Health care services for older people in COVID-19 pandemic times - A Nordic comparison.

OBJECTIVE: To explore the Nordic municipal health and care services' ability to promote principal goals within care for older people during the COVID-19 pandemic. DESIGN AND SETTING: Two surveys were conducted among managers of municipal health care services for older people in Denmark, Finland, Norway and Sweden; the first around 6 months into the pandemic (survey 1), and the second around 12 months later (survey 2). Data were analysed through descriptive statistics, and multiple regression (OLS). SUBJECTS: 1470 (survey 1, 2020) and 745 (survey 2, 2021) managers. 32% in home care, 51% in nursing homes, 17% combined. RESULTS: In all countries the pandemic seems to have had more negative impact on eldercare services' ability to promote an active and social life, than on the ability to promote or enhance older people's mental and physical health. The regression analysis indicates that different factors influence the ability to promote these goals. Managers within nursing homes reported reduced ability to promote mental and physical health and an active social life to a significantly lower degree than managers of home care. The effect of three prevention strategies (lock down, testing, and/or organisational change), were explored. Organisational change (reorganize staff and practice, restrict use of substitutes) tended to impact the units' ability to promote a social life in a positive direction, while lock down (areas, buffets etc) tended to impact both the ability to promote mental/physical health and a social life in a negative direction. CONCLUSION: Measures that can improve opportunities for an active and social life during a pandemic should have high priority, particularily within home care.

It is important to learn from how the COVID-19 outbreak in 2020 affected the municipal health and care services' ability to achieve principal goals within care for older people.The pandemic had a more negative impact on the services' ability to promote an active and social life, than on their ability to promote or enhance mental and physical health.Measures that can improve opportunities for an active and social life during a pandemic situation should have high priority, particularily within home-based care.

Marketing cosmetic surgery - a qualitative analysis. / Markedsføring av kosmetiske inngrep ­ en kvalitativ analyse.

BACKGROUND: Marketing cosmetic surgery is an under-researched topic in a Norwegian context, even though problematic aspects of such marketing have been pointed out in several contexts. This study draws attention to how providers of cosmetic surgery market their services, whom they target and how they do so. MATERIAL AND METHOD: Critical discourse analysis was used as a framework for a qualitative study of the marketing activity of 36 private clinics. The data material was collected from the Internet and newspapers, and consists of text, still photos and video clips. RESULTS AND INTERPRETATION: The article identifies the following marketing strategies: The providers refer to customers as patients, normalise cosmetic surgery, draw attention to physical flaws, play on femininity and sensuality, define natural appearance, promise a better self-image and quality of life, and offer package solutions and financing schemes. The underlying messages and patterns that emerge from the identified strategies are interpreted within theories on body and gender, nature and culture.

Contradictory discourses of health promotion and disease prevention in the educational curriculum of Norwegian public health nursing: a critical discourse analysis.

AIMS: Health care is under constant change creating new and demanding tasks for public health nurses. The curriculum for public health nursing students is controlled by governmental directives that decide the structure and content of their education. This paper analyses manifest and latent discourses in the curriculum, in order to reveal underlying governmental principles for how public health nurses should promote health and prevent diseases. METHODS: A critical discourse analysis of the Norwegian public health nursing curriculum was conducted. RESULTS: The study indicates i) 'a competing biomedical and social-scientific knowledge-discourse', with biomedical knowledge dominating the content of the curriculum; ii) 'a paternalistic meta-discourse', referring to an underlying paternalistic ideology despite a clear focus on user participation; and iii) 'a hegemonic individual discourse'. Even though the curriculum stipulates that public health nurses should work at both an individual and a societal level, there is very little population focus in the text. CONCLUSIONS: Recent political documents concerning public health nursing focus more on health promotion, however, this is not sufficiently explicit in the curriculum. The lack of emphasis on social scientific knowledge, and the blurred empowerment and population perspective in the curriculum, can lead to less emphasis on health promotion work in public health nursing education and practice. The curriculum should be revised in order to meet the recent governmental expectations.

The meaning of ethically charged encounters and their possible influence on professional identity in Norwegian public health nursing: a phenomenological hermeneutic study.

BACKGROUND: In today's health care, new health reforms focus on market values and demands of efficiency influence health workers' professional practice. Norwegian public health nurses work mainly with healthy populations, but the children, families and young people they meet can be in vulnerable and even dependent situations. Strategies in coping with ethically challenging encounters can be important for the identity of the profession. AIM: The aim of the study was to illuminate public health nurses' experiences of being in ethically charged encounters and to reflect upon how these experiences can influence their professional identity. METHOD: A purposive sample of 23 Norwegian public health nurses with experience ranging from 0.5 to 25 years narrated about their work-related experiences. The interviews were interpreted with a phenomenological hermeneutic method inspired by the philosophy of Paul Ricoeur. FINDINGS: Four themes were identified: feeling responsible, being committed, feeling confident and feeling inadequate. These experiences were related to both work and private life and involved an emotional commitment to the well-being of children, young people and families. CONCLUSION: On the basis of the findings, it can be estimated that PHNs are committed to their work, and defending children's rights is a strong driving force. Responsibility for service users is a deciding factor that can overshadow institutional demands. It seems as if value conflicts mobilised courage which is essential in maintaining moral strength. This is in turn important for a strong professional identity and can have positive implications for the quality of public health nursing work.

Radical changes or traditional approaches in a different guise? An analysis of the Norwegian mother-child service.

In recent years practitioners within the Norwegian mother and child health service have been advised to change their approach to parents, and in particular to play down their traditional "expert" role. On matters concerning their own child, parents have come to be regarded as the "experts," and scientific knowledge is no longer considered superior to skills gained through practical experience. However, current recommendations for practice are inconsistent, and rather than being reduced, professional authority and control have entered a new mode. Instead of being articulated and made explicit these aspects of the mother-child service are disguised. The language employed by the service might act to mask attempts to maintain the traditional relationship between professionals and parents. This article does not direct a one-sided critique toward the exercise of professional authority within this field of practice, but instead seeks to initiate a discussion on legitimate and illegitimate forms of authority and control. The analysis draws on two sources of data: documentary materials and interviews with public health nurses.