Journal of multidisciplinary healthcare, Sep 30, 2023
Societal change and rise in demand for healthcare call for new health professional practices and ... more Societal change and rise in demand for healthcare call for new health professional practices and task redistribution. Through negotiated order theory, this study explores how hospital rheumatologists (RT) and occupational therapists (OT) negotiate professional tasks in the clinical management of hand osteoarthritis. Methodology: Fourteen qualitative interviews and 16 observations in clinical consultations were conducted in two hospitals specialized in rheumatology in Norway. Participants included eight OTs, six RTs, and patients in consultations. Data were analyzed using reflexive thematic analysis. Results: Three themes were developed from codes: hierarchical ordering of hospital work impacts interprofessional negotiations; diagnostic organization of tasks preserves RT authority; and evidence-based recommendations in rheumatology enhance OT responsibilities. Overall, RTs and OTs enact tasks in succession where higher-ranking RTs establish a diagnosis and decide the subsequent inhospital trajectory entrenched in a medical knowledge system. When medicine does not hold evidence-based treatment alternatives for patients, OTs respond by providing therapeutic interventions that are legitimized through international recommendations in rheumatology when they equip patients with tools to cope with chronic illness. Conclusion: Negotiations over tasks do not take place from equal power positions when status and knowledge hierarchies frame professional practices. The enactment of tasks is concurrently highly influenced by the arena of the workplace, where the two professional groups both cross boundaries and work together in concert despite professional differences in order to meet patient interests and provide relevant healthcare.
To notat fra et forskningsprosjekt om selvhjelpsvirksomhet Utgivelsesdata Tittel:Om politisering ... more To notat fra et forskningsprosjekt om selvhjelpsvirksomhet Utgivelsesdata Tittel:Om politisering og laering i selvhjelpsfeltet. Forfatter(e):Marte FeiringSerie:HiOA smaskriftIssn:1893-4609Nr:2014 nr 1Utgiver:HiOAAvdeling/fakultet:HFSider:54Pris:130,–
Rapporten beskriver og analyserer driftsfasen ved DELTA-senteret. Den er en oppfølging av en tidl... more Rapporten beskriver og analyserer driftsfasen ved DELTA-senteret. Den er en oppfølging av en tidligere analyse av etablerings- og igangsettingsfasen. Senteret er et statlig organ som skal arbeide for økt tilgjengelighet for funksjonshemmede i samfunnet. Evalueringen viser at senteret utfører mange gode og interessante prosjekter til tross for at det fortsatt er uenighet om senterets organisering og tilknytningsform
Purpose: Examine students' experiences of being a physical activity mentor for patients with ... more Purpose: Examine students' experiences of being a physical activity mentor for patients with mental disorders, and assess if student experiences can contribute to professional competence. Method: Thematic analysis of three focus group interviews with 16 students who had completed their student practice.. Findings: The student practice takes place in the span of a medical and everyday context, and the students reflected on the dilemmas they met as an independent physical activity mentor. Meeting the patients' psychiatric symptoms, the students experienced that their knowledge of standardized tests and training had to be adapted to the individual patient. Individual adaptation required assessment ability and creative solutions, as well as a good relationship with the patient. Conclusion: The study shows that the practice as a physical activity mentor gives students practical knowledge and initial professional competence. The practice provides the opportunity to integrate theor...
Patient and public involvement (PPI) in health research has gained widespread attention and imple... more Patient and public involvement (PPI) in health research has gained widespread attention and implementation in the last 10–15 years. Numerous funding institutions now require research professions to state how they intend to involve people whose lives are implicated in the research project. However, as the various disciplines within health sciences are built on diverse epistemological traditions, the involvement of patients and public takes various forms and poses different challenges to researchers and research subjects. The aim of this chapter is to explore how PPI is conceptualised across a range of research projects. We describe different epistemological frameworks and how these influence the knowledge practices of professionals working in a range of health institutions. We approach public/patient involvement in two ways. First, we undertake a brief historical review of three research traditions where interaction between scientists and implicated parties is a central pivot. We term these: 1) pragmaticinteractionist, 2) ideological-political, and 3) consumerist research. We conclude by discussing three dilemmas of how patient and public involvement in research challenges the epistemological diversity of professional knowledge
Mobilizing Knowledge in Physiotherapy: Critical Reflections on Foundations and Practices is a col... more Mobilizing Knowledge in Physiotherapy: Critical Reflections on Foundations and Practices is a collection of 15 collaboratively written critical essays by 39 authors from 15 disciplines and seven countries. The book challenges some of the most important contemporary assumptions about physiotherapy knowledge, and makes the case for much more critical theory, practice, and education in physiotherapy health and social care. The book challenges the kinds of thinking that have traditionally bounded the profession and highlights the ways in which knowledge is now increasingly fluid, complex, and diffuse. The collection engages a range of critical social theories and interdisciplinary perspectives from within and without the profession. It includes sections focusing on evidence, practice, patient perspectives, embodiment, culture, diversity, digital worlds, and research methods. The book makes an important contribution to how we think about mobilizing knowledge, and it speaks to a diverse audience of academics, practitioners, educators, policy-makers, and students-both within physiotherapy and from a range of related health and social care disciplines. This book will be a useful reference for scholars interested in conceptions of professional knowledge and the theory of professional education and practice in physiotherapy and beyond.
This article unravels the genesis and history of neurorehabilitation (NR) in Denmark in order to ... more This article unravels the genesis and history of neurorehabilitation (NR) in Denmark in order to understand the transformation that this subfield has undergone since the 1970s and how this is reflected in the present structure. Seen through the lens of Bourdieu’s concept of field and based on a document review strategy of historical sources and political documents the article constructs three analytic periods: 1. the genesis of NR until the first half of the 1980s, 2. the institutionalization of NR from 1985-2006 and 3. the political restructuring of NR after the local government reform in 2007. Our analysis shows that NR is a multiand interdisciplinary practice characterized by heterogeneity, although with growing homogeneity in clinical practice due to an increased number of NR institutions, and later political guidelines. We conclude that despite an increased power to psycho-social and comprehensive approaches, biomedical knowledge is still dominant and reflected in doxa.
New Dynamics of Disability and Rehabilitation, 2019
This chapter examines how Danish and Norwegian authorities have designed political technologies o... more This chapter examines how Danish and Norwegian authorities have designed political technologies of guidelines and guides for rehabilitating brain injury survivors. Contemporary reforms to health services, including the Danish Structural Reform and Norwegian Coordination Reform, provide the national structures for framing rehabilitation services as composite practices. Engaging critical discourse analysis, we address these changes by adopting the twin perspectives of intertextuality and interdiscursivity. First, this study outlines how documents such as clinical guidelines and service guides are in dialogue with each other and with other political, legal, and professional texts. Second, focusing on the language of coordination on transferring brain-injured patients between hospitals and municipalities, we identify interdiscursivity between three broad areas of procedures and devices in both countries: inter-institutional agreements, interprofessional communication, and individual reh...
ABSTRACT This paper explores how creating the applied science psychotechnics redefined societies’... more ABSTRACT This paper explores how creating the applied science psychotechnics redefined societies’ views on abilities and disabilities during the early twentieth century. The main empirical sources are textbooks, articles and political documents. It studies the making of applied psychology as two interrelated processes: first, the early experimental laboratory developments of scientific knowledge and the new understanding of the relationship between body and mind, and second, the introduction of new quantitative techniques for measuring intelligence and aptitudes in schools, the military, and employment services – that is, for society in general. I name the first process ‘scientification’ and the second ‘politicisation of the new scientific techniques’. The two analytical terms point to how abilities and aptitudes were redefined due to scientific and political interests. This article first gives an overview of the international innovations that I term ‘social technologies’, and thereafter analyses how these technologies transformed the Norwegian system – first the special schools, then the vocational schools, and finally the employment services.
Rehabilitation is a contested interdisciplinary field, torn between medical dominance and psychos... more Rehabilitation is a contested interdisciplinary field, torn between medical dominance and psychosocial challenges. Since higher education is an important arena for epistemological work, this chapter elucidates the scholarly profile outlined in educational programmes within the area of rehabilitation. The authors conducted a text study of how programmes in Scandinavia, the United Kingdom, and Germany are presented. Three types of study programmes were identified: physiotherapy-based, interdisciplinary programmes, and educational counselling programmes. The diversity of programmes is discussed in light of Bourdieuan perspectives on field struggles in academic settings and the Mode 2 type of knowledge production at the intersection between clinical practice and academia.
Journal of multidisciplinary healthcare, Sep 30, 2023
Societal change and rise in demand for healthcare call for new health professional practices and ... more Societal change and rise in demand for healthcare call for new health professional practices and task redistribution. Through negotiated order theory, this study explores how hospital rheumatologists (RT) and occupational therapists (OT) negotiate professional tasks in the clinical management of hand osteoarthritis. Methodology: Fourteen qualitative interviews and 16 observations in clinical consultations were conducted in two hospitals specialized in rheumatology in Norway. Participants included eight OTs, six RTs, and patients in consultations. Data were analyzed using reflexive thematic analysis. Results: Three themes were developed from codes: hierarchical ordering of hospital work impacts interprofessional negotiations; diagnostic organization of tasks preserves RT authority; and evidence-based recommendations in rheumatology enhance OT responsibilities. Overall, RTs and OTs enact tasks in succession where higher-ranking RTs establish a diagnosis and decide the subsequent inhospital trajectory entrenched in a medical knowledge system. When medicine does not hold evidence-based treatment alternatives for patients, OTs respond by providing therapeutic interventions that are legitimized through international recommendations in rheumatology when they equip patients with tools to cope with chronic illness. Conclusion: Negotiations over tasks do not take place from equal power positions when status and knowledge hierarchies frame professional practices. The enactment of tasks is concurrently highly influenced by the arena of the workplace, where the two professional groups both cross boundaries and work together in concert despite professional differences in order to meet patient interests and provide relevant healthcare.
To notat fra et forskningsprosjekt om selvhjelpsvirksomhet Utgivelsesdata Tittel:Om politisering ... more To notat fra et forskningsprosjekt om selvhjelpsvirksomhet Utgivelsesdata Tittel:Om politisering og laering i selvhjelpsfeltet. Forfatter(e):Marte FeiringSerie:HiOA smaskriftIssn:1893-4609Nr:2014 nr 1Utgiver:HiOAAvdeling/fakultet:HFSider:54Pris:130,–
Rapporten beskriver og analyserer driftsfasen ved DELTA-senteret. Den er en oppfølging av en tidl... more Rapporten beskriver og analyserer driftsfasen ved DELTA-senteret. Den er en oppfølging av en tidligere analyse av etablerings- og igangsettingsfasen. Senteret er et statlig organ som skal arbeide for økt tilgjengelighet for funksjonshemmede i samfunnet. Evalueringen viser at senteret utfører mange gode og interessante prosjekter til tross for at det fortsatt er uenighet om senterets organisering og tilknytningsform
Purpose: Examine students' experiences of being a physical activity mentor for patients with ... more Purpose: Examine students' experiences of being a physical activity mentor for patients with mental disorders, and assess if student experiences can contribute to professional competence. Method: Thematic analysis of three focus group interviews with 16 students who had completed their student practice.. Findings: The student practice takes place in the span of a medical and everyday context, and the students reflected on the dilemmas they met as an independent physical activity mentor. Meeting the patients' psychiatric symptoms, the students experienced that their knowledge of standardized tests and training had to be adapted to the individual patient. Individual adaptation required assessment ability and creative solutions, as well as a good relationship with the patient. Conclusion: The study shows that the practice as a physical activity mentor gives students practical knowledge and initial professional competence. The practice provides the opportunity to integrate theor...
Patient and public involvement (PPI) in health research has gained widespread attention and imple... more Patient and public involvement (PPI) in health research has gained widespread attention and implementation in the last 10–15 years. Numerous funding institutions now require research professions to state how they intend to involve people whose lives are implicated in the research project. However, as the various disciplines within health sciences are built on diverse epistemological traditions, the involvement of patients and public takes various forms and poses different challenges to researchers and research subjects. The aim of this chapter is to explore how PPI is conceptualised across a range of research projects. We describe different epistemological frameworks and how these influence the knowledge practices of professionals working in a range of health institutions. We approach public/patient involvement in two ways. First, we undertake a brief historical review of three research traditions where interaction between scientists and implicated parties is a central pivot. We term these: 1) pragmaticinteractionist, 2) ideological-political, and 3) consumerist research. We conclude by discussing three dilemmas of how patient and public involvement in research challenges the epistemological diversity of professional knowledge
Mobilizing Knowledge in Physiotherapy: Critical Reflections on Foundations and Practices is a col... more Mobilizing Knowledge in Physiotherapy: Critical Reflections on Foundations and Practices is a collection of 15 collaboratively written critical essays by 39 authors from 15 disciplines and seven countries. The book challenges some of the most important contemporary assumptions about physiotherapy knowledge, and makes the case for much more critical theory, practice, and education in physiotherapy health and social care. The book challenges the kinds of thinking that have traditionally bounded the profession and highlights the ways in which knowledge is now increasingly fluid, complex, and diffuse. The collection engages a range of critical social theories and interdisciplinary perspectives from within and without the profession. It includes sections focusing on evidence, practice, patient perspectives, embodiment, culture, diversity, digital worlds, and research methods. The book makes an important contribution to how we think about mobilizing knowledge, and it speaks to a diverse audience of academics, practitioners, educators, policy-makers, and students-both within physiotherapy and from a range of related health and social care disciplines. This book will be a useful reference for scholars interested in conceptions of professional knowledge and the theory of professional education and practice in physiotherapy and beyond.
This article unravels the genesis and history of neurorehabilitation (NR) in Denmark in order to ... more This article unravels the genesis and history of neurorehabilitation (NR) in Denmark in order to understand the transformation that this subfield has undergone since the 1970s and how this is reflected in the present structure. Seen through the lens of Bourdieu’s concept of field and based on a document review strategy of historical sources and political documents the article constructs three analytic periods: 1. the genesis of NR until the first half of the 1980s, 2. the institutionalization of NR from 1985-2006 and 3. the political restructuring of NR after the local government reform in 2007. Our analysis shows that NR is a multiand interdisciplinary practice characterized by heterogeneity, although with growing homogeneity in clinical practice due to an increased number of NR institutions, and later political guidelines. We conclude that despite an increased power to psycho-social and comprehensive approaches, biomedical knowledge is still dominant and reflected in doxa.
New Dynamics of Disability and Rehabilitation, 2019
This chapter examines how Danish and Norwegian authorities have designed political technologies o... more This chapter examines how Danish and Norwegian authorities have designed political technologies of guidelines and guides for rehabilitating brain injury survivors. Contemporary reforms to health services, including the Danish Structural Reform and Norwegian Coordination Reform, provide the national structures for framing rehabilitation services as composite practices. Engaging critical discourse analysis, we address these changes by adopting the twin perspectives of intertextuality and interdiscursivity. First, this study outlines how documents such as clinical guidelines and service guides are in dialogue with each other and with other political, legal, and professional texts. Second, focusing on the language of coordination on transferring brain-injured patients between hospitals and municipalities, we identify interdiscursivity between three broad areas of procedures and devices in both countries: inter-institutional agreements, interprofessional communication, and individual reh...
ABSTRACT This paper explores how creating the applied science psychotechnics redefined societies’... more ABSTRACT This paper explores how creating the applied science psychotechnics redefined societies’ views on abilities and disabilities during the early twentieth century. The main empirical sources are textbooks, articles and political documents. It studies the making of applied psychology as two interrelated processes: first, the early experimental laboratory developments of scientific knowledge and the new understanding of the relationship between body and mind, and second, the introduction of new quantitative techniques for measuring intelligence and aptitudes in schools, the military, and employment services – that is, for society in general. I name the first process ‘scientification’ and the second ‘politicisation of the new scientific techniques’. The two analytical terms point to how abilities and aptitudes were redefined due to scientific and political interests. This article first gives an overview of the international innovations that I term ‘social technologies’, and thereafter analyses how these technologies transformed the Norwegian system – first the special schools, then the vocational schools, and finally the employment services.
Rehabilitation is a contested interdisciplinary field, torn between medical dominance and psychos... more Rehabilitation is a contested interdisciplinary field, torn between medical dominance and psychosocial challenges. Since higher education is an important arena for epistemological work, this chapter elucidates the scholarly profile outlined in educational programmes within the area of rehabilitation. The authors conducted a text study of how programmes in Scandinavia, the United Kingdom, and Germany are presented. Three types of study programmes were identified: physiotherapy-based, interdisciplinary programmes, and educational counselling programmes. The diversity of programmes is discussed in light of Bourdieuan perspectives on field struggles in academic settings and the Mode 2 type of knowledge production at the intersection between clinical practice and academia.
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Papers by Marte Feiring