Evidensbaserad barndiabetesvård i brytpunkten mellan ansvarslogik och egenvårdslogik

Abstract

Since the early 1990s more social sectors, including the health care sector, have been met by requirements to make their professional practices evidence-based. In 2013–2014, the evidence-based care model Hospital-based Home Care for children newly diagnosed with diabetes was implemented at a large paediatric diabetes care facility in Sweden. The first step of the implementation was to promote readiness for change among the professionals through regular meetings. Using ethnographic observations, these meetings were studied in order to analyze what the diabetes team perceived as the possibilities and obstacles with the evidence-based care-model. What conceptions, ideals and identities were complicated, or facilitated, by the implementation? Drawing from a discourse theoretical logics perspective, the article addresses the competing logics at play during the implementation process. The findings suggest that there is a need for an increased awareness of the conceptions and ideals that form the basis of a certain professional practice; in order to anticipate in what way these ideals might be challenged by the implemented evidence.