About the project
Knowledge is a fundamental condition for understanding of health and disease, organization of health care and health policy decisions. The aim and the situation determines which knowledge will be best suited for the purpose. In Norway, there is broad consensus that health care shall be evidence based. Still, large parts of the activity consist of complex and dynamic systems with frames set by social interaction and cultural dimensions. Hence, knowledge based practice embraces a balance between research based knowledge, experience based knowledge and the patient’s values and preferences.
It is therefore not always obcious what is valid knowledge or how such knowledge best can be developed. Knowledge from different paradigms has different status and utility, depending on the purpose and context. Biomedical knowledge is often insufficient when it comes to multifactorial health problems and multimorbidity, and evidence based knowledge does not always offer clear grounds for health care decisions. Patient perspectives are often missing in the knowledge base of medical theory and practice. Still, knowledge represents power and values that are applied in different levels of health care every day. In this project, we will study interactions between knowledge, power and health care.
Which are our approaches?
In the first part of the project, we have focused evidence based medicine (EBM), taking the Norwegian Knowledge Centre for the Health Services as our case to explore how this knowledge tradition has developed, what characterizes this kind of medical knowledge and health services research, and how deliveries from the EBM tradition fulfill their purpose as foundation for policy and practice. Four articles have been published.
In the second part of the project, we are focusing user participation in research. We explore political and governmental premises and processes in Norway as well as internationally. We have conducted a systematic review of research literature where such participation with the patient as co-researcher is documented all through the research process and explore characteristics, preconditions and outcomes of such projects. We are also planning a study about how user participation was promoted in Norwegian health care in the 1990es.
Researchers: Kirsti Malterud (Uni Research Helse), Anne Karen Bjelland (Dept. for social anthropology, University of Bergen), Kari Tove Elvbakken (Department of Administration and Organization Theory, University of Bergen)