Project Presentation
VULNERABILITY AS A STRENGTH
– how can disempowerment experiences be transformed into health resources?
Professor Kirsti Malterud MD PhD
Dept. of Public Health & Primary Health Care, University of Bergen,
Kalfarveien 31, N-5018 Bergen, Norway - tlf. +47 55 58 61 00 - fax: +47 55 58 61 30
kirsti.malterud@isf.uib.no
This cross-disciplinary network of 16 researchers from medicine, physiotherapy, psychology, and social sciences is coordinated by Kirsti Malterud and has been developed since 2002. Network members have ongoing or planned projects exploring the possibilities for people from marginalized or high risk groups (lesbian women, heavy drinkers, persons with familial hypercholesterolemia, heart disease, and disability in general) or with chronic disorders (musculoskeletal problems, mental illness) to live dignified lives, with a positive understanding of identity and health, supported by health care providers who are able to recognize people’s strong sides. From the juxtapositions of these projects, we study the preconditions for turning the balance between strain and growth into potential resources for health care, prevention, and rehabilitation, guided by theories about of empowerment, diversity, disability, and salutogenesis.
The working methods of the network include internal meetings (allowing participants to share knowledge across projects and disciplines), external networking (arrange workshops and conferences with international and other prominent speakers), and stimulating the research of the individual participant. The network is our tool to develop collaboration between the participants on their individual research projects, stimulate scientific publications, and strengthen the international network of the group.
We intend to pursue our studies on preconditions for how the balance between strain and growth can be turned into potential resources for health care, prevention, and rehabilitation (1,2), drawing on perspectives of empowerment (3-6), diversity and disability (7,8), and salutogenesis (9) broadly covered in previous research from this group.
OBJECTIVE - AIMS
The main purpose of the project is to explore preconditions for transforming demanding experiences from life and sickness into personal health resources, shifting the attention of health care providers from risk and weakness to strength and resources. Turning vulnerability into potential assets, we want to develop knowledge about the strong sides of people who suffer from chronic illness or belong to marginalised groups. Knowledge about people’s (maybe invisible) resources may encourage doctors towards empowering strategies in health promotion, diagnosis and treatment of disease, and rehabilition, suited to accommodate the diversity of members of different marginalized groups.
We want to study
· the impact of cultural dimensions such as diversity, vulnerability, identity and opportunities on development and experience of health and illness
· the use of recognition and mobilisation of patients’ strong sides in medical care
· the potentials of empowerment to promote recovery processes and counteract oppression
BACKGROUND
Normality, diversity, and dignity in the culture of modernity
Modern culture value conformity, effectiveness, independence, and health. People who are dependent on others, or who deviate from what is considered as ‘normal’, run the risk of social marginalization. In modernity there is a strong belief that suffering, disability, and deviance can and should be eliminated or normalized by medical intervention. The patterns of disease in Western society have changed from infections diseases towards chronic conditions such as musculoskeletal disorders, mental illness, dementia, and consequences of accidents or social sstigma. When cure is not optional (chronic disease) (10) nor desirable (diversity) (11) , the tasks of health care providers are changed from ‘repairing the failure’ towards commitment, care, or support. Yet, doctors may also function as agents of modernity, mediating attitudes of oppression, and dismissing the dignity of people who challenge the cultural ideals by just not getting well or normal. Members of the network have previously studied the conceptual impact of disability (12), diversity (13), and medically unexplained disorders (14), and described the oppressive potentials of the medical encounter (15,16). In this project, we will further explore the impact on health care of questions such as
· What happens to identity and dignity in people who do not fulfill the utopian cultural ideals of health, ability, and normality?
· How does medical theory and practice support or challenge such ideals?
· What is the impact of this on the capacity of coping with disease, hardship, and oppression?
· What happens to the human values in such a society?
Patients’ perspectives and resources
Chronic illness and life conditions that create experiences of oppression give rise to challenges for medical epistemology and practice (17). The biomedical tradition appreciates objective findings, while subjective symptoms have less clout. Patients with medically unexplained disorders complain that they do not feel taken seriously by the doctor for this reason. Yet, there is evidence for the impressive and independent predictive power of people’s self-assessed health regarding future cardiovascular disease, death, and reduced functional capacity (18). Patients’ perspectives are underestimated resources to understand more about health and illness, especially when these are different from the doctor’s assessments or assumptions. Salutogenetic perspectives underpin the importance of acknowledging the patient as a person and mobilising his or her strong sides (19), so that the patient’s resistance resources are given the best possible conditions in the fight against illness, suffering and oppression (20). Members of the network have previously developed strategies for new, empowering clinical dialogues supporting the role of patients’ experiences and knowledge and counteract further disempowerment (21,22). In the present project, we will further explore the potentials of empowerment in clinical care through questions such as
· Which are the discrepancies between doctor-assessed and patient-assessed health?
· How is clinical interaction affected by such discrepancies?
· Which theoretical models can be relevant to understand the subtle balance between patient-assessed and doctor-assessed health?
Recovery – approaching new foundations on own premises
The term ‘recovery’, developed within psychiatric rehabilitation, means coming to oneself in a broad sense – creating meaning and functioning, looking forward to the hope of a future, while still recognizing the realities of disability and suffering (23). Deegan says that the aim is to be the unique human being every person is, due to his or her assets (24). Placebo demonstrates how the belief that something works – hope – can mediate a medical effect. Biomedical research describes neuroimmunological mechanisms functioning as molecular messengers (25). Healing and recovery may also be mediated through such mechanisms. Members of the network have already explored the potentials of hope and acknowledgement in recovery (26,27). In our project, we will further investigate the role of hope as a foundation for building a good life, where disability and diversity can be accomodated. We focus on issues that can be applied by health care professionals, through questions such as
- What is needed for people with chronic diseases or from marginalized groups to regard their health as good?
- How can people who experience disampowerment due to disability or marginalization be supported towards hope and meaning?
- How can health care, rehabilitation, and health promotion be experiences as adequate and supportive for people with chronic disease or status of deviance, corresponding to the aims of the best possible life on own premises?
RESEARCH STRATEGY
Pursuing issues from previous or ongoing research
The network consists of 16 collaborating members (nine medical doctors - general practice, rehabilitation, and neurology, a medical student, a public health nurse, two sociologists, two psychologists, and one physiotherapist). Alone or together, all the researchers have projects exploring the interface between culture and health. All the projects explore the possibilities for people from marginalized or high risk groups (lesbians, heavy drinkers, familial hypercholesterolemia, heart disease, and disability in general) or with chronic disorders (musculoskeletal problems, mental illness) to live dignified lives, with a positive understanding of identity and health, supported by health care providers who are able to recognize people’s strong sides. All individual projects are in good progress, ranging from small-scale projects run by practitioners through master degree projects to projects on or above a PhD level.
Diversity of perspectives applied to interrelated issues
Professor Kirsti Malterud MD PhD (general practice) is the founder and coordinator of the network. She has completed a large number of studies about women’s health and patient perspectives, recently a large research network called “Symptoms as a source of knowledge”. The last decade, she has collaborated with professor Hanne Hollnagel MD PhD (general practice), Copenhagen, on patients’ self-assessed personal health resources. Having finished this project, a new study about the possible potentials of doctors’ vulnerability in patient encounters is in good progress.. PhD student Margrethe Aase MD started her PhD project 2006 about issues on life, death, and vulnerability for patients with serious heart disease and their doctors. Medical student Rune Slettbakk, Bergen, is working on a study about coping and management of chronic health problems, with headache and overweight as his first cases. Neurologist Jan C. Frich MD, Oslo, is working on his PhD about experiences of risk in people with familial hypercholesterolemia, based on qualitative interviews. Senior researcher Sissel Steihaug MD PhD (rehabilitation), Oslo, completed her PhD in 2002 on a project about the role of recognition in a treatment program for women with chronic pain, organized together with physiotherapist Birgitte Ahlsen PT, Oslo. Steihaug goes on with research about potentials for change among women with pain, while Ahlsen pursues the issues of body language experienced in the treatment groups for her master’s degree. Sociologist Anne Werner MSc PhD, Oslo, defended her PhD thesis in 2005 about women with chronic pain, focusing the hard work of being a patient while maintaining credibility and dignity. She plans for a postdoc project about male heavy drinkers, who succeed to quit drinking against all odds. Senior advisor Lillebeth Larun PT, MPH, Oslo, has recently started her PhD project on evidence, experience, and knowledge about Chronic Fatigue Syndrome. Senior resident Merete Undeland MD (neurology), Drammen, is working on her PhD project about diagnostic work in general practice, focusing the potential contributions of women patients in understanding the medically unexplained disorders. Assoc. professor Per Stensland MD PhD (general practice), Sogndal, completed his PhD in 2003 on a project where written home notes were used to create new dialogues in encounters between the general practitioner and patients with medically unexplained disorders. He is planning a postdoc project pursuing issues about clinical dialogues. Professor Per Solvang MSc PhD (sociology), Oslo, has done extensive research and also cultural dissemination work about disability, emphasizing the impact of bodily and cultural diversity, turning shame into pride and elaborating identities. Assoc. professor Anbjørg Ohnstad (psychologist), Oslo, is working on the analysis of data from her PhD project about identity development in lesbian women, drawing her long experience as a therapist. Specialist in general practice Mari Bjørkman MD, Oslo, is analysing focus group data from a small scale project about the impact of disclosure of sexual orientation when lesbian women see their doctors. Public health nurse RN Mona Flatval (Oslo) is in the middle of analysis of interview data in her master’s project about self-assessed health resources in lesbian women, focusing the benefit of lesbian life as compared to risks and disasters. Senior researcher Janecke Thesen MD (general practice), Bergen, has developed a teaching program for medical students about health care to marginalized groups, including lesbian women and people with major mental illness. She is working on development of empowerment strategies intended to counteract oppression experienced by people from marginalized groups.. Senior researcher PhD Patricia E. Deegan (psychology) has the last decades been a leading spokesperson for persons with mental disabilities, using her own long-term user experiences to explore values and strategies of recovery and resilience. Her present research deals with psychotropic medication and empowerment.
Common ground of network research – activities so far
The network has been organized to develop clinical and theoretical knowledge about empowerment and salutogenesis in health care, health promotion, and rehabilitation, beyond the outcome of the individual research project. The network creates an arena for multi-disciplinary collaboration and coordinates professional activities within and across the individual projects. Together or alone, the network members have published extensively from their projects, and further publications are upcoming.
The group meets for network seminars twice a year, and arranges conferences and workshops with prominent international speakers twice a year. We have collaborated on conference arrangements with the cross-disciplinary group of researchers at the University of Bergen “Health and disease in a cultural perspective”, especially with the social scientists Per Solvang (member of the network) and Kari Tove Elvbakken (founder of the cross-disciplinary group at UoB). We have also been involved with the UoB-based network “Gender and marginalization”. Our network has close connections to the University of Copenhagen and the Central Research Unit of Copenhagen, through the employment of network members Hollnagel and Malterud.
ACTIVITIES
2002
August Grant from Eckbo’s legacies
October Conference participation: ”Innovations in Recovery & Rehabilitation” arranged by Boston University (Deegan, Thesen, Malterud)
25.-26.10.02 Project meeting on personal medication project, Boston (Deegan, Thesen, Malterud).
20.-21.11.02 Network seminar for the group, Solstrand
2003
13.-15.02.03 Study visit & PhD dissertation: Anne Westerståhl/Gothenburg/Sweden: “Encounters in the medical context - Issues of gender and sexuality” (Malterud, Thesen)
19.-20.02.03 Network seminar for the group, Solstrand
21.03.03 Conference in Bergen: “Deviance as a strength – pride and recognition in a life of difference” (senior lecturer Paddy Ladd, Centre for Deaf Studies, University of Bristol, professor Nils Christie, University of Oslo, professor Per Solvang, University of Bergen, professor Kirsti Malterud, University of Bergen)
27.03.03 PhD dissertation Per Stensland: ” Approaching the locked dialogues of the body – Communicating symptoms through illness diaries” – University of Bergen
June Grant from University of Bergen
28.-30.08.03 Study visit & PhD dissertation: Pia Åsbring/Stockholm/Sweden: “Unexplained disorders – dilemmas and possitilities”. (Malterud, Thesen)
01.-02.10.03 Network seminar for the group, Solstrand
24.10.03 Conference in Bergen: ” Inside Outside: Building a Meaningful Life After the Hospital” (senior researcher Pat Deegan, Boston, professor Anne Karen Bjelland, University of Bergen, psychiatric user activist Bodil Pedersen, chief psychologist Leif Jonny Mandelid, Bergen University Hospital)
2004
11.-12.02.04 Network seminar for the group, Solstrand
11.06.04 Conference in Bergen: ”Oppression, Liberation, and Health” (professor Isaac Prilletensky, Vanderbilt University, Nashville USA, professor Hanne Hollnagel, University of Copenhagen, psychiatric use activist Bodil Pedersen, Bergen)
13.-14.06.04 Network seminar for the group, Solstrand
November Study trip to University of Western Sydney, Australia (Ohnstad, Thesen, Malterud)
2005
23.02.05 PhD dissertation Anne Werner: “The fight for credibility. Women with ‘unexplained’ disorders encountering the doctor and the everyday life ” - University of Oslo
20.-21.04.05 Network seminar for the group, Solstrand
Spring Fieldwork in San Francisco (Solvang)
May Grant from the Norwegian Research Council
May Conference participation: “European congress on obesity” Aten (Slettbakk)
June Project meeting on resilience and personal medication project, Lofoten (Deegan, Thesen, Malterud)
June Conference participation: “Boal drama techniques in empowerment” Stockholm (Thesen)
14.-15.06.05 Keynote and workshop at national rehabilitation conference, SKUR/Bodø (Deegan, Thesen, Malterud)
09.09.05 Workshop in Bergen: “Managing the Monstrous Feminine: Regulating the Reproductive Body”(professor Jane Ussher, School of Psychology, University of Western Sydney, Australia, assoc. professor Anbjorg Ohnstad, Oslo University College, assoc. professor Lise Widding Isaksen)
09.-11.09 Project meeting on lesbian health, Aurland (Ussher, Ohnstad, Thesen, Malterud)
October Supplement issue of Scand J Publ Health – Vulnerability as a strength - published
07.-08.10.05 Network seminar for the group, Solstrand
09.10.05 Workshop in Bergen: “Pain and vulnerability – being human” (professor Arne J. Vetlesen, University of Oslo, senior researcher Sissel Steihaug, Oslo, PhD student Margrethe Aase, Bergen)
October Conference participation: “Nidaroskongressen – workshop on overweight” Trondheim, Slettbakk
2006
05.-08.01.06 Study trip to London on narratives in medicine with John Launer, MD, Tavistock Clinic (Stensland, Thesen, Malterud et al)
22.-26.03.06 Project meeting on physician’s vulnerability, Bergen (Hollnagel, Malterud)
29.-30.03.05 Network seminar for the group, Solstrand
May Book release: “The practical art of medicine – doctor-patient communication” (Malterud, Nessa, Stensland, Thesen)
May Book release: “Lesbians and gays encountering the health care system” (Ohnstad, Malterud, Flatval et al)
02.06.06 Workshop participation: “Disability and equal opportunities” Bergen (Aase, Thesen, Malterud)
21.06.06 Workshop participation: “Emotion and medical decision making: friend or foe” Oslo (Aase, Malterud)
22.-23.11.06 Network seminar for the group, Solstrand
2007
February Project meeting - web based personal medication project, Boston (Deegan, Malterud, Thesen)
28.-29.03.07 Network seminar for the group, Solstrand
30.03.07 Workshop in Bergen: “Sårbarhet og urørlighetssone” (professor Kari Martinsen, Høgskolen i Harstad)
20.04.07 Workshop in Bergen: “Narrative-based practice” (senior lecturer John Launer, Tavistock Clinic, London)
Forthcoming events
21.09.07 Workshop in Bergen: “Interrupted lives” (?) (professor Catherine K. Riessman, Department of Sociology, Boston College)
25.-26.10.07 National conference: “Vulnerability, Power, and Voice”
Strategy and funding needs
· The individual projects are independently funded from various external sources. Network members Malterud, Hollnagel, Stensland, Solvang, and Thesen have received their salaries from parttime (mostly) or fulltime (a few) academic positions, while Steihaug, Werner, Ohnstad, and Frich have received PhD funding for different parts of the period. There is a need for funding of periods off regular work for several of the researchers. We want to stimulate the potentials of specific collaboration between the researchers across projects.
· Funding for secretary and network coordinator contributes to increased efficiency of the activity within and across the network. The project also needs funding for ordinary expenses to administrative issues, rent of office for secretary and guest researchers, equipment and so on. There is a need for funding of administrative facilities.
· Members of the network are spread widely around in Norway and Denmark, and infrastructure related to computerware and travel expenses are essential. Several of the researchers deal with advanced theoretical frontline perspectives where travels abroad (conferences, or establishing contact with potential partners for collaboration) will be important assets. We want to enhance the possibilities among network members of international contacts, including inviting guest researchers to join us for shorter periods.
· We intend to continue the internal network meetings, as well as the more high-profiled workshops or conferences with international guests, the latter approximately twice a year. The rich international network of the researchers provides an excellent opportunity to plan further arrangements with prominent guest lecturers and guest researchers.
· The network group was invited to be guest editors of a supplement issue of Scandinavian Journal of Public Health about vulnerability as a strength published in October 2005. This activity has required considerable financial input for printing support.
References:
1. Jørgensen M, Malterud K. Lægen Merete taler med patienten Anne. Månedsskr Prakt Lægegern 2004; 82: 171-7.
2. Malterud K, Hollnagel H. Positive self-assessed health in patients with medical problems. A qualitative study from general practice . Scand J Prim Health Care 2004; 22:11-5.
3. Malterud K. Allmennpraktikerens møte med kvinnelige pasienter. Oslo: TANO, 1990.
4. Hvas AC, Thesen J. At styrke patientens egne kræfter og at modvirke undertrykkende kræfter: "Empowerment" i et medicinsk perspektiv. Ugskr Læger 2002; 164: 5361-5.
5. Thesen J. Being a psychiatric patient in the community - reclassified as the stigmatized "other". Scand J Public Health 2001; 29: 248-55.
6. Thesen J, Malterud K. ”Empowerment” og pasientstyrking - et undervisningsopplegg. Tidsskr Nor Lægeforen 2001;121:1624-8.
7. Ohnstad, Anbjørg (1992) Den rosa panteren eller en i den grå masse. Forståelse av lesbiske i terapi. i Tidsskrift for Norsk Psykologforening nr 4, s.313 - 321
8. Solvang, Per (2000). "The emergence of an us and them discourse in disability theory", i Scandinavian Journal of Disability Reseach, volume 2, nr. 1, side 3–20.
9. Hollnagel H, Malterud K. Shifting attention from objective risk factors to patients`self-assessed health resources; a clinical model for general practice. Family Practice 1995;12:423-29.
10. Steihaug S, Ahlsen B, Malterud K. ”I am allowed to be myself”: women with chronic muscular pain being recognized. Scand J Public Health 2002; 30: 281-287.
11. Solvang, Per (2002). Annerledes. Uten variasjon, ingen sivilisasjon. Oslo: Aschehoug.
12. Helgøy, Ingrid, Bodil Ravneberg og Per Solvang (2003). The construction of independence in service relations, i Disability and Society, Volume 18, No 4, side 471-487.
13. Ohnstad, A ( 2003) Über das Lavieren zwischen verschiedenen. Beziehungsdiskursen. Identitätsstiftung und Identitätsprozesse lesbisher Frauen. s 66 - 71 Zeitschrift für Sexualforschung 16:1.
14. Malterud K. Symptoms as a source of medical knowledge Understanding medically unexplained disorders in women. Fam Med 2000; 32: 603-11
15. Werner, A., & Malterud, K. (2003). It is hard work behaving as a credible patient: encounters between women with chronic pain and their doctors. Social Science & Medicine, 57(8), 1409-1419.
16. Malterud K. Når livsstil ikke nytter - medikamentell risikointervensjon for dårlige mennesker. I Elvbakken KT, Solvang P red. Helsebilder. Sunnhet og sykdom i kulturelt perspektiv. Bergen, Fagbokforlaget, 2002:67-84
17. Malterud K, Candib L, Code L. Responsible and responsive knowing in medical diagnosis – The medical gaze revisited. Nora 2004; 12 (1): 8-19.
18. Idler EL, Benyamini Y.Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 1997 Mar;38(1):21-37.
19. Antonovsky A. Health, Stress, and Coping. New perspective on mental and physical well-being. Washington: Jossey-Bass Publishers; 1979: 1-255.
20. Malterud K, Hollnagel H. Talking with women about personal health resources in general practice. Key question about salutogenesis. Scand.J Primary Health Care. 1998;16:66-71.
21. Stensland P, Malterud K. Approching the locked dialogues of the body. Communicating symptoms through illness diaries. Scand J Prim Health Care 1999;17:75-80.
22. Steihaug S, Ahlsen B, Malterud K. From exercise and education to movement and interaction. Treatment groups in primary care for wonem with chronic muscular pain. Scand J Prim Health Care 2001; 19: 249-54.
23. Anthony WA. Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal 1996; 16, 11-23.
24. Deegan PE. Spirit breaking: When the helping professions hurt. The Humanistic Psychologist 1990; 18: 301-13.
25. Ader R, Cohen N, Felten D. Psychoneuroimmunology: interactions between the nervous system and the immune system. Lancet 1995; 345: 99-103.
26. Werner, A., Steihaug, S., & Malterud, K. (2003). Encountering the continuing challenges for women with chronic pain: Recovery through recognition. Qualitative Health Research, 13(4), 491-509.
27. Malterud K. The art of living with pain – recovery through acknowledgement. In Malterud K, Hunskaar S, eds. Patient-centred approaches to chronic myofascial pain in primary care. Oxon: Radcliffe Medical Press, 2002:167-71.
Additional publications from network members relevant for the project (most recent first)
2007
· Ahlsen B. ”Et sted å være” Noen kvinners erfaringer med å delta i behandlingsgruppe. Masteroppgave i helsefag Oslo: Institutt for sykepleievitenskap og helsefag/Det medisinske fakultet, Universitetet i Oslo: 2007.
· Bjorkman M, Malterud K. Being lesbian – does the doctor need to know? A qualitative study about the significance of disclosure in general practice. Scand J Prim Health Care 2007; 25: 58-62.
· Ehrenreich B, Hilden J, Malterud K. Patients’ written life stories – a gateway for understanding - A qualitative study from general practice. Scand J Prim Health Care 2007; 25: 33-37.
· Frich JC, Malterud K, Fugelli P. How do patients at risk portray candidates for coronary heart disease? A qualitative interview study. Scand J Prim Health Care 2007; 25: 112-6.
· Steihaug S. Women's strategies for handling chronic muscle pain: a qualitative study. Scand J Prim Health Care. 2007 Mar;25(1):44-8.
· Wyller VB, Bjørneklett A, Brubakk m fl. Kronisk utmattelsessyndrom – en gjennomgang av det vitenskapelige grunnlaget for behandling. Utposten 2007; 36 (2): 6-10.
· Malterud K, Hollnagel H. Avoiding humiliations in the clinical encounter. Scand J Prim Health Care 2007; 25: 69-74.
· Ulset E, Undheim R, Malterud K. Er fedmeepidemien kommet til Norge? Tidsskr Nor Lægeforen 2007; 127: 34-7.
2006
· Bergsjø P, Heiberg M; Telje J, Thesen J. Svangerskapsomsorg. [Prenatal care] Oslo: Gyldendal Akademisk 2006. (4. reviderte utgave av Bergsjø P, Sjøli S I, Telje J, Thesen J, red. Svangerskapsomsorg i allmennpraksis)
· Brunvatne R, Thesen J, Heiberg M, Telje J, Bergsjø P. Den gravide fra et annet land. I: Svangerskapsomsorg. Oslo: Gyldendal Akademisk 2006: 170-177
· Flatval, M. Forebygjande og helsefremjande arbeid retta mot lesbisk, homofil og bifil ungdom. I Ohnstad A, Malterud K, red. Lesbiske og homofile i møte med helse- og sosialtenesta. Oslo: Det Norske Samlaget. 2006: 115-121.
· Frich JC, Ose L, Malterud K, Fugelli P. Perceived vulnerability to heart disease in patients with familial hypercholesterolemia: a qualitative interview study. Ann Fam Med 2006; 4: 198-204.
· Frich JC, Malterud K, Fugelli P. Women at risk of coronary heart disease experience barriers to diagnosis and treatment. Scand J Prim Health Care 2006; 24: 38-43.
· Frich JC, Fugelli P. Forestillinger om sykdom – forventninger til helse. Tidsskr Nor Lægeforen 2006; 126: 45-8.
· Frich JC. Helse og helserettigheter. Tidsskr Nor Lægeforen 2006; 126: 196-7.
· Frich JC. Medisin og vitenskap i perspektiv. Tidsskr Nor Lægeforen 2006; 126: 143.
· Frich JC. Litteratur og medisin. Tidsskr Nor Lægeforen 2005; 125: 3406.
· Malterud K. Kjønn og helse. I: Lorentzen J, Mühleisen W, red. Kjønnsforskning. En grunnbok. Oslo: Universitetsforlaget, 2006: 198-206.
· Malterud K. The social construction of clinical knowledge – the context of culture and discourse J Eval Clin Pract 2006; 12 ( 3): 292–295.
· Malterud K, Nessa J, Stensland P, Thesen J. Legekunst i praksis – kommunikasjon lege-pasient. Oslo: Universitetsforlaget, 2006.
· Malterud K. Women's wisdom—a source of knowledge for medicine. Lancet 2006; 368: 1139-1140.
· Malterud K. ”Mener han at somatisering er noe jeg gjør?” En pragmatisk begrepsanalyse. Tidsskrift for Forskning i Sygdom og Samfund 2006 (5) 5-19.
· Ohnstad A, Malterud K, red. Lesbiske og homofile i møte med helse- og sosialtenesta. Oslo: Det Norske Samlaget, 2006.
· Anbjørg Ohnstad (2006) Å navigerer i kjent og ukjent landskap. I Ohnstad A, Malterud K, red. Lesbiske og homofile i møte med helse- og sosialtenesta. Oslo: Det Norske Samlaget, 2006.
· Reventlow SD, Hvas L, Malterud K. Making the invisible body visible. Bone scan, osteoporosis and women's bodily experiences. Soc Sci Med 2006 Jun;62(11):2720-31.
· Slettbakk R, Nilsen CV, Malterud K. Coping with headache - a focus group study about women's self-initiated actions and cognitive strategies. Scand J Prim Health Care 2006; 24: 22-26.
· Solvang, Per (2006). Aviksglade barn og normaliseringsivrige foreldre, i Tidsskrift for den Norske Lægeforening, nr 10, 2006, side 1448.
· Thesen J, Nessa J. Når pasienten ikke er som oss. I: Legekunst i praksis. Kommunikasjon lege-pasient. Oslo: Universitetsforlaget 2006: 45-55
· Thesen J. Pasienten du ikke liker. I: Legekunst i praksis. Kommunikasjon lege-pasient. Oslo: Universitetsforlaget 2006: 81-89.
· Thesen J, Heiberg M, Førde R, Telje J. Møtet med den gravide. I: Svangerskapsomsorg. Oslo: Gyldendal Akademisk 2006. :152-170
· Wyller VB, Bjørneklett A, Brubakk O, Festvåg L, Follestad I, Malt U, Malterud K, Nyland H, Rambøl H, Stubhaug B, Larun L. Diagnostisering og behandling av kronisk utmattelsessyndrom/myalgisk encefalopati (CFS/ME). Rapport Nr 9-2006. Oslo: Nasjonalt kunnskapssenter for helsetjenesten, 2006.
2005
· Hvas L, Reventlow S, Jensen HL, Malterud K. Awareness of risk of osteoporosis may cause uncertainty and worry in menopausal women. Scand J Publ Health 2005; 33: 203-7.
· Malterud K, Hollnagel H. The doctor who cried - A qualitative study about the doctor’s vulnerability. Ann Fam Med 2005; 3:348-52.
· Malterud K. Humiliation instead of care. Lancet 2005; 366: 785-6.
· Malterud K, Solvang P. Vulnerability as a strength: Why, when, and how? Scand J Publ Health 2005; 33 (Suppl 66): 3–6.
· Malterud K, Elvbakken KT, Solvang P. Sunnhet og sykdom i kulturelt perspektiv. Bidrag fra Helsekameratenes avslutningsseminar. Rokkansenteret Rapport 12 2005. Bergen: Stein Rokkan senter for flerfaglige samfunnsstudier, 2005.
· Malterud K. Sårbarhet som styrke – når kan avvik være helsefremmende? I Malterud K, Elvbakken KT, Solvang P. Sunnhet og sykdom i kulturelt perspektiv. Bidrag fra Helsekameratenes avslutningsseminar. Rokkansenteret Rapport 12 2005. Bergen: Stein Rokkan senter for flerfaglige samfunnsstudier, 2005: 11-16.
· Malterud K, Elvbakken KT, Solvang P. Helsekameratene. Gruppe for flerfaglig forskning om helse og sykdom i kulturelt perspektiv, Universitetet i Bergen 1999-2005. Rokkansenteret Notat 17-2005. Bergen: Stein Rokkan senter for flerfaglige samfunnsstudier, 2005.
· Nielsen KDB, Dyhr L, Lauritzen T, Malterud K. Long-term impact of elevated cardiovascular risk detected by screening. A qualitative interview study. Scand J Prim Health Care 2005; 23: 233-8
· Anbjørg Ohnstad (2005) Speaking vulnerable questions into existence – their consequences for psychotherapy pp 1-5 Scandinavian Journal of Public Health 33
· Steihaug S. Can chronic muscular pain be understood? Scand J Public Health 2005; 33(Suppl 66): 36-40.
· Steihaug S, Ahlsen B, Eide WA, Tjønneland AE, Refsnes KA, Kjær B, Sandvik E. Bydel Stovner – 14 år med grønn resept. Tidssk Nor Lægeforen 2005; 125: 310-1.
· Steihaug S. Hvordan kan kvinner med kroniske muskelsmerter endre sine kroppslige vaner? Tidsskr Nor Lægeforen 2005; 125: 2804-6.
· Steihaug S, Eide WA. Sammen er vi sterke - Friskvern som samarbeid mellom frivillige organisasjoner og ansatte i Bydel Stovner. Utposten 2005, nr. 7: 24-26.
· Stensland P. Aksjonsforskning på egen praksis. Metodologiske utfordringer. Ugeskr Læger 2005; 167: 2402-5.
· Stensland P. Har du hørt om andres kunstfeil? Det er en lederoppgave for leger å starte en samtale om feil – egne og andres. Tidsskr Nor Lægeforen 2005; 125: 2163.
· Stensland P, Vestbø E, Swensen E. En medisin for distriktene. Tidsskr Nor lægeforen 2005; 125: 119.
· Stenvoll D, Elvbakken KT, Malterud K. Blir norsk forebyggingspolitikk stadig mer individorientert? Tidsskr Nor Lægeforening 2005; 125:603-5.
· Solvang, Per (2005). Det poststrukturalistiske perspektiv i handikapforskningen, i Danermark, Berth (red.): Sociologiska perspektiv på funktionshinder och handikapp. Lund: Studentlitteratur.
· Solvang, Per, Jan-Kåre Breivik and Hilde Haualand (2005). Minority politics and disability discourse at global deaf events, in Gustavsson, Anders, Jan Tøssebro, Johans Sandvin and Rannveig Traustadottir (eds): Resitance, reflection and change: Disability and the role of research. Lund: Studentlitteratur.
· Solvang, Per (2005). Sykdom som ressurs. I Skolepsykologi, vol. 40, nr. 4, side 17–26.
· Söderlund A, Malterud K. Why did I get chronic fatigue syndrome? A qualitative interview study of causal attributions in women patients. Scand J Prim Health Care 2005; 23: 242-7.
· Thesen, Janecke. From oppression towards empowerment in clinical practice - offering doctors a model for reflection. Scand J Publ Health 2005; 33 Suppl 66: 47-52
· Werner A, Malterud K. “The pain isn’t as disabling as it used to be”: How can the patient experience empowerment instead of vulnerability in the consultation? Scand J Publ Health 2005; 33 (Suppl 66): 41-46.
· Werner, A. (2005). Kampen for (tro)verdighet. Kvinner med ‘ubestemte’ helseplager i møtet med legen og dagliglivet. Doktoravhandling. Universitetet i Oslo: Institutt for allmenn- og samfunnsmedisinske fag og Senter for kvinne- og kjønnsforskning.
http://wo.uio.no/as/WebObjects/theses.woa/wa/these?WORKID=25139
2004
· Tor-Johan Ekeland, Anbjørg Ohnstad, Oddmar Iversen, Grethe Nordhelle: (2004) Psykologi for helse og sosialarbeidere, Cappelen Akademiske Forlag kap 4, 9 og 10
· Lundeberg, Ingrid og Per Solvang (2004). Uaktsomhet ved dysleksi. I Spesialpedagogikk nr. 3, 2004, side 4-13.
· Malterud K. Health needs of women who have sex with women. Methodological assumptions underlying conclusions should have been questioned. BMJ 2004;328:463-464. (letter)
· Solvang, Per (2004). Mongoer in die offensive?, in Leben mit Downs no.45, pp. 34–36.
· Stensland P. Aksjonsforskning på egen praksis metodologiske utfordringer. Ugeskr for Læger 2004. In press.
· Stensland P. Tilnærming til fastlåste samtaler om kroppen. Tidsskr Nor Lægeforen 2004. In press.
· Stensland P. Legen må like pasienter et allmennmedisinsk perspektiv på behandling av mennesker med psykiske lidelser. Tidsskr Nor Lægeforen 2004. In press.
· Thesen J. Normalitet sett fra allmennlegekontoret . Utposten 2004; 33(5): 37-40
· Werner, A., Isaksen, L. W., & Malterud, K. (2004). ‘I am not the kind of woman who complains of everything’: Illness stories on self and shame in women with chronic pain. Social Science & Medicine, 59(5), 1035-1045.
· Werner, A. (2004). Kvinnor med kroniska muskelsmärtor – “(o)seriösa” patienter? K. Malterud (red.). Kvinnors oförstådda ohälsa, s 159-181. Stockholm: Natur och kultur.
· Walseth LT, Malterud K. Salutogenese og empowerment i allmennmedisinsk perspektiv. Tidsskr Nor Lægeforen 2004;124: 65-66.
2003
· Helgøy, Ingrid, Bodil Ravneberg og Per Solvang (2003). The construction of independence in service relations. In Disability and Society, Volume 18, No 4, pp. 471–487.
· Malterud K. Ethical reflections and presumed facts about medical risk factors and people affected by them. In: Grimen H, Elvbakken KT, eds. Cultural perspectives on risk, preventive medicine and health promotion. Report 15. Bergen: Stein Rokkan Centre for Social Studies, 2003: 59-70.
· Malterud K. Helseproblemer hos lesbiske og homofile. . I: Hunskår S, red. Allmennmedisin. Oslo: Gyldendal Akademisk, 2003: 776-8.
· Malterud K, Elvbakken KT. Overvekt og slanking - normer, strategier og kjønn. I Berg O, Søgaard AJ, Selikowitz HS, Aasland OG, red. Medisin og samfunn. Oslo: Unipub forlag, 2003: 211-23.
· Ohnstad, Anbjørg (2003) Über das Lavieren zwischen verschiedenen. Beziehungsdiskursen Identitätsstiftung und identitätsprozesse lesbischer Frauen. Zeitschrift für Sexualforschung nr 1(16) s 66 - 71
· Ohnstad, A ( 2003) "Kristne homofile i terapi - kva er deira smerte?" s 47 - 53 i Børtnes, J og Mikaelsson, L ( red) Når det står om livet. Kulturstudier nr 28 Høyskoleforlaget
· Solvang, Per (2003). Mongoer på offensiven?, i SOR-Rapport, nr. 2, vol. 49, side 8-9.
· Steihaug S, Malterud K. Part process analysis: a qualitative method for studying provider-patient interaction. Scand J Public Health 2003; 31: 107-12.
· Stensland P. Action research on own practice - methodological challenges. Scand J Prim Health Care 2003; 21: 77-82.
· Stensland P. Approaching the locked dialogues of the body. Communicating symptoms through illness diaries. Doktoravh. Inst for samfunnsmed fag. Univ i Bergen, 2003.
· Stensland P, Øien AM, Øhlckers J, Omdahl ER. Bekymring og håp for Sør-Afrika. Intervju med André Brink. Bergens Tidende 180703. http://www.bergenpuls.no/cityguides/nav/news.jhtml?context=literature&id =11304
· Stensland P, Heian F, Haga OS, Garløv I. Barn og barndom. I Hunskår S (red). Allmennmedisin. Oslo, Gyldendal 2003. Pp 692-704.
· Werner, A., & Malterud, K. (2003). It is hard work behaving as a credible patient: encounters between women with chronic pain and their doctors. Social Science & Medicine, 57(8), 1409-1419.
· Werner, A., Steihaug, S., & Malterud, K. (2003). Encountering the continuing challenges for women with chronic pain: Recovery through recognition. Qualitative Health Research, 13(4), 491-509.
2002
· Breivik, JK, H Haualand and P Solvang (2002). Rome – a temporary deaf city! Deaflypics 2001. Rokkan-notat 2: 2002. Bergen: Stein Rokkan Centre for Social Studies
· Hantho A, Jensen L, Malterud K. Mutual understanding – a communication model for general practice. Scand J Prim Health Care 2002;20:244-51.
· Hollnagel H, Malterud K. Samtaler om risiko og helbredsressourcer i almen praksis Ugeskr Læger 2002; 164: 164: 5225-9.
· Malterud K. Understanding the patient with medically unexplained disorders - a patient-centred approach. New Zealand Fam Pract 2002;29:374-9.
· Malterud K, Hunskaar S. The challenges of chronic myofascial pain: committment to patient perspectives. In Malterud K, Hunskaar S, eds. Patient-centred approaches to chronic myofascial pain in primary care. Oxon: Radcliffe Medical Press, 2002:175-9.
· Solvang, Per (2002). Pissing Woman – fornedrelse eller skjønnhet?, i Elvbakken, Kari Tove og Per Solvang (red.): Helsebilder. Sunnhet og sykdom i kulturelt perspektiv. Bergen: Fagbokforlaget.
· Solvang, Per (2002). The Amputee Body Desired: Beauty Destabilised? Disability Re-valued? Paper presented at The XVth ISA World Congress of Sociology, Brisbane, Australia, July 7–13, 2002.
· Solvang, Per (2002). Annerledes. Oslo: Aschehoug.
· Steihaug S, Malterud K. Recognition and reciprocity in encounters with women with chronic muscular pain. Scand J Prim Health Care. 2002; 20: 151-6.
· Steihaug S. Fra trening og undervisning til bevegelse og samhandling. Anerkjennelse av kvinner med kroniske muskelsmerter. Doktoravhandling: Universitetet i Oslo, 2002.
· Hvas AC, Thesen J. Empowerment i et medicinsk perspektiv. Oversigtsartikel. Ugeskr Læger 2002; 164: 5361-5.
· Undeland M, Malterud K. Diagnostic work in general practice: more than naming a disease. Scand J Prim Health Care 2002;20;145-50.
2001
· Ohnstad, Anbjørg (2001) Psykologiens fortellinger om lesbiske kvinner kvinnens egne fortellinger. I Åmås, Knut Olav (red), Brantsæter, Marianne; Eikvam, Turid; Kjær, Reidar Norsk homoforskning, Oslo, Universitetsforlaget s. 214 238.
· Malterud K, Hollnagel H, Witt K. Gendered health resources and coping –a study from general practice. Scand J Publ Health 2001; 29: 183-8.
· Malterud K. Subjektive symptomer uden objektive fund – en udfordring for almen medicinsk teori og praksis. Ugeskr Læger 2001;163: 6729-34.
· Malterud K. Lesbiske i medisinsk teori og praksis - Et kritisk perspektiv på kunnskap og helsetjenester. I Brantsæter MC, Eikvam T, Kjær R, Åmås KO, red. Norsk homoforskning. Oslo: Universitetsforlaget, 2001: 191-213.
· Malterud K, Taksdal A. Et felles refleksjonsrom med pasientens symptomer som gyldige kunnskapskilder. Tidsskr Nor Lægeforen 2001;121:3605-9.
· Steihaug S, Ahlsen B. Anerkjennelse og samhandling – gruppebehandling for kvinner med kroniske muskelsmerter. I Malterud K (red) Kvinners ubestemte helseplager. Oslo: Pax Forlag, 2001.
· Stensland P, Malterud K. Uravelling empowering internal voices A case study on the interactive use of illness diaries. Fam Pract 2001;18:425-9.
· Thesen J, Malterud K. ”Empowerment” og pasientstyrking - et undervisningsopplegg. Tidsskr Nor Lægeforen 2001;121:1624-8.
· Thesen J. Being a psychiatric patient in the community - reclassified as the stigmatized "other". Scand J Public Health 2001; 29: 248-255
· Werner, A. (2001). Kvinner med kroniske muskelsmerter - ”(u)seriøse” pasienter? I K. Malterud (red.): Kvinners ”ubestemte” helseplager. Oslo: Pax Forlag, side 121-136.
2000
· Apold, Anne Berit og Per Solvang (2000). Mangfoldighet i forståelse og ensidighet i praksis. Logopeder i klem mellom pedagogikk og juss, i Froestad, Jan, Per Solvang og Mårten Söder (red.) Funksjonshemming, politikk og samfunn. Oslo: Gyldendal Akademisk.
· Froestad, Jan og Per Solvang (2000). Forskningen om funksjonshemming: konstruksjon og narrasjon, profesjon og stat, i Froestad, Jan, Per Solvang og Mårten Söder (red.) Funksjonshemming, politikk og samfunn. Oslo: Gyldendal Akademisk.
· Helgøy, Ingrid, Bodil Ravneberg og Per Solvang (2000). Funksjonshemmede, deres hjelpere og byråkratiets ubehageligheter, i Romøren, Tor Inge (red.): Usynlighetskappen. Levekår for funksjonshemmede. Oslo: Akribe Forlag.
· Helgøy, Ingrid, Bodil Ravneberg, Per Solvang og Ingrid Lundeberg (2000). Tjenesteyting for et selvbestemt dagligliv? Funksjonshemmede mellom individuell frihet, faglig vurdering og byråkratisk regulering. SEFOS-notat 9/2000. Bergen: Senter for samfunnsforskning.
· Hollnagel H, Malterud K, Witt K. Men`s self-assessed personal health resources. Approaching patients’ strong points in general practice. Family Practice 2000;17:529-534
· Hollnagel H, Malterud K. From risk factors to health resources in medical practice. Medicine, Health Care and Philosophy 2000;3: 257-264
· Solvang, Per (2000). Funksjonshemmingen og det normale – om nødvendigheten av å balansere, i Froestad, Jan, Per Solvang og Mårten Söder (red.) Funksjonshemming, politikk og samfunn. Oslo: Gyldendal Akademisk.
· Solvang, Per (2000). The emergence of an us and them discourse in disability theory, in Scandinavian Journal of Disability Reseach, vol. 2, nr. 1, side 3–20.
· Stensland P. Kroppslige dialoger inngangsport til samtaler om fastlåste plager. Tidsskr Nor Lægeforen 2000;24;2925-8.
· Söderlund A, Skoge AM, Malterud K. "I could not lift my arm holding the fork..." Living with chronic fatigue syndrome. Scand J Prim Health Care 2000;18:165-9.
· Thesen J. Psykiatrisatsingen i primærhelsetjenesten - et hus uten grunnmur? Tidsskr Nor Lægeforening 2000; 120: 1843.
· Werner, A. & Viljugrein, T. (2000). Del 1. I "Kollektive brytere" En studie fra "Trøtthetsprosjektet" ISS notat nr 2. Univ i Oslo: Inst for sosiol og samf geografi, s. 3-47.
1999
· Hollnagel H. Explaining risk factors to patients during a genral practice consultation. Conveying group-based epidemiological knowledge to individual patients. Scand J Prim Health Care 1999;17:3-5
· Malterud K, Hollnagel H. Encouraging the strength of woman patients. A case study from general practice on empowering dialogues. Scand J. Public Health 1999;27:254-59.
· Malterud K. The (gendered) construction of medical diagnosis. Interpretation of symptoms and signs in female patients. Theoretical Medicine & Bioethics 1999;20:275-86
· Malterud K. Making Changes With Key Questions in Medical Practices: Studying What Makes a Difference. In Crabtree BF, Milller WL, eds. Doing Qualitative Research (2nd edition). Thousand Oaks: Sage Publications, 1999:313-30.
· Thesen J, Kuzel AJ. Participatory inquiry. In Crabtree BG, Miller WL red. Doing qualitative research. 2. utg. Thousand Oaks Ca; Sage Publications, 1999: 269-90.
1998
· Werner, A. (1998). Country report for Norway. I M.C. Timmerman & C. Bajema. (Eds.). Sexual harassment in European workplaces. A review in 11 member States (1987-1997). University of Groningen/Netherland: Universitair Centrum Genderstudies, s. 96-102.
1997
· Larsen M, Oldeide CC, Malterud K. Not so bad after all... Women's experiences of pelvic examinations. Family Practice 1997; 14: 148-52.
· Malterud K, Hollnagel H. Women`s self-assessed personal health resources. Scand J Primary Health Care 1997;15:163-168.
· Malterud K. Helseproblemer hos lesbiske og homofile. I: Hunskår S, red. Allmennmedisin. Klinisk arbeid. Oslo: Ad Notam Gyldendal, 1997: 697-9.
· Ohnstad, Anbjørg (1997) Homofil identitetsutvikling - faser og dilemmaer. I Benum,V, Friis,E, Offerdal, A (red), Vite for å forstå - 10 artikler om homoseksualitet og lesbiske i og homofiles livsvilkår i Norge i dag. Kompendium s.91 - 103
· Scheffels, J. & Werner, A. (1997). Tyskertøser – seksualitet som nasjonens eiendom. I Tredje Verden Magasinet X, 6 (1), s. 22-23.
· Stensland P, Malterud K. New gateways to dialogue in general practice. Development of a symptom diary to expand communication. Scand J Prim Health Care 1997;15:175-9.
· Werner, A. (1997). Kvinner, krig og kjærlighet. Et forprosjekt om forskningskompetanse, litteratur og interesser. Universitetet i Oslo: Nordisk institutt for kvinne- og kjønnsforskning, NIKK notat nr. 1.
· Werner, A. (1997). (U)Seriøse damer i forsvaret. I Fra kvinne som kjønn til kvinne- og kjønn. Senter for kvinneforskning 1986-1999. SFK arbeidsnotat nr 3, UiO: s. 99-102.
1996
· Werner, A. (1996). (U)Seriøse damer i forsvaret. En studie av kropp, kjønn og seksualitet i møtet med en militær avdeling.Univ i Oslo: Inst for sosiologi og samfunnsgeografi
· Hollnagel H, Malterud K. Shifting attention from objective risk factors to patients`self-assessed health resources; a clinical model for general practice. Family Practice 1995;12:423-29.
· Malterud K. Key questions - a strategy for modifying clinical communication. Transforming tacit skills into a clinical method. Scand J Prim Health Care 1994;12: 121-7.
· Steihaug S, Ahlsen B. Bevegelse og samtale i grupper. Behandling av kroniske muskelsmerter hos kvinner i allmennpraksis. Tidsskr Nor Lægeforen 1996; 116: 1335-8.
Previous
· Ohnstad, Anbjørg (1993) Den gode samtalen. Oslo, Det Norske Samlaget .
· Malterud K. Strategies for empowering women's voices in the medical culture. Health Care for Women International 1993; 14: 365-73.
· Solvang, Per (1994) Biografi, normalitet og samfunn: En studie av handikappedes veier til utdanning og abeid i Skandinavia. SEFOS/Sosiologisk institutt, UiB 1994.
· Jørgensen, Britt, Ohnstad, Anbjørg (1989) Familieterapi – en gammeldags forståelsesmåte i Nordisk Sosialt Arbeid nr 4.