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Maintaining professional integrity: Experiences of case workers performing the assessments that determine children’s access to personal assistance
Karolinska institutet.ORCID iD: 0000-0001-6333-2852
Högskolan i Gävle; Karolinska institutet; Karolinska universitetssjukhuset.
Karolinska institutet; Karolinska universitetssjukhuset.
Karolinska institutet; Karolinska universitetssjukhuset.
2018 (English)In: Disability & Society, ISSN 0968-7599, E-ISSN 1360-0508, Vol. 33, no 6, p. 909-931Article in journal (Refereed) Published
Abstract [en]

This qualitative study explores Swedish case workers experiences of decision making regarding disabled children's right to obtain assistance in their everyday life whereby they can live independently in the community. Data collection included seven focus-group interviews and 11 complementary individual interviews with case workers from different agencies responsible for decisions regardig access to personal assistance. Grounded theory methodology was used. Compromised professional integrity under shifting conditions emerged as a main concern and maintaing professional integrity was used as an approach to resolve it. The case workers are maintaining professional integrity by applying different strategies; struggling with division of responsibility, bureaucratizig, and justifying and protecting. The results indicate that present application of assessment criteria in combination with the utilization of precedent rulings has made it difficult for the case workers to make decisions that provide children access to assistance. Current practice raises questions about the case workers perspectives of professionalism. 

Place, publisher, year, edition, pages
2018. Vol. 33, no 6, p. 909-931
Keywords [en]
Personal assistance, Disabled children, Case workers, Decision making, Professionalism, Grounded theory
National Category
Social Work
Identifiers
URN: urn:nbn:se:esh:diva-10085DOI: 10.1080/09687599.2018.1466691OAI: oai:DiVA.org:esh-10085DiVA, id: diva2:1735505
Funder
Norrbacka-Eugenia Foundation, 531-14Available from: 2023-02-08 Created: 2023-02-08 Last updated: 2023-02-11Bibliographically approved
In thesis
1. Live life!: Young peoples' experience of living with personal assistance and social workers' experiences of handling LSS assessments from a child perspective
Open this publication in new window or tab >>Live life!: Young peoples' experience of living with personal assistance and social workers' experiences of handling LSS assessments from a child perspective
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The Act Concerning Support and Services to Persons with Certain Functional Impairments, in which the provision of personal assistance (PA) is included, came into force in 1994. It paved the way for strengthened rights for people with disabilities, in which the overall intention was to give disabled people equal opportunities and enable full participation in society.

This thesis explores adolescents’ and social workers’ perspectives on and experiences of personal assistance. The overall aim of this research was to gain empirical knowledge and a deeper understanding of young assistance users’ experiences of living with PA and the social workers’ experience of assessing children’s right to PA and other LSS interventions. In paper I, a grounded theory (GT) analysis showed that the adolescents’ main concern was to achieve normality, which was about doing rather than being normal. The findings underline and discuss the interconnectedness between the different enabling strategies adopted by the adolescents, and to a lesser extent discuss disabling barriers for which PA cannot compensate. In paper II the adolescents describe their experiences of the assessment process which precedes possible access to PA. The content analysis reveals that the adolescents’ participation was determined by the structure of the meetings, in which the assessments tools played a decisive part. The adolescents adapted their behaviour in response. Paper III is based on a phenomenological approach to social workers’ responses to children and young peoples’ ability to participate in meetings and decision making concerning their own support interventions. It reveals difficulties in grasping what participation should be and result in. In paper IV, a GT study, the emerging theory explains how case workers tried to maintain their professional integrity by adopting various strategies.

The synthesis of the four studies has resulted in a clarification of how the individual, organizational and societal levels interact through legislation and policy documents, meetings and norms to create certain processes and interactions between the different stakeholders. However, further research is necessary to explore the long-term effects of the current changes to Swedish LSS-legislation regarding both the professional conduct of the case workers responsible for assessing LSS interventions and the consequences of such decisions for assistance users and their families.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2018. p. 99
National Category
Social Work
Identifiers
urn:nbn:se:esh:diva-10102 (URN)978-91-7831-062-3 (ISBN)
Public defence
2018-05-24, Magnus Huss Aula, Stockholms sjukhem, Mariebergsgatan 22, Stockholm, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2023-02-14 Created: 2023-02-11 Last updated: 2023-02-14Bibliographically approved

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