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  • 1.
    Berggren, Elisabeth
    et al.
    Höskolan i Skövede.
    Sidenvall, Birgitta
    Hälsohögskolan i Jönköping.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Identity construction and meaning-making aftersubarachnoid haemorrhage2010In: British Journal of Neuroscience Nursing, ISSN 1747-0307, E-ISSN 2052-2800, Vol. 6, no 2, 86-93 p.Article in journal (Refereed)
  • 2.
    Blomgren Mannerheim, Ann
    et al.
    Karolinska Inst, Div Nursing, Dept Neurobiol Care Sci & Soc, S-17177 Stockholm, Sweden.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Siouta, Eleni
    Karolinska Inst, Div Nursing, Dept Neurobiol Care Sci & Soc, S-17177 Stockholm, Sweden; Karolinska Inst, Dept Learning Informat Management & Eth LIME, S-17177 Stockholm, Sweden; Sophiahemmet Univ, Box 5605, S-11486 Stockholm, Sweden.
    Parents’ experiences of caring responsibility for their adult child with schizophrenia2016In: Schizophrenia Research and Treatment, ISSN 2090-2085, E-ISSN 2090-2093, 1958198Article in journal (Refereed)
    Abstract [en]

    As a consequence of the latest psychiatry-related reform in Sweden and its implementation, relatives and family members have taken over from the formal healthcare system significant responsibility for the care of persons with a mental disability and illness. The aim of this study was to systematically describe and analyze the experiences of parents' informal care responsibility. The questions were, what are the experiences around parents' informal care activities and responsibilities and how do parents construct and manage their caring responsibility and with what consequences? Semistructured in-depth interviews were conducted (16 hours of recorded material) with eight parents who were all members of the Interest Association for Schizophrenia (Intresseforeningen for Schizofreni (IFS)) in Sweden. A mixed hermeneutic deductive and inductive method was used for the interpretation of the material. The parents endow their informal caring responsibility with meaning of being a good, responsible, and accountable parent with respect to their social context and social relationships as well as with respect to the psychiatric care representatives. In this tense situation, parents compromise between elements of struggle, cooperation, avoidance, and adaption in their interaction with the world outside, meaning the world beyond the care provision for their child, as well as with the world inside themselves.

  • 3.
    Delbene, Roxana
    et al.
    New York City College of Technology.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    “What’s the trouble sweetheart?”:: A Socio-pragmatic Analysis of the Play Wit.2013Manuscript (preprint) (Other academic)
  • 4.
    Furåker, Carina
    et al.
    Göteborgs universitet, Sahlgrenska akademin.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Walldal, Elvi
    Göteborgs universitet.
    Quality of care in relation to a critical pathway from thestaff´s perpective2004In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 12, 309-316 p.Article in journal (Refereed)
  • 5.
    Helander, Jeanette
    et al.
    Högskolan i Skövde.
    Karlsson, Emmelie
    Högskolan i Skövde.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. Högskolan i Skövde.
    Aspekter på vårdrelationen: – En intervjustudie om vårdrelationen ur sjuksköterskans perspektiv2007In: Omvårdaren, Tidskrift : för lärare och skolledare inom hälsa & fritid, vård & omsorg / utges av Lärarförbundet, Vol. 1, 8-12 p.Article in journal (Other (popular science, discussion, etc.))
  • 6.
    Hellberg, Ingela
    et al.
    Lidköpings kommun.
    Augustsson, Veronika
    Götene kommun.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Elderlypeople’s experiences of living in special housing2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6Article in journal (Refereed)
  • 7.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Accounts of pain experience and vulnerability in an elderly care context2014In: Meeting the Challenges for the health and elderly care:: Problematizing Vulnerability in Care Encounters. / [ed] Srikant Sarangi, 2014Conference paper (Refereed)
    Abstract [en]

    Reserarch statenet/question:

    The main concern in this presentation is to show how a discourse and communication based approach in the context of the care of elderly, provides a basis for reflecting on pain and of the vulnerability. How can the older client's vulnerability be reflected and reduced within the context of elderly?

     

    Theoretical framework:

    The presentation is based on a published article Hellström Muhli, U. (2010), entitled: Accounts of pain experience in an elderly care context, whose method, purpose and results are presented below.

     

    Methods:

    Based on six hours of recorded, transcribed and translated data from talk encounters between care professionals /elderly clients, an activity analysis of institutional settings and categorization of interactional discourse was made. There was a twofold focus: how elderly people initiate painful accounts, and how the professionals orient to such accounts.

     

    Findings:

    The pain-talks are governed by the institutional practice of phases: framing mapping troubles and symptoms, client’s self-presentations, counseling, and concluding. This structure shows the dialogical accounts as a communicative activity (type) of pain talk. A thematic interactional map of critical moments related to pain as 1) social death and hope, 2) and presentation of self as past and self as present, was achieved. The elderly talk about pain as an identity construction. Pain is a link between past, present and future identity.

     

    Conclusions:

    It is suggested that the caring aspect of professional skills is to support hope and to change the focus from social death, to life and recovering.

  • 8.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Accounts of pain experience in a elderly care context2009In: Multiparty talk: negotiating needs, capacities and experiences, 2009Conference paper (Refereed)
    Abstract [en]

    Background It is increasingly recognized that analysis of ‘ordinary’ language use and social interaction can contribute to our understanding of how individuals express and experience pain, as well as reveal ways in which human suffering is managed. However, there are few studies with a communicative approach to pain which focus on elderly clients. The purpose of this study is to describe language use with regard to accounts of pain experience in a Swedish context of elderly care.

     

    Method Based on six hours of recorded, transcribed and translated data from care encounters, an activity analysis of institutional settings as well as categorization of interactional discourse was made. There was a twofold focus: how elderly people initiate painful accounts, and how the professionals orient to such accounts. Attention is drawn to how both parties oriented primarily to the task of information exchange, and how they accomplished credibility by attending to aspects of role-relations and face-work and by shifting between institutional, professional and life-world frames in subtle, but different, ways.

     

    Findings It was found that the pain-talk encounters were a communicative activity (type), governed by the phases of: Framing, Mapping troubles and symptoms, Viz. clients`, Self presentations, Counseling, and Concluding. A thematic interactional map of critical moments related to pain as social death and hope, and presentation of self as past and self as present, was achieved.

     

    Interpretation It is suggested that the caring aspect of professional skills is to support hope and to change focus from social death to life and recovering. It is also suggests that experience of pain in old age can be characterized as not only pathological but also as social and relational. This knowledge contributes to better understanding of pain and pain-related phenomena in old age, which might be useful in nursing.

  • 9.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Accounts of pain experience in a Swedish elderly care context2008Conference paper (Refereed)
  • 10.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Accounts of Pain Experience in a Swedish Elderly CareContext2010In: Communication & Medicine, an Interdisciplinary Journal of Healthcare, Ethics and Society, Vol. 7, no 1, 55-64 p.Article in journal (Refereed)
  • 11.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. Högskolan i Skövde.
    Accounts of Professional and Institutional Tension in aSwedish Elderly Care Context.2010In: Journal of Aging Studies., no 24, 47-56 p.Article in journal (Refereed)
  • 12.
    Hellström Muhli, Ulla
    University of Gothenburg, Institute of Health Care Pedagogics.
    Att överbrygga perspektiv: En studie av behovsbedömningssamtal inom äldreinriktat socialt arbete2003Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The aim of the study was to describe and analyse institutional practice in need assessment dialogues. The questions were: How are the dialogues structured? How is the professional dialogue content combined with: the institutional, traditional and personal perspectives? How are communicative problems solved?

    Mapping, assessing and deciding on social welfare or other aid measures for elderly people is one part of the concretisation of the elderly care policy in the encounter with the individual citizen. This concretisation is not just a simple transfer of political goals but, rather, contains implications for elderly care institutions as a whole, for elderly oriented social work and for processing. Examples of such implications are demands on knowledge growth in elderly oriented social work and demands on professional practice. The institutional actors, the case officers, serve an important purpose for the elderly in the encounter with elderly care. The need assessment dialogue between case officers and elderly persons is thus seen as a communicative activity or practice through which they (re)produce elderly care. It is this that the study attempts to give shape to.

    The project has its theoretical underpinning in social constructionism and in dialogism, which explain people’s everyday actions and interaction and how people make their knowledge and assumptions comprehensible. The social constructionist theory also explains how social institutions are created and maintained in people’s interaction in institutional talk.

    Data have been collected in the form of video recordings of 16 need assessment meetings and consist of about 12 hours of recorded need assessment dialogues. Content analyses of interactive courses of events in need assessment dialogues have been performed.

    The results show that phases constitute the structure of the dialogues and make them comprehensible. The phases serve different functions in the need assessment dialogues. The phase structure can be seen as a sub activity, which has specific aims and solves different tasks that are central to the case officer’s work. The phase structure consists of: opening, framing, mapping of needs, information and counselling, the turning-point in the dialogue and conclusion. A prominent feature of the study is the relationship between institutional order and professional practice. This relationship is the basis of different dilemmas in the encounter with the client. The key task facing the case officer is to bridge these dilemmas by means of different strategies. The case officer’s professional task in need assessments is not only to assess care requirements but also to make the institutional prerequisites of the aid measures comprehensible to the client and to transform care requirements into institutional abstractions. The knowledge contribution consists of an understanding of the complexity of the dialogue and how meaning and perspectives in the dialogue are produced interactively in different ways. An important knowledge contribution is the importance of communication in elderly oriented social work. This is a key factor in establishing a working relationship between the client and the case officer. It is also a key factor in the case officer’s professional practice.

  • 13.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Biståndsmötet kärnan i omsorgsarbetet2002In: Äldre i Centrum, tidskrift för aktuell forskning, ISSN 1401-5110, no 3, 36-37 p.Article in journal (Other (popular science, discussion, etc.))
  • 14.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. Högskolan i Skövde.
    Bridging perspectives: - A study of need assessment dialogues in elderly orient social work.2004In: Advanced Health Sciences of Tomorrow / [ed] The Vårdal Institute, Lund University, Lund, 2004Conference paper (Refereed)
  • 15.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Bridgring Perspectives2006In: Socialt arbete i informationseran - polariseringar och nya paradigm i kunskapsproduktionen., 2006Conference paper (Refereed)
  • 16.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Can a care home feels like a home?: - Seniors´ experiences of living in special housing accommodation (SHA) in the context of Swedish care for seniors2012Conference paper (Refereed)
    Abstract [en]

    In my presentation I will discuss the senior’s experiences of living in SHA facilities. Of particular interest is living in a SHA as a phenomenon.

     

    SHA means alternative forms of housing such as nursing homes, elderly homes, and group housing. One of the most important principles of Swedish policy relating to seniors, as provided in the official statements, is that public policy is to be framed in such a way that seniors shall continue living in their own homes for as long as they possibly can, even if they are in need of extensive health and social care. However, SHAs are available for people who are no longer able to live in their own homes (regular housing). The various SHA facilities usually have one-room apartments with jointly owned, home-like premises, where they typically offer meals, SHA services also provide 24-h scheduled and unscheduled personal care.

     

    In Sweden, however, housing policies for seniors’ care, have generally focused on the development of assisted living and care standards (supply-based care), rather than on adapting the SHA to the requirements of the individual residents. This is despite the fact that the political discourse claims to offer care that is tailored to the individual’s needs (demand-based care). This poses some interesting questions. Specifically,

     

    1) What is the seniors’ experience living in a SHA when the accommodation mandates are based on both supply-based care standards and on the institutional order or discourse, rather than the individual influence?

     

    2) Can the SHA be viewed as a home where the person actually feels like being at home?

     

    3) Is the perceived life at a SHA experienced as something more than a solution to care requirements?

     

     

     

     

     

     

  • 17.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Delaktighet i äldreomsorgens språkliga möten2012In: Delaktighetens praktik: det professionella samtalets villkor och möjligheter / [ed] Pia Bülow, Daniel Persson Thunqvist & Inger Sandén, Malmö: Gleerups Utbildning AB, 2012Chapter in book (Other academic)
  • 18.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Elderly Peoples Experiences of Living in Special Housing Accommodation,2011Conference paper (Refereed)
  • 19.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Forskningsetik2014In: Att skriva uppsats med akribi / [ed] Jan Trost, Lund:: Studentlitteratur , 2014, 4:1, 1-96 p.Chapter in book (Other (popular science, discussion, etc.))
  • 20.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    I samtalet sker ett möte mellan två världar2008In: Vårdfacket, Tidning för Vårdförbundet, ISSN 0347-0911, no 3Article in journal (Other (popular science, discussion, etc.))
  • 21.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Komptens inom socialomsorgsledarskap1998In: Kompetens ur ett vårdpedagogiskt perspektiv: en antologi i vårdpedagogik / [ed] Ewa Pilhammar Andersson, Göteborg: Institutionen för vårdlärarutbildning, Göteborgs Universitet , 1998, 1, 82-119 p.Chapter in book (Refereed)
  • 22.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Refining the analytic lens to study elderly pain talk.2008Other (Other academic)
  • 23.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Refining the analytic lens to study elderly pain talk2008Other (Other (popular science, discussion, etc.))
  • 24.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Seniors’ experiences of living in specialhousing accommodation (SHA): - Challenges for Scandinavian elderly care2013In: The 20th IAGG World Congress of Gerontology and Geriatrics (IAGG 2013): Digital @geing: A New Horizon forHealth Care and Active Ageing, 2013Conference paper (Refereed)
    Abstract [en]

    Introduction

    In Sweden, housing policies for seniors’ care, have generally focused on the development of assisted living and care standards (supply-based care), rather than on adapting the SHA to the requirements of the individual residents. This is despite the fact that the political discourse claims to offer care that is tailored to the individual’s needs (demand-based care). This poses some interesting questions. Specifically, 1) What is the seniors’ experience living in a SHA when the accommodation mandates are based on both supply-based care standards and on the institutional order or discourse, rather than the individual influence? 2) Can the SHA be viewed as a home where the person actually feels like being at home? 3) Is the perceived life at a SHA experienced as something more than a solution to care requirements

    This oral presentation is based on a hermeneutic phenomenological analysis of interview material in which 12 seniors living in Special Housing Accommodation (SHA) facilities reflect on the experience of living in such facilities. Of particular interest in the analysis is living in a SHA as a phenomenon.

    Method

    The data material was collected by face-to-face interviews (each participant had one interview) using an interview guide (Fontana & Frey, 1994), containing the question topics of (i) life situation now, (ii) experiences of dwelling, (iii) being at home, and (iv) life situation in the future.

    Results

    The finding shows that the phenomenon of lived experience in a SHA seems to be a state of ambiguity regarding one’s existence, which is made up of several constituents (elements of meaning).The analysis contributes to the understanding of how the phenomenon of SHA living is coming into existence as a need, due to an individual’s failing health; however, the SHA is not considered to be a true home

    Conclusion

    The seniors learn to cope with living in the SHA by lowering their expectations of life and existence while the SHA provides the prerequisites for their existence. An implication for promoting care is to support the seniors to enable a full existence of life within SHA living.

  • 25.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    The Ethical Dimension of Presence in Elderly Care Talk-Encounters.2010In: Presence in Health Care Communication - Discursive and Ethical Dimensions., 2010Conference paper (Refereed)
  • 26.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Verbal strategies for supportive approach in need assessment dialogues with elderly2010In: CONSTRUCTING Communication as care, - tools, talk and tasks, 2010Conference paper (Refereed)
    Abstract [en]

    Background: Need assessments dialogues are framed by a bureaucratically order which fuel communicative problems, negative for the elderly clients’ well-being as not understanding the information, feeling of patronage patterns, etc. However, supportive utterances and commentaries are frequently used to accomplish the goal of individual-centered care and the utterances serve indirectly a purpose of supporting the individuals’ well-being. Thus, the dialogues are tools for constructing communication as care.

     

    Aim: The aim is to explore the use of supportive utterances and commentaries as recourses and verbal strategies for wellbeing in constructing communication as care.

     

    Methods: Supportive utterances are here understood as positively affective speech acts and are analyzed in interaction between elderly clients and care managers. The dialogues were recorded, transcribed and translated verbatim. An activity analysis of institutional settings and categorization of supportive utterances was made. There was a twofold focus: (i) how professionals initiate supportive utterances, and (ii) how the elderly clients orient to such utterances.

     

    Findings: I am making two major points about verbal strategies in need assessment dialogues. Firstly, each supportive utterance serves several purposes, one of them to confirm the expert role of the case manager. Secondly, verbal strategies in client-expertise dialogues reflect resources that are essential in the expert system to accomplish goals of individual wellbeing.

     

    Implications: Knowledge about supportive utterances as verbal strategies contributes crucially to feelings of well-being and to attitudes toward the need assessment dialogues, and furthermore, how the dialogues can be client-oriented and pedagogical.

     

                                                                         

  • 27.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Äldres framställningar om smärta2008In: Smärta, ISSN 1402-1048, no Publ.2, 14-17 p.Article in journal (Other (popular science, discussion, etc.))
  • 28.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Delbene, Roxana
    New York City College of Technology.
    The ethical dimension of presence in elderly care talk-encounter2013In: Presence in healthcare communication: implications for professional education / [ed] J.C. Gonçalves, Niterói: Editora da Universidade Federal Fluminense , 2013Chapter in book (Other academic)
  • 29.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Furåker, Carina
    Göteborgs universitet.
    Walldal, Elvi
    Göteborgs universitet.
    Quality of care in relation to a critical pathway from the staff´s perpective.2004In: Journal of Nursing Management,, no 12, 309-316 p.Article in journal (Refereed)
  • 30.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Gonçalves, José Carlos
    da Universidade Federal Fluminense, Brazil.
    Brannigan, Michael
    The College of Saint Rose, Albany, New York , USA.
    The ethical dimension of presence in elderly care talk-encounters2014In: Conference symposium: Discursive, ethical, and interactional dimensions of presence in healthcare communication- implications for professional education, by Carlos Gonçalves (chair), Michael Brannigan and Ulla Hellström Muhli at the Twelfth international conference on Communication, medicine & ethics (COMET) 26th-28th June, 2014 - Lugano, Switzerland., 2014Conference paper (Refereed)
  • 31.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Helander, J.
    Högskolan i Skövde.
    Karlsson, E.
    Högskolan i Skövde.
    Aspekter på vårdrelationen: En intervjustudie om vårdrelationen ur sjuksköterskans perspektiv2007In: Omvårdaren, ISSN 0280-4123, no 1, 8-12 p.Article in journal (Other (popular science, discussion, etc.))
  • 32.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Jansson,, Gunilla
    Stockholm University, Department of Swedish Language.
    Boman, Åse
    University West in Trollhättan, Nursing, Health and Culture, Sweden.
    Josephson, Iréne
    Jönköping University, School of Health Sciences, Sweden.
    Blomgren, Ann
    Karolinska Institution,Division of Nursing,Department of .
    Meeting the Challenges for the health and elderly care: Problematizing Vulnerability in Care Encounters. 2014In: Symphosium: Meeting the Challenges for the health and elderly care: Problematizing Vulnerability in Care Encounters., Equinox Publishing Ltd. , 2014Conference paper (Refereed)
    Abstract [en]

    Research statement/question: The main concern in this panel (colloquium) presentation was to show how a discourse and communication based approach in the context of the health and elderly care, provides a basis for reflecting on vulnerability. How can the patient`s and/or elderly client´s vulnerability be reflected and reduced within the context of health and elderly care?  How can professional vulnerability be understood in the light of patient involvement? In general, the panel (colloquium) analyzed the challenges of different kind of vulnerability in client encounters e.g. to be or not to treated as accountable.

    Theoretical framework: From a four-dimensional, interdisciplinary perspective. Discourse Analysis, Micro-sociology, Phenomenology and Nursing, the panel (colloquium) featured five different presentations.

    Methods: Different kind (video, audio and interview) of transcribed and translated data from talk encounters between care professionals and clients, have been analyzed.  Used analytical methods were qualitative method of Conversation Analysis; Meta-synthesis; activity analysis and phenomenographic analysis.

    Findings: When looking for possible convergence between principles characterizing the approaches used by the authors and their findings, in this panel (colloquium) there are key-ideas which also have to do with what we would call communicative vulnerability. E.g., considering the vulnerability of older persons with dementia, the authors argue that a flexibility of practices may be a step towards implementing a client-centred approach in care plan meetings; it is also suggested that the caring aspect of professional skills in client encounter is to support hope; and that awareness of and understanding of the own professional vulnerability may gain understanding of implicit motives for decision-making.

    Conclusions:Humanization of health and eldercare professionals´ work by identifying the aspect of patients´ vulnerability is dealt with in this panel (colloquium) through carefully applied research methods from areas as discourse analysis, phenomenology, phenomenographic, and micro-sociology. This panel (colloquium) attests to relevant productivity of the researcher network: Talk, Text and Tools (3T), Scandinavian Interdisciplinary Health Communication Research.

  • 33.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Mannerheim Blomgren, Ann
    Parents’ experiences of caring responsibility for  their adult child with schizophrenia2017In: ”Every Child has the Right to …”2nd International Young Carers Conference29 – 31 May 2017: Health and Social Care systems / [ed] Nationellt kompetenscentrum anhöriga - för ett anhörigvänligt samhälle, Malmö, 2017Conference paper (Refereed)
    Abstract [en]

    As a consequence of the latest psychiatry-related reform in Sweden and its implementation, related parties and family members have taken over from the healthcare system a large responsibility for the care of persons with a mental disability and illness. The aim of this study was to systematically analyze and describe the experiences of parents’ care responsibility. The questions were: what are the experiences around the parents informal care activities and responsibilities, how do parents construct and manage their caring responsibility and with what consequences? Semi-structured in-depth interviews were conducted (16 h data recorded material) with eight parents who were all members of the Interest Group for Schizophrenia [

    Intresseföreningen för schizophrenic (IFS)] in Sweden. A deductive hermeneutic method was used for the interpretation of the data material. The parents endow their informal caring responsibility with meaning of being a good parent, responsible and accountable within the context of their personal and social relationships as well as to the psychiatric care representatives. In this tense situation parents’ compromise between elements of struggle, cooperation, avoidance and adaption in their interaction with the world outside as well as the world inside.

  • 34.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Saferstein, barry
    Siouta, Eleni
    How Multiple Modes of Interaction Affect Patients and Clinicians: Participation, Authority, and Understanding in a Geriatric Medical ConsultationArticle in journal (Refereed)
    Abstract [en]

    Objectives: To extend the theoretical and empirical understanding of the interactional construction of authority and participation in geriatric medical and care consultations. To identify information resources and patterns of patient – clinician interaction that support geriatric patients’ understandings of and decisions about their health care treatments.

    Methods: This article is a case study from a research project entitled- Consultation encounters at a geriatric clinic – A study of communicative praxis. The larger project included forty (N=40) clinical consultations involving twenty-three patients, aged 65–90, and thirty-three clinicians (some consultations included two or more clinicians). The consultations at a Swedish university hospital were video recorded, and an interview with each patient was audio recorded subsequent to her or his consultation(s). Ten of the clinicians who participated in the recorded consultations volunteered to be recorded individually viewing and discussing their respective consultations. The case analyzed here involves consultation interaction between a patient and a pharmacist regarding the patient’s use of an inhaler, a device used to take medication at home. The recorded data are examined using methods developed to analyze interaction, conversation, and discourse. 

    Findings: The data analysis shows how a combination of verbal, visual, tactile, and embodied information contributes to a patient’s participation and authority during a consultation. The various types of information support patterns of interaction that contribute both to the patient’s understanding of information presented by the pharmacist and to the pharmacist’s assessment of the patient’s understanding of information presented by the patient. The data analysis also explicates the components of consultation interaction that address key concerns of the pharmacist and patient. For the pharmacist, those concerns include presenting and assessing the patient’s understanding of information about using an inhaler to deliver medication.

    Conclusions: Interaction involving verbal, visual, embodied, and tactile activities supports patient participation and authority during clinical consultations in ways that provide the patient with information, which clarifies the clinician’s initial explanation. Such interaction also provides the clinician with unelicited information about the patient’s physical capabilities and living situation that are relevant to use of the inhaler and other prescribed treatments.

    Practice implications: Providing multiple modes of information in consultations supports patterns of interaction that express information beyond that initially offered by a clinician. Patients can apply such information to understandings of medical treatment and decision options concerning that treatment. This case provides an example of aspects of a type of patient-clinician interaction that can be more widely applied to increase geriatric patients’ authority and participation in their healthcare.

     

  • 35.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Saferstein, Barry
    California State University San Marcos, Department of Communication, San Marcos, California, USA.
    Siouta, Eleni
    Department of Neurobiology, Care Sciences and Society--Division of Nursing, Karolinska Institutet, Stockholm, Sweden..
    Patient Participation, Authority, and Understanding: – A Case Study of Communication Patterns in a Geriatric Consultation when using a Medical DeviceManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: The object is to examine communication patterns in the discourse that emerges between a female geriatric patient and a pharmacist in the context of using an inhaler. This analysis is done in order to understand what clinicians (pharmacist) and a geriatric patient’ do when they construct institutional communication as a practice and how they do it in ways that support understanding medical information.

    Methods: This article is a qualitative case study from a project that video recorded forty (N=40) clinical consultations. The actual case was selected out since it is representative for use of material and visual information resources, applied by a pharmacist.

    Results: Benefits of the teach-back approach for a patient’s understanding of clinician advice are not based simply on the patient reinforcing behavior by repeating the clinician’s demonstration. Rather, the way that the patient’s discussion and manipulation of the inhaler produces a communication pattern that mitigates clinician control of topics and forms of expression.

    Conclusion: By combining verbal, visual and tactile actions, patients can join in consultations in a way that enhances their participation, authority and understanding.

    Practice implications: Many consultations can incorporate elder patients’ use of various information resources to improve their participation in treatment decisions.

  • 36.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Svensson, Ann-Marie
    Skara Kommun.
    Wellbeing in old age:: A question of both continuity and change.2017In: Well-being and Quality of Life - Medical Perspective, / [ed] Mukadder Mollaoğlu, nTech Open Access publisher , 2017, 147-161 p.Chapter in book (Refereed)
    Abstract [en]

    In this chapter, we are concerned with the well-being of people in old age, living at a

    residential care home (RCH), and how well-being can be supported in gerontological

    social work and care at the RCH. Based on empirical data consisting of well-being narratives

    with elderly residents (average age of 91), a dialogical performance analysis was

    undertaken about their experiences of well-being at the RCH. The findings of importance

    are reported through three themes: (1) childhood memories as a source of well-being,

    (2) family and work as a source of well-being, and (3) opportunities for the well-being of

    the elderly at the RCH. To be an individual with others is a phenomenon of a personal

    sense of self and a phenomenon of sociality. Well-being is also found in the individual’s

    self-renewal.

    Well-being is about a sense of both individual continuity and change. Well-being is

    created in social situations with others (including caregivers) in daily interactions and in

    human contacts at the RCH. This kind of individual self-renewal is about human growth

    and is a human need regardless of age. Consequently, the human growth in (and despite)

    old age at RCH should be the main target of gerontological social work and care.

  • 37.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Svensson, Ann-Marie
    Skara Municipality, Sweden.
    Well-being in old age: A question of both continuity and change2017In: Well-being and Quality of Life: Medical Perspective / [ed] Mukadder Mollaoğlu, Rijeka, Croatia: InTechOpen , 2017, 147-162 p.Chapter in book (Refereed)
    Abstract [en]

    In this chapter, we are concerned with the well-being of people in old age, living at a residential care home (RCH), and how well-being can be supported in gerontological social work and care at the RCH. Based on empirical data consisting of well-being narratives with elderly residents (average age of 91), a dialogical performance analysis was undertaken about their experiences of well-being at the RCH. The findings of importance are reported through three themes: (1) childhood memories as a source of well-being, (2) family and work as a source of well-being, and (3) opportunities for the well-being of the elderly at the RCH. To be an individual with others is a phenomenon of a personal sense of self and a phenomenon of sociality. Well-being is also found in the individual’s self-renewal.

    Well-being is about a sense of both individual continuity and change. Well-being is created in social situations with others (including caregivers) in daily interactions and in human contacts at the RCH. This kind of individual self-renewal is about human growth and is a human need regardless of age. Consequently, the human growth in (and despite) old age at RCH should be the main target of gerontological social work and care.

  • 38.
    Hellström Muhli, Ulla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Trost, Jan
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Siouta, Eleni
    Department of Neurobiology, Care Sciences and Society--Division of Nursing, Karolinska Institutet, Stockholm, Sweden..
    Patient Involvement in Medical Consultations – The cardiologist's perspective Manuscript (preprint) (Other academic)
    Abstract [en]

    Purposes: The purpose is to systematically analyse and describe how cardiologists describe patient involvement and participation authority in consultations about atrial fibrillation (AF) treatment. The research questions are: (i) how cardiologists practically handle patient involvement in medical consultations, and (ii) how cardiologists orientate to shared decision-making regarding AF treatment as part of the value structure of patient involvement.

    Design/methodology/approach: A descriptive study was designed.  Ten   (n=10) interviews with cardiologists at four Swedish hospitals were held and a qualitative content analyses was made from the collected data.

    Results: The analysis shows cardiologists´ accounts of (i) persuasive practice, (ii) protective practice, (iii) professional role, and (iv) medical craftsmanship when it comes to patient involvement and participation authority.

    Conclusions: The patients’ possibility for involvement and participation authority in consultations is dependent on how the cardiologists define their own situation in the consultation environment. However, the way in which cardiologists contribute to patient involvement is by the talk-interaction, assessing the patients’ abilities to be receptive to information.

    Originality/value: According to the ideology of shared decision-making there are two sets of decisions to be made, namely the patient’s and the cardiologist’s. However, these two sets are often labeled as only one set of decisions and might be called a “shared decision”.

    Policy and Practical Implications: Cardiologists should problematize patient involvement and participation authority in decision-making regarding AF treatment decisions in consultations when trying to meet patients’ expectations to provide a quality experience.

     

  • 39.
    Johansson, Richard
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Developing Care Professionals: Changing Disability Services in SwedenManuscript (preprint) (Other academic)
    Abstract [en]

    In Sweden, professionalisation projects in disability care services are currently underway in order to differentiate and establish a professional identity for professionals within care work. The aim of this paper was to analyse the experiences of care workers’ meaning of the professionalisation process concerning their occupation and their occupational identity in relation to tasks they perform in front-line contacts with persons with intellectual and developmental disabilities (IDD) at respite care service homes (RCSH). Semi-structured interviews were conducted with ten care workers at RCSH for persons with IDD. The meaning of the professionalisation projects is an ongoing process of a connected mission, meaning that the care work is performed in close contact with care receivers, takes place within an informal and free framework and is predicated on a logic of possessing a particular kind of ‘care-feeling’. This paper contributes to the developing knowledge base on the professionalisation process of care workers.

  • 40.
    Johansson, Richard
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Developing Care professionals: Possible Ramifications of Professional Projects within Swedish Disability Care ServicesManuscript (preprint) (Other academic)
  • 41.
    Johansson, Richard
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Developing Care Professionals: Possible Ramifications of Professional Projects within Swedish Disability Care Services2016Conference paper (Refereed)
  • 42.
    Lundin, Anette
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Berg, Lars-Erik
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Feeling existentially touched - A phenomenological notion of the well-being of elderly living in special housing accommodation from the perspective of care professionals2013In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, 20587- p.Article in journal (Refereed)
    Abstract [en]

    This article presents a phenomenological analysis of interview material, in which 12 care professionals in elderly care reflect on the elderly's well-being within the frame of special housing accommodation. The perspective of the care professionals is of special interest. The findings show that the well-being is characterized as the elderly's feelings of being existentially touched. The well-being is an existential experience of being acknowledged as a human being and is an approach that classifies the elderly's needs as those of having, loving, and being. The meaning of the phenomenon is elucidated by the constituents: (1) to feel the freedom of choice, (2) to feel pleasure, and (3) to feel closeness to someone or something. The findings contribute new understanding of well-being in the elderly care by its existential dimension of the well-being as "just being'' and of doing things in order to experience meaningfulness. Accordingly, the well-being of the elderly as it is seen from the perspective of the care professionals involves both carers' subjectivity and intersubjectivity between the care professional and the elderly. An implication for promoting elderly's well-being is to develop awareness of these existential dimensions.

  • 43.
    Lundin, Anette
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. Högskolan i Skövde.
    Berg, Lars-Erik
    Högskolan i Skövde.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Witnessing presence: Swedish care professionals’ experiences of supporting older people´s well-being processes within the frame of residential home care (RHC)2016In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 37, 1-9 p.Article in journal (Other academic)
    Abstract [en]

    In this article, we are concerned with analyzing the phenomenon of supportive social care for older people`s well-being from the carers’ meaning making through their life world perspective at a residential care home (RCH). Based on empirical data consisting of interview material with 12 care professionals in the context of Swedish eldercare, a phenomenological analysis was undertaken. The result shows that the phenomenon of supportive social care for well-being is a question of ambiguity in the professionals’ meaning making and in practice it balances between the residents´ needs and the conditions of the care organization. This phenomenon of ambiguity (the what) is made up by three constituents: (i) freedom of choice for the older people vs. institutional constraints, (ii) the residents’ need for activation vs. wanting not to be activated, and (iii) the residents’ need for routine vs. the carers´ not being able to know what the residents need. The conclusions drawn are that this ambiguity has consequences for the carers’ positions for supportive social care for older people´s well-being (the how) in that they have to navigate between the support for authenticity, dwelling and mobility, and carers’ presence and time. In performing a supportive social care for well-being, the carers have to consider aspects concerning the older person’s lifeworld, the social setting of the eldercare ward, and the institutional demands of the organisation. The practical implications for supporting well-being in the social care of older people is manifested in the importance of ‘the little things’, and the carer’s ability to give receptive attention, which requires the presence.  

  • 44.
    Markkula, Veronika
    et al.
    Högskolan i Skövde.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Diskursen om den svenska skolsköterskans hälsostödjande arbete i kvalitativ forskning: En kvalitativ metasyntes2013In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 33, no 2, 22-27 p.Article, review/survey (Refereed)
  • 45.
    Niggol, Ingalill
    et al.
    Skaraborgs kommunalförbund FoU.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Policy och praxis i särskilt boende och omsorg för äldre personer med Utvecklingsstörning: kommunala chefers framställningar2010Report (Other academic)
  • 46.
    Saferstein, Barry
    et al.
    California State University San Marcos.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Siouta, Eleni
    Karolinska Institutet, Huddinge..
    Effects of clinician-guided communication formats on elderly patients’ authority and understanding in consultations2016In: / [ed] Srikant Sarangi, Charlotte Hyldgaard, Bettina Jensen, Maj Ragner Laursen and Hanan Lassen Zakaria, 2016Conference paper (Refereed)
  • 47. Siouta, Eleni
    et al.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Fossum, Bjöörn
    Karlgren, Klas
    Cardiologists’ experiences and perceptions of patient involvement and communicationrelated to shared decision-making regarding atrial fibrillation treatment2017In: C&M448, Vol. 14, no (1), 39-50 p., https://doi.org/10.1558/cam.30587Article in journal (Refereed)
    Abstract [en]

    Objective: To feel involved in decisions about atrial fibrillation (AF) treatment, patients need supportive communication from cardiologists. Shedding light on cardiologists’ perceptions of patient involvement in AF care settings is thus of importance. We examine (1) how cardiologists describe patient involvement and communication related to shared decisionmaking regarding AF treatment, and (2) their perceptions of efforts to involve patients in the treatment decisions.

    Methods: Ten cardiologists were interviewed in four Swedish hospitals. A qualitative content analysis was performed on the interview data.

    Results: Cardiologists’ perceptions of patient involvement in treatment decisions are framed in terms of (1) ideology, (2) experience, and (3) responsibility.

    Conclusion: By taking into account patients’ feelings in the consultations, and by actively encouraging patients to be involved, the cardiologists contributed to patient involvement.

    Practice Implications: One key to improving compliance with legislation aimed at increasing patient involvement in treatment decisions could lie in paying attention to physician–patient communication and the conditions for patient involvement in decision-making about treatment.

  • 48.
    Siouta, Eleni
    et al.
    Karolinska Institutet.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Hedberg, Berith
    Jönköping Academi.
    Broström, Anders
    Jönköping University.
    Fossum, Bjöörn
    Sophiahemmet University.
    Karlsgren, Klas
    Karolinska Institutet.
    Patients’ Experiences of Involvement and Communication in Decision Making about Atrial Fibrillation Treatment in Consultations with Nurses and Physician.2015In: Scandinavian Journal of Caring Sciences.Article in journal (Refereed)
  • 49. Svensson, Ann-Marie
    et al.
    Martensson, Lena B.
    Muhli, Ulla H. Hellström
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Well-being dialogue: Elderly women's subjective sense of well-being from their course of life perspective2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, 19207Article in journal (Refereed)
    Abstract [en]

    In this article, we are concerned with narratives of elderly women's well-being from their perspectives of the latter parts of their life, living at special housing accommodation (SHA) in the context of Swedish elderly care. In focusing on narratives about well-being, we have a two-fold focus: (1) how the elderly women create their own identity and meaning-making based on lifetime experience; and (2) how narratives of well-being are reflected through the filter of life in situ at the SHA. Based on empirical data consisting of well-being narratives, a dialogical performance analysis was undertaken. The results show how relationships with important persons during various stages of life, and being together and enjoying fellowship with other people as well as enjoying freedom and self-determination, are central aspects of well-being. The conclusions drawn are that the characteristic phenomena of well-being (the what) in the narratives are continuity, identity, and sociality for the elderly person, and this is manifested (the how) as a question of contrasting the state of self-management and self-decline.

  • 50.
    Svensson, Ann-Marie
    et al.
    Högskolan i Skövde.
    Mårtensson, Lena
    Högskolan i Skövde.
    Hellström Muhli, Ulla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. Sociologiska institutionen Uppsala universitet.
    Wellbeing narratives by elderly persons living at Special Housing Accommodation (SHA) in the context of Swedish elderly care2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623Article in journal (Refereed)
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