1,721,036 research outputs found
Dietro le quinte. Lavoro invisibile e collaborazione professionale nelle pratiche di cura
Full text linkPratiche di welfare nel terzo millennio: verso l'integrazione sociosanitaria tra organizzazioni, tecnologie e professionisti
No full textEtnografia partecipativa e comunità di pratica: metodi formativi e risorse professionali per il nuovo welfare
No full textEtnografia partecipativa e comunità di pratica: metodi formativi e risorse professionali per il nuovo welfare – Riassunto. Gli ultimi decenni sono stati caratterizzati da profondi processi di ridefinizione delle pratiche in ogni settore del welfare, soprattutto negli ambiti sanitario e socio-sanitario. Le cause attengono a tre ordini di fenomeni: la crescente densità scientifico-tecnologica degli interventi; il diffondersi di strategie manageriali che enfatizzano la rilevanza dei meccanismi di controllo degli outcome e della customer satisfaction; infine, le trasformazioni
demografiche e socioculturali che vanno ridisegnando le interazioni tra persone e servizi. Il saggio illustra le potenzialità formative del metodo dell’etnografia partecipativa come strumento per affrontare le inedite sfide poste dalle esigenze di welfare attuali. Lo sguardo etnografico diventa una risorsa professionale efficace per il coordinamento delle comunità di pratica in un’ottica di valorizzazione delle competenze tacite e delle pratiche situate, elementi costitutivi della vita organizzativa nella società della conoscenza.Participatory ethnography and community of practice: training methods and professional resources for the new welfare (Article in Italian) – Summary. Last decades have been characterized by processes of redefinition of practices of welfare, especially in health and social care. The causes are related to three orders of phenomena: the increasing scientific-technological density of the interventions; the spread of managerial strategies that emphasize the relevance of mechanisms for managing outcome control and customer satisfaction; finally, the demographic and sociocultural transformations that are shaping the interactions between people and services. The article illustrates the educational potential of the community of practice paradigm to face the unprecedented challenges posed by current welfare needs. The ethnographic gaze, stimulated through the participatory ethnography method, becomes an effective professional resource for the coordination of the community of practice and for enhancing tacit knowledge and situated practice, strategic assets for organizational and professional success in the knowledge society
Ethnography of "Local Universality": admission practices in an intensive care unit among guidelines, routines, and humour
Full text linkThe article analyses the existing gap between the formal dimension of evidence-based medicine (EBM), as constituted by protocols, procedures, and guidelines, and actual professional practices in relation to a specific issue: the admission of patients to an intensive care unit (ICU). The results of a case study, carried out in the ICU of a hospital in the north of Italy between 2006 and 2007 are reported. The study was performed using ethnographic methods: participant observation, ethnographic interviews, and semi-structured interviews. Empirical data have been analysed using a grounded theory approach. The results show how three dimensions (macrosocial, organisational-interactional, and individual) become intertwined with the operational guidelines that have been drafted on the basis of international evidence. The standardisation process that the guidelines presuppose results in the adoption of a variety of different local styles with respect to the approach that individual doctors take in relation to the admission of a patient to an ICU. These styles can range from strict adherence to the international criteria to a greater compliance with medical–legal, organisational, and individual needs. Furthermore, the results of the study demonstrate how relational knowledge, as a form of situated knowledge, can allow the personnel involved to activate local resources (organisational, professional, and personal) in order to incorporate the formal prescriptions of EBM in professional practice
The Contingency of the Lifeworld in a World of Standards. Repertoires of Resignification in (Evidence-Based) Healthcare Organization
Full text linkIn this article I discuss the irremediable tension between the universalistic dimension of contemporary medicine, represented by the paradigm of evidence-based medicine (EBM), and local daily practices in specific healthcare organizations. This tension constantly challenges the unitary, universalistic vision to which modern medicine and science aspire. The EBM paradigm, which is currently the most prevalent in every medical-nursing discipline, aims to standardize care procedures through the process of constant scientific literature review and the production of operational guidelines based on what epistemic communities define as the most reliable and effective results: the so-called gold standards. In everyday clinical, therapeutic, and care activities, these procedures are intertwined with the multiplicity of elements that make up the lifeworld.
“Universalistic” premises are never merely “applied” to “local” interactive contexts but are always creatively “implicated” in them. Using data collected during a year of ethnographic research in an intensive care unit in Northern Italy, I discuss how the abstract indications of EBM and the formal dimension of health organizations are incorporated, through socially located interactive repertoires, in actual care trajectories. Following the Science and Technology Study perspective in a practice-based analysis of daily work, I show how interactions between human actors, technological artifacts and organizational apparatus in daily practices constitute repertoires of resignification through which local universality emerges, resolving the tension between medicine’s universalistic aspirations and the unpredictable, situated nature of the lifeworld. I consider two repertoires: the interpretative (examining the production and dissemination of knowledge) and the relational (focusing on informal interactions between different professional groups and communities of practice). The article shows how care practices cannot disregard the specific organizational conditions in which they unfold and suggests that research should develop reflective analysis skills on what Annemarie Mol calls the logic of care, thus ceasing to treat the local dimension as a disturbing element in formal systems but, on the contrary, taking note of its impact and unavoidability in actual practice
Making visible the invisible and vice versa. Bodies and organisational arrangements in the Intensive Care Unit
No full textBackground and aims: The effectiveness of the treatments carried out in the Intensive Care Unit (ICU) is guaranteed by a socio-technical ensemble where material resources, scientific knowledge, technological artefacts, social norms, spatial dispositions, and professional practices coexist and constantly interact. This paper intends to penetrate such an ensemble for analysing the moral order produced and maintained in everyday medical practice. Method: The results of a case study, carried out in the ICU of a hospital in the north of Italy between 2006 and 2007 are reported. The study was performed using ethnographic methods: participant observation, ethnographic interviews, and semi-structured interviews. Results: I illustrate how ward organisation and professional practices of medical and nurse staff create and reproduce two dispositions of body centred on the staff’s perception of the therapeutic appropriateness of patients. On one side, there are the bodies that staff expect to get better, and these bodies are exposed through a series of organisational devices and activities in order to make them immediately accessible and available for every type of treatment; on the other side, the bodies of chronic and terminal patients tend to become invisibles in the working practice of the unit. This process does not follow any guideline or protocol but is embodied in informal routine and communicative interactions. Conclusions: The invisibility surrounding certain patients can be seen as strategies for the management of professional conflict and bioethical issues that stem from different interpretations of the degree of severity of the patients’ conditions
[Recensione a:] Global Perspectives on ADHD: Social Dimensions of Diagnosis and Treatment in Sixteen Countries, Bergey, Meredith R.; Filipe, Angela M.; Conrad, Peter; Singh, Ilina (edds.), Baltimore, MD, Johns Hopkins University Press, 2018, 400 pp.
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