Discursive construction of the patient in online clinical cancer pathways information

Aasen, Elin Margrethe; Crawford, Paul; Dahl, Berit Misund

doi:10.1111/jan.14513

Cited by 10 publications

(12 citation statements)

References 29 publications

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“…The PCC approach was experienced positively by the participants in this study, and politically, legislatively and locally in the healthcare system, it is encouraged that the healthcare system is supported by this approach [ 75 , 76 ]. At the same time, Dahlborg and colleges argue that the healthcare system should be carried by a set of values in line with the new public management (NPM) principles [ 76 ].…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators for coherent rehabilitation among people with inflammatory arthritis – a qualitative interview study

Feddersen

Søndergaard²,

Andersen³

et al. 2022

BMC Health Serv Res

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Background People with chronic diseases have contact with several different professionals across hospital wards, municipality services and general practice and often experience lack of coherence. The purpose was to explore perceived barriers and facilitators to coherent rehabilitation pathways for health care users with inflammatory arthritis and how coherence can be improved. Methods Semi-structured individual interviews were conducted before a planned inpatient rehabilitation stay, 2-3 weeks and 4-6 months after discharge. Thematic reflexive analysis guided the analysis of data. Concepts of person-centred care, complex adaptive systems and integrated care were applied in the interpretations. Results In all, 11 participants with IA were included. There was one overarching theme, The importance of a person-centred approach, illuminating the significance of professionals who respect healthcare user’ preferences. To use a person-centred approach, demands professionals who are interested in exploring the persons own values, preferences and experiences and incorporate these when planning care and rehabilitation.Connected to the overarching theme, three sub-themes were derived; 1) Experiences of empowerment and dis-empowerment, covering that most want to be in control and act themselves, but felt overwhelmed and lost energy and they tended to give up; 2) Experiences of communication and coordination, encompass how people feel forced to take on coordination and communication tasks themselves although they do not always feel qualified for this. Some asked for a coordination person and 3) Facing everyday life after discharge, covering how initiatives taken by professionals were not always experienced as helpful after discharge. Some gave up and some tried to find alternative paths themselves. Conclusion Professionals taking a person-centred approach facilitated coherent rehabilitation pathways. This encompassed care with respect for individual needs and professionals who empowered patients to self-management. Furthermore, to be aware that interprofessional communication and coordination need to take place both between professional within the same department, between departments and between professionals in different sectors. After discharge, some patients were challenged in their everyday life when trying to follow the advice from the professionals. Professionals, who do not use a person-centred approach, hinder coherence. Patients thus feel compelled to take on communication and coordination tasks.

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Section: Discussionmentioning

confidence: 99%

Barriers and facilitators for coherent rehabilitation among people with inflammatory arthritis – a qualitative interview study

Feddersen

Søndergaard²,

Andersen³

et al. 2022

BMC Health Serv Res

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“…The network has previously studied online distributed information provided to cancer patients in each of the 3 countries. [25][26][27] The current study was designed as a secondary comparative qualitative analysis [27][28][29] of 2 published Scandinavian studies and 1 submitted study. The present study compared discursive practices, that is, the results of the 3 articles, 1 from each of the 3 countries.…”

Section: Methodsmentioning

confidence: 99%

Scandinavian Online Cancer Information as Expressions of Governmentality

Aasen

Dahl

Ottesen

et al. 2022

Advances in Nursing Science

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We compared online distributed information provided to patients with cancer in Scandinavian countries through the lens of governmentality. A secondary comparative qualitative analysis was conducted. Discourses in online patient information showed differences in governmentality techniques across the countries: Norway used a paternalist approach, Denmark an educative approach, and Sweden an individualistic approach and expected the patients to make the “right” decisions. Online information for patients with cancer in Denmark and Norway showed high professional and health care system involvement, whereas in Sweden, there was high patient involvement. There was almost no use of the person-centered approach among the online discourses.

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“…Since the use of language always seeks and results in specific responses from those who are addressed, all language use can be viewed as a form of social practice (Fairclough, 2013). In this study, we used a corpus‐assisted CDA, an approach that has been explored previously among health information researchers (see, e.gAasen et al, 2020; Crawford et al, 2014). The corpus‐assisted analysis works as a baseline from which further qualitative analyses can start.…”

Section: Methodsmentioning

confidence: 99%

The reasonable patient – A Swedish discursive construction

et al. 2021

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Sweden is a country that has moved from cultural homogeneity to greater cultural pluralism and faces increasing differences in terms of citizens' economic situations as well as their health. There is a prevailing population health gap; hence, a national public health goal is to close this gap (Public Health Agency of Sweden, 2019), and since the late 20th century, the marketisation of society has gradually changed healthcare.In Swedish healthcare today, the patient is expected to be involved and make active choices pertaining to their own health and care (SFS, 2014, p. 821). This perspective on patients differs from the healthcare provided within the previous welfare framework, where paternalistic perspectives on patients were often found. Between 2005 and 2011, there was political discussion about patient participation and equal care which ended up in a Patient Empowerment Inquiry (State Public Investigations, 2013) and formed the basis of the new Patient Act (SFS, 2014, p. 821). Today, healthcare in Sweden focuses on patient participation, agency and autonomy, with new legislation on patients' rights and the demands made on professional practitioners. Previously, a discourse analysis was conducted on the Patient Act (Dahlborg Lyckhage et al., 2017), depicting patients as persons with free will and the competence to make autonomous decisions. The

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Discursive construction of the patient in online clinical cancer pathways information

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 10 publications

References 29 publications

Barriers and facilitators for coherent rehabilitation among people with inflammatory arthritis – a qualitative interview study

Barriers and facilitators for coherent rehabilitation among people with inflammatory arthritis – a qualitative interview study

Scandinavian Online Cancer Information as Expressions of Governmentality

The reasonable patient – A Swedish discursive construction

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