The values of welfare technologies in FoU i Väst/Göteborgsregionens kommunalförbund – efficient care and sustainable work life, or a distant care and surveilled employees?
Welfare technologies are digital technologies aiming to contribute to the welfare of the population by increasing safety, activity, participation and independence for people who have, or risk developing, a disability. Door sensors, video-communication technologies and robot pets are examples of welfare technologies.
While there are a lot of hopes projected on welfare technologies, including a promise of efficient care and a sustainable work life, some worry that these technologies will replace human contact, involve a surveilled work practice or that it will lead to job losses. Thus, there are a lot of conflicting expectations about welfare technologies.
Building on an ethnographic, practice-oriented and explorative case-study approach, we investigate how elderly care personnel respond to and interact with welfare technology when it is introduced at their workplaces and what values on welfare and care that guides them. What values and expectations about welfare, care work and technology different groups of personnel voice when talking about welfare technologies? How do these values and expectations correspond with the use of the new technologies? And how is this reflected in resistance or acceptance, development and adaptation of the technologies among different groups of personnel? How do personnel express that work practices and work conditions have changed when applying the new technologies in practice?
Final report
In 2019, FoU I Väst (Research and Development in the West) in the Gothenburg Region (GR) and RJ called for proposals for a research project on welfare technology. I was commissioned to carry out the project, with a research plan dealing with the values of welfare technology. For two years I was employed by GR to conduct ethnographic and practice-oriented case studies in collaboration with its member municipalities aiming to investigate how staff in elderly care are affected by and interact with welfare technology when it is introduced at their workplaces.
As the project was beginning, the Covid-19 pandemic broke out in Sweden. Although the study's purpose and questions remained unchanged, both the methodology and the work plan required revisions. From September 2020 to June 2021, I conducted 44 interviews with 35 individuals across three municipalities in the Gothenburg region. In each municipality, I interviewed unit managers, administrative support staff, and assistant nurses. Due to the pandemic, nearly all interviews were conducted by phone or digitally via Teams. Additionally, I performed a brief ethnographic observation study at a nursing home in one of the municipalities.
The project has fostered increased collaboration between the University of Gothenburg and GR in several ways. My involvement with GR strengthened FoU i Väst's connections to the university, leading to the affiliation of several R&D researchers with the University of Gothenburg. I also organized a seminar where university researchers were invited to discuss collaboration with FoU I Väst. Furthermore, I worked closely with GR in presenting the project results, detailed further below.
An important finding from the study concerns the values and expectations related to welfare, care, and technology expressed by various staff groups when discussing welfare technology. My analysis indicates that there are no significant differences between these groups in how they justify the introduction or use of welfare technology. Instead, the same values are evident across all groups. According to the theories employed in this project, decisions are based on different assessments of what is particularly important to preserve and achieve in society. These assessments form the values that individuals reference when attempting to agree on the 'best' or most 'just' arrangement of a specific social order. The values identified in the interviewees' decisions to either work with or introduce welfare technology include efficiency, participation and security, freedom, privacy and dignity, and relationships.
Another important finding from this project is how these values influence the use of welfare technology and how this is reflected in any resistance, acceptance, or adaptation of the technology. My analysis shows that unit managers, administrative support staff, and assistant nurses all make context- and practice-specific judgments about whether welfare technology should be used. For instance, they argue that increasing efficiency is beneficial if it allows other values, such as relationships, to be strengthened. The analysis also suggests that when a value like independence is prioritized, other important values might be overlooked, potentially leading to value conflicts.
A final important result concerns how the staff describe changes in their work methods and conditions when welfare technology is introduced and utilized. My analysis shows that these changes can be both positive and negative. For example, safety alarms, which are the most common welfare technology in Sweden, allow staff to offer immediate availability, situation-specific, and flexible care to residents, ensuring that care staff can be present for them. On the other hand, the analysis indicates that safety alarms, under certain circumstances, lead to residents not participating in social activities and that both staff and residents experience stress due to the constant beeping of the alarms. Care provided with the assistance of alarms also makes certain types of availability and attention more difficult, as the alarms tend to interrupt and disrupt. This finding supports previous research indicating that the use of technology in care settings can increase stress for staff.
Tentative analysis suggests that welfare technology, particularly safety alarms and digital documentation systems, both unleashes various collaborative practices and requires collaboration to be effectively managed. Previous research has primarily focused on individual adaptation efforts and has not adequately addressed the collective aspects. New research questions emerging from this finding concern the nature of this collaboration: What do the collaborative practices enabled by welfare technology look like? What types of collaboration are necessary for welfare technology to function effectively?
During the project, I compiled an evaluation for a municipality in Gothenburg, authored two research reports published by GR, served as editor for and contributed to a research anthology on practice-oriented, caring, and engaged research, and wrote scientific articles, one of which is published and two which are under peer review. Additionally, I authored an article for the professional journal "Äldre i Centrum." The evaluation work was conducted in close collaboration with the concerned municipality, and the research reports were written following GR's templates and guidelines, incorporating feedback and comments from other members of the FoU group. Moreover, I have presented the result of the project at several academic conferences including the Society for Social Studies of Science Annual Conference in (virtual) Prague in 2020, and at the Nordic STS Conference in Oslo 2023.
Beyond disseminating the project's results through the aforementioned publications, I have presented the findings in various forums organized by GR. For example, I have given presentations at conferences and seminars for municipal employees arranged by GR. I have also shared the project's results in other relevant contexts, such as participating in a panel discussion on welfare technology at the MR-dagarna and lecturing at a seminar organized by FoU Sjuhärad for municipal employees. Furthermore, the project's results have been disseminated through relevant networks at GR.
As the project was beginning, the Covid-19 pandemic broke out in Sweden. Although the study's purpose and questions remained unchanged, both the methodology and the work plan required revisions. From September 2020 to June 2021, I conducted 44 interviews with 35 individuals across three municipalities in the Gothenburg region. In each municipality, I interviewed unit managers, administrative support staff, and assistant nurses. Due to the pandemic, nearly all interviews were conducted by phone or digitally via Teams. Additionally, I performed a brief ethnographic observation study at a nursing home in one of the municipalities.
The project has fostered increased collaboration between the University of Gothenburg and GR in several ways. My involvement with GR strengthened FoU i Väst's connections to the university, leading to the affiliation of several R&D researchers with the University of Gothenburg. I also organized a seminar where university researchers were invited to discuss collaboration with FoU I Väst. Furthermore, I worked closely with GR in presenting the project results, detailed further below.
An important finding from the study concerns the values and expectations related to welfare, care, and technology expressed by various staff groups when discussing welfare technology. My analysis indicates that there are no significant differences between these groups in how they justify the introduction or use of welfare technology. Instead, the same values are evident across all groups. According to the theories employed in this project, decisions are based on different assessments of what is particularly important to preserve and achieve in society. These assessments form the values that individuals reference when attempting to agree on the 'best' or most 'just' arrangement of a specific social order. The values identified in the interviewees' decisions to either work with or introduce welfare technology include efficiency, participation and security, freedom, privacy and dignity, and relationships.
Another important finding from this project is how these values influence the use of welfare technology and how this is reflected in any resistance, acceptance, or adaptation of the technology. My analysis shows that unit managers, administrative support staff, and assistant nurses all make context- and practice-specific judgments about whether welfare technology should be used. For instance, they argue that increasing efficiency is beneficial if it allows other values, such as relationships, to be strengthened. The analysis also suggests that when a value like independence is prioritized, other important values might be overlooked, potentially leading to value conflicts.
A final important result concerns how the staff describe changes in their work methods and conditions when welfare technology is introduced and utilized. My analysis shows that these changes can be both positive and negative. For example, safety alarms, which are the most common welfare technology in Sweden, allow staff to offer immediate availability, situation-specific, and flexible care to residents, ensuring that care staff can be present for them. On the other hand, the analysis indicates that safety alarms, under certain circumstances, lead to residents not participating in social activities and that both staff and residents experience stress due to the constant beeping of the alarms. Care provided with the assistance of alarms also makes certain types of availability and attention more difficult, as the alarms tend to interrupt and disrupt. This finding supports previous research indicating that the use of technology in care settings can increase stress for staff.
Tentative analysis suggests that welfare technology, particularly safety alarms and digital documentation systems, both unleashes various collaborative practices and requires collaboration to be effectively managed. Previous research has primarily focused on individual adaptation efforts and has not adequately addressed the collective aspects. New research questions emerging from this finding concern the nature of this collaboration: What do the collaborative practices enabled by welfare technology look like? What types of collaboration are necessary for welfare technology to function effectively?
During the project, I compiled an evaluation for a municipality in Gothenburg, authored two research reports published by GR, served as editor for and contributed to a research anthology on practice-oriented, caring, and engaged research, and wrote scientific articles, one of which is published and two which are under peer review. Additionally, I authored an article for the professional journal "Äldre i Centrum." The evaluation work was conducted in close collaboration with the concerned municipality, and the research reports were written following GR's templates and guidelines, incorporating feedback and comments from other members of the FoU group. Moreover, I have presented the result of the project at several academic conferences including the Society for Social Studies of Science Annual Conference in (virtual) Prague in 2020, and at the Nordic STS Conference in Oslo 2023.
Beyond disseminating the project's results through the aforementioned publications, I have presented the findings in various forums organized by GR. For example, I have given presentations at conferences and seminars for municipal employees arranged by GR. I have also shared the project's results in other relevant contexts, such as participating in a panel discussion on welfare technology at the MR-dagarna and lecturing at a seminar organized by FoU Sjuhärad for municipal employees. Furthermore, the project's results have been disseminated through relevant networks at GR.