Rehabilitation, language, and power: interdiscursive relationships between policy strategies and professional practices in Norway

ABSTRACT

The Norwegian government implemented a comprehensive welfare reform in 2012 to better manage an increasingly care-demanding patient demography while meeting budgetary constraints. This article discusses interdiscursive relationships between policy strategies and language use among rehabilitation professionals. It is based on a synthesis of textual analyses of policy documents and of transcribed interviews to produce complex insights into current rehabilitation discourse. The synthetic product is expressed in the form of two nodal discourses which subsume and articulate in particular ways the constituent discourses of the policies and interviews. One nodal discourse approaches rehabilitation as a clinical practice; the other concerns rehabilitation as a management practice. These discourses serve different purposes. One is based in traditional medical science as a means for political action and relates to the body as an object of government policies and practices. The other relies on the individual as a subject of life regulation governance. The management perspective of rehabilitation has gained force in the constraint in service availability instituted by the reform, including shorter stays with rapid discharge from hospitals to municipalities or home. The article argues that the policy strategies are fundamental to understanding the logic of current rehabilitation discourses.

KEYWORDS:

• Rehabilitation
• coordination reform
• Norway
• critical discourse analysis
• interdiscursive relationships

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Anne-Stine B. Røberg is a nurse specialist and researcher at TRS National Resource Center for Rare Disorders, including congenital, skeletal- and connective tissue disorders, Spina Bifida and limb deficiency. She holds a master’s degree in Nursing Science from the University of Oslo, and a PhD in Health Sciences from Oslo Metropolitan University. Her research interests include critical perspectives on disability and rehabilitation practices and how these relate to health policies and welfare state development. She has also contributed to knowledge development on nursing and traumatic brain injuries. Author postal address: Sunnaas sykehus HF, Forskningsavdelingen, 1450 Nesoddtangen, Norway. Email: [email protected]

Marte Feiring is Associate Professor at Oslo Metropolitan University, Norway, Faculty of Health, Master program on rehabilitation and habilitation. She holds a PhD in Sociology from the University of Oslo in the history of rehabilitation and is also trained as an occupational therapist. Her research projects cover historical and critical perspectives on health policies, welfare services, professional and multi-professional knowledge, rehabilitation practices and civil movements. In addition to lecturing on the history and contemporary practices of rehabilitation, Feiring holds courses in qualitative methods, text analysis (CDA) and academic writing. Email: [email protected]

Grace Inga Romsland is Senior Researcher at Sunnaas Rehabilitation Hospital, Norway, and Associate Professor at Oslo Metropolitan University, Faculty of Health. She has a professional background in nursing and additionally Cultural Studies/Critical Theory and Medical Anthropology. Her research interests are particularly including client experiences, power dimensions and discursive constructions of reality in the field of health and social services. Email: [email protected]