Care at a distance : on the closeness of technology PDF
Preview Care at a distance : on the closeness of technology
wc ea lr Dr. Jeannette Pols is senior researcher at the fe a & r Amsterdam Medical Centre, University of Amsterdam. e Jeannette Pols C a r e In Care at a Distance: On the Closeness of Technology Jeannette Pols Care at a Distance a demonstrates that actual care practices employing telecare do not resemble t a the hopes of the industry and policy makers, nor the nightmares of ethicists. D The detailed ethnographic studies of pioneering telecare practices show how i s t nurses and patients re-shape care when they start using telecare devices. The a n On the Closeness of Technology book frames urgent questions about the future of telecare and the ways in c e which innovative care practices can be built on facts rather than hopes, hypes or nightmares. P o l s Pols’s exciting new book provides important insights into how innovative telecare practices are ‘achieved’ in everyday practice and how ‘uncontrolled’ field studies can be used both to understand and improve care practices. Flis Henwood, Professor of Social Informatics in the School of Applied Social Science, University of Brighton, UK Jeannette Pols has written a timely and thought-provoking book about what happens when technologies are used to provide healthcare at a distance. By listening to the experiences of those who use the technologies, as healthcare providers or as patients, Pols provides a much-needed balance to the usual focus on efficiency. Sally Wyatt, Director of the Netherlands Graduate School of Science, Technology and Modern Culture Care at a Distance lays out a variety of ways in which long distance health care may work. Written attentively and with a real sense of engagement, it also offers long distance care. Intellectual care this time. For you, the captivated reader. Annemarie Mol, professor of Anthropology of the Body at the University of Amsterdam www.aup.nl ISBN 978 90 8964 397 1 9 789089 643971 A U P CareataDistance CARE &WELFARE Care and welfare are changing rapidly in contemporary welfare states. The Care & Welfare series publishes studies on changing relationships between citizensand professionals, on care and welfare governance, on identitypoliticsinthecontextofthesewelfarestatetransformations,and on ethical topics. It will inspire international academic and political de- batebydevelopingandreflectingupontheoriesof(health)careandwel- farethroughdetailednationalcasestudiesand/orinternationalcompar- isons.Thisserieswilloffernewinsightsintotheinterdisciplinarytheory ofcareandwelfareanditspractices. series editors JanWillemDuyvendak,UniversityofAmsterdam TrudieKnijn,UtrechtUniversity MoniqueKremer,NetherlandsScientificCouncilforGovernmentPolicy (WetenschappelijkeRaadvoorhetRegeringsbeleid–WRR) MargoTrappenburg,UtrechtUniversity,UniversityofAmsterdam previously published JanWillemDuyvendak,TrudieKnijnandMoniqueKremer(eds.):Policy, People,andtheNewProfessional.De-professionalisationandRe-professio- nalisationinCareandWelfare,2006 ISBN9789053568859 IneVanHoyweghen:RisksintheMaking.TravelsinLifeInsuranceand Genetics,2007 ISBN9789053569276 Anne-MeiThe:InDeath’sWaitingRoom.LivingandDyingwithDementia inaMulticulturalSociety,2008 ISBN9789053560778 BarbaraDaRoit:StrategiesofCare.ChangingElderlyCareinItalyandthe Netherlands,2010 ISBN9789089642240 JanetNewmanandEvelienTonkens(eds.):Participation,Responsibility andChoice.SummoningtheActiveCitizeninWesternEuropeanWelfare States,2011 ISBN9789089642752 PatriciaC.Henderson:AIDS,IntimacyandCareinRuralKwaZulu-Na- tal.AKinshipofBones,2011 ISBN9789089643599 Care at a Distance On the Closeness of Technology Jeannette Pols Coverphoto:RuudMast Cover design: Sabine Mannel, NEON graphic design company, Amster- dam Lay-out:JAPES,Amsterdam ISBN 9789089643971 e-ISBN 9789048513017(pdf) e-ISBN 9789048516292(ePub) NUR 882 ©JeannettePols/AmsterdamUniversityPress,Amsterdam2012 Allrightsreserved.Withoutlimitingtherightsundercopyrightreserved above, no part of this book may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise) without the written permission of both the copyright owner and the author of thebook. Contents Nightmares, promises and efficiencies in care and research 1 Introduction 11 Thetelecarehype 11 Lackofknowledge 12 Noiseanddust 14 Thisstudy 15 Varioustelecarepractices 16 Studyinginnovativetechnologies 17 Thechapters 20 Part I Norms and nightmares 2 Caringdevices:Aboutwarmhands,coldtechnologyand makingthingsfit 25 Warmcare,coldtechnologies 25 What(un)makesahuman? 26 PalliativecareinFriesland 27 Situatingmattersofdisease 29 Buildingrelationsthroughthewhitebox 32 Devicesdonotloveus 34 Fittingindividuals 37 Thenotionoffitting 38 Carethatdoesnotfit 40 Modestaesthetics 42 3 Theheartofthematter:Goodnursingatadistance 45 Goodnessoffit 45 Theheartofgoodnursing 46 Goodnursinginpractice 47 Theimportanceofspace 48 Divisionoflabour 49 Keepingupoldstandards:correctingtelecare 51 Telecareasanimprovement:changingnorms 53 Fromhealthstatustoprocess 53 Fromself-caretoprofessionalmonitoring 55 5 Newtasks,newgoals 57 Persistentvalues,shiftingnorms 59 Contestablenorms 60 Part II Knowledge and promises 4 Caringfortheself?Enactingproblems,solutionsandformsof knowledge 63 Shapingproblems 63 MrsJansenandtheheartmonitor 64 MrsJaspersenandthewebcam 65 Enactedtrouble:objectivesymptomsversussubjective experience 66 Monitoreddisease 66 Webcamworries 68 Articulatingproblems 71 Respondingtoproblems 72 Measurements 72 Mutualsupport 74 Enactingproblems,engaginginself-care 75 Fittinglogics 77 5 Knowingpatients:Onpracticalknowledgeforlivingwith chronicdisease 79 Theknowledgeofpatients 79 Knowingpatients? 79 Difference 80 Sameness 80 Indifference 81 Toolsforthecasestudy:scientificversuspracticalknowledge 82 Practicalknowledgeforcliniciansandpatients 82 PracticalknowledgeofpeoplewithCOPD 83 Introducing‘know-now’ 84 Transportingknowledge 87 Technologiesandtranslation 88 Coordinatingknowledge 90 Coordinationpractices,blurringdistinctions 90 Unhelpfulknowledge,translationfailures 92 Knowingpatients 94 Practicalknowledgeandwebcams 95 Part III Routines and efficiencies 6 Zoominginonwebcams:Ontheworkingsofamodest technology 99 6 careatadistance Doinginvisiblework 99 Webcampractices 99 Webcamsinaction 100 ‘Itismuchmorepersonalthanthetelephone’ 100 Webcamsintensifyconcentration 102 Breakingtheintensity 103 Togetherinthesameroom 104 Trust,familiarityandintrusion 107 Buildingonexistingrelations 109 Magnifyingrelationaldistance 111 Whatwebcamsdo 112 Shapingcarepractices 113 Modesttechnology 113 7 Economiesofcare:Newroutines,newtasks 115 What’sinaroutine? 115 Routineefficiency 116 Telecareandefficiency 117 Efficiencyinpractice 118 Theplaceofcaring 120 Reshufflingspace 122 Differenttechnologyandtasks 123 Interpretationroutines 126 Thetelekitasanumbilicalcord 126 Thetelekitasaninhaler 127 Routinesandidentities 128 Oldornewroutines? 129 Treacherousroutines 130 Efficientlyorganisingmessypractices 131 Conclusions: On studying innovation 8 Innovatingcareinnovation 135 Thepoliticsofinnovation 135 Theobjectofresearch:innovativetelecarepractices 136 Researchthatdoesnotfit 137 Fixedvariablesandunpredictableoutcomes 137 Subjectivityandpracticalknowledge 138 Interferencewithconstructionsites 140 Fromsubjectivitytonormativity 141 Fittingresearch 142 Uncontrolledfieldstudies 143 Theinfluenceofusers 143 Frombuying,sellingandvotingtoenactinginnovations 144 Articulatingpositions 145 Thestatusofarticulations:comparisonsandinvolvingothers 146 contents 7 Thestatusofpracticalknowledge 147 Discussionsunleashedbyanuncontrolledfieldstudy 148 Promises,practicesandclosepatients 148 Closeprofessionals 149 Closetechnologies 150 Closeresearch 150 Acknowledgements 153 Appendix:Projectsstudiedforthisbook 157 Notes 161 References 181 Indexofnames 197 Indexofsubjects 199 8 careatadistance Nightmares, promises and efficiencies in care and research
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