to examine young adults (16–30 years old) not attending school or work who participated in nature-based services in Norway. In particular, the study analyses mental health problems among the participants and in-group variations regarding their symptoms of mental health problems using the Hopkins Symptoms Checklist (HSCL-10). This paper compares symptoms of mental health problems among participants in nature-based services with those of a sample from the general population and a sample of those receiving clinical in-patient mental healthcare. A questionnaire was developed for the study and was completed by 93 participants in nature-based services. The majority of these participants were recruited from the Norwegian Labour and Welfare Administration (NAV), local mental health services, and school authorities. Results indicate that just more than half of the respondents exhibited symptoms of mental health problems based on their HSCL-10 scores. In general, they reported fewer symptoms than the clinical in-patient sample (18–30 years old) and more symptoms than the general population sample (18–19 years old). Among the participants in nature-based services, those recruited through NAV and local mental health services exhibited no differences in symptoms. Half of the participants older than 23 years in nature-based services had not completed upper secondary school. The participants, including those with symptoms of mental health problems and low expectations at the outset of their participation, generally expressed high satisfaction with the services.
有精神健康问题的年轻人不上学或不工作,对挪威的福利构成重大挑战。向这些个人提供的福利服务包括基于自然的服务,这些服务主要位于农场,并将自然和农业环境融入他们的日常活动中。本研究的目的是调查挪威参加自然服务的不上学或不工作的年轻人(16-30岁)。特别地,本研究使用霍普金斯症状检查表(HSCL-10)分析了参与者的心理健康问题以及他们心理健康问题症状的组内差异。本文比较了自然服务参与者的心理健康问题症状与一般人群样本和接受临床住院精神保健的样本。为这项研究编制了一份问卷,由93名从事自然服务的参与者完成。这些参与者中的大多数是从挪威劳工和福利管理局(NAV)、当地精神卫生服务机构和学校当局招募的。结果表明,根据他们的HSCL-10分数,只有一半以上的受访者表现出心理健康问题的症状。总的来说,他们报告的症状比临床住院患者样本(18-30岁)少,比一般人群样本(18-19岁)多。在以自然为基础的服务的参与者中,通过NAV和当地心理健康服务招募的参与者在症状上没有差异。从事以自然为基础的服务的23岁以上的参与者中有一半没有完成高中学业。参与者,包括那些在参与之初就有精神健康问题症状和期望较低的参与者,普遍对这些服务表示高度满意。
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引用次数: 4
Social Space for Self-Organising: An Exploratory Study of Timebanks in Finland and in the UK 自组织的社会空间:芬兰和英国时间银行的探索性研究
Pub Date : 2018-10-30 DOI: 10.7577/NJSR.2148
T. Eskelinen
The article examines the challenges to self-organisation and upscaling of alternative economies from the viewpoint of defending and negotiating social space. Timebanks in Finland and the UK are presented as examples, analysing the difference of defending such social space in the contexts of a traditional welfare state (in the case of Finland) and an austerity-driven government with a “Big Society” ideology (in the case of UK). Both systems of government present different kinds of pressures on timebanks, pushing them to a given ontological categories and to action in accordance with pre-defined political goals. This difference, along with timebank reactions and the question of prospects of opening ontological space, is analysed through material from observation, interviews with timebanks activists and brokers, and survey data from timebank users.
本文从捍卫和谈判社会空间的角度考察了替代经济的自组织和升级所面临的挑战。本文以芬兰和英国的时间银行为例,分析了在传统福利国家(芬兰)和以“大社会”为意识形态的紧缩政府(英国)背景下捍卫这种社会空间的差异。这两种政府制度对时间银行施加了不同的压力,迫使它们进入给定的本体论范畴,并按照预先确定的政治目标采取行动。这种差异,以及时间银行的反应和开放本体论空间的前景问题,通过观察材料、对时间银行活动家和经纪人的采访以及时间银行用户的调查数据进行了分析。
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引用次数: 3
Identity and self-understanding among transgender women in Norway 挪威跨性别女性的身份认同与自我理解
Pub Date : 2018-10-08 DOI: 10.7577/NJSR.2151
V. Moen, I. Aune
Aim: The aim of this study is to gain a deeper understanding of and more knowledge about the experience of transgender women in terms of identity and self-understanding. Method: Data are collected from six Norwegian adult transgender women who have told their life stories. A narrative analysis is used to analyse the stories of the participants. The narrative focus is on themes relating to identity, self-understanding and belonging. Results: The results of the study show that the participants exclusively have a female identity and sense of belonging. Despite this, two of the participants prefer to live as males out of consideration for those in their surroundings. The self-understanding of the informants is expressed in different ways, depending on personality and life experience. Conclusion: Whether or not one has ‘come out of the closet’ seems to be important for both identity and self-understanding. The participants who are open about their identity seem more secure than those who are not. The more acceptance and recognition they get from the social environment, the more it appears that the women in this study dare to be who they are.
目的:本研究的目的是为了更深入地了解和了解跨性别女性在身份和自我理解方面的经历。方法:收集6名挪威成年变性女性的数据,她们讲述了自己的生活故事。叙事分析是用来分析参与者的故事。叙事的重点是与身份、自我理解和归属感有关的主题。结果:研究结果显示,被试具有排他性的女性身份和归属感。尽管如此,出于对周围环境的考虑,其中两名参与者更喜欢以男性的身份生活。受调查者的个性和生活经历的影响,他们对自我的理解有不同的表达方式。结论:一个人是否“出柜”似乎对身份和自我理解都很重要。公开自己身份的参与者似乎比不公开的参与者更有安全感。在这项研究中,女性从社会环境中得到的接受和认可越多,她们就越敢于做自己。
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引用次数: 5
Eldercare policies in Scandinavia between 1993 and 2014: increased facilitation of family caregiving? 1993年至2014年斯堪的纳维亚半岛的老年护理政策:家庭护理的便利性增加?
Pub Date : 2018-05-10 DOI: 10.7577/NJSR.2145
C. Martens
Abstract This article asks whether legal rights provided through national legislation on services provision in Scandinavia have become, over time, more accommodating to the role of family caregiving to elderly relatives. The study is based on a comparison and analysis of changes in legislation between 1993 and 2014 in the three Scandinavian countries. It is limited to legislation on the right to eldercare services and on work-family facilitating policies in relation to the provision of care to an elderly relative. Work-family facilitating policies are those policies that enable the combining of employment in the formal economy with caring for family members without large prohibitive costs for the caregiver. The main findings in this article are that the Scandinavian countries strengthened the legal right to public care services between 1993 and 2014, but that there are few, if any, truly work-family facilitating policies. The existing schemes do not facilitate a combination of employment and care, but rather force the family caregiver to choose between them. The dilemma is whether to continue passively with a high, but declining, level of public service provision of eldercare, leaving unmet care needs to unpaid family carers, or to introduce work-family facilitating policies enabling remunerated family care in addition to extensive public services provision.
随着时间的推移,通过斯堪的纳维亚国家立法提供的服务提供的合法权利是否已经变得更加适应家庭照顾老年亲属的角色。这项研究是基于对三个斯堪的纳维亚国家1993年至2014年立法变化的比较和分析。它仅限于关于老年人护理服务权利的立法和关于为老年亲属提供护理的工作-家庭便利政策的立法。促进工作-家庭的政策是那些能够将正规经济中的就业与照顾家庭成员相结合,而不会使照顾者付出高昂代价的政策。本文的主要发现是,斯堪的纳维亚国家在1993年至2014年期间加强了公共护理服务的合法权利,但真正促进工作家庭的政策很少,如果有的话。现有的计划并没有促进就业和照顾的结合,而是迫使家庭照顾者在两者之间做出选择。进退两难的是,是继续被动地提供高但不断下降的老年护理公共服务水平,将未满足的护理需求留给无偿的家庭照顾者,还是引入工作家庭促进政策,在广泛的公共服务提供之外,还能提供有偿的家庭照顾。
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引用次数: 2
Not just "sweet old ladies" - challenges in voluntary work in the long-term care services 不仅仅是“可爱的老太太”——在长期护理服务中志愿工作的挑战
Pub Date : 2018-04-17 DOI: 10.7577/NJSR.2174
Laila Tingvold, Nina Olsvold
Introduction: The Norwegian government is addressing the need for increased voluntary work in the municipal care sector. Several reforms over the last decades have transferred important care tasks to the municipalities, as it is a political aim for people to live longer in their own homes. Despite important structural changes in the provision of public care services, less attention has been devoted to the investigation of how voluntary work interacts with the overall development of care tasks within municipal care services. This paper aims to discover how the contribution of volunteers matches the current needs of service recipients and the daily work of professional staff and, additionally, to discover what level of volunteer competence and qualifications are considered necessary when cooperating with staff.Method: Eight case studies addressing opportunities and barriers to voluntary work in long-term care were carried out. Our study included participants from both voluntary organisations and long-term care.Results: Volunteers were considered to fill important functions and gaps by providing social support, offering activities and by communicating with the service recipients. However, the poor health of service recipients risked putting undue strain on volunteers. Volunteers need to have personal qualifications, such as good observation and communication skills, in order to function well and be useful in their role as volunteers.Discussion: Care is seen as a complex task requiring time, effort, and technical and social skills. Relational care is not easily distinguished from the overall care needs of service recipients. Service recipients in the municipalities are seen as increasingly frail and have complex health needs. With the expected increase in the number of elderly with dementia in the future, we may need to question whether volunteers are equipped to take on such advanced health problems.
导言:挪威政府正在解决市政护理部门增加志愿工作的需求。过去几十年的几项改革已将重要的护理任务移交给市政当局,因为人们在自己家中生活更长时间是一项政治目标。尽管在提供公共护理服务方面发生了重要的结构性变化,但对志愿工作如何与市政护理服务中护理任务的整体发展相互作用的调查关注较少。本文旨在发现志愿者的贡献如何与服务对象的当前需求和专业人员的日常工作相匹配,并发现在与工作人员合作时,志愿者的能力和资格被认为是必要的。方法:对八个案例进行研究,探讨长期护理志愿工作的机会和障碍。我们的研究包括来自志愿组织和长期护理机构的参与者。结果:志愿者通过提供社会支持、提供活动和与服务对象的沟通,填补了重要的功能和空白。然而,服务接受者的健康状况不佳可能给志愿人员带来不适当的压力。志愿者需要具备个人资质,比如良好的观察能力和沟通能力,这样才能很好地发挥志愿者的作用。讨论:护理被视为一项复杂的任务,需要时间、精力、技术和社交技能。关系护理与服务接受者的整体护理需求不容易区分。市政当局的服务接受者被视为越来越虚弱,有复杂的保健需求。随着未来老年痴呆症患者数量的增加,我们可能需要质疑志愿者是否有能力承担这样的高级健康问题。
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引用次数: 10
A participatory discourse analysis of service users’ accounts of meeting places in Norwegian community mental health care 挪威社区精神卫生保健服务使用者关于会面地点的参与性话语分析
Pub Date : 2018-03-21 DOI: 10.7577/NJSR.2149
Lill Susann Ynnesdal Haugen, Andreas Envy, T. Ekeland, M. Borg, N. Anderssen
Since the 1960s, deinstitutionalisation has been salient in mental health reforms across the West. In Norway, this culminated in the National Action Plan for Mental Health (1999-2008), where meeting places in community mental health care were deemed a prioritised strategy to counter social isolation among people in psychosocial hardships. However, during the same period in England, meeting places were beginning to be contested for contributing to social exclusion. This is an inquiry of meeting places in Norway guided by the following research question: How do service users discuss their encounters with the spaces and people of meeting places? Situated in community psychology and participatory research traditions, we engaged in a participatory discourse analysis of four focus group discussions with 22 service users from meeting places. We detail and discuss four central discursive constructions of meeting places against the backdrop of a civil society identified as fraught with sanism that stigmatises and excludes service users: a compensatory public welfare arrangement positioning service users as citizens with social rights; a peer community positioning service users as peers who share common identities and interests; spaces of compassion validating service users as fellow human beings who are precious in their own right; and greenhouses facilitating service users to expand their horizons of possibility. This inquiry implies that meeting places could mean everything to the people who attend them by facilitating opportunities considered less accessible elsewhere in their everyday lives in a sanist civil society.
自20世纪60年代以来,去机构化一直是整个西方精神卫生改革的重要内容。在挪威,这在《国家精神卫生行动计划》(1999-2008年)中达到高潮,其中社区精神卫生保健场所被视为消除社会心理困难人群的社会孤立的优先战略。然而,在同一时期的英国,聚会场所开始因助长社会排斥而受到争议。这是一项关于挪威会议场所的调查,其研究问题如下:服务使用者如何讨论他们与会议场所的空间和人的相遇?基于社区心理学和参与性研究传统,我们对来自会议场所的22名服务用户进行了四次焦点小组讨论,并进行了参与性话语分析。我们详细讨论了在一个被认定为充满歧视和排斥服务使用者的sanism的公民社会背景下,会议场所的四种中心话语结构:一种补偿性的公共福利安排,将服务使用者定位为拥有社会权利的公民;将服务用户定位为具有共同身份和兴趣的同伴;同情空间,将服务使用者视为人类同胞,他们自己的权利是宝贵的;而温室为服务用户拓展可能性的视野提供便利。这项调查表明,对于参加会议的人来说,会议场所可能意味着一切,因为它为他们在一个人道主义公民社会的日常生活中提供了在其他地方难以获得的机会。
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引用次数: 1
Getting it Right: Estimating the Share of Volunteers in Denmark 做对了:估计丹麦志愿者的比例
Pub Date : 2018-02-07 DOI: 10.7577/NJSR.2146
J. Hermansen
Abraham, Helms and Presser (2009) demonstrated that people who volunteer are more likely to participate in surveys. The apparent consequence of such a pattern among respondents is that estimates of volunteering could be biased. Surveys with voluntary work as the main topic could be further biased due to the volunteers’ interest on this issue compared with non-volunteers. The article uses panel data from Denmark in order to examine the bias due to panel attrition as a special kind of nonresponse bias and its consequences for estimates of volunteering. The results show that panel attrition leads to an overestimation of the share of people who volunteer.
Abraham, Helms和Presser(2009)证明,志愿者更有可能参与调查。在受访者中,这种模式的明显后果是,对志愿服务的估计可能存在偏见。以志愿工作为主题的调查可能会进一步偏颇,因为志愿者对这个问题的兴趣比非志愿者更大。本文使用来自丹麦的小组数据,以检验由于小组磨损的偏见作为一种特殊的非反应偏见及其对志愿服务估计的后果。结果表明,小组人员流失导致了对志愿者比例的高估。
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引用次数: 3
期刊
Nordic Journal of Social Research
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