PurposeThe paper aims to compare and discuss the findings of discursive constructions of patients in legal texts from the three Scandinavian countries. Since traditional welfare state systems in Scandinavia are being challenged by new governance systems, new questions are being raised about patient positions and agency, carrying with them potential ethical dilemmas for healthcare professionals.Design/methodology/approachThe methodology of the paper is inspired by critical discourse analysis. Comprehensively analysing the findings of previous discourse studies on how “the patient” is constructed in central policy texts, this study compares the position of the patient in Norway, Sweden and Denmark.FindingsThe paper reveals ideological struggles across the Scandinavian countries, operating at a political level, a legislative level and a healthcare level. It is shown that national governance systems still exert hegemonic power by strongly influencing patients' degree of choice and autonomy. The discursive struggle between welfare state governance and other governance systems in Scandinavia indicates a shift towards a commercial healthcare market although a traditional welfare model is advocated by professionals and researchers.Research limitations/implicationsBecause of the specific conditions of Scandinavian healthcare policy, the findings lack generalisability. The research approach should therefore be explored further in additional contexts.Practical implicationsThe findings of this study can inform policymakers, professionals and patients of the ideological values underlying seemingly objective shifts in national policy.Originality/valueA comparative critical discourse analysis can expose patterns in the Scandinavian approaches to patient rights.
The Danish health care sector currently undergoes changes that imply a gradual transition from an evidence-based activity model to a value-based quality model centered on patient involvement and value-based governance. The patient naturally occupies a central position in health care, and the transition therefore raises important questions about health care quality and how successive national health quality strategies value quality and ascribe roles and agency to patients. To explore the complexity of these quality strategies, we analyze and discuss how political discourse moments influence the contents of the national health quality strategies and how variation in the construal of patient roles and agency indicates discursive struggle in Danish national health care policy. Underlying theoretical concepts are informed by New Public Management, the welfare state, health communication, and discourse theory. Our analytical approach is inspired by Critical Discourse Analysis and combines content analysis with linguistic analysis.
The article is based on an ongoing action research project at a nursing home. Relatives, employees, and the manager are involved as co-researchers in dialogue-based and co-creative processes, where it is investigated and worked on how song and music can become an integral part of the culture and everyday life for the residents living at the nursing home. An action research process is unfolded and put into perspective with focus on: “What co-creation can be, how it can take place and what it can contribute to”. A dialogical action research approach characterize the research and it is designed based on the research circle tradition. Methodologically, thematic analysis is used. As a result of the thematic analysis, the following significant themes are presented: 1) Dialogue provides interplay, counterplay and interaction; 2) Proximity to practice through using video and 3) Reflections “in” and “on” actions in practice.
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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