{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T01:01:45Z","timestamp":1789866105435,"version":"4.0.1"},"reference-count":63,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,9,3]],"date-time":"2018-09-03T00:00:00Z","timestamp":1535932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"KORFOR-Alcohol and Drug Research Western Norway and Division of Psychiatry"},{"name":"District General Hospital of F\u00f8rde"},{"name":"Western Norway University of Applied Sciences"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Service user involvement in service development and research is an international goal. However, research illuminating the patient stakeholder role is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim was to explore what may hinder patients\u2019 voices being heard when collaborating with staff and leaders to improve services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This action research project targeted Norwegian public mental health and substance abuse services, utilizing co\u2010operative inquiry principles. Data were collected and member\u2010checked collaboratively by the researcher and coresearchers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Results centre on patient involvement in services, service development and research. The patient voice was regarded as important but not necessarily decisive, as patients\u2019 change needs could be perceived as pathology\u2010based. Patients provided feedback about fellow patients and medication\u2014opioid maintenance treatment, in particular. Barriers to patient involvement included patients not being permitted to influence other patients\u2019 individual treatment and a leader's difficulty accepting patients\u2019 medication advice. Additionally, an apparent hierarchy among the professionals may have disempowered some staff members.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Results point to an organizational diagnostic culture, where stigmatizing and risk pathologization may limit patient input. Empowerment appeared to be perceived as something allowed by the staff and leaders, at their discretion. Although all parties may have agreed that patient involvement was valuable, acting as a united group about opioid maintenance treatment appeared difficult.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Barriers to patient involvement may hinder the availability and efficacy of patients\u2019 perspectives in service development. Awareness about reciprocal empowerment might contribute to service users\u2019 voices being heard, enabling a united voice from service users and providers regarding service development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.12828","type":"journal-article","created":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T00:24:16Z","timestamp":1536020656000},"page":"1231-1240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Empowerment and pathologization: A case study in Norwegian mental health and substance abuse services"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8620-3746","authenticated-orcid":false,"given":"Tone","family":"Larsen","sequence":"first","affiliation":[{"name":"Division of Psychiatry District General Hospital of F\u00f8rde  F\u00f8rde Norway"},{"name":"Faculty of Health and Social Sciences Western Norway University of Applied Sciences  Bergen Norway"},{"name":"University of Stavanger  Stavanger Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildegunn","family":"Sagvaag","sequence":"additional","affiliation":[{"name":"Departement of Public Health The Faculty of Health Sciences University of Stavanger  Stavanger Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,3]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Mental Health Action Plan 2013\u20102020","author":"Organization WH","year":"2013"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12007"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7375.1263"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-7625.2011.00743.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12321"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12039"},{"key":"e_1_2_9_8_1","unstructured":"LarsenE AasheimF NordalA.Brukermedvirkning \u2010 psykisk helsefeltet \u2010 M\u00e5l anbefalinger og tiltak i Opptrappingsplan for psykisk helse Oslo: Avdeling for psykisk helse Direktoratet SoH; 2006 04\/2006. 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