Brukerrepresentanters innflytelse i tilsyn av helse- og omsorgstjenester for mennesker med utviklingshemming – En kvalitativ studie av erfaringene til brukerrepresentanter og Fylkesmannens ansatte
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Background: This study follows a user involvement project in health care inspections of services for people with intellectual disabilities in three municipalities in Sør-Trøndelag. In these inspections users were interviewed and representatives form a support organisation, NFU, were involved in the inspection team. There is little empirical knowledge of experience with user involvement in inspection teams. User involvement at the system level can have impact on quality of health care, but can also easily turn into tokinism. The purpose of this study was to explore what experiences user representatives and professionals have with the user representatives' influence in inspections. Method: This was a qualitative interview study. The study included all six people who participated in the inspection team, three professionals and three user representatives. They were interviewed before, during and after the inspection process. Data was analyzed using Malterud's method systematic text condensation. Results: The user representatives were involved throughout the inspection process, became part of the team and were respected, listened to and appreciated. Dialogue and shared understanding were associated with influence. The user representatives added relevant knowledge to the team and emphasized the user perspective. The user representatives influenced within the frame of the main topic of the inspection and the inspection method. User representatives had an impact on what topics were most emphasized. To have influence in the team they had to relate to the legislation and the system level of health care, and they had to be objective. User representatives had great influence in planning and conducting user interviews, they supplemented the professionals during interviews of employees and managers in the municipalities and actively contributed to the summary of findings. Time pressure inhibited the influence when the inspection team decided on the conclusion of the inspections. The user representatives did not have authority to make decisions, but participated in discussion about the conclusion. Conclusion: Including user representatives in an inspection team seem to have had an impact on the findings in the inspection. Although they did not have any authority i decision-making, they seem to have had influence in decision-making trough dialogue. The results of the study support existing literature on user involvement and may be relevant to other kinds of user involvement projects where user representatives and professionals work together in teams.