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In Nordic countries, 'welfare technology' is a concept used increasingly by policymakers when discussing the promise of digitalisation in care for older people. In this paper, I draw on data from 14 qualitative ethnographic interviews with employees in municipal eldercare in Sweden, as well as observations carried out at a nursing home, to suggest the importance of studying how good care is enacted through welfare technology, whilst simultaneously attending to the adverse effects sometimes consequent from these practices. In this article, I explore what values are supported when doing care with welfare technology, and what values are neglected in this process. The theoretical starting point for this article takes its inspiration from recent discussions of care within Science and Technology Studies (STS). Employing a double vision of care, the article argues for the importance of understanding how good care is enacted with technology, while also attending to what these care practices exclude and neglect. Focusing on the use of social alarms, the article shows that when doing care with such technology, values such as independence, safety and some forms of togetherness and availability were enhanced; while other values such as other forms togetherness and availability, a stress-free working environment and functionality were neglected. [ABSTRACT FROM AUTHOR]

This article is concerned with the doing and production of data. We ask how data are made in intimate spaces such as the home in collaboration with the different parties involved in home-based care and services. The article builds on ethnographic field notes from 73 home visits, in the context of home-based mental health, substance abuse and social care for adults in Finland and Sweden. Drawing on affect theory, the article aims to foreground aspects of the production of data and research that are often edited out of the research process. In so doing, we argue that the production of data would not be possible without the active and affective collaboration of all parties involved in home visits. Thus, the article scrutinizes in detail the efforts made by different parties, such as researchers, clients and workers to do and produce data. While we study an atypical setting of institutional interaction, we contend that affects and affective relations gain particular importance in the home. [ABSTRACT FROM AUTHOR]

This article uses a material semiotic perspective to study a highly influential model of healthcare policy and practice today: person-centred care. While person-centred care is often regarded as implying a turn away from technology and standardization towards more humanistic values in care, this article shows that mundane standardization technologies, such as an assessment protocol, are integral components of person-centred care. Building on interviews and observational studies at a Swedish hospital introducing person-centred care, the article analyses the person-centred protocol in situ. The article teases out three core concerns inscribed in the protocol: a concern for the patient experience and perspective, a valuing of evidence-based knowledge and a managerial imperative. The article illustrates how these contrasting values were rendered compatible through the continuous tinkering of healthcare professionals. Finally, it shows how users modified the script of the protocol under analysis and how relations between the three core concerns were adjusted in the process. The article concludes that tinkering and user–technology relations are of significance for the fate of person-centred care at large. [ABSTRACT FROM AUTHOR]

The welfare systems in the global North has seen changes in professional care delivery systems in the margins of welfare, from care in large treatment institutions, to community care and, more recently, to care taking place in home spaces. Care and support are increasingly provided in the home of the service user through floating support and home visits. Drawing on empirical ethics, we aim to inquire into modes of doing good care during professional workers' home visits by building on observations of service interactions taking place during these home visits in two different settings: that is, a mental healthcare unit performing home visits in the context of psychiatric care and a special‐housing unit performing home visits in the context of homelessness services. We also build on interviews as retrospective reflections on service interactions. Drawing on these empirical materials, we ask what is considered as doing good in the margins of welfare and identify three ideal patterns: the relationality of care, the situatedness of care and the subject of care. Furthermore, these ideal patterns are connected to two different ideals of good care and conceptions of autonomy in care relations. [ABSTRACT FROM AUTHOR]

In recent decades, the ‘tenacious assumptions’ of biomedicine regarding the neutrality and universality of its knowledge claims have been significantly challenged by the growth of new collaborative and patient-focused models of Healthcare delivery. In this article, we discuss and critically reflect upon one such alternative Healthcare model developed at the University of Gothenburg Centre for Person-Centred Care in Sweden. This centre uses three clinical routines of narrative, partnership and documentation to provide Healthcare to people recognized as unique individuals rather than patients. Person-centred care in Gothenburg and more broadly is based on the assumption that a person is independently capable of reasoning and verbal expression and willing to provide clear and genuine narratives and cooperate with Healthcare professionals. However, we argue that by emphasizing individual capabilities of reasoning and verbal expression, an unnecessarily limited conception of personhood risks being imposed on these routines. Drawing upon semi-structured interviews with researchers in three very different Gothenburg Centre for Person-Centred Care research projects – about healthy ageing in migrant communities, neurogenic communication disorders, and psychosis – we highlight that how persons are recognized as unique and capable varies significantly in practice across different Healthcare settings. Thus, we assert that person-centred care’s own potentially tenacious assumptions about the attributes of personhood risk distracting attention away from the variety of creative ways that professionals and persons promisingly find for translating the ideal of person-centred care into practice. [ABSTRACT FROM AUTHOR]

The study contributes to discursive and interactional housing and home studies by analysing home visit conversations with clients who need support with their housing and living in the community. It focuses on the ways in which professionals comment on clients' home environments. The data, which consist of 20 audio-recorded home visits in Mobile Support directed at mental health and substance abuse rehabilitees, are analysed by applying the Foucauldian concepts of practices, normalization and inspecting gaze, Goffman's idea on face-work and the ethnomethodologically oriented research on the meanings of spaces in interactions. Five ways of using inspecting gaze are identified: pointing out, criticizing, giving advice, displaying concern and complimenting. The study provides a critical reflective basis for assessing the "soft" use of interactional power in clients' homes at a time when the provision of services in private home spaces is on the increase. [ABSTRACT FROM AUTHOR]

Background To empower patients and improve the quality of care, policy-makers increasingly adopt systems to enhance person-centred care. Although models of person-centredness and patient-centredness vary, respecting the needs and preferences of individuals receiving care is paramount. In Sweden, as in other countries, healthcare providers seek to improve person-centred principles and address gaps in practice. Consequently, researchers at the University of Gothenburg Centre for Person-Centred Care are currently delivering person-centred interventions employing a framework that incorporates three routines. These include eliciting the patient's narrative, agreeing a partnership with shared goals between patient and professional, and safeguarding this through documentation. Aim To explore the barriers and facilitators to the delivery of person-centred care interventions, in different contexts. Method Qualitative interviews were conducted with a purposeful sample of 18 researchers from seven research studies across contrasting healthcare settings. Interviews were transcribed, translated and thematically analysed, adopting some basic features of grounded theory. Ethical issues The ethical code of conduct was followed and conformed to the ethical guidelines adopted by the Swedish Research Council. Results Barriers to the implementation of person-centred care covered three themes: traditional practices and structures; sceptical, stereotypical attitudes from professionals; and factors related to the development of person-centred interventions. Facilitators included organisational factors, leadership and training and an enabling attitude and approach by professionals. Trained project managers, patients taking an active role in research and adaptive strategies by researchers all helped person-centred care delivery. Conclusion At the University of Gothenburg, a model of person-centred care is being initiated and integrated into practice through research. Knowledgeable, well-trained professionals facilitate the routines of narrative elicitation and partnership. Strong leadership and adaptive strategies are important for overcoming existing practices, routines and methods of documentation. This study provides guidance for practitioners when delivering and adapting person-centred care in different contexts. [ABSTRACT FROM AUTHOR]

Background Person-centred care ( PCC) is increasingly advocated as a new way of delivering health care, but there is little evidence that it is widely practised. The University of Gothenburg Centre for Person-Centred Care ( GPCC) was set up in 2010 to develop and implement person-centred care in clinical practice on the basis of three routines. These routines are based on eliciting the patient's narrative to initiate a partnership; working the partnership to achieve commonly agreed goals; and using documentation to safeguard the partnership and record the person's narrative and shared goals. Objective In this paper, we aimed to explore professionals' understanding of PCC routines as they implement the GPCC model in a range of different settings. Methods We conducted a qualitative study and interviewed 18 clinician-researchers from five health-care professions who were working in seven diverse GPCC projects. Results Interviewees' accounts of PCC emphasized the ways in which persons are seen as different from patients; the variable emphasis placed on the person's goals; and the role of the person's own resources in building partnerships. Conclusion This study illustrates what is needed for health-care professionals to implement PCC in everyday practice: the recognition of the person is as important as the specific practical routines. Interviewees described the need to change the clinical mindset and to develop the ways of integrating people's narratives with clinical practice. [ABSTRACT FROM AUTHOR]

Background: The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies.Methods: This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT).Results: In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication.Conclusion: NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes. [ABSTRACT FROM AUTHOR]