ABSTRACT
Intersectoral collaboration (IC) plays a significant role in the delivery of diabetes care and treatment of patients with type 2 diabetes (DM2), as the treatment and care of these patients take place in both primary care and specialist settings. The collaboration involves a large number of actors from primary and secondary healthcare sectors, who are expected to fulfil various roles when they engage in IC. We explored the actors' roles by applying the framework of positioning theory with the aim of revealing seemingly embedded understandings of such roles. The empirical data consisted of individual and focus group interviews. Our results indicate that naturalised understandings of the roles of actors interact with the way in which health professionals, patients, managers and relatives strive to develop IC that aims to help and guide patients who live with DM2.
ABSTRACT
In recent decades, the phenomenon of grief, when you lose a loved one, has been the subject of exploration and discussion among researchers. Because of this, prolonged grief is now recognized as a possible mental disorder as the latest version of the diagnosis manual; 'International Classification of Diseases' (ICD-11) being published in 2018 is featuring a new diagnosis called 'prolonged grief disorder'. The commencement of this new disorder indicates a shift in the way grief is being articulated why the notion of rupture from the French philosopher Michel Foucault is applied as a philosophical approach in this paper. A Foucault-inspired discourse analysis has been prepared and by considering the issue historically and tracing how the concept of grief has been articulated in different time periods throughout history, the aim is to map out the discursive transformation that has taken place and to gain insight into how the societal context has supported and enabled this transformation. This paper takes a historical look back from the 1800s to present and identifies when changes can be observed in the way grief is being articulated. These changes or ruptures are identified in the work of Søren Aabye Kierkegaard, Sigmund Freud and Margaret Stroebe & Henk Schut who all must be assumed to have contributed significantly to how grief is perceived in various historical time periods. The discourse analysis identifies how prominent thinkers have articulated grief in each period and how today's perception of grief, as a possible mental disorder, both relates to these prominent thinkers but also reflects dominant societal values and ideologies.
Subject(s)
Grief , Humans , Interprofessional Relations , Mental Disorders/etiology , Mental Disorders/psychologyABSTRACT
Background: Home-based rehabilitation exercise following Total Hip Arthroplasty (THA) shows similar outcomes compared to supervised outpatient rehabilitation exercise. Little is known about patients' experiences with home-based rehabilitation, and this study aimed to investigate how patients perceived home-based rehabilitation exercise and general physical activity after THA, focusing on facilitators and barriers. Methods: Semi-structured interviews of qualitative design were conducted with 22 patients who had undergone THA and who had performed home-based rehabilitation exercise. The study took place in a regional hospital in Denmark between January 2018 and May 2019. Data were analyzed using an interpretive thematic analysis approach, with theoretical underpinning from the concept 'conduct of everyday life'. The study is embedded within the Pragmatic Home-Based Exercise Therapy after Total Hip Arthroplasty-Silkeborg trial (PHETHAS-1). Results: The main theme, 'wishing to return to the well-known everyday life', and four subthemes were identified. Generally, participants found the home-based rehabilitation exercise boring but were motivated by the goal of returning to their well-known everyday life and performing their usual general physical activities, though some lacked contact to physiotherapist. Participants enrolled in the PHETHAS-1 study used the enrollment as part of their motivation for doing the exercises. Both pain and the absence of pain were identified as barriers for doing home-based rehabilitation exercise. Pain could cause insecurity about possible medical complications, while the absence of pain could lead to the rehabilitation exercise being perceived as pointless. Conclusions: The overall goal of returning to the well-known everyday life served as a facilitator for undertaking home-based rehabilitation exercise after THA along with the flexibility regarding time and place for performing exercises. Boring exercises as well as both pain and no pain were identified as barriers to the performance of home-based rehabilitation exercise. Participants were motivated towards performing general physical activities which were part of their everyday life.
