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Professional Authority (professional + authority)
Selected AbstractsUnderstanding the ,epidemic' of complete tooth loss among older New ZealandersGERODONTOLOGY, Issue 2 2010Philip V. Sussex doi:10.1111/j.1741-2358.2009.00306.x Understanding the ,epidemic' of complete tooth loss among older New Zealanders Objective:, The aim of this study was to obtain a deeper understanding of the social factors driving New Zealand's historic ,epidemic of edentulism' and how they operated. Method:, In-depth, semi-structured interviews with 31 older New Zealanders were analysed using applied grounded theory. Results:, Universal factors present in the data were: (a) the way in which New Zealand society accepted and indeed encouraged edentulism without stigma for those who had a ,sub-optimal' natural dentition; (b) how the predominant patterns of dental care utilisation (symptomatic and extraction-based) were often strongly influenced by economic and social disadvantage; and (c) the way in which lay and professional worldviews relating to ,calcium theory' and dental caries were fundamental in decisions relating to the transition to edentulism. Major influences were rural isolation, the importance of professional authority and how patient-initiated transitions to edentulism were ultimately facilitated by an accommodating profession. Conclusion:, The combined effects of geography, economics, the dental care system and the professional culture of the day, in the context of contemporary (flawed) understandings of oral disease, appear to have been the key drivers. These were supported (in turn) by a widespread acceptance by the profession and society alike of the extraction/denture philosophy in dealing with oral disease. [source] Psychiatric nurses' attitudes towards patient autonomy in depot clinicsJOURNAL OF ADVANCED NURSING, Issue 4 2001Bodil Svedberg RPN Psychiatric nurses' attitudes towards patient autonomy in depot clinics Aim.,The aim of this qualitative study was to explore how psychiatric nurses experience patient autonomy in relation to their professional role in depot clinics. Background.,The administration of depot neuroleptics at outpatient clinics is a common task for psychiatric nurses in many countries. The procedure is characterized by brief contacts often allowing little opportunity for adequate monitoring of the treatment and a dialog between nurses and patients. As nurses have an important role in involving patients in decision-making, there is a need to analyse the nurses' attitudes towards giving depot neuroleptics from the perspective of autonomy. Method.,Nine experienced psychiatric nurses were interviewed using open-ended questions. The steps of a phenomenological descriptive method guided the data analysis. Findings.,The structure describes how benevolent attitudes towards patient autonomy motivated the nurses' interventions in relation to how they experienced their own professional authority. The structure consists of four variations: (1) Beneficent interventions used with patients perceived as co-operative when the nurses experienced a high degree of professional authority. (2) Paternalistic interventions used with patients perceived as ambiguous towards medication when the nurses experienced an arbitrary professional authority in collaboration with team members. (3) Weak paternalistic interventions used with patients perceived as unwilling when the nurses experienced having sufficient professional authority in the treatment situation. (4) Nonmaleficent interventions used with patients perceived as being resigned when the nurses experienced a low degree of professional authority within the team. Conclusions.,The findings indicate that psychiatric nurses' experience of their professional authority is closely related to the organization of the depot treatment and that brief contacts do not favour the establishment of collaborative relationships with patients. When injection-giving nurses, as patients' key workers, have overall responsibility for co-ordinating the patients' treatment they can encourage patient autonomy by helping patients understand the meaning of depot medication and its benefits. Further clinical research regarding the involvement of nurses in the treatment as well as patients' experiences of treatment with depot neuroleptics is needed to allow suggestions about improvements of the organization of the treatment. [source] Technicians, clients, and professional authority: structured interactions and identity formation in technical workNEW TECHNOLOGY, WORK AND EMPLOYMENT, Issue 1 2002Asaf Darr This ethnographic study of technicians in action supplements a structural analysis of technical labour by delineating the distinct occupational identities of different technicians through their framed interactions with their clients and professionals with whom they work. We suggest that educational reform predicated on a structural conception of technicians will fail to redress the impending technical skill shortages. [source] A Loss of Faith: The Sources of Reduced Political Legitimacy for the American Medical ProfessionTHE MILBANK QUARTERLY, Issue 2 2002Mark Schlesinger Writing at the beginning of the 20th century, Shaw identified one of the significant contemporary transformations in industrial democracies. In part as the result of advances in science and technology, in part as a rejection of the monopolistic abuses of industrialization, and in part as a consequence of assiduous efforts by the professions themselves, this was a period in which the legitimacy and social authority of professionals increased dramatically (Brint 1994; Krause 1996; Larson 1977; Sandel 1996). Nowhere was this more evident than in medicine. Over several decades, medicine changed from an occupation with a mixed reputation and little political influence into one that would "dominate both policy and lay perceptions of health problems" (Freidson 1994, 31). In a number of countries, the professional authority and political influence of physicians also rose during this era (Coburn, Torrance, and Kaufert 1983; Krause 1996; Stone 1980), most dramatically in the United States (Starr 1982). The political legitimacy and policymaking influence of the medical profession have greatly declined in American society over the past 30 years. Despite speculation about the causes, there has been little empirical research assessing the different explanations. To address this gap, data collected in 1995 are used to compare attitudes of the American public and policy elites toward medical authority. Statistical analyses reveal that (1) elites are more hostile to professional authority than is the public; (2) the sources of declining legitimacy are different for the public than they are for policy elites; and (3) the perceptions that most threaten the legitimacy of the medical profession pertain to doubts about professional competence, physicians' perceived lack of altruism, and limited confidence in the profession's political influence. This article concludes with some speculations about the future of professional authority in American medicine. [source] | ||||||||||