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4. Using Psychodynamic Interaction as a Valuable Source of Information in Social Research

Author

Schmidt, Camilla

Abstract

This article will address the issue of using understandings of psychodynamic interrelations as a means to grasp how social and cultural dynamics are processed individually and collectively in narratives. I apply the two theoretically distinct concepts of inter- and intrasubjectivity to gain insight into how social and cultural dynamics are processed as subjective experiences and reflected in the interrelational space created in narrative interviews with trainee social educators. By using a combination of interactionist theory and psychosocial theory in the analysis of an interview with a student of social education, I demonstrate how the often conflicting demands and expectations are being played out in the interrelational tension between the researcher (myself) and the interviewee or narrator. In a confrontation with "inner" expectations and concerns regarding a future profession and one's ability to cope, and the "outer" socially and culturally embedded discourses as they are played out in the objectives of self-development and education, the narrative about a forthcoming internship is filled with tension and contradiction. In this article I will demonstrate how such tensions and contradictions are valuable sources of information in understanding the process of becoming a social educator.

Published
2012

10. 14 forskere: Børnedebatten er kørt af sporet

Author

Andersen, Peter Østergaard, Ellegaard, Thomas, Gulløv, Eva, Hedegaard, Mariane, Hjort, Katrin, Kampmann, Jan, Kjær, Bjørg, Nielsen, Birger Steen, Nielsen, Klaus, Plum, Maja, Palludan, Charlotte, Rasmussen, Kim, Schmidt, Camilla, and Sommer, Dion

Published
2012

18. Everyday practice and unnoticed professional competence in day care work

Author

Ahrenkiel, Annegrethe, Warring, Niels, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Ahrenkiel, Annegrethe, Warring, Niels, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In Denmark more than 9 out 10 children attend day care centers that are publicly funded and regulated. The main part of employees, the social educators, at day care centers have attended a 3½ years educational programme with both theoretical and practical elements. Nevertheless it has been hard for the social educators to get recognition for their professional competencies and the societal importance of their work. Neoliberal governance has imposed a lot of demands for documentation, evaluation etc., and a growing focus on children’s learning in day care centers has resulted in national goals for learning outcomes. For the social educators this has meant more time being spent on formal learning activities, and they have received the new demands with mixed feelings: on the one hand they can help the social educators getting more acknowledged for doing some valuable and visible work. On the other hand it can tend to underestimate the value of a large part of their work which is embedded in what in the paper will be explored as unnoticed professional competences. Building on empirical results from research in day care centers based on mixed methods (observations, interviews and action research based workshops) the paper will discuss work practice in an everyday life perspective. This perspective opens for understanding professional competence as part of creating coherence in children’s and families’ lives as well as during the day in the day care centers. It also opens for a discussion of how different forms of knowledge function together in the social educators’ work practice.

19. Alternatives to neoliberalism? : The development of day care centres and the role of social educators and their unions

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

This paper will discuss the consequences of neoliberal governance in Danish day care centres, the social educators’ response, and the possible development of alternatives based on collective participation of social educators and union representatives. We will show how important and unnoticed professional competencies come under pressure, and how collective interest representation is challenged. We will discuss how concepts of “gestural knowledge”, “coherence” and “rhythm” open for a new understanding of professional competence. And we will conclude that the social educators and their unions have the possibility to contribute to the development of a new welfare paradigm. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. The interviews have been open and loosely structured, with a focus on encouraging the participants to talk about important aspects of their work. Everyday work was also the starting point for research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

20. Unnoticed professional competence and knowledge in day care work

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In research on professions in the public care and health sector the issue of professional competence and knowledge is central. Discussions on tacit knowledge (Polanyi), modus 1 and 2 knowledge (Gibbons), intuitive expertise (Dreyfus), reflective practice (Schön), practical knowledge (Bourdieu), communities of practice (Wenger) have been influencing the discussion on professional development. Across the different notions there is a shared view that important parts of professional competence is part of daily practices and embedded in routines, experiences, shared repertoire, etc. NPM and neoliberalism has had an important impact on care and health work imposing demands for documentation, standardization and evaluation. These increasing demands seem to be in contrast with the tacit and embodied parts of professional competence that not easily can be documented, standardized and evaluated. It can be argued that there is a pressure on these aspects of professional competence and knowledge ultimately resulting in poorer quality of work for both employees and citizens – the exact opposite of what presumably has been the goal with the steering systems. In this paper we will discuss the case of social educators in day care centers. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. Finally, we facilitated research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

21. Unnoticed professional competence in day care work and the challenge of neoliberalism

Author

Ahrenkiel, Annegrethe, Warring, Niels, Schmidt, Camilla, Nielsen, Birger Steen, Sommer, Finn M., Ahrenkiel, Annegrethe, Warring, Niels, Schmidt, Camilla, Nielsen, Birger Steen, and Sommer, Finn M.

Abstract

New Public Management and neoliberalism has had a huge impact on care and health work imposing demands for documentation, standardization and evaluation. These demands seem to be in contrast with core aspects of the professional competence that are unnoticed. The paper explores how social educator’s work in day care centers can be explored, developed and potentially democratized acknowledging the unnoticed aspects of daily work practices and professional competence. The paper draws on empirical examples from two research projects (Ahrenkiel et al. 2009, 2011) and discuss how noticing and developing the professional competences of pedagogues holds the potential to develop alternatives to neoliberal regulation.

22. Unnoticed professional competence and knowledge in day care work

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In research on professions in the public care and health sector the issue of professional competence and knowledge is central. Discussions on tacit knowledge (Polanyi), modus 1 and 2 knowledge (Gibbons), intuitive expertise (Dreyfus), reflective practice (Schön), practical knowledge (Bourdieu), communities of practice (Wenger) have been influencing the discussion on professional development. Across the different notions there is a shared view that important parts of professional competence is part of daily practices and embedded in routines, experiences, shared repertoire, etc. NPM and neoliberalism has had an important impact on care and health work imposing demands for documentation, standardization and evaluation. These increasing demands seem to be in contrast with the tacit and embodied parts of professional competence that not easily can be documented, standardized and evaluated. It can be argued that there is a pressure on these aspects of professional competence and knowledge ultimately resulting in poorer quality of work for both employees and citizens – the exact opposite of what presumably has been the goal with the steering systems. In this paper we will discuss the case of social educators in day care centers. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. Finally, we facilitated research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

23. Everyday practice and unnoticed professional competence in day care work

Author

Ahrenkiel, Annegrethe, Warring, Niels, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Ahrenkiel, Annegrethe, Warring, Niels, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In Denmark more than 9 out 10 children attend day care centers that are publicly funded and regulated. The main part of employees, the social educators, at day care centers have attended a 3½ years educational programme with both theoretical and practical elements. Nevertheless it has been hard for the social educators to get recognition for their professional competencies and the societal importance of their work. Neoliberal governance has imposed a lot of demands for documentation, evaluation etc., and a growing focus on children’s learning in day care centers has resulted in national goals for learning outcomes. For the social educators this has meant more time being spent on formal learning activities, and they have received the new demands with mixed feelings: on the one hand they can help the social educators getting more acknowledged for doing some valuable and visible work. On the other hand it can tend to underestimate the value of a large part of their work which is embedded in what in the paper will be explored as unnoticed professional competences. Building on empirical results from research in day care centers based on mixed methods (observations, interviews and action research based workshops) the paper will discuss work practice in an everyday life perspective. This perspective opens for understanding professional competence as part of creating coherence in children’s and families’ lives as well as during the day in the day care centers. It also opens for a discussion of how different forms of knowledge function together in the social educators’ work practice.

24. Unnoticed professional competence and knowledge in day care work

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In research on professions in the public care and health sector the issue of professional competence and knowledge is central. Discussions on tacit knowledge (Polanyi), modus 1 and 2 knowledge (Gibbons), intuitive expertise (Dreyfus), reflective practice (Schön), practical knowledge (Bourdieu), communities of practice (Wenger) have been influencing the discussion on professional development. Across the different notions there is a shared view that important parts of professional competence is part of daily practices and embedded in routines, experiences, shared repertoire, etc. NPM and neoliberalism has had an important impact on care and health work imposing demands for documentation, standardization and evaluation. These increasing demands seem to be in contrast with the tacit and embodied parts of professional competence that not easily can be documented, standardized and evaluated. It can be argued that there is a pressure on these aspects of professional competence and knowledge ultimately resulting in poorer quality of work for both employees and citizens – the exact opposite of what presumably has been the goal with the steering systems. In this paper we will discuss the case of social educators in day care centers. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. Finally, we facilitated research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

25. Alternatives to neoliberalism? : The development of day care centres and the role of social educators and their unions

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

This paper will discuss the consequences of neoliberal governance in Danish day care centres, the social educators’ response, and the possible development of alternatives based on collective participation of social educators and union representatives. We will show how important and unnoticed professional competencies come under pressure, and how collective interest representation is challenged. We will discuss how concepts of “gestural knowledge”, “coherence” and “rhythm” open for a new understanding of professional competence. And we will conclude that the social educators and their unions have the possibility to contribute to the development of a new welfare paradigm. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. The interviews have been open and loosely structured, with a focus on encouraging the participants to talk about important aspects of their work. Everyday work was also the starting point for research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

26. Everyday practice and unnoticed professional competence in day care work

Author

Ahrenkiel, Annegrethe, Warring, Niels, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Ahrenkiel, Annegrethe, Warring, Niels, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In Denmark more than 9 out 10 children attend day care centers that are publicly funded and regulated. The main part of employees, the social educators, at day care centers have attended a 3½ years educational programme with both theoretical and practical elements. Nevertheless it has been hard for the social educators to get recognition for their professional competencies and the societal importance of their work. Neoliberal governance has imposed a lot of demands for documentation, evaluation etc., and a growing focus on children’s learning in day care centers has resulted in national goals for learning outcomes. For the social educators this has meant more time being spent on formal learning activities, and they have received the new demands with mixed feelings: on the one hand they can help the social educators getting more acknowledged for doing some valuable and visible work. On the other hand it can tend to underestimate the value of a large part of their work which is embedded in what in the paper will be explored as unnoticed professional competences. Building on empirical results from research in day care centers based on mixed methods (observations, interviews and action research based workshops) the paper will discuss work practice in an everyday life perspective. This perspective opens for understanding professional competence as part of creating coherence in children’s and families’ lives as well as during the day in the day care centers. It also opens for a discussion of how different forms of knowledge function together in the social educators’ work practice.

27. Unnoticed professional competence in day care work and the challenge of neoliberalism

Author

Ahrenkiel, Annegrethe, Warring, Niels, Schmidt, Camilla, Nielsen, Birger Steen, Sommer, Finn M., Ahrenkiel, Annegrethe, Warring, Niels, Schmidt, Camilla, Nielsen, Birger Steen, and Sommer, Finn M.

Abstract

New Public Management and neoliberalism has had a huge impact on care and health work imposing demands for documentation, standardization and evaluation. These demands seem to be in contrast with core aspects of the professional competence that are unnoticed. The paper explores how social educator’s work in day care centers can be explored, developed and potentially democratized acknowledging the unnoticed aspects of daily work practices and professional competence. The paper draws on empirical examples from two research projects (Ahrenkiel et al. 2009, 2011) and discuss how noticing and developing the professional competences of pedagogues holds the potential to develop alternatives to neoliberal regulation.

28. Everyday practice and unnoticed professional competence in day care work

Author

Ahrenkiel, Annegrethe, Warring, Niels, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Ahrenkiel, Annegrethe, Warring, Niels, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In Denmark more than 9 out 10 children attend day care centers that are publicly funded and regulated. The main part of employees, the social educators, at day care centers have attended a 3½ years educational programme with both theoretical and practical elements. Nevertheless it has been hard for the social educators to get recognition for their professional competencies and the societal importance of their work. Neoliberal governance has imposed a lot of demands for documentation, evaluation etc., and a growing focus on children’s learning in day care centers has resulted in national goals for learning outcomes. For the social educators this has meant more time being spent on formal learning activities, and they have received the new demands with mixed feelings: on the one hand they can help the social educators getting more acknowledged for doing some valuable and visible work. On the other hand it can tend to underestimate the value of a large part of their work which is embedded in what in the paper will be explored as unnoticed professional competences. Building on empirical results from research in day care centers based on mixed methods (observations, interviews and action research based workshops) the paper will discuss work practice in an everyday life perspective. This perspective opens for understanding professional competence as part of creating coherence in children’s and families’ lives as well as during the day in the day care centers. It also opens for a discussion of how different forms of knowledge function together in the social educators’ work practice.

29. Unnoticed professional competence in day care work and the challenge of neoliberalism

Author

Ahrenkiel, Annegrethe, Warring, Niels, Schmidt, Camilla, Nielsen, Birger Steen, Sommer, Finn M., Ahrenkiel, Annegrethe, Warring, Niels, Schmidt, Camilla, Nielsen, Birger Steen, and Sommer, Finn M.

Abstract

New Public Management and neoliberalism has had a huge impact on care and health work imposing demands for documentation, standardization and evaluation. These demands seem to be in contrast with core aspects of the professional competence that are unnoticed. The paper explores how social educator’s work in day care centers can be explored, developed and potentially democratized acknowledging the unnoticed aspects of daily work practices and professional competence. The paper draws on empirical examples from two research projects (Ahrenkiel et al. 2009, 2011) and discuss how noticing and developing the professional competences of pedagogues holds the potential to develop alternatives to neoliberal regulation.

30. Everyday practice and unnoticed professional competence in day care work

Author

Ahrenkiel, Annegrethe, Warring, Niels, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Ahrenkiel, Annegrethe, Warring, Niels, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In Denmark more than 9 out 10 children attend day care centers that are publicly funded and regulated. The main part of employees, the social educators, at day care centers have attended a 3½ years educational programme with both theoretical and practical elements. Nevertheless it has been hard for the social educators to get recognition for their professional competencies and the societal importance of their work. Neoliberal governance has imposed a lot of demands for documentation, evaluation etc., and a growing focus on children’s learning in day care centers has resulted in national goals for learning outcomes. For the social educators this has meant more time being spent on formal learning activities, and they have received the new demands with mixed feelings: on the one hand they can help the social educators getting more acknowledged for doing some valuable and visible work. On the other hand it can tend to underestimate the value of a large part of their work which is embedded in what in the paper will be explored as unnoticed professional competences. Building on empirical results from research in day care centers based on mixed methods (observations, interviews and action research based workshops) the paper will discuss work practice in an everyday life perspective. This perspective opens for understanding professional competence as part of creating coherence in children’s and families’ lives as well as during the day in the day care centers. It also opens for a discussion of how different forms of knowledge function together in the social educators’ work practice.

31. Unnoticed professional competence and knowledge in day care work

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In research on professions in the public care and health sector the issue of professional competence and knowledge is central. Discussions on tacit knowledge (Polanyi), modus 1 and 2 knowledge (Gibbons), intuitive expertise (Dreyfus), reflective practice (Schön), practical knowledge (Bourdieu), communities of practice (Wenger) have been influencing the discussion on professional development. Across the different notions there is a shared view that important parts of professional competence is part of daily practices and embedded in routines, experiences, shared repertoire, etc. NPM and neoliberalism has had an important impact on care and health work imposing demands for documentation, standardization and evaluation. These increasing demands seem to be in contrast with the tacit and embodied parts of professional competence that not easily can be documented, standardized and evaluated. It can be argued that there is a pressure on these aspects of professional competence and knowledge ultimately resulting in poorer quality of work for both employees and citizens – the exact opposite of what presumably has been the goal with the steering systems. In this paper we will discuss the case of social educators in day care centers. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. Finally, we facilitated research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

32. Alternatives to neoliberalism? : The development of day care centres and the role of social educators and their unions

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

This paper will discuss the consequences of neoliberal governance in Danish day care centres, the social educators’ response, and the possible development of alternatives based on collective participation of social educators and union representatives. We will show how important and unnoticed professional competencies come under pressure, and how collective interest representation is challenged. We will discuss how concepts of “gestural knowledge”, “coherence” and “rhythm” open for a new understanding of professional competence. And we will conclude that the social educators and their unions have the possibility to contribute to the development of a new welfare paradigm. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. The interviews have been open and loosely structured, with a focus on encouraging the participants to talk about important aspects of their work. Everyday work was also the starting point for research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

33. Unnoticed professional competence in day care work and the challenge of neoliberalism

Author

Ahrenkiel, Annegrethe, Warring, Niels, Schmidt, Camilla, Nielsen, Birger Steen, Sommer, Finn M., Ahrenkiel, Annegrethe, Warring, Niels, Schmidt, Camilla, Nielsen, Birger Steen, and Sommer, Finn M.

Abstract

New Public Management and neoliberalism has had a huge impact on care and health work imposing demands for documentation, standardization and evaluation. These demands seem to be in contrast with core aspects of the professional competence that are unnoticed. The paper explores how social educator’s work in day care centers can be explored, developed and potentially democratized acknowledging the unnoticed aspects of daily work practices and professional competence. The paper draws on empirical examples from two research projects (Ahrenkiel et al. 2009, 2011) and discuss how noticing and developing the professional competences of pedagogues holds the potential to develop alternatives to neoliberal regulation.

34. Alternatives to neoliberalism? : The development of day care centres and the role of social educators and their unions

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

This paper will discuss the consequences of neoliberal governance in Danish day care centres, the social educators’ response, and the possible development of alternatives based on collective participation of social educators and union representatives. We will show how important and unnoticed professional competencies come under pressure, and how collective interest representation is challenged. We will discuss how concepts of “gestural knowledge”, “coherence” and “rhythm” open for a new understanding of professional competence. And we will conclude that the social educators and their unions have the possibility to contribute to the development of a new welfare paradigm. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. The interviews have been open and loosely structured, with a focus on encouraging the participants to talk about important aspects of their work. Everyday work was also the starting point for research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

35. Unnoticed professional competence and knowledge in day care work

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In research on professions in the public care and health sector the issue of professional competence and knowledge is central. Discussions on tacit knowledge (Polanyi), modus 1 and 2 knowledge (Gibbons), intuitive expertise (Dreyfus), reflective practice (Schön), practical knowledge (Bourdieu), communities of practice (Wenger) have been influencing the discussion on professional development. Across the different notions there is a shared view that important parts of professional competence is part of daily practices and embedded in routines, experiences, shared repertoire, etc. NPM and neoliberalism has had an important impact on care and health work imposing demands for documentation, standardization and evaluation. These increasing demands seem to be in contrast with the tacit and embodied parts of professional competence that not easily can be documented, standardized and evaluated. It can be argued that there is a pressure on these aspects of professional competence and knowledge ultimately resulting in poorer quality of work for both employees and citizens – the exact opposite of what presumably has been the goal with the steering systems. In this paper we will discuss the case of social educators in day care centers. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. Finally, we facilitated research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

36. Unnoticed professional competence and knowledge in day care work

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

In research on professions in the public care and health sector the issue of professional competence and knowledge is central. Discussions on tacit knowledge (Polanyi), modus 1 and 2 knowledge (Gibbons), intuitive expertise (Dreyfus), reflective practice (Schön), practical knowledge (Bourdieu), communities of practice (Wenger) have been influencing the discussion on professional development. Across the different notions there is a shared view that important parts of professional competence is part of daily practices and embedded in routines, experiences, shared repertoire, etc. NPM and neoliberalism has had an important impact on care and health work imposing demands for documentation, standardization and evaluation. These increasing demands seem to be in contrast with the tacit and embodied parts of professional competence that not easily can be documented, standardized and evaluated. It can be argued that there is a pressure on these aspects of professional competence and knowledge ultimately resulting in poorer quality of work for both employees and citizens – the exact opposite of what presumably has been the goal with the steering systems. In this paper we will discuss the case of social educators in day care centers. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. Finally, we facilitated research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

37. Alternatives to neoliberalism? : The development of day care centres and the role of social educators and their unions

Author

Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, Sommer, Finn M., Warring, Niels, Ahrenkiel, Annegrethe, Nielsen, Birger Steen, Schmidt, Camilla, and Sommer, Finn M.

Abstract

This paper will discuss the consequences of neoliberal governance in Danish day care centres, the social educators’ response, and the possible development of alternatives based on collective participation of social educators and union representatives. We will show how important and unnoticed professional competencies come under pressure, and how collective interest representation is challenged. We will discuss how concepts of “gestural knowledge”, “coherence” and “rhythm” open for a new understanding of professional competence. And we will conclude that the social educators and their unions have the possibility to contribute to the development of a new welfare paradigm. The paper is based on material from two research projects (Ahrenkiel et al. 2009, 2011) involving social educators and union representatives in day care institutions. We have observed everyday work activities in day care centres and various meetings involving union representatives and on this basis interviewed both social educators and union representatives. The interviews have been open and loosely structured, with a focus on encouraging the participants to talk about important aspects of their work. Everyday work was also the starting point for research workshops in the projects, inspired by action research, where the focal point was the suggestions for change put forward by the social educators and union representatives themselves.

39. Sundhedsfremme og forebyggelse i sygeplejerskeuddannelsen – En empirisk undersøgelse af diskurser i konteksten dansk sygeplejerskeuddannelse

Author

Jensen, Christine Schütt, Schmidt, Camilla, and Holen, Mari

Abstract

This thesis is an examination of health promotion and prevention in the context of the Danish nursing education. The nursing education has been criticised among other Danish health educations for not giving the students the right skills to handle healthcare challenge in the primary healthcare system. Labour unions have recommended reforming the health educations, so that they contain more health promotion and preventions in order to ensure future solutions for the primary healthcare area. Theory building by Laclau and Mouffe and critical discourse analysis by Fairclough is used in a discourse analysis in order to look at the significations of health promotion and prevention in nursing educations. To understand the significations into the social context, the discourse analysis is supplementary examined in relation to the nursing education historic development. The empirical base of the project, is the Ministerial Order on the Bachelor of Science in Nursing Programme, act. No 29 of 24. January 2008 and selected parts of local composed descriptions of the Module Study Programme. The empiric precipitation is to examine health promotion and prevention in the order using the discourse theoretic term about floating signifiers, which is suitable to investigate diverse signification. The discourse analysis and historical examination show five different and competing significations of health promotion and prevention. Two dominating significations can be identified as a result of the relationship and competition between the five discourses. Health promotion and prevention are signified as actions, which can be linked to the practical part of the education. Other dominating significations are that health promotion and prevention is a part of a way to determine what nursing is. In relation to the history this can be seen as a part of the independent development of nursing sciences. These two dominating signifiers of health promotion and prevention are on a general level, which means that they are overruling the more specific signifiers that the five discourses offer.

Published
2015

40. 'Grib chancen og kom i gang, hvis du vil' - tilrettelæggelse af forløbsprogrammer for borgere med diabetes som sundhedsfremmende initiativ: 'Grib chancen og kom i gang, hvis du vil' – organization of group-based programme for citizens with type 2-diabetes in a Danish municipal as a health promotion initiative

Author

Rasmussen, Pernille, Damm, Tine, Vibits, Christina, Schmidt, Camilla, and From, Ditte-Marie

Subjects
læring, learning, forløbsprogrammer, Health, type 2-diabetes, Health promotion, Sundhedsfremme, Diskursanalyse, group-based programme, Sundhed, health care economics and organizations
Abstract

This case study thesis explores a group-based programme for citizens with type 2-diabetes in a Danish municipal. With its point of departure in social constructionisme this thesis use document analyzes, interviews and observation as methods to investigate the municipals and its health-care providers approach to learning, health and the health-care providers didactics reflections in the programmes. The theoretical concepts didactic, learning, health and health pedagogy is used to analyze the health-care providers and the municipals initiatives of health promotion for citizens with type 2 diabetes. The main aspect of the thesis is that the health-care providers and the municipals approach to health, learning and to the citizens with diabetes has a significance to the programmes possibility to provide health changes for the citizens. The perspective in the thesis may be used for health-care providers and the municipals to reflect and consider their health promotion and pedagogy approaches in the programme. This thesis may also be used as inspiration to other perspectives and new investigations about the programme.

Published
2015

41. Pædagoguddannelse og pædagogisk arbejde: Nyuddannede pædagogers måder at valorisere og organisere praksis

Author

Bøje, Jakob Ditlev, Krejsler, John, Ahrenkiel, Annegrethe, and Schmidt, Camilla

Subjects
Policy, Daginstitution, historie, profession
Abstract

Dette kapitel omhandler pædagoguddannelsen og den indirekte betydning, denne har for udviklinger og reproduktion af det pædagogiske arbejde. Denne betydning undersøges ved hjælp af materiale fra et etnografisk inspireret feltstudie af nyuddannede pædagoger i deres første arbejde. Kapitlet argumenterer for, at pædagoguddannelsen medvirker til at forme nyuddannedes orienteringer mod og handlinger i arbejdet. Med uddannelsen lærer de studerende sociale distinktioner at kende, som reproduceres i arbejdet efter uddannelsen. Disse distinktioner bruges, når hvad der har værdi skal skelnes fra, hvad der har mindre værdi, og hvad der i forlængelse heraf er henholdsvis vigtigt og mindre vigtigt at stræbe efter i arbejdet.

Published
2014

42. Du træner dem frem ligesom cirkusdyr - Et speciale om læreres kritik og retfærdiggørelser

Author

Steensen, Clara Ina Severin and Schmidt, Camilla

Subjects
pragmatisme, retfærdiggørelse, kritik, Luc Boltanski, folkeskolereform, lærerfaglighed, John Dewey, Rudolf Steiner
Abstract

The field of inquiry of this thesis is the critique put forward by public school teachers of two important tendencies in Danish educational policies. On the one hand the rising political focus on tests, evaluation and optimization of the measurable results of school pupils and on the other hand the simultaneous devaluation of less measurable dimensions of school life. As a counter image of the experiences and critique of the public school teachers the thesis explores the reflections of teachers on Waldorf schools on teaching as an art form and the school as an inspired world. The sociology of critical competencies developed by the French sociologist Luc Boltanski serves as analytical framework for the inquiry into the critique put forward by public school teachers. The empirical data consists of 7 qualitative in depth interviews with teachers, 4 of them with public school teachers and 3 of them with Waldorf teachers. On the basis of the inquiry the thesis concludes that the focus on tests and evaluation is a source of stress, leads to superficial forms of teaching and devaluates the social dimension of school life. The focus on political control and performance management creates a disempowering culture and a loss of the understanding of the teacher as a valuable and authoritative person that through an authentic and emotional engagement is capable of inspiring, motivating and engaging the pupils. In addition the thesis concludes that the reflections of the Waldorf teachers stand out as powerful counter image of the contemporary tendencies in the Danish public school sector.

Published
2014

43. Når dagtilbud kobles til den nationale konkurrenceevne:kvalitets-reform som udfordring til pædagog-professionen

Author

Krejsler, John B., Krejsler, John Benedicto, Ahrenkiel, Annegrethe, and Schmidt, Camilla

Subjects
daginstitutioner, Pædagoger, profession, transnational og national policy
Abstract

Hvor er dagtilbud for de 0-6-årige på vej hen, og hvad sker der med pædagog-professionen i lyset af udfordringerne fra moderniseringen af den offentlige sektor? Med udgangspunkt i policy-diskurser om kvalitetsreform og global vidensøkonomi kortlægger kapitlet, hvorledes nye vilkår for dagtilbud for de 0-6-årige i stigende grad skabes i omfattende styringskæder, der går fra trans-nationale aktører (OECD, EU m.m.) over national policy, Kommunernes Landsforening og kommuner til lokale organi-sationer. Det synliggøres herved, hvorledes dagtilbud for 0-6-årige integreres i de nationale uddannelsesstrategier, der ikke mindst skal sikre nationen en topplacering i den globale vidensøkonomi. Hermed ændres også pædagogprofessio-nens vilkår. OECD-rapporter, EUs Lissabon Strategi og Europe 2020, Bologna processen m.m. inspirerer den dan-ske regerings policy. Kvalitetsreform bliver udgangspunkt for forhandlinger med Kommunernes Landsforening og herigennem link til dagtilbud i kommunerne. New Public Management, lovgivning og styringsteknologier (læreplaner, børnemiljøvurderinger m.m.) spiller alt sammen med, når stigende krav om evaluering og dokumentation af ‘kvalitet’ skaber nye vilkår for dagtilbud og pædagog-professionen.

Published
2013

44. At forvalte kvalitetsreform lokalt:dagtilbud på spil mellem forvaltning, institutionsledelse og pædagoger

Author

Krejsler, John B., Krejsler, John Benedicto, Ahrenkiel, Annegrethe, and Schmidt, Camilla

Subjects
daginstitutioner, pædagoger, forvaltning, Early childhood, Dagtilbud, national og kommunal policy, profession, Uddannelsespolitik
Abstract

Dette kapitel sætter fokus på, hvorledes kvalitets-policy om dagtilbud for 0-6-årige forvaltes lokalt mellem forvaltning, institutionsledelser og pædagoger. Det vises, hvordan betydelige ændringer i rammerne for at føre national velfærdspo-litik slår ned i lokale forestillinger om, hvad kvalitet i dagtilbud består i. Nye dominerende forestillinger og organisati-onsformer slår igennem, som sætter nye rammer for, hvordan de enkelte aktører kan forstå sine positioner og handlin-ger. Det synliggøres, hvorledes ledelse er under forandring i retning af mere strategisk værdiledelse. Her får dagtilbudslederen en ny rolle som formidlingsled mellem forvaltning og pædagoger samt øvrige ansatte. Det vises også, hvordan læreplaner og andre sociale teknologier lokalt ændrer praksis for, hvordan det legitime dagtilbud kan fremtræ-de, og hvorledes pædagogen kan legitimere sin rolle og praksis. For at komme i nærkontakt med disse forandringer præsenteres to portrætter af denne udvikling i to forskellige kommuner. Det vises, hvorledes pædagoger, institutionsledere og centrale personer i Børne- og Ungeforvalt-ningen i disse to forskellige kontekster oplever kvalitetsreform og dens mulige konsekvenser.

Published
2013

45. Kampen om daginstitutionen:den danske model mellem kompetencetænkning, tradition og profession

Author

Krejsler, John B., Ahrenkiel, Annegrethe, and Schmidt, Camilla

Subjects
Pædagoger, daginstitution, Dagtilbud, Magt, profession, policy, Pædagogprofession, Uddannelsespolitik
Abstract

Daginstitutionen og pædagogens professionelle status udfordres i disse år af grundlæggende reformer af den offentlige sektor. Disse reformer er i høj grad er præget af anbefalinger fra OECD og EU og gør bl.a. daginstitutionsområdet til en del af den samlede nationale uddannelsespolitik. Kvalitets-reform, læreplaner og børnemiljøvurderinger er blot enkelte eksempler på, hvordan forestillinger om vidensøkonomi, kompetenceudvikling og livslang læring også ’rammer’ danske daginstitutioner og pædagogens arbejdsopgaver. Reformpædagogiske dannelsesforestillinger får konkurrence fra den transnationale kompetencetænkning, samtidig med at en række opgaver og diskurser om daginstitutionerne består. I denne bog giver centrale forskere indenfor pædagog- og daginstitutionsfeltet et overblik over de betydelige ændringer i den nationale velfærdspolitik for de 0-6 årige.. Det vises hvorledes disse ændringer slår ned lokalt i kommunale forvaltninger og i daginstitutionens daglige praksis med en blanding af brud og kontinuitet som følge Bogen er således delt op i: • En ’makro’-del, som kortlægger policy-udviklingen i spillene mellem OECD, EU, nationale og kommunale aktører på daginstitutionsområdet; synliggør historiske og sociologiske forudsætninger for børnepasningen og dens institutionalisering. • En ’meso’-del, som synliggør organiseringen af arbejdet i daginstitutioner: i relationerne mellem forvaltning og de enkelte daginstitutioner; mellem ledelse og tillidsrepræsentanter og medarbejdere; samt forskelle mellem nyuddannedes og erfarne pædagogers professionaliseringsstrategier. • En ’mikro’-del, som afdækker, hvordan de mange reformer får betydning for indholdet af det daglige liv og arbejde i dagtilbuddet, for relationer mellem børn og voksne, for de aktiviteter og tilbud, der prioriteres. Samlet tager bogen ikke stilling til om disse mangfoldige udviklinger er gode eller dårlige. Målet er at kortlægge det nye spillerum for at tænke og organisere pædagogisk arbejde i dagtilbud for de 0-6 årige. Bogen har således både kritisk blik for mulige tab af kvalitet og konstruktivt blik for nye muligheder i den store ommøblering af feltet. Bogen kan ses som en grundbog i forståelsen af sammenhænge mellem policy, organisation og det daglige pædagogiske arbejde. Bogen henvender sig til studerende på pædagogiske uddannelser såvel som til interesserede i forvaltninger og den større offentlighed med særlig interesse i, hvor den nationale velfærdspolitik for de 0-6 årige er på vej hen.

Published
2013

46. Introduktion: kampen om daginstitutionen:den danske model mellem kompetencetænkning, tradition og profession

Author

Krejsler, John B., Ahrenkiel, Annegrethe, Krejsler, John Benedicto, Ahrenkiel, Annegrethe, and Schmidt, Camilla

Subjects
daginstituitioner, pædagoger, Dagtilbud, Magt, profession, transnational og national policy, Pædagogprofession, Uddannelsespolitik
Abstract

Daginstitutionen og pædagogens professionelle status udfordres i disse år af grundlæggende reformer af den offentlige sektor. Disse reformer er i høj grad er præget af anbefalinger fra OECD og EU og gør bl.a. daginstitutionsområdet til en del af den samlede nationale uddannelsespolitik. Kvalitets-reform, læreplaner og børnemiljøvurderinger er blot enkelte eksempler på, hvordan forestillinger om vidensøkonomi, kompetenceudvikling og livslang læring også ’rammer’ danske daginstitutioner og pædagogens arbejdsopgaver. Reformpædagogiske dannelsesforestillinger får konkurrence fra den transnationale kompetencetænkning, samtidig med at en række opgaver og diskurser om daginstitutionerne består. I denne bog giver centrale forskere indenfor pædagog- og daginstitutionsfeltet et overblik over de betydelige ændringer i den nationale velfærdspolitik for de 0-6 årige.. Det vises hvorledes disse ændringer slår ned lokalt i kommunale forvaltninger og i daginstitutionens daglige praksis med en blanding af brud og kontinuitet som følge Bogen er således delt op i: • En ’makro’-del, som kortlægger policy-udviklingen i spillene mellem OECD, EU, nationale og kommunale aktører på daginstitutionsområdet; synliggør historiske og sociologiske forudsætninger for børnepasningen og dens institutionalisering. • En ’meso’-del, som synliggør organiseringen af arbejdet i daginstitutioner: i relationerne mellem forvaltning og de enkelte daginstitutioner; mellem ledelse og tillidsrepræsentanter og medarbejdere; samt forskelle mellem nyuddannedes og erfarne pædagogers professionaliseringsstrategier. • En ’mikro’-del, som afdækker, hvordan de mange reformer får betydning for indholdet af det daglige liv og arbejde i dagtilbuddet, for relationer mellem børn og voksne, for de aktiviteter og tilbud, der prioriteres. Samlet tager bogen ikke stilling til om disse mangfoldige udviklinger er gode eller dårlige. Målet er at kortlægge det nye spillerum for at tænke og organisere pædagogisk arbejde i dagtilbud for de 0-6 årige. Bogen har således både kritisk blik for mulige tab af kvalitet og konstruktivt blik for nye muligheder i den store ommøblering af feltet. Bogen kan ses som en grundbog i forståelsen af sammenhænge mellem policy, organisation og det daglige pædagogiske arbejde. Bogen henvender sig til studerende på pædagogiske uddannelser såvel som til interesserede i forvaltninger og den større offentlighed med særlig interesse i, hvor den nationale velfærdspolitik for de 0-6 årige er på vej hen.

Published
2013

47. En kønnet hverdag i SFO'en: - Betydningen af køn for børns muligheder og begrænsninger i en SFO

Author

Kjærside, Christina Foyn, Schmidt, Camilla, and Højholt, Charlotte

Subjects
Hverdag i SFO, interaktionistisk konstruktionistisk tilgang, børns muligheder og begrænsninger, Betydningen af køn, education, SFO, køn
Abstract

The thesis examines how gender categorization may affect children's opportunities and constraints of everyday life in an after school club. The analysis is based on four interviews with teachers working in an after school club, a series of participant observations of children and a small collection of statistical data. The researcher uses an interactionistic-constructionistic approach as a theoretical framework. The study’s analytical strategy draws on poststructuralist gender studies, situated learning theory and critical psychology The conclusions of the thesis show that gender categorization can have both expansive and restrictive impact on children and of “doing gender”. A group of boys playing soccer in their spare time, seems to guide the understanding of ways of “doing” boy. These boys seem to have some extended options in compared to other children. Expectations for “doing gender” seem to make it difficult to spot duality in children’s behavior which might constrain how to “do gender”. The results further more suggest that some girls, in an easier way than boys, can take advantage of both a very masculine and feminine connotes behavior. The study reveals that teaching can be the potential for expanding the possibilities of “doing gender”. The study also suggests that the design of the rooms in the after school club may affect ways of “doing gender”.

Published
2011

48. Considerations When Designing Inclusive Digital Health Solutions for Older Adults Living With Frailty or Impairments.

Author

Wegener EK, Bergschöld JM, Bergh S, van Berlo A, Schmidt CW, Konidari A, and Kayser L

Subjects
Humans, Aged, Telemedicine, Frail Elderly, Digital Health, Frailty
Abstract

This viewpoint is written by authors with industrial, clinical, and academic backgrounds within medical and social sciences. The purpose is to share our experiences with digital health innovation from a sociotechnical perspective. The audience for the viewpoint is innovators, researchers, service designers, and project managers with little or some experience with theory-informed programs, complex interventions, and implementation or reorganization of sociotechnical ecosystems in health care. In digital health innovation projects, barriers related to traditions and cultures among researchers, clinicians, and industry may arise. Moreover, the final digital solutions may not always fit into existing digital ecosystems and may thus require a reorganization of how health care is provided at horizontal and vertical levels. The collaborating researchers have experience working in the field of digital health innovation for more than a decade, and we have developed and used 4 frameworks and models that are particularly relevant for theory-based complex interventions and can be used to inform inclusive co-design of digital health solutions with a sociotechnical perspective. These are (1) the 4E, a matrix to include, engage, empower, and emancipate marginalized people; (2) the GO-TO model, which can be used as a design navigator; (3) the Epital Care Model, to inform infrastructure; and (4) the Readiness and Enablement Index for Health Technology instrument, to stratify service users. From January 2021 to September 2024, we had the opportunity to apply these into practice in 4 living labs located in Denmark, Norway, the Netherlands, and Canada as a part of a European Union-funded project on "Smart Inclusive Living Environments." The goal was to cocreate a digital solution and reorganize health care services to reduce social isolation, increase health literacy, and enhance well-being for older adults living with frailty or impairments. Based on our experiences with the Smart Inclusive Living Environments project, we have formed a proposal for how design guidelines for sociotechnical innovation projects can be structured, backed up with reflections based on our experiences. With that, design guidelines should include three areas: (1) a common vocabulary including theories, frameworks, and models; (2) templates and protocols for methods, including detailed guidelines and templates for the planned development of the technologies; and (3) methods to implement and provide education and training of service users and informal and formal caregivers. In the design process, we emphasize the importance of involving relevant stakeholders in the implementation of the created design guidelines to obtain preparedness in the organizations, as well as including putative service users to ensure the likelihood of adoption. Moreover, it is important to align expectations, have a common understanding of the applied frameworks and methods, and have access to the necessary resources to reach successful results., (©Emilie Kauffeldt Wegener, Jenny M Bergschöld, Sverre Bergh, Ad van Berlo, Camilla Wong Schmidt, Afroditi Konidari, Lars Kayser. Originally published in JMIR Formative Research (https://formative.jmir.org), 21.10.2024.)

Published
2024
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49. Co-Designing a Conversational Agent With Older Adults With Chronic Obstructive Pulmonary Disease Who Age in Place: Qualitative Study.

Author

Wegener EK, M Bergschöld J, Kramer T, Schmidt CW, and Borgnakke K

Subjects
Humans, Aged, Male, Female, Middle Aged, Aged, 80 and over, Pulmonary Disease, Chronic Obstructive therapy, Qualitative Research, Independent Living
Abstract

Background: As a reaction to the global demographic increase in older adults (aged 60+ years), policy makers call for initiatives to enable healthy aging. This includes a focus on person-centered care and access to long-term care for older adults, such as developing different services and digital health technologies. This can enable patients to engage in their health and reduce the burden on the health care systems and health care professionals. The European Union project Smart Inclusive Living Environments (SMILE) focuses on well-being and aging in place using new digital health technologies. The novelty of the SMILE project is the use of a cocreational approach focused on the needs and preferences of older adults with chronic obstructive pulmonary disease (COPD) in technology development, to enhance access, adaptation, and usability and to reduce stigma., Objective: The study aimed to describe the perspective, needs, and preferences of older adults living with COPD in the context of the design and development of a conversational agent., Methods: This study carried out a data-driven thematic analysis of interview data from 11 cocreation workshops with 33 older adults living with COPD., Results: The three particular features that the workshop participants wanted to implement in a new technology were (1) a "my health" function, to use technology to manage and learn more about their condition; (2) a "daily activities" function, including an overview and information about social and physical activities in their local area; and (3) a "sleep" function, to manage circadian rhythm and enhance sleep quality, for example, through online video guides. In total, 2 overarching themes were identified for the 3 functions: measurements, which were actively discussed and received mixed interest among the participants, and health literacy, due to an overall interest in learning more about their condition in relation to everyday life., Conclusions: The future design of digital health technology must embrace the complexities of the everyday life of an older adult living with COPD and cater to their needs and preferences. Measurements should be optional and personalized, and digital solutions should be used as a supplement to health care professionals, not as substitute., (©Emilie Kauffeldt Wegener, Jenny M Bergschöld, Tina Kramer, Camilla Wong Schmidt, Karen Borgnakke. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 08.10.2024.)

Published
2024
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50. Preferences, Needs, and Values of Patients With Chronic Obstructive Pulmonary Disease Attending a Telehealth Service: Qualitative Interview Study.

Author

Schmidt CW, Borgnakke K, Frølich A, and Kayser L

Subjects
Humans, Male, Female, Aged, Middle Aged, Denmark, Interviews as Topic, Needs Assessment, Pulmonary Disease, Chronic Obstructive therapy, Telemedicine, Qualitative Research, Patient Preference psychology
Abstract

Background: Digitally assisted health care services and technologies are gaining popularity. They assist patients in managing their conditions, thereby reducing the burden on health care staff. Digital health care enables individuals to receive care that is more tailored to their needs and preferences. When implemented properly, it can promote equity by considering each person's opportunities and limitations in the context of health care needs, preferences, values, and capabilities., Objective: This study aims to understand the needs, values, and preferences of individuals with chronic obstructive pulmonary disease (COPD) who are provided with a 24/7 digital health care service. Furthermore, we aim to understand the dynamics of the communities to which they belong and how these communities intersect. This will provide us with the essential knowledge to establish new methods of providing education, including the development of educational activities for health professionals to engage, train, and empower people living with COPD., Methods: The study included 7 informants diagnosed with COPD who received 24/7 digital health care service support from a regional project in Region Zealand, Denmark. The informants were visited 4 times during 2 months, including a "Hello" visit, a day with a semistructured interview, and 2 days with field observations. The informants participated in a semistructured interview, following participant observation and an ethnographic approach. The interview content was analyzed using an inductive methodology to categorize the empirical data., Results: Using the inductive approach, we identified 3 main categories related to the informants' needs, values, and preferences: (1) Health, (2) Value Creation, and (3) Resources. These 3 main categories were based on 9 subcategories: (1) health and barriers, (2) self-monitoring, (3) medication, (4) behavior, (5) motivation, (6) hobbies, (7) social networks, (8) health professionals, and (9) technology. These findings revealed that the informants placed value on maintaining their daily activities and preserving their sense of identity before the onset of COPD. Furthermore, they expressed a desire not to be defined by their COPD, as conversations about COPD often shifted away from the topic., Conclusions: Digital health solutions and the health care professionals who offer them should prioritize the individuals they serve, considering their needs, values, and preferences rather than solely focusing on the medical condition. This approach ensures the highest level of daily living and empowerment for those living with long-term health conditions. The communities surrounding individuals must engage in constant interaction and collaboration. They should work together to incorporate people's needs, values, and preferences into future digital health services, thereby promoting empowerment and self-management. New educational programs aimed at developing the digital health service competencies of registered nurses should facilitate collaboration between the 2 communities. This collaboration is essential for supporting patients with long-term health conditions in their daily activities., (©Camilla Wong Schmidt, Karen Borgnakke, Anne Frølich, Lars Kayser. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 21.06.2024.)

Published
2024
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