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Mental health services are increasingly employing peer workers (PWs), individuals who have lived experiences with mental health problems, to support patients and be part of mental health care teams. While the employment of PWs continues to increase, little is known about how the function unfolds in practice. This paper explores the broader context in which the PWs navigate and the concrete outcomes and everyday issues that exist at the individual level. Methodologically, the paper draws on 22 interviews with PWs employed in the mental health services in Denmark. Theoretically, it combines Lipsky's (1980) theory on street-level bureaucrats with sociological discussions concerning the lay-expert divide. The analysis shows that PWs experience both role ambiguity and goal uncertainty and that they use substantial discretion in determining the nature, amount and quality of their peer practices. This – combined with the PWs' diverse lived experiences – calls for a heterogeneous understanding of peer work and therefore the analysis presents three categories of peer workers: PWs as (1) a representative of patients' lifeworld, (2) an interdisciplinary professional and (3) an 'expert by experience'. These categories display PWs different enactments of their lived experiences and reveal ambiguities tied to the lay-expert divide. [ABSTRACT FROM AUTHOR]

Health care systems around the globe are currently orienting themselves towards 'personalized medicine', a medical care regime aimed at individualizing prevention, diagnosis, and treatment of disease through proliferating amounts and sources of data, including genetic information. In Denmark, national health policies on personalized medicine focus on harnessing the potentials of genomic science and technology to bring knowledge about patient-specific genetic variation into clinical application. A major hope is to improve public health and prevent common diseases by integrating genomic information in health care, yet to act preventively, a temporal path has to be established defining what kind of knowledge to create and to act upon, and when. This paper explores the temporal orderings of medical knowledge in two different areas: health policy and clinical practice. Examining policy papers on personalized medicine issued by Danish governmental and research institutions, and, comparing them with contemporary practices of using genetic information in preventive cardiac health care, we demonstrate that genetic knowledge-making is ordered around two different conceptual views of time: namely the sequential order and the speed with which such knowledge is produced. We argue that the visions of knowledge-making and early intervention through genomic science and technology as conveyed in policy papers on personalized medicine, challenge preexisting practices and understandings of what constitutes timely prevention and actionable knowledge within clinical care. We close the article discussing how prevention through genomics amplifies the significance of the clinical space for public health as a site for sense-making and translation of controversial genetic knowledge. [ABSTRACT FROM AUTHOR]

In this paper, we view health strategies in the field of personalised medicine as performative actions which articulate the development desired for a given society and demonstrate and affirm values and visions for that society. Based on a qualitative study in Denmark, we show how political actors and policy documents articulate visions for personalised medicine through a distinct sociotechnical imaginary. This sociotechnical imaginary mobilises the distinction between non-profit public and for-profit private organisations, placing personalised medicine in the public domain as the self-evidently desirable future for Danish health care In the Danish case, the issue of implementing personalised medicine becomes an opportunity to revisit the vision for the welfare state and verify public institutions as a shared space for state and citizens. While Danish political actors see personalised medicine as transformative, they articulate this transformation as being steered by public actors, at the same time downplaying the role of private companies. Where public health studies have focused on how political investments into personalised medicine may marginalise specific groups and populations, the Danish case shows that also powerful transnational players may be excluded from political discourse. It teaches us not to treat personalised medicine as one phenomenon, but to pay direct attention to the local contexts in which it operates and shapes what 'public' and 'health' become. [ABSTRACT FROM AUTHOR]

Health care systems as well as bodies of medical knowledge are dynamic and change as the result of political and social transformations. In recent decades, health care systems have been subjected to a whole assemblage of regulatory practices. The local changes undertaken in Denmark that are being explored here are indicative of a long-term shift that has occurred in many welfare states intended to make public services in the Global North more efficient and transparent. Departing in prolonged field work in Danish general practice and the anthropological literature on audit culture, this paper suggests that the introduction of regulatory practices has enhanced the need for triage as a key organising principle. The term triage literally means separating out and refers to the process of sorting and placing patients in time and space. The paper suggests that an increasing introduction of triage feeds into a reconfiguration of diagnostic work, where the clinical setting is gradually becoming more intertwined with the governing domains of policy, and the work of the secretary is gradually becoming more intertwined with that of the doctor. Finally, the paper argues that an increasing regulation of general practice poses an ethically charged challenge to existing welfare politics of responsibility between the state and the public, as it makes it increasingly difficult to negotiate access to care. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Being in nature and doing nature-based activities has been shown to reduce stress-related illnesses such as trauma and post-traumatic stress disorders. In 2016, the crisis shelter Danner in Denmark decided to implement a programme based on the therapeutic use of nature as a recovery method for their residents: women and children exposed to domestic violence. This was done in collaboration with the research group of University of Copenhagen. This paper describes the objectives of the project, the development of an educational programme and the implementation of nature-based therapy. The Danish model for qualifications in education developed by the Danish Ministry of Education was the overall structural framework for the programme. The education programme contained four overall elements: (1) a theoretical part on the nature–health relationship; (2) performance and development of practical nature activities in collaboration with staff; (3) case stories about the challenges of implementing nature-based therapy for the residents in the crisis shelter; and (4) the implementation phase of nature-based therapy at Danner. Developing qualifications related to the use of nature-activities and the use of nature-environment might be useful for social workers and strengthen their competences in their work with battered women and children. [ABSTRACT FROM AUTHOR]

This paper explores the moral implications of treatment of young people with functional somatic symptoms. Based on an ethnographic field study at a Danish pain clinic for youngsters (age 8 to 18), the paper seeks to unearth the cultural, moral values that clinical practice steers by and upholds, and the implications this has for the assessment and management of ill body-selves. Through an exposition of the general practice of the clinic and an investigation of two specific cases of youngsters, it is found that the assessment of symptoms and selves and the goals of treatment are informed by cultural ideals of 'the good self' and 'the good life' in which agency and work ethic – both pertaining to the notion of individual responsibility – figure as prevalent virtues. The study underpins the findings of other researchers who have found that ideals of individual autonomy and responsibility for own life and health permeate the Western health care system and the discourses of ill individuals. The contribution of this article is to portray in ethnographic detail how such a cultural ethics manifests in practice and what implications this have for the treatment of young people with functional symptoms at a specific location and in specific cases. The two cases illustrate that the underlying norms and values can give rise to very different moral assessments of symptoms and selves within the same diagnostic category. [ABSTRACT FROM AUTHOR]

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]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Based on fieldwork among Danes with a diagnosed risk of type 2 diabetes or cardiovascular disease, this paper investigates how the technological possibilities of diagnosing and monitoring invisible risks shape understandings of health and form subjectivity. It focuses on the experiences of being diagnosed with a risk condition in the form of high blood pressure or elevated blood glucose and the ensuing use of measuring devices. It argues that measurements of these conditions can be seen as ‘formative processes’ that produce and maintain a view of health as something that can best be known through the use of medical technology. The numerical values such measurements yield are seen as true indicators of health, and doing something about risk conditions is felt to be a personal imperative. The formative processes illustrated in this paper are motivational and thought provoking. The informants do not experience new symptoms after being diagnosed; rather they reflect upon their health in a new way and numbers become associated with personal responsibility and morality. However, because numbers influence subjective experiences, they can come to take up too much space in everyday life. Therefore, people have reservations about how often they should measure their values at home. The formative processes of being diagnosed with a risk condition are thus about subjectivity both in the sense of being subject to the demands of living with an illness and of being a subject who acts to keep life from being colonized by concerns about health. [ABSTRACT FROM PUBLISHER]

Usability evaluations provide software development teams with insights on the degree to which a software application enables a user to achieve his/her goals, how fast these goals can be achieved, how easy it is to learn and how satisfactory it is in use. Although usability evaluations are crucial in the process of developing software systems with a high level of usability, their use is still limited in the context of small software development companies. Several approaches have been proposed to support software development practitioners (SWPs) in conducting usability evaluations and this paper presents two in-depth empirical studies of supporting SWPs by training them to become barefoot usability evaluators. Findings show that the SWPs after 30 hours of training obtained considerable abilities in identifying usability problems and that this approach revealed a high level of downstream utility. Results also show that the SWPs created relaxed conditions for the test users when acting as test monitors but experienced problems with making users think aloud. Considering the quality of problem descriptions, we found that the SWPs were better at providing clear and precise problem descriptions than at describing the impact, cause, user actions and providing data support for observations. [ABSTRACT FROM PUBLISHER]

This paper provides an account of young people's experiences of and perspectives on help and support in drug reducing interventions. It is based on interviews with young people age 14–25 who were in contact with the Criminal Justice System (CJS) and, at the same time, participated in a drug reducing intervention. The interview data forms part of the EU funded EPPIC project. Two main themes emerged from the young peoples' accounts that cut across different types of interventions and social systems in both countries. The first revolves around the 'system' of welfare, criminal justice, health and educational services and the barriers young people encountered in navigating the system to find help. The second revolves around the young people's experiences with professionals, including what they appreciated and what they found problematic in professionals' approach to them. Basing our analysis on data from two different countries, we are able to emphasize similarities in the young peoples' perspectives, despite being enrolled in different drug reducing and CJS interventions. The insights gained indicate a need for systems and service changes that can facilitate a better balance between building individual resilience and providing appropriate, timely and adequate support within a 'resilience-building' environment. [ABSTRACT FROM AUTHOR]

The engagement of young people has been a neglected area in youth justice and drug policy and practice. This paper explores the concept of 'engagement' in relation to drug interventions in custodial and community settings in different European countries. Interviews were undertaken with young people (aged 14–25 years) in contact with the criminal justice system who use illegal drugs and with practitioners involved in the delivery of interventions for our target group in Denmark, Italy, Poland, and the UK. The key techniques to engage young people were described in similar terms across the countries. These included forming relationships based on trust, honesty, and empathy, setting goals collaboratively, and employing practitioners with lived experience and understanding. The objectives and activities on offer are often constrained by criminal justice contexts. Despite the differences between the countries in terms of criminal justice systems and the structure of drug interventions, there were remarkable similarities in the ways young people and practitioners described effective engagement. Strong emphasis on operational engagement to ensure positive relationships between young people and practitioners was important in the design and delivery of interventions. Practitioners working in criminal justice contexts need to have flexibility and autonomy to work creatively to find ways to engage, connect, and inspire young people. [ABSTRACT FROM AUTHOR]

Based on research undertaken as part of the EU funded EPPIC project, this paper aims to update and elaborate on the relationship between drug use and offending behaviours by exploring variations within a cross-national sample of drug-experienced young people in touch with criminal justice systems. Adopting a trajectory-based approach, interviews were undertaken with 198 young people aged 15–25 in six European countries (Austria, Denmark, Germany, Italy, Poland, and UK). Data were analysed by applying the Bennett and Holloway categorization of the drugs-crime link, with a focus on the concept of social exclusion as developed by Seddon. Three main types of mechanisms (economic, pharmaceutical, and lifestyles) are used to interpret the data, showing how the relationship between drugs and offending can vary according to type of substances and over time. Furthermore, it can be associated with very different degrees of social exclusion and needs. The results suggest that while economic inequalities still play key roles in explaining drug use and offending, both behaviours can originate from a state of relative deprivation, resulting from the contradictions inherent in 'bulimic societies' that raise aspirations and desires while providing young people scarce opportunities for self-realisation and social recognition. [ABSTRACT FROM AUTHOR]

Introducing continental European approaches to UK child welfare practice raises a problem of comparison: to what extent are the problems and issues similar to or different from one country compared to another. Social pedagogues trained in continental Europe and working in English residential care services often encountered the phrase ‘our young people are worse’ from their English colleagues, with the implication that the social pedagogic approach was not suitable for the client group. This paper examines two propositions: (1) that in the context of introducing the continental European approach of social pedagogy into children's residential care services in England, young people are ‘different’ in England compared to other European countries and (2) that the placement options and practices for young people living away from their birth parents in continental European countries differ from those in England. Using data from a five nation study of young people from public care backgrounds, the paper argues that while family backgrounds are remarkably similar there are marked differences in the child welfare systems that might account for the perception that young people in care are ‘worse’ in England. [ABSTRACT FROM AUTHOR]

This paper explores the intersection of gender and class concerning welfare clients with medically unexplained symptoms. The study is conducted in Denmark using qualitative interviews with welfare officers and clients. The paper's focus is on how issues of gender and class intersect in the negotiation of illness among welfare officers and clients. The particular client group in question consists of individuals that are defined by their lack of a bio-medical diagnosis. Their 'lack' of identity accentuates how gender and class become central in the categorisation practices, constructing the ill person as either bio-medically sick or as a person who may be suffering but only from diffuse psychological problems. The paper shows that it is predominantly poorly educated women without a bio-medical diagnosis that welfare officers describe as suffering from psychological problems despite the fact that the women themselves focus on physical ailments in their illness stories. Men and better-educated women are described by the welfare officers as tired and exhausted or truly stressed after a long working life. [ABSTRACT FROM AUTHOR]

Diagnosis constitutes a major categorisation tool in medicine. This paper adds to the paucity of knowledge about part of the work such a tool performs. It examines the ways in which diabetes epidemiology translates into attempts to prevent diabetes from occurring through screening and diagnosing, and then managing those categorised as ‘at high risk’. Using a qualitative design in the context of a small-scale Danish intervention study, the findings suggest that health professionals overinterpreted relative risk reductions and exaggerated treatment effects; simultaneously, prediabetics called into question the scientifically set thresholds. Nonetheless, arguments concerning changed behaviour’s benefits were sought to be incorporated into self-care routines. The data highlight how, by identifying a normatively set threshold, a diagnosis can determine health promotion messages’ impact in ‘high-risk’ prevention strategies. [ABSTRACT FROM PUBLISHER]

One of the core principles of providing care in general practice is giving more to those who need it most. We investigate some of the complexities of this ambition in the context of cancer care for patients defined as socially disadvantaged by their general practitioner (GP). We do this by exploring how care is sought, how it is offered, and what expectations patients and GPs carry with them when receiving and providing cancer care in the Danish welfare state. We carried out semi-structured interviews with eight GPs and seven socially disadvantaged cancer patients living with different types and stages of cancer. The interviews focused on needs and challenges in cancer follow-up in general practice and were thematically coded. Drawing on theoretical concepts of morality and Nordic individualism, we point to how one of the main challenges in cancer care and follow-up is to figure out how the doctor-patient relationship should be established, practiced, and maintained. Both GPs and patients stressed the importance of the relationship, but how it should be practiced amidst social norms about being a patient, a citizen and how care-seeking should unfold seems less clear. In conclusion we argue that giving more to those who need it the most is a difficult and ill-defined task that is shaped by the cultural, social, and political expectations of both GPs and patients. [ABSTRACT FROM AUTHOR]

This paper, analyzing interviews with men that donate their semen in Denmark, explores what it means to be a sperm donor. Breaking with the assumption that men have a specific and clearly identifiable motivation to become sperm donors, this paper leaves the confinement of such an accountable actor model implied in asking for men's motivations to donate semen. Instead, the author describes the experiences of sperm donors to show how the moral, organizational, and biomedical-technological context of sperm donation in Denmark makes for enactments of moral selves as well as specific embodiments of masculinity. Instead of looking for motivations that can be accounted for, the author engages with the question of how donating semen affords men the experience of moral and gendered selves. [ABSTRACT FROM AUTHOR]

Transnational Global Health programmes planned and financed in theNorth and executed in the Global South usually involve some transfer ofcapacity between sites or capacity building in place. Capacityinvestment in the form of skills, knowledge, experience and equipmentis often assumed to ‘flow' between countries, laboratories andinstitutions, following the trajectories of mobile subjects in theknowledge economy. Drawing on in-depth interviews with Danish andEast African scientists, this paper considers the mobilities that underpinscientific capacity building, drawing attention to the paradoxical in waysin which these programmes produce stasis and fixity, as well as mobilityand exchange. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

This qualitative study explores the structural barriers to preventive interventions targeting childhood obesity in the Danish health care system. Based on interviews with relevant health care professionals, the paper reports on the problems which are experienced by general practitioners and health visitors and which complicate implementation of the policies of the Danish health authorities. Findings show that the current system is not well equipped to treat early overweight. A gap in primary preventive health care for children at age 3–5, indistinct lines of responsibility, inadequate cooperation, and lack of resources together make it difficult for health care professionals to initiate interventions and reach the children in need of support. By analyzing the policy implementation process in a theoretical framework that discloses the discursive allocation of responsibilities, the study is able to provide a deeper description and analysis of the problem. The study makes it clear how preventive health care for overweight children rests on the negotiation of formal and performed responsibilities among health practitioners within a framework of scarce resources and communication deficit. [ABSTRACT FROM PUBLISHER]

Usability and user experience (UX) methods come from academic environments, where industrial conditions such as time and resources are not of prime importance. Furthermore, usability and UX methods originate from a time when almost all software developments followed a traditional approach, such as the waterfall model. These two facts entail that existing methods often are too resource demanding and complex to apply directly into today’s agile, industrial environments. In this paper we make the claim that methods must be updated and tailored in order to be applicable within the agile, industrial development framework of today. We pursue a solution to simplify well-known methods and to train software developers to perform the UX work. To do this, three methods are modified via an iterative process together with the development of supporting materials. Software developers in three companies are trained in the methods to assess the approach. We find that it indeed is feasible to update and tailor existing usability and UX methods to fit into an agile, industrial environment. Furthermore, we show that it is possible to train developers to perform the usability and UX methods via one-day,in-situsessions using an ‘instructor’-teaching approach. The training is based on hands-on exercises and real-life tasks. This further boosts the developers’ confidence in performing UX work and promises a better consideration of UX in the development phases. We evaluate our approach through observations of the developers performing the UX tasks on their own at a later point in time. [ABSTRACT FROM PUBLISHER]

Career decisions are amongst the most important we make. Unsurprisingly, much published research exists on this particular aspect of career behaviour. However, the overwhelming majority of studies have been carried out on young people making initial career decisions. This paper extends our understanding by examining how mid-career adults in three European countries (Denmark, France and Italy) actually make career decisions. Characteristic patterns of behaviour recur when individuals approach points of transition or of crisis; each of these transitioning styles is illustrated by an iconic case. Emergent findings support the growing body of evidence that challenges the dominant policy and practice orthodoxy, which places rationality at the centre of the process, by recognising the importance of emotion and context. [ABSTRACT FROM PUBLISHER]

More than 25% of the master's degrees in Denmark are taught using English as a medium of instruction (EMI), but not all university lecturers feel they have the appropriate academic English proficiency to meet the standard required. Based on interviews conducted at the Copenhagen Business School (CBS), this article sheds light on the challenges faced by a selection of these lecturers. The interviews formed part of the project Students' Perceptions of the English of Academics, which examines the use of EMI at CBS. Audio recordings were made of 33 lecturers. Questionnaires were distributed to almost 1800 students on a range of issues, including the lecturer's English proficiency. The lecturers themselves also completed a questionnaire. Subsequently, 17 of them were interviewed, five of whom belonged to the group with the weakest skills. Inspired by a categorisation used by Marschan-Piekkari, Welch, and Welch for their recommendations for managing English as a corporate language, the literature review in the present paper discusses university language management under the headings of staff selection, training and development, international assignments and performance appraisal. The insights gained from the interviews address issues such as attitudes to EMI policy, experience with EMI teaching, student evaluations and support. [ABSTRACT FROM AUTHOR]

This paper explores the lived experiences of older surgical patients' (aged 74 years and older) experienced challenges during a brief admission to hospital. Age, gender, polypharmacy, and the severity of illness are also factors known to affect the hospitalization process. For an ethnographic study using participant observation and interviews, surgical cancer patients (n=9, aged 74 years and older) were recruited during admission to a Danish teaching hospital. Using ethnographic strategies of participant observation and interviews, each patient was followed through the course of 1 day during their stay at the hospital. Interviews were carried out with all patients during this time. Three areas of concern were identified as prominent in the patients' experiences and challenges during their short hospital stay: teeth and oral cavity, eating in a hospital setting, and medication during hospitalization. Short-term hospitalization requires focused collaboration between staff and patient concerning individual challenges from their teeth and oral cavity as support of nutritional needs during surgical treatment for cancer. [ABSTRACT FROM AUTHOR]

This paper describes a phenomenological hermeneutic study of experiences of women who were recently diagnosed with osteoporosis. The research objective was to investigate women's experiences of living with osteoporosis during the first 6 months after diagnosis when treatment was first prescribed. Fifteen women were included in the study. The inclusion criteria were a DXA scan at one of the two hospitals showing a T-score below -2.5 (lower back or hip), age 65 years or older; no previous known osteoporotic fracture; at least one of the known risk factors for osteoporosis; and prescription of anti-osteoporotic treatment. Exclusion criteria were previous diagnosis of osteoporosis or previous treatment with anti-osteoporotic medication. Data were collected through in-depth interviews shortly after diagnosis and 6 months later. The performed analyses were inspired by Paul Ricoeur's theory of interpretation of texts comprising three levels: naïve reading, structural analysis, and critical interpretation and discussion. Three key themes emerged: 1) being diagnosed, 2) being prescribed medical treatment, and 3) being on the path of learning to live with osteoporosis. The findings suggest a need for improved support for the patients to gain understanding of their diagnosis and the risk of osteoporotic fracture as well as to learn to live with osteoporosis. The study highlights new health promotion areas for targeting interventions at newly diagnosed patients, helping them accept and interpret the diagnosis, and the medical treatment. [ABSTRACT FROM AUTHOR]

The aim of the article is to make the reader more conscious about the relationship between the conceptualization of scientific knowledge and the formulation of a concrete research design. In only 10% of all qualitative research papers in Denmark are the conceptualization of scientific knowledge made transparent (OIsen, 2002). In this paper it is argued that being aware of the conceptualization of scientific knowledge on which one's research is based both opens possibilities and create limits for the specific ways of designing, conducting and analyzing a research project. This paper outlines three approaches to the qualitative research interview based on different understandings of the conceptualization of scientific knowledge and presentation of data. A phenomenological/hermeneutic position, a social constructionist and an action-oriented position on the conceptualization of scientific knowledge are outlined and in continuation hereof three concrete examples of research projects using the presented positions are discussed. [ABSTRACT FROM AUTHOR]

The aim of this paper is to consider the extent to which and the ways in which part-time work is used in the health services of Denmark, France and the UK. The reasons for and the implications of introducing part-time work in the three EU countries are also analysed and compared. Data were collected using questionnaires and interviews from hospitals in Denmark, France and the UK. Questionnaires were completed by heads of department and by part-time employees. Interviews (for the UK sample only) were held with the managers responsible for the introduction of flexible working practices. The findings show that part-time employment is the most common flexible working practice in the health services of all three countries but that the purpose of its introduction differs from one country to another. Part-time work seemed to have satisfied the desire of those who run the National Health Service (NHS) in the UK for cost reduction and for flexibility of working practices. In the French health service it was aimed at creating jobs, whereas in Denmark it was a response to increasing employee demand for flexible working. It was also found that, contrary to the Danish case with its established tradition of flexible working and equality in employment, the full-time working traditions and the male-dominated cultures of the health services in France and in the UK have often undermined the importance and benefits of part-time employment. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this study, we investigate the nature and strength of the social relations of working-age individuals who have survived a severe traumatic brain injury. Fifty-three survivors diagnosed with severe traumatic brain injury completed the social network analysis questionnaire, enabling us to map their social networks using the software program EgoNet.QF. This was combined with interviews with four survivors and their significant members of their network and constructed narrative cases of the resources gained from their network. Half the survivors lost friends because of the brain injury. The most common social network post injury comprised parents followed by spouses. Close relatives experienced a dramatic change in the nature of their relationships with the survivor. They also struggled greatly with the rehabilitation health system, which in many cases affected their own careers. Persons with severe traumatic brain injury and their close relatives predominantly learn to manage the new situation, with functionality driving social interaction. However, as social networks often are limited to the close family, these individuals are placed in a vulnerable position. Existing networks (whether few or many) are of major importance for individuals with traumatic brain injury in the rehabilitation process. Close social relations possess knowledge about the survivor with traumatic brain injury that is important for the rehabilitation process. To support individuals and their families who lack strong resources and social networks, health care professionals should systematically identify these persons from admission to hospital and primary care. When these persons have been identified, individual plans for how to strengthen their network can be developed in collaboration with the individuals and their existing social network. [ABSTRACT FROM AUTHOR]

This study explored women's lived experience of making fertility decisions six years after attending the Fertility Assessment and Counselling (FAC) clinic in Copenhagen, Denmark, which is a personalised fertility awareness intervention. We conducted a qualitative interview study with 24 women who attended the FAC clinic 6 years earlier. Interviews were semi-structured and broadly examined the women's perceptions and experience of the intervention during follow-up. Data was analysed using a phenomenological framework and themes were identified related to women's experience of making fertility decisions after attending the FAC clinic. The overarching theme regarding the women's lived experience of making fertility decisions after attending the FAC clinic was: Fertility decisions were guided by the 'family clock'. There were four themes: (i) Deciding to 'get started' by attending the FAC clinic; (ii) Sense of making informed and empowered decisions; (iii) Influence of partner status on fertility decisions; and (iv) Decisions dictated by circumstance over preference and knowledge. At follow-up, the majority (21 women, 88%) had become parents. More than half of the women said that they had not achieved their desired family size. Consideration of women's 'family clock' is necessary in personalised fertility awareness interventions to enable women to achieve their family goals. [ABSTRACT FROM AUTHOR]

We discuss Dutch general practitioners' responses to patients, mostly women of migrant background, with needs related to Harmful Cultural Practices. Our aim was to discover whether they encounter these kind of health issues and how they respond. We suspected that the patients concerned would not get the care they needed. We found that there is reason for concern, as based on general practitioners' own accounts we conclude that notwithstanding their great commitment to these patients they were disinclined to intervene, because they were cautious to judge other cultures and because they may have over- or underestimated the women's autonomy. [ABSTRACT FROM AUTHOR]

This study aims to investigate the experienced and measured development in physical capacity in people with Chronic Obstructive Pulmonary Disease (COPD) undergoing a standard pulmonary rehabilitation programme with a focus on the diverging experiences of responders and non-responders. Twenty-one participants in standard pulmonary rehabilitation were included in the study. We measured the participants' change in the six-minute walk test (6MWT) during rehabilitation participation. We investigated their experiences of the changes in their physical capacity by combined participant observations and interviews. A convergent mixed analysis was conducted of the coherent data. Standard pulmonary rehabilitation had a different physical impact on people with COPD. Responders were delighted by a positive physical change, which improved their daily functioning and capability of fulfilling personal priorities. However, non-responders experienced decreased capacity and a lack of trust in their future. All participants found it challenging to exercise and achieve sustainable exercise habits. In this qualitative study, we found that absence of expected improvement to pulmonary rehabilitation seems to confer distress and feelings of hopelessness. The achievement of sustainable change in daily exercise behaviour appears yet to be insufficient. Thus, new and more individualized models of physiotherapists' guidance in exercise are imperative. It is vital to acknowledge differential response to people with the chronic obstructive pulmonary disease following eight-week standard pulmonary rehabilitation. Especially noteworthy feelings of distress and hopelessness are prominent to non-responders because of the absence of the promised improvements. Both responders and non-responders require intensive physiotherapist guidance to exercise. It is recommended to ensure individualised support to people with chronic obstructive pulmonary disease in rehabilitation programmes. [ABSTRACT FROM AUTHOR]

Common mental disorders (CMD) are major causes of sick leave and have huge negative impacts on psychosocial well-being and to overall society. The return to work (RTW) process involves various welfare sectors, but often lack collaboration across these sectors and may cause uneven RTW processes. This study reports from an intervention aimed to increase collaboration between the mental health care system (MHCS) and the social insurance sector (SIS). The intervention consisted of two phases: (a) a development phase building on a participatory approach and (b) an implementation phase. Interprofessional meetings, evaluation workshops and joint consultations with workers from SIS and MHCS, and patients, comprised the key components of the intervention. The study explores how the collaborative process is experienced during the implementation phase with a focus on how collaboration maintains and challenges professional identities. A qualitative design was employed consisting of individual interviews (n20), focus group discussions (4), and observations of interactions between Patients with CMDs, case managers from SIS, and professionals working in MHCS. Patients with CMDs felt supported and did not feel pushed to RTW prematurely. SIS and MHCS professionals reported that they were not sufficiently prepared and it was not clear who was responsible for which tasks. MHCS professionals experienced that their professional identities were in conflict with the aim of the intervention whereas SIS professionals found that the intervention improved their poor reputation. The results suggest that a higher level of participation in the intervention design and implementation process can improve a clear and transparent role distribution between professionals in MHCS and SIS. Collaboration across sectors is key to successful Return-to-work after sickness-related absence. Professional identities are challenged in collaborative interventions as different agendas are at play. Collaboration is most likely to be successful when engaging involved professions to decide goals and methods which are compatible with local work procedures. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Most previous studies about fertility knowledge and attitudes among men have been based on quantitative methods using questionnaires with fixed-choice response options. The aims of this qualitative study were to explore childless young men's reflections on fertility and infertility through semi-structured interviews. Danish (n = 17) and Swedish (n = 12) young childless men aged between 20 and 30 years in their last year of education were interviewed. Data were analysed using qualitative content analysis. Few informants had considered their own fertility, and most were positive towards fertility treatment. The young men had inadequate knowledge about factors that can potentially impair male and female fertility. On average, the young men each mentioned three different factors they believed influence male and female fertility: (i) health behaviour; (ii) factors beyond personal control; and (iii) age. None mentioned sexual transmitted infections (STIs) but most appeared aware of the effect of increasing age on fertility. The results of this study highlight the need for educational strategies to improve young men's knowledge about fertility and the factors that influence it, particularly about the potential adverse effect of STIs on fertility. [ABSTRACT FROM AUTHOR]

Purpose: To deepen the understanding of how survivors' experience and give meaning to the embodied phenomenon of chronic sensory disturbances in everyday life after oxaliplatin treatment for colorectal cancer. Methods: Data was generated by means of a semi-structured interview guide and drawings with the aim to explore eight survivors' lifeworld experiences. Data was analyzed through a phenomenological approach. Results: The essential meaning of sensory disturbances emerged in two main themes and four sub-themes. Theme A: 'A peculiar experience that is difficult to logically understand' with the subthemes; 'An ambiguous perception in hands and feet' and 'Being alienated from one's own body'. Theme B: Losing touch with the world' with the subthemes: 'A lack of sensory contact with physical surfaces' and 'Breakdown of sensitivity in hands hampers fine motor skills and social contact'. Conclusion: Sensory disturbances contributed to an ambiguous and discordant perception of an alienated body that was difficult to describe and affected the ability to act and connect to things and other people. Metaphors and drawings were valuable as means to verbalize and illustrate the changed body perception where the 'I can' changed into 'I cannot'. To support the embodied connection to the world new usage patterns were required. [ABSTRACT FROM AUTHOR]

Purpose: Becoming widowed is a stressful health-threatening event causing major life changes. We explored how widowed people experience becoming widowed and examined if these experiences are quantitatively associated with widowhood. Methods: A multi-methods study using an exploratory sequential mixed-methods approach including a qualitative descriptive study with widowed people from Denmark and a Swedish cohort study. Qualitative interviews (n = 9) were analysed using qualitative content analysis, describing experiences as explained by the widowed people. The quantitative association of the experiences was examined by identifying proxies for the qualitative experiences of widowhood in the cohort study and examining the occurrence in widowed people compared to married people (n = 1,095). Results: Six categories of experiences emerged: the circumstances around spousal death, mental health and well-being, physical health, social relations, activities and practicalities. The quantitative examination showed a significant association with widowhood regarding mental and physical health problems. Conclusion: The circumstances around spousal death and the time before spousal death, in general, were important to how participants felt being widowed. Being ill negatively affected mental health and well-being, partly because of the inability to participate in activities and social relations. This is important, as health problems are more common among widowed people than married people. [ABSTRACT FROM AUTHOR]

Unsuccessful weight loss or weight loss maintenance is due to different barriers and physical limitations related to participation in everyday life. It will, therefore, be relevant to investigate the field from an occupational therapy perspective, since occupational therapists are uniquely trained in focussing on people's resources, meaningfulness and participation in everyday life. The aim was to explore what motivates people to lose weight from an OT perspective and which opportunities people with obesity experience in their everyday lives to achieve and maintain lost weight. A descriptive phenomenological study including 21 semi-structured individual interviews was conducted as part of the DO:IT study. The data analysis led to the identification of three main themes: The influence of external circumstances on the desire for weight loss; use of time in everyday life; and changes in habits, routines and structure. People who are overweight or obese are motivated to lose weight because of health issues and feeling more comfortable with their body. The opportunities for weight loss lie in creating habits, routines and structuring everyday life activities to facilitate a healthier lifestyle. The findings indicate that an occupational therapist should be part of weight-loss interventions. [ABSTRACT FROM AUTHOR]

Assistive technologies in care work are expected to alleviate the challenges related to population aging, namely the pressure on public budgets and a shortage of care professionals. This study examines how various stakeholders view the potentials of assistive technology in an institutionalized care setting in Denmark. Using ethnographic field observations, interviews, and document analysis, we explore the residents', the staff's, and the municipality's perspectives on the technologies and analyze whether they live up to the stated expectations. We identify three parallel narratives representing each of the stakeholder's perspectives. The municipality's triple-win narrative emphasizes expected gains in terms of efficiency, improved working conditions, and better quality of care. The staff's ambiguity narrative contains both negative views regarding the motive for using technologies to save resources and positive accounts of how technologies have reduced work-related pain. The residents' limited agency narrative reflects an internalization of the staff's perspectives. We conclude that, despite both the staff and the municipality highlighting the residents' well-being and comfort as important outcomes of assistive technologies, the residents' wishes have limited influence on whether and, if so, how assistive technologies are used. Different stakeholders' views on assistive technology vary and are closely connected to their respective institutional interests and roles. These perspectives are important for a successful implementation of assistive technologies. Understanding the positions of staff and older care recipients, and differentiating between their respective perspectives can help both scholars and product developers understand the potentials and risks of AT in a more nuanced way. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Strengthening primary healthcare with highly qualified nurses in acute care units or teams is a new Danish initiative intended to detect acute diseases and the deterioration of chronic diseases and to develop treatment for outpatients. This study explores healthcare professionals' experiences with this initiative. Qualitative semi-structured interviews conducted in 2019–2020. Analysis was conducted with a systematic text condensation. This study is based on an acute care team in one Danish municipality called Acute Team Odense (ATO). ATO delivers acute nursing in patients' own homes (including nursing homes) in collaboration with different healthcare professionals. Individual interviews with general practitioners (GPs) (n = 15), five focus-group interviews with nurses and nursing assistants from the municipality (n = 19) and one focus-group interview with staff from the emergency department (ED) (n = 10). Experiences of different healthcare professionals' experiences with ATO. In general, all of the participants were very satisfied with the new acute care team and the cross-sectorial possibilities. The GPs usually referred ATO to assessments in which paraclinical equipment, competencies, accessibility, response time and communication were important. The municipal nurses and nursing assistants tended to use ATO if they needed second opinions or acute nurse assistance. The ED most often used ATO to assist with intravenous therapy after an ED visit. All participants reported that ATO increased what could be assessed and treated in patients' homes, which is central to preventing unnecessary hospitalisations. ATO created new possibilities in patient's homes which potentially might prevent unnecessary hospitalisations. Acute care units or teams are mandatory in Danish health care, but limited knowledge in the area is found. Healthcare professionals found that the acute care teams provided new possibilities to assess and treat patients in their own homes. Healthcare professionals experienced that the acute care team potentially prevented hospitalisations by fast clinical nurse assessments with paraclinical tests. [ABSTRACT FROM AUTHOR]

Adolescents with ADHD are at increased risk of having a co-existing medical disorder. Research shows that having co-existing ADHD and a medical disorder interferes with the adolescents' daily life, creating a dual task that cannot be managed as two independent disorders. Interventions to support adolescents in managing the dual task of living with co-existing ADHD and medical disorder are needed. The Guided-Self-Determination intervention might be suitable for this population, as it is an empowerment-based intervention facilitating patient involvement and self-management of a disease. The purpose of this study was to evaluate how the Guided Self-Determination intervention impacted 10 adolescents with ADHD and a co-existing medical disorder. The study used a convergent mixed methods design. Quantitative data measuring support from nurses, support from parents, and self-management were collected though self-reported questionnaires at baseline, 3 months, and 6 months and were analyzed with descriptive statistics. Qualitative data capturing the adolescents' experiences of the intervention and the intervention's impact on support from nurses, parents, and self-management were collected through semi-structured interviews and analyzed thematically. Results of the quantitative and qualitative analyses were integrated in a mixed methods analysis. The integrated results suggest that this intervention may improve adolescents' management of the difficulties of living with co-existing ADHD and a medical disorder, and that self-insight and nurse support are prerequisites for developing self-management strategies. However, the results showed that the intervention did not impact parental support. Further research is needed to evaluate the impact of the intervention on a larger scale. [ABSTRACT FROM AUTHOR]

In this study, researchers explored the relationship between alcohol use and life transitions among women aged 50 to 70 years in Australia and Denmark. Data were collected via semi-structured interviews of 49 women, with thematic analysis indicating that alcohol use is a normal and accepted activity among Australian and Danish women. Alcohol use was influenced by women's specific life transitions including their retirement status. Using alcohol as a crutch was not a legitimate story, but women found it acceptable to temporarily manage stress. The researchers provided insight to women's perceptions on drinking that may guide future international public health strategies for this group. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore significant others' perspectives on how information and communication technology can support the rehabilitation process after stroke and facilitate participation in everyday life. Method: Thirteen significant others were included in the study, and to capture their perspectives, two focus groups, and five individual interviews were carried out in Denmark and Sweden 6-12 months after the stroke incident. A grounded theory approach was used throughout the study and a constant comparative method was used in the analysis. Results: Five subcategories were identified from the analysis of the interviews: (1) Information and communication technology providing a sense of security, (2) Information and communication technology as a social mediator, (3) Information and communication technology as a compensator for deficits, (4) Information and communication technology as a way to reach information, and (5) Information and communication technology as a possibility to supplement the rehabilitation process. From these categories, one core category emerged: The potential of information and communication technology to facilitate participation in everyday life and thereby reduce the strains that significant others experience after stroke. Conclusion: Information and communication technology has the potential to facilitate participation in everyday life after stroke. It is important, therefore, to start using information and communication technology in the rehabilitation process after stroke, to bring meaning to everyday life and to support both the stroke survivors and their significant others. Integration of information and communication technology in the rehabilitation process after stroke can accommodate several of the significant others´ needs. Educating stroke survivors to use information and communication technology as part of the rehabilitation process offloads their significant others. Integration of information and communication technology in the rehabilitation process after stroke can bring new meaning in everyday life and can facilitate both independence and participation in everyday life. [ABSTRACT FROM AUTHOR]

Background: There is growing interest in interventions that promote positive outcomes and well-being for people with aphasia (PWA) and their families, but provision is inconsistent. An asset-based approach, based on the theory of salutogenesis, focuses on what makes you well rather than ill. This approach has been used successfully across a variety of research fields, including health and social care research and practice, and has the potential to provide coherent strategies to support people living successfully with aphasia. Aim: To explore the relevance and potential of an asset-based approach to promoting and sustaining well-being for PWA and their families, across contexts and cultures. Methods & procedures: Exploratory case studies were carried out in the United Kingdom (UK), Norway, Israel, Ireland, and Denmark in a variety of settings. Following an interpretative paradigm, we used qualitative methods including: interviews; appreciative inquiry; group discussions; and participatory action research. 95 PWA and 25 family members were asked to identify assets within themselves and their communities that promote, sustain and maintain well-being, by responding to: "What makes you feel good/well/healthy?" Data were analysed using thematic analysis. Outcomes & results: An asset-based approach proved to be a powerful means for PWA and family members to explore what helps them live well with aphasia. Key themes were identified: (1) personal journey; (2) helping others; (3) connecting to self; (4) connecting to others; (5) recreation; and (6) personal attributes. Self-identification of assets, within the person and their community, and connections to these, helped PWA and their family members to maintain well-being, overcome barriers and regain confidence. Using this approach, focusing on the person's recognition, activation and mobilisation of assets, could enhance the person's understanding and restore meaning around the stroke and onset of aphasia. Conclusion: This novel exploratory research demonstrates the relevance and potential across diverse cultural contexts of taking an asset-based approach to promoting and sustaining well-being for PWA and their families. Focusing on maintaining connections to these assets and developing meaning around the event, could prevent some of the negative sequela of stroke. The "patient–professional" relationship must transform into a collaborative partnership, with time and flexibility needed to introduce this approach. Further research should examine how service providers and PWA could develop and operationalise an asset-based approach in clinical and community settings and identify if there is an optimum timing for introducing this approach along the stroke pathway. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)