PhD defence: Therese Dwyer Løken

Portrett av Therese Dwyer Løken som ser i kamera

Therese Dwyer Løken will defend her PhD degree in Person-centred health care. The dissertation is about the integration of municipal health and social care services, and how professionals and managers adapt to and operationalize policies that regulate service integration.

09 Feb

Practical information

  • Date: 9 February 2024
  • Time: 10.00 - 16.00
  • Location: Østfold University College, campus Fredrikstad, Room H-113 and Zoom
  • Download calendar file

    • Watch the defence on Zoom

    Program

    Kl. 10.00: Trial lecture: Discuss possible barriers that various vulnerable or marginalized groups may face in the healthcare services.

    Kl. 12.00: Public defence: The dynamics between policy and practice. A case study on the integration of municipal health and social care services for people with mental health and substance abuse challenges.

    Evaluation committee

    • First opponent: Jonas Debesay, Professor, Department of Nursing and Health Promotion, Oslo Metropolitan University
    • Second opponent: Pernille Tanggaard Andersen, Professor, Department of Public Health, University of Southern Denmark
    • Administrator of the committee: Linda Madsen, Associate Professor, Department of Nursing and Health Sciences, University of South-Eastern Norway
    • Defence leader: Kirsti Skovdahl, vice dean, Østfold University College

    Supervisors

    • Principal supervisor: Catharina Bjørkquist, Professor, Østfold University College
    • Co-supervisors: Marit Kristine Helgesen, Professor, Østfold University College and Halvard Vike, Professor, University of South-Eastern Norway
Any questions?

Therese Dwyer Løken is defending her thesis for the degree philosophiae doctor (PhD) at the University of South-Eastern Norway.

She has completed the PhD programme in Person-centred health care. The doctoral work has been carried out at the Faculty of Health and Social Sciences.

Both the trial lecture and the PhD defence are open to the public.

Summary

This dissertation examines how professionals and managers in municipal health and social care services adapt to and operationalize policies that regulate these services. Professionals and managers must adapt to policies that regulate financial management on the one hand, and qualitative objectives on the other. It is the qualitative objective of integration of health and social care services for people with mental health and substance abuse challenges that is the primary focus of this thesis. This implies that the actors in the various sub-services both collaborate and coordinate their respective efforts around individual service recipients.

The dissertation emphasizes the relationship between control and trust between the Norwegian authorities and the municipalities. The state’s control of municipalities’ financial management prevents professionals and managers from effectively adapting to policies regarding coordination and collaboration. At the same time, Norwegian municipalities are given trust and autonomy to operationalize policies regarding integration of health and social care services in line with their own contextual and demographic needs. The municipalities that choose to organize and approach services based on the values of adaptability, flexibility, robustness, and resilience may succeed in coordination and collaboration.

The dissertation also reveals differences between the municipalities, regarding organization of services and professional approaches. This results in variations in how the municipalities provide health and social care services to service recipients with mental health and substance abuse challenges, and the degree of integration of these services. This has implications for the universal welfare state. When service recipients receive integrated services in one municipality, but not in another, it may indicate that the goal of universalism is under pressure. Such variations also raise the question of whether there is a need to evaluate the decentralized welfare model, where the municipalities are responsible for implementing and providing primary health and social care services.

Finally, the findings in this dissertation show that professional approaches, competence, and collaborative cultures are cornerstones in a sustainable service system. Professionals’ and managers’ capacity to respond to changes and challenges may promote sustainability in health and social care services. This highlights the importance of using resources on education and on developing competence and collaborative cultures among professionals and managers, rather than on costly reorganizations of services.