Wednesday 11 April 2012 at 12:00 - 13:30
MEDICINE, HEALTH AND ILLNESS Crawshaw, P.
ROGER STEVENS 03 Teesside University
Recent public health strategies in the UK and beyond have promoted the use of social marketing as a method to improve the health of populations. These strategies typically focus upon the promotion of behavioural change and are congruent with the lifestyle discourses which have become so characteristic of contemporary public health methodologies. This paper argues that the practice of social marketing posits a problematic as its focus is not the 'social' but rather the individual and that its assumptions are predicated upon constructing rational, risk averse actors with a reflexive awareness of, and interest in, either maintaining or optimising their own health and wellbeing. As the starting point for much public health work is the laudable goal of reducing inequalities, many of which are the direct outcome of structural and systemic factors, a paradox emerges whereby strategies of individualisation of responsibility are used to address social problems which emerge from macro issues. This paper argues that social marketing strategies constitute a low cost way to transfer responsibility for the management of risk to populations themselves and rather than representing policy solutions to tackling endemic inequalities, they are indicative of a preparation for the failure of social policy in diverse contexts, including health work. Empirical material from in depth qualitative interviews with 20 professionals working in the field of social marketing and health is presented in order to explore the implementation of social marketing in the context of institutions increasingly organised in terms of a troubling neo-liberalism.
Kroezen, M., van Dijk, L., NIVEL- Netherlands Institute for Health Services Research
Groenewegen, P.P., Francke, A.L. Problems, Professional Tasks and Jurisdiction: The Case of Nurse Prescribing
The tasks of professions are human problems amenable to expert service. Abbott states that where occupational groups manage to construct problems in such a way that their knowledge is acknowledged as expert knowledge, they can successfully claim jurisdiction over this task and consequently gain recognition as a profession in this area. Using Dutch nurse prescribing as case study, we investigated 1) how and to what extent the medical and nursing profession constructed the problem of prescribing of medicines, 2) where the limits of their strategies lie when it comes to gaining recognition as a profession and successfully claiming jurisdiction, and 3) what other factors play a role in this process.
We conducted thirteen semi-structured in-depth interviews with representatives of key Dutch professional nursing associations, medical associations and other relevant stakeholders, such as the Ministry of Health. The approved interview reports, supplemented by broad document analysis, formed the basis for our analysis. Data were analysed both deductively and inductively and several recurring themes were identified.
Preliminary results show that the medical profession tries to frame prescribing of medicines predominantly as an act of partnership in which a doctor should always participate and hold legal responsibility. The nursing profession tries to construct prescribing as a routine task which forms an integral part of nurses' jobs, one that they can generally perform independently. These problem constructions are influenced by other social forces, such as the striving for more cost efficiency within health care. This influences the division of jurisdictional control over prescribing.
Kenten, C., Deedat,S., Morgan, M. King's College London
Failed Nurses or an Essential Resource? The Embedding of Specialist Nurses for Organ Donation within Intensive Care Units
The Organ Donation Taskforce was established in 2006 with the remit to identify barriers to organ donation and recommend changes within the current legal framework to increase organ donation by 50% by 2013. 14 Recommendations were identified of which one (Recommendation 9) sought to see an increase in donor transplant co-ordinators and for these co-ordinators to be embedded in intensive care units (ICUs). The result has been the increase in Specialist Nurses for Organ Donation (SNODs) embedded in ICUs. The SNODs are employed by NHSBT, a Special Health Authority in the NHS, and work with ICU and A+E staff to identify potential organ donors and support next of kin through the organ donation process.
Drawing on empirical data from the DonaTE Programme, including observations and over 100 interviews with SNODs and ICU staff across five English hospitals, the paper considers the introduction of a 'new profession' to ICU and clinical staff views, both positive and negative, towards the role of the SNOD. The perspectives of embedded SNODs are reflected upon as they negotiate their new professional identities within ICUs including the strategies and tactics they employ to aid their embedment. The paper suggests that the extent to which the ICU or individuals embrace the role of the SNOD affects the ability of the SNOD to effectively carry out their role and ultimately this may affect the experiences of the next of kin and organ donation decisions.
97
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132 |
Page 133 |
Page 134 |
Page 135 |
Page 136 |
Page 137 |
Page 138 |
Page 139 |
Page 140 |
Page 141 |
Page 142 |
Page 143 |
Page 144 |
Page 145 |
Page 146 |
Page 147 |
Page 148 |
Page 149 |
Page 150 |
Page 151 |
Page 152 |
Page 153 |
Page 154 |
Page 155 |
Page 156 |
Page 157 |
Page 158 |
Page 159 |
Page 160 |
Page 161 |
Page 162 |
Page 163 |
Page 164 |
Page 165 |
Page 166 |
Page 167 |
Page 168 |
Page 169 |
Page 170 |
Page 171 |
Page 172 |
Page 173 |
Page 174 |
Page 175 |
Page 176 |
Page 177 |
Page 178 |
Page 179 |
Page 180 |
Page 181 |
Page 182 |
Page 183 |
Page 184 |
Page 185 |
Page 186 |
Page 187 |
Page 188 |
Page 189 |
Page 190 |
Page 191 |
Page 192 |
Page 193 |
Page 194 |
Page 195 |
Page 196 |
Page 197 |
Page 198 |
Page 199 |
Page 200 |
Page 201 |
Page 202 |
Page 203 |
Page 204 |
Page 205 |
Page 206 |
Page 207 |
Page 208 |
Page 209 |
Page 210 |
Page 211 |
Page 212 |
Page 213 |
Page 214 |
Page 215 |
Page 216 |
Page 217 |
Page 218 |
Page 219 |
Page 220 |
Page 221 |
Page 222 |
Page 223 |
Page 224 |
Page 225 |
Page 226 |
Page 227 |
Page 228 |
Page 229 |
Page 230 |
Page 231 |
Page 232 |
Page 233 |
Page 234 |
Page 235 |
Page 236 |
Page 237 |
Page 238 |
Page 239 |
Page 240 |
Page 241 |
Page 242 |
Page 243 |
Page 244 |
Page 245 |
Page 246 |
Page 247 |
Page 248 |
Page 249 |
Page 250 |
Page 251 |
Page 252 |
Page 253 |
Page 254 |
Page 255 |
Page 256 |
Page 257 |
Page 258 |
Page 259 |
Page 260 |
Page 261 |
Page 262 |
Page 263 |
Page 264 |
Page 265 |
Page 266 |
Page 267 |
Page 268 |
Page 269 |
Page 270 |
Page 271 |
Page 272 |
Page 273 |
Page 274 |
Page 275 |
Page 276 |
Page 277 |
Page 278 |
Page 279 |
Page 280 |
Page 281 |
Page 282 |
Page 283 |
Page 284 |
Page 285 |
Page 286 |
Page 287 |
Page 288 |
Page 289 |
Page 290 |
Page 291 |
Page 292 |
Page 293 |
Page 294 |
Page 295 |
Page 296 |
Page 297 |
Page 298 |
Page 299 |
Page 300 |
Page 301 |
Page 302 |
Page 303 |
Page 304 |
Page 305 |
Page 306 |
Page 307 |
Page 308 |
Page 309 |
Page 310 |
Page 311 |
Page 312 |
Page 313 |
Page 314 |
Page 315 |
Page 316 |
Page 317 |
Page 318 |
Page 319 |
Page 320 |
Page 321 |
Page 322 |
Page 323 |
Page 324 |
Page 325 |
Page 326 |
Page 327 |
Page 328 |
Page 329 |
Page 330 |
Page 331 |
Page 332 |
Page 333 |
Page 334 |
Page 335 |
Page 336 |
Page 337 |
Page 338 |
Page 339 |
Page 340