Pernille Tanggaard Andersen

Healthcare reform in Denmark

The article discusses and describes how healthcare reform from 2007 in Denmark has influenced the health sector. This reform has been labelled the most radical reform of the political administrative system since the first democratic constitution in 1849. Local government reform is the latest step in a process of reforming the welfare state and the health sector. In more concrete terms this article analyzes two key issues that have had top priority in the first period of reform implementation — the new planning of hospital structure and the first generation of health agreements.

Measurement of Community Empowerment in Three Community Programs in Rapla (Estonia)

Community empowerment approaches have been proven to be powerful tools for solving local health problems. However, the methods for measuring empowerment in the community remain unclear and open to dispute. This study aims to describe how a context-specific community empowerment measurement tool was developed and changes made to three health promotion programs in Rapla, Estonia. An empowerment expansion model was compiled and applied to three existing programs: Safe Community, Drug/HIV Prevention and Elderly Quality of Life. The consensus workshop method was used to create the measurement tool and collect data on the Organizational Domains of Community Empowerment (ODCE). The study demonstrated considerable increases in the ODCE among the community workgroup, which was initiated by community members and the municipality’s decision-makers. The increase was within the workgroup, which had strong political and financial support on a national level but was not the community’s priority. The program was initiated and implemented by the local community members, and continuous development still occurred, though at a reduced pace. The use of the empowerment expansion model has proven to be an applicable, relevant, simple and inexpensive tool for the evaluation of community empowerment.

The association between social position and self-rated health in 10 deprived neighbourhoods

BackgroundA number of studies have shown that poor self-rated health is more prevalent among people in poor, socially disadvantaged positions. The aim of the present study was to investigate the association between self-rated health and social position in 10 deprived neighbourhoods.MethodsA stratified random sample of 7,934 households was selected. Of these, 641 were excluded from the study because the residents had moved, died, or were otherwise unavailable. Of the net sample of 7,293 individuals, 1,464 refused to participate, 885 were not at home, and 373 did not participate for other reasons, resulting in an average response rate of 62.7%. Multiple logistic regression models were used to estimate the associations between the number of life resources and the odds of self-rated health and also between the type of neighbourhood and the odds of self-rated health.ResultsThe analysis shows that the number of life resources is significantly associated with having poor/very poor self-rated health for both genders. The results clearly suggest that the more life resources that an individual has, the lower the risk is of that individual reporting poor/very poor health.ConclusionsThe results show a strong association between residents’ number of life resources and their self-rated health. In particular, residents in deprived rural neighbourhoods have much better self-rated health than do residents in deprived urban neighbourhoods, but further studies are needed to explain these urban/rural differences and to determine how they influence health.

The association between socio-demographic characteristics and perceived stress among residents in a deprived neighbourhood in Denmark

BACKGROUND It is known that stress is associated with various negative health outcomes, and higher levels are found among people with low socio-economic status (SES) compared with those better-off. Evidence of the characteristics of deprived neighbourhoods with negative impact on health and stress is accumulating while little is known about the stress variation by the socio-demographic characteristics of the dwellers. The present study aimed to investigate how stress varies by socio-demographic characteristics of the residents in a deprived neighbourhood. METHODS The data used in this article were collected in the spring 2009. The 1160 participants, aged 16-104 years were randomly selected among the residents in a deprived neighbourhood in Esbjerg, Denmark. The survey was conducted through telephone and face to face interviews. Multiple linear regression analyses were carried on to examine the association of perceived stress with age, gender, ethnicity, education, civil status, economy, unemployment, sick leave, social deprivation and loneliness. RESULTS The results show higher levels of stress among women, immigrants, poor and lonely compared with their counterparts. Stress decreases as the economy situation improves and people get old. Education, civil status and unemployment, initially significant, lost power in association with stress when income and economic deprivation were taken into account. CONCLUSION The results of this study suggest that variation in the stress levels across socio-demographic characteristics may have specific features among people in the low SES hierarchy, dwellers of a deprived neighbourhood.

Social relations and experiences of social isolation among socially marginalized people

We aimed to obtain a greater understanding of the characteristics of social relations and experiences of social isolation among homeless people, substance users and other socially marginalized users of shelters and drop-in centres in Denmark. Based on in-depth interviews with 46 shelter/centre users, we created a typology of five groups: the socially related and content, the satisfied loners, the socially related but lonely, the socially isolated and the in-betweens. The characteristics of the groups did not seem related to interviewees’ degree of social marginalization. Professionals played a pivotal role, providing social support and help to improve interviewees’ life circumstances. The findings provide insight into the social lives of shelter/centre users that is useful for developing initiatives to improve their social wellbeing.

Meanings and experiences of assistive technologies in everyday lives of older citizens: a meta-interpretive review.

Abstract Purpose: The purpose of this study was to synthesize the available qualitative studies on the meaning of assistive technologies (AT) in elderly peoples everyday lives in order to identify central concepts, themes, and findings from existing research. Method: A systematic search of the literature was conducted, using predetermined search strategies. Exclusion criteria were, in accordance with the meta-interpretive approach, developed iteratively during the reading of abstracts and articles. Interpretations from the studies were used as data for thematic analysis and synthesis of findings. Results: Review of these studies show that older people not only have positive attitude towards AT, but also that acceptance of technologies is a potentially stressful process where trust towards technologies and other people are of importance. Older people have ambivalent experiences with technology, as it gives rise to possibilities as well as constraints, and safety as well as worries. AT enact sometimes conflicting values related to self and society. Conclusions: Although AT seem to support societal discourses on active aging, the empirical studies in this field show that the technologies enter older people’s lives in complex ways, enacting social values and ambivalences and interact with caretakers, relatives and other actors, within specific institutional settings. Implications for rehabilitation In implementing AT, attention should be paid to ambivalences and conflicting values enacted by AT in older peoples lives In implementing AT, attention should be paid not only to independency but also to the eventually dependencies, created by the use of AT

Gendered Negotiations of Competences and Management

In this article we present some results from our study on wage formation in four large Danish private businesses. Our aim is to show how the evaluation of employees, which appears to be gender‐neutral, in reality follows gender divisions, for example according to ideas of gendered parenting. The article discusses how negotiations of competences and management affect womens and mens opportunities in work‐life, especially womens opportunities in terms of reaching the executive level in Danish business.

Safety Representatives’ Roles and Dilemmas in the Danish Oil and Gas Industry

Abstract Safety representatives are supposed to play a crucial role in ensuring safe and healthy workplaces in the oil and gas industry, but the role is marked by dilemmas and constraints. This paper analyses how safety representatives in their daily practice develop a role that can create the necessary recognition from management and the manoeuvring space to fulfil their role. It is based on a study of three firms in the Danish oil and gas industry. The results indicate that safety representatives are marked by dilemmas between the rather extensive legislative demands and the conflicting expectations from colleagues and management, and constraints on the day-to-day fulfilment of the role. Danish legislation and Danish industrial relations focus on the collaborative aspect of the safety representative role, which impacts on the view of the role. The primary role of the safety representative is to solve small problems rather than protect the interests of colleagues. The focus on problem solving is caused not only by legislation, but by the policies of the individual companies-in the three companies studied, there were considerable differences between them, with one company including its safety representatives to a much larger extent than the others.

Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: a qualitative study

BackgroundThirty-five percent of Danish women experience sexual or physical violence in their lifetime. However, health care professionals are not in the practice of asking about intimate partner violence (IPV) in Denmark. It is currently unknown what hinders general practitioners from asking about partner violence and how Danish women would perceive such an inquiry. This aspect has not previously been explored in Denmark. An exploratory study was conducted to examine what hinders general practitioners (GPs) from asking and what Danish women’s views and attitudes are regarding being asked about IPV.MethodsData were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data.ResultsThis study provides important knowledge regarding the barriers and attitudes towards inquiry about IPV in primary care in Denmark. Results indicate that Denmark is facing the same challenges when responding to survivors of IPV as other similar countries, including Sweden, Norway, the UK, USA, and Australia. Danish women want general practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV.ConclusionsIt is acceptable to inquire about IPV with women in Denmark in a non-judgemental and respectful way. Informing about IPV prevalence is important prior to the inquiry. However, general practitioners require more awareness and training before a favourable environment for this change in procedure can be created. Further large-scale research is needed to support the evidence generated by this small study.

Municipalities Collaborating in Public Health: The Danish Smoking Prevention and Cessation Partnership

This study explored the Smoking Prevention and Cessation Partnership (SPCP) which builds upon a collaboration between two Danish municipalities targeted at the prevention of tobacco smoking. The aim of the study was to describe the processes of SPCP, to examine the difficulties this collaboration faced, and to assess how these experiences could be used to improve future partnership collaboration. We employed qualitative methodology comprising 12 semi-structured one-to-one interviews with SPCP’s stakeholders and an analysis of the partnership documents and reports. The findings suggested that the main potentials of the partnership were the personal relations between the members and stakeholders with the possibilities of the creation of new connections with other actors. Barriers to successful partnership building were the implementation of the new Local Government Reform as a competing task, and that the two municipalities were heterogenic in respect to organizational issues and working methods. Other impediments included the lack of continuity in leadership, the lack of clarity regarding the form of collaboration and roles, as well as different expectations of the stakeholders. We conclude that four factors remain critical for partnerships. The first is the clarity of the collaborative effort. Second, partnerships need to take into account the structural circumstances and culture/value systems of all stakeholders. Third is the impact of contextual factors on the development of the partnership; and the fourth factor is the bearing of personal/individual factors on the partnership e.g., personal engagement in the project. Early attention to these four factors could contribute to more effective partnership working.