Hildur Kalman

Framing of Intimate Care in Home Care Services

Provision of intimate care is a challenge for the care worker, as well as for the recipient of care, in terms both of how this care is to be performed and of how to manage feelings such as anxiety and embarrassment. In home care services, most intimate care work is performed by non-professionals who have received little or no formal or in-house training, and who are at risk of being left to devise their own methods or coping strategies. This article reports on a participant observation study of intimate care in home care services in Sweden. The strategies used to handle intimacy in care work displayed similarities, as well as dissimilarities, to those of professional framing identified in earlier studies of medical and nursing practice. There are similarities in terms of how framing was accomplished in a balance between a distanced matter-of-fact stance and one of personal acknowledgement created in interplay between care workers and care recipient. There are dissimilarities in terms of the challenges presented by the home care setting. As the relationship between care worker and care recipient in intimate care is a particularly precarious one, lack of guidance and formal training may hamper care and lead to neglect.

Social work students’ reflections on challenges during field education

Summary Field education is a key curriculum component in social work programmes. Students as well as researchers have identified this learning experience as central to the students’ transition to practice. This article reports on a qualitative study with the aim of analysing social work students’ narratives of their experiences during field education in order to elucidate their reasoning with regard to the challenges presented by unique clients and their contexts, along with their objectives set in the service user situation. The narratives of 23 social work students in Sweden describing a sum total of 46 problematic and unproblematic situations during field education were analysed, revealing circumstances that according to the students had either aggravated or facilitated professional action. Findings The experiences of being overwhelmed by emotions and of having too much latitude in the interpretation of principles and guidelines were experienced as aggravating circumstances, whereas having knowledge of legislation and clear guidelines to follow was experienced as facilitating client interaction and as providing a sense of security with the professional role. The analysis also revealed differing levels and scope of ambition with regard to the objectives set in the service user situation. Applications Our results demonstrate the importance of furthering students’ articulation of and active reflection on their interpretation of guidelines and legislation, and on their own setting of objectives specific to the individual cases and on how these objectives relate to the value base of social work.

Methodological challenges in the implementation and evaluation of social welfare policies

As social reality is quite elusive, even regarding seemingly well-recognized everyday concepts and objects, there are always methodological challenges underlying assessments and evaluations of implementation policies. The present article addresses this area of concern by presenting the results of a rereading of an empirical study of elderly home care services. Our results reveal the emergence of a dissolution of common and professional key concepts and objects in these welfare services to a degree that challenges both the implementation policy and the evaluation of policy. We claim that this has methodological implications for evaluation of implementation policies in general.

Are some sciences more basic than others? : Invited commentary

The answer to N. L. U. van Meeteren’s and P. J. M. Helders’ question raised in the title of their article ‘‘Physical therapy: What about basic sciences?’’ should of course be ‘‘Why not?’’, if it is the case that what the question is really referring to is basic research, whatever the branch of science involved. It is agreed that no single approach should be excluded a priori from the array of possible methods in the pursuit of knowledge, especially as the authors propose the judicious use of such methods. Their article raises some issues of more general epistemological concern, though, issues that will be addressed below.

The compassionate bureaucrat: processing cases, facilitating change, being human

Abstract This article reports on a study the aim of which was to sketch a tentative model for illuminating variations in the professional role of a social worker, based on Swedish social work students’ own experiences of knowledge use and its premises in client meetings during field practice. Social work students voluntarily submitted narratives depicting problematic and unproblematic situations experienced during field practice in one of three broad occupational positions of social work: casework; counselling; and social assistance. Three different formative aspects were identified as constituting premises for knowledge use in social work. Knowledge use from differing epistemological domains are set in relation to the identified formative aspects, all together comprising a role that we label ‘the Compassionate Bureaucrat’.

Care and concern in the research process: meeting ethical and epistemological challenges through multiple engagements and dialogue with research subjects

By addressing a case of data collection strategies applied in research on Thai migration to the Swedish wild-berry industry, this article argues for how a feminist approach based on care and concern for research subjects both safeguards ethical concerns and promotes good knowing. The data collection procedures were designed in a step-by-step manner, including the research subjects as much as possible at different times and in different ways in an attempt to create preconditions for a more inclusive production of knowledge. In-depth interviews, participant observation, photo documentation and group interviews were used, which facilitated the possibility to understand the content and meanings of wild-berry picking from the workers’ points of view. Through prolonged contact, including repeated encounters and dialogue with research subjects, in-depth knowledge was produced concerning Thai migrations to Sweden, as migration was set in relation to the migrants’ life courses and living conditions.

Strategies to handle the challenges of intimacy in nighttime home care services

ABSTRACT The provision of intimate and personal care constitutes a challenge for both careworkers and care recipients and is still a neglected area of research. An observational study of the interaction between the careworkers and care recipients in night-time home care services was conducted in a large municipality in Sweden. The results were analysed in light of previous research and theorising on strategies for handling intimacy in intimate care. The study highlights what appears to be a tension between the ways in which the recipient of care is conceptualised as an active consumer of care in present-day guidelines and the strategies chosen on the part of both caregivers and care recipients, when intimacy and integrity is most at stake, and framed as it is by the care recipients’ situation of dependency and vulnerability. Home care services night-time was shown to be a case that markedly differs from many other settings of intimate care, but in the interactional routines intimate care came forth as a smooth and minimally obtrusive activity. The careworkers and care recipients engaged in strategies such as disattention, eye-discipline, middle-distance orientation, and objectification, thereby serving the purpose of balancing the transgressions of thresholds of intimacy.