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Email is a born-digital form of communication, which can be studied in a number of ways using a variety of methods, as with any other socially and culturally mediated phenomenon. However, despite a great number of studies, the methodologies of the studies have attracted only little attention. In this paper, we wish to extend our knowledge regarding methodological challenges in studying emails. In particular, we will consider the methodological challenges, which any scholar will encounter when email in its digital form is transformed to and preserved as an object of study. Based on a review of existing studies' archiving strategies as well as our own study on email consultations in a healthcare setting, we will examine and discuss analytical and methodological consequences of different approaches to archiving and data management of emails. We demonstrate that the archived record is shaped by its context of creation. Since collection methods and archiving tools are not neutral, we call for a greater attentiveness to this part of the research process. We conclude by outlining implications for systematic empirical research into emails as a form of communication. [ABSTRACT FROM AUTHOR]

Arthritis affects many individuals and can cause pain and limit physical functioning. Exercise is an important treatment option for individuals with arthritis; however, adherence to exercise programs can be challenging. A new initiative in Denmark has introduced nature-based exercises for patients with arthritis. This qualitative study aimed to explore the experiences of the individuals who participated in those exercises. The study used a hermeneutic-phenomenological approach and conducted along-side interviews with 12 women and three men who participated in nature-based exercise programs for arthritis. Analysis of the data revealed two main themes. The first theme highlighted the positive effects of being in nature, such as increased vitality, reduced pain, and a sense of well-being. The second theme emphasized the social benefits of participating in these exercises, including a sense of connection and community with others. Overall, this study suggests that incorporating nature-based exercises in treatment programs for arthritis could have significant benefits for individuals with this condition. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the challenges women with neuromuscular disease face when having to urinate when away from home. The design for this study was qualitative using the interpretive description methodology and the Sense of Coherence theory. The method was three semi-structured focus group interviews with 12 women (3 ambulant and 9 non-ambulant) with neuromuscular diseases at a specialized rehabilitation hospital. We found that physical and functional barriers hampered the opportunity to urinate when away from home due to lack of accessibility and impaired physical functioning. Psychosocial impacts were related to inconvenience and dependency on relatives, fear of stigmatization and impacted dignity, and the constant social sacrifices. The challenge of access to adequate and equitable sanitation for women with neuromuscular diseases is not at always met in society, and these women consequently often must resort to repressing the fundamental need to urinate. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to explore the expectations of and experiences with the public healthcare system of domestic partners of people with Parkinson's disease (PD) in Denmark and Norway. Methods: A qualitative exploratory design was applied. The sample consisted of 14 people from Denmark (n = 9) and Norway (n = 5) living with a partner with PD. Semi-structured individual interviews were conducted between June and September 2020, digitally recorded, transcribed verbatim and analysed using a reflexive thematic analysis approach combining inductive and deductive approaches. Results: The main themes were 'negotiating systems of support' and 'balancing being both a partner and a family carer'. Partners take responsibility for the people with whom they live and attempt to fill gaps in the public healthcare system. The most frequently described needs were more information, service coordination as the illness progressed and acknowledgement of the complex role. Discussion: A recommendation for practice is recognition of the complex roles of partners to people with PD and reaching out to both regularly to determine needs. This may enhance the collaboration between partner carers, people with PD and healthcare providers, ensure sustainability of the system and optimise living with PD in the family. [ABSTRACT FROM AUTHOR]

Aims: Evidence for the effectiveness of return-to-work (RTW) interventions aimed at sickness absence beneficiaries with mental health problems (MHPs) is still relatively sparse and mostly inconclusive. This may in part reflect the varying settings and inconsistent implementations associated with the interventions. The aim of this paper is to identify barriers and facilitators for the implementation of a coordinated and tailored RTW-intervention implemented at three different sites. Methods: We used qualitative and quantitative data to assess the implementation according to process evaluation guidelines. Data sources were individual and group interviews, observations, national registers, and documents used in the intervention. Results: The quality of the implementation varied greatly across the three settings. Barriers included lack of skills to assess MHPs according to the inclusion criteria, different interpretations of sickness absence legislation among stakeholders, competing rehabilitation alternatives, and lack of managerial support for the intervention. An important facilitator was the motivation and availability of resources to solve disagreements through extensive communication. Conclusions: The different settings presented various barriers and facilitators, which resulted in different versions of the intervention. A higher degree of user involvement in the design and development phase is likely to improve the implementation quality of future interventions. [ABSTRACT FROM PUBLISHER]

Objectives: To explore what patients with chronic conditions emphasize as important in the patient-medical student conversation, and how the patients' experiences relate to trust. Methods: Twenty-one video-recorded sessions of patients' feedback in simulation-based communication courses for medical students were observed, transcribed, analyzed inductively and organized into three themes. Results: In the patients' feedback, three aspects were emphasized as important relating to trust: a) when the medical student relates medical information to the patient's lifeworld, b) when the student leads the patient throughout the conversation, and c) when the patient gets emotional support from the student. The patients felt that being met this way by the students grows trust and allows them to lean into the uncertainties they experience while still feeling safe. Discussion: The patients emphasize three aspects of importance in conversations with the medical students that grow trust. We argue that these aspects cannot be found in the traditional authority-led practice but can be found in leadership, which imply empathy and willingness to learn from patients. We suggest that students should learn that to effectively communicate with patients infers such leadership. By doing so, medical students can walk alongside their patients to build a relationship and nurture trust. [ABSTRACT FROM AUTHOR]

In recent years obesity has emerged as a potential public health crisis. This article examines how being overweight is framed as a social problem in two public Danish organizations. Using recorded interactions between health consultants and overweight people, this article explores how overweight people develop a sense of self in weight loss programmes. This article uses an interactionist approach in exploring the dual nature of identities involving both the self and social structure. Drawing on sociological literature concerning the relationship between the body, health, risk and society, this paper shows how overweight people in western society are currently perceived as being morally inferior. This societal context frames the participating organizations that offer weight loss programmes to overweight people, and hence results in organizational identities that equate being overweight with having psychological problems. The analysis in this article shows the importance of situating identity processes in the organizational framework in which they occur and situating organizations in a broader societal framework that casts some people as morally inferior and others as 'normal'. [ABSTRACT FROM AUTHOR]

Background: Rehabilitation is increasingly being introduced in dementia care but studies highlight extensive heterogeneity in practices, conceptual confusion and divergent perceptions of its relevance across care organizations and national contexts. As this have implications for development of dementia care as well as for people with dementia's access to care it is important to study the organizational narratives and practices in rehabilitation-oriented dementia care organizations. Methods: The study build on qualitative interviews (individual and group interviews) with health professionals (N = 26) engaged with dementia care and rehabilitation in two Danish municipalities. The interviews were conducted in 2018–2019. The empirical data was analyzed using abductive analysis and theory-based narrative analysis, using Loseke's conceptualizations of and approach to analyzing formula stories. Findings: Four dominant organizational narratives were constructed from the data. Each narrative produced a specific organizational narrative of client identity: the active participant in individualized rehabilitation, the inactive individual benefitting from enhanced social environments, the disengaging self and the vulnerable self. Conclusion: Introducing rehabilitation in dementia care may amplify the organizational polyphonic and provide a plurality of organizational identities each expressing different perceptions of personhood and agency for people with dementia. The organizational narratives were negotiated within a specific structural context where national regulation and dominant discourses on economic challenges and ageing gave precedence to some narratives more than others. In Danish elder care, the first narrative is the most influential but risks excluding people with dementia. Instead, rehabilitation in dementia care is positioned within a social and relational perspective, which may silence important discussion of agency and resistance. [ABSTRACT FROM AUTHOR]

Background: Many children and adolescents with incurable cancer and their families prefer to receive end-of-life care and to die at home. This implies a transition of care from hospital to home and presupposes the establishment of a well-functioning collaboration between the family and professionals across health care sectors. Aim: To identify and explore key elements of home-based end-of-life care collaboration for children with cancer, as experienced by their parents and grandparents and the hospital- and community-based professionals involved. Design: Descriptive qualitative multiple-case study. Data were collected by semi-structured interviews and written responses to open-ended questions, and analyzed inductively across cases using qualitative content analysis. Setting/participants: Cases comprised a criterion sample of five children (aged <18 years), who died of cancer at home. Cases were represented by the children's bereaved parents (n = 8) and grandparents (n = 7), and community-based professionals (n = 16). Also, hospital-based professionals (n = 10) were interviewed about the children's end-of-life care through group interviews. Results: We identified five main themes, describing key elements of the end-of-life collaboration: Establishing the collaboration, Bolstering family life, Elucidating organization and integration, Managing challenges, and Closing the collaboration. These themes all came under the overarching theme: A mutual trust-based collaboration. On this basis, we developed the "Home-Based Pediatric End-of-Life Care Model for Children with Cancer." Conclusions: By highlighting key elements in the family-centered, intersectoral and interprofessional end-of-life care collaboration, our "Home-Based Pediatric End-of-Life Care Model for Children with Cancer" offers a framework for further optimization of home-based end-of-life care services for children with cancer and their families. [ABSTRACT FROM AUTHOR]

Support interventions, such as nurse case managers, has been developed in response to the inequality in health and a growing population with multi-morbidity. The aim of the present study was to explore the everyday practices of nurse case managers at a Danish university hospital. An ethnographic approach with a constructionist perspective was applied. Data generation entailed participant observation and one group interviews with all nurse case managers in a Danish region (n=4). The data were analysed using thematic analysis. The everyday practices of nurse case managers were characterised by providing something else than the usual hospital nursing care by continuously establishing and maintaining relationships with their patients. They emphasised the patient’s psychosocial needs in a biomedical context and accompanied patients across different healthcare settings. The nurse case managers’ everyday practices resonate with the key values of nursing. These values are under pressure in healthcare dominated by technical rationality and efficiency leading to increased inequality in health. Further exploration of the potential benefits for multi-morbidity and co-existing social issues is needed. There is a need for continued critical debate about the conditions for caring for patients’ psychosocial needs. The implications of continuing to neglect patients’ psychosocial needs are related to further increasing inequality in health and impeding equal access to services. [ABSTRACT FROM AUTHOR]

Numerous dementia-specific guidelines are offered to support people with dementia and their informal caregivers in dealing with dementia. However, the extent to which such guidelines address ethical issues and provide guidance for dealing with the issues has not yet been assessed. This study investigates the extent to which ethical issues are addressedin those guidelines, which ethical themes are considered and whatrecommendations are offered. We analysed Danish collected via onlinesearch engines and manual contact with relevant governmental, municipal and patient organisations from November 2020 to January 2021. To assess the scope of ethical issues in such guidelines, we devised an analytical framework using Beauchamp and Childress's four principles of biomedical ethics and a data-processing method inspired by systematic reviews. We collected a total 653 dementia guidelines and screened them using formal inclusion criteria, such as publication year, target group and public availability. The guidelines that satisfied these criteria were screened for content related to ethical issues and recommendations. The guidelines that addressed ethical issues were then coded in NVivo 12 and analysed using thematic text analysis. In total, 59 guidelines satisfied the formal inclusion criteria. Among these guidelines, 15 addressed ethical issues, which fell into four transversal themes: (1) being open about the disease, (2) accepting help, (3) the line between dignified behaviour and overstepping boundaries and (4) decision-making and autonomy. The ethical issues addressed in Danish dementia-specific guidelines were diverse. However, the addressed issues did not represent a comprehensive spectrum of ethical issues as identified in relevant literature, and only a few guidelines contained substantial ethical content. In conclusion, this study indicates that the need for guidance on ethical issues is not being met by dementia-specific guidelines and that further research is required to provide additional ethical guidance that benefits people with dementia and their informal caregivers. [ABSTRACT FROM AUTHOR]

Ineffective use of the early warning score (EWS) can compromise recognition and response to patients’ deteriorating condition. This study explores nurses’ and physicians’ ideas on initiatives for supporting the effective use of the EWS in a hospital setting. Participatory workshops were conducted, and data were analyzed using content analysis. Ideas generated for integrating new functions into the EWS protocol to facilitate effective use are described. Also recommended was that all users receive training and an update on how to use the EWS score to support acceptance and confidence using the protocol and thereby increase adherence to the EWS. Further research is needed on the efficiency of incorporating nurses’ clinical judgment in the EWS protocol within different specialties and the effect on adherence to the tool. [ABSTRACT FROM AUTHOR]

Within the field of neurological disease, it seems that involvement of relatives is of utmost importance since the patients often are affected in several areas (physical, cognitive, and emotional) which impair their ability to participate in decision-making about their treatment and care. This study aimed to illuminate neuroscience nurses' comprehension of collaborating with and involvement of relatives. Semi-structured interviews were conducted with 19 neuroscience registered nurses. The qualitative data were analyzed utilizing inductive thematic analysis. The COREQ checklist was applied. The analysis identified how collaboration with, and involvement of relatives are perceived as a focus for nursing care and a resource for both patients and registered nurses. Registered nurses having personal experience as a relative find it easier to establish a relationship with relatives. This study emphasizes the importance of the establishment of a trusting relationship between registered nurses and relatives for a positive collaboration and thus involvement of relatives. [ABSTRACT FROM AUTHOR]

In Denmark, secure institutions are the most intrusive form of out-of-home placement. This article explores how children and young people experience participating in decisions involving secure placement. The analysis draws on a qualitative study, which includes interviews with young people, their case manager and case file data. The young people have all been placed in a secure institution for either observation or on grounds of being a danger to themselves or others, typically defined as a range of behavioral problems like absconding, abuse of drugs, transactional sex and/or crime involvement. Young people's experiences of participating in these decisions provide important insights for understanding the barriers and factors, which facilitate participation for some of the most vulnerable children and young people in the child welfare system. Drawing on a three-dimensional definition of participation inspired by Kloppenborg and Lausten, the analysis shows that young people in the 'deep-end' of child welfare services navigate an adult-centered system of assessment and decision-making, which curtails their possibilities to have a voice and influence decisions. The analysis contributes to a limited research field studying case work practices in relation to care orders, restrictive measures and the confinement of children and young people, where young people's perspectives are largely missing. Their voices provide important insights for the development of a child-centered approach to service provision, that balances their right to participation, protection and care. [ABSTRACT FROM AUTHOR]

The maintenance of physical distance, the absence of relatives and the relocation of registered nurses to COVID-19 units presumably affects nursing care at non-COVID-19 units. Using a qualitative design, this study explored registered nurses' experiences of how COVID-19 influenced nursing care in non-COVID-19 units at a Danish university hospital during the first wave of the virus. The study is reported using the COREQ checklist. The analysis offered two findings: (1) the challenge of an increased workload for registered nurses remaining in non-COVID-19 units and (2) the difficulty of navigating the contradictory needs for both closeness to and distance from patients. The study concluded that several factors challenged nursing care in non-COVID-19 units during the COVID-19 pandemic. These may have decreased the amount of contact between patients and registered nurses, which may have contributed to a task-oriented approach to nursing care, leading to missed nursing care. [ABSTRACT FROM AUTHOR]

This article is the second reporting on the findings from a study of the experiences of families following the death of a parent. Four Danish families consisting of four fathers and seven children were interviewed about their experiences following the death of the mother in the family. The results presented here focus on the experiences of the children. Using thematic analysis assisted by the qualitative data analysis software NVivo 12 Pro, two overall themes were found, "Life in the Home" and "Life Outside the Home." The children experienced a clear dichotomy between the two lifeworlds post-loss and found it difficult navigating between the two. The recommendations offered for an improvement of the care for bereaved children are based on the children's own advice. [ABSTRACT FROM AUTHOR]

Individuals are expected to be responsible for their own health and that of their families—and act accordingly. Yet, being in a position of responsibility might be undesirable for individuals either unable or reluctant to comply with the expectations this responsibility entails. In this article, I explore how parents experience the process of engaging responsibly with digital media in relation to the question of human papillomavirus vaccination. The study is based on interviews with eighteen Danish parents, and my findings show that these parents not only understand themselves but also other actors in terms of responsibility, and that being positioned in terms of responsibility can have negative affective consequences. I argue that meeting the expectations of biological citizenship should not necessarily be a goal in relation to complex health topics. [ABSTRACT FROM AUTHOR]

Both grandparenting and food provisioning practices play an important role in contemporary family life, but the role of food in grandparent–grandchild and wider family relationships is underresearched. Popular and academic discourse often focuses on grandparents as indulgent feeders with negative implications for children's weight and eating practices. Drawing on the concept of family identity bundles and interviews with Danish and New Zealand grandparents and grandchildren, it was found that, for both generations, being alone together was a treat in itself and a time for treats, although they were fluent in the discourse of balance and moderation. Grandparents' food-related practices were shaped by the internalized as well as actual presence of the parents, but they tended to experience rather than express tensions over parental feeding practices. These findings offer a nuanced account of grandparents' role in children's (un)healthy eating practices and of the role of food in intergenerational family relationships. [ABSTRACT FROM AUTHOR]

Introduction: Myalgic encephalomyelitis is a complex systemic condition, causing severe symptoms that limit the quality of life of the people living with it. This study examined changes in life, coping strategies, and the ability to obtain a successful occupational adaptation in people with myalgic encephalomyelitis in Denmark, viewed from the perspective of the model of human occupation. Method: In-depth qualitative interviews with seven persons with myalgic encephalomyelitis aged 31–61 years were analysed with qualitative content analysis. Results: The participants experienced severe changes in their lives leading to impaired occupational competences which affected their occupational identity and made them lonely. Pacing and environmental changes were the preferred coping strategies in their attempt to adapt to the new circumstances. Conclusion: The participants experienced major changes in everyday life with the onset of myalgic encephalomyelitis. Pacing and environmental changes were not sufficient strategies to secure a successful occupational adaptation. Thus, people living with myalgic encephalomyelitis need assistance to enable a successful occupational adaptation and preserve hope. Access to occupational therapy within the Danish programme for people living with myalgic encephalomyelitis may support more effective occupational adaptation in the population. [ABSTRACT FROM AUTHOR]

In this study, we explored specific mechanisms of a board game developed to facilitate peer support among people with Type 2 diabetes attending group-based diabetes education. The game was tested with 76 people with Type 2 diabetes who participated in focus groups after the game. Data from observations of audio-recorded games and focus groups were analyzed using Interpretive Description. Six mechanisms facilitating peer support among people with Type 2 diabetes were identified: (a) entering a safe space of normality created by emotional in-game mirroring; (b) mutual in-game acknowledgment of out-of-game efforts; (c) forming relationships through in-game humor; (d) health care professionals using game rules to support group dialogues of interest to people with Type 2 diabetes; (e) being inspired by in-game exchange of tips and tricks; and (f) co-players guiding each other during the game. Peer support was inhibited by the mechanism of game rules obstructing group dialogues. [ABSTRACT FROM AUTHOR]

Contemporary practice has started to rethink use of outdoor and community environments for advancing comprehensive rehabilitation outcomes. The aim is to examine health professionals' experiences and perceptions of providing rehabilitation in outdoor community settings. The purpose is to use these experiences to generate practice-based knowledge in using the outdoors as a means to guide community-based rehabilitation. The Interpretive Description methodology was accompanied by social practice theory. Fieldwork was conducted utilizing participant observation, photovoice, and focus-group interviews. Included were 27 health professionals. The analysis revealed how "naturalistic learning opportunities" offered health professionals strategies to empower activity and participation levels and yet invoked "rehabilitation setting tensions." A continuum was engaged in the theme "navigating a middle ground," representing an integrated environment approach; rehabilitation in conventional indoor and outdoor community settings. Development of a sustainable concept for outdoor community-based rehabilitation involves strengthening health professionals' competencies and skills for providing outdoor and community work. [ABSTRACT FROM AUTHOR]

A divergence exists between registered nurses' (RNs') intention to document together with the patient and their actual documentation practice; a practice that also diverges from official intentions of patient participation. This study aimed to explore and describe RNs' reflected experiences on patient participation in nursing documentation. A descriptive qualitative study was conducted based on three focus groups with 14 registered nurses from an acute medical ward. Content analysis and conversational analysis were performed. The reporting adhered to the COREQ checklist. The findings showed that nurses made little mention of patient participation in nursing documentation due to challenges in meeting both the patients' expected needs and nurses' needs. However, patient participation was important for time accurate and summative nursing documentation. This study adds to a critical debate on patient participation and contributes to a practice-based understanding of the challenges that registered nurses experience concerning patient participation in nursing documentation. [ABSTRACT FROM AUTHOR]

Much has been written about the stigmatisation and discrimination ascribed to people with dementia in society and in research. This marginalisation has led to a silencing of their voices and their experiences both on a national and international scale, and an often limited understanding about how people with dementia experience daily life. In this study, a participatory research project was conducted in collaboration with people with early-stage dementia who attended an adult school in Denmark. The study explored how to work collaboratively with people with dementia to develop their own research projects. Based on the findings, a qualitative participatory research model has been designed to support the active engagement of people with early-stage dementia in research. The project involved 12 people with early-stage dementia, who were divided into two groups (n = 6 in each group) and then trained in research skills. Each group was then supported to design, develop and undertake a group research project. This was one continuous process, and constantly took account of the individual competencies of each group member. Based upon the knowledge gained from the training in research skills and the participatory research project The Balanced Participation Model was developed. The model illustrates five phases in a participatory research process focusing on the considerations needed for participant recruitment, planning, training in research skills, the participatory research project, and the evaluation and dissemination of results. The core of the model highlights the importance of the researcher role in facilitating the collaboration. [ABSTRACT FROM AUTHOR]

Early diagnosis and rapid treatment are deemed essential in relation to cancer. In 2007, Denmark implemented accelerated cancer patient pathways with predetermined time frames to reduce waiting time. In this article, based on fieldwork with observations at two hospitals and ethnographic interviews, we examine temporal experiences of the cancer patient pathway for endometrial cancer of the uterus at stage I. Results show that while the cancer patient pathway helps suspend thoughts of death it also brings a sense of timely confusion and concerns about whether disease has spread. This ambivalence is linked to a political discourse of cancer in general as acute and a clinical, biomedical framing of endometrial cancer in particular as "good" due to its slow growth. We demonstrate how women customize their temporal experiences to accelerate or decelerate time and argue that waiting is not necessarily a passive state. We emphasize the need for professionals to be aware that the cancer patient pathway time and subjective patient time are not always synchronized. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) reports that routine immunization coverage has declined in Europe. In this article, we present the findings of a Norman Fairclough–inspired critical discourse analysis undertaken to explore how the Danish media came to suggest a possible linkage between the human papillomavirus (HPV) vaccine and serious side effects. The findings of the analysis highlight the social consequences of the controversy over the HPV vaccine, identified within the framework of three perspectives: (1) overall criticism of vaccine efficacy and safety, rooted in an ideological opposition; (2) a growing societal tendency to question the authority of the official health bodies; and (3) the specific controversy over the HPV vaccine. We suggest that the controversy over the HPV vaccine is rooted in an ideological conflict, and the declining acceptance implies that the perception that the vaccine causes serious side effects has gained currency among the general public. [ABSTRACT FROM AUTHOR]

This article shows how Barcoded Medication Administration technology institutionally organizes and rules the daily actions of nurses. Although it is widely assumed that Barcoded Medication Administration technology improves quality and safety by reducing the risk of human error, little research has been done on how this technology alters the work of nurses. Drawing on empirical and conceptual strategies of analysis, this qualitative study used certain tools of institutional ethnography to provide a view of how nurses negotiate Barcoded Medication Administration technology. The approach also uses elements from practice theory in order to discern how technology operates as a player on the field instead of being viewed as a 'mere' tool. A literature review preceded participant observation, whereby 17 nurses were followed and data on an orthopaedic ward were collected over a period of 9 months in 2011 and 2012. Barcoded Medication Administration technology relies on nurses' knowledge to mediate between the embedded logics of its design and the unpredictable needs of patients. Nurses negotiate their own professional logic of care in the form of moment-to-moment deliberations which subvert the ruling frame of the barcoded system and its objectified model of patient safety. The logic of Barcoded Medication Administration technology differs from the logic of nursing care, as this technology presumes medication distribution to be linear, even though nurses follow another line of actor-bound safety practices that we characterize as 'deliberations'. [ABSTRACT FROM AUTHOR]

In this article, I argue that ethnodramatic monologue is a valuable method for producing knowledge complementary to current research on living with chronic diseases. Inspired by discussions on ethnographic representations, I present the monologue of an older woman with chronic diseases. The monologue has been performed for a live audience, and several future performances are also booked; however, this article is an experiment on the textual presentation of a theatrical monologue. The protagonist's voice is based on three interlocutors from my doctoral anthropological fieldwork, which was conducted among older people with chronic diseases in rural Denmark. Drawing on earlier training as a method actor, I consolidated notes, interviews, and observations to create a piece of art displaying my research. This article thus blends social sciences and the arts, building on the tradition of ethnographic theater. [ABSTRACT FROM AUTHOR]

Background: Patients and their caregivers are expected to take joint responsibility for reporting symptoms and seeking medical assistance, for example, by calling oncology emergency telephones or other helplines during a cancer trajectory. Research objective: The aim was to explore the meaning of responsibility as it appeared in patients' or caregivers' experiences of calling an oncological emergency telephone. Design, participants and context: Inspired by qualitative description and qualitative content analysis, a secondary analysis of data from interviews with 12 participants calling the oncological emergency telephone at a Danish university hospital was performed. Ethical considerations: The project observes demands for safekeeping data and all regulations concerning research ethics in agreement with the Nordic Nurses Federation and the Danish Health Act. Findings: Two main themes emerged: (1) to act responsibly as a patient or caregiver was to 'be watchful and alert', 'report symptoms the right way' and 'do crosschecking' and (2) to deal with the burden of responsibility was to 'feel safe when dealing with the burden of responsibility' and 'be relieved from the burden of responsibility'. Discussion: Too much responsibility and a potential imbalance between healthcare professionals' expectations and callers' knowledge and capacity to act may place additional burdens on the callers, which may be eased by person-centred care. Conclusion: The meaning of responsibility appeared in the participants' capacity to act, where they observed, assessed and reported symptoms and controlled prescribed treatments as well as shared or handed over the responsibility to the healthcare providers. Thus, the analysis provided essential knowledge for healthcare professionals on how patients and caregivers handle this responsibility when faced with a cancer disease that is treated on an outpatient basis. [ABSTRACT FROM AUTHOR]

This study examined intimate partner stalking experienced by 196 mothers stalked by the father of their children. Respondents completed a questionnaire concerning experiences of stalking and level of support by the authorities. Results revealed higher rates of harassing than violent stalking. In many cases, the children were also targeted by the stalking. Encounters with several agencies were common, but respondents were often not recognized as victims of stalking and demoralized by extensive case proceedings. This study calls for a special sensitivity of professionals encountering stalked parents in their work and highlights a need for coordination and cooperation among multiple agencies. [ABSTRACT FROM AUTHOR]

The experience of parental death concomitant with parental divorce occurs for 46% of Danish children and 50% of American children who lose a parent to death. This experience of loss and double bereavement compounds increased risk of mental health problems. The aim of this study was to explore nursing interventions for double bereaved children that promoted their well-being. A phenomenological–hermeneutic approach was used to conduct 20 interviews with nurses in family cancer care. Ricoeur's theoretical framework was followed with naïve reading, structural analysis, and critical interpretation, resulting in the formulation of a new model of nursing care for these children: the Divorced Family–Focused Care Model. Four themes were apparent: (a) collection of information about family structure, (b) assessment of support needs, (c) initiation of well-being support, and (d) coordination and follow-up focused on the child's well-being. The new intervention model has implications for health care education and implementation of health care policies. [ABSTRACT FROM AUTHOR]

Collaborative research involving different stakeholders is increasingly becoming a preferred way of doing qualitative research to improve health care services. However, ethical research dilemmas arise when collaborative ties are tight. Based on lessons learned from two qualitative collaborative health care research projects in two different municipalities in Norway and Denmark, respectively, this article illuminates ethical research dilemmas around ethical principles and guidelines of autonomy (informed consent), confidentiality (anonymity), and integrity of research. Accordingly, there is a need to revisit and resume international ethical research guidelines formulated in the Declaration of Helsinki, when it comes to research guidelines of informed consent, anonymity, and integrity of research. Moreover, we suggest that collaborators contemplate and negotiate these ethical research issues to avoid unnecessary misunderstandings, conflicts, and pressures when doing research with stakeholders when collaboration ties are tight. [ABSTRACT FROM AUTHOR]

Background: Suicide is a tremendous public health issue and worldwide the second leading cause of death among young people. In 2015, Greenland had the highest burden of disease due to self-harm with loss of 2,952.97 disability-adjusted life years per 100,000 inhabitants, more than six times as many as Denmark. Aims: What are possible reasons for Greenland’s higher youth suicide rate compared to Denmark, despite being one kingdom of Denmark? Method: Mixed methods in the form of qualitative, semi-structured interviews, the analysis of available data for 2003–2016 and a literature review were conducted with the aim to answer this question. Results: Several exposures cause this difference, most significantly adverse effects of the colonial past, such as social issues and experienced traumas in Greenland compared to its former coloniser Denmark. Conclusion: The ongoing burden of youth suicide in Greenland requires enhanced actions of all stakeholders involved in suicide prevention, intervention and postvention. [ABSTRACT FROM AUTHOR]

Psoriasis is a long-term condition with a possibly cumulative life course impairment. Young people struggle to minimize its effects on appearance and functioning. To date, the self-management needs of adolescents suffering from psoriasis have been underinvestigated. Using focus groups and individual interviews, we present an interpretive description of young people’s experiences of living with psoriasis, the challenges they face, and the support they need to relieve suffering and come to terms with their condition. This process is characterized by loneliness, the self-imposition of limitations, and the lack of personalized knowledge and communication skills to manage the impact of disease and society’s reactions. Our study provides insight into needs of early interventions tailored to address condition, role, and emotional management, involving parent education, peer support, storytelling, and roles for professionals. We argue that further research should involve young people, their parents, and professionals in the development and evaluation of interventions. [ABSTRACT FROM AUTHOR]

Nonattendance constitutes a profound challenge in public sector services targeting young adults with mental health difficulties. Therefore, researchers and practitioners are occupied with trying to resolve this. For clinicians to be aware of their own naturalized and perhaps inappropriate communicative practices, we investigated the established normative organizational logics behind explanations and strategies related to nonattendance. We performed a critical discourse analysis on material collected through participatory research throughout 2015. Three discourses were identified: solicitude, responsibility, and youth discourse. Although the discourses were complex and entangled, they were used by all practitioners. Furthermore, some of the discourses, especially the responsibility and the solicitude discourses, were inherently tension filled, and practitioners experienced frustration in dealing with these tensions. The youth discourse can be understood as a coping mechanism to deal with these tensions because it distributes responsibility for nonattendance to general social and cultural processes. [ABSTRACT FROM AUTHOR]

Aims: To present and discuss implementation experiences regarding the involvement of community pharmacists with ethnic minority backgrounds in a medication review intervention for ethnic minority poly-pharmacy patients in Denmark. Methods: Data sources include 1) reflection notes from an introductory seminar with pharmacists and the cross-disciplinary research team and 2) five individual interviews and one focus group interview with pharmacists. Data were thematically coded and synthesised to identify underlying rationales and challenges encountered when involving professionals with ethnic minority backgrounds in interventions for ethnic minorities. Results: Informants perceived the need for interventions targeted at ethnic minority poly-pharmacy patients, and highlighted the potential of involving professionals with diverse ethnic backgrounds in such interventions. However, implementation created challenges, because the professional identity of the pharmacists reduced their options for serving as peers with the same ethnic background. Furthermore, issues related to organisational difficulties and overcoming language barriers in the intervention impacted on the potential of involving professionals with ethnic minority backgrounds. Conclusions: Involving healthcare professionals with ethnic minority backgrounds in encounters with ethnic minorities holds potential for the adaptation of services to ethnically diverse populations, thus improving access to and quality of care. However, it is important to ensure sufficient personal and organisational support and to acknowledge the delicate balance between simultaneously serving as a peer and as a professional. [ABSTRACT FROM AUTHOR]

Background: The prevalence of multimorbidity is increasing, creating challenges for patients, healthcare professionals, and healthcare systems. Given that chronic disease management increasingly involves eHealth, it is useful to assess its perceived value among people with multimorbidity. Objective: To explore challenges related to multimorbidity and patients' perspectives on eHealth. Design: Ten semi-structured interviews with adults, living with multimorbidity in Copenhagen, Denmark. Interviews focused on patient-experienced challenges, from challenges related to self-management to challenges experienced in the healthcare sector, as well as perceptions of eHealth. During interviews, participants were presented with pictures of different eHealth technologies. Data analysis followed the systematic text condensation approach. Results: Participants experienced challenges in their daily lives, e.g. when practicing self-management activities, when navigating the healthcare sector, and when interacting with healthcare professionals. Patient-perceived value of eHealth varied, depending on their burden of illness and treatment: those with a greater burden had more positive perceptions of eHealth, and expressed more intention to use it. Participants with less complex disease patterns and less burdensome treatment regimens were more likely to perceive Health as something worthless and undesirable. Participants stressed that eHealth should only be introduced as an optional supplement. Conclusions: eHealth can potentially address some patient-experienced challenges related to multimorbidity by promoting self-management, patient-centeredness, and access. However, patients' needs and preferences vary and eHealth cannot substitute the personal interaction between patient and healthcare professionals. Our findings point to the importance of patient assessment and stratification to ensure appropriate use of eHealth. [ABSTRACT FROM AUTHOR]

Assistive technologies are often considered to be passive tools implemented in targeted processes. Our previous study of the implementation of the robot bathtub in a Danish elder center suggested that purposeful rationality was not the only issue at stake. To further explore this, we conducted a constructivist secondary qualitative analysis. Data included interviews, participant observations, working documents, and media coverage. The analysis was carried out in two phases and revealed that the bathing of the older people was constructed as a problem that could be offensive to the users’ integrity, damaging to their well-being, and physically strenuous for the staff. The older users and the nursing staff were constructed as problem carriers. We conclude that technological solutions are not merely neutral and beneficial solutions to existing problems, but are rather part of strategic games contributing to the construction of the very problems they seek to solve. [ABSTRACT FROM AUTHOR]

Background: The prevalence of multiple comorbid chronic conditions, or multimorbidity, is increasing. Care provided to people with multimorbidity is often fragmented, incomplete, inefficient, and ineffective. As part of a research and development project focusing on improving care, we sought to involve patients with multimorbidity in the planning process. Objective: To identify opportunities for improving care by understanding how patients from a Danish University Hospital experience care coordination. Design: Qualitative semi-structured interviews with 14 patients with multimorbidity. Results: Patients with multimorbidity described important concerns about care that included: (1) disease-centered, rather than patient-centered, care; (2) lack of attention to comorbidities and patient preferences and needs; and (3) involvement of numerous healthcare providers with limited care coordination. Poor continuity of care resulted in lack of treatment for complex problems, such as pain and mental health issues, medication errors, adverse events, and a feeling of being lost in the system. Receiving care from generalists (e.g. general practitioners and healthcare professionals at prevention centers) and having a care coordinator seemed to improve patients' experience of continuity and coordination of care. Suggestions for service improvements when providing care for people with multimorbidity included using care coordinators, longer consultation times, consultations specifically addressing follow-up on prescribed medications, and shifting the focus of care from disease states to patients' overall health status. Conclusions: A need exists for a reorganization of care delivery for people with multimorbidity that focuses on improved care coordination and puts patient preferences at the center of care. [ABSTRACT FROM AUTHOR]

Background: It can be challenging to provide generalist palliative care in hospitals, owing to difficulties in integrating disease-oriented treatment with palliative care and the influences of cultural and organisational conditions. However, knowledge on the interactions that occur is sparse. Aim: To investigate the interactions between organisation and culture as conditions for integrated palliative care in hospital and, if possible, to suggest workable solutions for the provision of generalist palliative care. Design: A convergent parallel mixed-methods design was chosen using two independent studies: a quantitative study, in which three independent datasets were triangulated to study the organisation and evaluation of generalist palliative care, and a qualitative, ethnographic study exploring the culture of generalist palliative nursing care in medical departments. Setting/participants: A Danish regional hospital with 29 department managements and one hospital management. Results: Two overall themes emerged: (1) ‘generalist palliative care as a priority at the hospital’, suggesting contrasting issues regarding prioritisation of palliative care at different organisational levels, and (2) ‘knowledge and use of generalist palliative care clinical guideline’, suggesting that the guideline had not reached all levels of the organisation. Conclusion: Contrasting issues in the hospital’s provision of generalist palliative care at different organisational levels seem to hamper the interactions between organisation and culture – interactions that appear to be necessary for the provision of integrated palliative care in the hospital. The implementation of palliative care is also hindered by the main focus being on disease-oriented treatment, which is reflected at all the organisational levels. [ABSTRACT FROM AUTHOR]

People with limiting longstanding illness and low education may experience problems in the labor market. Reduced employment protection that maintains economic security for the individual, known as “flexicurity,” has been proposed as a way to increase overall employment. We compared the development of labor market policies and employment rates from 1990 to 2010 in Denmark and the Netherlands (representing flexicurity), the United Kingdom, and Sweden. Employment rates in all countries were much lower in the target group than for other groups over the study period. However, “flexicurity” as practiced in Denmark, far from being a “magic bullet,” appeared to fail low-educated people with longstanding illness in particular. The Swedish policy, on the other hand, with higher employment protection and higher economic security, particularly earlier in the study period, led to higher employment rates in this group. Findings also revealed that economic security policies in all countries were eroding and shifting toward individual responsibility. Finally, results showed that active labor market policies need to be subcategorized to better understand which types are best suited for the target group. Increasing employment among the target group could reduce adverse health consequences and contribute to decreasing inequalities in health. [ABSTRACT FROM AUTHOR]

Aim: To investigate the kinds of knowledge practitioners use when planning and designing for health in school buildings. Methods: Twelve semi-structured qualitative interviews were conducted with architects, teachers and officials to investigate use of knowledge in the making of school buildings. Results: Practitioners drew on many kinds and sources of knowledge, but in particular they made use of concepts, examples or pictures or thought-provoking knowledge. However, the interviews indicate a number of hurdles for efficient knowledge sharing between research and practice: (1) a considerable discrepancy between kinds of knowledge used by practice and knowledge traditionally produced by research; (2) research-knowledge and practice-knowledge form two circuits and the flow from one circuit to the other is weak; (3) practitioners’ knowledge was often based on experience and therefore person-dependent. It makes the knowledge vulnerable. Conclusions: Special attention has to be paid by research to concepts and principles to guide the decision-making in practice. Further is recommended to consider new kinds of collaboration between researchers and practitioners. [ABSTRACT FROM PUBLISHER]

AIMS - This article describes and analyses prisoners' experiences of drug treatment in prison in four Nordic countries: Denmark, Finland, Norway and Sweden. The article examines how prisoners experience drug treatment, control and sanctions as related to three main topics, namely motivation; the content of the measure and relations to staff; and control and sanctions. METHODS & DATA - The article is based on data from twelve prisons, three in each of the four countries; 91 interviews with prisoners; and around six months of observation. The two main kinds of drug treatment measures are drug treatment units and day programmes. RESULTS - Prisoners described several motives to participate in drug treatment measures: to leave drugs and crime; to renew relations with family and friends; to solve health problems; and to improve their prison conditions. Prisoners found that drug treatment measures offered possibilities to acquire new ways of being. Staff behaviour seemed to be more important to prisoners than the methods used, and some prisoners seemed more positive to staff involved with the drug treatment than to other staff. A surprising finding was the prisoners' limited critique of controls and sanctions. We see this as embedded in the situation of being a prisoner, and also in relation to contexts outside prison. CONCLUSION - In discussing their experiences in the treatment units, prisoners are not so concerned about the rehabilitative features or the controls and sanctions. They evaluate their present situation in light of a future, which is their real concern. This is in line with a main task for staff, which is to prepare prisoners for release. [ABSTRACT FROM AUTHOR]

Becoming a parent is regarded as a crucial event in the life course, inducing changes in dietary behaviors. However, little is known about how the healthiness of diets and eating habits is influenced during this transition. Qualitative problem-centered interviews with 15 Danish mothers were analyzed by content analysis. Three stages within the transition are identified. Pregnancy and birth can be perceived as separate turning points in women’s dietary behaviors. In addition, the child joining the family table affects parental diets. Factors of major influence in the three stages were the following: first, responsibility for the child, pregnancy discomfort, and liberation from weight concerns; second, the baby’s digestive discomfort, time scarcity, and social visits; and third, work environment, child care, the child’s food needs, and prioritizing the child’s nutrition. The results indicate a need to differentiate between transition stages, especially in order to curb a “drop” into unhealthy behaviors after birth. [ABSTRACT FROM PUBLISHER]

Aim: To examine the perceptions and meanings of alcohol use in Denmark with specific focus on drinking contexts. Methods: A qualitative study using focus group interviews. The sample consisted of five focus groups of adults with one group for each of the following age groups: 16–20; 21–34; 35–44; 45–64; and 65–82 years. The groups consisted of both men and women with five to six participants in each group (27 in total). Results: Alcohol use is perceived as legitimate in many social contexts with few being defined as inappropriate. Drinking alone is mostly associated with having alcohol-related problems, but considered legitimate if it is characterized by activity. Drinking socially plays an important role in people’s considerations of legitimate use and seems to overrule the actual alcohol amount consumed. Different contexts influence different meanings of drinking with context and purpose changing with age and life stages. Conclusions: The social drinking context is pivotal in people’s perception of the legitimacy of their alcohol use, leaving the alcohol amount less important. This calls for the need to focus on and incorporate the drinking context within public health initiatives aimed at reducing high risk drinking, just as the focus on the actual amount of alcohol people consume or their frequency of use. [ABSTRACT FROM PUBLISHER]

The agonistic approach—aimed at embracing opposing perspectives as part of a qualitative research process and acknowledging that process as fundamentally political—sheds light on both the construction of and the resistance to research identities. This approach involves reflexively embedding interview situations into the ethnographic context as a tool for analyzing how this context conditions and limits positions for research participants, thereby setting the stage for potential agonisms between the researcher and field participants. The author—an ethnic Danish researcher—uses the agonistic approach to examine the identity construction problems and resistance dynamics in interviews with ethnic minority boys at a crime-preventive recreation centre. Applying an agonistic analysis to apparently "uninformative" interview data not only creates insight into local discursive resources, practices, cultural understandings, and power relations but also transforms what initially appears to constitute methodological problems—in terms of "data gaps" from participant resistance—into important, substantial empirical material. [ABSTRACT FROM AUTHOR]