(En)gendering body politics. Physiotherapy as a window on health and illness

The aim of this study is to gain knowledge about what patients do to negotiate possibilities and constraints for recuperative encounters with physiotherapists. The historical tenets of Norwegian physiotherapy are recapitulated and contemporary gendered specialisation and work division are presented. The theoretical underpinning of the study, critical hermeneutics and the sociology of everyday life, are tied together by coining play as pivotal for understanding and interaction, and by embedding small behaviours as part of language. Hermeneutic understanding depends on the interpreters’ background, comprised of symbolic, structural and subjective aspects. A focus group method is applied, construed as situated social gatherings: 4 groups of men, 4 groups of women, 26 women, 20 men, aged 18-77, comprising experiences with sports related injuries, chronic pain, heart or lung diseases, physical disabilities or medical unexplained disorders. Knowledge proposals: According to the participants, bodily changes and well-being depends on verbal, bodily and hands-on dialogues, and an attentive present therapist. The dialogical situation is precariously constructed; self presentation is planned to details and carefully enacted. Social institutions as gender imprint interaction, understanding and treatment. Pain is construed as action, and is a paradigmatic exemplar of how verbal, bodily and hands-on communication, self presentation and gender intersect in physiotherapy. Independent of age, gender or bodily concerns the participants challenge and negotiate cultural, medical or personal boundaries to enhance well-being and/or to reach personal objectives e.g. increasing pain for a greater good. The participants’ accounts are interpreted as intentional human agency, and reconstructed as body politics. Construing vulnerability as strength, the participants appreciate some of the benefits gained from living with bodily constraints and challenges. Their actions and enactments create new body idioms and new accounts of health/illness. Physiotherapy represents a field of practices where contradictory and covert social expectations reside. When social expectations are not met, patients may experience embarrassment, and recuperative interaction may be at risk. Social disruption may be ignored, remedied or laughed at. Laughter may be interpreted as a sign of embarrassment due to fragile interaction. By studying embarrassment and laughter we can listen for social dissonance, and imply some conditions necessary for the interaction to come off. Some necessary conditions are implied above; the participants, as patients, try to avoid embarrassing situations by asserting a personal body politics and warranting amendments to the interaction order of therapeutic encounters

Communitas and Friluftsliv: equine-facilitated activities for drug users

This is a pre-copyedited, author-produced version of an article accepted for publication in Community Development Journal following peer review. The version of record Sudmann, T. T. (2018). Communitas and Friluftsliv: equine-facilitated activities for drug users. Community Development Journal, 53, 556–573, is available online at: https://academic.oup.com/cdj/article/53/3/556/4994218Available: 2020-05-09.A green care farm creates a temporal “thrown-togetherness”. Farm-based welfare services provide contact with animals and nature, supportive environments, social acceptance, fellowship with other participants, and meaningful activities. Most green care farms in Norway have horses, and equine-assisted activities are known to add value to green care for people with addiction and/or mental health problems. Farms facilitate connectedness between place and people, create “place-events”, and resemble friluftsliv activities. Friluftsliv creates a different temporality and rhythm, where nature is cared for and befriended. This article presents and discusses two different approaches to equine-assisted activity for drug-users from an inpatient treatment programme, and for guests from a dropin centre, respectively. Participation was non-conditional, and following the world view underpinning community work, the participants’ evaluations of benefits are the most significant outcome measure. The equine-assisted communities are both ephemeral and long-lasting, and have given many participants the motivation to stay in therapy and reduce their drug use, or they have gained access to new social arenas, volunteering, or to sheltered employment. Community work at farms offers possibility for communitas, i.e. a groups pleasure in sharing common experiences with one’s fellows, learning-in-context, friluftsliv and serendipitous benefits – the last adding an important contribution to participants’ health and well-being.acceptedVersio

Equine-facilitated physiotherapy – devised encounters with daring and compassion

Physiotherapy with horses and rider-patients builds on communication and interaction through groundwork and mounted work. This chapter discusses outdoor equine-facilitated physiotherapy on green care farms with three patients representing ideal types from the author’s clinical practice. The practice of co-creation and improvisation, i.e. devising, is used to discuss how the triad of physiotherapist, rider and horse, work together to support the rider’s step-by-step changes towards better health. Being with horses facilitates exploration of communicative strategies and embodied ways of being, whilst nature and physical activities add value to the therapeutic benefits. Horses represent risk and desire, as does the facing of bodily constraints or habits. Physiotherapy equine-facilitated physiotherapy 195 aims to facilitate a purposefully created change by playing with daring (out-of-the-ordinary experiences when usual boundaries are pushed) and compassion. Therapist, rider and horse face dares and desire together by experimenting, improvising, and testing new modes of co-being and becoming. The ideas and tools from applied drama (i.e. collaborative creation and contact improvisation) tune human and horse bodies to communication and action. Outdoor practice and devising equip physiotherapists with a larger toolbox for a playful practice.publishedVersio

Health Encounters with Minority Patients

During recent decades there has been an increasing claim for patient participation and shared decision-making in health services across the Western world. Focus on participation recasts the relationship between healthcare providers and their patients. Professionals are compelled to acquaint themselves with new worldviews, new ways of understanding illness and disease, and to communicate with patients with language, religion and cultural backgrounds increasingly different from their own. Contested concepts such as communication, tolerance, participation and shared decision-making emerge, as do claims about non-participation, oppressive practice and muting of patients. In this article we look into how the paternalistic tenets of intercultural communication, tolerance and the culture of medicine intersect in such ways that empowerment and shared decision-making in health can be constrained. Modern day health concerns such as lifelong disabilities or chronic illness have multiple faces, and there is no one agreed-upon approach to assessment, treatment or non-treatment. Patients and providers have to engage in communication to detect enablers and constraints, bodily and socially. If communication is envisioned as a one-way delivery of knowledge or prescriptions, or a difference in culture is magnified to a degree that other characteristics fade away, the patient risks oppression, muting, and poor healthcare. We argue in favour of appropriating a critical perspective on interaction in healthcare and intercultural communication, and in favour for interpreting face-to-face interaction as situated social practice. A situated social practice compels those present to communicate to create an agreed-upon situational definition, and to enter into a recuperative dialogue where patients too may exercise agency and present themselves as empowered

PENGEMBANGAN MULTIMEDIA PEMBELAJARAN INTERAKTIF “SIKLUS AIR” BERBASIS DIGITAL

Penelitian ini mengembangkan multimedia pembelajaran interaktif “Siklus Air” berbasis digital untuk siswa kelas V SD Negeri 23 Takku. Penelitian ini bertujuan untuk menghasilkan produk multimedia pembelajaran interaktif “Siklus Air” berbasis digital yang valid dan untuk mengetahui respon responden terhadap produk multimedia pembelajaran interaktif “Siklus Air” berbasis digital yang dikembangkan. Penelitian ini menggunakan jenis penelitian research and development (R&D) dengan menggunakan model pengembangan Alessi & Trollip. Subjek penelitian dalam penelitian ini adalah siswa kelas V A SD Negeri 23 Takku yang berjumlah 30 orang siswa. Prosedur penelitian dan pengembangan yang digunakan dalam penelitian ini adalah model pengembangan Alessi & Trollip yang dimulai dengan tahap perencanaan (planning), tahap perancangan (design) dan tahap pengembangan (development). Produk yang dikembangkan telah melalui uji alpha dan uji beta. Uji alpha dilakukan oleh 1 orang ahli media dan materi. Uji beta dilakukan oleh pengguna yang merupakan 30 siswa dan 1 guru SD Negeri 23 Takku. Instrumen yang digunakan untuk mengetahui kelayakan produk. Instrumen penilaian tersebut, diberikan kepada ahli media, ahli materi dan pengguna. Dimana nilai akhir yang diperoleh dari ahli media ditinjau dari aspek pemograman dan tampilan, yaitu sebesar 93,75% dengan kategori sangat layak. nilai akhir yang diperoleh dari ahli materi ditinjau dari aspek pembelajaran dan isi, yaitu sebesar 90,78% dengan kategori sangat layak. Nilai akhir yang diperoleh dari siswa dan guru sebagai pengguna, yaitu sebesar 87,91% dan 95,83% dengan kategori sangat layak. Berdasarkan penilaian tersebut, dapat disimpulkan bahwa produk yang dikembangkan ini snagat layak digunakan untuk siswa kelas V SD. Kata Kunci: multimedia pembelajaran interaktif, siklus air, digita

Supporting Collaboration in Rehabilitation Trajectories With Information and Communication Technologies: Scoping Review

Background: Despite a surge in health information and communication technology (ICT), there is little evidence of lowered cost or increased quality of care. ICT may support patients, health care providers, and other stakeholders through complex rehabilitation trajectories by offering digital platforms for collaboration, shared decision-making, and safe storage of data. Yet, the questions on how ICT can become a useful tool and how the complex intersection between producers and users of ICT should be solved are challenging. Objective: This study aims to review the literature on how ICTs are used to foster collaboration among the patient, the provider, and other stakeholders. Methods: This scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Studies were identified by searching MEDLINE (OVID), Embase (OVID), CINAHL (EBSCOhost), AMED (EBSCOhost), and Scopus. Unpublished studies were extracted from OAIster, Bielefeld Academic Search Engine, ProQuest Dissertations and Theses, NARIC, and Google Scholar. Eligible papers addressed or described a remote dialogue between stakeholders using ICT to address goals and means, provide decision support, or evaluate certain treatment modalities within a rehabilitation context. Due to the rapid development of ICTs, searches included studies published in the period of 2018-2022. Results: In total, 3206 papers (excluding duplicates) were screened. Three papers met all inclusion criteria. The papers varied in design, key findings, and key challenges. These 3 studies reported outcomes such as improvements in activity performance, participation, frequency of leaving the house, improved self-efficacy, change in patients’ perspective on possibilities, and change in professionals’ understanding of patients’ priorities. However, a misfit between the participants’ needs and the technology offered, complexity and lack of availability of the technology, difficulties with implementation and uptake, and lack of flexibility in setup and maintenance reduced the value of ICT for those involved in the studies. The low number of included papers is probably due to the complexity of remote collaboration with ICT. Conclusions: ICT has the potential to facilitate communication among stakeholders in the complex and collaborative context of rehabilitation trajectories. This scoping review indicates that there is a paucity of research considering remote ICT-supported collaboration in health care and rehabilitation trajectories. Furthermore, current ICT builds on eHealth literacy, which may differ among stakeholders, and the lack of sufficient eHealth literacy and ICT knowledge creates barriers for access to health care and rehabilitation. Lastly, the aim and results of this review are probably most relevant in high-income countries.publishedVersio

Aktivitet og fellesskap for eldre. Oppsummering av kunnskap og forskningsresultater som del av kunnskapsgrunnlaget for 'Live hele livet - en kvalitetsreform for eldre'. Deloppdrag 2 fra Helse- og omsorgsdepartementet

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Drivers and barriers for use of assistive technology among children with autism and/or intellectual disabilities: Parents perspective

The aim of this study was to detect drivers and barriers for use of assistive technology (AT) among children with au- tism spectrum disorder and/or intellectual disabilities. An online workshop with researchers and two parents produced the material. The main drivers for using AT are knowledge about its existence, its inherent possibilities, access and funding. Barriers are related to lack of information, accessibility, knowledge in schools, funding, poor user interface, and poor retail and maintenance service. The workshop co-created an online form which subsequently will be sent to other parents to address these issues further. The study highlights perspectives and aspects that are important to par- ents and encourages researchers and AT-designers to systematically include end-users in design and implementation.submittedVersio