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Policy Narratives on Palliative Care in Sweden 1974-2018
Axel Ågren1,2, Barbro Krevers3, Elisabet Cedersund4
1Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden. axel.agren@liu.se.
Health Care Analysis : HCA : Journal of Health Philosophy and Policy
|January 17, 2023
Summary
Swedish palliative care policy has evolved significantly since the 1970s. Analysis reveals shifts in focus from hospital deficiencies to home care, and finally to a holistic philosophy emphasizing human value and systematic indicators.
Area of Science:
- Public Health
- Health Policy Analysis
- Sociology of Health
Background:
- Swedish end-of-life care policy has been developing since the 1970s.
- Understanding policy evolution is crucial for improving palliative care.
- Previous research has not comprehensively analyzed the shifts in Swedish palliative care policy narratives.
Purpose of the Study:
- To analyze the formulation and evolution of policy narratives on palliative care in Sweden from the 1970s to 2018.
- To identify distinct policy episodes and their defining characteristics.
- To understand how changing narratives impact the perception and practice of end-of-life care.
Main Methods:
- Qualitative analysis of 65 Swedish policy documents related to end-of-life care.
- Identification and analysis of three distinct policy episodes.
- Historical policy analysis framework applied to track narrative changes.
Main Results:
- Three policy episodes were identified: 1) addressing hospital deficiencies with norms and psychological care, 2) prioritizing home care and hospice philosophy, and 3) emphasizing a universal palliative care philosophy, systematic indicators, human value, and choice.
- A notable increase in policy documents indicates growing public and governmental concern for death and dying.
- Significant shifts in policy narratives demonstrate evolving concepts of "good palliative care".
Conclusions:
- The evolution of palliative care policy in Sweden reflects a societal shift towards viewing death and dying as public responsibilities.
- Changing policy narratives have the potential to influence both the practice and substance of end-of-life care.
- Continued analysis of policy narratives is essential for adapting care to societal values and needs.
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