Advances in the social position of people with learning disabilities have led to a situation where research and evaluation studies are increasingly required to include the views and opinions of people with learning disabilities. One key outcome of this shift is that some of the major funding bodies now insist on the inclusion of people with learning disabilities as a condition of research funding. This has produced new possibilities and new challenges for researchers, and it has real consequences for people working in health and social care. The present paper sets out to explore some of the developments and challenges in research with people with learning disabilities. The author provides a selective overview of developments with the aim of demonstrating the richness, ingenuity and potential of research involving people with learning disabilities. The paper is divided into three broad sections that focus on: (1) the ethics and philosophy of participatory research; (2) the methodologies employed at particular points in the research process that are designed to ensure the involvement of participants in research; and (3) building capacity in participatory research as a precondition to the further development of this approach. An investment in capacity would enable this approach to move into the mainstream of research activity involving people with learning disabilities.
This paper sets out to challenge the basis upon which reflective practice and clinical supervision are promoted within nursing discourse by employing Michel Foucault's (1982) concept of governmentality. Theme. A broad Foucauldian perspective is used to demonstrate how the technologies of reflective practice and clinical supervision have been accommodated within modern forms of government. These technologies are consistent with the flattened hierarchies and increasing dispersal of practitioners in contemporary health care. In this context reflective practice and clinical supervision can be shown to function in two independent but interrelated ways. First as modes of surveillance disciplining the activity of professionals. Second, as "confessional" practices that work to produce particular identities--autonomous and self-regulating.
The concept of empowerment is one which is often invoked in discussions over the nature of nursing practice in a range of health and welfare services. A short excursion through the Cumulative Index to Nursing and Allied Health Literature reveals that over the last 10 years 378 papers are identified which list empowerment as one of the topics discussed. In 1993, the number is 55. These papers cover a diverse range of health related issues: health promotion and HIV; breast feeding; mental health; management and leadership; change, training and education; feminism and women's issues; sexual abuse and violence; advocacy and working with immigrants; professionalism; and nursing theory. However, few of these papers discuss the relationship between empowerment and the notion of power itself. This gives rise to particular problems for nursing practice, for without a clear conceptualization of what is meant by power it is difficult to convincingly argue that one form of practice is more or less empowering than another. Alternatively, this dilemma may be stated in the following question: how do we work to empower others when we have no clear notion of what power is? This paper demonstrates that the concept of power demands a very specific consideration. In order to illustrate this it briefly identifies problems within two models of power which are drawn upon in nursing. It also demonstrates the way in which the work of Michel Foucault can be drawn upon to inform nursing in the analysis of the relationship between power and health.
• Summary: This article explores relations of power in social work using insights drawn from the critical ‘toolkit’ emanating from work of French philosopher, Michel Foucault. The article discusses the relationship between Foucault’s conceptual tools of ‘knowledge and power’, the emergence of ‘the modern subject’ and the concept of ‘governmentality’. Despite ongoing pressures, professional expertise persists as a core element of neo-liberal government in the management of the population. We use a Foucauldian perspective to explore two issues central to contemporary practice: surveillance and discretion that epitomise dualism of power relations. On the one hand, surveillance brings with it a potentially problematic process especially in context of top down managerial power; yet, on the other hand, discretion is much more focused on what Foucault (1977) calls ‘the microphysics of power’ with opportunities for ‘resistance’ from the bottom up. • Findings: Professional expertise creates a paradox where surveillance and discretion operate within similar social space as the expression of power relations that encompass the matrix of users, carers and social workers. On one hand, surveillance restricts practice however; on the other, complexity opens the space for resistance and new formulations of power relations. • Applications : Exposing social work activity to a critical stance enables the exploration of relations of power identifying how commitments such as empowerment and anti-oppressive practice become detached from their original radical and humanitarian moorings to feature now as components of oppressive discourses they might once have challenged.
There are theoretical links between governmentality and trust. Similarly, in order to understand trust nurses need to understand the dynamic nature of the systems in which they operate. The proposition that trust could frustrate hope adds an element of controversy to the discussion of hope in the nursing literature.
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