Page: 1 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
Applicant
Project Owner
Institution / company (Norwegian HØGSKOLEN I OSLO OG AKERSHUS (HIOA) SENTER FOR VEL name)
Faculty
Institute
Department
Address Postboks 4 St. Olavs plass
Postal code 0130
City OSLO
Country Norway
E-mail [email protected]
Website
Enterprise number 974747715
eAdministration
Project administrator First name Bjørn
Last name Hvinden
Date of birth 061249
Personal number
Gender Male
Position/title Instituttdirektør
Phone
E-mail [email protected]
✔ The application has been approved by the Confirmation Project Owner Page: 2 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
Project manager First name Mia
Last name Vabø
Date of birth 030158
Personal number **********
Gender Female
Institution / company (Norwegian Høgskolen i Oslo og Akershus name)
Faculty Senter for velferds og arbeidsforskning
Institute NOVA
Department
Address Stensberggaten 26
Postal code 0131
City Oslo
Country Norway
Position/title Research professor
Academic degree phd
Preferred language Bokmål
Phone ++47025489
E-mail [email protected]
Project info
Project title Project title Creating integrated person-centred care in different settings
Primary and secondary objectives of the project The primary objective of the CONTEXT project is to increase knowledge Primary and secondary objectives about the conceptualization, implementation, and practice of integrated person-centred care in Norwegian and Danish elderly care. A particular Page: 3 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
focus is how contextual conditions such as disciplinary traditions, leadership styles or modes of governance can hinder or facilitate the realization of integrated person-centred care. Ultimately, the objective is to produce useable knowledge for care providers, care service managers, and care policy makers. Secondary objectives are: a) to establish arenas for knowledge sharing between researchers, local practitioners, and policy makers; b) to contribute to enhance inter-disciplinary learning in professional educations; c) to build on and continue to develop Nordic research collaborations and international comparative research on care services; and d) to provide an example of the analytic utility of combining qualitative case studies and survey data.
Project summary The movement towards integrated person-centred care has shown some positive effects, research indicates however that outcomes are highly context-specific. Success depends for instance on whether care organizations are able to influence the mindset of the staff, use economic incentives effectively, and modify the way work is organized. The implication, motivating this project, is that new research should address how settings and contexts which enhance people-centred care can be created. A mixed-method design is utilized. Qualitative analysis of care systems is integrated with quantitative analyses of survey data. The major part of the project consists of case studies of six local care systems which differ in national contexts (four Norwegian, two Danish study sites), type of community (urban/rural), and administrative style (more or less inspired by New Public Management). The overall issue is why interventions aiming at integrated person-centred care succeed in some settings, but fail in others. Project summary The analyses will explore initiatives aiming at a) making older people more self-reliant (e.g., home care reablement); b) improving integration between health services and elderly care; c) making staff-client relations more collaborative; and d) establishing collaborations between the care organization and local volunteers. Contextual preconditions for successful outcomes, in terms of aspects both of the care organizations and the surrounding environments, will be identified. The main technique of the case studies is a site switching approach drawing on the skills of a multi-disciplinary research team of academics and practitioners. Qualitative data from case studies will be linked to statistical analyses of a large Nordic survey among staff in elderly care conducted in 2005 (N=5,000) and 2015 (N=8,000). Survey findings will assist in determining how typical are the case-study work organizations, while the case studies will enhance interpretations of survey findings. Page: 4 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
Funding scheme
Supplementary info from applicant Programme / activity HELSEVEL
Application type Forskerprosjekt
Topics
Other relevant programmes/ activities/projects
Sociology, anthropology, political science, health sciences, social work Discipline(s) nursing, medicine
If applying for additional funding, specify project number
Have any related applications been submitted to the Research Council No and/or any other public funding scheme
If yes, please provide further information
Progress plan
Project period From date 20180301
To date 20211231
Main activities and milestones in the project period (year and quarter) Milestones throughout the project From To
A kick-off planning meeting 2018 2 2018 3
Making contacts, informing municipalities 2018 2 2019 3
Project planning /advertisment phd 2018 2 2018 4
A doctoral student is employed 2018 3 2018 3 Page: 5 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
Agreements are made with 4 municipalities 2018 3 2019 3
Data collection completed in two municipaliti 2018 3 2019 1
First meeting with HIOA interdisc. group 2018 3 2018 4
The post-doc researcher is employed 2018 3 2018 4
At least threer journal articles submitted 2019 1 2019 4
Site visit 3+ 4 completed 2019 1 2019 3
Writing up 2019 1 2021 3
Dialogue seminar with stakeholders etc 2019 3 2019 4
Agreements with municipality 5 + 6 2019 4 2020 4
Planning meeting with team/stakeholders 2019 4 2019 4
At least 4 new articles submitted 2020 1 2020 4
Second meeting with HIOA interdisc. group 2020 2 2020 3
Two last (Norwegian) site-visits completed 2020 2 2020 4
Nordic workshop/paper based 2020 3 2020 4
Planning the dialogue conference 2021 2 2021 3
Third seminar with HIOA interdisciplin 2021 2 2021 3
Dialog conference for stakeholders 2021 3 2021 3
Dissemination of project results Knowledge sharing is a core aim for the CONTEXT-project. Knowledge will be shared continuously through the research process. The project will create a web page for dissemination of results and will organize several workshops and conferences: (1) By the end of 2020 we will arrange a scientific workshops. Key national and international researchers from different academic disciplines will contribute by acting as discussants and peer reviewers of draft papers. Dissemination plan (2) We will organize three workshops for teaching staff /students participating in the Working Well group ? a group established at HIOA to discuss interdisciplinary working and interdisciplinary learning in elder care. This group is an arena for knowledge sharing based on oral presentation from the case studies as well as draft papers from researchers, teaching staff and students. (3) By the end of 2019 we will organize a dialogue seminar for stakeholders. Based on previous experience we will organize the seminar in line with a two Page: 6 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
step model. The first part about knowledge sharing (what do we know) and the second part knowledge translation (what can we do about it). (4) A closing conference will be organized, based on a combination of oral presentations from the research team and dialogue groups.
Scientific publications Papers from academic team members will be published in peer-reviewed journals. All our publications will use the contextualist approach as a frame of reference, but single publications may relate to many different scientific topics. Accordingly, several categories of scientific journals are relevant such as journals of social policy, public administration, social work, health care management, social gerontology etc. We have estimated that the project team will publish: 3 articles on topics based on the NORDCARE data (Drange, Elstad, and Vabø) 4 articles on topics related to public governance, health care management and leadership (Vabø, Rostgård, Graf, Romøren, post doc fellow) 3 articles on the micro politics of human service work (e.g. ( Vabø, Øye, Norvoll, post doc) 3 articles on caring relations and gerontology (Øye, Norvoll Rostgård) 1 article on comparative methods (Vabø, Norvoll) 1 doctoral thesis 2-3 master thesis and/or journal articles based on a small grant for students/teachers Publications for a wider audience The CONTEXT-project will publish policy briefs on the web site and will invite co-researchers i.e practitioners from municipalities, teaching staff /students from HIOA and representatives from senior organizations? to take part in dissemination of result by giving speeches and publish in professional journals, newspapers and booklets. Researchers will be encouraged to act as co-authors. Based on the realist evaluation approach we will publish a report from the project which is framed as a reflection tool for managers and practitioners who are responsible for implementing integrated person centered care.
Budget
Cost plan (in NOK 1000)
2018 2019 2020 2021 2022 2023 2024 2025 Sum
Payroll and indirect expenses 2419 3909 3704 2108 12140 Page: 7 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
2018 2019 2020 2021 2022 2023 2024 2025 Sum
Procurement of R&D services 200 422 433 452 1507
Equipment 0
Other operating expenses 789 1406 817 629 3641
Totals 3408 5737 4954 3189 0 0 0 0 17288
Specification See attached for detailed budget
Cost code (in NOK 1000)
2018 2019 2020 2021 2022 2023 2024 2025 Sum
Trade and industry 0
Independent research 200 310 320 331 1161 institutes
Universities and university 2654 4856 4052 2264 13826 colleges
Other sectors 0
Abroad 554 571 582 594 2301
Totals 3408 5737 4954 3189 0 0 0 0 17288
Funding plan (in NOK 1000)
2018 2019 2020 2021 2022 2023 2024 2025 Sum
Own financing 390 1170 1192 696 3448
International funding 0
Public funding 0
Private funding 0 Page: 8 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
2018 2019 2020 2021 2022 2023 2024 2025 Sum
The Research Council 3018 4567 3762 2493 13840
Totals 3408 5737 4954 3189 0 0 0 0 17288
Specification
Person for whom a fellowship/position is being sought
Basis for calculation of position Type of fellowship From date (yyyymmdd) To date (yyyymmdd)
Doctoral research fellowship 20180901 20210831
Person for whom a fellowship/position is being sought First name Last name National identity number
NN NN
Percentage of full time position 2018 2019 2020 2021 2022 2023 2024 2025
Percentage of full time 100 100 100 100 position
Basis for calculation of position Type of fellowship From date (yyyymmdd) To date (yyyymmdd)
Post-doctoral research fellowship 20181001 20200831
Person for whom a fellowship/position is being sought First name Last name National identity number Page: 9 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
NN NN
Percentage of full time position 2018 2019 2020 2021 2022 2023 2024 2025
Percentage of full time 100 100 100 position
Allocations sought from the Research Council (in 1000 NOK)
2018 2019 2020 2021 2022 2023 2024 2025 Sum
Student fellowships 0
Doctoral fellowships 0
Post-doctoral fellowships 283 1039 756 2078
Grants for visiting 0 researchers
Grants for overseas 0 researchers
Researcher positions 0
Hourly-based salary including 1745 1700 1756 1413 6614 indirect costs
Procurement of R&D services 200 422 433 452 1507
Equipment 0
Other operating expenses 790 1406 817 628 3641
From Research Council 3018 4567 3762 2493 0 0 0 0 13840
Partners Page: 10 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
Partners under obligation to provide professional or financial resources for the implementation of the project
1
Institution/ company KORA
Department/ section
Address Købmagergade 22
Postal code 1150
City Copenhagen
Country Denmark
Enterprise number
Contact person Tine Roostgard
Contact tel. 44455500
Contact e-mail [email protected]
Partner's role Research activity 2
Institution/ company HØGSKOLEN I OSLO OG AKERSHUS
Department/ section
Address Postboks 4 St.Olavs Plass
Postal code 0130
City OSLO
Country Norway
Enterprise number 997058925
Contact person Reidun Norvoll
Contact tel.
Contact e-mail [email protected]
Partner's role Research activity 3
Institution/ company UNIVERSITETET I OSLO
Department/ section Page: 11 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
Address Postboks 1072 Blindern
Postal code 0316
City OSLO
Country Norway
Enterprise number 971035854
Contact person Maria Romøren
Contact tel.
Contact e-mail
Partner's role Research activity
4
Institution/ company Senter for omsorgsforskning Vest
Department/ section
Address Postboks 7030
Postal code 5020
City BERGEN
Country Norway
Enterprise number 917641404
Contact person Oddvar Førland
Contact tel.
Contact e-mail [email protected]
Partner's role Research activity
Attachments
Project description
Filename context-final-version.pdf
Reference ES592788_001_1_Prosjektbeskrivelse_20170426 Page: 12 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
Curriculum vitae (CV) with list of publications
Filename mia-cv2017 short.pdf
Reference ES592788_002_1_CV_20170425
Filename tine-cv-short 2017.pdf
Reference ES592788_002_2_CV_20170425
Filename norvoll-cv-short.pdf
Reference ES592788_002_3_CV_20170425
Filename drange-cv-short.pdf
Reference ES592788_002_4_CV_20170425
Filename cv-forland-short 2017 .pdf
Reference ES592788_002_5_CV_20170425
Filename cv-oye-short 2017.pdf
Reference ES592788_002_6_CV_20170426
Filename cv-romoren-short.pdf
Reference ES592788_002_7_CV_20170425
Grade transcripts (Doctoral and student fellowships)
Filename
Reference
Filename
Reference Page: 13 Creating integrated person-centred care in different settings (Forskerprosjekt - HELSEVEL)
Application Number: ES592788 Project Number: -1
Referees
Filename anbefalte -panledeltakere.pdf
Reference ES592788_005_1_Fageksperter_20170426
Recommendation and invitation
Filename
Reference
Confirmation from partner(s)
Filename
Reference
Other items
Filename Budget.pdf
Reference ES592788_010_1_Annet_20170425
Filename userinvolvement-final.pdf
Reference ES592788_010_3_Annet_20170426 CREATING INTEGRATED PERSON-CENTRED CARE IN DIFFERENT SETTINGS – THE CONTEXT PROJECT
1. Relevance relative to the call for proposals In the White Paper The primary health and care services of tomorrow – localized and integrated (2014- 2015), the Norwegian Government recommends that health and social care should be more proactive and preventative, interdisciplinary expertise should be utilized better, and care quality would benefit from more cooperation between care providers, care recipients, family members and the wider community.1 This message echoes the recent call of the World Health Organization (WHO) for a paradigm shift towards ‘integrated people-centred care’2 – a strategy deemed to be particularly relevant for care services for elderly people with complex health problems which require continuous care in multiple settings.3,4 Research so far suggests that outcomes from interventions aiming at integrated person-centred care may be positive, but it also indicates that outcomes, both as to the creation of facilitating conditions and to improved client well-being, are highly context-specific.5 For example, interventions may be heavily reliant on the care organization’s ability to change the mindset of the staff, or on the way care work is organized and controlled. Recognizing the crucial role of contexts, WHO5 calls for researchers to move beyond evaluations of single interventions and to direct attention towards how settings and external environments can enhance integrated people-centred care. Relying on an effıcacy-based research paradigm established to answer questions under decontextualized, optimal conditions will not produce the solutions needed. The CONTEXT project responds to this plea for a contextualist turn in care research. The core aim is to make explicit how initiatives and mechanisms aiming at integrated person-centred care are facilitated or hampered by contextual conditions. The project will employ a comparative, mixed method, design, and will examine similar initiatives and care practices in different national and local contexts. A cross-case analysis based on qualitative studies in Norway and Denmark will be linked to quantitative, statistical analyses of a large Nordic survey among staff in elderly care in a way that permits a synergetic utilization of data. The CONTEXT project is highly relevant for themes highlighted in HELSEVEL’s present call for research proposals. It studies elderly care – a large welfare state sector of obvious importance for the HELSEVEL research programme. The project meets the critique that previous research has not considered sufficiently the role of context in developing care services. The project addresses three of HELSEVEL’s cross-cutting themes and prioritized research areas: (1) implementation; (2) vertical and horizontal integration; and (3) management, leadership and organization. The CONTEXT case studies will address implementation processes and the way they are influenced by contextual factors. We pay particular attention to measures and mechanisms aiming at horizontal integration, such as how coordination between general practitioners (GPs), home nurses and other home care providers is attained – a problem area underlined in HELSEVEL’s latest call. We believe that comparisons between Norway and Denmark as to how health and social care provision have been integrated will be very interesting for policy makers searching for innovative solutions. Quantitative and qualitative data will be used for investigating how the ‘inner context’ of care organizations, such as leadership style and management practices, is associated with the ability of frontline care staff to provide person-centred care. By bringing in a Danish partner and by extending a long-lasting collaboration between international and Nordic elderly care researchers, the CONTEXT project meets the call for comparative and international research.
2. Aspects relating to the research project Background and status of knowledge The concept of ‘integrated person-centred care’ The term ‘integrated person-centred care’ is often used in order to designate a new direction for attaining care services of high quality. The concept is not understood in a uniform way, but discussions of its definition usually implies that ‘integrated care’ is closely related to the notion of ‘person-centredness’. 8-11 1
Commonly, ‘person-centredness’ is understood as a multi-dimensional concept denoting individualized, holistic, empowering, and integrated care. Individualized care implies that interventions and measures are customized to the person’s unique needs and preferences, and not simply dictated by the care institution’s standards, routines, and fixed practices. Holistic care means that professionals understand how the whole person is affected by illness.11 Hence they take into consideration, not only the clients’ medical conditions and specific symptoms, but also psychological, spiritual and social aspects, including ‘the interdependencies and interconnectedness that shape our lives’.7 It is widely agreed that person-centred care is enhanced if families and local communities are engaged as collaborative partners.8 Care should furthermore be empowering by recognizing and cultivating the capabilities of the elderly person to manage their daily life, including medication and other health-preserving efforts. The integrated criterion has particular relevance for multi-problem patients with serious chronic and disabling conditions. Hence, integrated care denotes that services and interventions are comprehensive and adjusted to a complete understanding of the user’s problems, rather than based on the narrow perspective of specialist professionals.12 It should however be noted that ‘integration’ is also at the heart of organizational theory; the term may refer to the ways managers seek ‘from above’ to coordinate and bring together the different parts of the care system, for instance by ‘integrated pathways’, boundary spanning roles, and shared networks.3 The rise of person-centred care Although it may be argued that Nordic care policy has always been oriented towards ideals of integrated and person-centred care, the recent ‘Coordination Reform’ of Norway,13 which is highly inspired by the Danish ‘Structural reform’, has fuelled the operationalization of these ideals into a wide array of recommended initiatives.13-14 For instance, following the success of the city of Frederica in Denmark, many Danish and Norwegian municipalities have invested in home care reablement.15 This service is commonly defined as an early, time-limited, multi-disciplinary, and home-based intervention focusing especially on activities that matter subjectively to the well-being of older people.16 In addition to home care reablement, various instruments, such as structured multidisciplinary care plans and checklists, have been developed in order to improve adequate follow up after discharge from hospitals.17 Local governments seek moreover to reorient home care providers to be more proactive and enabling. A variety of different measures aimed at making older people as self-reliant as possible are tested out, for example supportive technology, training programmes for increasing staff motivation skills, and coordinating roles aiming at enhancing cooperation with families and volunteers. The ultimate aim is to re-establish or maintain daily living skills, as well as community participation, for elderly patients, and thereby enhance their physical, emotional and social wellness.18 Efforts towards integrated person-centred care are also occurring outside the Nordic countries. A cross- national study3 reveals that integrated care for older people has been introduced in a number of countries, at the interface between health and social care as well as between formal and informal care, with different approaches and instruments, depending on the state and the situation in the actual care services. Research findings on ‘integrated person-centred care’ Studies of outcomes for service users, after measures aiming at creating person-centred care have been implemented, are rare and often difficult to evaluate. Nevertheless, available studies suggest positive consequences and benefits for patients and care recipients, such as improvements in health, quality of life, fitness, and user satisfaction.5 In addition, several research contributions reveal that person-centred care practices can be highly valued by care staff.11,12 Person-centred care practices have proven to be significantly associated with job satisfaction among care workers.19,20 Preliminary research findings on effects of implementing home care reablement from Denmark and Norway point in the same direction.21,22 Thus, Nordic scholars regard the trend towards person-centred care to be a promising direction of change because of its potential for attracting and sustaining a competent work force in elderly care.21,23 In sum, there is certainly evidence for various types of positive benefits of the movement towards integrated person-centred care. Nevertheless, research has pointed out a number of barriers, as well as facilitators, which may hinder, or enhance, both the implementation of integrated person-centred care changes in care organizations, as well as influencing whether integrated person-centred care actually makes a difference to the life quality and wellbeing of the care recipients. Research indicates that the implementation of changes intended to lead towards person-centred care practices may be hampered by sceptical and stereotypical
2 mindsets among health care professionals, as well as by constraining bureaucratic structures, lack of time, and by the threat of dilution of professional power which the new policies may entail.9 These barriers may be attributed to prevailing ‘taken-for-granted beliefs’, as well as to existing power structures. For instance, initiatives which aim at promoting interdisciplinary co-operation may fail because of struggles between different professions and occupations for responsibility and authority.47 Efforts to work across sectoral boundaries can be hampered because audit and performance management systems, implemented ‘from above’, are mono-organizational rather than cross-cutting and hinder co-ordination of services between different parts of the care system.26 Various circumstances may, on the other hand, be facilitators. It has been recognized that, in order to make new decisions and respond adequately to shifting needs and preferences of service users, it is advantageous that managerial power is shared with frontline staff.11,14 Certain leadership styles seem to promote successful implementation and functioning of integrated person-centred care, such as managers who emphasize shared visions, encourage inter-professional team working, and encourage ‘distributed leadership’, i.e., leadership by non-designated leaders.27,28 Other facilitators may include organizational practices which inspire collective reflection, openness and knowledge sharing.29 The case for a contextualist turn Thus, current research indicates that the ability of a care organization to achieve successful outcomes – both as to implementing measures which are regarded as steps towards integrated person-centred care, and actually improving the care offered to users – is highly contextual.5 However, although contextual factors are often mentioned, previous research has mostly focused on narrowly-defined interventions. There has been less awareness both of why outcomes of specific interventions succeed in some contexts and not in others, and how outcomes of specific interventions are influenced by a number of surrounding factors. In order to inform future reform policies, it may be essential to construct a knowledge base on the interplay between reforms, interventions, contexts and outcome.30 Recognizing that interventions are shaped within contexts, WHO5 emphasizes that there is no ‘best route’ to integrated person-centred care, but perhaps many routes, each depending on circumstances. This contextualist perspective echoes the conclusion in Bate et al.’s study31 of successful hospital organizations: the most striking similarity between the organizations was the ability to address multiple challenges simultaneously and to find solutions adapted to their own organizational context. In line with this, several researchers, also those who have analysed specific initiatives such as ‘home care reablement’22 or ‘integrated pathways’,17 have remarked that the success and failure of the analysed initiative cannot be attributed to a specific golden standard. Implementation of new measures is not easy and straightforward. Previous research has for example indicated that: (1) Single initiatives may overlap and interact with adjacent initiatives, making separate analyses potentially misleading. (2) Local initiatives with similar labels (e.g.,‘home care reablement’) may be implemented by very different instruments and lead to different outcomes. (3) How particular interventions develop is often emergent – the path is made by walking, so to speak. (4) Emergent mechanisms may be either transformative or preservative, depending on contextual conditions. These lessons from previous research should be taken into account in new research on the complex, multi-faceted nature of care provision.18
Approaches, hypotheses and choice of method The contextualist approach The core aim of the CONTEXT project is to explore how initiatives aiming at integrated person-centred care are shaped, facilitated or constrained by contextual conditions. Our analytical framework draws on Pettigrew’s seminal work on contextualist research30 and Pawson & Tilley’s work on ‘realistic evaluation’ – both departing from the view that programmes aiming at some kind of change or improvement will always be embedded in a historical institutional context.33 Following this strand of research, the municipal elder care system should be seen as processes – i.e. continuing systems with a past, present and future, and not as static ‘frozen structures’. Initiatives taken to make improvements will be seen as a continuous, interdependent sequences of actions and events. Actors
3 involved will explain the origin, continuance and outcome of an initiative using the language of ‘becoming’, rather than ‘being’. Processes unfold at different levels – the CONTEXT project will pay attention to (a) the local government level of policymaking and planning, (b) the inter-organizational level, (c) the intra- organizational level, and (d) the inter-personal level of care provision, i.e., the dyadic relation between staff and service users or the triadic relation between staff, service user, and next of kin. The way these different levels are interrelated and how they are embedded in past events, relationships, and power struggles constitutes the context. Hence, the context encompasses both ‘hard’ (structural) and ‘soft’ (cultural) factors and is often seen as consisting of several layers: the inner context refers to aspects internal to the focal organization such as modes of cooperation, specialization of work, and leadership. The outer context concerns the wider economic, political, and social environments.30 However, rather than seeing context as having a unidirectional influence – e.g., that governments and politicians exert influence which ‘moves down’ to work places and individual practitioners – the contextualist approach acknowledges that contextual factors may be more or less modifiable. Processes are both constrained by structure or shaped by structures. One key research task of the CONTEXT project is to compare different national, local and organizational contexts in order to understand how contextual factors may (or may not) be modified in order to enhance integrated, person-centered care. ‘Realistic evaluations’ use contextualist thinking not by asking simply whether an initiative works or not, but rather by asking ‘what works for whom in what circumstances and why?’ In the CONTEXT project we will regard interventions aiming at integrated person-centred care as highly conditioned by such contextual factors as professional dominance or population heterogeneity: the meaning of person-centredness may vary between professionals from different disciplines; interventions that are person-centred for one person may not fit the wishes and values of another person. An explanation driven-approach The contextualist approach is an explanation-driven approach. Drawing attention to processes of implementation and change, research has to a large extent focused on stakeholders’ (often implicit) ideas about how and why particular interventions will lead to certain outcomes. These ‘how’ and ‘why’ questions are often referred to as a ‘programme theory’. Following Pawson & Tilley,32 a programme theory specifies what mechanisms will generate outcomes and what features of the context will affect whether or not these mechanisms operate as intended. As initiatives and programmes may overlap and carry different local labels, the CONTEXT project will focus attention on different mechanisms aiming at integrated person-centred care, rather than on specific initiatives. We find the concept of programme theory and mechanism of change useful both as analytical tools to make explicit the interpretations of various stakeholders about why (or why not) certain interventions work as intended, and secondly, as a reflective tool to be utilized in dialogues with policymakers and practitioners as a part of the realization of the project benefit (see 2.3 in the mandatory attachment). To avoid the project becoming boundless, however, we intend to ‘zoom in’ on mechanisms of change related to four focal points of research: Focal points of research Responsible team Mechanisms intended to improve the collaborative relation between Vabø, Rostgaard, GPs, home nurses and the home care services Romøren, Post doc fellow Mechanisms aiming at co-creation between the municipal care Vabø, Rostgaard, Norvoll, system and families/volunteers/social entrepreneurs Phd student Mechanisms aiming at changing the home care system towards Vabø, Rostgaard, Øye, (short term) reablement and (long term) enablement care. Drange, Graf, Post doc fellow Mechanisms aiming at changing the relation between frontline care Norvoll, Øye, Vabø, Phd staff and service users student
4
The project will have three overall research questions: 1. What are the mechanisms presumed to make services more integrated and person-centred? How are these mechanisms interrelated and how are they aligned with previous structures and mode of work? 2. How have efforts to implement integrated person-centred care been hampered or facilitated by contextual factors? Which of these contextual conditions are modifiable? Which contextual factors have been modified to fit the chosen mechanisms of change, and which contextual factors have constrained mechanisms of change? 3. How do actors at different levels of the care system assess the outcome of initiatives aiming at person- centred care? What kind of evidence is used to assess outcomes? For whom are new practices beneficial? In what respect do perceptions of integrated person-centred care vary among professionals from different disciplines? In what respect do perceptions between professionals and citizens/service users diverge?
More specific research topics/examples The sample of municipalities which will be selected for the CONTEXT project will be involved in similar programmes and initiatives intended to improve their care services, typically in terms of proactive interventions, interdisciplinary coordination, and individualized and holistic approach to care. However, we expect that both national and local variations may occur at all levels of analysis. Concerning different national contexts, we expect to see differences between Norway and Denmark regarding the way health and social care provision is integrated. Registered nurses in Denmark often operate ‘outside’ the ordinary home care system based on referrals from a general practitioner (GP), whereas in Norway registered nurses play a key role in the home care system. In Denmark initiatives have been taken to integrate GPs in interdisciplinary teams, whereas Norwegian research indicates that the autonomous role of GPs persists despite the integrative efforts occurring in the wake of the Coordination Reform.36 These differences give rise for further exploring how contextual differences affect critical routines such as medication reviews. Drawing on previous research, we find it of particular interest to explore how mechanisms aiming at person- centred care are aligned with structural arrangements for the New Public Management (NPM) wave of reform.33,34 Over the past twenty years there has been much criticism of the ways Nordic elderly care has been governed, often in terms of pointing out an implicit propensity of NPM proponents to regard care as a predefined commodity rather than a responsive interaction between care provider and care recipient. However, municipalities have adopted the NPM ideas in widely varying ways,33,34 and both in Denmark and Norway, ‘trust reforms’ are introduced which may dismantle NPM-related control systems and replace them by trust and motivation in the front line of care provision.35 One important research task of CONTEXT is to explore whether municipalities more or less inspired by NPM diverge in the way they implement integrated person-centred care. Drawing on international literature on integrated person-centred care, inner-context factors such as work organization, leadership, shift work management, and continuity of staff may indirectly influence outcomes via the way learning environments are created. A core research task of the CONTEXT project is to explore how particular workplace characteristics may facilitate or hamper person-centred care practices. At the micro-level of care provision we expect to see that notions of person-centredness may be dominated by one particular discipline – for instance ‘reablement’ or ‘enablement’ may be dominated by the view of physiotherapist and hence narrowly linked to problems related to lack of strength and physical function and not to nutrition, medication, hearing, incontinence, or psycho-social problems.18 The CONTEXT project aims to adopt a critical perspective on the way responsibilities for needs assessment and care provision are assigned to certain professional groups. The core research task of the Post doc fellow is to explore how different modes of inter-professional collaboration may influence the way ideals about person-centred care are translated into practice, and to explore how inter-disciplinary learning is facilitated or hampered in different care settings. The PhD student will pay particular attention to the way the person-centred practices of different professionals are perceived by service users and their next of kin.
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Methods The main part of the project is based on a multiple case study design, involving six municipal elderly care systems, four in Norway and two in Denmark, based on an innovative site switching approach (see below) which capitalizes on different disciplinary skills as well as on the practical skills of care professionals. The other part of the project consists of quantitative statistical analyses of two highly comparable, cross- sectional, surveys, conducted in 2005 and 2015, among frontline staff working in elderly care in four Nordic countries including Norway and Denmark. The CONTEXT project will thus employ a mixed method design in which qualitative studies and quantitative analyses will be combined and integrated. (A) The case studies The value of comparisons A case study design aiming at comparison of similar initiatives across different contexts is often the preferred design in contextualist research. The assumption is that particular measures trigger mechanisms of change somewhat differently in different contexts. By demonstrating how variability in context connects to the shape, pace and direction of the processes under investigation, a better understanding is expected to emerge about causal links between contextual factors and outcomes. In the CONTEXT project, this purpose will be attained by analysing a set of local municipal organizations for elderly care in Norway and Denmark. One reason for this choice is that Norwegian local politicians tend to be inspired by trends from Denmark. It has often been presumed that Denmark and Norway have similar health care systems,14 but previous research has revealed significant differences between the two countries.37 Such variability, concerning for example, the mix of skills in care staff, the integration of medical care/nursing and social care, and the use of shift work and part time work, will be used for attaining insight into contextual influences. As the purpose is to gain a deeper understanding of the role of contexts, we aim to select cases (elderly care organizations) which diverge in contextual conditions, i.e. they have different national contexts, different community context and different administrative structures. We presume that the urban/rural dimension may be significant regarding contextual factors such as staff continuity, population heterogeneity, and peoples’ sense of belonging. First, two sites are selected in each country – one in an urban area and one in a rural/small town area. At a later stage, the project will select two more Norwegian sites (one rural, one urban) which have organized care services differently from the first pair of sites, especially as to the practicing of NPM ideas. The unit of analysis for each case will be the network of health and social care services typically used by home-dwelling elderly people – these include home-based care, home care reablement, respite services and day care centres, GP services, pharmaceutical services, and social clubs and similar activities. However, our design will be a ‘layered’ or ‘nested case’ study38 – each case study will address a set of focal points (mentioned above) and make cross-case comparisons at different levels. Data collection (1) Data collected before site visits: Initially, we will collect (a) policy documents, evaluation reports, etc., describing the care policy of the municipality (or city district); (b) administrative data and statistics useful for describing service organizations, service volume, service coverage, staff skill mix and staffing level, sickness absenteeism and user satisfaction ratings; and (c) we will conduct interviews with managers and needs assessors in order to get a view of relevant services and essential mechanisms used for service development. (2) Site visits: In order to understand how key mechanisms are influenced by contextual factors we intend to collect data among managers, practitioners/frontline staff with first-hand knowledge of how different initiatives have been translated into practice. We seek to capture rich complexity rather than strictly comparative, single factor data. A new method in international care research will be utilized – ‘rapid site- switching ethnography’. This method, based on five days intensive field research combining interviews and observations, has proven to be suitable for studying how care work is conducted in different contexts.39 Central to the design is the idea of ‘bringing in fresh eyes’ from scholars with different disciplinary backgrounds and experiences from different contexts. The CONTEXT project will extend the method by a co-research approach that aims at capitalizing on the skills and knowledge of both academics and practitioners.40 Hence, a triad of researchers will visit each site: (a) an inter-disciplinary team of academics who manage the overall project including the initial framework of the study; (b) a host manager who will participate in the planning of the study and who will arrange for interviews and collect relevant
6 documentation and contextual data required by the team; and (c) a ‘co-researcher’ who will participate in data collection and interpretation. The ‘co-researcher’ is an ‘insider’ in the sense that s(he) is familiar with the type of organization being studied, but an ‘outsider’ to the extent that the organization may have a different structure, different staff mix, and different care cultures. Piloting this method in an ongoing research project18 we found that it helped to gain a fuller and more textured picture. Each site visit will include a focus group with senior club members and a reflection session where frontline home care staff will be invited to share their views on possible barriers and facilitators for developing person-centred care. (3) Follow-up interviews with users: During field research we intend to observe practical care work and we may chat with older people. However, based on ethical considerations we will avoid interfering unless people explicitly invite us to talk. Subsequent to the site visit, follow up interviews will be conducted with a smaller sample of service users/family members who are well informed and prepared to share their experiences. A PhD student will do this data collection, with a focus on how professional conceptions of person-centred care are synchronized with the views of older people and their families. An important purpose is to analyse the ‘care puzzle’ which confronts users and their families and to identify what kind of support they regard as essential for living a good life at home. (B) The NORDCARE surveys The other part of the CONTEXT project is to utilize data in two analogous Nordic cross-sectional surveys – the NORDCARE surveys – conducted in 2005 (N= ca. 5,000) and 2015 (N=ca. 8,000). The survey samples consist of care workers randomly selected from membership lists of care workers’ unions. Average response rates for the four countries were ca. 70 per cent in 2005 and 55 per cent in 2015. A number of identical questions were asked across the two waves, enabling analyses of changes between 2005 and 2015. These multi-purpose surveys include both open and closed questions on a range of themes related to practical care provision. Respondents were asked detailed questions about the content of work and the work context in the care organization. The surveys cannot provide information about particular programmes, but they enable analyses of the relationship between care practices associated with person-centred care and a range of contextual variables commonly assumed to influence care provision. Indicators of the extent that work practices are person-centred (the dependent variable) can be constructed from questions about how care workers relate to the service users/residents during the work day. Examples are questions about ‘the latitude to respond to individual needs’, to what extent they ‘support the capability of care recipients’, ‘support them in taking part in social activities’, ‘support them in physical rehabilitation’, and ‘motivate them to utilize their own strengths and abilities’. The surveys have also information about the extent that specialist professionals and family members are consulted about the service users/residents. The NORDCARE surveys also have an array of questions which will indicate contextual factors in the service organizations (the independent variables), for example questions concerning management (how often they meet with managers, to what extent they ‘feel supported by managers’, ‘have the possibility to influence the way work is performed’), concerning the ‘learning environment’ (to what extent care workers ‘are offered further education’, ‘are provided with opportunities to learn new skills at work’, ‘have time to discuss with colleagues’, etc.). Also possible constraints on person-centred care such as ‘lack of staff due to sickness absenteeism’ and ‘too many patients/clients per staff’ will be analysed. Standard quantitative techniques such as cross-tabulation, correlation, and multivariate regression methods, will be used. (C) The integration of the findings from case studies and survey analyses The mixed method approach may contribute to overcoming weaknesses inherent in single types of design. NORDCARE data, as they are nationally representative data, will be used for characterizing national contexts of the selected cases. Moreover, being representative, NORDCARE data will be used as reference points for deciding whether the analysed home care organizations in the case studies are typical or atypical (concerning, e.g., staffing level, care workers’ perceptions of work environments, and work practices) Reversed, the rich contextual data obtained in the case studies will be used for validating and interpreting findings from NORDCARE. We will do this systematically by inviting care workers participating in reflection groups (see above) to assist us in interpreting statistical patterns and also in creating relevant measures for future surveys. In particular, this will be useful for developing validated measurements and research tools for the work in collaboration with the Norwegian research network which is managed from the Centre for Care Research – Western Norway. This research network will also join us in developing a
7 reflection tool (based on data from the case studies), aiming at making municipal managers and policy makers more aware of the role of context in care service development.
3. The project plan, project management, organisation and cooperation Project management and organization The CONTEXT project will last from March 1, 2018, to November 30, 2021. Work with the case studies and the analysis of the Nordic surveys will proceed simultaneously in the first two years. The researchers participating in the case studies will explore their own particular research themes/focal points (see figure above, p.4). The data collection will be organized as teamwork – not as separate work packages. An appointed triad leader will prepare each site visit. The project will be administered from NOVA, a large social science and social policy research institute, which (since 2014) is part of Centre for Welfare and Labour Research at Oslo and Akershus University College of Applied Sciences (HiOA). The project manager will be Research Professor Mia Vabø, NOVA, who is an experienced research coordinator and has participated extensively in international projects and research networks addressing elder care. Other participants from NOVA include a Phd student, funded by NOVA, who will write his/her thesis about the role of context seen from user/family perspectives (based on data from the site visits and in-depth follow-up interviews). We will also apply for a post doc position for a researcher who will participate in the first four site visits and pay particular attention to challenges related to inter-professional collaboration in Norway and Denmark. Research Professor Jon Ivar Elstad will be a mentor and co-author in the NORDCARE analyses. The project will benefit from cooperation with colleagues from four different research institutions: (1) From the Work Research Institute (AFI), also part of the Centre for Welfare and Labour Research, HiOA: Ida Drange will have the leading role in the NORDCARE analysis. Reidun Norvoll, an experienced field researcher, will take a leading role in the homecare/ home care reablement part of the study and will also focus on topics related to initiatives aiming at co-creation with family/civil society. (2) From the Centre of Care Research – Western Norway, two experienced researchers will participate. Professor Christine Øye will contribute with a particular focus on client empowerment/professional-client power balances. Senior researcher Oddvar Førland, who has conducted multidisciplinary research in elder care for several years, will contribute to the development of evaluation tools which are important parts of the expected outcome of the project. (3) From the Department of General Practice, Institute for Health and Society at the University of Oslo, Maria Romøren, General Practitioner (GP) and Post doctoral researcher, will participate in the part of the field research focusing on coordination between home care, nursing and GPs. (4) From KORA in Copenhagen, Professor of Political Science Tine Rostgaard will take a leading role in the two Danish case studies, and will participate in the Norwegian case studies together with Lea Graff and one research assistant. Rostgaard has extensive experience as research coordinator and has led and participated in several national and international projects. Rostgaard will in particular focus on policymaking and the way shifting modes of governance and new service ideals impact on the lived experiences of older people. The academic scholars involved in the CONTEXT application are all involved in national and international research networks. The project will be strengthened by several of these networks. A national research network of Norwegian care researchers, led by Professor Frode Fadnes at the Centre of Care Research – Western Norway, organizes regular meetings to discuss topics of particular relevance for this project. A Nordic research network, led by Professor Marta Szebehely from Stockholm University, will act as an important arena for critical discussions. Researchers from this network have worked through several projects to achieve agreement over conceptual and functional equivalence and research parameters across Nordic countries. The project will moreover benefit from our collaborative relationship with colleagues from York University Canada, including an ongoing international comparative research project led by Professor Pat Armstrong, and new research plans of Associate Professor Tamara Daly which will, in many respects, overlap with the CONTEXT project.
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Budget We apply for funding for a post-doctoral researcher and for the salary costs for academic researchers. Our labour-intensive site-switching approach is estimated to cost approximately NOK 175 000 per visit (including remuneration for municipal co-researchers).
4. Key perspectives and compliance with strategic documents Compliance with strategic documents The CONTEXT project conforms to the strategic objectives and plans laid down by the Centre for Welfare and Labour Research at HiOA. The mandate of the Centre is to foster synergy between research previously conducted at separate research institutes, and moreover to contribute to research relevant for the development of knowledge-based education at Oslo and Akershus University College of Applied Sciences.
Relevance and benefit to society The project addresses a core challenge of Norwegian society: how to create effective and sustainable care solutions for a growing population of elderly people. The project will contribute to inform public debates about the care of elderly people and contribute to extend the knowledge base for service development.
Environmental impact The project and its activities do not have any direct impact on the environment.
Ethical perspectives Particular attention will be paid to the human dignity and privacy of elderly people during our site visits. The project will adhere to relevant guidelines for privacy protection and research ethics. All personal interviews will be based on informed consent and will be anonymized as they are transcribed. Audio files and transcripts will be encrypted and password protected and will only be accessible by members of the research team. We will comply with the ethical standards of the Norwegian National Research Ethic Committees and will not start data collection until the project is approved by NSD (Norwegian Centre for Research Data) and the Norwegian Data Protection Authority.
Gender issues Gender is always an important aspect of care research, both because the majority of care staff are women, and because caring relations will often be based on gendered expectations. Hence, our analysis will pay particular attention to gender issues and take into consideration insights from feminist care research. The project will strive for a gender-balanced research group.
5. Dissemination and communication of results The project intends to communicate with three relevant user groups (see attachment and dissemination plan)
6. References 1. Norwegian Ministry of Health and Care Services. The primary health and care services of tomorrow – localized and integrated (Meld. St. 26 (2014-2015) 2. WHO (2016) WHO global strategy on integrated people-centred health services 2016-2016 3. Leichsenring, K. (2012) Integrated care for older people in Europe – latest trends and perceptions, Int Journal of Integrated Care 12(1) 10-13 4. Wilberforce,M, Challis,D., Davies,L,et al. (2016), Person-centredness in the care for older adults: a systematic review of questionnaire-based scales and their measurement properties, BMC Geriatr.16 (63) DOI: 10.1186/s12877-016-0229- 5. WHO (2015) People-centred and integrated health services: an overview of the evidence. 6. Robert, G & Fulop, N. (2014) The role of context in successful improvement Bate P, Robert G, Fulop N,et al(eds). Perspectives on context: a selection of essays considering the role of context in successful quality improvement. London: The Health Foundation; 2014. p. 31-57. 7. Nolan, M, Davies, S, Brown, et.al. (2004) Beyond ‘person-centered’care: a new vision for gerontology nursing, Journal of Clinical Nursing, 3(3) 45-53 8. Ells, M., Hunt, R. & Chambers-Evans, J. Relational autonomy as an essential component of patient centered care, The international Journal of feminist approach to bioethics, Vol. 4, (2):79-101.
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9. Cormack, B. (2004) Person-centeredness in gerontological nursing: an overview of the literature, International Journal of Older People Nursing (13) 31-38 10. Dow B., Harlambous, B, Bremner, F. Fearn, M. (2006) What is person-centered health care? A literature review, Department of human services, State of Victoria. 11. Morgan, S & Yoder, L. (2012) A Concept Analysis of Person Centered Care, Journal of Holistic nursing, vol 30, (1):6-1 12. Kodner, D. & Spreeuwenberg, C.(2002) Integrated care: meaning, logic, applications, and implications – a discussion paper, International journal of integrated care 2 (4) DOI: http://doi.org/10.5334/ijic.67 13. Norwegian Ministry of Health and Care Services (Meld. St.47 (2008-2009) The Coordination Reform — Proper treatment – at the right place and right time 14. Grimsmo A. & Magnussen (2015) Norsk samhandlingsreform i et internasjonalt perspektiv, EVASAM, NFR 15. Rostgaard, T.(2014) Nordic care and care work in the public service model of Denmark: Ideational factors of change., Leon, M.(ed) Care Regimes in transitional European Societies PalgraveMacMillan 16. Langeland, E, Førland, O, Aas,E. Birkeland, A. Folkestad, B. Kjeken, I Jacobsen F.F og Tuntland, H. (2016) Modeller for hverdagsrehabilitering, en følgeevaluering i norske kommuner. Effekter for brukere og gevinster for kommunene? Senter for omsorgsforskning Vest. 17. Røsstad,T,Garåsen,H, Steinsbekk,A., Håland, E. Kristoffersen, L & Grimsmo, A. (2015) Implementing a care pathway for elderly patients, a comparative qualitative process evaluation in primary care, BMC Health Service Research, 15 (86) DOI: 10.1186/s12913-015-0751-1 18. Vabø (2017) Restorative care in the making – the significance of local government organization, Paper accepted for the ESPANET conference 2017 New horizons for European Social Policy. Risk, opportunities, challenges. Lisboa 19. Edvardsson, D., Fetherstonhaugh L, McAuliffe, Nay R., Chenco (2011): Job satisfaction amongst aged care staff: exploring the influence of person-centered care provision, International Psychogeriatrics 23 (8): 1205-1212) 20. Barbosa A., Sousa, L. Nolan, M., Figueiredo D. (2014) Effects of Person-Centered Care Approaches to Dementia Care on Staff , American Journal of Alzheimer’s Diseases & Other Dementias DOI: 10.1177/1533317513520213 21. Rostgaard, T & Ulrich, M.M (2016) At arbejde rehabiliterende i hjemmeplejen gør arbejdet meningsfuldt, , København: KORA 22. Hjelle,K.M, Tuntland, H, Førland, O. Alvsvåg, H ( 2016) Reablement teams` voices: A qualitative study of how an integrated team experience participation in reablement, Health and Social Care in the community, doi: 10.1111/hsc.12324 23. Hvid, H. & Kamp, A. (2012) The future elderly care–beyond New Public Management? Kamp A. & Hvid, H. (ed.) Elderly care in transition. Management, meaning and identity at work. A Scandinavian perspective. Copenhagen 24. Moore ,L., Britten, N. Lydahl, D., et al (2016) Barriers and facilitators to the implementation of person-centred care in different healthcare contexts. Scandinavian Journal of Caring Science doi: 10.1111/scs.12376 25. Lymbery, M. (2006) United we stand? Partnership Working in Health and Social Care and the Role of Social Work in Services for Older People, British Journal of Social Work, 36, 1119-1134 26. Glendinning C. (2003) Breaking down barriers: integrating health and care services for older people in England. Health Policy 65: 139–151 27. Best, A, Grehalg, T., Lewis, S et al(2012) Large-system transformation in health care:a realist review, Milbank Q 90(3) 421-56 28. West, M.A., Eckert, R., Steward, K. and Pasmore, B. (2014) Developing collective leadership for healthcare. London: The King’s Fund 29. Hall,J.E ( 2006) Professionalizing action research: a meaningful strategy for modernizing services? Journal of Nursing Management,14(3)195-200 30. Pettigrew,A.M.( 1990) Longitudinal field research on change: theory and practice, Organization Science, 3: 267-92 31. Bate SP, Mendel P and Robert G. (2008) Organising for Quality.The improvement journeys of leading hospitals in Europe and the United States. Oxford: Radcliffe Publishing 32. Pawson, R. and Tilley, N (1997) Realistic Evaluation. London: Sage 33. Vabø, M. (2015) Changing welfare institutions as sites of contestation, in Engelstad, F. & Hagelund, A. (eds) Cooperation and Conflict the Nordic Way. Work Welfare and Institutional Change in Scandinavia., Berlin: de Gruyter Open 34. Kamp A. & Hvid, H. (ed.) Elderly care in transition. Management, meaning and identity at work. A Scandinavian perspective. Copenhagen 35. Cogency (2012) Tillid i Københavns kommune, Pilotstudie (Report. Commissioned by the City of Copenhagen) 36. Kirchhoff , R.Bøyum-Folkeseth,L. Gjerde, I .et al (2017) Samhandlingsreformen og fastlegene– et avstandsforhold? Tidsskrift for omsorgsforskning 2( 95-106) DOI: 10.18261/issn.2387-5984-2016-02-04 37. Szebehely (ed.)(2005) Nordisk äldreomsorgsforskning. En kunskapsöversikt Tema Nord 2005:508. [Nordic eldercare research. An overview]. Copenhagen: Nordic Council of Ministers 38. Patton, M. Q. (2002) Qualitative Research & Evaluation Methods. (3.utg). London: SAGE. 39. Baines, D., Cunningham, I. (2014). Using comparative perspective rapid ethnography in international case studies: Strengths and challenges. In M. Tight (Eds.), Case studies, (pp. 309-324). New Delhi: Sage Publications. 40. Hartley J. & Benington J. (2000) Co-research: A new methodology for new times, European journal of work and organizational psychology, 9(4):436-476
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CURRICULUM VITAE
Mia Vabø Born: 3/1-1958, Stavanger, Norway E-post: [email protected] Tel.: (++ 47) 47 02 54 89
Current Position: Research Professor, NOVA
Academic Degrees 1986 Cand Sociol, University of Oslo, Norway 2007 Dr. Philos , University of Oslo, Norway
Work experience 1986- 1987 Ministry of Finance, Department of Planning 1997-1989 Maternity leave 1989- 1993 National Institute for Consumer Research (SIFO), researcher 1993-1996 Institute of Applied Social Research (INAS), researcher 1996-2010 NOVA- Norwegian Social Research, senior researcher 2010-2013. NOVA- Norwegian Social Research, research director 2014- NOVA- Oslo and Akershus University College of applied sciences
Research area Political, cultural and institutional changes in welfare states. How different modes of governance intersects and shape new patterns of practice. Governance and coordination in human service organizations. Care work in ageing and diversifying societies.
Resarch projects (recent years) Co-creating active ageing. New modes of work and collaboration in Eigersund and Karmøy, an collaborative research project funded by Regional Research fund of Western Norway (2014– 2017).The project focus on home care reablement services /community co-production Role: Project leader.
Social Inequalities in Ageing (SIA), health care and institutional reforms in the Nordic welfare model. Led by Prof. Johan Fritzel at Karolinska institute, funded by NORDFORSK Nordic Centre of Excellence. The aim is to compare how the different Nordic countries address the common challenge of population ageing. Role: Partner
1 NORDCARE, Individualised care and universal welfare - Dilemmas in an era of marketization, led by Professor Marta Szebehely, department of Social Work , University of Stockholm .The aim of this programme is to investigate the challenges and possibilities of individualised eldercare in Nordic countries (2012-2016). Funded by Forte - Swedish Research Council for Health, Working Life and Welfare. Role: Partner
HARP, Healthy Aging in Residential Places, led by Pat Armstrong, York University, funded by Era-Age European Commission, under the Seventh Framework Programme and / co-funded by NOVA.(2012-2016) http://reltc.apps01.yorku.ca/related-projects/harp .The project explores what constitutes active, healthy aging for people who live in and work in residential care facilities. What conditions support active healthy aging for residents and staff, taking gender, context and individual capacities into account in providing long-term residential care? Role: Partner
Health Care utilization among immigrants funded by Norwegian Research Council (NFR), Research Programme on Health and Care Services and NOVA (2013-2017). The project explores the pattern of health care utilization among immigrants and the health seeking behaviour among Pakistani and Somali immigrants. Role: Partner/ PHD supervisor
Contested spaces. Exploring how policy and practice shape Norwegian nursing homes funded by Norwegian Research Council (NFR), Research Programme on Health and Care Services (2011-2015) The project aims to explore the role of physical and organizational condition in residential care in order to understand more deeply how physical environments and organizational approaches can enhance the well being of residents and staff; Role: Project leader
Manoeuvring in hybrid health care organizations, funded by Norwegian Research Council (NFR), Research Programme on Health and Care Services (2006-2010).The aim is to explore the manoeuvring of health care staff and citizens in a health and long term care organizations pervade by conflicting policy aims and dispersed responsibilities. Role: Project leader.
L’aide au domicile des personnes fragiles à l’etranger ( LIVINDHOME), http://www.sfi.dk/Default.aspx?ID=7284, led by Tine Rostgård, Sosialforskningsinstituttet (SFI) København, funded by Mission Recherche (MiRe) of the DREES og CNSA – Caisse nationale de solidarité pour l’autonomie, (2010-2011). The project explores how 9 European countries have reformed their home care systems. The focus of attention is on the identification of drivers of changes and responses in regards to organisation, provision, regulation and quality of home care/help. Role: Partner
International research networks Normacare. Nordic Research Network on Marketization in Eldercare http://www.normacare.net/, The network’s convenors are Marta Szebehely (Stockholm University), Anneli Anttonen (University of Tampere) and Gabrielle Meagher (University of Sydney). Care in Ageing and Diversifying Societies based in the virtual centre: Nordic Centre of Excellence: ‘Reassessing the Nordic welfare model –hosted by NOVA (Professor Bjørn Hvinden). Coordinated by Professor Marta Szebehely from University of Stockholm Transformation of Care Living the Consequences of Changing Public Policies, led by Marta Szebehely, University of Stockholm, http://www.socarb.su.se/pub/jsp/polopoly.jsp?d=11253
2 Elderly People and Social Exclusion: A Network for Policy Analysis and Innovation funded by Economic & Social Research Council, UK (ESRC) (1997-1999), led by Tim Blackman, Oxford Brookes University
Other Professional activities Teaching: In 1994-96 teaching qualitative methods for master students at department of Sociology University of Oslo. Since 1994, occasionally engaged as supervisor for master students /doctoral students and as external examination at department of Sociology University of Oslo. Regularly giving lectures for doctoral students in health care science/ public organization and administration/political science. Member of an International Expert Panel for the Action Research project Learning life as Symbiotic Learning System of Employee-driven Innovation in Municipal Care Work , funded by NFR/FINNUT, coordinated by professor Olav Eikeland Member of editorial board: International Journal of Public and Private Healthcare Management and Economics (IJPPHME) http://www.irma-international.org/journal/international-journal- public-private-healthcare/41031/ Board of advisor for the project ‘Constructing Wellbeing in Elderly Care - Organization, Design and Management,' Department of Health Management and Policy, University of Kuopio,(professor Sari Rissanen) funded by Academy of Finland. Visiting researcher, at Department of Social Work, University of Stockholm spring 2004 and spring 2009. Visiting researcher at University of Sydney spring 2013 Reviewer, several journals i.e. Nordic Journal of Working Life Studies, Tidskrift for Velferdsforskning, Tidsskrift for samfunnsforskning, Nordiske organisasjonsstudier, Sosiologisk Tidsskrift, Tidsskrift for omsorgsforskning, Arbejdsliv, Gender Work and Organization, Ageing international Journal of Health Organization and Management, Time and Society, Health and care in the Community, Scandinavian Journal of Public Health, Social Policy & Society
Selected relevant publications
Vabo S. & Vabø M (2016) Kontroll og tilsyn som kilder til kvalitetsforbedring, Nordiske OrganisasjonsStudier 18 (1) 56-78 Næss, A, Fjær E.G & Vabø, M. (2015) The assisted presentations of self in nursing home life. Social Science and Medicine 150, 153-159 Vabø, M. (2015) Changing welfare institutions as sites of contestation, in Engelstad, F. & Hagelund, A. (eds) Cooperation and Conflict the Nordic Way. Work Welfare and Institutional Change in Scandinavia., Berlin: de Gruyter Open. Vabø, M. & Vabo, S. (eds) (2014) Velferdens organisering. Oslo:Universitetsforlaget. Vabø, Mia (2014). Reformtrender og endringsparadokser. Vabø,M. & Vabo, S. (eds) Velferdens organisering Oslo:Universitetsforlaget. Vabø, M. (2014). Bakkebyråkratiet - der emosjonelt arbeid blir politikk. Vabø,M. & Vabo, S. (eds) Velferdens organisering Oslo:Universitetsforlaget. Vabø, M. (2014). Dilemmaer i velferdens organisering. Vabø,M. & Vabo, S. (eds) Velferdens organisering Oslo:Universitetsforlaget. Rasmussen, B. Vabø, M.(2014). Inneklemt ledelse. Vabø,M. & Vabo, S. (eds) Velferdens organisering Oslo:Universitetsforlaget. Fjær, E. G. & Vabø, M.(2013) Shaping social situations: A hidden aspect of care work in nursing homes, Journal of Ageing Studies, 27, 419–427
3 Vabø. M. Christensen, K, Trætteberg, H.D, Jacobsen, F.F (2013) Marketization in Norwegian Eldercare. Preconditions, trends and resistance. Meagher G & Szebehely M, eds. Marketisation in Nordic eldercare: Legislation, oversight, extent and consequences. Stockholm University: Department of Social Work. Næss, A. Havig, A. K. and Vabø, M.(2013) Contested Spaces – The Perpetual Quest for Change in Norwegian Nursing Homes. I Hujala, A., Rissanen, S. & Vihma, S. (red.): Designing Wellbeing in Elderly Care Homes. Aalto University Publication Series, Crossover 2/2013 Helsinki, Finland: Aalto University, s. 68-83 Næss, A & Vabø, M. (2012) Negotiating Narratives of Elderly Care: the Case of Pakistani Migration to Norway Ageing international, DOI 10.1007/s12126-012-9147-2 Vabø, M. (2012) ”Norwegian home care in transition – heading for accountability, off-loading responsibilities" Health & Social Care in the Community. 20(3):283-291 Vabø, M. & Szebehely, M. (2012) A caring state for all older people? In: A. Anttonen, L. Häikiö & K. Stefanson (Eds) Welfare State, Universalism and Diversity, pp. 121-144. Edward Elgar, Cheltenham Vabø, M.(2011) Changing governance, changing needs interpretations. Implications for universalism, International Journal of Sociology and Social Policy, Vol 31 4/5:197-208 Vabø, M.(2011) Active citizenship in Norwegian elderly care. From activation to consumer activism, in: Newman J & Tonkens, E (eds) Participation, responsibility, Choice. Summoning the Active Citizen in Western European Welfare States, Amsterdam University Press Vabø, M. (2011) Home care in Norway. Shaped by competing drivers of change. i Rostgaard, T. (red.): LIVINDHOME. Living independently at home. Reforms in home care in 9 European countries. s. 207- 231 Vabø, M. (2009) Home care in transition: The complex dynamic of competing drivers of change in Norway Journal of Health Organisation and Management, Vol 23 no 3:346-359 Vabø, M. (2009) New Public Management: The neoliberal way of governance Ransokarritgerdir, Working paper no 4. University of Island Elstad J. I & Vabø, M. (2008),: Job stress, sickness absence and sickness presenteeism in Nordic elderly care. Scandinavian Journal of Public Health, 36(5):467-474 Vabø, M. (2007) Organisering for velferd. Hjemmetjenesten i en styringsideologisk brytningstid[ Organizing for welfare. Home care in an era of conflicting ideologies of governance Oslo: Unipub Vabø, M. (2006) Caring for people or caring for proxy consumers? European Societies, 8(3): 403-422 Vabø, M ( 2001) ”Norway” In: Blackman, T., Brodhurst, S. & J. Convery (eds): Social care and social exclusion. A Comparative Study of Older People's Care in Europe. Hampshire: Palgrave Publishers Ltd, pp.55-67. Vabø, M (2001): ”The case studies” (with T. Blackman, A. Amera, S. Brodhurst et al.) In: Blackman, T., Brodhurst, S., & Convery, J. (eds): Social Care and Social Exclusion. A comparative Study of Older People's Care in Europe. Hampshire: Palgrave Publishers Ltd, pp.122-151.
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[email protected] koanpera.dk +45 4274 3445
Købmagergade
22, 1150 K
CV Tine Rostgaard Copenhagen
Professor
Tine Rostgaard er professor MSO i KORA og har en ph.d. i Fieldvelfærdsanalyse. of specialisation Tine arbejder med social- og velfærdspolitik, bådePolicy kvantitativt analysis and og evaluationkvalitativt. of welfare and social care for children and older people, including the following research fields and methods: Long-term care policies, reablement/rehabilitation, frailty, demography and healthy ageing Governance and steering, implementation, innovation, co-production, trust relations, private- public partnership, consumerism, welfare professions Formal/informal care giving and care work, care related quality of life (ASCOT), quality of care and quality systems, welfare indicators Family policy, parental leave, day care for children, fertility Qualitative and quantitative methods, including vignettes and RTC, observations and interviews Comparative methods and analysis
Education Ph.D. in Social Policy Studies Southern Danish University, Odense, Denmark, 2004 following studies at LSE, England Master of Science in European Department of Social Sciences, Roskilde University 1995 Social Policy Analysis (MESPA) (RUC) and School of Social Sciences, University of from Bath, England, after ERASMUS course at Edinburgh University, Scotland. Bachelor degree Department of Social Sciences, Roskilde University 1993 (RUC) Humanistic International Basic Department of Humanistic Studies, Roskilde 1991 (HIB) module University, after courses in sociology at Manchester Polytechnic, England. A-levels, Classical side Østre Borgerdyd Gymnasium 1987 Employments Professor MSO KORA 2015 - Professor MSO Department of Political Studies, Aalborg 2011-2015
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University Senior researcher SFI – Det Nationale Forskningscenter for Velfærd 2006-2011 Researcher SFI - The Danish National Centre for Social 2004-2006 Research (formerly Socialforskningsinstitutet) Ph.d. student Socialforskningsinstituttet (SFI) 1998-2004 Research assistent Socialforskningsinstituttet (SFI) 1995-1998 Present scientific positions and activities President Danish Gerontological Society, DGS, http://www.gerodan.dk/ Member Nordic reablement researcher network Member International researcher network ‘Nordic Marketisation in Care’ (NorMaCare) Member National research center on public-private cooperation, ‘COPS’ (Center for forskning i offentlig-privat samspil) Member Review panel for FORTE Swedish Research Council for Health, Working Life and Welfare Lead author ‘The International Panel on Social Progress’, led by Profs. Amartya Sen, Nancy Fraser, Ravi Kanbur, and Helga Nowotny Organiser With Milan Polytechnic organising the international ‘Transforming Care conference series’, http://www.transforming-care.net/ Member of advisory committee ‘Tackling Inequalities in Time of Austerity (TITA), Turku Universitet, Finland Member ‘Nordic researcher network on gender equality’, Umeå Universitet Selected projects Social Inequalities in Ageing Health, care and institutional reforms in the Nordic welfare (SIA) model - The project will analyse and compare how the different Nordic countries address the common challenge of population ageing, in view of the institutional changes of the welfare state and other external changes. NORDFORSK Nordic Centre of Excellence, led by Prof. Johan Fritzel, (KORA part 2.4 million NOK) (2015-2019). Work package leader (2.400.000 DKK) Handbook in Child and Family Co-editor with Prof. Gudny Eydal, Iceland University. Policy International handbook to be published at Edward Elgar COPS – Center for Offentlig- National research center on public-private co-operation, ‘COPS’ Privat Samspil (Center for forskning i offentlig-privat samspil), 2016-2021. Financed by KORA Cost-effectiveness of A study of the effect of reablement for quality of life, health, reablement: a local study of loneliness and costs. We use amongst other ASCOT for a pre- Nyborg Municipality in post evaluation of outcomes, 2015-2019. PI. Financed by Dan Denmark Age (Ældre Sagen) and Nyborg Municipality (1.200.000 DKK) EffektDoku Danish research network analysing the oucomes of
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marketisation, 2014-2016. Financed by Roskilde University (180.000 DKK) Samspil og samarbejde i The project focusses on the creation of relation and cooperation rehabiliteringen (Co-creation and in reablement in LTC for older people, including the perspectives co-operation in reablement) of users and care workers. PI. Financed by Fremfærd (2015- 2016) (1 million DKK) Evaluation of the Danish model An evaluation for Socialstyrelsen, looking into the effects of of reablement Danish reablement (Hverdagsrehabilitering) and cross- disciplinary care work for older people, cooperation SFI/Rostgaard.2014-2017. PI qualitative part. (Total project 1.600.000 DKK) Transitions into and between A research project looking into the transitions for people with disability and ageing disability who age and for old people who gain a disability. We investigate the challenges for the individual as well as for the welfare state. PI. 2014-2017. Financed by VELUX (1.500.000 DKK) NORDCARE NORDCARE: Individualised care and universal welfare - Dilemmas in an era of marketization, increasing ethnic diversity and income inequality. Study of working environment and perceptions of professionalism in long term care, by means of survey among care workers. Led by Prof. Marta Szebehely, Stockholm University. Financed by FAS. PI for Danish study (2014-2017) (200.000 SEK). Care related quality of life for Quantitative ASCOT-investigation for the Elder Care residents in nursing homes Commission, 2012. PI. Financed by the Ministry of Social Affairs (2.500.000 DKK). Care related quality of life for Quantitative ASCOT-investigation for the Home Help recipients of home care Commission, 2012. Financed by the Ministry of Social Affairs, PI (1.500.000 DKK) New ageing (Ny aldring) Research projects investigating older peoples resources and needs on with the use of the Longitudinal Ageing Survey (Ældredatabasen), PI, 2012-14, financed by the Ministry of Social Affairs (800.000 DKK) LIVINDHOME Cross-national comparative analysis of drivers for reform changes in long-term care for older people in Europe for the Ministry of Health, France. PI. 2011(1.255.000 DKK). Care and ethnicity Research project about the implication of ethnicity in care work practices. PI, 2008-9. Financed by Helsefonden (1.600.000 DKK)
Selected scientific publications
Forthcoming: Gudny Eydal and Tine Rostgaard (eds.) ‘Handbook in Child and Family Policy’. Edward Elgar.
Forthcoming: Rostgaard, T. & Timonen, V. ‘Turning the problem into the solution: Hopes, trends and contradictions in home care for ageing populations in Europe’. In Thomas Boll; Dieter Ferring; Jaan Valsiner
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(eds.) Cultures of Care: Handbook of Cultural Geropsychology. Information Age Publishing, Advances in Cultural Psychology.
2015: Failing ageing? Risk management in the active ageing society, in Larsen, J.E, Frederiksen, M. and Bengtsson, T. (eds), in Risk and the modern welfare state - Sociological investigations of the Danish case, Palgrave MacMillan.
2015: Rostgaard, T. ‘Multiple strategies of quality improvement and integration – Motivations for migrant care work in Denmark’, in Karl, U. & Torres, S, (eds.) Ageing in contexts of migration, Routledge.
2014: Gíslason, I., Eydal, G, Rostgaard, T., Lammi-Taskula, J., Brandth, B. ‘Trends in parental leave in the Nordic countries: Has the forward march of gender equality halted?., Community, Work & Family, on-line version
2014: Eydal, G.B. & Rostgaard, T.,’ Introduction – Fatherhood Policies and Practices’, in Rostgaard, T. & Eydal, G.B.
(eds.).) Caring Fathers in the Nordic Welfare States - Policies and Practices of Contemporary Fatherhoods. Policy Press.
2014: Hakovirta, M., Haataja, A., Eydal, G.B. and Rostgaard, T. ‘Fathers’ rights to family cash benefits in Nordic countries, in Eydal, G. & Rostgaard, T. (eds.) Caring fathers in the Nordic welfare states - Policies and practices of contemporary fatherhoods . London: Policy Press.
2014: Rostgaard, T. & Møberg, R. ‘Fathering: the influence of ideational factors for male fertility behavior’, in Eydal, G. & Rostgaard, T. (eds.) Caring fathers in the Nordic welfare states - Policies and practices of contemporary fatherhood. London: Policy Press.
2014: Rostgaard, T. & Lausten, M. ‘Gender equality incentive policies and their consequences for men’s and women’s take up of parental leave in Denmark’, in Eydal, G. & Rostgaard, T. (eds.) Caring fathers in the Nordic welfare states - Policies and practices of contemporary fatherhoods . London: Policy Press.
2014: Leon, M., Ranzi, C. & Rostgaard, T., ‘Pressures towards and within universalism: Conceptualising change in care policy and discourse’, in Leon, M. (ed.) Care Regimes in Transitional European Societies, Palgrave Macmillan.
2014: León, M., Pavolini, E. & Rostgaard, T. Cross-national Variations in Care and Care as a Labour Market in Leon, M. (ed.) Care Regimes in Transitional European Societies, Palgrave Macmillan.
2014: Rostgaard, T. ‘Nordic care and care work in the public service model of Denmark: Ideational factors of change’, in Leon, M. (ed.) Care Regimes in Transitional European Societies, Palgrave Macmillan.
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Curriculum Vitae (abbreviated)
PERSONALIA: Name: Reidun Norvoll Address: Gjettumvn. 59, 1346 Gjettum e-mail: [email protected] mobil: + 47 98 24 51 45 Place and time of birth: Oslo, 24.11.1961
ONGOING PROJECTS (Some) Walking together with seniors: developing tools for increased paticipation of elderly in the community. Directorate of Health. Assisted Living: developing welfare technology for elderly through responsible research innovation. ELSA, Norwegian Council of Research Pilot Hadeland: Evaluation of two innovation- projects regarding everyday rehabilitation and welfare technology in the municipalites. A cluster randomized study on implementation of guidelines on family involvement during severe mental illness. HELSEVEL, Norwegian Council of Research, University of Oslo, Consortiumpartner/Work package leader. The role of next- of- kin in reducing and quality improve the use of coercion. National Centre for userbased knowledge in mental health. Mental health, ethics and coercion, Directorate of Health
EDUCATION: 2002- 2007 PhD in Sociology (Dr. polit), University of Oslo 1987-1994 Master in sociology (Cand. sociol), University of Oslo 1993-1994 Practical – pedagogic education, University of Oslo 1981-1984 Regular Nurse, Betanien College of Nursing
EMPLOYMENT: 2016 – Senior researcher, Research group on innovation and enterprise. Work Research Institute (AFI) Oslo and Akershus University College for Applied Sciences (HIOA). 2015- Guest Researcher, University of Central Lancashire (Uclan), 1 month. 2011- 2015 Post doc, Centre for Medical Ethics, Institute for Health and Society, University of Oslo. Project: Mental healthcare, ethics and coercion. 2011 – Senior Researcher, Work Research Institute (AFI) 2008- 2011 Associate professor, University College of South- Trøndelag (10 % employment) 2008- 2009 Ex.pat in Houston, USA, (Nov. 2008- July 2009) 2001-2009 Researcher, SINTEF Health. Research group on management, organization and collaboration in health services and Mental Health Services. 2000-2001 Researcher, Eastern Norway Research Institute (Østlandsforskning) 1996- 2000 Senior Lecturer in Medical sociology, health services and health politics. College of Deaconea and Nursing. 1996 Executive Officer, Ministry of Health and Social Affairs, Department of Health, Section for Municipal Health Services and Personell 1994-1996 Executive Officer, National Board of Health, Department for Specialist Health Services 1987-1992 Lecturer in Nursing, College of Deaconea and Nursing 1984-1987 Regular Nurse, Lovisenberg and Diakonhjemmet hospital.
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SUPERVISION: Co- supervisor for two PhD- students at University of Stavanger and HØEKH, Ahus. Supervisor for several master students in Sociology and sensor for others in the field of mental health. Second opponent in the public defence and Administrator of the assessment committee.
AWARDS AND NOMINATIONS 2016: Third Prize for the best review article of the year 2015, Journal of the Norwegian Medical Association. 2007: Nominated as one of the three best PhD- thesis of the year of the Council of Mental Health, to the funding Association of Health and Rehabilitation.
INTERNATIONAL PRESENTATIONS1
Norvoll, R. ‘Relational Damage? The Impact of Coercion on Family Relations.’ Part of international symposium: Newbigging, K, and J. Ridley et.al. ‘Service user and carer experiences of compulsion: International perspectives on coercion and human rights.’ 6th Qualitative Research in Mental Health Conference, Chania, May 2016 Norvoll, R. Developing insights in family on mental health policy from a Norwegian perspective. Guest Lecture, Research seminar, Uclan, UK, Sept. 30, 2015. Norvoll, R. Ethical challenges in mental health care in a family perspective. Referee to Key Note speaker Hilde Lindeman: ‘Facing health care from a family perspective.”. An international symposium. University of Oslo, Centre for Medical Ethics, June 5, 2015. Organizer of the symposium “Mental health and mental health care: family perspectives”, BSA Medical Sociology Group 46th Annual Conference, Aston University, Sept. 10-12, 2014 Norvoll, R. It depends on the relation - Coercion in a family perspective, BSA Medical Sociology Group 46th Annual Conference, Aston University, Sept. 10-12, 2014 Norvoll, R. Vårdkvalitet och tvång i psykiatrin ur ett patientperspektiv. Psykiatriskt forskningscentrum, Örebro, May 27, 2014. Norvoll, R., Hem, M.H. & Pedersen, R. Family members’ views on coercion and involvement in mental health care: some ethical dilemmas and challenges. ICCEC, Paris April, 2014
LIST OF PUBLICATIONS 2
Norvoll, R., Høiseth, J.R & D. Bjørgen (2017). «Både Og – God pårørendeinvolvering i et pasientperspektiv – med vekt på tvang». Report, Centre for medical ethics. Oslo: University of Oslo (Good involvement of next- of-kin – the patients’’ perspective, with a particular focus on coercion). Norvoll, R. & R. Pedersen (2017). Tvang og medvirkning i psykiske helsetjenester – pasienters og pårørendes syn og erfaringer. Ressurshefte fra prosjektet «Psykiske helsetjenester, etikk og tvang». Report. Centre for medical ethics. Oslo: University of Oslo (Coercion and participation in mental health care – patients’ and next- of- kin’ perspectives. Report from the project “Mental health care, ethics and coercion”). Skjeggestad, E., Norvoll, R., Sandal, G. & P. Gulbrandsen (2017). How do international medical graduates and colleagues perceive and deal with difficulties in everyday collaboration? A qualitative study. Scandinavian Journal of Public Health, 1–8, https://doi.org/10.1177/1403494817698286 Martinsen, E.H., Weimand, B., Pedersen, R. & R. Norvoll (2017). The silent world of young next of kin in mental health care. Nursing Ethics, /doi/10.1177/0969733017694498 Norvoll, R. and Pedersen, R. Patients’ moral views on coercion in mental healthcare. Nursing Ethics 1-2. 2016 Doi: 10.1177/0969733016674768 Norvoll, R., M.H. Hem and R. Pedersen. The Role of Ethics in Reducing and Improving the Quality of Coercion in Mental Health Care. HEC-Forum. doi: 10.1007/s10730-016-9312-1 Førde, R., Norvoll, R., Hem, M.H., Pedersen, R. Next of kin's experiences of involvement during involuntary hospitalisation and coercion. BMC Medical Ethics; Volume 17. (76), 2016 Norvoll, R. and R. Pedersen (2016). Exploring the views of people with mental health problems' on the concept of coercion: Towards a broader socio-ethical perspective. Social Science and Medicine. doi:10.1016/j.socscimed.2016.03.033 Norvoll, R.: Tvang. I: Levd Liv. Jubileumsantologi.. Skien: National Centre for userbased knowledge in mental health
1 Of relevance for the application 2 Of most relevance for the application 2
Skatvedt, A. & Norvoll, R. Hverdagsresponsivitet – et situasjonelt perspektiv på omsorgsarbeid og eldre med psykiske helseproblemer. I. Olsvold, N., Neumann, C. og T. Thagaard. Omsorgarbeidets sosiologi. Bergen: Fagbokforlaget (‘Responsiveness in everyday life – a situational perspective on care work for elderly people with mental health problems.’ In: A Sociology of Care Work. ) Bjørgen, D., Norvoll, R. Husum, T. L. (2015). Hvordan forebygge tvang? Chronicle. Tidsskrift for Norsk Psykologforening. 52 (12): 1076-1079. (‘How to prevent the use of coercion’, Journal of the Norwegian Psychological Association). Norvoll, R., Ruud, T & Hynnekleiv, T. (2015). Skjerming i akuttpsykiatrien. Vitenskapelig oversiktsartikkel. Tidsskrift for norsk legeforening. doi: 10.4045/tidsskr.14.0124 (‘Use of seclusion in acute psychiatry. A review of the literature’, Journal of the Norwegian Medical Association) Olsø, T., Almvik, A. & Norvoll, R. (2014). Hjelpsomme relasjoner. En kvalitativ undersøkelse av samarbeidet mellom brukere med alvorlige psykiske lidelser og rusproblemer og fagpersoner i to oppsøkende team. Nordisk tidsskrift for helseforskning 10 (2): 121-131. (‘Helpful relations. A qualitative study of the collaborations between service users with serious mental health and substance abuse problems and professionals in two outreach teams’. Nordic Journal of Health Research) Hem, M.H., Pedersen, R., Norvoll, R. & Molewijk, B. Evaluating clinical ethics support in mental health care – a systematic literature review. Nursing Ethics. August 2014, 10.1177/0969733014539783. Bjørgen, D., Slagvold, A, Norvoll, R. & Husum, T.L. ‘Alternativer til tvang i et bruker- og fagperspektiv. Ressurshefte.’ Erfaringskompetanse 2014:2. Skien: National Centre for userbased knowledge in mental health (Alternatives to coercion in a user- and professional perspective: A service user involved project) Husum, T.L. & Norvoll, R. ‘Alternativer til tvang i et fag- og forskningsperspektiv. Underhefte.’ Erfaringskompetanse 2014:2: Skien: National Centre for userbased knowledge in mental health. Norvoll, R. (2013) ‘Norway’. In: Samele, C., Frew, S. & Urquía, N. (eds.).’ Mental health Systems in the European Union Member States, Status of Mental Health in Populations and Benefits to be Expected from Investments into Mental Health European Profile of Prevention and Promotion of Mental Health (EuroPoPP-MH).’ Main Report. Chapter. 4.21. pp. 354-368. Nottingham: The Institute of Mental Health Nottingham Norvoll, R. (red). ‘Samfunn og psykisk helse. Samfunnsvitenskapelige perspektiver.’ Oslo: Gyldendal Akademisk. (Norvoll, R. (eds.) Society and Mental health. Social Science Perspectives.) Chapters: o Norvoll, R. Samfunnsfagenes bidrag til kunnskap om psykisk helse og psykiske helsetjenester. Kap. 1: 13-36. (The contribution of social sciences to the field of mental health) o Norvoll, R. Samfunnsvitenskapelige perspektiver på psykisk helse og psykiske helsetjenester. Kap. 2: 37-72 (Social science perspectives on mental health and mental health care) o Øye, C. og Norvoll, R. Psykisk helsearbeid i et makt- og kontrollperspektiv. Kap. 3:73-97 (Mental health care in a power- and social control perspective) o Elstad, T. og Norvoll, R. Sosial eksklusjon og inklusjon, Kap. 5: 118-148 (Social exclusion and inclusion) o Norvoll, R. Fremtidige utfordringer for det psykiske helsefeltet og den samfunnsvitenskapelige forskningen. Kap. 12: 313- 321 (Future challenges in the field of mental health and social science research)
Norvoll, R. (2012). Idealer og realiteter i dagens psykiatriske akuttposter. I: Tjora, A. (red).’Helsesosiologi. Oslo: Gyldendal akademiske forlag. (Ideals and realities in today’s acute wards. The historical tension between treatment and control in psychiatric hospitals. Chapter In: ‘Health Sociology’) Norvoll, R. & Husum, T.L. (2011). ‘Som natt og dag? Om forskjeller i forståelse mellom misfornøyde brukere og ansatte om bruk av tvang.’ AFI-notat 2011:9. Oslo: AFI-WRI (Work Research Institute) (As night and day? Differences in perspectives about coercion between staff and dissatisfied users) Norvoll, R. ‘Jeg vil ikke stå utenfor - Arbeid og utdanning sett med brukernes øyne.’ AFI- Notat 2011:10. Oslo: AFI-WRI (Work and education as seen from the service users perspectives) Norvoll, R. Kunnskapsstatus med hensyn til skadevirkninger av tvang i det psykiske helsevernet. In: NOU 2011: 9 Økt selvbestemmelse og rettssikkerhet). (Traumatic and adverse effects of coercion – a literature review. Attachment Green Paper) Almvik, A., Sagsveen, E., Olsø, T., Westerlund, H., Norvoll, R. (2011).” Å lage farger på livet til folk”. God hjelp til personer med rusproblemer og psykiske lidelser i ambulante team. Tidsskrift for psykisk helse. , nr.2, 154-163 (‘Helpful services to people with serious mental health - and substance abuse problems through outreach teams’). Norvoll, R. & Fossestøl, K. (2010). ‘Funksjonshemmede og arbeid. En kunnskapsstatus.’ AFI-notat 13/2010. Oslo: AFI -WRI (Disability and work. A literature rewiev.)
Two research-reports about implementing interventions aiming to reduce the use of coercion in acute psychiatric wards: Norvoll, R., Hatling, T. & Hem, K-M (2008). ‘Det er nå det begynner! Hovedrapport fra prosjektet: ”Brukerorienterte alternativer til tvang” (BAT).’ Rapport A8450, Trondheim: SINTEF Helse Norvoll, R. (2008). ‘Delrapport 1. Brukerorienterte alternativer til tvang i sykehus. En presentasjon av internasjonal og nasjonal litteratur.’ SINTEF A4572. Trondheim: SINTEF Helse
Norvoll, R. (2007). Det lukkede rom. Thesis. Department of Sociology and Human geography, University of Oslo. (Monography in Norwegian. An ethnographic study of seclusion in psychiatric acute wards).
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IDA DRANGE Date of birth: 23th of July 1981 ______
Oslo and Akershus University of Applied Sciences, Centre for Welfare and Labour Studies Work Research Institute Stensbergsgata 26, Post box 4, St. Olavs plass 0130 Oslo Norway
E-mail: [email protected]
Education
2008 - 2013 PhD in Professional studies. “A Study of Labour Market Careers for Professionals of Ethnic Minority Origin”. Oslo and Akershus University College of Applied Sciences.
2004 - 2007 Master of Philosophy in Sociology, University of Oslo
2001 – 2003 Bachelor of Philosophy in Sociology, University of Oslo
Academic positions
2013 – Senior Researcher, Oslo and Akershus University of Applied Sciences/Work Research Institute
2012 – 2013 Senior Researcher, Centre for the Study of Professions, Oslo and Akershus University of Applied Sciences. 10 % position.
2012 Research visit at Institutions, Inequalities and Internationalisation (AISSR), Universiteit van Amsterdam, 3 months. Host: Professor Herman van de Werfhorst
2007 – 2012 Researcher (social scientist), Work Research Institute AS (Leave of absence: Aug. 2008 – Aug. 2012)
2008 – 2012 PhD fellow, Oslo and Akershus University College of Applied Sciences
2007 Research assistant, Atferdssenteret AS
2006 – 2007 Master’s degree fellow, CULCOM. University of Oslo
Selected projects
- Income Inequality in Professional and Vocational Occupations. Project manager. Financed by the VAM programme, The Norwegian Research Council, 2014-2017 (4 999’ NOK).
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- Diversity in Academia. Financed by KIF-Komiteen, 2016. (495’ NOK) - A research review of diversity management. Project manager. Financed by Virke, 2014 (200’ NOK) - A research review of labour market participation among immigrant women. Financed by the VAM programme, The Norwegian Research Council, 2015 (108’ NOK) - Part-time in the Nordic region ii: A research review on important reasons. Financed by NIKK, The Nordic Council of Ministers, 2014 (1 400’ NOK) - A research review about interdisciplinary collaboration in schools. Financed by the Norwegian Directorate for Education and Training, 2014 (6 000’ NOK) - Attrition from the health occupations. Project manager. Financed by the Norwegian Directorate of Labour and Welfare, 2015 (400’ NOK) - Evaluation of the Norwegian pension reform. Financed by the EVAPEN programme, The Norwegian Research Council, 2014-2015 (3 000’ NOK) - Causes and consequences of part-time work. Financed by Spekter, 2014 (700’ NOK)
Recent Publications Bol, Thijs and Ida Drange (2016). Occupational closure and wages in Norway. Acta Sociologica. Online first, 1-22.
Drange, Ida and Hilde Johanne Karlsen (2016). Simply a matter of being male? Nurses’ employment outcomes in the Norwegian labour market. Nora. 24(2), 76-94.
Alecu, Andreea Ioana and Ida Drange (2016). Hvilken betydning har yrkesreguleringer for yrkesmobilitet i Norge? [Assessing the role of licensure and certifications for occupational mobility in Norway] Søkelys på arbeidslivet. 33(01-02), 101-121.
Egeland, Cathrine and Drange, Ida (2016). Å ta ansvar - deltidsvalgets ideologiske dimensjon. Begrunnelser for deltidsvalg i Norge [To take responsibility – the ideological dimensjon of part-time work] in Sigtona Halrynjo and Mari Teigen (Eds.), Ulik likestilling i arbeidslivet [Unequal equality in working life], p. 122-141. Oslo: Gyldendal Akademisk
Hagen, Aina Landsverk og Ida Drange (2015). Ytringsskader, sårbarhet og sosial «skamming»: Journalisters erfaringer med hatytringer i norsk offentlighet. [Speech-injuries, vulnerability and social shaming: Journalists' experiences with hate speech in the Norwegian public sphere] Sosiologi i dag. 45(4), 90-114.
Bergene, Ann Cecilie og Ida Drange (2015) "Pensjon? Hvafforno" Kunnskap og Informasjonsbehov om pensjon. [«Pension? What? Knowledge and need for information on pensions.] Søkelys på arbeidslivet. 32(3), 261-278.
Drange, Ida (2014): Degrees of Closure and Labour Market Success: Field of study and non-Western immigrant performance. Journal of Education and Work. 29(4), 402-426,
Abrahamsen, Bente and Ida Drange (2014): Career expectations among ethnic minority students: Navigating between ambition and discrimination. Sociology. 49(2), 252 - 269
Drange, Ida and André Vågan (2013): Stratification in the medical profession: non-western physicians in Norway. Professions and Professionalism, 3(1), 1-21.
Drange, Ida (2013): Early-career Income Trajectories among Physicians and Dentists: The Significance of Ethnicity. European Sociological Review, vol. 29(2): 346-358.
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Technical reports Maximova-Mentzoni, Tatiana, Cathrine Egeland, Ida Drange, Tanja Askvik, Liv-Anne Støren, Trude Røsdal and Agnete Vabø (2016). 'Being a foreigner is no advantage', Career paths and barriers for immigrants in Norwegian academia. 88 p. The Work Research Institute (AFI).
Orupabo, Julia and Ida Drange (2015). Kvinner med innvandringsbakgrunn i arbeidsmarkedet. Effekter av stønader og tiltak for arbeidsmarkedstilknytning. [Women with immgrant origin in the labour market. The effects of benefits and measures for labour market attachtment]. 42 p. The Norwegian Research Council.
Drange, Ida (2015). Drivkrefter bak avgang og arbeidsfastholdelse. Hvilke faktorer forklarer yrkesavgang blant ansatte i helsetjenesten og i pleie- og omsorgstjenestene. [Forces behind attrition and retention of workers? Which factors explain occupational attrition among workers in the health and caring service?]. 61 p. The Work Research Institute (AFI).
Drange, Ida, Frøyland, Kjetil, Mamelund, Svenn-Erik (2015). Unge mottakere av tiltakspenger. Om betydningen av tiltakspenger for gjennomføring av utdanning og overgang til arbeid. [Young recipients of cash benefits. The consequence of benefits for education and the transition to work]. 61 p. The Work Research Institute (AFI).
Egeland, Cathrine, Drange, Ida (2014). Part-Time Work in the Nordic Region II: A research review on important reasons. 162 p. Nordic Council of Ministers.
Borg, Elin, Drange, Ida, Fossestøl, Knut, Jarning, Harald (2014). Et lag rundt læreren. En kunnskapsoversikt. [A layer around the teacher. A research review]. 163 s. Arbeidsforskningsinstituttet.
Egeland, Cathrine, Drange, Ida (2014). Frivillig deltid - kun et spørsmål om tid? [Voluntary part-time work - just a question about time?]. 74 p. The Work Research Institute (AFI).
Drange, Ida (2014). Mangfoldsledelse. En kunnskapsoversikt. [Diversity management. A research review]. 64 p. The Work Research Institute (AFI).
Recent Conferences and Workshops
2016 "What is the consequence of occupational closure for non-Western immigrants’ earnings?" Occupations, skills and the labour market. Zentrum für Europäische Wirtschaftsforschung. Mannheim, Germany. 2016 "A Study of How Labour Market Institutions Affect within- and Between Occupation Wage Inequalities in Norway in the Period from 2003-2014". ISA World Forum. International Sociological Association. Vienna, Austria. 2016 "Barriers to Access? Immigrant origin and occupational attainment". Nordic Migration Research Conference. Oslo, Norway. 2015 "Occupational closure and wage inequality in Norway". European Consortium for Sociological Research. Tallinn, Estonia. 2015 "Are you moving up, or falling out? Self-perceived employability among Norwegian employees2. WORK 2015. Turku, Finland.
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Organisation of Scientific Meetings
2016 Coordinator. Workshop on occupational regulations. 2016 Session Leader Nordic Migration Research
Commission of trust
2015 - Editor for the Nordic Journal of Working Life Studies. 2017 - Editor for the Norwegian Journal of Sociology, the special issues section.
Teaching and supervision
2015- Second advisor. PhD-thesis of Else Marie Johansen. Faculty of Education and International studies. Oslo and Akershus University of Applied Sciences.
2014 - Second advisor. PhD-thesis of Karl-Ingar Kittelsen Røberg. Centre for the Study of Professions. Oslo and Akershus University of Applied Sciences.
2012 – 2015 Seminar leader in quantitative methods for bachelor and master’s students, University of Oslo
Post-graduate training in quantitative methods
2014 Pooled Time-Series Cross-Sectional Analysis. 2-week course. Essex Summer School of Social Science Data Analysis
Advanced Quantitative Data Analysis. 2-week course. Essex Summer School of Social Science Data Analysis
2013 Introduction to Multilevel models. 1-week course. Vienna Winter School of Social Science Data Analysis.
2011 Introduction to Duration Models. 2-week course. Essex Summer School of Social Science Data Analysis. Grade: Pass
2011 Intermediate programming in Stata. 1-week course. Essex Summer School of Social Science Data Analysis.
2009 Introduction to Panel Data Analysis. 2-week course. Essex Summer School of Social Science Data Analysis. Grade: Pass with distinction
2008 Regression Analysis with Categorical Dependent Variables, University of Oslo
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CV Oddvar Førland
Date of birth: February 5th 1962
E-mail: [email protected]
Address: Box 7030, 5020 Bergen
Current positions:
1. Senior researcher 50 %: Centre for Care Research – Western Norway, University of Applied Sciences and supported by a grant from the Norwegian Research Council. Since 2014. 2. Research advisor 50 % for the Centres for Development of Institutional and Home Care Services in Western Norway, on behalf of Centre for Care Research – Western Norway. Since 2010. 3. Associate professor 20 %, VID Specialized University. Since 2010.
Previous positions:
2012-2014: Co-director, Centre for Care Research – Western Norway, hosted by Bergen University College and financed by the Norwegian Research Council.
2006-2012: Researcher, Sociologist. Part-time post at Uni Research Health, National Centre for Emergency Primary Health Care.
1992-2010: University college teacher, assistant professor and associate professor. Full-time positions at Haraldsplass Deaconess University College.
1986-1992: Different full-time positions as registered nurse and leader in home care services in municipalities and in mental health care.
Education:
Nursing education (bachelor) (1986), sociology hovedfag (1998), philosophy of science (2006).
Areas of interest:
Public organization and service development, dissemination and implementation of reforms and new knowledge, health services research, municipal care services, rehabilitation services, user involvement, family carers, voluntary sector, medical sociology, professionalism and trust studies.
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Selected list of publications last four years:
2017: 1. Hjelle, K. M., Alvsvåg, H., & Førland, O. (2017). The relatives' voice: how do relatives experience participation in reablement? A qualitative study. Journal of Multidisciplinary Healthcare, 10, 1-11. doi:10.2147/jmdh.s122385 https://www.dovepress.com/the-relativesrsquo-voice-how-do-relatives-experience-participation-in--peer-reviewed- fulltext-article-JMDH * 2. Tuntland, H., Kjeken, I., Langeland, E., Folkestad, B., Espehaug, B., Førland, O., & Aaslund, M. K. (2017). Predictors of outcomes following reablement in community-dwelling older adults. Clinical interventions in aging, 12, 55-63. doi:10.2147/cia.s125762. https://www.dovepress.com/predictors-of-outcomes-following-reablement-in-community- dwelling-olde-peer-reviewed-fulltext-article-CIA * 3. Birkeland, A., Førland, O., Tuntland, H., Jakobsen, F.F. & Langeland, E. (2017): Interdisciplinary collaboration in reablement – a qualitative study. Journal of Multidisciplinary Healthcare. 2017:10, 1-9. *
2016: 1. Øye, C., Mekki, T. E., Jacobsen, F. F., & Førland, O. (2016). Facilitating change from a distance – a story of success? A discussion on leaders' styles in facilitating change in four nursing homes in Norway. Journal of Nursing Management. http://dx.doi.org/10.1111/jonm.12378 2. Hjelle, K. M., Tuntland, H., Førland, O., & Alvsvåg, H. (2016). Driving forces for home-based reablement; a qualitative study of older adults’ experiences. Health & Social Care in the Community. http://dx.doi.org/10.1111/hsc.12324 3. Hjelle, K. M., Skutle, O., Førland, O. & Alvsvåg, H.: The reablement team`s voice: A qualitative study of how an integrated multidisciplinary team experiences participation in reablement. Journal of Multidisciplinary Healthcare. Volume 9, 2016 4. Førland, O., & Folkestad, B. (2016). Hjemmetjenestene i Norge i et befolknings- og brukerperspektiv. En populasjonsstudie basert på innbyggerundersøkelsene fra 2010, 2013 og 2015. Senter for omsorgsforskning – Rapportserie. [Home care services]. Nr.1/2016. doi:http://hdl.handle.net/11250/2425093. https://brage.bibsys.no/xmlui/bitstream/handle/11250/2425093/SOF_1-2016_per0712.pdf?sequence=1&isAllowed=y 5. Sjøbø, Bjørg Aspenes, Teigen, Sønneve, Alvsvåg, Herdis og Førland, Oddvar (2016): Hvilken betydning har forebyggende hjemmebesøk? En kvalitativ studie av eldre menneskers erfaringer [Preventive home visits]. Tidsskrift for omsorgsforskning nr. 1/2016. https://www.idunn.no/tidsskrift_for_omsorgsforskning/2016/01/hvilken_betydning_har_forebyggende_hjemmebeso ek_-_en_kvalit 6. Førland, O., & Skumsnes, R. (2016). Hverdagsrehabilitering. En oppsummering av kunnskap [Reablement]. Omsorgsbiblioteket. Sentrene for omsorgsforskning: file:///C:/Users/ofr/Downloads/Hverdagsrehabilitering%20(3).pdf 7. Langeland E, Førland O, Aas E, Birkeland A, Folkestad B, Kjeken I, Jacobsen, F.F., Tuntland, H. (2016): Modeller for og effekter av hverdagsrehabilitering. En følgeevaluering i norske kommuner. Effekter for brukerne og gevinster for kommunene? [Reablement]. Senter for omsorgsforskning, rapportserie; 6/16. https://brage.bibsys.no/xmlui/bitstream/handle/11250/2389813/1/Rapport6_16_web.pdf 8. Førland, O. (2016): Legevakten som samfunnsinstitusjon [Emergency Care and Out of Hours Service]. I: Hansen, E. H. og Hunskår, S. (red.): Legevaktarbeid. En innføringsbok for leger og sykepleiere. Side 20-24. Oslo, Gyldendal akademiske: http://www.gyldendal.no/Faglitteratur/Medisin/Laereboeker/Legevaktarbeid 9. Førland, O. (2016): Pasienterfaringer og brukerundersøkelser som kilder til læring [Patients satisfaction surveys]. I: Hansen, E. H. og Hunskår, S. (red.): Legevaktarbeid. En innføringsbok for leger og sykepleiere. Side 265-272. Oslo, Gyldendal akademiske: http://www.gyldendal.no/Faglitteratur/Medisin/Laereboeker/Legevaktarbeid
2015: 1. Tuntland, H., Aaslund, M., Espehaug, B., Førland, O., & Kjeken, I. (2015). Reablement in community-dwelling older adults: a randomised controlled trial. BMC Geriatr, 15(1), 145: http://www.biomedcentral.com/1471-2318/15/145 2. Langeland, E., Tuntland, H., Førland, O., Aas, E., Folkestad, B., Jacobsen, F., & Kjeken, I. (2015). Study protocol for a multicenter investigation of reablement in Norway. BMC Geriatr, 15(1), 111. http://www.biomedcentral.com/1471- 2318/15/111 3. Dale, Bjørg, Folkestad, Bjarte, Førland, Oddvar, Hellesø, Ragnhild, Moe, Aud, & Sogstad, Maren (2015). Er tjenestene fortsatt «på strekk»? Om utviklingstrekk i helse- og omsorgstjenestene i kommunene fra 2003 til 2015. Senter for omsorgsforskning rapportserie nr.10/2015. http://hdl.handle.net/11250/2375415 http://hdl.handle.net/11250/2375415 4. Førland, Oddvar, Skumsnes, Randi, Teigen, Sønneve, Folkestad, Bjarte (2015): Forebyggende hjemmebesøk til eldre. Utbredelse, diffusjonsprosesser og spredning. Tidsskrift for omsorgsforskning nr. 2/2015. https://www.idunn.no/tidsskrift_for_omsorgsforskning/2015/02/forebyggende_hjemmebesoek_til_eldre_utbredelse_ diffusjons-
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5. Øye, Christine; Mekki, Tone Elin; Skår, Randi; Dahl, Hellen; Førland, Oddvar; Jacobsen, Frode F. (2015): Evidence Molded by Contact with Staff Culture and Patient Milieu: an Analysis of the Social Process of Knowledge Utilization in Nursing Homes. Vocations and Learning 2015;Volum 8. http://link.springer.com/article/10.1007%2Fs12186-015-9135- 2 6. Testad, I., Mekki, T. E., Forland, O., Oye, C., Tveit, E. M., Jacobsen, F., & Kirkevold, O. (2015): Modeling and evaluating evidence-based continuing education program in nursing home dementia care (MEDCED)-training of care home staff to reduce use of restraint in care home residents with dementia. A cluster randomized controlled trial. Int J Geriatr Psychiatry. http://onlinelibrary.wiley.com/doi/10.1002/gps.4285/abstract;jsessionid=EAA8E1A1713291E21248D35664BC0EF0.f03 t02 7. Kvalheim, Anne, Bjørnethun, Åshild, Bergflødt, Trond Eirik, Mekki, Tone Elin og Førland, Oddvar (2015): Trygger eldre som skrives ut av sykehus. Sykepleien nr. 08 2015. file:///C:/Users/ofr/Downloads/trygger_eldre_som_skrives_ut_av_sykehus.pdf 8. Skumsnes, R., Teigen, S., Alvsvåg, H., & Førland, O. (2015). Forebyggende hjemmebesøk til eldre. Idehåndbok med anbefalinger. Utviklingssentrene for sykehjem og hjemmetjenester på Vestlandet og Senter for omsorgsforskning Vest. http://idehandbok_eldre.stavanger.kommune.no/files/assets/common/downloads/publication.pdf 9. Førland, Oddvar (2015). Oppsummering av litteraturen om frivillig innsats og samspillet med offentlige omsorgstjenester. I: L. H. Jensen (Red.), Frivillighet i omsorgssektoren. Forlaget Aldring og helse. 10. Førland, Oddvar (2015). Hva er frivillig innsats i omsorgssektoren? I: L. H. Jensen (Red.), Frivillighet i omsorgssektoren. Forlaget Aldring og helse. 11. Jensen, Liv Helene, & Førland, Oddvar. (2015). Kjernepunkter i samarbeidet med frivillige i omsorgssektoren. I: L. H. Jensen (Red.), Frivillighet i omsorgssektoren. Forlaget Aldring og helse. 2014: 1. Førland, Oddvar og Skumsnes, Randi: Forebyggende hjemmebesøk til eldre i Norge. Resultater fra en landsomfattende kommuneundersøkelse. Senter for omsorgsforskning – Rapportserie nr. 7/2014. http://brage.bibsys.no/xmlui/bitstream/handle/11250/217477/1/Rapport7_14_web.pdf 2. Tuntland, Hanne; Espehaug, Birgitte; Førland, Oddvar; Hole, Astri Drange; Kjerstad, Egil; Kjeken, Ingvild (2014): Reablement in community-dwelling adults: study protocol for a randomised controlled trial. BMC Geriatrics 2014 ; Volum 14.(139): http://www.biomedcentral.com/1471-2318/14/139 3. Førland, Oddvar (2014): Fagutvikling og praksisutvikling i kommunale helse- og omsorgstjenester. I: Haugan, Gøril og Rannestad Toril (red): Helsefremming i kommunehelsetjenesten. Oslo, Cappelen Akademiske Forlag. https://www.cappelendammundervisning.no/vare/helsefremming-i-kommunehelsetjenesten-9788202436582 4. Førland, Oddvar (2014): Rommets gavmildhet og omsorgen. I: Alvsvåg, Herdis, Førland, Oddvar & Jacobsen, Frode F. (red.). Rom for omsorg? Bergen: Fagbokforlaget. 5. Alvsvåg, Herdis, Førland, Oddvar & Jacobsen, Frode F. (red.). 2014: Rom for omsorg? Bergen: Fagbokforlaget. https://fagbokforlaget.no/?isbn=9788245016031 6. Alvsvåg, Herdis, Førland, Oddvar & Jacobsen, Frode F. (2014): Rom, ting og medmennesker – en innledning. I: Alvsvåg, Herdis, Førland, Oddvar & Jacobsen, Frode F. (red.). Rom for omsorg? Bergen: Fagbokforlaget. 7. Cappelen, Kathrine, Disch, Per Gunnar og Førland, Oddvar (2014): Forskning for bedre kommunale helse- og omsorgstjenester. En håndbok om hvordan kommunene kan medvirke og tilrettelegge for forskning: https://www.regjeringen.no/contentassets/6f87afa79de242d28c613b682885e814/forskningshandbok_240414.pdf
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C.V. (short)
Name Christine Øye, født 15.11.1966. Current position Professor at Centre for Care Research – Western Norway e-mail [email protected]
Education
* 2009 Philosophiae Doctor (PhD), University of Bergen, Norway * 1995 Cand. Polit.-grad. fra Universitetet i Bergen, med hovedfag i sosial antropologi * 1990 Cand. mag.-grad. tildelt på Universitetet i Bergen
Publications
*Ågotnes, G. & Øye, C. (2017). "Facilitating resident community in nursing homes; a slippery slope? An analysis on collectivistic and individualistic approaches", Health, in press *Mekki, T.E., Øye, C., Kristensen, B., B., Dahl. H., Håland, A., Nordin, K.,M., A., Strandos, M., Terum, T.M., Ydstebø, A-E., & McCormack, B. (2017). The impact of context and facilitation on an education intervention to reduce restraint and agitation in nursing homes, Journal of Advanced Nursing, in press *Øye, C., Jacobsen, F. F & Mekki, T.E. (2016). Do organizational constraints explain the use of restraint? A comparative ethnographic study from three nursing homes in Norway, Journal of clinical nursing, DOI: 10.1111/jocn.13504, in press *Øye, C., Mekki, T.E., Jacobsen, F.F, & Førland, O. (2016). Facilitating change from a distance - as story of success? A discussion on leaders` styles in facilitating change in four nursing homes in Norway, Journal of nursing management, DOI: 10.1111/jonm.12378 *Øye, Stine; Mekki, Tone E.; Skår, Randi; Dahl, Hellen; Førland, Oddvar & Jacobsen, Frode F. (2015). Evidence Molded by Contact with Staff Culture and Patient Milieu: an Analysis of the Social Process of Knowledge Utilization in Nursing Homes. Vocations and Learning, 8 (3): 319- 334, DOI: 10.1007/s12186-015-9135-2 *Øye, C. (2015). Frivillighet og tvang i sykehjem – to sider av samme sak? Michael – Publication Series of The Norwegian Medical Society, 12 (2): 167-179. http://michaelquarterly.no/ *Glasdam, S. Oeye, C. & Thrysoee, L. (2015). Patients’ participation in decision-making in the medical field – ’projectification’ of patients in a neoliberal framed healthcare system, Nursing philosophy, 16(4): 226-238, DOI: 110.1111/nup.12092 *Testad, I., Mekki, T.E., Forland, O., Oeye, C., Tveit, E-M., Jacobsen, F. & Kirkevold, Ø. (2015). Modelling and evaluating eviDence based continuing education program in nursing home dementia care (MEDCED). Training of care home staff to reduce use of restraint in care home residents with dementia. A cluster randomized controlled trial, International journal of geriatric psychiatry, DOI: 10.1002/gps.4285. *Oeye, C., Soerensen, N.O. & Glasdam, S. (2015). Qualitative research ethics on the spot: Not only at the desktop, Nursing ethics, 1-10, DOI: 10.1177/0969733014567023 *Øye, C. (2014). Omsorg for den offentlige sfære – betraktninger om frivillighet og tvang i lys av Hannah Arendts tanker om frihet og handling, I: (red.), H. Alvsvåg, O. Førland, & F.F. Jacobsen, Rom for Omsorg?, Bergen: Fagbokforlaget. *Glasdam, S. & Øye, C. (2014). Alcohol abuse in cancer patients: A shadow side in the
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oncological field and research, Medicine, Health care and Philosophy, 17(3); 437-446. *Øye, C. & Bjelland, A.K. (2012). Deltagende observasjon i fare? En vurdering av noen forskningsetiske retningslinjer og godkjenningsprosedyrer, Norsk antropologisk Tidsskrift, 23(2);143-156. *Øye, C. & Skorpen, A. (2010). Miljøterapi som kollektivt eller individrettet fenomen? En etnografisk studie av dagliglivet i et psykiatrisk sykehus i individualismens tidsalder, Vård i Norden, nr. 3, s.25-30. *Øye, C. (2010). Omsorgens vilkår: Om gaver og tjenester som del av relasjonsdannelse i institusjonspsykiatrien når brukermedvirkning skal vektlegges, Michael – Publication Series of The Norwegian Medical Society,, 7; 218-33. http://www.dnms.no/index.php?seks_id=80562&a=1 *Øye, C. & Skorpen, A. (2009). Dagliglivet i en psykiatrisk institusjon. En analyse av miljøterapeutiske praksiser [Daily life in a psychiatric hospital: An analysis of the practices of milieu therapy]. Dissertation for the degree Philosophiae Doctor (PhD), University of Bergen, Norway *Oeye, C. Bjelland, A.K. Skorpen, A. & Anderssen, N. (2009). Raising adults as children? A report on milieu therapy in a psychiatric ward in Norway, Issues in Mental Health Nursing, 30(3), 151-158. *Oeye, C. Bjelland, A.K. Skorpen, A. & Anderssen, N. (2009). User participation when using milieu therapy in a psychiatric hospital in Norway – a mission impossible?, Nursing Inquiry, 16(4), 287-296. *Skorpen, A. Anderssen, N. Øye, C. & Bjelland, A.K. (2009). Treatment regimes in a psychiatric hospital apparent contradictions? Report from field work in a locked-up ward illustrated with a constructed case, International Journal of Mental Health Nursing. 18(6), 409- 416. * Øye, C. & Skorpen, A. (2009). Kjennskapens ritus - Fra Tukes te-selskap til fredagskos i et psykiatrisk sykehus, Tidsskrift for samfunnsforskning, 50(3), 267-292. * Skorpen, A. Anderssen, N. Øye, C. & Bjelland, A.K. (2008). Brukerperspektiv i norsk forskning om innlagte psykiatriske pasienter. En litteraturgjennomgang, Vård i Norden, 28(4), 19-23. * Skorpen, A. Anderssen, N. Oeye, C. & Bjelland, A-K. (2008). The smoking room as psychiatric patients` sanctuary: A place for resistance, Journal of Psychiatric and mental health nursing,15(9), 728-736. *Oeye, C. Bjelland, A.K & Skorpen, A. (2007). Doing participant observation in a psychiatric hospital – Research ethics resumed, Social Science & Medicine, 65(11), 2296-2306.
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Kort CV Maria Romøren
Legejobb
2000 Cand. Med. 2001-2003 Turnustjeneste 2003 Autorisasjon som lege 2003- Fastlegevikar i ulike stillingsbrøker, pt. 40% stilling ved Nøtterøy legesenter.
Vitenskapelig arbeid
2000-2008 Doktorgradsarbeid (delvis fulltid og delvis gradert, avbrutt av 1.5 år i turnustjeneste og fødselspermisjon i 2004 og 2007).
Juni 2009 Disputas
“Improving the magagement of sexually transmitted infections among pregnant women in sub-Saharan Africa.”
2009-2010 Universitetslektor 50%
2010-2016 Postdoktor stipend (3 år full tid fordelt over 6 år) Finansiering Helse Sør-øst, ansatt ved Sykehuset i Vestfold
”Intravenøs behandling ved infeksjoner hos sykehjemspasienter i Vestfold (3IV)”
Intravenøsprosjektets hovedmål er å evaluere om sykehjemsbeboere som trenger intravenøs væske eller antibiotika kan behandles like godt eller bedre på sykehjemmet som på sykehus. Intervensjonen, et strukturert opplæringsprogram i intravenøs behandling av dehydrering og infeksjoner i sykehjem, ble gjennomført ved 30 av 34 sykehjem i Vestfold fylke fra november 2009-desember 2011. Vi ser blant annet på om opplæringen kan føre til redusert antall innleggelser og liggedøgn i sykehus blant sykehjemsbeboere og om behandling med intravenøs væske eller antibiotika lokalt kan gi et like godt eller bedre pasientforløp. Vi har også en stor studie på etiske aspekter ved livsforlengende behandling basert på fokusgruppeintervjuer med sykehjems- og sykehusleger.
2012- Forsker ved Allmennmedisinsk forskningsenhet (20-50% stilling)
Relevante publikasjoner
Romøren, Gjelstad, Lindbæk (2017) A Structured Training Program in Intravenous Treatment with Fluids and Antibiotics in Nursing Homes: A Stepped-Wedge Cluster-Randomised Trial to Reduce Hospital Admissions. Forthcoming
Klomstad, Pedersen, Romøren (2016) Involvement in decisions about intravenous treatment for nursing home patients: Nursing homes versus hospital wards. Submitted to BMC Medical Ethics (nov2016).
Nyborg, Straand, Brekke, Gjelstad, Romøren (2017) Potentially inappropriate medication use in nursing homes according to submitted to BMC Medical Geriatrics
Romøren, Maria; Førde, Reidun & Pedersen, Reidar (2016). Én pasient – to verdener. Sykehjemsleger og sykehuslegers beskrivelser av samhandling om alvorlig syke sykehjemspasienter. Tidsskrift for Den norske legeforening. 2017; 137:193-7.
Romøren, Maria; Pedersen, Reidar & Førde, Reidun (2016). How do nursing home doctors involve patients and next of kin in end-of-life decisions? A qualitative study from Norway . BMC Medical Ethics. ISSN 1472-6939. 17 (1). doi: 10.1186/s12910-016-0088-2
Fagan, Mark Stephan; Lindbæk, Morten; Grude, Nils; Reiso, Harald; Romøren, Maria, Skaare, Dagfinn; Berild, Dag. (2015) Antibiotic resistance patterns of bacteria causing urinary tract infections in the elderly living in nursing homes versus the elderly living at home: an observational study. BMC Geriatrics Volum 15.
Horntvedt May-Elin T, Romøren Maria, Solvoll Betty-Ann. Ethical problems related to intravenous fluids in nursing homes. Nurs Ethics 2014 Dec;21(8):890-901. Epub 2014 mar 18
Anbefalte paneldeltakere:
Dosent Lena Lindgren
Förvaltningshögskolan Göteborgs universitet [email protected]
Professor Mark Exworthy
Health Services Management Centre, University of Birmingham. [email protected]
Cost Specification
1.1 Personal- and indirect cost 2018 2019 2020 2021 Total Name Units Rate Cost Units Rate Cost Units Rate Cost Units Rate Cost Units Rate Cost Units Rate Cost Cost Mia Vabø 8,0 131 040 1 048 320 7,0 135 364 947 550 7,0 139 831 978 819 7,0 144 446 1 011 120 3 985 810 Jon Ivar Elstad 1,0 90 168 90 168 - - - 90 168 PhD 4,0 90 168 360 672 11,0 93 144 1 024 579 11,0 96 217 1 058 390 7,0 99 392 695 747 3 139 388 Post. Doc. 3,0 104 208 312 624 11,0 107 647 1 184 116 8,0 111 199 889 594 - 2 386 333 - Ida Drange, AFI 2,0 121 398 242 796 3,0 125 404 376 212 3,0 129 542 388 627 - 1 007 636 Reidun Norvoll, AFI 3,0 121 398 364 194 3,0 125 404 376 212 3,0 129 542 388 627 3,0 133 817 401 452 1 530 486 - - Total personal- and indirect cost 2 418 774 3 908 670 3 704 058 2 108 320 - - 12 139 821
1.2 R&D services (only from norwegian university/college/institute. Purchase of other R&D services have to be listed under "other operating expense") 2018 2019 2020 2021 Total Units Rate Cost Units Rate Cost Units Rate Cost Units Rate Cost Units Rate Cost Units Rate Cost Cost Christine Øye, Senter for omsorgsforskning Vest 2,0 100 000 200 000 3,0 103 300 309 900 3,0 106 709 320 127 2,0 110 230 220 461 1 050 487 Oddvar Frøland, Senter for omsorgsforskning Vest - - - 1,0 110 230 110 230 110 230 Maria Romøren ,UiO Helse og Samfunn - 1,3 86 583,33 112 558 1,3 86 583,33 112 558 1,4 ######## 121 217 346 333 - - - Total R&D services 200 000 422 458 432 685 451 908 ------1 507 051
1.3 Equipment
2018 2019 2020 2021 Total Cost Cost Cost Cost Cost Cost Cost ------Total equipment ------
1.4 Other operating expense (This post includes purchase of R6D services from other than norwegian university/college/institute) 2018 2019 2020 2021 Total Units Rate Cost Units Rate Cost Units Rate Cost Units Rate Cost Units Rate Cost Units Rate Cost Cost Tine Rostgaard, KORA, DK 3,0 93 517 280 552 3,0 95 389 286 166 3,0 97 295 291 886 3,0 99 242 297 726 1 156 330 Lea Graff, KORA, DK 3,0 54 709 164 126 3,0 56 918 170 755 3,0 58 057 174 172 3,0 59 218 177 654 686 707 Assistant, KORA, DK 2,0 54 709 109 417 2,0 56 918 113 837 2,0 58 057 116 115 2,0 59 218 118 436 457 805 - Co-researchers municipality 100 000 200 000 100 000 400 000 Travel and stay (fieldwork) 100 000 500 000 100 000 700 000 Seminar and conference 35 000 35 000 35 000 35 000 140 000 Student grants 100 000 100 000 - Total other operating cost 789 095 1 405 758 817 173 628 816 - 3 640 842 Total cost for project 3 407 869 5 736 885 4 953 916 3 189 043 - - 17 287 714
Projects total cost is listed in this sheet. Cost that is covered from own financing or other financing has to be marked specifically.
Own financing 389 932 1 169 694 1 192 347 695 747 3 447 721 Other financing - From Research Council of Norway 3 017 937 4 567 191 3 761 569 2 493 296 13 839 992 Total 3 407 869 5 736 885 4 953 916 3 189 043 - - 17 287 714 Health and welfare research - Mandatory attachment for researcher projects
User involvement and anticipated benefits– the CONTEXT- project
1 User involvement
1.1 Description of relevant users The ultimate aim of the CONTEXT project is to contribute to evidence-informed service development in elder care. Hence, we regard (a) older people and their families – to be an important target group. Moreover, as we are particularly focusing on contextual preconditions and key facilitators for creating ‘integrated, person-centred care’, (b) policy makers and practitioners are also regarded as relevant users. Finally, (c) teachers and students of disciplines involved in eldercare are important users in particular regarding our focus on inter-disciplinary and transdisciplinary work.
1.2 User involvement in the planning of the project We have already consulted representatives from all three users groups and they are all willing to take part in a kick-off planning meeting if the project gets funded: (a) Representatives from The Norwegian Pensioner Association (Bye) and representatives from local Senior councils (Nyseter) – both organizations regarded as representing older people in elder care issues. (b) We have discussed the project plan with political and administrative executives as well as with front line managers in Oslo, Eigersund, Karmøy and Holstebro – all are regarded as relevant participants according to our sample criteria. They are positive and willing to assign particular persons who will be hired to participate in the planning and implementation of the site visits. (c) Teaching staff with a particular interest in inter- disciplinary care work (Lybye/Gjerpaasen) will take part at the planning stage of the project.
1.3 User involvement in implementation of the project User representatives will participate in research work in various ways: (a) For each site visit, we intend to cover travel costs for one senior representative with a particular interest in senior centres/activity centres (run by or in partnership with seniors) who will take part in dialogue meeting/ focus group with seniors from the host municipality. (b) Practitioners/managers from participating municipalities will act as co-researchers in three ways: 1. We intend to invite front-line managers from participating municipalities to join the research team and participate in fieldwork/data collection. 2. As a part of reflection groups arranged by the end of each site visit, care workers from the host municipality will be invited to comment and co-interpret preliminary findings from the NORDCARE survey. 3. Later, representatives from Norwegian municipalities will be invited to take part in the development of evaluation tools for future research – based on NORDCARE and the conceptual approaches of ‘realistic evaluation’. (c) We aim to invite staff/students professional educations at the Oslo University College to ‘zoom in’ on particular research questions of relevance for the CONTEXT project and to join the team for one or two visits. By means of small grants, they will be encouraged to write master theses/journal articles on topics related to interdisciplinary modes of work and/or interdisciplinary modes of learning in elder care. This work will be integrated in The Working-Well group’ (more detail below 1.4. b). All user groups involved in the site visits will be consulted in the interpretation of data and in preparing policy briefs for our website and popular science presentations.
1.4 User involvement in dissemination and implementation of the results (a) Representatives from the two senior organizations will take active part in dialogue seminars and conferences arranged for all stakeholders (see dissemination plan). (b) Based on our previous experiences and in particular, based on a small trial study of the ‘rapid site visit’ method conducted in 2016, we believe that the dissemination of results by user representatives will move beyond bringing home good ideas for their own municipality. Norway has long traditions of organizing joint programmes for service development across different municipalities. The Norwegian Association for Local Authorities (KS), has organized a large number of bench-learning networks for municipalities i.e. on topics like ‘home care reablement’ and ‘care-pathway’. We believe that municipal-co- Health and welfare research - Mandatory attachment for researcher projects researchers develop analytical skills which are useful in their knowledge sharing with other municipalities. Hence, we believe that the municipal co-researchers of the planned CONTEXT project will use their own experiences and data from the project in all arenas for service development.
(c) After the merging of several research institutes into University college of Oslo and Akershus (HIOA) steps have been taken to enhance collaboration between educational and research. The project leader Mia Vabø (NOVA) and Senior researcher Reidun Norvoll (AFI) have both been encouraged to act as bridge builders between the educational institutes and professional educations at HIOA. We have already organized meetings with teaching staff from several disciplines involved in elder care – including nursing studies (Hjerpaasen) physiotherapy (Feiring), occupational therapy (Lybye), pharmacy (Granås), nutrition (Terragni), Technology, Art and Design (Andersson), Social Work (Olsen) and Vocational Teacher Education (Johansen). In the CONTEXT project an inter-disciplinary group from HIOA will be summoned for critical discussion about challenges and approaches to interdisciplinary work and interdisciplinary learning. Through this group, we expect that outcomes from the CONTEXT project will find their way to curricula and lectures at several educational institutions at HIOA.
2 Anticipated benefits
2.1 Justification of the project With attention focused on keeping older people out of hospitals and nursing homes, the research topics of the CONTEXT project are topical research questions for policy makers and practitioners who are responsible for creating better solution of care provision. Previous research has to a largely focused attention on specific interventions and their outcome; the role of contextual factors at different levels is however a relatively neglected aspect (see project description). The contribution of the CONTEXT project is to highlight this neglect and to provide an alternative approach which is more adequate for exploring how contextual conditions influence implementation processes. Moreover, the contribution is to offer a research approach which explicitly seeks to take into consideration the view of different stakeholder groups situated in a dynamic and complex reality. Hence, in line with the HELSEVEL programme, CONTEXT bears the potential for bringing research closer to the local service apparatus.
2.2 Benefit for the users Comparing cases across jurisdictions is beneficial as it make actors less blinded by their own taken- for-granted reality. By drawing attention to contrasts between jurisdictions, we expect that the CONTEXT project may raise awareness of the role contextual conditions play in successful implementation. Thinking about context in a systematic manner will extend the knowledge base of decision makers who are responsible for service provision – practitioners, managers, teaching staff and policy makers. We also expect that the project will raise awareness about which contextual factors are modifiable by whom. As this awareness may contribute to the shaping of future programmes for improvements, it will also benefit the ultimate end user of services – older people and their families. The outcome of CONTEXT may also contribute to an emerging strand of international health care research – for instance through an EU research application. By bringing the perspective into a well- established international research community of elder care researchers the project may contribute to influence and extend the evidence base for service development in elder care more generally.
2.3 Realisation of project benefits The CONTEXT project understands knowledge transfer as integral to the research project, with knowledge shared in multiple exchanges throughout the project and many actors contributing with knowledge. Hence, benefits from the project may emerge as the project evolves. We also believe that the explanatory focus, based on stakeholders own explanations of ‘what works for whom under what circumstances’ have a great potential for being utilised by decision makers that are not directly involved in the project.