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People with Sami and Norwegian background are frequent users of traditional folk medicine (TM). Traditional healing, such as religious prayers of healing (reading) and the laying on of hands, are examples of commonly used modalities. The global aim of this study is to examine whether health personnel's knowledge, attitudes and experiences of traditional healing affect their clinical practice. Semi-structured individual interviews (n=32) and focus group interviews (n=2) were conducted among health personnel in two communities in Northern Norway. The text data was transcribed verbatim and analysed based on the criteria for content analysis. Six themes were identified. The participants had acquired their knowledge of traditional healing through their childhood, adolescence and experience as health personnel in the communities. They all expressed that they were positive to the patients' use of traditional healing. They justified their attitudes, stating that “there are more things in heaven and earth" and they had faith in the placebo effects of traditional healing. The health personnel respected their patients' faith and many facilitated the use of traditional healing. In some cases, they also applied traditional healing tools if the patients asked them to do so. The health personnel were positive and open-minded towards traditional healing. They considered reading as a tool that could help the patients to handle illness in a good way. Health personnel were willing to perform traditional healing and include traditional tools in their professional toolkit, even though these tools were not documented as evidence-based treatment. In this way they could offer their patients integrated health services which were tailored to the patients' treatment philosophy. [ABSTRACT FROM AUTHOR]

Background: Norwegian government white papers have stated that the Sami population is reluctant to seek help from healthcare services and has traditions of self-help and the use of local networks. Objective: In this article we explore healthcare professionals' discursive constructions of Sami persons with dementia and their families' reluctance to seek and accept help from healthcare services. Design: The article is based on an analysis of focus group interviews with healthcare professionals (n = 18) in four municipalities in Northern Norway with multiethnic populations. A narrative context analysis, which involved an examination of sequences of discourse, was employed. Results: Reluctance to seek and accept help among Sami service users and assumptions about self-support were recurring themes in the focus groups. The reluctance was attributed to macro contexts, such as socio-historical processes and cultural norms, and to micro contexts, such as individual and interpersonal factors including the healthcare professionals' cultural backgrounds and language competence. The healthcare professionals' positioning as insiders or outsiders (Sami or non-Sami) affected their attributions. Conclusions: Local healthcare professionals are at the front line for providing and assessing service users' needs for healthcare services. Consequently, their perceptions of service users' needs are pivotal for achieving equity in healthcare. The established opinion that Sami “take care of their own" and are reluctant to seek and accept help may lead to omissions or neglect. Healthcare professionals' awareness about how present encounters in healthcare settings are framed and shaped by the service users' previous and prevailing experiences of marginalisation and subordination is crucial to avoid omissions or neglect resulting from assumptions about cultural preferences. Discursively shaped boundaries and differences between groups may create the impression that the distance between the groups is too wide to traverse, which in turn may lead to further marginalisation of service users in healthcare encounters. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore how caregivers experience collaboration in rural municipalities in northern Norway. We conducted fieldwork with a dementia team in addition to seventeen qualitative in-depth interviews with formal and family caregivers. The caregivers had ethnic Sami and ethnic Norwegian affiliation. The theme ‘negotiating ethnic and ethno-political positions’ was identified through thematic analysis and developed using positioning theory. Ethnicity involves dynamic and situated personal affiliations, and participants negotiate each other's ethnic positions in practice. Negotiations of ethnic positions hamper collaboration between formal and family caregivers, and ethno-political positions reinforce stereotyped ethnic positions. This study contributes to the understanding of and the debate over positions on ethno-cultural collaboration in health care. In practice, participants negotiate the health policy concept of ‘cultural facilitation’, which must be broadened to ensure equal healthcare services. [ABSTRACT FROM PUBLISHER]

Objective: This study explores stroke survivors’ and relatives’ negotiation of relational and activity change in their interrelated long-term meaning-making processes of everyday life and what it means for the experience of progress and well-being.Material and methods: Repeated retrospective in-depth interviews were conducted with both the stroke survivor and relatives. A Critical Psychological Perspective gives the frame of reference to study more closely what is going on in and across particular contexts in family members’ ongoing social practices.Results: An asymmetric problematic relationship can develop among the participants in the context of family life. However, the analysis identifies six beneficial relational and activity changes, which contribute to a reciprocal, balanced repositioning, and help the family move in a more positive direction. The repositioning processes facilitate a new transformation of family we-ness, which is important for the participants’ experience of process and well-being. The comprehensive family work that has to be done is about managing the imbalance of everyday life, upholding separate activities outside the family sphere and dealing with the fact that peripheral others become more peripheral.Conclusion: The study addresses some arguments for taking a family-centred perspective in occupational therapy practice, as well as in a stroke rehabilitation service in general. [ABSTRACT FROM PUBLISHER]

Purpose: Research has mainly focused on the first year of recovery trajectory after stroke, but there is limited knowledge about how stroke survivors manage their long-term everyday lives. This study seeks to fill this gap by exploring the long-term (1-13 years) negotiations of stroke survivors when they experience progress, wellbeing and faith in the future. Method: Repeated in-depth interviews were conducted with nine people living with moderate impairment after stroke and their closest relatives. Concepts from phenomenology and critical psychology constituted the frame of reference of the study. Results: The long-term stroke recovery trajectory can be understood as a process of struggling to overcome tensions between three phenomena under ongoing change: the lived body, participation in everyday life and sense of self. During the recovery process, stroke survivors experience progress, well-being and faith in the future when moving towards renewed relationships, characterised by (1) a modified habitual body, (2) repositioned participation in specific everyday life contexts and (3) a transformed sense of self. Conclusions: This study stresses the importance of developing new forms of professional support during the long-term recovery trajectory, to stimulate and increase interaction and coherence in the relationship between the stroke survivor's bodily perception, participation in everyday life and sense of self. [ABSTRACT FROM AUTHOR]

Researching the outcomes of assistive technology devices (ATDs) for older clients is important to facilitate clinical decision-making. However, to understand the outcomes associated with ATDs, one must investigate the users' experiences and acknowledge the user as an active participant in diverse social contexts. Purpose: To enhance understanding of the users' perspective regarding ATDs, this study aimed to investigate the meaning of the ATD for older individuals still living in their home environment. Methods: To provide descriptions of ATD experiences, older individuals who received a new ATD to compensate for their challenges in moving around, assist in self-care or both were recruited for the study. Participants were interviewed twice, with a few months between interviews, about their experience in using their new ATD. The interview transcripts were analyzed in a hermeneutical-phenomenological research approach. Results: The analysis revealed three recurring themes associated with the description of ATD experiences: 'enabling performance and choice', 'transformation from requiring assistance to assisting others', and 'preparing for the future'. Conclusion: The results show that ATDs are used to enhance competence, mastery, control, self-worth, hope, and preparedness. The ATD service delivery should be client-centered and the client should be acknowledged as an active participant in producing change. [ABSTRACT FROM AUTHOR]

Objective: Providing assistive technology devices to older individuals living in their ordinary homes is an important intervention to increase and sustain independence and to enable ageing at home. However, little is known about older individuals' experiences and needs in the assistive technology device (ATD) service delivery process. The purpose of this study was to investigate older individuals' experiences during the service delivery process of ATDs. Methods: Nine older individuals were interviewed three times each throughout the ATD service delivery process. The interviews were analysed within a hermeneutical phenomenological perspective. Results: The results show that the service delivery process could be interpreted as an enigmatic journey and described using four themes: 'hope and optimistic expectations', 'managing after delivery or needing additional help', 'having available help versus being abandoned', and 'taking charge or putting up'. Conclusions: The results emphasize the need for occupational therapists to maintain an individualized approach towards older clients throughout the service delivery process. The experiences of older individuals were diverse and related to expectations that were not necessarily articulated to the occupational therapist. The situation when the ATD is delivered to the client was highlighted by the clients as an important event with the potential to facilitate a successful service delivery process. [ABSTRACT FROM AUTHOR]

An unmet need for assistive technology devices (ATD) occurs when a person would benefit from ATD, as assessed by health-care professionals or by the person In question. Unmet ATD needs In the elderly population have been documented, but little is known about the experience of living with such unmet needs. Purpose: To investigate the unmet need experiences of home-dwelling elderly people In Norway who have applied for ATD. Method: Nine elderly people who lived at home and had applied for ATD were interviewed. The interview transcripts were analysed withIn a hermeneutical phenomenological perspective. Results: The unmet ATD need experiences involved enduring a difficult situation by adjusting their expectations and activities, being introduced to ATD as a possible solution to the difficulties and negotiating this potential solution In light of the perceived situation. Conclusion: Observers assessments of unmet ATD needs are not readily experienced as such by the elderly. Adjusting expectations and activities enabled the participants to maintaIn meaningful activities but also made the difficulties less likely to be articulated as unmet needs. When encountering elderly people, health-care professionals must be sensitive to the unarticulated needs and potential difficulties of the elderly In performing everyday activities. [ABSTRACT FROM AUTHOR]

This study examined four policy documents published by the Norwegian government from 1995 to 2009 describing issues regarding the provision of public services to elderly Sami in Norway. Adopting a Foucauldian discourse analytic approach, we explored how the statements regarding elderly Sami and care services in these documents are situated within contemporary ethno-political and healthcare discourses. The documents exhibited two major and interrelated trends: the predominant portrayal of the Sami and the ethos of cultural congruent care. The analysis demonstrated a high degree of discursive continuity throughout the four documents, with the image of the elderly Sami constructed in the earliest document reproduced to a large extent in the newer documents. We suggest that a critical cultural perspective offers an alternative to the understanding of culture and the concept of cultural congruent care found in the documents. From a critical cultural perspective, culture is seen as relational, changing over time, and dependent on social context, history, gender, and other factors. In this view, cultural competence does not involve learning a fixed, coherent body of knowledge comprising “the Sami culture”. A critical cultural perspective challenges those who provide care to the elderly Sami to become aware of social, political, and historical processes while simultaneously acknowledging that the impacts of these processes on the lives of the individuals they encounter can never be fully known. Furthermore, this perspective prompts healthcare providers to reflect on how their assumptions about the people they encounter are shaped by their own social, cultural, economic, and professional backgrounds. We suggest that the authorities initiate a new policy document based on current insights into the everyday experiences of the current cohort of elderly Sami as well as contemporary social, ethno-political, and healthcare discourses. [ABSTRACT FROM PUBLISHER]

Background: When people in Northern Norway get ill, they often use traditional medicine. The global aim of this study was to examine the extended family networks' function and responsibility in cases of illness in the family, in two Northern Norwegian communities with a population of mixed ethnicity. Methods: Semi-structured individual interviews with 13 participants and 4 focus group interviews with total 11 participants were conducted. The text data was transcribed verbatim and analysed based on the criteria for content analysis. Results: The participants grew up in areas where it was common to seek help from traditional healers. They were organized in networks and shared responsibility for the patient and they provided practical help and support for the family. According to the networks, health-care personnel should make room for the entire network to visit the patient in severe and life-threatening situations. Conclusion: Traditional networks are an extra resource for people in these communities. The networks seem to be essential in handling and disseminating hope and manageability on an individual as well as a collective level. Health personnel working in communities with mixed ethnicity should have thorough knowledge of the mixed culture, including the importance of traditional network to the patients. [ABSTRACT FROM AUTHOR]