Den allt snabbare digitaliseringen, inbäddad i centrala samhällsfunktioner, gör det svårt för många att vara delaktiga i samhället. Vi kan kalla problemet ”ofrivilligt digitalt utanförskap”.

Samhällets resurser behöver omfördelas genom en rättvis skattereform och socialförsäkringssystemets överskott bör investeras i välfärd. På så vis kan vi förbättra den ekonomiska tryggheten för kroniskt sjuka och personer med nedsatt funktionsförmåga, skriver Marina Carlsson, Stina Melander, och Sara Hultqvist. 

Expectations and demands on coproduction in research have increased. Therefore, there is a need for knowledge on how these coproducing processes where researchers and practitioners work side by side during the research process can be carried out. In this article, methodological questions related to coproduction and collaboration between researchers and practitioners in the field ofsocial work are raised and discussed. The article draws on an on going research project where participatory action research (PAR) is the leading guideline. PAR in a contemporary context is understood as a democratization process, where values such as participation, mutual learning, empowerment, improvement and development of practice are given as much attention as the actual research findings. The research project discussed takes its starting point in Swedish eldercare, investigating situations of moral stress and moral agency. The project is carried out in close cooperation with three municipalities and institutions where future staff for eldercare are trained (social workers and auxiliary nurses). In the article the relations between researchers and practitioners are discussed. Strategies on how to establish cooperation applying a synergistic approach are highlighted. Furthermore, strategies for dissemination or research results are discussed. The article suggests PAR as a specific social work signature methodology, as PAR acknowledges the need for relational work as well as an action-oriented research agenda, well in line with the core values and understanding of social work as a professional practice and academic discipline. In the article, applying PAR in a contemporary context, is understood as a key component when striving for socially robust knowledge; that is, knowledge that is considered relevant and reliable in the eyes of all actors involved, in this case staff in municipal eldercare, as well as in academia.

Låga löner, osäkra anställningar och otillräcklig utbildning är regel snarare än undantag i äldreomsorgen. Det konstaterade Coronakommissionen i sitt delbetänkande i slutet av 2020. Internationella organisationer som WHO och OECD, liksom många internationella forskare, noterade att pandemin synliggjort resursmässiga och organisatoriska brister i äldreomsorgen. Brister som påtalats under många år, men som nu kommit i öppen dager och blivit kända också för allmänheten. Den skisserade mörka bilden till trots uttrycktes i betänkandet en trösterik önskan: ”Förhoppningsvis leder erfarenheterna från pandemin till att äldreomsorgen får bättre villkor ur alla dessa aspekter.” (s. 84).

Background: Ageing population, high levels of sick leave among eldercare personnel and financial constraints on municipal budgets impact eldercare. Daily care work is complex and ethical dilemmas are constantly present for eldercare personnel. This project aims to a) identify situations that give rise to moral stress, b) study the relationship between moral stress and moral agency c) explore how moral agency can be fostered in eldercare. The argument underpinning this research project is that ethical dilemmas in the work cause moral stress among staff in eldercare. While much research on moral stress highlights the connection between moral stress and negative effects on health and wellbeing, our focus is on the possible connection between moral stress and moral agency. Moral agency encompasses cognitive capacity, feelings, skills, and actions.

Methods/Design: This project has a systemic approach to eldercare and interprets eldercare as an advanced system where a range of different skills is required. Participatory action research (PAR) will be used as an overall methodology. Focus-groups and research circles will be conducted with care workers, first line manages and needs assessors. 

Discussion: An ongoing discussion on relevant knowledge production in research, stresses the importance of participation. This is expressed by concepts such as deliberative democracy, user participation, empowerment, collaboration, follow-up research and citizen dialogue. In our research project we refer to robust knowledge as relevant knowledge that is valid in the eyes of care workers, care municipal needs assessors and first line managers. As the research is performed in collaboration with these three vocational groups, local politicians, and trade unions in three municipalities as well as two educational settings, different sorts of knowledge will be present. This unique stand will show how moral agency, as a response to moral stress, can be the ground for social changes and improve quality of care.

Vi kan bara vitalisera det demokratiska samtalet om våra politiska företrädare tar plats i offentligheten och klargör syfte och mål med sin politik, slutreplikerar flera socialpolitiska forskare till Árni Páll Árnason.

Vi välkomnar Nordiska Ministerrådets utredning av hur ett nordiskt socialpolitiskt samarbete kan se ut. Frågan är bara: Varför? Vad är syftet?

In this chapter, we discuss dilemmas related to research in the field of labour market policies, with special focus on young people’s perspectives and experiences. In short, we argue for the urgency to hear the voices of the young in research and knowledge production. To be able to increase the quality of the services offered young unemployed and to be able to develop practice to meet the needs of those who are concerned, we need to take their experiences into account. However, institutional and organisational structures constitute barriers for including young unemployed in the research process. These barriers, aspects of time and money, are highlighted and discussed in this chapter.

This thesis investigates ‘the doing’ of the Swedish social insurance program Activity Compensation (AC). AC is an example of disability policies in Western welfare states. These policies have two goals: to ensure financial security and to promote social participation. In 2003 AC replaced Early Retirement Pension for persons aged 19 to 29 years and who, for medical reasons, have reduced work capacity.

Three features characterize AC. Young adults are differentiated in a separate system. For them, benefits are time-limited. Benefits include an established right to participate in activities.

Doing AC is studied bottom-up. Interviews with two actor groups have provided the empirical base: 1) persons accorded AC and medically certified to have an anxiety and/or a depression diagnosis and 2) the respective administrator(s) at the Swedish Social Insurance Agency. National legislative preparatory texts and legal documents complete the data.

The conclusions of this study are three-fold addressing goal displacement and non-contact. Firstly, a discursive change in respect to the denotation of social participation within the politics of principle has appeared throughout OECD countries over the last decennium. This goal displacement obscures the goal of economic security emphasizing the profitability of work. AC explicitly manifests this change in establishing a right to activity participation for beneficiaries. This displacement is without full impact in the politics of practice when actors’ experience of doing AC is examined. Financial security remains the foremost goal in the local politics of practice mirroring the initial function of safeguard for those with reduced work capacity due to certified illness.

Relating to this lexical displacement, the study concludes that social participation is revealed as a goal to be realized in a specific form, salaried employment, within a distinct arena, the labor market. Values such as life-quality are neglected as regulatory efforts to get persons on the track to work have been underscored.

Finally, the prescribed contact between the insured young adults and their administrator(s) is not consistently present. This contact is a necessary condition for the intended planning of activities to take place. When non-contact prevails, the established regulatory right to participate in activities can not materialize.

Den nordiska välfärdsstaten bygger på en idé om jämlikhet och inkludering. Men finns det människor som faller utanför? Sara Hultqvist reflekterar kring barnmigranter och välfärdsstatens ansvar.

Collaboration between academia and actors outside academia (AOAs) has been proclaimed as a way for society to confront challenges in different fields. This ‘participatory imperative’ is anchored in EU research policy. The paper explores the participatory imperative in contemporary Swedish aging research. Three kinds of motives for participatory research as a way to societal impact emerged in the social voices of researchers granted money and AOAs with experience of participating in research. Participatory research was a suitable research method for certain types of research objectives, an answer to AOAs’ outspoken needs for new knowledge and a result from the interviewee’s double identity as a clinician and a researcher. Moreover, four types of activities were talked of. Participatory research was described as dissemination of results, as commissioned work, as joint action and as education. The paper closes by promoting a synergistic approach where collaboration is enacted within already existing infrastructures of research and education. Scholars are encouraged to integrate collaboration with AOAs in their daily work as teachers and researchers. By doing so, new constellations of actors will emerge; constellations that are equipped to tackle real-world issues in new ways.

Andelen unga som beviljas förtidspension under lång tid har ökat, särskilt de med en psykisk diagnos eller unga med lindrig psykisk ohälsa. Denna form av utanförskap innebär att betydande andelar av en generation av unga människor har liten eller ingen koppling till arbetsmarknaden under en större del av sitt vuxna liv.

Bara i Sverige har antalet förtidspensionerade mellan 19-29 år fördubblats under de senaste 15 åren.

Rapporten visar att samtliga nordiska länder har välfärdsystem riktade till gruppen unga med psykisk ohälsa. Danmark, Finland, Island, Norge och Sverige har alla socialpolitiska ambitioner om en välfärdsstat där det offentliga har ett ansvar för medborgarnas välfärd, i de fall ohälsa hindrar människor från att försörja sig genom lönearbete. De olika systemen i de olika länderna skiljer sig dock åt i sin uppbyggnad.

Exempelvis gäller detta den så kallade inkomstbortfallsprincipen. Den är grundprincip i samtliga länders system, med undantag för Danmark. Det danska systemet är ett flat-ratesystem utan någon inkomstrelaterad del. Finland och Island har två parallella ekonomiska och sociala system riktade till gruppen unga med långvarig psykisk ohälsa. I Danmark, Norge och Sverige har nyligen genomförda lagändringar förändrat systemens funktionssätt.

Objective: The objective of this paper is to describe the initial phase of a long-term collaboration initiative between a municipality and the Faculty of Medicine at a university in Sweden. The overall ambition of the collaboration is to strengthen the quality of care for older people. The concrete goal is to equip academically trained registered health care professionals (HCP) with tools for transferring evidence-based knowledge into practice. As municipal healthcare for older people is mainly carried out by staff lacking academic education, reg. HCP are key actors to bring in and consolidate an evidence-based approach in this setting. Developmental evaluation (DE) has been used to evaluate four separate activities in the initial phase. The activities where sequenced in a cumulative design to provide knowledge for further development of adequate tools.

Results: The cumulative design originally planned did not fit the internal logic of the municipality. Therefore, workflow and pace adjustments were made to proceed towards the joint ambition; the creation of fruitful conditions for the uptake of evidence-based knowledge. Long-term collaboration between academia and organizations outside academia demands a sensitive and flexible research approach, recognizing that collaboration implies mutuality and restricts the sovereignty of academia in designing research.

Det verkar vettlöst att vi utbildar undersköterskor och sedan hindrar dem från att göra nytta, skriver forskarna Sara Hultqvist, Magdalena Elmersjö och Katarina Hollertz.

Det är hög tid att vi systematiskt tar tillvara de levda erfarenheter som gjorts under de gångna två åren, skriver forskare vid Linnéuniversitetet.

This paper concerns the role of teachers as street level buerarucrats in Swedish vocational healthcare education for adult students. At the center of the analysis are the challenges related to policy implementation when many of the students are second language speakers and language and communication play a role. Policy documents provide the analysis with a normative framework. Interviews with teachers give the analysis its standpoint. As a societal context, the field of elderly care suffers from labour shortages with difficulties recruiting trained staff. Policy stakeholders place high expectation on adult care education to both supply the labour market with trained staff, and to contribute to a smooth integration of migrants into society. As a matter of fact, half of the students in Swedish adult vocational healthcare education are migrants and the majority of those who complete the education get employment within elderly care. Thus, healthcare teachers are incremental to the implementation of policies. In their role as street level bureaucrats, they use different strategies to handle the press transferring sometimes contradictory policies into practice in the direct encounters with students. The results stress the importance of communication and language in healthcare education – and in elderly care practice.

In this article, we argue that basic social policy concepts can fertilise the discussion on active labour market policy (ALMP). During the last decades, research on ALMP has become a flourishing field. This is an overall positive development. However, the development tends to fractionate the wider picture of social policy and distance the discussion from social policy seen as a multifold set of government measures that have a direct impact on the welfare of the citizens, by providing services and/or income. We analyse a local ALMP programme in the light of three classical social policy concepts: universalism, selectivism and need. To understand what is going on in ALMP programmes, we argue that it is as important to uncover claims made by the state as it is to satisfy the human needs most often presented as the objectives of ALMP programmes. We propose that the programme under study be characterised as a hybrid, combining elements frequently perceived as dichotomies in social policy literature. Selectivism and universalism are both present as principles and the programme consists of benefits in cash and in kind.

The aim of this article is to explore the opportunities of using theoretical concepts as way of gaining a shared language for people participating in an active labour market program (ALMP). The investigated programme offered vocational education preparing for work in eldercare to unemployed individuals. Data was collected through interviews with ten participants and two teachers, and through observations. All participants had experienced social problems such as homelessness, indebtedness, criminality. Half of the group had Swedish as their first language. In the other half of the group, several languages were spoken. Some spoke Swedish without difficulties, whereas others had big difficulties speaking, reading, and understanding Swedish. The programme included an introduction to Aaron Antonovsky's theory Sense of Coherence (SOC). This article reports from, and reflects on, the acquisition of a theoretical vocabulary serving as a pedagogical short-cut for the participants. By filling the concept of SOC with meaning, participants got access to a new language, a language that was surely not 'plain Swedish', but rather a language of abstract theory. The pedagogical work created literacy - and a shared platform for increased understanding of one's own life story and current situation. Using the empirical case of an ALMP serves as an attempt to cross-fertilize the theory of SOC and educational ideas in a way that is not conventional in social work research. We suggest that introducing a theoretical language relevant for one's own personal story might enhance well-being and thus prime learning in social work interventions.

När det gäller arbetsmarknadspolitik på det kommunala planet, har det ofta funnits utrymme för profession och politik att skapa och utforma lokala program. Utgångspunkterna har inte sällan varit ’innovativa idéer’ i syfte att tillgodose flera behov samtidigt. Sällan har verksamheterna vilat på forskning och beprövad erfarenhet. Systematisk uppföljning och kunskap om programmens konsekvenser har lyst med sin frånvaro, såväl i termer av kvantitativt mätbara effekter (exempelvis antal som går vidare till studier eller anställning) som i termer av kvalitativa följder (exempelvis deltagares erfarenheter och upplevelser av programmen). Göteborgs stads och ARBVUX satsning på Det stegvisa jobb- och kunskapslyftet är på en och samma gång ett lokalt innovativt arbetsmarknadspolitiskt program och ett försök att bygga in ett evidensbaserat utvecklingsarbete i befintlig kommunal struktur. Den del av Det stegvisa jobb- och kunskapslyftet som är analyserad i föreliggande rapport är vårdstegen. Den empiriska tonvikten ligger på vårdstegens första trappsteg. En klass med 12 deltagare har följts under 2018, när de befann sig på det inledande traggsteg som är utbildningen till serviceassistent. Intervjuer med 10 av deltagarna och observationer i klassrummet utgör den empiriska basen, men analysen vilar också på intervjuer med lärare, mötesobservationer, intervjuer med kommunala tjänstepersoner och läsning av dokument. Analysen utgår ifrån deltagarnas erfarenheter och berättelser samt ett antal empiriskt och teoretiskt grundande begrepp. Studiedesignen är på det arbetsmarknadspolitiska fältet metodologiskt nydanande.

Orientation towards application, transdisciplinarity and social distribution are prominent ideas when policy prescribes how to conduct research on complex, real-world issues. Issues dealt with in ageing research are both epistemologically complex and politically contentious. By using the metaphor of ‘travelling ideas,' we have followed these ideas on their journey into 17 approved grant proposals on ageing and their assessments in Sweden in 2016. We considered collaboration as the modus operandi of the implementation of the three ideas. Thus, we analyzed how plans for collaboration were described in the data. The result shows that although the ideas were clearly present in the policy documents, they were almost eviscerated in the majority of proposals and assessments. Only three out of 17 proposals reflected the ideas. Thus, collaboration as an aspect of research was not codified. As long as there is no established way of describing collaboration, researchers struggle to invent their own tentative versions, that is, a collaborology.

The Scandinavian countries have a long history of active labour market policy, using activation to promote work among those with no problems besides unemployment. However, activation policy is now permeating social policies providing economic protection for young adults who cannot work for health reasons, which has been legitimised through a strong emphasis on paid work as the main source of social participation. In this article, we discuss the consequences of this activation policy in Denmark and Sweden, and argue that the strong emphasis on work has counterproductive consequences when directed towards individuals with health problems.

I forskningsöversikten ställs frågan Varför är kvinnor mer sjukskrivna än män? i de nordiska länderna. Studier som med olika metoder och utifrån skilda vetenskapliga utgångspunkter söker svar på frågan presenteras. Rapporten lyfter fram undersökningar publicerade i Norden från år 2000 till mitten av 2016. Tre vanliga hypoteser; om kvinnohälsa, om arbetsmiljö och om dubbelarbete, läggs fram. Mycket av den forskning som gjorts är inspirerade av dessa tre hypoteser, men de har hittills kunnat förklara bara en bråkdel av skillnaderna i mäns och kvinnors sjukskrivningsnivåer.

Denna rapport till Rädda Barnen belyser och analyserar hur verksamhetsprogrammet ”Vägen in” kan utvärderas i en lokal kontext.

Studien är genomförd i Malmö under hösten 2017 med deltagande av ett begränsat antal unga migranter. Den ska ses som en förstudie till en mer fullskalig studie – genomförd under en längre tidsperiod och med ett större antal deltagare. Forskarna har haft rollen som aktionsforskare där tanken har varit att tydliggöra metodproblem och tentativa resultat som kan vägleda ett ständigt pågående utvecklingsarbete av programmet.

Vägen in är ett unikt program genom att det tar sin utgångspunkt i både individperspektiv och utformningen av samhällets stöd för etableringen i Sverige. När det gäller individperspektivet är fokus att tillskapa egenkraft hos deltagarna. Den bärande idén är att denna i sin tur initierar förutsättningar för deltagarna att agera på ett integrerande sätt i det svenska samhället inom olika områden såsom boende, skola och försörjning.

This chapter intends to illuminate the issues within social work. In order to highlight what can distinguish and characterize these specific relationships within the field of social work, the chapter begins with a discussion of the fluid role of the citizen and how democratic government policies are developed in advanced welfare societies like that in Sweden. It presents the general developments and changes in the role of the citizen that have taken place in recent years, both within Swedish political debates as well as in the concrete manifestations of various welfare activities. The chapter then discusses the specific contexts and prerequisites of governmental authority-based professional social work. It assesses the welfare systems that citizens feel they engage with and have perspectives on. The chapter ends with a critical reflection on the consensus-orientation permeating social action in the Nordic tradition of organizing society.

Utredningen Framtidens socialtjänst har lämnat ett förslag till ny socialtjänstlag (SoL) som ska ersätta den befintliga. Förslaget är nu ute på remiss till den 1 februari 2021. Vi vill uppmana så många socionomer som möjligt att läsa och begrunda vad förslagen skulle komma att innebära för arbetet på den egna arbetsplatsen. Som socionomer behöver vi vara med och både diskutera lokalt och gärna också framföra våra åsikter centralt i frågor som berör vårt yrkesfält.

Landets socionomer måste tycka till om innehållet i förslaget till ny socialtjänstlag, skriver debattörerna.

En åldrande befolkningen har identifierats som en samhällsutmaning. En tydlig utveckling inom forskning om sådana utmaningar är krav på medverkan från patientgrupper, brukarorganisationer och andra aktörer utanför akademin. Syftet med artikeln är att introducera en modell för utformning och värdering av samverkan mellan akademiska forskare och aktörer utanför akademin. Modellen bygger på en genomgång av internationellt etablerade traditioner och ramverk för sådan samverkan och ramas in av komponenterna syfte, aktör, process och omfattning (SAPO) eller enklare uttryckt genom frågorna: varför, med vem, när och hur mycket? Med hjälp av modellen kan både forskare och aktörer utanför akademin föra mer systematiska och kritiskt värderande resonemang om samverkan. Det kan i sin tur leda till effektivare arbetsformer och nyttiggörande av resultat från det mångfasetterade forskningsområde som rör den åldrande befolkningen.

Background

Participatory research has been described to improve the relevance of research findings for the society in terms of quality of healthcare services and other public benefits. Nevertheless, there is limited guidance on how to conduct participatory research, and especially in relation to persons living in residential care facilities. To make the voices of this group heard, we therefore take a stance in the democratic approach to participatory research, and we have applied the theoretical framework Model of Human Occupation (MoHO) on participation to evaluate photo-elicitation interviews as a participatory research method with this group.

Methods

A total of 13 persons living in two residential care facilities were involved in the study and asked to take photographs of their everyday life over one week. They were then invited to an individual interview to narrate the meaning of the photographs and to describe how they experienced the photo-elicitation method. The interviews were analysed in the six steps of theoretically driven reflexive thematic analysis.

Results

The findings are described in the theme ‘Uncovering hidden abilities for participation in research’ that describes how photo elicitation interviews facilitated the older persons’ participation in research. This is illustrated by four sub-themes: ‘Bridging the ageing body’, ‘Altering habituation to everyday life’, ‘Empowering storytelling’, and ‘Negotiating the institutional culture’.

Conclusions

Our study findings support further application and evaluation of photo-elicitation interviews as a method for participatory research in residential care facilities. The major finding is how photo-elicitation interviews were used to reduce the impact of the institutional culture on the older persons’ participation in research. The method is, however, not without limitations and we encourage researchers to study the dynamic relationship between physical, social, and cultural aspects of residential care facilities in relation to the use of photo-elicitation interviews with the persons living there.

The Covid-19 pandemic has revealed the importance of social protection systems, including income security, when health problems arise. The aims of this study are to compare the follow-up regimes for sick-listed employees across nine European countries, and to conduct a qualitative assessment of the differences with respect to burden and responsibility sharing between the social protection system, employers and employees. The tendency highlighted is that countries with shorter employer periods of sick-pay typically have stricter follow-up responsibility for employers because, in practice, they become gatekeepers of the public sickness benefit scheme. In Germany and the UK, employers have few requirements for follow-up compared with the Nordic countries because they bear most of the costs of sickness absence themselves. The same applies in Iceland, where employers carry most of the costs and have no obligation to follow up sick-listed employees. The situation in the Netherlands is paradoxical: employers have strict obligations in the follow-up regime even though they cover all the costs of the sick-leave themselves. During the pandemic, the majority of countries have adjusted their sick-pay system and increased coverage to reduce the risk of spreading Covid-19 because employees are going to work sick or when they should self-quarantine, except for the Netherlands and Belgium, which considered that the current schemes were already sufficient to reduce that risk.

I en rapport från Riksrevisionen antyds att sjukskrivning är hälsovådlig och att en än mer strikt rätts­tillämpning skulle hjälpa männi­skor. Det kan inte sägas utgöra en seriös forsknings- eller rapportinsats, skriver tre forskare vid Lunds universitet.

För forskare i socialt arbete och socialpolitik är det en grundregel att det inte existerar någon värdeneutral ingång till studiet av socialpolitik.

Vi önskar att i en tid av tilltagande politisk polarisering understryka vikten av att politiska företrädare tar plats i offentligheten.