Search

Medicalisation of hospice care has been discussed simultaneously with the development of palliative care into a medical speciality. However empirical knowledge of the role of medicalisation in hospice practice is underexplored. This paper considers hospice managers' perspectives on hospice care in the complex between values related to hospice philosophy and a specialised medical approach to hospice care. Focus groups and small group interviews were conducted with hospice managers from 16 out of the 19 Danish hospices. Drawing on hope as a theoretical framework, the study contributes to further understanding of the complexity of navigating hospice care in the impasse between an existential hope focused on meaning at the end of life and a medical hope for control of the dying body. Hospice care appeared as pulled between these dimensions of hope. The hospice managers took a pragmatic approach to medicalisation but their emphasis on dying as an existential event also points to a role for hospices as a critical voice against over-medicalisation of dying. [ABSTRACT FROM AUTHOR]

This paper presents the rationale and content of PASS, a Danish school-based prevention program targeting cannabis-culture-related beliefs among high school students (i.e. typically 15–19 years). The objective of the program is to prevent or delay initiation of cannabis use and limit use among students who already initiated. PASS is a combined social competence and social influence curriculum consisting of five 90-min modules. The program is combined of a unique conceptual framework integrated in a theoretical model based on well-established theory and evidence-based methodologies. The unique conceptual framework offers a novel approach to school-based prevention by introducing the concepts of normalisation, neutralisation and glorification. The assumption is that normalisation, neutralisation and glorification are important predictors of cannabis use and that prevention approaches can benefit from targeting these factors. The conceptual framework and the theoretical model of the PASS program are presented in this paper. Although PASS presents a novel conceptual framework, the theoretical model behind the program is based on well-established theory and the program curriculum integrates evidence-based methodologies from the field of drug prevention. In this paper, we address some of the challenges of adapting evidence-based methodologies to a Danish cultural setting. Because the effects of PASS are uncertain, until supported by empirical evidence, a rigorous evaluation of the program is required prior to any dissemination. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of the onset of acquired hearing impairment. The focus of attention is why a person seeks treatment. The Danish welfare state serves the population 'in need' such as those with an audiological need and gives them guidance on becoming hearing aid wearers in order to rehabilitate them back to 'normalcy'. However, within audiological research, noncompliance has attracted much attention as investigations have shown that more than 20 percent of hearing aids are very seldom, if ever, in use and 19 percent are used only occasionally. As shown in the paper the form a problem takes is in large part a product of micro-political struggles. Hence, at the onset 'need' is often embedded in social pressure from significant others. The paper examines these two discursive frameworks and their constitution of (hearing) problems and concludes that norms of disease are complex and epistemologically contested and can help explain why noncompliance is dominant when it comes to hearing rehabilitation for hearing impaired adults. [ABSTRACT FROM AUTHOR]

Purpose:Over the past two decades, attempts have been made to describe the nurse’s role and functions in the inpatient stroke rehabilitation; however, the nursing contribution is neither clear nor well-defined. Previous studies have highlighted the need for research aimed at developing interventions in the neuro-nursing area. The objective of this paper was to describe the development of a nursing intervention aimed at optimising the inpatient rehabilitation of stroke patients by strengthening the role and functions of nursing staff. Method:A systematic approach was used, consistent with the framework for developing and evaluating complex interventions by the UK’s Medical Research Council (MRC). Based on qualitative methods and using the Behaviour Change Wheel’s (BCW) stepwise approach, we sought behaviours related to nursing staffs’ roles and functions. Results:We conducted a behavioural analysis to explain why nursing staff were or were not engaged in these behaviours. The nursing staff’s Capability, Opportunity and Motivation were analysed with regard to working systematically with a rehabilitative approach and working deliberately and systematically with the patient’s goals. Conclusion:We developed the educational intervention Rehabilitation 24/7. Following the MRC and the BCW frameworks is resource-consuming, but offers a way of developing a practical, well-structured intervention that is theory- and evidence based. [ABSTRACT FROM PUBLISHER]

Purpose: To describe and analyse social interactions among the users, partners and stakeholders involved in developing a rehabilitation park to determine a future approach to community-based rehabilitation. Materials and methods: The design was qualitative using the methodology interpretive description and symbolic interactionism as the theoretical framework. Data was generated through a two-year ethnographic fieldwork throughout the development of the SPARK (Sound Park Activities Rehabilitation and Climate) rehabilitation park. The participants were users, partners, and stakeholders of the park and data consisted of participant observations comprising observations, informal conversations, and field notes. Results: Three themes formed an understanding of the significance of involvement; A shared vision reflected the participants' joint overall idea for the rehabilitation park containing possibilities for health promotions for everyone. Perceived solidarity represented an experience of a project where everyone's opinion counted whilst Profound Acknowledgement signified a state of a deeper experience of being valued and heard. Conclusions: The findings suggest consistent and continuous involvement of users, partners, and stakeholders, creating possibilities for co-creation in rehabilitation in new settings. The development of rehabilitation parks like the SPARK park in a shared public arena may benefit people with disability, and everyone and further help reduce stigma around disability. The rehabilitation definition forms the base for co-creation of rehabilitation initiatives among people in need of rehabilitation as such and professionals with different approaches and professions. Conducting rehabilitation practice in a shared outdoor arena may provide professional development and expansion towards interdisciplinary approaches across diagnoses and professions. Outdoor rehabilitation may (despite different target groups) function as a facilitator for professional and chance meetings in the park and thereby create a community for meeting across professional disciplines, founding, and enabling a practice that allows to reflect on and learn from different approaches within rehabilitation. Community-based rehabilitation in a public shared arena may generate possibilities for reducing stigma towards people with disability. [ABSTRACT FROM AUTHOR]

Aim: This study examined the ways in which citizens who have self-identified as having problem drug use experienced welfare state encounters in Denmark and considered the findings in the context of the social investment paradigm. Methods: We conducted qualitative interviews with 106 Danish citizens who identified as having a problem drug use. The interviews were transcribed and coded in Nvivo to classify different types of welfare state encounters experiences. Results: Previous research has documented extensive prevalence of drug-related stigmatization in welfare state encounters; however, approximately two-thirds of the citizens in this study did not recount this kind of stigmatization as predominating. Three prevailing narratives were conveyed by these participants: (1) narratives describing encounters where welfare state authorities approached the participant as 'a whole person,' (2) narratives depicting encounters where the participants were submissive, and (3) narratives about welfare state authorities who discredited the significance of the participants' drug problems and imposed expectations considered unrealistic by the participants, e.g. expectations related to labor market performance. In the third type of encounter, participants experienced incongruence between their actual and virtual identities; not because problem drug use was granted master status but because their self-identified severe drug problems were downplayed by the welfare state authorities. Conclusion: Encountering welfare state authorities who downplayed the importance of drug problems gave rise to a form of stigmatization which we conceptualize as 'neo-stigmatization' to emphasize the contrast to drug related stigmatization where the importance of drug use is elevated to the point of master status. Neo-stigmatization emerges as politically productive in the context of the social investment paradigm that increasingly ties social worth to labor market value. Alleviating neo-stigmatization requires a political-economic framework that recognizes the value of citizens as not just workers but also caregivers and care receivers. [ABSTRACT FROM AUTHOR]

This study examined an intervention, which aimed at improving the dual diagnosis treatment at eight Danish mental health centres. The intervention included training in dual diagnosis treatment to program champions who were intended to implement at their workplace the knowledge gained from training. The study used mixed methods (questionnaires, interviews, and field observations) to examine whether there was a change in the knowledge, attitudes, and practices of the colleagues of the program champions following the intervention. Results showed that the intervention overall yielded improvement in knowledge and attitudes, while the impact on assessment and treatment practices was limited. Possible factors that might have affected the implementation of the intervention as well as the weaknesses of the intervention and the study are discussed. [ABSTRACT FROM AUTHOR]

This article discusses how opioid substitution treatment policy has developed from 2000 to 2011 in Denmark. Empirically, it takes its point of departure in a stakeholder analysis including 17 qualitative interviews with stakeholders who have played important roles in this field. Analytically, it is inspired by Kingdon's concepts of agenda and policy window. Three major shifts are identified: a shift from psychosocial to medical thinking and practice, from an abstinence driven ideology to health care, and from perceptions of passive clients to user involvement. These shifts are discussed in relation to the legal context of substitute prescribing medicine. [ABSTRACT FROM AUTHOR]

Introduction: Danish and Dutch new consultants' perceptions regarding the transition to consultant were compared to gain insight into this period, particularly the influence of contextual factors concerning the organisation of specialty training and health care therein. Preparation for medical and generic competencies, perceived intensity and burnout were compared. Additionally, effects of differences in working conditions and cultural dimensions were explored. Methods: All consultants registered in the Netherlands in 2007-2009 (n = 2643) and Denmark in 2007-2010 (n = 1336) received in June 2010 and April 2011, respectively, a survey about their preparation for medical and generic competencies, perceived intensity and burnout. Power analysis resulted in required sample sizes of 542. Descriptive statistics and independent t-tests were used for analysis. Results: Data were available of 792 new consultants in the Netherlands and 677 Danish new consultants. Compared to their Dutch counterparts, Danish consultants perceived specialty training and the transition less intensely, reported higher levels of preparation for generic competencies and scored lower on burnout. Conclusions: The importance of contextual aspects in the transition is underscored and shows that Denmark appears to succeed better in aligning training with practice. Regulations regarding working hours and progressive independence of trainees appear to facilitate the transition. [ABSTRACT FROM AUTHOR]

The purpose of this article is to show that social relationships and participation in communities are of central importance to promoting positive educational pathways for young people from a public care background. The article will explore what facilitates and hinders young people's educational pathways. In addition to a general description of facilitators and barriers, this article focuses primarily on the importance of social relationships. This is done with reference to an EU research project calledYoung people from a public care background: Pathways to education in Europe.This article will show that young people's age at entry to care, pre-care experiences and in-care experiences influence their educational pathways. The article argues for the importance of professionals to be proactive in helping young people access and engage in social communities. [ABSTRACT FROM AUTHOR]

Intermarried couples in Denmark face a range of psychosocial challenges in the context of dominant discourses of homogeneity coexisting with ethnic diversity. This article deals with the couples’ managing of everyday life, mental health, well-being and implications for health promotion and counselling. The participants in this qualitative study (n = 10) are persons in mixed relationships where one partner is from South Asia and the other a native Dane, forming visibly ethnically different households [Phoenix, A. (2011). Psychosocial intersections: Contextualising the accounts of adults who grew up in visibly ethnically different households. In Lutz, V., & L. Supik (Eds.), Framing intersectionality: Debates on a multi-faceted concept in gender studies. Surrey: Ashgate]. The analysis indicates that internal, personal and family aspects, such as realistic plans, mixing everyday practices and focussing on the fun part, are in interplay with external aspects such as formal and informal acceptance of the intermarriage in society, dominant gender roles, recognition and inclusion for the mixed couples. Recognition of the significance of these aspects and practices is important for promoting positive mental health and well-being over the life course. [ABSTRACT FROM PUBLISHER]

This article explores risk conceptions related to alcohol use among Danes who drink ‘too much’ (based on the National Health Board’s standards for safe drinking). It analyses drinking patterns and risk management strategies among interviewees from different socio-economic backgrounds, and explores the differences between the behaviours and conceptions of these individuals and the risk advice and definitions provided by health agencies. The article shows that people from different socio-economic backgrounds respond differently to the neo-liberal strategy of alcohol risk minimisation, with middle- and upper-class participants being more in tune with the public health ethos of alcohol consumer ‘autonomisation’ and ‘responsibilisation’. Cutting across socio-economic differences, though, are risk conceptions that clash with the public health model of risk prevention. While the risk communication of the health agencies builds on the logic of ‘a will to health’, drinkers at relatively high consumption levels tend to prefer other rationales, associating alcohol use with socialisation, pleasure and relaxation, and defining alcohol risks in terms of ‘addiction’ rather than detrimental health effects. The article contributes to the discussion of the ‘prevention paradox’, showing that rational initiatives at a general population level are not always comprehended as such at the individual level. [ABSTRACT FROM PUBLISHER]