Purpose: This project investigates the opportunities and limitations of health promotion in the practice of the needs assessment conversation with cancer patients. The aim is to gain insight into whether this new practice together with the use of an assessment tool, a questionnaire from Region H Støtte til livet med kræft, is favouring educated patients compared to cancer patients with no or low education. The project will in this way seek to uncover whether this practice is increasing inequality in health in the Danish society.
Background:The number of cancer survivors is increasing, and as a result, an increasing number of patients are in need of rehabilitation. National and regional guidelines recommend that patient's needs for rehabilitation are identified through a needs assessment conversation based on an assessment tool. This is a new practice within the Danish health care system, and there is a lack of research on how the health professional and the cancer patient practice this task.
Method: The analytical data for this project has been produced in three Danish hospitals and in a health centre in a Danish municipality. The data is based on 9 recorded field observations, followed up by a semistrutured interview with the health professional, who had performed the needs assessment. A few days after the needs assessment conversation, the field observer conducted a short telephone interview with the cancer patient. The analysis has been performed by in depth analysis of four of the field observations together with associated interviews, using Pierre Bourdieu’s sociological tools: capital, habitus, field and practice. We include knowledge from Erik Riiskjær and Mari Holen, who both have contributed with new research work within the Danish hospitals systems. Riiskjær unfolds four different types of management logics, which together with Holens research work that identifies four different norms within the hospitals that patients are expected to fit into, affect the practice of the needs assessment. The four in-depth analyses together with the rest of the empirical data will be the basis for a cross analysis to compare overall points in six themes with focus on the opportunities and limitations of health promotion created in the practice of the needs assessment conversation with cancer patients.
Conclusion: The results in this project indicate that the practice of the needs assessment to a certain degree is favouring educated patients, to cancer patients with no or low education, in a way that provides more health-promoting interventions to these patients. Some of the findings in the data also indicate that within the clinical practice there is an exclusion of patients who neither understand Danish nor English. The most significant finding in the project was how the nurses’ practice of the needs assessment was dependent on the terms and conditions available, and this became essential for the opportunities for health promotion that could be created within the practice. The findings seems to indicate that the nurses with an independent clinic, separated from the medical practise, had better conditions to create opportunities for health promotion, and it also seemed to provide better chances for development of the practice, and better opportunities for competence development among the nurses in relation to this new task.
|Uddannelser||Master i Sundhedsfremme (MSF), (Masteruddannelse) Master|
|Udgivelsesdato||14 jun. 2017|