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This study explores how actors deal with normative complexity in the design and implementation of practices of preventative care. Previous studies have identified conflicting (e)valuations of prevention within health care at large, but little empirical research describes how these conflicts are resolved in day‐to‐day interactions. Zooming in on the work of a single actor, our ethnographic study describes a Dutch psychiatrist developing a novel type of hospital bed that provides preventative psychiatric care for women in the post‐partum period. Drawing on pragmatic sociology of justification, we construe 'beds'—and the time, people and resources they represent—as points of convergence between conflicting valuations of care. The results show that embedded modes of valuation in a curative hospital setting generate significant normative complexity during implementation. We identify three main strategies through which normative complexity is managed: (a) translating between different modes of valuing prevention, (b) compromising in (material) design of care beds and (c) transcending embedded valuations through moral appeals. By showing the normative complexity of prevention in practice, our study highlights the need for a diverse and situated accounting for preventative care. [ABSTRACT FROM AUTHOR]

The article examines the use of professional talks by middle managers in health care sector to cultivate professionalism in health care workers. It states that the use of professional talk could bring in conflict in managers and professionals relationship. It mentions four professional talk subjects such as personal appearance and conduct, personal values, work methods and competency. It also mentions how managers use professional talk to bring changes in work environment.

Purpose – The purpose of this paper is to improve the general operationalization of an “active patient,” by examining the specific activities and skills expected of active patients. Design/methodology/approach – Expected activities and necessary skills were studied through a qualitative case study into the development and use of an assistive technology (i.e. web site) aimed at stimulating active patient-ship. Interviews, observations and document analysis were used to capture and explore designers’ inscribing practices and their consequences regarding expected competences and activities of patients using the web site. Findings – Designers inscribed two “co-design roles” that active patients were expected to perform on the web site (co-designing their own healthcare and co-designing the healthcare of peers), for which at least eight different competencies were needed. The absence of skills or facilities to apply these skills resulted in incomplete use, a different use than intended by designers and non-use of the web site. Practical implications – Technological choices and inscribing processes determine who is able or facilitated to become active and who is not. Due to inscribed co-design roles, it also influences the extent to which already active peers are able to perform health-related activities. Different users with different conditions should be taken into account in the design as specific group characteristics can influence level of individual activity. Originality/value – This study is, as far as the authors know, the first that examines the “active patient” concept by studying an assistive technology and using scripting literature, resulting in an improved understanding of what it means to become “active” in terms of skills and activities. [ABSTRACT FROM AUTHOR]

Abstract: The use of epidemiological research in local health policy development is claimed to be problematic. In three in-depth case studies in Dutch municipalities, we examined the interface between local epidemiological research and local health policy development, and the use of epidemiological reports, published as Local Health Messages (LHMs). The qualitative study design is based on an earlier developed theoretical framework of extended interaction. We collected data about 129 actors, via face-to-face semi-structured interviews, telephone interviews, internet questionnaires, observations, and organizational documents. Local health report development was characterized by multiple interactions between Regional Public Health Service epidemiologists, policy advisors, and local health officials. The LHMs as well as the policy memoranda can be considered as socially constructed. Preliminary interaction helped to manage the expectations of the local health officials and improved a specific type of use of LHMs in the policy process. However, we discovered a lack of use of the LHMs by specific groups of actors within the policy network, which could be explained by factors influencing the actors, such as personal belief systems and values, institutional interests, and contextual factors such as the design of the policy processes. We concluded that the necessity of interactions depends on the frames of references of the potential users and as a consequence it is difficult to give a single solution for improvement of epidemiological research utilization for local health policy. Different interaction mechanisms between researchers and policy actors can be active at the same time and may differ between municipalities. Therefore it becomes important to obtain insight in the policy process and tailor strategically promising ways of interaction. [Copyright &y& Elsevier]