“Just deal with it” Health and social care staff´s perspectives on changing work routines by introducing ICT Perspectives on the process and interpretation of values

Abstract: Policymakers emphasize that the increased use of information andcommunication technologies (ICT) will improve efficiency and reinforceaccountability in health and social care. Care has an intrinsic value that isunquestionable; everyone needs care more or less throughout their life. The twodifferent rationalities, the technical rationality and the caring rationality,raise the question of how technologies can be used in the care sector as ameans to support care.    The overall aim of thisdoctoral thesis was to describe and interprethealth and social care staff´s expectations, perceptions, experiencesand values when changing work routines by introducing ICT.Data was collected through group- and individual interviews with primary healthcare and social care staff during a research and development (R&D) project.The R&D project aimed at developing work procedures for staff in health andsocial care by introducing new ICT applications. Data was analyzed with qualitative interpretiveapproaches.   The results showedthat expectations from participating staff were overshadowed by earlier development work and they distancedthemselves from the R&D project. Staff perceived the ICT solution inrelation to utility in their daily practice but also on its impact on thealready strained economy and the working environment. Participants experiencedunclear decisions and hardly any power of influence in the project. Similarexperiences from the past seemed to trigger participants as they were emotionaland upset. Once again they experienced low power to influence. Interpretedvalues showed that staff did not reject technologies per se but they argued foror against the technologies in relation to what they believed would supporttheir view of what good care was.   This leads to the conclusionthat disturbance-free interactions with the care receiver were prerequisitesfor accepting any technologies. Furthermore, participants had a wish of takingresponsibility in care work and of being confirmed, in an organization withclear visions and management. The caregiving process and its challenges fromthe perspective of the caregivers need consideration and the concept of caringrationality needs to be put on the agenda. More concern of what good care is and who is defining it should be more investigated and discussed.Change processes in health and social care often focuses on finance andeffectiveness. R&D projects and nursing researchers should consider thatfrom a staff perspective it would be beneficial to use approaches where powerrelations are questioned, and organizations that management should encouragechange initiatives from staff.   Key words: Care, ICT, staff perspectives, values, nursing, individual interviews, group interviews, qualitative interpretive analysis, feminist ethics of care