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Health promotion has been a part of the policies, strategies and services of the Nordic welfare states since the beginning of the millennium. This article contributes to analyses of health promotion in political programs, institutions and practices in Denmark in later years, and holds a special interest in how inequality in health is addressed. In the Nordic countries, universalism has been a key tenet of welfare services, with great potential of guiding health promotion towards more equality in health. However, a neoliberal development over the last two decades has influenced the field of health and also the ideas, conceptions and strategies of health promotion. This article looks into how health promotion has taken form in Denmark, through conflicts of interest in health policies, and changes in central health promotion programs, that turn away from earlier universalistic and social political framing of health prevention and promotion. Health promotion in Denmark has been marked by years of conflicts and the interest in influencing the psychosocial environment of health to gain more equality in health has weakened.

Transformation of the welfare sectors challenge professional identities of care and welfare workers in Scandinavia. At the same time welfare and care workers take part in these changes and are changed in the psycho-social setting of the workplace. This article presents research about care work in Denmark with a focus on subjective processing of work identity, applying a psycho-societal theoretical and methodical approach. A life historical and experiential understanding of Alfred Lorenzer's cultural theory is applied to understand societal transformations, here in the work place and of professionals in relation to their present scene of work and in relation to their life history. Two concepts are applied, interaction form and scenic understanding, because of their potentials for analyzing workers' experience. The analysis is based on a combined ethnographic and life historical investigation in nursing and involves a young nurse in scenes of the hospital, where gendered life history is re-enacted and present in a gendered work life with fragile possibilities of identification. Social dynamics interact with subjective dynamics in ways that illuminate not only habitual and creative orientations and practices of professionals in care, but also the contradictory transformations of the work, e.g. marketization and democratization in the work place.

"Transformation of the welfare sectors challenge professional identities of care and welfare workers in Scandinavia. At the same time welfare and care workers take part in these changes and are changed in the psycho-social setting of the workplace. This article presents research about care work in Denmark with a focus on subjective processing of work identity, applying a psycho-societal theoretical and methodical approach. A life historical and experiential understanding of Alfred Lorenzer's cultural theory is applied to understand societal transformations, here in the work place and of professionals in relation to their present scene of work and in relation to their life history. Two concepts are applied, interaction form and scenic understanding, because of their potentials for analyzing workers' experience. The analysis is based on a combined ethnographic and life historical investigation in nursing and involves a young nurse in scenes of the hospital, where gendered life history is re-enacted and present in a gendered work life with fragile possibilities of identification. Social dynamics interact with subjective dynamics in ways that illuminate not only habitual and creative orientations and practices of professionals in care, but also the contradictory transformations of the work, e.g. marketization and democratization in the work place." (author's abstract)

Veränderungen im Gesundheitswesen und der sozialen Wohlfahrt fordern die Berufsidentitäten von Krankenschwestern und Sozialarbeiter/innen in Skandinavien heraus. Diejenigen, die von solchen Veränderungen betroffen sind, werden durch das neue psychosoziale Setting an ihren Arbeitsplätzen auch persönlich tangiert.In diesem Aufsatz wird ein Forschungsprojekt mit dänischen Krankenschwestern und Sozialarbeiter/innen vorgestellt. Der Fokus liegt auf der sich verändernden Arbeitsidentität, und dieser subjektive Entwicklungsprozess macht einen besonderen theoretischen und methodologischen Forschungsansatz notwendig: Das Verstehen von lebensgeschichtlicher und beruflich bedingter Erfahrung wird in der Perspektive von Alfred LORENZER's Kulturtheorie untersucht. Es geht darum, den gesellschaftlichen Wandel zu verstehen, der den Arbeitsplatz, die Berufsausübung und die jeweilige Lebensgeschichte in besonderer Weise betrifft. Zwei Konzepte von LORENZER, ein theoretisches und ein methodisches, nämlich die "Interaktionsform" und das "szenische Verstehen", wurden in der Untersuchung angewendet, weil man mit ihnen eine optimale methodische Perspektive zur Analyse der Arbeitserfahrung entwickeln kann. Eine ethnografische und lebensgeschichtlich orientierte Untersuchung von jungen Krankenschwestern in Krankenhäusern wird vorgestellt, in welchen die Arbeit geschlechtsspezifisch organisiert ist und nur geringe Möglichkeiten zu einer Identifikation mit der Arbeit bestehen. Es werden soziale und persönliche Dynamiken untersucht, in denen habituelle und kreative Orientierungen und Praktiken in der Gesundheitsversorgung sichtbar gemacht werden. In gleicher Weise werden die widersprüchlichen Veränderungen der Arbeit – ihre Vermarktung und ihre Demokratisierung – analysiert.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1203214 ; La transformación de los sectores de bienestar desafía a las identidades profesionales del cuidado y a los trabajadores del bienestar en Escandinavia. Los trabajadores del cuidado y del bienestar toman parte en ...

"Veränderungen im Gesundheitswesen und der sozialen Wohlfahrt fordern die Berufsidentitäten von Krankenschwestern und Sozialarbeiter/ innen in Skandinavien heraus. Diejenigen, die von solchen Veränderungen betroffen sind, werden durch das neue psychosoziale Setting an ihren Arbeitsplätzen auch persönlich tangiert. In diesem Aufsatz wird ein Forschungsprojekt mit dänischen Krankenschwestern und Sozialarbeiter/ innen vorgestellt. Der Fokus liegt auf der sich verändernden Arbeitsidentität, und dieser subjektive Entwicklungsprozess macht einen besonderen theoretischen und methodologischen Forschungsansatz notwendig: Das Verstehen von lebensgeschichtlicher und beruflich bedingter Erfahrung wird in der Perspektive von Alfred Lorenzer's Kulturtheorie untersucht. Es geht darum, den gesellschaftlichen Wandel zu verstehen, der den Arbeitsplatz, die Berufsausübung und die jeweilige Lebensgeschichte in besonderer Weise betrifft. Zwei Konzepte von Lorenzer, ein theoretisches und ein methodisches, nämlich die Interaktionsform' und das szenische Verstehen', wurden in der Untersuchung angewendet, weil man mit ihnen eine optimale methodische Perspektive zur Analyse der Arbeitserfahrung entwickeln kann. Eine ethnografische und lebensgeschichtlich orientierte Untersuchung von jungen Krankenschwestern in Krankenhäusern wird vorgestellt, in welchen die Arbeit geschlechtsspezifisch organisiert ist und nur geringe Möglichkeiten zu einer Identifikation mit der Arbeit bestehen. Es werden soziale und persönliche Dynamiken untersucht, in denen habituelle und kreative Orientierungen und Praktiken in der Gesundheitsversorgung sichtbar gemacht werden. In gleicher Weise werden die widersprüchlichen Veränderungen der Arbeit - ihre Vermarktung und ihre Demokratisierung - analysiert." (Autorenreferat)

Med paradigmet om brugerinddragelse forventes borgere i dag at påtage sig et ansvar for at styre, mestre og overvåge deres egen sundhed. Brugerinddragelse lægger derfor op til mere grundlæggende forandringer i relationen mellem borger og professionel, og udfor- drer eksisterende videns- og ansvarshierarkier. I denne artikel undersøger vi hvordan de professionelle i psykiatrien oversætter idéer om brugerinddragelse til praksis, og hvordan deres professionelle ansvar, viden og relationsarbejde samtidig forandres og sættes under pres. Artiklen er baseret på narrative interviews med professionelle i en større institution i den regionale distriktspsykiatri. Vi demonstrerer hvordan spændinger imellem forskel- lige forståelser af recovery, og deres praktiske fortolkninger hos henholdsvis professionelle og borgerne, former den måde brugerinddragelse bliver til på. Vi viser desuden, hvordan mestring af brugerinddragelse med vægt på brugerens viden og autonomi, fører til prakti- sering af 'tilbageholdt faglighed'. En tilgang til det psykiatriske arbejde, der skal opmuntre borgeren til at indtage positionen som ansvarlig og rationelt målrettet handlende aktør i eget liv. Dette er dog ikke uproblematisk; vi viser hvordan borgernes perspektiver og mål indgår i brugerinddragelsens forhandlingsrum, og hvordan de fagprofessionelles viden og vurdering og borgerens mål ofte kommer i konflikt. Vi peger således på hvordan balancer imellem risiko og ansvar i sundhedspraksis spilles ud på nye måder. I et arbejde hvor etab- lering af langvarige relationer til borgerne opfattes som centralt for at kunne lykkes med behandling, spiller emotionelt arbejde en vigtig rolle i at forhandle borgernes personlige mål, at opnå professionelle mål, samt som en del af at etablere et meningsfuldt arbejde. Vi diskuterer afslutningsvis hvordan spændinger i den brugerinddragende praksis har impli- kationer for det emotionelle arbejde.

This article examines meetings between people living a complicated everyday life with multimorbidity and an assessor responsible for providing a rehabilitation programme, home care or neither. The background to this is a health policy change towards more home-based rehabilitation and less home care, which began with new legislation in the Danish Consolidation Act on Social Services in 2015. The question raised is whether these meetings support the everyday lives of people with multimorbidity or exacerbate their already vulnerable situation, and how their agency plays a role in the assessor's decision. The article is based on an ethnographic field study in Denmark. Twenty-six individuals with multimorbidity aged 28-86 years, applying for or already receiving home care, were studied. The article uses three cases to explore the distinct ways in which the people relate to the assessment meeting, and how the meeting affects their vulnerable situation, while the analysis reveals the widely varying involvement of the people's agency. We find support for these people in their everyday lives with multimorbidity, when everyday life and challenges in practical daily activities are understood in context, and when the meeting is based on the people's experience of their lives. Conversely, assessment meetings that exclude their experience of meaningful everyday life and their need for help to handle their complicated life with multimorbidity result in restricted access to rehabilitation and home care. This creates inequality in access to health and social care and in the possibility to live a meaningful everyday life, which reinforces these people's vulnerability.

AbstractThe purpose of this article is to explore social inequity in palliative care in Denmark, a country that is seen as a stronghold of universal health care. Using data stemming from 2 years of research, we have selected two cases for analysis. They consist of palliative conversations with two quite different patients. Drawing on sociocultural class theory, we find that the conversations involve social exclusion processes due to discourses of active ageing. We find that one privileged patient performs in line with an entrepreneurial self and is supported by the nurse. The other, disadvantaged patient performs in a passive way, and the conversation mainly alleviates the disrespect he has experienced in healthcare encounters. We conclude that palliative care reinforces classifying practices and distinctions between "good" and "bad" patients, when active ageing becomes a dominant factor. We suggest improving the quality and sensitivity of medical training and call for increased reflexivity among professionals on the unequal situation of patients in order to reduce inequity in access to health care when close to death.

This article examines people's vulnerability and agency, existing in complex everyday life with multimorbidity, and created in the meeting with the municipal assessor about provi- sion/ non-provision of a rehabilitation programme or home care. The question is how the meetings support these people's everyday lives or, by contrast, create additional vulnera- bility. The article's basis is an ethnographic field study in a west Copenhagen municipa- lity, with 26 people, aged between 28 and 86, that have multimorbidity and are applying for home care or already getting it. The article's three cases look at four key informants - one married couple and two people living alone. The article's finding is that people are supported in an everyday life with multimorbidity when everyday life and challenges in daily life's practical activities are not separated, and where the meeting with the assessor is grounded in the person's everyday life with multimorbidity. Conversely rehabilitation potential assessment, entailing marginalisation of people's everyday life with multimorbidity, and excluding from the meeting people's experiences of a meaningful everyday life and need for help in coping with complicated everyday life, results in unequal access to rehabilitation and home care, and creates additional vulnerability among those with multimorbidity.