心 "与 "思想":说明澳大利亚残疾专职医疗服务市场化政策变革中生活和工作的人们的身份紧张关系。

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Health Pub Date : 2025-01-01 Epub Date: 2024-02-13 DOI:10.1177/13634593241230018
Kristen Foley, Stacie Attrill, Chris Brebner
{"title":"心 \"与 \"思想\":说明澳大利亚残疾专职医疗服务市场化政策变革中生活和工作的人们的身份紧张关系。","authors":"Kristen Foley, Stacie Attrill, Chris Brebner","doi":"10.1177/13634593241230018","DOIUrl":null,"url":null,"abstract":"<p><p>Service-based caring sectors like disability are increasingly being operated via market logic, including shifts towards personalised funding. These shifts must be brought to life in/through people already located in relation to ideas and values that underpin historical policies. Our manuscript examines how identities are re/shaped in relation to marketised policy change and explores how identity change unfolds (or not) during periods of transition: situated within the transition to the National Disability Insurance Scheme executed in Australia as a major disability funding reform. Our qualitative dataset involves interview and focus group data collected with service recipients/carers (<i>n</i> = 28), providers/managers (<i>n</i> = 17) and advocates (<i>n</i> = 2) during shift from government- to personally-controlled funding of allied health services for people with disability in Australia (2017-2020). We used layered sociological inference to develop and interrogate processes of tension and identity change amidst lived experience(s) of policy change. Our analysis elucidates how various identities were encouraged, desired, resisted and constrained in relation to the policy transition. We bring together sub-themes from analysis of recipient/carer data (getting value-for-money; critiquing service quality; and experiencing system shortfalls) and manager/provider data (learning to transact; the call to care; and structural frictions in/and identity transitions) to interpret that recipients/carers are <i>Feeling (like) the dollar sign</i> and that managers/providers are <i>Troubling profits.</i> In both cases 'hearts' and 'minds' are perceived to be diametrically opposed and symbolic in/against processes of marketisation. We synthesise our data into an illustrative framework that facilitates understanding of how this perception of opposed 'hearts' and 'minds' seems to constrain the identity transitions encouraged by personalised funding, and explore ways in which desired identities might be supported amidst marketising policy transition.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"39-61"},"PeriodicalIF":1.9000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"'Hearts' and 'minds': Illustrating identity tensions of people living and working through marketising policy change of allied health disability services in Australia.\",\"authors\":\"Kristen Foley, Stacie Attrill, Chris Brebner\",\"doi\":\"10.1177/13634593241230018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Service-based caring sectors like disability are increasingly being operated via market logic, including shifts towards personalised funding. These shifts must be brought to life in/through people already located in relation to ideas and values that underpin historical policies. Our manuscript examines how identities are re/shaped in relation to marketised policy change and explores how identity change unfolds (or not) during periods of transition: situated within the transition to the National Disability Insurance Scheme executed in Australia as a major disability funding reform. Our qualitative dataset involves interview and focus group data collected with service recipients/carers (<i>n</i> = 28), providers/managers (<i>n</i> = 17) and advocates (<i>n</i> = 2) during shift from government- to personally-controlled funding of allied health services for people with disability in Australia (2017-2020). We used layered sociological inference to develop and interrogate processes of tension and identity change amidst lived experience(s) of policy change. Our analysis elucidates how various identities were encouraged, desired, resisted and constrained in relation to the policy transition. We bring together sub-themes from analysis of recipient/carer data (getting value-for-money; critiquing service quality; and experiencing system shortfalls) and manager/provider data (learning to transact; the call to care; and structural frictions in/and identity transitions) to interpret that recipients/carers are <i>Feeling (like) the dollar sign</i> and that managers/providers are <i>Troubling profits.</i> In both cases 'hearts' and 'minds' are perceived to be diametrically opposed and symbolic in/against processes of marketisation. We synthesise our data into an illustrative framework that facilitates understanding of how this perception of opposed 'hearts' and 'minds' seems to constrain the identity transitions encouraged by personalised funding, and explore ways in which desired identities might be supported amidst marketising policy transition.</p>\",\"PeriodicalId\":12944,\"journal\":{\"name\":\"Health\",\"volume\":\" \",\"pages\":\"39-61\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/13634593241230018\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/13 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/13634593241230018","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/13 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0

摘要

以服务为基础的关爱部门,如残疾人部门,正越来越多地通过市场逻辑运作,包括向个性化资助转变。这些转变必须通过与支撑历史政策的理念和价值观相关的人群来实现。我们的手稿研究了在市场化的政策变化中,身份是如何被重塑的,并探讨了在过渡时期,身份的变化是如何展开的(或没有展开):在澳大利亚,国家残疾保险计划的过渡是一项重大的残疾资助改革。我们的定性数据集包括从政府到个人控制的澳大利亚残疾人联合医疗服务资助转变期间(2017-2020 年)收集的访谈和焦点小组数据,访谈对象包括服务接受者/护理者(n = 28)、提供者/管理者(n = 17)和倡导者(n = 2)。我们利用分层社会学推论来发展和探究在政策变化的生活经历中的紧张和身份变化过程。我们的分析阐明了在政策转型过程中,各种身份是如何受到鼓励、期望、抵制和限制的。我们将对受助者/护理者数据(物有所值;对服务质量的批评;以及对系统不足的体验)和管理者/提供者数据(学会交易;对护理的呼唤;以及身份转换中的结构性摩擦)分析得出的次主题结合在一起,解释了受助者/护理者正在感受(喜欢)美元符号,而管理者/提供者正在为利润而烦恼。在这两种情况下,"心 "和 "思想 "被认为是截然相反的,是市场化进程中的象征。我们将数据归纳为一个说明性框架,该框架有助于理解这种 "心 "与 "意 "对立的观念是如何限制个性化资助所鼓励的身份转变的,并探讨在市场化政策过渡中支持理想身份的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
'Hearts' and 'minds': Illustrating identity tensions of people living and working through marketising policy change of allied health disability services in Australia.

Service-based caring sectors like disability are increasingly being operated via market logic, including shifts towards personalised funding. These shifts must be brought to life in/through people already located in relation to ideas and values that underpin historical policies. Our manuscript examines how identities are re/shaped in relation to marketised policy change and explores how identity change unfolds (or not) during periods of transition: situated within the transition to the National Disability Insurance Scheme executed in Australia as a major disability funding reform. Our qualitative dataset involves interview and focus group data collected with service recipients/carers (n = 28), providers/managers (n = 17) and advocates (n = 2) during shift from government- to personally-controlled funding of allied health services for people with disability in Australia (2017-2020). We used layered sociological inference to develop and interrogate processes of tension and identity change amidst lived experience(s) of policy change. Our analysis elucidates how various identities were encouraged, desired, resisted and constrained in relation to the policy transition. We bring together sub-themes from analysis of recipient/carer data (getting value-for-money; critiquing service quality; and experiencing system shortfalls) and manager/provider data (learning to transact; the call to care; and structural frictions in/and identity transitions) to interpret that recipients/carers are Feeling (like) the dollar sign and that managers/providers are Troubling profits. In both cases 'hearts' and 'minds' are perceived to be diametrically opposed and symbolic in/against processes of marketisation. We synthesise our data into an illustrative framework that facilitates understanding of how this perception of opposed 'hearts' and 'minds' seems to constrain the identity transitions encouraged by personalised funding, and explore ways in which desired identities might be supported amidst marketising policy transition.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Health
Health Multiple-
CiteScore
4.90
自引率
0.00%
发文量
0
期刊介绍: Health: is published four times per year and attempts in each number to offer a mix of articles that inform or that provoke debate. The readership of the journal is wide and drawn from different disciplines and from workers both inside and outside the health care professions. Widely abstracted, Health: ensures authors an extensive and informed readership for their work. It also seeks to offer authors as short a delay as possible between submission and publication. Most articles are reviewed within 4-6 weeks of submission and those accepted are published within a year of that decision.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信