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Standardisering och autonomi i vårdens gränsland: En kvalitativ studie om NPM:s påverkan på yrkesutövning inom psykiatrin
Halmstad University, School of Health and Welfare.
Halmstad University, School of Health and Welfare.
2025 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Den här studien har syftat till att undersöka hur styrningsmodellen New Public Management (NPM), med fokus på effektivitet, standardisering och resultatmätning har påverkat personalens yrkesutövning samt deras syn på patientens autonomi inom psykiatrin. Det empiriska materialet bestod av sju semistrukturerade intervjuer med personal från olika professioner på psykiatriska mottagningar. Studien utgick från ett hermeneutiskt angreppssätt och har analyserats abduktivt med teoretisk förankring i Erving Goffmans dramaturgiska perspektiv och Michel Foucaults teori om disciplinär makt. 

Resultatet visade att NPM omformat arbetsvillkoren genom ökade administrativa krav och skapade rollkonflikter. Trots detta framgick det att vårdpersonalen strävade efter att bevara etiska och relationella värden i det patientnära arbetet. Genom Goffmans teori synliggjordes hur vårdpersonalen balanserade mellan yttre förväntningar och inre yrkesideal och förstå hur styrningen internaliseras i det dagliga arbetet med förankring i Foucaults perspektiv.

Sammantaget visar studien hur professionell identitet formas i ett spänningsfält mellan organisatorisk kontroll och individuell autonomi, och hur vårdpersonalen möter dessa krav genom både anpassning och motstånd.

Abstract [en]

This study aimed to examine how the governance model of New Public Management (NPM), with its focus on efficiency, standardisation, and performance measurement, affected healthcare professionals’ practice and their perceptions of patient autonomy within psychiatric care. The empirical material consisted of seven semi-structured interviews with staff from various professional roles at psychiatric outpatient clinics. The study adopted a hermeneutic approach and was analysed abductively, using theoretical frameworks from Erving Goffman’s dramaturgical perspective and Michel Foucault’s theory of disciplinary power.The findings showed that NPM reshaped working conditions through increased administrative demands and contributed to role conflicts. Despite this, participants consistently expressed a desire to uphold ethical and relational values in patient-centred care. Goffman’s theory made visible how healthcare professionals balanced external expectations with internal professional ideals, while Foucault’s perspective helped illuminate how governance was internalised in everyday practice.

In sum, the study demonstrated how professional identity is shaped within a field of tension between organisational control and individual autonomy, and how healthcare professionals navigate these demands through both adaptation and resistance.

Place, publisher, year, edition, pages
2025. , p. 51
Keywords [en]
New public management, psychiatry, healthcare professionals, autonomy, governance
Keywords [sv]
New public management, psykiatri, vårdpersonal, autonomi, styrning
National Category
Sociology
Identifiers
URN: urn:nbn:se:hh:diva-56962OAI: oai:DiVA.org:hh-56962DiVA, id: diva2:1980932
Subject / course
Sociology
Educational program
Social Change and Social Sustainability, 180 credits
Presentation
2025-06-04, Halmstad, 08:34 (Swedish)
Supervisors
Examiners
Available from: 2025-07-03 Created: 2025-07-03 Last updated: 2025-10-01Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
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