ABSTRACT
'Client involvement' has been a mantra within health policies, education curricula and healthcare institutions over many years, yet very little is known about how 'client involvement' is practised in home-care services. The aim of this article is to analyse 'client involvement' in practise seen from the positions of healthcare professionals, an elderly person and his relative in a home-care setting. A sociologically inspired single case study was conducted, consisting of three weeks of observations and interviews. The study has a focus on the relational aspects of home care and the structural, political and administrative frames that rule home- care practice. Client involvement is shown within four constructed analytical categories: 'Structural conditions of providing and receiving home care'; 'Client involvement inside the home: performing a professional task and living an everyday life'; 'Client involvement outside the home: liberal business and mutual goal setting'; and 'Converting a home to a working place: refurnishing a life'. The meaning of involvement is depending on which position it is viewed from. On the basis of this analysis, we raise the question of the extent to which involvement of the client in public home-care practice remains limited.
Subject(s)
Community Health Nursing , Home Care Services/organization & administration , Nursing Methodology Research , Patient Participation , Aged , Denmark , Female , Humans , Interior Design and Furnishings , Interviews as Topic , Male , Nurse-Patient Relations , Nursing Theory , Observation , SpousesABSTRACT
This article presents a study of Sara Bro's Diary (2004), a book montage of images and texts recording the experiences of a Danish breast cancer survivor, Sara Bro. It examines two montages of photography and text, drawing on Roland Barthes' concept of 'the third meaning' to explain and discuss the effect of the layered meanings in the montage alongside their multi-medium and self-referential expression. The discussion is centred on the aesthetic practices that are invited by Bro's book montage. The article considers how the juxtaposition of images and texts are experienced and co-created by the reader. It points to the effect of the aesthetics of disguise and carnival implicit in the visual-verbal montage and argues that these generate a third meaning. This meaning is associated with the breast cancer experience but is not directly discernible in the montage. The article concludes by discussing how Bro's montage acts as an ideological statement, subverting or 'poaching on' the health care system.
Subject(s)
Breast Neoplasms/history , Medicine in the Arts , Survivors/history , Breast Neoplasms/psychology , Esthetics , Female , History, 21st Century , Humans , Narration , Photography , Video RecordingABSTRACT
A diagnosis of breast cancer is not just life-threatening but often also disfiguring. Breast cancer research has pointedly focused on the connection between bodily loss and loss of self. We will examine the narratives of two Danish women who have been treated for breast cancer and are dealing with the consequences of their treatment. Drawing upon theories of phenomenology and literary-semiotics we demonstrate how the women are negotiating their identities. In narratives of breast cancer bodily practices play a prominent role in helping or hindering the re-construction of identity. We will focus on breast reconstruction as a bodily practice and seek to understand how and why breast cancer survivors either accept or reject the possibility of reconstructing their identity through breast reconstruction. We suggest that the literary-semiotic concept of marking can lead to a broader understanding of the connection between illness, body and identity. Breast reconstruction and the refusal of breast reconstruction can be viewed as part of a semiotic monitoring and marking of the body that can take place in the aftermath of treatment for breast cancer.
