Brugerinddragelse: forhandlinger af autoritet, relation og viden

Abstract

Samfund, nr. 22,[5][6][7][8][9][10][11][12][13][14][15][16][17] Brugerinddragelse er på alles laeber i sundhedsvaesenet. Det står nedskrevet i hospitalernes vaerdiformuleringer, der bliver afholdt temadage og konferencer om patientinddragelse, der er øget politisk fokus på emnet, og både ledelse og frontpersonale naevner inddragelse som en afgørende kompetence i arbejdet med patienter (Jønsson et al. 2013). Men hvad ligger der egentlig i et så bredtfavnende begreb og hvorfor denne pludselige popularitet? Inden for sundhedsområdet er en dominerende forståelse, at brugerinddragelse er en social reaktion på en paternalistisk tradition. Kernen i denne udlaegning er, at det indtil for nogle årtier siden var normen i sundhedsvaesenet at betragte laeger som alvidende eksperter, der forventedes at traeffe beslutninger på deres patienters vegne ofte med meget lidt eller slet ingen input fra patienterne eller deres pårørende. Patientens eneste opgave var at demonstrere tillid til laegens kompetencer ved lydigt at følge dennes anvisninger, men blev ellers holdt fri for øvrige krav og forventninger. Øko-nom Erik Riiskjaer argumenterer for, at den paternalistiske model stadig spiller en vigtig rolle i den kliniske praksis, fordi den gennem år er indlejret hos både

The ruling relations of patient involvement in cardiac rehabilitation programs

“…Time, culture, and healthcare professionals' attitudes to patient involvement, along with (un)willingness to relinquish control, power, and authority, are often highlighted as facilitators or barriers to patient involvement. 26,[31][32][33][34][35] The findings of the present article add institutional texts, in their structuring and authorisation of institutional procedures and tasks, as a significant factor in local practice. As the analysis shows, institutional texts structure healthcare professionals' focus and actions as in- o n l y stitutional actors.…”

Patientology revisited: Toward tailored care pathways

“…Since the 1990s, the understanding of what it means to be a patient and what role patients play in the healthcare system has been undergoing a significant process of change, 6 where many recent trends in the healthcare system merge and necessitate a patientological perspective on these changes. Patient‐centred care 7 and treatment have been described as a counterpoint to the healthcare system's ‘paternalistic tradition’ 8 . Attempts at implementing, studying and discussing patient‐centred care have relied on a variety of adjacent, often overlapping, but typically ill‐defined concepts 9 such as patient empowerment 10 and patient participation 11 that emphasize the active autonomous or collaborative roles of patients in care processes.…”

“…Patient-centred care 7 and treatment have been described as a counterpoint to the healthcare system's 'paternalistic tradition'. 8 Attempts at implementing, studying and discussing patient-centred care have relied on a variety of adjacent, often overlapping, but typically ill-defined concepts 9 such as patient empowerment 10 and patient participation 11 that emphasize the active autonomous or collaborative roles of patients in care processes. Table 1 presents an overview contrasting four key concepts: patient empowerment and patient activation, which focus on processes that enable patients to play a more active role, and patient involvement and patient participation, which focus on behaviours related to task delegation and shared decision-making.…”