Uden en diagnose - En kvalitativ holdningsundersøgelse af sygedagpengesagsbehandleres oplevelser af at arbejde med borgere med diffuse smerter

Without a diagnosis. A qualitative vignette study about the experiences of social workers working with citizens with medically unexplained symptoms.

Salomonsen, Pernille ; Haals, Sofie Ververs Groth

4. semester

Socialt Arbejde, Kandidat

2018

2018-06-01

92

Dette speciale undersøger, hvordan socialrådgivere oplever og vurderer sager om borgere med medicinsk uforklarede symptomer (MUS), og hvordan disse erfaringer afspejles i deres vurderinger i relation til arbejdsmarkedets krav. Studiet bygger på en fortolkende, filosofisk hermeneutisk tilgang og et kvalitativt design. Vi fulgte en abduktiv proces, hvor vi vekslede mellem data og teori for at finde mønstre og plausible forklaringer. Data blev indsamlet via kvalitative interviews med udgangspunkt i en kort, fiktiv case (vignette) om Bente, der var sygemeldt fra arbejde på grund af MUS. Vi interviewede otte socialrådgivere i en mellemstor kommune på Sjælland. Analysen er rammesat af Michael Lipskys teori om street-level bureaucracy, særligt hans forståelse af frontmedarbejdere og deres mestringsstrategier. Analysen har tre dele. For det første gør arbejdsmarkedets politikker og administrative rammer sagsarbejdet med MUS mere komplekst. Fraværet af en diagnose begrænser markant socialrådgivernes handlemuligheder. For det andet er socialrådgivernes forståelse af og tro på borgere med MUS afgørende for samarbejdet og for mulighederne for tilbagevenden til arbejde; at se personen, som vedkommende ser sig selv, styrker samarbejdet. For det tredje har socialrådgivernes motivation betydning: de oplever både motivation og demotivation i arbejdet med denne gruppe. Samlet set har konteksten for sagsarbejdet stor betydning. Når der ikke foreligger en diagnose, bliver det sværere at handle, hvilket kan svække tro, prioritering og motivation i arbejdet med denne gruppe. Specialet afsluttes med refleksioner over, hvordan resultaterne kan omsættes i praksis.

This thesis explores how social workers experience and assess cases involving citizens with medically unexplained symptoms (MUS), and how these experiences appear in their evaluations in relation to labour market demands. The study uses an interpretive, philosophical hermeneutic approach and a basic qualitative design. We followed an abductive process, moving between data and theory to identify patterns and develop plausible explanations. Data were collected through qualitative interviews built around a short vignette about Bente, who was off work due to MUS. We interviewed eight social workers in a medium-sized municipality in Zealand. The analysis is guided by Michael Lipsky's theory of street-level bureaucracy, especially his ideas about frontline workers and their coping strategies. The analysis has three parts. First, labour market policies and administrative conditions make casework with MUS more difficult. The absence of a medical diagnosis strongly limits what social workers feel able to do. Second, social workers' understanding of and belief in citizens with MUS are crucial for cooperation and for the chances of returning to work; seeing the person as they see themselves supports better collaboration. Third, social workers' motivation matters: they describe being both motivated and demotivated when working with this group. Overall, the context in which casework takes place has a strong impact. When no diagnosis is available, social workers find it harder to act, which can reduce their confidence, prioritisation and motivation to work with this group. The thesis ends with reflections on how these insights can be applied in practice.

[Dette resumé er genereret ved hjælp af AI]

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Salomonsen, Pernille:

• Without a diagnosis. A qualitative vignette study about the experiences of social workers working with citizens with medically unexplained symptoms. (2018)

Haals, Sofie Ververs Groth:

• Without a diagnosis. A qualitative vignette study about the experiences of social workers working with citizens with medically unexplained symptoms. (2018)